Luca Coppeta

Incidence of metabolic syndrome among night-shift healthcare workers

Objective: Night-shift work is associated with ischaemic cardiovascular disorders. It is not currently known whether it may be causally linked to metabolic syndrome (MS), a risk condition for ischaemic cardiovascular disorders. The syndrome presents with visceral obesity associated with mild alterations in glucidic and lipidic homeostasis, and in blood pressure. The aim of this study was to assess whether a causal relationship exists between night-shift work and the development of MS. Methods: Male and female nurses performing night shifts, free from any component of MS at baseline, were evaluated annually for the development of the disorder during a 4-year follow-up. Male and female nurses performing daytime work only, visited during the same time period, represented the control group. Results: The cumulative incidence of MS was 9.0% (36/402) among night-shift workers, and 1.8% (6/336) among daytime workers (relative risk (RR) 5.0, 95% CI − 2.1 to 14.6). The annual rate of incidence of MS was 2.9% in night-shift workers and 0.5% in daytime workers. Kaplan–Meier survival curves of the two groups were significantly different (log-rank test; p<0.001). Multiple Cox regression analysis (forward selection method based on likelihood ratio) showed that among selected variables (age, gender, smoking, alcohol intake, familiar history, physical activity, and work schedule) the only predictors of occurrence of MS were sedentariness (hazard ratio (HR) 2.92; 95% CI 1.64 to 5.18; p = 0.017), and night-shift work (HR 5.10; 95% CI 2.15 to 12.11; p<0.001). Conclusions: The risk of developing MS is strongly associated with night-shift work in nurses. Medical counselling should be promptly instituted in night-shift workers with the syndrome, and in case of persistence or progression, a change in work schedule should be considered.

Extended high-frequency audiometry and noise induced hearing loss in cement workers.

BACKGROUND It has been suggested that extended high-frequency audiometry (EHFA) might be more sensitive than conventional audiometry in detecting early signs of hearing impairment. However, this technique has not been adequately tested in an occupational environment. We therefore investigated the usefulness of this method in noise-exposed workers. METHODS We compared conventional frequency audiometry (0.25-8 kHz) and EHFA (9-18 kHz) in 184 noise-exposed and 98 non-noise-exposed workers. RESULTS Both methods showed significantly higher threshold levels (P < 0.05) in noise-exposed workers for most of the tested frequencies; however, the differences were more marked for EHFA, especially in young exposed workers. Significant differences in the EHF range were detected also in the subgroup of noise-exposed workers with normal findings at conventional audiometry. Stepwise regression analysis showed that in 21- to 40-year-old workers the noise effect was largely predominant at both conventional audiometry and EHFA, whereas in older subjects the noise effect was predominant up to 6 kHz frequency, the effect of age being significantly greater at higher frequencies. CONCLUSIONS These data indicate that EHFA is more sensitive than conventional audiometry in detecting noise induced hearing loss. However, hearing loss in the EHF range seems an age-dependent phenomenon with progression into the lower speech range frequencies with increasing age. These changes seem to be accentuated in the early years by noise exposure, suggesting that EHFA could represent a useful preventive measure in young exposed workers.

Study of factors influencing susceptibility and age at onset of type 1 diabetes: A review of data from Continental Italy and Sardinia

AIM To investigate the role of protein tyrosin phosphatase 22 (PTPN22), maternal age at conception and sex on susceptibility and age at onset of type 1 diabetes (T1D) in Continental Italy and Sardinian populations. METHODS Three hundred seventy six subjects admitted consecutively to the hospital for T1D and 1032 healthy subjects as controls were studied in Continental Italy and 284 subjects admitted consecutively to the hospital for T1D and 5460 healthy newborns were studied in Sardinia. PTPN22 genotype was determined by DNA analysis. Maternal age at conception and age at onset of disease were obtained from clinical records. χ(2) test of independence, student t test for differences between means and odds ratio analysis were carried out by SPSS programs. Three way contingency table analysis was carried out according to Sokal and Rohlf. RESULTS The pattern of association between PTPN22 and T1D is similar in Continental Italy and Sardinia: the proportion of *T allele carriers is 13.6% in T1D vs 6.7% in controls in Continental Italy while in Sardinia is 7.3% in T1D vs 4.4% in controls. The association between T1D and maternal age at conception is much stronger in Sardinia than in Italy: the proportion of newborn from mother aging more than 32 years is 89.3% in T1D vs 32.7% in consecutive newborn in Sardinia (P < 10(-6)) while in Continental Italy is 32.2% in T1D vs 19.1% in consecutive newborns (P = 0.005). This points to an important role of ethnicity. A slight prevalence of T1D males on T1D females is observed both in Continental Italy and Sardinia. PTPN22 genotype does not exert significant effect on the age at onset neither in Continental Italy nor and Sardinia. Maternal age does not influence significantly age at onset in Italy (8.2 years in T1D infants from mothers aging 32 years or less vs 7.89 years in T1D infants from mothers aging more than 32 years: P = 0.824) while in Sardinia a border line effect is observed (5.75 years in T1D infants from mothers aging 32 years or less vs 7.54 years in T1D infants from mothers aging more than 32 years: P = 0.062). No effect of sex on age at onset is observed in Continental Italy while in Sardinia female show a lower age at onset of T1D as compared to males (8.07 years in males vs 6.3 years in females: P = 0.002). CONCLUSION The present data confirm the importance of ethnicity on susceptibility and on the age at onset of T1D.

Correlation between birth weight and placental weight in healthy and diabetic puerperae

OBJECTIVE The birth weight/placental weight ratio has an important predictive value for perinatal mortality and morbidity and for cardiovascular diseases in adult life. In this study, we compared the birth weight/placental weight (BW/PW) ratio and the correlation between the two parameters in diabetic women with that observed in healthy women. MATERIALS AND METHODS A total of 347 consecutive newborn infants from healthy puerperae, 164 newborns from puerperae with gestational diabetes, 148 newborns from puerperae with preexisting type 1 diabetes, and 40 newborns from puerperae with preexisting type 2 diabetes have been studied from the White population of Rome. The research project was approved by the Institutional Review Board and informed written consent was obtained from the participating mothers. RESULTS The BW/PW ratio is higher, and the correlation between the two parameters is lower in all classes of diabetes as compared to healthy puerperae. A remarkably low correlation is observed in preexisting diabetes pointing to a dissociation of fetal growth from placental growth. DISCUSSION In diabetic pregnancy the BW/PW ratio is higher, and the correlation between birth weight and placental weight is lower in all classes of diabetic as compared to healthy puerperae pointing to a relative dissociation between the two parameters. It has been suggested that the increase of glycemic levels in diabetic pregnancy predisposes to important diseases in adult life. The dissociation of BW from PW in infants of diabetic pregnancy could be a predictor of the risk for such diseases of adult life.

The genetics of feto-placental development: a study of acid phosphatase locus 1 and adenosine deaminase polymorphisms in a consecutive series of newborn infants.

BackgroundAcid phosphatase locus 1 and adenosine deaminase locus 1 polymorphisms show cooperative effects on glucose metabolism and immunological functions. The recent observation of cooperation between the two systems on susceptibility to repeated spontaneous miscarriage prompted us to search for possible interactional effects between these genes and the correlation between birth weight and placental weight. Deviation from a balanced development of the feto-placental unit has been found to be associated with perinatal morbidity and mortality and with cardiovascular diseases in adulthood.MethodsWe examined 400 consecutive newborns from the Caucasian population of Rome. Birth weight, placental weight, and gestational length were registered. Acid phosphatase locus 1 and adenosine deaminase locus 1 phenotypes were determined by starch gel electrophoresis and correlation analysis was performed by SPSS programs. Informed verbal consent to participate in the study was obtained from the mothers.ResultsHighly significant differences in birth weight-placental weight correlations were observed among acid phosphatase locus 1 phenotypes (p = 0.005). The correlation between birth weight and placental weight was markedly elevated in subjects carrying acid phosphatase locus 1 phenotypes with medium-low F isoform concentration (A, CA and CB phenotypes) compared to those carrying acid phosphatase locus 1 phenotypes with medium-high F isoform concentration (BA and B phenotypes) (p = 0.002). Environmental and developmental variables were found to exert a significant effect on birth weight-placental weight correlation in subjects with medium-high F isoform concentrations, but only a marginal effect was observed in those with medium-low F isoform concentrations. The correlation between birth weight and placental weight is higher among carriers of the adenosine deaminase locus 1 allele*2, which is associated with low activity, than in homozygous adenosine deaminase locus 1 phenotype 1 carriers (p = 0.04). The two systems show a cooperative effect on the correlation between birth weight and placental weight: the highest value is observed in newborns carrying adenosine deaminase locus 1 allele*2 and acid phosphatase locus 1 phenotypes with medium-low F isoform concentration (p = 0.005).ConclusionThese data suggest that zygotes with low adenosine deaminase locus 1 activity and low F activity may experience the most favourable intrauterine conditions for a balanced development of the feto-placental unit.

Effects of Smoking Electronic Cigarettes on Pulmonary Function and Environmental Parameters

Methods: Thirty healthy workers (seventeen men and thirteen women, age range 27-37) were included in the study. Immediately before and after a 5-minute smoking session performed in two different days (first-day e-cig, second-day tobacco cigarette [t-cig]), they underwent spirometry evaluation. Furthermore, environmental particle monitoring was performed during the experimental procedure (i.e. before, during and after active smoking).

Are Shiftwork and Indoor Work Related to D3 Vitamin Deficiency? A Systematic Review of Current Evidences

Background Reported cases of vitamin D3 deficiency have been increasing in incidence worldwide. Although there is a lack of consensus relating to optimal levels of vitamin D, generally serum 25-(OH)D concentrations lower than 50 nmol/L (20 ng/mL) are at least considered to be detrimental to bone health. Aim Aim of this systematic review is to investigate if occupations, and specifically shiftworking and indoor working, may be considered as possible contributors to the increased incidence of vitamin D3 deficiency in industrialized nations. Materials and Methods Systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement using PubMed, Scopus, and ISI Web of Knowledge databases. Results Overall 90 papers were found, 23 articles through PubMed, 30 through Scopus, and 37 through ISI Web of Knowledge. Successively, 46 duplicates and 34 articles that did not respect the inclusion criteria were excluded. Finally 10 articles were selected: 9 cross-sectional studies and 1 systematic review. Results of the studies included revealed that certain occupations are either suffering from, or have a predilection to suffer from, a deficiency of this vitamin. Shiftworkers and indoor workers are consistently reported as being the occupational group most likely to suffer from a deficiency of vitamin D3. It would appear prudent to investigate the potential of providing nutritional education to workers in addition to including preventative measures in the workplace.