T. Casale

Is urinary 1-hydroxypyrene a valid biomarker for exposure to air pollution in outdoor workers? A meta-analysis

The aim of this study was to evaluate the usefulness and specificity of urinary 1-hydroxypyrene (1-OHPu) as a biomarker of the exposure from urban pollution to polycyclic aromatic hydrocarbons (PAHs) among outdoor workers in a meta-analysis. Our meta-analysis was performed according to standard methods, and the results show that the concentrations of 1-OHPu tend to be higher in exposed workers than in unexposed workers (if we exclude two highly heterogeneous articles), in exposed non-smokers than in unexposed non-smokers and in exposed than in unexposed workers who were carriers of the CYP1A1 genotype and in those with the glutathione-S-transferase M1 (−)genotype. These genotypes enhance the effect of exposure, particularly in non-smokers. Smoking reduces the differences between exposed and unexposed subjects. In conclusion, our results suggest that the use of the 1-OHPu biomarker appears to be reliable for studying occupational exposure to PAHs from urban pollution, as long as environmental and behavioural factors are considered.

Cadmium and hypertension in exposed workers: A meta-analysis

ObjectivesIn the general population, cadmium seems to be responsible for hypertension, atherosclerosis and an increase in acute coronary events. Therefore, the purpose of this meta-analysis was to analyze controlled studies conducted on cadmium and arterial pressure in occupationally-exposed workers.Materials and MethodsAfter analyzing all the relevant articles found in the literature, 6 publications were selected.ResultsA higher prevalence of hypertension and higher values of systolic and diastolic blood pressure were recorded in the exposed subjects.ConclusionsCadmium in occupationally-exposed individuals appears to induce an increase in systolic and diastolic blood pressure and an increase in the prevalence of hypertension.

Noise-induced hearing loss in workers exposed to urban stressors.

The technological and industrial progress together with the intensification of vehicular traffic and the adoption of new social habits are the cause of an increasing noise pollution with possible negative effects on the auditory system. This study aims to assess the noise exposure levels and the effects on the hearing threshold in outdoor and indoor male workers of a big Italian city. The study was carried out on 357 outdoor male workers, exposed to urban noise and on a control group of 357 unexposed indoor workers. Noise levels were measured in 30 outdoor and indoor areas. The subjects underwent tonal liminal audiometry in order to determine the value of their hearing threshold. During their working activity, outdoor and indoor workers are exposed to different noise levels LEX<80 dB(A). At mid-low frequencies (250-2000 Hz), the results show significant differences in the average values of hearing threshold between the two groups in both ears and for all age classes; there are no significant differences between the two groups at higher frequencies. The outdoor noise levels measured are not usually ototoxic and the hearing loss at mid-low frequencies is not characteristic of the exposure to industrial noise. For these reasons the Authors hypothesize that the results may be due to the combined effect of the exposure to noise and to ototoxic air pollutants. The impairment of speech frequencies is disabling and involves the risk of missed forensic recognition.

Work related etiology of amyotrophic lateral sclerosis (ALS): a meta-analysis.

BACKGROUND The aim of this meta-analysis was to evaluate the association between ALS and occupational exposure to physical (ELF-EMF) and chemicals (solvents, heavy metals and pesticides) agents. METHODS We considered articles published from 1980 up to April 2013; in total, 750 publications were evaluated. The studies had to satisfy the following criteria: 1) cohort or case-control studies; 2) the presence of individual exposures; 3) clinical diagnosis of sporadic ALS or sporadic ALS on the death certificate. We followed the evaluation of quality in two steps. The first step classified studies according to a rating system based on a mix of criteria developed by scientific organizations, especially developed for studies of risk factors for ALS. The ratings obtained range from I (highest) to V (lowest). The data on risk factors derived from studies with Armon ratings of I, II, and III can reach levels of evidence A (established risk factor), B (likely risk factor), or C (possible risk factor). The second step evaluated the exposure and a score from 1 to 4 was assigned to each item; an exposure with a score of 3 or 4 was considered sufficient. Different analyses were performed on ALS and exposure to metals, solvents, pesticides and electromagnetic fields. In our study the heterogeneity was assessed both by χ2-based Q-tests and through the index of inconsistency I² while the measure RR/OR and CI of 95% to estimate the relationship between ALS and the various considered risk factors was employed. RESULTS The association between exposure to pesticides and ALS as a whole is weak and not significant. With regard to the results of individual studies the following critical synthesis can be reported: 1) the selected studies showed a low level of association between ALS and electromagnetic fields; 2) as regards the solvents, the association with ALS in some studies is combined with a slightly increased risk, particularly in women, and in others a slight but significant linear association is observed; 3) for the metals, in some cases there was a stronger association in women than in men; for individual metals, there was an association especially with chromium and lead; 4) lastly, with regard to the products of agricultural pesticides in general, there was an association with ALS in men but not in women, with a dose-response relationship. CONCLUSIONS The lack of statistically significant association between occupational exposure and ALS is mainly due to the methodological diversity of the studies and the lack of prospective studies at the workplace.

Anesthetic gases and occupationally exposed workers

The aim of this study is to estimate whether the occupational exposure to low dose anesthetic gases could cause alterations of blood parameters in health care workers. 119 exposed subjects and 184 not exposed controls were included in the study. Each worker underwent the complete blood count test (CBC), proteinaemia, leukocyte count, serum lipids, liver and kidney blood markers. The liver blood markers show statistically significant differences in health care workers compared with controls (p<0.05), a statistically significant decrease in neutrophils and an increase of lymphocytes in health care workers compared with controls (p<0.05). The prevalence of values outside the range for GPT, GGT, total bilirubin, lymphocytes and neutrophils was statistically significant in health care workers compared with controls (p<0.05). The results suggest that occupational exposure to low dose anesthetic gases could influence some haematochemical hepatic and hematopoietic parameters in exposed health care workers.

Workers exposed to low levels of benzene present in urban air: Assessment of peripheral blood count variations

BACKGROUND Few studies in the literature have examined the effects of benzene on blood cells. AIM The aim of this study was to evaluate the possible correlation between the blood benzene levels and the blood cell counts. MATERIALS AND METHODS From a population of 2658 workers, we studied a group of 215 subjects. Each worker underwent blood sampling for the assessment of the blood benzene levels and the blood cell counts. The Mann-Whitney U test for two-mode variables and the Kruskal-Wallis test for more-than-two-mode variables were performed on all subjects. We estimated the Pearson correlation index between the variables in the total sample and the subgroups divided according to sex, the smoking habit, and job. After the main confounding factors were evaluated, multiple linear regression was performed on both the total sample and the subgroups. RESULTS A significant inverse correlation was found among the blood benzene levels and the white blood cells, lymphocytes, and neutrophils in traffic policemen, motorcyclists, and other outdoor workers. We did not find any significant correlation with any other parameters of blood cell count. DISCUSSION AND CONCLUSIONS Our results, which must be considered preliminary, indicate that increased blood benzene levels in outdoor workers lead to decreased counts of white blood cells, neutrophils, and lymphocytes, because of possible immune effects. These are worth investigating in the future by specific immune tests.

Evaluation of some cardiovascular risk parameters in health professionals exposed to night work.

BACKGROUND Shift work and night work in particular represent a risk factor for the health of exposed workers; aim of our study is to evaluate whether night work may cause alteration of some cardiovascular risk parameters in health workers. MATERIALS AND METHODS The research was carried out on 415 health workers, 163 exposed to night work and 252 not exposed. A blood sample was taken from each worker, between 8.00 a.m. and 10.00 a.m. before lunch time, to test total cholesterol, HDL cholesterol, and triglycerides. Blood pressure and heart rate were also measured. Workers with cardiovascular diseases, thyroid diseases, diabetes mellitus, dyslipidemia, those who made use of antihypertensive drugs, hypoglycemic and/or lipid-lowering drugs, subjects with body mass index (BMI) (kg/m2) higher than 30 were excluded. RESULTS In the group of exposed compared to controls, increasing values of arterial pressure and heart rate, were not significant. The mean values of total cholesterol and triglycerides were significantly higher in exposed compared to controls while values of HDL cholesterol were significantly lower. CONCLUSIONS Night workers have clinically significant changes in blood levels of total cholesterol, HDL cholesterol and triglycerides, such alterations are presumably related to poor food hygiene and to psychosocial stressors.

Plasma dopamine in workers exposed to urban stressor

The aim of this study is to evaluate if the occupational exposure to urban stressor could cause alterations in dopamine (DA) plasma levels and related diseases in traffic police officers compared to a control group. After excluding subjects with principal confounding factors, 306 traffic police officers (139 female and 167 male) and 301 controls (134 female and 167 male) were included in the study. In traffic police officers, mean DA values were significantly higher compared with controls (P = 0.006 and P = 0.000 in male and female, respectively). The distribution of DA values in traffic police officers and controls was significant ( P = 0.000 and P = 0.000 in male and female, respectively). The number of male traffic police officers with a positive response to the questionnaires items concerning anxiety, depression and panic attacks was higher than controls, though not significant (7.2% traffic police officers versus 4.2% controls). This difference was also not significant in female traffic police officers compared with controls. According to our previous researches on other neuro-immune-endocrine parameters, DA could be used as an early biological marker, valuable for the group to be employed in occupational sets, even before the onset of pathology. Toxicology and Industrial Health 2007; 23: 421—427.

Exposure to Urban Stressor and Effects on Luteinizing Hormone (LH) in Female Outdoor Workers

There are few studies in literature about exposure to urban pollutants and effects on female reproductive health. The aim of the study was to evaluate if the occupational exposure to chemical urban stressor could cause luteinizing hormone (LH) plasma levels alterations in female traffic police compared to a control group. One hundred and eighty subjects were included in the study, subdivided into three different groups according to the day of the menstrual cycle (7th, 14th, 21st) in which a blood sample was taken. In follicular and lutheal phase of ovarian cycle, the LH mean levels were significantly higher in traffic police vs. controls. The distribution of LH values in traffic police and controls was significant in follicular, and lutheal phase. In ovulatory phase, LH mean levels were lower but not significant in traffic police compared to controls. An increase was found concerning mental health disorders referred to the questionnaire items in traffic police vs. controls, although the difference was not significant. Our results suggest that occupational exposure to urban stressor in female traffic police, may alter LH plasma concentrations. LH may be used in occupational set as an early biomarker of exposure to urban stressor.

Overweight and urban pollution: Preliminary results

The aim of this study is to determine whether in workers exposed to urban pollution the risk of developing overweight and obesity is higher in workers exposed to urban pollution compared to a control group. The study was conducted on 150 volunteers, 75 workers exposed to urban pollution (50 women and 25 men) and 75 indoor workers (50 women and 25 men). Once measured the weight and height and calculated body mass index (BMI) for each worker, the research was based on the comparison, between the two groups, of the mean values of the measurements and of the frequency of workers with BMI index higher than the cut-off of normality. The only statistically significant difference found was for the mean value of weight in women, which was higher among outdoor workers compared to indoor workers. The mean values of BMI and the frequency of workers with BMI higher than normal was higher among outdoor workers compared to indoor workers in both sexes, but not statistically significant. The data suggest that outdoor workers may be subject to an additional risk of developing obesity as a result of exposure to urban air pollution (which, like obesity, is a source of oxidative stress). So, our preliminary study encourages to continue this line of research by implementing the sample and considering all the confounding factors. Furthermore, the results highlight the necessity to take account of gender differences in the context of health surveillance of workers.