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Biomedical subjects

A Colombi

Publications and source records attributed to A Colombi.

At least 127 records · Page 7Linked to original sources

[Evaluation of the dose of mercury in exposed and control subjects].

OBJECTIVES: The aim of this paper was to analyse the concentrations of HgU and HgB in three different groups: 122 workers exposed, 18 workers formerly exposed and 196 subjects not occupationally or environmentally exposed to mercury. METHODS: All the subjects filled out a questionnaire concerning personal data, lifestyle, occupational or non-occupational exposure to Hg and medical history. The amalgam fillings area was measured by a standardised method. RESULTS: Urinary mercury excretion was significantly greater in the group of the exposed workers respect to the group of subjects not occupationally exposed (Median value of 8.3 micrograms/g creatinine and the 5 degrees and 95 degrees percentile respectively of 2.66 e 23.50 micrograms/g creatinine against Median value of 1.2 micrograms/g creatinine and the 5 degrees and 95 degrees percentile respectively of 0.18 and 5.42 micrograms/g creatinine). U-Hg in formerly exposed workers were comparable to U-Hg in non-occupationally exposed subjects, with a median value of 1.6 micrograms/g creatinine. B-Hg values were similar in the three groups: the median value was 3.1 micrograms/l in the non-occupationally exposed, 4.0 micrograms/l in the exposed workers and 3.9 micrograms/l in the past exposed. These value were not significantly different. Among the considered variables (amalgam fillings, fish consumption, age, sex, alcohol intake, chewing-gum and smoking) dental amalgam and fish consumption were significantly related with the Hg urinary excretion and the B-Hg levels. This is particularly true considering the subjects altogether: for the exposed workers, indeed, the occupational exposure was the most relevant variable. CONCLUSIONS: The results of the present research confirmed that the U-Hg excretion in non-occupationally exposed subjects is influenced by amalgam dental fillings. Furthermore, in our study Hg urinary excretion was significantly related with fish consumption. This fact can be explained, according to several recent experimental human and animal trials, considering that methylmercury contained in fish is partially converted, through breakage of the carbon-Hg bond, into Hg inorganic forms, which accumulate in the kidney and have a urinary excretion pathway.

Absorption↗

[Renal effects of low doses of mercury].

OBJECTIVES: The present study was aimed at investigating early markers of renal damage and dysfunction in subjects exposed to low doses of mercury from different sources. Different groups of subjects were examined with urinary Hg excretion (HgU) ranging from 0.1 to 35.0 micrograms/g creatinine: 122 occupationally exposed workers, 22 subjects living in a non-polluted area, but consuming large amounts of tuna and sword fish, and 197 controls. METHODS: Several markers of renal changes were measured in urine (albumin, fibronectin, beta 2-microglobulin, retinol-binding protein, tubular antigens, N-acetyl-beta-D-glucosaminidase activity) and serum (beta 2-microglobulin and cystatin C). Serum autoantibodies towards collagen, laminin and tubular antigens were assessed in subjects with abnormal renal markers. The role of glutathione-S-tranferases GSTT1 and GSTM1 polymorphisms in the inter-individual variability of biological response to Hg was also investigated. RESULTS: Renal markers were not correlated with HgU. None of such markers differed significantly between exposed workers and controls, except for urinary beta 2-microglobulin, which was decreased in Hg-exposed workers (GM = 55.8 vs 86.6 micrograms/g creatinine), in the absence of any changes in serum concentration. Subjects usually eating tuna and sword fish showed an increased urinary excretion of beta 2-microglobulin, albumin and fibronectin. Serum titres of auto-antibodies did not differ between the groups. Neither in controls nor in exposed workers were the observed differences modified by the GSTM1 and GSTT1 genotypes. CONCLUSION: The present study did not provide evidence of any changes in kidney integrity and function in subjects exposed to very low levels of inorganic Hg resulting in urinary Hg lower than 35 micrograms/g creatinine. Nor did we obtain evidence of Hg-induced autoimmunity towards kidney components. The potential modifying role of GST polymorphisms could not be clarified in the absence of effects associated with exposure to the risk factor, i.e., to inorganic Hg. Preliminary data suggesting nephrotoxic effects of organic Hg from a diet rich in large fish resulting in increased levels of both blood and urinary Hg--which however did not exceed 20 micrograms/g creatinine--deserves further investigation.

Adult↗

[Immunologic effects of exposure to low levels of inorganic mercury].

OBJECTIVE: The immune system is a target for the toxic effects of inorganic mercury, both in humans and animals. In humans it has been observed that occupational and environmental exposure to inorganic mercury may cause both clinical (autoimmunity, hypersensitivity) and subclinical effects (cellular and humoral immunologic variable modifications). To obtain a better definition of these effects with respect to the exposure levels, a multicentre study was performed on 117 workers exposed to very low doses of inorganic mercury and 172 subjects from the general population of the same geographical area with environmental exposure to mercury from dental amalgams and dietary fish intake. RESULTS: The white blood cell count was included in the normality range for all subjects and there was no difference between exposed and non exposed subjects. The immunologic variables studied showed an increase of the CD4+ and CD8+ number in exposed workers compared to non-exposed subjects, with a statistically significance only for CD4+, while no difference was observed regarding CD4+, CD8+, NK+ percentage and CD4+/CD8+ ratio. A significative decrease of serum IL-8 and an inverse correlation between serum levels of this cytokine and HgU were observed in exposed workers compared to non exposed subjects. No association between immunologic variables and both dental amalgams and dietary fish intake was found in subjects not occupationally exposed to inorganic mercury. DISCUSSION: The decrease in IL-8 serum levels observed in exposed workers might suggest an immunosuppressive effect of occupational exposure to very low doses of inorganic mercury. This result suggests the need to revise of current HgU BEI after further definition of its prognostic significance.

Adult↗

[Adaptation of the TriTEST TM for the investigation of blood samples for a multicenter study taken to a single laboratory].

BACKGROUND: Immunotoxicological studies in humans are usually carried out via the determination of some selected immune parameters in subjects occupationally and/or environmentally exposed to immunotoxic substance. One of the most often measured parameters is the determination of lymphocyte subsets, which needs to be carried out in a very short time (a few hours) after blood collection. This is the major problem limiting the determination of lymphocyte subpopulations in field studies, where samples are usually collected directly at the workplace, and very often at the end of the workshift. Unfortunately, these collection modalities significantly prolong the time between collection and analysis. The problem is more evident in multicentric studies, where a further problem is represented by the time needed to send samples to the laboratory. OBJECTIVE: Since an immune evaluation was planned, including the determination of lymphocyte subpopulations CD4 (T-helper), CD8 (T-suppressor cytotoxic) and CD16/CD56 (natural killer) in the project "Assessing health effects in man from exposure to low doses of inorganic mercury in environmental and occupational settings", a method was developed for performing cytofluorimetric analysis in "field studies". METHODS: The method is based on commercially-available kits, and involves in loco treatment. Whole blood is labeled with monoclonal antibodies, and fixed samples immediately after collection. After the treatment, the samples are ready for flow cytometric analysis, which may be performed after a two-day period from sample collection. RESULTS AND CONCLUSION: The method described is adequate for immunotoxicity testing in field studies because it prolongs the maximum latency time from collection and cytofluorimetric analysis up to 48 hours. A second interesting characteristic of the method is the possibility of using whole blood, without any need of either complex manipulations or particular equipment.

Antibodies, Monoclonal↗

[Evaluation of the neurotoxic and nephrotoxic effects following long-term exposure to metallic mercury in employed at a chlorine/sodium-hydroxide plant].

OBJECTIVES: Within the frame work of a wide multicentre study, a sub-study was developed in order to explore the occurrence of early effects on the central nervous system, on the kidney and on the neuro-immune system in the workers of a chloro-alkali production plant exposed to metallic mercury at airborne concentration levels lower than 0.025 mg/m3 (TLV-TWA). They were compared to a control population of employees of the same huge petrochemical plant with different job that did not implicate exposure to mercury vapors. Specifically, the study aimed at revealing the occurrence of early effects on the central nervous system related with mercury exposure, as can be assessed through neurophysiological and neurobehavioral tests. METHODS: The excretion of urinary mercury was measured by atomic absorption spectrometry. The study of renal function was assessed by measurement of the urinary excretion of some high and low molecular weight protein markers (albumin, beta 2-microglobulin, retinol-binding protein, fibronectin, specific proximal tubule brush border antigens, N-acetyl-beta-D-glucosaminidase). The neurobehavioral status of the study subjects was assessed by means of several test parameters (Simple Reaction Time, Color Word Vigilance Test, Symbol Digit, Finger Tapping, Mood Scale of Kjellberg and Iwanowski, Subjective symptoms questionnaire (QSS), Luria Nebraska Motor Scale, Branches Alternate Movement Task and Tremometry). RESULTS: The values of urinary excretion averaged 12 +/- 8 micrograms Hg/g of creatinine for the exposed workers group (n = 38), while for the reference group (n = 34 cases) urinary excretion was statistically lower, averaging 4 +/- 6 micrograms Hg/g of creatinine. Neither the parameters selected for the assessment of renal functions, nor those chosen to probe the neurobehavioral status of the probands revealed statistically reliable differences between the group of exposed workers (length of exposure: range 1-34 years) and the control group. Nevertheless, some minor but still statistically reliable correlations were found between some neurobehavioral parameters and some demographic variables describing the whole group of tested workers, but not to the level of occupational exposure to mercury. CONCLUSIONS: The results of the study confirm the lack of toxic effects of clinical importance on the central nervous system and on the kidney for values of mercury urinary excretion lower than the suggested index of biological exposure (IBE) of 35 micrograms Hg/gram of creatinine.

Adult↗

[Evolution of industrial toxicology toward vanishing doses and the human genome].

BACKGROUND: This article aims to discuss the influence that the application of the recent discoveries in genomics will have on the theory and practice of industrial toxicology in developed post-industrial countries. It is stressed that the recent advances in toxicogenomics can be integrated into the existing wealth of knowledge on the toxic properties of industrial chemicals to improve the efficacy of prevention of toxicological risk. METHODS AND RESULTS: The understanding of the biochemical and physiological mechanisms underlying susceptibility or resistance to the toxic effects of industrial xenobiotics, and in particular to carcinogens, allows us to split the epidemiologically derived relationship linking the frequency of disease in the exposed population to the level of workplace contamination into a set of sequential sub-relationships linking: a) the exposure level to that of workplace contamination; b) the internal dose to the exposure level; c) the biological effect (e.g., measured through biochemical markers of early effect) to the internal dose; d) the frequency of disease to that of observation of early biochemical effects. Each of the cited relationships is affected by a degree of uncertainty due to the variability of biological response among the examined individuals, which in turn requires a definition of the statistical limits for the association functions between the variables. As a consequence, the possibility of investigating the individual biochemical and physiological steps in the causal mechanism that links toxic exposure to disease does not necessarily lead to an increase in the information potential of biological monitoring, since the uncertainty due to inter-individual variability is amplified through the sequence of causal relationships to the point that the data from biological monitoring become valueless with regard to the prediction of the frequency or probability of disease. This is particularly true when exposure to 'low doses' is investigated, as is now increasingly frequent in post-industrial developed countries, where workplace contamination is now greatly reduced to levels which may be borderline with those in the general environment. Thus at the low-dose end of the range of contamination and exposure values there is an area where, for statistical reasons consequent to the heterogeneity of examined populations, a quantitative prediction of internal exposure due to environmental contamination, of biological adverse effects due to exposure levels and of frequency of disease due to the extent or frequency of biological effects is no longer reliably possible. This in turn impairs the preventive efficacy of biological monitoring. CONCLUSIONS: A closer integration between industrial toxicology and state-of-the-art molecular genetics derived from the recent sequencing of the human genome is the way to overcome the limitations described. In particular, the individual subjects in the examined populations can be classified with regard to some genetically controlled characters relevant to the biotransformation of xenobiotics and to DNA repair and the statistical analysis of data can be performed on more homogeneous subpopulations, in order to decrease inter-individual variability of biochemical and physiological response. This in turn increases the predictive power of the biological markers, both of dose and effect, and improves the efficacy of prevention, e.g., by highlighting oversensitive subpopulations or lifestyles which can increase the risk of occupational and environmental disease.

Carcinogens, Environmental↗

[Measurements and environmental and biological monitoring of occupational exposure to inhalation anesthetics].

This paper reports the data of nitrous oxide (N2O) environmental pollution in 269 operating rooms of 47 hospitals in Italy in 1989-91. In 40% of the operating rooms the N2O concentrations are lower than 50 ppm, limit value proposed by Health Council for new operating rooms. In 65.4% of the operating room studied, N2O mean environmental concentrations are lower than 100 ppm, value proposed by the above-mentioned Health Council as limit value for the already existing operating rooms. Concerning the biological monitoring, the authors report several N2O data in urine (2193), whose levels confirm the data obtained with environmental monitoring. The authors believe that they presently have reliable methods to perform biological and environmental monitoring: the two techniques are complementary in the assessment of the exposure. The method of measuring N2O concentrations as exposure index, both for the environmental and biological monitoring, is considered very useful to simplify the performance of the analyses. In order to assess exposure more precisely, it is however necessary also to determine the environmental and/or biological measure of the other different anaesthetics used.

Air Pollutants, Occupational↗

[Health risks for waste disposal industry workers].

Waste disposal currently constitutes a major public health problem in Italy and other industrialized countries. In view of the increasing volume of waste accumulated and disposed of without control, there is now an ever pressing need for regulated disposal that involves minimum risk for the environment and the community. Hence a new industrial sector has emerged that is highly specialized and varied, on account of the wide field of activity and technology, from collection and storage of refuse, processing and definitive disposal, to reclamation and improvement of illegal dumps. The industrial waste sector has not been fully developed and it is currently believed that most disposal is performed without sanitary control. Little attention has been given to the environmental impact of these operations and similarly little is known of the possible health effects for the operators. Acquisition of toxicological and health data is therefore essential to establish correct and appropriate regulations for the development of this industrial sector. An objective risk evaluation will require filling in many information gaps, which are partly the results of a natural uncertainty surrounding any innovative process, but are above all due to the vastness of the problem that is not easily defined in concrete terms as regards types of waste and number of operators involved.

Humans↗

[Acute exposure to vanadium-containing dusts: the health effects and biological monitoring in a group of workers employed in boiler maintenance].

The authors describe an episode of acute intoxication due to inhalation of vanadium-containing dusts in a group of 10 workers during maintenance work inside a boiler of an oil-fired electricity power station. Historical, clinical and biological monitoring data concerning the acute exposure phase and subsequent checks are presented. The appearance of irritative symptoms of the upper airways, green tongue (in 6 out of 10 subjects) and the values of urinary excretion of vanadium (means = 92, D.S. = 47 micrograms/l: limits 20-270 micrograms/l) indicated acute vanadium exposure. With the use of appropriate individual protection devices and shorter shifts, 2 weeks after the episode there was a complete remission of the symptoms and a return of urinary vanadium concentrations to 38, D.S. = 26 micrograms/l. Checks made 6 months, 1 and 2 years later did not reveal any alterations in the general blood chemistry parameters and the urinary vanadium concentrations were below 1 microgram/l (reference value). As already often reported in the literature, this episode confirms the danger involved in working in the presence of fuel oil residues or ashes and the need to adopt appropriate prevention measures.

Acute Disease↗

[An integrated course in occupational medicine. A proposed teaching program based on the new organization of the degree course in medicine and surgery].

The curriculum of Italian Medical School of the Faculty of Medicine has been recently renewed at a national level. Considering the numerous innovations introduced, a new role has been attributed to the teaching of occupational health, particularly occupational medicine. Occupational Medicine is usually regarded as a part of community medicine and, despite the fact that occupational disease may be in decline in industrially developed countries, the increasing concern regarding environmental pollution related health effects, stress the relevance of the methodologies already formulated within the occupational health disciplines. Of all environmental factors, occupational medicine has contributed largely to the knowledge about the health effects of occupation and its role in the complex problem at work related to today's medical students as a way of introducing the appreciation of worldwide environmental effects and how to measure, monitor and modify them. In this article the content of the occupational health course is revised and according to the principles of modern medical pedagogy, the teaching is divided in primary and secondary objectives and organized to the resolution of real problems. The importance of the relevant evidences of clinical occupational medicine is discussed and their insertion into other clinical disciplines is proposed. The knowledge of distribution, recognition, management and prevention of the major occupational diseases is a final target of the teaching. The introduction of innovative teaching methods such as factory visits, case history discussion or role playing exercises is suggested as an integrated, multidisciplinary approach able to promote the preventive attitude of students. The efficacy of the teaching has to be evaluated with appropriate methods every time, to verify both informative and formative aspects.

Curriculum↗

[Determination of blood bile acids using high pressure liquid chromatography: comparison of chromatographic, enzymatic and immunoenzymatic methods].

A method has been developed for measuring serum conjugated bile acids by HPLC. Serum samples, to which the internal standard is added, are purified by a solid phase procedure and injected on a reverse phase C18 column. Elution is accomplished by means of a flow gradient and peaks are detected at 198 nm. The detection limit ranges between 0.05 and 0.20 mumol/l for different analytes; between-day precision (CV 5.8%), working linear range (up to 50 mumol/l) and recovery (87%) were established. Comparison of the results obtained with HPLC, enzymatic and immuno-enzymatic methods gave high correlation coefficients. The method was applied for diagnostic purpose to a group of subjects suffering from various liver diseases. Also, 106 healthy workers, not occupationally exposed to known or potentially hepatotoxic agents, were studied in order to establish reference values for use in biological monitoring of chronic low level exposure to solvents. The method has the advantage of a more simple procedure compared to previously reported HPLC methods and appears to be well suited for routine use in toxicological and clinical test laboratories.

Adult↗

[Biological limits of exposure: evolution of interpretative and methodologic criteria].

Biological monitoring is an extremely efficient investigation tool in evaluation of exposure to exogenous substances, in both occupational and environmental settings. However, although biological tests have been widely acclaimed as the ideal approach to or as a completion of environmental measurements, they have had difficulty in becoming firmly established due to a number of limitations of various nature. Besides the numerous uncertainties in the set-up phase, which depend on the choice of indicators or criteria for their use, difficulties are still incurred in making a univocal interpretation of the results. These difficulties are due to the limited pharmaco-kinetic information available on the various substances and to the wide variability in individual biological response. The possibility of extrapolating Biological Exposure Limits (BELs) from the corresponding TLV-TWA, by means of calculations based on the experimental regressions observed between internal and external dose indices, has up to now been considered a dubious operation from a formal point of view and merely indicative for practical purposes. This paper examines the possibility of establishing BELs that are fixed taking account of the influence of the various biological variables, thus permitting a more correct, objective and generalised use of biological indicators in current practice. From the regression function and relative tolerance limits, intended as a range of values within which regression values can be expected to be found with a probability that can be fixed a priori, it is possible to calculate 3 BEL values for each environmental TLV-TWA concentration. The question of which of these different values should be selected as a BEL for practical purposes must be solved on the basis of a series of observations related to the type of investigation being performed and the context in which the results are to be used. It should be emphasized that each BEL value has its own particular sensitivity and specificity, i.e., the possibility of correctly classifying the exposure conditions in relation to the environmental values. If sensitivity and specificity values are known, it is possible to calculate the predictive value of the biological measurements compared to the environmental measurements; if numerical data on these parameters are available, account can be taken of the variability of the results in a rigourously scientific manner.(ABSTRACT TRUNCATED AT 400 WORDS)

Air Pollutants, Occupational↗

[Biological monitoring of occupational exposure to airborne pollutants].

Biological monitoring of inert substances requires knowledge of the mechanisms regulating respiratory absorption. The authors examine the influence of parameters such as work load, exposure duration and biotransformation on the respiratory absorption of inert airborne pollutants in the workplace. Attention is also given to the possibility of using biological thresholds or Biological Equivalent Limits (BELs).

Air Pollutants, Occupational↗

[Application of high-pressure liquid chromatography in the analysis of urinary metabolites of aromatic solvents].

The introduction of HPLC methods in industrial toxicology represents a valuable tool for the routine monitoring of workers occupationally exposed to aromatic solvents. The HPLC method described here permits the simultaneous determination of metabolites of ethylbenzene, styrene, toluene, xylene isomers, benzene, phenol and cresol isomers in diluted urine samples. Pretreatment of urine samples with steam distillation is necessary only for determination of phenol and cresols because of their low concentrations. A comparison between a GLC and the HPLC procedure for mandelic and phenylglyoxylic acids confirmed the satisfactory performance of the HPLC method.

Adult↗