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Biomedical subjects

B Saia

Publications and source records attributed to B Saia.

At least 55 records · Page 3Linked to original sources

[Diseases in hospital workers].

Occupational diseases and labour accidents in health care workers (Azienda Ospedaliera di Padova) were evaluated from 1990 to 2000; the information collected is compared with the same data of Regione Veneto and INAIL. 262 occupational diseases were found; nurses are more affected than other health care workers. In both reports (Azienda Ospedaliera di Padova and Osservatorio epidemiologico della Regione Veneto) half of the occupational diseases and injuries are represented by allergic disease. Low back pain is also equally represented in Azienda Ospedaliera and in Osservatorio epidemiologico results (5.3% and 6.6% respectively). Among the labour accidents reported to INAIL from 1994 to 2000, 25% of them were represented by falls and slips, 23% by car accidents, 17% were caused by tools, 17% by movement of goods and persons, 8% by contact with splinters, liquids, dusts, 5% by assaults and 5% by contact with blood or body fluid. The latter result is widely underestimated in the INAIL report, because these events usually produce a temporary inability of less than 3 days; in fact, they represent more than half of the labour accidents treated at the Azienda Ospedaliera di Padova. Medical surveillance (in exposure to aldehydes, anaesthetic gases, chemioterapic drugs) has shown many other occupational health problems that often need specific structural intervention (restructuration and restoration of workplaces in health care environments), and work organization changes.

Accidents, Occupational↗

[Occupational exposure to electromagnetic fields in physiotherapy departments].

An assessment of the electromagnetic fields emitted from short and ultrashort wave diathermy sources and from magneto therapy operating at a frequency of 50 Hz was made to evaluate the occupational exposure to the operators. Operators were exposed to electromagnetic fields which rarely exceed the recommended limits of International Commission on Non-Ionizing Radiation Protection (ICNIRP) and American Conference of Governmental Industrial Hygienists (ACGIH). Only a measurement of electromagnetic fields near short wave diathermy equipment operating at a frequency of 27.12 MHz exposed operators to levels above those recommended by ICNIRP at a distance of 1 metre. Magnetic fields of magneto therapy exceeded residential exposition of 1 microtesla, at a distance of 4 metres.

Diathermy↗

[The occupational risks in a company producing aluminum alloy wheels].

An environmental hygiene study was carried out in a factory making aluminium alloy wheels via pressure moulding. Physical risk factors (noise and microclimate) and chemical risk factors (respirable dust, mineral oils, solvents, fluorides, formaldehyde, CO) were assessed. Analysis of the data showed that physical risk factors were prevalent, whereas chemical pollution was insignificant due to technical improvements made by the management in the course of several redesigns of the plants.

Air Pollutants, Occupational↗

[Musculoskeletal diseases among a group of geriatric residence workers].

A total of 274 workers of a geriatric residence underwent physical and anamnestic examination in order to ascertain the existence of diseases associated with occupational risks of manual handling of patients. Data on musculo-skeletal disorder of the spine and of the upper limbs were collected. The correlation between manual handling of patients and musculo-skeletal disorder in this worker population is consistent with those already reported in the literature. Data was compared with prevalence estimates of musculo-skeletal disorder in worker population not exposed. This comparison showed significant increase of scapulo-humeral periarthritis in female over 35 years of age. In conclusion, this duty is a specific risk for the upper limbs; therefore more risk evaluation studies are needed. Also, a check for these types of disorders should be included in all duty specific medical exam protocols.

Adolescent↗

[Occupational chronic obstructive pulmonary disease: Italian law (decree no. 336/1994) and epidemiological evidence].

BACKGROUND: In Italy, occupational diseases are required by law to be listed (however, any occupational diseases not included in the list may be compensated if workers demonstrate causation in court). The list is periodically updated in order to incorporate new findings from medical research. Decree no. 336/94 uses a less inclusive term (chronic obstructive bronchitis) than that used in the earlier decree, no. 482/75 (chronic obstructive pulmonary disease, COPD). Moreover, it includes fewer occupations that involve a risk of developing COPD. OBJECTIVES: In order to find an epidemiological basis that might justify the above changes to Italian law, risk of COPD was investigated in relation to occupation and time, using a case-referent design. METHODS: The same definition for COPD (clinical history of >2 years with shortness of breath and/or winter phlegm and an FEV1 less than 80% of the predicted value, only minimally reversible with bronchodilators and without marked change during the hospital observation period) was used in two case-referent studies. The first study was carried out from 1972 to 1980 (202 cases of COPD and 202 referents matched for age and sex) and the second from 1990 to 1997 (131 cases of COPD and 298 referents, every fourth eligible patient in each calendar year of observation). In both studies cases and referents were classified into 16 occupational categories, and office workers were the reference. All subjects were selected from male patients admitted to the Occupational Health Clinic in Padua. Smoking-adjusted (Mantel-Haenszel analysis, first study), or age-smoking-adjusted (logistic regression analysis, second study) Odds Ratio (OR) and 95% confidence interval (CI) for COPD were estimated in each occupational category and in two main groups: workers employed in occupations at either high or low risk for COPD. The latter OR and the fraction of exposed cases (pc) were used to estimate the population attributable risk (PAR) through: pc(OR-1)/OR. RESULTS: Significantly high risks for COPD in miners and chemical workers were observed in the first period, but not in the second time window. On the other hand, an increased time trend for OR estimates was found in welders, wood carpenters, construction and foundry workers. Among farmers, painters, cotton textile and refractory brick workers, the OR for COPD was significantly above unity in both time periods. PAR was 37% in the first and 52% in the second study. CONCLUSIONS: The restrictive definition of occupational COPD, which was introduced by Decree no. 336/94, contrasts with the epidemiological evidence showing that the risk of occupational COPD has increased over time: up to 50% of COPD cases referred to an occupational medicine physician might have an occupational origin.

Adult↗

[Interactions between solvents and noise: state of the art].

There are several environmental and occupational scenes where a co-exposure of noise and solvents occurs, therefore between a neurotoxic and a ototoxic agent. Epidemiological and experimental studies with simultaneous exposure to noise and solvents like toluene, styrene and carbon disulfide have been analysed. These studies investigate possible ototoxic effects through audiometry, auditory brainstem response, potential recall and reflex decay test. The current available data show that with high exposure levels, that are responsible for tissue damage by themselves, the interaction between noise and solvents could occur. The present knowledge can not permit a conclusion for low exposure levels.

Adult↗

Protection of third parties in current legislation and preventive practice.

The problem of safety and the management of risks to third parties, which may be caused by a change in the mental or physical health of an employee, is one which affects a number of different areas (infectious diseases, psychiatric illnesses, conditions of drug and alcohol abuse, etc.). Italian legislation deals with the issue of fitness for work through a variety of laws, decrees and regulations which, because many of them were issued in different historical circumstances, are not always mutually harmonized. The growing complexity of the workplace makes the role of the Occupational Physician more complex, and to this person the law assigns the exclusive task of monitoring the health of employees in the cases covered by the current regulations. In our opinion, the Occupational Physician, to the best of his knowledge and conscience, having taken into consideration all the aforementioned factors, must take each case on its merits, in the most responsible manner possible, weighing up the complexity and delicacy of the aspects discussed earlier, and decide to deliver a verdict of fitness and/or to break or not to break the obligation of confidentiality, tending, in our view, to favour the need to safeguard collective health, or that of third parties, should there be a conflict of interest.

Humans↗

[Mutagens and carcinogens in city air].

Many urban air pollutants are recognized to be mutagenic and carcinogenic agents. Combustion processes, which generate gaseous and particulate complex mixtures, are responsible for the major part of urban air pollution. Emissions from automotive sources are estimated to be nowadays the main cause of mutagenic/carcinogenic risk for people living in urban areas of industrialized countries. Increasing vehicle traffic also contributes to the presence in urban air of valuable concentrations of asbestos fibers and benzene, both well-known potent carcinogens.

Air Pollutants↗

[The AMES test in environmental and occupational medicine].

The authors review the use of the gene mutation test on Salmonella typhimurium, better known as the Ames test, in environmental and occupational health. This test, which was originally intended as a predictive test of the carcinogenicity of chemical substances, has been widely applied in in vitro screening of complex mixtures of substances present in the environment and in the biological monitoring of high risk populations. Data are reported on the main environmental exposures that were positive with the Ames test and it is stressed how this biological assay has contributed to the identification of new classes of genotoxic compounds (nitropyrenes, mutagen X). The Ames test performed on extracts of human urine was used to study exposure to carcinogenic substances in the working environment. Many occupational exposures can cause an increase in mutagenic activity in the exposed subjects (cytostatic drugs, rubber manufacture, polycyclic aromatic hydrocarbons). It is recommended to restrict the use of the urinary mutagenesis test to group studies and carefully check confounding factors (e.g., smoking and diet).

Carcinogenicity Tests↗

[Environment and the immune system].

A large number of xenobiotics (i. e. chemicals, drugs and biologicals) may adversely affect the immune system in consequence of different mechanisms: 1) the capacity of a large variety of xenobiotics to cause an allergic sensitization and different types of allergic sequelae (e.g. bronchial asthma, rhinitis, hypersensitivity pneumonitis, contact dermatitis); 2) the adjuvant effect, potentiating the IgE mediated immuno-response against ubiquitous allergens (e.g. pollens); 3) the direct or indirect action on the immune system, at doses that did not cause overt toxicity. This effect is studied by a new discipline, called Immunotoxicology; 4) the indirect action on the target organ, which facilitate the onset of respiratory symptoms in previously asymptomatic subjects. The widespread distributions of xenobiotics in the environment suggests that our current knowledge of their adverse health effects may represent only the tip of the iceberg and that exposure to such immunotoxic agents may play a greater role than heretofore suspected in disease causation. The exposure to immunotoxic agents in the workplace might represent and additional risk to HIV positive individuals.

Allergens↗

[Kinds of home accidents].

A survey on hospitalization due to domestic accidents conducted in Padua in three public hospitals shows that between 1979 and 1988 there were 12.251 cases. Women in particular seemed to be affected by the phenomenon (7.926 cases, 64.7% of total) especially if aged 45 years or over (6.382 hospitalizations). Home injuries among females are the second cause of hospitalization due to trauma and represent the leading cause of accidental deaths (355 cases during the period of the survey). Lethality of this kind of injury progressively increases starting from the ages 30-44, and reaches 7.1% in older people (60 years or over). The causes of these accidents have been analyzed in 197 cases of fatal domestic accidents during the five years 1984 to 1988 and in 277 cases of non fatal accidents that involved subjects between the ages of 15 and 59 during the years 1986. In both situations the most frequent cause was falling (132 fatal, 159 non fatal cases); this finding shows the importance of a primary prevention programme based on the improvement of domestic structures and more care in furniture planning. The second place both among fatal and non fatal injuries belongs to burns (21 fatal and 17 non fatal). These frequently arise from incorrect behavior and emphasize in this way the necessity of improving sanitary education. A great number of home accidents (33 hospitalizations), can be attributed to bad working instruments or absence of security devices. This all shows the necessity of specific security regulations regarding installations and utensils of domestic use.

Accidental Falls↗

[Urinary excretion of mutagens and cisplatin among the nursing staff at a medical oncology department exposed to cytostatic drugs].

Exposure to cytostatic drugs was assessed in a group of 9 nurses employed in a hospital cancer therapy department by measuring the post-shift levels of urinary mutagens and cis-platinum. A slight but significant increase in urinary mutagenic activity compared to 11 controls was observed in the non-smokers: the mean values of mutagenic activity on the Ta100 strain in the presence of both microsomal and deconjugating enzymes were 4418 +/- 1186 and 2468 +/- 1681 respectively. Conversely, the urinary platinum concentration was below the detection limit of the analytical method (10 micrograms/l) in all samples. The increased urinary mutagenic activity in the exposed group can probably be attributed to the absorption of cyclophosphamide either during preparation and administration of the drug, or due to accidental contact with contaminated biological fluids, in view of the fact that the level of mutagens in urine samples from cyclophosphamide-treated patients is extremely high (up to 319,478 revertants/g creatinine in the case we examined).

Antineoplastic Agents↗