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Biomedical subjects

G Chiappino

Publications and source records attributed to G Chiappino.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

[Presence of asbestos in naval vessels: study of airborne fiber concentrations on Italian railways ferry boats].

Asbestos has been widely used on ships as an insulating material due to its fire-resistant and sound-absorbent properties. It was therefore deemed appropriate to measure the concentrations of airborne asbestos fibres on two ferries in regular service on the Civitavecchia-Golfo Aranci route. Decontamination work had been carried out on these vessels in order to remove, as far as possible, or to confine asbestos. Between 1994 and 1998, the Ultrastructures Laboratory of the Istituto Superiore di Sanità analysed 123 samples via scanning electron microscopy (SEM) with elementary dispersion X spectroscopy (EDXS). The results showed that in 98.4% of the samples concentrations in the air were below 2 fibres/litre, which is the value set by Ministerial Decree of 6/9/94 for buildings to qualify for effective decontamination status. Concentrations above this value, between 2 and 10 fibres/litre, were found in one ferry engine room, where workers were not continuously present since a remote control box was installed there. The results show that there is no environmental dispersion of asbestos fibres in usual navigation conditions; the situation is comparable to that in buildings where asbestos-containing safety materials have been used and that are subject to period checks in accordance with the guidelines included in Ministerial Decree of 6/9/94. Legislation is deemed necessary to make law 257/92 applicable to naval vessels in order to define univocal criteria for risk evaluation, checking, maintenance and custody procedures of asbestos-insulated vessels, and procedures for each job on board involving handling or removal of asbestos-containing material.

Air Pollutants↗
PubMedDate not supplied

[Neoformed multiple hepatic angiomas after exposure to vinyl chloride monomer: report of a case].

The paper describes the case of a 60 years old man with previous protracted exposure to CVM. After a latency of 20 years, the man developed two hepatic hemangiomas, one characterized by rapid growth (4 cm of diameter in 1 year) and surgically removed. On the basis of the anamnestic data (15 years in a PVC polymerization factory in the reactor vessels department) considering the degree and duration of exposure to CVM, an occupational origin of the hepatic hemangiomas is probable. The ability of CVM to induce sclerosis, necrosis and endothelial hyperplasy in the liver tissue may represent the primum movens of hemangiomas.

Carcinogens↗
PubMedDate not supplied

[Prostate diseases of occupational origin].

BACKGROUND: Prostatitis is a poorly defined group of syndromes with multiple causes. Chronic prostatitis may be non-bacterial and due to intrapelvic venous congestion. If the causes persist and adequate treatment is not given, the congestive syndrome may become chronic and interfere with fertility with severe biological damage. OBJECTIVES: Little is known in the field of occupational medicine (as regards clinical and pathogenic aspects) and, on the other hand, little is known by urologists (as far as the aetiological aspects are concerned), the prostatitis-like syndrome due to intrapelvic congestion has been defined in recent studies as non-bacterial prostatitis or prostatodynia, but we prefer to call it "prostatosis". The results of a close cooperation between urologists and occupational physicians are reported. METHODS: Patients with non-bacterial chronic prostatosis were evaluated from the urological and occupational point of view and all the etiological factors of both occupational and non occupational origin were considered. When occupational factors are a conditio sine qua non prostatosis is considered an occupational disease. RESULTS: Two cases of "occupational prostatosis" are described where driving vehicles and a sedentary employment played the most important etiological part. Many other similar cases were observed. CONCLUSIONS: Close cooperation between urologists and occupational physicians makes it possible to complete clinical diagnosis with a careful evaluation of all the factors of both occupational and non-occupational origin and allows the identification of those cases that must be defined as occupational diseases. Prostatosis due to venous congestion deserves the attention of occupational physicians since the distinction between occupational and non-occupational origin must be found both in individual cases and in groups of workers subject to the same factors. Moreover, the present state of knowledge is enough to take preventive measures aimed at reducing the frequency of new cases and avoiding the deterioration of existing cases. It is also possible that some cases of pseudo-cystitis in women might be the result of intrapelvic venous congestion of occupational origin. Anatomical and physiological non-occupational factors as well as certain habits of life style can favor intrapelvic venous congestion, producing conditions of hypersusceptibility to occupational factors and could sometimes cause the disease even in the absence of causes connected to work.

Adult↗
PubMedDate not supplied

[The Occupational Medicine Post-Graduate School of Milan].

From its very foundation, post-graduate work for medical doctors has been the main objective of the "Clinica del Lavoro". This completion of the doctor's training has, in the course of the past century, moved in time with the evolution of Occupational Medicine as a science: new developments in the field, the results of experimentation and research carried out in the Clinic, have immediately been passed on to young doctors. The professionals trained in the Clinic have always been considered the very best and have been sought after by the most important medical facilities in the country. Since the beginning of the last century, when Luigi Devoto began to evaluate the infectious, poisonous, and deficiency pathologies connected with the workplace, to the post-war years of rapid growth, when Enrico Vigliani studied and prepared our doctors to deal with dust-related pulmonary diseases, metal-based poisons, and many other problems connected with the transformation of an agricultural society to an industrial society, and up to the present years, which have been characterized by the post-industrial new economy, the "Clinica del Lavoro" has always taught and put into practice the motto of Luigi Devoto: "Occupational medicine is not a part of medicine, but rather a particular way to practice medicine".

Education, Medical, Graduate↗
PubMedDate not supplied

[Asbestos risk in the textile industry: final confirmation of data from the Lombardy Mesothelioma Registry].

BACKGROUND: Cases of mesothelioma in non-asbestos textile workers have been frequently reported but the identification of asbestos dispersion sources in the workplaces has never been adequately performed. During 3 years of activity of the Mesothelioma Register for Lombardy, 40 cases (10.8% of all cases) were collected in textile workers engaged in all types of productive activities. The hypothesis that a significant asbestos risk for textile workers appeared not negligible. OBJECTIVES: The research was aimed at the identification of asbestos dispersion sources in textile factories. METHODS: Specific information was collected by technicians, maintenance personnel and other experts and direct inspections were carried out in numerous workplaces that had not yet undergone significant changes with respect to the past. Also the industrial machinery utilised in the previous 40-50 years was thoroughly examined. RESULTS: Epidemological evaluation of the recorded cases showed a widespread distribution in the different phases of textile production. Inspections also showed that a large amount of asbestos had been regularly used applied to the ceilings and also to the walls of factories in order to avoid both condensation of steam and reflection of noise. In addition, asbestos had also been widely used to insulate water and steam pipes. The braking systems of most of the machines also had asbestos gaskets, and on several looms some brakes operated continuously in order to keep the warp in constant tension. CONCLUSIONS: Our observations confirmed that since production techniques in the textile industry required working in damp and warm conditions with the noise of the rapidly moving machines, asbestos was very often used because of its absorbent and soundproofing qualities and its resistance to friction. We demonstrated that asbestos was thus widely used in the industry and this certainly produced considerable fibre dispersions in the atmosphere of the workplaces. Asbestos risk must therefore be recognised for all those who have worked in the textile industry in the recent past and, as a result, cases of mesothelioma must be considered occupational diseases.

Asbestos↗
PubMedDate not supplied

[Benign pleuropathies due to asbestos: their clinical prognostic significance and the medicolegal aspects].

Benign pleural disease due to asbestos, which at present is frequently the sole lesion in asbestos-exposed subjects due to the fall in full-blown asbestosis, consists of a series of phenomena of increasing severity, from minor manifestations without functional impairment, to manifestations associated with proven functional damage due directly to or as a consequence of as yet undiagnosed parenchymal asbestosis. In assessing individual cases from a medico-legal viewpoint, benign pleural disease must always be considered as a morbid manifestation of asbestos exposure. The implications for prognosis and insurance purposes must, however, take account of various factors such as internal dose, whenever detectable, time elapsed since beginning of exposure, presence and extent of functional damage. The tendency of assessing pleural disease merely as an indicator of past asbestos exposure should in any case be abandoned.

Asbestos↗
PubMedDate not supplied

[Malignant mesothelioma of the pleura in a worker with brief atypical exposure to chrysotile asbestos].

BACKGROUND: The appearance of malignant mesothelioma in workers exposed to asbestos dusts even for relatively short periods of time is amply demonstrated in the literature. The workers however were usually exposed to amphiboles in jobs well known as involving exposure, that are characterized by high levels of dusts. OBJECTIVES: To describe a clinical case of pleural mesothelioma that occurred in a patient exposed to chrysotile, in a job (driver) that cannot be directly linked to such high exposure, and which moreover he only did for a few months. METHODS: The clinical history was reconstructed by analyzing the clinical files of the hospital admittances from May 2002 to August 2003, during which the patient underwent radiological examinations (chest x-rays, chest and abdomen TC), cytological examination of the pleural fluid, videothoracoscopic surgery with histological examination (including immunohistochemical coloration) of the tissue taken in biopsy. The job history, as well as any possible non-occupational exposures to asbestos, was examined via a standardised questionnaire, which the patient himself answered, as used in the Lombardy Mesothelioma Register, in operation at the "Clinica del Lavoro" in Milan. RESULTS: Examination of all clinical files confirmed the diagnosis of malignant pleural mesothelioma. Analysis of job history was found appropriate for defining as certain an occupational aetiology due to inhalation of asbestos fibres which occurred for few months as a truck driver in a chrysotile mine.

Aged↗
PubMedDate not supplied

[Mesothelioma: the aetiological role of ultrathin fibres and repercussions on prevention and medical legal evaluation].

BACKGROUND: Mesothelioma has until now been considered to be a manifestation, occurring in the pleura and/or peritoneum, of the carcinogenic action of the total burden of inhaled asbestos fibres, in the same way as lung cancer. Because of the pathogenic potential of very low exposure levels, the fact that the onset of the neoplasm always occurs in the parietal pleura, and the absence of any synergism with smoking, which is typical in the case of carcinoma, it was suspected that aetiopathogenetic differences existed but the reasons for such differences still could not be explained. In the past experimental results indicated the oncogenicity of very thin fibres but mesothelioma in practice was not exclusively linked to this specific dimensional size class. OBJECTIVES: The paper proposes to take full advantage of the significant knowledge that must emerged from research carried out in recent years and use this knowledge to reconstruct the mosaic of the aetiopathogenesis of mesothelioma. Due consideration will also be given to the consequent new approach required in the field of medical-legal evaluation of cases and in the field of prevention. RESULTS: The most important knowledge that must today be taken as certain is the fact that mesothelioma is not caused, as is the case for asbestosis, by all the fibres that are inhaled but only by the ultrathin fraction of these fibres, having diameter of 0.2 microm and length of only a few microm. Only fibres of this class of size can cross the pulmonary-pleural barrier and are, therefore, the causal agent of mesothelioma and other benign pleural manifestations (plaques). Moreover the ultrathin fibres that translocate from the lung to the pleura are not distributed casually on the parietal and visceral surfaces but move over the surfaces, to concentrate around the lymphatic reabsorption stomata situated on the parietal pleura. Due to their shape, the fibres cannot easily be absorbed into the stoma via the lymphatic flow and so remain clustered for an indefinite period of time among the mesothelial cells that surround the stoma. The concentration of ultrathin fibres in punctiform areas of the parietal pleura and the extremely long biopersistence of the amphiboles now finally explain how very low exposures can cause mesothelioma in susceptible subjects and why the neoplasm always occurs on the parietal pleura. CONCLUSIONS: In medical-legal assessments of cases of mesothelioma the etiological importance of the ultrathin fraction of fibres means that any assumption of the disease being avoidable must be discarded, at least up to the second half of the 1980s because until then this class of fibres, which today must be considered as the true causal agent of the neoplasm, was not visible under the optical microscope, nor could such fibres be measured or eliminated from the atmosphere of working environments. The filter materials available both for fixed ventilation systems and for individual protective masks were not able to block the ultrathin fibres and were therefore only efficacious for the prevention of asbestosis and probably pulmonary carcinoma. It was only with the use of highly efficient HEPA filters and "absolute" filters towards the end of the 1980s that efficacious protection against all size classes of respirable fibres became possible in industrial plants. Preventive measures in the public hygiene area must also take account of the aetiological role of ultrathin fibres by making full use of electron microscope investigations and by using "absolute" filters for domestic purposes, in ventilation systems and above all in the filter systems of the mechanical devices used in town street cleaning operations.

Asbestos↗
PubMedDate not supplied

[Asbestos risk in the textile industry: braking systems on machinery used until the 1990's].

BACKGROUND: We recently described asbestos risk in the non-asbestos textile industry as the result of fibre dispersion from ceilings, pipe insulation and machines. OBJECTIVES: The widespread use of brakes with asbestos linings on the machines as well as other functional details were considered for a proper evaluation of their role in producing atmospheric pollution METHODS: All the information was collected on the basis of the personal technical experience of two of the Authors and by direct observation of the machines. RESULTS: All the textile machines (ring spinning, twisting, warping, winding, looms) used until the 1990's were without exception equipped with asbestos-lined mechanical brakes. The heavy action required produced relatively rapid wear of the linings and the dust produced was spread into the atmosphere by the continuous action of the "travelling blowing cleaners" and by the daily cleaning of the machines using compressed air at the end of the shift: violent air blowing undoubtedly caused redispersion of the fine dust from the brakes and also acted as a mechanical grinder on the bundles that sedimented on the machines from the ceilings and pipes, producing more ultrathin respirable fibres. CONCLUSIONS: the contribution of textile machinery to atmospheric pollution by asbestos fibres was significant and due both to the widespread use of brakes with asbestos-containing materials and to the continuous action on the machines of compressed air blowers. Asbestos pollution was certainly high in all the factories so that in the near future still further mesothelioma cases among ex-workers are to be expected.

Air Pollutants, Occupational↗
PubMedDate not supplied

[Pleural fibrosis in asbestosis and ventilatory function: a study of 50 cases].

The importance of non-malignant pleural fibrosis in asbestosis in relation to respiratory function is still open to debate because of the differing results obtained in studies of different population groups. In the present study we selected 50 subjects with occupational exposure to asbestos presenting mono- or bilateral pleural fibrosis at X-ray but without lung impairment. Each subject underwent bronchial lavage and ventilatory function tests. The subjects were divided into 4 groups on the basis of the degree of pleural alterations according to the ILO Classification of Pneumoconioses. The results revealed that the mean values of CV and FEV1 in each group were within physiological limits. Moreover, analysis of the type of lung function showed a normal situation in 64% and restricted function in 28% of the cases. The prevalence of the latter finding was not correlated to the severity of pleural fibrosis in the various groups. Also, comparison between severity of pleural fibrosis and number of asbestos bodies/ml of BAL liquid on the one hand and frequency of alveolitis on the other did not reveal any relationship. Therefore, the onset of pleural fibrosis appears to be independent of the quantity of inhaled asbestos fibres and due to different mechanisms from those leading to lung fibrosis. In practice, a correct interpretation of the presence of pleural fibrosis from a clinical and prognostic viewpoint also requires other investigations such as BAL and a complete respiratory function study.

Adult↗
PubMedDate not supplied

[Atmospheric asbestos pollution in the urban environment: Milan, Casale Monferrato, Brescia, Ancona, Bologna and Florence].

The atmospheric concentrations of asbestos fibres were measured in 6 towns by long term sampling of air (3 weeks) and by counting at TEM both long and short fibres. Chrisotile and amphiboles were separately counted. For each town high traffic, low traffic and no traffic zones were considered as well as industrial areas and areas with possible and probable sources of asbestos pollution. For Milano the seasonal variations in atmospheric concentrations of asbestos fibres were also recorded in a central square. The maximum concentrations of total fibres was found in Milano (251.7 fibres/liter) and the minimum in Bologna (0.3 fibres/liter). Chrisotile and ultrashort fibres are the most frequent component of the atmospheric pollution. The fibre counts to which people is exposed are far below the levels at which it has been possible to detect risks in industry: however the possibility of a synergism between asbestos and other pollutants with consequent increase of the total carcinogenic potential of the polluted atmosphere cannot be ruled out. The control of the most active sources of asbestos dispersion must be considered in a correct balance between costs and social benefits.

Air Pollutants↗
PubMedDate not supplied

[The erosion of asbestos cement roofs: an important source of environmental pollution].

A microscopic investigation on samples of asbestos cement roofs weathered from 2 months to 15 years or more was carried out. Surface alterations begin as early as 2 months, are well visible after a few years and become very severe after 5-10 years. The deterioration of the cement structure, due mainly to the chemical attack of the acid rains produces a release of fibres that is more evident with increasing duration of the exposure. The surface of the "old" roofs must be considered as important source of environmental pollution, that increases the total carcinogenic potential of the polluted atmosphere in a non-negligible way, considering also the enormous extension of the surfaces. Instead of replacing the roofs, adequate primers and sealants can be applied after careful preparatory cleaning: gross contamination of water and/or surrounding areas must be avoided by appropriate work procedures. The deteriorated materials containing amphiboles must be considered with priority.

Asbestos↗