Biomedical subjects

M Bovenzi

Publications and source records attributed to M Bovenzi.

At least 37 records · Page 2Linked to original sources

PubMed1997

Factors associated with cognitive impairment among older Italian inpatients. Gruppo Italiano di Farmacovigilanza nell'Anziano (G.I.F.A.).

OBJECTIVE: To examine the association of cognitive impairment with educational, demographic, and nutritional variables in older hospitalized people. DESIGN: Survey of older patients admitted consecutively to a hospital during two 2-month periods in 1993. SETTING: Patients admitted for general medical care at 35 hospitals participating in the GIFA study throughout Italy. PARTICIPANTS: A total of 3628 patients aged 65 or older were studied. MEASUREMENTS: The Hodkinson Abbreviated Mental Test (HAMT) was used as a screening method to assess the patients' basic cognitive function. Multiple logistic regression was used to examine the association between cognitive impairment and demographic, educational or nutritional variables. RESULTS: Twenty-nine percent of older inpatients were classified as having cognitive impairment, with similar distribution of HAMT score found in both genders. Educational attainment has a highly significant inverse relationship with cognitive impairment (highest education: OR 0.32; 95% CI 0.20-0.52). Moreover, cognitive impairment decreased with increasing body mass index (3rd tertile: OR 0.69; 95% CI: 0.51-0.93), cholesterol serum level (highest values: OR 0.59; 95% CI 0.37-0.93), circulating lymphocytes (highest values: OR 0.55; 95% CI 0.45-0.69), and serum albumin (highest values: OR 0.60; 95% CI 0.47-0.76), with a gradient of influence for each variable. CONCLUSIONS: Educational attainment affects cognitive function in older inpatients. The strong association between cognitive impairment and nutritional variables suggests that every effort to improve nutritional status is needed in approaching cognitive impairment in older patients.

Age Distribution↗

PubMed1997

Haemodynamic changes in ipsilateral and contralateral fingers caused by acute exposures to hand transmitted vibration.

OBJECTIVES: To investigate changes in digital circulation during and after exposure to hand transmitted vibration. By studying two frequencies and two magnitudes of vibration, to investigate the extent to which haemodynamic changes depend on the vibration frequency, the vibration acceleration, and the vibration velocity. METHODS: Finger skin temperature (FST), finger blood flow (FBF), and finger systolic pressure were measured in the fingers of both hands in eight healthy men. Indices of digital vasomotor tone-such as critical closing pressure and vascular resistance-were estimated by pressure-flow curves obtained with different hand heights. With a static load of 10 N, the right hand was exposed for 30 minutes to each of the following root mean squared (rms) acceleration magnitudes and frequencies of vertical vibration: 22 m.s-2 at 31.5 Hz, 22 m.s-2 at 125 Hz, and 87 m.s-2 at 125 Hz. A control condition consisted of exposure to the static load only. The measures of digital circulation and vasomotor tone were taken before exposure to the vibration and the static load, and at 0, 20, 40, and 60 minutes after the end of each exposure. RESULTS: Exposure to static load caused no significant changes in FST, FBF, or indices of vasomotor tone in either the vibrated right middle finger or the non-vibrated left middle finger. In both fingers, exposure to vibration of 125 Hz and 22 m.s-2 produced a greater reduction in FBF and a greater increase in vasomotor tone than did vibration of 31.5 Hz and 22 m.s-2. In the vibrated right finger, exposure to vibration of 125 Hz and 87 m.s-2 provoked an immediate vasodilation which was followed by vasoconstriction during recovery. The non-vibrated left finger showed a significant increase in vasomotor tone throughout the 60 minute period after the end of vibration exposure. CONCLUSIONS: The digital circulatory response to acute vibration depends upon the magnitude and frequency of the vibration stimulus. Vasomotor mechanisms, mediated both centrally and locally, are involved in the reaction of digital vessels to acute vibration. The pattern of the haemodynamic changes in the fingers exposed to the vibration frequencies used in this study do not seem to support the frequency weighting assumed in the current international standard ISO 5349.

Adult↗

PubMed1997

Changes over a workshift in aesthesiometric and vibrotactile perception thresholds of workers exposed to intermittent hand transmitted vibration from impact wrenches.

OBJECTIVES: To investigate the changes over a workshift in fingertip tactile perception thresholds in users of impact wrenches exposed to intermittent hand transmitted vibration. A further aim was to assess the relation between acute changes in tactile sensation, sensorineural disorders, and vibration dose. METHODS: The study populations consisted of 30 workers exposed to vibration (16 men and 14 women) and 25 control manual workers (10 men and 15 women). Sensorineural disorders in the fingers and hands were graded according to the staging system of the Stockholm workshop scale. Tactile function was tested by measuring aesthesiometric thresholds (two point discrimination and depth sense perception) and vibrotactile perception thresholds at 16, 31.5, and 125 Hz before and after a workshift. Temporary threshold shift was then calculated as the difference between threshold measures before and after the shift. The measurement and assessment of exposure to vibration were made according to the international standard ISO 5349. The vibration dose accumulated over a workshift (m2s-4h) was estimated for each user of impact wrenches. Daily exposure to vibration was also expressed in terms of eight hour energy equivalent frequency weighted acceleration ((ahw)eq(8) in ms-2 rms). RESULTS: After adjustment for age and alcohol consumption, vibrotactile perception thresholds before exposure were greater in the workers exposed to vibration than in the controls. No differences in aesthesiometric thresholds before the shift were found between the study groups. Sensorineural disorders were mild in the workers exposed to vibration and minor neurological abnormalities were detected at the physical examination. Owing to the intermittent use of impact wrenches, the estimated mean (ahw)eq(8) for the subjects exposed to vibration was low (1.3 ms-2 rms). A significant temporary threshold shift in vibration perception at all test frequencies was found in the workers exposed to vibration but not in the controls. A significant increase in depth sense perception thresholds was found in the men exposed to vibration. The temporary threshold shift in vibration perception at 125 Hz, and to a lesser extent at 16 and 31.5 Hz, was associated with the severity of sensorineural disorders. In the workers exposed to vibration the temporary threshold shift in vibration sense at all test frequencies was positively related to the estimated dose of vibration received over a workshift. No significant relation was found between aesthesiometric threshold changes and vibration dose. CONCLUSIONS: Intermittent exposure to hand transmitted vibration over a workshift can cause a deterioration of tactile perception in the fingers of users of impact wrenches. Acute tactile dysfunction was related to both the estimated dose of vibration and the severity of sensorineural symptoms. The temporary threshold shift in vibration perception suggested that fast adapting skin mechanoreceptors such as Pacinian and Meissner corpuscles were mainly involved in the acute sensory impairment to the fingertips of the workers exposed to vibration. Changes in tactile perception can occur in workers with daily exposure to vibration that is considered to be associated with a minimal risk of adverse health effects induced by vibration.

Adult↗

PubMed1997

Polymorphism of the apolipoprotein E gene and early carotid atherosclerosis defined by ultrasonography in asymptomatic adults.

Clinical and autoptical studies have suggested a predisposing role of the allele E4 of apolipoprotein E (apoE) in the development of atherosclerosis and cardiovascular disease. To investigate the possible contribution of apoE allele polymorphism to the carotid intima-media thickness (IMT) as assessed by ultrasound, we studied 260 asymptomatic nondiabetic subjects (121 men, 139 women; mean +/- SD age, 53 +/- 7 years), randomly selected from the population register of the inhabitants of Trieste, Italy. B-mode ultrasound was used to quantify the maximum IMT at 12 sites on the near and far wall of the common, bifurcation, and internal carotid arteries. ApoE genotypes were determined from amplified apoE sequences by restriction isotyping. The frequencies of E2, E3, and E4 alleles were 0.073, 0.827, and 0.100, respectively. As expected, subjects with E4 allele had the highest levels of total serum cholesterol and LDL cholesterol, subjects with E2 allele had the lowest levels, and those with E3 genotype had intermediate levels. The echographic measurements of carotid IMT showed increasing values from E2 to E4 carriers. After adjustment for total and LDL cholesterol serum levels, triglycerides, ratio of LDL to HDL cholesterol, age, sex, and body mass index, ANCOVA showed that the common carotid IMT was significantly greater (P = .029) in subjects with E4 allele compared with E3 carriers. Our data confirm the influence of apoE4 on cholesterol levels and clearly show that apoE genotype affects carotid atherosclerosis in its early stages in middle-aged asymptomatic subjects.

Adult↗

PubMed1997

Cigarette smoking and histologic type of lung cancer in men.

STUDY OBJECTIVES: To determine whether intensity, duration, age at initiation, and cessation of cigarette smoking act differently in the development of various histologic types of lung cancer. DESIGN: A case-control study among deceased men who underwent autopsy, a procedure that involves approximately 73% of all local deaths. SETTING: The Province of Trieste in northeastern Italy PARTICIPANTS: Seven hundred fifty-five patients with lung cancer, including 267 with squamous cell carcinoma, 218 with small cell carcinoma, 90 with large cell carcinoma, 158 with adenocarcinoma, and 22 with other histologic types, and 755 control subjects who had died of causes other than chronic lung diseases and certain tumors. Information on smoking habits, residential history, and occupational exposure was obtained from each subject's next of kin. RESULTS: Compared with nonsmokers, the odds ratio (OR) for current smokers was 13.4 for all types combined, 18.8 for squamous cell carcinoma, 14.3 for small cell carcinoma, 34.3 for large cell carcinoma, and 7.9 for adenocarcinoma. Intensity of smoking, duration, age at starting, and dose were all directly associated with all histologic types of lung cancer, although the OR was lower for adenocarcinoma than for other cell types. When results were restricted to ever smokers, exposure-response curves were similar across histologic types. The risk of lung cancer attributable to smoking was 88% for all types combined, 91% for squamous cell carcinoma, 89% for small cell carcinoma, 95% for large cell carcinoma, and 82% for adenocarcinoma. CONCLUSIONS: This study confirms that cigarette smoking causes all types of lung cancer, but the proportion of cases attributable to smoking is lower for adenocarcinoma than for other types, due to a higher proportion of nonsmokers.

Adenocarcinoma↗

PubMed1996

Low back pain disorders and exposure to whole-body vibration in the workplace.

Occupational exposure to whole-body vibration (WBV) and postural stress in a driving environment may contribute to an increased risk for low back pain (LBP) disorders. In two epidemiological studies of bus drivers and tractor drivers, LBP disorders were found to be associated with age, back accidents, cumulative WBV dose, and postural overload. A review of the literature showed that the exposure-response relationship for WBV and injuries to the lower back is not fully clarified. There is a shortage of information on the health risk from WBV in female workers. Because it is estimated that several thousand women are exposed to intense WBV in the workplace, the health effects of WBV on female reproductive organs and vertebral column should be carefully investigated.

Automobile Driving↗

PubMed1996

Air pollution and lung cancer in Trieste, Italy: spatial analysis of risk as a function of distance from sources.

To investigate the relationship between four sources of environmental pollution (shipyard, iron foundry, incinerator, and city center) and lung cancer risk, we conducted a case-control study of decreased men in Trieste, Italy. We identified 755 cases of lung cancer and 755 controls through the local autopsy registry. Information on smoking habits, occupational history, and place of residence were obtained from the subject's next of kin. The case-control design was used to properly account for subject-specific confounders, which represent a major problem in geographical analysis. Spatial models were used to evaluate the effect of sources of pollution on lung cancer after adjustment for age, smoking habits, likelihood of exposure to occupational carcinogens, and levels of air particulate. The models are based on distance from the sources and enable estimation of the risk gradient and directional effects separately for each source. The risk of lung cancer was highly related to the city center (p = 0.0243), with an excess relative risk at zero distance of 2.2 and a smooth decrease moving away from the source (-0.015), and related to the incinerator (p = 0.0098), with an excess relative risk of 6.7 in the source and a very steep decrease (-0.176). These results are consistent with findings of previous analyses and provide further evidence that air pollution is a moderate risk factor of lung cancer.

Air Pollutants↗

PubMed1996

Exposure-response relationship for vibration-induced white finger among forestry workers.

The relation between the occurrence of white finger and vibration exposure was investigated in a group of 222 forestry workers using chain saws. The forestry workers and 195 controls never exposed to hand-transmitted vibration were interviewed by occupational health physicians. The diagnosis of vibration-induced white finger (VWF) was made on the basis of subjective symptoms of finger blanching and the results of a cold test with plethysmographic measurement of finger systolic blood pressure. Vibration was measured on a representative sample of AV and non-AV chain saws. Daily vibration exposure was assessed in terms of 8 h energy-equivalent frequency-weighted acceleration [A(8)]. A lifetime vibration dose was estimated for each of the forestry workers. The overall prevalence of VWF among the forestry workers was 23.4%. Raynaud's phenomenon was discovered in 2.6% of the controls. In the forestry workers, the risk of VWF showed positive increments with each increment of vibration dose, suggesting a monotonic dose-response relationship. The responsiveness to cold in the digital arteries of the forestry workers was also found to increase with increasing vibration dose. The estimated relation between VWF and vibration exposure showed that the expected occurrence of VWF increased in approximately linear proportion to either A(8) (with exposure duration unchanged) or the number of years of exposure (with equivalent acceleration unchanged). In this study of VWF among forestry workers the estimated exposure-response relation showed that if the magnitude of vibration acceleration is doubled, the total duration of exposure should be halved to produce an equivalent effect. On the basis of the assessment of vibration exposure, the estimated risk for VWF in the study population was found to be lower than that predicted by the International Standard ISO 5349. The results of this study tend to support the vibration exposure levels currently under discussion within the European Union.

Adult↗

PubMed1995

Air pollution and lung cancer in Trieste, Italy.

To investigate the relation between air pollution and histologic type of lung cancer, the authors conducted a case-control study among men who had died in Trieste, Italy, from 1979 to 1981 and from 1985 to 1986. Through the local autopsy registry, 755 cases of lung cancer and 755 controls were identified. Information on smoking habits, occupation, and place of residence was obtained from each subject's next of kin. Air pollution at the residence of each subject was estimated from the average value of total particulate at the nearest monitoring station. Logistic regression was used to evaluate the effect of residence and air pollution on lung cancer after adjustment for age, smoking habits, likelihood of exposure to occupational carcinogens, and social group. The risk of lung cancer increased with increasing level of air pollution for all types of lung cancer combined (p = 0.022), for small cell carcinoma (p = 0.016), and for large cell carcinoma (p = 0.049). Compared with inhabitants of the residential area, residents of the rural area had a relative risk (RR) of 0.6 (95% confidence interval (CI) 0.4-1.0). The RR was 1.5 (95% CI 1.0-2.2) for residents of the center of the city and 1.4 (95% CI 1.0-2.1) for residents of the industrial area. In the center of the city, the excess risk was almost completely restricted to small cell carcinoma (RR = 2.0) and to large cell carcinoma (RR = 2.6). In the industrial area, the risk was increased especially for adenocarcinoma (RR = 2.1). These results provide evidence that air pollution is a moderate risk factor for certain histologic types of lung cancer.

Adenocarcinoma↗

PubMed1995

Dose-response relation for vascular disorders induced by vibration in the fingers of forestry workers.

OBJECTIVES: To study the relation between the prevalence of vascular disorders (white finger) and vibration exposure in a group of 222 forestry workers, of whom 164 (73.9%) had work experience limited to antivibration (AV) chain saws only and 58 (26.1%) had operated both non-AV and AV chain saws. METHODS: The chain saw operators and 195 control workers never exposed to hand transmitted vibration were interviewed with health and workplace assessment questionnaires. The diagnosis of vibration induced white finger (VWF) was made on the basis of subjective symptoms of finger blanching and the results of a cold test with plethysmographic measurement of systolic blood pressure of the finger. Vibration was measured on a representative sample of AV and non-AV chain saws. Daily vibration exposure was assessed as eight hour energy equivalent frequency weighted acceleration (A(8)). A lifetime vibration dose was estimated for each of the forestry workers. RESULTS: The overall prevalence of VWF among the forestry workers was 23.4%. The diagnosis of VWF was made in 13.4% of the forestry workers who handled only AV chain saws and in 51.7% of those who had also operated non-AV chain saws in the past. Raynaud's phenomenon was found in 2.6% of the controls. In the forestry workers, the risk for VWF showed positive increments with each increment of vibration dose, suggesting a monotonic dose-response relation. The responsiveness to cold in the digital arteries of the forestry workers was also found to increase with increasing vibration dose and severity of VWF. The estimated relation between VWF and vibration exposure showed that the expected prevalence of VWF increased almost linearly to either A(8) (with exposure duration unchanged) or the number of years of exposure (with equivalent acceleration unchanged). CONCLUSIONS: In this study of VWF among forestry workers, the estimated dose-response relation showed that if the magnitude of vibration acceleration is doubled, the total duration of exposure should be halved to produce an equivalent effect. On the basis of the assessment of vibration exposure, the estimated risk for VWF in the study population was found to be lower than that predicted by the international standard ISO 5349. These findings suggest a revision of the risk estimates for VWF currently provided by ISO 5349.

Case-Control Studies↗

PubMed1995

Acute effects of vibration on digital circulatory function in healthy men.

OBJECTIVES: To investigate the local and central pathophysiological mechanisms involved in the acute effects of unilateral vibration on the digital circulation of healthy men. METHODS: Finger blood flow (FBF) and finger skin temperature (FST) in thermoneutral conditions, and the percentage change in finger systolic pressure (FSP%) after local cooling from 30 to 10 degrees C were measured in the fingers of both hands in eight men (aged 23-47 years) who were not occupationally exposed to hand transmitted vibration. The right hand was exposed for 30 minutes to sinusoidal vibration with a frequency of 125 Hz and an acceleration of 87.5 m.s-2 rms (root mean square). A control condition consisted of exposure to static load only (10 N) without vibration. The measures of digital circulation were taken before exposure to vibration and static load and at 0, 30, 60, and 90 minutes after the end of each exposure. RESULTS: Exposure to static load caused no significant changes in FBF, FST, or FSP% in either the test right or the control left finger. Immediately after vibration exposure, there was a temporary increase in FBF in the vibrated right finger, whereas the non-vibrated left finger showed no vasodilation. In both the vibrated and non-vibrated fingers, FBF and FST were significantly reduced during the recovery time. A large variability between subjects was found for FBF and, to a lesser extent, for FST. In the vibrated right hand the decrease in FBF was significantly related to cold induced vaso-constriction in the digital vessels. Such a relation was not found in the non-vibrated left hand. CONCLUSIONS: The results of this investigation suggest that acute vibration can disturb the function of digital vessels through two different and opposite mechanisms. Vibration seems to produce local vasodilation and to trigger a central sympathetic reflex vasoconstriction that can be recorded in the ipsilateral and the contralateral finger to vibration. Both local and central vasoconstrictor mechanisms are likely to be involved in the responsiveness to cold found in the digital vessels of a vibrated finger.

Adult↗

PubMed1995

Pre-employment screening among trainee bakers.

OBJECTIVES: To assess the prevalence of atopy in a vocational school so as to evaluate the feasibility of pre-employment screening. METHODS: The prevalence of atopy by family diathesis, prick tests, immunoglobulin E (IgE) concentrations, and personal history of allergic respiratory diseases was investigated in 144 trainee bakers and 81 students on a graphic artists course (mean age 15.4 years). Skin sensitisation to wheat, rye, and barley flours, to alpha amylase, and to storage mites was also evaluated. RESULTS: Personal allergic symptoms were reported by 13.2% of the bakers and 14.7% of the graphic artists and there was a significant association between symptoms and atopy by prick tests (odds ratio (OR) 17.2; 95% confidence interval (95% CI) 5.27-56.4) and by family history (OR 3.11; 95% CI 1.02-9.53). When bakers were grouped according to the presence of allergic symptoms and results of immunological tests, 6.9% had asthma, 6.3% had rhinoconjunctivitis, and a high percentage (28.5%) were without symptoms but scored positive on prick tests or family symptoms. Skin sensitisation to storage mites had similar prevalences (16%) in the two groups of trainees and occurred nearly always in atopic people. Positive skin tests to wheat flour (3.5%), rye (0.7%), and alpha amylase (0.7%) were specific to bakers. CONCLUSIONS: Pre-employment screening is a useful source of medical information and allows for counseling. The presence of asthma, or of another allergic disease in a severe form, is suggested as a criterion for excluding students of a vocational school from training as bakers. Student bakers without allergic symptoms but atopic by other criteria should be informed about their risks of developing occupational asthma, and periodic check ups must be recommended. Screening studies in vocational school provide a better understanding of specificity of skin sensitisation to occupational allergens.

Adolescent↗

PubMed1995

Scleroderma and occupational exposure.

OBJECTIVES: A case-referent study was conducted in the province of Trento, Italy, to investigate the possible association between occupational exposure and scleroderma (systemic and localized variants). METHODS: Twenty-one cases of scleroderma were ascertained from the computerized admission files of all of the local hospitals from 1976 to 1991. For each case, two age- and gender-matched referents were selected that were discharged from the hospital on the same day as the case. The subjects were interviewed with a structured questionnaire which included items for personal, work, and medical history. Exposure to organic solvents, other selected chemicals, silica dust, and hand-arm vibration was carefully investigated. RESULTS: A significant association was found between exposure to organic solvents (aromatic hydrocarbons) and scleroderma [odds ratio (OR) 9.28, 95% confidence interval (95% CI) 1.08-243.8]. For the men, the OR for exposure to silica was 5.20 (95% CI 0.48-74.1), whereas for the women it was 2.11 (95% CI 0.20-22.0) for exposure to other selected chemicals. CONCLUSIONS: The results of this case-referent study are consistent with those of previous case reports on the important role of occupation in the etiology of scleroderma. In particular, our findings confirm that exposure to organic solvents and silica is associated with this rare connective tissue disease.

Case-Control Studies↗

PubMed1995

[Comparison of epidemiologic methods in a case-control study of lung cancer and air pollution in Trieste, Italy].

To investigate the relationship between air pollution and histologic type of lung cancer we conducted a case-control study among deceased men in Trieste, Italy. 755 cases of lung cancer and 755 controls were identified through the local autopsy registry. Information on smoking habits, occupation and place of residence was obtained from the subject's next-of-kin. Air pollution at the residence of each subject was estimated from the average value of total particulate at the nearest monitoring station. Spatial models and logistic regression were used to evaluate the effect of residence and air pollution on LC after adjustment for age, smoking habits, likelihood of exposure to occupational carcinogens and social group. The risk of lung cancer increased with increasing level of air pollution for all types of lung cancer combined (P = 0.022), for small cell carcinoma (P = 0.016) and for large cell carcinoma (P = 0.049). Compared with inhabitants of the residential area, residents of the rural area had a relative risk (RR) of 0.6 (95% confidence interval (CI): 0.4-1.0). The RR was 1.5 (1.0-2.2) for residents of the center of the city and 1.4 (1.0-2.1) for residents of the industrial area. In the center of the city the excess risk was almost completely restricted to small cell carcinoma (RR = 2.0) and to large cell carcinoma (RR = 2.6). In the industrial area the risk was increased especially for adenocarcinoma (RR = 2.1). These results provide evidence that air pollution is a moderate risk factor for certain histologic types of lung cancer.

Adenocarcinoma↗

PubMed1995

Vascular responses to acute vibration in the fingers of normal subjects.

The aim of this experimental study was to investigate the pathophysiological mechanisms involved in the acute effects of unilateral vibration on the digital circulation of healthy men. In the fingers of both hands of eight male subjects (age 23-47 years) who had never worked with vibrating tools, finger blood flow (FBF) and finger skin temperature (FST) in thermoneutral conditions, and the percentage change of finger systolic pressure (FSP %) after local cooling from 30 to 10 degrees C were measured. The right hand was exposed for 30 min to sinusoidal vibration with a frequency of 125 Hz and an acceleration of 87.5 m.s.-2r.m.s. A control condition consisted of exposure to the same static load (10 N) but without vibration. The measures of digital circulation were taken before exposure to vibration and static load and at 0, 30, 60, and 90 min after the end of each exposure. Exposure to static load caused no significant changes in FBF, FST, or FSP % in either the test right or the control left finger. Immediately after vibration, there was a temporary increase in FBF in the vibrated right finger, while the non-vibrated left finger exhibited no vasodilation. In both the vibrated and non-vibrated fingers, FBF and FST significantly reduced during the recovery time. A large inter-subject variability was observed for FBF and, to a lesser extent, for FST. In the vibrated right finger the decrease in blood flow was significantly related to cold-induced vasoconstriction in the digital vessels. Such a relation was not observed in the non-vibrated left finger. The results of this investigation suggest that acute vibration can disturb the function of digital vessels through two different and opposite mechanisms. Vibration appears to produce local vasodilation and to trigger a central sympathetic reflex vasoconstriction which can be recorded in the ipsilateral and the contralateral finger to vibration. Both local and central vasoconstrictor mechanisms are likely to be involved in the response to cold observed in the digital vessels of a vibrated finger.

Adult↗

PubMed1994

Low-back disorders in agricultural tractor drivers exposed to whole-body vibration and postural stress.

The occurrence of low-back pain (LBP) was investigated in a population of 1155 tractor drivers exposed to whole-body vibration (WBV) and postural stress (response rate 91.2%) and in a control group of 220 office workers (response rate 92.2%). The subjects were questioned about several types of low-back symptom (LBP, sciatic pain, acute LBP, transient and chronic LBP) and various work- and individual-related risk factors, by using a standardized questionnaire. Vibration measurements were performed on a representative sample of the vehicles driven by the tractor drivers in the last ten years. Vibration magnitude and duration of exposure were used to calculate a vibration dose for each tractor driver. Perceived postural load was assessed in terms of frequency and/or duration of awkward postures at work. The prevalence of LBP was found to be greater in the tractor drivers than in the controls. After controlling for potential confounders by logistic modelling, low-back disorders were found to be significantly associated with both vibration dose and postural load. Back accidents and age were also significant predictors for LBP. Quantitative regression analysis indicated that vibration exposure and postural load were independent contributors to the increased risk for LBP according to a multiplicative model. The exposure levels for WBV recently recommended by a proposal of European Directive on physical agents seem to be more adequate to prevent long-term health effects on the lower back than the exposure limits suggested by the International Standard ISO 2631/1.

Journal Article↗

PubMed1994

Hand-arm vibration syndrome among travertine workers: a follow up study.

In a six year follow up study of the handarm vibration syndrome, 62 stoneworkers operating hand held vibrating tools in 10 travertine quarries and mills were first investigated in 1985 and then in 1991. The frequency weighted acceleration of vibration from the rock drills and stone hammers used by the travertine workers exceeded 20 m/s2, indicating a hazardous work activity according to the proposal of the EC directive for physical agents. A clinical examination and a cold provocation test were repeated with the same procedures as those adopted at the time of the first survey. The stoneworkers were divided into groups according to current work state: active stoneworkers who continued to use powered tools during the follow up (n = 21, median exposure time 22 years), and ex-stoneworkers with retirement vibration free intervals of three years (n = 22, median exposure time 27.5 years) and of six years (n = 19, median exposure time 20 years). In the group of active stoneworkers, a 38% onset a new cases of vibration-induced white finger (VWF) was found during the follow up (p < 0.01). Among the retired stoneworkers affected with VWF (n = 24), one recovered from VWF, one showed improvement, 20 remained stationary, and two deteriorated. The ex-stoneworkers experienced no significant change in sensorineural disturbances and a decrease in musculoskeletal symptoms of the upper limbs. At the cold provocation test, the currently active stoneworkers with VWF showed, on a group basis, a delayed finger rewarming time between the two examinations (p = 0.002). An abnormal response to cold provocation persisted in the fingers of the ex-stoneworkers with VWF, even in those reporting subjective improvement. These findings indicate a tendency towards the irreversibility of sensorineural and VWF symptoms in a group of ex-stoneworkers with prolonged exposure to high vibration levels in the past. The increased occurrence of VWF in the active stone workers after a few extra years of vibrating tool usage argues for an urgent implementation of preventive measures in the stone industry.

Arm↗

PubMed1994

Allergic airway disease in Italian bakers and pastry makers.

A survey was carried out on respiratory symptoms and skin prick test response to common allergens (atopy), storage mites, and occupational allergens among 226 bakers and pastry makers from 105 small businesses in northern Italy. Atopy was present in 54 workers (23.4%); 40 workers (17.7%) were skin positive to at least one storage mite, 27 (11.9%) to wheat flour and 17 (7.5%) to alpha-amylase. Work related asthma was reported by 11 (4.9%) workers and rhinoconjunctivitis by 31 (17.7%); 22 workers (10.2%) complained of chronic bronchitis. The distribution of skin prick test results among bakers and among 119 white collar workers did not indicate (by logistic analysis) an increased risk for bakers to skin sensitisation to common allergens, storage mite, or to a group of five flours. Sensitisation to wheat flour, on the other hand, was present only among exposed workers. Skin sensitisation to occupational allergens was significantly associated with atopy (p < 0.001), smoking habit (p = 0.015), and work seniority (p = 0.027). The risk of work related symptoms was associated with sensitisation to wheat or alpha-amylase, and with atopy, but not with sensitisation to storage mites, work seniority, or smoking habit. The results of the study indicate that there is still a significant risk of allergic respiratory disease among Italian bakers. Not only wheat allergens, but also alpha-amylase must be considered as causative agents, although sensitisation to storage mites is not important in the occupational allergic response. Atopy must be regarded as an important predisposing factor for skin sensitisation to occupational allergens and for the onset of symptoms at work. The data confirm that for effective prevention, greater care should be taken not only in limiting environmental exposure, but also in identifying susceptible people.

Adult↗