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Biomedical subjects

P Apostoli

Publications and source records attributed to P Apostoli.

At least 163 records · Page 9Linked to original sources

[An important variability factor in determination of urinary activity of N-acetyl-beta-D-glucosaminidase: contamination of urine with semen].

BACKGROUND: Urinary N-acetyl-beta-D-glucosaminidase (U-NAG) and its isoenzyme B (U-NAG-B) have been demonstrated useful and early markers of renal damage, although they are present in many other tissues and organs. OBJECTIVES: To evaluate semen contamination of the urine and its role in variability of U-NAG. METHODS: To assess control group values beta2-microglobulin, retinol-binding protein and U-NAG were measured in the urine of 30 healthy, non-smoking and non metal-exposed adults (19 females and 11 males). RESULTS: In four urine samples U-NAG was higher than the method reference value (5 U/g creatinine), without increases in other functional markers. Microscope examination revealed the presence of sperm in these samples. U-NAG variability decreased after the exclusion of these four values. The role of contamination was confirmed by adding semen to urine: when semen to urine ratio was 1:1000, enzyme activity was more than twice the basal level. CONCLUSIONS: U-NAG variability is strongly increased by contamination with semen, where enzyme concentration (especially NAG-B) is very high. Increased excretion of U-NAG and of its iso-form (U-NAG-B) in males, not correlated with other renal alterations or with exposure to heavy metals or other renal toxic substances, should be carefully evaluated and microscopic observation is advisable to detect the presence of sperm in urine.

Acetylglucosaminidase↗

[Comparative analysis of the use of 4 methods in the evaluation of the biomechanical risk to the upper limb].

In the last years notices of Work Related Musculo-Skeletal Disorders are significantly increased, for a much widespread mechanism of disease and risk identification. About the last, the methods of assessment, even if in great number, are not universally recognized. This study reports the application of four methods (Check list OCRA, OREGE, Strain Index, ACGIH) to evaluate 12 work emplacements at a different biomechanical overload level. The comparison revealed variability between the methods in situations of middle risk, while the methods substantially gave similar results in situations without any risk or with high risk. Methods could not reveal every component of the risk in a reproducible and univocal way also when the risk assessment was accordant. It is necessary a following analytical evaluation of each risk factor contributing to define the sintetic index. In the complex of biomechanical risk factors these ones might not be considered able to define unequivocally "accettable" or "not accettable" components.

Arm↗

[New biomarkers of exposure].

In this paper we have defined the new biomarkers of exposure (NBE) as those biomarkers discovered in the last five years and, among previously validated biomarkers, also those applied in different ranges of doses or those determined in biological matrices which differ from matrices originally considered. We examined the results from the surveys carried out by the main Italian research units involved in biological monitoring, i.e. those from the Universities of Brescia, Milan, Naples, Padua, Parma, Pavia, Turin and Verona. The data were collected using a standardized model and included the following: type of element or organic compound, type of biomarker, analytical technique and method, their relationship with environmental monitoring data, their relationship with effect indicators or effects in general, improvement with respect to old biomarkers, reference values. Twenty two NBEs were identified: 14 elements and chemical compounds as such or as metabolites, 4 examples of mixtures, 3 of new matrices, one of speciation. Among the others, aspects such as interest in requiring NBE, quality assurance, availability, cost-benefit ratio were discussed. We conclude that development of this specific field of research appears to be a crucial point for future improvement in risk assessment and health surveillance procedures.

Animals↗

[Data quality and the interpretation of biological monitoring results].

Quality assurance criteria are not uniformly applied to routine biological determination, in particular with regard to the biomonitoring of exposure to organic solvents. Quality assurance is not an abstract concept but rather a flexible tool which can be adapted to different situations, such as the measurement of different exposure levels or the use of different analytical methods, for a range of purposes (routine determination, risk assessment procedures, research). The occupational health physician should be actively involved in the definition of quality objectives, as well as in checking that they have been implemented. This paper deals with some general issues regarding quality assurance, and in particular with certain requirements of analytical quality (analytical uncertainty, imprecision, bias) and its implementation (quality control, reference materials, standardization, reference values), contextualized to the biological monitoring of organic compounds and the relative metabolites.

Environmental Monitoring↗

[Occupational Medicine Programme in the university degree on prevention techniques in living and working environments].

This document has been prepared by a working group of University Professors belonging to the Italian Society of Occupational Medicine and Industrial Hygiene, with the aim of defining the role of this discipline in the university course on Prevention Techniques in Working and Living Environments. The course trains health professionals to apply risk assessment techniques, preventive measures and legislative tools for safety and health in working and living environments, food and beverages hygiene, and Public Health. The document describes the organization and the structure of the course, general and specific learning objectives, occupational medicine teaching and other organization aspects. Also, training of non-graduate technicians working for local health authorities is discussed.

Curriculum↗

[Report on the activities carried out in the research project of the Ministry of Instruction, University, and Research entitled "Environmental and occupational exposure to inorganic lead: assessment of toxic effects of current doses and related preventive measures"].

It is here presented the project sustained by the Ministry of Public Instruction, University and Research "Environmental and Occupational Exposure to Inorganic Lead: assessment of human health effects due to current doses and preventive measures" ruled out between 2001 and 2003. The aim of the study was to investigate about the toxic effects related to current occupational exposures to inorganic lead (particularly those effects concerning blood pressure, carcinogenic risk, nervous and immunological systems), to identify hypersusceptibility conditions, particularly the ALAD genetic polymorphism and to evaluate the role of traditional biomarker and the possibility of introducing new ones. In the present article the procedures followed during the project lasting and the contribution of each Unit are described. The results of the research, presented in detail in the current issue, do confirm the inadequacy of the biological exposure index nowadays ruled by Lex 25/2002.

Humans↗

[Lead: indicators of dose and effects on heme].

In the present study the role of the traditional biomarkers of exposure and effect on haeme system during lead exposure was analysed: the opportunity of introducing new biomarkers such as lead and delta-aminolevulinic acid in plasma was also evaluated, especially by considering the current levels of exposure. The population in study was constituted by 371 males owning to different production fields and selected by five national units. The results suggest caution in the use of lead in plasma as a biomarker of lead exposure in the biological monitoring procedures, mainly in reason of its great variability affecting in particular the sampling time and the pre-analytical treatment of the sample. The other biomarkers were well correlated between them and with the exposure biomarkers for lead in blood >300 microg/L, suggesting the BEI to which the protection of workers exposed to lead would be guaranteed (instead the actual of 600 microg/L).

Biomarkers↗

[Lead and blood pressure].

Evidence, even if not univocal, of increase of systolic and diastolic blood pressure for Pb doses lower than 30 microg/dl stimulated studies in the last years and opened a discussion on a possible relapse in morbility and mortality, since hypertension is an important factor of cardiovascular risk. In this study, it was possible to investigate the relationship between lead and blood pressure of 303 subjects occupationally exposed to this metal with blood-Pb between 10 and 80 microg/dl and 206 subjects belonging to the general population with blood-Pb between 0.5 and 9 microg/dl. In both groups it resulted a positive and statistically significant correlation between blood-Pb values and systolic and diastolic blood pressure values, in detail in hypertensive subjects, belonging to the not-occupationally exposed group, this effect is proportionally higher. The effect of lead on blood pressure appears therefore proved, as confirmed by previous literature, but taking into consideration three specific information. It presents itself in a large range of doses, it is quantitatively very modest, it appears more evident at low doses, thus we could hypothesize different mechanisms for different doses.

Adult↗

[Neuroendocrine and renal effects of inorganic lead].

In this study 371 workers occupationally exposed to inorganic Pb (range of blood lead concentrations, PbB: 100-800 microg/l) were examined in order to assess neuroendocrine and renal effects, with regard to exposure levels and ALAD polymorphism. Plasma prolactin, urinary excretion of plasmaproteins and renal tissue constituents were measured. None of such markers differed significantly between workers stratified according to PbB levels, except for heat-stable isoenzyme NAG-B: its very low prevalence of values above the upper reference limit increased significantly with increasing PbB. No significant differences were found in indicators by ALAD genotype. Our findings did not provide evidence of any renal and neuroendocrine effects in workers exposed to the current lead levels.

Adult↗

[ALAD polymorphism and indicators of dose and effects of occupational exposure to inorganic lead].

The delta-aminolevulinate dehydrase (ALAD) genetic polymorphism was investigated along with biomarkers of lead exposure and effect on 333 male workers, occupationally exposed to lead, with blood lead levels (PbB) higher than 100 microg/l. ALAD genotype frequencies were distributed as expected among Caucasians. Workers bearing at least one ALAD-2 allele showed PbB values slightly higher than those from ALAD-1-1 subjects, who also exhibited higher urinary delta-aminolevulinic acid (ALAU) and blood zinc protoporphyrin (ZPP) levels. The plasmatic lead (PbP)/PbB ratio was similar in both groups. Exposure and effect biomarkers were significantly each other correlated among ALAD-1-1 subjects only, who showed also a significant inverse relationship between ALAD activity and ZPP values. Results confirm previous studies, supporting the hypothesis that ALAD polymorphism may interfere with toxico-kinetic and toxico-dynamic parameters of occupational exposure to Pb.

Adult↗

[Effects of inorganic lead exposure on the autonomic nervous system and on the variability of heart rate among workers at a battery plant].

Inorganic Lead can cause a toxic effect on Central Nervous System, Peripheral Nervous System and Autonomic Nervous System (ANS). A damage of the ANS can determine an heart rate variability (HRV) reduction. In this study 43 battery workers exposed to inorganic lead with mean PbB = 31.63 microg/dl (DS 14.77 microg/dl) and 35 not exposed subjects underwent to an evaluation of heart rate variability by specific tests. Heart rate variability in the exposed group was, for some tests (lying to standing, lying to standing-standing to lying) reduced compared with not exposed subjects and for other tests (Valsalva manouvre, lying to standing-standing to lying) correlated with PbB and Zinc Protoporphyrin (ZPP), but not with BMI, age and smoking habits. This study, like others conducted on similar populations, suggest an effect of occupational inorganic lead exposure on Autonomic Nervous System and heart rate variability

Adult↗

[Anemia in workers exposed to lead: update on differential diagnosis].

Occupational lead exposure can cause anemia at blood lead levels >50 microg/dl, as high as rarely occurs in industrialized countries nowadays. Whereas other forms of anemia are fairly probable to be found in lead exposed workers, especially in areas highly endemicfor extraoccupational anemias, such as beta thalassemia and iron deficiency anemia. The etiology of anemias has to be correctly defined in order to assess suitable therapeutical approaches and medicolegal consequences. The objective of this study is to verify in male lead exposed workers whether an accurate evaluation of hemocromocytometric parameters and of usual biological indices of lead exposure and effect on heme can differentiate the most common forms of anemia in Southern Italy. 68 workers occupationally exposed to low to moderate lead doses were studied and 59 workers of an alimentary plant have been taken as control group. On venous blood samples collected from these workers a complete hemocromocytometric test was performed and blood lead and erythrocytic zincoprotoporphyrin were determined. Anemia (Hb <l3 g/dl) was detected in six lead exposed workers and in a nonexposed worker. The reasoned evaluation of laboratory parameters led to identify among lead exposed workers four subjects with high probability of beta-thalassemic trait and two with lead poisoning anemia. Moreover a diagnostic algorithm was developed based on literature that seems to be able to discriminate lead poisoning from other causes of anemia in lead exposed workers in this study.

Adult↗

[Reduced thymulin production during occupational exposure to lead].

Thymulin is a thymic hormone that being activated by binding a zinc ion promotes differentiation and several functions of T lymphocytes. It has been demonstrated only in experimental animals that metallic lead (Pb) is able to cause adverse effects on thymocyte number and function. The objective of this study is to evaluate the plasmatic level of active thymulin of 58 male workers being exposed for more than one year to low lead doses with respect to 59 male never exposed workers. All these were subjected to anamnesis collection, medical examination and determination of blood lead (PbB), plasmatic lead (PbPl), plasmatic thymulin, urinary lead (PbU) and urinary zinc (ZnU) levels. The mean plasma concentration of active thymulin was significantly lower in lead exposed than in non exposed workers. Active thymulin was also significantly and negatively correlated to PbB, PbPl and PbU level and resulted to be significantly and negatively influenced by PbB. Lead exposed workers had slightly higher zinc concentration in urine than non exposed workers, increasing ZnU levels by class of PbB. It is the first time that a toxic effect of lead on plasmatic active thymulin levels is demonstrated in humans, particularly in occupationally exposed workers. This study opens perspectives for further research that would both confirm the results and verify the mechanisms of action of lead on thymulin either direct or indirect and the possible role of zinc.

Adult↗

[Inorganic lead stimulates endothelin secretion in the MDCK cell line].

BACKGROUND: Lead (Pb) is an environmental toxin whose acute intoxication causes haematological, gastrointestinal and neurological dysfunctions. Moreover it is well-established that prolonged exposure to low levels of inorganic Pb compounds is closely related to hypertension in experimental animals and occupationally exposed humans. Previous reports have suggested that endothelins (ETs), a family of peptides with potent vasoconstrictive properties, might be involved in the pathogenesis of lead-induced hypertension. In vivo studies demonstrated that rats chronically exposed to Pb low levels exhibited blood pressure elevation coupled with an increase of ET-3 concentration in plasma and urine in comparison with control animals. OBJECTIVE: Since kidney is one of the target organs of lead injury, as well as the site of production/action of ETs, we investigated the effects of an inorganic Pb compound (Pb chloride) on the synthesis and secretion of these peptides, using, as in in vitro model, a renal-derived cell line (MDCK). METHODS: The ETs assays in culture media of sub-confluent cell cultures exposed to different concentration of PbCl2 were performed by Enzyme linked Immunoassay (EIA), using two experimental procedures: a) cultures were exposed to 1100 and 200 microM PbCl2 for 30 min, next cells received Pb-free culture medium up to 24 h (pulse/chase experiment); b) cultures were fed continuously up to 24 h with treatment media containing the same PbCl2 concentrations (pulse experiment). Concomitantly, the Pb influence on cell viability was evaluated by different cytotoxicity assays (LDH release, DAPI staining and cell density assays). The mRNA expression of ET-1 was evaluated in pulse experiments by RT-PCR analysis before and after cell exposure to PbCl2. The Pb2+ cellular content of parallel MDCK cell cultures was assessed by AAS analysis. RESULTS: In our experimental conditions, the administration of PbCl2 to sub-confluent MDCK cell cultures did not significantly affect cell viability. Either in pulse or in pulselchase experiments, the ETs content, evaluated in culture media of cells exposed to 100 microM PbCl2, significantly increased. On the contrary, cell treatment with 1 or 200 microM PbCl2 did not modify the ETs secretion. Because the amounts of ETs released in culture media were similar in both kinds of experiment, our results suggest that the metal induces the ETs secretion already after 30 min of cell exposure to the toxicant. Moreover, the ET-3 EIA specific assay did not reveal any immunoreactivity, excluding the involvement of this isoform in the Pb-induced secretion of ETs. Additionally, our results seem to exclude any Pb-induced up-regulation of ET-1 transcripts. The Pb2+ quantification in cell extracts demonstrated that the uptake of the metal is dose- and time-dependent and, in pulse experiments, it was maximum after six hours from the beginning of treatments, then the intracellular Pb2+ content decreased. This last phenomenon suggests the involvement of an ATP-dependent transporter in the mechanism of Pb cell excretion. Moreover, the ETs cell release in culture media of MDCK cells appears to depend on the intracellular content of Pb ions reached within 30 min of treatment. CONCLUSION: Our results indicate that there is a range of PbCl2 doses (100 microM) at which MDCK cells enhance their ETs secretion. Lower doses (1 microM) of Pb salt seem to be ineffective to stimulate ETs release, while, doses equivalent to 200 microM seem to inhibit this phenomenon.

Cell Line↗

[Work-related musculoskeletal disorders of the upper extremity in spinning: lack of risk or of adequate methods for assessing risk?].

The existence of a risk of musculoskeletal disorders work-related of the upper extremity (UEWMSDs) in the textile industry, specifically in particular working phases as spinning, appears today controversial. The upper limb disorders, sometimes described, have not a location ever plausible with the level of the biomechanical overload, as when carpal tunnel syndromes are signalled during activities in which the shoulder is the only segment eventually interested. Moreover these findings are shown in workers appointed at tasks or actions not clearly identified at risk. For example the spinning activity, that requires the movement of shuttles of modest weight, sometimes on levels above the shoulder line, is organized with cyclical cadences sometimes as repetitive tasks concentrated in a short period, sometimes in longer during the entire shift. Distribution and number of the actions, would however allow a sufficient biomechanical recovery. The identification of the single technical action may result difficult, due to interindividual variability of actions, of their speed and complexity. Furthermore the other possible activities, alternate with specific spinning activities, can require strength or not correct posture even if they may have short duration. In this paper we present and discuss the results of the ergonomic survey for risk assessment of musculoskeletal disorders work-related of the upper limb. These analysis have been carried out in two textile plants, in which some cases of disorders of the upper limb in workers employed in spinning activities have been described by occupational health physicians. In addition to assessment of possible risk for UEWMSDs in spinning activities, we founded the capability of usual methods for ergonomic analysis to adequately examine work situations like spinning, in which the hazardous actions are diluted over the entire shift or concentrate in a short period and in which there is a specific biomechanically overloaded segment i.e. the shoulder. Finally attention was paid to evaluate psychosocial factors which appear to be important when biomechanical factors are low-lying.

Arm↗

[Work-related musculoskeletal disorders and diseases of the arm].

Among work-related diseases, musculoskeletal disorders of the upper extremities have obtained increasing attention in recent last decades. Because of their relevance, the Italian Society of Occupational Medicine and Industrial Hygiene has decided to draw up a set of National Guidelines on the subject. This paper discusses their production and contents, including definitions, rationale, physiopathogenesis, occupational physician's contribution to biomechanical overload risk evaluation, medical surveillance of exposed workers.

Arm↗

[Heme oxygenase 1 expression in foundry workers].

Heme oxygenase 1 (HO-1) catalyses the oxidation of heme to biliverdin, and its expression is induced by oxidative stress. This study was aimed at assessing the role of metabolic polymorphisms (CYP1A1, CYP1B1, GSTM1, GSTP1, EPHX) in the modulation of HO-1 gene expression in 37 foundry workers. Blood and urine samples were obtained at the beginning (BS) and at the end (ES) of work shift, in February (T1) and June (T2). Urinary 1-hydroxypyrene (1-OHP) was measured as a tracer of PAH exposure. HO-1 gene expression in ES samples normalized to BS values (HO-1 ES/BS) was higher at T2 respect to T1. HO-1 gene induction was related to ES 1-OHP when considering either T2 samples or the combination of the two samplings. HO-1 ES/BS was significantly increased in subjects with at least a mutant allele for GSTP1 as compared to subjects with GSTP1AA genotype (1.23 +/- 0.002 vs 0.88 +/- 0.002, p < 0.05). Only in subjects with at least one vari.nt allele for GSTP1, a positive correlation between HO-1 ET/IT expression and 1-OHP FT levels was observed (r2 = 0.21, p = 0.016). The present study demonstrates a correlation between PAH exposure, as assessed by urinary 1-OHP, and the induction of HO-1 expression. Such a correlation seems to be limited to subjects bearing variant alleles for GSTP1. At the same exposure levels, these subjects showed a greater expression of HO-1 FT as compared to subjects with GSTP1 wild type genotype, possibly due to a higher oxidative stress in the subjects expressing the mutant GSTP1-1 isoform, which could imply a limited scavenging capacity.

Adult↗

[Quality assurance to efficacy-effectiveness measuring in occupational medicine].

The occupational medicine was asked to play an important role in quality assurance procedures as demonstrated by the implementation of main principles of prevention in ISO EMAS and SA schemes. Peculiar condition appeared to be the promotion of quality in occupational physician activities as, for example, provided in these last three years the Italian Society of Occupational Medicine and Industrial Hygiene (SIMLII) by its excellence accreditation programme. The next step will be the identification and application of adequate indicators of efficacy-effectiveness of occupational medicine practices to demonstrate need and role of our discipline in guaranteeing and improving health in working places. To these aims has been addressed the meeting held in Bergamo and organized by the Lombard section of SIMLII in December 2005 whose main contributions are published in this GIMLE special issue.

Italy↗