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Biomedical subjects

U Maugeri

Publications and source records attributed to U Maugeri.

54 records · Page 3Linked to original sources
PubMedDate not supplied

Environmental pollution in central and eastern European countries: a basis for cancer epidemiology.

The main objective of this paper is to discuss the environmental issues in the countries of central and eastern Europe (CCEE) and to show their significance for cancer epidemiology. Of known cancer risk factors that may be related to environmental exposure in the CCEE, tobacco smoking is probably the most important. The worsening trends in cancer mortality noted in middle-aged men in the CCEE can be attributed to smoking. Other lifestyle factors that interact with environmental hazards include high alcohol consumption and unhealthy nutrition. Among other factors, the most common environmental exposure in the CCEE that has potential adverse effects on health in terms of cancer incidence is related to high levels of ambient and indoor pollutants exceeding the air quality guidelines of the World Health Organization. Millions of people, usually in urban areas, are estimated to be exposed to such levels of pollution. Outdoor air pollution is a substantial environmental problem in many areas of the CCEE, where heavy industries are concentrated without adequate technology for emission control. Chemically contaminated drinking water provides a major route of exposure for many potential environmental health hazards. The pollution of water resources, including groundwaters, by industrial and agricultural wastes is a widespread problem in both the CCEE and the former USSR. An estimated 13% of treatment plants in the Russian Federation lack the necessary equipment to treat drinking water, particularly for disinfection, to meet the required standards. Many countries in the region have problems in rural areas, where the networks are small or consumers depend on private wells, and treatment of drinking water is either poor or nonexistent. Consequently, because the standards are difficult to meet, drinking-water accumulates high levels of arsenic and nitrates. The main concern is nitrate, arsenic, fluoride, and pesticides. In countries like Bulgaria, Hungary, Romania, and Slovakia, locations are known where nitrate concentration in drinking water are high enough to cause methemoglobinemia. Lack of appropriate data hamper valid estimates of the extent of unhealthy working conditions or of poor housing conditions. Unsafe industrial installations are potential environmental health hazards, the possible scale of which is difficult to estimate reasonably.

Adolescent↗
PubMedDate not supplied

Reversibility of asthma-like symptoms and lung function growth over two-year follow-up in preadolescent children.

BACKGROUND: The interesting feature of childhood asthma is the great reversibility of symptoms. The main purpose of this study was to assess the effect of persistent and reversed asthma-like symptoms on lung function growth in preadolescent children. MATERIAL AND METHODS: The follow-up respiratory health survey has been conducted in the sample of 1129 children aged 9 yrs over two years follow-up. The basic health end-points was the occurrence of asthma-like symptoms and the slower lung function growth (SLFG). RESULTS: Adjusted OR for SLFG(FVC) was significantly higher only in the children having the continued symptoms(OR = 3.40; 95% CI: 1.32-8.77). There was a consistent trend of adjusted ORs for SLFG(FEV1) with the category of symptoms, where OR was 1.46 (95% CI: 1.02-2.10) in children with recent new symptoms; 2.06; (95% CI: 0.93-4.58) in those with symptoms remitted, while 3.46; (95% CI: 1.43-8.40) in children who had persistent symptoms. The corresponding ORs for SLFG(FEF25-75%) were 2.03; (95% CI: 0.97-4.28), 2.63; (95% CI: 1.38-4.99), and 5.84; (95% CI: 2.53-13.50). CONCLUSIONS: The consistent association between reversibility of asthma-like symptoms and lung function gain in preadolescent children confirmed the clinical significance of the symptoms in question. The observed slower lung function gain in preadolescence may have implications for the development of chronic lung disease later in adulthood.

Asthma↗
PubMedDate not supplied

Total exposure assessment in occupational epidemiology for risk management.

Exposure assessment is an integral and essential component of occupational epidemiology necessary for risk assessment, risk management as well as for diagnostic and intervention efforts. It is a multidisciplinary approach that usually requires the combined expertise of environmental and industrial hygienists, toxicologists, epidemiologists, physicians, social scientists and statisticians. Exposure-assessment methodology employs various direct and indirect techniques, including environmental measurements, personal monitoring, biological markers, questionnaires, and mathematical modelling. Exposure assessments for occupational environment must be considered in the framework of potential contributions from other media and adding the incremental exposure from other media when necessary. Furthermore, to achieve effective risk assessment, all media and routes of exposure must be assessed for the relative magnitude of their contributions before an assessment of one medium is conducted. In the paper the concept of total human exposure assessment is introduced and measurement approaches have been discussed focusing attention on environmental research surveys.

Humans↗
PubMedDate not supplied

On improvement of communication between producers and users of epidemiological and statistical information on health of workers and their occupation.

In order to assess the health status of workers at the national or regional level there are necessary expensive studies on the morbidity of various occupational groups. The papers turns the attention to ambulatory care data that may be used successfully to measure directly through ambulatory medical encounters the health status of working population and its subgroups. To overcome a major weaknesses in primary health statistics a special form for survey of occupational morbidity in primary health center has been worked out. The form is very simply to fill in and most of the informations to be needed are in precoded form and it helps greatly in processing the items of information necessary for calculation of morbidity rates generated from health primary activities. This ambulatory care record should be filled in by a selected general practitioner at each visit in district ambulatories, chosen randomly from all ambulatories in the whole country or in the whole region, i.e., in Lombardy. In the statistical analysis the data collected through the survey continuously can be related to the population characteristics, such as sex, age distribution and minor or major occupational groups. The authors believe that this simple approach may be used sensible for monitoring the health status of the population in relation to occupational hazards and for the planning and management of primary health services.

Ambulatory Care↗
PubMedDate not supplied

Prevalence of hypertension and cardiovascular risk factors in workers of petrochemical industry. The Pavia Study.

The survey carried out in the large sample (2379 workers) of petrochemical industry in Lombardia region was intented to provide current estimates of prevalence of hypertension and cardiovascular risk factors in the industrial population. The prevalence of elevated blood pressure (borderline hypertension and definite hypertension) was 40% in men and 19% in women, the rate for definite hypertension were 17% in men and 7% in women. The relative impact of age and weight on blood pressure status appeared to be rather substantial. Estimated positive effects of the weight control program cold have reduced the prevalence of hypertension by about 45%. The survey data confirmed that subjects with hypertension were more often dyslipidemic, had higher blood glucose and serum uric acid levels than normotensive persons. It was rather intriguing to find very clear, however, not very strong effect of uric acid level on blood pressure also among normotensive workers. The importance of this factor may be strengthened by the fact that there was also statistically significant association between the changes in the optic fundi and serum uric acid level after controlling for age and blood pressure. The results of the study disclosed the positive effects of physical activity at leisure on blood pressure status and this was independent on weight and age. The high consumption of wine increased the relative risk of hypertension mainly in men. On the basis of the survey data collected it was not possible to confirm a definite relationship between smoking and hypertension.

Adult↗
PubMedDate not supplied

The effect of prolonged occupational exposure to the low concentrations of nitrogen oxides in combination with ammonia on chronic bronchitis and the lung function.

The purpose of this study was the assessment of the effect of low concentrations of nitrogen oxides and ammonia on the appearance of the chronic bronchitis symptoms and lung function. The material in total consisted of 183 workers employed in the Chemical Factory in Tarnów (Poland). The study methods encompassed the environmental factors in all places of work and the questionnaire based interviews with the lung function testing of the workers. The results obtained prove that prolonged effect of the exposure to nitrogen oxides, even below the accepted safety level, causes a more frequent appearance of chronic bronchitis symptoms and lower FMF values. This may signal the narrowing of bronchiole as a result of the exposure to nitrogen oxides, independent of the effects on the mucous membranes of the bronchi, demonstrated by the excessive prevalence of chest symptoms. There is no reason to believe, as based on the results of this study, that the effects of nitrogen oxides could be in any way dependent on the tobacco smoking or on the accompanying concentrations of NH3.

Adult↗
PubMedDate not supplied

The joint effect of overweight and familial predisposing factors on the occurrence of hypertension in the industrial population. The Pavia study.

The main purpose of the study was to assess the effect of overweight and predisposing familial factors on the occurrence of hypertension in the industrial population. The data were based on large sample (1523 males and 438 females) of workers employed in the petrochemical industry. The results of the cross-sectional study show that the prevalence of hypertension and borderline hypertension was significantly related to age, obesity and cardiovascular familial history. The effect of obesity alone was slightly stronger than the impact of family history on the occurrence of hypertension among men, but inverse relationship has been found in women Relative excess risk due to interaction between obesity and heredity was 0.60 in males and 2.75 in females. Total proportion of hypertension cases attributable to overweight and heredity together or singly in men was 71.5% and in women 79.4%. That part of the disease attributable to interaction between both factors was 17.1% in men and 56.7% in women.

Adult↗
PubMedDate not supplied

Biological markers of host susceptibility to air pollutants in epidemiologic studies on chronic airways obstruction.

Measuring the variations in risk among individuals or populations of environmentally induced chronic airways obstruction is necessary to develop rational policy to reduce the incidence of those diseases in a given population. Before being able to formulate this policy, however, one must know how to detect those individuals who are susceptible to ari pollutants since they are at increased risk of disease. In the paper the authors discussed several monitoring techniques to detect markers of early biological events relevant to host susceptibility and disease progression. The biological markers are based on genetic traits, pulmonary function tests, biochemical and immune changes. The authors discuss merits and demerits of particular approaches in identifying persons prone to chronic airways obstruction. They stress the point that more research is needed on biochemical and immunological markers of lung injury to assess their usefulness in identifying individuals at higher risk.

Air Pollutants↗
PubMedDate not supplied

Better perspectives on use of biological markers in monitoring of lung cancer risk in occupational settings.

Although conventional approaches in cancer epidemiology and prevention have provided a wealth of information, they are seriously limited in their ability to detect and evaluate carcinogenic hazards. However, traditional methods combined with newly developed laboratory procedures provide biological markers of molecular or biochemical events linked to carcinogen exposure and open a new approach to the study of human cancer risk assessment. The goal of the new approach is to identify as precisely as possible specific carcinogenic hazards in the environment, to assess their biologically effective dose and biological effect, and to provide a means of appraising host factors that modify susceptibility. A particular promising new tool of cancer risk assessment is the highly sensitive immunoassay for carcinogen-DNA adducts. These assays may provide a tissue dosimeter of carcinogen exposure. In this paper research studies were mentioned that aimed at assessing the levels of benzo[a]pyrene-DNA adducts and protein adducts, utilizing white blood cells, or tissue specimens obtained from tissue biopsy or autopsy. Another promising method in discovering BAP exposure are levels of carcinogen-metabolizing enzymes. The potential significance in surveillance and monitoring of aryl-hydrocarbon hydroxylase (AHH) has been discussed.

Aryl Hydrocarbon Hydroxylases↗
PubMedDate not supplied

Needs and requirements for undergraduate and graduate training in environmental and occupational epidemiology.

Training in modern medicine aims at teaching not only the structure and function of the human organism in health and in disease, but also it aims at revealing the factors responsible for human health. The second field of teaching is based mainly on epidemiology. In undergraduate teaching, the epidemiological training should be introduced as early as possible in the curriculum and possibly divided into two parts, theoretical and practical. With the increasing awareness that the maintenance of health in populations is an ecological problem, there is also a growing need for professional epidemiologists who could assist in recognizing health risks, assessing and developing prevention strategies and in arranging of health services in a responsible way. The objectives of graduate teaching in epidemiology are different from those of undergraduate teaching. The graduate teaching should cover not only professional epidemiologists but also should be addressed to health services administrators, clinicians and graduates from other specialists and paramedical and auxiliary personnel. The needs and requirements for teaching epidemiology in undergraduate and postgraduate levels have been discussed against the background of currently available courses in Europe and local perception of environmental and occupational problems in European countries.

Education, Medical, Graduate↗
PubMedDate not supplied

Individual susceptibility to inhaled pollutants--identification, mechanisms and public health policy implications.

In every community, there are individuals whose chances of illness or accident are greater than those of others. In susceptible persons, adverse health effects occur at a lower exposure than in the majority of population. The reason for this, though often weak, can usually be ascertained. The paper focuses primarily on host factors that may increase an individual's susceptibility to air pollutants present in the general environment. These factors include genetic background, age, gender, nutritional status, physiological status, presence of coexisting lung disease, and lifestyle. They relate to various mechanisms of individual susceptibility to air pollutants from the environment into the body, to alterations in detoxification and immunological reactions, and to variations in the responsiveness of lung tissues. Several epidemiological techniques to detect biological events relevant to host susceptibility and disease progression are mentioned. They are mainly based on genetic traits, host characteristics, pulmonary function tests, biochemical and immune changes. Measuring the variations in risk among susceptible individuals is necessary to assess correctly respiratory health risk due to inhaled pollutants at the population level, and subsequently to develop rational public health policy to reduce the incidence of those diseases in a given population. Before being able to formulate this policy, however, one must know how to detect those individuals who are susceptible to air pollutants.

Age Factors↗