The novel physicochemical properties of engineered nanoparticles (ENPs) make them very attractive for industrial and biomedical purposes, but concerns have been raised regarding unpredictable adverse ...health effects in humans. Current evidence for the risk posed by ENPs to exposed workers is the subject of this review.
To perform an in-depth review of the state of art of nanoparticle exposure at work.
Original articles and reviews in Pubmed and in principal databases of medical literature up to 2013 were included in the analysis. In addition, grey literature released by qualified regulatory agencies and by governmental and non-governmental organizations was also taken into consideration.
There are significant knowledge and technical gaps to be filled for a reliable evaluation of the risk posed for workers by ENPs. Evidence for potential workplace release of ENPs however seems substantial, and the amount of exposure may exceed the proposed occupational exposure limits (OELs). The rational use of conventional engineering measures and of protective personal equipment seems to mitigate the risk.
A precautionary approach is recommended for workplace exposure to ENPs, until health-based OELs are developed and released by official regulatory agencies.
Objective:Night-shift work is associated with ischaemic cardiovascular disorders. It is not currently known whether it may be causally linked to metabolic syndrome (MS), a risk condition for ...ischaemic cardiovascular disorders. The syndrome presents with visceral obesity associated with mild alterations in glucidic and lipidic homeostasis, and in blood pressure. The aim of this study was to assess whether a causal relationship exists between night-shift work and the development of MS.Methods:Male and female nurses performing night shifts, free from any component of MS at baseline, were evaluated annually for the development of the disorder during a 4-year follow-up. Male and female nurses performing daytime work only, visited during the same time period, represented the control group.Results:The cumulative incidence of MS was 9.0% (36/402) among night-shift workers, and 1.8% (6/336) among daytime workers (relative risk (RR) 5.0, 95% CI − 2.1 to 14.6). The annual rate of incidence of MS was 2.9% in night-shift workers and 0.5% in daytime workers. Kaplan–Meier survival curves of the two groups were significantly different (log-rank test; p<0.001). Multiple Cox regression analysis (forward selection method based on likelihood ratio) showed that among selected variables (age, gender, smoking, alcohol intake, familiar history, physical activity, and work schedule) the only predictors of occurrence of MS were sedentariness (hazard ratio (HR) 2.92; 95% CI 1.64 to 5.18; p = 0.017), and night-shift work (HR 5.10; 95% CI 2.15 to 12.11; p<0.001).Conclusions:The risk of developing MS is strongly associated with night-shift work in nurses. Medical counselling should be promptly instituted in night-shift workers with the syndrome, and in case of persistence or progression, a change in work schedule should be considered.
Abstract
Background
Healthcare workers (HCWs) have an increased exposure risk to measles, which can put them, their patients and their relatives at risk of infection. In Italy, 4617 cases of measles ...were reported in 2017; 302 involving HCWs. According to the Italian National Immunization and Prevention Plan, all HCWs should have demonstrable evidence of immunity to measles.
Aims
To evaluate measles immunization status in HCWs at a large Italian teaching hospital.
Methods
We analysed clinical records and measles-specific IgG antibody titres of HCWs undergoing occupational health surveillance between 1 January and 31 August 2017.
Results
Among the 1532 HCWs (mean age 32.7 ± 10.4 years) included in the study, 87% (1328) had protective antibody titres. The proportion of protective titres was highest in those born before 1982. No significant gender differences in mean measles-specific IgG antibody titres were detected.
Conclusions
Our study shows non-protective measles IgG antibody titres in a substantial percentage of HCWs, especially those born in the 1980s and 1990s. Due to the increased risk of measles transmission in the hospital environment, increased prevention strategies are required, including rigorous screening and prompt vaccination of non-immune workers.
Purpose
Epidemiological studies have suggested that indoor hospital employees, either day or night shift workers, are at high risk of metabolic and cardiovascular diseases. Interestingly, previous ...reports have also described a higher prevalence of vitamin D (25OHD) deficiency among these workers. However, few studies have determined the monthly variations in 25OHD levels in indoor hospital employees.
Methods
To address this lack of knowledge, in 2018, during the periodic health surveillance checks at the Service of Occupational Medicine, we measured 25OHD levels in a group of indoor hospital workers (88 rotating night shift workers vs 200 day workers). Each participant received a single annual health surveillance check.
Results
The mean levels of 25OHD were consistently below the lower limit of the normal range in both groups throughout the year. Only in the summer, day workers but not rotating night shift workers (mean 25.9 ± 11.3 ng/ml vs 23.1 ± 9.1 ng/ml;
p
= 0.042) showed levels significantly higher than those in the other seasons. This difference remained statistically significant even after correction for study covariates
β
= − 1.649 (CI − 0.283/− 3.482),
p
= 0.039. A cosinor analysis confirmed that the difference in the 25OHD levels between groups was present later in the year.
Conclusions
We found that relatively young healthy hospital workers, especially those with rotating night shifts, in the absence of significant metabolic risk factors, have a high risk of 25OHD deficiency/insufficiency. Because 25OHD deficiency may lead to a progression to more severe conditions such as osteoporosis or bone fractures, our results should be verified in larger cohorts including different ancestries.
There is recent mounting evidence that nanoparticles may have enhanced toxicological potential in comparison to the same material in the bulk form. The aim of this study was to develop a new method ...for unmask asbestos nanofibers from Formalin-Fixed, Paraffin-Embedded tissue. There is an increasing amount of evidence that nanoparticles may enhance toxicological potential in comparison to the same material in the bulk form. The aim of this study was to develop a new method to unmask asbestos nanofibers from Formalin-Fixed Paraffin-Embedded (FFPE) tissue. For the first time, in this study we applied Energy Dispersive X-ray (EDX) microanalysis through transmission electron microscopy to demonstrate the presence of asbestos nanofibers in histological specimens of patients with possible occupational exposure to asbestos. The diagnostic protocol was applied to 10 randomly selected lung cancer patients with no history of previous asbestos exposure. We detected asbestos nanofibers in close contact with lung cancer cells in two lung cancer patients with previous possible occupational exposure to asbestos. We were also able to identify the specific asbestos iso-type, which in one of the cases was the same rare variety used in the workplace of the affected patient. By contrast, asbestos nanofibers were not detected in lung cancer patients with no history of occupational asbestos exposure. The proposed technique can represent a potential useful tool for linking the disease to previous workplace exposure in uncertain cases. Furthermore, Formalin-Fixed Paraffin-Embedded (FFPE) tissues stored in the pathology departments might be re-evaluated for possible etiological attribution to asbestos in the case of plausible exposure. Since diseases acquired through occupational exposure to asbestos are generally covered by workers' insurance in most countries, the application of the protocol used in this study may have also relevant social and economic implications.
Abstract
Background
Workers in pathology and anatomy laboratories may be exposed to formaldehyde. An evaluation of the early effects of this substance is, therefore, paramount. This preliminary study ...was conducted to evaluate if nasal cytology could be used as a tool to detect changes in nasal mucosa in workers exposed to formaldehyde.
Aims
To assess whether nasal cytology was able to reveal any alteration of nasal mucosa in workers exposed to formaldehyde compared to unexposed subjects, and to ascertain whether a specific pattern of alterations correlated with years of exposure in order to evaluate long-term occupational exposure effects.
Methods
The study included a group of workers exposed to formaldehyde and a group of non-exposed workers. All subjects underwent clinical examination, followed by nasal cytology. Pathological indices from each rhinocytograms were compared between the two groups.
Results
Nasal cytology revealed a chronic inflammatory non-allergic condition in the exposed group. Qualitative analysis of data distribution of neutrophils and mucous-secreting/ciliated cells ratio showed data clustering with a cut-off set at 15 years of exposure. The mean formaldehyde concentrations ranged from <0.04 to 0.15 parts per million (ppm). The maximum levels of formaldehyde concentrations ranged from 0.2 to 0.67 ppm.
Conclusions
Our data indicate that nasal cytology may be a promising tool for the health surveillance of workers exposed to formaldehyde and may also represent a useful research tool for the study of the health effects of other chemicals irritants for the upper airways.
We are observing a growing trend towards the use of waste incineration in waste-to-energy (WTE) plants in Italy. Various authors started to investigate their potential health effects, but without ...univocal outcomes. The aim of this study is to assess whether or not main pulmonary function indexes could be decreased in a group of workers employed in a municipal solid WTE plant located in Central Italy, and if there's a correlation between the levels of exposure to airborne pollutants and alterations in the pulmonary apparatus.
The study was conducted with a retrospective cohort approach. We reviewed data from clinical records of 58 waste-to-energy plant workers undergoing annual health surveillance in the period 2010-2015. We considered the exposure to airborne dust and the main parameters of respiratory function (FVC, FEV1, Tiffeneau Index and FEF 25-75%) at time zero and after a period of 5 years. We divided our study population into two groups: low (< 1 mg/m3) and high (> 1 mg/m3) exposure. We estimated odds ratios (OR) with 95% confidence interval (95% CI) adjusted for potential confounders.
We observed a decrease in lung function parameters both in high and in low exposure group after a five-years exposure period. FEV1, FEV1/VC ratio and FEF 25-75% were worst in more exposed group, even if this difference resulted not significant at Wilcoxon test.
Active employee in WTE plants is associated to a non-significant worsening in the main parameters of lung function after 5 years exposure. Clinical significant of these variations need to be assessed.
To investigate if Helicobacter pylori (HP) eradication could make an effective and long-lasting improvement in the pharmacokinetic and clinical response to l-dopa in patients with Parkinson disease ...(PD) and motor fluctuations.
In a group of 34 HP-infected, motor-fluctuating patients with PD, the short-term (1-week) and long-term (3-month) beneficial effect of HP eradication (n = 17) was investigated in a double-blind fashion in comparison with a generic antioxidant treatment (n = 17), by means of pharmacokinetic, clinical, and gastrointestinal assessments. Results were compared with placebo treatment.
Differently from the antioxidant-treated patients, the HP-eradicated patients showed a significant increase of l-dopa absorption, which was coupled with a significant improvement of clinical disability and with a prolonged "on-time" duration, whereas gastritis/duodenitis scores significantly decreased in line with a better l-dopa pharmacokinetics.
These data demonstrate a reversible Helicobacter pylori (HP)-induced interference with l-dopa clinical response related to the impaired drug absorption, probably due to active gastroduodenitis. Therefore, the authors suggest that HP eradication may improve the clinical status of infected patients with Parkinson disease and motor fluctuations by modifying l-dopa pharmacokinetics.
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