Annali dell'Istituto Superiore di Sanità
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Asbestos contamination in feldspar extraction sites: a failure of prevention?
Get PDFFibrous tremolite is a mineral species belonging to the amphibole group. It is present almost everywhere in the world as a natural contaminant of other minerals, like talc and vermiculite. It can be also found as a natural contaminant of the chrysotile form of asbestos. Tremolite asbestos exposures result in respiratory health consequences similar to the other forms of asbestos exposure, including lung cancer and mesothelioma. Although abundantly distributed on the earth\u27s surface, tremolite is only rarely present in significant deposits and it has had little commercial use. Significant presence of amphibole asbestos fibers, characterized as tremolite, was identified in mineral powders coming from the milling of feldspar rocks extracted from a Sardinian mining site (Italy). This evidence raises several problems, in particular the prevention of carcinogenic risks for the workers. Feldspar is widespread all over the world and every year it is produced in large quantities and it is used for several productive processes in many manufacturing industries (over 21 million tons of feldspar mined and marketed every year). Until now the presence of tremolite asbestos in feldspar has not been described, nor has the possibility of such a health hazard for workers involved in mining, milling and handling of rocks from feldspar ores been appreciated. Therefore the need for a wider dissemination of knowledge of these problems among professionals, in particular mineralogists and industrial hygienists, must be emphasized. In fact both disciplines are necessary to plan appropriate environmental controls and adequate protections in order to achieve safe working conditions.
For an alliance between science, ethics and politics in promoting paediatric trials
Get PDFAfter several decades during which children tended to be excluded from clinical trials, provisions to encourage trials with children have been in place for some years both at international level and in individual countries. The Nuffield Council on Bioethics has published a broad-ranging report on the subject, which makes concrete proposals for decision-makers and comes at a crucial moment in the definition of European Union regulations on this topic
Quality of life in refugees and asylum seekers in Italy: a pilot study
Get PDFInterest in measuring the Health Related Quality of Life (HRQoL) of the immigrants increased in recent years in Italy as in other countries. Our purpose was to evaluate the HRQoL of refugees welcomed in Tuscany using the SF-36 Questionnaire. We collected 114 questionnaires from 2011 to 2015. Our samples was constituted by 98 males and 16 females, coming from different regions of the world; the mean age was 27,4. Statistical analysis showed that gender, length of stay and educational qualification are not associated with a poorer HRQoL. Instead, elderly refugees showed lower scores; refugees from African region reported a better HRQoL than the others, and there are also differences between refugees welcomed in different cities of Tuscany. Our purpose is to continue this study enlarging the sample size and the geographical coverage, in order to have a more interesting description of the health perception of refugees welcomed in Italy.
The influence of sex and gender on immunity, infection and vaccination
Get PDFSex/gender significantly contribute to shape the immune responses, contributing to differences in the pathogenesis of infectious diseases in males and females, the response to viral vaccines and the prevalence of autoimmune diseases. Females typically develop higher innate, humoral and cellular immune responses to viral infections and in response to vaccine. At the same time, women are more prone to autoimmune diseases and experience more adverse reactions to vaccination. Hormonal, genetic and environmental factors between males and females may affect the immune responses and the sex-related outcome of vaccination. Knowledge of the mechanisms involved in sex disparity in immune responses will contribute to identify the ways to reduce adverse reactions in females and to improve the immune responses in males. This is necessary to adequately protect both sexes against the immune-mediated and infectious diseases with the longterm goal of personalizing the therapies for males and femal
Climate change impact on microclimate of work environment related to occupational health and productivity
Get PDFIntroduction. Climate change is a global emergency that influences human health and occupational safety. Global warming characterized by an increase in temperature of the ambience and humidity affects human health directly impairing body thermoregulation with serious consequences: dehydration, fatigue, heat stroke and even death. Several studies have demonstrated negative effects of climate change on working populations in a wide variety of workplaces with particular regard to outdoor and uncooled indoor workplaces. Most vulnerable workers are outdoor workers in tropical and subtropical countries usually involved in heavy labor during hot seasons. Many of the consequences therefore, regarding working people are possible, even without health symptoms by reducing work productivity. Aim. The scope of this review is to investigate effects of climate change on workers both in relation to health and work productivity. Methods. This study has been realized by analyzing recent international literature. Conclusions. In order to reduce negative effects of climate change on working populations it is essential to implement preventive measures with a multidisciplinary strategy limiting health risks and improving work productivity
Climate change and occupational, allergies: an overview on biological, pollution, exposure and prevention
Get PDFIntroduction. Climate change, air pollution, temperature increase and other environmental variables are modifying air quality, contributing to the increase of prevalence of allergic respiratory diseases. Allergies are complex diseases characterized by multilevel interactions between individual susceptibility, response to immune modulation and environmental exposures to physical, chemical and biological agents. Occupational allergies introduce a further complexity to these relationships by adding occupational exposure to both the indoor and outdoor ones in the living environment. Objective. The aim of this paper is to overview climate-related allergy affecting environmental and occupational health, as literature data are scanty in this regard, and to suggest a management model of this risk based on a multidisciplinary approach, taking the case of biological pollution, with details on exposure and prevention. Conclusions. The management of climate-related occupational allergy should take into account preventive health strategies, environmental, public and occupational interventions, as well as to develop, implement, evaluate, and improve guidelines and standards protecting workers health under changing climatic conditions; new tools and strategiesbased on local conditions will have to be developed. Experimental studies and acquisitionof environmental and personal data have to be matched to derive useful informationfor the scope of occupational health and safety
“Wind of change”: the role of human centered healthcare factors in the implementation of clinical governance in an Italian University teaching hospital
Get PDFBackgroundClinical Governance (CG) is an approach to quality improvement in healthcare aimed at achieving a patient-centered health care system. The aim of this study was to analyze the results of a CG assessment in the Teaching Hospital “A. Gemelli”, in order to identify strategic levers for improving healthcare provided and assessing its level of humanization.Materials and methodsCG implementation levels were assessed through OPTIGOV, a CG scorecard methodology. In order to identify the variables generating latent factors that can influence the governance of the Hospital, the multiple correspondence analysis (MCA) was applied.ResultsThe application of OPTIGOV showed a good CG implementation level in the Gemelli Hospital. By applying MCA, the variables aggregated so as to define 3 latent factors (F1: assessment for people oriented improvement strategy; F2: assessment for people targeted management; F3: tracking for timely accountable people) explaining as a whole 82.68% of the total variance and respectively 48.09 % ( F1), 24.95% (F2 ) and 9.64% (F3 ).ConclusionsThe heuristic interpretation of the three latent factors could bring back to the concept of humanization in healthcare. This study shows that in the Teaching Hospital “A. Gemelli” humanization in healthcare is the driver of health care quality improvement
Efficacy and safety of spinning exercise in middle-aged and older adults with metabolic syndrome: randomized control trial
Get PDFBackground. Physical training should represent the primary therapeutic approach to prevent cardiovascular disease, overall in the subjects with metabolic syndrome (MetS). Few studies have been conducted to investigate the effects of spinning exercise on cardio-vascular weal. Despite this it has been emphasized that spinning puts strain on the cardiovascular system, questioning whether it can be recommended in the elderly. AIM. to assess whether a 6 months spinning training, combined with proper diet, is more effective than standard training programs and diet alone in improving metabolic abnormalities in elderly patients with MetS. DESIGN. Randomized clinical trial. SETTING. Rehabilitation Unit of the Department of Geriatric Sciences, Sapienza University of Rome POPULATION. elderly patients with MetS according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) diagnostic criteria METHODS. Patients were randomly assigned to receive treatment with diet (group A, n = 10), with diet and general gymnastics program (group B, n = 10), with diet and spinning physical training program (group C, n = 10). The effects of interventions were assessed by differences in changes in components of MetS and associated biomarkers between the three groups. RESULTS. Thirty patient were recruited at this study and all completed the 6 months protocol. During the study period we observed a significant reduction in blood pressure (group C: systolic blood pressure p = 0.03; diastolic blood pressure p = 0.04 / group B: systolic blood pressure p = 0.001), in lipid profile (group B: plasma total cholesterl p < 0.0001; triglycerides p < 0.0001 / group C: plasma total cholesterol p = 0.04); in fasting blood glucose (group B: p = 0.01; group C: p = 0.008); in Homeostatic Model Assessment of Insulin Resistance (HOMA) (group B: p = 0.01; group C: p = 0.001); in waist circumference (group C: p = 0.005; group A: p = 0.022; group B: p = 0.037). CONCLUSION. Our results confirm the effectiveness of spinning physical training combined with diet in the management of MetS. CLINICAL REHABILITATION IMPACT. The findings provide a preliminary evidence to support that spinning training may represent a useful and safe intervention in geriatric patients with multiple CV risk factors. The working group and the presence of an instructor may lead to increase the adherence to physical exercise
Risk factors for dysmenorrhea among young adult female university students
Get PDFObjectives. The aim of this study was to investigate associated risk factors for dysmenorrhea in a sample of Serbian university students. Methods. A case-control study was conducted among undergraduate students (n = 288) attending lectures during 2014/2015 academic year at the Faculty of Medical Sciences, University of Kragujevac. Results. The only significant associations were between dysmenorrhea and age at menarche (OR adjusted = 0.74; 95% CI 0.58-0.95; p = 0.017), family history of dysmenorrhea (OR adjusted = 3.39; 95% CI 1.74-6.63; p = 0.000), duration of menstrual flow (OR adjusted = 1.52; 95% CI 1.16-1.99; p = 0.002) and smoking at least one cigarette a day (OR adjusted = 5.09; 95% CI 1.83-14.15; p = 0.002). The factors associated with dysmenorrhea were not interacting with each other. Conclusion. Our results suggest that earlier age at menarche, longer duration of menstrual flow, prior family history of dysmenorrhea and smoking at least one cigarette a day are important risk factors associated with dysmenorrhea. Smoking cessation should be strongly encouraged.