1,720,980 research outputs found
Liver function assessment in workers exposed to vinyl chloride
No full textObjective: To investigate liver function in vinyl chloride workers and assess its relation with current/past occupational exposure to vinyl chloride monomer (VCM). Methods: A medical examination including the execution of liver function tests (LFTs) and liver ultrasonography was executed in a group of 757 workers with a long-standing service in the production of VCM/ polyvinylchloride (PVC). Cumulative and maximum VCM exposures were calculated. History of viral hepatitis and alcohol intake were carefully investigated. Regression analysis explored the association between abnormal LFTs and a group of possible determinants (VCM cumulative and maximum exposure, BMI, age, history of viral hepatitis, alcohol and triglyceride levels). Also, synergistic effect between VCM and a history of hepatitis was analysed, as well as the possible association between VCM exposure and aspartate aminotransferase/alanine amino transferase (AST/ALT) ratio >1. Distribution of abnormal LFTs was also assessed in relation to the results provided by liver ultrasonography. Results: The most frequently abnormal serum parameters were, in decreasing order: total cholesterol (27.3%), triglycerides (12.2%), total bilirubin (9.1%), gamma glutamil transpeptidase (GGT; 9.0%) and ALT (8.2%). The AST/ALT ratio >1 was present in 28.1% of workers. Abnormal LFTs were not found to be associated with current or past VCM exposure. High ALT resulted positively associated with BMI, AST with alcohol intake, GGT with alcohol intake and triglycerides. No synergistic effect on LFTs of exposure to VCM and a history of hepatitis was observed. The AST/ALT ratio >1 was not found to be associated with VCM exposure. The prevalence of abnormal LFTs was higher in case of liver steatosis (ALT) or periportal fibrosis (GGT), but not in case of pure hepatomegaly, as documented by ultrasonography. Conclusions: Liver function assessment only including LFTs is not able to detect VCM-induced liver damage, but reveals alterations due to non-occupational factors, such as dietary and/or metabolic disfunctions. The LFTs are however of importance to detect conditions that could recommend avoidance of exposure to VCM and are useful for medical counselling and health promotion purposes
Risk assessment and management of occupational exposure to pesticides in agriculture
No full textNearly 50% of the world labour force is employed in agriculture. Over the last 50 years, agriculture has deeply
changed with a massive utilisation of pesticides and fertilisers to enhance crop protection and production, food quality
and food preservation. Pesticides are also increasingly employed for public health purposes and for domestic use.
Pesticide are unique chemicals as they are intrinsically toxic for several biological targets, are deliberately spread into
the environment, and their toxicity has a limited species selectivity. Pesticide toxicity depends on the compound
family and is generally greater for the older compounds; in humans, they are responsible for acute poisonings as well
as for long term health effects, including cancer and adverse effects on reproduction. Due to their intrinsic toxicity,
in most countries a specific and complex legislation prescribes a thorough risk assessment process for pesticides prior to
their entrance to the market (pre-marketing risk assessment). The post-marketing risk assessment takes place during
the use of pesticides and aims at assessing the risk for exposed operators. The results of the risk assessment are the base
for the health surveillance of exposed workers. Occupational exposure to pesticides in agriculture concerns product
distributors, mixers and loaders, applicators, bystanders, and rural workers re-entering the fields shortly after treatment.
Assessing and managing the occupational health risks posed by the use of pesticides in agriculture is a complex
but essential task for occupational health specialists and toxicologists. In spite of the economic and social importance
of agriculture, the health protection of agricultural workforce has been overlooked for too many years, causing an
heavy tribute paid in terms of avoidable diseases, human sufferance, and economic losses. Particularly in the developing
countries, where agricultural work is one of the predominant job, a sustainable model of development calls for
more attention to occupational risks in agriculture. The experience of many countries has shown that prevention of
health risk caused by pesticides is technically feasible and economically rewarding for the individuals and the whole
community. A proper risk assessment and management of pesticide use is an essential component of this preventative
strategy
Periportal fibrosis and other liver ultrasonography findings in vinyl chloride workers
No full textAims: To investigate the presence of liver lesions and their relation with vinyl chloride monomer (VCM) exposure or other personal risk factors, in workers involved in the production of VCM and polyvinyl chloride (PVC).
Methods: A liver ultrasonography examination was conducted in 757 workers, some of whom had long standing service in the production of VCM and PVC. The study involved: assessment of individual past and present VCM exposure of each worker; collection of past personal health history, lifestyle and personal data; routine liver function tests; and liver ultrasonography.
Results: No cases of liver malignancies were detected. Angiomas and liver cysts were found with a frequency of occurrence within the expected range of the general population. The main findings consisted of hepatomegaly (34.7%), steatosis (31.8%), and periportal fibrosis (16.0%). A logistic regression analysis indicated that hepatomegaly and steatosis were associated with obesity and lipid metabolism disturbances and not with VCM exposure. Periportal fibrosis, in addition to constitutional or dietary factors, was shown to be associated with VCM exposure, but only when maximum exposure in the subject’s history had been at least 200 ppm as a yearly average; no effects were observed at 50 ppm or below.
Conclusions: Workers exposed to 200 ppm VCM for at least one year have a fourfold increased risk of developing periportal liver fibrosis. Liver ultrasonography is a suitable and important diagnostic test for the medical surveillance of vinyl chloride workers
Progetto PM Care : Diminuzione della funzionalità respiratoria in soggetti esposti ad aumentati livelli di particolato urbano
No full text
Influenza vaccination in health care workers of a university hospital in Milan
No full textThe study analyses the percentage of influenza vaccination in health care workers of a big university hospital in Milan during the season 2006/2007. The percentage of vaccinated subjects was 19.8%. The frequency of vaccination has also been assessed according to sex, age, job and school title. Observed data indicates that the number of vaccinated sanitary workers is far below the levels reached in other European countries and in the USA. Thus, in order to reach a higher adhesion to vaccination programs, sensitisation campaigns are necessary
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