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VITAMINA D E ALLERGIE RESPIRATORIE NEI PANIFICATORI
No full textIl lavoro notturno può influenzare la concentrazione della vitamina D sierica. Numerosi dati della Letteratura mostrano un crescente interesse scientifico per gli effetti non scheletrici della vitamina D, evidenziando un possibile ruolo della vitamina D nelle malattie allergiche.
Lo scopo principale di questo lavoro è stato quello di valutare gli effetti del turno di lavoro sulla concentrazione di vitamina D sierica in panificatori di Verona e Provincia, impiegati da almeno un anno nel settore dell’arte bianca. Si è voluto inoltre valutare se la concentrazione di vitamina D si modificava in relazione alla presenza di malattie allergiche d origine professionale.
Sono stati quindi studiati 44 panificatori che avevano in precedenza partecipato ad un’indagine postale il cui fine era di valutare la prevalenza di patologie respiratorie allergiche nei soggetti esposti a farine di cereali. Ogni lavoratore è stato sottoposto a visita medica generale, prove allergologiche cutanee per allergeni inalatori ambientali e professionali, prelievo ematico venoso, spirometria con eventuale test di bronco dilatazione e/o test di provocazione bronchiale con metacolina. Trentatre panificatori lavoravano prevalentemente la notte, mentre undici durante le ore diurne. Solo tre panificatori avevano concentrazioni normali di vitamina D (>30 ng/mL); questi avevano turni di lavoro diurni.
La concentrazione di vitamina D sierica era significativamente inferiore nei lavoratori notturni (mediana:15.1 ng/mL, range 4.9-26.3) rispetto a coloro con turno di lavoro diurno (mediana 27.1 ng/mL, range 17.8-41.7).
Un deficit di vitamina D (<20 ng/mL) era presente in 27 (82%) panificatori con turno di lavoro notturno, mentre in un solo lavoratore con turno di lavoro diurno.
Il rapporto vita fianchi (WHR) (Spearman’s rho = -0.406, p<0.01) e la presenza di malattie professionali allergiche (p=0.01) erano predittori significativi della concentrazione di vitamina D nell’analisi univariabile.
Nell’analisi multivaribile solo il turno di lavoro notturno si è dimostrato essere un significativo fattore predittivo della concentrazione di vitamina D (p<0.001). In base ai risultati del modello di regressione quantilica, la mediana dei livelli di vitamina D nei panificatori con turno di lavoro notturno era inferiore di 9.6 ng/mL (95% CI -16.3 - -2.9) rispetto ai lavoratori con turno diurno (p=0.006). Nonostante questo studio sia limitato a un ristretto numero di pazienti, si può comunque notare che l’insufficienza di vitamina D è comune nei panificatori, in particolar modo tra coloro con turni di lavoro notturni. Un deficit di vitamina D era presente nel 64% dei lavoratori partecipanti allo studio. Questo studio sembra evidenziare che il principale fattore di rischio per il deficit di vitamina D nei panificatori sia la tipologia di turno di lavoro notturno, mentre nel nostro campione l’obesità centrale e la presenza di malattie professionali allergiche sembrano non influenzare significativamente la concentrazione di vitamina DBackground.Night work can influence vitamin D level and growing evidence connects vitamin D with allergic
diseases.
Aims. To evaluate the effect of working schedule on vitamin D levels in bakers.
Methods.Forty-four bakers, participating in a survey on the prevalence of occupational allergic diseases, underwent a
clinical evaluation, including waist-to-hip ratio (WHR) assessment, vitamin D measurement, spirometry, methacholine
challenge, SPT to bakery's allergens, NET evaluation.
Results.Thirty-tree bakers were working at night, while 11 during daytime. Normal vitamin D levels (>30 ng/mL) were
observed only in 3 bakers, all of them working during daytime. Median vitamin D level was significantly lower in night
workers (15.1 ng/mL, range 4.9-26.3) than in daytime workers (27.1 ng/mL, range 17.8-41.7). Vitamin D deficiency (<20
ng/mL) was observed in 27 night working bakers (82%) but only in one daytime working baker. WHR (Spearman's rho =
-0.406, p<0.01) and the presence of occupational allergic diseases (n=31) were significantly associated with vitamin D
levels in univariable analysis.
In multivariable analysis only working schedule was a significant predictor of vitamin D levels (p<0.001). According to a
quantile regression model, median vitamin D level in night working bakers was lower by 9.6 ng/mL (95% CI 16.3 – 2.9)
with respect to daytime working bakers (p=0.006).
Conclusion.Vitamin D insufficiency is very common in bakers, especially in night workers. The main risk factor of vitamin D
deficiency was working at night, while WHR and occupational allergic diseases did not independently affect vitamin D levels
in this small sample
Who should monitor job sick leave?
No full textWe use a large and unique administrative dataset from Italy, covering the period 2009-2014, to investigate opportunistic behavior (moral hazard) and the effectiveness of monitoring policies related to insurance against illness-related income losses. The analysis is based on the outcome of mandatory medical visits aimed at verifying the health status of employees during sickness spells. We find that employers are more effective than the public insurer in selecting sickness episodes to monitor. However, a reduction in the number and a better targeting of visits with the support of appropriate statistical tools may close the gap. We discuss the impact of using direct measures of health, such as the outcome of a medical visit, on the study of the determinants of opportunistic behavior and argue that simply looking at days of work lost, without appropriately controlling for health status, may lead to misleading conclusions if the goal is studying moral hazard
Job Sick Leave: Detecting Opportunistic Behavior
No full textWe utilize a large administrative dataset of sickness leave in Italy, i) to investigate whether private firms are more effective than the public insurer in choosing who to monitor, and ii) to study the correlation between potentially opportunistic behavior and the observable characteristics of the employee. We find that private employers are more likely to select into monitoring employees who are fit for work despite being on sick leave, if the public insurer is not supported by any data-driven tool. However, the use of a scoring mechanism, based on past records, allows the public insurer to be as effective as the employer. This result suggests that the application of machine learning to appropriate databases may improve the targeting of public monitoring to detect opportunistic behavior. Concerning the association between observable characteristics and potentially opportunistic behavior, we find that males, employees younger than 50, those on short leaves or without a history of illness are more likely to be found fit for work
Omalizumab in persistent severe bakers_ asthma
No full textOmalizumab in persistent severe bakers_ asthm
Associazione di polimorfismi del gene SPINK5 con l’asma occupazionale allergico nei panificatori
No full textExposure to additives or multigrain flour is associated with high risk of work-related allergic symptoms among bakers
No full textWheat flour exposure in bakers can elicit respiratory and skin symptoms. Scarce data are available on the prevalence of such conditions in bakers. We investigated the prevalence of work-related rhinitis, asthma-like symptoms and dermatitis in bakers according to job task and type of allergens involved
Two typologies of endodontic instrument handle are here investigated for tactility modifications.
No full textAIM: The purpose of this comparative study was to evaluate possible modifications of tactility (deep and discriminative tactile sensitivity) using manual endodontic instruments equipped with traditional handles compared with innovative silicone handle versions.
METHODS: Sixteen subjects were selected and supplied with resin Endo-Training-Block simulators, latex gloves and manual endodontic instruments with diameters ranging from 10 to 40 mm. All instruments had traditional and silicon handles. The investigation of deep and discriminative tactile sensitivity was performed at 0, 15, 30, and 45 minutes of the manual instrumentation with an esthesiometer. We obtain each of our data from the median of three consecutive measurements. The results were then statistically analyzed thanks to the ANOVA test: P=0.003 for subjects, P<0.001 for time factor, and P=0.010 for sensitivity-time interaction.
RESULTS: We observed a better tactility with silicone handle instruments, comparing the two kinds of handle (regardless of the finger tested) as well as singly analyzing the thumb and index finger.
CONCLUSION: Despite the sample limited extension, the loss of deep cutaneous and discrimination sensitivity seems to be reduced using silicone handles, most likely favoring an improvement of the working performance
[Prevalence of occupational allergic symptoms among bakers of Verona].
No full textThe aim of the study is to evaluate the prevalence of respiratory and skin symptoms among bakers in the district of Verona by means of two standardized questionnaires, a clinical one administered to the bakeries employees, either directly exposed to flour dust or not exposed, and one concerning the characteristics of the bakery environment. The study involved 613 bakery workers, 401 bakers and 212 sales personnel employed in 152 bakeries. Bakers exposed to flour dust reported nasal symptoms in 29.2% of cases, ocular symptoms in 13.2%, cough, shortness of breath, chest tightness, wheezing respectively in 8.7%, 7%, 4.5% 6.2% of cases, itch and skin burning with paleness respectively in 9.7% and 8.5%. A significantly lower prevalence of these symptoms, except skin paleness, was reported among the sales personnel. In bakers, a significant correlation was found between ocular-nasal and respiratory symptoms and family or self-reported history of atopy (p = 0.001). Reported flour dust air pollution at the workplace correlated with occupational ocular-nasal and respiratory symptoms (p = 0.001). Flour dust on skin and clothes correlated with crusts and excoriations (p = 0.01). Our study confirms the high prevalence of allergic symptoms among bakers and the need of clinical assessment
Fractional exhaled nitric oxide levels in relation to work-related respiratory burden and sensitization to wheat flour and multigrain in bakers
Full text linkWork-related lower airway symptoms (WR-LAS), rhinitis (WRR), and asthma (WRA) are very common among bakers, due to airborne exposure to wheat flour and multigrain. Limited data is available regarding fractional exhaled nitric oxide (FeNO) in bakers in relation to respiratory burden and occupational sensitization in a real-life situation
Associazione di varianti geniche nei geni FCER1A e STAT6 con le IgE Seriche totali nei panificatori
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