Valutazione dei dati sperimentali per la neurotossicit\ue0 dello sviluppo dei pesticidi

EVALUATION OF EXPERIMENTAL DATA FOR DEVELOPMENTAL NEUROTOXICITY OF PESTICIDES. Epidemiological studies on neurodevelopmental effects of pesticides are inconclusive. Experimental developmental neurotoxicity studies, sometimes show effects on pups given doses lower than adults; most of the times these effects were transient, aspecific, with scattered biochemical, molecular or neurobehavioural changes, generally associated with high bolus doses. At repeated low doses, effects in pups did not occur at doses lower than in adults.Since the effects of high bolus doses are possible, preventive interventions should aim at reducing these exposures

Trends in occupational diseases in the Italian agricultural sector, 2004-2017

Objective: To estimate the incidence of, trends in and effect of change in reporting rules on occupational diseases (ODs) in the Italian agricultural sector. Methods: Over a 14-year period (2004-2017), ODs among Italian agricultural workers were diagnosed by physicians and reported to the National Institute for Insurance against Workplace Accidents and Occupational Diseases. OD was defined as a disease with a specific clinical diagnosis (International Classification of Diseases) and was predominantly caused by work-related factors. Trends in incidence and effects of changed eligibility criteria for reporting occupational musculoskeletal disorders (MSDs) and noise-induced hearing loss (NIHL) were estimated using a Poisson regression model. Results: In 2017, the incidence of all ODs was 1295 per 100 000 agricultural workers. MSDs (961 per 100 000 workers) were the most frequently occurring ODs. MSDs and NIHL showed statistically significant increasing time trends, 26% and 7% annual increase, respectively, during the 2004-2017 period. There was no statistically significant change in the incidence of occupational respiratory, skin and cancer diseases during the 14-year period. After changes in reporting rules, the incidence of MSDs showed an immediate increased effect, with an incidence rate ratio (IRR) of 2.9 (95% CI 2.65 to 3.14) and a significant annual decreasing trend of -9% (95% CI -6% to -12%) over the years after the changed reporting rules (from 2008 to 2017), and an immediate effect on NIHL with an IRR of 1.3 (95% CI 1.13 to 1.53). Conclusion: In total, 1.3% of the Italian agricultural workers were diagnosed in 2017 as having an OD. Over a 14-year period, the annual incidence of ODs showed a considerable increasing trend consistent with changed eligibility reporting criteria for occupational MSDs and to a lesser extent for NIHL

Assessment of penconazole exposure in winegrowers using urinary biomarkers

Penconazole (PEN) is a fungicide used in agriculture. The aim of this work was to evaluate the exposure to PEN in vineyard workers focusing on urinary biomarkers. Twenty-two agricultural workers were involved in the study; they were investigated during PEN applications and re-entry work, performed for 1-4 consecutive working days, for a total of 42 mixing and applications and 12 re-entries. Potential and actual dermal exposure, including hand exposure, were measured using pads and hand washes. Urine samples were collected starting before the first application, continuing during the work shift, and ending 48\u202fh after the last shift. The determination of PEN in dermal samples and PEN metabolites in urine was performed by liquid chromatography tandem mass spectrometry. Dermal potential body exposure and actual total exposure showed median levels ranging from 18 to 3356\ub5g and from 21 to 111\u202f\ub5g, respectively. Urinary monohydroxyl-derivative PEN-OH was the most abundant metabolite; its excretion rate peaked within 24\u202fh after the work shift. In this period, median concentrations of PEN-OH and the carboxyl-derivative PEN-COOH ranged from 15.6 to 27.6\u202f\ub5g/L and from 2.5 to 10.2\u202f\ub5g/L, respectively. The concentration of PEN-OH during the work shift, in the 24\u202fh after and in the 25-48\u202fh after the work shift were correlated with actual body and total dermal exposure (Pearson's r from 0.279 to 0.562). Our results suggest that PEN-OH in the 24\u202fh post-exposure urine is a promising candidate for biomonitoring PEN exposure in agricultural workers

Developing approaches to control SARS-CoV-2 in a public hospital

The Territorial Public Health Care Company (in Italian, ASST) of the Saints Paolo e Carlo of Milano includes two large public hospitals, and several outpatients and territorial healthcare services. It employs 5642 workers. The outbreak of novel coronavirus disease 2019 (COVID-19) reached our ASST in the last week of February when a doctor in the Intensive Care Unit of the San Paolo Hospital was diagnosed with COVID-19. Our Occupational Health Unit immediately introduced measures to control the epidemic. Our approach was based on contact tracing and isolation of asymptomatic infected workers. A \u2018close contact\u2019 was defined as a person who had face-to-face contact or spent at least 15 min in an indoor environment with a positive subject (patient, colleague or relative) without any protective equipment (surgical mask). From 27 February to 23 April we tested 2907 workers (51% of the total workforce) with nasopharyngeal swabs (NPS) using rtPCR for SARS-CoV-2 detection [1,2], with positive results in 152 hospital and 33 territorial workers (3% of the total workforce). All the infected workers were asked to fill in a daily electronic data collection form for the duration of the infection. About 50% remained substantially asymptomatic for the quarantine period, which ended when the workers underwent two NPS on two consecutive days with a negative result. The time to recovery took from 12\u201347 days, with a median duration of about 30 days, which is longer than normally expected. Symptomatic workers showed only very mild symptoms; mainly loss/change of smell and taste. Four were hospitalized but none had severe or life-threatening infection. The data suggest that the \u2018active search approach\u2019 is more effective in closed communities such as groups of healthcare workers than generalized testing. We have started a retrospective survey of 100 positive workers studying symptoms, source of exposure and co-morbidities using a modified version of the \u2018WHO novel coronavirus acute respiratory infection clinical characterization data tool\u2019, administered by telephone interview. Finally, in order to prepare for future outbreaks, we are testing a novel telemedicine approach enabling us to follow quarantined workers with a digital platform with a mobile phone app that provides remote video examinations and online symptoms and health parameter checking (body temperature, oxygen saturation, etc.). The platform facilitates rapid intervention. Using this approach, we can follow a large cohort of workers with continuous monitoring. The tool may also be able to reduce the rate of patients\u2019 hospitalization. We are also comparing those with positive and negative swabs using a rapid immunochromatographic assay for the detection of IgG and IgM antibodies to SARS-CoV-2 virus in whole blood to assess potential immunity. Preliminary results are promising for IgG, even though the protective capacity of this immunoglobulin is still unknown

I valori limite per agenti chimici alla luce del Regolamento REACH

The European Regulation 1907/2006 (REACH - Registration, Evaluation, Authorization and Restriction of Chemicals) obliges manufacture companies and import chemicals to assess the risks arising from their use and to take the necessary measures to manage the risks identified. The Chemical Safety Report provides an accurate assessment of hazards to human health and the environment necessary to prepare an exposure scenario for the \u201cidentified uses\u201d of the substance. An exposure scenario is the set of conditions that describe how the substance is manufactured or used during its life cycle and how the manufacturer or importer controls, or recommends downstream users to control the \u2018exposure to humans and the environment. Firms therefore need specific skills. The spectrum of toxicological risk is extremely large, the information required in some cases are very complex and undoubtedly require a thorough knowledge in toxicology and environmental industry. The expertise and experience in toxicology of the occupational physician in this case may become useful in the environmental field as well as another familiar figure of relevant importance is the occupational hygienist who develop exposure scenarios for workers and their uses experience for the exposure scenarios for the consumer. It provides an obvious involvement of medical toxicologists and occupational hygienists for public tasks of control and inspection of chemical safety reports and, locally, even the accuracy of risk that arise from this

Occupational Health Services Integrated in Primary Health Care in Iran

Introduction A healthy workforce is vital for maintaining social and economic development on a global, national and local level. Around half of the world's people are economically active and spend at least one third of their time in their place of work while only 15 of workers have access to basic occupational health services. According to WHO report, since the early 1980s, health indicators in Iran have consistently improved, to the extent that it is comparable with those in developed countries. In this paper it was tried to briefly describe about Health care system and occupational Health Services as part of Primary Health care in Iran. Methods To describe the health care system in the country and the status of occupational health services to the workers and employers, its integration into Primary Health Care (PHC) and outlining the challenges in provision of occupational health services to the all working population. Findings Iran has fairly good health indicators. More than 85 percent of the population in rural and deprived regions, for instance, have access to primary healthcare services. The PHC centers provide essential healthcare and public-health services for the community. Providing, maintaining and improving of the workers' health are the main goals of occupational health services in Iran that are presented by different approaches and mostly through Workers' Houses in the PHC system. Conclusions Iran has developed an extensive network of PHC facilities with good coverage in most rural areas, but there are still few remote areas that might suffer from inadequate services. It seems that there is still no transparent policy to collaborate with the private sector, train managers or provide a sustainable mechanism for improving the quality of services. Finally, strengthening national policies for health at work, promotion of healthy work and work environment, sharing healthy work practices, developing updated training curricula to improve human resource knowledge including occupational health professionals are recommended. © 2015 The Authors