Respiratory health in waste collection and disposal workers

Waste management, namely, collection, transport, sorting and processing, and disposal, is an issue of social concern owing to its environmental impact and effects on public health. In fact, waste management activities are carried out according to procedures that can have various negative effects on the environment and, potentially, on human health. The aim of our study was to assess the potential effects on respiratory health of this exposure in workers in the waste management and disposal field, as compared with a group of workers with no occupational exposure to outdoor pollutants. The sample consisted of a total of 124 subjects, 63 waste collectors, and 61 office clerks. Informed consent was obtained from all subjects before inclusion in the study. The entire study population underwent pulmonary function assessments with spirometry and completed two validated questionnaires for the diagnosis of rhinitis and chronic bronchitis. Statistical analyses were performed using STATA 13. Spirometry showed a statistically significant reduction in the mean Tiffenau Index values in the exposed workers, as compared with the controls, after adjusting for the confounding factors of age, BMI, and smoking habit. Similarly, the mean FEV1 values were lower in the exposed workers than in the controls, this difference being again statistically significant. The FVC differences measured in the two groups were not found to be statistically significant. We ran a cross-sectional study to investigate the respiratory health of a group of workers in the solid waste collection and disposal field as compared with a group of office workers. In agreement with most of the data in the literature, our findings support the existence of a prevalence of respiratory deficits in waste disposal workers. Our data suggest the importance of adopting preventive measures, such as wearing specific individual protection devices, to protect this particular category of workers from adverse effects on respiratory health

Benzo[a]pyrene modelling over Italy: comparison with experimental data and source apportionment

Abstract This work describes the extension of the Flexible Air quality Regional Model (FARM) to polycyclic aromatic hydrocarbons (PAHs). Modules accounting for the partitioning of these species between gaseous and particulate phases were inserted in a simplified version of the model and in a more state–of–the–art configuration implementing the SAPRC99 gas–phase chemical mechanism coupled with the aero3 aerosol module. Both versions of FARM were applied over Italy for the year 2005. The analysis of model results was focused on benzo[a]pyrene (B[a]P), which is considered a marker substance for the carcinogenic risk of PAHs. Simulated B[a]P concentrations were compared with observed data, collected at background sites mainly located in Po Valley, and with concentrations produced at continental scale by EMEP/MSC–E model. Higher B[a]P yearly average concentrations were simulated by the national modelling system as a result of different factors: the higher resolution adopted by the national modelling system, the greater Italian emissions estimated by the national inventory and the effects induced by the use of a high resolution topography on meteorological fields and thus on the dispersion of pollutants. The comparison between observed and predicted monthly averaged concentrations evidenced the capability of the two versions of FARM model to capture the seasonal behaviour of B[a]P, characterised by higher values during the winter season due to the large use of wood for residential heating, enhanced by lower dispersion atmospheric conditions. The statistical analysis evidenced, for both versions of the model, a good performance and better indicators than those associated to EMEP/MSC–E simulations. A source apportionment was then carried out using the simplified version of the model, which proved to perform similarly to the full chemistry version but with the advantage to be computationally less expensive. The analysis revealed a significant influence of national sources on B[a]P concentrations, with non–industrial combustion employing wood burning devices being the most important sector. The contribution of the industrial sectors is relevant around major industrial facilities, with the largest absolute contribution in Taranto (above 1 ng m −3 ), where steel industries are the largest individual source of PAHs in the country

Successful Pregnancies, Births, and Children Development Following Oocyte Cryostorage in Female Cancer Patients During 25 Years of Fertility Preservation

Simple Summary The study goal is to demonstrate that oocyte cryopreservation is a feasible and efficient option for fertility preservation in cancer patients through the comparison of in vitro fertilization treatments in nononcological patients. The preservation of fertility in cancer patients is a crucial aspect of modern reproductive medicine. Amenorrhea and infertility often occur after cancer therapy, worsening the quality of life. Cryopreservation of oocytes in young cancer patients is a therapeutic option for preserving fertility. A prospective study was conducted on 508 cancer patients who underwent oocyte cryopreservation to preserve fertility between 1996 and 2021 including the COVID-19 pandemic period. Patients underwent ovarian stimulation, followed by egg retrieval, and oocytes were cryopreserved by slow freezing or vitrification. Sixty-four thawing/warming cycles were performed. Survival, fertilization, pregnancy, and birth rate over the thawing/warming cycles were obtained. The data were compared with those from a group of 1042 nononcological patients who cryopreserved supernumerary oocytes. An average of 8.8 +/- 6.9 oocytes were retrieved per cycle, and 6.1 +/- 4.2 oocytes were cryopreserved. With their own stored oocytes, 44 patients returned to attempt pregnancy. From a total of 194 thawed/warmed oocytes, 157 survived (80%). In total, 100 embryos were transferred in 57 transfer/cycles, and 18 pregnancies were achieved. The pregnancy rate per transfer and pregnancy rate per patient were 31% and 41%, respectively. No statistically significant differences were observed between oncological patients and nononcological patients. A total of 15 babies were born from oncological patients. Children born showed normal growth and development. One minor malformation was detected

Very Early Onset-IBD: evidence for the need of a multidisciplinary approach

Very early onset inflammatory bowel disease (VEO-IBD) represents approximately 25% of cases of IBD-like colitis occurring during childhood and, by definition, it is characterized by an onset prior to 6 years of age. This subgroup of patients presents significant differences from IBD occurring in older children and in adults, including a more severe clinical course, a reduced responsiveness to conventional IBD therapy, and a greater proportion of cases featuring an underlying monogenic disorder. Histological findings from gastro-intestinal (GI) biopsies are characterized by an IBD-like, apoptotic or enterocolitis-like pattern, complicating the differential diagnosis with other pediatric diseases involving GI tract. Moreover, individuals with monogenic disorders may develop significant comorbidities, such as primary immunodeficiency (PID), impacting treatment options. Without an appropriate diagnosis, the clinical course of VEO-IBD has greater potential for escalated treatment regimens involving extensive surgery, more intensive medical therapies and, even more important, inadequate recognition of underlying monogenic defect that may lead to inappropriate (sometimes fatal) therapy. For these reasons, an adequate context leading to an appropriate diagnosis is imperative, calling for a close collaboration between pediatricians, pathologists, geneticists, and immunologists

Giudizi di idoneità alla mansione specifica in operatori sanitari di un'azienda ospedaliero-universitaria del sud Italia

Le limitazioni alla mansione specifica degli operatori sanitari rappresentano un problema emergente in ambito di management e politica sanitaria, destinato ulteriormente ad aggravarsi in considerazione dell’invecchiamento della popolazione lavorativa e del ridotto turnover. Tale fenomeno è intimamente connesso agli obiettivi aziendali di tutela della salute dei lavoratori garantendo la qualità dell’assistenza, la sicurezza dei pazienti ed il contenimento della spesa pubblica. Scopo dello studio è stato quello di valutare la prevalenza di idoneità con limitazioni e non idoneità nel triennio 2013-2015 in operatori sanitari dell’Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, la più grande del Sud Italia

Uterine Preservation Treatments in Sarcomas: Oncological Problems and Reproductive Results: A Systematic Review

Uterine sarcomas are rare cancers, sometimes diagnosed in women of childbearing age. Hysterectomy is the standard treatment in early stages. The option of lesion removal to save fertility is described in the literature, but it is still considered experimental. The objective of this systematic review is to report on the available evidence on the reproductive and oncological outcomes of fertility-sparing treatment in women with uterine sarcomas. PubMed, Scopus and Cochrane Central Register of Controlled Trials were searched between 1 January 2011 and 21 June 2021 for publications in English about women with uterine sarcoma treated with a fertility-sparing intervention. Thirty-seven studies were included for a total of 210 patients: 63 low-grade endometrial stromal sarcomas, 35 embryonal rhabdomyosarcomas of the cervix, 19 adenosarcomas, 7 leiomyosarcomas and 2 uterine tumors resembling an ovarian sex cord. Conservative treatment ensured pregnancy in 32% of cases. In terms of oncological outcomes, relapse was related to histology and the worst prognosis was reported for leiomyosarcoma, followed by low-grade endometrial stromal sarcoma, which relapsed in 71% and 54% of cases, respectively. The highest death rate was associated with leiomyosarcoma (57.1%). This study demonstrated that fertility-sparing treatments may be employed in selected cases of early stage uterine sarcoma