Gender differences and occupational factors for the risk of obesity in the Italian working population

BACKGROUND

Obesity is a multifactorial condition and a major risk factor associated with several non-communicable diseases, such as cardiovascular disease, and with a higher risk of premature death and disability. Sex-specific factors have key roles and must be taken into consideration in studying occupational factors associated with the risk of obesity. The aim of this study was to investigate gender differences in body mass index (BMI) in a large cohort representative of Italian workers and, correlating this index with several demographic and occupational variables, to verify sex- and work-dependent differences in the risk of obesity.

METHODS

We utilized data from INSuLa, a cross-sectional, nationally representative survey of the Italian worker population conducted in 2013 by the Italian Workers' Compensation Authority to investigate health and safety at work. Analyses were run on a sample of 8000 Italian workers, aged from 16 to 64 years. Logistic regression models were employed to assess gender differences in the relation between occupational characteristics and BMI. We adjusted for age, education, variables related to health protection at work, and chronic conditions and diseases.

RESULTS

There were several significant differences in the BMI between males and females, linked to some occupational factors. For instance, female shift workers were 1.32 times (95% CI 1.11-1.57) more likely to be overweight or obese than normal-weight workers, and this association was maintained when controlling for confounders. The likelihood of overweight or obesity among women who worked 1-2 night shifts per week was significantly higher - 1.5-1.6 times - than those on day shifts.

CONCLUSIONS

Gender-specific differences in occupational factors associated with the risk of obesity are useful with a view to characterizing this risk and helping identify workplace-targeted intervention strategies.

Urinary biomarkers of exposure and of oxidative damage in children exposed to low airborne concentrations of benzene

The aim of this work was to evaluate the oxidative damage to nucleic acids in children (5-11 years) associated with exposure to environmental pollutants and tobacco smoke (ETS). For each subject, urinary sampling was done twice (evening and next morning) to measure by tandem LC-MS-MS such oxidated products of nucleic acids as 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodGuo), 8-oxo-7,8-dihydroguanosine (8-oxoGuo), and 8-oxo-7,8-dihydroguanine (8-oxoGua). Methyl tert-butyl ether (U-MTBE), benzene (U-Benz), and its metabolites (t,t-muconic and S-phenylmercapturic acids, t,t-MA and S-PMA, respectively) were determined as biomarkers of exposure to air pollution, and cotinine as a biomarker of exposure to ETS. Biomarkers of exposure (S-PMA and U-MTBE) and of DNA oxidation (8-oxodGuo) were dependent on the urbanization and industrialization levels and increased in the evening sample as compared to next morning (p<0.05). In both evening and next morning samples, 8-oxodGuo and 8-oxoGuo correlated with each other (r=0.596 and r=0.537, respectively, p<0.01) and with biomarkers of benzene exposure, particularly S-PMA (r=0.59 and r=0.45 for 8-oxodGuo and r=0.411 and r=0.383 for 8-oxoGuo, p<0.01). No such correlations were observed for U-MTBE and cotinine. Multiple linear regression analyses showed that 8-oxodGuo was positively associated with S-PMA at both sampling times (β=0.18 and β=0.14 for evening and next morning sampling, respectively; p<0.02) and weakly with U-MTBE (β=0.07, p=0.020) only in the evening urines. These results suggest that the selected biomarkers of exposure to benzene, particularly S-PMA, are good tracers of exposure to complex mixtures of oxidative pollutants and that the associated oxidative damage to nucleic acids is detectable even at very low levels of exposure.

[Development of an educational programme for schools to promote the awareness on child labour]

The main aim of the ISPESL project "Child Labour: to know in order to take action" is to introduce the subject of the problem of child labour in primary schools. This is done through pedagogical tools and communication methods, using the child's curiosity and point of view as a starting point and giving support to the child as he/she expresses his feelings, messages and emotions and at the same time, develops his own reaction to the problem. This project has been developed within the activities of ISPESL as WHO Collaborating Center and addressed to all the reference figures interacting with school such as teachers, educators and headmaster, but also families and local Institutions who promote understanding and awareness on child labour. The project aims at giving a general picture of the phenomenon, by focusing on the multiple and complex causes affecting the physical and psychosocial well-being of children and on fostering the increase of awareness among children on child labour issues. Observation and investigation tools will be developed and used in specific training modules suited to the cultural and geographic framework of each field of teaching, in order to allow the children to acknowledge and express their better awareness on child labour.

[Health risks associated with child labor: activities and proposals of WHO collaboration centers]

Child labour should be analyzed with regard to the main frameworks where it arises: particularly, the small family based enterprises in agricultural, hospitality and restaurateurs' sectors play a leading role. In these contexts the child can underestimate the risks related to the carried out work activity and assimilate the work background to the family background. In spite of the national thorough regulations on child labour, the network of WHO Collaborating Centres is working to develop a common awareness in order to evaluate, communicate and prevent the occupational health and safety risks for children, at national and international level.

[Training needs and role of general practitioners for preventing measures and medical surveillance of ex-exposed to occupational carcinogens]

The study was aimed at investigating in a sample of general medicine practitioners the level of epidemiologic and law knowledge as well as the degree of sensitivity to the topic of subjects formerly affected by occupational cancer. From the research, carried out on a sample of 745 practitioners from two northern Italy highly industrialized regions, come out the need for training and information on the problems associated with identification and management of subjects formerly exposed to professional cancer.

Cytogenetic biomonitoring of workers from laboratories of clinical analyses occupationally exposed to chemicals

A cytogenetic monitoring study was carried out on a group of workers in clinical analysis laboratories to investigate the risk of occupational exposure to chronic low levels of chemicals.Thirty-four clinical laboratories have been involved in the study. In these laboratories, toxicants and analytical procedures utilized have been characterized. The individual occupational exposure of workers was assessed by use of a questionnaire concerning the chemical substances utilized. About 300 different chemicals have been identified. Cytogenetic analyses (chromosomal aberration and micronucleus tests) were carried out on a strictly selected group of 50 workers enrolled from these laboratories and compared to 53 controls (healthy blood donors) matched for gender and age. The exposed group shows a significantly higher frequency of genetic damage than the control group. Both chromatid and chromosome aberration frequencies in workers appear significantly higher than in controls. Similarly, comparison between micronucleated cells rates of exposed and unexposed groups show significantly higher frequencies of binucleated cells with micronucleus (BNMN) and of total micronuclei (MN tot) in workers than in controls.

[Delphi study in the identification of research need in occupational medicine in Italy]

The aim of the study was to identify the research priorities and strategies in Occupational Safety and Health (OSH) in Italy with a high degree of consensus. Based on the Delphi technique, a two-phase questionnaire was sent to experts at Universities, Local Health Units (ASLs) and Trade Unions. In the first phase, experts were requested to indicate three research topics in the OSH sector. A total of 27 topics for both universities and ASLs and 18 topics for Trade Unions were identified. In the second phase, experts were requested to assign a score from one (low relevance) to five (high relevance) to each topic previously identified. On the basis of a mean score reported for each topic, two ranked lists of priorities, one referred to universities and ASLs the other referred to Trade Unions, were formulated. The highest priority identified by universities and ASLs was occupational carcinogenesis, followed by quality in occupational medicine. Workers' information, education and participation was also identified with a high degree of priority. For Trade Unions, occupational cancers as well as training, information, participation and prevention awareness had the highest priority. Trade Unions also identify small-industries and occupational accidents as topics with high priority for research development. This study allowed a high degree of consensus to be reached regarding the research priorities in the OSH sector in Italy. Differences in the topics identified, or regarding the mean score of topics commonly identified, were related to the origin of the expert recruited to this study (University, ASLs or Trade Unions) and, for universities and ASLs, to the geographical area. In the authors' opinion, the full transfer of existing scientific data to occupational health practice and the harmonization of the priorities identified by this investigation are crucial if the research needs in the OSH sector in Italy are to be met.

[Laboratory diagnosis: correlated health and environmental risks]

Method description and initial results of a study to assess risks to health sector workers and environment due to chemical agents used and waste products generated in diagnostic clinical chemical laboratories, and image diagnostic testing. A survey was conducted of the methods and agents used and their toxicological classification, the number of workers exposed and an analytical profile of the waste produced. The assessment of risk to workers was based on cytogenetic tests (chromosome aberrations and micronuclei); the assessment of environmental risk from waste disposal was based on tests on plant systems.

[Research and sanitary significance of the presence of heavy metals in cow's milk produced in the Province of Rome]

The presence of Lead, Mercury, Cadmium and Chromium has been estimated in the cow's milk produced in the Rome County. The results show the presence of the metals in cow's milk in different concentrations (5.6-102 micrograms/kg for Pb; 0.9-38 micrograms/kg for Hg: 2.3-53 micrograms/kg for Cr; only one sample positive at 0.77 microgram/kg for Cd). The sanitary evaluation of the data was based on the amounts of metals theorically assumed with milk, and compared with the "tolerable" values as suggested by International Organizations.