Staging models in eating disorders: A systematic scoping review of the literature

Eating Disorders (ED) are characterized by low remission rates, treatment drop-out, and residual symptoms. To improve assessment and treatment of ED, the staging approach has been proposed. This systematic scoping review is aimed at mapping the existing staging models that explicitly propose stages of the progression of ED. A systematic search of PubMed, PsycINFO, Scopus was conducted with the terms staging, anorexia nervosa, bulimia nervosa, binge-eating disorders, eating disorders. Eleven studies met inclusion criteria presenting nine ED staging models, mostly for anorexia nervosa. Three were empirically tested, one of which was through an objective measure specifically developed to differentiate between stages. Most staging models featured early stages in which the exacerbation of EDs unfolds and acute phases are followed by chronic stages. Intermediate stages were not limited to acute stages, but also residual phases, remission, relapse, and recovery. The criteria for stage differentiation encompassed behavioral, psychological, cognitive, and physical features including body mass index and illness duration. One study recommended stage-oriented interventions. The current review underscores the need to empirically test the available staging models and to develop and test new proposals of staging models for other ED populations. The inclusion of criteria based on medical features and biomarkers is recommended. Staging models can potentially guide assessment and interventions in daily clinical settings.

Assessment of Stress Salivary Markers, Perceived Stress, and Shift Work in a Cohort of Fishermen: A Preliminary Work

Due to work-related stress, today, work itself represents a daily challenge that must be faced in many occupations. While, in the past, the scientific community has focused on the helping professions, since, an increasing number of professions have since been investigated. Therefore, different approaches exist in order to assess this disorder, representing a scientific field wherein biological and psychological dimensions both need to be evaluated. In this paper, we consider three biological salivary markers: interleukin 1 beta (IL-1β), cortisol, and melatonin. The choice derives from recent contributions to the literature in which the interplay between these markers has been verified. Briefly, such interplay could explain how the central nervous, endocrine, and immune systems communicate with each other, supporting a holistic concept of person. In 30 marine fishermen from the Apulia region of Italy, perceived stress was measured using the Professional Stress Scale (PSS) and sleep disturbances were assessed through the Pittsburgh Sleep Quality Index (PSQI). Salivary markers were collected at 8:00 a.m. and 2:00 p.m. Those subjects reporting sleep disturbance and having altered scores in two PSS subclasses, home-work conflict and self-esteem, presented inverted salivary melatonin and cortisol nictemeral rhythms (with regard to melatonin levels at 8:00 a.m., those workers reporting values higher than the median showed 64.1% versus 48.6% home-work conflict with respect to cortisol levels, subjects having an inverted circadian rhythm showed 69.9% versus 52.5% home-work conflict, and these values resulted 47.7% versus 25.3% when the self-esteem was considered). As regards melatonin, PSQI score is statistically different in the two groups of subjects as identified by median melatonin at 8:00 a.m.; specifically, the subjects who had mean values higher than the median shared higher PSQI scores (10.8 versus 9.8). The same subjects reported more frequent home-work conflict and more sleep disorders. We found a negative correlation between IL-1β at 8:00 a.m. and Cortdiff (the difference between cortisol at 8:00 a.m.-cortisol at 2:00 p.m.), and that high IL-1β at 8:00 a.m. was associated with low Cortdiff. Based on our results we would like to propose this approach in health surveillance, in order to prevent mental and/or physical disorders, however our study is surely preliminary. The interesting perspectives and hypotheses cited in this paper, in which the roles of IL-1β and norepinephrine appear central and important, could remain hypothetical if not supported by more robust observation in order to produce, truly, new knowledge. In the future we will deepen this study with a larger sample, and if these results will be confirmed, this approach could allow preventing, not only mental and physical disorders, but also immuno-mediated diseases, and, perhaps, cancer.

Urinary Nickel and Progesterone in Workers Exposed to Urban Pollutants

OBJECTIVE

The aim of this study is to evaluate whether the exposure to a low dose of nickel could determinate a variation in levels of progesterone in outdoor workers.

MATERIALS AND METHODS

Two hundred sixty one subjects were divided by sex, task, age, seniority, and cigarette smoking habit. For each workers was evaluated the dose of blood progesterone and urinary nickel.The statistical analysis was performed.

RESULTS

The Pearson correlation showed a statistically significant correlation between urinary nickel levels and progesterone. The multiple linear regression showed a significant correlation between progesterone and urinary nickel in the total sample and in the subgroups of smokers and workers with tasks of traffic direction.

CONCLUSIONS

The results of our study suggest that occupational exposure to low doses of nickel present in urban pollution may influence to progesterone levels in outdoor workers.

Prevalence of chronic venous pathology in healthcare workers and the role of upright standing

BACKGROUND

Chronic venous disease (CVD) affects around 25% of adult population in developed countries and it often represent a health problem for different kind of workers, in particular for who spend much of the working time in upright standing.

METHODS

The study was carried out on a population of 173 nonmedical workers of a midsize hospital in Italy (91 nurse, 31 support staff workers and 51 employees). The study protocol was taken from a previous study of our group and included a clinical examination and a questionnaire.

RESULTS

From the analysis of data it emerged a particular importance of upright standing as major risk factor for CVD. The prevalence of venous pathology seems to be greater among nurses and auxiliaries than the administrative staff and, as expected, it was significantly higher among female workers than in males.

CONCLUSIONS

The results obtained show that the clinical-diagnostic protocol described can be used by doctors for screening venous pathology at workplaces.

No Correlation between Blood Benzene Levels and Luteinizing Hormone Plasma Values in Outdoor Workers

OBJECTIVE

The purpose of the study is to evaluate whether low-dose exposure to benzene, an environmental pollutant to which male and female traffic policemen are daily exposed to could cause alterations in plasma luteinizing hormone (LH) levels.

METHODS

From an initial sample of 1594 workers, we only selected 95 workers of whom study we knew the values of late-shift benzene and LH hormone. All subjects underwent biological monitoring (final blood benzene evaluation) and luteinizing hormone dosing. Excluding subjects with the main confounding factors, the final sample included 76 workers. The normal distribution of the variables was evaluated using the Kolmogorov - Smirnov test, followed by the logarithmic transformation of the LH and benzene values. The comparison among means was performed by using the t-test for the independent samples. The ANOVA test was performed for variables with more than 2 modes (ages and seniority) and Pearson correlation index between variables in the total sample and after subdivision as to sex, job, sports activity and smoking. The results were considered significant when p values were less than 0.05.

RESULTS/CONCLUSION

The study did not show a correlation between benzene levels and LH plasma levels in outdoor workers.

Distortion-product otoacoustic emissions in workers exposed to urban stressors

The study aimed to compare the distortion-product otoacoustic emissions (DPOAEs) with the pure-tone audiometry and to analyze the changes in participants exposed to noise. The results show a prevalence of participants with impaired DPOAEs higher than the prevalence of participants with impaired audiometries in the total sample, in men, and in outdoor workers and a prevalence of impaired DPOAEs and of impaired audiometries in men higher than in women and in outdoor workers higher than in indoor workers. The comparison of mean values between outdoor and indoor workers shows a significant difference only on some frequencies, in the DP-gram. The results suggest a higher effectiveness of DPOAEs compared with the pure-tone audiometry in identifying the presence of any damage in individuals exposed to noise at an early stage.

Effects on Plasmatic Androstenedione in Female Workers Exposed to Urban Stressors

The purpose of this study is to investigate whether occupational exposure to urban stressors can cause alterations on androstenedione plasma levels and related diseases in female traffic police compared to a control group. The research was carried out on an initial sample of 468 female workers (209 traffic police and 259 controls). After excluding the subjects with confounding factors, 192 female subjects: 96 traffic police and 96 controls were included in the study. Traffic police and controls were matched by age, length of service, body mass index, alcohol consumption and cigarette smoking habits, habitual consumption of Italian coffee, and habitual intake of soy and liquorice in diet. The results show that the percentage of subjects with fertility and mental health disorders were no different between traffic police and controls. Mean androstenedione values were significantly higher in female traffic police compared to controls. The distribution into classes of androstenedione values in traffic police was statistically significant. The percentage of traffic police with fertility and mental health disorders were not significant compared to controls. Our results suggest that the occupational exposure to urban stressors could alter plasma androstenedione levels in female traffic police. According to our previous research all the hormonal parameters studied, including androstenedione, could be used as early biological markers of chronic exposure to urban stressors, usable in occupational sets.

Work related stress and blood glucose levels

AIM

The aim of the study is to evaluate work-related subjective stress in a group of workers on a major Italian company in the field of healthcare through the administration of a valid "questionnaire-tool indicator" (HSE Indicator Tool), and to analyze any correlation between stress levels taken from questionnaire scores and blood glucose values.

MATERIAL AND METHODS

We studied a final sample consisting of 241 subjects with different tasks. The HSE questionnaire - made up of 35 items (divided into 7 organizational dimensions) with 5 possible answers - has been distributed to all the subjects in occasion of the health surveillance examinations provided by law. The questionnaire was then analyzed using its specific software to process the results related to the 7 dimensions. These results were compared using the Pearson correlation and multiple linear regression with the blood glucose values obtained from each subject.

RESULTS

From the analysis of the data the following areas resulted critical, in other words linked to an intermediate (yellow area) or high (red area) condition of stress: sustain from managers, sustain from colleagues, quality of relationships and professional changes. A significant positive correlation (p <0.05) between the mean values of all critical areas and the concentrations of glucose values have been highlighted with the correlation index of Pearson. Multiple linear regression confirmed these findings, showing that the critical dimensions resulting from the questionnaire were the significant variables that can increase the levels of blood glucose.

CONCLUSION

The preliminary results indicate that perceived work stress can be statistically associated with increased levels of blood glucose.

Correlation between benzene and testosterone in workers exposed to urban pollution

AIM

Many studies have examined the effects of benzene on testosterone. The purpose of this study was to evaluate the possible correlation between the blood levels of benzene and the levels of testosterone.

MATERIALS AND METHODS

The study involved a group of 148 subjects. For every worker have been made out a blood sample for the evaluation of benzene and testosterone levels and an urine analysis for the evaluation of the levels of trans, trans-muconic acid and S-phenylmercapturic acid. We estimated the Pearson correlation coefficient between the variables in the sample and the urinary metabolites, age, length of service, gender, BMI. For the analysis of the major confounding factors it was performed a multiple linear regression.

RESULTS

The Pearson correlation coefficiet showed: 1. a significant inverse correlation between the S-phenyl mercapturic acid and free testosterone; 2. a significant direct correlation between trans-trans muconic acid and BMI. After dividing the sample according to the median of blood benzene (161.0 ng / L), Pearson correlation coefficient showed a significant inverse correlation between the S-phenyl mercapturic acid and free testosterone in the group with values below this median.

CONCLUSIONS

Our results, to be considered preliminary, suggest that occupational exposure to low levels of benzene, present in urban pollution, affect the blood levels of testosterone. These results need to be confirmed in future studies, with the eventual possibility of including more specific fertility tests.

Blood pressure in indoor and outdoor workers

INTRODUCTION

The aim of our study is to evaluate the changes in systolic and diastolic blood pressure in two occupational categories: outdoor workers (traffic policemen and environment technicians) and indoor workers.

MATERIALS AND METHODS

The study was conducted comparing the results obtained from three samples of male workers: 175 outdoor traffic policemen, 175 outdoor environment technicians and 175 indoor workers. The outdoor and indoor groups were made comparable by age, length of service, body mass index, alcohol consumption, smoking status.

RESULTS

The mean values of systolic and diastolic blood pressure were found higher in traffic policemen and technicians than in indoor workers, as well as higher values of systolic blood pressure in traffic policemen than in technicians.

CONCLUSIONS

The results suggest that outdoor working affects the blood pressure, contributing to an increased cardiovascular risk.

Blood pressure changes and polycyclic aromatic hydrocarbons in outdoor workers

OBJECTIVES

Everyday outdoor workers are exposed to chemicals including the polycyclic aromatic hydrocarbons (PAHs). The aim of the study is to evaluate the relationship between hydroxypyrene and blood pressure in outdoor workers.

MATERIALS AND METHODS

374 subjects of both sexes entered the study. We evaluated the assay of urinary hydroxypyrene (1-HOP); their blood pressure (BP) was measured in upright position and in the supine position and the correlation between the levels of 1-HOP and BP was assessed using Pearson test and linear multiple regression.

RESULTS

The results obtained show that in the total sample the levels of urinary 1-OHP are negatively associated with systolic and diastolic BP in supine position and in upright position. The significance is maintained despite the stratification of the sample according to age; in non-smokers we found a negative relationship between 1-OHP and differential blood pressure, both systolic and diastolic.

CONCLUSIONS

The results of the study suggest that occupational exposure to PAHs may be able to significantly influence the blood pressure probably acting on the autonomic nervous system.

[Prolonged exposure to urban pollutants and arterial blood pressure: a whole evaluation of our researches]

AIM

A significant relationship between exposure to cadmium and PAHs from urban air pollution and blood pressure has already been found. The aim of the study is to evaluate if other urban pollutants maintain a similar relationship in outdoor workers.

MATERIALS AND METHODS

349 subjects of both sexes were enrolled in the study; we evaluated values of environmental and biological monitoring of respirable dust, arsenic, lead, benzene, toluene, xylene and we measured blood pressure (BP) in upright and in supine position; to analyze data we used multiple linear regression. Also we valued our results in the light of those we have obtained in previous research.

RESULTS

Multiple linear regression showed no significant results that demonstrate a relationship between BP and these pollutants.

CONCLUSIONS

The results of our study lead to assume that exposure to urban pollutants studied has not connection with blood pressure, and to retain valid the relationship previously observed for cadmium and PAHs, which seem to be the only pollutants that can affect blood pressure.

Risonanza magnetica funzionale: Localizzazione dell'area motoria primaria in pazienti portatori di lesioni espansive cerebrali Risultati preliminari

La Risonanza Magnetica Funzionale (RMF) ha dimostrato di poter localizzare la sede di aree corticali funzionali in numerosi protocolli su volontari sani. La identificazione prechirurgica di aree corticali eloquenti è molto importante al fine della realizzazione di un intervento il meno lesivo possibile per la funzione. Il sowertimento più o meno grossolano della regione anatomica da parte di un processo espansivo rende spesso difficile la identificazione di determinati reperi anatomici.

Ci siamo proposti di studiare con RMF, su tomografo convenzionale, pazienti affetti da neoplasie intra ed extrassiali che interessavano il lobo frontale posteriore o quello parietale. Sono stati studiati quindici pazienti, tutti destrimani, di età compresa tra i 15 ed i 64 anni. Sono state ottenute mappe di attivazione, che hanno evidenziato aree di significativo aumento del segnale in regione parieto-frontale posteriore.

La morfologia delle aree di significativo aumento di segnale era il più delle volte di tipo serpiginoso. Quando l'effetto massa era netto, l'area attivata nell'emisfero patologico appariva dislocata rispetto a quella nell'emisfero controlaterale. Sino ad ora sono stati ripetuti gli esami di RMF dopo l'intervento chirurgico in tre pazienti che non presentavano deficit motori significativi all'arto superiore.

Neoplasms compressing or infiltrating cerebral cortex often alter the normal anatomy in such a way that the neurosurgeon can not easily localize and spare functional areas. Moreover, the results of mass effect on brain functional anatomy have not been extensively investigated in vivo yet.

Urban stressors and plasmatic 17-β-estradiol (E2) in male exposed workers

The aim of the study is to evaluate if the occupational exposure to urban stressors could cause alterations in 17-β-estradiol (E2) plasma levels and related disorders in male traffic police compared with a control group. After excluding from the study, the subjects with the principal confounding factors, traffic police and controls were matched by age, working life, Body Mass Index (BMI), smoking and drinking habit. A total of 171 male traffic police and 171 controls were included in the study. In traffic police, mean E2 values were significantly lower versus controls ( P < 0.001). The distribution of E2 values in traffic police and controls was significant ( P < 0.001). No significant differences were found in percentage of traffic police versus controls concerning the following questionnaire items: fertility and mental health diseases. Our results suggest that the occupational exposure to chemical urban stressor, interacting with and adding to the psychosocial ones, could alter plasma E2 concentrations in male traffic police compared with a control group. According to our previous researches on other neuro-immune-endocrine parameters, E2 could be used as an early biological marker, valuable for the group, to be used in occupational set even before the onset of the pathologies.

Workers exposed to low levels of benzene present in urban air: Assessment of peripheral blood count variations

BACKGROUND

Few studies in the literature have examined the effects of benzene on blood cells.

AIM

The aim of this study was to evaluate the possible correlation between the blood benzene levels and the blood cell counts.

MATERIALS AND METHODS

From a population of 2658 workers, we studied a group of 215 subjects. Each worker underwent blood sampling for the assessment of the blood benzene levels and the blood cell counts. The Mann-Whitney U test for two-mode variables and the Kruskal-Wallis test for more-than-two-mode variables were performed on all subjects. We estimated the Pearson correlation index between the variables in the total sample and the subgroups divided according to sex, the smoking habit, and job. After the main confounding factors were evaluated, multiple linear regression was performed on both the total sample and the subgroups.

RESULTS

A significant inverse correlation was found among the blood benzene levels and the white blood cells, lymphocytes, and neutrophils in traffic policemen, motorcyclists, and other outdoor workers. We did not find any significant correlation with any other parameters of blood cell count.

DISCUSSION AND CONCLUSIONS

Our results, which must be considered preliminary, indicate that increased blood benzene levels in outdoor workers lead to decreased counts of white blood cells, neutrophils, and lymphocytes, because of possible immune effects. These are worth investigating in the future by specific immune tests.

[Evaluation of liver function between indoor and outdoor workers: preliminary results]

INTRODUCTION

The aim of our study is to compare liver damage in "outdoor" environment technicians, a category occupationally exposed, and in "indoor" workers.

MATERIALS AND METHODS

We studied 142 male technicians of the environment exposed to urban pollution and 142 male "indoor" workers not exposed. We compared mean and standard deviation of the following liver parameters: glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), gamma-glutamyl-traspeptidasi (γGT) and alkaline phosphatase (PHA), total bilirubin (TB) and direct (DB). We made the two groups comparable for age, length of service, BMI, alcohol consumption and smoking habits, and excluded the workers who presented confounding factors.

RESULTS

We found statistically significant differences about the levels of γGT, PHA, GPT and albumin between the "outdoor" workers exposed and the "indoor" control group. In the outdoor group we observed statistically significant values, GPT (51.8 ± 30.6 I.U./l vs. 30 ± 22.3 I.U./l; p = 0.000), γ-GT (42.2 ± 29.4 I.U./l vs. 22.4 ± 20.7 I.U./l; p = 0.000) and PHA (75.7 ± 20.6 I.U./l vs. 59.1 ± 19.6 I.U./l; p= 0.000) compared to the unexposed group. No statistically significant difference emerged between the averages for the values of GOT (25.3 ± 20.7 I.U./l vs. 26 ± 17.7 I.U./l; p = 0.736) in two groups.

CONCLUSIONS

It clearly emerges that the contaminants may alter the values of liver tests after prolonged exposure.

Work-related stress in healthcare workers

BACKGROUND

In the assessment of work-related stress it is crucial to find the factors that generate and increase it in order to identify categories of individuals at risk, to plan interventions for prevention, elimination or reduction of risk. The aim of the study is to assess the subjective stress in 68 workers of a large Italian company dealing with human health, through the use of a questionnaire-indicating tool, elaborated by the Italian National Institute for insurance against accidents at work (INAIL) and developed by the Health and Safety Executive (HSE).

METHODS

We studied a final sample of 68 individuals (34 drivers/rescuers and 34 video display unit (VDU) operators). The questionnaire consists of 35 items (divided into six areas) with five possible answers each, that cover working conditions considered potential causes of stress.

RESULTS

The drivers/rescuers had a better performance than the VDU operators, especially in the areas "demand", "relationships" and "role". We compared men and women in the two groups, finding that, in VDU operators, women had a better performance than men in all areas, except "role" and "changes", in which the overall scores were the same in men and women. In the drivers/rescuers women showed more critical scores in the items "relationships" and "change".

CONCLUSION

The results show that: the questionnaire-indicating tool is useful, with a demonstrated effectiveness for the occupational physician during the visits and proven validity; additional future efforts should focus on understanding the psycho-social, organizational and individual problems related to stress and the consequent implementation of preventive measures.

Correlation between urinary cadmium and thyroid hormones in outdoor workers exposed to urban stressors

OBJECTIVES

The aim of this study is to evaluate whether exposure to low concentrations of cadmium (Cd) can have effects on the thyroid hormone level of outdoor workers exposed to urban pollutants.

METHODS

The study was conducted on a final sample of 277 individuals (184 males and 93 females). The environmental monitoring of Cd was evaluated through the use of portable dosimeters, while the biological monitoring was achieved through the assessment of urinary Cd and thyroid hormones. The total sample was divided according to sex and task. The Pearson's correlation coefficient among the variables was calculated after subdivision on the basis of sex and task. The multiple linear regression was performed to take into account the major confounding factors.

RESULTS

Statistical tests showed a negative correlation between urinary Cd levels and free triiodothyronine and free thyroxine and a positive correlation between urinary Cd and thyroid-stimulating hormone levels.

CONCLUSIONS

Our early results seem to point out that occupational exposure to low concentrations of Cd present in urban air affects the thyroid hormone levels in exposed workers.

Overweight and urban pollution: preliminary results

The aim of this study is to determine whether in workers exposed to urban pollution the risk of developing overweight and obesity is higher in workers exposed to urban pollution compared to a control group. The study was conducted on 150 volunteers, 75 workers exposed to urban pollution (50 women and 25 men) and 75 indoor workers (50 women and 25 men). Once measured the weight and height and calculated body mass index (BMI) for each worker, the research was based on the comparison, between the two groups, of the mean values of the measurements and of the frequency of workers with BMI index higher than the cut-off of normality. The only statistically significant difference found was for the mean value of weight in women, which was higher among outdoor workers compared to indoor workers. The mean values of BMI and the frequency of workers with BMI higher than normal was higher among outdoor workers compared to indoor workers in both sexes, but not statistically significant. The data suggest that outdoor workers may be subject to an additional risk of developing obesity as a result of exposure to urban air pollution (which, like obesity, is a source of oxidative stress). So, our preliminary study encourages to continue this line of research by implementing the sample and considering all the confounding factors. Furthermore, the results highlight the necessity to take account of gender differences in the context of health surveillance of workers.

[Stress and work-related injuries]

OBJECTIVE

The aim of this study was to evaluate in scientific literature the more frequent work injuries among the occupational categories examined (construction workers, healthcare workers, night workers and shift work, drivers) and to identify occupational stressors that increase the risk of injury.

MATERIALS AND METHODS

The research was conducted through review of the scientific literature between 1990 and 2014. Two hundred articles were found of which 42 selected in the following categories: construction workers, healthcare workers, shift workers, lorry drivers.

RESULTS

The movement of machinery and working at height are due to injury for building sector and they were positively correlated with physical (r = 0,206) and mental (r = 0,254) stress. In health workers the injuries are more frequently bruises and sprains (50%). Studies showed a higher rate of injury in a group of shift workers compared to a control group on a rota basis (p <0.0001). Road accidents for drivers represent the most frequent cause of injury of which 13% comes from falling asleep, while 31% from distractions (OR = 3.16; CI = 1:22 to 8:24).

CONCLUSIONS

Nurses have frequent injuries due to bruises, lumbago, punctures with needles and surgical wounds. Construction workers often suffer serious injury derived from falls at height, handling machinery. For workers on a rota basis, injuries are often related to lack of sleep. Road accidents in drivers are the most common injuries. A synergistic action finalized to promote health and safety organization, to ensure a work environment more secure, is advisable.

Work related etiology of amyotrophic lateral sclerosis (ALS): a meta-analysis

BACKGROUND

The aim of this meta-analysis was to evaluate the association between ALS and occupational exposure to physical (ELF-EMF) and chemicals (solvents, heavy metals and pesticides) agents.

METHODS

We considered articles published from 1980 up to April 2013; in total, 750 publications were evaluated. The studies had to satisfy the following criteria: 1) cohort or case-control studies; 2) the presence of individual exposures; 3) clinical diagnosis of sporadic ALS or sporadic ALS on the death certificate. We followed the evaluation of quality in two steps. The first step classified studies according to a rating system based on a mix of criteria developed by scientific organizations, especially developed for studies of risk factors for ALS. The ratings obtained range from I (highest) to V (lowest). The data on risk factors derived from studies with Armon ratings of I, II, and III can reach levels of evidence A (established risk factor), B (likely risk factor), or C (possible risk factor). The second step evaluated the exposure and a score from 1 to 4 was assigned to each item; an exposure with a score of 3 or 4 was considered sufficient. Different analyses were performed on ALS and exposure to metals, solvents, pesticides and electromagnetic fields. In our study the heterogeneity was assessed both by χ2-based Q-tests and through the index of inconsistency I² while the measure RR/OR and CI of 95% to estimate the relationship between ALS and the various considered risk factors was employed.

RESULTS

The association between exposure to pesticides and ALS as a whole is weak and not significant. With regard to the results of individual studies the following critical synthesis can be reported: 1) the selected studies showed a low level of association between ALS and electromagnetic fields; 2) as regards the solvents, the association with ALS in some studies is combined with a slightly increased risk, particularly in women, and in others a slight but significant linear association is observed; 3) for the metals, in some cases there was a stronger association in women than in men; for individual metals, there was an association especially with chromium and lead; 4) lastly, with regard to the products of agricultural pesticides in general, there was an association with ALS in men but not in women, with a dose-response relationship.

CONCLUSIONS

The lack of statistically significant association between occupational exposure and ALS is mainly due to the methodological diversity of the studies and the lack of prospective studies at the workplace.

[Arterial pressure in workers exposed to urban stressors]

The aim of this study is to evaluate whether occupational exposure to urban stressors could cause alterations of systolic and diastolic blood pressure in "outdoor" workers. The research was conducted on a sample of 101 municipal policemen. The sample was divided in 2 groups according to length of service: group A (length of service between 1 and 15 years) and group B (length of service > 15 years). Group A and Group B were matched for age, overall length of service, cigarette smoking habit and consumption of alcohol and spirits. Group A was then divided into: Al (length of service between 1 and 7 years) and A2 (length of service between 7 and 15 years). The mean values of systolic and diastolic blood pressure at rest showed statistically significant differences with increased values in group B compared to both groups Al (p<0.05) and A2 (p<0.05). The study suggests that occupational exposure to urban stressors affects the blood pressure regulating system enhancing the risk of blood hypertension.

Work-related stress assessment in a population of Italian workers. The Stress Questionnaire

The present study shows detailed information about the reliability and validity of the psychosocial risk scale included in the Stress Questionnaire (SQ) developed by our research group. The primary purpose of this work is to test the factor structure of the psychosocial risk scale through a first-order confirmatory factor analysis (CFA) using a large pooled dataset obtained from a population of 2026 employees of 15 Italian medium-large companies. Data were collected by a team of researchers who examined demographic variables, work-related stress, workplace bullying, mental health and other constructs. In addition to these substantive issues, the survey was designed to better understand response bias. After the evaluation of the results we conclude that the psychosocial risk scale reported a satisfactory reliability and validity. In addition, it allowed a careful measurement of work related stress, considering both leader's and follower's perspectives.

Ballet and stress. A pilot study

BACKGROUND

Work-related stress is a complex problem requiring a work environment-based assessment. Artists like dancers represent a category of atypical workers potentially at high risk for work-related stress. Aim of our pilot study is to evaluate organizational stress in a population of professional dancers, using the HSE Indicator Tool for Work Related Stress.

METHODS

We administered the Italian version of the HSE Indicator Tool to 38 ballet dancers, males and females. The questionnaire evaluates 7 key organizational dimensions: demand, control, managers' support, peer support, relationships, role and change.

RESULTS

The standards required-ideal conditions are achieved in none of the above-mentioned dimensions. Change is the only dimension for which results fall between the 20th and the 50th percentile, while for other dimensions results fall below the 20th percentile suggesting the need for immediate corrective action. In male dancers an acceptable situation is highlighted for the dimension "change" compared to female dancers. In both sexes there is a high frequency of subjects complaining of verbal abuse, bullying and harassment.

CONCLUSIONS

Despite the small sample size, our pilot study highlights the presence of heightened levels of organizational stress. Preventive measures targeted towards improving communication between managers and dancers and aimed at team building should be implemented.

Correlation between cadmium and blood counts in workers exposed to urban stressor

The objective of this study was to assess the exposures to cadmium (Cd) in urban workers and the association between Cd exposure and values of blood counts. Urinary Cd, blood Cd, and blood counts were obtained from 355 outdoor workers; a subgroup of 99 subjects were monitored to evaluate personal exposure to airborne Cd. The mean value of personal exposure to Cd was 1.5 ng/m3 for traffic assistants and 1.2 ng/m3 for drivers. Urinary and blood Cd were correlated to the airborne Cd (respectively r=3 and r=4). The multiple linear regression models showed the associations among white blood cell, the percentage of neutrophils (NEU%), the percentage of lymphocytes (LYM%), and the concentrations of blood Cd (respectively R2=27, R2=37, R2=581). The subjects with blood Cd values higher than 1.2 μg/L showed an increase of LYM% mean values and a decrease of NEU% mean values with respect to the group with blood Cd values lower than 1.1 μg/L.

Professional exposure to anaesthetic gases in health workers: estimate of some hepatic and renal tests

OBJECTIVES

The aim of this study is to estimate whether the occupational exposure to low dose of anaesthetic gases could cause alterations of haematochemical hepatic and renal parameters in the health workers of a city hospital.

MATERIALS AND METHODS

After excluding the main confounding factors, 154 exposed subjects and 98 not exposed controls were included in the study. The exposed subjects were divided in more exposed (group 1: n.54) and less exposed (group 2: n.100). Each worker included in this study underwent the CBC test (Complete Blood Count test). The differences between means were compared using the Student T test for unpaired data and considered significant when the p value was < 0.05.

RESULTS

The mean values of serum albumin, alpha 1, alpha 2, beta and gamma globulins were significantly decreased in health workers of both groups compared to controls. The mean values of serum creatinine and gamma-GT were significantly higher in health workers of group 2 compared to controls.

CONCLUSIONS

The obtained results suggest that occupational exposure to low dose of anaesthetic gases could influence haematochemical hepatic and renal parameters in exposed health workers.

Urinary hydroxypyrene and estradiol in an occupationally exposed "outdoor" population

BACKGROUND

Polycyclic aromatic hydrocarbons (PAHs) are widely present in the air pollution. The urinary hydroxypyrene (1-HOPu) is considered the main biological biomarker currently available to measure the exposure to PAH. It is supposed responsible of an increase of estradiol levels in males. Aim of this study is to verify whether there is a relation between 1-HOPu and plasmatic estradiol in non-smoker male workers.

METHODS

The study was conducted on a sample of 122 non-smoker policemen in a large Italian city; we monitored their levels of 1-HOPu and the values of estradiol. The sample was divided into three groups according to the levels of urinary hydroxypyrene. The indices of correlation (r) and multiple linear regression (β), between levels of 1-HOPu and estradiol were calculated. It was also calculated the student's t-test among the groups to check the differences.

RESULTS

We found statistically significant correlations and multivariate linear regressions between 1-HOPu and estradiol in the total sample and in group III (levels of 1-HOPu above the 75th percentile). The average levels of estradiol in group III was statistically and significantly higher than in the group I (levels of 1-HOPu below the 25th percentile) and group II (levels 1-HOPu between 25th and the 75th percentile).

CONCLUSIONS

1-HOPu in non-smoker male workers is related with an increase of plasmatic estradiol. We believe that PAHs, of which 1-HOPu is the main biomarker, can interact with the hypothalamic-pituitary axis. The preliminary results suggest that the topic needs further research on male and female as well.

Nickel and blood counts in workers exposed to urban stressors

Nickel (Ni) and Ni compounds are widely present in the urban air. The purpose of this study is to estimate exposure of individuals to Ni and the correlation between this exposure and the values of blood counts in outdoor workers. This study focused on a sample of 101 outdoor workers (55 male and 46 female; 65 nonsmokers and 36 smokers), all employed in the municipal police in a large Italian city. The personal levels of exposure to Ni were assessed through (a) environmental monitoring of Ni present in the urban air obtained from individual samples and (b) biological monitoring of urinary and blood Ni. The blood count parameters were obtained from the hemochromocytometric tests. Pearson correlation coefficients ( r) were calculated to assess the association between the blood and urinary Ni and the complete blood count. Multiple linear regression models were used to examine the associations between the complete blood count and the independent variables (age, gender, years of work for current tasks, cigarette smoking habit (current and never smoker), values of airborne Ni, and blood and urinary Ni). Multiple linear regression analysis performed on the total group of 101 subjects confirms the association among the red blood cells count, the hematocrit, and the urinary Ni ( R2 = 0.520, p = 0.025 and R2 = 0.530, p = 0.030). These results should lead to further studies on the effects of Ni in working populations exposed to urban pollutants. The possibility that the associations found in our study may be partially explained by other urban pollutants (such as benzene, toluene, and other heavy metals) not taken into consideration in this study cannot be ruled out.

Workers of the printing industry and hepatic damage

BACKGROUND

Typesetting industry is still the primary instrument of communication, despite the development of new technological systems. This study focuses on the analysis of the hepatic effects induced by the use of some organic solvents employed in the printing industry.

METHODS

We studied a group of 194 workers: 93 exposed and 101 not exposed. The level of the exposure to chemical pollutants were assessed through the environmental monitoring of blood concentrations and the analysis of airborne substances. The health survey was performed through the collection of the medical history and the use of hepatic tests, which were evaluated by calculating Mean, Standard Deviation, Student's t-test and X² test with Yates Correction, to investigate statistically significant differences in some hepatic parameters: AST, ALT, ALP, GGT, fractional and total bilirubin. The environmental data sometimes exceeded the TLV-TWA.

RESULTS

The clinical evaluation of the hepatic parameters showed statistically significant differences as to the hematic concentrations of AST, ALT, GGT.

CONCLUSIONS

The results we obtained support the hypothesis of a risk among the printing industrial workers attributable to the hepatotoxic solvents. This risk seems to be related to the use of a mixture of solvents, although at low doses, and the analysis of the results obtained confirms the validity of the investigation for the health screening protocol adopted in order to identify subjects and/or population at risk of hepatotoxicity.

Exposure to formaldehyde in health care: an evaluation of the white blood count differential

The aim of our study is to estimate if the occupational exposure to formaldehyde can cause alterations of leukocytes plasma values in health care workers employed in a big hospital compared to a control group. We studied employees in operating rooms and laboratories of Pathological Anatomy, Molecular Biology, Molecular Neurobiology, Parasitology and Experimental Oncology (exposed to formaldehyde) and employees of the Department of Internal Medicine (not exposed). The sample studied was composed of 86 workers exposed to formaldehyde and 86 workers not exposed. All subjects underwent a clinical-anamnaestic examination and for all subjects were measured the following values: total white blood cells, lymphocytes, monocytes and granulocytes (eosinophils, basophils, neutrophils). Statistical analysis of data was based on calculation of the mean, standard deviation and the distribution into classes according to the nature of each variable. Differences were considered significant when p was < 0.05. The mean and the distribution of values of the white blood cells, lymphocytes, monocytes and eosinophils were significantly higher in male subjects exposed to formaldehyde compared to not-exposed. Not significant differences were found in female subjects exposed compared to not exposed. The results underline the importance of a careful risk assessment of workers exposed to formaldehyde and the use of appropriate preventive measures. The health care trained and informed about the risks he is exposed to should observe good standards of behavior and, where it is not possible to use alternative materials, the indoor concentrations of formaldehyde should never exceed occupational limit values.

Correlation between urinary nickel and testosterone plasma values in workers occupationally exposed to urban stressors

BACKGROUND

The purpose of this study is to assess whether occupational exposure to low doses of nickel (Ni) present in urban air can cause alterations in the concentration of plasma testosterone in workers of the Municipal Police of a large Italian city assigned to different types of outdoor tasks.

METHODS

359 male subjects were included in the study and divided on the basis of job, age, length of service and smoking habits. The dosage of the atmospheric Ni was performed by personal dosimetries on a sample of the workers included in the study. For each worker included in the study the dosage of whole blood Ni and of the plasma testosterone was carried out. The total sample was subjected to the independent-samples T-test and the Mann-Whitney U test for variables with 2 modes (smoking cigarette) and the ANOVA test and the Kruskal Wallis test for variables with more than 2 modes (age, length of service and job function). The correlation of Pearson with p at 2 wings between the variables was evaluated in the total sample and after subdivision on the basis of smoking and on the basis of the job. After taking into account the major confounding factors the multiple linear regression was performed on the total sample and after breakdown by tasks.

RESULTS

The correlation between the values of urinary Ni and the values of plasma testosterone on the total sample and for all classes of subdivision was found constantly negative. These results were confirmed by multiple linear regression, which indicated the Ni as the only significant variable that can contribute to the alterations of the testosterone.

CONCLUSIONS

Based on the results, the Authors suggest that occupational exposure to low doses of Ni present in the urban environment is able to influence some lines of the hypothalamic-pituitary-gonadal axis in exposed workers.

Thyroid hormones in male workers exposed to urban stressors

BACKGROUND

The occupational exposure to urban pollution may induce adverse effects on the human health.

METHODS

Plasma levels of thyrotropin stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) of 50 outdoor workers and 50 indoor workers were compared.

RESULTS

In the outdoor workers the TSH levels were significantly higher than in the control subjects (p =0.02) while the average of FT3 and FT4 values, was not significantly different compared to the controls (p > 0.05).

CONCLUSIONS

The differences found for TSH levels between outdoor and indoor workers, though not high, suggest that, due to greater exposure to environmental pollutants, the outdoor workers are more susceptible to the development of function abnormalities of the thyroid gland compared to indoor workers.

Liver damage in automotive and industrial workers of the glass

OBJECTIVE

High doses of organic solvents can cause hepatic disease. We investigated whether exposure to low doses of solvents in automotive and industrial workers may lead to changes in liver tests.

METHODS

We studied the liver parameters (glutamic oxaloacetic transaminase (GOT), glutamic-pyruvic transaminase (GPT), gamma-glutamyl-traspeptidasi (γ-GT), alkaline phosphatase (PHA), total (TB) and direct bilirubin (DB) of 24 workers exposed to organic solvents and of 30 unexposed controls.

RESULTS

A significant increase of GOT, GPT and γ-GT was found in exposed workers compared to unexposed controls workers. The ratio GPT/GOT was significantly higher among the exposed compared to controls.

CONCLUSIONS

The results confirmed the hypothesis that exposure to low doses of solvents may determine a liver damage.

Can noise cause high blood pressure? Occupational risk in paper industry

OBJECTIVES

The authors hypothesize cardiovascular effects in paper industry workers exposed to noise.

MATERIALS AND METHODS

The study included 72 paper industry workers exposed to noise and two control groups not exposed to noise. The workers completed a questionnaire and underwent a medical examination, measurement of blood pressure, electrocardiogram, blood tests, audiometry and measurement of noise exposure.

RESULTS

The workers exposed to noise, all hearing impaired, were compared with not exposed and showed: significant increase of mean systolic and diastolic blood pressure values (p<0.001), higher frequency of hypertension, systolic and diastolic blood pressure (p<0.01 and p<0.001) and electrocardiografic abnormalities (p<0.05), significant reduction of blood pressure response in orthostatism (p<0.005).

CONCLUSIONS

Our results suggest that for the workers of the paper industry the noise is an occupational risk factor for cardiovascular effects.

Peripheral blood counts in workers exposed to synthetic fibres

Acrylonitrile is an intermediary with possible adverse health effects in the synthesis of organic products, such as acrylic fibres. This investigation was undertaken to determine the possible changes in the peripheral blood counts in workers of a polyacrylic fibres plant. The study involved 218 workers exposed to acrylonitrile at low doses and a control group of 200 unexposed workers. The chosen subjects underwent blood tests in order to check their haematological parameters. There were no statistically significant differences between the two groups in terms of the red blood cells, haemoglobin and total number of leukocytes. An increase in the neutrophils associated with a reduction of lymphocytes, both statistically significant, was observed. The authors hypothesized that the neutrophils are influenced by the exposure to acrylonitrile at low doses.

Workers exposed to urban stressors and the effects on antidiuretic hormone secretion

BACKGROUND

The aim of this study was to evaluate whether urban pollutants can affect plasma levels of antidiuretic hormone (ADH) in outdoor workers.

MATERIALS AND METHODS

We selected 208 subjects, 104 exposed to urban stressors and 104 non exposed to urban stressors. We divided these workers in 3 groups: Group 1 (non-smokers and non-drinkers), Group 2 (smokers and not drinkers) and Group 3 (drinkers and not smokers). The means and standard deviations of ADH were calculated, and a Student's t-test was used to compare means. The data were considered significant at p ≤ 0.05.

RESULTS

The outdoor workers in Group 1 had significantly reduced plasma levels of ADH. In contrast, the outdoor workers in Groups 2 and 3 had increased plasma levels of ADH. These results were consistent in both men and women.

CONCLUSIONS

The results suggest that urban pollutants may influence the secretion of ADH.

Is urinary 1-hydroxypyrene a valid biomarker for exposure to air pollution in outdoor workers? A meta-analysis

The aim of this study was to evaluate the usefulness and specificity of urinary 1-hydroxypyrene (1-OHPu) as a biomarker of the exposure from urban pollution to polycyclic aromatic hydrocarbons (PAHs) among outdoor workers in a meta-analysis. Our meta-analysis was performed according to standard methods, and the results show that the concentrations of 1-OHPu tend to be higher in exposed workers than in unexposed workers (if we exclude two highly heterogeneous articles), in exposed non-smokers than in unexposed non-smokers and in exposed than in unexposed workers who were carriers of the CYP1A1 genotype and in those with the glutathione-S-transferase M1 (-)genotype. These genotypes enhance the effect of exposure, particularly in non-smokers. Smoking reduces the differences between exposed and unexposed subjects. In conclusion, our results suggest that the use of the 1-OHPu biomarker appears to be reliable for studying occupational exposure to PAHs from urban pollution, as long as environmental and behavioural factors are considered.

Anesthetic gases and occupationally exposed workers

The aim of this study is to estimate whether the occupational exposure to low dose anesthetic gases could cause alterations of blood parameters in health care workers. 119 exposed subjects and 184 not exposed controls were included in the study. Each worker underwent the complete blood count test (CBC), proteinaemia, leukocyte count, serum lipids, liver and kidney blood markers. The liver blood markers show statistically significant differences in health care workers compared with controls (p<0.05), a statistically significant decrease in neutrophils and an increase of lymphocytes in health care workers compared with controls (p<0.05). The prevalence of values outside the range for GPT, GGT, total bilirubin, lymphocytes and neutrophils was statistically significant in health care workers compared with controls (p<0.05). The results suggest that occupational exposure to low dose anesthetic gases could influence some haematochemical hepatic and hematopoietic parameters in exposed health care workers.

Liver function in workers exposed of the cosmetics industry

BACKGROUND

The purpose of this study is to assess whether occupational exposure to substances used in the cosmetic factories may cause effects on the liver and blood counts in exposed workers.

METHODS

The study included 48 exposed workers and 86 unexposed controls. All workers included in the study underwent blood count, white blood count, total, direct and indirect bilirubin, transaminases, alkaline phosphatase and cholinesterase. The differences between the means and frequencies were compared using the Student's t-test and chi-square test with Yates correction and were considered significant when the p value was <0.05.

RESULTS

The analysis of the results shows that 35.4% of workers in the cosmetics industry had liver test values above the range. We noted a statistically significant higher prevalence of GPT (p <0.05) and total bilirubin (p <0.05) in the workers of the cosmetics industry compared with the control group.

CONCLUSIONS

The results obtained suggest that occupational exposure to low doses of substances used in the cosmetic industry is able to influence some liver parameters in occupationally exposed workers.

Dynamic blood pressure in workers exposed to urban stressors

BACKGROUND

The occupational exposure to urban pollution may induce adverse effects on the cardiovascular system.

METHODS

Basal blood pressure, electrocardiogram (ECG) and the dynamic blood pressure monitoring during the work shift of 16 policemen (outdoors workers) and 16 administrative employees (indoor workers) were compared.

RESULTS

The mean value of all the diastolic blood pressure surveys in policemen (84,53 ± 10,78) is significantly higher (p = 0,014) than the mean value of all the diastolic blood pressure surveys in indoor workers (82,74 ± 11.52).

CONCLUSIONS

The results of our study suggest that the occupational exposure to urban stressors may induce an increase of the diastolic blood pressure in workers during the working hours.

Urinary nickel and prolactin in workers exposed to urban stressors

The aim of our study is to verify whether the exposure to low Ni doses in urban air may have some effects on the prolactin values of outdoor workers exposed to urban pollutants. 334 workers have been included in the study and divided on the basis of gender, job, age, length of service and smoking habits. Each worker underwent urinary Ni and prolactin sampling. The t-test for independent samples, the Mann-Whitney U test for two mode variables (gender, smoking habit), the univariate ANOVA test and the Kruskal Wallis test for the variables in more than two modes (age, length of service and job duties) were performed on the total sample. Pearson's correlation coefficient (p two-tailed) among the parameters was evaluated both in the total sample and after the stratification by gender, smoking habit and job. Multiple linear regression was performed after taking account of the major confounding factors on the total sample and on the subcategories. The statistical tests showed a significant correlation between urinary Ni and prolactin both in the total sample and in the subcategories. We believe that the occupational exposure to low doses of Ni present in urban pollution may influence the prolactin values in exposed workers.

Noise-induced hearing loss in workers exposed to urban stressors

The technological and industrial progress together with the intensification of vehicular traffic and the adoption of new social habits are the cause of an increasing noise pollution with possible negative effects on the auditory system. This study aims to assess the noise exposure levels and the effects on the hearing threshold in outdoor and indoor male workers of a big Italian city. The study was carried out on 357 outdoor male workers, exposed to urban noise and on a control group of 357 unexposed indoor workers. Noise levels were measured in 30 outdoor and indoor areas. The subjects underwent tonal liminal audiometry in order to determine the value of their hearing threshold. During their working activity, outdoor and indoor workers are exposed to different noise levels LEX<80 dB(A). At mid-low frequencies (250-2000 Hz), the results show significant differences in the average values of hearing threshold between the two groups in both ears and for all age classes; there are no significant differences between the two groups at higher frequencies. The outdoor noise levels measured are not usually ototoxic and the hearing loss at mid-low frequencies is not characteristic of the exposure to industrial noise. For these reasons the Authors hypothesize that the results may be due to the combined effect of the exposure to noise and to ototoxic air pollutants. The impairment of speech frequencies is disabling and involves the risk of missed forensic recognition.

[Carpal tunnel syndrome and steel industry]

OBJECTIVES

The carpal tunnel syndrome (CTS) is a common working pathology. The CTS diagnosis is not so easy because neurophysiological investigations are necessary. The purpose of this study is to evaluate the working risks and the presence of CTS signs using a focused anamnestic and clinical procedure.

MATERIALS AND METHODS

We evaluated the working risks of CTS in a population of 65 male workers of a steel industry (average age 25.1 and seniority 2.82), performing 5 different tasks. The Borg Scale was used to evaluate the subjective muscle effort. Diurnal paresthesia (V1FG), nocturnal paresthesia (V1FN), hypersensitivity (V1IS), hypostenia (V1IT) were considered.

RESULTS

We identified three main working risks repetitiveness of single actions, static and prolonged posture of the truck, muscle effort. 21.5% of the workers showed at least one of the three symptoms;13.8% showed one or more symptoms; the clinical objectivity was observed in 18.5%. A relation between V1FG, V1FN, clinical objective linked to the workers age of the task 1 (p =0.035) is showed.

CONCLUSIONS

To prevent CTS, the use of the Borg Scale associated with identification of the risks and with the anamenstic-clinical investigation is useful to discriminate people at risk of CTS.

Relationship between occupational exposure to cadmium, transaminases and γ-GT in workers exposed to urban stressors

BACKGROUND

The exposure to Cd has been linked to many disease and liver is the major target organ of Cd toxicity following acute or chronic exposure.No study has ever evaluated the association between liver function tests and exposure to Cd present in urban air in outdoor workers.

MATERIALS AND METHODS

In order to assess the relationship between the exposure to urban Cd and the associated changes in liver functionality markers, we conducted a study on 110 municipal policemen divided into 2 groups according to their tasks: 60 traffic policemen and 50 drivers, underwent tests for the determination of the urinary values of Cd correlated with the blood levels of transaminases and ?-GT. Moreover we investigated the exposure to Cd in the air through a personal dosimetry on a subgroup of 40 subjects (20 traffic policemen 20 police drivers).

RESULTS

The results showed that the average personal exposure to air Cd was significantly higher in traffic policemen than drivers. Furthermore, in the subset of 40 subjects and in the total sample of 110 subjects, the mean values of urinary Cd were significantly higher in traffic policemen rather than in the police drivers. No significant difference was observed in the mean values of liver functionality in both groups.

CONCLUSIONS

Due to the few studies on the effects of the exposure to Cd in big cities, the results of the present study offers useful information about occupational exposure to Cd on the road and in the car and the lack of effects on liver function.

[Biological risk among health workers]

INTRODUCTION

In health care the contact with body fluids, such as saliva or blood is frequent. The aim of our study was to analyze whether the exposure to biological risks in health care, in particular exposure to HBV and HCV, could cause alterations of some liver parameters.

MATERIALS AND METHODS

Our study analyzes of 254 health care workers of a big hospital in Rome. The subjects exposed to biological risks were divided into two groups, one exposed to a high biological risk and the other one exposed to a low biological risk, according to individual duties and/or the departments where they carry out their work. We checked the markers for hepatitis B and C in order to highlight a possible infection, the possible vaccine coverage and the control of the antibody titer by previous infection. We measured the values of transaminases, GGT, alkaline phosphatase, total bilirubin and fractional proteinaemia total and electrophoresis.

RESULTS

In health care workers exposed to high risk the average values of transaminases, total protein, alkaline phosphatase, gamma GT, total bilirubin were not significant compared to the some values formed in workers exposed to low risk (p > 0.05). Subjects positive for hepatitis B and C were 4% in the group of workers exposed to high risk (class 1) while in the group of workers exposed to low risk (class 2) the percentage of exposed individuals was 0.01% for the hepatitis B and 2.6% for hepatitis C.

DISCUSSION AND CONCLUSIONS

We found a small numbers of positive cases of hepatitis B and C in people exposed to biological agents. We did not find alterations of the average values of transaminases, total protein, alkaline phosphatase, gamma GT, total bilirubin and albumin in positive cases, so that we can say that the proper use of personal protective equipment, training and information of workers and the observance of universal precautions are effective in protecting workers.