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Fabriziomaria GOBBA
SENIOR PROFESSOR
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze sede ex-Medicina, Endocrinologia, Metabolismo e Geriatria
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Pubblicazioni
2024
- Protective role of SARS-CoV-2 anti-S IgG against breakthrough infections among European healthcare workers during pre and post-Omicron surge—ORCHESTRA project
[Articolo su rivista]
Spiteri, Gianluca; D’Agostini, Marika; Abedini, Mahsa; Ditano, Giorgia; Collatuzzo, Giulia; Boffetta, Paolo; Vimercati, Luigi; Sansone, Emanuele; De Palma, Giuseppe; Modenese, Alberto; Gobba, Fabriziomaria; Liviero, Filippo; Moretto, Angelo; Dell’Omo, Marco; Fiordi, Tiziana; Larese Filon, Francesca; Mauro, Marcella; Violán, Concepción; Mates, Dana; Oravec Bérešová, Jana; Monaco, Maria Grazia Lourdes; Carta, Angela; Verlato, Giuseppe; Porru, Stefano
abstract
Purpose Anti SARS-CoV-2 vaccination initially showed high effectiveness in preventing COVID-19. However, after the surge of variants of concern, the effectiveness dropped. Several studies investigated if this was related to the decrease of the humoral response over time; however, this issue is still unclear. The aim of this study was to understand whether SARS-CoV-2 anti-S IgG levels can be used to predict breakthrough infection risk and define the timing for further booster doses administration. Method Within the framework of the ORCHESTRA Project, over 20,000 health workers from 11 European centers were enrolled since December 2020. We performed two Cox proportional hazards survival analyses regarding pre-Omicron (from January to July 2021) and Omicron (December 2021-May 2022) periods. The serological response was classified as high (above the 75th percentile), medium (25th-75th), or low (< 25th). Results Seventy-four (0.33%) and 2122 (20%) health workers were infected during the first and second periods, respectively. Both Cox analyses showed that having high anti-S titer was linked to a significantly lower risk of infection as compared to having medium serological response [HR of high vs medium anti-S titer = 0.27 (95% CI 0.11-0.66) during the first phase, HR = 0.76 (95% CI 0.62-0.93) during the second phase]. Conclusion Vaccine effectiveness wanes significantly after new variants surge, making anti-S titer unsuitable to predict optimal timing for further booster dose administration. Studies on other immunological indicators, such as cellular immunity, are therefore needed to better understand the mechanisms and duration of protection against breakthrough infection risk.
2023
- A Multi-Center Study Investigating Long COVID-19 in Healthcare Workers from North-Eastern Italy: Prevalence, Risk Factors and the Impact of Pre-Existing Humoral Immunity—ORCHESTRA Project
[Articolo su rivista]
Cegolon, L.; Mauro, M.; Sansone, D.; Tassinari, A.; Gobba, F. M.; Modenese, A.; Casolari, L.; Liviero, F.; Pavanello, S.; Scapellato, M. L.; Taus, F.; Carta, A.; Spiteri, G.; Monaco, M. G. L.; Porru, S.; Larese Filon, F.
abstract
: Introduction: The impact of long-COVID-19 syndrome is rather variable, since it is influenced by several residual confounders. This study aimed to investigate the prevalence of long COVID-19 in healthcare workers (HCWs) from four university hospitals in north-eastern Italy: Trieste, Padua, Verona, and Modena-Reggio Emilia. Methods: During the period June 2022-August 2022, HCWs were surveyed for past COVID-19 infections, medical history, and any acute as well as post-COVID-19 symptoms. The prevalence of long COVID-19 was estimated at 30-60 days or 61+ days since first negative swab following first and second COVID-19 episode. Furthermore, the risk of long COVID-19 was investigated by multivariable logistic regression. Results were expressed as the adjusted odds ratio (aOR) with a 95% confidence interval (95%CI). Results: 5432 HCWs returned a usable questionnaire: 2401 were infected with SARS-CoV-2 at least once, 230 were infected at least twice, and 8 were infected three times. The prevalence of long COVID-19 after a primary COVID-19 infection was 24.0% at 30-60 days versus 16.3% at 61+ days, and 10.5% against 5.5% after the second SARS-CoV-2 event. The most frequent symptoms after a first COVID-19 event were asthenia (30.3%), followed by myalgia (13.7%), cough (12.4%), dyspnea (10.2%), concentration deficit (8.1%), headache (7.3%), and anosmia (6.5%), in decreasing order of prevalence. The risk of long COVID-19 at 30-60 days was significantly higher in HCWs hospitalized for COVID-19 (aOR = 3.34; 95%CI: 1.62; 6.89), those infected with SARS-CoV-2 during the early pandemic waves-namely the Wuhan (aOR = 2.16; 95%CI: 1.14; 4.09) or Alpha (aOR= 2.05; 95%CI: 1.25; 3.38) transmission periods-and progressively increasing with viral shedding time (VST), especially 15+ days (aOR = 3.20; 95%CI: 2.07; 4.94). Further determinants of long COVID-19 at 30-60 days since primary COVID-19 event were female sex (aOR = 1.91; 95%CI: 1.30; 2.80), age >40 years, abnormal BMI, or administrative services (reference category). In contrast, HCWs vaccinated with two doses before their primary infection (aOR = 0.57; 95%CI: 0.34; 0.94), undergraduate students, or postgraduate medical trainees were less likely to experience long COVID-19 at 30-60 days. Apart from pandemic waves, the main determinants of long COVID-19 at 30-60 days were confirmed at 61+ days. Conclusions: The risk of long COVID-19 following primary infection increased with the severity of acute disease and VST, especially during the initial pandemic waves, when more virulent viral strains were circulating, and susceptibility to SARS-CoV-2 was higher since most HCWs had not been infected yet, COVID-19 vaccines were still not available, and/or vaccination coverage was still building up. The risk of long COVID-19 therefore decreased inversely with humoral immunity at the individual level. Nevertheless, the prevalence of long COVID-19 was remarkably lower after SARS-CoV-2 reinfections regardless of vaccination status, suggesting that hybrid humoral immunity did not increase protection against the syndrome compared to immunity mounted by either natural infection or vaccination separately. Since the risk of long COVID-19 is currently low with Omicron and patients who developed the syndrome following SARS-CoV-2 infection in the early pandemic waves tend to return to a state of full health with time, a cost-effective approach to screen post-COVID-19 symptoms during the Omicron time could be restricted to vulnerable individuals developing severe disease and/or with prolonged VST.
2023
- COVID-19, LONG-COVID E REINSERIMENTO LAVORATIVO: PRIMI RISULTATI DI UNA SURVEY PER MEDICI COMPETENTI DELL’EMILIA-ROMAGNA
[Abstract in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
2023
- COVID-19, long-COVID and return-to-work a questionnaire to investigate the experience of the occupational physicians from an Italian region
[Abstract in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
2023
- COVID-19, long-COVID and return-to-work: the experience of Italian occupational physicians on musculoskeletal symptoms and occupational ergonomic risks
[Abstract in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
2023
- Digitally measuring solar ultraviolet radiation in outdoor workers: A study protocol for establishing the use of electronic personal dosimeters in Portugal
[Articolo su rivista]
Paulo, Ms; Symanzik, C; Maia, Mr; Lapao, Lv; Carvalho, F; Conneman, S; Dias, Jb; Gobba, F; John, Sm; Loney, T; Pinho, C; Rodrigues, A; Strehl, C; Tenkate, T; Wittlich, M; Modenese, A
abstract
IntroductionThe rising incidence of skin cancer over the years has made it a significant public and occupational health issue. However, skin cancer is highly preventable, mainly through reduced exposure to solar ultraviolet radiation (UVR), which can be achieved by a variety of individual and collective protective measures and interventions. The relative risk associated with different patterns of exposure to solar UVR differs for the subtypes of keratinocyte cancers (KC). Specifically, whether the exposure is intermittent or continuous, and occurs in an occupational or leisure/recreational setting. The main aim of the study using this protocol is to contribute to raising public and policy awareness on solar UVR-inflicted occupational skin cancers in Lisbon. This will be achieved by performing direct measurements of the solar UVR dose received by outdoor workers using a digital platform. Results will likely contribute to further understanding the risk estimates for keratinocyte cancer estimations in this population. MethodsA prospective observational study will be conducted in Lisbon, Portugal. Personal electronic dosimeters (GENESIS-UV system) integrated with a digital platform will be used to assess occupational solar UVR doses of gardeners, masons, and gravediggers of the municipality of Lisbon. Two hundred and ten outdoor workers will be selected to wear the dosimeter for 1 month each, between April and October during their daily working hours. A digital web-based platform that offers private access to information through dashboard visualization will provide information for the outdoor workers and facilitate communication with the participants. DiscussionThe expected results of the overall proposal comprise the occupational solar UVR doses, expressed in standard erythemal dose (SEDs) per day of outdoor work for 7 months. Study data will provide outdoor workers with information on their personal solar UVR exposure during their working hours and an estimate of their risk of developing skin cancer. It is expected that the occupational solar UVR doses of the outdoor workers in Portugal will be above the threshold of 1 to 1.33 SED/day, due to the latitude of Lisbon and the nature of the occupations. The results prospectively should flow into the design of adequate prevention campaigns for skin cancer in outdoor workers.
2023
- ESPOSIZIONE OCCUPAZIONALE A RADIOFREQUENZE E POSSIBILI RISCHI CANCEROGENI: UNA REVISIONE SISTEMATICA
[Abstract in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
2023
- Factors Associated with SARS-CoV-2 Infection Evaluated by Antibody Response in a Sample of Workers from the Emilia-Romagna Region, Northern Italy
[Articolo su rivista]
Paduano, S; Granata, M; Turchi, S; Modenese, A; Galante, P; Poggi, A; Marchesi, I; Frezza, G; Dervishaj, G; Vivoli, R; Verri, S; Marchetti, S; Gobba, F; Bargellini, A.
abstract
Factors associated with SARS-CoV-2 infection risk are still debated. This case–control study
aims to investigate the possible relationship between SARS-CoV-2 infection, evaluated through antibody response, and the main sociodemographic, occupational, clinical-anamnestic, and biochemical
factors in a population of Modena province (Northern Italy), mainly workers. Both workers who
voluntarily joined the screening campaign proposed by companies and self-referred individuals who
underwent serological testing were enrolled. Subjects with antibody positivity were recruited as
cases (n = 166) and subjects tested negative (n = 239) as controls. A questionnaire on sociodemographic, occupational, and clinical data was administered through telephone interviews. Serum
zinc/iron/copper/chromium/nickel, vitamins D/B12, folates, triglycerides, and LDL/HDL/total
cholesterol were measured. Cases lived more often in urban areas (61.8% vs. 57%). Cases and
controls did not differ significantly by working macrocategories, but the percentage of workers in the
ceramic sector was higher among cases. Low adherence to preventive measures in the workplace
was more frequent among seropositives. Folate concentration was significantly lower among cases.
Therefore, adequate folate levels, living in rural areas, and good adherence to preventive strategies
seem protective against infection. Workers in the ceramic sector seem to be at greater risk; specific
factors involved are not defined, but preventive interventions are needed.
2023
- Factors Associated with SARS-CoV-2 Infection Evaluated by Antibody Response in a Sample of Workers from the Emilia-Romagna Region, Northern Italy
[Articolo su rivista]
Paduano, Stefania; Granata, Michele; Turchi, Sara; Modenese, Alberto; Galante, Pasquale; Poggi, Alessandro; Marchesi, Isabella; Frezza, Giuseppina; Dervishaj, Giulia; Vivoli, Roberto; Verri, Sara; Marchetti, Simona; Gobba, Fabriziomaria; Bargellini, Annalisa
abstract
Factors associated with SARS-CoV-2 infection risk are still debated. This case-control study aims to investigate the possible relationship between SARS-CoV-2 infection, evaluated through antibody response, and the main sociodemographic, occupational, clinical-anamnestic, and biochemical factors in a population of Modena province (Northern Italy), mainly workers. Both workers who voluntarily joined the screening campaign proposed by companies and self-referred individuals who underwent serological testing were enrolled. Subjects with antibody positivity were recruited as cases (n = 166) and subjects tested negative (n = 239) as controls. A questionnaire on sociodemographic, occupational, and clinical data was administered through telephone interviews. Serum zinc/iron/copper/chromium/nickel, vitamins D/B12, folates, triglycerides, and LDL/HDL/total cholesterol were measured. Cases lived more often in urban areas (61.8% vs. 57%). Cases and controls did not differ significantly by working macrocategories, but the percentage of workers in the ceramic sector was higher among cases. Low adherence to preventive measures in the workplace was more frequent among seropositives. Folate concentration was significantly lower among cases. Therefore, adequate folate levels, living in rural areas, and good adherence to preventive strategies seem protective against infection. Workers in the ceramic sector seem to be at greater risk; specific factors involved are not defined, but preventive interventions are needed.
2023
- Il progetto BRiC INAIL “Sviluppo di dispositivo multisensore smart dotato di software di funzionamento per il monitoraggio dell’esposizione personale di lavoratori outdoor alla radiazione ultravioletta (UV) solare": risultati preliminari
[Articolo su rivista]
Burattini, C.; Modenese, A.; Gobba, F.; Borra, M.; Leccese, F.; Militello, A.; Salvadori, G.; Rocca, M.; Bisegna, F.
abstract
2023
- Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project
[Articolo su rivista]
Porru, Stefano; Monaco, Maria Grazia Lourdes; Spiteri, Gianluca; Carta, Angela; Caliskan, Gulser; Violán, Concepción; Torán-Monserrat, Pere; Vimercati, Luigi; Tafuri, Silvio; Boffetta, Paolo; Violante, Francesco Saverio; Sala, Emma; Sansone, Emanuele; Gobba, Fabriziomaria; Casolari, Loretta; Wieser, Andreas; Janke, Christian; Tardon, Adonina; Rodriguez-Suarez, Marta Maria; Liviero, Filippo; Scapellato, Maria Luisa; Dell'Omo, Marco; Murgia, Nicola; Mates, Dana; Calota, Violeta Claudia; Strhársky, Jozef; Mrázová, Mariana; Pira, Enrico; Godono, Alessandro; Magnano, Greta Camilla; Negro, Corrado; Verlato, Giuseppe
abstract
Background: SARS-CoV-2 breakthrough infections (BI) after vaccine booster dose are a relevant public health issue. Methods: Multicentric longitudinal cohort study within the ORCHESTRA project, involving 63,516 health workers (HW) from 14 European settings. The study investigated the cumulative incidence of SARS-CoV-2 BI after booster dose and its correlation with age, sex, job title, previous infection, and time since third dose. Results: 13,093 (20.6%) BI were observed. The cumulative incidence of BI was higher in women and in HW aged < 50 years, but nearly halved after 60 years. Nurses experienced the highest BI incidence, and administrative staff experienced the lowest. The BI incidence was higher in immunosuppressed HW (28.6%) vs others (24.9%). When controlling for gender, age, job title and infection before booster, heterologous vaccination reduced BI incidence with respect to the BNT162b2 mRNA vaccine [Odds Ratio (OR) 0.69, 95% CI 0.63-0.76]. Previous infection protected against asymptomatic infection [Relative Risk Ratio (RRR) of recent infection vs no infection 0.53, 95% CI 0.23-1.20] and even more against symptomatic infections [RRR 0.11, 95% CI 0.05-0.25]. Symptomatic infections increased from 70.5% in HW receiving the booster dose since < 64 days to 86.2% when time elapsed was > 130 days. Conclusions: The risk of BI after booster is significantly reduced by previous infection, heterologous vaccination, and older ages. Immunosuppression is relevant for increased BI incidence. Time elapsed from booster affects BI severity, confirming the public health usefulness of booster. Further research should focus on BI trend after 4th dose and its relationship with time variables across the epidemics.
2023
- Neutralizing anti-sars-cov-2 antibody titer after three doses of mrna vaccine in a sample of italian nursing home personnel
[Abstract in Rivista]
Bargellini, Annalisa; Modenese, Alberto; Paduano, Stefania; Turchi, Sara; Marchesi, Isabella; Bellucci, Rossana; Marchetti, Simona; Vivoli, Roberto; Bruno, Fulvio; Grazioli, Pietro; Gobba, Fabriziomaria
abstract
2023
- Occupational Exposure to Solar Radiation and the Eye: A Call to Implement Health Surveillance of Outdoor Workers
[Articolo su rivista]
Modenese, Alberto; Chou, B Ralph; Ádám, Balázs; Loney, Tom; Silva Paulo, Marilia; Tenkate, Thomas; Gobba, Fabriziomaria
abstract
Globally, hundreds of millions of outdoor workers are exposed to solar radiation (SR) for most of their work. Such occupational exposure is known to induce various adverse health effects on the eyes, mainly related to its ultraviolet (UV) component. The present work is a call to action to raise awareness of the need for health surveillance to prevent chronic ocular diseases in outdoor workers. Photo-chemical chronic damage can induce pterygium at the eye's outer layer and cataracts in the lens. Considering carcinogenic effects, rare squamous-cell tumors of the cornea and/or the conjunctiva and ocular melanomas are associated with UV radiation exposure. Solar UV-related eye diseases should be considered "occupational diseases" when workers have sufficient exposure. Still, they are often not recognized and/ or frequently not reported to the national compensation authorities. Therefore, to prevent the burden of these work -related eye pathologies, an adequate risk assessment with identification of appropriate preventive measures and a provision of periodic health surveillance to the exposed workers, particularly those at higher risk of exposure or with individual susceptibility, should be urgently implemented.
2023
- PREVENTION OF THE OCCUPATIONAL RISK RELATED TO SOLAR UV EXPOSURE OF OUTDOOR WORKERS: THE INTERNATIONAL PROJECT MEAOW@SOLARUV
[Relazione in Atti di Convegno]
Silva Paulo, Marília; Modenese, Alberto; Maia, Mélanie R.; Velez Lapão, Luís; Gobba, Fabriziomaria
abstract
2023
- PROGETTARE INTERVENTI DI TOTAL WORKER HEALTH®: LA MISURAZIONE DELLA CAPACITÀ LAVORATIVA DEGLI OPERATORI DELL’AOU DI MODENA
[Relazione in Atti di Convegno]
Casolari, Loretta; Rossi, Giorgia; D’Elia, Cristiana; Garavini, Denise; Glieca, Francesca; Mariani, Stefania; Venturelli, Luca; Vivoli, Daniela; Mastroberardino, Michele; Broccoli, Lorenzo; Nicastro, Ottavio; Pistoresi, Barbara; Poma, Erica; Curzi, Ylenia; Fabbri, Tommaso; Modenese, Alberto; Gobba, Fabriziomaria
abstract
2023
- Risk of cutaneous squamous cell carcinoma due to occupational exposure to solar ultraviolet radiation: Protocol for a systematic review and meta-analysis
[Articolo su rivista]
Paulo, Marília Silva; Symanzik, Cara; Ádam, Balázs; Gobba, Fabriziomaria; Kezic, Sanja; van der Molen, Henk F; Peters, Cheryl E; Rocholl, Marc; Tenkate, Thomas; John, Swen Malte; Loney, Tom; Modenese, Alberto; Wittlich, Marc
abstract
: Solar ultraviolet radiation (UVR) is the most significant occupational carcinogenic exposure in terms of the number of workers exposed (i.e., outdoor workers). Consequently, solar UVR-induced skin cancers are among the most common forms of occupational malignancies that are potentially expected globally. This systematic review is registered in PROSPERO (CRD42021295221) and aims to assess the risk of cutaneous squamous cell carcinoma (cSCC) associated to occupational solar UVR exposure. Systematic searches will be performed in three electronic literature databases (PubMed/Medline, EMBASE, and Scopus). Further references will be retrieved by a manual search (e.g., in grey literature databases, internet search engines, and organizational websites). We will include cohort studies and case-control studies. Risk of Bias assessment will be conducted separately for case-control and cohort studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) will be used for the certainty of assessment. In case quantitative pooling is not feasible, a narrative synthesis of results will be performed.
2023
- Risk/protective factors associated with anti-SARS-CoV-2 antibody response in a sample of workers from the emilia romagna region, Italy
[Abstract in Rivista]
Granata, Michele; Galante, Pasquale; Paduano, Stefania; Modenese, Alberto; Poggi, Alessandro; Marchesi, Isabella; Vivoli, Roberto; Bellucci, Rossana; Verri, Sara; Marchetti, Simona; Gobba, Fabriziomaria; Bargellini, Annalisa; Turchi, Sara
abstract
2023
- The Occupational Health Surveillance of Workers Exposed to Electromagnetic Fields and the Problem of ‘Workers at Particular Risk’
[Capitolo/Saggio]
Modenese, A.; Gobba, F.
abstract
Electromagnetic fields (EMF) represent a recognised occupational risk factor, and the number of potentially exposed workers is huge; but, to date, the problem of an adequate occupational health surveillance (OHS) programme for the protection of EMF-exposed workers is still open. So far, scant agreement is available, especially on the OHS-specific contents to adequately ensure an effective prevention and early detection of adverse effects such as the stimulation of muscles, nerves or sensory organs, and limb currents or thermal effects, generally not expected in the usual working situations, commonly not exceeding exposure limits; but that can appear especially in the case of overexposures. A further problematic aspect of OHS programme is the protection of workers with conditions inducing their higher susceptibility (‘workers at particular risk’) as are, in the case of EMF exposure, for example, subjects with implanted medical devices and pregnant workers. It should be considered that the adverse effects are usually prevented in the case of strict compliance with occupational exposure limit values, but an exceeding of the limits is possible, at least during certain working activities. Furthermore, the current occupational limits may not provide an adequate protection for workers at particular risk. For this reason, an adequate information of the workers on the risk, on exposure levels and on conditions possibly inducing a particular susceptibility to EMF, as well as an early identification and a medical periodical examination of these workers, should be an essential component of any appropriate OHS programme. A last point to be raised here is the fact that the overall results of the OHS should be adequately collected and preserved in a suitable form in order to be consulted at a later date, as required by the European legislation, offering a potential important source of evidence on the possible EMF-related effects; but the unavailability of shared OHS programmes makes it almost impossible. Unfortunately, at our knowledge to date no international effort is ongoing, and apparently none is planned to overcome these challenges.
2022
- A systematic review on occupational exposure to radiofrequency electromagnetic fields and risk of cancer: preliminary results from an Italian research project
[Relazione in Atti di Convegno]
Modenese, Alberto; Bravo, Giulia; Grandi, Carlo; Biffoni, Mauro; Gobba, Fabriziomaria
abstract
2022
- Adesione ed esitazione vaccinale in una coorte di operatori di un’Azienda Ospedaliero-Universitaria
[Abstract in Atti di Convegno]
Glieca, Francesca; Bertoldi, Chiara; Rossi, Giorgia; Della Vecchia, Elena; D’Elia, Cristiana; Garavini, Denise; Mariani, Stefania; Venturelli, Luca; Vivoli, Daniela; Modenese, Alberto; Gobba, Fabriziomaria; Casolari, Loretta
abstract
2022
- Aggiornamento in tema di sintomatologia soggettiva riferita da operatori di Risonanza Magnetica: principali risultati di un recente studio italiano
[Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
2022
- Analisi degli eventi di violenza nei confronti degli operatori sanitari dell’Azienda Ospedaliero-Universitaria di Modena
[Abstract in Atti di Convegno]
Bertoldi, Chiara; Glieca, Francesca; Casolari, Loretta; D’Elia, Cristiana; Garavini, Denise; Mariani, Stefania; Rossi, Giorgia; Venturelli, Luca; Vivoli, Daniela; Marchegiano, Patrizia; Mastroberardino, Michele; Modenese, Alberto; Gobba, Fabriziomaria
abstract
2022
- Andamento del titolo anticorpale ad 1 e 3 mesi dal completamento del ciclo vaccinale primario anti-Covid-19 nei lavoratori dell’Azienda USL di Modena
[Abstract in Atti di Convegno]
Pedretti, Simona; Gualtieri, Giulia; Rita Tarantini, Anna; Lacirignola, Michele; Abenante, Maria; Modenese, Alberto; Gobba, Fabriziomaria
abstract
2022
- Biological effects induced by EMF exposure and conditions determining a particular risk for the exposed workers
[Relazione in Atti di Convegno]
Modenese, Alberto; Wittlich, Marc; Gobba, Fabriziomaria
abstract
2022
- COVID-19-Related Mortality amongst Physicians in Italy: Trend Pre- and Post-SARS-CoV-2 Vaccination Campaign
[Articolo su rivista]
Modenese, Alberto; Loney, Tom; Gobba, Fabriziomaria
abstract
2022
- Correction to: Occupational exposure to electromagnetic fields in magnetic resonance environment: an update on regulation, exposure assessment techniques, health risk evaluation, and surveillance (Medical & Biological Engineering & Computing, (2022), 60, 2, (297-320), 10.1007/s11517-021-02435-6)
[Articolo su rivista]
Hartwig, V.; Virgili, G.; Mattei, F.; Biagini, C.; Romeo, S.; Zeni, O.; Scarfi, M. R.; Massa, R.; Campanella, F.; Landini, L.; Gobba, F.; Modenese, A.; Giovannetti, G.
abstract
The original article contained a mistake. The original article reports wrong affiliations. The final affiliations have reported below.
2022
- Esposizione alla radiazione ultravioletta solare e rischio occupazionale nei lavoratori outdoor: risultati preliminari di un progetto BRiC INAIL
[Abstract in Atti di Convegno]
Modenese, Alberto; Burattini, Chiara; Bisegna, Fabio; Borra, Massimo; Leccese, Francesco; Militello, Andrea; Salvadori, Giacomo; Gobba, Fabriziomaria
abstract
2022
- European Postgraduate Assessment in Occupational Medicine in Practice
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Reijula, Kari
abstract
2022
- Evaluation of an Online Course Promoting Health and Wellbeing for University Students and Employees.
[Articolo su rivista]
Ricci, F.; Modenese, A.; Gobba, F.; Morlini, I.
abstract
Published studies dealing with health promotion activities, such as the improvement of physical activity and healthy eating, for workers and students prove the effectiveness of these preventive interventions. The consequent benefits include better prevention of cardiovascular risk and an improvement in quality of life. Considering this, an intervention aimed at promoting healthy eating and non-sedentary lifestyles has been implemented within an Italian university: the aim of the present research is to evaluate its effectiveness. The intervention consisted of a targeted asynchronous e-learning two-hour course on healthy eating and non-sedentary lifestyles. The attendants were 2004 university students and employees. We conducted two surveys before and after the training intervention, and, through the responses obtained, we evaluated the effectiveness of the intervention. We applied different statistical methods, including unpaired t-tests and nonparametric tests, principal components and cluster analysis. Our results indicate that the post-training knowledge has been significantly improved, compared to that pre-training (7.3 vs. 8.7, p < 0.001). Moreover, the whole sample showed an improved awareness of the importance of healthy behaviors, and perception of the University as an institution promoting a healthy lifestyle. Through the principal components analysis, we identified a unidimensional latent factor named “health and behaviors”. The cluster analysis highlighted that the sub-group reporting the lowest scores at the survey before the training was the one with the highest improvement after the intervention. To the best of our knowledge, this is the first Italian study testing, before and after a health promotion intervention, the knowledge and the attitudes and behaviors towards healthy lifestyles of a group of students and workers. Moreover, we also evaluated the pre- and post-intervention perceived health status, as well as the level of engagement of the attendants, with respect to their colleagues and management in an educational institution promoting wellbeing. The conclusions of our study support the need for further adoption of health promotion training interventions, similar to the one we performed, in order to improve healthy eating and non-sedentary behaviors among workers and students.
2022
- Il percorso per la stesura delle Linee Guida
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
2022
- Investigation of Possible Factors Influencing the Neutralizing Anti-SARS-CoV-2 Antibody Titer after Six Months from the Second Vaccination Dose in a Sample of Italian Nursing Home Personnel
[Articolo su rivista]
Modenese, Alberto; Paduano, Stefania; Bellucci, Rossana; Marchetti, Simona; Bruno, Fulvio; Grazioli, Pietro; Vivoli, Roberto; Gobba, Fabriziomaria; Bargellini, Annalisa
abstract
2022
- OCCUPATIONAL EXPOSURE TO ELECTROMAGNETIC FIELDS AND HEALTH SURVEILLANCE OF WORKERS
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
2022
- Occupational Health and Safety in the Healthcare Sector
[Curatela]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
Healthcare workers are exposed to several different occupational risk factors, and they pay
an important tribute in terms of occupational diseases and work-related injuries. Currently, the
COVID-19 pandemic has focused the attention on the problem of the infectious risk, which is certainly
among the risks typically expected and specifically recognized for the health personnel, but also other
occupational risks should not be overlooked, as, e.g., the risks associated with work-organization
factors and with the exposure to chemical and physical agents. The health consequences associated
with the exposure to all these factors have relevant impacts in terms of induced diseases, DALYs,
sickness absence from work and costs for the health systems.
According to these premises, this reprint has collected manuscripts addressing topics related
to the prevention of the occupational risks in the healthcare sector, including original articles and
reviews on the prevention of work-related illnesses and injuries of the health personnel, as well as
on the evaluation of the risks in the healthcare workplaces, and on the topics of risk perception and
of the knowledge and attitudes of the workers towards the preventive procedures and the use of
protections. The themes of the prevention of occupational infectious risk, biomechanical overload
of the musculoskeletal system and work-related psychosocial factors are specifically discussed in the
papers collected.
2022
- Occupational exposure to electromagnetic fields in magnetic resonance environment: an update on regulation, exposure assessment techniques, health risk evaluation, and surveillance
[Articolo su rivista]
Hartwig, V.; Virgili, G.; Mattei, F.; Biagini, C.; Romeo, S.; Zeni, O.; Scarfi, M. R.; Massa, R.; Campanella, F.; Landini, L.; Gobba, F.; Modenese, A.; Giovannetti, G.
abstract
Magnetic resonance imaging (MRI) is one of the most-used diagnostic imaging methods worldwide. There are ∼50,000 MRI scanners worldwide each of which involves a minimum of five workers from different disciplines who spend their working days around MRI scanners. This review analyzes the state of the art of literature about the several aspects of the occupational exposure to electromagnetic fields (EMF) in MRI: regulations, literature studies on biological effects, and health surveillance are addressed here in detail, along with a summary of the main approaches for exposure assessment. The original research papers published from 2013 to 2021 in international peer-reviewed journals, in the English language, are analyzed, together with documents published by legislative bodies. The key points for each topic are identified and described together with useful tips for precise safeguarding of MRI operators, in terms of exposure assessment, studies on biological effects, and health surveillance. Graphical abstract: [Figure not available: see fulltext.]
2022
- Occupational health surveillance of workers exposed to electromagnetic fields according to the current Italian legislation
[Relazione in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
Summary—The health surveillance (HS) of workers exposed to electromagnetic fields (EMF) aims at the prevention of known EMF adverse effects. No specific lab tests or medical investigations are useful for routine monitoring of exposure and/or in the prevention of adverse effects occurrence. The main HS scopes are the recognition of workers at particular risk and/or of the occurrence of unexpected symptoms.
2022
- Risposta anticorpale neutralizzante anti-SARS-CoV-2 in operatori di una RSA del nord-Italia a 1 mese dalla vaccinazione e suo andamento a 6 mesi, e possibili fattori associati
[Abstract in Atti di Convegno]
Modenese, Alberto; Paduano, Stefania; Bargellini, Annalisa; Bellucci, Rossana; Marchetti, Simona; Bruno, Fulvio; Grazioli, Pietro; Vivoli, Roberto; Gobba, Fabriziomaria
abstract
2022
- SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers
[Articolo su rivista]
Porru, Stefano; Monaco, Maria Grazia Lourdes; Spiteri, Gianluca; Carta, Angela; Pezzani, Maria Diletta; Lippi, Giuseppe; Gibellini, Davide; Tacconelli, Evelina; Dalla Vecchia, Ilaria; Sala, Emma; Sansone, Emanuele; De Palma, Giuseppe; Bonfanti, Carlo; Lombardo, Massimo; Terlenghi, Luigina; Pira, Enrico; Mansour, Ihab; Coggiola, Maurizio; Ciocan, Catalina; Godono, Alessandro; Tardon, Adonina; Rodriguez-Suarez, Marta-Maria; Fernandez-Tardon, Guillermo; Jimeno-Demuth, Francisco-Jose; Castro-Delgado, Rafael-Vicente; Iglesias Cabo, Tania; Scapellato, Maria Luisa; Liviero, Filippo; Moretto, Angelo; Mason, Paola; Pavanello, Sofia; Volpin, Anna; Vimercati, Luigi; Tafuri, Silvio; De Maria, Luigi; Sponselli, Stefania; Stefanizzi, Pasquale; Caputi, Antonio; Gobba, Fabriziomaria; Modenese, Alberto; Casolari, Loretta; Garavini, Denise; D’Elia, Cristiana; Mariani, Stefania; Filon, Francesca Larese; Cegolon, Luca; Negro, Corrado; Ronchese, Federico; Rui, Francesca; De Michieli, Paola; Murgia, Nicola; Dell’Omo, Marco; Muzi, Giacomo; Fiordi, Tiziana; Gambelunghe, Angela; Folletti, Ilenia; Mates, Dana; Calota, Violeta Claudia; Neamtu, Andra; Perseca, Ovidiu; Staicu, Catalin Alexandru; Voinoiu, Angelica; Fabiánová, Eleonóra; Bérešová, Jana; Adamčáková, Zora Kľocová; Nedela, Roman; Lesňáková, Anna; Holčíková, Jana; Boffetta, Paolo; Abedini, Mahsa; Ditano, Giorgia; Asafo, Shuffield Seyram; Visci, Giovanni; Violante, Francesco Saverio; Zunarelli, Carlotta; Verlato, Giuseppe
abstract
2022
- Seroprevalence Survey of Anti-SARS-CoV-2 Antibodies in a Population of Emilia-Romagna Region, Northern Italy
[Articolo su rivista]
Paduano, Stefania; Galante, Pasquale; Berselli, Nausicaa; Ugolotti, Luca; Modenese, Alberto; Poggi, Alessandro; Malavolti, Marcella; Turchi, Sara; Marchesi, Isabella; Vivoli, Roberto; Perlini, Paola; Bellucci, Rossana; Gobba, Fabriziomaria; Vinceti, Marco; Filippini, Tommaso; Bargellini, Annalisa
abstract
taly was the first Western European country to be severely hit by the COVID-19 pandemic. Variations in seroprevalence rates were reported according to geographical and temporal differences of previous surveys, as well as depending on demographic and occupational factors. In this cross-sectional study, we evaluated the prevalence of anti-SARS-CoV-2 antibodies in a population of the Emilia-Romagna region in Northern Italy after the first wave in the period from 26 September 2020–26 March 2021. We included 5128 subjects who voluntarily underwent serological tests to determine anti-SARS-CoV-2 antibody positivity, including both self-referred individuals (24.2%) and workers adhering to company screening programs (76.8%). Overall, seroprevalence was 11.3%, higher in self-referred (13.8%) than employed-referred (10.5%) individuals. A slightly higher seroprevalence emerged in women compared to men (12.3% and 10.7%), as well as in the extreme age categories (18.6% for 60–69 years, 18.0% for ≥70 years, and 17.1% for <20 years compared to 7.6% for 20–39 years). Healthcare professionals showed the highest prevalence of seropositivity (22.9%), followed by workers in direct contact with customers, such as the communication, finance, and tourism sectors (15.7%). Overall subgroups seroprevalence increased compared to the first wave data but the trends agreed between the first and subsequent waves, except for an increase in the younger age group and in the sector in direct contact with customers. Among the occupational categories, our study confirms that healthcare workers and workers in the sports sector were at high risk of exposure to SARS-CoV-2.
2022
- Telefoni cellulari e tumori: quali evidenze?
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
2022
- The health surveillance of workers exposed to EMF: an outline of criteria
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
2022
- UV radiation exposure in occupation and leisure time - detailed knowledge for holistic prevention
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
2021
- Anti-SARS-CoV-2 antibodies frequency in non-Health Care Workers in a highly industrialized province of northern Italy
[Relazione in Atti di Convegno]
Modenese, Alberto; Mazzoli, Tommaso; Berselli, Nausicaa; Ferrari, Davide; Bargellini, Annalisa; Borella, Paola; Filippini, Tommaso; Marchesi, Isabella; Paduano, Stefania; Vinceti, Marco; Gobba, Fabriziomaria
abstract
2021
- Blood cell gene expression profiles: A narrative review of biomarkers and effects of low-dose ionizing radiation exposure
[Articolo su rivista]
Panera, Nadia; Camisa, Vincenzo; Brugaletta, Rita; Vinci, Maria Rosaria; Santoro, Annapaola; Coscia, Emanuele; Pastore, Anna; Cannatà, Vittorio; Gobba, Fabriziomaria; Modenese, Alberto; Chirico, Francesco; Magnavita, Nicola; Alisi, Anna; Zaffina, Salvatore
abstract
Ionizing radiation (IR) is a ubiquitous environmental agent whose effects on organisms are well known. This review provides a summary about definitions and man-made low-dose ionizing radiation (LDIR) sources and dosimeters used in radiation protection. Moreover, the main purpose of this article was to overview the pro-oncogenic effects of LDIR, and to provide experimental evidence that reinforce the use of gene expression data as biomarkers of LDIR effects. Our review showed that basic studies on biological response to LDIR are considered priority. Further, understanding occupational exposure to LDIR may provide valuable information to organize the prevention and prevent from the onset of long-term health effects in radiation workers. Currently, the biodosimetry-based assessment in certain high risk occupational groups may be performed by using peripheral blood cells as samples for testing and validation of biomarkers specificity and sensitivity. Most of the studies on this topic are aimed at establishing new biomarkers and approaches to biological dosimetry, for allowing non-invasive monitoring of long-term health effects of LDIR. Analysis on changes in gene-expression, which is an early specific biological response to LDIR, could provide rapid estimates of individual dose in occupational cohorts, improving the management of periodical medical examination in subjects exposed to LDIR sources.
2021
- DALLA PRESUNZIONE ALLA VALUTAZIONE DEL RISCHIO PER LA GRAVIDANZA ED IL POST-PARTO: ESPERIENZE NELL’ESPOSIZIONE A RISCHI FISICI
[Abstract in Atti di Convegno]
Pagliaro, G.; Debarbieri, N.; Gobba, F.
abstract
2021
- Evaluation of Personal Solar UV Exposure in a Group of Italian Dockworkers and Fishermen, and Assessment of Changes in Sun Protection Behaviours After a Sun-Safety Training
[Articolo su rivista]
Modenese, Alberto; Bisegna, Fabio; Borra, Massimo; Bravo, Giulia; Burattini, Chiara; Grasso, Anna; Gugliermetti, Luca; Filon, Francesca Larese; Militello, Andrea; Ruggieri, Francesco Pio; Gobba, Fabriziomaria
abstract
2021
- Exposure to Optical Radiation and Electromagnetic Fields at the Workplace: Criteria for Occupational Health Surveillance According to Current European Legislation
[Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
2021
- Factors associated with SARS-CoV-2 infection risk among healthcare workers of an italian university hospital
[Articolo su rivista]
Modenese, A.; Casolari, L.; Rossi, G.; Della Vecchia, E.; Glieca, F.; D'Elia, C.; Garavini, D.; Righi, E.; Mariani, S.; Venturelli, L.; Vivoli, D.; Gobba, F.
abstract
We report the results of a study on the cumulative incidence of SARS-CoV-2 infections in about 6000 workers of the University Hospital of Modena, Northern Italy, in the period March 2020–January 2021, and the relations with some individual and occupational factors. Overall, in healthcare workers (HCW) the cumulative incidence of COVID-19 during the period was 13.8%. Results confirm the role of overweight and obesity as significant risk factors for SARS-CoV-2 infection. Chronic respiratory diseases, including asthma, also proved to be significantly associated with the infection rate. Considering occupational factors, the COVID-19 risk was about threefold (OR: 2.7; 95% CI 1.7–4.5) greater in nurses and nurse aides than in non-HCW, and about double (OR: 1.9; 95% CI 1.2–3.2) in physicians. Interestingly, an association was also observed between infection risk and nightshifts at work (OR: 1.8; 95% CI 1.4–2.3), significantly related to the total number of shifts in the whole eleven-month period. Even if the vaccination campaign has now greatly modified the scenario of SARS-CoV-2 infections among HCW, the results of this study can be useful for further development of health and policy strategies to mitigate the occupational risk related to the new variants of coronavirus, and therefore the evolution of the pandemic.
2021
- Frequency of anti-sars-cov-2 antibodies in various occupational sectors in an industrialized area of northern italy from may to october 2020
[Articolo su rivista]
Modenese, A.; Mazzoli, T.; Berselli, N.; Ferrari, D.; Bargellini, A.; Borella, P.; Filippini, T.; Marchesi, I.; Paduano, S.; Vinceti, M.; Gobba, F.
abstract
The results of a voluntary screening campaign for the presence of anti-SARS-CoV-2 serum antibodies are presented, performed on workers in the highly industrialized province of Modena in northern Italy in the period 18 May–5 October 2020. The employment activities of the subjects that tested positive for anti-SARS-CoV-2 IgM and/or IgG antibodies were determined and classified using the International Standard Industrial Classification of All Economic Activities (ISIC). The distribution across different sectors was compared to the proportion of workers employed in the same sectors in the province of Modena as a whole. Workers with anti-SARS-CoV-2 serum antibodies were mainly employed in manufacturing (60%), trade (12%), transportation (9%), scientific and technical activities (5%), and arts, entertainment and recreation activities (4.5%). Within the manufacturing sector, a cluster of workers with positive serological tests was observed in the meat processing sector, confirming recent data showing a possible increased risk of SARS-CoV-2 infection in these workers.
2021
- LA VALUTAZIONE DEL RISCHIO DA MOVIMENTAZIONE PAZIENTI: RISULTATI DELL’APPLICAZIONE DEL METODO SPOSO-POLETTI
[Abstract in Atti di Convegno]
Gualtieri, G.; Dieci, C.; Romiti, E.; Morini, G.; Mineo, F.; Perazzoli, F.; Coriani, S.; Modenese, A.; Gobba, F.
abstract
2021
- La sorveglianza sanitaria dei lavoratori esposti a campi elettromagnetici: aspetti legislativi, particolare sensibilità al rischio, indicazioni per l’idoneità
[Articolo su rivista]
Filosa, Laura; Gobba, Fabriziomaria; Modenese, Alberto
abstract
2021
- Linee Guida per la sorveglianza sanitaria dei lavoratori esposti a campi elettromagnetici
[Monografia/Trattato scientifico]
Gobba, Fabriziomaria; Falsaperla, Rosaria; Grandi, Carlo; Moccaldi, Roberto; Modenese, Alberto; Polichetti, Alessandro; Rossi, Paolo; Stanga, Andrea
abstract
2021
- Neutralizing Anti-SARS-CoV-2 Antibody Titer and Reported Adverse Effects, in a Sample of Italian Nursing Home Personnel after Two Doses of the BNT162b2 Vaccine Administered Four Weeks Apart
[Articolo su rivista]
Modenese, Alberto; Paduano, Stefania; Bargellini, Annalisa; Bellucci, Rossana; Marchetti, Simona; Bruno, Fulvio; Grazioli, Pietro; Vivoli, Roberto; Gobba, Fabriziomaria
abstract
Background:
The immunization of healthcare workers (HCWs) plays a recognized key role in prevention in the COVID-19 pandemic: in Italy, the vaccination campaign began at the end of December 2020. A better knowledge of the on-field immune response in HCWs, of adverse effects and of the main factors involved is fundamental.
Methods:
We performed a study on workers at a nursing home in Northern Italy, vaccinated in January–February 2021 with two doses of the BNT162b2 vaccine four weeks apart, instead of the three weeks provided for in the original manufacturer protocol. One month after the second dose, the serological titer of IgG-neutralizing anti-RBD antibodies of the subunit S1 of the spike protein of SARS-CoV-2 was determined. The socio-demographic and clinical characteristics of the subjects and adverse effects of vaccination were collected by questionnaire.
Results:
In all of the workers, high antibody titer, ranging between 20 and 760 times the minimum protective level were observed. Titers were significantly higher in subjects with a previous COVID-19 diagnosis. Adverse effects after the vaccine were more frequent after the second dose, but no severe adverse effects were observed.
Conclusions:
The two doses of the BNT162b2 vaccine, even if administered four weeks apart, induced high titers of anti-SARS-CoV-2 neutralizing IgG in all the operators included in the study.
2021
- Occupational exposure to electromagnetic fields and health surveillance according to the european directive 2013/35/eu
[Articolo su rivista]
Modenese, A.; Gobba, F.
abstract
In the European Union, health surveillance (HS) of electromagnetic fields (EMF)-exposed workers is mandatory according to the Directive 2013/35/EU, aimed at the prevention of known direct biophysical effects and indirect EMF’s effects. Long-term effects are not addressed in the Directive as the evidence of a causal relationship is considered inadequate. Objectives of HS are the prevention or early detection of EMF adverse effects, but scant evidence is hitherto available on the specific procedures. A first issue is that no specific laboratory tests or medical investigations have been demonstrated as useful for exposure monitoring and/or prevention of the effects. Another problem is the existence of workers at particular risk (WPR), i.e., subjects with specific conditions in-ducing an increased susceptibility to the EMF-related risk (e.g., workers with active medical devices or other conditions); exposures within the occupational exposure limit values (ELVs) are usually adequately protective against EMF’s effects, but lower exposures can possibly induce a health risk in WPR. Consequently, the HS of EMF-exposed workers according to the EU Directive should be aimed at the early detection and monitoring of the recognized adverse effects, as well as an early identification of WPR for the adoption of adequate preventive measures.
2021
- P-228 Occupational exposure to radiofrequency electromagnetic fields and risk of cancer: preliminary data from the Italian research project BRIC 2018 – ID 06
[Poster]
Modenese, Alberto; Bravo, Giulia; Grandi, Carlo; Biffoni, Mauro; Gobba, Fabriziomaria
abstract
2021
- PROTOCOLLO DI REVISIONE SISTEMATICA DELLA LETTERATURA SU ESPOSIZIONE OCCUPAZIONALE A RADIOFREQUENZE E TUMORI NELL’AMBITO DEL PROGETTO BRIC ID6 2018
[Abstract in Atti di Convegno]
Modenese, A.; Bravo, G.; Gobba, F.; Grandi, C.
abstract
2021
- Protocol for a Systematic Review on the Effectiveness of Interventions to Reduce Exposure to Occupational Solar UltraViolet Radiation (UVR) Among Outdoor Workers
[Articolo su rivista]
Modenese, A.; Loney, T.; Rocholl, M.; Symanzik, C.; Gobba, F.; John, S. M.; Straif, K.; Silva Paulo, M.
abstract
Background: Solar UltraViolet Radiation (UVR) is considered the most relevant occupational carcinogenic exposure in terms of the number of workers exposed (i.e., outdoor workers) and UVR-induced skin cancers are among the most frequent types of occupational cancers worldwide. This review aims to collect and evaluate all the available preventive interventions conducted on outdoor workers to reduce their solar UVR related risk, with the final purpose of reducing the burden of occupational skin cancers for outdoor workers. Methods: We will search the following databases for peer-reviewed original research published: MEDLINE (through PubMed), Scopus, and EMBASE. We will include only interventional studies, both randomized and non-randomized, with an adequate comparison group, therefore excluding cross-sectional studies, as well as case-reports/series, reviews, and letters/comments. The systematic review will adhere to the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) guidelines for reporting systematic reviews. After the literature search, studies to be included will be independently reviewed by two Authors, first based on title and abstract, then based on the full text, according to the inclusion criteria. Conflicts will be solved by a third Author. Two authors will independently extract the required data from included studies and perform quality assessment according to the relevant domain for Risk of Bias assessment proposed by the Cochrane collaboration group. In case of sufficient homogeneity of interventions and outcomes evaluated, results from subgroups of studies will be pooled together in a meta-analysis. Discussion: Following the principles for the evaluation of interventions for cancer prevention established by the International Agency for Research on Cancer, this systematic review will investigate the effectiveness of the interventions, and consequently it will provide reliable indications for the actual reduction of skin cancer incidence in outdoor workers.
2021
- RISPOSTA ANTICORPALE ED EVENTI AVVERSI A VACCINAZIONE ANTI SARS-COV-2 NEGLI OPERATORI DELL’AZIENDA OSPEDALIERO-UNIVERSITARIA DI MODENA
[Abstract in Atti di Convegno]
Casolari, L.; Rossi, G.; Della Vecchia, E.; Glieca, F.; Muscatello, M.; Modenese, A.; Cannizzo, C.; D’Elia, C.; Garavini, D.; Neri, S.; Salvatori, D.; Mariani, S.; Righi, E.; Sarti, M.; Venturelli, L.; Vivoli, D.; Gobba, F.
abstract
2021
- RISULTATI DELLO SCREENING SIEROLOGICO PER SARS-COV-2 IN OPERATORI DELL’AUSL DI MODENA NEL PERIODO 01/04/2020-31/05/2020
[Abstract in Atti di Convegno]
Muscatello, M.; Grasso, A.; Gualtieri, G.; Lacirignola, M.; Pedretti, S.; Tarantini, A. R.; Vaccari, C.; Modenese, A.; Gobba, F.
abstract
2021
- Risk Perception in the Construction Industry: Differences Between Italian and Migrant Workers Before and After a Targeted Training Intervention
[Articolo su rivista]
Ricci, F.; Bravo, G.; Modenese, A.; Pasquale, F. D.; Ferrari, D.; Gobba, F.
abstract
We developed a visual tool to assess risk perception for a sample of male construction workers (forty Italian and twenty-eight immigrant workers), just before and after a sixteen-hour training course. The questionnaire included photographs of real construction sites, and workers were instructed to select pictograms representing the occupational risks present in each photograph. Points were awarded for correctly identifying any risks that were present, and points were deducted for failing to identify risks that were present or identifying risks that were not present. We found: (1) Before the course, risk perception was significantly lower in immigrants compared to Italians (p <.001); (2) risk perception improved significantly (p <.001) among all workers tested; and (3) after the training, the difference in risk perception between Italians and immigrants was no longer statistically significant (p =.1086). Although the sample size was relatively small, the results suggest that the training is effective and may reduce the degree to which cultural and linguistic barriers hinder risk perception. Moreover, the use of images and pictograms instead of words to evaluate risk perception could also be applied to nonconstruction workplaces.
2021
- Risk perception and ethnic background in construction workers: Results of a cross-sectional study in a group of trainees of a vocational school in italy
[Articolo su rivista]
Ricci, F.; Bravo, G.; Modenese, A.; De Pasquale, F.; Ferrari, D.; Bello, M.; Favero, G.; Soddu, S.; Gobba, F.
abstract
Risk perception can be influenced by cultural background. The study aims to evaluate risk perception, considering different ethnicities of construction workers from vocational schools in Italy. We administered a questionnaire investigating four different dimensions: Perceived behavioral control (PBC), Danger perception (DP), Safety climate (SC), and Attitude towards safe actions (ATSA). 562 workers answered: 72.4% from Italy, 14.2% from eastern Europe, 9.4% from Balkans, and 3.9% from North Africa. The participants indicated quite low control, attributable to the haste in performing the job. The workers perceived their specific job tasks as riskier compared to the tasks of their colleagues. They reported as fundamental the respecting of safety rules, but indicating that supervisors do not adequately promote safety behaviors. Finally, construction workers judged as “brave” the colleagues working without protective equipment. When compared to Italians, North Africa workers showed a lower perception of the possibility to control their safe behaviors (p = 0.040), while both eastern Europeans and Balkan obtained higher scores at the ATSA dimension, indicating a kind of fatalistic acceptance of the risky situations at work. Eastern Europeans also showed a lower perception of the dangers (p = 0.002), while Balkan demonstrated a perception of SC even better than the Italian group (p = 0.005).
2021
- SORVEGLIANZA SANITARIA DEL RISCHIO DA SARS-COV-2 NELL’AZIENDA OSPEDALIEROUNIVERSITARIA DI MODENA: PRIMI RISULTATI
[Abstract in Atti di Convegno]
Rossi, G.; Della Vecchia, E.; Glieca, F.; Venturelli, L.; Casolari, L.; D’Elia, C.; Garavini, D.; Mariani, S.; Pala, F.; Vivoli, D.; Modenese, A.; Gobba, F.
abstract
2021
- Seroprevalence of anti-SARS-CoV-2 antibodies after the first COVID-19 wave: a cross-sectional study in the province of Modena, city of a Northern Italy region
[Abstract in Rivista]
Berselli, N; Filippini, T; Paduano, S; Malavolti, M; Modenese, A; Gobba, F; Borella, P; Marchesi, I; Vivoli, R; Perlini, P; Bellucci, R; Bargellini, A; Vinceti, M
abstract
2021
- Seroprevalence of anti-SARS-CoV-2 antibodies in the Northern Italy population before the COVID-19 second wave
[Articolo su rivista]
Berselli, Nausicaa; Filippini, Tommaso; Paduano, Stefania; Malavolti, Marcella; Modenese, Alberto; Gobba, Fabriziomaria; Borella, Paola; Marchesi, Isabella; Vivoli, Roberto; Perlini, Paola; Bellucci, Rossana; Bargellini, Annalisa; Vinceti, Marco
abstract
The COVID-19 pandemic is due to SARS-CoV-2 coronavirus infections. It swept across the world in the spring of 2020, and so far it has caused a huge number of hospitalizations and deaths. In the present study, the authors investigated serum anti-SARS-CoV-2 antibody prevalence in the period of June 1-September 25, 2020, in 7561 subjects in Modena, Northern Italy.
2021
- Studio di fattori di rischio/protettivi associati alla risposta anticorpale anti-SARS-CoV-2 in un campione di lavoratori della provincia di Modena e province limitrofe
[Abstract in Rivista]
Paduano, S; Modenese, A; Filippini, T; Berselli, N; Marchesi, I; Vinceti, M; Borella, P; Gobba, F; Bargellini, A
abstract
2021
- Subjective Symptoms in Magnetic Resonance Imaging Personnel: A Multi-Center Study in Italy
[Articolo su rivista]
Bravo, Giulia; Modenese, Alberto; Arcangeli, Giulio; Bertoldi, Chiara; Camisa, Vincenzo; Corona, Gianluca; Giglioli, Senio; Ligabue, Guido; Moccaldi, Roberto; Mucci, Nicola; Muscatello, Martina; Venturelli, Irene; Vimercati, Luigi; Zaffina, Salvatore; Zanotti, Giulio; Gobba, Fabriziomaria
abstract
2021
- The effect of occupational exposure to solar ultraviolet radiation on malignant skin melanoma and non- melanoma skin cancer: a systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury
[Monografia/Trattato scientifico]
Boniol, Mathieu; Hosseini, Bayan; Ivanov, Ivan; Náfrádi, Bálint; Neira, Maria; Olsson, Ann; Onyije, Felix; Pega, Frank; Pintado Nunes, Joaquim; Prüss-Üstün, Annette; Schubauer-Berigan, Mary; Schüz, Joachim; Ujita, Yuka; Maria Leon-Roux, Emilie van Deventer.; Momen, Natalie; Ádám, Balázs; Akagwu, Ojochide; Akparibo, Issaka; Al Rifai, Rami; Bazrafshan, Sholeh; Bravo, Giulia; Gobba, Fabriziomaria; Green, Adele; Kezic, Sanja; Loney, Tom; Modenese, Alberto; Paulo, Marilia; Peters, Cheryl; Tenkate, Thomas; Whiteman, David; Wittlich, Marc; John, Swen
abstract
A systematic review and meta-analysis of studies were conducted reporting on the association between occupational exposure to solar ultraviolet radiation (UVR) and both malignant skin melanoma (melanoma) and non-melanoma skin cancer (NMSC), with the aim of enabling the estimation of the numbers of deaths and disability-adjusted life years from melanoma and NMSC attributable to occupational exposure to solar UVR, for the development of the World Health Organization (WHO)/International Labour Organization (ILO) Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates).
A protocol was developed and published, applying the Navigation Guide as an organizing systematic review framework where feasible. Electronic bibliographic databases were searched for potentially relevant records; electronic grey literature databases and organizational websites were also searched, reference lists of previous systematic reviews and included study records were hand-searched, and additional experts were consulted. Randomized controlled trials and cohort, case–control and other non-randomized studies were included that estimated the effect of any occupational exposure to solar UVR, compared with no occupational exposure to solar UVR, on melanoma (excluding melanoma of the lip or eye) or NMSC prevalence, incidence or mortality. At least two reviewers independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage. Adjusted relative risks were combined using random-effects meta-analysis. Two or more reviewers assessed the risk of bias, quality of evidence and strength of evidence.
Fifty-three (48 case–control, three case–case and two cohort) eligible studies were found, published in 62 study records, including over 457 000 participants in 26 countries of three WHO regions (Region of the Americas, European Region and Western Pacific Region), reporting on the effect on melanoma or NMSC incidence or mortality. No studies on the prevalence of melanoma or NMSC were found. In most studies, exposure was self-reported in questionnaires during interviews and the health outcome was assessed via physician diagnosis based on biopsy and histopathological confirmation. The risk of bias of the body of evidence was judged to be generally “probably low”, although there were some concerns regarding risks of exposure misclassification bias, detection bias and confounding.
The main meta-analyses of relevant case–control studies revealed a relative risk (RR) of melanoma and NMSC incidence of 1.45 (95% confidence interval (CI): 1.08–1.94; I2 = 81%) and 1.60 (95% CI: 1.21–2.11; I2 = 91%), respectively. No statistically significant differences in risk of melanoma and NMSC incidence were found when conducting subgroup analyses by WHO region, and no differences in risk of NMSC incidence in a subgroup analysis by sex. However, in a subgroup analysis by NMSC subtype, the increased risk of basal cell carcinoma (RR: 1.50; 95% CI: 1.10–2.04; 15 studies) was probably lower (P = 0.05 for subgroup differences) than the increased risk for squamous cell carcinoma (RR: 2.42; 95% CI: 1.66–3.53; 6 studies). The sensitivity analyses found that effect estimates of NMSC incidence were significantly higher in studies with any risk of bias domain rated as “high” or “probably high” compared with studies with only a “low” or “probably low” risk of bias, and in studies not reporting the health outcome by International Statistical Classification of Diseases and Related Health Problems (ICD) code compared with the two studies reporting ICD codes. The quality of available evidence of the effect of any occupational exposure to solar UVR on melanoma incidence and mortality and on NMSC mortality was rated as “low”, and the quality of evidence for NMSC incidence was rated as “moderate”.
The strength of the existing bodies of ev
2021
- The under-reporting of UV induced occupational non-melanoma skin cancers and actinic keratoses in Italy
[Poster]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
2021
- UV solar exposure of outdoor workers in Mediterranean area
[Relazione in Atti di Convegno]
Burattini, Chiara; Pompei, Laura; Modenese, Alberto; Salvadori, Giacomo; Militello, Andrea; Leccese, Francesco; Borra, Massimo; Gobba, Fabriziomaria; Bisegna, Fabio
abstract
2021
- VALUTAZIONE SOGGETTIVA DEL SONNO IN UN CAMPIONE DI AUTOTRASPORTATORI: DATI PRELIMINARI
[Abstract in Atti di Convegno]
Ruggieri, F. P.; Melloni, P.; Modenese, A.; Gobba, F.
abstract
2021
- What sun protection practices should be adopted by trainee teachers to reduce the risk of skin cancer and other adverse outcomes?
[Articolo su rivista]
De Castro-Maqueda, G.; Franco, C. L.; Gutierrez-Manzanedo, J. V.; Gobba, F.; Sanchez, N. B.; De Troya-Martin, M.
abstract
Excessive sun exposure and insufficient protection are the main risk factors for the onset of melanoma and non-melanoma skin cancer (the most common types of cancer suffered by fair-skinned populations) and other adverse effects on the skin and eyes. Epidemiological data highlight the scant awareness of this risk among young people and the high rates of sunburn often recorded among this population. The main aim of the present study is to examine sun exposure and protection behavior by university students. A cross-sectional questionnaire-based study was undertaken to investigate sun exposure and protection practices among students of education sciences at a university in southern Spain. The data obtained were used to perform a descriptive, comparative analysis, by groups and by gender, of photoprotection and skin self-examination practices. The reliability and validity of the questionnaire were both tested. Of the 315 students who completed the questionnaire, 74.6% had suffered at least one sunburn during the previous year. Few made frequent use of sunscreen or protective clothing and 89.5% did not self-examine their skin. The metric properties of the questionnaire revealed its excellent reliability and validity. Among the Spanish university students considered, there was little awareness of the risk of excessive sun exposure, self-protection was insufficient, the potential exposure to dangerous levels of ultraviolet radiation was high, and most had suffered one or more sunburns in the last year. Intervention strategies should be implemented to highlight the risks involved and the need for more appropriate sun protection practices. Information campaigns should be conducted in this respect so that, when these students become teachers, they will have adequate knowledge of the risks involved and of the benefits of addressing this problem effectively, and will ultimately transfer these health education competences to their own students.
2020
- A One-Month Monitoring of Exposure to Solar UV Radiation of a Group of Construction Workers in Tuscany
[Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria; Paolucci, Valentina; John, Swen Malte; Sartorelli, Pietro; Wittlich, Marc
abstract
2020
- Ethnic background and risk perception in construction workers: development and validation of an exploratory tool
[Articolo su rivista]
Ricci, Federico; Modenese, Alberto; Bravo, Giulia; De Pasquale, Fabrizio; Ferrari, Davide; Bello, Massimo; Carozza, Lorenzo; Longhi, Francesca; Favero, Gianluca; Soddu, Sergio; Gobba, Fabriziomaria
abstract
Among occupational sectors, construction is still one of the branches with the highest reported numbers of work-related injuries and diseases, which can even lead to death and in many cases induce permanent health consequences. The vast majority of these occupational injuries and diseases are preventable; accordingly, an improvement in preventive strategies, also through a better knowledge of the main factors involved in these events, is one of the most important objectives for better occupational health and safety in the construction sector. Considering the individual factors associated with a higher risk of work-related adverse health effects in workers, an inadequate perception of occupational risks is among the most relevant issues. Risk perception can vary according to different cultural backgrounds, highly influenced by ethnicity, and it affects the relations between workers in the work environment, and the way by with they undergo the specific occupational tasks and manage risky situations frequently occurring on construction sites. Accordingly, the aim of the authors was to develop a new tool for the assessment of risk perception in construction workers with different ethnic backgrounds.
2020
- Global evidence on occupational sun exposure and keratinocyte cancers: a systematic review
[Articolo su rivista]
Loney, T.; Paulo, M. S.; Modenese, A.; Gobba, F.; Tenkate, T.; Whiteman, D. C.; Green, A. C.; John, S. M.
abstract
2020
- Increased Risk of COVID-19-Related Deaths among General Practitioners in Italy
[Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
To date, data on COVID-19-related death cases among physicians from different medical specialties are incomplete and scattered. In Italy, available data highlight that general practitioners (GPs) are, apparently, the most heavily affected group. Indeed, they currently represent 44.1% of the total COVID-19 related death cases occurred among physicians, whereas they constitute about 15% of the total number of doctors. This high proportion is most likely the consequence of a work-related contagion happening especially during the first weeks of the epidemic, and persisting also in the following weeks, after the national lockdown. There are various reasons for these higher contagion rates: GPs perform a lot of medical examinations daily, usually in close contact with patients. Especially at the beginning of the epidemic, GPs might have had scant information on the specific safety procedures for the prevention of SARS-CoV-2 transmission (e.g., there was limited knowledge on the possibility of contagions deriving from asymptomatic patients) and, moreover, the availability of personal protective equipment was insufficient. Furthermore, the risk of infection is highly increased by the virus' characteristics, like its survival for several hours/days on different surfaces and its persistence in the air after an aerosolization process, with possibilities to be transmitted over distances longer than two meters. Following these observations, and considering the high cost in term of GPs' lives, the COVID-19 pandemic will probably revolutionize the approach to patients in general practice. Clear and effective guidelines are absolutely and urgently needed for the refinement of adequate measures to prevent SARS-CoV-2 infections among GPs.
2020
- Occupational Exposure to Non-Ionizing radiation. Main effects and criteria for health surveillance of workers according to the European Directives
[Relazione in Atti di Convegno]
Modenese, A.; Gobba, F.
abstract
Occupational exposure to Non-Ionizing radiation (NIR), including Electromagnetic fields (EMF) and Optical radiation (OR), is almost ubiquitous. EMF may induce various effects: in the case of direct short term effects, static and low-frequency fields interact with the biological tissues through the induction of currents, while high frequency fields through thermal mechanisms. EMF can also induce indirect effects, as interference, causing a specific risk e.g. in workers with active medical devices as pacemakers. The induction of various long term effects has also been proposed, but up now data supporting a causal effect are considered insufficient by almost all authoritative international agencies. Moving to OR, sources can be artificial (incoherent or coherent in the case of LASER) or natural; the main source of occupational OR exposure is natural: the Sun, exposing millions of outdoor workers worldwide. The main targets of OR effects are the skin and the eye. Among OR bands, the ultraviolet component is of particular relevance, inducing photochemical alterations in human cells that can cause both acute and long term effects as burns and skin cancers or cataract. For all workers NIR risk should be evaluated and, in case of significant risk, an adequate health surveillance (HS) should be implemented, also considering the possible presence of workers with conditions inducing a higher susceptibility to the risk, as subjects with active medical devices for EMF or subjects with a fair skin photo-type or eye alterations as aphakia or aniridia for OR. Aims of HS of occupational NIR exposure are the prevention and early detection of related health effects. The appropriate specific HS content depends on the NIR band(s) and on the specific work activities but, in general, at least a screening of the conditions inducing a particular risk and an active seeking of symptoms possibly induced by exposure should be performed before of the employment, and periodically repeated.
2020
- Occupational Exposure to Solar UV Radiation in a Group of Dock-workers in North-East Italy
[Relazione in Atti di Convegno]
Modenese, A.; Bisegna, F.; Borra, M.; Burattini, C.; Gugliermetti, L.; Filon, F. L.; Militello, A.; Toffanin, P.; Gobba, F.
abstract
Occupational solar ultraviolet radiation (UVR) exposure is a relevant heath risk in dock workers, potentially exposed to both direct and reflected radiation, but apparently was scantly studied up now and few studies on measurements of solar UVR levels are currently available for these workers. Our aim was to provide an evaluation of UVR exposure in 10 longshoremen and 4 port traffic coordinators/goods acceptors of a dock in North-East Italy. During a Summer day, workers' exposure was measured with personal UV dosimeters, and the environmental UV effective radiant exposure with a spectroradiometer. Personal solar UV dose ranged between 257-1975 J/m2 in longshoremen, and between 44-139 J/m2 for port traffic coordinators/goods acceptors. The percentage of personal compared to ambient exposure resulted between 16 and 59% for longshoremen, while were much lower, between 2 and 7%, in port traffic coordinators/goods acceptors. Eye exposure was also estimated using an ocular UV dosimeter placed on a stem of the sunglasses in a subject spending the day close to the longshoremen, resulting in a non-weighted solar UV-A ocular dose between 133.9 and 401.8 J/m2. Our results show an occupational solar UVR exposure of uncovered skin exceeding the suggested occupational limit of 1 - 1.3 standard erythemal dose per day, in all longshoremen. In one case this value was exceeded also in one of the port traffic coordinators /good acceptors, despite the overall lower UVR doses received. In conclusion, our UV measurement campaign in a group of Italian dock-workers support the existence of a significantly high occupational UVR risk at least for longshoremen, possibly inducing long-term UV-related adverse skin effects. Accordingly, an effort for the development of adequate interventions to protect these workers from solar UV risk is highly recommended in Italy.
2020
- Occupational risk related to natural optical radiation exposure and skin cancers
[Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
Skin tumors are the most frequent neoplasms worldwide in Caucasian subjects, and UV exposure is one of the most relevant risk factors in their etiology. Cumulative UV exposure is strongly associated with an increased occurrence of both basal and squamous cell carcinomas (i.e. Non melanoma skin cancers - NMSC), while for malignant melanoma the role of UV radiation as risk factors seems more related to intermittent and intense exposures, able to induce repeated sunburns, at young ages. Considering the occupational risk, currently UV radiation, part of the solar radiation (SR) spectrum, is one of the major risks in all jobs including outdoor activities (outdoor work - OW): many studies show high levels of solar UV exposure during OW, nevertheless to date the European, and Italian, legislation on occupational risks prevention does not include specific requirements for SR compleexposure at work, as occupational exposure limits values or workers' health surveillance. This is not coherent with the strong associations showed in scientific literature in particular between the occurrence of NMSC and a history of OW. Accordingly, considering the high exposure levels, the large number of outdoor workers and the strong associations with NMSC, we'd expect a relevant number of occupational skin cancers (OSC) to be reported every year to the national workers' compensation authorities in European countries. Nevertheless, in Italy, as in other European countries, the number of reported UV-induced OSC is much lower than the expected number of OSC, with less than 40 cases reported on average in Italy in last years compared to about a thousand of expected cases incident in outdoor workers per year. An increasing in the reporting of OSC would certainly be important, for the purpose of a better recognition of the real dimension of the phenomenon, and to stimulate the implementation of adequate preventive strategies, in order to guarantee an improved protection of outdoor workers and a more appropriate prevention of the adverse health effects related to solar UV exposure.
2020
- Occupational solar UV exposure in construction workers in Italy: Results of a one-month monitoring with personal dosimeters
[Relazione in Atti di Convegno]
Modenese, A.; Gobba, F.; Paolucci, V.; John, S. M.; Sartorelli, P.; Wittlich, M.
abstract
Occupational exposure to solar UV radiation (UVR) is relevant in the construction sector. We performed a one month monitoring period in late spring of direct individual solar UVR exposure measurements in a group of three construction workers from the Tuscany Italian region, using the GENESIS-UV system for personal dosimetry and for the collection of long-term exposure data in a centralized dataset. Then, we compared personal UVR exposure data with the environmental erythemal dose in the same days in clear-sky conditions. The individual solar UVR exposures of the construction workers in the period between 22nd May and 22nd June 2017 in Tuscany varied between 85.5 and 1556.8 J/m2, while the average daily exposure considering all the three workers resulted 573.3 J/m2. The percentage between individual vs environmental exposure varied from 2.7 up to 31.2%, resulting 12.2 on average. Of the total amount of 40 days/worker measured we detected exposure levels above the 100 J/m2 proposed limit value in 39 days/worker, with exceeding of the limit up to ten times per day, more than five times on average. In terms of cumulative UVR exposure, the construction workers received on average a total one month exposure, based on 21 working days, of 12 kJ/m2, and we estimated an annual exposure of about 70 kJ/m2, approximately corresponding to 700 Standard Erythemal Doses. Our data show that the exposure levels of the Italian construction workers are very high in late spring, systematically exceeding the limit values. These UVR exposure levels can be considered potentially dangerous, in particular if associated with relevant cumulative annual UV doses received at the body, which are related to an increased risk of adverse effects, including skin cancers. Accordingly, a big effort is needed, to urgently reduce occupational solar UVR exposure in the construction sector, improving the application of preventive measures.
2020
- Personal solar ultraviolet radiation dosimetry in an occupational setting across Europe
[Articolo su rivista]
Wittlich, M; John, Sm; Tiplica, Gs; Sălăvăstru, Cm; Butacu, Ai; Modenese, A; Paolucci, V; D’Hauw, G; Gobba, F; Sartorelli, P; Macan, J; Kovačić, J; Grandahl, K; Moldovan, H
abstract
2020
- Physicians' deaths related to SARS-Cov-2 infections in Italy
[Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
2020
- Rischio di cataratta ed esposizione alle radiazioni ionizzanti negli operatori sanitari: un aggiornamento
[Articolo su rivista]
Modenese, Alberto; Della Vecchia, Elena; Muscatello, Martina; Rossi, Giorgia; Gobba, Fabriziomaria
abstract
2020
- Risk of cataract in health care workers exposed to ionizing radiation: A systematic review
[Articolo su rivista]
Vecchia, E. D.; Modenese, A.; Loney, T.; Muscatello, M.; Paulo, M. S.; Rossi, G.; Gobba, F.
abstract
Background: The eye is an important sensory organ occupationally exposed to ionizing radiation (IR) in healthcare workers (HCWs) engaged in medical imaging (MI). New evidence highlights the possible induction of cataract at IR exposure levels to be much lower than expected in the past. Objective: Conduct an updated review on the current evidence on cataract risk in healthcare workers exposed to IR. Methods: Published scientific studies on cataract risk in IR exposed healthcare workers were collected through a systematic search of two biomedical databases (MEDLINE and Scopus). Data from included studies was extracted and summarized. Study quality was also assessed. Results: All 21 eligible studies reported an increased prevalence of cataract, especially posterior subcapsular cataract, in IR exposed HCWs with a higher prevalence in interventional cardiology staff. Discussion: Our review synthesizes the latest evidence to support the hypothesis of a significantly increased risk of occupational cataract in healthcare workers operating MI and exposed to IR, especially in interventional cardiologists. Data also support a dose-response relationship between IR exposure and the prevalence of opacities, especially posterior subcapsular opacities. Con-clusions: Findings highlight the need for effective control measures including appropriate training, adherence to protective procedures, and a constant use of shields and eye personal protective equipment in healthcare workers with optical exposure to IR. Periodic health surveillance programs, possibly including lens evaluation, are also important to monitor cataract risk in these MI operators.
2020
- Sun protection habits and behaviors of a group of outdoor workers and students from the agricultural and construction sectors in north-Italy
[Articolo su rivista]
Modenese, A.; Loney, T.; Ruggieri, F. P.; Tornese, L.; Gobba, F.
abstract
Background: Despite the relevant frequency of ultraviolet induced adverse health effects in workers, solar ultraviolet radiation (UVR) exposure is an occupational risk not adequately minimized in Italy. Objective: To assess the characteristics and prevalence of sun exposure habits and behaviors in a group of students and outdoor workers (OW) from the agricultural and construction sectors of a north-Italian region. Methods: Based on a previously developed standardized questionnaire, we collected full information on individual sun exposure habits at work and during leisure activities. Results: In 2018, 380 high school students and OW from the agricultural and construction sectors participated in a sun-safety campaign. More than a third (39.0%) of OW reported never using sunglasses, 52.8% never applied sunscreens at work, and a quarter never wear a UV protective hat. Considering leisure-time, students reported more frequent sunburns compared to OW: 25.0% vs. 13.8%; half (51.6%) of students and a third (36.4%) of OW reported never wearing a UV protective hat. A third (30.1%) of students and 37.2% of OW never or only seldom applied sunscreens on holidays. Discussion: The majority of OW in our study reported poor protective solar exposure habits. Young students of the construction and agricultural sectors indicated even worse sun-protective behaviors, both during apprenticeship and leisure activities. Our study highlights the low health literacy related to solar UVR in OW and apprentices. Further educational initiatives are required in Italy to improve the adoption of protective behaviors during outdoor activities.
2020
- The development of the new guidelines of the Italian association of medical radioprotection (AIRM) for the protection of the workers exposed to EMF related risks: new approaches and criteria
[Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
An up-to-date knowledge on the occupational risk related to electromagnetic fields (EMF) exposure and its prevention, and on the criteria and methods for an appropriate health surveillance (HS) of exposed workers are highly important, as: EMF are almost ubiquitous; in recent years, relevant changes and advancements in the technologies applied have been observed, e.g. the introduction of new equipment for Magnetic Resonance, involving potentially higher exposures for operators, and the development of the 5G technology, using also EMF bands with millimetric wavelengths, not often applied previously; in Italy the new Legislative Decree 159/2016 has been promulgated, implementing the Directive 2013/35/EU and, accordingly, introducing several substantial changes to the Legislative Decree 81/2008 on safety and health at work, in particular to its fourth chapter of the eight section ("Physical Agents"), entitled "The protection of workers from the risks related to electromagnetic fields exposure". For these reasons, the Italian Association of Medical Radioprotection (AIRM) has fully revised the "Guidelines for the health surveillance of workers exposed to non-ionizing radiation", published in 2012 together with the Italian Society of Occupational Medicine (SIML). Therefore, AIRM involved a multidisciplinary panel of experts, working in accordance to a rigorous scientific methodology, based on the recognized international indications for the development of guidelines (GL) in the medical field, as those proposed by the Guidelines International Network (GIN), the Grading of Recommendations Assessment, Development and Evaluation (GRADE), the National Institute for Health and Care Excellence (NICE) and the Appraisal of Guidelines for Research and Evaluation (AGREE) collaboration. Furthermore, the multidisciplinary panel conducted a systematic review of the scientific literature according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyzes" (PRISMA) criteria, aimed at answering to specific research questions, including the "PECO" (Populations of interest, Exposures, Comparators, and Outcomes) questions. The final stages of the GL include the revision of the GL-draft from an external group of independent experts, giving also an overall evaluation and opinions on the Recommendations elaborated, so that the panel group can elaborate a final document to be shared again, after agreement among all the experts, with a consensus reached by Delphi method in case of disagreement. The main GL objective is to guide occupational physicians in charge for the HS of EMF exposed workers, providing up-to-date indications on the contents and methods for an adequate HS of the workers, but also on the regulations and standards applicable, on the relevant occupational EMF exposure sources, on the possible adverse effects to be considered, including indications on the biological mechanisms involved, on the conditions of particular susceptibility to the EMF risk, on the criteria to be considered for the evaluation of "fitness to work" in case of occupational EMF exposure and finally also on the contents of adequate information and training for the workers exposed. As a final objective, the AIRM GL on HS of workers exposed to EMF will be proposed for public consultation to the Italian National Guidelines System, as required according to the Law n. 24/2017, also known as the «Gelli law».
2019
- CEM: le condizioni che possono comportare una maggiore suscettibilità dei lavoratori e le misure di prevenzione.
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
2019
- Evaluation of Occupational Exposure to Perchlorethylene in a Group of Italian Dry Cleaners Using Noninvasive Exposure Indices
[Articolo su rivista]
Modenese, Alberto; Gioia, Tiziana Concetta; Chiesi, Andrea; Abbacchini, Carlotta; Borsari, Lucia; Ferrari, Davide; De Pasquale, Fabrizio; Di Rico, Renato; Ricci, Raffaella; Sala, Antonella; Gianaroli, Ennio; Predieri, Guerrino; Verri, Sara; Gobba, Fabriziomaria
abstract
Recent data suggest a general trend in decreased occupational exposure to perchlorethylene (PCE) in the dry-cleaning sector. The aims of this study were to confirm this trend to lower exposure levels in a group of Italian dry cleaners and to evaluate the current occupational PCE exposure in these works using noninvasive biological indices. Environmental exposure was assessed by personal sampling in 60 operators working in 21 dry cleaning shops in North Italy. PCE in the exhaled alveolar air (PCEalv), urinary concentration of PCE and of trichloroacetic acid (TCA) (PCEu and TCAu respectively), were measured as biological exposure indices. Median PCE environmental concentration in the whole sample was 10.6 mg/m3 (i.e., less than the 25% of the levels measured in the same area in a previous study). All values were less than 10% of the occupational limits. PCEu measured in samples collected at the end of the work shift resulted the biological markers having the strongest correlation with environmental PCE (r = 0.81). PCEalv also resulted in a high correlation (r = 0.66), while a lower correlation was found for TCAu measured at the end shift (r = 0.32). According to our results, PCEu can be proposed as a valid, noninvasive, and easily reliable exposure index to evaluate PCE exposure at the low levels currently observed in dry cleaners, therefore representing a promising alternative to invasive blood sample collections needed to determine PCE blood concentration.
2019
- Health surveillance of EMF-exposed workers at particular risk
[Relazione in Atti di Convegno]
Gobba, F.
abstract
SUMMARY: Present knowledge on the conditions possibly inducing a particular sensitivity to EMFs, and the relevant mechanisms involved, are presented and discussed. On the basis of the knowledge presented, the criteria that should be applied for the health surveillance of the workers in whom these conditions have been identified, are discussed.
2019
- Macular degeneration and occupational risk factors: a systematic review
[Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
Purpose: Macular degeneration is a multi-factorial disease, leading cause of blindness for people over 50 years old in developed countries. To date, the knowledge on possible occupational factors involved in the development of the disease is scant. Method: We performed a systematic scientific literature search on the association between macular degeneration and occupational risk factors searching the MedLine and Scopus databases. Results: We examined 158 articles and, according to the inclusion criteria, 13 peer-reviewed studies evaluating occupational risk factors for macular degeneration or reporting the frequency of the disease in specific groups of workers were included in the review. Ten on thirteen articles evaluated the presence of macular degeneration in workers exposed to solar radiation. Only one study found that non-specific history of occupational chemical exposure was associated with the disease. Two studies showed an association between macular degeneration and the general category of “blue-collar” workers, but they did not identify the specific risk factors involved. Conclusions: To date few studies have examined occupational risk factors for macular degeneration. Nevertheless, available data indicate that long-term occupational solar radiation exposure, in particular for its blue-light component, is associated with macular degeneration in outdoor workers.
2019
- Occupational Exposure to Solar UV Radiation of a Group of Fishermen Working in the Italian North Adriatic Sea
[Articolo su rivista]
Modenese, Alberto; Ruggieri, Francesco Pio; Bisegna, Fabio; Borra, Massimo; Burattini, Chiara; Della Vecchia, Elena; Grandi, Carlo; Grasso, Anna; Gugliermetti, Luca; Manini, Marco; Militello, Andrea; Gobba, Fabriziomaria
abstract
Occupational solar radiation exposure is a relevant heath risk in the fishing sector. Our aim was to provide a detailed evaluation of individual UV exposure in three different fishing activities in Italy, with personal UV dosimeters and a simple formula to calculate the fraction of ambient erythemal UV dose received by the workers. The potential individual UV exposure of the fishermen was between 65 and 542 Joules/m2. The percentages of the ambient exposure were estimated between 2.5% and 65.3%. Workers’ UV exposure was mainly influenced by the characteristics of the work activity, the postures adopted, and the type of boats. Overall, our data showed that 43% of the daily measurements could result largely above the occupational limits of 1–1.3 standard erythemal dose (i.e., 100 Joules/m2) per day, in case of exposure of uncovered skin areas. Measurements of individual UV exposure are important not only to assess the risk but also to increase workers’ perception and stimulate the adoption of preventive measures to reduce solar UV risk. Furthermore, the simple method proposed, linking ambient erythemal UV dose to the workers’ exposure, can be a promising tool for a reliable assessment of the UV risk, as time series of environmental UV dose are widely available
2019
- Occupational exposure to electromagnetic fields and prevention of possible adverse effects in workers: results of 20 years of research at the University of Modena and Reggio Emilia
[Capitolo/Saggio]
Modenese, Alberto; Bargellini, Annalisa; Gobba, Fabriziomaria
abstract
The occupational risk related to electromagnetic fields (EMF) exposure in workplaces is one of the main research fields developed in the last 20 years by the Chair of Occupational Medicine and the Chair of Hygiene of the Public Health Section of the Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia. During this period we have approached several topics in the field of exposure and prevention of EMF risk in occupational settings, including:
- the occupational and environmental Extremely Low Frequency – Electromagnetic Fields (ELF-EMF) exposure and effects in different groups of workers;
- the possible mechanisms of ELF-EMF effects in biological tissues;
- the development of best practices to manage and prevent the EMF related occupational risk in workers according to the European Directives, with particular consideration for health surveillance of exposed workers;
- the occupational risk and the health surveillance of Magnetic Resonance Imaging operators;
- the epidemiology of proposed adverse long-term effects of occupational EMF exposure.
2019
- PREVENZIONE DEL RISCHIO OCCUPAZIONALE DA ESPOSIZIONE A RADIAZIONE SOLARE: UN INTERVENTO FORMATIVO RIVOLTO A LAVORATORI DEL SETTORE MARITTIMO
[Abstract in Rivista]
Ruggieri, Francesco Pio; Grasso, Anna; Della Vecchia, Elena; Larese Filon, Francesca; Manini, Marco; Modenese, Alberto; Toffanin, Paolo; Gobba, Fabriziomaria
abstract
2019
- PROTEZIONE DEI LAVORATORI DAI CAMPI ELETTROMAGNETICI (CEM) E SORVEGLIANZA SANITARIA: DATI PRELIMINARI DI UNA RICERCA NELL’AMBITO DEL BANDO INAIL RICERCHE IN COLLABORAZIONE (BRiC) 2016
[Relazione in Atti di Convegno]
Modenese, A.; Carlotti, D.; Contessa, G. M.; D’Agostino, S.; Falsaperla, R.; Grandi, C.; Lopresto, V.; Pinto, R.; Polichetti, A.; Pozzi, R.; Gobba, F. M.
abstract
2019
- Prevenzione del rischio occupazionale da radiazione solare: realizzazione di un intervento formativo per i lavoratori e gli studenti del comparto agricolo ed edile in provincia di Modena
[Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
2019
- REVISIONE DI LETTERATURA SULLE CONOSCENZE SCIENTIFICHE RECENTI IN TEMA DI RISCHIO BIOLOGICO E CHIMICO NELLE STRUTTURE SANITARIE: UN’ATTIVITÀ REALIZZATA NELL’AMBITO DI UN PROGETTO CONGIUNTO UNIMORE, INAIL E AUSL DI MODENA, FINALIZZATO ALLA PREDISPOSIZIONE DI INDICAZIONI PRATICHE DI PREVENZIONE PER IL PERSONALE SANITARIO
[Abstract in Rivista]
Modenese, Alberto; Glieca, Francesca; Gualtieri, Giulia; Mazzoli, Tommaso; Rossi, Giorgia; Rosa Avino, Maria; Bonetti, Daniela; Bravo, Giulia; Ferrari, Davide; Innocenti, Massimo; Gobba, Fabriziomaria
abstract
2019
- STUDIO SUGLI EFFETTI SENSORIALI SOGGETTIVI IN OPERATORI DI RISONANZA MAGNETICA
[Abstract in Rivista]
Bertoldi, C.; Muscatello, M.; Venturelli, I.; Modenese, A.; Bravo, G.; Arcangeli, G.; Camisa, V.; Corona, G.; Giglioli, S.; Ligabue, G.; Moccaldi, R.; Mucci, N.; Vimercati, L.; Zaffina, S.; Zanotti, G.; Gobba, F.
abstract
2019
- Skin cancer in outdoor workers exposed to solar radiation: a largely underreported occupational disease in Italy
[Articolo su rivista]
Gobba, F; Modenese, A; John, S M
abstract
Background Solar UV radiation (sUVR) is one of the main carcinogen exposures in occupational settings, and UV-induced skin cancers are the most frequent tumours in fair-skinned individuals worldwide. Objectives According to this premise, we should expect a high number of occupational skin cancers reported to the national workers' compensation authorities each year, also considering that the incidence of skin cancers has been constantly increased in recent years Methods We examined the data on reported non-melanoma skin cancers (NMSC) and actinic keratoses (AK) to the Italian National Workers Compensation Authority (INAIL) from 2012 to 2017, and we compared the number of reported skin cancers for outdoor workers with the expected numbers, obtained from currently available NMSC incidence rates for the Italian population applied to the occupational sUVR-exposed workers estimated with the CAREX methodology in Italy in 2005. Results The cases of NMSC reported each year to INAIL in Italy are 34 per year on average, while for AK the mean number of reported cases is of only 15/year. We estimated a number of expected NMSC cases in Italy for solar UV-exposed workers ranging between 432 and 983, representing a proportion between reported vs. expected skin cancers of only 3.5-6.2%. Conclusions Our study clearly shows that occupational skin cancers in Italy are largely underreported, and, accordingly, urgent initiatives should be taken to raise appropriate awareness to the problem of occupational sUVR-induced skin cancers, so that adequate preventive measures can be implemented rapidly.
2019
- TUMORI PROFESSIONALI DELLA CUTE: ESPOSIZIONI A RISCHIO E ASPETTI EPIDEMIOLOGICI
[Abstract in Rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
2019
- WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of occupational exposure to solar ultraviolet radiation and of the effect of occupational exposure to solar ultraviolet radiation on cataract
[Articolo su rivista]
Tenkate, Thomas; Adam, Balazs; Al-Rifai, Rami H.; Chou, B. Ralph; Gobba, Fabriziomaria; Ivanov, Ivan D.; Leppink, Nancy; Loney, Tom; Pega, Frank; Peters, Cheryl E.; Prüss-Üstün, Annette M.; Silva Paulo, Marilia; Ujita, Yuka; Wittlich, Marc; Modenese, Alberto
abstract
Background: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. Here, we present the protocol for two systematic reviews of parameters for estimating the number of disability-adjusted life years of cataracts from occupational exposure to solar ultraviolet radiation, to inform the development of the WHO/ILO joint methodology. Objectives: We aim to systematically review studies on occupational exposure to solar ultraviolet radiation (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational exposure to solar ultraviolet radiation on the development of cataract (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework and conducting both systematic reviews in tandem and in a harmonized way. Data sources: Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and Web of Sciences. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand search reference list of previous systematic reviews and included study records; and consult additional experts. Study eligibility and criteria: We will include working-age (≥15 years) workers in WHO and/or ILO Member States, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative studies on the prevalence of relevant levels of occupational exposure to solar ultraviolet radiation and of the total working time spent outdoors from 1960 to 2018, stratified by sex, age, country and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of any occupational exposure to solar ultraviolet radiation (i.e. ≥30 Jm −2 /day of occupational solar UV exposure at the surface of the eye) on the prevalence or incidence of cataract, compared with the theoretical minimum risk exposure level (i.e. <30 Jm −2 /day of occupational solar UV exposure at the surface of the eye). Study appraisal and synthesis methods: At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration: CRD42018098897.
2019
- WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of occupational exposure to solar ultraviolet radiation and of the effect of occupational exposure to solar ultraviolet radiation on melanoma and non-melanoma skin cancer
[Articolo su rivista]
Paulo, Marilia Silva; Adam, Balazs; Akagwu, Cyril; Akparibo, Issaka; Al-Rifai, Rami H.; Bazrafshan, Sholeh; Gobba, Fabriziomaria; Green, Adele C.; Ivanov, Ivan; Kezic, Sanja; Leppink, Nancy; Loney, Tom; Modenese, Alberto; Pega, Frank; Peters, Cheryl E.; Prüss-Üstün, Annette M.; Tenkate, Thomas; Ujita, Yuka; Wittlich, Marc; John, Swen M.
abstract
Background: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from melanoma and non-melanoma skin cancer (or keratinocyte carcinoma) from occupational exposure to solar ultraviolet radiation, to inform the development of the WHO/ILO joint methodology. Objectives: We aim to systematically review studies on occupational exposure to solar ultraviolet radiation (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational exposure to solar ultraviolet radiation on melanoma and non-melanoma skin cancer (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework and conducting both systematic reviews in tandem and in a harmonized way. Data sources: Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and Web of Science. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records and consult additional experts. Study eligibility and criteria: We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative studies on the prevalence of relevant levels of occupational exposure to solar ultraviolet radiation (i.e. <0.33 SED/d and ≥0.33 SED/d) and of the total working time spent outdoors, stratified by country, sex, age and industrial sector or occupation, in the years 1960 to 2018. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of any occupational exposure to solar ultraviolet radiation (i.e., ≥0.33 SED/d) on the prevalence of, incidence of or mortality due to melanoma and non-melanoma skin cancer, compared with the theoretical minimum risk exposure level (i.e. <0.33 SED/d). Study appraisal and synthesis methods: At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess the risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42018094817.
2018
- 1334 A simple method to determine the cumulative dose in outdoor workers exposed to solar radiation
[Abstract in Rivista]
Borra, M; Bisegna, F; Burattini, C; Gobba, F; Grandi, C; Gugliermetti, F; Militello, A; Modenese, A
abstract
2018
- 1616a Main factors influencing occupational solar uv exposure
[Abstract in Rivista]
Gobba, Fabriziomaria
abstract
2018
- 1616 Title of (joint) special session ‘oed’ and ‘radiation at work’: how to tackle the increasing disease burden of occupational skin cancer
[Abstract in Rivista]
Malte John, Swen; Gobba, Fabriziomaria
abstract
2018
- 1649 Electromagnetic fields: occupational exposure and prevention in workers. an update
[Abstract in Rivista]
Gobba, Fabriziomaria
abstract
2018
- 1650a Subjective symptoms in magnetic resonance imaging operators: preliminary results of an italian study
[Abstract in Rivista]
Zanotti, G; Modenese, A; Bravo, G; Arcangeli, G; Camisa, V; Corona, G; Giglioli, S; Ligabue, G; Moccaldi, R; Mucci, N; Vimercati, L; Zaffina, S; Gobba, F
abstract
2018
- 1650 Magnetic resonance imaging (mri) workers: emf exposure, occupational risk and prevention. an update
[Abstract in Rivista]
Gobba, Fabriziomaria
abstract
2018
- 1651 Solar uv: a relevant occupational risk overlooked. exposure in workers, effects, prevention
[Abstract in Rivista]
Gobba, Fabriziomaria
abstract
2018
- 931 Occupational skin cancer in outdoor workers in italy: expected number vs cases recognised by the italian national compensation authority (inail)
[Abstract in Rivista]
Modenese, Alberto; Korpinen, Leena; Gobba, Fabriziomaria
abstract
2018
- 934 Gliomas incidence in italy
[Abstract in Rivista]
Modenese, Alberto; Korpinen, Leena; Gobba, Fabriziomaria
abstract
2018
- Cataract frequency and subtypes involved in workers assessed for their solar radiation exposure: a systematic review
[Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
Cataract is currently the primary cause of blindness worldwide, and one of its main risk factors is solar ultraviolet radiation exposure. According to the localization of lens opacities, three main subtypes of cataract are recognized: nuclear, cortical and posterior subcapsular cataract. One of the main determinants of individual long-term solar radiation exposure is outdoor work. We systematically reviewed scientific literature from the last 20 years to update the recent development of research on the risk of cataract in outdoor workers and on the specific subtypes involved, also investigating the methods applied to evaluate the occupational risk. A total of 15 studies were included in the review, of which 12 showed a positive association. The studies confirm the relationship of long-term occupational solar radiation exposure with cortical cataract and give new support for nuclear cataract, although no substantial new data were available to support a relation with the posterior subcapsular subtype. In most of the studies, the exposure assessment was not adequate to support a representative evaluation of the ocular risk; however, outdoor work is clearly a relevant risk factor for cataract. Further research providing a better evaluation of the relation between solar radiation exposure levels and lens damage in workers is needed and aimed to establish adequate occupational exposure limits and better preventive measures, studying also their effectiveness.
2018
- Developing an algorithm to assess the UV erythemal dose for outdoor workers Validation through direct measures
[Relazione in Atti di Convegno]
Borra, M; Grandi, C; Militello, A; Burattini, C; Gugliermetti, L; Mangione, A; Bisegna, F; Modenese, A; Gobba, F
abstract
An algorithm has been developed to determine the annual dose of UV solar radiation for outdoor workers. The dose is indirectly assessed basing on satellite data, mean global irradiance values, workers' data obtained by means of a questionnaire and corrective coefficients provided by a mathematical model. The values obtained by the use of the algorithm are compared with those obtained by measurement records in different environments. Results demonstrated that the algorithm estimates the mean daily erythemal dose with good approximation.
2018
- I RISCHI OCCUPAZIONALI ATTUALI NEL PERSONALE SANITARIO DELLA DIAGNOSTICA PER IMMAGINI: UNA REVISIONE DEI DATI DELLA LETTERATURA
[Abstract in Atti di Convegno]
Della Vecchia, Elena; Muscatello, Martina; Rossi, Giorgia; Modenese, Alberto; Gobba, Fabriziomaria
abstract
2018
- L'esposizione a campi elettromagnetici (CEM) nelle strutture sanitarie: le principali sorgenti, dati attuali sui possibili effetti
[Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
2018
- LA COPERTURA VACCINALE ANTINFLUENZALE NEGLI OPERATORI SANITARI
[Abstract in Atti di Convegno]
Stefani, M.; Corona, G.; Marchegiano, P.; Melloni, P.; Modenese, Alberto; Nikollau, N.; Placidi, D.; Gobba, Fabriziomaria
abstract
2018
- MONITORAGGIO DOSIMETRICO DELL’ESPOSIZIONE A RADIAZIONE SOLARE IN LAVORATORI DEL SETTORE MARITTIMO
[Abstract in Atti di Convegno]
Ruggieri, Francesco Pio; Bisegna, Fabio; Borra, Massimo; Burattini, Chiara; Della Vecchia, Elena; Foddis, Rudy; Grandi, Carlo; Grasso, Anna; Gugliermetti, Luca; Larese Filon, Francesca; Manini, Mauro; Militello, Andrea; Modenese, Alberto; Toffanin, Paolo; Gobba, Fabriziomaria
abstract
2018
- Occupational exposure to solar radiation at different latitudes and pterygium: A systematic review of the last 10 years of scientific literature
[Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
Pterygium is a chronic eye disease: among its recognized risk factors there is long-term exposure to ultraviolet (UV) radiation. The Sun is the main source of UV exposure: according to the World Health Organization, the Population Attributable Fraction of pterygium due to solar radiation (SR) is 42–74%. Outdoor work can deeply influence the eye exposure to solar UV rays, but, despite this, pterygium is currently not adequately considered as a possible occupational disease in this working category, at least in Europe. For this reason, we performed a systematic review of the scientific literature published in the last ten years (2008–2017) considering the role of outdoor work as a risk factor for pterygium, in order to give new support for the prevention of this UV related disease in workers. We identified 29 relevant papers. Our results show that pterygium prevalence highly increased with latitude and mean annual UV index, and outdoor work is one of the most relevant risk factors, as well as age and male sex, both in high risk and in moderate risk World areas considering the environmental UV levels. Accordingly, pterygium occurring in outdoor workers should be considered an occupational disease. Moreover, our findings clearly support the need of further research on more effective prevention of the occupational risk related to long-term solar radiation exposure of the eye.
2018
- PREVENZIONE DEL RISCHIO DA ESPOSIZIONE OCCUPAZIONALE A RADIAZIONE SOLARE: UN INTERVENTO FORMATIVO RIVOLTO A LAVORATORI, DOCENTI E STUDENTI DEI SETTORI AGRICOLO E EDILE
[Abstract in Atti di Convegno]
Modenese, Alberto; Avino, M. R.; Delli Carri, R.; Innocenti, M.; Gobba, Fabriziomaria
abstract
2018
- Self-reported wrist and finger symptoms associated with other physical/mental symptoms and use of computers/mobile phones
[Articolo su rivista]
Korpinen, Leena; Pã¤ã¤kkã¶nen, Rauno; Gobba, Fabriziomaria
abstract
Recently, computer, mobile phone and Internet use has increased. This study aimed to determine the possible relation between self-reported wrist and finger symptoms (aches, pain or numbness) and using computers/mobile phones, and to analyze how the symptoms are specifically associated with utilizing desktop computers, portable computers or mini-computers and mobile phones. A questionnaire was sent to 15,000 working-age Finns (age 18â65). Via a questionnaire, 723 persons reported wrist and finger symptoms often or more with use. Over 80% use mobile phones daily and less than 30% use desktop computers or the Internet daily at leisure, e.g., over 89.8% quite often or often experienced pain, numbness or aches in the neck, and 61.3% had aches in the hips and the lower back. Only 33.7% connected their symptoms to computer use. In the future, the development of new devices and Internet services should incorporate the ergonomics of the hands and wrists.
2018
- Solar radiation exposure and outdoor work: An underestimated occupational risk
[Articolo su rivista]
Modenese, Alberto; Korpinen, Leena; Gobba, Fabriziomaria
abstract
A considerably high number of outdoor workers worldwide are constantly exposed for the majority of their working life to solar radiation (SR); this exposure is known to induce various adverse health effects, mainly related to its ultraviolet (UV) component. The skin and the eye are the principal target organs for both acute and long-term exposure. Actinic keratosis, non-melanoma skin cancers, and malignant melanoma are the main long-term adverse skin effects, whereas in the eye pterygium, cataracts, and according to an increasing body of evidence, macular degeneration may be induced. Despite this, SR exposure risk is currently undervalued, if not neglected, as an occupational risk factor for outdoor workers. SR exposure is influenced by various environmental and individual factors, and occupation is one of the most relevant. For a better understanding of this risk and for the development of more effective prevention strategies, one of the main problems is the lack of available and adequate methods to estimate SR worker exposure, especially long-term exposure. The main aims of this review were to provide a comprehensive overview of SR exposure risk of outdoor workers, including the UV exposure levels and the main methods recently proposed for short-term and cumulative exposure, and to provide an update of knowledge on the main adverse eye and skin effects. Finally, we also outline here preventive interventions to reduce occupational risk.
2018
- Stakeholders' views on vocational rehabilitation programs: a call for collaboration with Occupational Health Physicians
[Articolo su rivista]
Mattei, Giorgio; Sacchi, Valentina; Alfieri, Salvatore; Bisi, Antonella; Colombini, Niccolò; Ferrari, Silvia; Giubbarelli, Giuseppe; Gobba, Fabriziomaria; Modenese, Alberto; Pingani, Luca; Rigatelli, Marco; Rossetti, Marisa; Venturi, Giulia; Starace, Fabrizio; Galeazzi, Gian Maria
abstract
The triple-dip recession taking place in Italy in 2008-2014 impacted negatively on health, mainly by increasing the rate of unemployment. This increased the prevalence of mental health disorders, while reducing the number of available places on vocational rehabilitation programs (VRPs) delivered by the psychiatric services.
2018
- Strumenti web interattivi per supportare le PMI nella gestione della SSL orientata al miglioramento continuo
[Relazione in Atti di Convegno]
Mosconi, Simone; Avino, M. R.; Gobba, F.; Iotti, A.; Zuccarello, G. A.; Melloni, R.
abstract
Il presente lavoro illustra un approccio metodologico, supportato da un applicativo web, per
l’individuazione e la condivisione di azioni di prevenzione da attuare nel settore merceologico
della metalmeccanica, con particolare attenzione alle attività di assemblaggio, fonte
importante di malattie professionali che comportano disturbi muscolo scheletrici.
L’approccio metodologico presentato è caratterizzato da un elevato grado di flessibilità per
cui risulta estensibile a qualunque settore merceologico. La finalità del progetto proposto è
lo sviluppo di strumenti di condivisione del patrimonio delle conoscenze in materia di salute
e sicurezza sul lavoro, distribuito sulle diverse figure operanti a vario titolo nel mondo
della produzione, finalizzato alla realizzazione di uno strumento web che consente la condivisione
delle condizioni di pericolo, la raccolta e la messa in comune delle cause, spesso di
natura comportamentale e organizzativa, l’individuazione delle azioni di prevenzione, al fine
di facilitare gli attori della prevenzione e fornire un supporto efficace ai datori di lavoro, agli
RSPP, agli RLS e ai preposti.
2017
- Effetti dei campi elettromagnetici nei lavoratori professionalmente esposti: le evidenze scientifiche, le decisioni della magistratura.
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto; Zanotti, Giulio
abstract
2017
- Epidemiologia delle neoplasie indotte dall’esposizione a NIR
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
2017
- Esposizione a radiazione solare e cataratta: un aggiornamento delle conoscenze della letteratura scientifica.
[Abstract in Atti di Convegno]
Mazzoli, T; Grasso, A; Gualtieri, G; Carozza, Lm; Modenese, A; Gobba, F.
abstract
Esposizione a radiazione solare e cataratta: un aggiornamento delle conoscenze della letteratura scientifica.
2017
- Esposizione occupazionale ed ambientale a radiazione solare e degenerazione maculare: una revisione dei dati epidemiologici dell’ultimo decennio.
[Abstract in Atti di Convegno]
Gualtieri, Giulia; Grasso, Anna; Mazzoli, Tommaso; Carozza, Lm; Modenese, A; Gobba, F.
abstract
Esposizione occupazionale ed ambientale a radiazione solare e degenerazione maculare: una revisione dei dati epidemiologici dell’ultimo decennio.
2017
- Esposizione professionale a radiazione solare: il dosaggio di dimeri di timina urinari per la stima del danno cutaneo da UV.
[Abstract in Atti di Convegno]
Loscerbo, Roberto; Modenese, A; Tomasini, Emanuela; Gobba, F.
abstract
Esposizione professionale a radiazione solare: il dosaggio di dimeri di timina urinari per la stima del danno cutaneo da UV.
2017
- Health Risk Assessment per esposizione occupazionale a sostanze chimiche cancerogene e non cancerogene nel riciclo di rifiuti di apparecchiature elettriche e elettroniche (RAEE): dati dal progetto WeeenModels.
[Abstract in Atti di Convegno]
Modenese, A; Ferrari, Am; Gamberini, R; Grasselli, L; Neri, P; Pini, M; Rimini, B; Vinceti, M; Violi, F; Gobba, F.
abstract
Health Risk Assessment per esposizione occupazionale a sostanze chimiche cancerogene e non cancerogene nel riciclo di rifiuti di apparecchiature elettriche e elettroniche (RAEE): dati dal progetto WeeenModels.
2017
- Impact of the economic crisis on mental health. Report of a multidisciplinary Seminar held in Sassuolo (Modena), June 17th, 2016
[Articolo su rivista]
Visentini, Chiara; Mattei, Giorgio; Gobba, Fabriziomaria; Giubbarelli, G; Ferrari, Silvia
abstract
Il paper descrive un'esperienza di collaborazione a fini formativi tra psichiatri e medici del lavoro, nell'ambito di un più ampio progetto integrativo in corso in provincia di Modena.
2017
- La sorveglianza sanitaria dei lavoratori esposti a campi elettromagnetici: obblighi alla luce dei recenti aggiornamenti normativi in Italia
[Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
2017
- La valutazione dell’esposizione professionale a radiazione solare negli studi epidemiologici su lavoratori: una revisione della letteratura.
[Abstract in Atti di Convegno]
Carozza, Lm; Grasso, A; Mazzoli, T; Gualtieri, G; Modenese, A; Gobba, F.
abstract
La valutazione dell’esposizione professionale a radiazione solare negli studi epidemiologici su lavoratori: una revisione della letteratura.
2017
- Latenza dei disturbi muscolo scheletrici in un campione di personale sanitario
[Abstract in Atti di Convegno]
Stefani, Marco; Lanfranchi, Giordano; Modenese, A; Gobba, F.
abstract
Abstract presentato al 80° Congresso Nazionale SIMLII tenutosi a Padova dal 20 al 22 Settembre 2017, riportante dati sulla latenza dell'insorgenza di disturbi muscolo scheletrici in un campione di personale sanitario
2017
- Monitoraggio dosimetrico dell’esposizione a radiazione solare nel settore edile
[Abstract in Atti di Convegno]
Modenese, A; Paolucci, V; D’Hauw, G; Gobba, F; Sartorelli, P.
abstract
Monitoraggio dosimetrico dell’esposizione a radiazione solare nel settore edile.
2017
- Near Retirement Age (≥55 Years) Self-Reported Physical Symptoms and Use of Computers/Mobile Phones at Work and at Leisure
[Articolo su rivista]
Korpinen, Leena; Pääkkönen, Rauno; Gobba, Fabriziomaria
abstract
The aim of this research is to study the symptoms and use of computers/mobile phones of individuals nearing retirement age (≥55 years). A questionnaire was sent to 15,000 Finns (aged 18-65). People who were ≥55 years of age were compared to the rest of the population. Six thousand one hundred and twenty-one persons responded to the questionnaire; 1226 of them were ≥55 years of age. Twenty-four percent of the ≥55-year-old respondents used desktop computers daily for leisure; 47.8% of them frequently experienced symptoms in the neck, and 38.5% in the shoulders. Workers aged ≥55 years had many more physical symptoms than younger people, except with respect to symptoms of the neck. Female daily occupational users of desktop computers had more physical symptoms in the neck. It is essential to take into account that, for people aged ≥55 years, the use of technology can be a sign of wellness. However, physical symptoms in the neck can be associated with the use of computers.
2017
- Studio sugli infortuni oculari professionali nel territorio di Modena e Provincia.
[Abstract in Atti di Convegno]
Dall’Olio, E; Clo', Elena; Sernesi, Mv; Gualdi, Eugenia; Gobba, F; Cavallini, G.
abstract
Studio sugli infortuni oculari professionali nel territorio di Modena e Provincia.
2017
- The biomechanical overload of the upper limb: a neglected occupational hazard in animal facility operators
[Articolo su rivista]
Occhionero, Vincenzo; Ghersi, Rinaldo; Prandini, Lucio; Korpinen, Leena; Gobba, Fabriziomaria
abstract
Data on biomechanical overload of the upper limb in animal facility operators are currently scanty. We decided to study this risk in a university animal facility. Eleven different tasks performed by operators were identified. For each of them, the biomechanical overload of the upper limb was evaluated by applying 4 different methods frequently used, hypothesising a task duration of 4 and 8 h. Then two 'typical' real working days of the examined facility were reconstructed, and the risk for operators was calculated using the OCRA Index, Checklist and Mini-Checklist. Considering the specific tasks, the results show some difference among methods, but the overall results show an acceptable/slight risk of biomechanical overload of the upper limb in animal facility operators during typical working days. Practitioner Summary: Upper limb biomechanical overload (UL-BO) is a neglected risk in animal facilities. In a university facility, 11 different tasks were identified, and 2 typical working days were analysed. Even if some task at increased risk may exist, during typical working days, the overall results show that the risk of UL-BO in operators can be considered usually acceptable or, at worst, slight
2017
- Work-related eye injuries: A relevant health problem. main epidemiological data from a highly-industrialized area of northern Italy
[Articolo su rivista]
Gobba, Fabriziomaria; Dall'Olio, Enrico; Modenese, Alberto; DE MARIA, Michele; Campi, Luca; Cavallini, Gian Maria
abstract
The province of Modena is one of the most industrialized areas of Northern Italy. The medical records of the Ophthalmological Emergency Department (OED) of Modena University Hospital were studied: there were 13, 470 OED accesses in 2014 and in 754 cases that an occupational eye injury occurred. The frequency of work-related eye injuries (3â °) was lower compared to other published studies, but the absolute number is still relevant, showing the need for more adequate prevention, especially in metal work, construction work, and agriculture, where the worst prognoses were observed. Intervention programs must be implemented as early as possible in the working life, considering that the frequency in younger workers is about double that of the oldest age class (3.5â °vs. 1.8â °), and special attention should also be given to foreigners, who have a 50% higher injury risk. Furthermore, the planning of specific interventions for eye-injured workers may be useful, considering that a previous injury does not appear to encourage the adoption of preventive interventions, and a subgroup of eye-injured workers have a potential risk for new injuries. Finally, the data presented here indicates how OED records, integrated with specific occupational information, can be applied for studies on work-related eye injuries.
2017
- Work-related stress and role of personality in a sample of Italian bus drivers
[Articolo su rivista]
Bergomi, Margherita; Modenese, Alberto; Ferretti, Enrica; Ferrari, Angela; Licitra, Giuseppe; Vivoli, Roberto; Gobba, Fabriziomaria; Aggazzotti, Gabriella
abstract
BACKGROUND: Several studies have shown that professional drivers are at risk of developing work-related stress. Stress may be responsible for a variety of adverse effects and may also be associated with an increased number of accidents. OBJECTIVE: Perform an integrated, objective and subjective evaluation of work-related stress in bus drivers, that also considered the role of personality traits. METHODS: Salivary α-amylase and cortisol were measured in 42 bus drivers. Subjective stress evaluation was performed with the Perceived Stress Scale (PSS-10) and Driver Stress Inventory (DSI). To evaluate personality traits, we administered the Eysenck Personality Questionnaire-Revised (EPQ-R) and the Impulsivity Inventory (IVE). RESULTS: Salivary biomarkers showed no associations with PSS-10 and personality traits. Cortisol levels were positively correlated with fatigue (r = 0.44) at the middle of the work-shift and with aggression (r = 0.51) at the end of a day off. At the end of the work-shift, cortisol levels were negatively correlated with hazard monitoring (r = -0.37) and salivary α-amylase was positively correlated with thrill-seeking (r = 0.36). Neuroticism (β = 0.44) and impulsiveness (β = 0.38) were predictors of perceived stress by multiple regression. CONCLUSIONS: An integrated method, considering both objective and subjective indicators, seems adequate to evaluate work-related stress in professional drivers. Personality traits are relevant in determining perception of stress.
2016
- Assessing Cancer Risk from Heavy Metals in Recycling Waste Electrical and Electronic Equipment: Preliminary Results from the WEENMODELS European Life Programme
[Abstract in Rivista]
Violi, Federica; Modenese, Alberto; Gobba, Fabriziomaria; Ferrari, Anna Maria; Rimini, Bianca; Gamberini, Rita; Pini, Martina; Neri, Paolo; Filippini, Tommaso; Grasselli, Luigi; Montanari, Pinuccia; Vinceti, Marco
abstract
Introduction
The growing amount of waste derived from electrical and electronic equipment (WEEE) poses significant challenges to waste management, due to the presence of toxic chemicals with environmental and health implications for the general population and for occupationally-exposed workers.
Methods
Based on an toxicological and epidemiologic evaluation, we carried out a health risk assessment to evaluate the cancer risk deriving from environmental and occupational exposure to heavy metals released during different WEEE recycling procedures (electronic scrap in blister copper, treatment of metals recovery in copper smelter, treatment of shredding, pyrometallurgical treatment of Li-ion battery). We considered the typical WEEE production in a municipality of 150.0000 inhabitants, carrying out a Life Cycle Assessment. Outdoor (1 square km around a treatment plant) and indoor (for a factory volume of 3200 m3) emissions generated during the WEEE recycling procedures were computed. In particular, we estimated the amount of Cd, Ni and As inhaled by the potentially exposed population. We computed the cancer risk due to inhalation of these heavy metals in residents and workers using the methodology proposed by the California Office of Environmental Health and Hazard Assessment
Results
For the metals considered, our results showed negligible cancer risk (from 2,21x10-11 to 4,31x10-08) for the general population around the plant. On the converse, occupational exposures linked to specific procedures were associated with a cancer risk of 1,42x10-3 for workers in the shredding procedures mainly due to Ni exposure, and of 4,68x10-4 for workers with electronic scrap and exposed to As.
Conclusions
Based on our preliminary results from an integrated toxicological and epidemiologic approach, WEEE life cycle may be linked to health risks for workers in the recycling procedures, while it does not seem to adversely affect health of the general population around the treatment plants.
2016
- Assessing cancer risk from heavy metal exposure in recycling waste of electrical and electronic equipment: preliminary results from the Weeenmodels European Life Programme.
[Abstract in Atti di Convegno]
Violi, Federica; Modenese, Alberto; Gobba, Fabriziomaria; Ferrari, Anna Maria; Rimini, Bianca; Gamberini, Rita; Pini, M; Neri, P; Filippini, Tommaso; Grasselli, Luigi; Montanari, P; Vinceti, Marco
abstract
Introduction
The growing amount of waste derived from electrical and electronic equipment (WEEE) poses significant challenges to waste management, due to the presence of toxic chemicals with environmental and health implications for the general population and for occupationally-exposed workers.
Methods
Based on an toxicological and epidemiologic evaluation, we carried out a health risk assessment to evaluate the cancer risk deriving from environmental and occupational exposure to heavy metals released during different WEEE recycling procedures (electronic scrap in blister copper, treatment of metals recovery in copper smelter, treatment of shredding, pyrometallurgical treatment of Li-ion battery). We considered the typical WEEE production in a municipality of 150.0000 inhabitants, carrying out a Life Cycle Assessment. Outdoor (1km2 around a treatment plant) and indoor (for a factory volume of 3200m3) emissions generated during the WEEE recycling procedures were computed. In particular, we estimated the amount of Cd, Ni and As inhaled by the potentially exposed population. We computed the cancer risk due to inhalation of these heavy metals in residents and workers using the methodology proposed by the California Office of Environmental Health and Hazard Assessment
Results
For the metals considered, our results showed negligible cancer risk (from 2,21x10-11 to 4,31x10-08) for the general population around the plant. On the converse, occupational exposures linked to specific procedures were associated with a cancer risk of 1,42x10-3 for workers in the shredding procedures mainly due to Ni exposure, and of 4,68x10-4 for workers with electronic scrap and exposed to As.
Conclusions
Based on our preliminary results from an integrated toxicological and epidemiologic approach, WEEE life cycle may be linked to health risks for workers in the recycling procedures, while it does not seem to adversely affect health of the general population around the treatment plants.
2016
- Blue-Collar Workers' Accidents and Close Call Situations Connected to the Use of Cell Phones among Finns Aged 18-65
[Articolo su rivista]
Korpinen, Leena; Pääkkönen, Rauno; Gobba, Fabriziomaria
abstract
There has been discussion if the use of mobile phones causes accidents. We studied workers’ accidents and near accidents related to the use of phones. This study is part of a large cross-sectional study that was carried out on 15,000 working-age Finns. We noticed that there were 4–5 times more close call situations than accidents connected to mobile phones and also work related accidents were fewer than leisure related. There are confusing parameters like the use of mobile phones at work, differences in work content between women and men.
2016
- CANCER RISK FROM HEAVY METAL EXPOSURE IN RECYCLING WASTE OF ELECTRICAL AND ELECTRONIC EQUIPMENT: PRELIMINARY RESULTS FROM THE WEEENMODELS EUROPEAN LIFE PROGRAM
[Abstract in Atti di Convegno]
Violi, Federica; Modenese, Alberto; Gobba, Fabriziomaria; Ferrari, Anna Maria; Rimini, Bianca; Gamberini, Rita; Pini, Martina; Neri, Paolo; Filippini, Tommaso; Grasselli, Luigi; Montanari, Pinuccia; Vinceti, Marco
abstract
Background and objectives: When electrical and electronic equipment reaches
its end of life, it becomes ‘Waste Electrical and Electronic Equipment’ (WEEE).
The growing amount of this type of waste has posed significant challenges to
waste management, since WEEE contains a whole range of toxic chemicals
having relevant environmental and health implications. The WEEE life cycle
may expose the general population and workers to various toxic chemicals, such
as heavy metals.
We conducted a health risk assessment to evaluate the cancer risk derived from
environmental and occupational exposure to trace elements from different
recycling procedures (electronic scrap in blister copper, treatment of metals
recovery in copper smelter, treatment of shredding, pyrometallurgical treatment of
Li-ion battery). We considered the typical production of WEEE in a municipality
of 150.0000 inhabitants, where a Life Cycle assessment (LCA) was carried out.
Methods: Outdoor (1km2 around a WEEE treatment plant) and indoor (factory
volume of 3200m3) emissions generated from the above-mentioned procedures
were computed, to perform a health risk assessment for occupationally-exposed
workers and for the general population around the plant. Dose of the heavy
metals cadmium, nickel, arsenic inhaled by the potentially exposed population
was estimated using the values obtained through a toxicological model. Cancer
risk due to inhalation was calculated using the method proposed by the California
Office of Environmental Health and Hazard Assessment.
Results and Conclusions: For the heavy metals considered, generated from
WEEE treatment, these preliminary results show negligible cancer risk for the
general population. On the converse, some risks may be present for occupational
exposures linked to specific procedures (from cancer risk of 1,42x10-3 for men
working in shredding procedure and exposed to nickel to cancer risk of 4,68x10-
4 for women working with electronic scrap and exposed to arsenic).
2016
- Corioretinite acuta da esposizione a ROA nel campo dell’infrarosso in un lavoratore di una acciaieria.
[Articolo su rivista]
Taino, Giuseppe; Modenese, Alberto; Zanotti, Giulio; Gobba, Fabriziomaria
abstract
L’esposizione a Radiazione Ottica Artificiale (ROA) incoerente, per quanto concerne l’ambito della radiazione infrarossa (IR), interessa le lunghezze d’onda di radiazione non ionizzante da 780 nm a 1 millimetro, ovvero dell’IR-A (780-1400 nm), IR-B (1400-3000 nm) e IR-C (3000 nm – 1 mm).
La radiazione IR, come le altre componenti della ROA, visibile e ultravioletto (UV), ha un potere di penetrazione nei tessuti biologici relativamente basso, e per questo il principale rischio è la possibilità di insorgenza di effetti avversi a livello oculare e cutaneo.
Con particolare riferimento all’occhio, si ricorda che le IR sono assorbite da diverse strutture oculari in dipendenza della lunghezza d’onda: la quasi totalità di IR-C e una parte sostanziale di IR-B sono assorbiti a livello corneale; l’IR B è assorbito in buona parte anche da altre strutture quali l’iride ed il cristallino, mentre l’IR-A, o “vicino infrarosso”, in quanto confinante con la regione del visibile, è assorbito dal cristallino, ma in gran parte anche a livello retinico.
L’interazione delle IR con le strutture oculari avviene con meccanismi di tipo termico, ovvero l’insorgenza del possibile danno oculare dipende strettamente dall’aumento di temperatura indotto dalla radiazione nell’occhio. Tra gli effetti avversi a breve termine si ricordano le ustioni corneali e retiniche, tra quelli a lungo termine va certamente citata la possibilità di insorgenza di cataratta.
Il rischio lavorativo da IR incoerenti è noto già dal XXVII secolo e le prime dettagliate descrizioni delle problematiche oculari a cui potevano andare incontro i lavoratori esposti a IR sono rintracciabili all’interno del De Morbis Artificum Diatriba di Bernardino Ramazzini.
Ad oggi l’esposizione occupazionale a IR è rimasta, come da alcuni secoli a questa parte, principalmente determinata dalla lavorazione di materiali, quali metalli e vetro, portati ad elevatissime temperature. Accanto a queste lavorazioni che potremmo definire storiche, attualmente le IR sono ampiamente utilizzate anche in apparecchi ad uso industriale quali ad esempio sistemi per la visione notturna e la termografia.
Come le altre bande della ROA, il rischio occupazionale da IR è normato a livello nazionale dal titolo VIII, capo V, del D.Lgs. 81/2008 e s.m.i. e nell’allegato XXXVII sono riportate le tabelle dei Valori Limite di Esposizione (VLE) attualmente vigenti per le IR incoerenti, sia per quanto riguarda il rischio retinico, dove, come per la radiazione visibile troviamo limiti espressi come radianza (L), sia per il rischio delle strutture oculari anteriori, per le quali i limiti sono espressi come irradianza (E).
Nonostante le lavorazioni di fusione del vetro e dei metalli, seppur molto diverse rispetto al passato, siano ancora oggi largamente diffuse e i livelli di esposizione a IR in queste attività siano certamente rilevanti, le pubblicazioni della letteratura scientifica recente sull'argomento sono poche e la maggior parte dei casi segnalati di effetti avversi oculari da IR incoerente a probabile eziologia lavorativa risalgono a vari anni orsono.
Sulla base di queste premesse viene descritto e discusso il caso di un lavoratore presso una acciaieria andato incontro ad un infortunio riconducibile all’azione fototermica delle IR sulle strutture oculari.
2016
- Directive 2013/35/EU for electromagnetic fields of workers' exposure and working from the ladder near a 400 kV power line
[Relazione in Atti di Convegno]
Korpinen, L.; Pääkkönen, R.; Farrugia, L.; Tarao, H.; Gobba, F.
abstract
Directive 2013/35/EU for electromagnetic fields of workers' exposure and working from the ladder near a 400 kV power line.
2016
- Effetti precoci della esposizione a percloroetilene nei lavoratori delle lavanderie a secco sulla funzione visiva
[Articolo su rivista]
Chiesi, Andrea; Gioia, Tiziana Concetta; Modenese, Alberto; Abbacchini, Carlotta; Borsari, Lucia; Clo', Emanuele; DI RICO, Renato; Ferrari, Davide; Gobba, Fabriziomaria
abstract
Introduzione: Alcuni studi hanno dimostrato la possibile correlazione tra esposizione a percloroetilene (PCE) negli addetti delle lavanderie a secco ed alterazioni della percezione cromatica. Obiettivi: Abbiamo voluto verificare l’eventuale
presenza di alterazioni della funzione visiva in un gruppo di lavoratori esposti ai livelli attuali di PCE.
Metodi: Lo studio è stato condotto su 38 lavoratori esposti a PCE in 21 lavanderie del distretto di Modena e 60 controlli scelti in base a criteri di confrontabilità. I lavoratori delle lavanderie sono stati sottoposti a monitoraggio ambientale dell’esposizione a PCE (esposizione media pari a 16,9 mg/m3). Ad entrambi i gruppi sono poi stati somministrati un questionario anamnestico ed il test di Ishihara per valutare i criteri di esclusione e, successivamente, i test di Lanthony D15d e di Acuità Visiva a Contrasto Ridotto (VCS) per valutare alterazioni della funzione visiva.
I risultati del test di Lanthony sono stati espressi mediante l’Indice di Confusione Cromatica (ICC). Risultati: Nei casi il valore medio di ICC è 1,28 (DS 0,21) e nei controlli è 1,15 (DS 0,21); la differenza risulta statisticamente significativa (p<0.01). I valori di ICC sono tendenzialmente peggiori negli addetti al solo lavaggio, esposti a livelli di PCE più elevati (esposizione media pari a 26,8 mg/m3). I valori di VCS per ciascuna frequenza non mostrano invece differenze significative tra i due gruppi. Conclusioni: I nostri dati indicano che anche esposizioni occupazionali
a PCE ben al di sotto degli attuali valori limite possano essere comunque in grado di indurre alterazioni della percezione cromatica e non sarebbero pertanto adeguatamente protettivi almeno nei confronti di questi effetti.
2016
- Esposizione occupazionale negli addetti alle attività di riciclo e riuso dei rifiuti di apparecchiature elettriche e elettroniche (RAEE): dati preliminari dal progetto WEEENMODELS.
[Abstract in Atti di Convegno]
Modenese, A.; Violi, F.; Pini, M.; Gioia, T. C.; Ferrari, A. M.; Gamberini, R.; Grasselli, L.; Montanari, G.; Neri, P.; Rimini, B.; Vinceti, M.; Gobba, F.
abstract
Esposizione occupazionale negli addetti alle attività di riciclo e riuso dei rifiuti di apparecchiature elettriche e elettroniche (RAEE): dati preliminari dal progetto WEEENMODELS.
2016
- Health risk related to occupational exposure in WEEE management
[Capitolo/Saggio]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
2016
- La valutazione del rischio CEM in Ospedale
[Relazione in Atti di Convegno]
Gobba, F.
abstract
La valutazione del rischio CEM in Ospedale.
2016
- Outdoor work and solar radiation exposure: Evaluation method for epidemiological studies.
[Articolo su rivista]
Modenese, Alberto; Bisegna, Fabio; Borra, Massimo; Grandi, Carlo; Gugliermetti, Franco; Militello, Andrea; Gobba, Fabriziomaria
abstract
Background: The health risk related to an excessive exposure to solar radiation (SR) is well known. The Sun represents the main exposure source for all the frequency bands of optical radiation, that is the part of the electromagnetic spectrum ranging between 100 nm and 1 mm, including infrared (IR), ultraviolet (UV) and visible radiation. According to recent studies, outdoor workers have a relevant exposure to SR but few studies available in scientific literature have attempted to retrace a detailed history of individual exposure. Material and Methods: We propose a new method for the evaluation of SR cumulative exposure both during work and leisure time, integrating subjective and objective data. The former is collected by means of an interviewer administrated questionnaire. The latter is available through the Internet databases for many geographical regions and through individual exposure measurements. The data is integrated into a mathematical algorithm, in order to obtain an esteem of the individual total amount of SR the subjects have been exposed to during their lives. Results: The questionnaire has been tested for 58 voluntary subjects. Environmental exposure data through online databases has been collected for 3 different places in Italy in 2012. Individual exposure by electronic UV dosimeter has been measured in 6 fishermen. A mathematical algorithm integrating subjective and objective data has been elaborated. Conclusions: The method proposed may be used in epidemiological studies to evaluate specific correlations with biological effects of SR and to weigh the role of the personal and environmental factors that may increase or reduce SR exposure.
2016
- Possibilities to decrease the electric field exposure with a shield over worker under the 400 kV power lines.
[Relazione in Atti di Convegno]
Pääkkönen, R.; Korpinen, L.; Tarao, H.; Gobba, F.
abstract
Possibilities to decrease the electric field exposure with a shield over worker under the 400 kV power lines
2016
- Possibilities to decrease the extremely low-frequency electric field exposure with a Faraday cage under a 400 kV power line
[Relazione in Atti di Convegno]
Pääkkönen, R.; Farrugia, L.; Tarao, H.; Gobba, F.; Korpinen, L.
abstract
"Possibilities to decrease the extremely low-frequency electric field exposure with a Faraday cage under a 400 kV power line
2016
- Prevalenza di fattori di rischio per patologie croniche in un gruppo di dipendenti di un’azienda USL.
[Abstract in Atti di Convegno]
Stefani, M.; Tassinari, G.; Lanfranchi, G.; Nikollau, Nikoleta; Melloni, P.; Gobba, F.
abstract
Prevalenza di fattori di rischio per patologie croniche in un gruppo di dipendenti di un’azienda USL.
2016
- Questionnaire-based evaluation of occupational and non-occupational solar radiation exposure in a sample of Italian patients treated for actinic keratosis and other non-melanoma skin cancers
[Articolo su rivista]
Modenese, Alberto; Farnetani, Francesca; Andreoli, Alessandro; Pellacani, Giovanni; Gobba, Fabriziomaria
abstract
Background An adequate evaluation of the ultraviolet (UV) cumulative exposure is a major problem in epidemiological studies on chronic skin damage. Questionnaires may be applied as useful tools. Objective We developed an original questionnaire to evaluate individual cumulative exposure to solar radiation (SR) in patients affected by actinic keratosis (AK), basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Method The questionnaire, considering both working and leisure exposure, was applied to evaluate the whole life history of solar UV radiation exposure in a group of patients of the Dermatologic Clinic of UNIMORE. Results In outdoor workers (OW), the co-presence of AK/in situ SCC and invasive non-melanoma skin cancers (NMSCs) was increased compared to indoor workers (IW), as was the frequency of multiple skin lesions. The prevalence of skin lesions of the face was significantly higher in OW. Work 'sometimes' or 'often' in the shades was associated with an absence of skin lesions on the shoulders and neck, while workers adopting 'sometimes' or 'often' a downward bent position were more likely to develop lesions on the top of the head. Considering leisure activities, the use of tanning beds was associated to the presence of skin lesions on the shoulders, neck and chest. Considering vacation periods, subjects spending at least 2 h outdoor in the period 11 am to 1 pm presented earlier diagnoses of skin cancers. Conclusion Results of the original questionnaire developed are coherent with current knowledge and confirm the important role of UV exposure, both occupational and recreational, in the development of AK and NMSCs. Data support the hypothesis that this questionnaire can be applied as useful tool for the evaluation of cumulative UV exposure in future epidemiological studies.
2016
- Rischio sanitario correlato all'esposizione occupazionale nella gestione dei RAEE
[Capitolo/Saggio]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
2016
- Self-Reported Ache, Pain, or Numbness in Feet and Use of Computers amongst Working-Age Finns
[Articolo su rivista]
Korpinen, Leena; Pääkkönen, Rauno; Gobba, Fabriziomaria
abstract
The use of the computers and other technical devices has increased. The aim of our work was to study the possible relation between self-reported foot symptoms and use of computers and cell phones using a questionnaire. The study was carried out as a cross-sectional study by posting a questionnaire to 15,000 working-age Finns. A total of 6121 responded, and 7.1% of respondents reported that they very often experienced pain, numbness, and aches in the feet. They also often experienced other symptoms: 52.3% had symptoms in the neck, 53.5% in had problems in the hip and lower back, and 14.6% often had sleeping disorders/disturbances. Only 11.2% of the respondents thought that their symptoms were connected to the use of desktop computers. We found that persons with symptoms in the feet quite often, or more often, had additional physical and mental symptoms. In future studies, it is important to take into account that the persons with symptoms in the feet may very often have other symptoms, and the use of computers can influence these symptoms.
2016
- Sintomi soggettivi negli operatori di risonanza magnetica ed in un gruppo di controllo: studio su alcuni fattori correlate.
[Abstract in Atti di Convegno]
Zanotti, G; Ligabue, G; Corona, G; Venturelli, L; Longhi, F; Ruggieri, F; Tomasini, E.; Gobba, F.
abstract
Sintomi soggettivi negli operatori di risonanza magnetica ed in un gruppo di controllo: studio su alcuni fattori correlate.
2016
- Subjective symptoms in Magnetic Resonance Imaging operators: prevalence, short-term evolution and possible related factors
[Articolo su rivista]
Zanotti, Giulio; Ligabue, Guido; Korpinen, Leena; Gobba, Fabriziomaria
abstract
The number of Magnetic Resonance Imaging (MRI) operators is rapidly increasing. In these workers, a high prevalence of certain subjective symptoms has been described but until now scant research is available on this topic.
2016
- The European Status Quo in legal recognition and patient-care services of occupational skin cancer
[Articolo su rivista]
Ulrich, Claas; Salavastru, CARMEN MARIA; Agner, Tove; Bauer, Andrea; Brans, Richard; Crepy, MARIE NOELLE; Ettler, Karel; Gobba, Fabriziomaria; Goncalo, Margarida; IMKO WALCZUK, Beata; Lear, John; Macan, Jelena; Modenese, Alberto; Paoli, John; Sartorelli, Pietro; Stangeland, Katarina; Weinert, Patricia; Wroblewski, Nora; Wulf, HANS CHRISTIAN; John, SVEN MALTE
abstract
BACKGROUND:
Skin cancer is the most common malignancy in Caucasian populations worldwide and ultraviolet radiation (UVR) is known for being the number one carcinogen. As, especially in outdoor workers, UVR is an inevitable carcinogen, the prevention and management of UVR-related skin cancers in these at-risk populations represent a collective challenge for dermatologists and healthcare policymakers likewise.
OBJECTIVE:
To provide an overview on the current regulations on the acknowledgement and management of work-related skin cancer in 11 European countries.
METHODS:
Dermatologists from 11 countries networking within the EU Horizon 2020 COST Action TD1206 'StanDerm' contributed to a standardized survey regarding current national regulations, implemented for the recognition, prevention and management as well as possible compensation regulations in their individual country of residence.
RESULTS:
Ten of 11 participating countries in this survey reported the existence of an established programme available on certain occupational diseases; work-related skin diseases were only specifically recognized in eight countries. Seven of 11 countries recognize cutaneous squamous cell carcinoma in outdoor workers as 'occupational skin cancer'. Basal cell carcinoma (6 of 11), actinic keratosis (5 of 11), Bowen's disease (5 of 11) and malignant melanoma (5 of 11) are not as regularly approved as potentially 'work-induced'. Only a few of the countries included into this survey established a general documentation system (national registry) on occupational skin diseases. So far, representatives of only three countries of this survey referred to a specific established national programme for the prevention, management or compensation of occupational skin cancers acquired during work-related UVR exposure.
CONCLUSION:
This survey highlights the need for mandatory regulations on the prevention, management and potential compensation of work-related UV-induced skin cancer across Europe. Against the background of a joint European domestic market, equal standards of occupational safety across Europe should include binding regulations for the protection and management of work-related skin cancer. The design of a common regulation to meet the increasing incidence of skin cancers in outdoor workers should become part of the European agenda, ensuring equal working and living conditions in the member states.
2016
- Traduzione in lingua italiana e validazione del Nordic Occupational Skin Questionnaire (NOSQ-2002) [Italian translation and validation of the Nordic Occupational Skin Questionnaire (NOSQ-2002)]
[Articolo su rivista]
Chiesi, Andrea; Pellacani, Giovanni; Di Rico, Renato; Farnetani, Francesca; Giusti, Giulia; Pepe, Patrizia; Prampolini, Paola; Gobba, Fabriziomaria
abstract
Because of their frequent occurrence, in various situations it may be appropriate to carry out screening of skin disorders in groups of workers. For this purpose the self-administered standardized questionnaires are of great use. Among the best known is the Nordic Occupational Skin Questionnaire (NOSQ-2002), which had not yet been translated and validated in Italian.
2016
- Traduzione in lingua italiana e validazione del questionario Work, Osteoarthritis and joint-Replacement Questionnaire (WORQ): dati preliminari.
[Abstract in Atti di Convegno]
Lanfranchi, G.; Rovesta, C.; Chiesi, A.; Modenese, A.; Catani, F.; Gobba, F.
abstract
Traduzione in lingua italiana e validazione del questionario Work, Osteoarthritis and joint-Replacement Questionnaire (WORQ): dati preliminari.
2015
- Accidents and Close Call Situations Connected to the Use of Mobile Phones in Working-Age People ≥ 50 Years Old
[Articolo su rivista]
Korpinen, Leena; Pääkkönen, Rauno; Gobba, Fabriziomaria
abstract
The aim of this paper is to investigate accidents and close call situations connected to the use of mobile phones in
working-age people ≥ 50 years old. The paper is part of a crosssectional study that was carried out in 2002 in 15,000 working-age Finns. The study showed that mobile-phone-related accidents and close call situations, both at work and at leisure, are more common in people under 50 years that in people ≥ 50 years old. However, people under 50 use mobile phones more than those aged ≥ 50.
2015
- Agenti fisici. Radiazioni non ionizzanti
[Capitolo/Saggio]
Gobba, Fabriziomaria
abstract
Le radiazioni non ionizzanti (“Non Ionizing Radiation” -NIR-) hanno meccanismi di interazione con la materia differenti dalla ionizzazione. Sono classificabili in base alla frequenza, espressa in Hertz (Hz), e lunghezza d´onda (λ): le NIR sono le radiazioni con frequenza compresa tra 0 e 3 x 1015 Hz, e possono essere di origine naturale (es. campo geomagnetico terrestre, radiazione solare, ecc.) o artificiale (es. distribuzione e applicazioni della corrente elettrica, telecomunicazione, risonanza magnetica nucleare, illuminazione, riscaldamento, lavorazione metalli, tecnologie laser, ecc). Usualmente vengono considerati separatamente i Campi Elettromagnetici (CEM), e le Radiazioni Ottiche (RO). Data la loro diffusione sostanzialmente ubiquitaria, praticamente la totalità dei lavoratori è esposta. I CEM sono ulteriormente distinti in campi statici e campi variabili nel tempo (ELF, IF, RF e MO). Possono indurre vari affetti acuti per esposizioni elevate, mentre sui possibili effetti a lungo termine delle basse esposizioni, ovvero quelle usualmente riscontrabili negli ambienti di lavoro e di vita, le conoscenze sono meno conclusive. Sia le ELF che le RF sono attualmente classificate nel Gr. 2B IARC (possibili cancerogeni). Le RO sono suddivise in radiazioni IR, visibili ed UV, e possono essere di tipo incoerente o coerente (laser). I principali organi bersaglio sono la cute e l’occhio, e gli effetti diretti possono essere di tipo acuto (principalmente ustioni, fotocheratiti, fotocongiuntiviti e fotoretiniti) o cronico (principalmente photoaging, cheratosi attiniche, epiteliomi baso- e spinocellari, melanomi, cataratta e pterigio); le radiazioni UV sono cancerogene Gr. 1 IARC. Inoltre, le RO visibili ed UV possono indurre fotosensibilizzazioni.
2015
- Analisi dei ricorsi avverso il giudizio del medico competente pervenuti all’ASL di Bologna nel periodo 2012-14.
[Abstract in Atti di Convegno]
Abbacchini, C; Panico, G; Marinilli, P; Guglielmin, Am; Gobba, F.
abstract
Analisi dei ricorsi avverso il giudizio del medico competente pervenuti all’ASL di Bologna nel periodo 2012-14.
2015
- Dichiarazione ICRP sulle reazioni tissutali ed effetti immediati e tardivi delle radiazioni nei tessuti e negli organi normali - Dosi soglia per le reazioni tissutali nell’ambito della radioprotezione
[Traduzione di Libro]
Cantone, Marie Claire; Castellani, Giulia; Ciani, Vittorio; Ciuffa, Valerio; Claudiani, Franco; De Luca, Giuseppe; Fantuzzi, Elena; Fresca Fantoni, Roberto; Giovani, Concettina; Gobba, Fabriziomaria; Marengo, Mario; Moccaldi, Roberto; Moroder, Ehrenfried; Osimani, Celso; Ottenga, Fabrizio; Pennarola, Raffaele; Rossi, Francesco; Trenta, Giorgio; Vignaroli, Tiziano; Virgili, Massimo
abstract
La pubblicazione ICRP 118 riesamina gli effetti precoci e tardivi delle radiazioni ionizzanti nei diversi organi ed apparati e fornisce stime aggiornate sulle dosi soglia per l'induzione delle
numerose reazioni tissutali analizzate. In particolare, a seguito dei progressi nelle conoscenze radiobiologiche e cliniche, pubblicati in numerosi testi specialistici, vengono dettagliatamente presentate le evidenze che hanno condotto alle modificazioni, rispetto alle Raccomandazioni ICRP 103/2007, nella individuazione delle dosi soglia per la induzione della cataratta e delle patologie del sistema
circolatorio da parte delle radiazioni ionizzanti. A queste rilevanti considerazioni si affiancano gli approfonditi aggiornamenti sulle conoscenze radiobiologiche e cliniche e le integrazioni delle dosi soglia, individuate in modo più articolato rispetto alle precedenti pubblicazioni, per tutte le altre reazioni tissutali, che rendono questo documento un indispensabile strumento di lavoro e di analisi per tutti coloro
che si occupano di radioprotezione, con particolare riferimento agli specialisti di radioprotezione medica. La traduzione in italiano dell’intero testo vuole facilitare la diffusione delle peculiari
informazioni contenute nella pubblicazione e motivare una sempre più approfondita ricerca in questo settore che indubbiamente contribuisce a ridurre i rischi derivanti dall’esposizione
alle radiazioni ionizzanti.
La realizzazione della versione italiana di questa pubblicazione ha richiesto un notevole impegno qualitativo e quantitativo ed è stata possibile per il considerevole e qualificante
contributo dei medici dell’AIRM e dei membri del Comitato Internazionale dell'AIRP. A tutti coloro che hanno collaborato alla sua traduzione, revisione e pubblicazione con
notevole spirito di sacrificio, è rivolto l'apprezzamento e la riconoscenza delle nostre Associazioni, che riuniscono gli operatori attivi nei vari settori di interesse della radioprotezione.
2015
- Disturbi soggettivi in operatori addetti dalla Risonanza Magnetica (RM): risultati preliminari in un campione pilota
[Articolo su rivista]
Zanotti, Giulio; Arcangeli, Giulio; Moccaldi, Roberto; Mucci, Nicola; Gobba, Fabriziomaria
abstract
INTRODUZIONE
Alcuni studi nel personale addetto alla Risonanza Magnetica (RM) suggeriscono un’aumentata prevalenza di alcuni sintomi soggettivi quali sensazione di sapore metallico, vertigini e sensazione di movimento, nausea e cefalea, ed un possibile effetto su alcuni test neuro-comportamentali e neurofisiologici, reversibili dopo interruzione dell’esposizione (1,2,3,4). I dati sono però moto limitati. In questo lavoro presentiamo uno studio che stiamo avviando su tali sintomi in addetti alla RM, ed alcuni dati preliminari raccolti in un gruppo pilota per testare lo strumento.
MATERIALI E METODI
E' stato somministrato un questionario sulla presenza di disturbi soggettivi quali: sensazione di sapore metallico, vertigini e sensazione di movimento, nausea e cefalea, formulato sulla base dei risultati di precedenti studi. Verrà studiata l’esistenza di una relazione tra la prevalenza e l’intensità dei sintomi e l’entità e la durata dell’esposizione. I dati saranno confrontati con un gruppo di controllo. In questa sede vengono presentati alcuni risultati di un test preliminare di fattibilità.
RISULTATI
Sono stati raccolti 28 questionari, 15 partecipanti di sesso maschile e 13 di sesso femminile, tutti addetti a RM di potenza variabile da 1 Tesla (T) a 3T. La durata dell’attività lavorativa con apparecchiature RM è risultata molto variabile, da 1 a 22 anni (media 5,2 anni ± 5, DS).
Con questa premessa, sono riportati i dati sui sintomi soggettivi riferiti: delle 28 persone studiate, ben 25 hanno riferito di aver avuto, nel corso dell’ultimo anno, almeno uno dei sintomi indagati. Solo 6 operatori li hanno lamentati almeno una volta alla settimana, e solo 4 si sono fatte visitare da un medico a causa di tali disturbi. I sintomi più frequenti sono risultati: nausea (3 lavoratori), mal di testa, capogiri/vertigini e sonnolenza inusuale/stanchezza (2 lavoratori). 5 operatori ritenevano che la sintomatologia potesse essere causata/aggravata dal lavoro nei locali della RM. Per quanto riguarda il tempo richiesto per la regressione dopo l’allontanamento, nella maggioranza dei casi la comparsa avveniva dopo pochi minuti dall’inizio dell’esposizione, e la regressione entro 15-30 minuti.
CONCLUSIONI
Viene presentato uno studio mediante questionario, basato sui dati della letteratura più recente, volto ad indagare la prevalenza ed intensità di sintomi soggettivi in addetti alla RM. Le domande che vengono poste sono analoghe a quelle contenute in questionari in corso di raccolta in altre Nazioni Europee, in modo che i risultati siano confrontabili. Sono anche presentati i risultati di un test preliminare di fattibilità del questionario, basato sulla somministrazione in un gruppo di 28 volontari, non considerabili rappresentativi per la modesta numerosità e la modalità di raccolta.
2015
- Ergonomics Aspects of Work with Computers
[Articolo su rivista]
Korpinen, Leena; Pääkkönen, Rauno; Gobba, Fabriziomaria
abstract
This paper is based on a large questionnaire study. The
paper presents how all participants and subgroups (upper- and
lower-level white-collar workers) answered the question, “Have you
had an ache, pain, or numbness, which you associate with desktop
computer use, in the different body parts during the last 12 months?’
14.6% of participants (19.4% of women and 8.2% of men) reported
that they had often or very often physical symptoms in the neck. Even
if our results cannot prove a causal relation of symptoms with
computer use, show that workers believe that computer use can
influence their wellbeing: this is important when devising treatment
modalities to decrease these physical symptoms
2015
- Esposizione occupazionale a radiazione solare in un campione di pazienti dermatologici.
[Abstract in Atti di Convegno]
Modenese, A; Pellacani, G; Farnetani, F; Andreoli, A; Gobba, F.
abstract
Esposizione occupazionale a radiazione solare in un campione di pazienti dermatologici.
2015
- Health surveillance according to the new EU Directive 2013/35/EU: possible criteria
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Korpinen, Leena
abstract
In a discussion on possible criteria for health surveillance (HS) of workers exposed to electromagnetic fields (EMF) it should be stated beforehand that the new EMF Directive 2013/35/EU specifically refers to the protection from the risks associated with known direct biophysical and indirect effects caused by EMF (0-300 GHz), while does not address to suggested long-term effects. HS of EMF exposed workers should be performed based on the results of the risk assessment, but until now no international guidelines or authoritative documents on criteria to be applied are available. A further specific problem is HS of workers "at particular risk", as: (a) no shared comprehensive definition of these workers is currently available, and (b) an adherence to the ELVs of the Directive 2013/35/UE do not necessarily provide an adequate protection workers at particular risk and e.g. interference problems, especially with pacemakers, may occur at lower levels. As a conclusion, at present the problem concerning the HS of workers exposed to EMF is that sound scientific data, especially on groups at higher risk, are largely insufficient, and do not give an adequate support to the occupational physician to face the problem; accordingly, no consensus exists regarding adequate procedures to be applied
2015
- I disturbi muscolo-scheletrici lavoro-correlati negli addetti alle professioni sanitarie: cause, sintomi, rimedi
[Articolo su rivista]
Roggia, E.; Gobba, Fabriziomaria; Rovesta, Claudio; Galeazzi, Gian Maria; Monzani, Daniele
abstract
I DMS-LC, ai quali si associano quasi costantemente dolore e limitazione funzionale, comprendono le infiammazioni tendinee (tendinopatia della cuffia dei rotatori, epicondilite, borsite del ginocchio) riferibili per lo più a sovraccarichi funzionali, le sindromi compressive (sindrome del tunnel carpale), le degenerazioni/dislocazioni dei dischi intervertebrali con conseguente insorgenza di sindromi compressive a livellodelle radici dei nervi spinali (cervico-brachialgia, lombo-sciatalgia) o più genericamente le mialgie distrettuali (soprattutto del collo del trapezio e della schiena) a patogenesi multifattoriale. Anche alcune patologie cronico-degenerative delle articolazioni, come ad esempio l’osteoartrosi del ginocchio, sono più frequenti in alcune categorie di lavoratori rispetto alla popolazione in generale .
2015
- Il reinserimento professionale del lavoratore cardiopatico: primi risultati di un progetto multidisciplinare collaborativo tra cardiologia riabilitativa e medicina del lavoro.
[Abstract in Atti di Convegno]
Serra, Donata; Bottari, S; Gioia, Tc; Gavioli, M; Ferrari, Davide; Penna, Mattia; Sala, D; Gobba, F.
abstract
Il reinserimento professionale del lavoratore cardiopatico: primi risultati di un progetto multidisciplinare collaborativo tra cardiologia riabilitativa e medicina del lavoro.
2015
- LED Lighting Interviews and Assessment in Forest Machines
[Articolo su rivista]
Pääkkönen, Rauno; Gobba, Fabriziomaria; Korpinen, Leena
abstract
The objective of the study is to assess the implementation of LED lighting into forest machine work in the dark.
In addition, the paper includes a wide variety of important and relevant safety and health parameters. In modern, computerized work in the cab of forest machines, artificial illumination is a demanding task when performing duties, such as the visual inspections of wood and computer calculations. We interviewed entrepreneurs and gathered the following as the most pertinent themes: (1) safety, (2) practical problems, and (3) work with LED lighting. The most
important comments were in regards to the practical problems of LED lighting. We found indications of technical problems in implementing LED lighting, like snow and dirt on the surfaces of lamps that dim the emission of light. Moreover, service work in the dark forest is dangerous and increases the risks of on-site accidents.
We also concluded that the amount of blue light to the eyes should be assessed, especially, when the drivers are working in a semi-dark cab.
2015
- Long-Term Eye Effects And Occupational Exposure To Solar Radiation: A Systematic Review Of The Recent Literature.
[Abstract in Atti di Convegno]
Modenese, A.; Zanotti, G.; Gobba, F.
abstract
Long-Term Eye Effects And Occupational Exposure To Solar Radiation: A Systematic Review Of The Recent Literature.
2015
- Metodologia per una valutazione complessiva dell’esposizione a radiazione solare nei lavoratori all’aperto.
[Abstract in Atti di Convegno]
Borra, M; Grandi, C; Militello, A; Bisegna, F; Gugliermetti, F; Modenese, A; Gobba, F.
abstract
Metodologia per una valutazione complessiva dell’esposizione a radiazione solare nei lavoratori all’aperto.
2015
- Occupational and environmental exposure to extremely low frequency-magnetic fields in a large group of workers
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Rossi, Paolo; Bravo, Giulia; Contessa, GIAN MARCO; Korpinen, Leena
abstract
The aim of this study was to provide: (a) an evaluation of current ELF-MF exposure in workers, (b) the specific contribution of occupational exposure to overall 24-hour exposure, and (c) the representativeness of a Job Exposure Matrix. 543 workers were monitored for 2 whole days using personal meters. Time-Weighted Average (TWA) levels at work, at home, and outside the home (respectively work TWA, home TWA and environmental TWA) were calculated. Tasks were classified according to the ISCO 88 International Standard Classification of Occupations. In about 10% of the entire sample, the monitoring was repeated after 6-9 months. In the whole sample, the median of TWA am during work was 0.14 µT (5°-95° percentiles: 0.04-2.50 µT). Median Home TWA and Environmental TWA were respectively 0.03 (5°-95° percentiles 0.01-0.24 µT) and 0.05 µT (5th-95th percentiles 0.02-0.28 µT). The correlation between TWA values during the first monitoring and the replication was r=0.80. The contribution of occupational exposure to the overall 24-hour exposure was estimated showing that, during working days, about the 60% of exposure is related to work. The variability of individual work TWA among subjects included in the same ISCO 88 task, evaluated using ANOVA, proved significant in 56% of the tasks.
2015
- Occupational exposure to solar radiation and age-related macular degeneration: a case control study.
[Abstract in Atti di Convegno]
Modenese, A; Gobba, F; Mattioli, S; Violante, Fs; Zanotti, G; Curti, S; Marinelli, Francesco; Campos, Emilio; Fresina, M.
abstract
Occupational exposure to solar radiation and age-related macular degeneration: a case control study.
2015
- Possible Exposure of Persons with Cardiac Pacemakers to Extremely Low Frequency (ELF) Electric and Magnetic Fields
[Articolo su rivista]
Korpinen, Leena; Pääkkönen, Rauno; Gobba, Fabriziomaria; Virtanen, Vesa
abstract
The number of persons with implanted cardiac pacemakers (PM) has increased in Western countries. The aim of this
paper is to investigate the possible situations where persons with a PM may be exposed to extremely low frequency (ELF) electric (EF) and magnetic fields (MF) that may disturb their PM. Based on our earlier studies, it is possible to find such high public exposure to EFs only in some places near 400 kV power lines, where an EF may disturb a PM in unipolar mode. Such EFs cannot be found near 110 kV power lines. Disturbing MFs can be found near welding machines. However, we do not have measurement data from welding. Based on literature and earlier studies at Tampere University of Technology, it is difficult to find public EF or MF exposure that is high enough to interfere with PMs.
2015
- Prevalence of subjective symptoms in a group of physicians recently involved in Magnetic Resonance Imaging (MRI) procedures.
[Abstract in Atti di Convegno]
Zanotti, G; Modenese, A; Corona, G; Ligabue, G; Gobba, F.
abstract
Prevalence of subjective symptoms in a group of physicians recently involved in Magnetic Resonance Imaging (MRI) procedures.
2015
- Prevalenza di sintomi soggettivi negli operatori di risonanza magnetica ed in un gruppo di controllo.
[Abstract in Atti di Convegno]
Zanotti, G; Ligabue, G; Gobba, F.
abstract
Prevalenza di sintomi soggettivi negli operatori di risonanza magnetica ed in un gruppo di controllo.
2015
- Self-reported ache, pain, or numbness in hip and lower back and use of computers and cell phones amongst Finns aged 18-65
[Articolo su rivista]
Korpinen, Leena; Pääkkönen, Rauno; Gobba, Fabriziomaria
abstract
The aim of our work is to study persons who self-reported aches, pain, or numbness in the hip and lower back very often and their use of computers and cell phones via a questionnaire. The study was carried out as a cross-sectional study by posting a questionnaire to 15,000 working-age persons, and among all respondents (6121), 8.2% of them reported that they very often experienced pain, numbness, and aches in the hip/lower back. Thirty-eight percent of them used a desktop computer at work daily, and 79.0% used cell phones at leisure. As a group, they had more physical and mental symptoms than others. We found also significant differences in the use of different computers at work. In the future, it is important to take into account that persons' physical symptoms in the hip and lower back very often can be associated with other physical or mental symptoms and computer usage.
2015
- Solar radiation: a neglected health risk in exposed workers.
[Abstract in Atti di Convegno]
Modenese, A.; Gobba, F.
abstract
Solar radiation: a neglected health risk in exposed workers.
2015
- Sorveglianza sanitaria degli operatori esposti a CEM (RM; sala operatoria; FKT).
[Abstract in Atti di Convegno]
Gobba, F.; Arcangeli, Giulio
abstract
Sorveglianza sanitaria degli operatori esposti a CEM (RM; sala operatoria; FKT).
2015
- Studio sugli infortuni oculari professionali in Provincia di Modena.
[Abstract in Atti di Convegno]
Dall’Olio, E; Clò, E; Gobba, F; Sernesi, Mv; Gualdi, E; De Maria, M; Cavallini, G.
abstract
Studio sugli infortuni oculari professionali in Provincia di Modena. Atti del 78° Congresso Nazionale SIMLII.
2015
- Subjective symptoms and their evolution in a small group of magnetic resonance imaging (MRI) operators recently engaged
[Articolo su rivista]
Zanotti, Giulio; Ligabue, Guido; Gobba, Fabriziomaria
abstract
Using a specific questionnaire, we examined subjective symptoms in a group of 17 physicians (9 males and 8 females, mean age 32.9 ± 3.71), attending a Postgraduate Medical School in Radiology and engaged in MRI for less than 1 year. Sixteen subjects (94%) reported the presence of at least one of the investigated symptoms during the period of MRI activity. The main symptoms were: unusual drowsiness/tiredness (88%), concentration problems (82%), headaches (76%), sleep disorders (47%), nausea (47%), illusion of movement (47%) and dizziness/vertigo (35%); the former two were subjectively related to MRI by the majority of the operators. These symptoms appeared (or worsened) in more than 15 min and, in the vast majority disappeared 30 min, or more, after the end of exposure. In 13 subjects (81%), the symptom (or some symptoms) appeared at least weekly. In this small group of health care workers recently exposed to MRI, the prevalence of subjective symptoms was higher than reported in other similar studies but, notably, the majority of subjects (77%) reported a regression within 4-8 weeks, suggesting some form of adaptation.
2015
- The incidence of micronuclei in buccal mucosa cells as a possible biomarker in the evaluation of occupational risk for MRI workers.
[Abstract in Atti di Convegno]
Sannino, A; Romeo, S; Zeni, O; Massa, R; Scarfì, Mr; Zanotti, G; Modenese, A; Gobba, F.
abstract
The incidence of micronuclei in buccal mucosa cells as a possible biomarker in the evaluation of occupational risk for MRI workers.
2015
- Valutazione di un triennio di attività dell’Ambulatorio del disagio occupazionale presso il Servizio di Prevenzione e Sicurezza negli Ambienti di Lavoro dell’Az. USL di Bologna
[Abstract in Atti di Convegno]
Cisotta, G; Cervino, D; Guglielmin, Am; Marinilli, P; Gobba, F.
abstract
Contrributo presentato al 78° Congresso Nazionale SIMLII tenutosi a Milano dal 25 al 27 Novembre 2015 riportante i risultati delle attività svolte nel corso di un triennio dall’Ambulatorio del disagio occupazionale presso il Servizio di Prevenzione e Sicurezza negli Ambienti di Lavoro dell’Azienda USL di Bologna
2014
- A new method for the evaluation of cumulative solar radiation exposure in outdoor workers.
[Abstract in Atti di Convegno]
Modenese, Alberto; Bisegna, Fabio; Borra, Massimo; Grandi, Carlo; Gugliermetti, Franco; Militello, Andrea; Gobba, Fabriziomaria.
abstract
A new method for the evaluation of cumulative solar radiation exposure in outdoor workers.
2014
- Accertamenti sanitari di assenza di tossicodipendenza nella Provincia di Modena: tendenze nel periodo 2009-2013
[Abstract in Rivista]
Terzi, Stefano; Ferretti, C; Gabrielli, C; Bigarelli, M; Licata, Manuela; Gobba, Fabriziomaria
abstract
La normativa attuale in materia di accertamento di assenza di tossicodipendenza nei lavoratori prevede specifici accertamenti sanitari negli addetti alle mansioni a rischio indicate nel provvedimento n.99/C.U. del 30/10/ 2007. Il primo livello prevede uno screening su campioni urinari e, in caso di positività, un ricontrollo da parte di un laboratorio accreditato. In caso di conferma, i lavoratori sono inviati al SERT per accertamenti di secondo livello. Abbiamo analizzato quanti campioni sono stati inviati per ricontrollo di primo livello nella provincia di Modena nel periodo 2009-2013, quanti sono stati confermati, quanti lavoratori sono stati inviati ai SERT per il secondo livello, e quali erano le principali sostanze utilizzate.
2014
- Assessing the cumulative solar radiation exposure among outdoor workers: presentation of a method for epidemiological studies
[Abstract in Atti di Convegno]
Modenese, Alberto; Bisegna, F; Borra, M; Grandi, C; Gugliermetti, F; Militello, A; Gobba, Fabriziomaria
abstract
So far, few studies on occupational risk related to Solar Radiation (SR) in outdoor workers have attempted to retrace a detailed history of individual exposure. We propose a new method for the evaluation of the SR cumulative exposure both during work and leisure time, integrating subjective and objective exposure data. The former are collected with a questionnaire, which investigates in detail work and leisure activities during life. The latter are available through internet databases for many geographical regions and provide an estimate of the SR on the Earth's surface in specific areas and periods. These data will be integrated in a mathematical model, in order to obtain an esteem of the individual total amount of SR the subjects have been exposed to during their life. This personal exposure index can be used to evaluate specific correlations with the biological effects and to weigh the role of the personal and environmental factors that can increase or reduce SR exposure.
2014
- Esposizione a PCE nei lavoratori delle lavanderie a secco ed alterazioni della funzione visiva
[Abstract in Rivista]
Chiesi, Andrea; Gioia, Tiziana Concetta; Modenese, Alberto; Abbacchini, Carlotta; Borsari, Lucia; Clò, E; Di Rico, R; De Pasquale, F; Ferrari, D; Gobba, Fabriziomaria
abstract
Alcuni studi hanno dimostrato la possibile correlazione tra esposizione a percloroetilene (PCE) negli addetti delle lavanderie a secco ed alterazioni della percezione cromatica. L’esposizione a tale solvente si è però progressivamente ridotta nel tempo: abbiamo voluto verificare l’eventuale presenza di alterazioni della funzione visiva in un gruppo di lavoratori esposti ai livelli attuali di PCE.
2014
- Esposizione professionale a Percloroetilene nelle lavanderie a secco
[Abstract in Rivista]
Gioia, Tiziana Concetta; Chiesi, Andrea; Modenese, Alberto; Abbacchini, Carlotta; Borsari, Lucia; Clò, E; De Pasquale, F; Di Rico, R; Ferrari, D; Ricci, R; Pugni, S; Sala, A; Gianaroli, E; Predieri, G; Verri, S; Gobba, Fabriziomaria
abstract
Il percloroetilene (PCE) è tuttora il principale solvente in uso nelle lavanderie a secco. Spesso il monitoraggio biologico dei lavoratori si basa sul solo dosaggio dell’acido tricloroacetico (TCA), suo principale metabolita urinario. Abbiamo voluto verificare la correlazione dei valori di tale metabolita con il PCE ambientale ai livelli attuali di esposizione.
2014
- Evolution of Subjective Symptoms in a Group of Operators Recently Engaged in Magnetic Resonance Imaging (MRI)
[Relazione in Atti di Convegno]
Zanotti, Giulio; Gobba, Fabriziomaria
abstract
We have examined subjective symptoms in a group of operators engaged in MRI from less than 1 year. The 94% referred at least one of the investigated symptoms. The most frequent were unusual drowsiness/tiredness, headache and concentration problems.
The majority of the operators referred a regression of the symptoms in 1-2 months suggesting the possibility of a some form of
adaptation.
2014
- Evoluzione della sintomatologia soggettiva in un gruppo di operatori sanitari recentemente assunti in Risonanza Magnetica per Immagini (RMI)
[Abstract in Rivista]
Zanotti, Giulio; Ligabue, Guido; Gobba, Fabriziomaria
abstract
Abbiamo valutato la sintomatologia soggettiva in un gruppo di operatori addetti alla RMI da meno di un anno. Una proporzione molto alta (94%) ha riferito almeno uno dei sintomi indagati e quelli più frequenti erano: astenia, cefalea e difficoltà di concentrazione. Il 76,5% di questi ha però riferito una regressione della sintomatologia dopo circa 1-2 mesi. Questi risultati suggeriscono un possibile adattamento nel breve termine.
2014
- Prevalenza dei sintomi soggettivi negli addetti alla Risonanza Magnetica per Immagini (RMI) presso l’Azienda Sanitaria Provinciale di Potenza
[Abstract in Rivista]
Zanotti, Giulio; Negrone, M; Di Lascio, D; Gobba, Fabriziomaria
abstract
Abbiamo confrontato la prevalenza di alcuni sintomi soggettivi tra operatori della Diagnostica per Immagini addetti alla RMI e non addetti. Il 63,6% degli addetti alla RMI ha lamentato almeno un sintomo contro il 50% dei controlli ed inoltre anche il numero medio e la prevalenza di alcuni sintomi sono risultati maggiori nel primo gruppo seppure non statisticamente significativi. Questo aumento di sintomi negli addetti alla RMI andrà confermato su casistiche più ampie.
2014
- Prevalenza di disturbi muscolo-scheletrici nella popolazione giovanile
[Abstract in Atti di Convegno]
Chiesi, Andrea; Corona, Gianluca; Garavini, Denise; Minerva, Maddalena; Occhionero, Vincenzo; Cisotta, Giuseppe; Abbacchini, Carlotta; Gobba, Fabriziomaria
abstract
I disturbi muscolo-scheletrici (DMS) sono un problema frequente in vari gruppi di lavoratori, ma alcuni dati suggeriscono la loro comparsa già in età giovanile, all’ingresso nel mondo del lavoro. Su queste basi ci siamo proposti di valutare la prevalenza di tali disturbi in un gruppo di studenti universitari.
In 219 studenti del primo anno di vari CdL dell’Università di Modena e Reggio Emilia è stata raccolta la versione italiana del “Nordic Muscoloskeletal Questionnaire” per lo studio dei DMS soggettivi. In 134 partecipanti è stato somministrato anche un questionario “ad hoc” per valutare correlazioni con alcuni possibili fattori di rischio.
La prevalenza di disturbi è risultata del 32% al collo, 31% al rachide lombare, 23% al ginocchio, 17% al rachide dorsale e 15% alla spalla; inferiore al 10% in tutti gli altri distretti. Tra i fattori correlati sono emersi un BMI>25, il lavoro extra-scolastico, le attività domestiche ed anche lo sport, che non è risultato pertanto protettivo.
Le prevalenze di disturbi rilevate negli studenti risultano essere non trascurabili specie in alcuni distretti come collo e rachide lombare; tali risultati sono coerenti con gli scarsi dati disponibili in letteratura scientifica.
2014
- Proposta di una metodologia di valutazione dell'esposizione cumulativa a radiazione solare nei lavoratori all'aperto
[Abstract in Atti di Convegno]
Modenese, Alberto; Bisegna, F; Bombarda, M; Borra, M; Grandi, C; Gugliermetti, F; Militello, A; Gobba, Fabriziomaria
abstract
Le attività lavorative all'aperto comportano una significativa esposizione alla radiazione solare (RS), che è anche la principale fonte di radiazione ultravioletta (RUV); i lavoratori outdoor sono quindi a rischio per l'insorgenza di effetti avversi, acuti e cronici, principalmente a carico di occhio e cute, legati a queste radiazioni. Tuttavia, ad oggi vari aspetti della relazione tra esposizione a RS e patologie non sono adeguatamente definiti. Su queste basi, ci siamo proposti di elaborare un metodo per la valutazione dell'esposizione attuale e pregressa a RS, che integri dati soggettivi e oggettivi di esposizione, tenendo conto dei possibili fattori ambientali e individuali che modulano l'esposizione a RS, sia durante l'attività lavorativa che nel tempo libero.
2014
- RMN: effetti negli operatori esposti
[Abstract in Rivista]
Gobba, Fabriziomaria
abstract
Gli operatori della Risonanza Magnetica per Immagini (RM) sono esposti vari campi elettromagnetici (CEM). Diversi studi sono stati condotti sui possibili effetti a breve termine correlati a tali CEM nei pazienti, ma i dati sugli operatori professionalmente esposti sono ancora scarsi. Presentiamo i principali dati della letteratura scientifica sulla relazione tra esposizione ai CEM negli operatori della RM e l’insorgenza di effetti, ed alcuni nostri risultati preliminari.
2014
- Revisione di letteratura: degenerazione maculare senile e lavoro
[Abstract in Rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
La Degenerazione Maculare Senile (DMS) è la prima causa di ipovisione sopra i 50 anni nei Paesi industrializzati. Tra i fattori di rischio, oltre a familiarità, età e fumo vi è l’esposizione a radiazione ottica (RO) visibile (in particolare luce blu) e ad UV.
In questo lavoro si è proceduto ad un’estensione ed aggiornamento dei dati, che tenesse conto anche di altri possibili fattori lavorativi.
2014
- Sensory Organs
[Capitolo/Saggio]
Gobba, Fabriziomaria
abstract
The effect of chemicals on the sensory perception in humans has received scant attention until now, but available data have shown that vision, hearing, smell, and taste can be affected by several chemicals, including pharmaceutical drugs, toxic metals, and various organic and inorganic compounds. The pathogenesis of the toxicity of chemicals to sensory perception can be related to an action on receptors, nerve fibers, and/or the brain. Even if evidence is incomplete, it is hypothesized that the decline of sensory perception with age can be, at least partly, related to chemical exposure.
2014
- Sovraccarico biomeccanico dell'arto superiore nelle attività di uno stabulario: confronto tra diversi metodi di valutazione
[Abstract in Atti di Convegno]
Occhionero, V; Ghersi, R; Prandini, L; Gobba, Fabriziomaria
abstract
Gli addetti agli stabulari per attività di ricerca, sono una categoria studiata in letteratura scientifica soprattutto per rischi come quello allergologico, ma scarsamente considerata per quanto riguarda il rischio da sovraccarico biomeccanico dell’arto superiore. Tale rischio, è un problema comune a numerose attività lavorative e deriva da diversi fattori variamente combinati, tra i quali ripetitività, forza, posture incongrue, stereotipia, frequenza d’azione, carenza di periodi di recupero e fattori complementari.
Su queste basi ci siamo proposti di studiare le attività di questi addetti mediante applicazione di diversi metodi di valutazione, ed abbiamo confrontato i risultati.
Abbiamo individuato i compiti svolti dagli addetti di uno stabulario universitario della regione Emilia-Romagna, e li abbiamo analizati singolarmente mediante i metodi OCRA, Checklist e Mini-Checklist OCRA, Job Strain Index, RULA e ACGIH-HAL, considerando una durata ipotetica di 4 e di 8 ore.
Sono stati individuati 11 diversi compiti svolti; per ciascuno di questi, il sovraccarico biomeccanico è stato analizzato, considerando una durata ipotetica di 4 e di 8 ore (rispettivamente con 1 o 2 pause da 10 min.), mediante i metodi più frequentemente utilizzati: OCRA Index, Checklist e Mini-Checklist OCRA, Job Strain Index, RULA e ACGIH-HAL. Sono poi state ricostruite due “giornate lavorative tipo” degli addetti, ed è stato calcolato il rischio da sovraccarico biomeccanico dell’arto superiore con l’OCRA Index, la Checklist e la Mini-Checklist OCRA, ovvero i metodi che permettono l’analisi di mansioni “multi-compito”.
Da questa valutazione è emerso che, considerando una durata di 4 ore, un solo compito (“svuotamento biberon”), risulta sempre in “area rossa”; altri 5 rientrano in “area verde” per la maggioranza dei metodi, con l’eccezione del RULA che, in generale, indica una prevalenza di mansioni in “area gialla”.
Per una durata ipotetica di 8h, lo “svuotamento biberon” si conferma in “area rossa” per tutti i metodi, il “rabbocco biberon e controllo gabbie” è in “area verde” tranne che con il RULA; altri 2 compiti rientrano in “area gialla” per 4 metodi su 6. Con l’Ocra Index, per durate di 8h, i valori sono prevalentemente in “area rossa”, in conseguenza del peso attribuito al fattore tempo; il Job Strain Index indica 5 compiti in “area rossa”, 5 in “area gialla” e 1 in “area verde”. Invece, il RULA, passando da 4 a 8 ore lavorative, non presenta variazioni nei risultati, mostrando come sia orientato prevalentemente allo studio delle posture di lavoro; non si modifica neanche l’HAL-ACGIH, che prende in considerazione solo forza e frequenza. Per Checklist e mini Checklist Ocra prevalgono i compiti in “area verde”, pur aumentando quelli ad “area gialla” e “rossa”.
Per quanto riguarda la valutazione delle “giornate tipo”, la “giornata I” è risultata, mediante Ocra Index, in “area gialla”, molto vicina comunque, al limite dell’area verde accettabile, mentre Checklist e mini Checklist Ocra sono in “area verde”; la “giornata II” rientra in “area verde” con tutti e 3 i metodi.
In conclusione i risultati dell’Ocra Index, Checklist e mini Checklist Ocra, non sono dimostrativi di un significativo rischio di sovraccarico biomeccanico dell’arto superiore negli addetti agli stabulari per ricerca.
Si conferma, però, una incompleta o modesta concordanza tra diversi metodi di valutazione di tale rischio, già osservata in precedenti studi di letteratura scientifica.
2014
- The Use of Computers in Different Age Groups and their Self-reported Neck Symptoms
[Relazione in Atti di Convegno]
Korpinen, Leena; Paakkonen, Rauno; Gobba, Fabriziomaria
abstract
The aim of this paper was to investigate the self-reported physical symptoms in the neck and the use of computers in different age groups. The study was carried out as a cross-sectional study by posting the questionnaire to 15,000 working-age Finns. The daily use of desktop computers at work is quite popular (over 60%) in the age groups 31-40, 41-50, and 51-60. In these same age groups, a very similar percentage of the respondents reported having physical symptoms in the neck as 'very often'. Copyright © 2014 SCITEPRESS - Science and Technology Publications. All rights reserved.
2014
- The use and know-how of ICT-technology in different age groups
[Relazione in Atti di Convegno]
Korpinen, Leena; Paakkonen, Rauno; Gobba, Fabriziomaria
abstract
When developing various ICT solutions to support people's well-being, the systems are quite often based on the use of computers or smart phones. However, in different age groups, the skills to use ICT can vary; therefore, not all people can use new technical systems. The aim of this paper was to investigate the selfreported use and know-how of the ICT-technology in different age groups and using the answers to the following questions: 'how often do you use a desktop computer at leisure?' and 'how well do you know the desktop computer?'. The study was carried out as a cross-sectional study by posting the questionnaire to 15,000 working-age Finns. To the question 'how well do you know the desktop computer?', 22% of the 20- 30 age group answered 'very well' and 19.1% of the 31-40 age group also replied 'very well'. In the 41-50 age group, the value was 15.7%, and in the age group 51-60, the value was 10.6%. In the future, when new well-being ICT technology is developed, it is important to take into account that older people do not know as much about ICT as younger people
2014
- Upper limb musculoskeletal disorders in healthcare personnel
[Articolo su rivista]
Vincenzo, Occhionero; Leena, Korpinen; Gobba, Fabriziomaria
abstract
The literature on upper limb musculoskeletal disorders (UL-MSD) in different groups of healthcare workers was reviewed:
65 relevant studies were collected. In dentists, the neck was the most frequently affected segment, with prevalences up to
73% and exceeding 50% in 7 out of 12 studies. In dental hygienists and in laboratory technicians, the hand/wrist had the
highest prevalence in the majority of the studies. In nurses, the most seriously affected anatomic sites were the neck and
shoulders. Physiotherapists had the lowest prevalence of UL-MSD. A high prevalence of upper limb disease, mainly carpal
tunnel syndrome, was reported in dentists, dental hygienists, anesthesia nurses and endoscopists. The high prevalence of
upper limb disorders/diseases reported in health personnel supports the hypothesis of a significant risk in these workers.
However, the possible role of biomechanical overload, as much as that of stress or other personal factors, cannot be currently assessed.
2013
- Approccio Metodologico per la valutazione della dose cumulativa di radiazione solare pregressa nei lavoratori outdoor
[Abstract in Rivista]
M., Borra; Modenese, Alberto; A., Militello; F., Bisegna; C., Grandi; F., Gugliermetti; Gobba, Fabriziomaria
abstract
Uno dei rischi più significativi del lavoro outdoor è l’esposizione a Radiazione Solare (RS), che può determinare numerosi effetti acuti e cronici a carico di occhio e cute, quali cataratta, pterigio, cheratosi attinica e tumori cutanei (carcinoma squamocellulare, basocellulare e melanoma); la RS è nel gruppo I (IARC) dei “cancerogeni certi per l’uomo”.
Tra i limiti più rilevanti degli studi epidemiologici condotti finora sull’associazione tra RS e patologie cutanee e oculari va certamente rilevato quello della stima della dose cumulativa di radiazione all’occhio.
Per valutare tale dose stiamo elaborando un metodo innovativo, che integra i dati di un dettagliato questionario su durata e modalità di esposizione pregressa a RS, sia occupazionale che extraoccupazionale, con dati di irraggiamento solare ricavabili da fonti disponibili.
2013
- Effetti acuti reversibili nel personale addetto alla Risonanza Magnetica Nucleare (RMN) : una revisione dei dati della letteratura
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Zanotti, Giulio
abstract
Le procedure di RMN sono una tecnologia di imaging sempre più diffusa per i nuovi orizzonti che aprono sia per la diagnostica che per la ricerca. Le apparecchiature per la RMN maggiormente diffuse hanno attualmente potenze fino a 1,5 Tesla (T) o 3 T, ma i modelli più recenti arrivano a 7 T e, per ricerca, anche oltre.
Ci siamo proposti di effettuare una revisione dei lavori presenti nella letteratura scientifica dal 2003 ad oggi sugli effetti acuti negli operatori di RMN e sulla possibile relazione con i livelli di esposizione.
2013
- Epidemiologia degli esposti a NIR: la posizione IARC
[Abstract in Rivista]
Gobba, Fabriziomaria
abstract
Le Radiazioni Non Ionizzanti (NIR) includono i Campi Elettromagnetici (CEM) e la Radiazione Ottica: qui saranno trattati solamente i primi, caratterizzati da frequenze comprese fino a 300 GHz. I CEM sono attualmente ubiquitari, e praticamente la totalità della popolazione è esposta sia a quelli Extremely Low Frequency (ELF) indotti dalle linee elettriche e dalle apparecchiature funzionati con la corrente elettrica, che alle frequenze intermedie (IF) e radiofrequenze (RF) dovute alle telecomunicazioni, sistemi antifurto elettronici, usi elettromedicali ed industriali, ecc.
Nella grande maggioranza delle persone e delle attività i livelli di esposizione ai CEM sono bassi, ma esposizioni elevate possono essere presenti in alcune particolari situazioni, più spesso in ambito lavorativo.
2013
- Esposizione a Campi Elettromagnetici: effetti sulla salute dei lavoratori e prevenzione
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria
abstract
I Campi Elettromagnetici (CEM) hanno attualmente una diffusione ubiquitaria, e, nelle nazioni industrializzate la quasi totalità dei lavoratori, e più in generale della popolazione, è esposta sia a quelli a bassissima frequenza (Extremely Low Frequency, ELF) indotti dalle linee elettriche e dalle apparecchiature funzionanti con la corrente elettrica, che alle frequenze intermede (IF) ed alle radiofrequenze (RF) legate alle trasmissioni radiotelevisive, ai telefoni cellulari, ai sistemi di antifurto elettronici, agli usi elettromedicali, ecc. E' però da riconoscere che le ricerche finora condotte indicano esposizioni contenute, o molto contenute, nella grande maggioranza delle persone e delle attività anche se, indubbiamente, esistono alcune particolari situazioni, specie in ambito lavorativo, nelle quali possono essere raggiunti livelli elevati di campo.
2013
- Esposizione occupazionale a radiazione ottica e pterigio: revisione dei dati della letteratura scientifica negli ultimi 20 anni
[Relazione in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
Lo Pterigio è un'anomala crescita del tessuto congiuntivale di forma caratteristicamente triangolare che si espande ad invadere la cornea sul lato nasale e la cui unica terapia definitiva, resta ad oggi, l'asportazione chirurgica. L'eziologia di tale patologia è in parte sconosciuta ma tra i fattori ambientali in grado di determinare un'irritazione cronica della superficie oculare gioca sicuramente un ruolo non trascurabile l'esposizione cronica a radiazioni UVR. In ragione di ciò, e considerato che varie attività lavorative comportano una significativa esposizione ad UVR, abbiamo effettuato una revisione degli studi presenti nella letteratura scientifica riguardo i fattori di rischio occupazionale per l'insorgenza dello Pterigio e la prevalenza di tale patologia nelle varie attività lavorative.
2013
- Esposizione occupazionale a radiazione ottica e rischio di cataratta: revisione dei dati recenti della letteratura
[Relazione in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
Secondo dati dell'Organizzazione Mondiale della Sanità, nel 2002 le persone nel mondo affette da visual impairment erano circa 161 milioni, e, in quasi la metà dei casi (47,8%), la causa era la presenza di cataratta. Tra i vari fattori di rischio tipicamente connessi con l'attività lavorativa rientrano, oltre ai traumi oculari, l'esposizione a vari tipi di radiazioni: ionizzanti, infrarossa (IR), ottica naturale (radiazione solare) e ottica artificiale. Scopo di questo lavoro è di effettuare un aggiornamento dei dati della letteratura scientifica più recente sui rapporti tra esposizione occupazionale a radiazione ottica e insorgenza di cataratta.
2013
- Examples of UV Measurements under 400 kV Powerlines in Finland
[Relazione in Atti di Convegno]
Paakkonen, R; Korpinen, L; Gobba, Fabriziomaria
abstract
The aim of our study is to investigate UV exposure under 400 kV powerlines in
Finland through sample measurements as a typical case study. The Finnish exposure limit
value at work for weighted ultraviolet radiation (UV-BC) is 30 J/m2 per eight hours of exposure
(based on European directive (2006/25/EU)), which is not applicable to solar radiation. This
means as instantaneous irradiance about 1mW/m2. We measured UV-BC weighted radiation and
calculated a daily dose, which is about 10 percent of the Finnish exposure limit value. However,
technical means are also needed in Scandinavia against ultraviolet sun exposure. These means
are the use of sun protective lotions, reasonable clothing, sunglasses, avoiding direct sunshine in
midday, using shadow etc..
2013
- Il ruolo del test da sforzo cardio-polmonare (CPET) nel reinserimento lavorativo di pazienti con cardiopatia ischemica
[Abstract in Rivista]
A., Giorgio; P., Grazioli; P., Tzani; M., Aiello; Bottari, Stefano; E., Marangio; Gobba, Fabriziomaria; Chetta, Alfredo Antonio
abstract
Sono stati studiati 6 soggetti di sesso maschile da reinserire al lavoro dopo sindrome coronarica acuta. Questi soggetti avevano un’attività lavorativa con dispendio energetico da lieve a moderato. Tutti i soggetti hanno eseguito ecocardiografia, spirometria e CPET incrementale massimale. Il 40% del valore di VO2 al picco è stato considerato criterio per il reinserimento lavorativo.
Tutti i soggetti sono risultati nelle classi NYHA I e II ed in tutti la spirometria è risultata nella norma e il CPET è stato ben tollerato senza alterazioni ecg di rilievo.
Al picco dell’esercizio il valore medio del carico di lavoro è stato 107watt ±18 con un consumo di ossigeno (VO2) di 17,7 ml/kg/min±4 (METS 5,1 ±1).
Il CPET ha permesso un reinserimento di tutti i soggetti in un’attività lavorativa con dispendio energetico lieve (<3 METS). Il presente studio ha inoltre confermato l’assenza di relazione tra la valutazione clinico-funzionale a riposo e la capacità di esercizio massimale in soggetti cardiopatici.
2013
- Linee Guida AIRM
Sorveglianza medica dei lavoratori esposti a radiazioni ionizzanti
[Monografia/Trattato scientifico]
Gobba, Fabriziomaria
abstract
Le Linee Guida AIRM sono un documento che costituisce la base scientifica, normativa ed operativa dell'attività del medico di radioprotezione. L'aggiornamento della dottrina, dei criteri di base e delle conoscenze maturate nel tempo successivo a livello internazionale e l'esperienza acquisita a livello nazionale hanno fornito motivo e stimolo per la revisione e l'aggiornamento dell'edizione ora indicata. Il risultato di questo riesame non ha aggiunto molto all'indirizzo di base a suo tempo evidenziato e proposto; mentre si può rilevare una più consistente dovizia di informazioni, suggerimenti ed indicazioni di carattere epidemiologico e gnoseologico che rafforzano e giustificano le fondamenta della disciplina. Dalla: Presentazione del Presidente AIRM Prof. Giorgio Trenta
2013
- Linee guida per il monitoraggio biologico
[Monografia/Trattato scientifico]
Mutti, A; De Palma, G; Andreoli, R; Bonini, S; Bollati, V; Carrieri, M; Catalani, S; Coggiola, M; Fustinoni, S; Gobba, Fabriziomaria; Goldoni, M; Manno, M; Perbellini, L; Scapellato, Ml; Apostoli, P.
abstract
Il monitoraggio biologico sta ricevendo un crescente interesse per la possibilità di quantificare l'esposizione/dose assorbita di xenobiotici attraverso diverse vie e, quindi, di caratterizzare in modo razionale i rischi per la salute connessi con specifici scenari. Il crescente interesse in tossicologia ambientale si associa ad un palpabile declino in ambito occupazionale, a causa dei costi crescenti e dell'andamento negativo della produzione industriale negli ultimi anni. Questa nuova edizione delle "Linee Guida per il Monitoraggio Biologico" , aggiornata rispetto alle precedente e con una struttura di più agevole alla lettura, contiene tutte le informazioni necessarie per la corretta utilizzazione degli indicatori di esposizione.
2013
- Linee guida per la Sorveglianza Sanitaria in agricoltura
[Monografia/Trattato scientifico]
Colosio, C; Angotzi, G; Ariano, E; Borghesi, S; Bovenzi, M; De Vito, G; Gerardi, D; Gobba, Fabriziomaria; L'Abbate, N; Lucchini, R; Maso, S; Mattioli, S; Messineo, A; Miraglia, N; Moretto, A; Musti, M; Occhipinti, E; Peretti, A; Riva, Ma; Romeo, L; Ronchese, F; Rubino, Fm; Saldutti, E; Sannolo, N; Simonelli, A; Somaruga, C; Vellere, F; Vitelli, N.
abstract
Nel Dicembre 2012 gli Organismi Dirigenti della Società Italiana di Medicina del Lavoro e Igiene Industriale (SIMLII) si sono impegnati in un programma ambizioso ed impegnativo volto ad aggiornare, entro la fine del 2014, la vigente normativa di tutte le linee guida fino ad oggi pubblicate. L’agricoltura rappresenta tradizionalmente un importante settore dell’economia italiana. Queste Linee Guida SIMLII per la Sorveglianza Sanitaria in agricoltura rappresentano un importantissimo strumento di supporto all’attività del Medico Competente impegnato in questo delicato settore.
2013
- Patologie croniche oculari nei lavoratori outdoor: un rischio sottovalutato
[Abstract in Rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
Lo pterigio e la cataratta, in particolare la forma corticale (CC), ma anche, seppure con evidenza minore, la nucleare (CN) e sottocapsulare posteriore (CSP), sono patologie croniche oculari correlate con l’esposizione a radiazione solare ultravioletta (RSUV). La RSUV è un importante fattore di rischio del lavoro outdoor: abbiamo effettuato una revisione dei dati della letteratura scientifica su pterigio e cataratta da RSUV in questi lavoratori.
2013
- Prevalenza di disturbi muscolo scheletrici: confronto tra i risultati ottenuti mediante questionario e quelli di una visita medica
[Abstract in Rivista]
Occhionero, Vincenzo; G., Corona; D., Garavini; M., Minerva; Bottari, Stefano; Zanotti, Giulio; Gobba, Fabriziomaria
abstract
La prevalenza di disturbi muscolo scheletrici (DMS), problema di grande rilevanza in Medicina del Lavoro, viene correntemente studiata mediante questionari. La concordanza dei dati ricavabili mediante i questionari rispetto agli esiti di una visita medica non è però stata valutata in modo adeguato. Ci siamo proposti di condurre uno studio per comparare i risultati del questionario standardizzato “Nordic Musculoskeletal Questionnaire” (NMQ) sui DMS con quelli della visita medica.
2013
- Prevalenza di disturbi muscolo-scheletrici nella popolazione giovanile
[Abstract in Rivista]
Occhionero, Vincenzo; G., Corona; D., Garavini; M., Minerva; Chiesi, Andrea; Bottari, Stefano; Zanotti, Giulio; Gobba, Fabriziomaria
abstract
I disturbi muscolo-scheletrici (DMS) sono un problema frequente in vari gruppi di lavoratori, ma alcuni dati suggeriscono la loro comparsa già in età giovanile, all’ingresso nel mondo del lavoro. Su queste basi ci siamo proposti di valutare, mediante la versione italiana del “Nordic Muscoloskeletal Questionnaire”, la prevalenza di tali disturbi in un gruppo di studenti.
2013
- Radiazione solare e lavoro: esposizione, effetti, prevenzione
[Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract
2013
- Self-reported neck symptoms and use of personal computers, laptops and cell phones among Finns aged 18–65
[Articolo su rivista]
Leena, Korpinen; Rauno, Pääkkönen; Gobba, Fabriziomaria
abstract
The purpose of this study was to investigate the possible relation between self-reported neck symptoms (aches, pain or
numbness) and use of computers/cell phones. The study was carried out as a cross-sectional study by posting a questionnaire
to 15,000 working-age persons, and 15.1% of all respondents (6121) reported that they very often experienced physical
symptoms in the neck. The results showed that they also had many other symptoms very often, and 49% used a computer
daily at work and 83.9% used cell phones. We compared physical/mental symptoms of persons with symptoms in the neck
quite often or more, with others. We found significant differences in the physical/mental symptoms and use of cell phones
and computers. The results suggest taking into account in the future that those persons’ symptoms in the neck can be
associated with use of cell phones or computers.
2013
- Studio sui disturbi soggettivi in operatori addetti dalla Risonanza Magnetica Nucleare (RMN)
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Zanotti, Giulio
abstract
I risultati di alcuni studi condotti finora nel personale della RMN suggeriscono un’aumentata prevalenza di alcuni sintomi soggettivi.
I dati finora disponibili suggeriscono che tutti gli effetti siano rapidamente e totalmente reversibili con l’interruzione dell’esposizione ma una valutazione complessiva dei dati è però problematica. Inoltre, del tutto carenti sono le conoscenze sull’andamento dei sintomi in relazione alla durata dell’esposizione.
Per queste ragioni, presentiamo uno studio, condotto mediante un questionario che stiamo sviluppando, ed alcuni dati preliminari raccolti in un gruppo pilota per testare lo strumento.
2013
- Studio sui sintomi soggettivi in addetti alla Risonanza Magnetica Nucleare (RMN)
[Abstract in Rivista]
G., Arcangeli; Gobba, Fabriziomaria; R., Moccaldi; N., Mucci; Zanotti, Giulio
abstract
Alcuni studi nel personale addetto alla Risonanza Magnetica Nucleare (RMM) suggeriscono un’aumentata prevalenza di alcuni sintomi soggettivi quali sensazione di sapore metallico, vertigini e sensazione di movimento, nausea e cefalea, ed un possibile effetto su alcuni test neuro-comportamentali e neurofisiologici, reversibili dopo interruzione dell’esposizione.
I dati sono però moto limitati. In questo lavoro presentiamo uno studio che stiamo avviando su tali sintomi in addetti alla RMN, ed alcuni dati preliminari raccolti in un gruppo pilota per testare lo strumento.
2012
- ANOSMIA AFTER EXPOSURE TO A PYRETHRIN-BASED INSECTICIDE: A CASE REPORT
[Articolo su rivista]
Gobba, Fabriziomaria; Abbacchini, Carlotta
abstract
We present the case of a subject developing anosmia, preceded by nasal transient irritation and short lasting phantosmia and torqosmia, upon re-entrance into a room treated with a pyrethrins-based insecticide. The concentration of the insecticide in the room is unknown, but relatively high levels are predicted basing upon the modality of exposure and by the irritation symptoms in the subject. Despite corticosteroids therapy, anosmia has persisted unmodified for more than three years; according to, and based on evidence in the literature on olfactory disturbance prognosis, anosmia in this patient is likely to be permanent. The significance of this case report is related to the current wide use of insecticides containing pyrethrin and pyrethroids and highlights the need for more adequate attention to lowering airborne concentrations of pyrethrins and pyrethroids prior to re-entering the treated rooms. In particular, in a closed space sprayed with pyrethrins and pyrethroids insecticide, any irritant symptoms and/or dysosmia should be immediately considered relevant warning signs, and must be avoided.
2012
- Benessere e lavoro: il punto di vista della medicina del lavoro
[Capitolo/Saggio]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
Il concetto "benessere dei lavoratori" ha un significato ampio, comprende differenti aspetti, e non è facilmente quantificabile in modo univoco da un punto di vista scientifico, ma, soprattutto, ha seguito un'importante evoluzione nel tempo. Attualmente nel D.Lgs. 81/2008 all'art. 2 la "salute" viene descritta come lo "stato di completo benessere fisico, mentale e sociale" e non solo come una semplice assenza di malattia o di infermità. Per questo motivo lo scopo odierno della medicina del lavoro è quello di tutelare e promuovere il benessere e la salute nei luoghi di lavoro. Al fine di avere un'adeguata comprensione del percorso, della sua difficoltà, e dell'importanza dell'obbiettivo ottenuto, questo volume tratta: una contestualizzazione storica delle conoscenze sui rapporti tra salute e lavoro, il ruolo della disciplina scientifica della medicina del lavoro e la figura professionale del medico del lavoro nella tutela e nella promozione della salute e della sicurezza dei lavoratori.
2012
- EXPERIENCES OF INTEGRATING MSc STUDENT RESEARCH PROJECTS IN THE 'ELECTROMAGNETIC FIELDS AND HEALTH' AREA
[Abstract in Atti di Convegno]
Korpinen, Leena; Paakkonen, Rauno; GONZALEZ SOSA, JAROLD AURELIO; Gobba, Fabriziomaria
abstract
The aim of this paper is to present the process of integrating MSc student theses with our existing research projects, in the area of electromagnetic fields and health. Since 2004, we have integrated ten MSc theses into our research projects. In Finland, a thesis generally spans a six month working period. Typically, thesis planning starts with a research plan and identifies possible funding sources for the project. For students, it is important to find tasks that are possible to complete within 6 months. We cite example cases and show how we have integrated students into projects and in-turn try to develop the teaching process as an integral part of our research projects.
2012
- Effetti acuti in esposti ai campi elettromagnetici indotti dalla Risonanza Magnetica Nucleare (RMN): revisione dei dati di letteratura
[Relazione in Atti di Convegno]
Zanotti, Giulio; Gobba, Fabriziomaria
abstract
La RMN comporta un’esposizione a campi statici e a frequenza variabile. Le conoscenze sui possibili rischi per gli operatori sanitari esposti sono scarse. E’ stata condotta una ricerca sistematica degli studi presenti nella letteratura scientifica sulla relazione tra l’esposizione ai campi elettromagnetici indotti dalla Risonanza Magnetica Nucleare (RMN) e l’insorgenza di effetti nei lavoratori. Sono stati raccolti 14 studi. I risultati dimostrano alcuni disturbi soggettivi, come percezione di sapore metallico, vertigini, senso di movimento, nausea e cefalea, ed effetti neurocomportamentali quali alterazioni della coordinazione oculo-motoria e performance visiva. Gli effetti sono essenzialmente dose dipendenti, e regrediscono rapidamente al termine dell’esposizione. Carenti sono le conoscenze su eventuali effetti a lungo termine.
2012
- Esposizione a radiazione solare in agricoltura: un rischio sottovautato
[Articolo su rivista]
Gobba, Fabriziomaria
abstract
La Radiazione Solare (RS), ed in particolare la sua componente ultravioletta (UV), rappresentano un rischio occupazionale rilevante in agricoltura, anche se largamente sottovalutato. I dati disponibili confermano come molto spesso le esposizioni in questo comparto eccedano i limiti occupazionali, causando un aumento del rischio di vari effetti acuti e cronici, principalmente a carico della cute e dell’occhio. Tra i più importanti è l’effetto cancerogeno: sia gli UV che la RS sono inclusi dalla IARC nel gruppo dei cancerogeni accertati (Gr.1). I tumori correlati sono gli epiteliomi spinocellulari e basocellulari, ed i melanomi maligni cutanei, la cui incidenza è in costante aumento nella razza caucasica negli ultimi 50 anni. Una valutazione del rischio da RS nei lavoratori dell’agricoltura e nelle attività assimilabili, quale l’orticoltura, il giardinaggio e altre, e la messa in atto di adeguate misure, rappresentano pertanto misure preventive indispensabili. Il ruolo del Medico Competente nella prevenzione di questo rischio è fondamentale
2012
- Linee Guida per la Sorveglianza Sanitaria dei lavoratori esposti a Radiazioni non Ionizzanti
[Monografia/Trattato scientifico]
F., Ottenga; M., Bellia; A., Giovanazzi; Gobba, Fabriziomaria; N., L'Abbate; G., Mariutti; R., Moccaldi; P., Rossi; A., Stanga
abstract
Uno degli obblighi esplicitamente contemplati da parte del medico competente è quello della sorveglianza sanitaria degli esposti per cause lavorative a radiazioni non ionizzanti (NIR). La SIMLII e l'AIRM, organismi scientifici societari, si sono collocati in questa prospettiva, ed hanno emanato Linee guida per la sorveglianza sanitaria degli esposti a NIR che oggi però si rende necessario aggiornare, non solo per rispondere alle informazioni tecniche e scientifiche nel frattempo maturate, ma anche per aderire alla rinnovata recente normativa in tema di tutele lavorative con riferimento alle radiazioni non ionizzanti.
Le "Linee Guida" qui presentate raccolgono conoscenze sulla natura, sulle caratteristiche tecniche, sui molteplici campi di impiego, sulle modalità di interazione con l'organismo e soprattutto sui criteri di prevenzione, con l'intento di indirizzare l'attuazione della sorveglianza sanitaria dei lavoratori esposti in aderenza alle migliori evidenze scientifiche e tecniche ed in conformità ai criteri della medicina basata sull'evidenza.
2012
- Menometrorrhagia in magnetic resonance imaging operators with copper intrauterine contraceptive devices (IUDS): a case report
[Articolo su rivista]
Gobba, Fabriziomaria; Bianchi, N; Verga, P; Contessa, Gm; Rossi, P.
abstract
The paper describes the cases of 3 female health operators with implanted copper IUDs, developing menometrorrhagia some months after an increase of the working time in a Magnetic Resonance Imaging (MRI) Unit (1.5 T), that progressively disappeared when the previous organization, involving discontinuous work shifts at MRI, was re-established. No known factors possibly related to menometrorrhagia were evidenced in the 3 operators, supporting the hypothesis of a role of the exposure to the electromagnetic fields (EMF) induced by the MRI system in symptoms induction. The possible mechanism remains unsettled, but menometrorrhagia might be triggered by a phlogistic stimulus caused by EMF, possibly the low-frequency currents induced in the wires of the IUD during the movements of the operator inside the static magnetic field generated by the MRI permanent magnet. Until now, the problem of possible interactions between copper IUDs and EMF induced by MRI has been considered in patients undergoing imaging, but the possible risk in MRI Units operators has been largely neglected. To our knowledge, the occurrence of menometrorrhagia is not routinely checked in health surveillance of MRI operators, so these symptoms can pass unnoticed, especially if they are transitory. Therefore, underreporting is rather possible. The cases described here support the need for further research on this topic, especially considering the progressive diffusion of more powerful MRI scanners (3 T and more), and of the interventional magnetic resonance imaging, both potentially involving higher EMF exposures, and a large number of MRI female operators, possibly using IUDs. The possibility that MRI operators with implanted metallic IUDs can be included in the group of "workers at particular risk" according to the EU Directive 2004/40/EC should be considered.
2012
- Occupational Exposure to Extremely Low Frequency Electric Fields in Office Work
[Poster]
Gobba, Fabriziomaria
abstract
The aim of this study is to investigate occupational exposure to extremely low
frequency (ELF) electric fields (EF) in office work. The background electric fields (n = 4) were 2-
25V/m and the highest electric field measured was 1000 V/m. Different devices found in the office
environment were measured for EF exposure. Results included, e.g., (1) spot lamps: 400V/m
and 1000V/m (from surface) and 30V/m (distance 50 cm), (2) coffee maker: 10-20V/m (from
surface), (3) the transformer of a computer: 100-200V/m (from surface), (4) the alternator of a
cellular phone: 40-60 V/m, (5) a UPS (uninterruptible power supply): 300V/m (from surface)
and 5V/m (distance 1 m), (6) a PC table speaker: 250V/m (from surface). The measured values
obtained are clearly below 10 000V/m threshold stipulated in the guidelines of ICNIRP (The
International Commission on Non-ionizing Radiation Protection).
2012
- Occupational risk related to optical radiation exposure in construction workers
[Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract
Optical Radiation is a relevant occupational risk in construction workers, mainly as a consequence of the exposure to the ultraviolet (UV) component of solar radiation (SR). Available data show that UV occupational limits are frequently exceeded in these workers, resulting in an increased occupational risk of various acute and chronic effects, mainly to skin and to the eye. One of the foremost is the carcinogenic effect: SR is indeed included in Group IIARC (carcinogenic to humans). UV exposure is related to an increase of the incidence of basal cell carcinoma, squamous cell carcinoma of the skin and cutaneous malignant melanoma (CMM). The incidence of these tumors, especially CMM, is constantly increasing in Caucasians in the last 50 years. As a conclusion, an adequate evaluation of the occupational risk related to SR, and adequate preventive measures are essential in construction workers. The role of occupational physicians in prevention is fundamental.
2012
- Rischio da stress lavoro-correlato e disturbi muscolo-scheletrici in operatori socio-sanitari di residenze assistenziali per anziani.
[Abstract in Atti di Convegno]
Modenese, A.; Gobba, F.
abstract
Rischio da stress lavoro-correlato e disturbi muscolo-scheletrici in operatori socio-sanitari di residenze assistenziali per anziani.
2012
- The Possible Exposure of Children to Extremely Low Frequency Magnetic Fields in the Home
[Poster]
Gobba, Fabriziomaria; Paakkonen, R; Tarao, H; Korpinen, L.
abstract
This paper aims to analyze common magnetic field exposure situations to children
in the home, to determine possibly relevant sources. Part of the data presented here derives from
measurements performed in projects in Finland and Italy. In the home, the important sources of
children's exposure are electrical systems and devices. In conclusion we can say that it is quite
easy to find exposure levels that exceed 0.3-0.4 µT in the home.
2012
- White-Collar Workers’ Self-Reported Physical Symptoms Associated With Using Computers
[Articolo su rivista]
L., Korpinen; R., Pääkkönen; Gobba, Fabriziomaria
abstract
The aim of our work was to study the physical symptoms of upper- and lower-level white-collar workers using
a questionnaire. The study was cross-sectional with a questionnaire posted to 15 000 working-age persons.
The responses (6121) included 970 upper- and 1150 lower-level white-collar workers. In the upper- and
lower-level white-collar worker groups, 45.7 and 56.0%, respectively, had experienced pain, numbness and
aches in the neck either pretty often or more frequently. When comparing daily computer users and nonusers,
there were significant differences in pain, numbness and aches in the neck or in the shoulders. In addition, age
and gender influenced some physical symptoms. In the future, it is essential to take into account that working
with computers can be especially associated with physical symptoms in the neck and in the shoulders when
workers use computers daily.
2011
- Bernardino Ramazzini's intuitions and modern occupational medicine
[Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto; Occhionero, Vincenzo
abstract
Bernardino Ramazzini is the recognized father of occupational medicine. His work De morbis artificum diatriba, printed in Modena in 1700, is the first comprehensive treatise on the diseases of workers. Ramazzini was the first physician to investigate systematically the relationship between work and disease. The method applied, including an accurate medical examination, an inspection to workplaces to observe workers' activities, and a collection of existing knowledge, is surprisingly up-to-date. But the most modern part of his method was the acknowledgement of the role of prevention: Ramazzini identified several precautions to limit exposure to hazards, and also recognized the fundamental role of informing and training the workers about the occupational risks and how to protect themselves. As a conclusion, the contribution of Bernardino Ramazzini to occupational medicine is not limited to the recognition of a large number of occupational diseases, but is also, and mainly, in the method developed
2011
- Current densities and internal electric field from occupational exposure to electric fields in work tasks at 110 kV substations in the Tampere Region
[Relazione in Atti di Convegno]
Pääkkönen, R; Tarao, H; Gobba, Fabriziomaria; Korpinen, L.
abstract
The aim of this paper is to investigate the current densities and internal electric field induced from occupational exposure to electric
fields in work tasks at 110 kV substations in the Tampere region using a sphenoid model. From the highest measured field the
calculated current density was 4.2mA/m² and the internal electric field 0.4 - 0.8mV/m. Results show that even if the action values of
the EU Directive 2004/40/EC were exceeded in some of the examined areas, the limit values were never exceeded. According to
data, the limits of the Directive are currently respected in substations.
2011
- Degenerazione maculare ed esposizione professionale a radiazioni ottiche: revisione dei dati di letteratura
[Relazione in Atti di Convegno]
Bello, Massimo Antonio Armando; Gobba, Fabriziomaria
abstract
La degenerazione maculare senile (DMS), una delle cause più frequenti di cecità nel mondo occidentale, è una patologia a genesi multifattoriale. Tra i fattori di rischio ambientali occupa una posizione ancora non ben definita l’esposizione a radiazione ottica (RO). Obiettivo del nostro studio è stato approfondire le conoscenze attuali sul possibile ruolo dell’esposizione professionale a RO sulla comparsa di DM. Interrogando le principali banche dati abbiamo raccolto gli studi riguardo questa possibile relazione patogenetica. Al momento i dati risultano però insufficienti e poco conclusivi, soprattutto per quanto riguarda gli studi epidemiologici riferiti all’esposizione occupazionale.
2011
- Disturbi muscolo-scheletrici e stress lavoro-correlato nel personale sanitario: indagine pilota in due strutture residenziali per anziani dell’Emilia Romagna
[Poster]
Modenese, Alberto; Migliore, Agostino; I., Degli Antoni; S., Pedretti; Gobba, Fabriziomaria
abstract
Gli operatori socio-sanitari (OSS) impiegati in strutture residenziali per anziani sono a rischio per l’insorgenza di stress e disturbi muscolo-scheletrici (DMS) lavoro-correlati. In un campione di 46 OSS, sono state rilevate mediante il Nordic Musculoskeletal Questionnaire elevate prevalenze di disturbi (69,9-41,3%) e impedimenti (39,1-19,6%) a spalle, collo, rachide lombare e polso/mano. Agli stessi operatori, è stato somministrato il “questionario-strumento indicatore” INAIL-HSE. I risultati indicano come aree critiche per l’insorgenza di stress l’autonomia nell’esecuzione della propria attività lavorativa (Controllo=2,96±0,71), il carico di lavoro percepito (Domanda=3,40±0,60) e la gestione dei conflitti (Relazioni=3,38±0,68) e dei cambiamenti organizzativi (Cambiamento=3,54±0,74). Nei lavoratori con disturbi e impedimenti a collo e rachide lombare il questionario ha rilevato un rischio maggiore alle scale Domanda e Relazioni rispetto ai colleghi in cui tali DMS sono assenti (p<0,05 per collo, p<0,01 per rachide lombare). Gli OSS con disturbi e impedimenti del polso/mano giudicano maggiormente critiche le dimensioni Controllo e Supporto rispetto a quelli che non riferiscono tali problematiche (p<0,01). I risultati ottenuti suggeriscono la presenza di un’associazione tra stress e DMS lavoro-correlati.
2011
- Implicazioni per la tutela della salute dei lavoratori esposti ai campi elettromagnetici [Possible consequence on measures for the protection of electromagnetic fields exposed workers]
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria
abstract
In this paper are discussed the possible consequences of the recent classification of Radiofrequencies as Group 2B IARC, and of the revision of the European Directive 2004/40/CE currently in progress, on measures for the protection of workers exposed to electromagnetic fields in Italy. No conclusion is possible regarding the revision of 2004/40/CE, until the definitive text is approved, and implemented in Italy. Balanced information on 2B IARC classification of RF (but also of ELF) should be included in information of workers on the occupational risk; furthermore, unnecessary exposure should be avoided, and exposure minimized, as part of general measures for protection.
2011
- Medical aspects of overexposures to electromagnetic fields
[Articolo su rivista]
B., Hocking; Gobba, Fabriziomaria
abstract
Overexposures to electromagnetic fields are uncommon events but are distressing to patients and demanding of physicians when they occur. The paper outlines some of the biophysical considerations in relation to health effects, the settings in which overexposures may occur, the characterisation of the overexposure, the clinical approach to a patient, and concludes with comments on medico-legal issues and the reporting of such cases.
2011
- Occupational and environmental exposure to extremely low frequency-magnetic fields: a personal monitoring study in a large group of workers in Italy.
[Articolo su rivista]
Gobba, Fabriziomaria; Bravo, G; Rossi, P; Contessa, Gm; Scaringi, M.
abstract
An inaccurate evaluation of exposure is considered a possible cause for the inadequate conclusiveness of epidemiological research on adverse effects of extremely low frequency-magnetic fields (ELF-MF). The objective of this study is to provide an evaluation of current ELF-MF exposure in workers, the specific contribution of occupational exposure to overall 24-h exposure, and the representativeness of a job exposure matrix (JEM). ELF-MF exposure was monitored in 543 workers for 2 days using personal meters. Time-weighted average (TWA) levels at work, at home and outside the home were calculated. A JEM based on the 1988 International Standard Classification of Occupations (ISCO 88) was created. Median exposure at work, at home and outside the home were 0.14, 0.03 and 0.05 μT, respectively. Occupational exposure accounted for about 60% of 24-h exposure. In the JEM, about 50% of the classified occupations included significantly different individual TWAs. Occupational exposure to ELF-MF appeared low. Median exposure levels at home and outside were 20-28% of the occupational level, giving a minor contribution to overall day-to-day exposure. The frequent occurrence of workers with different TWA included under the same job title highlights the risk of misclassification in epidemiological studies on ELF-MF effects based on JEM.Journal of Exposure Science and Environmental Epidemiology advance online publication, 6 April 2011; doi:10.1038/jes.2011.9.
2011
- Placche pleuriche multiple dopo esposizione para-professionale a basse dosi di amianto: un caso clinico.
[Poster]
Mora, Erika; Valente, Annalisa; D., Serra; Gobba, Fabriziomaria
abstract
Le placche pleuriche, la più frequente patologia benigna della pleura da esposizione ad amianto, sono descritte in letteratura quasi esclusivamente in pazienti con esposizioni professionali, e sono considerate secondarie ad esposizioni significative.
In questo lavoro è descritto il caso di una donna con placche pleuriche bilaterali calcifiche secondarie ad esposizione non professionale a livelli ambientali verosimilmente bassi, e per un periodo relativamente contenuto (4 anni). Questa osservazione è in accordo con alcune recenti ipotesi sulla possibilità che anche basse dosi possano comportare il rischio di patologie benigne della pleura. Un ulteriore problema in questo caso è la gestione nel tempo della paziente, infatti, sebbene la presenza di placche pleuriche non sia direttamente correlata alla comparsa di patologie tumorali, la loro presenza è indicativa di una esposizione certa. Su queste basi sono state consigliate alcune indicazioni comportamentali, come l’astensione dal fumo, mentre la necessità di un follow-up nel tempo è meno definita.
2011
- Prevalenza di disturbi muscolo scheletrici in gruppi di lavoratori: confronto tra le prevalenze ottenibili mediante questionari e visita medica
[Relazione in Atti di Convegno]
Occhionero, Vincenzo; G., Corona; Frascari, Elisabetta; Gobba, Fabriziomaria
abstract
Un problema ancora aperto degli studi sulla prevalenza
di disturbi muscolo scheletrici valutati mediante questionari è la
rappresentatività. Su queste basi ci si è proposti di condurre uno studio al fine di confrontare i risultati sui disturbi muscolo-scheletrici e la disabilità a carico di vari segmenti corporei, rilevabili mediante auto-somministrazione
del Nordic Musculoskeletal Questionnaire con i risultati
di una successiva visita medica. Sono stati studiati 105 studenti e 90 infermieri.
Negli studenti il questionario ha mostrato prevalenze di disturbi
più alte al collo (30%), rachide lombare (28%), ginocchio (21%)
e mano/polso (14%); le prevalenze di disturbi per gli stessi distretti, ottenute in base ai risultati della visita medica, sono inferiori, rispettivamente:
1%, 10%, 0 e 2%.
Negli infermieri, il questionario ha rilevato le seguenti prevalenze:
rachide lombare (76,7%), collo (64,5%), spalla (51%), rachide dorsale (42,3%) e mano/polso (37,8%), mentre negli stessi distretti, le prevalenze ottenute dalla visita medica sono rispettivamente: 52,3%, 24,5%,12,3%, 11% e 8%.
Per quanto riguarda il confronto questionario-visita nel gruppo studenti la sensibilità è molto variabile, la specificità và da 0,7 a 0,96; il grado di concordanza (K di Cohen) è risultato piuttosto basso (0,05-0,47). Nel gruppo infermieri, la sensibilità varia da 0,64 a 1, la specificità da 0,4 a 0,9, il K di Cohen è risultato essere discreto/buono per rachide lombare, anca/coscia e ginocchio.
Questi risultati, suggeriscono che i questionari auto-somministrati
possano essere un utile strumento di screening preliminare con un minimo numero di falsi negativi, ma che sovrastimino la prevalenza di disturbi muscoli scheletrici.
2011
- Use of electric blankets and ELF-MF exposure in the general population
[Relazione in Atti di Convegno]
Palonen, S; Korpinen, L; Pääkkönen, R; Gobba, Fabriziomaria
abstract
The aim of the paper was to study public exposure to MF of electric blankets. For example it is quite possible that children can sleep
one the electric blankets, so it was important to study how high the MF exposure of the electric blankets can be. In our quite limited
material the exposure from electric blankets can quite easily be over 0.3 or 0.4 microT. If we compare the results of electric blankets
to guidelines for general public, these values are clearly less (less than 2%) than the guidelines. Therefore, there is nothing illegal in
selling and buying these products.
2010
- Heat stroke in the workplace: description of a case with fatal outcome
[Articolo su rivista]
Roccatto, L; Modenese, Alberto; Occhionero, V; Barbieri, Alberto; Serra, D; Miani, E; Gobba, Fabriziomaria
abstract
BACKGROUND: Heat exposure represents an occupational risk factor in various work settings. Adverse effects may range from mild symptoms, like muscular cramps, to life threatening conditions, like heat stroke. Data on the occurrence of work-related adverse effects of heat exposure in Italy are lacking.OBJECTIVES:To highlight the risk of heat stroke in a common working activity.METHODS:The case of a fatal heat stroke in a 19-year-old worker, in apparently good health, employed in maintenance of open park spaces is presented. After working 7 hours outdoors on a sunny day he was found unconscious. He was immediately taken to the local Emergency Department, where he arrived in hyperthermic and comatose conditions, and died due to multiple organ failure after 36 hours. After excluding other main causes of hyperthermia, heatstroke was identified as the initial cause of death.RESULTS:The case presented describes the possible extreme consequences of an underestimation of the risk related to occupational heat exposure, even in young and apparently healthy workers. Heat-related adverse effects may occur in a number of common activities, not necessarily involving heavy workload or extreme temperatures. Different methods, including simplified methods, are available for heat stress risk evaluation. The main preventive measures include adequate acclimatization, periodic interruption of exposure, sufficient fluid intake, adequate clothing and appropriate Personal Protective Equipment. Adequate training and workers' health surveillance are also essential.CONCLUSIONS:Heat exposure may be a significant occupational risk, potentially inducing life-threatening conditions, in a number of common activities but is frequently underestimated. An example of undervaluation of the risk and of the possible consequences, are presented and discussed in this case report.
2010
- I disturbi muscolo scheletrici a carico dell'arto superiore nel personale sanitario: revisione dei dati di letteratura
[Relazione in Atti di Convegno]
Occhionero, Vincenzo; Gobba, Fabriziomaria
abstract
Musculoskeletal disorders are a well known problem in health care personnel. Up now research focussed mainly to low back pain, while scant attention has been devoted to the upper limb. Using PubMed, Embase and Scopus we searched for studies on work-related upper limb symptoms in health care personnel We included studies: published since 1990, with at least 25 persons and a response rate >50% and which assessed symptoms using the “Nordic Musculoskeletal Questionnaire”. Based on the selection criteria, 18 articles were collected in 4 different groups: dentist, nurses, physiotherapists, laboratory technicians.
The highest prevalence of neck symptoms was observed in dental personnel (73% - 54%) and in nurses (54.7% -13.2%). Considering the shoulder, prevalence ranging 65% - 49.8% were observed in dentist, and from 71.9% to 35.1% in nurses. For the elbow, the laboratory technicians and dental personnel had the higher values (23% and 27-18% respectively). Finally, for the hand / wrist, the highest prevalence was found in laboratory technicians (59%) and in dentists (54 - 47.5%).
As a conclusion, the results show that the upper limb symptoms should be considered a significant problem in health workers, and adequate preventive strategies should be developed and implemented.
2010
- Lo stress lavoro-correlato: i recenti documenti regionali e del comitato tecnico interregionale
[Relazione in Atti di Convegno]
Modenese, Alberto; A., Migliore; Gobba, Fabriziomaria
abstract
Since May 2009, many Italian Regions and the Interregional Technical Committee have developed guidance for work-related stress risk assessment. These documents have similarities but also differences. Risk assessment is a three steps process in the documents of Lombardia, Veneto, Toscana and Interregional Committee: it implies an objective evaluation, a subjective one and a final report with definition of the hazard level. Only Lombardia asserts that stress perception’s evaluation is necessary even if no risk emerged from the objective investigation. In another document, proposed in Emilia Romagna region, two checklists of objective indicators for risk assessment are proposed. For the “Emilia Romagna work-group –ERPER-“, stress risk assessment is particularly problematic in small companies (less than 10 employees); this group suggests training meetings, each lasting two hours, for both employees and management, to provide knowledge, policy and tools for better dealing with work-related stress. Regarding workers’ health surveillance, the Interregional Committee provides a list of the main disorders correlated with stress, but it doesn’t recommend any specific monitoring procedure, while in other documents the importance of specific health surveillance focused on prevention of stress risk is stressed. Up now an agreement on criteria for an adequate prevention of WR stress are lacking in Italy.
2010
- Risks of repetitive movements in health personnel
[Articolo su rivista]
Gobba, Fabriziomaria; Bacis, M; Capodaglio, E; De Michieli, P; Larese, F; Occhionero, V.
abstract
To date, scant attention has been devoted to the occupational risk related to repetitive movements in health personnel. Using three database, PubMed, Scopus, and EMBASE, we found 57 papers on this topic, and on possibly related upper limb symptoms and diseases. In these studies, evaluation of the risk, e.g. using the methods currently applied in industry, are lacking. Although in several studies data on the prevalence of upper limb symptoms and disorders are presented, a comparison of results is difficult as different methods were applied. Furthermore, a comparison with adequate controls is frequently lacking, and/or correlation with the risk was not studied. Despite these limitations, an overall evaluation of the results shows that in health personnel the prevalence of upper limb symptoms/disorders is generally high. Highest prevalences were observed for the neck, shoulder, wrist/hand symptoms and for Carpal Tunnel Syndrome (CTS) in dental personnel, for symptoms to the neck, shoulder and wrist/hand in sonographers, and to the neck, shoulder, elbow, and, especially, wrist/hand in laboratory technicians using manual pipettes. In the nursing personnel highly variable prevalences were observed; this is possibly due to the variability of the tasks performed by this occupational group. Repetitive movements of upper limb are a known risk factor for symptoms to the neck, shoulder, elbow, and wrist/hand, and some disorders, as CTS: the high prevalences observed in health workers may be related to this risk. Nevertheless, other factors such as effort, posture and precision work may play an important role too. As a conclusion, available data are insufficient for an adequate evaluation of the occupational risk related to repetitive movements in health workers
2010
- Stress occupazionale e sottopopolazioni linfocitarie e citochine infiammatorie nei lavoratori.
[Abstract in Atti di Convegno]
Modenese, A.; Gobba, F.
abstract
Stress occupazionale e sottopopolazioni linfocitarie e citochine infiammatorie nei lavoratori.
2009
- Adverse health effect of Electromagnetic Fields: an update of the results of epidemiological research.
[Abstract in Atti di Convegno]
Gobba, F.
abstract
Adverse health effect of Electromagnetic Fields: an update of the results of epidemiological research.
2009
- Colour Vision Impairment In Workers Exposed To Neurotoxic Chemicals
[Abstract in Atti di Convegno]
Gobba, F.
abstract
Colour Vision Impairment In Workers Exposed To Neurotoxic Chemicals
2009
- Extremely low frequency-magnetic fields (ELF-EMF) occupational exposure and natural killer activity in peripheral blood lymphocytes
[Articolo su rivista]
Gobba, Fabriziomaria; Bargellini, Annalisa; M., Scaringi; Bravo, Giulia; Borella, Paola
abstract
Extremely Low Frequency-Magnetic Fields (ELF-MF) are possible carcinogens to humans and some data suggest that they can act as promoters or progressors. Since NK cells play a major role in the control of cancer development, an adverse effect on ELF-MF on NK function has been hypothesized. We examined NK activity in 52 workers exposed to different levels of ELF-MF in various activities. Individual exposure was monitored during 3 complete work-shifts using personal dosimeters. Environmental exposure was also monitored. ELF-MF levels in the workers were expressed as Time-Weighted Average (TWA) values. NK activity was measured in peripheral blood lymphocytes (PBL). In the whole group the median occupational TWA was 0.21 microT. According to the TWA levels, workers were classified as low exposed (26 subjects, TWA < or =0.2 microT) and higher exposed workers (26 subjects; TWA >0.2 microT). In higher exposed workers, we observed a trend to reduce NK activity compared to low exposed, but the difference was not significant. Then we selected a subgroup of highest exposed workers (12 subjects; TWA >1 microT); no difference was observed between low and highest exposed subjects in the main personal variables. Considering both E:T ratios from 12:1 to 50:1 and Lytic Units, a significant reduction in NK activity was observed in the highest exposed workers compared to the low exposed. Multivariate analysis showed a significant negative correlation between exposure and LU, while no correlation was evidenced with other personal characteristics. ELF-MF are considered possible carcinogens, and existing data suggest that they can act as promoters. Due to the role of NK activity in host defence against cancer, the results obtained in this study in workers exposed to ELF-MF levels exceeding 1 microT are in agreement with this hypothesis, and support the need for further investigation in this field.
2009
- I disturbi muscolo-scheletrici lavoro-correlati in una casistica di operatori della sanità: prima applicazione del questionario Nordic e del questionario parestesie
[Poster]
Valente, Annalisa; G., Bugli; Clerici, Pierina Viviana; R., Ghersi; Gobba, Fabriziomaria
abstract
Data on symptoms and/or functional impairments are essentials in research on work-related musculoskeletal disorders (WRMSDs). The use of standardized questionnaires is extremely important, since they permit comparison of different working conditions, and a comparison among different studies. We have applied the validated italian version of the Nordic Musculoskeletal Questionnaire (NMQ), and a new questionnare on paresthesias, to study work-related MS symptoms in a group of 317 health personnel, engaged in different tasks in 8 different hospitals. The questionnaire was completed by 206 workers (65%). In the whole group the prevalence of symptoms ranged from 18 % in lower limbs up to 79 - 82 % in the vertebral column, with relatively large difference among different workig activities. The overall prevalence of spine symptoms was high: poor working conditions in the examined hospitals, relatively high age (median age: > 40 y/o), may account for the high proportion of workers with symptoms, but the the low response rate (65%) should be considered among possibile causes.
An assessment of the musculoskeletal risk in the hospitals involved in the study is in progress, to compare symptoms and working conditions.
2009
- La percezione del rischio nelle prestazioni infermieristiche degli studenti del Corso di Laurea in Infermieristica di Reggio Emilia: uno studio osservazionale.
[Articolo su rivista]
Mecugni, D.; Serpe, A.; Iacobelli, F.; Bravo, G.; Iemmi, M.; Gobba, F.
abstract
Negli ultimi anni il problema del rischio professionale e della sicurezza in sanità è diventato sempre più rilevante. Uno dei fattori che vengono correntemente indagati nella letteratura che si occupa del rischio nei vari contesti lavorativi riguarda la percezione del rischio. Tuttavia, la percezione del rischio in ambito infermieristico, ed in particolare negli studenti infermieri, risulta essere stata scarsamente analizzata. Su queste basi ci siamo proposti di indagare la percezione del rischio negli studenti del Corso di Laurea in Infermieristica di Reggio Emilia, attraverso la somministrazione di un questionario che va ad esplorare oltre ala percezione del rischio generale e personale, anche il livello di competenza autoriportato, l’esperienza personale e osservata di eventi negativi. I risultati ottenuti negli studenti sono stati confrontati con quelli ottenuti in un campione di infermieri professionisti. I dati emersi mostrano che, in generale, i partecipanti allo studio possiedono una percezione del rischio relativamente bassa in merito ai reali pericoli presenti nell’ambiente di lavoro (INAIL, 2007). Questi risultati possono essere utili per la progettazione di attività formative al fine di favorire la realizzazione e la promozione di un cambiamento culturale in tema di sicurezza, iniziando già dagli studenti infermieri che sono impegnati nelle attività formative, tra cui il tirocinio clinico, parte preponderante del percorso formativo.
2009
- Natural killer cell activity decreases in workers occupationally exposed to extremely low frequency magnetic fields exceeding 1 μT
[Articolo su rivista]
Gobba, Fabriziomaria; Bargellini, Annalisa; Bravo, Giulia; M., Scaringi; L., Cauteruccio; Borella, Paola
abstract
In a preliminary study a reduction in Natural Killer (NK) cell activity in peripheral blood lymphocytes (PBL) was observed in a group of workers exposed to levels of Extremely Low Frequency- Magnetic Fields (ELF-MF) exceeding 1 microT. This study was performed to confirm the results. In 121 workers engaged in various occupational activities, individual ELF-MF exposure was monitored for 2 work shifts. Exposure levels were calculated as Time-Weighted Average (TWA). Subjects were classified as Low exposure (TWA ≤ 0.2 μT) Medium exposure (TWA 0.21-0.99 microT), or Higher exposure (TWA > 1 μT). In higher exposure workers NK activity proved significantly reduced compared to low exposure,(p<0.01). In medium exposure a reduction was also observed, but the difference was not significant. Multivariate analysis also confirmed the relation between exposure and NK activity. It has been suggested that ELF might affect tumour progression by inducing changes in the immune system: due to the role played by NK activity in host defence against cancer, the interference with the NK cell activity observed in this study is in agreement with this hypothesis. Furthermore, an increased risk for some neurodegenerative disorders has been reported in some epidemiological studies in ELF-MF-exposed workers: changes in NK function were also described in these diseases. Our results, showing the effect on NK activity of exposure exceeding 1 microT, suggest a possible mechanism for ELF-MF effects. This could open new horizons regarding the adverse long-term effects of these fields.
2009
- Normativa europea e normativa nazionale
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria
abstract
EUROPEAN AND ITALIAN LAW ON THE PREVENTION AND PROTECTION OF WORKERS FROM THE RISKS ARISING FROM ARTIFICIAL OPTICAL RADIATION EXPOSURE. The Titolo VIII of the Decreto Legislativo 81/2008 introduces in Italy a specific legislation on the prevention and protection of workers from the risk related to occupational exposure to physical agents. The Capo V of Titolo VIII, specifically dedicated to the artificial optical radiation (AOR), represents the Italian implementation of the Directive 2006/25/EC of the European Parliament and of the Council of 5 April 2006 on the minimum health and safety requirements regarding the exposure of workers to risks arising from physical agents (artificial optical radiation). In the text, the contents of Capo V are illustrated in details. The text of the Titolo VIII, Capo V, of the Decreto Legislativo 81/2008, that brings into force in Italy the EU Directive 2006/25/EC, is similar to the European Directive. We can conclude that in the Italian law on the minimum health and safety requirements regarding the exposure of workers to the risks arising from physical agents, there are no significant differences from the practical point of view, compared to the original EU Directive.
2009
- Risk factors for operated carpal turnel syndrome: multicenter population-based case control study.
[Articolo su rivista]
Mattioli, S; Baldasseroni, A; Bovenzi, M; Curti, S; Cooke, Rm; Campo, G; Barbieri, Pg; Ghersi, R; Broccoli, M; Cancellieri, Mp; Colao, Am; Dell'Omo, M; Fateh Moghadam, P; Franceschini, F; Fucksia, S; Galli, P; Gobba, Fabriziomaria; Lucchini, R; Mandes, A; Marras, T; Sgarrella, C; Borghesi, S; Fierro, M; Zanardi, F; Mancini, G; Violante, Fs
abstract
Background: Carpal tunnel syndrome (CTS) is a socially and economically relevant disease caused by compression or entrapment of the median nerve within the carpal tunnel. This population-basedcase-control study aims to investigate occupational/non occupational risk factors for surgically treated CTS.Methods: Cases (n = 220) aged 18-65 years were randomly drawn from 13 administrative databases of citizens who were surgically treated with carpal tunnel release during 2001. Controls (n = 356) were randomly sampled from National Health Service registry records and were frequency matched by age-gender-specific CTS hospitalization rates.Results: At multivariate analysis, risk factors were blue-collar/housewife status, BMI ≥ 30 kg/m2, sibling history of CTS and coexistence of trigger finger. Being relatively tall (cut-offs based on tertiles: women ≥165 cm; men ≥175 cm) was associated with lower risk. Blue-collar work was a moderate/strong risk factor in both sexes. Raised risks were apparent for combinations ofbiomechanical risk factors that included frequent repetitivity and sustained force.Conclusion: This study strongly underlines the relevance of biomechanical exposures in both nonindustrial and industrial work as risk factors for surgically treated CTS.
2008
- Esposizione occupazionale a campi magnetici a frequenza estremamente bassa (ELF-MF) e attività natural killer in linfociti di sangue periferico
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Borella, Paola; Bargellini, Annalisa; M., Scaringi; Bravo, Giulia; Giacobazzi, Pierluigi
abstract
I campi magnetici a frequenza estremamente bassa (ELF-MF) costituiscono un rischio di grande interesse nell’ambito della Medicina del Lavoro data la loro presenza praticamente ubiquitaria e per la loro classificazione tra i possibili cancerogeni per l’uomo (Gruppo 2B, IARC). In particolare, gli ELF-MF non sembrano causare effetti genotossici diretti, ma alcuni dati suggeriscono una possibile azione sulla promozione e/o sulla progressione. In accordo con questa possibilità sarebbero i risultati di alcuni studi che hanno osservato effetti a carico del sistema immunitario in seguito ad esposizioni occupazionali croniche ELF-MF. In particolare è stato riportato un effetto avverso sull’attività citotossica dei linfociti Natural Killer (NK); i risultati sono, però, finora limitati e poco conclusivi. Su questa base ci siamo proposti di esaminare gli effetti della esposizione occupazionale a campo magnetico ELF a carico dell’attività citotossica delle cellule NK nei linfociti di sangue periferico.E’ stato studiato un campione di 109 lavoratori addetti a diverse mansioni in vari comparti lavorativi. L’esposizione personale a campi magnetici ELF è stata valutata mediante dosimetria personale protratta per due turni lavorativi completi. I valori sono stati espressi come Time-Weighted Average (TWA) calcolati come media delle misurazioni nel periodo campionato.L’attività citotossica delle cellule NK è stata valutata nei linfociti di sangue periferico con un metodo basato sulla lisi di cellule target (T), costituite da cellule eritroleucemiche (Erythroleukaemic cell line K562) a differenti concentrazioni di cellule NK attivate (Effector cells -E-), e viene espressa sia come % di lisi a differenti rapporti tra NK e cellule target (E:T ratio: 100:1, 50:1, 25:1, 12:1, 6:1) ,che come numero di Unità Litiche (UL) per 107 linfociti. L’esposizione personale mediana nell’intero gruppo è risultata pari a 0,17 µT con 5° e 95° percentile rispettivamente 0,03 e 2,85 µT.Il campione è stato suddiviso in tre sottogruppi di esposizione: bassa esposizione (56 lavoratori; TWA 0,2 µT), esposizione intermedia (30 lavoratori; 0,2 <TWA < 1 µT), esposizione più elevato (23 lavoratori; TWA 1 µT).Nessuna differenza significativa è stata osservata nei rispettivi gruppi per le variabili demografiche e personali di rilievo (sesso, età, BMI, attitudine al fumo).Tra il gruppo a bassa esposizione ed il gruppo ad esposizione intermedia (0,2 <TWA < 1 µT) è stata osservata una significativa riduzione del numero di U.L. (57,43 vs 40,55; p =0,02). Ponendo invece a confronto il gruppo di soggetti a bassa esposizione (≤ 0,2 µT) con quelli ad esposizione più elevata (> 1 µT), non solo la riduzione delle U.L. viene confermata, ma emerge anche una significativa riduzione degli E:T ratio per tutte la concentrazioni testate.Questi risultati sono in accordo con un nostro studio preliminare, e confermano una possibile interferenza di un’esposizione cronica a livelli di ELF-MF superiori a 1 µT sull’attività funzionale delle cellule NK. Sebbene non sia possibile trarre delle conclusioni in ambito clinico, i risultati di questa osservazione sono coerenti con l’ipotesi di un possibile ruolo degli ELF-MF sulla promozione e/o progressione, mediante un effetto avverso sulla difesa immunitaria.
2008
- Sviluppo di una Job Exposure Matrix (JEM) per la esposizione a campi elettromagnetici a frequenza estremamente bassa (ELF-MF)
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Bravo, Giulia; Scaringi, M; Rossi, P; VANDELLI A., M; Romanelli, A; Guerzoni, A; Gagliarini, E; Minisci, S.
abstract
Ci siamo proposti di era sviluppare una Matrice di Esposizione Occupazionale (Job Exposure Matrix - JEM) applicabile per studi sugli effetti avversi dell’esposizione a campi magnetici a frequenza estremamente bassa (ELF-MF) in lavoratori addetti a varie mansioni.Sono stati monitorati con dosimetri personali 543 lavoratori di 9 comparti lavorativi. Le mansioni sono state codificate secondo la classificazione ISCO-88 (International Standard Classification of Occupations); sono state ottenute 31 occupazioni. L’esposizione è stata monitorata per due turni lavorativi completi per tenere conto della possibile variabilità dell’esposizione giornaliera; contestualmente è stata valutata anche l’esposizione non occupazionale sia a casa che fuori casa. Per ogni lavoratore abbiamo raccolto circa 5600 misurazioni durante il periodo lavorativo e oltre 11500 in ambito extra-lavorativo. L’esposizione individuale è stata espressa come Time-Weighted Average (TWA), calcolato come media sia aritmetica che geometrica di tutte le misurazioni (rispettivamente TWAam e TWAgm). Suddividendo la giornata in funzione delle attività svolte, è stato possibile calcolare la esposizione durante il lavoro, quella in casa e quella fuori casa. La rappresentatività dei livelli di esposizione ottenuti è stata verificata nel 10% circa del campione, mediante ripetizione delle misurazioni dopo 6-9 mesi, dimostrando un’ottima ripetibilità dei TWA tra la prima e la seconda misurazione: coefficiente di correlazione di Spearman = 0,80. Nella JEM per ciascuna occupazione individuata sono state calcolate la media aritmetica dei TWAam e TWAgm, i rispettivi valori di deviazione standard, la mediana ed 5° e 95% percentile. La stima delle esposizioni mediante TWAam e TWAgm sono risultate altamente correlate, come dimostrato dal coefficiente di correlazione di Spearman pari 0,85.Considerando i valori dei TWAam, il 35 % delle mansioni analizzate ha presentato un’esposizione superiore a 0,4 mT, considerata una soglia per possibili effetti avversi sulla base di alcuni dati epidemiologici. Tra queste mansioni, quelle con valori di esposizione più elevati sono risultate quelle di manutentore idraulico in ceramica (Cod ISCO 7135, TWA = 2,64 mT), addetto ai forni in metalmeccanica (Cod ISCO 8121, TWA = 2,45 mT), elettricisti e manutentori elettrici in vari comparti (Cod ISCO 7241, TWA = 1,94 mT) e saldatori (Cod ISCO 721, TWA = 1,70 mT), mentre tra le più basse erano quelle di muratore in ceramica (Cod.ISCO 712, TWA = 0,04 mT), fattorino (Cod. ISCO 9151, TWA = 0,05 mT) ed operatori nel settore biomedicale (Cod.ISCO 823, TWA = 0,08).Per quanto riguarda l’esposizione extralavorativa, il 50° percentile dei TWA a casa è risultato 0,03 mT (5° e 95° percentile 0,01 e 0,24), quello fuori casa 0,05 mT (5° e 95° percentile 0,02 e 0,28). Per ciascun soggetto è stato inoltre calcolato il contributo relativo fornito dall’esposizione lavorativa e da quella ambientale extralavorativa, all’esposizione complessiva nelle 24 ore. E’ stato così stimato un contributo lavorativo mediano di 0,59 (5°-95° percentile: 0,23-0,91) rispetto a quelli dell’esposizione ambientale e residenziale, pari rispettivamente allo 0,25 e 0,12. La definizione complessiva di una JEM per l’esposizione ad ELF-MF in varie attività è ancora in via di ampliamento, ma i primi risultati sono già disponibili per un’applicazione in studi di tipo epidemiologico.
2008
- Traduzione in lingua italiana e validazione del questionario standardizzato Nordic IRSST per la rilevazione di disturbi muscoloscheletrici
[Articolo su rivista]
Gobba, Fabriziomaria; R., Ghersi; S., Martinelli; A., Richeldi; P., Clerici; P., Grazioli
abstract
BACKGROUND: Data on self-reported symptoms and/or functional impairments are important in research on work-related musculoskeletal disorders (WRMSDs). In such cases the availability of international standardized questionnaires is extremely important since they permit comparison of studies performed in different Countries. OBJECTIVES: Translation into Italian and validation of the Nordic Musculoskeletal Questionnaire (NMQ), a tool which is widely used in studies on WRMSDs in the international scientific literature. METHODS: The extended Canadian version of the NMQ was translated into Italian. As per the current guidelines, the cross-cultural adaptation was performed by translation of the items from French, back-translation by independent mother-tongue translators and committee review. The resulting version of the questionnaire underwent pre-testing in 3 independent groups of subjects. The comprehensibility, reliability (internal consistency and reproducibility) and sensitivity were evaluated. RESULTS: After translation/back-translation and review of the items the comprehensibility of the Italian version of the questionnaire was judged good in a group of 40 workers. The internal consistency was evaluated using the Cronbach's Alpha test in the same group and in another 98 engineering workers: the results were on the whole acceptable. The reproducibility, which was tested with Cohen's Kappa test in the 40 workers, was good/excellent. In a preliminary evaluation, performed in 30 outpatients of a of Rehabilitation Service, sensitivity was very good. CONCLUSIONS: The results show that the Italian version of the Nordic Musculoskeletal Questionnaire is valid for self-administration and can be applied in 'field" studies on self-reported musculoskeletal symptoms and functional impairments in group of workers.
2007
- Analisi del fenomeno infortunistico 1999-2006 in un’azienda Ospedaliera Lombarda
[Relazione in Atti di Convegno]
P., Melloni; E., Antoniazzi; V., Somenzi; L., Galli; R., Fazioli; A., Mottinelli; C., Franzosi; Cirla, A. M.; Gobba, Fabriziomaria
abstract
Abbiamo condotto uno studio sul fenomeno infortunistico nel periodo 1999- 2006 presso l’Azienda Istituti Ospitalieri di Cremona, in cui operano circa 2400 dipendenti.
Dall’analisi dei dati del Registro Infortuni, è emersa una riduzione del numero totale di infortuni del 30% circa nel periodo esaminato, con una distribuzione non uniforme sulle diverse tipologie di infortunio.
Gli infortuni più frequenti sono stati la puntura d’ago (25,8 %), i traumi (22,9%) e gli infortuni in itinere (7,8%). Una tipologia di infortunio finora poco considerata sono le aggressioni,. Gli infermieri professionali sono gli operatori più frequentemente coinvolti; mentre i reparti maggiormente interessati appartengono al Dipartimento Internistico. La prognosi media più prolungata è relativa agli infortuni in itinere (11,6 giorni). Un aspetto finora poco analizzato sono la ripetitività degli infortuni nello stesso operatore: un’infermiera professionale ha subito ben 9 infortuni (di varia tipologia) nei 7 anni considerati.
La riduzione degli infortuni è verosimilmente da attribuirsi all’efficacia delle attività di prevenzione intraprese nel periodo in esame. Gli infortuni a rischio biologico, per i quali è stato possibile attuare programmi di prevenzione, si sono marcatamente ridotti, mentre non altrettanto è avvenuto per quelli in itinere, dipendenti in modo rilevante da fattori esterni non facilmente eliminabili.
2007
- Detection of HSP27-like molecules in the annelid Enchytraeus japonensis after exposure to extremely low frequency magnetic fields (50 Hz).
[Articolo su rivista]
Malagoli, Davide; Marchetti, M; Gobba, Fabriziomaria
abstract
The immunocytochemical study performed on the annelid Enchytraeus japonensis revealed the presence of immunoreactive heat shock protein (HSP)27 molecules in different areas of the body. Positivity was observed in coelomocytes and in epithelial cells of the intestine wall. The exposition of the animals to 400 μT magnetic fields (50 Hz) for 30 min provoked an increased immunoreactivity in some specimens, but after immunoblot experiments, no significant differences in the total content of HSP27-like molecules were found between exposed and non-exposed animals.
2007
- ELF-MF occupational exposure: repeated measures on workers.
[Relazione in Atti di Convegno]
Bravo, Giulia; Scaringi, Meri; Vandelli, Am; Romanelli, A; Rossi, P; Gobba, Fabriziomaria
abstract
The aim of our study was to estimate occupational exposure to Extremely Low Frequency-Magnetic Fields (ELF-MF). Using personal dosimeters we evaluated occupational exposure in 543 workers employed in 9 occupational settings (about 150 jobs), representative of the main occupational activities in Emilia-Romagna region. In the whole sample, the median Time-Weighted Average (TWA) exposure resulted 0.14 microT (5 degrees - 95 degrees percentiles: 0.04 - 2.50 microT); Tile production presented the highest occupational setting TWA (0.46 +/- 1.83 microT), while the lower job TWA was Stock Clerk in Tile Production and Stock Clerk in Garment Production. After 6-9 months we repeated measurement in about 10% of the original sample (about 48 subjects) to verify the resulted obtained. At repeated measurement analysis with SPSS 12.0 no variation was found compared the previous monitoring. Individual occupational exposure to ELF-MF evaluated in a relatively large group of workers engaged in the main occupational activities proved low values compared to the proposed occupational limit.
2007
- ESPOSIZIONE A LUNGO TERMINE A CAMPI ELETTRICI, MAGNETICI ED ELETTROMAGNETICI E SALUTE UMANA: LE CONOSCENZE ATTUALI
[Capitolo/Saggio]
Gobba, Fabriziomaria
abstract
-
2007
- La valutazione del rischio da campi elettromagnetici ai sensi della Direttiva Comunitaria 2004/40/CE: Esposizione professionale in corso di gravidanza [Evaluation of the occupational risk related to exposure to electromagnetic fields according to the EC Directive 2004/40 EC: exposure during pregnancy]
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; M., Tavani; N., Bianchi
abstract
The EU Directive 2004/40/EC on the minimum health and safety requirements regarding the exposure of workers to the risks arising from physical agents (electromagnetic fields) will introduce the need of an evaluation of the risk related to EMF occupational exposure in pregnancy. Nevertheless, data from research in this field are scarcely conclusive to date. Furthermore knowledge on this risk seems insufficient among OH physicians in Italy. Accordingly, there is an urgent need for further research, and for a diffusion of knowledge among OH physicians on possible risk to pregnancy due to occupational exposure to EMF.
2007
- La valutazione dell’esposizione nei lavoratori.
[Abstract in Atti di Convegno]
Gobba, F.
abstract
La valutazione dell’esposizione nei lavoratori.
2007
- Personal exposure to elf magnetic fields in various Occupational activities in Italy Book of abstracts of Ebea 2007: 8th international congress of the European Bioelectromagnetics Association
[Abstract in Atti di Convegno]
Gobba, F; Bravo, G; Scaringi, M; Vandelli, Am; Romanelli, A.
abstract
Personal exposure to elf magnetic fields in various Occupational activities in Italy
2007
- Valutazione della genotossicità dei Campi Magnetici a Frequenza Estremamente Bassa (ELF- MF) in lavoratori esposti per ragioni professionali [Evaluation of the genotoxicity of the extremely low frequency-magnetic fields (ELF-MF) in workers exposed for professional reasons]
[Relazione in Atti di Convegno]
Scaringi, Meri; Temperani, Paola; Bravo, Giulia; Gobba, Fabriziomaria; Rossi, P
abstract
Whether or not ELF-MF has genotoxic potential is a controversial issue. In the present study, we investigated the genotoxic effect using cytogenetic assays (CA - SCE - MN), in 109 workers exposed to ELF-MF. The mean value of occupational exposure in the whole group was 0.35 microT. According to the exposure level the workers were stratified in two different groups: low exposed (n. 39, TWA < or = 0.2 microT) and higher exposed (n. 70; TWA > 0.2 microT): the groups did not significantly differ for the examined variables. Due to these results we decided to re-evaluate the effect only considering the highest exposed workers: we selected 31 workers exposed to TWA levels exceeding 1 microT, and compared vs. the low exposed subjects: again, the difference in the groups examined were not significant. At multivariate regression analysis was also applied: no correlation was observed with cytogenetic biomarkers. The results of this study does not support the hypothesis of any direct genotoxic effect of ELF-MF, at least at the environmental levels currently found in an occupational settings.
2007
- Versione in lingua italiana del questionario standardizzato autocompatibile Nordic IRSST per la rilevazione dei disturbi muscoloscheletrici [The Italian version of Nordic Musculoskeletal Standardized Questionnaire]
[Relazione in Atti di Convegno]
R., Ghersi; A., Richeldi; P., Grazioli; Gobba, Fabriziomaria; Martinelli, Simona; Clerici, Pierina Viviana
abstract
We translated into Italian the Nordic musculoskelethal questionnaire, as completed by Canadian IRSST with Authors' agreement in 2001, according to OMS recommendations. This translation involved the following items: aches and troubles of neck, dorsal region, low back, shoulders, elbows, hands and wrists, hips and thighs, ankles and feet in the last 12 months. The questionnaire was then submitted to reliability and stability tests. The Italian version of the questionnaire, already used in different languages, proved to be suitable and reliable also for self administration.
2006
- 50 Hz magnetic fields of constant or fluctuating intensità: effects on immunocyte HSP 70 in the mussel Mytilus galloprovincialis
[Articolo su rivista]
Malagoli, Davide; Gobba, Fabriziomaria; Ottaviani, Enzo
abstract
Effects of a single 30 min exposure to a 50 Hz, 400 mu T sinusoidal extremely low frequency magnetic field (ELF MF) on hsp70 expression in immunocytes from the bivalve Mytilus galloprovincialis was investigated using RT-PCR and immunoblot approaches. The results indicate that in M. galloprovincialis immunocytes hsp70 expression was unaltered at both transcriptional and translational level after exposure to constant or fluctuating intensity MFs. Bioelectromagnetics 27:427-429, 2006.
2006
- Assessment of the risk of occupational biomechanical overload: comparison of methods currently used.
[Abstract in Rivista]
Martinelli, Simona; Ghersi, R; Grazioli, P; Minisci, E; Gobba, Fabriziomaria
abstract
Some of the most common methods for the evaluation of the ergonomic risk of Work-Related Musculo Skeletal Disorders were applied to different workplaces. The results show that an evaluation of the single components of the synthetic risk-indices given by the methods is needed to evidence the specific critical aspects.
2006
- EFFETTO DELL’ESPOSIZIONE A CAMPI MAGNETICI ELF SULLE DIFESE IMMUNITARIE: RIDUZIONE DELL’ATTIVITÀ FUNZIONALE DELLE CELLULE NATURAL KILLER
[Abstract in Rivista]
Bargellini, Annalisa; Scaringi, Meri; Bravo, Giulia; Cauteruccio, Laura; Marchesi, Isabella; Gobba, Fabriziomaria
abstract
I campi magnetici a frequenza estremamente bassa (ELF) costituiscono un rischio ambientale di grande attualità ed interesse nell’ambito della Sanità Pubblica, data la loro presenza praticamente ubiquitaria negli ambienti di vita e di lavoro. Studi in vitro e sperimentali suggeriscono che gli ELF possano causare effetti avversi sulla funzione immune, ma i dati sono contraddittori. In uno studio pilota condotto su lavoratori professionalmente esposti a vari livelli di ELF, abbiamo evidenziato una possibile interferenza dell’esposizione a tali campi sull’attività funzionale delle cellule natural killer (NK). Scopo di questo lavoro è di approfondire questo aspetto, allargando lo studio ad un gruppo numericamente più consistente (circa 100) di lavoratori addetti a varie mansioni in diversi comparti lavorativi (aziende di servizi, metalmeccanico, ceramico, tessile ed alimentare). Mediante l’utilizzo di dosimetri personali, in ogni soggetto è stata misurata per due turni lavorativi successivi l’esposizione ad ELF, espressa in microTesla (T) e calcolata come media ponderata nel tempo (Time Weighted Average –TWA-). In base ai risultati il campione è stato suddiviso in tre gruppi di esposizione: bassa, intermedia, elevata. Da un campione di sangue periferico sono stati separati i linfociti per la misura dell’attività citolitica delle cellule NK tramite metodo non radioattivo (Borella et al, JIM 1995). L’indagine è tuttora in corso, ma la elaborazione dei dati di un primo gruppo di soggetti è indicativa di una riduzione dell’attività NK nei lavoratori ad esposizione più elevata rispetto al gruppo meno esposto. Questo risultato è in accordo con i dati preliminari e l’interferenza sulla funzionalità delle cellule NK suggerisce che gli ELF possano svolgere un ruolo di co-promozione nello sviluppo di tumori, tramite una riduzione delle difese immunitarie.
2006
- LIVELLI DI ESPOSIZIONE A CAMPI MAGNETICI A BASSA FREQUENZA (ELF) E RISCHIO PROFESSIONALE NEI LAVORATORI
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria
abstract
I CAMPI ELETTROMAGNETICI (CEM) RAPPRESENTANO CERTAMENTE UNO DEI RISCHI FISICI PIU' DIFFUSI IN AMBITO SIA AMBIENTALE CHE OCCUPAZIONALE. NELLE SOCIETA' INDUSTRIALIZZATE SI PUO' AFFERMARE CHE NON VI SONO PERSONE NON ESPOSTE AI CAMPI GENERATI DALLA RETE DI DISTRIBUZIONE ELETTRICA (ELF-MF) ED A QUELLI AD ALTA FREQUENZA GENERATI DALLE TRASMISSIONI RADIOTELEVISIVE E DALLA TELEFONIA CELLULARE. VENGONO PRESENTATI E DISCUSSI I RISULTATI DELLA RICERCA SIA SUI LIVELLI DI CAMPI RILEVABILI NEGLI AMBIENTI DI LAVORO E DI VITA CHE SUI RISCHI CORRELATI A TALI ESPOSIZIONI. LA CONCLUSIONE E' CHE SEBBENE VI SIA UN ACCORDO SUGLI EFFETTI ACUTI, PER QUANTO RIGUARDA QUELLI CRONICI VI SONO ANCORA ALCUNI ASPETTI MERITEVOLI DI APPROFONDIMENTO
2006
- No association between occupational exposure to ELF magnetic field and urinary 6 – Sulfatoximelatonin in workers
[Articolo su rivista]
Gobba, Fabriziomaria; Bravo, Giulia; Scaringi, Meri; L., Roccatto
abstract
A suppression in melatonin secretion is one of the mechanisms proposed to explain the possible adverse effects of extremely low frequency magnetic fields (ELF-MF), but the results of research are inconclusive. This study investigated the effect of occupational ELF-MF exposure on 6-sulfatoximelatonin (6-OHMS). Exposure was monitored for three complete work shifts in 59 workers using personal exposure meters. Environmental exposure was also evaluated. Urinary 6-OHMS in morning samples, an indicator of night-time melatonin production, was measured. Urine was collected twice on Friday and the following Monday. Workers were classified according to ELF exposure as low exposed (<or=0.2 microT) or higher exposed (>0.2 microT): 6-OHMS did not differ between groups (P > .05) in either Friday or Monday urine samples. In addition, 6-OHMS was not related to exposure under multivariate analysis. The ratio between 6-OHMS in Monday versus Friday samples was also calculated to test the hypothesis of a possible variation in pineal function after 2 days, interruption of occupational ELF-MF exposure: again no exposure-related difference was observed. Our results do not support the hypothesis that occupational exposure to ELF-MF significantly influences melatonin secretion.
2006
- Occupational exposure to ELF-MF: Comparison of exposure levels measured in different jobs and the action level provided by the EU Directive 2004/40/CE
[Articolo su rivista]
Bravo, G.; Scaringi, M.; Vandelli, A. M.; Romanelli, A.; Giovanardi, G.; Gobba, F.
abstract
The Directive 2004/40/EC introduces Action values for the prevention of occupational risk related to Extremely Low Frequency-Magnetic Fields (ELF-MF) exposure. We measured exposure in workers engaged in some of the most common occupational tasks in the area of Modena and Reggio Emilia, and compared the results with the 2004/40/EC Action values. Using personal dosimeters worn during two complete work-shifts, we monitored individual exposure to ELF-MF in 404 workers employed in more than 120 different jobs. In the whole sample the mean of individual Time Weighted Average (TWA) exposure resulted 0.78 ± 3.82 μT, while the median was 0.13 μT, and the 5th-95th percentiles 0.04 - 2.48. The Action value for ELF-MF was never exceeded. Exposure was lower than 0.4 μT in more than 80% of the workers. For each task we calculated the "mean job related exposure (JRE)" as the mean of individual TWA of all workers engaged in that job: in the 91% of the examined tasks exposure was lower than 0.4 μT. JRE levels exceeded 0.4 μT in 11 tasks, mainly in tile production and in wood industry. Our results suggest an exposure to ELF-MF largely lower than the proposed Action level in the large majority of the workers.
2006
- Olfactory toxicity: long-term effects of occupational exposures
[Articolo su rivista]
Gobba, Fabriziomaria
abstract
Objective: To present and discuss the results of research on olfactory function impairments related to chronic occupational exposure to industrial chemicals. Methods: This review is mainly focused on the results of epidemiological studies on olfactory function, evaluated using quantitative testing methods, in workers chronically exposed to airborne industrial chemicals. Papers published in peer-reviewed scientific journals were mainly considered. Results: The prevalence of olfactory impairments related to occupational exposure to chemicals is unknown: frequencies ranging 0.5-5% of all olfactory dysfunctions have been proposed, considering both exposure to chemicals and the use of pharmaceutical drugs, but the real relevance of this problem is possibly overlooked, especially considering that occupational exposure may account for a significant part of idiopathic smell disorders, i.e., the 10-25% of all olfactory problems within the general population. An adverse effect has been reported in workers chronically exposed to some metals as cadmium, chromium, manganese, arsenic, mercury, and organic lead, and to other chemicals as acrylates, styrene, and solvent mixtures. The results of relevant studies are discussed. A problem in the evaluation of data is that different methods have been applied in different studies, affecting the comparability of results. Conclusions: To date, knowledge of the effect of chronic occupational exposure to industrial chemicals on olfactory function is largely incomplete, but supports the hypothesis that olfactory neuroepithelium is susceptible to environmental exposures to chemicals. Occupational-related olfactory impairment is usually sub-clinical, and can be only detected using adequate quantitative olfactory function testing procedures. Available data show the need for further good quality research in this field.
2006
- Risk assessment of occupational biomechanical overloading: Comparison between the commonly used methods
[Articolo su rivista]
Martinelli, S.; Ghersi, R.; Grazioli, P.; Minisci, E.; Gobba, F.
abstract
Some of the most common methods for the evaluation of the ergonomic risk of Work-Related Musculo Skeletal Disorders were applied to different workplaces. The results show that an evaluation of the single components of the synthetic risk-indices given by the methods is needed to evidence the specific critical aspects.
2005
- CONFRONTO CRITICO DEI RISULTATI DI DIVERSI METODI PER LA VALUTAZIONE DEL RISCHIO DA SOVRACCARICO BIOMECCANICO
[Abstract in Atti di Convegno]
S., Martinelli; R., Ghersi; P., Grazioli; Gobba, Fabriziomaria
abstract
Sono state confrontate 9 postazioni di lavoro di un'azienda di produzione di infissi in legno. Abbiamo applicato i metodi Job Strain Index, OCRA Check List e ACGIH-HAL per la valutazione del sovraccarico dell'arto superioree Gruppo di Lavoro NIOSH ed EN 1005-2 per il rachide.Le valutazioni del sovraccarico biomeccanico dell'arto superiore sono solo parzialmente confrontabili, in funzione delle differenze del numero di fattori di rischio considerati, del peso ad essi attribuito e delle modalità di calcolo degli indici. L'analisi dei soli indici sintetici di rischio sembra insufficiente per identificare i fattori critici di mansione e, di conseguenza, si raccomanda una valutazione analitica delle singole componenti.
2005
- ESPOSIZIONE PERSONALE A CAMPI MAGNETICI A FREQUENZA ESTREMAMENTE BASSA IN VARIE MANSIONI
[Abstract in Atti di Convegno]
Scaringi, Meri; Bravo, Giulia; A. M., Vandelli; A., Romanelli; G., Besutti; R., Ghersi; Gobba, Fabriziomaria
abstract
L'obiettivo di questo studio era quello di valutare l'esposizione professionale a campi magnetici ELF mediante dosimetri personali in lavoratori addetti alle principali mansioni nella eraltà produttiva dell'Emilia Romagna. I dati suggeriscono che l'esposizione professionale a campi ELF sia < 2 microT nella grande maggioranza dei lavoratori: solo nel 2% infatti tale livello è stato superato. Sono il 19% i lavoratori con esposizione TWA > 0,2 microT. Considerando i TWA medi per mansione, infine, in una sola mansione il valore era superiore a 0,2 microT, mentre la maggior parte era < 0,1 microT, quindi modesta nella maggioranza delle mansioni e dei lavoratori esaminati.
2005
- Personal exposure to ELF magnetic fields in workers engaged in various occupations.
[Articolo su rivista]
Scaringi, Meri; Bravo, Giulia; A. M., Vandelli; A., Romanelli; R., Ghersi; Gobba, Fabriziomaria; G., Besutti
abstract
Using personal dosimeters worn during two complete work-shifts, we measured occupational exposure to Extremely Low Frequency-Magnetic Fields (ELF-MF) in 290 workers employed in 56 jobs, representative of the main occupational activities in the area of Modena and Reggio Emilia (Italy). Environmental nonoccupational exposure was also monitored. In the whole sample, the mean Time-Weighted Average (TWA) exposure during work resulted 0.59 microT (SD 3.2), while the median was 0.13 microT. Exposure was lower than 1 microT in more than 90% of the workers. In one job only exposure was greater than 1 microT (job-related median TWA); in other 8 exposure was between 1 and 0.4 microT, while about 84% of the jobs presented a median TWA lower than 0.4 microT. A high variability among workers engaged in the same job resulted in various occupational tasks. Non-occupational exposure was lower than 0.4 microT in more than 98% of the examined workers. Our results show a low to moderate occupational exposure to ELF-MF in the greatest part of the workers and working activities. Also the non-occupational exposure resulted low in the large majority of the subjects. The high variability observed among workers engaged in some occupations may represent a problem in exposure evaluation. Personal monitoring is particularly useful in such a situations.
2004
- 50 Hz magnetic fields activate mussel immunocyte p38 MAP kinase and induce HSP70 and 90
[Articolo su rivista]
Malagoli, Davide; M., Lusvardi; Gobba, Fabriziomaria; Ottaviani, Enzo
abstract
Fifty hertz magnetic fields (MFs) induced the expression of heat shock proteins (HSPs) 70 and 90 in immunocytes of the mussel Mytilus galloprovincialis. Animals exposed at 300 muT for three different times (30; 2 X 30; 3 X 30 min), did not show differences in the HSP densitometric values in comparison with non-exposed mussels. At 400 muT, exposed animals showed a time-dependent increase in HSP expression as revealed by Western blot. After exposure to 600 muT, the HSP densitometric values were significantly higher than controls but not related to exposure duration. The induction of HSPs is concomitant with the activation of p38 MAP kinase signalling pathway. The present findings suggest the possibility to modulate the expression of HSPs by an appropriate time-intensity magnetic field exposure.
2004
- ESPOSIZIONE A LUNGO TERMINE A CAMPI ELF E SALUTE UMANA: LE CONOSCENZE ATTUALI
[Capitolo/Saggio]
Gobba, Fabriziomaria
abstract
-
2004
- Esposizione professionale a campi elettromagnetici a frequenza estremamente bassa (ELF) in lavoratori addetti a varie mansioni
[Articolo su rivista]
Gobba, Fabriziomaria; Roccatto, G; Vandelli, Am; Besutti, G; Ghersi, R; Nicolini, O.
abstract
-
2004
- Low back pain risk in nurses and its prevention
[Articolo su rivista]
Martinelli, S.; Artioli, G.; Vinceti, Marco; Bergomi, Margherita; Bussolanti, N.; Camellini, R.; Celotti, P.; Capelli, P.; Roccato, L.; Gobba, Fabriziomaria
abstract
We present the results of a study on the prevalence of low back pain (LBP) in a group of hospital nursing personnel. In 180 subjects (89% women) a questionnaire on LBP was collected. The prevalence of LBP episodes during the last 12 months was 63,9%; no difference was observed according to the working area (medicine, surgery, emergency). The proportion of subjects with LBP tended to increase according to the previous duration of work, but not with age. The prevalence of LBP was significantly lower in nursing personnel working according the team nursing model, that is less repetitive, and involves less work load, compared to the functional nursing model. Furthermore, LBP prevalence was lower among nurses that received an adequate formation on the prevention of occupational LBP. The results of the study confirm the relevance of LBP in nursing personnel, but suggest also that an adequate preventive programme can significantly reduce the risk.
2003
- Acute health effects after accidental exposure to styrene from drinking water in Spain.
[Articolo su rivista]
Arnedo Pena, A.; Bellido Blasco, J; Villamarin Vasquez, Jl; Aranda Mares, Jl; Font Cardona, N.; Gobba, Fabriziomaria; Kogevinas, M.
abstract
OBJECTIVES: We studied subjective health symptoms in a population accidentally exposed to high styrene concentrations in drinking tap water. The contamination occurred during the reparation of a water tank. METHODS: Residents of 27 apartments in two buildings using the contaminated water were contacted. A questionnaire on subjective symptoms was administered to 84 out of 93 persons living in the apartments at the time of the accident. Styrene concentration was measured in samples of water collected two days after the accident. The means of exposure associated with appearance of symptoms were examined through case-control analyses. RESULTS: Styrene in water reached concentrations up to 900 microg/L. Symptoms were reported by 46 persons (attack rate 55 %). The most frequent symptoms were irritation of the throat (26%), nose (19%), eyes (18%) and the skin (14%). General gastrointestinal symptoms were observed with 11% reporting abdominal pain and 7% diarrhea. The factors most strongly associated with symptoms were drinking tap water (OR = 7.8, 95% CI 1.3-48), exposure to vapors from the basement (OR = 10.4, 2.3-47) and eating foods prepared with tap water (OR = 8.6, 1.9-40). All residents in the ground floor reported symptoms. CONCLUSIONS: This accidental contamination led to very high styrene concentrations in water and was related to a high prevalence of subjective symptoms of the eyes, respiratory tract and skin. Similar exposures have been described in workers but not in subjects exposed at their residence. Various gastrointestinal symptoms were also observed in this population probably due to a local irritative effect.
2003
- Color discrimination impairment in workers exposed to mercury vapor
[Articolo su rivista]
Urban, P; Gobba, Fabriziomaria; Nerudova, J; Lukas, E; Cabelkova, Z; Cirkt, M.
abstract
Objective: To study color discrimination impairment in workers exposed to elemental mercury (Hg) vapor. Subjects:Twenty-four male workers from a chloralkali plant exposed to Hg vapor, aged 429.8 years, duration of exposure14.79.7 years, were examined. The 8 h TWA air-borne Hg concentration in workplace was 59 mg/m3; mean Hg urinaryexcretion (HgU) was 20.519.3 mg/g creatinine; mean Hg urinary excretion after the administration of a chelatingagent, sodium 2,3-dimercapto-1-propane-sulfonate (DMPS), was 751.9648 mg/48 h. Twenty-four age- and gendermatchedcontrol subjects were compared. Visual acuity, alcohol intake, smoking habits, and history of diseases or drugspotentially influencing color vision were registered. Methods: The Lanthony 15-Hue desaturated test (L-D15-d) was usedto assess color vision. The results were expressed quantitatively as Bowman’s Color Confusion Index (CCI), andqualitatively according to Verriest’s classification of acquired dyschromatopsias. Results: The CCI was significantlyhigher in the exposed group than in the control (mean CCI 1.15 versus 1.04; P ¼0.04). The proportion of subjects witherrorless performance on the Lanthony test was significantly lower in the Hg exposed group compared to referents (52%versus 73%; P ¼0.035). The exposed group showed higher frequency of type III dyschromatopsias (blue–yellowconfusion axis) in comparison with the control group (12.5% versus 8.3%), however, the difference did not reachstatistical significance. Multiple regression did not show any significant relationship between the CCI, and age, alcoholconsumption, or measures of exposure. Conclusion: In agreement with previous studies by Cavalleri et al. [Toxicol. Lett.77 (1995) 351; Environ. Res. Sec. A 77 (1998) 173], the results of this study support the hypothesis that exposure tomercury vapor can induce sub-clinical color vision impairment. This effect was observed at an exposure level below thecurrent biological limit for occupational exposure to mercury. This raises doubts on the actual protection afforded by thislimit concerning the effect of mercury on color vision.
2003
- Color vision impairment in workers exposed to neurotoxic chemicals
[Articolo su rivista]
Gobba, Fabriziomaria; A., Cavalleri
abstract
Recent research shows that occupational exposure to several solvents, metals and other industrial chemicals can impair color vision in exposed workers. Occupation-related color vision impairment usually results in blue yellow color discrimination loss or, less frequently, a combination of blue-yellow and red-green loss. The eyes may be unequally involved, and the course is variable depending on exposure and other factors. The pathogenesis of occupational color vision loss has not been elucidated; it may be due to, e.g. a direct action of neurotoxins on receptors, possibly on the cone's membrane metabolism, and/or to an interference with neurotransmitters within the retina. Other possible pathogenetic mechanisms, such as a direct effect to the optic nerve, have also been suggested. Occupational color vision loss is usually sub-clinical, and workers are unaware of any deficit. It can be assessed using sensitive tests, such as the Farnsworth-Munsell 100 Hue (FM-100) or the Lanthony D-15 desaturated panel (D-15 d). The latter is the most widely used for studies in groups of exposed workers, and offers the possibility of a quantitative evaluation of the results by calculation of the Bowman's Color Confusion Index (CCI), or of the Vingrys' and King Smith's Confusion Index (CI). Other advantages of D-15 d are the possibility to perform the test directly at the workplace, and the reproducibility when performed in standardized conditions. In most cases, occupation-related color vision impairment is correlated to exposure levels, and has often been observed in workers exposed to environmental concentrations below the current occupational limit proposed by the ACGIH. Progression with increasing cumulative exposure has been reported, while reversibility is still discussed. Acquired color vision impairment related to occupational exposure to styrene, perchloroethylene (PCE), toluene, carbon disufide, n-hexane, solvent mixtures, mercury and some other chemicals are discussed. Results show that color vision testing should be included in the evaluation of early neurotoxicity of chemicals in exposed workers. The D-15 d would be useful in the surveillance of workers exposed to solvents and other chemicals toxic to the visual system. (C) 2003 Elsevier Science Inc. All rights reserved.
2003
- Cytotoxic activities of natural killer (NK) lymphocytes in workers exposed to various levels of extremely low frequency magnetic field
[Articolo su rivista]
Gobba, F.; Bargellini, A.; Roccatto, L.; Giacobazzi, P.; Borella, P.
abstract
2003
- Effects of 50 hz magnetic fields on fMLP-induced shape changes in invertebrate immunocytes: The role of calcium ion channels
[Articolo su rivista]
Gobba, Fabriziomaria; Malagoli, Davide; Ottaviani, Enzo
abstract
Plasma membrane Ca2+ channels in immunocytes from the mussel Mytilus galloprovincialis exposed to 50 Hz sine wave magnetic fields (MFs) of various strengths were studied. At levels of 300 muT and above, MFs reduce shape changes in immunocytes induced by the chemotactic substance N-formyl-Meth-Leu-Phe, and this effect involves L-type Ca2+ channels. Upon the addition of the Ca2+ blocker verapamil to molluscan immunocytes exposed to MFs results in a synergistic cytotoxic action, while in the presence of the Ca2+ opener SDZ-202, 791, a reactivation of the cells is observed. This suggests that, as previously reported for potassium channels, the damage to Ca2+ channels induced by short exposure to MF at appropriate intensities is not permanent.
2003
- Effects of 50-Hz magnetic fields on the signalling pathways of fMLP-induced shape changes in invertebrate immunocytes: the activation of an alternative stress pathway
[Articolo su rivista]
Malagoli, Davide; Gobba, Fabriziomaria; Ottaviani, Enzo
abstract
N-formyl-Meth-Leu-Phe (fMLP)-induced immunocyte shape changes in the mussel Mytilus galloprovincialis through both the phosphatidylinositol and the cAMP pathways are studied. Fifteen- and thirty-minute exposures of mussels to 50-Hz magnetic fields (MFs) at intensities of 300 and 400 muT do not provoke permanent cell damage, since immunocytes maintain the capacity to respond to fMLP. This avoidance of external insult seems to be achieved through the activation of a stress pathway which is not functionally detectable in nonexposed animals and which involves mitogen activated protein (MAP) kinase members. This phenomenon is clearly evident at 400 muT. Contemporaneously, a different expression of Jun transcriptional regulatory proteins is also found. (C) 2002 Elsevier Science B.V. All rights reserved.
2003
- Fase di avanzamento degli studi promossi dal gruppo collaborativo MODS. [Progress of studies promoted by the MODS collaborative group].
[Relazione in Atti di Convegno]
Mattioli, S; Mancini, G; Fucksia, S; Gnudi, F; Arduini, R; Baldasseroni, A; Barbieri, G; Barbieri, Pg; Bena, A; Bissi, C; Bovenzi, M; Broccoli, M; Campo, G; Cancellieri, Mp; Caso, Ma; Colao, Am; Dell'Omo, M; FATEH MOGHADAM, P; Franceschini, F; Galli, P; Ghersi, R; Gobba, Fabriziomaria; Lucchini, R; Mandes, A; Marras, T; Mauro, B; Sgarrella, C; Tartaglia, R; Veneri, L; Violante, F. S.
abstract
n industrialised countries, carpal tunnel syndrome (CTS) is considered an epidemic work-related disease. We have set up the MODS (Malattie Occupazionali Da Sovraccarico biomeccanico, biomechanical overload-related occupational diseases) collaborative group, formed by epidemiologists, ergonomists and occupational physicians to investigate CTS in Italy, applying the methods that epidemiologists commonly use to understand epidemics. Several studies are already ongoing. Two different descriptive studies based on current hospitalisation data are in the reporting phase. A pilot case-control multicentre study (260 cases and 520 controls in 13 centres) is in the final phase of data collection. A longitudinal study on a cohort of 3000 subjects exposed to different risk factors has reached the third year of follow-up. Moreover, a surveillance system has been set up to cover selected districts of the Emilia Romagna region. These studies will generate new information about the prevalence and incidence of CTS in Italy, along with identification of regional, high-risk job titles and work sectors, and the relative influence of non-occupational factors.
2003
- Livelli di esposizione occupazionale a campi elettromagnetici a frequenza estremamente bassa ELF) in lavoratori addetti a varie mansioni.
[Abstract in Rivista]
Gobba, Fabriziomaria; Rossi, P; Roccatto, L.
abstract
Using personal dosimeters, occupational exposure to ELF-MF was measured in 150 workers employed in 28 different occupations. The main results are presented. The overall arithmetical mean in the whole sample was 0.36 microT, the overall geometric mean 0.21 microT. A high variability among workers engaged in the same occupation, and among different days in the same worker, was observed. The results suggest a relatively low exposure to ELF-MF in the large part of workers. Nevertheless, the higher levels measured in some workers, and the high variability, show the need of adequate measurements of ELF-MF exposure in workers.
2003
- Occupational exposure to chemicals and sensory organs: a neglected research field
[Articolo su rivista]
Gobba, Fabriziomaria
abstract
The effect of industrial chemicals on the sensory perception of exposed workers has received scant attention from the medical community to date, and the scientific literature is mainly limited to some case-reports or isolated studies. Possible explanations for this include the complexity of sensory perception, and the lack of agreement among researchers on methods for testing large groups of subjects. Nevertheless, some published studies showed that vision, hearing and olfactory function can be affected by various industrial metals and solvents, and some data exist also for touch and taste. This review discusses the main industrial chemicals involved. The pathogenesis of the toxicity of chemicals to sensory perception may be related to an action on receptors, nerve fibers, and/or the brain; probably, different pathogenetic mechanisms are involved. One of the main problems in this research field is that most of the studies to date evaluated the effect of a single industrial chemical on a single sense: as an example, we know that styrene exposure can impair smell and also hearing and vision but we have little idea whether different senses are impaired in the same worker or whether each impairment is independent. In addition, workers are frequently exposed to different chemicals: co-exposure may have no effect, or result in both an increase or a decrease of the effect, as was observed for hearing loss, but studies on this aspect are largely insufficient. Research shows that both occupational and environmental exposure to industrial chemicals can affect sense organs, and suggests that the decline of perception with age may be, at least partly, related to this exposure. Nevertheless, available evidence is incomplete, and is largely inadequate for an estimation of a safe threshold of exposure. Good quality further research in this field is needed. This is certainly complex and demands adequate resources, but is justified by the ultimate result: the possibility to prevent an avoidable part of the decline in sensory function with age. (C) 2003 Elsevier Science Inc. All rights reserved.
2003
- Perchloroethylene in alveolar air, blood and urine as biological indices of low level exposure
[Articolo su rivista]
Gobba, Fabriziomaria; Righi, Elena; Fantuzzi, Guglielmina; L., Roccatto; Predieri, Guerrino; Aggazzotti, Gabriella
abstract
We studied the reliability of biologic indices for monitoring perchlorethylene (PCE) exposure at low environmental solvent concentrations. Environmental monitoring was performed by personal sampling, biologic monitoring by measuring PCE in alveolar air (PCE-Alv), blood (PCE-B), and urine (PCE-U) in 26 low-exposed dry-cleaners. Correlation coefficients (r) between environmental PCE and PCE-B, PCE-Alv, and PCE-U were 0.94, 0.81, and 0.67 respectively. A high correlation was also found among biologic indices: r value was 0.96 between PCE-B and PCE-Alv, 0.95 between PCE-B and PCE-U, and 0.87 between alveolar PCE-Alv and PCE-U. The examined biologic indices proved sensitive enough for biologic monitoring of low exposure to PCE and can give substantially similar information in terms of exposure evaluation. PCE-Alv offers some advantages because it correlated better with exposure and is analytically simpler.
2003
- Scambi tra Cromatidi Fratelli (SCE) e High-Frequency Cells in lavoratori professionalmente esposti a campi magnetici a frequenza estremamente bassa (ELF).
[Articolo su rivista]
Gobba, Fabriziomaria; L., Roccatto; B., Sinigaglia; Temperani, Paola
abstract
BACKGROUND: Up now no firm conclusions can be drawn on the genotoxicity of Extremely Low Frequency (ELF) Magnetic Fields (MF) in exposed workers: both an increase in chromosomal aberrations (CA) and micronuclei (MN) or no effects were observed in substation workers, while a slight increase in CA, but not in sister chromatid exchanges (SCE) or MN was reported in linesman; an increase in CA was observed in cable splicers and, more recently, in train engine drivers, but results have not been replicated. OBJECTIVES: Objective of the study was an evaluation of possible genotoxicity of occupational exposure to ELF-MF. METHODS: SCE, high-frequency cells (HFC) and SCE in HFC were measured in peripheral blood lymphocytes from 70 workers exposed to various levels of ELF-MF in different occupations, not involving exposure to known mutagens or carcinogens. In all participants, individual ELF-MF exposure was measured throughout the whole work-shift for 3 consecutive days by personal monitoring. RESULTS: Time Weighted Average (TWA) values of ELF-MF in the whole group ranged from 0.01 to 3.48 microT; the geometric mean was 0.19 mT, and only 3 subjects exceeded 2 microT. According to the individual TWA exposure, subjects were divided into two groups: low exposed (< or = 0.2 microT) and highly exposed (> 0.2 microT). The mean values of SCE, HFC and SCE in HFC were compared between low and highly exposed: no significant differences were observed. The result was further tested by selection and comparison of workers exposed up to 0.1 microT vs. exposed > 0.4 microT only, i.e. excluding intermediate exposures: again no difference in genotoxicity indices was observed. Also multivariate analysis did not show any correlation between individual ELF-MF exposure and genotoxicity indices. CONCLUSIONS: The results of our study do not give any support to the hypothesis that occupational exposure to ELF-MF up to about 2 microT, i.e. at the levels currently found in most workplaces, can exert a genotoxic effect in workers.
2003
- Sensory perception: An overlooked target of occupational exposure to metals
[Articolo su rivista]
Gobba, Fabriziomaria
abstract
The effect of exposure to industrial metals on sensory perception of workers has received only modest interest from the medical community to date. Nevertheless, some experimental and epidemiological data exist showing that industrial metals can affect vision, hearing and olfactory function, and a similar effect is also suggested for touch and taste. In this review the main industrial metals involved are discussed. An important limit in available knowledge is that, to date, the number of chemicals studied is relatively small. Another is that the large majority of the studies have evaluated the effect of a single chemical on a single sense. As an example, we know that mercury can impair hearing, smell, taste, touch and also vision, but we have scant idea if, in the same worker, a relation exists between impairments in different senses, or if impairments are independent. Moreover, workers are frequently exposed to different chemicals; a few available results suggest that a co-exposure may have no effect, or result in both an increase and a decrease of the effect, as observed for hearing loss, but this aspect certainly deserves much more study. As a conclusion, exposure to industrial metals can affect sensory perception, but knowledge of this effect is yet incomplete, and is largely inadequate especially for an estimation of "safe" thresholds of exposure. These data support the desirability of further good quality studies in this field.
2003
- Sindrome da ipersensibilità.
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria
abstract
We present a review on the electromagnetic hypersensitivity (EHS), a fenomenon where individuals experience adverse health effects while using, or being in the vicinity, of electric, magnetic or electromagnetic field sources and devices. Apparently, symptoms can be induced by both low and high frequencies, even at low level, and can vary substantially among different individuals. Scientific data do not support the hypothesis of a causal relationship between fields and EHS, even if knowledge is largely incomplete. Further studies in this field are needed.
2002
- 50 Hz magnetic fields of varying flux intensity affect cell shape changes in invertebrate immunocytes: the role of potassium ion channels
[Articolo su rivista]
Ottaviani, Enzo; Malagoli, Davide; A., Ferrari; Tagliazucchi, Davide; Conte, Angela; Gobba, Fabriziomaria
abstract
The effect induced by exposure to 50 Hz magnetic fields (MFs) in immunocytes from the mussel Mytilus galloprovincialis is evaluated. The whole animal was exposed for 15 and 30 min to MF intensities ranging from 200 to 1,000 microT. The changes in the cellular shape of immunocytes, expressed as shape factor (SF), were studied at different times after addition of the chemotacting substance N-formyl-Meth-Leu-Phe (fMLP). Results show that MFs provoke differing delays in fMLP-induced cellular shape changes: 200 microT are ineffective, while levels from 300 microT upwards cause a significant increase in immunocyte SF values compared to controls. Reactivation of the cells is possible up to an intensity of 600 microT. The use of PCO 400, an opener of ATP-sensitive K+ channels, shows that potassium channels are involved in the effect of MFs on M. galloprovincialis immunocytes.
2002
- Natural killer activity in workers exposed to various levels of Extremely Low Frequency-Electromagnetic Fields (ELF-EMF)
[Abstract in Rivista]
Gobba, Fabriziomaria; Borella, Paola; L., Roccatto; Giacobazzi, Pierluigi; Bargellini, Annalisa
abstract
Data on the effects of Extremely Low Frequency (ELF) Magnetic Fields (MF) on immune system in humans are conflicting. The aim of this study was to evaluate the NK cytotoxic activity in peripheral lymphocytes of a group of workers exposed to different levels of ELF-MF.
2002
- Sintomatologia soggettiva aspecifica riferita ai campi elettromagnetici: descrizione di due casi.
[Articolo su rivista]
Gobba, Fabriziomaria
abstract
In Italy, as in several other countries, an apparently increasing number of subjects are claiming the appearance of various types of subjective symptoms, that they refer to the exposure to electric, magnetic or electromagnetic fields (EMF) from nearby electric appliances. Nervous and cardiovascular systems, and the skin, are most frequently (but not exclusively) involved. Terms like “electricity hypersensitivity” (EHS), “EMF hypersensitivity”, or other, are frequently adopted to describe such symptoms, nevertheless up now, they cannot be considered established medical terms. No accepted diagnostic criteria or procedures were proposed for the diagnosis of EHS; on the contrary, apart from the subject’s self-attribution of the symptoms to EMFs, there is no established cause-effect relationship between EHS symptoms and electromagnetic fields. Furthermore, any credible pathogenetic mechanism is lacking, even if some was proposed, but not proved. In this paper, the cases of two people who developed symptoms of EHS referred to overhead power lines in the proximity of the house are presented and discussed. Approaches for similar cases, involving the participation of different medical and non-medical technical scientific disciplines are also briefly discussed.
2001
- Occupational exposure to trihalomethanes in indoor swimming pools
[Articolo su rivista]
Fantuzzi, Guglielmina; Righi, Elena; Predieri, Guerrino; G., Ceppelli; Gobba, Fabriziomaria; Aggazzotti, Gabriella
abstract
The study evaluated occupational exposure to trihalomethanes (THMs) in indoor swimming pools. Thirty-two subjects, representing the whole workforce employed in the five public indoor swimming pools in the city of Modena (Northern Italy) were enrolled. Both environmental and biological monitoring of THMs exposure were performed. Environmental concentrations of THMs in different areas inside the swimming pools (at the poolside, in the reception area and in the engine-room) were measured as external exposure index, while individual exposure of swimming pool employees was estimated by THMs concentration in alveolar air. The levels of THMs observed in swimming pool water ranged from 17.8 to 70.8 ug/l; the mean levels of THMs in ambient air were 25.6 +/- 24.5 ug/m3 in the engine room, 26.1 +/- 24.3 ug/m3 in the reception area and 58.0 +/- 22.1 ug/m3 at the poolside. Among THMs, only chloroform and bromodichloromethane were always measured in ambient air, while dibromochloromethane was detected in ambient air rarely and bromoform only once. Biological monitoring results showed a THMs mean value of 20.9 +/- 15.6 ug/m3. Statistically significant differences were observed according to the main job activity: in pool attendants, THMs alveolar air were approximately double those observed in employees working in other areas of the swimming pools (25.1 +/- 16.5 ug/m3 vs. 14.8 +/- 12.3 ug/m3, P < 0.01), THMs in alveolar air samples were significantly correlated with THMs concentrations in ambient air (r = 0,57, P < 0.001). Indoor swimming pool employees are exposed to THMs at ambient air levels higher than the general population. The different environmental exposure inside the swimming pool can induce a different internal dose in exposed workers. The correlation found between ambient and alveolar air samples confirms that breath analysis is a good biological index of occupational exposure to these substances at low environmental levels.
2000
- Color vision: A sensitive indicator of exposure to neurotoxins
[Articolo su rivista]
Gobba, Fabriziomaria
abstract
In the last 15 years an increasing number of studies have investigated color discrimination in workers exposed to various neurotoxins. Color vision was generally evaluated using the Lanthony D-15 desaturated panel (D-15 d) a test suited to identify mild acquired impairments, that can be easily performed at the workplace. In most studies, results were! quantitatively expressed using the method of Bowman or that of Vingrys and King-Smith: the former is the most widely reported, while the latter gives information on the type of color defect. Applying D-15 d, or other color perception tests, impairment in color vision was observed among workers exposed to several solvents (styrene, perchloroethylene, toluene, n-hexane, and carbon disulfide) or to solvent mixtures, and also to metals like mercury. Chemical related color vision loss is a sub-clinical early effect, and in most studies proved dose-related. For styrene and perchloroethylene, and also for solvent mixtures, an impairment was observed at exposure levels lower than the current occupational limits, suggesting that these limits may be inadequate for a proper protection of visual function of workers.
2000
- Dose-related color vision impairment in toluene-exposed workers
[Articolo su rivista]
A., Cavalleri; Gobba, Fabriziomaria; E., Nicali; V., Fiocchi
abstract
Occupational exposure to various neurotoxic chemicals can impair color vision. We evaluated this possibility in toluene-exposed workers. Thirty-three rubber workers and 16 referents were studied. We estimated toluene exposure by measuring urinary excretion of the unmodified form of the solvent (i.e., TolU). Color vision was tested with the Lanthony D-15 desaturated panel, and the outcomes were expressed quantitatively with the Color Confusion Index and the Total Confusion Index. Toluene-exposed workers had a subclinical reduction in color vision, compared with referents. We related this effect to solvent cumulative exposure-estimated as the product of urinary excretion of unmodified toluene by previous toluene exposure duration. This approach supports the hypothesis that impairment progresses as exposure continues. In the examined group of workers, toluene exposure was within the occupational limit proposed by the American Conference of Governmental Industrial Hygienists. The observed loss in color vision raises doubts on the real protection afforded by this limit-at least for effects of the solvent on the eyes. Finally, the Total Confusion Index was a more sensitive index than the Color Confusion Index in the evaluation of toluene-related color-vision impairment, suggesting that this index should be adopted in future studies of the effects of chemicals on color perception.
2000
- Evaluation of half-mask respirator protection in styrene-exposed workers
[Articolo su rivista]
Gobba, Fabriziomaria; S., Ghittori; M., Imbriani; A., Cavalleri
abstract
Objective: The protection afforded by respirators to styrene (St)-exposed workers varies considerably. Our objective was to study the effective 'in the field' reduction in St exposure obtained by negative-pressure half-mask respirators worn by a group of fiberglass-reinforced plastics (FRP) workers. Protection was evaluated by measuring the reduction in urinary St (StU) excretion, Methods: Seven FRP workers not using respiratory protection devices were studied for a week. External exposure to St was evaluated by personal passive sampling, and the internal dose by StU measurement. Then workers were asked to use a half-mask respirator for a week for the entire morning half-shift, and St exposure and internal dose were re-assessed. Results:. Mean environmental levels of St during the morning half-shift were 230-280 mg/m(3), i.e., about three times the current limit proposed by ACGIH; the difference among days was not significant. Using respirators was accompanied by a large inter-individual and also intra-individual variability: the estimated reduction of StU values ranged from 30% to 90% (mean 60%). Mean StU values increased by 50% from Monday to Friday, while environmental St concentrations remained steady. Furthermore, the proportion of workers exceeding the biological equivalent exposure limit (BEEL) was 14% on Monday, double (33%) on Thursday, and triple (43%) on Friday. These data suggest a decrease of protection during the week. Conclusions: The protection afforded by negative-pressure half-mask respirators varies widely, which stresses the need to assess the effective reduction of exposure whenever these devices are introduced for St-exposed workers. If respirators are to be re-used for several days, their performance must be evaluated during the last shift of use. Measurement of urinary excretion of unmodified St proved a useful tool for the evaluation of respirator effectiveness in exposed workers.
2000
- Evolution of color vision loss induced by occupational exposure to chemicals
[Articolo su rivista]
Gobba, Fabriziomaria; Cavalleri, A.
abstract
evolution of occupationally induced color vision loss was studied in workers exposed to various chemicals. Exposure was evaluated by biological monitoring or personal air samplers, and color vision using the Lanthony D-15 desaturated panel (D-15 d). The effect of short-term interruption of exposure was studied in 39 Styrene (St) exposed workers: at a first examination a dose-related color vision loss was disclosed; a re-lest performed after one month´s interruption of exposure did nor show any improvement of the effect. The evolution during longer periods was studied in another group of 30 St workers. Exposure and color vision were evaluated, then a follow-up was done 12 months later the exposure was unmodified or slightly decreased in 20 subjects, and D-15 d outcomes remained unchanged, while St levels had increased and color vision loss progressed in the other 10. Similar results were obtained in 33 PCE exposed dry-cleaners: no change in color perception was observed in 14 workers whose exposure decreased, while in the other 19 a rise in PCE levels was followed by a significant color vision worsening. In 27 Hg exposed workers whose mean urinary excretion of Hg was threefold the BEI proposed by ACGIH, a dose-related impairment in color perception was observed. 12 months after a marked reduction of exposure, an almost complete recovery of the impairment was observed. Our data show that an increase in exposure can induce a worsening in color Vision loss. A short interruption in exposure did not reduce the effect. A more prolonged reduction of dose reversed color vision loss in Hg exposed workers, while in solvent-exposed individuals the progression deserves further evaluation. D-15 d proved a useful test for studies on the evolution of color perception in workers exposed to eye-toxic chemicals.
2000
- L’esposizione a Percloroetilene nelle lavanderie a secco e nelle case degli addetti: monitoraggio ambientale, monitoraggio biologico e studio degli effetti precoci sulla funzione visiva.
[Articolo su rivista]
Aggazzotti, Gabriella; Fantuzzi, Guglielmina; Righi, Elena; Predieri, Guerrino; Gobba, Fabriziomaria
abstract
Gli autori riportano i risultati di due indagini condotte sull'esposizione a percloroetilene nelle lavanderie del comune di Modena
2000
- Potenziali rischi per un eccesso di igiene in casa.Potential risks from an excess of hygienic cleaning in the domestic setting
[Articolo su rivista]
Borella, Paola; Aggazzotti, Gabriella; Angelillo, I. F.; Balli, Fiorella; Barbone, F.; Carpenè, E.; Cossarizza, Andrea; Chiericozzi, M.; Gobba, Fabriziomaria; Seidenari, Stefania; Triassi, M.; Vercilli, F.
abstract
The most relevant and recent risks associated with an excessive hygiene are here presented. Besides general observations on the relationship between hygiene and immune system, we discuss possible acute and chronic effects due to home exposure to detergents. The specific problem of hygienic cleaning introduced on a vaste scale at home requires the comparison with similar experiences in the hospitals,, evaluation of efficacy, comprhension of risks such as the selection of resistant micro-organisms.
1999
- Aspetti di legislazione in materia di prevenzione e tutela della salute del personale sanitario.
[Capitolo/Saggio]
Mattioli, S; Roccatto, L; Galassi, C; Gobba, Fabriziomaria
abstract
Vengono presentate e discusse le principali norme per la prevenzione e la promozione della salute sui luoghi di lavoro con riferimento al personale sanitario
1999
- Assessment of Indoor exposure to perchloroethylene (PCE) in dry-cleaners' family members
[Articolo su rivista]
Aggazzotti, Gabriella; Righi, Elena; Fantuzzi, Guglielmina; Predieri, Guerrino; Gobba, Fabriziomaria
abstract
this study evaluated the exposure to perchlorothylene for dry-cleaners' family member occuring inside their private houses
1999
- Do low electromagnetic fields cause subjective symptoms and do they have hazardous health effects?
[Capitolo/Saggio]
Aringer, L.; Bergqvist, U.; Cunningham, J.; Neubauer, G.; Gobba, F.; Leitgeb, N.; Miro, L.; Ruppe, I.; Vecchia, P.; Vogel, E.; Wadman, C.
abstract
1999
- Genetic polymorphisms influence variability in benzene metabolism in humans
[Articolo su rivista]
A. M., Rossi; C., Guarnieri; Rovesti, Sergio; Gobba, Fabriziomaria; S., Ghittori; Vivoli, Gianfranco; R., Barale
abstract
The role of genetic polymorphism in modulating urinary excretion of two benzene metabolites, i.e. trans,trans-muconic acid (t,t-MA) and S-phenylmercapturic acid (PMA), has been investigated in 59 non-smoking city bus drivers, professionally exposed to benzene via vehicle exhausts. Exposure to benzene was determined by personal passive samplers (mean +/- SD = 82.2 +/- 25.6 micrograms/m3), while internal dose and metabolic rate were evaluated by measuring urinary excretion of unmodified benzene (mean +/- SD = 361 +/- 246 ng/l), t,t-MA (mean +/- SD = 602 +/- 625 micrograms/g creatinine), and PMA (mean +/- SD = 5.88 +/- 4.76 micrograms/g creatinine). Genetic polymorphism at six loci encoding cytochrome-P450-dependent monooxygenases (CYP2E1 and CYP2D6), glutathione-S-transferases (GSTT1, GSTP1 and GSTM1) and NAD(P)H:quinone oxidoreductase (NQOR) was determined by polymerase chain reaction-based methods. No evidence emerged for a possible role of CYP2E1, GSTM1 and GSTP1 polymorphisms in determining the wide differences observed in the rate of benzene biotransformation. Conversely, a significantly higher t,t-MA urinary excretion was found to be correlated to, GSTT1 null genotype, and a significantly lower PMA excretion was detected in the subjects lacking NQOR activity and in the CYP2D6 extensive-metabolizers. Many biological (i.e. age and body burden) or lifestyle factors (i.e. rural or urban residence, use of paints and solvents, medication, alcohol and coffee intake), also taken into account as potential confounders, did not influence the correlations found. These findings suggest that CYP2D6, GSTT1 and NQOR polymorphisms contribute in explaining the metabolic variability observed in our sample. Therefore, these polymorphisms should be regarded as potential risk factors for benzene-induced adverse health effects.
1998
- Modification in serum concentrations of aminoterminal propeptide of type III procollagen in patients with previous transmural myocardial infarction
[Articolo su rivista]
Modena, Maria Grazia; R., Molinari; Rossi, Rosario; Njr, Muia; A., Castelli; Mattioli, Giorgio; L., Bacchella; Gobba, Fabriziomaria
abstract
The aim of our study was to evaluate the modification of serum concentration of aminoterminal propeptide of type III procollagen (PIIINP) in 70 patients with previous transmural myocardial infarction. In 38 patients (group 1) PIIINP levels increased at 6 and 12 months after infarction; in 32 patients (group 2) PIIINP increased at 6 months, returning to baseline at 12 months. At the same time we observed a significant left ventricular enlargement and worsening of the performance in group 1, whereas in group 2 an improvement was seen in left ventricular volumes and performance. In conclusion, rearrangement of collagen myocardial matrix plays an important role in left ventricular postinfarction modification. This process can be easily followed over time in a noninvasive manner by dosing serum PIIINP concentrations.
1998
- Reversible color vision loss in occupational exposure to metallic mercury
[Articolo su rivista]
Cavalleri, A; Gobba, Fabriziomaria
abstract
Color vision was evaluated in twenty-one mercury exposed workers and referents matched for sex, age, tobacco smoking, and alcohol habits. The Lanthony 15 Hue desaturated panel (D-15 d) was applied. In the workers, mean urinary Hg (HgU) was 115 +/- 61.5 mu g/g creatinine; in all but one the values exceeded the biological limit (BEI) proposed by the American Conference of Governmental Industrial Hygienists. A dose-related subclinical color vision impairment was observed in Hg-exposed workers compared to the referents. Just after the survey, working conditions were improved. Twelve months later the workers were reexamined. Mean HgU was 10.0 mu g/g creatinine and in no subjects was the BEI exceeded. Color perception was significantly improved compared to the first examination and, furthermore, no differences were observed between exposed workers and referents. The results add evidence that the color vision loss observed during the first part of the study was related to Hg exposure and, moreover, show that this effect is reversible. These data indicate that metallic Hg can induce a reversible impairment in color perception. This suggests that color vision testing should be included in studies on the early effects of Hg, The possibility of applying the D-15 d as an early effect index in the biological monitoring of Hg exposed workers should also be entertained.
1998
- Two-years evolution of perchloroethylene-induced colour vision loss
[Articolo su rivista]
Gobba, Fabriziomaria; Righi, Elena; Fantuzzi, Guglielmina; Predieri, Guerrino; L., Cavazzuti; Aggazzotti, Gabriella
abstract
Progression of perchloroethylene-induced color-vision impairment was studied in 33 dry-cleaner workers at 12 establishments in Modena, Italy In an initial survey, we evaluated exposure with personal passive samplers, and we assessed color vision with the Lanthony D-15 desaturated panel. Two years later, workers were reexamined. in 19 workers (subgroup A), exposure to perchloroethylene had increased (median of 1.7 ppm versus 4.3 ppm, respectively), whereas in the remaining 14 workers (subgroup B) exposure was reduced (2.9 ppm versus 0.7 ppm, respectively), Color vision worsened in subgroup A, but no vision changes were apparent in subgroup B. The results indicated that an increase in expo sure during a 2-y period, even if slight, can cause color vision to deteriorate. A similar slight reduction in exposure did not lead to color-vision improvement; perhaps this lack of improvement resulted from (a) an insufficient reduction in exposure, (b) an insufficient reduction in duration of exposure, or
1997
- Changes in serum levels of N-terminal procollagen type III propeptide as an index of postinfarction ventricular remodeling
[Articolo su rivista]
Molinari, R.; Rossi, R.; Muia, Jr. N.; Castelli, A.; Modena, M. G.; Mattioli, G.; Bacchella, L.; Gobba, F.
abstract
The levels of aminoterminal propeptide of type III procollagen (PIIINP) can be used as an index of collagen breakdown. The aim of our study was to evaluate modifications in serum concentration of PIIINP (PIIINPs) in patients with a first episode of myocardial infarction. We examined 70 patients admitted at our Institution for acute myocardial infarction and 10 normal subjects. PIIINPs dosage was obtained by radioimmunoassay method utilizing a commercial available kit. All patients underwent three PIIINPs dosages: within 24 hours after admission, at 6 and 12 months after myocardial infarction. Control values were 0.4 +/- 0.1 U/ml. In 38 patients (Group I) PIIINPs levels increased at 6 and 12 months after infarction: 0.53 +/- 0.2, 0.75 +/- 0.2 and finally 0.76 +/- 0.1 U/ml. In the remaining 32 patients (Group II) PIIINPs values increased at 6 months and then returned to baseline at 12 months: 0.56 +/- 0.2, 0.75 +/- 0.1 and then 0.46 +/- 0.1 U/ml. The end-diastolic volume index did not change significantly in Group I (from 93.7 +/- 21 to 79.7 +/- 20 ml/m2) while it decreased after 12 months in Group II (from 88.9 +/- 13 to 58.6 +/- 11 ml/m2; confidence interval 95% from 2 to 55 ml/m2; p = 0.03). Similarly, there was no significant variation in end-systolic volume index (ESVI, from 39.7 +/- 11 to 36.9 +/- 11 ml/m2) and ejection fraction (from 60 +/- 10 to 59 +/- 15%) in Group I; while in Group II ESVI decreased significantly (from 33.6 +/- 13 to 20 +/- 5 ml/m2, confidence interval 95% from 3 to 24 ml/m2; p = 0.02) and ejection fraction improved (from 62 +/- 11 to 72 +/- 15%; confidence interval 95% from -20 to -1%; p = 0.04). In conclusion, patients with elevated levels of PIIINPs at 12 months did not improve ventricular function while patients with PIIINPs returning to baseline at 12 months had an improvement. Our results suggest an active participation of newly formed collagen in post-infarct ventricular remodeling. Therefore PIIINPs may be a marker of this process.
1997
- Colour vision loss in perchloroethylene exposed dry-cleaning workers.
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Righi, E; Fantuzzi, Guglielmina; Predieri, G; Aggazzotti, Gabriella
abstract
-
1997
- Excretion of N-acetyl-S-(1-phenyl-2-hydroxyethyl)-cysteine and N-acetyl-S-(2-phenyl-2-hydroxyethyl)-cysteine in workers exposed to styrene
[Articolo su rivista]
Gobba, Fabriziomaria; L., Maestri; M., Imbriani; S., Ghittori; E., Capodaglio; A., Cavalleri
abstract
Styrene (S) has been shown to be responsible for neurotoxic effects, including behavioural changes and neuroendocrine disturbances. The initial step of S metabolism is conversion to styrene 7,8-epoxide (SO), which is present in two enantiomeric forms [(R)(+)-SO and (S)(-)-SO]; this electrophilic intermediate is considered to be directly responsible for most toxic effects of S. The major urinary metabolites derived from the biotransformation of SO in man are mandelic acid (MA) and phenylglyoxylic acid (PGA). In rats an alternative pathway has been demonstrated, which involves the conjugation of SO to glutathione (GSH), leading to the excretion of two specific mercapturic acids, N-acetyl-S-(l-phenyl-2-hydroxyethyl)-cysteine (M1) and N-acetyl-S-(2-phenyl-2-hydroxy-ethyl)-cysteine [M2]; a close relationship has been found between exposure to S and urinary excretion of M1 and M2 in rats. As a consequence of the chiral nature of SO, both M1 and M2 consist of two diastereoisomers (M1-´R´, M1-´S´, M2-´R´ and M2-´S´). Early reports have shown that the conversion of S to mercapturic acids is much lower in man (below 1% of the absorbed dose) than in rats (about 10%). We propose an analytical method for the determination of urinary M1 and M2 in man, which involves a urine clean-up by a chromatographic technique with a short reversed-phase pre-column; purified samples are then deacetylated with porcine acylase and deproteinized by centrifugal ultrafiltration. A derivatization is then performed with o-phthaldialdehyde and 2-mercaptoethanol and the fluorescent derivatives are separated on a reversed-phase analytical column. The mobile phase consists of acetate buffer and methanol mixed at variable proportions, the fluorescence detector is set at 330 nm (exc.) and 440 nm (em.). M1-´S´ and M1-´R´ are separated (retention times = 52.8 and 73.7 min, respectively) while the diastereoisomers of M2 coelute as a single peak at 70.5 min. The detection limit is about 7 mu g/l, the coefficients of variation are below 7% and the error percentages are less than 6%. The method was applied to 25 urine samples from workers exposed to S: significant correlations were found between mercapturic acids and MA and PGA, the best correlation being between M2 and PGA (r= 0.79). Urine samples from unexposed subjects showed no detectable amounts of the analytes. A high stereoselectivity is shown by the enzymes involved in the metabolism of S to mercapturic acids: M1-´S´, which derives from (S)-SO, is excreted in much higher amounts than M1-´R´, which derives from (R)-SO.
1997
- Il monitoraggio ambientale e biologico dell’esposizione occupazionale a percloroetilene nelle lavanderie a secco.
[Articolo su rivista]
Gobba, Fabriziomaria; Rosa, P; Ghittori, S; Imbriani, M; Ferrari, G; Cavalleri, A.
abstract
Occupational exposure to perchloroethylene (PCE) was studied in a total of 106 workers in 78 dry cleaning shops in the province of Pavia, Northern, Italy. Environmental monitoring was performed by personal passive sampling. The median time weighted average (TWA) level of PCE was 57 mg/m3, i.e., about 30% of the current Threshold Limit Value (TLV) proposed by the American Conference of Governmental Industrial Hygienists (ACGIH). However, in 12 workers exposure exceeded this limit. Biological monitoring was performed via measurement of urinary trichloroacetic acid (TCA), i.e. the exposure index currently used in Italy, and urinary excretion of unmodified perchloroethylene (PCE-U) in samples collected at the end of the half-shift. Median levels of TCA and PCE were 1.03 mg/l and 17.7 micrograms/l respectively. The correlation coefficient between environmental TWA concentrations of perchloroethylene and PCE-U was 0.755 (0.809 after logarithmic transformation), compared to 0.660 for TCA values. The subjects were then classified as "low exposed" and "heavily exposed" according to whether personal exposure was lower or higher than 57 mg/m3, the median TWA value of the whole group. PCE-U levels were significantly correlated to exposure in both subgroups whereas TCA was correlated only in the "heavily exposed subjects", but not in those with lower exposure. The results of the study show that in the majority of dry cleaning shops exposure to PCE was well below the current occupational limits. Nevertheless surveillance of dry cleaners is recommended as nearly 10% of the workers exceeded the environmental and biological limits. Urinary excretion of unmodified PCE appears to be a very reliable indicator for biological monitoring of PCE exposure in dry cleaning and is also significantly correlated to exposure at low levels. The estimated biological equivalent exposure level (BEEL) for PCE-U, corresponding to the current TLV-TWA proposed by the ACGIH, is 55 micrograms/l. Urinary TCA seems to be less suitable for assessment of individual exposure to perchloroethylene in dry cleaners as it is poorly representative of exposure to low levels of the solvent, which is a very common occurrence in this occupational group nowadays
1997
- Inter-individual variability of benzene metabolism to trans-trans-muconic acid and its implications in the biological monitoring of occupational exposure
[Articolo su rivista]
Gobba, Fabriziomaria; Rovesti, Sergio; Borella, Paola; R., Vivoli; Caselgrandi, Eva; Vivoli, Gianfranco
abstract
Unmodified benzene (UBz) and trans,trans-muconic acid (t,t-MA) were measured in urine samples collected at the end of the first half-shift in 80 bus drivers from a large city in Northern Italy. Mean UBz was 1155 ng/l (S.D. = 494), range 85-1980 ng/l; these values roughly correspond to 10-1000 micrograms/m3 of benzene in air. Mean t,t-MA was 297 micrograms/g creatinine; the range was large (20-1295 micrograms/g creatinine), and the distribution of values was bimodal. At further analysis of t,t-MA data, two subgroups of 59 and 18 subjects were identified (3 outliers were excluded): mean values of the index were 108 (S.D. = 65) and 916 (S.D. = 264) micrograms/g creatinine respectively, and the values within each subgroup were normally distributed. The mean ratio between t,t-MA and UBz in the subgroups were 0.15 and 0.85, respectively; the difference was significant. The first subgroup was defined as 'poor t,t-MA metabolizers', the other as 'efficient t,t-MA metabolizers'. No inter-subgroup differences were observed regarding the main characteristics (age, dietary and smoking habits, etc.). As the parent compound of t,t-MA, trans,trans-muconaldehyde is myelotoxic, and its production has been implicated in benzene-induced leukemia. 'efficient' t,t-MA metabolizers may be at higher risk of developing benzene toxicity. If confirmed in further studies, the inter-individual variability rate of metabolizing benzene to t,t-MA may introduce some limitations in the application of this metabolite as an exposure index of low benzene exposure. Nevertheless, the t,t-MA/UBz ratio may be an important index of susceptibility to benzene toxicity.
1997
- The urinary excretion of solvents and gases for the biological monitoring of occupational exposure: A review
[Articolo su rivista]
Gobba, Fabriziomaria; S., Ghittori; M., Imbriani; L., Maestri; E., Capodaglio; A., Cavalleri
abstract
´In the field´ application of the measurement of urinary excretion of unmodified solvent for the biological monitoring of exposed workers has been investigated in many recent papers. The results obtained for several solvents are reviewed. The values of correlation coefficients (r) and regression lines obtained for benzene, toluene, xylene, styrene, n-hexane, cyclohexane, 2- and 3-methylpentane, methyl chloride, tetrachloroethylene, carbon tetrachloride, methyl chloroform, p-dichlorobenzene, nitrous oxide, halothane, isoflurane, enflurane, acetone, methyl ethyl ketone and methyl isobutyl ketone are presented. The correlations observed were generally good: r values range from 0.50-0.97, and the majority are between 0.84 and 0.90. The regression lines reported far the same solvent in different studies present some variability: this is possibly due to an inadequate control of factors influencing the relationship between external dose and absorption, such as differences in body burden, work load, individual characteristics, etc. These factors are discussed. As a whole, results reported in the literature show that measuring of urinary excretion of unmodified solvents provides a highly sensitive and specific exposure index, and can also be applied for the biological monitoring of occupational exposure to low levels of solvents or to solvent mixtures. Nevertheless, for an adequate assessment of biological limit values, further studies evaluating the reproducibility of regression lines are needed, given that the aspects influencing the correlation between external dose and urinary excretion are fully controlled. Another crucial aspect is the correlation with early effects: even though this has yet to be evaluated for several solvents, for others such as styrene and perchloroethylene a good correlation was obtained, further supporting the usefulness of the measurement of urinary excretion of solvent for the biological monitoring of occupational exposure.
1996
- Color vision loss among styrene-exposed workers neurotoxicological threshold assessment
[Articolo su rivista]
Campagna, D; Gobba, Fabriziomaria; Mergler, D; Moreau, T; Galassi, C; Cavalleri, A; Huel, G.
abstract
Styrene represents nowadays one of the most used organic solvent. The current exposure limit proposed for this chemical differs significantly from country to country: the Threshold Limit Value - Time Weighted Average (TLV-TWA) proposed by the American Conference of Governmental Industrial Hygienists (ACGIH) is 50 ppm while the German, Finnish and Swedish occupational exposure limit is 20 ppm. Nevertheless, effects on the nervous system were recently reported in workers exposed at TWA styrene levels below the current TL V. Neuro-optic pathways have been sh own to be particularly vulnerable to organic solvent exposure. Analysis and measurements of visual functions can provide important information on early neurotoxic effects. Previous studies support the hypothesis that styrene exposure can induce a dose-dependent color vision loss. The aim of this study is to assess a threshold level below which no detectable effect occurs for color vision. We applied a sub-application of the change point problem in two-phase regression considering one phase as a constant line. In accordance with this model the maximum-likelihood technique was used as a method to examine the dose-effect relationship between externa I styrene exposure and chromatic discrimination. The present article presents a joint analysis of data from two previously published studies, one carried out in Canada and the other in Italy. The age and seniority of the workers from both countries were remarkably similar, as were the process type, the chemicals used and the work-tasks oi exposed subjects. The mathematical method presented here shows the existence of a statistically significant threshold. This finding shows that, in fiberglass-reinforced plastics industry, visual color impairment could be significantly detected above 4 ppm (upper limit of the confidence interval at 5% = 26 ppm). The exact clinical meaning of this effect, and also the progress of the impairment in exposed workers, is still to be assessed in further studies. The results of our study support the need of a reduction of the occupational limits for styrene in workplaces to values close to or lower than German, Finnish or Swedish exposure limits.
1995
- BIOMONITORING OF LOW-LEVELS OF EXPOSURE TO STYRENE
[Articolo su rivista]
Gobba, Fabriziomaria; Ghittori, S; Cavalleri, A.
abstract
-
1995
- COLOR-VISION LOSS IN WORKERS EXPOSED TO ELEMENTAL MERCURY-VAPOR
[Articolo su rivista]
Cavalleri, A; Belotti, L; Gobba, Fabriziomaria; Luzzana, G; Rosa, P; Seghizzi, P.
abstract
We evaluated colour vision in 33 workers exposed to elemental mercury (Hg) vapour and in 33 referents matched for sex, age, alcohol consumption and cigarette smoking. The results were expressed as colour confusion index (CCI). In the workers urinary excretion of Hg (HgU) ranged from 28 to 287 mu g/g creatinine. Subclinical colour vision loss, mainly in the blue-yellow range, was observed in the workers. This effect was related to exposure, as indicated by the correlation between HgU and CCI (r = 0.488, P < 0.01). In the workers whose HgU exceeded 50 mu g/g creatinine, mean CCI was significantly increased compared to the matched referents. The results suggest that exposure to elemental Hg inducing HgU values exceeding 50 mu g/g creatinine can induce a dose-related colour vision loss.
1995
- METHYL-BROMIDE INDUCED NEUROPATHY - A CLINICAL, NEUROPHYSIOLOGICAL, AND MORPHOLOGICAL-STUDY
[Articolo su rivista]
Cavalleri, F; Galassi, G; Ferrari, Stefano; Merelli, E; Volpi, G; Gobba, Fabriziomaria; Delcarlo, G; Deiaco, A; Botticelli, Ar; Rizzuto, N.
abstract
A case of distal axonopathy and acquired dyschromatopsia in a fumigator exposed to methyl bromide is described.
1995
- Peripheral neuropathy in styrene-exposed workers
[Articolo su rivista]
Gobba, Fabriziomaria; Cavalleri, F; Bontadi, D; Torri, P; Dainese, R.
abstract
Background The toxicity of styrene on the peripheral nervous system is still debated. Cases The paper presents two cases of peripheral sensorimotor neuropathy in styrene-exposed workers. Exposure, evaluated by biological monitoring, ranged between 100 and 150% of the current limits proposed by the American Conference of Governmental Industrial Hygienists (ACGM). The subjects complained of leg weakness and numbness, cramps, and paresthesia. Electrophysiology revealed a moderate peripheral sensorimotor neuropathy of a demyelinating type. Color-vision testing showed a subclinical deficit. Common inherited and acquired causes of peripheral neuropathy and dyschromatopsia other than styrene were ruled out by personal history, medical examination, laboratory data, and chest X-ray. Conclusions The results suggest that long-term occupational exposure to environmental levels of styrene that are equal, or slightly above, the ACGM limits can induce a clinical form of peripheral neuropathy and a subclinical impairment of color vision. As a consequence, a careful reappraisal of the real preventive meaning of the current ACGM occupational limit for styrene, at least on an individual basis, is needed.
1994
- OCCUPATIONAL AND ENVIRONMENTAL EXPOSURE TO PERCHLOROETHYLENE (PCE) IN DRY CLEANERS AND THEIR FAMILY MEMBERS
[Articolo su rivista]
Aggazzotti, Gabriella; Fantuzzi, Guglielmina; Righi, Elena; Predieri, Guerrino; Gobba, Fabriziomaria; M., Paltrinieri; A., Cavalleri
abstract
Perchloroethylene exposure in 28 dry-cleaning establishments and in 25 homes occupied by dry cleaners in Modena, Italy, was investigated. Environmental air samples and alveolar air samples from dry cleaners (n = 60) and from their family members (n = 23) were collected. The degree of perchloroethylene on the dry-cleaning premises varied widely from establishment to establishment. Spot sampling ranged from 0.6 to 75 mg/m3, whereas sampling by personal passive dosimeters ranged from 2.6 to 221.5 mg/m3 (8-h time weighted average values). Perchloroethylene in alveolar air samples collected at the end of the work day correlated closely with the 8-h time weighted average values (r = .750, p = .001), and correlated also with alveolar air samples collected at home in the evening (r = .665, p = .001) and the following morning (r = .549, p < .001). Perchloroethylene levels inside the homes of dry cleaners appeared significantly higher than in 29 houses selected as controls (Mann Whitney U test, p < .001). Perchloroethylene in alveolar air samples collected at home suggests that nonoccupational exposure to perchloroethylene for family members of dry cleaners exists.
1994
- PERCHLOROETHYLENE EXPOSURE CAN INDUCE COLOR-VISION LOSS
[Articolo su rivista]
A., Cavalleri; Gobba, Fabriziomaria; M., Paltrinieri; Fantuzzi, Guglielmina; Righi, Elena; Aggazzotti, Gabriella
abstract
We evaluated colour vision in 35 dry-cleaners exposed to perchloroethylene (PCE) and in a paired number of controls matched for sex. age, alcohol consumption and cigarette smoking. A subclinical colour vision loss, mainly in the blue-yellow range, was present in dry-cleaners. This effect was related to PCE exposure levels. and appeared at environmental concentrations of the solvent well below the current exposure limits for exposed workers. The results suggest that PCE exposure, even at low environmental levels, can induce a dose-related impairment of colour vision.
1993
- Kinetics of urinary excretion and effects on colour vision after exposure to styrene
[Capitolo/Saggio]
Gobba, F.; Cavalleri, A.
abstract
We evaluated the influence of the body burden of styrene on biological indices of exposure and the effects of this solvent on colour perception. The exposure of 19 workers was followed during a working week by personal sampling and biological monitoring. Although no significant difference in daily exposure was observed, pre-shift values of urinary styrene and urinary mandelic acid increased significantly during the week, and the regression line between external dose and biological exposure indices changed correspondingly. These data suggest that body burden can influence the results of biological monitoring of styrene. The effect of styrene on colour vision was evaluated in two further groups: 73 exposed workers and 53 referents and 36 pairs of workers and controls. A dose-related impairment was observed, which appeared to be synergistic with age and was not significantly improved by a one-month interruption of exposure. Our data show the need to improve biological monitoring of exposure to styrene and, in particular, to establish dose-effect and dose-response relationships between exposure and early effects. Urinary excretion of styrene and colour vision assessment represent, respectively, promising indices of exposure to and an effect of styrene.
1993
- Re: 'Urinary styrene in the biological monitoring of styrene exposure.' [1]
[Articolo su rivista]
Aitio, A.; Gobba, F.; Galassi, C.; Imbriani, M.; Cavalleri, A.
abstract
1993
- URINARY STYRENE IN THE BIOLOGICAL MONITORING OF STYRENE EXPOSURE
[Articolo su rivista]
Gobba, Fabriziomaria; Galassi, C; Ghittori, S; Imbriani, M; Pugliese, F; Cavalleri, A.
abstract
The urinary excretion of styrene represents a promising indicator of exposure to this solvent. Nevertheless extensive research under field conditions is scant. In this investigation 214 styrene-exposed workers from 10 fiberglass-reinforced plastics factories were studied. Environmental monitoring was performed by personal passive sampling. Blood styrene and the urinary excretion of styrene and its main metabolites, mandelic acid (MA) and phenylglyoxylic acid (PGA), were measured. The correlation coefficient between the time-weighted average of environmental styrene and the mean urinary excretion of styrene was 0.88 (0.91 after logarithmic transformation), compared with the 0.82 and 0.78 of the end-of-shift MA and PGA values, respectively. A high correlation (0.86) was also found between styrene in the blood and urine. The results, obtained under field conditions with a large group of exposed workers, confirm the usefulness of the urinary excretion of styrene as an exposure index for the biological monitoring of styrene exposure.
1993
- Work/vision relationship in a preventive medicine context: Inital guidelines for a correct ergophthalmologic approach proposed by the Italian Group for the Study of Work/Vision Relationships. Part 1: Presentation
[Articolo su rivista]
Apostoli, P.; Bellucci, R.; Bergamaschi, A.; Broglia, A.; Catenacci, G.; Colangelil, C.; Costa, G.; Betta, A.; De Concini, M.; Di Bari, A.; Gobba, F.; Lupidi, G.; Mannucci, L.; Martinoli, M.; Petrella, L.; Pierini, F.; Rechichi, C.; Romano, C.; Salano, R.
abstract
Modern technology poses numerous and complex problems concerning the implications for health in the work/vision relationship. While many of the hypotheses made in the past about the possibility of serious eye alterations in non-industrial workers have not been confirmed by recent investigations, considerable attention is at present being addressed to the short- and long-term effects of office work, especially in the case of tasks requiring prolonged visual effort 'at near point'. The prevalence of asthenopia in such workers is rather high, between 40 and 80%. The considerable aspecificity of the symptoms and the shortcomings in assessment of exposure in most of the research done so far has meant that no clear and unequivocable causal relationship between work involving intense visual effort and onset of asthenopia has been established. Nevertheless, from an analysis of the literature three main guidelines for a correct ergophthalmologic assessment can be identified: a) ophthalmologic assessments that will detect any transitory inefficiencies of the accomodation and convergence system; b) specific analysis of the technical and illumination conditions with special attention to the distribution of the natural and artificial light sources; c) quantification of airborne pollutants that have a potential irritative effect on the 'ocular surface'. Other environmental parameters that could be considered are electric and magnetic fields in the vicinity of VDTs and PCs and the microclimate of the workplace.
1993
- Work/vision relationship in a preventive medicine context: Initial guidelines for a correct ergophthalmologic approach proposed by the Italian Group for the Study of Work/Vision Relationships. Part 2: Methods
[Articolo su rivista]
Apostoli, P.; Bellucci, R.; Bergamaschi, A.; Broglia, A.; Catenacci, G.; Colangeli, C.; Costa, G.; Betta, A.; De Concini, M.; Di Bari, A.; Gobba, F.; Lupidi, G.; Mannucci, L.; Martinoli, M.; Petrella, L.; Pierini, F.; Rechichi, C.; Romano, C.; Salano, R.
abstract
In view of the numerous problems concerning the relationship between work and vision, the Italian Group for the Study of Work/Vision Relationships has developed a document that sets out initial guidelines for environmental monitoring and health surveillance in ergophthalmology. Particular emphasis is given to fact-finding inspections and collection of subjective assessments that will enable the occupational health physician to identify any adverse factors in the working environment and assess the visual effort of the operators. The importance of cooperation between occupational health physician and ophthalmologists in the various phases of ergophthalmological assessment is stressed. An analytical list is provided of the parameters that the ophthalmologist should measure during eye examination as well as the appropriate assessments that the occupational health physician should perform if an ophthalmological specialist is not available. Suggestions for periodic controls on the basis of visual effort and ophthalmological status are made. It is the task of the occupational health physician to establish the fitness or otherwise of the patients for the job, and for this the Group is preparing further documents.
1992
- Erratum: Authors' reply to the letter of Miltray, Jung, and Konietzko (Journal of Occupational Medicine (May 1992) 34 (563-564))
[Articolo su rivista]
Miltray, Jung; Konietzko, ; Gobba, F.
abstract
1992
- The determination of serum type III procollagen aminoterminal propeptide (PIINP) in occupational exposure to rock wool fibres
[Articolo su rivista]
Cavalleri, A.; Gobba, F.; Ferrari, D.; Bacchella, L.; Robotti, M.; Mineo, F.; Pedroni, C.
abstract
Fifty-six males workers exposed to rock wool during production, and 20 referents were examined. Exposure, evaluated by personal sampling, ranged from 0.05 to 0.74 fibres/ml (median 0.15). The subjects underwent a medical examination, chest X-ray according to IFO recommendations and pulmonary function tests. In all subjects the serum levels of type III procollagen N-terminal propeptide (PIIINPs) were determined. No evidence of pulmonary fibrosis, nor work-related lung diseases were observed. PIIINPs mean values in the exposed (9.8 ng/ml; 2.8 S.D.) were slightly higher, but not significantly different when compared to referents (8.5 ng/ml; 2.5 S.D.). No significant correlation between PIIINPs and rock wool exposure (both airborne levels and exposure duration) was observed. Furthermore, peptide levels were not related to pulmonary function test results. Our results suggest that occupational exposure to rock wool fibres lower than 0.75 fibres/ml for less than 20 years does not induce definite cases of pulmonary fibrosis nor an increase of type III collagen synthesis in the lung.
1991
- Acquired dyschromatopsia among styrene-exposed workers.
[Articolo su rivista]
Gobba, Fabriziomaria; C., Galassi; M., Imbriani; S., Ghittori; S., Candela; A., Cavalleri
abstract
We investigated the occurrence of color vision loss in 75 styrene-exposed workers and in 60 referents. Color vision was evaluated by adopting the Lanthony D 15 desaturated panel, a test specifically suited to detect mild acquired dyschromatopsia. The results of the test were expressed as Color Confusion Index. Styrene exposure was evaluated with both environmental and biological monitoring. Airborne levels of the solvent were 3.2 to 549.5 mg/m3. In styrene-exposed workers color vision was significantly impaired when compared with referents matched for age. A significative correlation was found between environmental and urinary levels of styrene and Color Confusion Index excluding the influence of age in multiple regression analysis, indicating the possibility of a dose-effect relationship. The findings suggest that styrene can induce an early appearance of a dose-dependent color vision loss.
1991
- Evaluation of serum aminoterminal propeptide of type III procollagen as an early marker of active fibrotic process in asbestos-exposed workers
[Articolo su rivista]
A., Cavalleri; Gobba, Fabriziomaria; L., Bacchella; D., Ferrari
abstract
In an evaluation of the possibility of type III procollagen N-terminal propeptide (PIIINP) being an early marker of the active fibrotic process in asbestos-exposed workers, 91 asbestos workers had higher serum PIIINP concentrations than 108 referents. In 24 workers exposed to low levels of airborne asbestos, the serum PIIINP was higher than in the referents but lower than in an exposed group with higher exposure; furthermore a significant correlation (r = 0.63) was found between serum PIIINP and individual cumulative exposure. These data suggest a dose-effect relationship between asbestos exposure and PIIINP serum concentration. In addition workers with a reduced pulmonary function had higher PIIINP values than the referents or the exposed workers with normal pulmonary function. The serum PIIINP levels were related to asbestos exposure even at low airborne concentrations and may represent an early biological marker of impending fibrotic process induced by asbestos.
1991
- MORTALITY AMONG MALE FARMERS LICENSED TO USE PESTICIDES.
[Articolo su rivista]
Alberghini, V.; Luberto, F.; Gobba, Fabriziomaria; Morelli, C.; Gori, E.; Tomesani, N.
abstract
The mortality experience of 4,580 male farmers licensed to buy and use pesticides in Northern Italy was examined from 1974 to 1987. The historical cohort was determined from the registers of the agricultural inspectorate offices. The vital status at the end of the study period was ascertained by municipality records and only 4 subjects were lost to follow-up. Death certificates were obtained for 100% of the 565 identified deaths. External comparison on to the Italian male population was supplemented by regional comparison. Mortality deficits were observed for all causes, all neoplasms and most specific malignancies. A non-significant mortality excess due to brain cancer, compared both to national and regional populations, was found (11 cases, Standardized Mortality Ratio 169 and 139, respectively). The excess of brain cancer became statistically significant in the age group 65-75 years. Caution must be used in the interpretation of our findings. Nevertheless, it seems reasonable to hypothesize an association of the observed excess of brain cancer with the occupational and/or environmental exposure of the cohort.
1990
- Biological monitoring of occupational exposure to styrene:comparison between urinary mandelic acid concentration and styrene concentration in urine and blood.
[Articolo su rivista]
Imbriani, M; Gobba, Fabriziomaria; Ghittori, S; DI RICO, R; Piscitelli, M; Capodaglio, E; Cavalleri, A.
abstract
-
1989
- Does lead overload develop in hemodialysis patients?
[Articolo su rivista]
Martegani, M.; Gobba, F.; Frattini, G.; Donati, D.; Gastaldi, L.
abstract
1989
- Identification of occupations with greater risk of accidents and micro-accidents
[Articolo su rivista]
Cavalleri, A.; Gobba, F.
abstract
Occupational accidents represent an important problem in Occupational Medicine, not fairly investigated till now; as a consequence, data on the matter are lacking. The frequency of accidents is higher in the building, metal and wood industry. As regard to mycro-accidents, information are deeply lacking, and any comparison among different occupational groups is difficult, even if for some workers the risk is high. A very important issue concerning labour injuries is at present time represented by the risk of occupational HIV infection. From this point of view, we can distinguish three groups of workers: 1) health care workers (the group at highest risk); 2) other workers at risk of direct contact with infected blood, such as low-enforcement and correctional-facility officers; 3) workers not at risk of blood contact for occupational causes. Only in the first group some cases of seroconversion (18 until 1988) have been documented. The risk of occupational infection by HIV seems currently low, but a great effort must be devoted to accidents prevention, especially in relation to the great increase of seropositivity prevalence in the population.
1989
- L'esposizione a cloroformio (CHCl3) nell'ambiente di vita e di lavoro
[Articolo su rivista]
Gobba, Fabriziomaria; D., Ferrari; Fantuzzi, Guglielmina; Aggazzotti, Gabriella
abstract
-
1989
- Miopizzazione temporanea e sintomatologia soggettiva in operatori al videoterminale
[Articolo su rivista]
Luberto, F; Gobba, Fabriziomaria; Broglia, A.
abstract
The study covered a group of female VDT operators assigned to data entry and data acquisition. Subjective VDT-related symptoms of asthenopia were assessed by means of a questionnaire. All operators were examined by an ophthalmologist. Visual acuity was measured using vision tables with optotypes. In order to achieve an objective assessment of VDT-induced visual fatigue, refractive power was measured at the beginning and at the end of the shift, using an infra-red autorefractometer. Changes in refractive power were then related to VDT work and asthenopia symptoms. Visual acuity defects were observed in 63.5% of the operators; in 36% of the cases the subjects were either unaware of the defects or the defects were not adequately corrected. 62.5% of the operators complained of subjective asthenopia symptoms. Asthenopia was not related to the number of hours at the VDT. The results suggest that ametropic subjects are likely to be more susceptible to visual fatigue than emmetropic subjects, since there was a tendency for the prevalence of asthenopia to increase in the former group. A significant decrease in refractive power (temporary myopization) was observed in 20% of the operators at the end of the shift at the VDT: all these subjects also complained of asthenopia, compared to 50% of the workers without end-of-shift myopization. The difference between the groups was highly significant (p less than 0.01); contrarywise, none of the subjects without asthenopia developed myopization. On the basis of these results, it can be concluded that end-of-shift myopization, as measured by an automatic refractometer, may be used as a reliable objective measurement of VDT-related visual fatigue
1988
- Determination of blood procollagen III peptide as an early indicator of pulmonary fibrosis in exposure to asbestos
[Articolo su rivista]
A., Cavalleri; Gobba, Fabriziomaria; D., Ferrari; L., Bacchella; S., Candela; N., Magnani
abstract
La concentrazione sierica di peptide del procollagene tipo III (PIIIP) è stata determinata in 29 lavoratori esposti ad asbesto ed in 29 controlli. I valori medi rilevati negli esposti erano 16,86 (DS=3,9) ng/ml, quelli nei controlli 11,64 (DS=2,9) ng/ml: la differenza è altamente significativa (p < 0,0001).
La casistica è stata poi stratificata in base all’entità dell’esposizione: Gruppo 1 : esposti a basse concentrazioni di fibre (0,2 f/ml), Gruppo 2: soggetti a più alta esposizione (0,2-3,8 ff/ml). I livelli medi di PIIIP sierico nel gruppo 1 (15,23 ng/ml: DS= 2,7 ng/ml) erano significativamente più elevati dei controlli, quelli del Gruppo 2 (19,0; DS=4,39 ng/ml) significativamente più elevati sia rispetto ai controlli che al Gruppo 1 (p < 0,05). Per 12 lavoratori esposti da 5 anni o meno ad asbesto è stato inoltre possibile dimostrare una correlazione significativa (r=0,69) tra dose inalata (ff/ml x anno) e valori di PIIIP sierico.
Suddividendo inoltre il gruppo di esposti in base ai risultati delle PFR, è stato possibile dimostrare che nei lavoratori con CVF ridotta rispetto ai valori teorici di riferimento i livelli dell’indicatore erano significativamente più elevati (p < 0,005) di quelli osservati nei soggetti con CVF uguale o superiore ai valori di riferimento; un comportamento analogo è risultato anche rispetto al VEMS.
I risultati suggeriscono che il PIIIP sierico possa rappresentare un importante indicatore precoce di effetto dell’asbesto da prendere in considerazione per il monitoraggio biologico dei lavoratori.
1988
- McCollough effect in green phosphors video display terminal users
[Articolo su rivista]
Gobba, F.; Luberto, F.; Cavalleri, A.
abstract
1988
- Serum type III procollagen peptide in asbestos workers: an early indicator of pulmonary fibrosis
[Articolo su rivista]
Cavalleri, A; Gobba, Fabriziomaria; Bacchella, L; Luberto, F; Ziccardi, A.
abstract
erum type III procollagen peptide (PIIIP) concentrations were determined in 36 male workers exposed to asbestos fibres in the production of asbestos cement items and in 13 healthy male controls. Mean (SD) PIIIP serum concentrations were 9.3 (1.5) ng/ml (range 7-12) in the controls and 13.7 (3.5)ng/ml (range 7.5-20) in the asbestos workers; the difference was statistically significant (p less than 0.01). The exposed workers were subdivided according to presence or absence of radiological signs of asbestosis and intensity and duration of exposure. PIIIP serum values of workers with asbestos related interstitial fibrosis were the highest of the groups at 14.6 (2.3) ng/ml. In workers with heavy exposure the PIIIP values were significantly related to duration of exposure (r = 0.95; p less than 0.01). PIIIP serum values may be a useful index for the early diagnosis of asbestos induced pulmonary fibrosis and its use should be considered as part of the biological monitoring of exposed workers
1988
- Visual fatigue in video display terminal operators: objective measure and relation to environmental conditions
[Articolo su rivista]
Gobba, F.; Broglia, A.; Sarti, R.; Luberto, F.; Cavalleri, A.
abstract
The lighting conditions, luminance, contrast, and design of the workplace were studied in video display terminal (VDT) work stations operated by a group of female VDT data-acquisition clerks. VDT-induced symptoms were assessed by means of subject answers to a questionnaire. To measure VDT-induced ocular fatigue objectively, refraction power was determined before and at the end of workshift by an infrared autorefractometer. Job-induced refraction changes were then related to visual complaints and conditions in the workplace. The results confirmed that VDT data-acquisition work can lead to temporary myopia (myopization) in a remarkable percentage of operators; a significant correlation between eye discomfort, ocular asthenopia, and myopization was also found. Illumination levels, luminance, and contrast seem to be of paramount importance regarding visual symptoms: neither asthenopia nor myopization was observed when all of these conditions were adequate. If the ergonomic design of the workplace and the viewing distance are adequate, there are also usually fewer musculoskeletal symptoms. Our results suggest that changes in the ocular refraction status before and at the end of the workshift, as determined by an automatic refractometer, provide a good objective index of VDT-induced "ocular fatigue", which in our study proved to be significantly related to workplace conditions. © 1988 Springer-Verlag.
1987
- Cardiocirculatory findings in a group of workers exposed to nitro derivatives. A pathogenetic hypothesis of withdrawal hazard
[Articolo su rivista]
Taccola, A.; Zaliani, A.; Di Maio, D.; Gobba, F.
abstract
After briefly recalling the professional pathology characteristics of workers exposed to nitro derivatives and the perplexities surrounding the actual pathogenetic mechanism of the "Withdrawal hazard", the AA report the results of an investigation carried out among the workers of a dynamite producing plant. In the study, the NG and EGDN environmental levels were checked and the workers were submitted to ECG tracings, ECG D according to Holter, and monitoring of postural pressure changes both during exposure to the substances and during time-outs. The results obtained showed that the concentrations found in the plant were practically within the recommended TLV values, with no pathological modifications of the parameters examined. The AA put forward a pathogenetic hypothesis based on these findings and analyzing epidemiologic data on coronary sudden death as well as the mechanisms regarded as responsible for the disorders described in the literature in professionally exposed subjects. According to such hypothesis, the "Withdrawal hazard" (if any) would not be due to the cessation of the vasodilation effect of the nitro derivatives but would be a "rebound" phenomenon following the NG - and EGDN - inhalation induced stimulation to the production of endothelial prostaglandins, and of EDRF in particular, in exposed workers. The withdrawal of nitro derivatives inhalation would thus eliminate a vascular and coronary protection mechanism in the case of pathogenetic noxae at cardiovascular level. Such an interpretation would at last account for the time elapsing between cessation of work and occurrence of the disorders, which would not be justified by the cessation of the mere vasodilating action, since this wears out within a few hours.(ABSTRACT TRUNCATED AT 250 WORDS)
1987
- Occupational exposure to noise and hearing injury: estimation of the frequency of hearing loss among workers in Emilia-Romagna
[Articolo su rivista]
Cavalleri, A.; Gobba, F.; Sarti, R.; Di Rico, R.; Luberto, F.; Prestinoni, A.
abstract
1986
- The McCollough effect and visual fatigue induced by the use of green phosphorus monochromatic video terminals
[Articolo su rivista]
Gobba, Fabriziomaria; Magnani, N; Luberto, F; Cavalleri, A.
abstract
We examined 101 students (40 men, 61 women) aged 16-19 years, working 1-3 hours daily with video display terminals (VDT) with luminous green characters on dark background. McCollough visual aftereffect (ME) was reported, almost occasionally, in 80.2% of the examined group. 68% of the students referred daily ME appearance. Usually the effect appeared after 1 hour or less of VDT work and might persist for 1 hour or more. ME prevalence and persistence were significantly greater in women than in men. Apparently no relations were observed between ME prevalence and VDT work hours of visual defects. ME prevalence and persistence were significantly related to VDT induced visual asthenopia symptoms, but not with ocular asthenopia. According to our results, ME appearance may represent an early index of individual susceptibility to visual asthenopia induced by green characters VDT and/or be itself a precocious visual asthenopia symptom
1985
- Behavior of various indicators of biological effects in male and female subjects moderately exposed to inorganic lead
[Articolo su rivista]
Gobba, Fabriziomaria; G., Besutti; G., Giubbarelli
abstract
Sono stati esaminati i risultati di uno studio effettuato su una popolazione di 580 lavoratori (275 maschi e 305 femmine) esposti a livelli ambientali di piombo inorganico moderati e relativamente costanti. I valori di piombemia (PbB) erano compresi tra 16 e 40 microgrammi/100 ml nel sesso maschile e tra 12 e 40 microgrammi/100 ml in quello femminile. E’ stata rilevata una significativa risposta della ZPP già per questi ridotti valori di esposizione. Il confronto tra i sessi delle curve dose-effetto e dose-risposta tra i vari indicatori ha confermato l’esistenza di una maggiore risposta della ZPP nelle femmine. E’ stata inoltre dimostrata una significativa correlazione tra PbB ed Hb solamente in questo sesso a conferma della maggiore suscettibilità al piombo della biosintesi dell’eme. Non sono state invece dimostrate differenze nella risposta dell’ALA U. Questi dati suggeriscono che l’eme sintetasi rappresenti l’enzima inibito più precocemente ed in modo più marcato nelle donne.
La ZPP sembra pertanto rappresentare un indicatore di effetto precoce di particolare utilità nel sesso femminile, specie nel caso di esposizione a modesti livelli ambientali di piombo.
1984
- Cardiotoxicity of freons. Literature review and preventive measures
[Articolo su rivista]
Taccola, A.; Gobba, F.
abstract
1980
- Platelet changes and occupational carbon disulfide poisoning. I. Variations of platelet adhesiveness
[Articolo su rivista]
Taccola, A; Cipolli, Pl; Bossi, Mc; Gobba, Fabriziomaria; Grampella, D.
abstract
Platelet adhesiveness was studied in 83 workers exposed to CS2 and 47 controls. Results show an increase of platelet adhesiveness statistically significant in workers in comparison with controls and in workers with high exposure vs. workers with mild exposure. Authors suggest the usefulness of platelet adhesiveness evaluation for prevention and early diagnosis of CS2 intoxication