[Urinary excretion of mutagens and cisplatin among the nursing staff at a medical oncology department exposed to cytostatic drugs]

Exposure to cytostatic drugs was assessed in a group of 9 nurses employed in a hospital cancer therapy department by measuring the post-shift levels of urinary mutagens and cis-platinum. A slight but significant increase in urinary mutagenic activity compared to 11 controls was observed in the non-smokers: the mean values of mutagenic activity on the Ta100 strain in the presence of both microsomal and deconjugating enzymes were 4418 +/- 1186 and 2468 +/- 1681 respectively. Conversely, the urinary platinum concentration was below the detection limit of the analytical method (10 micrograms/l) in all samples. The increased urinary mutagenic activity in the exposed group can probably be attributed to the absorption of cyclophosphamide either during preparation and administration of the drug, or due to accidental contact with contaminated biological fluids, in view of the fact that the level of mutagens in urine samples from cyclophosphamide-treated patients is extremely high (up to 319,478 revertants/g creatinine in the case we examined).

[Kinds of home accidents]

A survey on hospitalization due to domestic accidents conducted in Padua in three public hospitals shows that between 1979 and 1988 there were 12.251 cases. Women in particular seemed to be affected by the phenomenon (7.926 cases, 64.7% of total) especially if aged 45 years or over (6.382 hospitalizations). Home injuries among females are the second cause of hospitalization due to trauma and represent the leading cause of accidental deaths (355 cases during the period of the survey). Lethality of this kind of injury progressively increases starting from the ages 30-44, and reaches 7.1% in older people (60 years or over). The causes of these accidents have been analyzed in 197 cases of fatal domestic accidents during the five years 1984 to 1988 and in 277 cases of non fatal accidents that involved subjects between the ages of 15 and 59 during the years 1986. In both situations the most frequent cause was falling (132 fatal, 159 non fatal cases); this finding shows the importance of a primary prevention programme based on the improvement of domestic structures and more care in furniture planning. The second place both among fatal and non fatal injuries belongs to burns (21 fatal and 17 non fatal). These frequently arise from incorrect behavior and emphasize in this way the necessity of improving sanitary education. A great number of home accidents (33 hospitalizations), can be attributed to bad working instruments or absence of security devices. This all shows the necessity of specific security regulations regarding installations and utensils of domestic use.

[Environment and the immune system]

A large number of xenobiotics (i. e. chemicals, drugs and biologicals) may adversely affect the immune system in consequence of different mechanisms: 1) the capacity of a large variety of xenobiotics to cause an allergic sensitization and different types of allergic sequelae (e.g. bronchial asthma, rhinitis, hypersensitivity pneumonitis, contact dermatitis); 2) the adjuvant effect, potentiating the IgE mediated immuno-response against ubiquitous allergens (e.g. pollens); 3) the direct or indirect action on the immune system, at doses that did not cause overt toxicity. This effect is studied by a new discipline, called Immunotoxicology; 4) the indirect action on the target organ, which facilitate the onset of respiratory symptoms in previously asymptomatic subjects. The widespread distributions of xenobiotics in the environment suggests that our current knowledge of their adverse health effects may represent only the tip of the iceberg and that exposure to such immunotoxic agents may play a greater role than heretofore suspected in disease causation. The exposure to immunotoxic agents in the workplace might represent and additional risk to HIV positive individuals.

Mortality of workers compensated for silicosis during the period 1959-1963 in the Veneto region of Italy

After reports appeared from other countries indicating an excess risk of lung cancer among silicotics, a cohort of workers compensated for silicosis during the period 1959-1963 in the Veneto region of Italy was constructed and followed for mortality through 1984. The results of the study showed a large mortality excess for infectious diseases (180 observed versus 9.5 expected), due to silicotuberculosis, and for diseases of the respiratory system (270 observed versus 33.5 expected) due to silicosis. An elevated standardized mortality ratio of 239 (70 observed versus 29.3 expected) from lung cancer was also detected. An increasing pattern was observed with time since first exposure, while the relationship with employment category and duration of exposure was less clear-cut. The lung cancer excess was also strongly associated with cigarette smoking, there being a dose-response relationship with daily cigarette consumption. The study confirms the results from other epidemiologic studies on silicotics which show this pathological condition to be associated with increased lung cancer mortality.

Study of immunological parameters in farmer's lung

A cross-sectional epidemiological study was carried out on 2932 farmers (response rate 92%) living in Northern Italy. A questionnaire on respiratory symptoms was supplied, chest X-ray taken and simple spirometry tests made. Thirty-nine subjects reported attacks of breathlessness associated with fever after exposure to mouldy hay; thirty-six had a clinical history of farmer's lung and X-ray and/or respiratory function changes indicative of chronic farmer's lung; 113 were classified as having bronchial asthma. These 118 subjects and a random sample of 131 non-symptomatic subjects were examined by intracutaneous skin tests and double diffusion precipitation tests with antigens associated with farmer's lung. All sera positive by precipitation were examined by immunoelectrophoresis, counterimmunoelectrophoresis, and C1q binding test, and Bovine conglutinin test in solid phase for the detection of circulating immunocomplexes. 27.8% cases of chronic farmer's lung, 4.4% of cases of bronchial asthma and 2.3% of non-symptomatic subjects showed precipitating antibodies against farmer's lung antigens. Of the precipitin-positive subjects, the majority had precipitating antibodies against Micropolyspora faeni. No differences in immunoelectrophoregrams in number and pattern of precipitation arcs for M. faeni were found between chronic farmer's lung and bronchial asthma subjects. Circulating immune complexes were present in 50% of chronic farmer's lung patients, 40% of those with bronchial asthma and 33.3% of non-symptomatic subjects. Three farmer's lung subjects (9.3%) showed immediate skin-test reactions to rural environmental allergens.

Epidemiological study of pneumoconiosis in the Italian poly(vinyl chloride) industry

Among 1216 workers employed in a poly(vinyl chloride) production factory, 20 cases of pneumoconiosis were found. None of these workers had had previous exposure to organic or inorganic dusts; 731 had been exposed to PVC dust (employed in drying, sacking and blending of polymer) and 485 had been exposed to monomer alone. Chest x-ray films were read by two independent physicians utilizing the ILO/UC Pneumoconiosis Classification, 1971. X-ray abnormalities were characterized by limited profusion, irregular type and low gravidity; in a small percentage of cases these were associated with slight restrictive respiratory function impairments. All 20 workers with PVC-induced pneumoconiosis had been exposed to high PVC dust pollution for at least five years. Mild nonspecific alterations (profusion of 0/1 class) were found both in the group exposed to PVC dust and in the group exposed to VCM alone. Such changes (observed in 388 cases, 31.9% of the whole population), are related mainly to age and smoking habits, and the role of exposure is minor.

Descriptive Epidemiology of Hodgkin's Disease in the Province of Padova, 1970-1974

The age-standardized incidence rates of Hodgkin's disease in the province of Padova during the period 1970-1974 were 4.33/105 per year for males and 3.70/105 per year for females. These rates are higher (particularly for females) than in other European countries and close to those reported for North America. A bimodal distribution by age is present in the province as a whole. These findings, with the limitations due to the small population and diagnostic difficulties taken into account, are discussed with a view to further investigation.

Descriptive Epidemiology of Non-Hodgkin's Lymphoma in the Province of Padova, 1970-1974

The age-standardized incidence rates of non-Hodgkin's lymphoma in the province of Padova during the period 1970-1974 were 3.19/105/year for males and 1.60/105/year for females. These rates are similar to those found in other industrialized countries and slightly higher than in the province of Torino. An increasing trend with age is described, beginning in the age group 35-44, while low rates were found in younger ages in both sexes. No relevant' pattern was shown in the geographical distribution of cases, and no observed/expected ratio was significant in any of the administrative districts considered. The influence of environmental factors and the limitations due to uncertain diagnostic criteria and the small size of the population considered are discussed.

Polyvinyl chloride pneumoconiosis: epidemiological study of exposed workers

Among 1216 workers who were employed in a polyvinyl chloride production factory and who had had no previous dust exposure elsewhere, 20 cases of pneumoconiosis were found. Chest x-ray abnormalities were characterized by limited profusion, irregular type and low gravity. All 20 workers had been exposed to high PVC dust levels. The chest x-ray changes were observed after a minimum exposure of five years and, in a small percentage of cases, were associated with slight restrictive respiratory function impairments. Moreover, in the whole group of workers 388 cases (31.9%) were found with non-specific x-ray abnormalities mainly related to age and smoking.

[Clinical and statistical study on the allergy of type 1 to mycetes (author's transl)]

From 1963 to 1977 the authors have examined 5700 patients; 11.5% of those positive to intradermal test were sensitive to Mold spores. 78 individuals showed allergic sensitivity exclusively to Mold spores; 89% were affected by bronchial asthma. Symptom onset was observed more frequently in subjects 30 to 50 years old. The authors intend to stress the important role played by the allergy to Mold spores in determining type 1 immunologic reactions.

[Chronic broncopneumopathy and pneumoconiosis in workers employed in phosphoric acid production (author's transl)]

Thirty-five subjects employed in a phosphoric acid producing plant were studied by the authors. The investigation included: history, according to the C.E.C.A. questionnaire for chronic bronchitis and emphysema; physical examination, chest X-ray spirometry and lung diffusing capacity for carbon monoxide by the steady state method (DLCOSS). High prevalence of chronic bronchitis (45.7%), obstructive spirometric impairment (37.1%), and decreased values of DlcoSS (31.4%) were detected. Two subjects were found to be affected with p 1/0 and 7 with p 0/1 pneumoconiosis. Such findings were significantly related to the lenght of working activity as well as to dust and gaseous fluoride (hydrofluoric acid, hexafluorosilicic acid and silicon tetrafluoride) exposure.

[Epidemiologic evaluation of isocyanate immediate irritative action: 'one day effect' control (author's transl)]

Nineteen MDI exposed workers showed ventilatory changes, after eight hour exposure, mainly involving upper respiratory airways; the changes reversed following a bronchodilator aerosol. An incomplete recovery of VC was found in some subjects; therefore, the possibility of changes in the lung elastic recoil forces was hypothesized. No statistically significant differences were found as to occupation and smoking habit, which suggests that even low MDI concentrations could be enough to give rise to acute effects. The greater impairment found in subjects who were already affected by morning time emphasizes the necessity that such subjects were not employed in their specific work.