[Gender-sensitive risk assessment and health medical surveillance: some operative tools.]

OBJECTIVES

A thorough and fully application of the principles of gender mainstreaming, in accordance with the European Community guidelines, to the health and safety at work, implies the systematic review of the whole prevention from the gendered point of view. This means that both biology- and gender-based differences between male and female workers should be conceived not only as determinants of health but also as factors affecting either positively or negatively the health and safety risk prevention. In this evolutionary cultural step the role of the occupational physician is particularly important.

METHODS

In this paper we propose some operative tools that can concretely implement gender perspective in all the various areas of prevention, where the occupational physician has a leading, if not even exclusive, role such as risk assessment, training and health medical surveillance.

[160 activities analyzed by the risk of biomechanical overload on the upper limbs in small industry, handicrafts, services and agriculture]

We analyzed 160 work activities in the sectors of small industries, handicrafts, services and agriculture to evaluate the risk of biomnechanical overload of the upper limbs with the OCRA Checklist. The aim was to provide a tool available for the risk assessment in activities generally underestimnated for this risk and typical of the Italian production. The information was provided in the form of cards containing easily accessible data, risk scenarios in different timing, along with some of the key prevention interventions that can be realized.

[Biomechanical overcharge of the upper limbs in hairdressers: from the task analysis to the job/exposition matrix]

The analysis of professional diseases denounced from hairdressers in Italy and in Tuscany shows among these workers a reduction of some "typical" work related diseases, like dermatitis, asthma, etc. and a raise of upper limbs disorders. The upper limbs risk assessment process is very tough for the hairdresser's activity, because the working cycle includes different tasks (shampoo, cut, dyeing, etc.) and their combination in a working day is related to customers requests. The job illustrates the first results of a project started last year from the Tuscany Technical Advisory Department for Risk Assessment and. Prevention (CONTARP) of the Italian Workers' Compensation Authority (INAIL) and PISLL "G. Pieraccini" - ASL 10 of Florence. Through a study conducted with the OCRA Check List method on a sample constituted by 12 employees of five shops of the Florentine territory, we have arrived to a job-exposure matrix that allows to draw an index of exposure to the specific risk for every task, keeping in mind the contributions of the single repetitive assignment performed by the operator during the working day.

N(6) or N(9) substituted 2-phenyl-8-azaadenines: affinity for A1 adenosine receptors. VII

The A1 activities shown respectively by N(6) or N(9) substituted 8-azaadenines were compared. At least in some cases, the biological results indicated the ability of the receptor to accept the exogenous molecule in various arrangements, and an attempt to rationalizing these arrangements was made by means of a model with two different molecular orientations.

Expression of aphidicolin-induced fragile sites in lymphocytes of patients with breast cancer

The expression of fragile sites induced by aphidicolin (APC) was evaluated on metaphase chromosomes obtained from the peripheral blood lymphocytes of 26 women with breast cancer and 15 sex- and age-matched normal controls. Both the proportion of damaged cells (P < 0.001) and the mean number of gaps and breaks per cell (0.02 < P < 0.05) were significantly higher in the patient group. There were no differences in either the age-related fragile site levels or the expression of single fragile sites between patients and controls. Our findings indicate an increased genetic instability in women with breast carcinoma.

Serum lipids and lipoproteins in type 2 diabetic patients with persistent microalbuminuria

To investigate whether persistent microalbuminuria is related to altered levels of both lipids and apolipoproteins in Type 2 diabetes mellitus serum total-cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, apolipoprotein A-I, and apolipoprotein B were measured by standard methods in a group of Type 2 diabetic patients affected by persistent microalbuminuria (albumin excretion rate (AER) 20-200 micrograms min-1) as compared with a group of sex- and age-matched non-microalbuminuric patients (AER less than 20 micrograms min-1). The groups were stratified according to a short (less than or equal to 5 years) or a longer (greater than 5 years) duration of diagnosed diabetes. Microalbuminuria was not associated with significant changes of serum total-cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, and apolipoproteins in the group of patients with a duration of disease greater than 5 years, while microalbuminuric patients less than or equal to 5 years from diagnosis (n = 11) had serum total-cholesterol, triglycerides, LDL-cholesterol, and apoprotein B higher than non-microalbuminuric control patients (n = 26) (cholesterol 6.2 +/- 0.9 vs 5.1 +/- 1.0 mmol l-1 (p = 0.003); triglycerides 2.1 +/- 0.7 vs 1.7 +/- 1.3 mmol l-1 (p = 0.03); LDL-cholesterol 4.1 +/- 0.8 vs 3.0 +/- 0.7 mmol l-1 (p less than 0.001); apo-B 1.3 +/- 0.3 vs 1.1 +/- 0.3 g l-1 (p = 0.02). In these patients with shorter duration of diabetes many of the serum lipid measures correlated positively with AER.

Ticlopidine activity on platelet function in patients with enhanced platelet aggregation. A short-term crossover study

In a single-blind crossover study, the effect of ticlopidine (250 mg t.i.d.) on platelet function was investigated in 16 patients, with enhanced platelet aggregation, before treatment, on the third and seventh day of treatment with the drug or the placebo. Bleeding time was significantly lengthened by ticlopidine administration. Platelet aggregation, both in vivo and in vitro, was significantly inhibited during the week on ticlopidine. Beta-thromboglobulin concentration was on an average significantly decreased. The inhibition by PGI2 of platelet aggregation by PGD2 was slightly but not significantly increased. Platelet TxB2 production after stimulation with thrombin was unchanged during ticlopidine administration, whereas conversion of exogenous arachidonic acid into TxB2 was slightly but significantly reduced. The present results confirm that ticlopidine acts in vivo as a powerful antiaggregating agent. The antiaggregating activity seems to be due to an interference of ticlopidine with platelet membrane and, as a consequence, with various platelet membrane receptors and activities.

Effect of tissue degeneration on drug transfer across in vitro rat intestine

A modified rat intestinal sac technique involving a closed circulation of the mucosal drug solution through the lumen was developed with the aim of clarifying the influence of tissue degeneration on drug transfer in the current in vitro methods for studying intestinal absorption. Data on salicylate transfer in agreement with the literature reports on the everted rat intestinal sac technique were obtained with the physiological Tyrode or Krebs-Henseleit buffers. In neither case was the transfer rate influenced by a progressive disruption of the mucosa which resulted upon histological examination of the perfused sacs. The rate-controlling barrier to drug transport, probably located in the inner tissues, maintained a constant permeability to salicylate in the said physiological solutions over a period of 80 min. On the other hand, the gut permeability underwent a nonreversible alteration by each of two phosphate buffers employed in the past for studies with the everted rat intestine. The liability of such an alteration to occur at nonphysiological pH was found to be a major obstacle to the study of the effects of pH on drug transport. A case where the reversibility of these effects could be verified allowed us to state that unionized salicylic acid was transported at a 8.6-fold faster rate than salicylate. Apart from the inherent limitations of the in vitro preparation, the technique presented here provides the following advantages over the classical everted intestinal sac technique: 1) eversion of intestine is avoided; 2) constancy of the mucosal drug concentration is guaranteed throughout the experiment; 3) volume variations of the serosal solution due to water absorption by the intestinal tissues and/or to osmotic phenomena are negligible.