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Visonà SD, Bertoglio B, Capella S, Belluso E, Austoni B, Colosio C, Kurzhunbaeva Z, Ivic-Pavlicic T, Taioli E. Asbestos burden in lungs of mesothelioma patients with pleural plaques, lung fibrosis and/or ferruginous bodies at histology: a postmortem SEM-EDS study. Carcinogenesis 2024; 45:131-139. [PMID: 38069464 DOI: 10.1093/carcin/bgad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/02/2023] [Accepted: 12/04/2023] [Indexed: 03/12/2024] Open
Abstract
The causal attribution of asbestos-related diseases to past asbestos exposures is of crucial importance in clinical and legal contexts. Often this evaluation is made based on the history of exposure, but this method presents important limitations. To assess past asbestos exposure, pleural plaques (PP), lung fibrosis and histological evidence of ferruginous bodies (FB) can be used in combination with anamnestic data. However, such markers have never been associated with a threshold value of inhaled asbestos. With this study we attempted to shed light on the dose-response relationship of PP, lung fibrosis and FBs, investigating if their prevalence in exposed individuals who died from malignant mesothelioma (MM) is related to the concentration of asbestos in lungs assessed using scanning electron microscopy equipped with energy dispersive spectroscopy. Moreover, we estimated the values of asbestos concentration in lungs associated with PP, lung fibrosis and FB. Lung fibrosis showed a significant positive relationship with asbestos lung content, whereas PP and FB did not. We identified, for the first time, critical lung concentrations of asbestos related to the presence of PP, lung fibrosis and FB at histology (respectively, 19 800, 26 400 and 27 400 fibers per gram of dry weight), that were all well-below the background levels of asbestos identified in our laboratory. Such data suggest that PP, lung fibrosis and FB at histology should be used with caution in the causal attribution of MM to past asbestos exposures, while evaluation of amphibole lung content using analytical electron microscopy should be preferred.
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Affiliation(s)
- S D Visonà
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - B Bertoglio
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - S Capella
- Department of Earth Sciences, University of Torino, Torino, Italy
- Interdepartmental Center for Studies on Asbestos and other Toxic Particulates 'G. Scansetti', University of Torino, Torino, Italy
| | - E Belluso
- Department of Earth Sciences, University of Torino, Torino, Italy
- Interdepartmental Center for Studies on Asbestos and other Toxic Particulates 'G. Scansetti', University of Torino, Torino, Italy
| | - B Austoni
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - C Colosio
- Department of Health Sciences, University of Milan, Milan, Italy
- Occupational Health Unit, Santi Paolo e Carlo Hospital, Milan, Italy
| | - Z Kurzhunbaeva
- Department of Health Sciences; Course of Research Doctorate in Public Health Sciences, University of Milan, Milan, Italy
| | - T Ivic-Pavlicic
- Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - E Taioli
- Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Visonà SD, Capella S, Borrelli P, Villani S, Favaron C, Kurzhunbaeva Z, Colosio C, Belluso E. Asbestos burden in lungs of non-occupationally exposed women from Broni (Pavia, Italy): a postmortem SEM-EDS study. J Thorac Dis 2023; 15:6555-6569. [PMID: 38249898 PMCID: PMC10797346 DOI: 10.21037/jtd-23-1061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/11/2023] [Indexed: 01/23/2024]
Abstract
Background In Italy the incidence of malignant mesothelioma (MM) among women is remarkably high, due to the several contexts in which women had been exposed to asbestos. However, very few studies in literature focus on the inorganic lung content in women. The aim of this retrospective, observational study is to investigate the asbestos lung burden, in terms of concentration, dimensions and type of asbestos, in 42 women who died from MM and had been non-occupationally exposed to asbestos during the activity of the asbestos-cement plant located in Broni (Pavia, Northern Italy) where mainly chrysotile, crocidolite and amosite were used. Methods Lung samples taken during forensic autopsies have been digested using sodium hypochlorite and filtered through a cellulose-ester membrane. The filter was examined using a scanning electron microscope and the chemical composition of the fibers was analyzed using an electron dispersive spectroscopy. The number of detected inorganic fibers, asbestos fibers and asbestos bodies (ABs) were normalized to 1 gram of dry tissue. Results In six samples no asbestos has been detected. Overall, the most represented kind of asbestos was amosite, followed by crocidolite, tremolite/actinolite asbestos and chrysotile. The concentration of all inorganic fibers was significantly higher in women with environmental and household exposures compared with those with only environmental exposure (P=0.025), as well as the concentration of asbestos fibers (P=0.019) and ABs (P=0.049). We found a significant correlation between the concentration of asbestos fibers and the duration of exposure (rho =0.413, P=0.008), as well as with the latency of MM (rho =0.427, P=0.005). The distance of the residential address from the factory and the time spent daily in contact with asbestos did not influence the lung asbestos burden. Conclusions These results suggest the relevance of the lung clearance of asbestos, regarding mainly chrysotile. As a consequence, although scanning electron microscopy -energy dispersive X-ray spectroscopy (SEM-EDS) is considered the most reliable tool for assessing previous exposure to asbestos, its results should be interpreted with caution, especially in a legal context. In addition, our data confirm the relevance of environmental and household exposure in determining asbestos concentration in lungs and highlight the importance of household exposure.
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Affiliation(s)
- Silvia Damiana Visonà
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - Silvana Capella
- Department of Earth Sciences, University of Torino, Torino, Italy
- Interdepartmental Center for Studies on Asbestos and other Toxic Particulates “G. Scansetti”, University of Torino, Torino, Italy
| | - Paola Borrelli
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
| | - Simona Villani
- Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, Pavia University, Pavia, Italy
| | - Cristina Favaron
- Department of Biology and Biotechnology “L. Spallanzani”, University of Pavia, Pavia, Italy
| | - Zhyldyz Kurzhunbaeva
- Department of Health Sciences, Course of Research Doctorate in Public Health Sciences, University of Milan, Milan, Italy
| | - Claudio Colosio
- Department of Health Sciences, University of Milan, Milan, Italy
- Occupational Health Unit, Santi Paolo e Carlo Hospital, Milan, Italy
| | - Elena Belluso
- Department of Earth Sciences, University of Torino, Torino, Italy
- Interdepartmental Center for Studies on Asbestos and other Toxic Particulates “G. Scansetti”, University of Torino, Torino, Italy
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Visonà SD, Bertoglio B, Favaron C, Capella S, Belluso E, Colosio C, Villani S, Ivic-Pavlicic T, Taioli E. A postmortem case control study of asbestos burden in lungs of malignant mesothelioma cases. J Transl Med 2023; 21:875. [PMID: 38041166 PMCID: PMC10693031 DOI: 10.1186/s12967-023-04761-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/24/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Asbestos lung content is regarded as the most reliable tool for causal attribution of malignant mesothelioma (MM) to previous asbestos exposures. However, there is a lack of studies on asbestos burden in lungs of MM patients in comparison with healthy individuals. This study aims to provide such a comparison, investigating, as well, differences in asbestos lung burden with sex and time trends. METHODS Asbestos lung content has been assessed on formalin-fixed lung fragments using scanning electron microscopy coupled with energy dispersion spectroscopy (SEM-EDS) on individuals deceased from MM (cases) and healthy subjects without any lung disease who died from violent causes (controls) between 2005 and 2023. RESULTS Asbestos and asbestos bodies (ABs) were found, respectively, in 73.7% and 43.2% of cases and in 28 and 22% of controls; in MM cases the most represented asbestos types were crocidolite and amosite, whereas in controls it was tremolite-actinolite asbestos. The concentration of both asbestos fibers and ABs was statistically significantly higher in MM cases compared to controls. The mean asbestos fibers width was also significantly higher in cases than controls. Males and females with MM showed similar asbestos and ABs concentrations, but females had higher concentrations of chrysotile, and significantly lower fibers width compared to males. Time trends show that MM lung asbestos concentrations decreased starting in 2011. DISCUSSION The results suggest a correlation between asbestos burden in lungs and MM risk. The different concentration of chrysotile, as well as the different width of asbestos fibers in MM males and females might reflect a sex difference in response of the lung microenvironment to inhaled asbestos. Finally, this study provides the first pathological evidence of the effect of the ban of asbestos use, demonstrating a significant decrease of asbestos lung content after 2011.
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Affiliation(s)
- S D Visonà
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences, University of Pavia, Pavia, Italy.
| | - B Bertoglio
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - C Favaron
- Department of Biology and Biotechnology "L. Spallanzani", University of Pavia, Pavia, Italy
| | - S Capella
- Department of Earth Sciences, University of Torino, Turin, Italy
- Interdepartmental Center for Studies on Asbestos and other Toxic Particulates "G. Scansetti", University of Torino, Turin, Italy
| | - E Belluso
- Department of Earth Sciences, University of Torino, Turin, Italy
- Interdepartmental Center for Studies on Asbestos and other Toxic Particulates "G. Scansetti", University of Torino, Turin, Italy
| | - C Colosio
- Department of Health Sciences, University of Milan, Milan, Italy
- Occupational Health Unit, Santi Paolo e Carlo Hospital, Milan, Italy
| | - S Villani
- Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, Pavia University, Pavia, Italy
| | - T Ivic-Pavlicic
- Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - E Taioli
- Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Larese Filon F, Spadola O, Colosio C, Van Der Molen H. Trends in Occupational Diseases in Italian Industry and Services From 2006 To 2019. Med Lav 2023; 114:e2023035. [PMID: 37534423 PMCID: PMC10415848 DOI: 10.23749/mdl.v114i4.14637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/06/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND There is a paucity of data on occupational disease incidence in Italy, and we analyzed the trend on time as an incidence rate ratio (IRR). METHODS Occupational diseases reported to the Italian National Insurance for Occupational Diseases (INAIL) in industrial and services sectors from 2006 to 2019 were considered and analyzed. Annual case counts were analyzed using a Poisson regression model to estimate incidence trends. RESULTS The incidence of occupational diseases in the industrial and services sectors in 2019 was 261 cases for 100,000 workers, with musculoskeletal disorders (MSDs) representing 65% of the total cases, their incidence being 169.5 cases per 100,000 workers. The incidence of ear diseases (ED) decreased to 20.8 cases for 100,000 workers. The annual change in incidence (IRR) was 1.08 (CI 95% 1.07-1.11) for MSDs, 1.08 (CI 95% 1.06-1.10) for cancers, and 1.04 (CI 95% 1.03-1.06) for respiratory diseases. The trend was significantly negative for ear diseases, 0.96 (CI 95% 0.96-0.97), and skin diseases 0.93 (CI 95% 0.92-0.93). No changes were found for asbestos and mental diseases. CONCLUSIONS During the study period, occupational diseases increased in Italy, mainly for MSDs, due to a changeover in eligibility criteria from 2008. However, the overall incidence was lower than in other EU Countries. More efforts are needed to harmonize the legislation for joint action in the prevention and recognition of occupational diseases.
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Antonangeli LM, Kenzhebekova S, Colosio C. Neurobehavioral Effects of Low-Dose Chronic Exposure to Insecticides: A Review. Toxics 2023; 11:192. [PMID: 36851066 PMCID: PMC9963921 DOI: 10.3390/toxics11020192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
The modes of action of insecticides frequently involve a neurotoxic effect; therefore, the study of neurotoxic effects caused by long-term and low-dose insecticide exposure is of particular interest. This study looks at whether or not new studies conducted after 2009 and up to 2021 have provided new evidence for a better understanding of the actual neurobehavioral risk associated with long-term insecticide exposure. We selected and reviewed studies carried out on the neurobehavioral effects of neurotoxic insecticides (organophosphates and/or carbamates, pyrethroids, multiple or undefined insecticides, and organochlorines) considering occupational and non-occupational exposures. The articles were also scored and ranked based on seven parameters. Eighty-six studies were chosen for a final review process from among the 950 scientific papers identified. Twenty-six addressed occupational exposure and six environmental exposure. Among the latter group of studies, 17 focused on rural residents, to be assumed exposed because of living in rural areas, and 43 on the general population. Pending doubts have not been resolved in the last ten years due to the presence of contradictory and hardly comparable results and the fact that in most of the studies showing an evident neurobehavioral impairment the frequent presence of a previous episode of poisoning and hospitalization, with severe brain hypoxia, impaired the possibility of confirming the presence of a causal association with insecticide exposure. Interestingly, the most severely exposed groups, such as applicators who did not wear personal protective equipment, performed worse on neurobehavioral tests. As for residential exposure, there is sufficient evidence to suggest that prenatal OP exposure may increase the risk of ADHD in children.
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Affiliation(s)
| | - Saniya Kenzhebekova
- Department of Health Sciences, University of Milan, International Centre for Rural Health of the Santi Paolo e Carlo ASST of Milan, 20142 Milano, Italy
| | - Claudio Colosio
- Department of Health Sciences, University of Milan, International Centre for Rural Health of the Santi Paolo e Carlo ASST of Milan, 20142 Milano, Italy
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Visonà SD, Crespi E, Belluso E, Capella S, De Matteis S, Filippi F, Lai M, Loscerbo R, Meloni F, Pilia I, Cocco P, Colosio C. Reconstructing historical exposure to asbestos: the validation of 'educated guesses'. Occup Med (Lond) 2022; 72:534-540. [PMID: 35943161 DOI: 10.1093/occmed/kqac084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In both the epidemiological and legal context, the causal attribution of asbestos-related lung diseases requires retrospective exposure assessment (REA). AIMS To assess the correlation between the retrospective assessment of occupational and anthropogenic environmental exposure to asbestos and its content in the lung tissue. METHODS Based on the available exposure information, a team of occupational physicians retrospectively assessed cumulative exposure to asbestos in 24 subjects who died of asbestos-related diseases. The asbestos lung content was analysed using analytical scanning electron microscope (SEM-EDS). The Log10 asbestos fibre count in the autoptic samples was predicted as a function of the Log10 estimated cumulative exposure using univariate regression analysis. RESULTS The median count of asbestos fibres by grams of dry weight (ff/gdw) in the lung tissue was 81 339 (range 0-2 135 849.06); it was 287 144 (range 0-2 135 849.06) among the occupationally exposed, and 29 671 (range 0-116 891) among the subjects who only had anthropogenic environmental and/or household exposure. Amphiboles, and particularly amosite (52%) and crocidolite (43%), were detected in all the study subjects. Chrysotile was not detected in any of the samples. Overall, the retrospective estimate of lifetime cumulative exposure to asbestos showed a moderate correlation with the total asbestos fibre count in the autoptic lung, with the regression model explaining 38-55% of the total variance. CONCLUSIONS Detailed information on occupational, environmental and household exposure circumstances would be indispensable for experienced industrial hygienists and/or occupational physicians to reliably assess past exposure to amphiboles or mixed types of asbestos.
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Affiliation(s)
- S D Visonà
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences, University of Pavia, Pavia 27100, Italy
| | - E Crespi
- Occupational Health Unit, Santi Paolo e Carlo Hospital, Milan 20142, Italy
| | - E Belluso
- Department of Earth Sciences, University of Torino and Interdepartmental Center for Studies on Asbestos and other Toxic Particulates "G. Scansetti", University of Torino, Torino 10125, Italy
| | - S Capella
- Department of Earth Sciences, University of Torino and Interdepartmental Center for Studies on Asbestos and other Toxic Particulates "G. Scansetti", University of Torino, Torino 10125, Italy
| | - S De Matteis
- Department of Medical Sciences and Public Health, Occupational Health Unit, University of Cagliari, Cagliari 09124, Italy
| | - F Filippi
- Department of Medical Sciences and Public Health, Occupational Health Unit, University of Cagliari, Cagliari 09124, Italy
| | - M Lai
- Department of Medical Sciences and Public Health, Occupational Health Unit, University of Cagliari, Cagliari 09124, Italy
| | - R Loscerbo
- Department of Medical Sciences and Public Health, Occupational Health Unit, University of Cagliari, Cagliari 09124, Italy
| | - F Meloni
- Department of Medical Sciences and Public Health, Occupational Health Unit, University of Cagliari, Cagliari 09124, Italy
| | - I Pilia
- Department of Medical Sciences and Public Health, Occupational Health Unit, University of Cagliari, Cagliari 09124, Italy
| | - P Cocco
- Centre for Occupational and Environmental Health, Division of Population Health, Healthcare Research & Primary Care, University of Manchester, Manchester, UK
| | - C Colosio
- Department of Health Sciences, University of Milan, Milan M13 9PL, Italy
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Proserpio P, Zambrelli E, Lanza A, Dominese A, Di Giacomo R, Quintas R, Tramacere I, Rubino A, Turner K, Colosio C, Cattaneo F, Canevini M, D'Agostino A, Agostoni E, Didato G. Sleep disorders and mental health in hospital workers during the COVID-19 pandemic: a cross-sectional multicenter study in Northern Italy. Sleep Med 2022. [PMCID: PMC9300242 DOI: 10.1016/j.sleep.2022.05.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Masci F, Spatari G, Giorgianni CM, Antonangeli LM, D’Arrigo A, Biasina AM, Priori A, Colosio C. Occupational hand and wrist disorders among forestry workers: An exposed-control study to investigate preventive strategies. Work 2022; 72:1249-1257. [DOI: 10.3233/wor-205034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: In the arboriculture sector, some activities are still manually performed by forestry workers, which result consequently exposed to a high risk of developing muscle skeletal disorders. The Italian Compensation Authority reported an increase of work-related tendinopathies and carpal tunnel syndrome in loggers, but screening protocols are not available yet. OBJECTIVES: The objectives were: a) to evaluate the prevalence of tendinopathies and carpal tunnel syndrome in a sample of loggers and b) identify a sound screening approach. METHODS: 41 loggers and 41 paired control workers were recruited for a total of 164 hands. The protocol included 1) demographic data; 2) medical history; 3) identification of CTS symptoms through a questionnaire and a hand-chart; 4) upper limbs clinical examination; 5) Raynaud’s diseases questionnaire; 6) wrists ultrasound; 7) NCS of the distal median nerve. RESULTS: The prevalence of tendinopathies was statistically significant only in the non-dominant hand (75, 5% in the exposed group and 53, 6% in the non-exposed group). The prevalence of CTS was 32, 2% in the exposed group and 15, 5% in the non-exposed group. The questionnaire had a sensitivity of 56, 7% and a specificity of 75%. The hand-chart had a sensitivity of 30% and a specificity of 92%. The clinical examination had sensitivity of 30% and specificity of 80%. The ultrasound had a sensitivity of 70% and a specificity of 56%. CONCLUSIONS: Loggers are a population at risk of occupational hand and wrist disorders. The hand-chart could be considered, together with the questionnaire, as the best secondary prevention tool to diagnose CTS.
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Affiliation(s)
- Federica Masci
- Department of Health Sciences, University of Milano, Milan, Italy, International Centre for Rural Health, Occupational Health Unit, Hospitals Santi Paolo e Carlo, Milan, Italy
| | - Giovanna Spatari
- Department of Biomedical, Dental and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Concetto Mario Giorgianni
- Department of Biomedical, Dental and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Laura Maria Antonangeli
- Department of Health Sciences, University of Milano, Milan, Italy, International Centre for Rural Health, Occupational Health Unit, Hospitals Santi Paolo e Carlo, Milan, Italy
| | | | | | - Alberto Priori
- “Aldo Ravelli” Research Center, Department of Health Sciences, University of Milan, Milan, Italy
| | - Claudio Colosio
- Department of Health Sciences, University of Milano, Milan, Italy, International Centre for Rural Health, Occupational Health Unit, Hospitals Santi Paolo e Carlo, Milan, Italy
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Masci F, Spatari G, Bortolotti S, Giorgianni CM, Antonangeli LM, Rosecrance J, Colosio C. Assessing the Impact of Work Activities on the Physiological Load in a Sample of Loggers in Sicily (Italy). IJERPH 2022; 19:ijerph19137695. [PMID: 35805360 PMCID: PMC9265621 DOI: 10.3390/ijerph19137695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/15/2022] [Accepted: 06/18/2022] [Indexed: 11/16/2022]
Abstract
Occupational logging activities expose workers to a wide range of risk factors, such as lifting heavy loads, prolonged, awkward positioning of the lower back, repetitive movements, and insufficient work pauses. Body posture has an important impact on the level of physiological load. The present study involved a group of 40 loggers in the province of Enna (Sicily, Italy) with the aim of defining the impact of logging activities on the workers’ physiological strain during the three primary work tasks of felling, delimbing, and bucking. The Zephyr Bioharness measurement system was used to record trunk posture and heart rate data during work tasks. The NASA TLX questionnaire was used to explore workers’ effort perception of the work tasks. Based on our results, the most demanding work task was tree felling, which requires a higher level of cardiac cost and longer periods spent in awkward trunk postures. The perceived physiological workload was consistently underestimated, especially by the more experienced loggers. Lastly, as the weight of the chainsaw increased, the cardiac load increased.
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Affiliation(s)
- Federica Masci
- Department of Health Sciences, International Centre for Rural Health of the Santi Paolo e Carlo ASST of Milan, University of Milan, 20142 Milano, Italy;
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA;
- Correspondence:
| | - Giovanna Spatari
- Department of Biomedical, Dental and Morphological and Functional Imaging, University of Messina, 98122 Messina, Italy; (G.S.); (C.M.G.)
| | | | - Concetto Mario Giorgianni
- Department of Biomedical, Dental and Morphological and Functional Imaging, University of Messina, 98122 Messina, Italy; (G.S.); (C.M.G.)
| | | | - John Rosecrance
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA;
| | - Claudio Colosio
- Department of Health Sciences, International Centre for Rural Health of the Santi Paolo e Carlo ASST of Milan, University of Milan, 20142 Milano, Italy;
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Proserpio P, Zambrelli E, Lanza A, Dominese A, Di Giacomo R, Quintas R, Tramacere I, Rubino A, Turner K, Colosio C, Cattaneo F, Canevini MP, D'Agostino A, Agostoni EC, Didato G. Sleep disorders and mental health in hospital workers during the COVID-19 pandemic: a cross-sectional multicenter study in Northern Italy. Neurol Sci 2022; 43:2241-2251. [PMID: 35022932 PMCID: PMC8754520 DOI: 10.1007/s10072-021-05813-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION From the beginning of the COVID-19 pandemic, healthcare workers had to face unprecedented emergency needs associated with an extraordinary amount of psychological distress. In this cross-sectional multicenter study, we investigated sleep disturbances, and the level of anxiety and depression among the healthcare and non-healthcare staff of three hospitals in Milan (Italy) during the COVID-19 outbreak. Moreover, we explored potential predisposing factors for affective symptoms and poor sleep. METHODS Between June and July 2020, we administered an online questionnaire to evaluate the presence of sleep disorders (Pittsburgh Sleep Quality Index), insomnia (Sleep Condition Indicator), anxiety (State Trait Anxiety Inventory), and depression (Beck Depression Inventory-II). We used univariate and multivariate analysis to evaluate the association between the personal conditions and sleep and affective disorders. RESULTS The 964 participants reported high rates of sleep disorders (80.3%)-mainly insomnia (30.5%)-anxiety (69.7%), and depression (32.8%). The multivariate analysis showed a strong association of sleep disorders, especially insomnia, with female gender (p = 0.004), divorced marital status (p = 0.015), self-isolation (p = 0.037), and chronic diseases (p = 0.003). Anxiety was significantly associated with teleworking (p = 0.001), while depressive symptoms were associated with self-isolation (p = 0.028), modified work schedules (p = 0.03), and chronic diseases (p = 0.027). CONCLUSION In hospital workers, the high prevalence of sleep and psychiatric symptoms during the COVID-19 outbreak appears to be determined mainly by modifications of personal or work habits. Teleworking was associated with increased anxiety. An accurate planning of hospital activities and a psychological support are needed to prevent and manage sleep and mental disorders.
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Affiliation(s)
- Paola Proserpio
- Department of Neuroscience, Sleep Medicine Centre, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 20162, Milan, Italy
| | - Elena Zambrelli
- Epilepsy Centre, Sleep Medicine Centre, Childhood and Adolescence Neuropsychiatry Unit, ASST Santi Paolo E Carlo, San Paolo Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Andrea Lanza
- Department of Neuroscience, Sleep Medicine Centre, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 20162, Milan, Italy
| | - Ambra Dominese
- Epilepsy Unit, Sleep Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Roberta Di Giacomo
- Epilepsy Unit, Sleep Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Rui Quintas
- Epilepsy Unit, Sleep Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Irene Tramacere
- Department of Research and Clinical Development, Scientific Directorate, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Annalisa Rubino
- Department of Neuroscience, Sleep Medicine Centre, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 20162, Milan, Italy
| | - Katherine Turner
- Epilepsy Centre, Sleep Medicine Centre, Childhood and Adolescence Neuropsychiatry Unit, ASST Santi Paolo E Carlo, San Paolo Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Claudio Colosio
- Occupational Health Unit, ASST Santi Paolo E Carlo, San Paolo Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Federica Cattaneo
- Department of Neuroscience, Sleep Medicine Centre, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 20162, Milan, Italy
| | - Maria Paola Canevini
- Epilepsy Centre, Sleep Medicine Centre, Childhood and Adolescence Neuropsychiatry Unit, ASST Santi Paolo E Carlo, San Paolo Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy.,Department of Health Sciences, Università Degli Studi, Milan, Italy
| | - Armando D'Agostino
- Department of Health Sciences, Università Degli Studi, Milan, Italy.,Department of Mental Health and Addiction, ASST Santi Paolo E Carlo, Milan, Italy
| | - Elio Clemente Agostoni
- Department of Neuroscience, Sleep Medicine Centre, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 20162, Milan, Italy
| | - Giuseppe Didato
- Epilepsy Unit, Sleep Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
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11
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Maddalon A, Iulini M, Galbiati V, Colosio C, Mandić-Rajčević S, Corsini E. Direct Effects of Glyphosate on In Vitro T Helper Cell Differentiation and Cytokine Production. Front Immunol 2022; 13:854837. [PMID: 35359959 PMCID: PMC8960435 DOI: 10.3389/fimmu.2022.854837] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/11/2022] [Indexed: 12/15/2022] Open
Abstract
Glyphosate (G) is the active ingredient of the most used herbicides worldwide. Its use is currently very debated, as several studies indicating its hazard and toxicity are emerging. Among them, there is evidence of adverse effects on the immune system. The aim of this work was to investigate if G could directly affect immune cells. Peripheral blood mononuclear cells (PBMC) obtained from healthy donors were used as experimental model. PBMC were expose to G and stimulated with PMA/ionomycin, T helper (Th) cell differentiation and cytokine production were assessed by flow cytometry and enzyme-linked immunosorbent assay, respectively. A reduction of Th1/Th2 ratio, mainly due to a decrease in Th1 cells, was observed following G exposure. Results show an enhancement of IL-4 and IL-17A production, and a reduction of IFN-γ. Based on literature evidence that suggest G being an endocrine disruptor, we investigated the role of nuclear estrogen receptors (ER). ERα/ERβ inhibition by ICI 182,780 abolished the effects of G on IFN-γ and IL-4 release, suggesting a role of ER in the observed effects. To further characterize the mechanism of action of G, miRNAs, both in exosome and intracellular, were investigated. A statistically significant increase in miR-500a-5p was observed following G treatment. The blockage of miR-500a-5p, using a specific antagomir, prevented G-induced reduction of IFN-γ production. Finally a relationship between miR-500a-5p up-regulation and ER was observed. Overall, these results suggest that G can directly act on T cells, altering T cell differentiation and cytokines production.
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Affiliation(s)
- Ambra Maddalon
- Laboratory of Toxicology, Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Martina Iulini
- Laboratory of Toxicology, Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Valentina Galbiati
- Laboratory of Toxicology, Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Claudio Colosio
- Occupational Health Unit, International Centre for Rural Health, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Stefan Mandić-Rajčević
- Occupational Health Unit, International Centre for Rural Health, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Emanuela Corsini
- Laboratory of Toxicology, Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
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12
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Carugno M, Colosio C, Niu S. The Guidance Notes for Diagnostic Criteria and Prevention of Occupational Diseases. Saf Health Work 2022. [DOI: 10.1016/j.shaw.2021.12.1491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Colosio C. Special Session 29 Pesticides Issue with a Focus on Glyphosate. Saf Health Work 2022. [DOI: 10.1016/j.shaw.2021.12.872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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14
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Rubino F, Mandic-Rajcevic S, Ariano E, Fargnoli, Laurendi V, Lombardi M, Puri D, Colosio C. The PESTIRISK tool for personal planning of pesticide safe use by field users: concept and development. Saf Health Work 2022. [DOI: 10.1016/j.shaw.2021.12.812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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15
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Visonà SD, Capella S, Bodini S, Borrelli P, Villani S, Crespi E, Colosio C, Previderè C, Belluso E. Evaluation of Deposition and Clearance of Asbestos (Detected by SEM-EDS) in Lungs of Deceased Subjects Environmentally and/or Occupationally Exposed in Broni (Pavia, Northern Italy). Front Public Health 2021; 9:678040. [PMID: 34354974 PMCID: PMC8329042 DOI: 10.3389/fpubh.2021.678040] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/21/2021] [Indexed: 11/19/2022] Open
Abstract
Biodurability is one of the main determinants of asbestos hazardousness for human health. Very little is known about the actual persistence of asbestos in lungs and its clearance, nor about differences in this regard between the different mineralogical types of asbestos. The aim of the present study was to evaluate the amount, the dimensional characteristics and the mineralogic kinds of asbestos in lungs (measured using SEM-EDS) of a series of 72 deceased subjects who were certainly exposed to asbestos (mainly crocidolite and chrysotile) during their life. Moreover, we investigated possible correlations between the lung burden of asbestos (in general and considering each asbestos type), as well as their dimension (length, width, and l/w ratio) and the duration of exposure, the latency- in case of malignant mesothelioma (MM), the survival and the time since the end of exposure. In 62.5% of subjects, asbestos burden in lungs was lower that the threshold considered demonstrative for occupational exposure. In 29.1% of cases no asbestos was found. Chrysotile was practically not detected. The mean length of asbestos fibers and the length to width ratio were significantly related to the duration of exposure to asbestos. No other statistically significant correlations were found between the amount and dimensional characteristics of asbestos (nor with the relative amount of each asbestos type) and the other chronological variables considered. In conclusion, it was pointed out that chrysotile can be completely removed from human lungs in <8 years and, instead, amphiboles persist much more time. The present results suggest, as well, that the finding of no asbestos in lungs cannot rule out the attribution of MM to asbestos (in particular, chrysotile) inhaled in an occupational setting. This point is of crucial importance from a legal point of view.
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Affiliation(s)
- Silvia D Visonà
- Unit of Legal Medicine and Forensic Sciences, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Silvana Capella
- Department of Earth Sciences, University of Torino, Turin, Italy.,Interdepartmental Center for Studies on Asbestos and other Toxic Particulates "G. Scansetti", University of Torino, Turin, Italy
| | - Sofia Bodini
- Unit of Legal Medicine and Forensic Sciences, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Paola Borrelli
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, Pavia University, Pavia, Italy.,Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, Pavia University, Pavia, Italy
| | - Eleonora Crespi
- Occupational Health Unit, Santi Paolo e Carlo Hospital, Milan, Italy
| | - Claudio Colosio
- Occupational Health Unit, Santi Paolo e Carlo Hospital, Milan, Italy.,Department of Health Sciences, University of Milan, Milan, Italy
| | - Carlo Previderè
- Unit of Legal Medicine and Forensic Sciences, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Elena Belluso
- Department of Earth Sciences, University of Torino, Turin, Italy.,Interdepartmental Center for Studies on Asbestos and other Toxic Particulates "G. Scansetti", University of Torino, Turin, Italy
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16
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Masci F, Spatari G, Giorgianni CM, Pernigotti E, Antonangeli LM, Bordoni V, Magenta Biasina A, Pietrogrande L, Colosio C. Hand-Wrist Disorders in Chainsaw Operators: A Follow-Up Study in a Group of Italian Loggers. Int J Environ Res Public Health 2021; 18:ijerph18147217. [PMID: 34299668 PMCID: PMC8307102 DOI: 10.3390/ijerph18147217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 11/16/2022]
Abstract
Despite the mechanization process implemented in arboriculture, logging tasks are still manually performed by chainsaw operators, which therefore are exposed to the risk of developing hand-wrist musculoskeletal disorders. Our research aimed to: (a) define whether the slight changes observed in 2017 showed an evolution to overt diseases; (b) study some risk determinants for these diseases such as age, working experience, and performing a secondary job. We recruited in a two-year follow-up study, 38 male forestry workers performing logging tasks employed in the Sicilian Forestry Department located in Enna. All the subjects underwent: (1) personal data collection; (2) administration of questionnaire addressed at upper limbs symptoms with a hand chart; (3) physical examination of the upper limbs, including Tinel’s and Phalen’s maneuvers; (4) ultrasound investigation of the hand-wrist area. In the two-year follow-up study we registered an overall increasing in wrist disorders, thus we can assume that forestry workers may be a target population for wrist diseases and deserve a particular attention in workers’ health surveillance programs. Interestingly, the prevalence of wrist-hand disorders resulted to be higher in younger workers.
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Affiliation(s)
- Federica Masci
- Department of Health Sciences of the University of Milano and International Centre for Rural Health of the Occupational Health Unit of the Hospitals Santi Paolo e Carlo, 20142 Milano, Italy; (L.M.A.); (C.C.)
- Correspondence:
| | - Giovanna Spatari
- Department of Biomedical, Dental and Morphological and Functional Imaging, University of Messina, 98125 Messina, Italy; (G.S.); (C.M.G.)
| | - Concetto Mario Giorgianni
- Department of Biomedical, Dental and Morphological and Functional Imaging, University of Messina, 98125 Messina, Italy; (G.S.); (C.M.G.)
| | - Elisa Pernigotti
- Post Graduate School in Orthopedics and Traumatology, University of Milan, 20142 Milano, Italy;
| | - Laura Maria Antonangeli
- Department of Health Sciences of the University of Milano and International Centre for Rural Health of the Occupational Health Unit of the Hospitals Santi Paolo e Carlo, 20142 Milano, Italy; (L.M.A.); (C.C.)
| | - Vittorio Bordoni
- Post Graduate School in Occupational Medicine, University of Milan, 20122 Milano, Italy;
| | - Alberto Magenta Biasina
- Diagnostic and Interventional Radiology School of Santi Paolo and Carlo ASST of Milan, 20142 Milano, Italy;
| | - Luca Pietrogrande
- Department of Health Sciences, University of Milan, 20142 Milano, Italy;
| | - Claudio Colosio
- Department of Health Sciences of the University of Milano and International Centre for Rural Health of the Occupational Health Unit of the Hospitals Santi Paolo e Carlo, 20142 Milano, Italy; (L.M.A.); (C.C.)
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17
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Maddalon A, Galbiati V, Colosio C, Mandić-Rajčević S, Corsini E. Glyphosate-based herbicides: Evidence of immune-endocrine alteration. Toxicology 2021; 459:152851. [PMID: 34246717 DOI: 10.1016/j.tox.2021.152851] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/10/2021] [Accepted: 07/06/2021] [Indexed: 12/28/2022]
Abstract
Glyphosate (G) is the active ingredient of the most widely used herbicide products. It targets the enzyme 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS), which lacks in humans, suggesting to confer a low mammalian toxicity to G-based herbicides (GBHs). Despite this, the use of G is currently under intense debate. Many studies indicating its hazard and toxicity on non-target organisms are emerging, and associations between GBHs and immune-endocrine disturbances have been described. This review aims to investigate, based on recent epidemiological studies and studies performed in vitro and in vivo in animals, the possible association between GBHs and immune-endocrine alterations. Published data suggest that GBHs have endocrine disrupting potentiality targeting sex and thyroid hormones, although its relevance for humans will require further investigations. Evidence of immunotoxicity are limited compared to those on endocrine effects, but overall highlight possible noxious effects, including lung inflammation and rhinitis. An attractive hypothesis could be the one that connects microbiota dysbiosis with possible immune-endocrine outcomes. Indeed, several intestinal microorganisms express the enzyme EPSPS and, studies are emerging that highlight a possible G-induced dysbiosis. Considering the wide use of GBHs in agriculture, further studies investigating their noxious effects at levels relevant for human exposure should be performed. A critical analysis of emerging evidence of G toxicity is required to better characterize its safety profile. In addition, attention should be paid to the differences between G alone and its formulations, which, containing substances able to increase G absorption, may present a different toxicity profile.
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Affiliation(s)
- Ambra Maddalon
- Laboratory of Toxicology, Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milan, Italy
| | - Valentina Galbiati
- Laboratory of Toxicology, Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milan, Italy.
| | - Claudio Colosio
- Occupational Health Unit, International Centre for Rural Health, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Stefan Mandić-Rajčević
- Occupational Health Unit, International Centre for Rural Health, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Emanuela Corsini
- Laboratory of Toxicology, Department of Environmental and Political Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milan, Italy
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18
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Colosio C. In This Issue of Occupational Medicine. Occup Med (Lond) 2021. [DOI: 10.1093/occmed/kqab054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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d'Arminio Monforte A, Tavelli A, Perrone PM, Za A, Razzini K, Tomasoni D, Bordoni V, Romanò L, Orfeo N, Marchetti G, Colosio C. Association between previous infection with SARS CoV-2 and the risk of self-reported symptoms after mRNA BNT162b2 vaccination: Data from 3,078 health care workers. EClinicalMedicine 2021; 36:100914. [PMID: 34095793 PMCID: PMC8165130 DOI: 10.1016/j.eclinm.2021.100914] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Health care workers (HCWs) are at high risk of contracting an infection by SARS CoV-2 and thus they are a priority for vaccination. We hereby aim to investigate whether the risk of severe and moderate systemic symptoms (MSS) after vaccination is higher in HCWs with a history of previous COVID-19. METHODS An online questionnaire was offered to the cohort all HCWs undergoing anti-SARS CoV-2 mRNA BNT162b2 vaccination between January 4th and February 9th 2021 in two large tertiary hospitals (ASST Santi Paolo and Carlo) in Milan, Italy. Previous SARS-CoV-2 infection/COVID-19 was recorded. Local and systemic symptoms after each of the two doses were reported. MSS were those either interfering with daily activities or resulting in time off-work. Factors associated to MSS were identified by logistic regression. FINDINGS 3,078 HCW were included. Previous SARS-CoV-2 infection/COVID-19 occurred in 396 subjects (12·9%). 59·6% suffered from ≥1 local or systemic symptom after the first and 73·4% after the second dose. MSS occurred in 6·3% of cases (14·4% with previous vs 5·1% with no COVID-19 p<0·001) and in 28·3% (24·5% in COVID-19 vs 28·3% no COVID, p = 0·074) after the first and second dose, respectively. Subjects already experiencing COVID-19 had an independent 3-fold higher risk of MSS after the first and a 30% lower risk after the second dose. No severe adverse events were reported. INTERPRETATION Our data confirm in a real-world setting, the lack of severe adverse events and the short duration of reactogenicity in already infected HCWs. Possible differences in immune reactivity are drivers of MSS among this group of HCWs, as well as among females and younger individuals. FUNDING None.
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Affiliation(s)
- Antonella d'Arminio Monforte
- Unit of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
- Corresponding author at: Unit of Infectious and Tropical Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Via A di Rudinì 8 -20142, Milan, Italy.
| | - Alessandro Tavelli
- Unit of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Pier Mario Perrone
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Alessandro Za
- Medical Direction, ASST Santi Paolo e Carlo, Milan, Italy
| | - Katia Razzini
- Medical Direction, ASST Santi Paolo e Carlo, Milan, Italy
| | - Daniele Tomasoni
- Unit of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Vittorio Bordoni
- Occupational Health Unit, International Centre for Rural Health, Department of Health Sciences, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Luisa Romanò
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Nicola Orfeo
- Medical Direction, ASST Santi Paolo e Carlo, Milan, Italy
| | - Giulia Marchetti
- Unit of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Claudio Colosio
- Occupational Health Unit, International Centre for Rural Health, Department of Health Sciences, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
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20
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Lamiani G, Borghi L, Poli S, Razzini K, Colosio C, Vegni E. Hospital Employees' Well-Being Six Months after the COVID-19 Outbreak: Results from a Psychological Screening Program in Italy. Int J Environ Res Public Health 2021; 18:ijerph18115649. [PMID: 34070468 PMCID: PMC8197452 DOI: 10.3390/ijerph18115649] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 01/05/2023]
Abstract
The COVID-19 outbreak has taken a heavy toll on the mental well-being of healthcare workers. This study aims to describe a psychological screening program developed at a large University Hospital in Milan, Italy, and assess the psychological outcomes of employees and associated factors. A survey was electronically conducted among hospital employees between July and October 2020. Sociodemographic data, information about COVID-19 experience and three scales assessing anxiety (STAI-Y1), depression (HAM-D) and post-traumatic stress disorder (PCL-5) were collected. A total of 308 employees (80% women; mean age 45.1 years) responded: 16% physicians, 68% other healthcare professionals, and 16% administrative staff. Employees reported moderate/severe symptoms of anxiety (23%), depression (53%), and post-traumatic stress disorder (40%). At multivariate logistic regression analysis, having suffered a loss for COVID-19 in the personal context was independently associated with higher risk of moderate/severe anxiety (OR = 2.40; 95% CI 1.16–4.98), being female was associated with higher risk of moderate/severe depression (OR = 2.82; 95% CI 1.43–5.59), and having had a family member affected by COVID-19 was associated with higher risk of moderate/severe post-traumatic stress disorder (OR = 2.75; 95% CI 1.01–7.48). COVID-19 personal experience may have a profound impact on hospital workers’ mental health and should be considered in supportive interventions.
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Affiliation(s)
- Giulia Lamiani
- Department of Health Sciences, University of Milan, 20142 Milan, Italy; (L.B.); (C.C.); (E.V.)
- Correspondence: ; Tel.: +39-02-5032-3129
| | - Lidia Borghi
- Department of Health Sciences, University of Milan, 20142 Milan, Italy; (L.B.); (C.C.); (E.V.)
| | - Silvia Poli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Katia Razzini
- Prevention and Protection Service, ASST Santi Paolo e Carlo, 20142 Milan, Italy;
| | - Claudio Colosio
- Department of Health Sciences, University of Milan, 20142 Milan, Italy; (L.B.); (C.C.); (E.V.)
- Occupational Health Unit, ASST Santi Paolo e Carlo, 20142 Milan, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, 20142 Milan, Italy; (L.B.); (C.C.); (E.V.)
- Clinical Psychology Unit, ASST Santi Paolo e Carlo, 20142 Milan, Italy
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21
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Hulshof CTJ, Pega F, Neupane S, Colosio C, Daams JG, Kc P, Kuijer PPFM, Mandic-Rajcevic S, Masci F, van der Molen HF, Nygård CH, Oakman J, Proper KI, Frings-Dresen MHW. The effect of occupational exposure to ergonomic risk factors on osteoarthritis of hip or knee and selected other musculoskeletal diseases: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. Environ Int 2021; 150:106349. [PMID: 33546919 DOI: 10.1016/j.envint.2020.106349] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 12/04/2020] [Accepted: 12/16/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Evidence from mechanistic data suggests that occupational exposure to ergonomic risk factors may cause selected other musculoskeletal diseases, other than back or neck pain (MSD) or osteoarthritis of hip or knee (OA). In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of disability-adjusted life years from MSD or OA that are attributable to occupational exposure to ergonomic risk factors, for the development of the WHO/ILO Joint Estimates. OBJECTIVES We aimed to systematically review and meta-analyse estimates of the effect of occupational exposure to ergonomic risk factors (force exertion, demanding posture, repetitiveness, hand-arm vibration, lifting, kneeling and/or squatting, and climbing) on MSD and OA (two outcomes: prevalence and incidence). DATA SOURCES We developed and published a protocol, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic academic databases for potentially relevant records from published and unpublished studies, including the International Trials Register, Ovid Medline, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines and organizational websites; hand-searched reference list of previous systematic reviews and included study records; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (<15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of occupational exposure to ergonomic risk factors (any exposure to force exertion, demanding posture, repetitiveness, hand-arm vibration, lifting, kneeling and/or squatting, and climbing ≥ 2 h/day) compared with no or low exposure to the theoretical minimum risk exposure level (<2 h/day) on the prevalence or incidence of MSD or OA. STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors independently screened 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. Missing data were requested from principal study authors. We combined odds ratios using random-effect meta-analysis. Two or more review authors assessed the risk of bias and the quality of evidence, using Navigation Guide tools adapted to this project. RESULTS In total eight studies (4 cohort studies and 4 case control studies) met the inclusion criteria, comprising a total of 2,378,729 participants (1,157,943 females and 1,220,786 males) in 6 countries in 3 WHO regions (Europe, Eastern Mediterranean and Western Pacific). The exposure was measured using self-reports in most studies and with a job exposure matrix in one study and outcome was generally assessed with physician diagnostic records or administrative health data. Across included studies, risk of bias was generally moderate. Compared with no or low exposure (<2 h per day), any occupational exposure to ergonomic risk factors increased the risk of acquiring MSD (odds ratio (OR) 1.76, 95% confidence interval [CI] 1.14 to 2.72, 4 studies, 2,376,592 participants, I2 70%); and increased the risk of acquiring OA of knee or hip (OR 2.20, 95% CI 1.42 to 3.40, 3 studies, 1,354 participants, I2 13%); Subgroup analysis for MSD found evidence for differences by sex, but indicated a difference in study type, where OR was higher among study participants in a case control study compared to study participants in cohort studies. CONCLUSIONS Overall, for both outcomes, the main body of evidence was assessed as being of low quality. Occupational exposure to ergonomic risk factors increased the risk of acquiring MSD and of acquiring OA of knee or hip. We judged the body of human evidence on the relationship between exposure to occupational ergonomic factors and MSD as "limited evidence of harmfulness" and the relationship between exposure to occupational ergonomic factors and OA also as "limited evidence of harmfulness". These relative risks might perhaps be suitable as input data for WHO/ILO modelling of work-related burden of disease and injury. Protocol identifier: https://doi.org/10.1016/j.envint.2018.09.053 PROSPERO registration number: CRD42018102631.
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Affiliation(s)
- Carel T J Hulshof
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Subas Neupane
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Claudio Colosio
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Joost G Daams
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Prakash Kc
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Paul P F M Kuijer
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Stefan Mandic-Rajcevic
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Federica Masci
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Henk F van der Molen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Clas-Håkan Nygård
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Jodi Oakman
- Centre for Ergonomics and Human Factors, School of Psychology and Public Health, LaTrobe University, Melbourne, Australia.
| | - Karin I Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Amsterdam, the Netherlands.
| | - Monique H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
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22
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Visonà SD, Capella S, Bodini S, Borrelli P, Villani S, Crespi E, Frontini A, Colosio C, Belluso E. Inorganic Fiber Lung Burden in Subjects with Occupational and/or Anthropogenic Environmental Asbestos Exposure in Broni (Pavia, Northern Italy): An SEM-EDS Study on Autoptic Samples. Int J Environ Res Public Health 2021; 18:ijerph18042053. [PMID: 33669843 PMCID: PMC7923219 DOI: 10.3390/ijerph18042053] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/10/2021] [Accepted: 02/15/2021] [Indexed: 11/25/2022]
Abstract
Increased mortality due to malignant mesothelioma has been demonstrated by several epidemiologic studies in the area around Broni (a small town in Lombardy, northern Italy), where a factory producing asbestos cement was active between 1932 and 1993. Until now, the inorganic fiber burden in lungs has not been investigated in this population. The aim of this study is to assess the lung fiber burden in 72 individuals with previous occupational and/or anthropogenic environmental exposure to asbestos during the activity of an important asbestos cement factory. Inorganic fiber lung burden was assessed in autoptic samples taken from individuals deceased from asbestos-related diseases using a scanning electron microscope equipped with an energy-dispersive spectrometer. Significant differences in the detected amount of asbestos were pointed out among the three types of exposure. In most lung samples taken from patients who died of mesothelioma, very little asbestos (or, in some cases, no fibers) was found. Such subjects showed a significantly lower median amount of asbestos as compared to asbestosis. Almost no chrysotile was detected in the examined samples. Overall, crocidolite was the most represented asbestos, followed by amosite, tremolite/actinolite asbestos, and anthophyllite asbestos. There were significant differences in the amount of crocidolite and amosite fibers according to the kind of exposure. Overall, these findings provide novel insights into the link between asbestos exposure and mesothelioma, as well as the different impacts of the various types of asbestos on human health in relation to their different biopersistences in the lung microenvironment.
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Affiliation(s)
- Silvia Damiana Visonà
- Unit of Legal Medicine and Forensic Sciences, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- Correspondence: ; Tel.: +39-03-8298-7596; Fax: +39-03-8252-8025
| | - Silvana Capella
- Department of Earth Sciences, University of Torino, 10125 Torino, Italy; (S.C.); (E.B.)
- Interdepartmental Center for Studies on Asbestos and Other Toxic Particulates “G. Scansetti”, University of Torino, 10121 Torino, Italy
| | - Sofia Bodini
- Unit of Legal Medicine and Forensic Sciences, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Paola Borrelli
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (P.B.); (S.V.)
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (P.B.); (S.V.)
| | - Eleonora Crespi
- Occupational Health Unit, Santi Paolo e Carlo Hospital, 20142 Milano, Italy; (E.C.); (C.C.)
| | - Andrea Frontini
- Department of Life and Environmental Science, Polytechnic University of Marche, 60131 Ancona, Italy;
| | - Claudio Colosio
- Occupational Health Unit, Santi Paolo e Carlo Hospital, 20142 Milano, Italy; (E.C.); (C.C.)
- Department of Health Sciences, University of Milan, 20122 Milano, Italy
| | - Elena Belluso
- Department of Earth Sciences, University of Torino, 10125 Torino, Italy; (S.C.); (E.B.)
- Interdepartmental Center for Studies on Asbestos and Other Toxic Particulates “G. Scansetti”, University of Torino, 10121 Torino, Italy
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23
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Mandić-Rajčević S, Masci F, Crespi E, Franchetti S, Longo A, Bollina I, Velocci S, Amorosi A, Baldelli R, Boselli L, Negroni L, Zà A, Orfeo NV, Ortisi G, Centanni S, Colosio C. Source and symptoms of COVID-19 among hospital workers in Milan. Occup Med (Lond) 2021; 70:672-679. [PMID: 33269398 PMCID: PMC7798912 DOI: 10.1093/occmed/kqaa201] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Healthcare workers (HCWs) are commonly infected by SARS-CoV-2 and represent one of the most vulnerable groups. Adequate prevention strategies are necessary to guarantee HCWs’ safety, as well as to prevent dissemination of the infection among patients. Aims To describe a case series of SARS-CoV-2-positive HCWs in a large public healthcare organization in Milan (Italy) during the most devastating weeks of the epidemic and analyse the sources, symptoms and duration of SARS-CoV-2 infection. Methods This study included 172 SARS-CoV-2-positive HCWs who were infected between the 25th of February and the 7th of April 2020. A nasopharyngeal swab (NPS) and RT-PCR were used to indicate. Results Initially, the most common sources of infection were other positive HCWs (49%). Medical doctors and nursing assistants were most frequently infected, with infection rates of 53/1000 and 50/1000, respectively. COVID-19 departments were less affected than internal medicine, surgery, intensive care, or emergency room. The most commonly reported symptom was mild cough, while loss of smell (anosmia) and loss of taste (ageusia) were reported as moderate and severe by 30–40% of HCWs. The time necessary for 50% of workers to recover from the infection was 23 days, while it took 41 days for 95% of HCWs to become virus-free. Conclusions HCWs are commonly infected due to close contacts with other positive HCWs, and non-COVID departments were most affected. Most HCWs were asymptomatic or subclinical but contact tracing and testing of asymptomatic HCWs help identify and isolate infected workers.
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Affiliation(s)
- S Mandić-Rajčević
- Department of Health Sciences, University of Milan, Milan, Italy.,Occupational Health Unit, International Centre for Rural Health, Saints Paolo and Carlo Hospitals, Milan, Italy
| | - F Masci
- Department of Health Sciences, University of Milan, Milan, Italy.,Occupational Health Unit, International Centre for Rural Health, Saints Paolo and Carlo Hospitals, Milan, Italy
| | - E Crespi
- Occupational Health Unit, International Centre for Rural Health, Saints Paolo and Carlo Hospitals, Milan, Italy
| | - S Franchetti
- Occupational Health Unit, International Centre for Rural Health, Saints Paolo and Carlo Hospitals, Milan, Italy.,Postgraduate School of Occupational Medicine, University of Milan, Milan, Italy
| | - A Longo
- Occupational Health Unit, International Centre for Rural Health, Saints Paolo and Carlo Hospitals, Milan, Italy.,Postgraduate School of Occupational Medicine, University of Milan, Milan, Italy
| | - I Bollina
- Occupational Health Unit, International Centre for Rural Health, Saints Paolo and Carlo Hospitals, Milan, Italy
| | - S Velocci
- Occupational Health Unit, International Centre for Rural Health, Saints Paolo and Carlo Hospitals, Milan, Italy
| | - A Amorosi
- Central Health Care Management, Saints Paolo and Carlo Hospitals, Milan, Italy
| | - R Baldelli
- Central Health Care Management, Saints Paolo and Carlo Hospitals, Milan, Italy
| | - L Boselli
- Central Health Care Management, Saints Paolo and Carlo Hospitals, Milan, Italy
| | - L Negroni
- Central Health Care Management, Saints Paolo and Carlo Hospitals, Milan, Italy
| | - A Zà
- Central Health Care Management, Saints Paolo and Carlo Hospitals, Milan, Italy
| | - N V Orfeo
- Central Health Care Management, Saints Paolo and Carlo Hospitals, Milan, Italy
| | - G Ortisi
- Laboratory of Virology and Microbiology Analysis, Saints Paolo and Carlo Hospitals, Milan, Italy
| | - S Centanni
- Department of Health Sciences, University of Milan, Milan, Italy.,Unit of Pulmonology, Saints Paolo and Carlo Hospitals, Milan, Italy
| | - C Colosio
- Department of Health Sciences, University of Milan, Milan, Italy.,Occupational Health Unit, International Centre for Rural Health, Saints Paolo and Carlo Hospitals, Milan, Italy
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24
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Priori A, Baisi A, Banderali G, Biglioli F, Bulfamante G, Canevini MP, Cariati M, Carugo S, Cattaneo M, Cerri A, Chiumello D, Colosio C, Cozzolino M, D'Arminio Monforte A, Felisati G, Ferrari D, Gambini O, Gardinali M, Marconi AM, Olivari I, Orfeo NV, Opocher E, Pietrogrande L, Previtera A, Rossetti L, Vegni E, Toschi V, Zuin M, Centanni S. The Many Faces of Covid-19 at a Glance: A University Hospital Multidisciplinary Account From Milan, Italy. Front Public Health 2021; 8:575029. [PMID: 33490013 PMCID: PMC7820812 DOI: 10.3389/fpubh.2020.575029] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/19/2020] [Indexed: 01/08/2023] Open
Abstract
In March 2020, northern Italy became the second country worldwide most affected by Covid-19 and the death toll overtook that in China. Hospital staff soon realized that Covid-19 was far more severe than expected from the few data available at that time. The Covid-19 pandemic forced hospitals to adjust to rapidly changing circumstances. We report our experience in a general teaching hospital in Milan, the capital of Lombardy, the most affected area in Italy. First, we briefly describe Lombardy's regional Covid-19-related health organizational changes as well as general hospital reorganization. We also provide a multidisciplinary report of the main clinical, radiological and pathological Covid-19 findings we observed in our patients.
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Affiliation(s)
- Alberto Priori
- Neurology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Alessandro Baisi
- Thoracic Surgery, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Giuseppe Banderali
- Pediatrics, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Federico Biglioli
- Maxillofacial Surgery, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Gaetano Bulfamante
- Pathology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Maria Paola Canevini
- Pediatric Neuropsychiatry, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Maurizio Cariati
- Radiology Unit, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Stefano Carugo
- From the Units of Cardiology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Marco Cattaneo
- Internal Medicine, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Amilcare Cerri
- Dermatology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Davide Chiumello
- Intensive Care, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Claudio Colosio
- Workers' Health, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Mario Cozzolino
- Nephrology & Dialysis, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Antonella D'Arminio Monforte
- Infectious Disease, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Giovanni Felisati
- Otorhinolaryngology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Daris Ferrari
- Oncology Unit, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Orsola Gambini
- Psychiatry, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Marco Gardinali
- Emergency Unit, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Anna Maria Marconi
- Obstetrics & Gynecology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Isotta Olivari
- Neurology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Nicola Vincenzo Orfeo
- Strategic Hospital Management, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Enrico Opocher
- Surgery, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Luca Pietrogrande
- Orthopedy & Traumatology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Antonino Previtera
- Rehabilitation, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Luca Rossetti
- Surgical Ophthalmology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Elena Vegni
- Clinical Psychology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Vincenzo Toschi
- Transfusion Unit, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Massimo Zuin
- Gastroenterology & Hepatology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Stefano Centanni
- Respiratory Medicine, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
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25
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Hulshof CTJ, Pega F, Neupane S, van der Molen HF, Colosio C, Daams JG, Descatha A, Kc P, Kuijer PPFM, Mandic-Rajcevic S, Masci F, Morgan RL, Nygård CH, Oakman J, Proper KI, Solovieva S, Frings-Dresen MHW. The prevalence of occupational exposure to ergonomic risk factors: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. Environ Int 2021; 146:106157. [PMID: 33395953 DOI: 10.1016/j.envint.2020.106157] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Evidence from mechanistic and human data suggests that occupational exposure to ergonomic (or physical) risk factors may cause osteoarthritis and other musculoskeletal diseases (excluding rheumatoid arthritis, gout, and back and neck pain). In this paper, we present a systematic review and meta-analysis of the prevalence of occupational exposure to physical ergonomic risk factors for estimating the number of disability-adjusted life years from these diseases that are attributable to exposure to this risk factor, for the development of the WHO/ILO Joint Estimates. OBJECTIVES We aimed to systematically review and meta-analyse estimates of the prevalence of occupational exposure to ergonomic risk factors for osteoarthritis and other musculoskeletal diseases. DATA SOURCES We searched electronic bibliographic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines and organizational websites; hand-searched reference list of previous systematic reviews and included study records; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (<15 years) and unpaid domestic workers. The exposure was defined as any occupational exposure to one or more of: force exertion, demanding posture, repetitive movement, hand-arm vibration, kneeling or squatting, lifting, and/or climbing. We included all study types with an estimate of the prevalence of occupational exposure to ergonomic risk factors. STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors independently screened 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. We combined prevalence estimates using random-effect meta-analysis. Two or more review authors assessed the risk of bias and the quality of evidence, using the ROB-SPEO tool and QoE-SPEO approach developed specifically for the WHO/ILO Joint Estimates. RESULTS Five studies (three cross-sectional studies and two cohort studies) met the inclusion criteria, comprising 150,895 participants (81,613 females) in 36 countries in two WHO regions (Africa, Europe). The exposure was generally assessed with questionnaire data about self-reported exposure. Estimates of the prevalence of occupational exposure to ergonomic risk factors are presented for all five included studies, disaggregated by country, sex, 5-year age group, industrial sector or occupational group where feasible. The pooled prevalence of any occupational exposure to ergonomic risk factors was 0.76 (95% confidence interval 0.69 to 0.84, 3 studies, 148,433 participants, 35 countries in the WHO Europe region, I2 100%, low quality of evidence). Subgroup analyses found no statistically significant differences in exposure by sex but differences by age group, occupation and country. No evidence was found for publication bias. We assessed this body evidence to be of low quality, based on serious concerns for risk of bias due to exposure assessment only being based on self-report and for indirectness due to evidence from two WHO regions only. CONCLUSIONS Our systematic review and meta-analysis found that occupational exposure to ergonomic risk factors is highly prevalent. The current body of evidence is, however, limited, especially by risk of bias and indirectness. Producing estimates for the burden of disease attributable to occupational exposure to ergonomic risk factors appears evidence-based, and the pooled effect estimates presented in this systematic review may perhaps be used as input data for the WHO/ILO Joint Estimates. Protocol identifier:https://doi.org/10.1016/j.envint.2018.09.053. PROSPERO registration number: CRD42018102631.
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Affiliation(s)
- Carel T J Hulshof
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Subas Neupane
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Henk F van der Molen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Claudio Colosio
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Joost G Daams
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Alexis Descatha
- AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France; Inserm Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), Villejuif, France; Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Angers, France.
| | - Prakash Kc
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Paul P F M Kuijer
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Stefan Mandic-Rajcevic
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Federica Masci
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, Canada.
| | - Clas-Håkan Nygård
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Jodi Oakman
- Centre for Ergonomics and Human Factors, School of Psychology and Public Health, LaTrobe University, Melbourne, Australia.
| | - Karin I Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | | | - Monique H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
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26
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Bruinen de Bruin Y, Lequarre AS, McCourt J, Clevestig P, Pigazzani F, Zare Jeddi M, Colosio C, Goulart M. Initial impacts of global risk mitigation measures taken during the combatting of the COVID-19 pandemic. Saf Sci 2020; 128:104773. [PMID: 32296266 PMCID: PMC7158845 DOI: 10.1016/j.ssci.2020.104773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 05/03/2023]
Abstract
This paper presents an analysis of risk mitigation measures taken by countries around the world facing the current COVID-19 outbreak. In light of the current pandemic the authors collated and clustered (using harmonised terminology) the risk mitigation measures taken around the globe in the combat to contain, and since March 11, 2020, to limit the spread of the SARS-CoV-2 virus known to cause the Coronavirus disease 2019 (COVID-19). This overview gathers lessons learnt, providing an update on the current knowledge for authorities, sectors and first responders on the effectiveness of said measures, and may allow enhanced prevention, preparedness and response for future outbreaks. Various measures such as mobility restrictions, physical distancing, hygienic measures, socio-economic restrictions, communication and international support mechanisms have been clustered and are reviewed in terms of the nature of the actions taken and their qualitative early-perceived impact. At the time of writing, it is still too premature to express the quantitative effectiveness of each risk mitigation cluster, but it seems that the best mitigation results are reported when applying a combination of voluntary and enforceable measures.
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Affiliation(s)
- Yuri Bruinen de Bruin
- European Commission Joint Research Centre, Italy
- Corresponding author at: European Commission, Joint Research Centre, Via E. Fermi, 2749, 21027 Ispra, VA, Italy.
| | | | | | - Peter Clevestig
- On-Site Technical Expert to the Regional EU CBRN CoE Secretariat for the Gulf Cooperation Council Countries, Abu Dhabi, United Arab Emirates
| | - Filippo Pigazzani
- Division of Molecular and Clinical Medicine, MEMO Research, University of Dundee, United Kingdom
| | - Maryam Zare Jeddi
- Unit of Biostatistics, Epidemiology, and Public Health, University of Padua, Padua, Italy
| | - Claudio Colosio
- Department of Health Sciences of the University of Milan and Occupational Health Unit of the Saints Paolo and Carlo Hospitals, Milan, Italy
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27
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Mandić-Rajčević S, Rubino FM, Colosio C. Establishing health-based biological exposure limits for pesticides: A proof of principle study using mancozeb. Regul Toxicol Pharmacol 2020; 115:104689. [DOI: 10.1016/j.yrtph.2020.104689] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/12/2020] [Accepted: 05/21/2020] [Indexed: 01/06/2023]
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28
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Bruinen de Bruin Y, Lequarre AS, McCourt J, Clevestig P, Pigazzani F, Zare Jeddi M, Colosio C, Goulart M. Initial impacts of global risk mitigation measures taken during the combatting of the COVID-19 pandemic. Saf Sci 2020; 128:104773. [PMID: 32296266 PMCID: PMC7158845 DOI: 10.1016/j.ssci.2020.104773%0a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 11/10/2023]
Abstract
This paper presents an analysis of risk mitigation measures taken by countries around the world facing the current COVID-19 outbreak. In light of the current pandemic the authors collated and clustered (using harmonised terminology) the risk mitigation measures taken around the globe in the combat to contain, and since March 11, 2020, to limit the spread of the SARS-CoV-2 virus known to cause the Coronavirus disease 2019 (COVID-19). This overview gathers lessons learnt, providing an update on the current knowledge for authorities, sectors and first responders on the effectiveness of said measures, and may allow enhanced prevention, preparedness and response for future outbreaks. Various measures such as mobility restrictions, physical distancing, hygienic measures, socio-economic restrictions, communication and international support mechanisms have been clustered and are reviewed in terms of the nature of the actions taken and their qualitative early-perceived impact. At the time of writing, it is still too premature to express the quantitative effectiveness of each risk mitigation cluster, but it seems that the best mitigation results are reported when applying a combination of voluntary and enforceable measures.
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Affiliation(s)
| | | | | | - Peter Clevestig
- On-Site Technical Expert to the Regional EU CBRN CoE Secretariat for the Gulf Cooperation Council Countries, Abu Dhabi, United Arab Emirates
| | - Filippo Pigazzani
- Division of Molecular and Clinical Medicine, MEMO Research, University of Dundee, United Kingdom
| | - Maryam Zare Jeddi
- Unit of Biostatistics, Epidemiology, and Public Health, University of Padua, Padua, Italy
| | - Claudio Colosio
- Department of Health Sciences of the University of Milan and Occupational Health Unit of the Saints Paolo and Carlo Hospitals, Milan, Italy
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Sotgiu G, Barassi A, Miozzo M, Saderi L, Piana A, Orfeo N, Colosio C, Felisati G, Davì M, Gerli AG, Centanni S. SARS-CoV-2 specific serological pattern in healthcare workers of an Italian COVID-19 forefront hospital. BMC Pulm Med 2020; 20:203. [PMID: 32727446 PMCID: PMC7388425 DOI: 10.1186/s12890-020-01237-0] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/15/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND COVID-19 is an infectious disease caused by a novel coronavirus (SARS-CoV-2). The immunopathogenesis of the infection is currently unknown. Healthcare workers (HCWs) are at highest risk of infection and disease. Aim of the study was to assess the sero-prevalence of SARS-CoV-2 in an Italian cohort of HCWs exposed to COVID-19 patients. METHODS A point-of-care lateral flow immunoassay (BioMedomics IgM-IgG Combined Antibody Rapid Test) was adopted to assess the prevalence of IgG and IgM against SARS-CoV-2. It was ethically approved ("Milano Area 1" Ethical Committee prot. n. 2020/ST/057). RESULTS A total of 202 individuals (median age 45 years; 34.7% males) were retrospectively recruited in an Italian hospital (Milan, Italy). The percentage (95% CI) of recruited individuals with IgM and IgG were 14.4% (9.6-19.2%) and 7.4% (3.8-11.0%), respectively. IgM were more frequently found in males (24.3%), and in individuals aged 20-29 (25.9%) and 60-69 (30.4%) years. No relationship was found between exposure to COVID-19 patients and IgM and IgG positivity. CONCLUSIONS The present study did show a low prevalence of SARS-CoV-2 IgM in Italian HCWs. New studies are needed to assess the prevalence of SARS-CoV-2 antibodies in HCWs exposed to COVID-19 patients, as well the role of neutralizing antibodies.
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Affiliation(s)
- Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical, Experimental Sciences, University of Sassari, Sassari, Italy.
- Clinical Epidemiology and Medical Statistics Unit, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
| | - Alessandra Barassi
- Laboratory of Clinical Chemistry, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Monica Miozzo
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical, Experimental Sciences, University of Sassari, Sassari, Italy
| | - Andrea Piana
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical, Experimental Sciences, University of Sassari, Sassari, Italy
| | - Nicola Orfeo
- Medical Direction ASST Santi Paolo e Carlo, Milan, Italy
| | - Claudio Colosio
- Occupational Health Unit, International Center for Rural Health, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Felisati
- Head and Neck Dapartment, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Matteo Davì
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Stefano Centanni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
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Crespi E, Velocci S, Masci F, Mandić-Rajčević S, Bollina I, Franchetti S, Longo A, Colosio C. Developing approaches to control SARS-CoV-2 in a public hospital. Occup Med (Lond) 2020. [PMCID: PMC7313830 DOI: 10.1093/occmed/kqaa090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Moradhaseli S, Farhadian H, Colosio C, Abbasi E, Ghofranipour F. Development of Psychometric Properties of Farmers' Occupational Health Behavior Questionnaire for Iranian Farmers. J Agromedicine 2020; 25:279-285. [PMID: 31594488 DOI: 10.1080/1059924x.2019.1674227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: Agriculture is one of the most dangerous industries throughout the world, and its risk level is dictated by several determinants whose real weights are often unknown. Objective: The present work aims to develop psychometric properties of farmers' occupational health behavior questionnaire for Iranian farmers. Methods: In this qualitative-quantitative study, the items of the instrument were derived from the qualitative phase. Face validity, content validity, reliability, and consistency methods were applied. Construct validity was estimated by the exploratory factor analysis. Results: Eleven factors with factor loads of >0.501 were extracted as the main factors. They altogether captured about 58.97% of the variance of factors affecting farmers' occupational health behavior. The reliability of the instrument was confirmed as its Cronbach's alpha was in the range of 0.72-0.93. Conclusion: Given the complicated nature of occupational health behaviors among farmers, it is imperative to measure the factors influencing these behaviors precisely. Therefore, the development of a proper instrument can be very crucial in identifying influential factors. The findings showed that the developed instrument was optimally reliable and valid.
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Affiliation(s)
- Somayeh Moradhaseli
- Department of Agricultural Extension and Education, Tarbiat Modares University , Tehran, Iran
| | - Homayoun Farhadian
- Department of Agricultural Extension and Education, Tarbiat Modares University , Tehran, Iran
| | - Claudio Colosio
- Department of Health sciences, Milan university , Milan, Italy
| | - Enayat Abbasi
- Department of Agricultural Extension and Education, Tarbiat Modares University , Tehran, Iran
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Masci F, Rosecrance J, Mixco A, Cortinovis I, Calcante A, Mandic-Rajcevic S, Colosio C. Personal and occupational factors contributing to biomechanical risk of the distal upper limb among dairy workers in the Lombardy region of Italy. Appl Ergon 2020; 83:102796. [PMID: 30611466 PMCID: PMC9531529 DOI: 10.1016/j.apergo.2018.12.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 06/01/2023]
Abstract
Biomechanical overload in the wrist flexor and extensor muscles, together with awkward hand positions during work activities, can result in occupational wrist and hand disorders. Dairy workers, specifically those that work in the milking parlor, are exposed to highly repetitive and forceful exertions of the upper limb throughout their work shift. There are very few studies that have investigated the determinants that contribute to the risk of distal upper limb musculoskeletal disorders among dairy workers. The purpose of the present study was to identify the variables affecting the biomechanical overload of the distal upper limb among milking parlor workers, define risk profiles, and propose possible interventions to reduce the high physical loads to the distal upper limb during milking activities. Forty male workers from the three most common milking parlor systems in Lombardy Italy were recruited to participate in this study. Multiple correspondence analysis of personal characteristics and occupational risk factors, followed by cluster analysis, led to the identification of three distinct groups of workers. Low, medium and high risk profiles were assigned to each group based on the risk assessments performed using the Strain Index and electromyography of the distal upper limb. The main risk determinants were workstation characteristics, work organization and milking routine. A well-organized milking routine, milking cluster weight below 2.4 kg or the use of supporting arms for the milking cluster may reduce the risk of biomechanical overload.
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Affiliation(s)
- F Masci
- Department of Health Sciences of the University of Milan and International Center for Rural Health of Santi Paolo e Carlo Hospital, Milan, Italy.
| | - J Rosecrance
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - A Mixco
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - I Cortinovis
- Laboratory "G.A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - A Calcante
- Department of Agricultural and Environmental Sciences, University of Milan, Milan, Italy
| | - S Mandic-Rajcevic
- Department of Health Sciences of the University of Milan and International Center for Rural Health of Santi Paolo e Carlo Hospital, Milan, Italy
| | - C Colosio
- Department of Health Sciences of the University of Milan and International Center for Rural Health of Santi Paolo e Carlo Hospital, Milan, Italy
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van der Molen HF, Marsili C, Vitali A, Colosio C. Trends in occupational diseases in the Italian agricultural sector, 2004-2017. Occup Environ Med 2020; 77:340-343. [PMID: 31996472 PMCID: PMC7231438 DOI: 10.1136/oemed-2019-106168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/06/2020] [Accepted: 01/14/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To estimate the incidence of, trends in and effect of change in reporting rules on occupational diseases (ODs) in the Italian agricultural sector. METHODS Over a 14-year period (2004-2017), ODs among Italian agricultural workers were diagnosed by physicians and reported to the National Institute for Insurance against Workplace Accidents and Occupational Diseases. OD was defined as a disease with a specific clinical diagnosis (International Classification of Diseases) and was predominantly caused by work-related factors. Trends in incidence and effects of changed eligibility criteria for reporting occupational musculoskeletal disorders (MSDs) and noise-induced hearing loss (NIHL) were estimated using a Poisson regression model. RESULTS In 2017, the incidence of all ODs was 1295 per 100 000 agricultural workers. MSDs (961 per 100 000 workers) were the most frequently occurring ODs. MSDs and NIHL showed statistically significant increasing time trends, 26% and 7% annual increase, respectively, during the 2004-2017 period. There was no statistically significant change in the incidence of occupational respiratory, skin and cancer diseases during the 14-year period. After changes in reporting rules, the incidence of MSDs showed an immediate increased effect, with an incidence rate ratio (IRR) of 2.9 (95% CI 2.65 to 3.14) and a significant annual decreasing trend of -9% (95% CI -6% to -12%) over the years after the changed reporting rules (from 2008 to 2017), and an immediate effect on NIHL with an IRR of 1.3 (95% CI 1.13 to 1.53). CONCLUSION In total, 1.3% of the Italian agricultural workers were diagnosed in 2017 as having an OD. Over a 14-year period, the annual incidence of ODs showed a considerable increasing trend consistent with changed eligibility reporting criteria for occupational MSDs and to a lesser extent for NIHL.
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Affiliation(s)
- Henk F van der Molen
- Amsterdam UMC, University of Amsterdam, Department: Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Chiara Marsili
- Occupational Health Unit and International Centre for Rural Health, ASST of the Saints Paolo and Carlo, Milano, Italy
| | - Andrea Vitali
- University of Milan, Department of Health Sciences, Occupational Health Unit and International Centre for Rural Health, ASST of the Saints Paolo and Carlo, Milano, Italy
| | - Claudio Colosio
- Occupational Health Unit and International Centre for Rural Health, ASST of the Saints Paolo and Carlo, Milano, Italy.,University of Milan, Department of Health Sciences, Occupational Health Unit and International Centre for Rural Health, ASST of the Saints Paolo and Carlo, Milano, Italy
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Ursini C, Omodeo Salè E, Fresegna A, Ciervo A, Jemos C, Maiello R, Buresti G, Colosio C, Rubino F, Mandić-Rajčević S, Chiarella P, Carbonari D, Delrio P, Maiolino P, Marchetti P, Boccia R, Iavicoli S, Cavallo D. Antineoplastic drug occupational exposure: a new integrated approach to evaluate exposure and early genotoxic and cytotoxic effects by no-invasive Buccal Micronucleus Cytome Assay biomarker. Toxicol Lett 2019; 316:20-26. [DOI: 10.1016/j.toxlet.2019.08.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/30/2019] [Accepted: 08/24/2019] [Indexed: 11/28/2022]
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Masci F, Crespi E, Pernigotti E, Tassoni M, Rosecrance J, Colosio C. Carpal tunnel syndrome among milking parlor workers in Northern Italy: a comparison of screening approaches. Med Lav 2019; 110:271-277. [PMID: 31475688 PMCID: PMC7809995 DOI: 10.23749/mdl.v110i4.8359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 06/24/2019] [Indexed: 01/24/2023]
Abstract
Background: Occupational tasks characterized by repetitive, awkward and forceful movements of the hand and wrist may heighten the risk of carpal tunnel syndrome (CTS) among dairy parlor workers. Median nerve impairment can be investigated with ultrasonography (US) and nerve conduction studies (NCS) but a structured questionnaire may help identify early symptoms. Objectives: Our objectives were to: a) compare the sensitivity of US investigations and NCS to detect early signs of CTS; b) explore the correlation of the results of these two tests with CTS symptoms obtained from the administration of a targeted questionnaire. Methods: Forty male milking parlor workers were recruited. The study protocol included: 1) the identification of characteristic CTS symptoms through a targeted questionnaire; 2) US imaging of the carpal tunnel inlet (using a portable ultrasound device; 3) NCS of the distal median nerve. Results: The symptom questionnaire was considered positive if at least one CTS symptom was present within two weeks prior to the examination. The symptom questionnaire showed a high level of specificity (92,6%) and sensitivity (61%) when compared with NCS results. Ultrasound results revealed a prevalence of median neuropathy of 55%, but when compared to NCS, the ultrasound showed quite low predictive values (NPV of 37% and PPV of 38%). Discussion: The symptom questionnaire was associated with the median nerve pathology often seen in CTS. Moreover, the study results have shown the questionnaire to be the most effective screening method when compared to ultrasound.
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Hulshof CTJ, Colosio C, Daams JG, Ivanov ID, Prakash KC, Kuijer PPFM, Leppink N, Mandic-Rajcevic S, Masci F, van der Molen HF, Neupane S, Nygård CH, Oakman J, Pega F, Proper K, Prüss-Üstün AM, Ujita Y, Frings-Dresen MHW. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to occupational ergonomic risk factors and of the effect of exposure to occupational ergonomic risk factors on osteoarthritis of hip or knee and selected other musculoskeletal diseases. Environ Int 2019; 125:554-566. [PMID: 30583853 PMCID: PMC7794864 DOI: 10.1016/j.envint.2018.09.053] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 05/20/2023]
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 disability-adjusted life years from osteoarthritis of hip or knee, and selected other musculoskeletal diseases respectively, attributable to exposure to occupational ergonomic risk factors to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on exposure to occupational ergonomic risk factors (Systematic Review 1) and systematically review and meta-analyze estimates of the effect of exposure to occupational ergonomic risk factors on osteoarthritis of the hip or knee, and selected other musculoskeletal diseases respectively (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, 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 Medline, EMBASE, Web of Science and CISDOC. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference lists 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. The included occupational ergonomic risk factors will be any exposure to one or more of: force exertion; demanding posture; repetitiveness; hand-arm vibration; lifting; kneeling and/or squatting; and climbing. Included outcomes will be (i) osteoarthritis and (ii) other musculoskeletal diseases (i.e., one or more of: rotator cuff syndrome; bicipital tendinitis; calcific tendinitis; shoulder impingement; bursitis shoulder; epicondylitis medialis; epicondylitis lateralis; bursitis elbow; bursitis hip; chondromalacia patellae; meniscus disorders; and/or bursitis knee). For Systematic Review 1, we will include quantitative prevalence studies of any exposure to occupational ergonomic risk factors stratified by country, gender, age 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 relative effect of any exposure with occupational ergonomic risk factors on the prevalence or incidence of osteoarthritis and/or selected musculoskeletal diseases, compared with the theoretical minimum risk exposure level (i.e., no exposure). 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 number: CRD42018102631.
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Affiliation(s)
- Carel T J Hulshof
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Claudio Colosio
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Joost G Daams
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - K C Prakash
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland.
| | - Paul P F M Kuijer
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Stefan Mandic-Rajcevic
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Frederica Masci
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Henk F van der Molen
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Subas Neupane
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland.
| | - Clas-Håkan Nygård
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland.
| | | | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Karin Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Amsterdam, Netherlands.
| | - Annette M Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
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Mandic-Rajcevic S, Rubino FM, Ariano E, Cottica D, Negri S, Colosio C. Exposure duration and absorbed dose assessment in pesticide-exposed agricultural workers: Implications for risk assessment and modeling. Int J Hyg Environ Health 2019; 222:494-502. [DOI: 10.1016/j.ijheh.2019.01.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 12/21/2018] [Accepted: 01/17/2019] [Indexed: 11/27/2022]
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Fargnoli M, Lombardi M, Puri D, Casorri L, Masciarelli E, Mandić-Rajčević S, Colosio C. The Safe Use of Pesticides: A Risk Assessment Procedure for the Enhancement of Occupational Health and Safety (OHS) Management. Int J Environ Res Public Health 2019; 16:E310. [PMID: 30678137 PMCID: PMC6388156 DOI: 10.3390/ijerph16030310] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 01/17/2019] [Accepted: 01/19/2019] [Indexed: 01/18/2023]
Abstract
The attention paid to the use of pesticides has increased notably in recent years as demonstrated by the issue of laws and regulations requiring their safe and environmentally-conscious use (e.g. Directive 2009/128/EC and Regulation (EC) no. 1272/2008). Despite the benefits that can be achieved by pursuing the targets of stricter legislative framework, the difficulties for farmers in complying with it are remarkable, especially for small-sized companies. In fact, in contrast to other occupational health and safety (OHS) contexts, in the case of pesticides even a preliminary analysis on the relationship between pesticide use and the consequent exposure risks for the workers is a complex task. In order to reduce the above-mentioned gap, the present study is focused on the development of an easy-to-use tool for carrying out occupational risk assessment of agricultural activities related to the use of pesticides. The procedure was developed by starting from the Agricultural Health Study (AHS) approach and its improvements, and continuing to the thorough development of a tool for preliminary risk assessment, providing a simplified model for its practical application by farmers. A case study concerning olive cultivation was used for its first verification. The results achieved should be considered as an initial step for the promotion of safer practices when using pesticides, providing a consistent base for their further validation.
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Affiliation(s)
- Mario Fargnoli
- Department of Rural Development, Ministry of Agriculture, Food and Fishery, DISR I, via XX Settembre 20, 00187 Rome, Italy.
- Department of Chemical Engineering Materials Environment (DICMA), Sapienza-University of Rome, via Eudossiana 18, 00184 Rome, Italy.
| | - Mara Lombardi
- Department of Chemical Engineering Materials Environment (DICMA), Sapienza-University of Rome, via Eudossiana 18, 00184 Rome, Italy.
| | - Daniele Puri
- Department of Technological Innovations and Safety of Plants, Products and Anthropic Settlements (DIT), National Institute for Insurance against Accidents at Work (INAIL), Via Fontana Candida 1, 00078 Monte Porzio Catone (RM), Italy.
| | - Laura Casorri
- Department of Technological Innovations and Safety of Plants, Products and Anthropic Settlements (DIT), National Institute for Insurance against Accidents at Work (INAIL), Via R. Ferruzzi, 38/40, 00143 Rome, Italy.
| | - Eva Masciarelli
- Department of Technological Innovations and Safety of Plants, Products and Anthropic Settlements (DIT), National Institute for Insurance against Accidents at Work (INAIL), Via R. Ferruzzi, 38/40, 00143 Rome, Italy.
| | - Stefan Mandić-Rajčević
- Department of Health Sciences of the University of Milan, International Centre for Rural Health of the SS. Paolo and Carlo Hospital, Via San Vigilio 43, 20142 Milan, Italy.
| | - Claudio Colosio
- Department of Health Sciences of the University of Milan, International Centre for Rural Health of the SS. Paolo and Carlo Hospital, Via San Vigilio 43, 20142 Milan, Italy.
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Mercadante R, Polledri E, Rubino FM, Mandic-Rajcevic S, Vaiani A, Colosio C, Moretto A, Fustinoni S. Assessment of penconazole exposure in winegrowers using urinary biomarkers. Environ Res 2019; 168:54-61. [PMID: 30268961 DOI: 10.1016/j.envres.2018.09.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/20/2018] [Accepted: 09/12/2018] [Indexed: 06/08/2023]
Abstract
Penconazole (PEN) is a fungicide used in agriculture. The aim of this work was to evaluate the exposure to PEN in vineyard workers focusing on urinary biomarkers. Twenty-two agricultural workers were involved in the study; they were investigated during PEN applications and re-entry work, performed for 1-4 consecutive working days, for a total of 42 mixing and applications and 12 re-entries. Potential and actual dermal exposure, including hand exposure, were measured using pads and hand washes. Urine samples were collected starting before the first application, continuing during the work shift, and ending 48 h after the last shift. The determination of PEN in dermal samples and PEN metabolites in urine was performed by liquid chromatography tandem mass spectrometry. Dermal potential body exposure and actual total exposure showed median levels ranging from 18 to 3356µg and from 21 to 111 µg, respectively. Urinary monohydroxyl-derivative PEN-OH was the most abundant metabolite; its excretion rate peaked within 24 h after the work shift. In this period, median concentrations of PEN-OH and the carboxyl-derivative PEN-COOH ranged from 15.6 to 27.6 µg/L and from 2.5 to 10.2 µg/L, respectively. The concentration of PEN-OH during the work shift, in the 24 h after and in the 25-48 h after the work shift were correlated with actual body and total dermal exposure (Pearson's r from 0.279 to 0.562). Our results suggest that PEN-OH in the 24 h post-exposure urine is a promising candidate for biomonitoring PEN exposure in agricultural workers.
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Affiliation(s)
- Rosa Mercadante
- Department of Clinical Sciences and Community Health, University of Milano, Via S. Barnaba 8, 20122 Milan, Italy
| | - Elisa Polledri
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via S. Barnaba 8, 20122 Milan, Italy
| | - Federico Maria Rubino
- Department of Health Sciences of the University of Milan, Laboratory for Analytical Toxicology and Metabolomics (LaTMA) and International Centre for Rural Health of the University Hospital San Paolo, Via di Rudini 8, Milan, Italy
| | - Stefan Mandic-Rajcevic
- Department of Health Sciences of the University of Milan, Laboratory for Analytical Toxicology and Metabolomics (LaTMA) and International Centre for Rural Health of the University Hospital San Paolo, Via di Rudini 8, Milan, Italy
| | - Andrea Vaiani
- Department of Health Sciences of the University of Milan, Laboratory for Analytical Toxicology and Metabolomics (LaTMA) and International Centre for Rural Health of the University Hospital San Paolo, Via di Rudini 8, Milan, Italy
| | - Claudio Colosio
- Department of Health Sciences of the University of Milan, Laboratory for Analytical Toxicology and Metabolomics (LaTMA) and International Centre for Rural Health of the University Hospital San Paolo, Via di Rudini 8, Milan, Italy
| | - Angelo Moretto
- Department of Biomedical and Clinical Sciences, University of Milano, and International Centre for Pesticides and Health Risks Protection (ICPS), "Luigi Sacco" Hospital, Via G.B. Grassi 74, 20157 Milano, Italy
| | - Silvia Fustinoni
- Department of Clinical Sciences and Community Health, University of Milano, Via S. Barnaba 8, 20122 Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via S. Barnaba 8, 20122 Milan, Italy.
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Katsikantami I, Colosio C, Alegakis A, Tzatzarakis MN, Vakonaki E, Rizos AK, Sarigiannis DA, Tsatsakis AM. Estimation of daily intake and risk assessment of organophosphorus pesticides based on biomonitoring data - The internal exposure approach. Food Chem Toxicol 2018; 123:57-71. [PMID: 30352298 DOI: 10.1016/j.fct.2018.10.047] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/17/2018] [Accepted: 10/19/2018] [Indexed: 12/13/2022]
Abstract
Human exposure to pesticides can be estimated through different approaches. The approach adopted in this study is based on internal dose measures. Studies published during 2001 and 2017 were collected from PubMed and Scopus databases, filtered and organized. The intake of parent compounds is estimated based on the urinary excretion of different OP metabolites applying a mathematical model previously used for similar purposes. Once defined an Estimated Daily Intake (EDI), risk assessment is performed through comparison with specific guideline values and hazard index (HI) is calculated to assess cumulative health risk. The EDI was expressed as malathion, diazinon, parathion, phorate and dimethoate equivalents. Differences in exposure between pregnant women, general population, children and farmers are highlighted and exposures are presented by country and sampling year. Higher exposure to OPs was calculated for farmers, followed by children whereas pregnant women were less exposed. Median HQ values for children ranged between 0.016 and 0.618, for pregnant women 0.005-0.151, for general population 0.008-0.206 and for farmers 0.009-0.979. Combined exposure to dimethoate and phorate was the worst-case scenario. The annual distribution of the urinary DAPs showed that exposure to OPs since 1998 tends to be stable for both children and adults.
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Affiliation(s)
- Ioanna Katsikantami
- Department of Chemistry, University of Crete, Foundation for Research and Technology-Hellas, FORTH-IESL, GR-71003, Heraklion, Crete, Greece; Laboratory of Toxicology, Medical School, University of Crete, GR-71003, Heraklion, Crete, Greece
| | - Claudio Colosio
- Department of Occupational and Environmental Health of the University of Milan, International Centre for Rural Health of the University Hospital San Paolo, S. Paolo Hospital Unit, Via San Vigilio 43, 20142 Milan, Italy
| | - Athanasios Alegakis
- Laboratory of Toxicology, Medical School, University of Crete, GR-71003, Heraklion, Crete, Greece
| | - Manolis N Tzatzarakis
- Laboratory of Toxicology, Medical School, University of Crete, GR-71003, Heraklion, Crete, Greece
| | - Elena Vakonaki
- Laboratory of Toxicology, Medical School, University of Crete, GR-71003, Heraklion, Crete, Greece
| | - Apostolos K Rizos
- Department of Chemistry, University of Crete, Foundation for Research and Technology-Hellas, FORTH-IESL, GR-71003, Heraklion, Crete, Greece
| | - Dimosthenis A Sarigiannis
- Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, Greece; HERACLES Research Centre on the Exposome and Health, Centre for Interdisciplinary Research and Innovation (KEDEK), Aristotle University of Thessaloniki, Greece; Environmental Health Engineering, Institute for Advanced Study IUSS, Pavia, Italy
| | - Aristides M Tsatsakis
- Laboratory of Toxicology, Medical School, University of Crete, GR-71003, Heraklion, Crete, Greece.
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Mandrioli D, Schlünssen V, Ádám B, Cohen RA, Colosio C, Chen W, Fischer A, Godderis L, Göen T, Ivanov ID, Leppink N, Mandic-Rajcevic S, Masci F, Nemery B, Pega F, Prüss-Üstün A, Sgargi D, Ujita Y, van der Mierden S, Zungu M, Scheepers PTJ. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of occupational exposure to dusts and/or fibres and of the effect of occupational exposure to dusts and/or fibres on pneumoconiosis. Environ Int 2018; 119:174-185. [PMID: 29958118 DOI: 10.1016/j.envint.2018.06.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 05/20/2018] [Accepted: 06/06/2018] [Indexed: 05/18/2023]
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 attributable to pneumoconiosis from occupational exposure to dusts and/or fibres, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on occupational exposure to dusts and/or fibres (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational exposure to dusts and/or fibres on pneumoconiosis (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework. 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 Medline, EMBASE, Web of Science and CISDOC. 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) study participants in the formal and informal economy in any WHO and/or ILO Member State but exclude children (<15 years) and unpaid domestic workers. Eligible risk factors will be dusts and/or fibres from: (i) asbestos; (ii) silica; and/or (iii) coal (defined as pure coal dust and/or dust from coal mining). Included outcomes will be (i) asbestosis; (ii) silicosis; (iii) coal worker pneumoconiosis; and (iv) unspecified pneumoconiosis. For Systematic Review 1, we will include quantitative prevalence studies of occupational exposure to dusts and/or fibres (i.e. no versus any exposure) stratified by country, sex, age 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 any occupational exposure to dusts and/or fibres on the prevalence of, incidence of or mortality due to pneumoconiosis, compared with the theoretical minimum risk exposure level of no exposure. 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 NUMBER CRD42018084131.
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Affiliation(s)
- Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy.
| | - Vivi Schlünssen
- Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark.
| | | | - Robert A Cohen
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
| | - Claudio Colosio
- Department of Health Sciences, University of Milano, Milano, Italy; International Centre for Rural Health, San Paolo Hospital, Milano, Italy.
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | | | | | - Thomas Göen
- University of Erlangen-Nuremberg, Erlangen, Germany.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | | | - Federica Masci
- Department of Health Sciences, University of Milano, Milano, Italy.
| | | | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Annette Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | | | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | | | - Muzimkhulu Zungu
- National Institute for Occupational Health, South Africa, Johannesburg, Gauteng Province, South Africa.
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands.
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Baur X, Budnik LT, Zhao Z, Verschoor L, Rubino FM, Colosio C, Jepsen JR. Correction to: Health risks in international container and bulk cargo transport due to volatile toxic compounds. J Occup Med Toxicol 2018; 13:25. [PMID: 30123313 PMCID: PMC6088401 DOI: 10.1186/s12995-018-0207-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Xaver Baur
- European Society for Environmental and Occupational Medicine (EOM), Berlin, Germany.,2Institute for Occupational Medicine, Charité University Medicine, Charité-Campus Benjamin Franklin, Berlin, Germany
| | - Lygia Therese Budnik
- European Society for Environmental and Occupational Medicine (EOM), Berlin, Germany.,Division Occupational Toxicology and Immunology, Institute for Occupational and Maritime (ZfAM), University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - Zhiwei Zhao
- 4Dalian Maritime University (DMU), Dalian, Ganjingzi China
| | - Louis Verschoor
- Expertise Centre Environmental Medicine (ECEMed), Rijnstate Teaching Hospital, Velp, The Netherlands
| | - Federico Maria Rubino
- 6Department of Health Sciences of the University of Milano and International Centre of Rural Health, San Paolo University Hospital Milano, Milan, Italy
| | - Claudio Colosio
- 6Department of Health Sciences of the University of Milano and International Centre of Rural Health, San Paolo University Hospital Milano, Milan, Italy
| | - Jorgen R Jepsen
- European Society for Environmental and Occupational Medicine (EOM), Berlin, Germany.,7Centre of Maritime Health and Society, Institute of Public Health, University of Southern Denmark, Odense, Denmark
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43
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Mandic-Rajcevic S, Rubino FM, Ariano E, Cottica D, Neri S, Colosio C. Environmental and biological monitoring for the identification of main exposure determinants in vineyard mancozeb applicators. J Expo Sci Environ Epidemiol 2018; 28:289-296. [PMID: 28901326 DOI: 10.1038/jes.2017.14] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 03/30/2017] [Indexed: 05/13/2023]
Abstract
Grapevine is a vulnerable crop to several fungal diseases often requiring the use of ethylenebisdithiocarbamate (EBDC) fungicides, such as mancozeb. This fungicide has been reported to have goitrogenic, endocrine disrupting, and possibly immunotoxic effects. The aim of this study was to assess workers' exposure in two scenarios of mancozeb application and analyse the main determinants of exposure in order to better understand their mechanism of influence. Environmental monitoring was performed using a modified Organisation for Economic Co-operation and Development (OECD) "patch" methodology and by hand-wash collection, while mancozeb's metabolite, ethylenethiourea (ETU), was measured in 24-h preexposure and postexposure urine samples. Liquid chromatography-mass spectrometry was used for determination of mancozeb and ETU in different kinds of samples. Closed tractor use resulted in 40 times lower potential exposure compared with open tractor. Coveralls reduced skin exposure 4 and 10 times in case of open and closed tractors, respectively. Gloves used during application resulted in 10 times lower hand exposure in open but increased exposure in closed tractors. This study has demonstrated that exposure to mancozeb is low if safe occupational hygiene procedures are adopted. ETU is confirmed as suitable biological marker of occupational exposure to mancozeb, but the absence of biological exposure limits significantly reduces the possibility to interpret biological monitoring results in occupationally exposed workers.
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Affiliation(s)
- Stefan Mandic-Rajcevic
- Department of Health Sciences of the University of Milan and International Centre for Rural Health of the San Paolo Hospital, Via San Vigilio 43, 20142 Milan, Italy
| | - Federico M Rubino
- Department of Health Sciences of the University of Milan and International Centre for Rural Health of the San Paolo Hospital, Via San Vigilio 43, 20142 Milan, Italy
| | - Eugenio Ariano
- Working Group for Prevention in Agriculture of the Region of Lombardy, Milan, Italy
| | - Danilo Cottica
- Centre for Environmental Research, Fondazione Salvatore Maugeri, Pavia, Italy
| | - Sara Neri
- Centre for Environmental Research, Fondazione Salvatore Maugeri, Pavia, Italy
| | - Claudio Colosio
- Department of Health Sciences of the University of Milan and International Centre for Rural Health of the San Paolo Hospital, Via San Vigilio 43, 20142 Milan, Italy
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44
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Kogevinas M, Gwinn WM, Kriebel D, Phillips DH, Sim M, Bertke SJ, Calaf GM, Colosio C, Fritz JM, Fukushima S, Hemminki K, Jensen AA, Kolstad H, Mráz J, Nesnow S, Nylander-French LA, Parent ME, Sandy M, Smith-Roe SL, Stoner G, Suzuki T, Teixeira JP, Vodicka P, Tornero-Velez R, Guyton KZ, Grosse Y, El Ghissassi F, Bouvard V, Benbrahim-Tallaa L, Guha N, Vilahur N, Driscoll T, Hall A, Middleton D, Jaillet C, Mattock H, Straif K. Carcinogenicity of quinoline, styrene, and styrene-7,8-oxide. Lancet Oncol 2018; 19:S1470-2045(18)30316-4. [PMID: 29680246 DOI: 10.1016/s1470-2045(18)30316-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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45
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Colosio C, Mandić-Rajčević S, Godderis L, van der Laan G, Hulshof C, van Dijk F. Reply. Occup Med (Lond) 2018; 68:148. [DOI: 10.1093/occmed/kqy005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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46
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De Matteis S, Heederik D, Burdorf A, Colosio C, Cullinan P, Henneberger PK, Olsson A, Raynal A, Rooijackers J, Santonen T, Sastre J, Schlünssen V, van Tongeren M, Sigsgaard T. Current and new challenges in occupational lung diseases. Eur Respir Rev 2017; 26:170080. [PMID: 29141963 PMCID: PMC6033059 DOI: 10.1183/16000617.0080-2017] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 09/02/2017] [Indexed: 01/13/2023] Open
Abstract
Occupational lung diseases are an important public health issue and are avoidable through preventive interventions in the workplace. Up-to-date knowledge about changes in exposure to occupational hazards as a result of technological and industrial developments is essential to the design and implementation of efficient and effective workplace preventive measures. New occupational agents with unknown respiratory health effects are constantly introduced to the market and require periodic health surveillance among exposed workers to detect early signs of adverse respiratory effects. In addition, the ageing workforce, many of whom have pre-existing respiratory conditions, poses new challenges in terms of the diagnosis and management of occupational lung diseases. Primary preventive interventions aimed to reduce exposure levels in the workplace remain pivotal for elimination of the occupational lung disease burden. To achieve this goal there is still a clear need for setting standard occupational exposure limits based on transparent evidence-based methodology, in particular for carcinogens and sensitising agents that expose large working populations to risk. The present overview, focused on the occupational lung disease burden in Europe, proposes directions for all parties involved in the prevention of occupational lung disease, from researchers and occupational and respiratory health professionals to workers and employers.
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Affiliation(s)
- Sara De Matteis
- Respiratory Epidemiology, Occupational Medicine and Public Health, Imperial College London, London, UK
| | - Dick Heederik
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Alex Burdorf
- Dept of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Claudio Colosio
- Dept of Health Sciences of the University of Milan and International Centre for Rural Health of the S. Paolo Hospital, Milan, Italy
| | - Paul Cullinan
- Respiratory Epidemiology, Occupational Medicine and Public Health, Imperial College London, London, UK
| | - Paul K Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Ann Olsson
- International Agency for Research on Cancer, Lyon, France
| | - Anne Raynal
- Occupational Medicine Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Jos Rooijackers
- Netherlands Expertise Center for Occupational Respiratory Disorders, Utrecht, The Netherlands
| | - Tiina Santonen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Joaquin Sastre
- Allergy Service, Fundacion Jimenez Diaz, Faculty of Medicine Universidad Autonoma de Madrid, CIBER of Respiratory Diseases, Ministry of Economy, Madrid, Spain
| | - Vivi Schlünssen
- Dept of Public Health, Section of Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Martie van Tongeren
- Centre for Occupational and Environmental Health; Centre for Epidemiology; Division of Population Health, Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Torben Sigsgaard
- Dept of Public Health, Section of Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
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47
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Colosio C, Mandic-Rajcevic S, Godderis L, van der Laan G, Hulshof C, van Dijk F. Workers’ health surveillance: implementation of the Directive 89/391/EEC in Europe. Occup Med (Lond) 2017; 67:574-578. [DOI: 10.1093/occmed/kqx113] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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48
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Masci F, Tassoni M, Bossi M, Magenta Biasina A, Serrao G, Rosecrance J, Colosio C. Assessing the effects of biomechanical overload on dairy parlor workers' wrist: Definition of a study approach and preliminary results. Work 2017; 55:747-756. [PMID: 28059827 DOI: 10.3233/wor-162462] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Dairy milking is a demanding work task that has been associated with hand and wrist musculoskeletal disorders. Clinical approaches to identify the early effects of musculoskeletal disorders among dairy parlor workers' wrist have not been well defined. OBJECTIVES The purpose of this pilot study was to develop a study protocol that would assist in the identification and quantification of hand and wrist disorders among dairy workers that perform tasks in the dairy parlor. Additionally, such a study protocol was needed to perform relatively rapid assessments of the wrist/hand on large samples of dairy workers. METHODS Fourteen dairy parlor workers were assessed for i) upper limb symptoms and work history through questionnaire, ii) a physical examination of the upper limb and in particular wrists and iii) wrist ultrasonography. An additional 21 unexposed paired participants (the control group) also participated in the data collection. RESULTS The study results identified two ultrasound acoustic windows characterized by the highest predictive value for alteration of the wrist's structure. Study results indicated an impairment of the distal median nerve in structure and mobility and impairment of the distal tendon of the muscle extensor carpi ulnaris that included dislocation and frank damage. CONCLUSIONS This study identified at least two acoustic windows that should be assessed with ultrasound studies on larger groups and in prospective periodical health surveillance of dairy workers. The study confirmed the wrist was at risk for biomechanical stress among workers conducting milking tasks in the dairy parlors.
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Affiliation(s)
- F Masci
- Department of Health Sciences of the University of Milan and International Center for Rural Health of San Paolo Hospital, Milan, Italy
| | - M Tassoni
- San Paolo Ultrasounds Medical School, S. Paolo Hospital, University of Milan, Milan, Italy
| | - M Bossi
- Department of Health Sciences of the University of Milan and International Center for Rural Health of San Paolo Hospital, Milan, Italy
| | - A Magenta Biasina
- San Paolo Ultrasounds Medical School, S. Paolo Hospital, University of Milan, Milan, Italy
| | - G Serrao
- San Paolo Ultrasounds Medical School, S. Paolo Hospital, University of Milan, Milan, Italy
| | - J Rosecrance
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - C Colosio
- Department of Health Sciences of the University of Milan and International Center for Rural Health of San Paolo Hospital, Milan, Italy
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49
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Gatault P, Kamar N, Büchler M, Colosio C, Bertrand D, Durrbach A, Albano L, Rivalan J, Le Meur Y, Essig M, Bouvier N, Legendre C, Moulin B, Heng AE, Weestel PF, Sayegh J, Charpentier B, Rostaing L, Thervet E, Lebranchu Y. Reduction of Extended-Release Tacrolimus Dose in Low-Immunological-Risk Kidney Transplant Recipients Increases Risk of Rejection and Appearance of Donor-Specific Antibodies: A Randomized Study. Am J Transplant 2017; 17:1370-1379. [PMID: 27862923 DOI: 10.1111/ajt.14109] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/05/2016] [Accepted: 10/30/2016] [Indexed: 01/25/2023]
Abstract
The aim of this study (ClinicalTrials.gov, NCT01744470) was to determine the efficacy and safety of two different doses of extended-release tacrolimus (TacER) in kidney transplant recipients (KTRs) between 4 and 12 mo after transplantation. Stable steroid-free KTRs were randomized (1:1) after 4 mo: Group A had a 50% reduction in TacER dose with a targeted TacER trough level (C0 ) >3 μg/L; group B had no change in TacER dose (TacER C0 7-12 μg/L). The primary outcome was estimated GFR at 1 year. Of 300 patients, the intent-to-treat analysis included 186 patients (group A, n = 87; group B, n = 99). TacER C0 was lower in group A than in group B at 6 mo (4.1 ± 2.7 vs. 6.7 ± 3.9 μg/L, p < 0.0001) and 12 mo (5.6 ± 2.0 vs. 7.4 ± 2.1 μg/L, p < 0.0001). Estimated GFR was similar in both groups at 12 mo (group A, 56.0 ± 17.5 mL/min per 1.73 m²; group B, 56.0 ± 22.1 mL/min per 1.73 m²). More rejection episodes occurred in group A than group B (11 vs. 3; p = 0.016). At 1 year, subclinical inflammation occurred more frequently in group A than group B (inflammation score [i] >0: 21.4% vs. 8.8%, p = 0.047; tubulitis score [t] >0: 19.6% vs. 8.7%, p = 0.076; i + t: 1.14 ± 1.21 vs. 0.72 ± 1.01, p = 0.038). Anti-HLA donor-specific antibodies appeared only in group A (6 vs. 0 patients, p = 0.008). TacER C0 should be maintained >7 μg/L during the first year after transplantation in low-immunological-risk, steroid-free KTRs receiving a moderate dose of mycophenolic acid.
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Affiliation(s)
- P Gatault
- EA4245 Dendritic Cells, Immunomodulation and Grafts, François-Rabelais University, Tours, France.,Department of Nephrology and Clinical Immunology, CHRU Tours, Tours, France
| | - N Kamar
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.,INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.,Université Paul Sabatier, Toulouse, France
| | - M Büchler
- EA4245 Dendritic Cells, Immunomodulation and Grafts, François-Rabelais University, Tours, France.,Department of Nephrology and Clinical Immunology, CHRU Tours, Tours, France
| | - C Colosio
- Department of Kidney Transplantation, CHU Reims, Reims, France
| | - D Bertrand
- Department of Kidney Transplantation, CHU Rouen, Rouen, France
| | - A Durrbach
- Department of Kidney Transplantation, Kremlin-Bicêtre Hospital, Villejuif, France
| | - L Albano
- Department of Kidney Transplantation, CHU Nice, Nice, France
| | - J Rivalan
- Department of Kidney Transplantation, CHU Rennes, Rennes, France
| | - Y Le Meur
- Department of Kidney Transplantation, CHU Brest, Brest, France
| | - M Essig
- Department of Kidney Transplantation, CHU Limoges, Limoges, France
| | - N Bouvier
- Department of Kidney Transplantation, CHU Caen, Caen, France
| | - C Legendre
- Department of Kidney Transplantation, Necker Hospital, Paris, France.,INSERM Unité 845, Paris, France
| | - B Moulin
- Department of Kidney Transplantation, CHRU Strasbourg, Strasbourg, France
| | - A-E Heng
- Department of Kidney Transplantation, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - P-F Weestel
- Department of Kidney Transplantation, CHU Amiens, Amiens, France
| | - J Sayegh
- Department of Kidney Transplantation, CHU Angers, Angers, France
| | - B Charpentier
- Department of Kidney Transplantation, Kremlin-Bicêtre Hospital, Villejuif, France
| | - L Rostaing
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.,INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.,Université Paul Sabatier, Toulouse, France
| | - E Thervet
- Department of Kidney Transplantation, Georges-Pompidou Hospital, Paris, France
| | - Y Lebranchu
- EA4245 Dendritic Cells, Immunomodulation and Grafts, François-Rabelais University, Tours, France.,Department of Nephrology and Clinical Immunology, CHRU Tours, Tours, France
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50
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Pallet N, Etienne I, Buchler M, Bailly E, Hurault de Ligny B, Choukroun G, Colosio C, Thierry A, Vigneau C, Moulin B, Le Meur Y, Heng AE, Legendre C, Beaune P, Loriot MA, Thervet E. Long-Term Clinical Impact of Adaptation of Initial Tacrolimus Dosing to CYP3A5 Genotype. Am J Transplant 2016; 16:2670-5. [PMID: 26990694 DOI: 10.1111/ajt.13788] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 02/12/2016] [Accepted: 03/03/2016] [Indexed: 01/25/2023]
Abstract
Pretransplantation adaptation of the daily dose of tacrolimus to CYP3A5 genotype is associated with improved achievement of target trough concentration (C0 ), but whether this improvement affects clinical outcomes is unknown. In the present study, we have evaluated the long-term clinical impact of the adaptation of initial tacrolimus dosing according to CYP3A5 genotype: The transplantation outcomes of the 236 kidney transplant recipients included in the Tactique study were retrospectively investigated over a period of more than 5 years. In the Tactique study, patients were randomly assigned to receive tacrolimus at either a fixed dosage or a dosage determined by their genotype, and the primary efficacy end point was the proportion of patients for whom tacrolimus C0 was within target range (10-15 ng/mL) at day 10. Our results indicate that the incidence of biopsy-proven acute rejection and graft survival were similar between the control and the adapted tacrolimus dose groups, as well as between the patients who achieve the tacrolimus C0 target ranges earlier. Patients' death, cancer, cardiovascular events, and infections were also similar, and renal function did not change. We conclude that optimization of initial tacrolimus dose using pharmacogenetic testing does not improve clinical outcomes.
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Affiliation(s)
- N Pallet
- Clinical Chemistry Department, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France.,Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France.,Sorbonne Paris Cité, INSERM UMRS 1147, Paris, France
| | - I Etienne
- Department of Nephrology-Clinical Immmunology, CHU Rouen, Rouen, France
| | - M Buchler
- Department of Nephrology, CHU Tours, Tours, France
| | - E Bailly
- Department of Nephrology, CHU Tours, Tours, France
| | | | - G Choukroun
- Department of Nephrology, CHU Amiens, Amiens, France
| | - C Colosio
- Department of Nephrology, CHU Reims, Reims, France
| | - A Thierry
- Department of Nephrology, CHU Poitiers, Poitiers, France
| | - C Vigneau
- Department of Nephrology, CHU Rennes, Rennes, France
| | - B Moulin
- Department of Nephrology, CHU Strasbourg, Strasbourg, France
| | - Y Le Meur
- Department of Nephrology, CHU Brest, Brest, France
| | - A-E Heng
- Department of Nephrology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - C Legendre
- Department of Nephrology, Necker Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - P Beaune
- Clinical Chemistry Department, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France.,Sorbonne Paris Cité, INSERM UMRS 1147, Paris, France
| | - M A Loriot
- Clinical Chemistry Department, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France.,Sorbonne Paris Cité, INSERM UMRS 1147, Paris, France
| | - E Thervet
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France.,Sorbonne Paris Cité, INSERM UMRS 1147, Paris, France
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