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Abstract
Fifteen human volunteers were exposed to 1,1,1-trichloroethane (methyl chloroform) vapor at 72-495 mg/m3 for a period of 2 to 4 hours at rest (ten cases) and during light physical exercise (five cases). Subsequently 60 workers occupationally exposed to 1,1,1-trichloroethane in a refrigerator manufacturing plant were studied (median value: 178 mg/m3; geometrical standard deviation: 2.19 mg/m3). As expected, the relative uptake (R) of 1,1,1-trichloroethane decreased in the course of exposure at rest (R = 0.44 after 20 minutes of exposure; R = 0.26 after 240 minutes of exposure). Both in the experimentally exposed subjects and in the occupationally exposed workers, the urinary concentration of 1,1,1-trichloroethane showed a linear relationship to the corresponding environmental time-weighted average concentration. The correlation coefficients (r) were 0.95 in occupationally exposed subjects and more than 0.90 in experimentally exposed groups. A linear equation also existed between urinary concentration and amount of 1,1,1-trichloroethane absorbed (r = 0.88). The findings indicate that the urinary concentration of 1,1,1-trichloroethane can be used as an appropriate biological exposure indicator. In occupationally exposed subjects performing moderate work, the urinary 1,1,1-trichloroethane concentration corresponding to the time-weighted average of the threshold limit value was found to be 860 micrograms/L and its 95% lower confidence limit (biological threshold) 805 micrograms/L.
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[Risks of awkward posture]. GIORNALE ITALIANO DI MEDICINA DEL LAVORO ED ERGONOMIA 2010; 32:215-222. [PMID: 21061697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
For posture we mean the position of the body in the space and the relationship with its segments. The correct posture is determined by neurophysiological, biomechanical, emotional, psychological and relation factors, enabling us to perform daily and working activities with the lowest energy expenditure. When possible we suggest during posture variation, a preventive measure where there are prolonged fixed activities.
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[Risks of repetitive movements in health personnel]. GIORNALE ITALIANO DI MEDICINA DEL LAVORO ED ERGONOMIA 2010; 32:223-226. [PMID: 21061698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
To date, scant attention has been devoted to the occupational risk related to repetitive movements in health personnel. Using three database, PubMed, Scopus, and EMBASE, we found 57 papers on this topic, and on possibly related upper limb symptoms and diseases. In these studies, evaluation of the risk, e.g. using the methods currently applied in industry, are lacking. Although in several studies data on the prevalence of upper limb symptoms and disorders are presented, a comparison of results is difficult as different methods were applied. Furthermore, a comparison with adequate controls is frequently lacking, and/or correlation with the risk was not studied. Despite these limitations, an overall evaluation of the results shows that in health personnel the prevalence of upper limb symptoms/disorders is generally high. Highest prevalences were observed for the neck, shoulder, wrist/hand symptoms and for Carpal Tunnel Syndrome (CTS) in dental personnel, for symptoms to the neck, shoulder and wrist/hand in sonographers, and to the neck, shoulder, elbow, and, especially, wrist/hand in laboratory technicians using manual pipettes. In the nursing personnel highly variable prevalences were observed; this is possibly due to the variability of the tasks performed by this occupational group. Repetitive movements of upper limb are a known risk factor for symptoms to the neck, shoulder, elbow, and wrist/hand, and some disorders, as CTS: the high prevalences observed in health workers may be related to this risk. Nevertheless, other factors such as effort, posture and precision work may play an important role too. As a conclusion, available data are insufficient for an adequate evaluation of the occupational risk related to repetitive movements in health workers.
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[New developments in occupational therapy and ergonomics]. GIORNALE ITALIANO DI MEDICINA DEL LAVORO ED ERGONOMIA 2007; 29:47-51. [PMID: 17569418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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[Work and rehabilitation in IRCCS "Salvatore Maugeri"]. GIORNALE ITALIANO DI MEDICINA DEL LAVORO ED ERGONOMIA 2002; 24:167-9. [PMID: 12161957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Abstract
S-phenylmercapturic acid (S-PMA) was measured in urine from 145 subjects exposed to low benzene concentrations in the air (C(I), benzene). The 8-h, time-weighted exposure intensity of individual workers was monitored by means of charcoal tubes and subsequent gas-chromatographic analysis after desorption with CS2. S-PMA excretion level in urine was determined by high-performance liquid chromatography with fluorescence detection. The following linear correlation was found between S-PMA concentrations in urine and benzene concentrations in the breathing zone: log(S-PMA, microg/g creatinine) = 0.712 log (C(I)-benzene, ppm) + 1.644 (n = 145, r = 0.74, P < 0.001). The geometric mean (GSD) of S-PMA concentrations in urine from 45 subjects occupationally not exposed to benzene but smoking more than 20 cigarettes/day was 7.8 microg/g creatinine (2.11), the corresponding value among non-smokers being 1.0 microg/g creatinine (2.18). It is concluded that the urinary level of S-PMA can be regarded as a useful indicator of exposure to benzene.
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[Activity: indicator of quality of health]. GIORNALE ITALIANO DI MEDICINA DEL LAVORO ED ERGONOMIA 1998; 20:59-61. [PMID: 9658235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Excretion of N-acetyl-S-(1-phenyl-2-hydroxyethyl)-cysteine and N-acetyl-S-(2-phenyl-2-hydroxyethyl)-cysteine in workers exposed to styrene. THE SCIENCE OF THE TOTAL ENVIRONMENT 1997; 199:13-22. [PMID: 9200843 DOI: 10.1016/s0048-9697(97)05477-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Styrene (S) has been shown to be responsible for neurotoxic effects, including behavioural changes and neuroendocrine disturbances. The initial step of S metabolism is conversion to styrene 7,8-epoxide (SO), which is present in two enantiomeric forms [(R)(+)-SO and (S)(-)-SO]; this electrophilic intermediate is considered to be directly responsible for most toxic effects of S. The major urinary metabolites derived from the biotransformation of SO in man are mandelic acid (MA) and phenylglyoxylic acid (PGA). In rats an alternative pathway has been demonstrated, which involves the conjugation of SO to glutathione (GSH), leading to the excretion of two specific mercapturic acids, N-acetyl-S-(-(1-phenyl-2-hydroxyethyl)-cysteine [M1] and N-acetyl-S-(2-phenyl-2-hydroxy-ethyl)-cysteine [M2]; a close relationship has been found between exposure to S and urinary excretion of M1 and M2 in rats. As a consequence of the chiral nature of SO, both M1 and M2 consist of two diastereoisomers (M1-'R', M1-'S', M2-'R' and M2-'S'). Early reports have shown that the conversion of S to mercapturic acids is much lower in man (below 1% of the absorbed dose) than in rats (about 10%). We propose an analytical method for the determination of urinary M1 and M2 in man, which involves a urine clean-up by a chromatographic technique with a short reversed-phase pre-column; purified samples are then deacetylated with porcine acylase and deproteinized by centrifugal ultrafiltration. A derivatization is then performed with o-phthaldialdehyde and 2-mercaptoethanol and the fluorescent derivatives are separated on a reversed-phase analytical column. The mobile phase consists of acetate buffer and methanol mixed at variable proportions, the fluorescence detector is set at 330 nm (exc.) and 440 nm (em.). M1-'S' and M1-'R' are separated (retention times = 52.8 and 73.7 min, respectively) while the diastereoisomers of M2 coelute as a single peak at 70.5 min. The detection limit is about 7 micrograms/l, the coefficients of variation are below 7% and the error percentages are less than 6%. The method was applied to 25 urine samples from workers exposed to S: significant correlations were found between mercapturic acids and MA and PGA, the best correlation being between M2 and PGA (r = 0.79). Urine samples form unexposed subjects showed no detectable amounts of the analytes. A high stereoselectivity is shown by the enzymes involved in the metabolism of S to mercapturic acids: M1-'S', which derives from (S)-SO, is excreted in much higher amounts than M1-'R', which derives from (R)-SO.
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The urinary excretion of solvents and gases for the biological monitoring of occupational exposure: a review. THE SCIENCE OF THE TOTAL ENVIRONMENT 1997; 199:3-12. [PMID: 9200842 DOI: 10.1016/s0048-9697(97)05476-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
'In the field' application of the measurement of urinary excretion of unmodified solvent for the biological monitoring of exposed workers has been investigated in many recent papers. The results obtained for several solvents are reviewed. The values of correlation coefficients (r) and regression lines obtained for benzene, toluene, xylene, styrene, n-hexane, cyclohexane, 2- and 3-methylpentane, methyl chloride, tetrachloroethylene, carbon tetrachloride, methyl chloroform, p-dichlorobenzene, nitrous oxide, halothane, isoflurane, enflurane, acetone, methyl ethyl ketone and methyl isobutyl ketone are presented. The correlations observed were generally good: r values range from 0.50-0.97, and the majority are between 0.84 and 0.90. The regression lines reported for the same solvent in different studies present some variability: this is possibly due to an inadequate control of factors influencing the relationship between external dose and absorption, such as differences in body burden, work load, individual characteristics, etc. These factors are discussed. As a whole, results reported in the literature show that measuring of urinary excretion of unmodified solvents provides a highly sensitive and specific exposure index, and can also be applied for the biological monitoring of occupational exposure to low levels of solvents or to solvent mixtures. Nevertheless, for an adequate assessment of biological limit values, further studies evaluating the reproducibility of regression lines are needed, given that the aspects influencing the correlation between external dose and urinary excretion are fully controlled. Another crucial aspect is the correlation with early effects: even though this has yet to be evaluated for several solvents, for others such as styrene and perchloroethylene a good correlation was obtained, further supporting the usefulness of the measurement of urinary excretion of solvent for the biological monitoring of occupational exposure.
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Abstract
Styrene is an important chemical of wide industrial use, particularly in the manufacture of polymers and reinforced plastics. Environmental and occupational exposures to styrene occur predominantly via inhalation. Styrene undergoes biotransformation mainly by side chain oxidation catalyzed by cytochrome P-450 enzymes to its reactive metabolite, styrene oxide. The (R)- and (S)-enantiomers of styrene oxide can be conjugated with glutathione to both (R)- and (S)-diastereoisomers of specific mercapturic acids, N-acetyl-S-(1-phenyl-2-hydroxyethyl)-L-cysteine (M1) and N-acetyl-S-(2-phenyl-2-hydroxyethyl)-L-cysteine (M2). We conducted this biomonitoring study with the aim of evaluating the association between excretion of specific mercapturic acids (M1 and M2) and level of exposure to styrene among occupationally exposed people. The mean time-weighted average (TWA) exposure was about one-half the current threshold limit value, the range of the values varied from 44 to 228 mg/m3. Geometric mean (GM) concentrations of 650, 1,084, and 31.8 micrograms/g creatinine were measured, respectively, for M1-S, M2, and M1-R. The environmental styrene concentration exhibited a significant correlation with total specific mercapturic acid (Mtot = sum of M1-R, M1-S, and M2), making it possible for the first time to calculate the approximate relationship between styrene uptake and excretion of these substances. The M2 mercapturic acid had a better correlation (r = 0.56) with respect to M1-R and M1-S. Significant correlations were found also between the excretion of specific mercapturic acids and biological exposure indices (i.e., mandelic and phenylglyoxylic acids and urinary styrene).
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Anesthetic in urine as biological index of exposure in operating-room personnel. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH 1995; 46:249-60. [PMID: 7563221 DOI: 10.1080/15287399509532032] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The aim of this study was to determine if a relationship existed between some inhalation anesthetics airborne exposure levels (Cl) and the concentration of anesthetics in samples of urine produced throughout the exposure time (Cu). The concentrations of nitrous oxide (N2O), halothane (fluothane), enflurane (ethrane), and isoflurane (forane) in the ambient atmosphere were determined in 190 operating theaters of 41 hospitals in Italy. Nitrous oxide, halothane, enflurane and isoflurane were detected in the urine of 1521 exposed subjects (anesthetists, surgeons, and nurses). The environmental measurements were performed using personal passive samplers, and the biological measurements were performed using the head space method. Significant correlations were found between the anesthetics concentration in urine produced during the shift collected after a 4-h exposure (Cu, microgram/L) and anesthetics environmental concentration (Cl, ppm). The results show that the urinary anesthetic concentration can be used as an appropriate biological exposure index. The biological values (urinary concentration values) proposed are the following: nitrous oxide, 25 micrograms/L, for an environmental value of 50 ppm; halothane, 97 micrograms/L, corresponding to 50 ppm of environmental exposure; 6.2 micrograms/L, corresponding to 2 ppm of environmental exposure; enflurane, 145 micrograms/L for an environmental exposure of 75 ppm and 5.6 micrograms/L for an environmental exposure of 2 ppm; isoflurane, 5.3 micrograms/L for an environmental exposure of 2 ppm. The values proposed are the respectively 95% lower confidence limit and therefore should be considered as a protection for the individual, especially if each biological value is corrected according to analytical variability of the measurements. In our opinion, the method of choice in the assessment of occupational exposure to inhalation anesthetics is the measurement of the urinary anesthetic concentration.
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Determination of 2,5-hexandione by high-performance liquid chromatography after derivatization with dansylhydrazine. JOURNAL OF CHROMATOGRAPHY. B, BIOMEDICAL APPLICATIONS 1994; 657:111-7. [PMID: 7952056 DOI: 10.1016/0378-4347(94)80076-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A sensitive method for the determination of free and total urinary 2,5-hexandione (2,5-HD) using high-performance liquid chromatography with fluorescence detection was developed. After purification of urine with a disposable C18 cartridge, 2,5-HD was derivatized with dansylhydrazine; 1,3-diacetyl benzene (1,3-DAB) was added to the samples, as internal standard, prior to extraction. The resulting fluorescent adducts were separated on a reversed-phase column with a gradient mobile phase of 25 mM phosphate buffer (pH 6.4) and acetonitrile. The retention times of the 2,5-HD and 1,3-DAB derivatives were 9.4 and 13.7 min, respectively. The derivatives were detected by a fluorescence detector (excitation 340 nm, emission 525 nm). The mean recoveries of 2,5-HD and 1,3-DAB were 92.0 and 94.0%, respectively; the detection limit of 2,5-HD (signal-to-noise ratio of 3) was 5 micrograms/l in urine without hydrolysis and ca. 12 micrograms/l in hydrolyzed samples. The method was applied to 39 urine samples from workers exposed to n-hexane; the mean values were 2.597 mg/l (S.D. = +/- 0.758) for total 2,5-HD and 0.179 mg/l (S.D. = +/- 0.086) for free 2,5-HD. Urine samples of 22 non-exposed subjects showed a mean concentration of 0.437 mg/l (S.D. = +/- 0.109) and 0.022 mg/l (S.D. = +/- 0.011) for total and free 2,5-HD, respectively.
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Biological monitoring of occupational exposure to enflurane (ethrane) in operating room personnel. ARCHIVES OF ENVIRONMENTAL HEALTH 1994; 49:135-40. [PMID: 8161244 DOI: 10.1080/00039896.1994.9937467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Biological monitoring of occupational exposure to enflurane (ethrane) can be achieved by measuring concentrations of inorganic fluorides in the blood and urine and of enflurane in alveolar air and venous blood. Measurement of these concentrations, however, has limitations. Another method for monitoring exposure to enflurane is to measure its concentration in urine throughout the period of exposure. In this study, we measured the environmental and urinary concentrations of enflurane. Enflurane in the ambient atmosphere was determined in 18 operating theaters of eight hospitals in Italy. Ambient air concentrations exceeded the National Institute for Occupational Safety and Health-recommended time-weighted average exposure level of 1 ppm (median: 1.31 ppm). Enflurane was detected in urine of 159 exposed subjects (anesthetists, surgeons, and nurses). A significant correlation was found between enflurane concentration in urine produced during the shift and environmental concentration (r = 0.77, p = .0001). The results showed that urinary enflurane concentration can be used as an appropriate biological exposure index. The biological values proposed are 153 micrograms/l, corresponding to 75 ppm of environmental exposure; 22 micrograms/l, corresponding to 10 ppm of environmental exposure; and 3.5 micrograms/l, corresponding to 1 ppm of environmental exposure. The proposed values can be regarded as time-weighted average samples, reflecting exposure for a 4-h period.
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Abstract
The hepatic effects of 1,2-dichloropropane (DCP) were investigated in male Wistar rats exposed to 15, 50, 100, 250, 450, 1000, 1300, 1800 or 4900 mg DCP m-3. At the end of a 4-h period of exposure, average blood DCP levels were 0.025 and 5.38 micrograms ml-1 in animals treated with 15 and 1300 mg m-3, respectively. Blood DCP concentrations were correlated with the air DCP concentrations in the inhalation chamber. At DCP concentrations of 100 mg m-3 or higher, the liver non-protein thiol (NPT) content was significantly reduced. Assays performed 20 h after 4-h DCP exposure showed that exposure to 100-1000 mg DCP m-3 had no effect on hepatic NPT levels. The NPT content increased only in the liver of rats exposed to higher (1300-4900 mg m-3) DCP concentrations. Treatment with DCP did not cause hepatic lipid peroxidation and did not modify total protein content. The observed changes in liver cell thiol homeostasis are likely to reflect the action of reactive intermediates formed during DCP metabolism. These changes can occur in rats following exposure to considerably low levels of DCP vapour.
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Trace element reference values in tissues from inhabitants of the European community. I. A study of 46 elements in urine, blood and serum of Italian subjects. THE SCIENCE OF THE TOTAL ENVIRONMENT 1990; 95:89-105. [PMID: 2402627 DOI: 10.1016/0048-9697(90)90055-y] [Citation(s) in RCA: 211] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Neutron activation analysis-electrothermal atomic absorption spectroscopy (ETA-AAS) and inductively coupled plasma atomic emission spectrometry (ICP-AES) have been used for the determination of 46 elements in urine, 35 in blood and 26 in serum of unexposed Italian subjects living in the same region (Lombardy). The results allowed the proposal of reference values for various elements determined in more than 350 healthy subjects, these being Ag, Al, As, Be, Bi, Cd, Co, Cr, Cu, Hg, Mn, Ni, Pb, Sb, Se, Tl, V, Zn, in urine; Ag, As, Bi, Cd, Cr, Co, Cu, Hg, Pb, Se, Tl, Zn in blood; and Ag, Al, Be, Cd, Co, Cr, Cu, Hg, Mn, Ni, Pb, Se, Tl, V, Zn in serum (or plasma). For all other elements indicative values are suggested. In addition to the mean value and the "reference range", a "range of uncertainty" and an upper limit above which metabolic abnormalities could be expected have also been defined on the basis of simple statistical considerations.
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Methyl ethyl ketone (MEK) in urine as biological index of exposure. GIORNALE ITALIANO DI MEDICINA DEL LAVORO 1989; 11:255-61. [PMID: 2562745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Fifteen human volunteers were exposed to methyl ethyl ketone (MEK) vapor at 11.9-621.8 mg/m3 for a period of 2 to 4 hours at rest (ten cases) and during light physical exercise (five cases). Subsequently 78 workers occupationally exposed to MEK in a manufacture of leather suitcases (median value: 75.5 mg/m3; geometrical standard deviation: 3.12 mg/m3; range: 6-790) were studied. The analyses were performed by means of a Gas Chromatograph (GC) Hewlett-Packard 5880 A connected with a Mass Selective Detector (MSD). The relative uptake (R) of MEK was about 0.54 (standard deviation: 0.05) and it keeps practically constant either at rest or during light effort (V < 30 L/min). A linear relationship existed in the experimentally exposed subjects between urinary concentration (Cu) and amount of MEK absorbed (U) (Cu = 3.05 x U-162.1; r = 0.95; n = 15) (Cu = micrograms/L; U = mg). Both in the experimentally exposed subjects and in the occupationally exposed workers, the urinary concentration of MEK shoved a linear relationship to the corresponding environmental time-weighted average concentration (CI). The correlation coefficients (r) were 0.93 in occupationally exposed subjects (regression equation: Cu = 0.004 x CI + 0.118; n = 78); Cu = mg/L; CI = mg/m3) and more than 0.93 in experimentally exposed groups. The findings indicate that the urinary concentration of MEK can be used as an appropriate biological exposure indicator.(ABSTRACT TRUNCATED AT 250 WORDS)
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Evaluation of exposure to isoflurane (Forane): environmental and biological measurements in operating room personnel. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH 1988; 25:393-402. [PMID: 3199455 DOI: 10.1080/15287398809531219] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The concentration of isoflurane (Forane) in the ambient atmosphere was determined in 11 operating theaters of 5 hospitals in Italy. The concentration of isoflurane in the ambient air exceeds the recommended time-weighted average exposure levels (median value: 113 mumol/m3). Isoflurane was detected in the urine of 45 exposed subjects (anesthetists, surgeons, and nurses). A significant correlation was found between the isoflurane concentration in urine produced during the shift (Cu' nmol/l) and isoflurane environmental concentration (Cl' mumol/m3) (Cu = 0.243 X Cl + 3.712) (r = .90). The results show that the urinary isoflurane concentration can be used as an appropriate biological exposure index. The authors suggest a biological exposure index of 18 nmol/l (3.4 micrograms/l). This is the biological value obtained after 4 h of an average environmental exposure to 81 mumol/m3 (2 ppm).
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Urinary concentration, environmental concentration, and respiratory uptake of some solvents: effect of the work load. AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL 1988; 49:546-52. [PMID: 3195471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The physical demands of the workplace differ depending on specific jobs. This implies that workers exposed to the same environmental level of an airborne contaminant can absorb different amounts of it depending on their pulmonary ventilation. Starting from the relationship between the uptake (U) and the urinary concentration of six solvents (Cu) (acetone, styrene, toluene, xylenes, methylchloroform, tetrachloroethylene) and from the equation expressing their lung uptake (U = K.V.CI.R.T) the expected values of a biological index after a given time of exposure can be derived. Such values are a function not only of the environmental level of exposure (CI) but also of the pulmonary ventilation (V - dependent solvent) and of the retention index (R) (V - R dependent solvent).
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Nitrous Oxide (N2O) in Urine as Biological Index of Exposure in Operating Room Personnel. ACTA ACUST UNITED AC 1988. [DOI: 10.1080/08828032.1988.10390299] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Urinary excretion of tetrachloroethylene (perchloroethylene) in experimental and occupational exposure. ARCHIVES OF ENVIRONMENTAL HEALTH 1988; 43:292-8. [PMID: 3415356 DOI: 10.1080/00039896.1988.10545952] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Fifteen human volunteers were exposed to tetrachloroethylene (perchloroethylene, tetrachloroethene) vapor at 3.6-316 mg/m3 for 2-4 hr at rest (10 cases) and during light physical exercise (5 cases). Subsequently, 55 workers who were occupationally exposed to tetrachloroethylene in eight commercial dry cleaning facilities were studied (median value, 66 mg/m3; geometric standard deviation, 3.15 mg/m3). In both the experimentally exposed subjects and occupationally exposed workers the urinary concentration of tetrachloroethylene showed a linear relationship to the corresponding environmental time-weighted average concentration. The findings indicate that the urinary concentration of tetrachloroethylene can be used as an appropriate biological exposure indicator. In occupationally exposed subjects performing moderate work, the urinary tetrachloroethylene concentration corresponding to the time-weighted average of the threshold limit value proved to be 120 mcg/L and its 95% lower confidence limit (biological threshold) 100 mcg/L. The effects of workload on the tetrachloroethylene urinary elimination are also accounted for.
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Abstract
Addition of silver nitrate or silver lactate to freshly isolated hepatocytes caused dose-dependent loss of cell viability, measured by trypan blue exclusion, at concentrations within 30-70 microM. Silver cytotoxicity was accompanied by a decrease in hepatic thiol concentration and an increase in lipid peroxidation. Treatment of hepatocytes with the reduced glutathione (GSH)-depleting agent diethylmaleate markedly increased their vulnerability to silver toxicity whereas protective effects were produced by the thiol-reducing agent, dithiothreitol. Both alpha-tocopherol, which protected from the onset of silver-associated lipid peroxidation, and the iron chelator agent, deferoxamine failed to prevent loss of cell viability. These data suggest that perturbation of intracellular thiol homeostasis may play a critical role in the mechanism underlying silver-induced lethal damage to isolated rat hepatocytes.
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The urinary concentration of solvents as a biological indicator of exposure: proposal for the biological equivalent exposure limit for nine solvents. AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL 1987; 48:786-90. [PMID: 3687738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Organic solvents are generally volatile substances that are absorbed mainly through the lungs; they are eliminated chiefly through the lungs and kidneys. In urine they are present as metabolites and, in very little part, as parent compound. The urinary concentration of solvent (Cu) can be used for the biological monitoring of exposed subjects to evaluate their exposure and correlate with the Threshold Limit Value (TLV) during the working day. The authors report some results obtained with workers occupationally exposed to solvents. The results concern the correlation between urinary concentration (Cu, micrograms/L) vs. average environmental concentration (Ci, mg/m3) measured in the breathing zone. For each solvent studied (acetone, 2-cyclohexane, 1,2-dichloropropane, n-hexane, methyl ethyl ketone, perchloroethylene, styrene, toluene, 1,1,1-trichloroethane) the authors propose a Biological Equivalent Exposure Limit (BEEL) corresponding to the environmental TLV.
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[Urinary elimination of xylene in experimental and occupational exposure]. LA MEDICINA DEL LAVORO 1987; 78:239-49. [PMID: 3657694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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[Proposal of the biological monitoring of inhalation anesthetics]. GIORNALE ITALIANO DI MEDICINA DEL LAVORO 1987; 9:111-8. [PMID: 3509083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The long-term occupational exposure to inhalation anaesthetics might represent a health hazard; mainly it may have an adverse effect on the reproductive outcome. Nitrous oxide is the anaesthetic employed in the largest amount during general anaesthesia and it can be used as an indicator of occupational exposure to all the components the mixture; but if the pattern of dispersion of them (when leaking into the operating theater) are not the same, two indicators should be used: N2O (gas) + another component the mixture (vapour). Our results concern practically 5 points: --Analysis of N2O by means of a diffusive personal sampler (comparison with a conventional sampling method) --Analysis of N2O in urine collected after 4 hours of exposure during routine anaesthetic work (headspace method) --Comparison of environmental and biological data concerning N2O --Comparison of environmental and biological data concerning a component of the anaesthetic mixture, forane --Proposal of biological exposure indices for nitrous oxide and forane. A close relationship between air and urine was found in 363 subjects occupationally exposed to N2O and 45 subjects exposed to forane (r: 0.95 and 0.90 respectively). On the basis of such a relationship the biological exposure index for N2O corresponding to an ambient concentration of 100 ppm (European limit) turned out to be 55 micrograms/L; the ones for forane corresponding to ambient concentrations of 2 or 10 ppm are respectively 3.4 or 14.5 micrograms/L (urinary concentrations in samples collected after 4 hours of exposure).
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26
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[Toxicological and analytical lists: chromium and its compounds]. GIORNALE ITALIANO DI MEDICINA DEL LAVORO 1987; 9:53-105. [PMID: 3333641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The main aspects of occupational exposure to chromium and chromium compounds are surveyed. Special attention is paid to the toxic action of this metal at the different target organs. The nutritional aspect of CrIII is examined preliminarily, and data detailing the metal contents in water and food are provided. As far the different working processes that entail occupational exposure to chromium are concerned, hygienic and environmental problems are discussed while identifying the average environment exposure to the different chemical forms of chromium (CrIII, CrIV, soluble and not soluble), as a function of the worker's tasks, and the relevant human response (total human Cr). Different hygienic and environmental standards in force in various countries and applicable to chromium compounds are compared. Additional information is given on the main aspects of chromium metabolism (absorption, distribution, excretion), and on the prevailing toxic actions, with specific reference to cancerogenesis. As far as biologic monitoring of the exposed people is concerned, the significance of Cr-U as dose-exposure indicator is discussed, also in the light of a critical review of the reference values. The report describes a series of analytical methods for the identification of chromium in aqueous and biologic matrices. The problems connected with health monitoring and fitness for work are eventually covered.
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27
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Urinary elimination of acetone in experimental and occupational exposure. Scand J Work Environ Health 1986; 12:603-8. [PMID: 3823809 DOI: 10.5271/sjweh.2096] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Fifteen volunteers were exposed to an acetone vapor concentration of 964-8, 610 mumol/m3 (56-500 mg/m3) for 2-4 h in an exposure chamber. Ten subjects were at rest during the exposure, and five were exposed at alternate rest and light physical exercise. Subsequently 104 workers occupationally exposed to acetone were studied. The relative uptake averaged about 53%, and the ratio of the alveolar concentration to the environmental concentration averaged about 0.28. Both for the experimentally exposed subjects and the occupationally exposed workers the urinary acetone concentration showed a linear relationship to the corresponding environmental time-weighted average concentration. A linear equation also existed between urinary concentrations and the amounts of acetone absorbed. The findings enable a consideration of the urinary concentration of the unaltered acetone as an appropriate exposure indicator and the proposal of a "biological equivalent threshold" to be used in the field of biological monitoring.
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[Relationship of environmental levels, respiratory absorption and urinary concentrations of various solvents: effects of work load]. GIORNALE ITALIANO DI MEDICINA DEL LAVORO 1986; 8:109-17. [PMID: 3452554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The physical demand in the workplaces can be different depending on each specific job. This involves that workers exposed to the same environmental level of an airborne can absorb different amounts of it depending on their pulmonary ventilation. Starting from the relationship between the uptake (U) and the urinary concentration (Cu) of 6 solvents (Acetone, Styrene, Xylenes, Toluene, Methylchloroform, Tetrachloroethylene) and from the equation expressing their lung uptake the expected values of a biological index after a given time of exposure can be derived. Such values are a function not only of the environmental levels of exposure (CI) but also of the pulmonary ventilation (V) (V--dependent solvents) and of the retention index (R) (V--R--dependent solvents).
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30
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Urinary elimination of styrene in experimental and occupational exposure. Scand J Work Environ Health 1985; 11:371-9. [PMID: 4071003 DOI: 10.5271/sjweh.2210] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Twenty human volunteers were exposed to styrene vapor at 273-1 654 mumol/m3 (28.4-172.3 mg/m3) for a period of 1 to 3 h at rest (15 cases) and during light physical exercise (5 cases). Subsequently 51 workers occupationally exposed to styrene were studied during a workweek (median value 1 138 mumol/m3, geometric standard deviation 2.23). As expected, the relative uptake averaged about 65%, and the ratio of the alveolar concentration to the time-weighted average of the environmental concentration averaged about 0.15. Both in the experimentally exposed subjects and in the occupationally exposed workers the urinary styrene concentration showed a linear relationship to the corresponding environmental time-weighted average concentration. The correlation coefficients of the regression lines ranged between 0.88 (occupationally exposed group) and more than 0.93 (experimentally exposed groups). The regression coefficients were closely linked to the amount of styrene taken up and to the exposure times. The findings show that the urinary styrene concentration can be used as an appropriate biological exposure indicator whose meaning differs from that of other suggested indices. As an example, in occupationally exposed subjects performing moderate work the urinary styrene concentration corresponding to the time-weighted average of the threshold limit value is 815 nmol/l, and the 95% lower confidence limit (biological threshold) is 740 nmol/l.
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31
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[Environmental and biological monitoring of subjects occupationally exposed to precious metals (gold lost-wax casting)]. GIORNALE ITALIANO DI MEDICINA DEL LAVORO 1985; 7:65-73. [PMID: 3836910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Environmental monitoring during lost wax casting in jewelry handicrafts was performed for gold, silver, zinc and copper by means of personal samplers and ICP-AAS techniques were used for determining airborne metals. Personal sampling was prolonged for a working week by continuous monitoring during 8 hours shifts, replacing the membrane filter every 2 hours, in 6 workers; in the same workers urine samples were collected during the week and levels of Au, Ag, Zn and Cu were measured by ETA-AAS. During casting process Ag air concentrations ranged 0.27-0.6 mg/m3 while mean levels of Au, Cu, and Zn were 0.028 0.030 and 0.056 mg/m3 respectively. Urinary excretion of Ag (I) determined by solvent extraction and separation by liquid anion exchanger proved very high, after 24-36 h from the casting processes.
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32
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Urinary elimination of p-dichlorobenzene (p-DCB) and weighted exposure concentration. GIORNALE ITALIANO DI MEDICINA DEL LAVORO 1985; 7:59-63. [PMID: 3836909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The aim of the present work is to determine p-DCB concentration in the urine of exposed workers and to verify a possible correlation with the environmental exposure. The authors studied four subjects exposed to different p-DCB environmental concentrations during a working week. The measurement of the substances was performed by means of a Hewlett-Packard 5880 A gas-chromatograph supplied with a Hewlett-Packard 5970 A Mass Selective Detector. The analysis was performed by a head space method (after determining the urine/air partition coefficient (lambda) by the multiple phase equilibration method). The lambda value (urine/air) of p-DCB is 10.8. The Authors found a significant relationship between the difference of p-DCB urinary concentration at the beginning and end of a daily work delta Cu (microgram/l) and the p-DCB environmental concentration C-I (mg/m3) (r = 0.64) (P less than 0.01); delta Cu = 0,48C-I + 15.61. We found that with an environmental exposure of 44.7 mg/m3 median value (geometrical deviation 1.15) there is an increase of p-DCB concentration in the urine of workers during the working week. For a daily environmental exposure of 450 mg/m3 (ACGIH TLV, 1984), we think that it is possible to propose a Biological Exposure Index (B.E.I.) of 250 micrograms/l as difference between beginning and end of a daily work.
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[Significance of urinary elimination of toluene as an indicator of exposure. II. Results obtained in occupationally exposed subjects]. LA MEDICINA DEL LAVORO 1985; 76:61-6. [PMID: 4010615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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34
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[Significance of urinary elimination of toluene as an indicator of exposure. I. Results obtained during experimental exposure]. LA MEDICINA DEL LAVORO 1985; 76:44-60. [PMID: 4010613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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35
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Abstract
The concentration of n-hexane in urine was determined in 30 subjects occupationally exposed to n-hexane (median value 59.6 mg/m3) in a shoe factory. The measurement of the substance was performed by means of a Hewlett-Packard 5880 gas chromatograph supplied with a Hewlett-Packard 5970 Mass Selective Detector. The analyses were performed by the head space method (constant volume method, after determination of the urine partition coefficient by the multiple phase equilibration method). The authors found a significant correlation between the n-hexane urine concentrations (microgram/l, Cu) and the n-hexane environmental concentrations (mg/m3, Ci) (r = 0.84; Cu = 0.0669 X Ci + 0.8396).
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36
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[N-hexane and toluene in the urine of occupationally exposed subjects. Measurement and significance of its presence]. BOLLETTINO DELLA SOCIETA ITALIANA DI BIOLOGIA SPERIMENTALE 1984; 60:1919-25. [PMID: 6518102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
N-hexane and toluene in the urine of occupationally exposed subjects. Measurement and significance of their presence. The determination of n-hexane and toluene in urine was performed in 23 subjects who were occupationally exposed to n-hexane and in 8 subjects exposed to toluene, by means of the head space technique. A Hewlett-Packard 5880 A gas chromatograph supplied with Hewlett-Packard 5970 A Mass Selective Detector was employed. The Authors found significant correlations between urine concentration of the substance and environmental concentration (for n-hexane r = 0,866; for toluene r = 0,770.
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37
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[Use of passive personal samplers in industrial hygiene]. GIORNALE ITALIANO DI MEDICINA DEL LAVORO 1983; 5:145-51. [PMID: 6679837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Passive personal samplers are very easy devices to monitor occupational exposure and today they are wildely used on the field. In this study we don't speak about background theory of passive sampler but we critically review parameters influencing the results like: maximum and minimum detectable concentration, adsorbing substrate, sampling time, answer time, control and comparison with standard methods. We also illustrate some industrial hygiene strategy to use passive personal sampler on the field, the possible goals, the individuals of which we need collaboration.
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38
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[Measurement of the coefficient of solubility of airborne substances in blood. II. Solvents of wide industrial use]. GIORNALE ITALIANO DI MEDICINA DEL LAVORO 1983; 5:49-63. [PMID: 6671502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A list of industrial solvents largely employed and produced in Italy (and somewhere else too) is presented. Using two methods previously described, blood/air partition coefficient of such solvents have been measured. Then a discussion is made about the possibility of their employment in the field of biological monitoring of subjects professionally exposed to solvent vapours.
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39
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[Evaluation of a new alveolar air sampler]. GIORNALE ITALIANO DI MEDICINA DEL LAVORO 1982; 4:271-8. [PMID: 6315518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A new alveolar air sampler is described and tested; it can be used in monitoring subjects exposed to gas and vapours in their working places. The tests were made under different experimental conditions, using both vapours of industrial solvents as acetone, ethanol, trichloroethylene, methyl ethyl ketone, n-hexane, ethyl acetate and respiratory gas (O2, CO2).
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40
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[The measurement of the solubility coefficients of aeriforms in the blood or other solvent liquids. I. The methods]. GIORNALE ITALIANO DI MEDICINA DEL LAVORO 1982; 4:251-61. [PMID: 7187355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The Authors describe some methods (at constant pressure and constant volume) which can be used when solubility coefficients of gas and vapours in liquids (water, blood, oil etc.) are to be measured; they are easily performed methods, which are based on the validity of Henry's law.
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41
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[Monitoring of subjects to noise risk. Proposed methods of audiometric classification]. LA MEDICINA DEL LAVORO 1981; 72:183-9. [PMID: 7029233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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42
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[Smoking habits, atmospheric dust and occupational respiratory risks. Survey in foundry-workers]. BRONCHO-PNEUMOLOGIE 1978; 28:186-94. [PMID: 756784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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43
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[Functional conditions of the respiratory system and work site pollution. III. Relationships between "risk indicators" and "respiratory risk" in a chemical industry (author's transl)]. LAVORO UMANO 1976; 28:33-47. [PMID: 1018572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The results are reported of a retrospective study carried out by the authors on 717 workers of a chemical industry whose exposure was diversified and quantified through a work environment survey. A comparison between "risk indicators" and both objective (respiratory function changes) and subjective (chronic bronchopneumopathy symptoms) "risks" showed a significant probability of the causal role played by work environment pollution in respect of the repiratory changes found by the authors.
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44
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[Functional conditions of the respiratory system and work site pollution. II. Prevalence of respiratory function changes in workers employed in bichromate and chromic acid production (author's transl)]. LAVORO UMANO 1975; 27:175-87. [PMID: 1207348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The authors report the prevalence of respiratory function changes in two groups of workers employed in bichromate and chromic acid production. In the first group (82 subjects) examined at the Institute of Occupational Medicine, the following tests were performed: filling out of a questionnaire for cronic bronchitis; chest x-ray; spirometry; pulmonary diffusing capacity (DLco) measurement; blood gas analysis on arteriolized capillary; He and CO2 rapid expiratory curves determination. No environmental pollution data were available. In the second group (180 subjects) examined at the working site, the following tests were performed: filling out of a questionnaire -or chronic bronchitis; spirometric determination. Environmental pollution data were available. A causal connection is hypothesized by the authors between either roentgenologic or respiratory functional changes and chromium exposure, and an increased proportion between lung function changes and exposure length is stressed.
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45
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[Bronchopneumopathies caused by plant dusts]. LA MEDICINA DEL LAVORO 1975; 66:488-524. [PMID: 768732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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46
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[Cooperation between the occupational physician and industrial hygienist]. LA MEDICINA DEL LAVORO 1975; 66:284-7. [PMID: 1226167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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47
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[Measurement of "flow-volume" curves and "closing volume" in occupational medicine. Normal findings in healthy subjects (author's transl)]. LAVORO UMANO 1975; 27:42-58. [PMID: 1226046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A method is described for measuring, by a single test, some functional respiratory indexes, such as lung volumes, dynamic tests (flow-volume curve included), rapid He and CO2 curves, "closing volume". The normal values of "closing volume" and of forced expiratory flows obtained in 114 healthy subjects (65 men and 49 women) are then reported. Such values are comparable to those obtained by other authors. An equipment is used by the authors which is easily transportable to the workplace; their method can therefore be used for surveys of workers exposed to occupational respiratory risk during a working shift. The described respiratory index should be able to detect in a pre-clinical stage the early functional changes in chronic bronchitis.
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[Functional state of the respiratory system and work environment pollution. I. A respiratory function and environmental pollution survey in a department for the production of inorganic pigments (author's transl)]. LAVORO UMANO 1974; 26:97-124. [PMID: 4437261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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49
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[M.A.C. (Maximum Allowable Concentration) in high-temperature work places]. LA MEDICINA DEL LAVORO 1973; 64:198-205. [PMID: 4779935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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50
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[Orientational methods for individual evaluation of disorders of distribution and gas exchange in occupational chronic bronchopneumopathies]. LAVORO UMANO 1973; 25:1-22. [PMID: 4744548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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