francesco violante - Academia.edu (original) (raw)

Papers by francesco violante

Journal of Chromatography B: Analytical Technologies in the Biomedical and Life Sciences, 2006

BMC Public Health, 2009

Background Carpal tunnel syndrome (CTS) is a socially and economically relevant disease caused by... more Background Carpal tunnel syndrome (CTS) is a socially and economically relevant disease caused by compression or entrapment of the median nerve within the carpal tunnel. This population-based case-control study aims to investigate occupational/non-occupational risk factors for surgically treated CTS. Methods Cases (n = 220) aged 18-65 years were randomly drawn from 13 administrative databases of citizens who were surgically treated with carpal tunnel release during 2001. Controls (n = 356) were randomly sampled from National Health Service registry records and were frequency matched by age-gender-specific CTS hospitalization rates. Results At multivariate analysis, risk factors were blue-collar/housewife status, BMI ≥ 30 kg/m2, sibling history of CTS and coexistence of trigger finger. Being relatively tall (cut-offs based on tertiles: women ≥165 cm; men ≥175 cm) was associated with lower risk. Blue-collar work was a moderate/strong risk factor in both sexes. Raised risks were apparent for combinations of biomechanical risk factors that included frequent repetitivity and sustained force. Conclusion This study strongly underlines the relevance of biomechanical exposures in both non-industrial and industrial work as risk factors for surgically treated CTS.

International Archives of Occupational and Environmental Health, 2004

Objective: Information is required on levels of agreement between different sets of median nerve ... more Objective: Information is required on levels of agreement between different sets of median nerve conduction studies (NCS) and symptoms of carpal tunnel syndrome (CTS) in at-risk subjects. Methods: We performed a reanalysis of an extensive data set from a population of 114 “highly exposed” meat workers (without prior diagnosis of CTS), who were interviewed for the presence of current symptoms typical of CTS and systematically submitted to median NCS. Results: Agreement between presence/absence of symptoms and NCS normal/abnormal findings ranged from 81% for wrist sensory latency (WSL) to 49% for motor conduction velocity wrist-to-palm (MCV-WP) in the nondominant hands (from 60% to 50%, respectively, in the dominant hands). Mean values of WSL, sensory conduction velocity-WP (SCV-WP), wrist motor latency, MCV-WP, and the SCV-WP/SCV-elbow-to-wrist ratio all showed significant differences between symptomatic and asymptomatic workers. In nondominant hands, these parameters all reached significant P values at chi-squared tests for κ coefficients of agreement, the best κ coefficients being 0.57 for WSL and 0.40 for SCV-WP. However, in the dominant hand only SCV-WP reached significance (κ coefficient=0.20). Conclusions: Given the importance of the dominant hand in working populations, these data support use of SCV-WP (or WSL) as an informative NCS parameter for occupational studies on CTS.

Epidemiology, 2008

People with myopia (near sightedness) are at increased risk for retinal detachment. We explored o... more People with myopia (near sightedness) are at increased risk for retinal detachment. We explored other factors that may be associated with retinal detachment within this high-risk group. We conducted a case-control study comprising 61 cases with retinal detachment and myopia and 99 hospital controls who also had myopia. Cases were recruited from a general hospital, and controls from ophthalmologic clinics. Participants compiled a questionnaire including details of past and current occupational lifting tasks to explore Valsalva maneuver as a possible risk factor. We devised a cumulative lifting index to distinguish light and heavy lifting. After adjusting for potential confounders, we found strong associations of retinal detachment with eye surgery, eye or head trauma, severe myopia (all known risk factors), and heavy lifting (vs. no lifting, odds ratio = 4.4 [95% confidence interval = 1.5-13]) and high body mass index (>or=25.5 kg/m, 6.8 [1.6-29]). Heavy occupational lifting and being overweight may be important risk factors for retinal detachment among people with myopia. The role of these risk factors in the etiology of retinal detachment deserves to be explored in more general populations.

Journal of Toxicology and Environmental Health-part A-current Issues, 2001

Benzene is a widespread pollutant whose main source in the environment is automotive emission. Th... more Benzene is a widespread pollutant whose main source in the environment is automotive emission. There is increasing interest in the exposure of the population to this pollutant as benzene is present also in the indoor environment due to cigarette smoke, drinking water, and food. The aim of this study was to evaluate, in an adult nonsmoking population not occupationally exposed to benzene, whether it is possible to detect differences in the urinary concentration of trans,trans-muconic acid (t,t-MA) between low and high environmental exposure to benzene. A study sample of 31 employees working in pharmacies in a large town in Italy with low environmental exposure to benzene (4.8 microg/m3) was compared to a high (8.1 microg/m3) benzene exposure group. Analysis of urinary t,t-MA was carried out by high-performance liquid chromatography (HPLC; photodiode array detector); analysis of environmental benzene samples was by gas chromatography/mass spectroscopy (GC-MS). The statistical analysis revealed no significant differences in urinary levels of t,t-MA of subjects with high (mean concentration: 157.9 microg/g creatinine) versus low exposure (mean concentration: 114.2 microg/g creatinine). Data show that it is difficult to correlate urinary t,t-MA with benzene exposure at parts per billion levels.

International Archives of Occupational and Environmental Health, 2002

Objectives: The aim of this study was to assess the prevalence of carpal tunnel syndrome (CTS) in... more Objectives: The aim of this study was to assess the prevalence of carpal tunnel syndrome (CTS) in a group of meat industry workers, using typical symptoms, median nerve conduction studies (NCSs) and their combinations. In the case definition including the NCSs, we tested the electrodiagnostic reference values derived from the general healthy population and from the asymptomatic study population. Methods: One-hundred fourteen workers were examined by clinical interviews and median NCSs. Results: The prevalence of CTS varied from 11% to 53%, with a progressive reduction passing from symptoms to NCSs to the their combinations. The prevalence was identical and the highest at the same time (53%) considering the case definitions based only on the symptoms and only on the NCSs with Kimura's reference values. Using the asymptomatic workers' electrodiagnostic reference values, alone or in combination with symptoms, the prevalence of CTS was the lowest (respectively, 15% and 11%). Conclusions: In the epidemiological studies, median NCSs should be considered desirable, if not essential, for confirming a clinical diagnosis, most of all in the longitudinal studies. In the future of CTS diagnosis, attention should be paid to the electrodiagnostic reference values that are discriminating to confirm the presence or not of the disease.

Mutation Research-genetic Toxicology and Environmental Mutagenesis, 2005

Among the toxic chemicals present in the ambient air of urban centres, benzene raises particular ... more Among the toxic chemicals present in the ambient air of urban centres, benzene raises particular concern due to its haematoxicity and leukaemogenic hazards, probably related to clastogenic factors. However, little is known about the health risks associated with environmental – rather than industrial – exposure to benzene. We analysed micronucleus (MN) frequencies in peripheral lymphocytes by use of the cytokinesis-block technique, and haematological parameters among 49 traffic police and 36 indoor workers (controls) in the city of Bologna. The analysis of urban air provided by a municipal air-quality monitoring station indicated that the levels of environmental benzene were often above the recommended threshold level (10 μg/m3) whereas other pollutants – nitrogen oxides, polycyclic aromatic hydrocarbon compounds, total suspended particulate matter, carbon monoxide, sulfur dioxide – did not exceed the maximum atmospheric concentration established for air-quality standards. Mean levels of individual airborne benzene exposure – as measured by personal devices worn during 4-h morning work-shifts – were six-fold higher in the traffic police than in controls (P = 0.001). While no significant difference in haematological parameters was found between the two groups, MN frequency was significantly higher among the traffic police than in indoor workers (P = 0.001). Among the study population, MN frequency was found to increase with age, but no influence was observed for gender or smoking. Although it cannot be excluded that the increase of MN frequency observed in traffic police could also depend, apart from benzene, on the complex mixture of pollutants encountered in urban air, our data indicate that elevated personal benzene exposure could represent a genetic risk. The analysis of biomarkers of genetic damage in subjects particularly exposed to environmental benzene deserves careful study.

Archives of Environmental Health, 2002

Benzene is a widespread pollutant of which the main source in the outside environment is automoti... more Benzene is a widespread pollutant of which the main source in the outside environment is automotive traffic. Benzene is also present in cigarette smoke, and small quantities exist in drinking water and food; all of these sources contribute to pollution of indoor environments. Benzene exposure may be studied with biologic indicators. In the present study, the authors evaluated whether differences in urinary concentrations of trans,transmuconic acid (t,t-MA) were detectable in a sample of 150 children and if the chemical was correlated with environmental exposures to low levels of benzene. The children attended primary schools that had significantly different-but low-environmental benzene levels. Analysis of urinary t,t-MA was achieved with high-performance liquid chromatography (photodiode array detector), and analysis of passive air samplers for benzene was performed with gas chromatography-mass spectrometry. Statistical analysis (Kruskal-Wallis test) indicated that differences in urinary levels of t,t-MA in children from urban and rural areas were not statistically significant (p = .07), nor were there significant differences between children with and without relatives who smoked (p = .69). As has been shown in other studies of children and adults, results of our study evidenced (1) the difficulty of correlating concentrations of urinary biomarkers with environmental exposure to benzene at a parts-per-billion level (i.e., traffic and environmental tobacco smoke) and, consequently, (2) the lack of specificity of t,t-MA as a biological indicator for the study of a population's exposure.

Environmental Research, 2003

Despite growing concern for possible carcinogenic effects associated with environmental benzene e... more Despite growing concern for possible carcinogenic effects associated with environmental benzene exposure in the general population, few studies exist at parts per billion (ppb) levels. We investigated the existence of a relationship between airborne/biological measurements of benzene exposure (i.e., personal/area sampling and unmodified urinary benzene/trans,trans-muconic acid; t,t-MA) and micronuclei induction (cytochalasin B technique) among exposed chemical laboratory workers (n=47) and traffic wardens (n=15). Although urinary t,t-MA (106.9±123.17 μg/Lurine) correlated (R2=0.37) with urinary benzene (0.66±0.99 μg/Lurine), neither biological measurement correlated with environmental benzene exposure (14.04±9.71 μg/m3; 4.39±3.03 ppb), suggesting that, at ppb level (1 ppb=3.2 μg/m3), airborne benzene constitutes a fraction of the total intake. Traffic wardens and laboratory workers had comparable numbers of micronuclei (4.70±2.63 versus 5.76±3.11; n.s.), similar to levels recorded in the general population. With univariate/multivariate analysis, no association was found between micronuclei induction and air/urinary benzene exposure variables. Notably, among the personal characteristics examined (including age, gender, smoking, drinking, etc.), high body mass index correlated with micronuclei induction while, among females, use of hormonal medication was associated with less micronuclei. Thus the present study provides no evidence that ppb levels of environmental benzene exposure appreciably affect micronuclei incidence (against the background of other relevant factors). However, this should not be taken as an argument against efforts aiming to reduce environmental benzene pollution.

Chemosphere, 2008

The categories of urban workers undergoing prolonged exposure to gasoline due to vehicle emission... more The categories of urban workers undergoing prolonged exposure to gasoline due to vehicle emissions, evaporation and traffic fumes are considered occupationally exposed to benzene, even if at low concentrations. The aim of this study was to evaluate the specificity of unmetabolized benzene excreted in urine (UBz) and S-phenylmercapturic acid (SPMA) as biomarkers of exposure to very low levels of benzene, and to study the impact of putative individual confounders like smoking and alcohol habits, co-exposure to other toxicants and body mass index on the exposure assessment. Environmental and biological monitoring of exposure to benzene were performed in 114 Urban Policemen. The mean value of UBz in non-smokers was significantly lower than in either groups of light to moderate smokers and heavy smokers (0.24, 1.82 and 2.82 μg L−1, respectively). On the contrary, SPMA values did not discriminate exposure resulting from smoking habits. Moreover, the concentration of UBz in non-smokers appears to be correlated with environmental benzene concentration (BenzA) (R2 = 0.13, β = 0.37, p = 0.002). On the other hand, no significant correlation was found between SPMA concentration (corrected for creatinine excretion and log transformed, LogSPMA) and LogBenzA (R2 = 0.003, β = 0.05, p = 0.6). Our findings reinforce previous research on the use of unmetabolized urinary benzene as a specific and sensitive biomarker of low-level exposure to benzene and confirm that smoking habits strongly influence the excretion of UBz.

International Archives of Occupational and Environmental Health, 2008

Objective To provide an overview of the spectrum of available for measurement and evaluation of w... more Objective To provide an overview of the spectrum of available for measurement and evaluation of work-related psychosocial factors. Methods We systematically searched the literature/internet to identify and describe the main available questionnaires and observational instruments for assessment of work-related psychosocial factors (with/without other job stressors). Results A total of 33 instruments were identified (26 questionnaires, 7 observational), many (11 questionnaires, 5 observational) linked to national institutions/intiatives. Accessibility of relevant information (on the internet or elsewhere) regarding the instruments varied widely. Conclusions This summary of the range of instruments currently available for evaluation of multiple work stressors at individual, group and/or organizational levels may provide a useful tool for operators and researchers.

Rapid Communications in Mass Spectrometry, 2005

8-Hydroxy-2′-deoxyguanosine (8OHdG), one of the major oxidative DNA lesions induced by radical ag... more 8-Hydroxy-2′-deoxyguanosine (8OHdG), one of the major oxidative DNA lesions induced by radical agents, is commonly used as a biomarker for oxidative stress, nowadays preferably in urine. In the absence of a commercially available internal standard a micro-high-performance liquid chromatography/electrospray ionization tandem mass spectrometry (micro-HPLC/ESI-MS/MS) method, suitable for routine analysis of 8OHdG in human urine using external calibration, was developed. Evaluation of the matrix effect showed that the method allows highly sensitive and accurate quantitation despite the absence of an internal standard. HPLC analysis was performed using gradient elution at a flow rate of 10 μL min−1 using a capillary reversed-phase column and an injection volume of 0.5 μL, with detection of 8OHdG in positive multiple reaction monitoring (MRM) mode. The absolute limit of detection was 0.35 fmol using m/z 168 as a quantifier (fragment) ion. A linear (R2 > 0.999) calibration curve in urine was obtained over a range 0.2–10 ng mL−1. This method is about 20 times more sensitive than previously described procedures, and is characterized by high accuracy (mean 90%) and good reproducibility (RSD < 10%). The optimized method was applied to determination of 8OHdG in 18 urinary samples derived from three healthy volunteers. 8OHdG urinary excretion ranged from 3.0–7.9 μg/day, and a large intra-individual variation was found. This method, which effectively circumvents the need for isotopically labeled 8OHdG (internal standard), is suitable for routine monitoring of exposure to DNA-damaging factors in a large number of subjects. Copyright © 2004 John Wiley & Sons, Ltd.

American Journal of Industrial Medicine, 1992

In compliance with the mandatory medical surveillance of workers exposed to tetrachloroethylene (... more In compliance with the mandatory medical surveillance of workers exposed to tetrachloroethylene (PCE) in Italy, isoenzyme fractioning of serum gamma-glutamyltransferase (GGT) was performed on 141 workers of both sexes and on 130 control subjects.None of the workers showed any clinical symptoms of liver disease and their enzymatic profiles, including AST, ALT, 5′-NU, ALP, and GGT, were within the normal reference limits. A statistically significant increase in total GGT serum level was found in the exposed subjects, which was associated with an increase in one of the two fractions normally present in healthy individuals (GGT-2), as well as with the appearance and progressive increase of the level of a fraction (GGT-4) considered to be an expression of hepato-biliary impairment.Further research is ongoing among these workers, which will clarify whether or not electrophoretic GGT tests may be useful in detecting liver function changes due to occupational exposure to PCE. © 1992 Wiley-Liss, Inc.

Rapid Communications in Mass Spectrometry, 2005

Bisphenol A (BPA) is a toxic industrial chemical that affects the endocrine system even at low co... more Bisphenol A (BPA) is a toxic industrial chemical that affects the endocrine system even at low concentrations. A new method, based on capillary high-performance liquid chromatography/electrospray ionization tandem mass spectrometry (HPLC/ESI-MS/MS) analysis, has been developed to determine BPA in atmospheric samples. The method involves collection of air samples (typically 2 m3) on glass fiber filters, with ultrasonic extraction and sample concentration under vacuum before analysis. HPLC analysis was performed isocratically at a flow rate of 10 µL min−1 using a capillary reversed-phase column and MS/MS analysis in negative ion multiple reaction monitoring (MRM) mode, using BPA-d16 as internal standard. The present method provides linear response in the range 0.007–3.5 µg/filter (R2 > 0.999) and is characterized by high accuracy (mean bias 2%) and good reproducibility (mean RSD 5%). High sensitivity (LOD = 2 ng/m3 based on 2 m3 of air collected), specificity, and speed of the analysis make the present method suitable for routine determination of BPA in the atmosphere, both for ambient and personnel monitoring. Copyright © 2005 John Wiley & Sons, Ltd.

Journal of Mass Spectrometry, 2005

A new high-performance liquid chromatographic/electrospray ionization tandem mass spectrometric (... more A new high-performance liquid chromatographic/electrospray ionization tandem mass spectrometric (HPLC/ESI-MS/MS) method was developed for the simultaneous quantification of 5-fluorouracil (5FU), methotrexate (MTX) and cyclophosphamide (CP) in environmental samples. These compounds, commonly used in the treatment of cancer, are recognized as genotoxic. In order to estimate the occupational exposure of hospital personnel handling these drugs, wipe samples were taken from the working surfaces and directly analyzed (with trophosphamide as internal standard) using a reversed-phase capillary column and MS/MS detection. This is the first HPLC/MS/MS method for the simultaneous determination of 5FU, MTX and CP. The present method offers high sensitivity, with detection limits of 1.1 µg l−1 for MTX and CP and 33.3 µg l−1 for 5FU, avoiding any sample preconcentration procedure. Rapidity, specificity, high accuracy (mean values between 92.4 and 99.9%) and precision (mean RSD values between 3.4 and 12.1%) make the method suitable for the routine determination of these three antineoplastic drugs. Copyright © 2005 John Wiley & Sons, Ltd.

Journal of Chromatography B-analytical Technologies in The Biomedical and Life Sciences, 2006

A sensitive and specific HPLC–ESI-MS/MS method for the direct determination of glucosamine in hum... more A sensitive and specific HPLC–ESI-MS/MS method for the direct determination of glucosamine in human plasma has been developed and validated. Plasma samples were analyzed after a simple, one-step protein precipitation clean-up with trichloroacetic acid using a polymer-based amino high-performance liquid chromatography (HPLC) column and a water/acetonitrile mobile phase elution gradient, with d-[1-13C]glucosamine as the internal standard. Detection was performed by mass spectrometry, using an electrospray source and employing multiple reaction monitoring to separately monitor glucosamine and the internal standard. The limit of quantification of the method was 10 ng/ml of glucosamine and the calibration curve showed a good linearity up to 1000 ng/ml. The precision (R.S.D.) and the accuracy (bias) of the method at the limit of quantification were 13.8 and 4.0%, respectively, and the mean recovery of glucosamine at three concentration levels was 101.6 ± 5.7%. The method was applied for the determination of glucosamine concentrations in human plasma samples collected from untreated healthy volunteers and, in a separate bioavailability study, to evaluate plasma glucosamine pharmacokinetics profiles after oral administration of crystalline glucosamine sulfate.

Mutation Research-fundamental and Molecular Mechanisms of Mutagenesis, 2004

Chromosome aberrations frequency was estimated in peripheral lymphocytes from hospital workers oc... more Chromosome aberrations frequency was estimated in peripheral lymphocytes from hospital workers occupationally exposed to low levels of ionizing radiation and controls. Chromosome aberrations yield was analyzed by considering the effects of dose equivalent of ionizing radiation over time, and of confounding factors, such as age, gender and smoking status. Frequencies of aberrant cells and chromosome breaks were higher in exposed workers than in controls (P=0.007, and P=0.001, respectively). Seven dicentric aberrations were detected in the exposed group and only three in controls, but the mean frequencies were not significantly different. The dose equivalent to whole body of ionizing radiation (Hwb) did appear to influence the spectrum of chromosomal aberrations when the exposed workers were subdivided by a cut off at 50 mSv. The frequencies of chromosome breaks in both subgroups of workers were significantly higher than in controls (≤50 mSv, P=0.041; >50 mSv, P=0.018). On the other hand, the frequency of chromatid breaks observed in workers with Hwb >50 mSv was significantly higher than in controls (P=0.015) or workers with Hwb ≤50 mSv (P=0.046). Regarding the influence of confounding factors on genetic damage, smoking status and female gender seem to influence the increase in chromosome aberration frequencies in the study population. Overall, these results suggested that chromosome breaks might provide a good marker for assessing genetic damage in populations exposed to low levels of ionizing radiation.

Journal of Occupational and Environmental Medicine, 2002

Risk factors for renal-cell carcinoma, the most frequent type of kidney cancer, remains enigmatic... more Risk factors for renal-cell carcinoma, the most frequent type of kidney cancer, remains enigmatic. Time trends in incidence and changes in the regional distribution of this cancer are suggestive of environmental risk factors. This study reports on occupational risk factors for renal-cell carcinoma in Denmark. In a population-based study, 365 persons with histologically verified renal-cell carcinoma and 396 referents were interviewed. Information was collected on occupation, education, and occupational exposure to a number of suspected substances, including hydrocarbons, asbestos, and radiation. Risk of renal-cell carcinoma was found to be associated with employment as a truck driver, exposure to gasoline, other hydrocarbons, and insecticides and herbicides. The risk of renal-cell carcinoma was higher in the lower socioeconomic strata for both the men and the women. Nonsignificantly elevated risks were observed for employment in oil refineries, gasoline stations, and the iron and steel industry. No association was found for exposure to radiation or for employment in industries such as leather manufacturing and health care, which have previously been linked to an increased risk of renal-cell carcinoma. The risk of renal-cell carcinoma is increased in lower socioeconomic strata, and previously identified or suspected risk factors do not explain the excess in risk. This study adds additional support to the hypothesis of a link between renal-cell carcinoma and hydrocarbons and also demonstrates the need for further studies on occupational risk factors for renal-cell carcinoma.

Chemosphere, 2006

We initiated the PETER (pedestrian environmental traffic pollutant exposure research) project to ... more We initiated the PETER (pedestrian environmental traffic pollutant exposure research) project to investigate pedestrians’ exposure to traffic related atmospheric pollutants, based on data obtained with the collaboration of selected categories of pedestrian urban workers. We investigated relations between roadside personal exposure levels of volatile aromatic hydrocarbons (including benzene) and particulate matter <10 μm (PM10) among traffic police (n = 126) and parking wardens (n = 50) working in downtown Bologna, Italy. Data were collected from workshifts throughout four 1-week periods in different seasons of 2000–2001. For benzene and PM10, comparisons were made with measurements by fixed monitoring stations, and influence of localized traffic intensity and meteorological parameters was examined. Roadside personal exposure to benzene correlated more strongly with other volatile aromatic hydrocarbons (toluene, xylenes and ethylbenzene) than with PM10. Benzene and PM10 personal exposure levels were higher than fixed monitoring station values (both p < 0.0001). At multivariate analysis, benzene and PM10 data from fixed monitoring stations both correlated with meteorological variables, and were also influenced by localized traffic intensity. Plausibly because of the downtown canyon-like streets, weather conditions (during a period of drought) only marginally affected benzene personal exposure, and moderately affected PM10 personal exposure. These findings reinforce the concept that urban atmospheric pollution data from fixed air monitoring stations cannot automatically be taken as indications of roadside exposures.

Journal of Chromatography B: Analytical Technologies in the Biomedical and Life Sciences, 2006

BMC Public Health, 2009

Background Carpal tunnel syndrome (CTS) is a socially and economically relevant disease caused by... more Background Carpal tunnel syndrome (CTS) is a socially and economically relevant disease caused by compression or entrapment of the median nerve within the carpal tunnel. This population-based case-control study aims to investigate occupational/non-occupational risk factors for surgically treated CTS. Methods Cases (n = 220) aged 18-65 years were randomly drawn from 13 administrative databases of citizens who were surgically treated with carpal tunnel release during 2001. Controls (n = 356) were randomly sampled from National Health Service registry records and were frequency matched by age-gender-specific CTS hospitalization rates. Results At multivariate analysis, risk factors were blue-collar/housewife status, BMI ≥ 30 kg/m2, sibling history of CTS and coexistence of trigger finger. Being relatively tall (cut-offs based on tertiles: women ≥165 cm; men ≥175 cm) was associated with lower risk. Blue-collar work was a moderate/strong risk factor in both sexes. Raised risks were apparent for combinations of biomechanical risk factors that included frequent repetitivity and sustained force. Conclusion This study strongly underlines the relevance of biomechanical exposures in both non-industrial and industrial work as risk factors for surgically treated CTS.

International Archives of Occupational and Environmental Health, 2004

Objective: Information is required on levels of agreement between different sets of median nerve ... more Objective: Information is required on levels of agreement between different sets of median nerve conduction studies (NCS) and symptoms of carpal tunnel syndrome (CTS) in at-risk subjects. Methods: We performed a reanalysis of an extensive data set from a population of 114 “highly exposed” meat workers (without prior diagnosis of CTS), who were interviewed for the presence of current symptoms typical of CTS and systematically submitted to median NCS. Results: Agreement between presence/absence of symptoms and NCS normal/abnormal findings ranged from 81% for wrist sensory latency (WSL) to 49% for motor conduction velocity wrist-to-palm (MCV-WP) in the nondominant hands (from 60% to 50%, respectively, in the dominant hands). Mean values of WSL, sensory conduction velocity-WP (SCV-WP), wrist motor latency, MCV-WP, and the SCV-WP/SCV-elbow-to-wrist ratio all showed significant differences between symptomatic and asymptomatic workers. In nondominant hands, these parameters all reached significant P values at chi-squared tests for κ coefficients of agreement, the best κ coefficients being 0.57 for WSL and 0.40 for SCV-WP. However, in the dominant hand only SCV-WP reached significance (κ coefficient=0.20). Conclusions: Given the importance of the dominant hand in working populations, these data support use of SCV-WP (or WSL) as an informative NCS parameter for occupational studies on CTS.

Epidemiology, 2008

People with myopia (near sightedness) are at increased risk for retinal detachment. We explored o... more People with myopia (near sightedness) are at increased risk for retinal detachment. We explored other factors that may be associated with retinal detachment within this high-risk group. We conducted a case-control study comprising 61 cases with retinal detachment and myopia and 99 hospital controls who also had myopia. Cases were recruited from a general hospital, and controls from ophthalmologic clinics. Participants compiled a questionnaire including details of past and current occupational lifting tasks to explore Valsalva maneuver as a possible risk factor. We devised a cumulative lifting index to distinguish light and heavy lifting. After adjusting for potential confounders, we found strong associations of retinal detachment with eye surgery, eye or head trauma, severe myopia (all known risk factors), and heavy lifting (vs. no lifting, odds ratio = 4.4 [95% confidence interval = 1.5-13]) and high body mass index (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or=25.5 kg/m, 6.8 [1.6-29]). Heavy occupational lifting and being overweight may be important risk factors for retinal detachment among people with myopia. The role of these risk factors in the etiology of retinal detachment deserves to be explored in more general populations.

Journal of Toxicology and Environmental Health-part A-current Issues, 2001

Benzene is a widespread pollutant whose main source in the environment is automotive emission. Th... more Benzene is a widespread pollutant whose main source in the environment is automotive emission. There is increasing interest in the exposure of the population to this pollutant as benzene is present also in the indoor environment due to cigarette smoke, drinking water, and food. The aim of this study was to evaluate, in an adult nonsmoking population not occupationally exposed to benzene, whether it is possible to detect differences in the urinary concentration of trans,trans-muconic acid (t,t-MA) between low and high environmental exposure to benzene. A study sample of 31 employees working in pharmacies in a large town in Italy with low environmental exposure to benzene (4.8 microg/m3) was compared to a high (8.1 microg/m3) benzene exposure group. Analysis of urinary t,t-MA was carried out by high-performance liquid chromatography (HPLC; photodiode array detector); analysis of environmental benzene samples was by gas chromatography/mass spectroscopy (GC-MS). The statistical analysis revealed no significant differences in urinary levels of t,t-MA of subjects with high (mean concentration: 157.9 microg/g creatinine) versus low exposure (mean concentration: 114.2 microg/g creatinine). Data show that it is difficult to correlate urinary t,t-MA with benzene exposure at parts per billion levels.

International Archives of Occupational and Environmental Health, 2002

Objectives: The aim of this study was to assess the prevalence of carpal tunnel syndrome (CTS) in... more Objectives: The aim of this study was to assess the prevalence of carpal tunnel syndrome (CTS) in a group of meat industry workers, using typical symptoms, median nerve conduction studies (NCSs) and their combinations. In the case definition including the NCSs, we tested the electrodiagnostic reference values derived from the general healthy population and from the asymptomatic study population. Methods: One-hundred fourteen workers were examined by clinical interviews and median NCSs. Results: The prevalence of CTS varied from 11% to 53%, with a progressive reduction passing from symptoms to NCSs to the their combinations. The prevalence was identical and the highest at the same time (53%) considering the case definitions based only on the symptoms and only on the NCSs with Kimura's reference values. Using the asymptomatic workers' electrodiagnostic reference values, alone or in combination with symptoms, the prevalence of CTS was the lowest (respectively, 15% and 11%). Conclusions: In the epidemiological studies, median NCSs should be considered desirable, if not essential, for confirming a clinical diagnosis, most of all in the longitudinal studies. In the future of CTS diagnosis, attention should be paid to the electrodiagnostic reference values that are discriminating to confirm the presence or not of the disease.

Mutation Research-genetic Toxicology and Environmental Mutagenesis, 2005

Among the toxic chemicals present in the ambient air of urban centres, benzene raises particular ... more Among the toxic chemicals present in the ambient air of urban centres, benzene raises particular concern due to its haematoxicity and leukaemogenic hazards, probably related to clastogenic factors. However, little is known about the health risks associated with environmental – rather than industrial – exposure to benzene. We analysed micronucleus (MN) frequencies in peripheral lymphocytes by use of the cytokinesis-block technique, and haematological parameters among 49 traffic police and 36 indoor workers (controls) in the city of Bologna. The analysis of urban air provided by a municipal air-quality monitoring station indicated that the levels of environmental benzene were often above the recommended threshold level (10 μg/m3) whereas other pollutants – nitrogen oxides, polycyclic aromatic hydrocarbon compounds, total suspended particulate matter, carbon monoxide, sulfur dioxide – did not exceed the maximum atmospheric concentration established for air-quality standards. Mean levels of individual airborne benzene exposure – as measured by personal devices worn during 4-h morning work-shifts – were six-fold higher in the traffic police than in controls (P = 0.001). While no significant difference in haematological parameters was found between the two groups, MN frequency was significantly higher among the traffic police than in indoor workers (P = 0.001). Among the study population, MN frequency was found to increase with age, but no influence was observed for gender or smoking. Although it cannot be excluded that the increase of MN frequency observed in traffic police could also depend, apart from benzene, on the complex mixture of pollutants encountered in urban air, our data indicate that elevated personal benzene exposure could represent a genetic risk. The analysis of biomarkers of genetic damage in subjects particularly exposed to environmental benzene deserves careful study.

Archives of Environmental Health, 2002

Benzene is a widespread pollutant of which the main source in the outside environment is automoti... more Benzene is a widespread pollutant of which the main source in the outside environment is automotive traffic. Benzene is also present in cigarette smoke, and small quantities exist in drinking water and food; all of these sources contribute to pollution of indoor environments. Benzene exposure may be studied with biologic indicators. In the present study, the authors evaluated whether differences in urinary concentrations of trans,transmuconic acid (t,t-MA) were detectable in a sample of 150 children and if the chemical was correlated with environmental exposures to low levels of benzene. The children attended primary schools that had significantly different-but low-environmental benzene levels. Analysis of urinary t,t-MA was achieved with high-performance liquid chromatography (photodiode array detector), and analysis of passive air samplers for benzene was performed with gas chromatography-mass spectrometry. Statistical analysis (Kruskal-Wallis test) indicated that differences in urinary levels of t,t-MA in children from urban and rural areas were not statistically significant (p = .07), nor were there significant differences between children with and without relatives who smoked (p = .69). As has been shown in other studies of children and adults, results of our study evidenced (1) the difficulty of correlating concentrations of urinary biomarkers with environmental exposure to benzene at a parts-per-billion level (i.e., traffic and environmental tobacco smoke) and, consequently, (2) the lack of specificity of t,t-MA as a biological indicator for the study of a population&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s exposure.

Environmental Research, 2003

Despite growing concern for possible carcinogenic effects associated with environmental benzene e... more Despite growing concern for possible carcinogenic effects associated with environmental benzene exposure in the general population, few studies exist at parts per billion (ppb) levels. We investigated the existence of a relationship between airborne/biological measurements of benzene exposure (i.e., personal/area sampling and unmodified urinary benzene/trans,trans-muconic acid; t,t-MA) and micronuclei induction (cytochalasin B technique) among exposed chemical laboratory workers (n=47) and traffic wardens (n=15). Although urinary t,t-MA (106.9±123.17 μg/Lurine) correlated (R2=0.37) with urinary benzene (0.66±0.99 μg/Lurine), neither biological measurement correlated with environmental benzene exposure (14.04±9.71 μg/m3; 4.39±3.03 ppb), suggesting that, at ppb level (1 ppb=3.2 μg/m3), airborne benzene constitutes a fraction of the total intake. Traffic wardens and laboratory workers had comparable numbers of micronuclei (4.70±2.63 versus 5.76±3.11; n.s.), similar to levels recorded in the general population. With univariate/multivariate analysis, no association was found between micronuclei induction and air/urinary benzene exposure variables. Notably, among the personal characteristics examined (including age, gender, smoking, drinking, etc.), high body mass index correlated with micronuclei induction while, among females, use of hormonal medication was associated with less micronuclei. Thus the present study provides no evidence that ppb levels of environmental benzene exposure appreciably affect micronuclei incidence (against the background of other relevant factors). However, this should not be taken as an argument against efforts aiming to reduce environmental benzene pollution.

Chemosphere, 2008

The categories of urban workers undergoing prolonged exposure to gasoline due to vehicle emission... more The categories of urban workers undergoing prolonged exposure to gasoline due to vehicle emissions, evaporation and traffic fumes are considered occupationally exposed to benzene, even if at low concentrations. The aim of this study was to evaluate the specificity of unmetabolized benzene excreted in urine (UBz) and S-phenylmercapturic acid (SPMA) as biomarkers of exposure to very low levels of benzene, and to study the impact of putative individual confounders like smoking and alcohol habits, co-exposure to other toxicants and body mass index on the exposure assessment. Environmental and biological monitoring of exposure to benzene were performed in 114 Urban Policemen. The mean value of UBz in non-smokers was significantly lower than in either groups of light to moderate smokers and heavy smokers (0.24, 1.82 and 2.82 μg L−1, respectively). On the contrary, SPMA values did not discriminate exposure resulting from smoking habits. Moreover, the concentration of UBz in non-smokers appears to be correlated with environmental benzene concentration (BenzA) (R2 = 0.13, β = 0.37, p = 0.002). On the other hand, no significant correlation was found between SPMA concentration (corrected for creatinine excretion and log transformed, LogSPMA) and LogBenzA (R2 = 0.003, β = 0.05, p = 0.6). Our findings reinforce previous research on the use of unmetabolized urinary benzene as a specific and sensitive biomarker of low-level exposure to benzene and confirm that smoking habits strongly influence the excretion of UBz.

International Archives of Occupational and Environmental Health, 2008

Objective To provide an overview of the spectrum of available for measurement and evaluation of w... more Objective To provide an overview of the spectrum of available for measurement and evaluation of work-related psychosocial factors. Methods We systematically searched the literature/internet to identify and describe the main available questionnaires and observational instruments for assessment of work-related psychosocial factors (with/without other job stressors). Results A total of 33 instruments were identified (26 questionnaires, 7 observational), many (11 questionnaires, 5 observational) linked to national institutions/intiatives. Accessibility of relevant information (on the internet or elsewhere) regarding the instruments varied widely. Conclusions This summary of the range of instruments currently available for evaluation of multiple work stressors at individual, group and/or organizational levels may provide a useful tool for operators and researchers.

Rapid Communications in Mass Spectrometry, 2005

8-Hydroxy-2′-deoxyguanosine (8OHdG), one of the major oxidative DNA lesions induced by radical ag... more 8-Hydroxy-2′-deoxyguanosine (8OHdG), one of the major oxidative DNA lesions induced by radical agents, is commonly used as a biomarker for oxidative stress, nowadays preferably in urine. In the absence of a commercially available internal standard a micro-high-performance liquid chromatography/electrospray ionization tandem mass spectrometry (micro-HPLC/ESI-MS/MS) method, suitable for routine analysis of 8OHdG in human urine using external calibration, was developed. Evaluation of the matrix effect showed that the method allows highly sensitive and accurate quantitation despite the absence of an internal standard. HPLC analysis was performed using gradient elution at a flow rate of 10 μL min−1 using a capillary reversed-phase column and an injection volume of 0.5 μL, with detection of 8OHdG in positive multiple reaction monitoring (MRM) mode. The absolute limit of detection was 0.35 fmol using m/z 168 as a quantifier (fragment) ion. A linear (R2 > 0.999) calibration curve in urine was obtained over a range 0.2–10 ng mL−1. This method is about 20 times more sensitive than previously described procedures, and is characterized by high accuracy (mean 90%) and good reproducibility (RSD < 10%). The optimized method was applied to determination of 8OHdG in 18 urinary samples derived from three healthy volunteers. 8OHdG urinary excretion ranged from 3.0–7.9 μg/day, and a large intra-individual variation was found. This method, which effectively circumvents the need for isotopically labeled 8OHdG (internal standard), is suitable for routine monitoring of exposure to DNA-damaging factors in a large number of subjects. Copyright © 2004 John Wiley & Sons, Ltd.

American Journal of Industrial Medicine, 1992

In compliance with the mandatory medical surveillance of workers exposed to tetrachloroethylene (... more In compliance with the mandatory medical surveillance of workers exposed to tetrachloroethylene (PCE) in Italy, isoenzyme fractioning of serum gamma-glutamyltransferase (GGT) was performed on 141 workers of both sexes and on 130 control subjects.None of the workers showed any clinical symptoms of liver disease and their enzymatic profiles, including AST, ALT, 5′-NU, ALP, and GGT, were within the normal reference limits. A statistically significant increase in total GGT serum level was found in the exposed subjects, which was associated with an increase in one of the two fractions normally present in healthy individuals (GGT-2), as well as with the appearance and progressive increase of the level of a fraction (GGT-4) considered to be an expression of hepato-biliary impairment.Further research is ongoing among these workers, which will clarify whether or not electrophoretic GGT tests may be useful in detecting liver function changes due to occupational exposure to PCE. © 1992 Wiley-Liss, Inc.

Rapid Communications in Mass Spectrometry, 2005

Bisphenol A (BPA) is a toxic industrial chemical that affects the endocrine system even at low co... more Bisphenol A (BPA) is a toxic industrial chemical that affects the endocrine system even at low concentrations. A new method, based on capillary high-performance liquid chromatography/electrospray ionization tandem mass spectrometry (HPLC/ESI-MS/MS) analysis, has been developed to determine BPA in atmospheric samples. The method involves collection of air samples (typically 2 m3) on glass fiber filters, with ultrasonic extraction and sample concentration under vacuum before analysis. HPLC analysis was performed isocratically at a flow rate of 10 µL min−1 using a capillary reversed-phase column and MS/MS analysis in negative ion multiple reaction monitoring (MRM) mode, using BPA-d16 as internal standard. The present method provides linear response in the range 0.007–3.5 µg/filter (R2 > 0.999) and is characterized by high accuracy (mean bias 2%) and good reproducibility (mean RSD 5%). High sensitivity (LOD = 2 ng/m3 based on 2 m3 of air collected), specificity, and speed of the analysis make the present method suitable for routine determination of BPA in the atmosphere, both for ambient and personnel monitoring. Copyright © 2005 John Wiley & Sons, Ltd.

Journal of Mass Spectrometry, 2005

A new high-performance liquid chromatographic/electrospray ionization tandem mass spectrometric (... more A new high-performance liquid chromatographic/electrospray ionization tandem mass spectrometric (HPLC/ESI-MS/MS) method was developed for the simultaneous quantification of 5-fluorouracil (5FU), methotrexate (MTX) and cyclophosphamide (CP) in environmental samples. These compounds, commonly used in the treatment of cancer, are recognized as genotoxic. In order to estimate the occupational exposure of hospital personnel handling these drugs, wipe samples were taken from the working surfaces and directly analyzed (with trophosphamide as internal standard) using a reversed-phase capillary column and MS/MS detection. This is the first HPLC/MS/MS method for the simultaneous determination of 5FU, MTX and CP. The present method offers high sensitivity, with detection limits of 1.1 µg l−1 for MTX and CP and 33.3 µg l−1 for 5FU, avoiding any sample preconcentration procedure. Rapidity, specificity, high accuracy (mean values between 92.4 and 99.9%) and precision (mean RSD values between 3.4 and 12.1%) make the method suitable for the routine determination of these three antineoplastic drugs. Copyright © 2005 John Wiley & Sons, Ltd.

Journal of Chromatography B-analytical Technologies in The Biomedical and Life Sciences, 2006

A sensitive and specific HPLC–ESI-MS/MS method for the direct determination of glucosamine in hum... more A sensitive and specific HPLC–ESI-MS/MS method for the direct determination of glucosamine in human plasma has been developed and validated. Plasma samples were analyzed after a simple, one-step protein precipitation clean-up with trichloroacetic acid using a polymer-based amino high-performance liquid chromatography (HPLC) column and a water/acetonitrile mobile phase elution gradient, with d-[1-13C]glucosamine as the internal standard. Detection was performed by mass spectrometry, using an electrospray source and employing multiple reaction monitoring to separately monitor glucosamine and the internal standard. The limit of quantification of the method was 10 ng/ml of glucosamine and the calibration curve showed a good linearity up to 1000 ng/ml. The precision (R.S.D.) and the accuracy (bias) of the method at the limit of quantification were 13.8 and 4.0%, respectively, and the mean recovery of glucosamine at three concentration levels was 101.6 ± 5.7%. The method was applied for the determination of glucosamine concentrations in human plasma samples collected from untreated healthy volunteers and, in a separate bioavailability study, to evaluate plasma glucosamine pharmacokinetics profiles after oral administration of crystalline glucosamine sulfate.

Mutation Research-fundamental and Molecular Mechanisms of Mutagenesis, 2004

Chromosome aberrations frequency was estimated in peripheral lymphocytes from hospital workers oc... more Chromosome aberrations frequency was estimated in peripheral lymphocytes from hospital workers occupationally exposed to low levels of ionizing radiation and controls. Chromosome aberrations yield was analyzed by considering the effects of dose equivalent of ionizing radiation over time, and of confounding factors, such as age, gender and smoking status. Frequencies of aberrant cells and chromosome breaks were higher in exposed workers than in controls (P=0.007, and P=0.001, respectively). Seven dicentric aberrations were detected in the exposed group and only three in controls, but the mean frequencies were not significantly different. The dose equivalent to whole body of ionizing radiation (Hwb) did appear to influence the spectrum of chromosomal aberrations when the exposed workers were subdivided by a cut off at 50 mSv. The frequencies of chromosome breaks in both subgroups of workers were significantly higher than in controls (≤50 mSv, P=0.041; >50 mSv, P=0.018). On the other hand, the frequency of chromatid breaks observed in workers with Hwb >50 mSv was significantly higher than in controls (P=0.015) or workers with Hwb ≤50 mSv (P=0.046). Regarding the influence of confounding factors on genetic damage, smoking status and female gender seem to influence the increase in chromosome aberration frequencies in the study population. Overall, these results suggested that chromosome breaks might provide a good marker for assessing genetic damage in populations exposed to low levels of ionizing radiation.

Journal of Occupational and Environmental Medicine, 2002

Risk factors for renal-cell carcinoma, the most frequent type of kidney cancer, remains enigmatic... more Risk factors for renal-cell carcinoma, the most frequent type of kidney cancer, remains enigmatic. Time trends in incidence and changes in the regional distribution of this cancer are suggestive of environmental risk factors. This study reports on occupational risk factors for renal-cell carcinoma in Denmark. In a population-based study, 365 persons with histologically verified renal-cell carcinoma and 396 referents were interviewed. Information was collected on occupation, education, and occupational exposure to a number of suspected substances, including hydrocarbons, asbestos, and radiation. Risk of renal-cell carcinoma was found to be associated with employment as a truck driver, exposure to gasoline, other hydrocarbons, and insecticides and herbicides. The risk of renal-cell carcinoma was higher in the lower socioeconomic strata for both the men and the women. Nonsignificantly elevated risks were observed for employment in oil refineries, gasoline stations, and the iron and steel industry. No association was found for exposure to radiation or for employment in industries such as leather manufacturing and health care, which have previously been linked to an increased risk of renal-cell carcinoma. The risk of renal-cell carcinoma is increased in lower socioeconomic strata, and previously identified or suspected risk factors do not explain the excess in risk. This study adds additional support to the hypothesis of a link between renal-cell carcinoma and hydrocarbons and also demonstrates the need for further studies on occupational risk factors for renal-cell carcinoma.

Chemosphere, 2006

We initiated the PETER (pedestrian environmental traffic pollutant exposure research) project to ... more We initiated the PETER (pedestrian environmental traffic pollutant exposure research) project to investigate pedestrians’ exposure to traffic related atmospheric pollutants, based on data obtained with the collaboration of selected categories of pedestrian urban workers. We investigated relations between roadside personal exposure levels of volatile aromatic hydrocarbons (including benzene) and particulate matter <10 μm (PM10) among traffic police (n = 126) and parking wardens (n = 50) working in downtown Bologna, Italy. Data were collected from workshifts throughout four 1-week periods in different seasons of 2000–2001. For benzene and PM10, comparisons were made with measurements by fixed monitoring stations, and influence of localized traffic intensity and meteorological parameters was examined. Roadside personal exposure to benzene correlated more strongly with other volatile aromatic hydrocarbons (toluene, xylenes and ethylbenzene) than with PM10. Benzene and PM10 personal exposure levels were higher than fixed monitoring station values (both p < 0.0001). At multivariate analysis, benzene and PM10 data from fixed monitoring stations both correlated with meteorological variables, and were also influenced by localized traffic intensity. Plausibly because of the downtown canyon-like streets, weather conditions (during a period of drought) only marginally affected benzene personal exposure, and moderately affected PM10 personal exposure. These findings reinforce the concept that urban atmospheric pollution data from fixed air monitoring stations cannot automatically be taken as indications of roadside exposures.