• Dario Consonni1

  1. Clinica del lavoro, Milano
Dario Consonni -

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Ricerca bibliografica periodo dal 16 febbraio 2014 al 15 aprile 2014

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Stringa: ("occupational exposure"[MeSH Terms] OR "occupational diseases"[MeSH Terms]) OR "occupational health"[MeSH Terms]) OR "workplace"[MeSH Terms]) OR "accidents, occupational"[MeSH Terms]) OR "employment"[MeSH Terms]) OR occupation[Title/Abstract]) OR occupational[Title/Abstract]) OR worker[Title/Abstract]) OR workers[Title/Abstract]) AND ("italy"[MeSH Terms] OR "italy"[All Fields]) AND ("2014/02/01"[PDAT] : "2014/04/15"[PDAT])
1. Ascoli V(1), Romeo E(2), Carnovale Scalzo C(2), Cozzi I(2), Ancona L(2), Cavariani F(3), Balestri A(3), Gasperini L(3), Forastiere F(2). Familial malignant mesothelioma: A population-based study in Central Italy (1980-2012). Cancer Epidemiol. 2014 Mar 27. pii: S1877-7821(14)00037-X. doi: 10.1016/j.canep.2014.02.014. [Epub ahead of print]
Author information: (1)Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University, Viale Regina Elena, 324, 00161 Rome, Italy. Electronic address: (2)Department of Epidemiology, Lazio Regional Health Service, Via di Santa Costanza, 53, 00198 Rome, Italy. (3)Laboratory of Industrial Hygiene-Asbestos Regional Center, Local Health Unit, Via Nepesina, 1/a, 01033 Civita Castellana, Viterbo, Italy.

Malignant mesothelioma is a sporadic cancer linked to asbestos exposure. Its occurrence among blood relatives (familial mesothelioma) may point to genetic susceptibility or shared exposures. The burden of the familial disease is unknown. The aims of the study were to assess at population level the proportion of familial mesotheliomas among all mesotheliomas and to investigate the family history of cancer among relatives of mesothelioma cases. We actively searched familial clusters based on a mesothelioma registry from central Italy (5.5 million people, 10% of the Italian population) of the National Mesothelioma Register network (ReNaM) as well as a pathology-based archive. Among 997 incident mesotheliomas recorded in a 32-year-period (1980-2012), we detected 13 clusters and 34 familial cases, accounting for 3.4% of all mesotheliomas. The most common clusters where those with affected siblings and unaffected parents. Asbestos exposure was occupational (n=7 clusters), household (n=2), environmental (n=1), or not attributable for insufficient information (n=3). There were 25 additional cancers in nine families. Some were cancer sites for which there is sufficient evidence (lung and larynx) or limited evidence (stomach and colon) of causal association with asbestos. The results suggest potential genetic recessive effects in mesothelioma that interact with asbestos exposure, but it is not possible to estimate the specific proportion attributable to each of these components.

Breve commento a cura di Dario Consonni
Come è ben noto gli effetti negativi dell’esposizione ad amianto non colpiscono solo i lavoratori ma anche i loro familiari e la popolazione in generale. Tuttavia, mentre i tumori da esposizione occupazionale ad amianto sono studiabili tramite studi di coorte, indagare i casi familiari e ambientali risulta in genere molto più complesso perché la popolazione-tempo è difficilmente definibile. I dati del Registro Nazionale Mesoteliomi (ReNaM), che coprono quasi tutta la popolazione italiana, potrebbero costituire a questo proposito una fonte molto importante. Questo articolo costituisce un interessante esempio di uso dei dati ReNaM per investigare aggregazioni familiari di casi di mesotelioma maligno e altri tumori correlati ad amianto.

2. Golubic R(1), May AM(2), Benjaminsen Borch K(3), Overvad K(4), Charles MA(5), Diaz MJ(6), Amiano P(7), Palli D(8), Valanou E(9), Vigl M(10), Franks PW(11), Wareham N(1), Ekelund U(1), Brage S(1). Validity of Electronically Administered Recent Physical Activity Questionnaire (RPAQ) in Ten European Countries. PLoS One. 2014 Mar 25;9(3):e92829. doi: 10.1371/journal.pone.0092829. eCollection 2014.
Author information: (1)MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom. (2)Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. (3)Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. (4)Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark and Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. (5)Inserm, Centre for research in Epidemiology and Population Health, U1018, Lifelong epidemiology of obesity, diabètes and chronic renal disease Team, F-94807, Villejuif, France; Univ Paris-Sud, UMRS 1018, F-94807, Villejuif, France. (6)Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department Sociosanitary Sciences, Murcia School of Medicine, Murcia, Spain. (7)Subdirección de Salud Pública de Gipuzkoa, Gobierno Vasco, San Sebastian, Spain. (8)Molecular and Nutritional Epidemiology Unit, ISPO, Cancer Prevention and Research Institute, Florence, Italy. (9)Hellenic Health Foundation (HHF), Athens, Greece. (10)Department of Epidemiology, Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke, Nuthetal, Germany. (11)Department of Clinical Sciences, Genetic & Molecular Epidemiology Unit, Skåne University Hospital, Lund University, Malmö, Sweden; Genetic Epidemiology & Clinical Research Group, Department of Public Health & Clinical Medicine, Section for Medicine, Umeå University, Umeå, Sweden.

OBJECTIVE: To examine the validity of the Recent Physical Activity Questionnaire (RPAQ) which assesses physical activity (PA) in 4 domains (leisure, work, commuting, home) during past month. METHODS: 580 men and 1343 women from 10 European countries attended 2 visits at which PA energy expenditure (PAEE), time at moderate-to-vigorous PA (MVPA) and sedentary time were measured using individually-calibrated combined heart-rate and movement sensing. At the second visit, RPAQ was administered electronically. Validity was assessed using agreement analysis. RESULTS: RPAQ significantly underestimated PAEE in women [median(IQR) 34.1 (22.1, 52.2) vs. 40.6 (32.4, 50.9) kJ/kg/day, 95%LoA: -44.4, 63.4 kJ/kg/day) and in men (43.7 (29.0, 69.0) vs. 45.5 (34.1, 57.6) kJ/kg/day, 95%LoA: -47.2, 101.3 kJ/kg/day]. Using individualised definition of 1MET, RPAQ significantly underestimated MVPA in women [median(IQR): 62.1 (29.4, 124.3) vs. 73.6 (47.8, 107.2) min/day, 95%LoA: -130.5, 305.3 min/day] and men [82.7 (38.8, 185.6) vs. 83.3 (55.1, 125.0) min/day, 95%LoA: -136.4, 400.1 min/day]. Correlations (95%CI) between subjective and objective estimates were statistically significant [PAEE: women, rho = 0.20 (0.15-0.26); men, rho = 0.37 (0.30-0.44); MVPA: women, rho = 0.18 (0.13-0.23); men, rho = 0.31 (0.24-0.39)]. When using non-individualised definition of 1MET (3.5 mlO2/kg/min), MVPA was substantially overestimated (∼30 min/day). Revisiting occupational intensity assumptions in questionnaire estimation algorithms with occupational group-level empirical distributions reduced median PAEE-bias in manual (25.1 kJ/kg/day vs. -9.0 kJ/kg/day, p<0.001) and heavy manual workers (64.1 vs. -4.6 kJ/kg/day, p<0.001) in an independent hold-out sample. CONCLUSION: Relative validity of RPAQ-derived PAEE and MVPA is comparable to previous studies but underestimation of PAEE is smaller. Electronic RPAQ may be used in large-scale epidemiological studies including surveys, providing information on all domains of PA.

4. Fustinoni S(1), Mercadante R(1), Polledri E(1), Rubino FM(2), Mandic-Rajcevic S(2), Vianello G(2), Colosio C(2), Moretto A(3). Biological monitoring of exposure to tebuconazole in winegrowers. J Expo Sci Environ Epidemiol. 2014 Mar 12. doi: 10.1038/jes.2014.14. [Epub ahead of print]
Author information: (1)Department of Clinical Sciences and Community Health, University of Milano and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. (2)Department of Health Sciences of the University of Milan, Laboratory for Analytical Toxicology and Metabolomics (LaTMA) and International Centre for Rural Health of the University Hospital San Paolo, Milan, Italy. (3)Department of Biomedical and Clinical Sciences, University of Milano, and International Centre for Pesticides and Health Risks Protection (ICPS), Luigi Sacco Hospital, Milano, Italy.

Tebuconazole (TEB) is a fungicide widely used in vineyards and is a suspected teratogen for humans. The aim of this research was to identify urinary biomarkers and the best sampling time for the biological monitoring of exposure to TEB in agricultural workers. Seven vineyard workers of the Monferrato region, Piedemont, Italy, were investigated for a total of 12 workdays. They treated the vineyards with TEB for 1-2 consecutive days, one of them for 3 days. During each application coveralls, underwears, hand washing liquids and head coverings were used to estimate dermal exposure. For biomonitoring, spot samples of urine from each individual were collected starting from 24 h before the first application, continuing during the application, and again after the application for about 48 h. TEB and its metabolites TEB-OH and TEB-COOH were measured by liquid chromatography/triple quadrupole mass spectrometry. TEB contamination of coveralls and total dermal exposure showed median levels of 6180 and 1020 μg. Urinary TEB-OH was the most abundant metabolite; its excretion rate peaked within 24 h after product application (post 24 h). In this time frame, median levels of TEB-OH and TEB-COOH ranged from 8.0 to 387.8 μg/l and from 5.7 to 102.9 μg/l, respectively, with a ratio between the two metabolites of about 3.5. The total amount of urinary metabolites (U-TEBeq) post 24 h was significantly correlated with both TEB on coveralls and total dermal exposure (Pearson's r=0.756 and 0.577). The amount of metabolites excreted in urine represented about 17% of total dermal TEB exposure. Our results suggest that TEB-OH and TEB-COOH in post-exposure urine samples are promising candidates for biomonitoring TEB exposure in agricultural workers.

5. Costantino C(1), Mazzucco W(1), Azzolini E(2), Baldini C(3), Bergomi M(4), Biafiore AD(5), Bianco M(6), Borsari L(4), Cacciari P(7), Cadeddu C(8), Camia P(9), Carluccio E(4), Conti A(10), De Waure C(8), Di Gregori V(7), Fabiani L(11), Fallico R(12), Filisetti B(13), Flacco ME(14), Franco E(15), Furnari R(12), Galis V(6), Gallea MR(12), Gallone MF(16), Gallone S(16), Gelatti U(13), Gilardi F(15), Giuliani AR(11), Grillo OC(10), Lanati N(17), Mascaretti S(13), Mattei A(11), Micò R(5), Morciano L(15), Nante N(2), Napoli G(1), Nobile C(5), Palladino R(18), Parisi S(1), Passaro M(18), Pelissero G(17), Quarto M(16), Ricciardi W(8), Romano G(3), Rustico E(7), Saponari A(14), Schioppa FS(14), Signorelli C(9), Siliquini R(6), Trabacchi V(9), Triassi M(18), Varetta A(17), Ziglio A(3), Zoccali A(10), Vitale F(1), Amodio E(1). Influenza vaccination coverage among medical residents: An Italian multicenter survey. Hum Vaccin Immunother. 2014 Mar 6;10(5). [Epub ahead of print]
Author information: (1)Department of Science for Health Promotion and Mother to Child Care G. D'Alessandro; University of Palermo; Palermo Italy. (2)Department of Public Health; University of Siena; Siena, Italy. (3)Department of Medicine and Public Health; University of Verona; Verona, Italy. (4)Department of Public Health Sciences; University of Modena and Reggio Emilia; Modena, Italy. (5)Department of Health Sciences; University of Catanzaro Magna Græcia; Catanzaro, Italy. (6)Department of Public Health and Microbiology; University of Torino; Torino, Italy. (7)Department of Medicine and Public Health; University of Bologna; Bologna, Italy. (8)Department of Public Health; University of Sacred Heart of Roma; Rome, Italy. (9)Department of Public Health; University of Parma; Parma, Italy. (10)Department of Hygiene, Preventive Medicine and Public Health; University of Messina; Messina, Italy. (11)Department of Internal Medicine and Public Health; University of L'Aquila; L'Aquila, Italy. (12)Department of Hygiene and Public Health G.F. Ingrassia; University of Catania; Catania, Italy. (13)Institute of Hygiene, Epidemiology and Public Health; University of Brescia; Brescia, Italy. (14)Department of Medicine and Science of Aging; University G. D'Annunzio of Chieti; Chieti, Italy. (15)Department of Public Health; University of Rome Tor Vergata; Rome, Italy. (16)Department of Biomedical Sciences; University of Bari Aldo Moro; Bari, Italy. (17)Department of Public Health, Neuroscience, Experimental and Legal Medicine; University of Pavia; Pavia, Lombardi, Italy. (18)Department of Public Health; University Hospital Federico II of Naples; Naples, Italy.

Although influenza vaccination is recognized to be safe and effective, recent studies have confirmed that immunization coverage among health care workers remain generally low, especially among medical residents (MRs). Aim of the present multicenter study was to investigate attitudes and determinants associated with acceptance of influenza vaccination among Italian MRs. A survey was performed in 2012 on MRs attending post-graduate schools of 18 Italian Universities. Each participant was interviewed via an anonymous, self-administered, web-based questionnaire including questions on attitudes regarding influenza vaccination. A total of 2506 MRs were recruited in the survey and 299 (11.9%) of these stated they had accepted influenza vaccination in 2011-2012 season. Vaccinated MRs were older (P = 0.006), working in clinical settings (P = 0.048), and vaccinated in the two previous seasons (P<0.001 in both seasons). Moreover, MRs who had recommended influenza vaccination to their patients were significantly more compliant with influenza vaccination uptake in 2011-2012 season (P<0.001). "To avoid spreading influenza among patients" was recognized as the main reason for accepting vaccination by less than 15% of vaccinated MRs. Italian MRs seem to have a very low compliance with influenza vaccination. And they seem to accept influenza vaccination as a habit that is unrelated to professional and ethical responsibility. Otherwise, residents who refuse vaccination in the previous seasons usually maintain their behaviors. Promoting correct attitudes and good practice in order to improve the influenza immunization rates of MRs could represent a decisive goal for increasing immunization coverage among health care workers of the future.

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