Giornale italiano di medicina del lavoro ed ergonomia
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G Ital Med Lav Ergon · Jan 2001
Comparative Study[Incremental stress test: comparison between protocols and cardiorespiratory reference values in healthy workers].
The aim of this study was double: to compare two different incremental stress protocols and to obtain reference values for a standardised exercise test in healthy workers. Firstly, eighty healthy male workers, 40 coal miners and 40 hospital workers, aged 19-54, performed in 2 different days 2 cycle ergometer tests up to exhaustion, increasing the work load respectively by 30 watts every 3 minutes (protocol A) and by 30 watts each minute (protocol B). Ventilatory and gas exchange measurements were done by a breath-by-breath apparatus equipped with a turbine and fast gas analysers for O2 and CO2. ⋯ Thus, these results suggest a very good comparability between the two protocols, concerning both the levels of maximal and sub-maximal aerobic capacity (V'O2 max, V'O2 VAT) and the cardio-respiratory pattern related to the oxygen uptake. Reference values for the 30 watts/3 minutes cycle ergometer stress test were achieved in other 320 healthy Sardinian workers concerning both the maximal (V'O2 max) and sub-maximal (V'O2 VAT) aerobic capacity and the range of normality for the cardio-respiratory pattern during the test, particularly for completely aerobic work loads, namely work loads not above the V'O2 VAT. These prediction equations can be useful for the evaluation of working capacity of workers employed in manual jobs characterised by moderate-to-high dynamic energy expenditure.
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Latex allergy is progressively increasing due to the widespread use of individual protective disposals, especially latex gloves among health care workers. A multidisciplinary Working Group of the Association of Health Care Workers' Preventive Medicine published, in 1995, the Guidelines for the prevention of allergic reactions both in workers and patients. ⋯ A short questionnaire was prepared to identify latex sensitisation in patients undergoing invasive procedures; tests are performed only in selected subjects. Preventive measures require the use of nonlatex gloves and the identification and substitution of all latex products in health care settings; such measures are necessary when emergency procedures are performed.
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Numerous occupational intoxications (acute, chronic and their sequelae) may affect the central nervous system and result in a wide variety of neuropsychiatric effects, ranging from subtle behavioural disturbances to overt psychosis. Chemicals causing such manifestations include many metals and organometals (Hg, Mn, Pb, Al, Sn), pesticides (organophosphates), compounds utilised in the industrial setting as solvents or intermediates (carbon disulfide, hydrocarbons and their halogenated derivatives), and combustion products (carbon monoxide). ⋯ Thus, occupational exposures to chemicals (Al, Pb, organic solvents) might be involved in the causation of neurodegenerative diseases--such as Alzheimer's disease--which are usually labelled as "idiopathic". A careful occupational anamnesis is crucial to diagnose work-related psychiatric manifestations and--consequently--to interrupt the toxic exposure, to start therapy, and to promote insurance compensation.
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Origin, significance, production and use of reference values (RV) in environmental and occupational medicine are discussed. The concept of RV was established in last sixties to correctly interpret data from modern clinical chemistry, but its acceptance in occupational medicine was neither immediate nor easy. These difficulties were mainly due to the nature and biological fate of analytes for which RV were requested, quite different from those of clinical chemistry. ⋯ The Italian Society of Reference Values (SIVR) attempted to achieve concepts and practice for RVs and proposed RVs produced by specific investigations for some metals and organic compounds. Furthermore in this paper two provisional lists of RVs for metals and organic substances are proposed. Finally the relationship between RVs and other more familiar guide line values such as action levels and limit values is discussed.
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G Ital Med Lav Ergon · Jan 1998
Comparative StudyThe biological monitoring of inhalation anaesthetics.
The biological monitoring of inhalation anaesthetics. Occupational exposure to inhalation anaesthetics is an undesired consequence of the work in the operating theatre. Anaesthesia is currently practised using nitrous oxide associated with one or more potent anaesthetics (halothane, enflurane, isoflurane). ⋯ The results show that the urinary anaesthetic concentration can be used as an appropriate biological exposure index. The biological threshold values (urinary concentration values) proposed are the following: nitrous oxide, 15, 28 and 57 micrograms/L for an environmental exposure of 25, 50 and 100 ppm respectively; halothane, 97 micrograms/L (for an environmental exposure of 50 ppm), 6.1 micrograms/L (for an environmental exposure of 2 ppm) and 3.3 micrograms/L (for an environmental exposure of 0.5 ppm); enflurane, 145 micrograms/L (for an environmental exposure of 50 ppm), 22.7 micrograms/L (for an environmental exposure of 10 ppm), 3.7 micrograms/L (for an environmental exposure of 1 ppm); isoflurane, 5.3 micrograms/L (for an environmental exposure of 2 ppm) and 1.8 micrograms/L (for an environmental exposure of 0.5 ppm). These values apply to urine samples collected at the end of 4-hours' exposure to the anaesthetics.