Publications by authors named "Caterina Ledda"

84 Publications

Epidemiological Research on Occupational and Environmental Carcinogens.

Authors:
Caterina Ledda

Int J Environ Res Public Health 2021 Feb 24;18(5). Epub 2021 Feb 24.

Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy.

The cancer risk associated with exposure to environmental and occupational carcinogens such as asbestos, benzene, radiation, or lifestyle carcinogens such as cigarette smoking depends on the entire history of exposure to the carcinogen, including the age of exposure and the time-varying intensity of exposure [...].
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http://dx.doi.org/10.3390/ijerph18052215DOI Listing
February 2021

Apoptotic mechanism activated by blue light and cisplatinum in cutaneous squamous cell carcinoma cells.

Int J Mol Med 2021 Apr 12;47(4). Epub 2021 Feb 12.

Section of Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, I-60126 Ancona, Italy.

New approaches are being studied for the treatment of skin cancer. It has been reported that light combined with cisplatinum may be effective against skin cancer. In the present study, the effects of specific light radiations and cisplatinum on A431 cutaneous squamous cell carcinoma (cSCC) and HaCaT non‑tumorigenic cell lines were investigated. Both cell lines were exposed to blue and red light sources for 3 days prior to cisplatinum treatment. Viability, apoptosis, cell cycle progression and apoptotic‑related protein expression levels were investigated. The present results highlighted that combined treatment with blue light and cisplatinum was more effective in reducing cell viability compared with single treatments. Specifically, an increase in the apoptotic rate was observed when the cells were treated with blue light and cisplatinum, as compared to treatment with blue light or cisplatinum alone. Combined treatment with blue light and cisplatinum also caused cell cycle arrest at the S phase. Treatment with cisplatinum following light exposure induced the expression of apoptotic proteins in the A431 and HaCaT cell lines, which tended to follow different apoptotic mechanisms. On the whole, these data indicate that blue light combined with cisplatinum may be a promising treatment for cSCC.
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http://dx.doi.org/10.3892/ijmm.2021.4881DOI Listing
April 2021

Apoptotic mechanism activated by blue light and cisplatinum in cutaneous squamous cell carcinoma cells.

Int J Mol Med 2021 Apr 12;47(4). Epub 2021 Feb 12.

Section of Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, I-60126 Ancona, Italy.

New approaches are being studied for the treatment of skin cancer. It has been reported that light combined with cisplatinum may be effective against skin cancer. In the present study, the effects of specific light radiations and cisplatinum on A431 cutaneous squamous cell carcinoma (cSCC) and HaCaT non‑tumorigenic cell lines were investigated. Both cell lines were exposed to blue and red light sources for 3 days prior to cisplatinum treatment. Viability, apoptosis, cell cycle progression and apoptotic‑related protein expression levels were investigated. The present results highlighted that combined treatment with blue light and cisplatinum was more effective in reducing cell viability compared with single treatments. Specifically, an increase in the apoptotic rate was observed when the cells were treated with blue light and cisplatinum, as compared to treatment with blue light or cisplatinum alone. Combined treatment with blue light and cisplatinum also caused cell cycle arrest at the S phase. Treatment with cisplatinum following light exposure induced the expression of apoptotic proteins in the A431 and HaCaT cell lines, which tended to follow different apoptotic mechanisms. On the whole, these data indicate that blue light combined with cisplatinum may be a promising treatment for cSCC.
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http://dx.doi.org/10.3892/ijmm.2021.4881DOI Listing
April 2021

SARS-CoV-2 Seroprevalence Post-First Wave among Primary Care Physicians in Catania (Italy).

Trop Med Infect Dis 2021 Feb 9;6(1). Epub 2021 Feb 9.

Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy.

Family physicians or pediatricians and general practitioners (GPs) work in non-hospital settings. GPs usually visit many patients, frequently at their homes, with low potential, if any, to control the work setting. Particularly during the initial phases of the COVID-19 outbreak, they were not informed about the occurrence of SARS-CoV-2-infected patients, with inadequate information regarding the risk, a lack of suitable protective measures and, in some cases, deficient or poor accessibility to personal protective equipment (PPE). During the first wave of COVID-19, primary care physicians were on the front line and isolated the first cases of the disease. The present study aims to estimate the seroprevalence of SARS-CoV-2 in a cohort of 133 GPs working in Catania (Italy) after the first wave of COVID-19. Serological analysis revealed a low seroprevalence (3%) among GPs. The low seroprevalence highlighted in the results can be attributed to correct management of patients by GPs in the first wave. It is now hoped that mass vaccination, combined with appropriate behavior and use of PPE, can help further reduce the risk of COVID-19 disease.
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http://dx.doi.org/10.3390/tropicalmed6010021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930996PMC
February 2021

Oxidative stress and DNA damage in agricultural workers after exposure to pesticides.

J Occup Med Toxicol 2021 Jan 7;16(1). Epub 2021 Jan 7.

Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, Via Santa Sofia, 89 - 95123, Catania, Italy.

Background: Recent epidemiological studies on workers describe that exposure to pesticides can induce oxidative stress by increased production of free radicals that can accumulate in the cell and damage biological macromolecules, for example, RNA, DNA, DNA repair proteins and other proteins and/or modify antioxidant defense mechanisms, as well as detoxification and scavenger enzymes. This study aimed to assess oxidative stress and DNA damage among workers exposed to pesticides.

Methods: For this purpose, 52 pesticide exposed workers and 52 organic farmers were enrolled. They were assessed: the pesticide exposure, thiobarbituric acid reactive substances (TBARS), total glutathione (TG), oxidized glutathione levels (GSSG), and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG), levels.

Results: Correlation between pesticide exposure was positively associated with high TBARS and 8-oxodG levels (p <  0.001). A negative association was founded with TG and GSSG and pesticide exposure.

Conclusions: The present investigation results seem to indicate a mild augment in oxidative stress associated with pesticide exposure, followed by an adaptive response to increase the antioxidant defenses to prevent sustained oxidative adverse effects stress.
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http://dx.doi.org/10.1186/s12995-020-00290-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791774PMC
January 2021

Attitudes and Perception of Healthcare Workers Concerning Influenza Vaccination during the 2019/2020 Season: A Survey of Sicilian University Hospitals.

Vaccines (Basel) 2020 Nov 16;8(4). Epub 2020 Nov 16.

Department of Biomedical Sciences and Morphological and Functional Images (BIOMORF), University of Messina, 98124 Messina, Italy.

Influenza is an infectious disease with a high impact on the population in terms of morbidity and mortality, but despite International and European guidelines, vaccination coverage rates among healthcare workers (HCWs) remain very low. The aim of the present study was to evaluate influenza vaccination adherence in the three Sicilian University Hospitals of Catania, Messina, and Palermo and to understand the attitudes and perceptions of vaccinated healthcare workers and the main reasons for vaccination refusal. A cross-sectional survey through a self-administered questionnaire was conducted during the 2019/2020 influenza season. Overall, 2356 vaccinated healthcare workers answered the questionnaire. The main reason reported for influenza vaccination adherence during the 2019/2020 season was to protect patients. Higher self-perceived risk of contracting influenza and a positive attitude to recommending vaccination to patients were significantly associated with influenza vaccination adherence during the last five seasons via multivariable analysis. Fear of an adverse reaction was the main reason for influenza vaccine refusal. In accordance with these findings, Public Health institutions should develop and tailor formative and informative campaigns to reduce principal barriers to the immunization process and promote influenza vaccination adherence among HCWs.
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http://dx.doi.org/10.3390/vaccines8040686DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7711679PMC
November 2020

Thyroid Cancer and Circadian Clock Disruption.

Cancers (Basel) 2020 Oct 24;12(11). Epub 2020 Oct 24.

Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi-Nesima Hospital, University of Catania, 95122 Catania, Italy.

Thyroid cancer (TC) represents the most common malignancy of the endocrine system, with an increased incidence across continents attributable to both improvement of diagnostic procedures and environmental factors. Among the modifiable risk factors, insulin resistance might influence the development of TC. A relationship between circadian clock machinery disfunction and TC has recently been proposed. The circadian clock machinery comprises a set of rhythmically expressed genes responsible for circadian rhythms. Perturbation of this system contributes to the development of pathological states such as cancer. Several clock genes have been found deregulated upon thyroid nodule malignant transformation. The molecular mechanisms linking circadian clock disruption and TC are still unknown but could include insulin resistance. Circadian misalignment occurring during shift work, jet lag, high fat food intake, is associated with increased insulin resistance. This metabolic alteration, in turn, is associated with a well-known risk factor for TC i.e., hyperthyrotropinemia, which could also be induced by sleep disturbances. In this review, we describe the mechanisms controlling the circadian clock function and its involvement in the cell cycle, stemness and cancer. Moreover, we discuss the evidence supporting the link between circadian clockwork disruption and TC development/progression, highlighting its potential implications for TC prevention, diagnosis and therapy.
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http://dx.doi.org/10.3390/cancers12113109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690860PMC
October 2020

Coverage rates against vaccine-preventable diseases among healthcare workers in Sicily (Italy).

Eur J Public Health 2021 Feb;31(1):56

Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties, University of Palermo, Palermo, Italy.

Background: Vaccination of healthcare workers (HCWs) reduces the risk of occupational vaccine-preventable diseases (VPDs), prevents their nosocomial transmission and preserves healthcare delivery during outbreaks. Extensive implementation of vaccination programmes for HCWs allowed the elimination or control of several VPDs within healthcare facilities; despite these, the vaccine adherence rates among HCWs are persistently suboptimal.

Methods: A questionnaire was self-administered by HCWs to assess their vaccination rates against several VPDs and self-reported immunity in two university hospitals of Southern Italy (Catania and Palermo).

Results: A total of 2586 questionnaires were analysed. More than 50% of HCWs did not know their own immunization status against diphtheria, tetanus and pertussis. More than half of the HCWs interviewed at University Hospital (UH) of Catania (UHC) was immune against measles (72.1%), in contrast with data reported at the UH of Palermo (UHP) (45.9%). Immunization status against mumps (67.5% UHC vs. 40.6% UHP), rubella (69.9% UHC vs. 46.6% UHP) and varicella (70.4% UHC vs. 50.7% UHP). Overall, about 30% of HCWs did not know their own immunization status against these VPDs. Moreover, 84.2% at UHC and 66.7% at UHP stated that was previously vaccinated against hepatitis B.

Conclusion: Vaccination coverage rates reported from the HCWs against influenza during the last three seasons were considerably low. In conclusion, totally inadequate vaccination rates against several VPDs were found in two university hospitals in Sicily, in terms of preventing not only disease transmission by susceptible HCWs, but also nosocomial outbreaks, confirming data from previous national and international studies.
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http://dx.doi.org/10.1093/eurpub/ckaa179DOI Listing
February 2021

MacroH2A1 Immunoexpression in Breast Cancer.

Front Oncol 2020 21;10:1519. Epub 2020 Aug 21.

Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, Catania, Italy.

MacroH2A1 has two splice isoforms, macroH2A1.1 and macroH2A1.2, that have been studied in several form of cancer. In the literature there are not many scientific papers dealing with the role of macroH2A1 in breast cancer. Breast cancer is the most frequent form of malignancy in females. It tend to metastasize to the bone in ~70% of patients. Despite treatment, new bone metastases will still occur in 30-50% of cases with advanced disease. Overall 5-year survival after the diagnosis of bone metastasis is ~20%. Osteoclasts and osteoblasts of the bone microenvironment are engaged by soluble factors released by neoplastic cells, resulting in bone matrix breakdown. This malfunction enhances the proliferation of the cancer cells, creating a vicious cycle. We investigated immunohistochemical expression of macroH2A1 in primitive breast cancer, focusing on the comparison of metastatic and non-metastatic cases. Furthermore, the immunohistochemical expression of macroH2A1 has been evaluated both in all cases of nodal metastases and in distant metastases. Our data demonstrated that macroH2A1 expression was higher expressed in metastatic breast cancer (77%) vs. non-metastatic breast cancer (32%). Also in analyzed metastases cases, a high macroH2A1 expression was detected: 85 and 80% in nodal and distant metastases cases, respectively. These results supported the fact that macroH2A1 is more highly expressed in breast cancer with worst prognosis.
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http://dx.doi.org/10.3389/fonc.2020.01519DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7471871PMC
August 2020

Occupational and Environmental Carcinogenesis.

Cancers (Basel) 2020 Sep 8;12(9). Epub 2020 Sep 8.

Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia, 87-95123 Catania, Italy.

Occupational carcinogens have been shown to cause a considerable disease burden at a national and global level [...].
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http://dx.doi.org/10.3390/cancers12092547DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564008PMC
September 2020

Biological Monitoring of Exposure to Benzene in Port Workers.

Front Public Health 2020 17;8:271. Epub 2020 Jul 17.

Interdisciplinary Department of Medicine (DIM), Section of Occupational Medicine "B.Ramazzini", School of Medicine, University of Bari "A. Moro", Bari, Italy.

Port workers are exposed to a wide range of occupational hazards that can cause injuries and occupational diseases. Among these, exposure to benzene is one of the most important but least studied. The highest occupational exposures for port workers occur during the filling and loading of gasoline, and cleaning of tanks and receptacles. The aim of the study was to evaluate occupational exposure to low levels of benzene by measuring trans,trans-muconic acid (t,t-MA) in urine samples from workers operating at fuelling stations in a tourist port of Southern Italy. The overall sample was composed of 43 port workers of a tourist port in Southern Italy. In 2018, each participant provided two (morning and evening) urine samples for the determination of urinary t,t-MA. Urinary excretion of t,t-MA was always higher at the end of the work shift than at the beginning with significant difference ( = 0.002). In smokers, median t,t-MA urinary excretion is higher than non-smokers both at the beginning (90.5 μg/g creatinine vs. 61.45 μg/g creatinine) and at the end of the work shift (128.2 μg/g creatinine vs. 89.5 μg/g creatinine). Urinary excretion of t,t-MA is higher at the end of the work shift than at the beginning in both smokers and non-smokers, but the difference is significantly higher in non-smokers ( = 0.003) than in smokers ( = 0.05). In conclusion, our results showed that the role of inhaled benzene at fuelling stations in a tourist port can be relevant. On the basis of these results and the known adverse effects of benzene on human health, we encourage the use of personal protective equipment in the fuelling area of ports in order to minimize exposure to benzene to workers.
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http://dx.doi.org/10.3389/fpubh.2020.00271DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7379907PMC
July 2020

3 Etnean Occupational Medicine Workshop-Breast Cancer and Work.

Cancers (Basel) 2020 Jul 16;12(7). Epub 2020 Jul 16.

Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy.

Breast cancer, the most frequently occurring cancer in women, is a major public health problem, with over 1 million estimated new cases worldwide and nearly 459,000 related deaths every year [...].
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http://dx.doi.org/10.3390/cancers12071925DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409062PMC
July 2020

A randomized controlled trial to compare group motivational interviewing to very brief advice for the effectiveness of a workplace smoking cessation counseling intervention.

J Addict Dis 2020 Oct-Dec;38(4):465-474. Epub 2020 Jul 7.

Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.

Background: Studies show that smokers have a lower work performance due to time spent smoking, increased fatigue perception and are more absent from work due to smoking-related diseases. The workplace could represent an important location to promote smoking cessation.

Methods: This study is a multi-center, controlled trial for smoking cessation counseling at the participants' workplace, where 656 randomized participants received four sessions of group motivational interviewing or four sessions of very brief advice and were followed up for 52 weeks.

Results: The Continuous Quit Rate (CQR) was higher for the smoking cessation counseling group than for the very brief advice group during weeks 9 to 12 (17.5% vs. 3.6%) weeks 9 to 24 (13.4% vs. 3.4%) and weeks 9 to 52 (10.3% vs. 3.1%).

Conclusions: This study demonstrated that motivational interviewing is an efficacious smoking cessation approach for smokers at their workplace. The short-term and long-term cessation rate of the intervention of the smoking cessation counseling group exceeded that of very brief advice.
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http://dx.doi.org/10.1080/10550887.2020.1782564DOI Listing
July 2020

Modulation of microRNA expression levels after naturally occurring asbestiform fibers exposure as a diagnostic biomarker of mesothelial neoplastic transformation.

Ecotoxicol Environ Saf 2020 Jul 21;198:110640. Epub 2020 Apr 21.

Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, 95123, Catania, Italy; Research Center for Prevention, Diagnosis and Treatment of Cancer (PreDiCT), University of Catania, 95123, Catania, Italy.

Fluoro-edenite (FE) is a silicate mineral identified in the lava products of Monte Calvario from stone quarries located in the southeast of Biancavilla, a small city of the Etnean volcanic complex (Sicily, Italy). Inhalation of FE fibers has been associated with a higher incidence of Malignant Mesothelioma (MM), a highly aggressive neoplasm of the serosal membranes lining the pleural cavity. Only 5% of MM patients are diagnosed at an early stage and the median survival is approximate 6-12 months. Many diagnostic biomarkers have been proposed for MM. Several studies demonstrated that microRNAs (miRNAs) may be used as good non-invasive diagnostics, as well as prognostic biomarkers for various human diseases, including cancer. On these bases, the aim of the present study was to identify a set of miRNAs involved in the development and progression of MM and potentially used as diagnostic biomarkers. For these purposes, in silico analyses were performed on healthy/exposed to asbestos fibers subjects vs. patients with MM. These analyses revealed a set of miRNAs strictly involved in MM by merging the lists of miRNAs found differentially expressed in the three miRNA expression datasets analyzed. The result of these computational evaluations allowed the execution of functional in vitro experiments performed on normal pleural mesothelial cell line (MeT-5A) and MM cell line (JU77) in order to test the carcinogenetic effects and epigenetic modulation induced by FE exposure. The in vitro results showed that the expression levels of hsa-miR-323a-3p vary significantly in both supernatant- and cell-derived miRNAs derived from treated and untreated cells. Secreted and cellular hsa-miR-101-3p in MeT-5A treated with FE fibers and JU77 cells showed different trends of expression. As regard hsa-miR-20b-5p, there was no differential expression between secreted and cellular hsa-miR-20b-5p. This miRNA has been shown a significant up-regulation in JU77 cells vs. control and treated MeT-5A. As a future plan, translational analyses will be performed on a subset of patients chronically exposed to FE fibers to further verify the clinical role of such miRNAs in high-risk individuals and their possible use as biomarkers of FE exposure or MM early onset.
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http://dx.doi.org/10.1016/j.ecoenv.2020.110640DOI Listing
July 2020

Defense and protection mechanisms in lung exposed to asbestiform fiber: the role of macrophage migration inhibitory factor and heme oxygenase-1.

Eur J Histochem 2020 Apr 16;64(2). Epub 2020 Apr 16.

Anatomy and Histology, Department of Biomedical and Biotechnologies Sciences, University of Catania.

Fluoro-edenite (FE), an asbestiform fiber, is responsible for many respiratory pathologies: chronic obstructive diseases, pleural plaques, fibrosis, and malignant mesothelioma. Macrophage migration inhibitory factor (MIF) is one of the first cytokines produced in response to lung tissue damage. Heme oxygenase-1 (HO-1) is a protein with protective effects against oxidative stress. It is up regulated by several stimuli including pro-inflammatory cytokines and factors that promote oxidative stress. In this research, the in vivo model of sheep lungs naturally exposed to FE was studied in order to shed light on the pathophysiological events sustaining exposure to fibers, by determining immunohistochemical lung expression of MIF and HO-1. Protein levels expression of HO-1 and MIF were also evaluated in human primary lung fibroblasts after exposure to FE fibers in vitro. In exposed sheep lungs, MIF and HO-1 immunoexpression were spread involving the intraparenchymal stroma around bronchioles, interstitium between alveoli, alveolar epithelium and macrophages. High MIF immunoexpression prevails in macrophages. Similar results were obtained in vitro, but significantly higher values were only detected for HO-1 at concentrations of 50 and 100 μg/mL of FE fibers. MIF and HO-1 expressions seem to play a role in lung self-protection against uncontrolled chronic inflammation, thus counteracting the strong link with cancer development, induced by exposure to FE. Further studies will be conducted in order to add more information about the role of MIF and HO-1 in the toxicity FE-induced.
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http://dx.doi.org/10.4081/ejh.2020.3073DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171426PMC
April 2020

An Immunohistochemical Study on MacroH2A.1 in Lung and Lymph-Node Tissues Exposed to an Asbestiform Fiber.

Curr Mol Med 2020 ;20(8):653-660

Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.

Aims: The aim of this study was to investigate MacroH2A.1 immunoexpression in tissues of sheep exposed to FE.

Background: The correlation between asbestiform fibers, lung cancer, pleural mesothelioma, and other lung diseases is already well established as the pathophisiological pathophysiological respiratory mechanisms involved by inhalation of Fluoro-edenite (FE). The latter is represented by cell proliferation and inducing the release of growth factors, cytokines, and reactive oxygen and nitrite species, with DNA damage that causes chronic inflammation and carcinogenesis. MacroH2A.1, and histone variant, seems to play a role in sensing the metabolic state of the cell and linking it with chromatin. Physiologically, MacroH2A.1 is expressed at low levels in stem cells and it became upregulated during differentiation, preventing reprogramming of induced pluripotent stem cells and after nuclear transfer. In particular, MacroH2A.1 has been shown to explicate a potent antitumor mechanism in vivo as it results upregulated in senescent cells determining a permanent growth-arrest.

Objective: Evaluate the possible role of the histone variant in the organism in response to deep insight understanding the mechanisms of toxicity and the cellular response to FE.

Methods: Lung and lymph nodes of exposed sheep were selected. Samples were processed for histological and immunihistochemical immunohistochemical evaluations. Densitometric, morphometric, and statistical analysis analyses were conducted.

Results: Tissue sections of FE exposed sheep demonstrated overexpression of MacroH2A.1 vs unexposed samples. The data suggest an involvement of these this molecule in the cellular response triggered by FE directed exposure.

Conclusion: In this contest, MacroH2A.1 overexpression supports its function as an epigenetic stabilizer that helps to establish and maintain differentiated states.
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http://dx.doi.org/10.2174/1566524020666200220130023DOI Listing
January 2020

Straining at Work and Its Relationship with Personality Profiles and Individual Consequences in Healthcare Workers (HCWs).

Int J Environ Res Public Health 2020 01 17;17(2). Epub 2020 Jan 17.

Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy.

Straining is an attenuated form of mobbing, in which the continuity of vexatious actions is not driven by a discriminatory intent. With the objective of testing the possible moderating role of personality in the relationship between perceptions about straining at work and individual consequences, a correlational design research involved 374 healthcare workers (HCWs) from two Italian hospitals. The following questionnaires were administered: (1) Short Negative Acts Questionnaire (S-NAQ), to assess discriminative actions at work); (2) the Italian version of the Big Five Inventory (BFI-10 scale), to assess personality factors; (3) Occupational Stress Indicator (OSI), to measure psychological and physical health. Regression analysis and Structural Equation Models (SEM) were computed in order to test the relationships between variables. Perceived straining showed significant correlations with both psychological and physical health. Conscientiousness was inversely proportional to work-related bullying (WB), as agreeableness was to personal bullying (PB). Emotional stability was negatively correlated with all the three component scales of S-NAQ: WB, PB, and social bullying. The results seem to confirm that straining perceptions especially elicit, through emotional stability, psychological consequences. As regards the role of emotional stability in risk perceptions, it seems management has to pay thorough attention to personal factors in organizational perceptions and to straining actions.
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http://dx.doi.org/10.3390/ijerph17020610DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027001PMC
January 2020

Night-Time Shift Work and Related Stress Responses: A Study on Security Guards.

Int J Environ Res Public Health 2020 01 15;17(2). Epub 2020 Jan 15.

Department of Sciences for Health Promotion and Mother and Child Care "Giuseppe D'Alessandro", University of Palermo, via del Vespro 133, 90127 Palermo, Italy.

Work-related stress can induce a break in homeostasis by placing demands on the body that are met by the activation of two different systems, the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. Night-shift work alters the body's exposure to the natural light-dark schedule and disrupts circadian (daily) rhythms. The greatest effect of night-shift work is the disruption of circadian rhythms. The impact that these disruptions may have on the pathogenesis of many diseases, including cancer, is unknown. This study aims to discover the relationship among three different job activities of security guards and their stress-related responses by evaluating salivary cortisol levels and blood pressure.

Methods: Ninety security guards, including night-time workers and night-time and daily-shift workers, were recruited for this study. Each security guard provided two saliva samples before and after three scheduled time points: (i) at 22:00, (ii) at 06:30, and (iii) at 14:00.

Results: The results of the study showed a significant alteration in cortisol levels. Night-time shift cortisol levels significantly increased before and after the work shifts. A physiological prevalence of the vagal tone on the cardiocirculatory activity was found during night-shift work.

Conclusions: This study indicates that cortisol levels and blood pressure are sensitive markers of biological responses to severe work stress. Shift-change consequences may occur at the end of the night shift when there is a significant increase in the cortisol level and a significant variation in cardiovascular parameters.
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http://dx.doi.org/10.3390/ijerph17020562DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013811PMC
January 2020

Exposure to Toxic Heavy Metals Can Influence Homocysteine Metabolism?

Antioxidants (Basel) 2019 Dec 28;9(1). Epub 2019 Dec 28.

Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.

Background: Homocysteine is a sulfur amino acid whose metabolism is activated in two pathways: remethylation to methionine, which requires folate and vitamin B, and transsulfuration to cystathionine, which needs pyridoxal-5'-phosphate. High homocysteine level increases the risk of developing heart disease, stroke, peripheral vascular diseases, and cognitive impairment. Some evidence showed that exposure to these metals increased plasma homocysteine levels.

Methods: A systematic review was carried out to clarify the relationship between homocysteine blood levels and exposure to toxic heavy metals (Lead, Cadmium, Mercury, and Chromium).

Results: The results of this systematic review indicate that exposure to Pb, Cr, Cd, and Hg is connected with nonphysiological homocysteine levels or vitamin B and folate serum concentrations.

Conclusions: These findings reinforce the importance of involvement in exposure to heavy metals in homocysteine metabolism. This supports the role of blood metals as potential upstream modifiable risk factors to prevent the development of other established risk factors as hyperhomocysteinemia.
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http://dx.doi.org/10.3390/antiox9010030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7022705PMC
December 2019

Management of High-Pressure Injection Hand Injuries: A Multicentric, Retrospective, Observational Study.

J Clin Med 2019 Nov 16;8(11). Epub 2019 Nov 16.

Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.

Hand injuries after high-pressure injection are a medical emergency. These events occur frequently in workers during industrial cleaning, painting, and lubrication, and may have devastating consequences, leading to eventual amputation and poor functional outcomes. The authors have investigated the evolution, management, and outcome. Medical records of occupational medicine units and hand surgery units were collected in order to spot the high-pressure gear accident cases. Records were analyzed by dividing the subjects into two groups: those treated within 6 h and after 6 h of the trauma. A follow-up was carried out at least 1 year after treatment; the post-treatment outcomes were assessed. Of the 71 (100%) subjects, 26 (37%) were treated ≤6 h and 45 (63%) >6 h. A total of 28% ( = 20) underwent amputation. In 61% of cases, accidents had occurred in the iron and steel sector. High viscosity materials with a delayed treatment beyond 6 h seemed to determine compartmental syndrome and following amputation. A significantly better outcome was reported among subjects treated ≤6 h compared to those treated >6 h, 20% ( = 7) versus 26% ( = 9), respectively. Early management of this type of injury is crucial. The results of this study may contribute to providing guidelines to occupational physicians in order to best manage this type of emergency.
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http://dx.doi.org/10.3390/jcm8112000DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912633PMC
November 2019

Immunization Status against Measles of Health-Care Workers Operating at Three Sicilian University Hospitals: An Observational Study.

Vaccines (Basel) 2019 Nov 3;7(4). Epub 2019 Nov 3.

Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.

Measles is a highly contagious vaccine-preventable disease (VPD) that also commonly affects health-care workers (HCWs). Measles immunization of HCWs was strongly recommended by international health authorities, in order to limit the spreading of the illness to susceptible patients and colleagues. An observational study, evaluating the immunization and vaccination status against measles of HCWs working at three Sicilian university hospitals, was conducted. All subjects not completely immune (vaccinated with only one dose in their lifetime), not immune (not vaccinated or not naturally immunized), and with an unknown immunization status were considered not immunized. Among HCWs operating in the three Sicilian university hospitals, 54.6% were not immune against measles. The average age of not immune HCWs was 51.3 (SD ± 9.8), ranging between 25 and 71 years old. In particular, 46.9% of HCWs not immunized worked in "at-risk" hospital units, based on medical conditions of patients which increases the probability of contracting an infection. Vaccination coverage rates observed against measles are considerably lower than other European countries and inadequate. It is therefore crucial to tackle vaccine hesitancy among HCWs, promoting strategies targeted to evaluate immunization status against VPDs and to significantly increase vaccine coverages, such as tailored training and vaccination offer or compulsory vaccination programs.
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http://dx.doi.org/10.3390/vaccines7040175DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963751PMC
November 2019

Vaccination of healthcare personnel in Europe: Update to current policies.

Vaccine 2019 12 14;37(52):7576-7584. Epub 2019 Oct 14.

Director, Mayo Vaccine Research Group, Mayo Clinic, Rochester, MN, United States.

We investigated and compared current national vaccination policies for health-care personnel (HCP) in Europe with results from our previous survey. Data from 36 European countries were collected using the same methodology as in 2011. National policies for HCP immunization were in place in all countries. There were significant differences in terms of number of vaccinations, target HCP and healthcare settings, and implementation regulations (recommended or mandatory vaccinations). Vaccination policies against hepatitis B and seasonal influenza were present in 35 countries each. Policies for vaccination of HCP against measles, mumps, rubella and varicella existed in 28, 24, 25 and 19 countries, respectively; and against tetanus, diphtheria, pertussis and poliomyelitis in 21, 20, 19, and 18 countries, respectively. Recommendations for hepatitis A immunization existed in 17 countries, and against meningococcus B, meningococcus C, meningococcus A, C, W, Y, and tuberculosis in 10, 8, 17, and 7 countries, respectively. Mandatory vaccination policies were found in 13 countries and were a pre-requisite for employment in ten. Comparing the vaccination programs of the 30 European countries that participated in the 2011 survey, we found that more countries had national vaccination policies against measles, mumps, rubella, hepatitis A, diphtheria, tetanus, poliomyelitis, pertussis, meningococcus C and/or meningococcus A, C, W, Y; and more of these implemented mandatory vaccination policies for HCP. In conclusion, European countries now have more comprehensive national vaccination programs for HCP, however there are still gaps. Given the recent large outbreaks of vaccine-preventable diseases in Europe and the occupational risk for HCP, vaccination policies need to be expanded and strengthened in several European countries. Overall, vaccination policies for HCP in Europe should be periodically re-evaluated in order to provide optimal protection against vaccine-preventable diseases and infection control within healthcare facilities for HCP and patients.
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http://dx.doi.org/10.1016/j.vaccine.2019.09.061DOI Listing
December 2019

Relation between psychosomatic disturbances and job stress in video display unit operators.

Work 2019 ;64(2):303-310

Department of Clinical and Molecular Sciences, Occupational Medicine, Polytechnic University of Marche, Ancona, Italy.

Background: Some psychosomatic disturbances have been related to protracted video display unit (VDU) use at work, and they may be associated with job stress.

Objective: This study aimed at assessing the association between psychosomatic disturbances with job-related and subjective stress in 990 VDU.

Methods: Job stress was evaluated by Karasek's Questionnaire, psychological job demands and job decision latitude scores were calculated. Workers were assigned to four categories: high-strain job, low-strain job, active job, and passive job. Subjective perception of stress was evaluated with the Rapid Stress Assessment Scale.

Results: None of the psychosomatic disturbances investigated were associated with higher psychological job demands scores, whereas many of them were significantly related to lower job decision latitude scores and high-strain jobs. All psychosomatic disturbances were significantly associated with personal stress. Logistic regression confirms the protective role of job decision latitude on headache, fatigue, intestinal gas, disturbed sleep and the significant role of subjective stress on all psychosomatic disturbances studied.

Conclusions: Whereas subjective stress is harmful, job decision latitude is a protective factor for several psychosomatic disturbances reported by VDU operators. Improvement in the job decision latitude might be a preventive specific measure in work planning to reduce possible stress-related disorders.
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http://dx.doi.org/10.3233/WOR-192993DOI Listing
April 2020

Gene Diurnal Variation in Healthy Volunteers and Expression Levels in Shift Workers.

Biomed Res Int 2019 31;2019:7582734. Epub 2019 Jul 31.

Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy.

Objective: The gene links nutrient absorption and metabolism to the circadian clock. Shift workers are at a heightened risk of overweight and of developing obesity and metabolic syndrome. This study investigates the diurnal variation of in healthy volunteers and its expression levels in rotational shift and daytime workers.

Methods: expression levels were evaluated in peripheral blood lymphocytes from 15 healthy volunteers at 4-hour intervals for 24 h. Metabolic parameters and expression were measured in workers engaged in shift and daytime work.

Results: In the group of volunteers expression showed diurnal variation, with a peak at 8:00 AM. expression was higher in shift workers than in daytime workers. Multivariate analysis confirmed the role of shift work as an independent factor affecting expression. Notably, its level correlated directly with body mass index and inversely with total energy expenditure.

Conclusions: Measuring expression levels in human peripheral blood lymphocytes can improve investigations on the relationship between changes in circadian rhythm and metabolic disorders. Shift workers show higher levels than daytime workers.
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http://dx.doi.org/10.1155/2019/7582734DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6699378PMC
January 2020

and Gene Expression: Diurnal Variability and Influence of Shift Work

Cancers (Basel) 2019 08 9;11(8). Epub 2019 Aug 9.

Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy.

and genes are involved in DNA double-strand break repair and related to breast cancer. Shift work is associated with biological clock alterations and with a higher risk of breast cancer. The aim of this study was to investigate the variability of expression of genes through the day in healthy subjects and to measure expression levels in shift workers. The study was approached in two ways. First, we examined diurnal variation of and genes in lymphocytes of 15 volunteers over a 24-hour period. Second, we measured the expression of these genes in lymphocytes from a group of shift and daytime workers. The change in 24-hour expression levels of and genes was statistically significant, decreasing from the peak at midday to the lowest level at midnight. Lower levels for both genes were found in shift workers compared to daytime workers. Diurnal variability of and expression suggests a relation of DNA double-strand break repair system with biological clock. Lower levels of and found in shift workers may be one of the potential factors related to the higher risk of breast cancer.
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http://dx.doi.org/10.3390/cancers11081146DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721503PMC
August 2019

Mandatory vaccinations for children in Italy: The need for a stable frame.

Vaccine 2019 07 4;37(32):4419-4420. Epub 2019 Jul 4.

Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Italy.

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http://dx.doi.org/10.1016/j.vaccine.2019.05.095DOI Listing
July 2019

Touch DNA: impact of handling time on touch deposit and evaluation of different recovery techniques: An experimental study.

Sci Rep 2019 07 2;9(1):9542. Epub 2019 Jul 2.

Department of Medical and Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy.

"Touch DNA" is DNA obtained from biological material transferred from a donor to an object or a person during physical contact. This particular kind of evidence could play an essential role in forensic laboratory work and is considered an important tool for investigators. Even though the principal aspects of "Touch DNA" have been extensively studied, to date, there are few reports in the research field of DNA retrieval from garments that have been worn. This study aimed to investigate the "handling time", analyzing particularly the minimum contact time required to deposit a sufficient amount of DNA on a garment to produce an interpretable profile of the "handler". Moreover, three different sampling techniques were compared ("dry swab", "cutting out", and "adhesive tape") with the aim of defining the technique that guarantees the best recovery of the three methods tested. Analyzing the data of this experimental model, a "handling time" of two seconds is enough to release sufficient DNA on to a garment to obtain a complete profile. Moreover, this study demonstrated that when targeting for foreign DNA, the sample area should be narrowed down as much as possible to the smallest area possible to maximize target DNA recovery.
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http://dx.doi.org/10.1038/s41598-019-46051-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6606590PMC
July 2019

Fibulin-3 as biomarker of malignant mesothelioma.

Biomark Med 2019 07 25;13(10):875-886. Epub 2019 Jun 25.

Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy.

Many malignant diseases are associated with past asbestos exposure; the most lethal and strictly related to previous fiber exposure being malignant mesothelioma (MM). Effective preventive protocols may include sensitive and specific biomarkers. The role of Fb-3 has been recently investigated for MM early detection, but its role is still under debate. After an independent search for scientific literature, nine studies were included for a systematic review. Human Fb-3 levels seem to be able to separate healthy people with previous exposure to asbestiform fibers from MM patients. Fb-3 blood levels can distinguish MM effusions from other malignant and benign effusions. Furthers investigations on more significant groups of patients are desirable to validate and assess the validity of combining Fb-3 with other biomarkers.
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http://dx.doi.org/10.2217/bmm-2018-0285DOI Listing
July 2019

Tuberculosis screening among healthcare workers in Sicily, Italy.

Future Microbiol 2019 Jun 12;14:37-40. Epub 2019 Jun 12.

Occupational Medicine, Department of Clinical & Experimental Medicine, University of Catania, Italy.

Tuberculosis (TB) is a diffuse communicable disease; and healthcare workers (HCWs) are among the at-risk populations for the disease. This study reports the result of TB surveillance in HCWs operating in three hospitals: one classified as 'low' risk for TB and two as 'medium' risk. A total of 2228 HCWs underwent TB screening using the standard Mantoux technique (also known as the tuberculin sensitivity test [TST]). Interferon-γ release assay (IGRA) was carried out in TST-positive subjects. Results showed an overall positivity of 21% to TST and 2% to IGRA test. TST and IGRA results were statistically associated with HCWs born after 1981. This result is due to university policies that highly recommend TB immunization. Data support the use of IGRA assay in TST-positive HCWs, in order to identify latent TB infection from vaccination.
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http://dx.doi.org/10.2217/fmb-2018-0265DOI Listing
June 2019

Vaccine-preventable disease in healthcare workers in Sicily (Italy): seroprevalence against measles.

Future Microbiol 2019 Jun 12;14:33-36. Epub 2019 Jun 12.

Occupational Medicine, Department of Clinical & Experimental Medicine, University of Catania, Sicily, Italy.

Measles is one of the most infectious communicable diseases. The objective of this study was to determine the immunity to measles of healthcare workers (HCWs) operating in three hospitals of Catania. A total of 549 HCWs underwent measles screening. A 5 ml blood sample was taken from each worker to measure IgG antibody levels. Overall seroprotection was 86%. Unvaccinated HCWs agreed to undergo the vaccination offered by the hospital. Furthermore, it was found that younger workers are less seroprotected than older ones. Model legislation may be helpful to countries wishing to implement immunization requirements in healthcare settings in order to virtually eliminate the risk of acquiring and spreading measles in healthcare settings.
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http://dx.doi.org/10.2217/fmb-2018-0263DOI Listing
June 2019