Publications by authors named "Marcello Campagna"

80 Publications

Biomarkers of Low-Level Environmental Exposure to Benzene and Oxidative DNA Damage in Primary School Children in Sardinia, Italy.

Int J Environ Res Public Health 2021 Apr 27;18(9). Epub 2021 Apr 27.

Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, 092109 Cagliari, Italy.

Background: The main anthropic sources of exposure to airborne benzene include vehicular traffic, cigarette smoke, and industrial emissions.

Methods: To detect early genotoxic effects of environmental exposure to benzene, we monitored environmental, personal, and indoor airborne benzene in children living in an urban area and an area near a petrochemical plant. We also used urinary benzene and S-phenylmercapturic acid (S-PMA) as biomarkers of benzene exposure and urinary 8-hydroxydeoxyguanosine (8-OHdG) as a biomarker of early genotoxic effects.

Results: Although always below the European Union limit of 5 μg/m, airborne benzene levels were more elevated in the indoor, outdoor, and personal samples from the industrial surroundings compared to the urban area ( = 0.026, = 0.005, and = 0.001, respectively). Children living in the surroundings of the petrochemical plant had urinary benzene values significantly higher than those from the urban area in both the morning and evening samples ( = 0.01 and = 0.02, respectively). Results of multiple regression modelling showed that age was a significant predictor of 8-OHdG excretion, independent of the sampling hour. Moreover, at the low exposure level experienced by the children participating in this study, neither personal or indoor airborne benzene level, nor personal monitoring data, affected 8-OHdG excretion.

Conclusions: Our results suggest the importance of biological monitoring of low-level environmental exposure and its relation to risk of genotoxic effects among children.
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http://dx.doi.org/10.3390/ijerph18094644DOI Listing
April 2021

Occupational exposure to glyphosate and risk of lymphoma:results of an Italian multicenter case-control study.

Environ Health 2021 Apr 28;20(1):49. Epub 2021 Apr 28.

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Background: The International Agency for Research on Cancer (IARC) recently classified glyphosate, the most used herbicide worldwide, as a probable human carcinogen. We inquired into the association between occupational exposure to glyphosate and risk of lymphoma subtypes in a multicenter case-control study conducted in Italy.

Methods: The Italian Gene-Environment Interactions in Lymphoma Etiology (ItGxE) study took place in 2011-17 in six Italian centres. Overall, 867 incident lymphoma cases and 774 controls participated in the study. Based on detailed questionnaire information, occupational experts classified duration, confidence, frequency, and intensity of exposure to glyphosate for each study subject. Using unconditional regression analysis, we modelled risk of major lymphoma subtypes associated with exposure to glyphosate adjusted by age, gender, education, and study centre.

Results: Very few study subjects (2.2%) were classified as ever exposed to glyphosate. Risk of follicular lymphoma (FL) was elevated 7-fold in subjects classified as ever exposed to glyphosate with medium-high confidence, 4.5-fold in association with medium-high cumulative exposure level, 12-fold with medium-high exposure intensity, and 6-fold with exposure for 10 days or more per year. Significant upward trends were detected with all the exposure metrics, but duration. The overall p-value for an upward trend with four independent metrics was 1.88 × 10. There was no association with risk of lymphoma (any subtype), Non Hodgkin Lymphoma, B-cell lymphoma, or the major lymphoma subtypes other than FL.

Conclusions: Our findings provide limited support to the IARC decision to classify glyphosate as Group 2A human carcinogen.
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http://dx.doi.org/10.1186/s12940-021-00729-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082925PMC
April 2021

Response of the Cardiac Autonomic Control to Exposure to Nanoparticles and Noise: A Cross-Sectional Study of Airport Ground Staff.

Int J Environ Res Public Health 2021 03 3;18(5). Epub 2021 Mar 3.

Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy.

Airport activity causes the emission of particulate matter and noise, two environmental contaminants and potential health hazards, particularly for the personnel operating nearby taxiways. We explored the association between exposure to fine/ultrafine particles (UFPs) and noise with heart rate variability (HRV), an early indicator of cardiovascular autonomic response, among a sample of airport ground staff. Between May and June 2018, thirty-four male operators (mean age = 43 years and SD = 6.7) underwent personal monitoring of exposure to nanoparticles and noise, and HRV during their work activity. We conducted univariate and multivariate analysis to test the effect of UFP and noise exposure HRV. Total Lung Deposition Surface Area (LDSA) was significantly associated with a decrease in HRV Total Power and Triangular index ( = -0.038 = 0.016 and = -7.8 × 10, = 0.042, respectively). Noise peak level showed an opposite effect, which was significant for Total Power ( = 153.03, = 0.027), and for Triangular index ( = 0.362, = 0.035). Further investigation is warranted to clarify the effect of the concurrent exposure to UFPs and noise on early changes of cardiac autonomic regulation.
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http://dx.doi.org/10.3390/ijerph18052507DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967637PMC
March 2021

Task-oriented exercises improve disability of working patients with surgically-treated proximal humeral fractures. A randomized controlled trial with one-year follow-up.

BMC Musculoskelet Disord 2021 Mar 20;22(1):293. Epub 2021 Mar 20.

Bicocca University of Milan, Milan, Italy.

Background: General physiotherapy is a common means of rehabilitation after surgery for proximal humeral fracture (PHF). Better-targeted exercises seem worthy of investigation and the aim of this study was to assess the efficacy of a rehabilitation program including task-oriented exercises in improving disability, pain, and quality of life in patients after a PHF.

Methods: By means of a randomized controlled trial with one-year follow-up, 70 working patients (mean age of 49 ± 11 years; 41 females), who were selected for open reduction and internal fixation with plates caused by PHF, were randomized to be included in an experimental (n = 35) or control group (n = 35). There was a permuted-block randomization plan, and a list of program codes was previously created; subsequently, an automatic assignment system was used to conceal the allocation. The first group underwent a supervised rehabilitation program of task-oriented exercises based on patients' specific job activities, and occupational therapy. The second group underwent general physiotherapy, including supervised mobility, strengthening and stretching exercises. Both groups individually followed programs of 60-min session three times per week for 12 weeks in the outpatient setting. The Disability Arm Shoulder Hand questionnaire (DASH; scores range from 0 to 100; primary outcome), a Pain intensity Numerical Rating Scale (scores range 0 to 10; secondary outcomes), and the Short-Form Health Survey (scores range from 0 to 100; secondary outcomes) assessed the interventions. Participants were evaluated before surgery, before and after rehabilitation (primary endpoint), and at the one-year follow-up (secondary endpoint). A linear mixed model analysis for repeated measures was carried out for each outcome measure (p < 0.05).

Results: Time, group and time by group showed significant effects for all outcome measures in favour of the experimental group. The DASH and the DASH work achieved clinically important between-group differences of 16.0 points (95% confidence interval [C.I.] 7.3 to 24.7) and 19.7 (95% C.I. 9.0 to 30.5) at follow-up, respectively. The NRS achieved a between-group difference of 2.9 (95% C.I. 1.0 to 3.9) at follow-up. As for SF-36, there were between-group differences ranging from 17.9 to 37.0 at follow-up.

Conclusions: A rehabilitation program based on task-oriented exercises was useful in improving disability, pain, and quality of life in working patients after PHFs. Improvements lasted for at least 12 months.

Trial Registration: On 16/12/2019, the trial was retrospectively registered in the ISRCTN registry with the ID number 17996552 .
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http://dx.doi.org/10.1186/s12891-021-04140-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7981858PMC
March 2021

Concerns, Perceived Impact, Preparedness in Coronavirus Disease (COVID-19) Pandemic and Health Outcomes among Italian Physicians: A Cross-Sectional Study.

J Prim Care Community Health 2021 Jan-Dec;12:21501327211000245

Università degli Studi di Cagliari, Monserrato (Ca), Italy.

Background: Health care workers (HCWs) are among the professionals at serious risk for the impact of the COVID-19 pandemic on their mental health. In this sense, the next public health challenge globally will be to preserving healthy HCWs during this pandemic.

Aim: The present study has the aim of investigating the relationship among concerns, perceived impact, preparedness for the COVID-19 pandemic and the mental health of Italian physicians.

Methods: From March 29th to April 15th 2020, we conducted an online survey using snowball sampling techniques through Limesurvey platform. Data were analyzed using descriptive statistics and multiple binary logistic regressions.

Results: Multivariate analysis showed that the risk factors for perceived job stress were concerns about catching COVID-19 (OR = 3.18 [95% CI = 2.00-5.05]  < .001), perceived impact on job demands (OR = 1.63 [95% CI = 1.05-2.52]  < .05), perceived impact on job role (OR = 2.50 [95% CI = 1.60-3.90]  < .001), and non-working concerns (OR = 1.86 [95% CI = 1.15-3.03]  < .05). With respect to the risk factors for rumination about the pandemic emerged concerns about catching COVID-19 (OR 1.74, [95% CI = 1.12-2.71]  < .05), perceived impact on job role (OR = 1.68 [95% CI = 1.12-2.52]  < .05), and impact on personal life (OR = 2.04 [95% CI = 1.08-3.86]  < .05). Finally, the risk factors for crying at work were perceived impact on job role (OR = 2.47, [95% CI = 1.20-5.09]  < .05), rumination about the pandemic (OR = 3.027 [95% CI = 1.27-7.19]  < .01), watching colleagues crying at work (OR = 3.82 [95% CI = 1.88-7.77]  < .01), and perceived job stress (OR = 3.53 [95% CI = 1.24-10.07]  < .05).

Conclusion: In general, our results highlighted that being concerned about being infected/infecting other people, carrying out new and unusual tasks, and witnessing colleagues crying at work were important risk factors for physicians' well-being. Additional data are necessary to advance understanding of these risk factors in a long-term perspective.
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http://dx.doi.org/10.1177/21501327211000245DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983480PMC
March 2021

Dealing With COVID-19 Patients: A Moderated Mediation Model of Exposure to Patients' Death and Mental Health of Italian Health Care Workers.

Front Psychol 2021 24;12:622415. Epub 2021 Feb 24.

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

The COVID-19 pandemic is asking health care workers (HCWs) to meet extraordinary challenges. In turn, HCWs were experiencing tremendous psycho-social crisis as they have had to deal with unexpected emotional requirements (ERs) arising from caring for suffering and dying patients on a daily basis. In that context, recent studies have highlighted how HCWs working during the COVID-19 outbreak manifested extreme emotional and behavioral reactions that may have impacted their mental health, increasing the risk for developing post-traumatic stress symptoms. The aim of the study was to investigate post-traumatic stress symptoms, such as intrusion symptoms, as a potential mediator of the link between ERs and crying at work, and whether rumination moderates the relationship between ERs and intrusion-based PTS symptoms among HCWs who have had to deal with patients dying from COVID-19. An online cross-sectional study design was performed. A total of 543 Italian HCWs (physicians and nurses) participated in the study. Participation was voluntary and anonymous. We used the SPSS version of bootstrap-based PROCESS macro for testing the moderated mediation model. ERs had an indirect effect on crying at work through the mediating role of intrusion symptoms. Results from the moderated mediation model showed that rumination moderated the indirect effect of ERs on crying at work via intrusion symptoms, and this effect was significant only for high rumination. Furthermore, when we tested for an alternative model where rumination moderates the direct effect of ERs on crying at work, this moderation was not significant. As the second wave of the COVID-19 pandemic is ongoing, there is an urgent need for decision-makers to rapidly implement interventions aimed at offering timely psychological support to HCWs, especially in those contexts where the risk of emotional labor associated to patients dying from COVID-19 is higher.
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http://dx.doi.org/10.3389/fpsyg.2021.622415DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943721PMC
February 2021

Mental health among university students: The associations of effort-reward imbalance and overcommitment with psychological distress.

J Affect Disord 2021 03 30;282:953-961. Epub 2020 Dec 30.

Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.

Background: Mental health problems are highly prevalent among university students, but little is known about their underlying determinants. This study explores mental health among university students, the association between "effort-reward imbalance" (ERI), overcommitment and mental health, and to what extent ERI and overcommitment explain gender differences in mental health.

Methods: Cross-sectional data were analyzed from 4760 Italian university students. The Kessler Psychological Distress Scale-10 was used to measure self-reported psychological distress, as an indicator of mental health, and the ERI - Student Questionnaire to measure effort, reward and overcommitment. The associations between ERI and overcommitment with psychological distress were estimated with multinomial logistic regression analyses.

Results: 78.5% of the respondents experienced psychological distress, with 21.3%, 21.1%, and 36.1% reporting respectively mild, moderate and severe psychological distress. Female students were more likely to report moderate and severe psychological distress. ERI and overcommitment were strongly associated with severe psychological distress with ORs respectively up to 19.9 (95% CI: 12.2-32.5) and 22.2 (95% CI: 16.1-30.7). ERI and overcommitment explained part of the higher odds of severe psychological distress among female students comparing to males, attenuating the ORs from 2.3 (95% CI: 1.9-2.7) to 1.4 (95% CI: 1.2-1.7).

Limitations: This cross-sectional study was performed on a large, but convenient sample.

Discussion: More than one out of three students reported severe psychological distress. Decreasing ERI and overcommitment may be beneficial in the prevention of psychological distress among university students and may reduce gender differences in psychological distress. Longitudinal studies are needed to further investigate these associations.
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http://dx.doi.org/10.1016/j.jad.2020.12.183DOI Listing
March 2021

Human Leukocyte Antigen Complex and Other Immunogenetic and Clinical Factors Influence Susceptibility or Protection to SARS-CoV-2 Infection and Severity of the Disease Course. The Sardinian Experience.

Front Immunol 2020 4;11:605688. Epub 2020 Dec 4.

Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy.

Aim: SARS-CoV-2 infection is a world-wide public health problem. Several aspects of its pathogenesis and the related clinical consequences still need elucidation. In Italy, Sardinia has had very low numbers of infections. Taking advantage of the low genetic polymorphism in the Sardinian population, we analyzed clinical, genetic and immunogenetic factors, with particular attention to HLA class I and II molecules, to evaluate their influence on susceptibility to SARS-CoV-2 infection and the clinical outcome.

Method And Materials: We recruited 619 healthy Sardinian controls and 182 SARS-CoV-2 patients. Thirty-nine patients required hospital care and 143 were without symptoms, pauci-symptomatic or with mild disease. For all participants, we collected demographic and clinical data and analyzed the HLA allele and haplotype frequencies.

Results: Male sex and older age were more frequent in hospitalized patients, none of whom had been vaccinated during the previous seasonal flu vaccination campaignes. Compared to the group of asymptomatic or pauci-symptomatic patients, hospitalized patients also had a higher frequency of autoimmune diseases and glucose-6-phosphate-dehydrogenase (G6PDH) deficiency. None of these patients carried the beta-thalassemia trait, a relatively common finding in the Sardinian population. The extended haplotype HLA-A*02:05, B*58:01, C*07:01, DRB1*03:01 [OR 0.1 (95% CI 0-0.6), Pc = 0.015] was absent in all 182 patients, while the HLA-C*04:01 allele and the three-loci haplotype HLA-A*30:02, B*14:02, C*08:02 [OR 3.8 (95% CI 1.8-8.1), Pc = 0.025] were more frequently represented in patients than controls. In a comparison between in-patients and home care patients, the HLA-DRB1*08:01 allele was exclusively present in the hospitalized patients [OR > 2.5 (95% CI 2.7-220.6), Pc = 0.024].

Conclusion: The data emerging from our study suggest that the extended haplotype HLA-A*02:05, B*58:01, C*07:01, DRB1*03:01 has a protective effect against SARS-CoV-2 infection in the Sardinian population. Genetic factors that resulted to have a negative influence on the disease course were presence of the HLA-DRB1*08:01 allele and G6PDH deficiency, but not the beta-thalassemic trait. Absence of influenza vaccination could be a predisposing factor for more severe disease.
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http://dx.doi.org/10.3389/fimmu.2020.605688DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746644PMC
December 2020

Job Demand-Control-Support Latent Profiles and Their Relationships with Interpersonal Stressors, Job Burnout, and Intrinsic Work Motivation.

Int J Environ Res Public Health 2020 12 16;17(24). Epub 2020 Dec 16.

Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy.

In the Job Demand-Control-Support (JDCS) model, the combination of job demands, job control, and social support was hypothesized to lead to eight different constellations of job types. According to the model, these constellations are linked to wellbeing/health and learning outcomes. In the last three decades, these constellations of job types have been investigated by adopting a variable-centered perspective. However, latent profile analyses (LPA) enable a person-centered approach and empirically capture constellations of job types. In the present study, we used LPA to empirically identify distinct profiles of JDCS among Italian healthcare workers. Furthermore, we investigated the role of social stressors (workplace relationships and coworkers' incivility) as antecedents of these profiles and the association of these profiles with job burnout and work motivation. Results from LPA ( = 1671) revealed four profiles: Isolated Prisoner, Participatory Leader, Moderate Strain, and Low Strain. Negative relationships at work and coworkers' incivility increased the chances of being included in both Isolated prisoner and Participatory Leader profiles. Finally, the Isolated Prisoner and Moderate Strain profiles showed the highest levels of emotional exhaustion and cynicism and the lower levels of intrinsic work motivation. This study extends previous JDCS research, highlighting that researchers should consider empirically identified profiles rather than theoretically defined subgroups. Implications for stress theory, future research, and practice are discussed.
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http://dx.doi.org/10.3390/ijerph17249430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765581PMC
December 2020

Haemolymphatic cancer among children in Sardinia, Italy: 1974-2003 incidence.

BMJ Open 2020 11 3;10(11):e037163. Epub 2020 Nov 3.

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Objectives: To explore the time trend and geographical distribution of childhood leukaemia incidence over the territory of the Italian region of Sardinia.

Setting: All hospitals departments, diagnostic centres and social security agencies in Sardinia were regularly screened in 1974-2003 to identify, register and review the diagnoses of incident cases of haematological malignancies (HM).

Participants: The whole child population aged 0-14 resident in Sardinia.

Primary And Secondary Outcome Measures: Incidence and time trend of childhood HM and childhood acute lymphoblastic leukaemia (ALL) over the study period, and use of Bayesian methods to plot the probability of areas with excess incidence on the regional map.

Results: Overall, 675 HM cases, including 378 ALL cases, occurred among children aged 0-14 years resident in Sardinia in 1974-2003, with an incidence rate of 6.97×10 (95% CI 6.47 to 7.51) and 3.85×10 (95% CI 3.48 to 4.26), respectively. Incidence of HM and ALL showed an upward trend along the study period especially among females. Three communes out of the 356 existing in 1974, namely Ittiri, Villa San Pietro and Carbonia, stand out as areas with excess incidence of HM and ALL in particular and another, Carloforte, for ALL only.

Conclusions: Our results might serve as convincing arguments for extending the coverage of routine cancer registration over the whole Sardinian population, while prompting further research on the genetic and environmental determinants in the areas at risk.
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http://dx.doi.org/10.1136/bmjopen-2020-037163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7640504PMC
November 2020

Occupational exposure to organic dust and risk of lymphoma subtypes in the EPILYMPH case-control study.

Scand J Work Environ Health 2021 Jan 25;47(1):42-51. Epub 2020 Sep 25.

Department of Medical Sciences and Public Health, Occupational Medicine unit, University of Cagliari, Monserrato (Cagliari) Italy.

Objectives This study aimed to estimate the risk of lymphoma and its major subtypes in relation to occupational exposure to specific organic dusts. Methods We explored the association in 1853 cases and 1997 controls who participated in the EpiLymph case-control study, conducted in six European countries in 1998-2004. Based on expert assessment of lifetime occupational exposures, we calculated the risk of the major lymphoma subtypes associated with exposure to six specific organic dusts, namely, flour, hardwood, softwood, natural textile, synthetic textile, and leather, and two generic (any types) groups: wood and textile dusts. Risk was predicted with unconditional regression modeling, adjusted by age, gender, study center, and education. Results We observed a 2.1-fold increase in risk of follicular lymphoma associated with ever exposure to leather dust [95% confidence interval (CI) 1.01-4.20]. After excluding subjects who ever worked in a farm or had ever been exposed to solvents, risk of B-cell lymphoma was elevated in relation to ever exposure to leather dust [odd ratio (OR) 2.2, 95% CI 1.00-4.78], but it was not supported by increasing trends with the exposure metrics. Risk of Hodgkin lymphoma was elevated (OR 2.0, 95% CI 0.95-4.30) for exposure to textile dust, with consistent upward trends by cumulative exposure and three independent exposure metrics combined (P=0.023, and P=0.0068, respectively). Conclusions Future, larger studies might provide further insights into the nature of the association we observed between exposure to textile dust and risk of Hodgkin lymphoma.
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http://dx.doi.org/10.5271/sjweh.3925DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7801142PMC
January 2021

Gastrointestinal coronavirus disease 2019: epidemiology, clinical features, pathogenesis, prevention, and management.

Expert Rev Gastroenterol Hepatol 2021 Jan 24;15(1):41-50. Epub 2020 Nov 24.

Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari , Cagliari, Italy.

Introduction: The new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the etiologic agent of coronavirus disease 2019. Some authors reported pieces of evidence that patients with SARS-CoV-2 infection could have direct involvement of the gastrointestinal tract, and in symptomatic cases, gastrointestinal symptoms (diarrhea, nausea/vomiting, abdominal pain) could be very common.

Area Covered: In this article, we reviewed current-published data of the gastrointestinal aspects involved in SARS-CoV-2 infection, including prevalence and incidence of specific symptoms, the presumptive biological mechanism of GI infection, prognosis, clinical management, and public health-related concerns on the possible risk of oral-fecal transmission.

Expert Opinion: Different clues point to direct virus infection and replication in mucosal cells of the gastrointestinal tract. In vitro studies showed that SARS-CoV-2 could enter into the gastrointestinal epithelial cells by the Angiotensin-Converting enzyme two membrane receptor. These findings, coupled with the identification of viral RNA found in stools of patients, clearly suggest that direct involvement of the gastrointestinal tract is very likely. This can justify most of the gastrointestinal symptoms but also suggest a risk for an oral-fecal route for transmission, additionally or alternatively to the main respiratory route.
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http://dx.doi.org/10.1080/17474124.2020.1821653DOI Listing
January 2021

Schrödinger's Worker: Are They Positive or Negative for SARS-CoV-2?

Int J Environ Res Public Health 2020 08 31;17(17). Epub 2020 Aug 31.

Department of Medical Sciences and Public Health, Occupational Medicine Unit, University of Cagliari, SS 554, km 4.500, 09042 Monserrato (Cagliari), Italy.

In these days of 2020, tests for the diagnosis of SARS-CoV-2, and their use in the context of health surveillance of workers, are becoming popular. Nevertheless, their sensitivity and specificity could vary on the basis of the type of test used and on the moment of infection of the subject tested. The aim of this viewpoint paper is to make employers, workers, occupational physicians, and public health specialists think about the limits of diagnostic tests currently available, and the possible implication related to the erroneous and incautious assignment of "immunity passports" or "risk-free certificates" to workers during screening campaigns in workplaces.
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http://dx.doi.org/10.3390/ijerph17176316DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7504136PMC
August 2020

Stress among medical students: factor structure of the University Stress Scale among Italian students.

BMJ Open 2020 09 1;10(9):e035255. Epub 2020 Sep 1.

Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands

Objectives: The main purpose of the current study was to investigate the psychometric properties of the Italian version of the University Stress Scale (USS) among Italian medical students.

Design, Setting And Participants: A cross-sectional observational study based on data from an online cross-sectional survey from 11 to 23 December 2018. A total of 1858 Italian medical students participated in the study.

Outcome Measures: We measured perceived stress among medical students using the USS, the Effort-Reward Imbalance Student Questionnaire (ERI-SQ) and the Kessler-10 (K10).

Results: Results showed that a bifactor-Exploratory Structural Equation Modeling solution provided excellent levels of fit to the data. Our results suggest that the modified version of 19 items of the Italian version of the USS does not have a simple unidimensional structure. Overall, an inspection of ancillary indices (omega indices, ECV and percentage of uncontaminated correlations) revealed that these were too low to suggest the use of the USS as a composite measure of university stress. We tested an alternative unidimensional short form (eight items; USS-S) that assessed all the five sources of stress. This version provided a good fit to the data. Evidence of convergent validity of the USS-S was observed by analysing the correlations between the USS and ERI-SQ (ranging from -0.34 to 0.37, all p<0.01). Finally, based on the clinical cut-off recommended on the K10, results from receiver operating characteristic showed that considering the clinical cut-off of the USS is 7.5 and that 59.70% of medical students reported stress levels in the clinical range.

Conclusion: Finally, our results showed a lack of support for using the USS to measure a general university stress factor, as the general USS factor accounted for little variance in our sample. In this sense, stress scores among Italian students can be better assessed by the use of the USS-S.
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http://dx.doi.org/10.1136/bmjopen-2019-035255DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7467511PMC
September 2020

Occupational exposure to antineoplastic drugs in hospital environments: potential risk associated with contact with cyclophosphamide- and ifosfamide-contaminated surfaces.

Med Pr 2020 Sep 9;71(5):519-529. Epub 2020 Jul 9.

University of Florence, Florence, Italy (Department of Experimental and Clinical Medicine).

Background: Cyclophosphamide (CP) and ifosfamide (IP) contaminations have been detected in hospital environments. This study was conducted to determine if there was any contamination in the spaces (floors and door handles) between the hospital exit and the antineoplastic drugs (ADs) preparation and administration units. At the same time, the authors proposed a new automation of the analytical procedure to considerably decrease the time needed for sample preparation and analysis.

Material And Methods: To evaluate the ADs contamination of surfaces, 829 wipe tests were performed in a campaign involving 3 hospitals located in Italy. Sampling was performed using an innovative kit. The levels of ADs were measured in each wipe sample using liquid chromatography/triple quadrupole.

Results: On-line solid-phase extraction guarantees the construction of a robust and reproducible analytical method. The CP and IP recoveries from stainless steel, polycarbonate and polyvinyl chloride ranged >80%, and the wipe holders and the automation tested ensured desorption efficiencies close to 100% for both the ADs. Of the 552 wipes taken on the spaces between the hospital exit and the preparation, administration and pharmacy warehouse units, 22 were greater than or equal to the limit of quantification, all adjacent to the administration units.

Conclusions: This study provides an insight into the exposure situation against ADs residues. In order to improve environmental monitoring programs, the authors propose to evaluate the ADs contamination also outside the preparation, administration and pharmacy warehouse units. Med Pr. 2020;71(5):519-29.
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http://dx.doi.org/10.13075/mp.5893.00931DOI Listing
September 2020

Occupational exposure to ionizing radiation and risk of lymphoma subtypes: results of the Epilymph European case-control study.

Environ Health 2020 04 25;19(1):43. Epub 2020 Apr 25.

Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy.

Background: Evidence linking risk of lymphoma and B-cell lymphoma subtypes to ionizing radiation is inconclusive, particularly at low exposure levels.

Methods: We investigated risk of lymphoma (all subtypes), B-cell lymphomas, and its major subtypes, associated with low-level occupational exposure to ionizing radiation, in 2346 lymphoma cases and 2463 controls, who participated in the multicenter EpiLymph case-control study. We developed a job-exposure matrix to estimate exposure to ionizing radiation, distinguishing between internal and external radiation, and we applied it to the lifetime occupational history of study subjects, We calculated the Odds Ratio (OR) and its 95% confidence interval (95% CI) for lymphoma (all subtypes combined), B-cell lymphoma, and its major subtypes using unconditional, polytomous logistic regression adjusting for age, gender, and education.

Results: We did not observe an association between exposure metrics of external and internal radiation and risk of lymphoma (all subtypes), nor with B-cell lymphoma, or its major subtypes, at the levels regularly experienced in occupational settings. An elevated risk of diffuse large B cell lymphoma was observed among the most likely exposed study subjects with relatively higher exposure intensity, which would be worth further investigation.

Conclusions: Further investigation is warranted on risk of B cell lymphoma subtypes associated with low-level occupational exposure to external ionizing radiation, and to clarify whether lymphoma should be included among the cancer outcomes related to ionizing radiation.
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http://dx.doi.org/10.1186/s12940-020-00596-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183712PMC
April 2020

Compassion fatigue, watching patients suffering and emotional display rules among hospice professionals: a daily diary study.

BMC Palliat Care 2020 Feb 25;19(1):23. Epub 2020 Feb 25.

Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, SS554 bivio per Sestu, 09042, Monserrato, CA, Italy.

Background: Hospice workers are required to regularly use emotional regulation strategies in an attempt to encourage and sustain terminally ill patients and families. Daily emotional regulation in reaction to constantly watching suffering patients may be intensified among those hospice professionals who have high levels of compassion fatigue. The main object of this study was to examine the relationship between daily exposition to seeing patient suffering and daily emotional work, and to assess whether compassion fatigue (secondary traumatic stress and burnout) buffers this relationship.

Methods: We used a diary research design for collecting daily fluctuations in seeing patients suffering and emotional work display. Participants filled in a general survey and daily survey over a period of eight consecutive workdays. A total of 39 hospice professionals from two Italian hospices participated in the study.

Results: Multilevel analyses demonstrated that daily fluctuations in seeing patients suffering was positively related to daily emotional work display after controlling for daily death of patients. Moreover, considering previous levels of compassion fatigue, a buffering effect of high burnout on seeing patients suffering - daily emotional work display relationship was found.

Conclusions: A central finding of our study is that fluctuations in daily witness of patients suffering are positively related to daily use of positive emotional regulations. Further, our results show that burnout buffers this relationship such that hospice professionals with high burnout use more emotional display in days where they recurrently witness patients suffering.
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http://dx.doi.org/10.1186/s12904-020-0531-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043034PMC
February 2020

Manual handling of patients: role of kinesiophobia and catastrophizing in health workers with chronic low back pain.

Eur J Phys Rehabil Med 2020 Jun 25;56(3):307-312. Epub 2020 Feb 25.

Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Cagliari, Italy.

Background: Biomechanical overload due to patients' manual handling represents a relevant contributor to chronic low back pain (LBP). Fear of movement (also known as kinesiophobia) and catastrophising may influence the development of chronic complaints and lower performances also in working environments, despite these issues are poorly investigated.

Aim: The aim of this study is twofold: 1) to evaluate the levels of kinesiophobia and catastrophizing in a sample of health personnel with chronic LBP and employed in activities specifically requiring patients' manual handling; 2) to appraise the influence of these factors on disability.

Design: Cross-sectional observational study.

Setting: Four Italian hospitals.

Population: Sixty-four healthcare workers suffering from nonspecific low back pain, exposed to the spinal risk of biomechanical overload due to patients' manual handling.

Methods: We assessed kinesiophobia, catastrophizing and disability by means of validated questionnaires (the Tampa Scale of Kinesiophobia [TSK], the Pain Catastrophizing Scale [PCS], and the Oswestry Disability Index [ODI], respectively). Values of central tendency and dispersion of the variable of interest were calculated, along with the association among variables through multiple linear regression analysis.

Results: The results showed presence of kinesiophobia (TSK=34.0; IQR=28.2-42.09), catastrophizing (PCS=20.5; IQR=10.2-29.0) and disability (ODI=28.8; IQR=13.5-40.0) in the population enrolled. Disability was significantly predicted by kinesiophobia and catastrophizing (R2=0.529 P=0.00003).

Conclusions: Kinesiophobia and catastrophizing are present in health workers with chronic LBP involved in patients' manual handling and are linked to disability. Further investigations in this field are recommended to investigate a role for cognitive-behavioral strategies aimed at managing catastrophizing and kinesiophobia to increase working abilities.

Clinical Rehabilitation Impact: The assessment of catastrophizing and kinesiophobia is crucial in health workers engaged with patients' manual handling and suffering from chronic LBP.
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http://dx.doi.org/10.23736/S1973-9087.20.06004-9DOI Listing
June 2020

Return to Work of Breast Cancer Survivors: Perspectives and Challenges for Occupational Physicians.

Cancers (Basel) 2020 Feb 4;12(2). Epub 2020 Feb 4.

Department of Medical Sciences and Public Health, University of Cagliari, Blocco I, SS 554, km 4,500, 09042 Monserrato, Italy.

Breast cancer is one of the most common diseases worldwide, mainly affecting the female gender. Considering the increase of breast cancer incidence and the decrease of mortality due to news diagnostic and therapeutic tools, the return to work issue after treatment is going to be very common in the next years. Occupational physicians therefore need to face the return to work and the fitness for work of workers previously diagnosed with breast cancer with a sufficient cultural and technical background. In addition to individual characteristics preceding the diagnosis, clinical outcome, lifestyles and occupational variables are the most impactful factors on return to work that need to be taken into account. The aim of this work is to analyze these factors and discuss the central role of occupational physicians in the decision-making process of returning to work in breast cancer survivors.
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http://dx.doi.org/10.3390/cancers12020355DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7072532PMC
February 2020

Reply to Comment on Lecca, L.I.; Portoghese, I.; Mucci, N.; Galletta, M.; Meloni, F.; Pilia, I.; Marcias, G.; Fabbri, D.; Fostinelli, J.; Lucchini, R.G.; Cocco, P.; Campagna, M. Association between Work-Related Stress and QT Prolongation in Male Workers.

Int J Environ Res Public Health 2020 01 14;17(2). Epub 2020 Jan 14.

Department of Medical Sciences and Public Health, University of Cagliari, Blocco I, SS 554, km 4,500, 09042 Monserrato, Italy.

We appreciate the interest raised by our paper on the association between conditions linked to work-related stress and the prolongation of the QT interval on the electrocardiogram [...].
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http://dx.doi.org/10.3390/ijerph17020510DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013757PMC
January 2020

Pulmonary Function and CT Scan Imaging at Low-Level Occupational Exposureto Asbestos.

Int J Environ Res Public Health 2019 12 19;17(1). Epub 2019 Dec 19.

Department of Medical Sciences and Public Health, Occupational Health unit, University of Cagliari, Asse didattico-Blocco I SS 554, 09042 Monserrato, Italy.

: In spite of the reduced exposure level, and its ban in numerous countries, compensation claims for asbestos-related diseases are far from decreasing. : We used retrospective exposure assessment techniques to explore respiratory function and a computerized tomography (CT) scan in relation to past asbestos exposure in 115 male workers retired from an acrylic and polyester fiber plant. Based, on detailed information on exposure circumstances, we reconstructed a cumulative exposure estimate for each patient. : Time-weighted average exposure in our study population was 0.24 fibers/ml (95% confidence inteval (CI) 0.19-0.29), and the average cumulative exposure was 4.51 fibers/mL-years (95% CI 3.95-5.07). Exposure was elevated among maintenance workers, compared to other jobs ( = 0.00001). Respiratory function parameters did not vary in relation to the exposure estimates, nor to CT scan results. Risk of interstitial fibrosis showed a significant upward trend (Wald test for trend = 2.62, = 0.009) with cumulative exposure to asbestos; risk associated with 5.26 fibers/mL-years or more, was 8-fold (95% CI 1.18-54.5). : Our results suggest that a CT scan can detect pleuro-parenchymal lung alterations at asbestos exposure levels lower than previously thought, in absence of respiratory impairment. Further studies are required to validate our techniques of retrospective assessment of asbestos exposure.
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http://dx.doi.org/10.3390/ijerph17010050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981734PMC
December 2019

Occupational exposure to airborne formaldehyde in hospital: setting an automatic sampling system, comparing different monitoring methods and applying them to assess exposure.

Med Lav 2019 Dec 17;110(6):446-458. Epub 2019 Dec 17.

Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.

Background: In recent years, under-vacuum sealing (UVS) and containers with formalin encapsulated in the lid have been proposed for the reduction of occupational exposure to airborne formaldehyde (FA) in healthcare environments.

Objectives: We are presenting a study focused on the assessment of FA in hospitals: an automatic sampling system was set, different sampling devices were compared, and the concentration of FA was assessed, following its use in different scenarios.

Methods: Three different devices for sampling/measuring FA were compared. They are based on: 1. silica gel cartridges impregnated with 2,4-dinitrophenylhydrazine (2,4-DNPH); 2. SPME® fiber using O-(2,3,4,5,6-pentafluorobenzyl)hydroxylamine; 3. direct reading commercial instrumentation. Three typical scenarios using FA were investigated: operating theatres where small biopsies are soaked into closed-circuit system 4% FA containers, secretariat of pathology laboratories during the registration of biopsies and pathology laboratories during the filling procedure by UVS and the slicing of biopsies.

Results: The automatic sampling system allowed short-, long-, and in continuous-sampling time to measure airborne FA. Different sampling devices provided comparable results when tested to assess FA concentration ranging from 0.020-0.320 ppm in a test chamber, although  the devices based on 2,4-DNPH were  the best in terms of sensitivity and accuracy. The results of 246 samples showed that the FA concentration was less than 0.04 ppm in 91% of the measurements.

Conclusions: The automatic methods efficiently allow sampling and measurement of FA in hospital settings. When using safe practices, the concentration of FA is well below occupational limit values.
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http://dx.doi.org/10.23749/mdl.v110i6.8038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7809934PMC
December 2019

Indexes of cardiac autonomic profile detected with short term Holter ECG in health care shift workers: a cross sectional study.

Med Lav 2019 Dec 17;110(6):437-445. Epub 2019 Dec 17.

Department of Medical Science and Public Health, University of Cagliari, Italy..

Background: The assessment of early effect of shift work-related circadian rhythms desynchronization and work-related stress in health care workers has gained a primary role among the duties of the occupational physician.

Objectives: Aim of our study was to assess the cardiac autonomic modulation through quantification of sinus rhythm variability, as an index of the adaptability to shift work of the cardiovascular system in healthcare shift workers.

Methods: We measured Heart Rate Variability (HRV) by short-term (60 minutes) Holter Electrocardiography (ECG) during the regular duties in the respective department of 42 healthcare workers (31 nurses and 11 physicians) of an Italian Hospital (12 male and 30 females, aged 24-58 years), working on 3 shifts with a forward fast rotation with rest at the end of the night shift (7 am - 2 pm; 2 pm - 10 pm; 10 pm - 7 am) or in a fixed daytime shift (8 am - 2 pm). Measurements were all performed between 9 am and 12 am for fixed day workers and between 9 am and 12 pm or between 10 pm and 1 am for shift workers. The following HRV parameters were compared between the subgroups of shift workers and daytime workers: mean heart rate (HR), standard deviation of all normal RR (NN) intervals (SDNN), standard deviation of the averages of NN intervals in all 5-minute segments of a recording (SDaNN) and the triangular index (the integral of the density distribution divided by the maximum of the density distribution). We used parametric tests for independent series to compare HRV parameters by subgroups within the study subjects. We also tested correlation between the variables of interest and the association between HRV and shift work modality, along with other covariates, by means of a multiple linear regression analysis.

Results: We found significantly lower values of SDaNN in shift workers compared with workers engaged solely on day shifts (50.80 ms vs 66.71 ms; p=0,014). The mean heart rate did not show any significant difference between day workers and shift workers (85.78 bmp vs 85.53 bpm respectively). Multivariate analysis showed a significant association between SDNN and female gender and age, while no significant associations were found between HRV and shift work.

Discussion: The autonomic control of the heart rhythm could be disrupted by desynchronization of the biological rhythm secondary to the organization of shift work and night work. Shift work is an important factor of social and biological distress, influencing the adaptability of the cardiovascular system to stimuli and demands of work organization.
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http://dx.doi.org/10.23749/mdl.v110i6.8048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7809936PMC
December 2019

Association between Work-Related Stress and QT Prolongation in Male Workers.

Int J Environ Res Public Health 2019 11 28;16(23). Epub 2019 Nov 28.

Department of Medical Sciences and Public Health, University of Cagliari, Blocco I, SS 554, km 4,500, 09042 Monserrato, Italy.

Background: Work-related stress is a potential cardiovascular risk factor, but the underlying mechanism is not fully explained. The autonomic nervous system control of cardiac function might play a specific role; therefore, monitoring the QT interval in the electrocardiogram can highlight an autonomic imbalance induced by occupational stressors. The aim of our study was to explore the QT interval parameters as early indicators of imbalance of the autonomic cardiac function in relation to work-related stress.

Methods: During 2015-2016 annual workplace health surveillance, we measured work-related stress in 484 workers of a logistic support company using the Health and Safety Executive (HSE) tool. We assessed the frequency-corrected QT (QTc) interval and the QT index (QTi) on the electrocardiogram of each participant, and collected demographic and clinical data. We compared the QTc values by the four Karasek's categories (active/passive jobs, low/high strain job), and by job support (present/lacking), and conducted multivariate analysis to adjust for possible confounders.

Results: The results of the multivariate regression analysis showed that QTc was prolonged among workers operating at a specific site where stress level was found to be elevated. Regular physical activity showed a beneficial effect against QTc prolongation. We did not observe an effect on QTc length by the cross-combined Karasek's categories of job control, job demand, and job support.

Conclusions: Our study suggests subclinical effects of conditions associated with work-related stress on the autonomic regulation of cardiac function. Further research is warranted to elucidate the combined effect of work organization and lifestyle factors on autonomic cardiac function.
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http://dx.doi.org/10.3390/ijerph16234781DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926840PMC
November 2019

New fully automated gas chromatographic analysis of urinary S-phenylmercapturic acid in isotopic dilution using negative chemical ionization with isobutane as reagent gas.

J Mass Spectrom 2020 Jul 2;55(7):e4481. Epub 2019 Dec 2.

Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Sesto Fiorentino, Italy.

The determination of urinary S-phenylmercapturic acid (S-PMA) represents the most reliable biomarker to monitor the intake risk of airborne benzene. Recently, the European Chemical Agency deliberated new occupational exposure limits for benzene and recommended an S-PMA biological limit value of 2-μg/g creatinine. This limit is an order of magnitude lower than the previous one, and its determination constitutes a challenge in the analytical field. We developed and validated a method that allows the fully automated and sensitive determination of S-PMA by the use of gas-chromatography negative chemical ionization tandem mass spectrometry in isotopic dilution. For negative chemical ionization, we selected a mixture of 1% isobutane in argon as reactive gas, by studying its chemical ionization mechanism and optimal parameters compared with pure isobutane or pure methane. This gas mixture produces a more abundant signal of the target analyte than isobutane or methane, and it extended the operative lifetime of the ion source, enabling us to start a high-throughput approach of the S-PMA analysis. Moreover, energy-resolved mass spectrometry experiments were carried out to refine the MS/MS analysis conditions, testing nitrogen and argon as collision gases. The method optimization was pursued by a chemometric model by using the experimental design. The quantification limit for S-PMA was 0.10 μg/L. Accuracy (between 98.3% and 99.6%) and precision (ranging from 1.6% to 6.4%) were also evaluated. In conclusion, the newly developed assay represents a powerful tool for the robust, reliable, and sensitive quantification of urinary S-PMA, and because of its automation, it is well suited for application in large environmental and biological monitoring.
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http://dx.doi.org/10.1002/jms.4481DOI Listing
July 2020

Stress among university students: factorial structure and measurement invariance of the Italian version of the Effort-Reward Imbalance student questionnaire.

BMC Psychol 2019 Oct 26;7(1):68. Epub 2019 Oct 26.

Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, SS554 bivio per Sestu, 09042, Monserrato, CA, Italy.

Background: In the last decade academic stress and its mental health implications amongst university students has become a global topic. The use of valid and theoretically-grounded measures of academic stress in university settings is crucial. The aim of this study was to examine the factorial structure, reliability and measurement invariance of the short student version of the effort-reward imbalance questionnaire (ERI-SQ).

Methods: A total of 6448 Italian university students participated in an online cross-sectional survey. The factorial structure was investigated using exploratory factor analysis and confirmatory factor analysis. Finally, the measurement invariance of the ERI-SQ was investigated.

Results: Results from explorative and confirmatory factor analyses showed acceptable fits for the Italian version of the ERI-SQ. A modified version of 12 items showed the best fit to the data confirming the 3-factor model. Moreover, multigroup analyses showed metric invariance across gender and university course (health vs other courses).

Conclusions: In sum, our results suggest that the ERI-SQ is a valid, reliable and robust instrument for the measurement of stress among Italian university students.
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http://dx.doi.org/10.1186/s40359-019-0343-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815363PMC
October 2019

Urinary H NMR metabolomics profile of Italian citizens exposed to background levels of arsenic: a (pre)cautionary tale.

Biomarkers 2019 Dec 24;24(8):727-734. Epub 2019 Oct 24.

Department of Medical Sciences and Public Health, Occupational Health Section, University of Cagliari, Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy.

Arsenic is a toxic metal ubiquitous in the environment and in daily life items. Long-term arsenic exposure is associated with severe adverse health effects involving various target organs. It would be useful to investigate the existence of metabolic alterations associated with lifestyle and/or with the environment. For this purpose, we studied the correlation between urinary arsenic levels and urinary proton nuclear magnetic resonance spectroscopy (H NMR) metabolomics profiles in a non-occupationally nor environmentally arsenic exposed general population. Urine samples were collected from 86 healthy subjects. Total and non-alimentary urinary arsenic (U-naAs) levels, namely the sum of arsenite, arsenate, monomethylarsonate and dimethylarsinate, were measured and H NMR analysis was performed. Orthogonal Projection to Latent Structures was applied to explore the correlation between the metabolomics profiles and U-naAs levels. Despite the extremely low U-naAs levels (mean value = 6.13 ± 3.17 µg/g creatinine) of our studied population a urinary metabolomics profile related to arsenic was identified. The identified profile could represent a fingerprint of early arsenic biological effect and could be used in further studies as an indicator of susceptibility, also in subjects exposed to a low arsenic dose, with implications in occupational health, toxicology, and public health.
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http://dx.doi.org/10.1080/1354750X.2019.1677777DOI Listing
December 2019

Monitoring of Air-Dispersed Formaldehyde and Carbonyl Compounds as Vapors and Adsorbed on Particulate Matter by Denuder-Filter Sampling and Gas Chromatographic Analysis.

Int J Environ Res Public Health 2019 06 3;16(11). Epub 2019 Jun 3.

Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.

Carbonyl compounds (CCs) are products present both as vapors and as condensed species adsorbed on the carbonaceous particle matter dispersed in the air of urban areas, due to vehicular traffic and human activities. Chronic exposure to CCs is a potential health risk given the toxicity of these chemicals. The present study reports on the measurement of the concentrations of 14 CCs in air as vapors and 2.5 µm fraction PM by the ENVINT GAS08/16 gas/aerosol sampler, a serial sampler that uses annular denuder, as sampling device. The 14 CCs were derivatized during sampling prior to gas-chromatographic separation and multiple detection by mass spectrometry, nitrogen-phosphorus thermionic, electron capture detection. Outdoor air multiple samples were collected in four locations in the urban area of Florence. The results evidenced that formaldehyde, acetaldehyde, and acetone were the more abundant CCs in the studied areas. The data collected was discussed considering the particle to vapor ratio of each CC found. The CCs pollution picture obtained was tentatively related to the nature and intensity of the traffic transiting by the sampling sites. This approach allowed to determine 14 CCs in both concentrated and diluted samples and is proposed as a tool for investigating outdoor and indoor pollution.
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http://dx.doi.org/10.3390/ijerph16111969DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603861PMC
June 2019

Association between burnout and sense of coherence among speech and language therapists: an exploratory study in Italy.

Acta Biomed 2019 03 28;90(4-S):25-31. Epub 2019 Mar 28.

Department of Health Sciences and Public Health, University of Cagliari, Italy.

Background And Aim: Job burnout has been recognized as a serious occupational hazard among professionals, such as health care professionals. The sense of coherence (SoC) is deemed to be a personal resource capable of reducing the impact of job stressors and, consequently, the experience of job burnout. The purpose of this study was to investigate the relationship between SoC and job burnout among speech and language therapists.

Materials And Methods: A descriptive and cross-sectional analysis was carried out through an online self-reported questionnaire. A total of 217 Italian speech and language therapists were involved in the study. The Anova test, T-test and logistic regression were performed to study the association between SoC and job burnout.

Results: The Anova test showed that job tenure was not associated to job burnout. The T-test showed that speech and language therapists having a low SoC exhibited significantly higher emotional exhaustion, higher cynicism, and lower professional efficacy (t=-7.190 d.f.=215 p<.001) when compared to those having a high SoC. Finally, the odds ratio showed that low SoC was associated with high emotional exhaustion (OR=11.86; 95% CI=5.52-25.49; p<0.05), low SoC was associated with high cynicism (OR=4.41, CI=2.50-7.80; p<0.05), and low SoC was associated with low personal efficacy (OR=4.70; CI=2.59-8.52; p<0.05).

Conclusion: Our results are in line with previous studies which showed that SoC is a fundamental personal resource which may activate workers' reaction to various stressors, thus reducing the experience of burnout.
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http://dx.doi.org/10.23750/abm.v90i4-S.8261DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625562PMC
March 2019

The role of collective affective commitment in the relationship between work-family conflict and emotional exhaustion among nurses: a multilevel modeling approach.

BMC Nurs 2019 18;18. Epub 2019 Feb 18.

1Department of Medical Sciences and Public Health, University of Cagliari, SS554 bivio per Sestu, 09042 Cagliari, Monserrato Italy.

Background: Work-family conflict (WFC) is a crucial problem in nursing because of the demanding conditions of the job, such as strenuous shifts, physical and emotional workload, and intense patient involvement. Using a multilevel approach, this study investigated the moderating role of collective affective commitment as a protective resource in the relationship between WFC and emotional exhaustion.

Methods: The sample included 647 nurses from 66 working units in 4 Italian hospitals. A self-administrated questionnaire was administered to nurses. To analyze data, hierarchical linear modeling was used to examine cross-level relationships between variables.

Results: The results indicated that emotional exhaustion increased with augmenting of WFC and that this relationship was stronger when collective affective commitment was low and weaker when it was high.

Conclusions: The study thus suggests that collective affective commitment may be considered a protective resource for nurses. Moreover, the results show that high work-family conflict should not represent a serious problem when nurses have high affective commitment. Interventions at both individual and group level are discussed in order to mitigate WFC, promoting collective affective commitment and thus reducing emotional exhaustion.
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http://dx.doi.org/10.1186/s12912-019-0329-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379994PMC
February 2019