Immunologic status of agricultural workers in the region of Lombardy, Northern Italy

Purpose. Farming is associated with a wide variety of hazardous exposures including physical, chemicals and biological agents. Animal farmers are exposed to dust which contains microorganisms, mycotoxins, endotoxins, animal feed particles, allergens and chemical agents. Organic dust exposure is known to cause allergic and non-allergic rhinitis, and organic dust toxic syndrome. This study was undertaken to evaluate the relationship between occupational health hazards and serum pro-inflammatory cytokines among agricultural workers, in particular we investigated whether animal breeders react differently to biological agents than non breeder farmers. Methods. One hundred subjects working in agricultural enterprises in the region of Lombardy, were enrolled into the study in 2010. Serum cytokines including interleukin (IL)-6, IL-8, IL-10, IFN\u3b3 and tumor necrosis factor-\u3b1 (TNF\u3b1) were measured. Cytokines were assessed by commercially available enzyme-linked-immunosorbent assay (ELISA). Results of the study. Compared to control subjects, increased TNF-\u3b1, IL-8, and IL-10 levels were found in animal breeders, and a statistically significant relationship between type of job (breeder/non breeder workers) and increased serum pro-inflammatory cytokines. Results suggest that animal breeders might be at higher risk of occupational diseases and biological hazards than other farmers with less contact to animals

La dieta come elemento cardine della promozione della salute nei luoghi di lavoro nella ricerca scientifica e nella pratica : primi risultati del progetto EU FAHRE

DIET AS A KEY ELEMENT OF HEALTH PROMOTION AT THE WORKPLACE IN SCIENTIFIC RESEARCH AND PRACTICE. FIRST RESULTS OF THE EU PROJECT FAHRE. The globalization of markets have led to rapid changes in diet and lifestyle in the developed countries, where living standards have improved, and availability and variety of food has increased while physical activity decreases have led to an augment in chronic diseases (obesity and diabetes mellitus), cardiovascular diseases and some specific cancers. In this context there is a need to develop health promotion activities. Workers represent a very appropriate group for such activities because they are relatively homogeneous, easily reachable because they can be found together in the same place and time and the occupational physician has good knowledge of the of health status of individual worker. In this scenario, a renew interest must be posed to the relationship between diet and health. In this context our Group is participating at the FAHRE project (Food and Health Research in Europe). The project aims to establish the state of the art of research at the interface of nutrition and health in the European Union, identifying its strengths and weaknesses in order to propose strategies to increase coordination and improve its functioning as a European Research Area

Research for food and health in Europe: themes, needs and proposals

Background Diet, in addition to tobacco, alcohol and physical exercise, is a major factor contributing to chronic diseases in Europe. There is a pressing need for multidisciplinary research to promote healthier food choices and better diets. Food and Health Research in Europe (FAHRE) is a collaborative project commissioned by the European Union. Among its tasks is the description of national research systems for food and health and, in work reported here, the identification of strengths and gaps in the European research base. Methods A typology of nine research themes was developed, spanning food, society, health and research structures. Experts were selected through the FAHRE partners, with balance for individual characteristics, and reported using a standardised template. Results Countries usually commission research on food, and on health, separately: few countries have combined research strategies or programmes. Food and health are also strongly independent fields within the European Commission's research programmes. Research programmes have supported food and bio-technology, food safety, epidemiological research, and nutritional surveillance; but there has been less research into personal behaviour and very little on environmental influences on food choices - in the retail and marketing industries, policy, and regulation. The research is mainly sited within universities and research institutes: there is relatively little published research contribution from industry. Discussion National food policies, based on epidemiological evidence and endorsed by the World Health Organisation, recommend major changes in food intake to meet the challenge of chronic diseases. Biomedical and biotechnology research, in areas such as 'nutrio-genomics', 'individualised' diets, 'functional' foods and 'nutri-pharmaceuticals' appear likely to yield less health benefit, and less return on public investment, than research on population-level interventions to influence dietary patterns: for example policies to reduce population consumption of trans fats, saturated fats, salt and energy density. Research should now address how macro-diets, rather than micro-nutritional content, can be improved for beneficial impacts on health, and should evaluate the impact of market changes and policy interventions, including regulation, to improve public health. Conclusions European and national research on food and health should have social as well as commercial benefits. Strategies and policies should be developed between ministries of health and national research funding agencies. Collaboration between member states in the European Union can yield better innovation and greater competitive advantage

Animal influence on water, sanitation and hygiene measures for zoonosis control at the household level: A systematic literature review

Neglected zoonotic diseases (NZDs) have a significant impact on the livelihoods of the world’s poorest populations, which often lack access to basic services. Water, sanitation and hygiene (WASH) programmes are included among the key strategies for achieving the World Health Organization’s 2020 Roadmap for Implementation for control of Neglected Tropical Diseases (NTDs). There exists a lack of knowledge regarding the effect of animals on the effectiveness of WASH measures. This review looked to identify how animal presence in the household influences the effectiveness of water, hygiene and sanitation measures for zoonotic disease control in low and middle income countries; to identify gaps of knowledge regarding this topic based on the amount and type of studies looking at this particular interaction

Basic occupational health services for rural workers : dream or reality?

Only part of the Italian agricultural workers is provided with occupational health surveillance. They have a lack of preventive activities and underreporting of occupational diseases and accidents. Typical characteristics of agriculture are small and family based enterprises, not covered by OHS legislation and health care facilities neither at the enterprise level nor in the territory. Since significant health and safety risks are present in the sector, actions addressed at improving and widening preventive activities are strongly needed. In this frame a project is running in the Region, addressed at the creation of BOHSs for agricultural workers. BOHSs will be spread in the territory, depending on local needs, and a complex body of activities will be there carried out; health surveillance with specific laboratory and instrumental examinations (electrocardiography; respiratory function examination; hearing function evaluation, biological specimen collection, vaccinations and education and training). Services should preferably be equipped also with occupational hygiene instruments, to fulfil any need of occupational risk assessment. Since very often Rural GPs are the only health care providers for agricultural workers, the BOHSs project anticipates some experimental activities of collaboration between Occupational Health Physician and Rural GPs. Collaboration will be based on information exchange, in some cases also through electronic files sharing. The possibility of creating BOHSs in selected rural GPs\u2019 services and of asking Rural GPs to perform specific instrumental examinations will be explored. A further field of collaboration will be the conduction of health promotion activities, such as campaigns for the prevention of cardiovascular risk. The preliminary results of our experience show that providing rural and agricultural workers with health surveillance at the workplace is a fully reachable objective and that, where BOHSs exist and are active, notifications of occupational disease increases and workers are healthier

Tuberculosis and cattle breeding : the case of an Egyptian milker

Occupational health in breeding activities is strongly embedded with animal health. Tuberculosis (TB) \u2013 known for its critical progress and for the long duration of the drug treatment \u2013 has the specificity of a bi-directional infectious potential. Tuberculosis is still endemic in Africa, Asia and Balkan Area. Among these, the most risky regions for the disease are North Africa and India. In the Italian agricultural system, about 37000 migrants are legally employed, most of them in seasonal activities (e.g.: harvesting) but if we consider Northern Italy, we can easily find a significant presence of foreign workers also in animal breeding. In our experience, we have observed that people from India and North Africa are often involved in cattle breeding. Case-report This case report deals with a worker from Aegypt, employed as milker in an Italian enterprise since 1990. The worker, a 51 years old man, affected by chronic HCV, showed suddenly symptoms and signs suggesting lung TB (cough, haemoptysis, weight loss and thoracic pain). A diagnosis of lung TB was made in the past and the worker underwent a multidrug therapy. A re-activation of a silent lung TB due to the immunodepression linked to the chronic liver disease or to a new infection have been inquired with questionnaire. The diagnostic approach performed included BK search in the sputum, lung X-ray, Mantoux test, pulmonary evaluation. The worker was held temporarily not suitable for work. Consequences Preventive measures provide to perform Mantoux test to all milker\u2019s colleagues and to perform tuberculin test to all animals reared. The occupational risk of TB to cattle breeders is discussed in light of bovine TB cases in Lombardy Region

On some deaths potentially associated with the use of propofol [Su alcuni decessi potenzialmente associabili all'uso di propofol]

This article discusses the adverse effects of propofol after surgery that lead to the death of healthy dogs from Italy. The occurrence of blood diarrhoea, establishment of rapid, but not immediate symptoms and constant use of propofol are highlighte

Il medico del lavoro competente e la sorveglianza sanitaria in agricoltura

Despite the underreporting of occupational diseases in agriculture, available data clearly show a significant health risk, and therefore the need of health surveillance at the workplace. The implementation of health surveillance programs for agricultural workers relies on the possibility of creating a system able to reach the workers at their workplaces, with the collaboration of employers’ associations, able to support enterprises in several issues, including risk assessment and management. The health surveillance program can be organized in a component common for all workers, based on physical examination, chemistry, electrocardiography, hearing and lung functions examinations, and on tests addressing specific risks, if present: vibration, physical overload, chemicals, biological agents, allergens. The frequency of examinations must be decided based on risk assessment and health surveillance outcome