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In occupational epidemiology, job coding is an important—but time-consuming—step in assigning exposure. We implemented a tool (i.e. a crosswalk) to translate occupation codes from the Italian (ISTAT-CIP-91, n = 6319 five-digit job codes) to the International Standard Classification of Occupations (ISCO-68, n = 1881 five-digit job codes). The former is currently used in Italy for various purposes (e.g. in the National Mesothelioma Registry). The latter has been used in several studies on occupational cancers because it facilitates communication of results to the scientific community and, most importantly, because some job exposure matrices (JEMs) are based on international codes. Three authors created a table containing the crosswalk structure, providing an interpretation for each of the ISTAT-CIP-91 codes job descriptions and then manually recoding them according to ISCO-68. Two other authors independently revised it. The performance of the final version was assessed by comparison with results obtained by manual ISCO-68 coding performed in two previous case-control studies on asbestos and mesothelioma. More specifically, the automatically obtained ISCO-68 codes were merged with a JEM (DOM-JEM). The resulting individual asbestos exposure estimates (ever versus never exposed) were compared to those originally obtained (using the same DOM-JEM) from manual translation of ISTAT-CIP-91 to ISCO-68 (considered as the 'gold standard'). In the first study, among 159 peritoneal mesothelioma cases (400 job codes), Cohen's kappa was 0.91, sensitivity 0.95, and specificity 0.96. In the second study, among 716 pleural mesothelioma cases and controls (4400 job codes) kappa was 0.86, sensitivity 0.94, and specificity 0.91. Performance was better among in women. For men, performance was lower among cases than among controls (kappa 0.70, sensitivity 0.95, specificity 0.72 versus kappa 0.87, sensitivity 0.97, and specificity 0.92). In conclusion, the proposed tool allowed a rapid translation of thousands of job codes with good to excellent accuracy. The table containing ISTAT-CIP-91 codes and job descriptions and the corresponding ISCO-68 codes and job descriptions is made publicly available and can be freely used for epidemiological analyses in Italy and international collaborations. [ABSTRACT FROM AUTHOR]

The number of people infected with severe acute respiratory syndrome—coronavirus 2 (SARS-CoV-2), i.e. the virus causing coronavirus disease (COVID-19), is dramatically increasing worldwide to the size of a pandemic. At the time of writing Italy is ranking first among countries both in terms of number of COVID-19 confirmed cases and in terms of number of deaths. Such a wide spread of COVID-19 has led to concern among workers who are facing the risk of becoming infected during the execution of their duties. We believe it is useful to remark on the need for professional expertise in the field of Occupational Hygiene in this emergency context, in which the indications provided by national and international bodies, the available scientific literature and the legal provisions are constantly and rapidly evolving. It is of fundamental importance that there is an effective analysis of expert inputs, to provide essential guidance to Health, Safety and Environmental managers and other prevention managers in workplaces. In this regard, not only a constant update of the regulatory framework is needed, but also a development and circulation of operational guidance to all the stakeholders to translate general indications into clear operating procedures and implementation tools to be adopted in the workplaces. We believe that the scientific associations in the field of Occupational Hygiene play a crucial role in guiding and assisting prevention professionals. There is considerable expertise in the occupational hygiene and exposure science communities that can help employers and workers to contain and delay the spread of COVID-19. For this reason, the Italian Association of Industrial Hygienists (AIDII—Associazione Italiana degli Igienisti Industriali) published documents containing operational guidelines to provide correct and constantly updated information for: (i) workers employed in essential activities (with low and medium risk of contagion), (ii) health workers and other workers at high or very high risk of contagion, and (iii) for the correct use and handling of personal protective equipment for workers and for the population in general. It is worth pointing out that the documents produced are not intended to replace those produced by authoritative bodies, but to comply with and complete them by reporting an effective summary and further indications about the measures that should be taken in practice under the light of the Italian legislation. At present, the challenge is to produce scientifically sound knowledge, appropriate tools, and effective methodologies, by coordinating the initiatives of different scientific associations, with the final aim to effectively transfer them to employers and workers. [ABSTRACT FROM AUTHOR]

The PRIMATE study is an Italian translational research project, which aims to identify personalized biomarkers associated with clinical characteristics of malignant pleural mesothelioma (MPM). For this purpose, characteristics of MPM patients with different degrees of asbestos exposure will be compared to identify somatic mutations, germline polymorphism, and blood inflammatory biomarkers. In this framework, we assessed exposure to asbestos for 562 cases of MPM extracted from the Lombardy region Mesothelioma Registry (RML), for which a complete interview based on a standardized national questionnaire and histopathological specimens were available. Exposure assessment was performed: (1) through experts' evaluation (considered as the gold standard for the purpose of this study), according to the guidelines of the Italian National Mesothelioma Registry (ReNaM) and (2) using a job-exposure matrix (SYN-JEM) to obtain qualitative (ever/never) and quantitative estimates of occupational asbestos exposure (cumulative exposure expressed in fibers per mL (f/mL)). The performance of SYN-JEM was evaluated against the experts' evaluation. According to experts' evaluation, occupational asbestos exposure was recognized in 73.6% of men and 23.6% of women; furthermore, 29 men (7.8%) and 70 women (36.9%) had non-occupational exposure to asbestos. When applying SYN-JEM, 225 men (60.5%) and 25 women (13.2%) were classified as occupationally exposed, with a median cumulative exposure higher for men (1.7 f/mL-years) than for women (1.2 f/mL-years). The concordance between the two methods (Cohen's kappa) for occupational exposure assessment was 0.46 overall (0.41 in men, and 0.07 in women). Sensitivity was higher in men (0.73) than in women (0.18), while specificity was higher in women (0.88) than in men (0.74). Overall, both methods can be used to reconstruct past occupational exposure to asbestos, each with its own advantages and limitations.

Background: Human exposure to air pollutants, and specifically to particulate matter (PM) and volatile organic compounds (VOCs), may pose a relevant risk on human health., Aim: To evaluate the personal exposure of adults living and working in Milan (Italy) by environmental and biological monitoring., Methods: Personal exposure of 51 volunteer adults to PM 2.5 , PM 2.5 - 10 and selected VOCs, including benzene, toluene, ethylbenzene, o-xylene, m + p-xylene, methyl tert-butyl ether, naphthalene, hexane, cyclohexane, heptane, and limonene was assessed along a 24-h period via personal cascade impactors and radial diffusive samplers. Urine spot samples were collected to investigate the corresponding urinary biomarkers. Time-activity patterns were filled in by participants to explore the performed activities. Multiple regression models were applied to investigate the association between personal exposure, biomarker levels, and tobacco smoke, traffic exposure, commuting mode, cooking activities, and personal characteristics., Results: Median personal exposure to PM 2.5 , PM 2.5 - 10 , benzene, toluene, ethylbenzene o-xylene, m + p-xylene, methyl tert-butyl ether, naphthalene, hexane, cyclohexane, heptane, and limonene were 36.1, 7.8, 2.3, 7.8, 2.1, 1.8, 4.7, 0.8, 0.3, 1.4, 2.5, 1.6, and 59.9 μg/m 3 , respectively. Median levels of urinary benzene, toluene, ethylbenzene o-xylene, m + p-xylene, naphthalene, hexane, and heptane were 78.0, 88.1, 21.5, 15.2, 43.9, 21.0, 11.0, and 22.5 ng/L, respectively. For personal exposure, multiple regression models explained up to 67% (PM 2.5 ) and 61% (benzene) of variability, with major contribution from commuting mode and environmental exposure. For biological monitoring, multiple regression analysis explained up to 74% of urinary benzene, with a major contribution given by creatinine, and secondary contributions by commuting mode, personal exposure to airborne benzene and smoking., Conclusions: Personal exposure to air pollutants was lower than that measured in the past in Milan. Personal exposure was mainly driven by traffic variables, while internal dose was mainly driven by personal characteristics and smoking habit., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

To characterise the mass concentration, size-distribution, and respiratory deposition of selected trace metals (Cr, Mn, Fe, Ni, Cu, Zn, Ba, and Pb) in size-segregated PM 2.5 , a long-term monitoring campaign was undertaken at an urban background site in Como (Northern Italy). 96-h aerosol samples were collected weekly, from May 2015 to March 2016, using a 13-stage low pressure impactor and analysed via laser ablation-inductively coupled plasma-mass spectrometry. Significantly higher levels of trace metals were generally found during the heating season (two to more than four times) compared to the non-heating period at all size ranges, especially for concentrations in PM 0.1-1 . Distinct distribution profiles characterised the different elements, even though the corresponding heating and non-heating shapes always exhibited similar features, with negligible seasonal shifts in the average mass median aerodynamic diameters. Fe, Ba, and Cu had >70% of their mass in PM 1-2.5, whereas Pb, Zn, and Ni showed higher contributions in the accumulation mode (>60%). Finally, broad size-distributions were found for Cr and Mn. The multiple-path particle dosimetry model estimated the overall deposition fractions in human airways varying between 27% (Pb) and 48% (Ba). The greatest deposition variability was always registered in the head region of the respiratory system, with the highest contributions for those metals predominantly accumulated in the PM 2.5 coarse modes. In contrast, the deposition in the deepest respiratory tract maintained nearly constant proportions over time, becoming notably important for Pb, Ni, and Zn (∼13%) with respect to their total deposition. The comparison with national limits established for Pb and Ni suggested the absence of significant risks for the local population, as expected, with average concentrations two orders of magnitude lower than the corresponding annual limit and objective value. Similar findings were reported for all the other metals, for which the estimated hazard quotients were always well <1., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

During rush hours, commuters are exposed to high concentrations and peaks of traffic-related air pollutants. The aims of this study were therefore to extend the inhaled dose estimation outcomes from a previous work investigating the inhaled dose of a typical commuter in the city of Milan, Italy, and to extend these results to a wider population. The estimation of the dose of pollutants inhaled by commuters and deposited within the respiratory tract could be useful to help commuters in choosing the modes of transport with the lowest exposure and to increase their awareness regarding this topic. In addition, these results could provide useful information to policy makers, for the creation/improvement of a mobility that takes these results into account. The principal result outcomes from the first part of the project (case study on a typical commuter in the city of Milan) show that during the winter period, the maximum deposited mass values were estimated in the "Other" environments and in "Underground". During the summer period, the maximum values were estimated in the "Other" and "Walking (high-traffic conditions)" environments. For both summer and winter, the lowest values were estimated in the "Car" and "Walking (low-traffic conditions)" environments. Regarding the second part of the study (the extension of the results to the general population of commuters in the city of Milan), the main results show that the period of permanence in a given micro-environment (ME) has an important influence on the inhaled dose, as well as the pulmonary ventilation rate. In addition to these results, it is of primary importance to report how the inhaled dose of pollutants can be strongly influenced by the time spent in a particular environment, as well as the subject's pulmonary ventilation rate and pollutant exposure levels. For these reasons, the evaluation of these parameters (pulmonary ventilation rate and permanence time, in addition to the exposure concentration levels) for estimating the inhaled dose is of particular relevance.

In 1969, the Italian Association of Industrial Hygienists (AIDII) was founded in Milan by Academics working at the Clinica del Lavoro, one of the oldest institutions for work prevention in the world and within the most prolific institutes in the world on Occupational Medicine and Industrial Hygiene. AIDII was founded as a scientific association with the primary purpose of promoting the development, deepening and dissemination of Industrial Hygiene, the scientific discipline aimed at identifying, assessing and controlling chemical, physical and biological risk factors (as well as transversal risks) either inside or outside the workplace, which can alter the health and wellbeing status of workers and/or the general population, for the purpose of effective prevention and protection of human health. Over the decades, the activities of AIDII have evolved to meet some of the current needs and challenges, while remaining consistent with the basics set by the founders.

Average daily ultrafine particles (UFP) exposure of adult Milan subpopulations (defined on the basis of gender, and then for age, employment or educational status), in different exposure scenarios (typical working day in summer and winter) were simulated using a microenvironmental stochastic simulation model. The basic concept of this kind of model is that time-weighted average exposure is defined as the sum of partial microenvironmental exposures, which are determined by the product of UFP concentration and time spent in each microenvironment. In this work, environmental concentrations were derived from previous experimental studies that were based on microenvironmental measurements in the city of Milan by means of personal or individual monitoring, while time-activity patterns were derived from the EXPOLIS study. A significant difference was observed between the exposures experienced in winter (W: 28,415 pt/cm3) and summer (S: 19,558 pt/cm3). Furthermore, simulations showed a moderate difference between the total exposures experienced by women (S: 19,363 pt/cm3; W: 27,623 pt/cm3) and men (S: 18,806 pt/cm3; W: 27,897 pt/cm3). In addition, differences were found as a function of (I) age, (II) employment status and (III) educational level; accordingly, the highest total exposures resulted for (I) 55-59 years old people, (II) housewives and students and (III) people with higher educational level (more than 10 years of scholarity). Finally, significant differences were found between microenvironment-specific exposures.

Indoor size-fractioned particulate matter (PM) was measured in seven schools in Milan, to characterize their concentration levels in classrooms, compare the measured concentrations with the recommended guideline values, and provide a preliminary assessment of the efficacy of the intervention measures, based on the guidelines developed by the Italian Ministry of Healthand applied to mitigate exposure to undesirable air pollutants. Indoor sampling was performed from Monday morning to Friday afternoon in three classrooms of each school and was repeated in winter 2011-2012 and 2012-2013. Simultaneously, PM2.5 samples were also collected outdoors. Two different photometers were used to collect the PM continuous data, which were corrected a posteriori using simultaneous gravimetric PM2.5 measurements. Furthermore, the concentrations of carbon dioxide (CO2) were monitored and used to determine the Air Exchange Rates in the classrooms. The results revealed poor IAQ in the school environment. In several cases, the PM2.5 and PM10 24 h concentrations exceeded the 24 h guideline values established by the World Health Organization (WHO). In addition, the indoor CO2 levels often surpassed the CO2 ASHRAE Standard. Our findings confirmed that important indoor sources (human movements, personal clouds, cleaning activities) emitted coarse particles, markedly increasing the measured PM during school hours. In general, the mean PM2.5 indoor concentrations were lower than the average outdoor PM2.5 levels, with I/O ratios generally <1. Fine PM was less affected by indoor sources, exerting a major impact on the PM1-2.5 fraction. Over half of the indoor fine particles were estimated to originate from outdoors. To a first approximation, the intervention proposed to reduce indoor particle levels did not seem to significantly influence the indoor fine PM concentrations. Conversely, the frequent opening of doors and windows appeared to significantly contribute to the reduction of the average indoor CO2 levels.