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The aim of this study was to investigate the practicability of exhaled breath condensate (EBC) as a biological matrix to detect and measure hexavalent chromium (Cr(VI)) and trivalent chromium (Cr(III)) in workers occupationally exposed to Cr(VI). EBC samples were collected from workers in France, Finland, Italy, The Netherlands and the United Kingdom from three different target activities: chrome platers, stainless steel welders and surface treatment workers. Pre and post working week EBC samples were collected from 177 exposed workers and 98 unexposed workers (control group). Hyphenated chromatography systems with inductively coupled plasma - mass spectrometry (ICP-MS) were for the analysis. The results showed that the occupationally exposed workers had significantly higher levels of Cr(VI) and Cr(III) than the control group. Chrome platers exhibited the highest Cr(VI) levels in their EBC samples, with a significant increase from their pre to post samples for both Cr(VI) and Cr(III). A significant difference was also found between pre and post EBC samples for Cr(III) in welders. This study has shown that EBC has the potential to be a valid, non-invasive biological matrix to assess occupational exposure to Cr(VI) and Cr(III) for biological monitoring assessment, with the ability to detect low level inhalation exposures.

Introduction: Idiopathic pulmonary fibrosis (IPF) and asbestosis are pulmonary interstitial diseases that may present overlapping clinical aspects in the full-blown phase of the disease. For both clinical entities the gold standard for diagnosis is histological examination, but its execution poses ethical problems, especially when performed for preventive or forensic purposes. Objective: To evaluate the application of internationally accepted clinical, anamnestic and radiological criteria for differential diagnosis between asbestosis and IPF, and to assess the ability to discriminate between the two diseases. Even if clinically similar, the two diseases present extremely different prognostic and therapeutic perspectives. Methods: Two clinical cases of IPF are reported, in which the differential diagnosis was made by studying occupational exposure to asbestos, the onset and progression of clinical symptoms, and the identification of specific radiological elements by means of chest High Resolution Computed Tomography (HRCT). Results: The diagnosis of IPF could be made on the basis of the absence of significant exposure to asbestos, the early onset and rapid progression of dyspnea and restrictive ventilatory defects, in association with a pulmonary radiological pattern characterized by peculiar elements such as honeycombing. Discussion: The diagnostic procedure adopted to make a differential diagnosis with asbestosis provides practical clinical elements facilitating the differentiation between the two forms of pulmonary fibrosis, a fundamental aspect of the activity of the occupational physician.

HBM4EU chromates study team: Kukka Aimonen8, Guillaume Antoine1, Rob Anzion9, Manuella Burgart1, Andrea Cattaneo11, Domenico M. Cavallo11, Alcina Costa12, Giuseppe De Palma13, Flavien Denis1, Giovanni Forte3, Angela Gambelunghe14, Ogier Hanser1, Carina Ladeira15, Elisabeth Leese16, Risto Lehtinen8, Henriqueta Louro7 Piero Lovreglio17, Nicole Majery18, Philippe Marsan1, Mathieu Melczer1, Armandida Miranda12, Edna Ribeiro15, Françoise Schaefers4, Marta Senofonte3, Filomena Seuanes12, Maurice van Dael9, Riitta Velin8 1French National Research and Safety Institute, Vandoeuvre-les-Nancy, France 2Department of Public Health, University of Naples Federico II, Naples, Italy 3 Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy 4Department of Health Protection, Laboratoire National de Santé (LNS), Dudelange, Luxembourg 5Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), Kapucijnenvoer 35, 3000, Leuven, Belgium 6Nofer Institute of Occupational Medicine, Lodz, Poland 7National Institute of Health Dr. Ricardo Jorge, Department of Human Genetics and Environmental Health Lisbon, Portugal 8Finnish Institute of Occupational Health, Helsinki, Finland 9Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands 10NOVA NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600–560 Lisbon, Portugal; Comprehensive Health Research Center (CHRC), 1169–056 Lisbon, Portugal. 11Department of Science and High Technology, University of Insubria, Como, Italy 12National Institute of Health Dr. Ricardo Jorge, Department of Health Promotion, Lisbon, Portugal 13Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy 14Departement of Medicine and Surgery, University of Perugia, Perugia, Italy 15H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa; Comprehensive Health Research Center (CHRC), 1169–056 Lisbon, Portugal 16Health and Safety Executive, Buxton, SK17 9JN, United Kingdom 17Interdisciplinary Departement of Medecine, University of Bari, Bari, Italy 18Service de Santé Au Travail Multisectoriel (STM), Luxembourg Occupational exposures to hexavalent Chromium (Cr(VI)) can occur in welding, hot working stainless steel processing, chrome plating, spray painting and coating activities. Recently, within the human biomonitoring for Europe initiative (HBM4EU), a study was performed to assess the suitability of different biomarkers to assess the exposure to Cr(VI) in various job tasks. Blood-based biomarkers may prove useful when more specific infor-mation on systemic and intracellular bioavailability is necessary. To this aim, concentrations of Cr in red blood cells (RBC-Cr) and in plasma (P–Cr) were analyzed in 345 Cr(VI) exposed workers and 175 controls to understand how these biomarkers may be affected by variable levels of exposure and job procedures. Compared to controls, significantly higher RBC-Cr levels were observed in bath plating and paint application workers, but not in welders, while all the 3 groups had significantly greater P–Cr concentrations. RBC-Cr and P–Cr in chrome platers showed a high correlation with Cr(VI) in inhalable dust, outside respiratory protective equipment (RPE), while such correlation could not be determined in welders. In platers, the use of RPE had a significant impact on the relationship between blood biomarkers and Cr(VI) in inhalable and respirable dust. Low correlations between P–Cr and RBC-Cr may reflect a difference in kinetics. This study showed that Cr-blood-based biomarkers can provide information on how workplace exposure translates into systemic availability of Cr(III) (extracellular, P–Cr) and Cr(VI) (intracellular, RBC-Cr). Further studies are needed to fully appreciate their use in an occupational health and safety context. Highlights: Suitability of blood biomarkers was evaluated to assess occupational Cr(VI)exposure; Bath platers and painters had higher Red Blood Cells-Cr levels compared to controls; Bath platers, painters and welders had higher plasma-Cr levels compared to controls; Red Blood Cells- and Plasma-Cr were highly correlated with inhalable Cr(VI) in platers; Blood-Cr biomarkers can provide information on systemic and intracellular availability. This work has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 733032 and received co-funding from the author’s organizations and/or Ministries. Luxembourg entered the study at a later stage and thus financed the study at its own means. info:eu-repo/semantics/publishedVersion

Human T-cell lymphotropic virus type 1 (HTLV-1) infection affects millions of individuals worldwide and can lead to severe leukemia, myelopathy/tropical spastic paraparesis, and numerous other disorders. Pursuing a safe and effective immunotherapeutic approach, we compared the viral polyprotein and the human proteome with a sliding window approach in order to identify oligopeptide sequences unique to the virus. The immunological relevance of the viral unique oligopeptides was assessed by searching them in the immune epitope database (IEDB). We found that HTLV-1 has 15 peptide stretches each consisting of uniquely viral non-human pentapeptides which are ideal candidate for a safe and effective anti-HTLV-1 vaccine. Indeed, experimentally validated HTLV-1 epitopes, as retrieved from the IEDB, contain peptide sequences also present in a vast number of human proteins, thus potentially instituting the basis for cross-reactions. We found a potential for cross-reactivity between the virus and the human proteome and described an epitope platform to be used in order to avoid it, thus obtaining effective, specific, and safe immunization. Potential advantages for mRNA and peptide-based vaccine formulations are discussed.