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Background: Several studies evaluated exposure to lead in relatively small groups of firearms instructors and shooters, mainly operating at indoor ranges., Objective: To assess the levels of lead exposure in a large sample of firearms instructors of the Italian State Police (SP) operating at either indoor or outdoor ranges., Methods: A crosssectional study was conducted in firearms instructors working in indoor (No. 188) and outdoor (No. 188) ranges compared with 170 foodplant workers. The personal and work characteristics and current blood lead (Pb-B) levels were evaluated The concentrations of environmental lead (Pb-E) were measured using personal samplers in 6 indoor and 6 outdoor firing ranges., Results: The Pb-B levels in the two groups of firearms instructors were well below the ACGIH BEI, but significantly higher than in food plant workers. In the entire study sample the Pb-B level was seen to be influenced by age and job group. An excess risk of having Pb-B >100 microg/l was found in indoor range instructors and in those with greater job seniority. Pb-E <25 pg/m3 was measured in all the firing ranges examined., Discussion: The low Pb-B and Pb-E levels assessed are the result of primary and secondary prevention interventions carried out over the years by the Italian State Police. The current Pb-B levels also seemed to be poorly influenced by higher past environmental and/or occupational lead exposure. In fact a certain number of firearms instructors, mainly operating at indoor ranges and with greater job seniority, had Pb-B levels consistent with occupational exposure to lead. Environmental and biological monitoring of lead exposure and specific health surveillance are therefore still necessary in this job group topreventpossible adverse health effects of lead even at low doses.

Commuting accidents (CA) play an important role in many systems of workers' compensation insurance and with good reason, as they generally bring about more serious consequences in terms of permanent disablement and death than ordinary occupational accidents; this usually leads to high social costs. Nevertheless, research investigations aimed at studying the possible causes underlying the phenomenon are not available in medical literature. Objective of the present study is to evaluate whether excessive daytime sleepiness (EDS) might influence the occurrence of CA. 463 CA occurred to 411 police officers in northern Italy during the period 1999 - 2002 were collected; 51.9% of the subjects were working on shifts, 48.1% were non-shift workers. The study was carried out by submitting a self-administered questionnaire to gather information on age and physical characteristics, working conditions, sleep-related problems and accidents occurrence; EDS was measured by the Epworth Sleepiness Scale (ESS). A large number of workers (36%) complained of EDS; a strict significant relationship between shift - work condition and the presence of EDS was found, thus suggesting that CA are significantly influenced by EDS. The shift work schedule adopted by Italian Police might be accountable for the disruption of the balance between circadian and homeostatic factors.

The aim of this present study was to inquire about spine morfo-functional alterations among policemen with jobs regarded as potentially hazardous, in order to identify preclinical alterations of column and to plan adequate preventive measures. A physiopathologic and working anamnesis was carried out by means of questionnaire about personal data, jobs, reported rachidian symptomatology and presence of orthopedic diseases, given to policemen on duty in Bari. Every chosen worker was subject to orthopedic and neurological examination, radiography of column, Formetric tridimensional examination, telethermography of spine. We stratified the sample on the basis of age and job. Under the jobs we individuated 4 biomechanical hazardous activities, performed separately or together: driving motorcycle, driving car, flying helicopter, video terminal use. The whole sample, formed by 211 subjects, all male, had the average age of 39 years (Standard Deviation: +/- 4). About the reported rachidian symptomatology, only 41 (17, 98%) subjects were asymptomatical, contrary to clinical results, that were normal in almost the entire sample, with the exception of 3 workers (1, 31%), who had neurological clinical alterations. Structural alterations were checked by radiography among 64, 9% of subjects. The Formetric examination found alterations in different tract of rachis, also coexiting between each other. The telethermographic changes affected 63,99% of the sample and involved especially the lumbar tract (38,86%), dorsal region (18%) and cervical zone (7,1%). The relative frequency of dorsal tract increased with growing of age. The morfo-functional changes of the sample seem to depend rather on the performed job, than on degenerative process of age, partly because the average age of the sample is not much elevated and because the enlistment in Italian Police Force is subordinated to verification of optimum conditions, also characterized by absence of anomaly of column. The absence of clinical alteration, in contrast to reported rachidian symptomatology by 82,02% of subjects and with discovered objectivity, demands more clinical attention in presence of symptomatology and proposes supplementary non-invasive techiniques of investigation, as the telethermography and the formetric tridimensional examination.

Unlabelled: Firearm instructors represent a particular occupational group exposed to low lead (Pb) doses. Even low blood lead levels (PbB) of this metal can cause an increase of blood pressure (BP)., Objective: To assess the Pb exposure of the firearm instructors of the Italian State Police (SP) and the effects of Pb on their PA., Subjects and Methods: 376 instructors were studied, including 188 subjects working at indoor and 188 at outdoorfiring ranges. After obtaining informed consent, information on work, social and pathological history was collected and measurements of body mass index (BMI), BP and blood lead (PbB) level were obtained from the medical records., Results: The mean PbB level of the instructors of outdoor ranges (6.7 +/- 5.3 microg/dl) was significantly lower than those of indoor ranges (8.5 +/- 7.6 microg/dl). In the instructors of outdoor ranges the diastolic BP (DBP) was significantly influenced by BMI and PbB, also considering the common confounding factors., Discussion: The mean PbB level of the firearm instructors of the Italian SP resulted to be clearly below the biological limit value for Pb. In the instructors of outdoor ranges the even low PbB levels detected were able to determine a slight, but significant increase of DBP, also after correction for the main confounding variables. It is therefore necessary to keep on effecting biological monitoring and health surveillance of firearm instructors of SP and to promote the reduction of their body weight.

Shift-work disrupts the sleep-wake cycle and could bring about sleep disorders and excessive daytime sleepiness. We studied two samples of shift-workers, a group of 178 nurses and one of 174 police officers, all working in the town of Palermo (Italy); their answers to a sleep disorder questionnaire were scored and added in order to create a Sleep Disorder Score (SDS). The SDS cut-off value, discrimining pathological values from physiological ones, was settled a-priori. In both groups SDS did not depend on sex, age, weight, height nor on working seniority, but it increased non linearly (cubic form) with shift-work seniority. In nurses this mathematical description of SDS exceeded the cut-off value after 15 years of shift-work seniority; in police officers it settled asymptotically under the critical value. This could be ascribable both to the different composition in sex of the two samples (nurses: 49% F-51% M vs. police officers: 6% F-94% M) both to the self-selection process that seems to undergo police officers (nurses do not leave shift-work because of salary incentives).

The enhancement of ascites following a high dose of contrast medium has been recently described. The CT behavior of 26 peritoneal, pleural or pericardial effusions has been studied in 23 patients after the administration of a high dose of urographic contrast medium. The effusions were enhanced in all patients but one. No difference between malignant and non-malignant effusions could be observed with ionic and non-ionic contrast medium. Low molecular weight of the urographic contrast medium (600-800 daltons) can explain the free passage of the solute through peritoneum, pleura, and pericardium. The knowledge of such a phenomenon is mandatory to avoid misdiagnosing hematic effusion or urinary-peritoneal fistula.

The authors have analysed the flank stripe in 70 normal subjects and in patients with abdominal disease. The flank stripe has a wide variability and is very useful to detect and locate abdominal pathologic conditions.