Innocente Franchini

1. Med Lav. 1974 Sep-Oct;65(9-10):379-88. [Determination of delta-aminolevulinic acid in urine]. [Article in Italian]. Franchini I, Cavatorta A, Guariglia A, Asinari G, Coruzzi P, Mutti A. PMID: 4465721 [PubMed - indexed for MEDLINE]. Publication Types: English Abstract. MeSH Terms. Aminolevulinic Acid/urine*; Autoanalysis/methods; Humans; Levulinic Acids/urine*. Substances. Levulinic Acids; Aminolevulinic Acid.

For biological indicators of exposure, effect or susceptibility, appropriate reference values should be available for a comparative evaluation at individual or at group level. Reference values can be either measured in the same subjects before the exposure starts (internal reference), or extrapolated from an appropriately selected group (external reference). In both cases, confounding factors as well as possible sources of variability (biological and analytical), must be taken into account and controlled. Proceeding from clinical chemistry to occupational and environmental medicine, different exclusion and partition criteria in producing reference values should be adopted. Whereas clinical chemistry is aimed at discriminating people as having or not diseases, preventive medicine deals with healthy subjects to prevent effects derived from abnormal exposure to xenobiotics. To this purpose, it is mandatory that general requirements are satisfied, such as the clear definition of the reference population, the conditions under which the specimens were obtained, the adequacy of the indicator itself to provide information, provided that all laboratory results were produced by adequately standardized methods under sufficient quality control. Since we are shifting from macro to microdoses, reference values would help in discriminating natural or man-made sources of exposure.

According to the investigations carried out on workers of two chromium plating plants, the authors believe that chromium urinary excretion allows to determine the degree of its acute absorption. Moreover, the renal clearance of diffusible chromium allows the evaluation of chromium body burden and is related to the duration as well as to the severity of exposure. This interpretation is supported by the relation between the exposure biological indexes and the clinical and instrumental investigations which make possible the evaluation of lesions caused by chromium exposure, mostly concerning the respiratory system.

Biological and environmental monitoring of chromium exposure was carried out on 20 welders working with special electrodes in the manufacture of tank-cars. The workers were divided in groups, according to the different degree of chromium accumulation, which was determined by renal clearance of diffusible chromium. A closed linear relationship between TWA concentration of hydrosoluble chromium in air and urinary excretion of the metal at the end of exposure was observed. The parameters of regression lines in welders with more (clearance 10 ml/min) or less (clearance 5 ml/min) accumulation of chromium suggest that the renal burden influences not only the basal excretion, but also the excretion at the end of exposure. We underline the difficulty in the determination of correct biological limits if we take them from TLV in air. We must at least consider the degree of accumulation in exposed workers too.

1. Ann Ital Med Int. 1988 Jan-Mar;3(1):10-8. [Urine proteins and excretion of brush-border antigens in the early stages of diabetic nephropathy]. [Article in Italian]. Mutti A, Ghiggeri GM, Alinovi R, Bergamaschi E, Spaggiari M, Franchini I, Queirolo C, Borghetti A. PMID: 3152832 [PubMed - indexed for MEDLINE]. Publication Types: English Abstract; Research Support, Non-US Gov't. MeSH Terms. Albuminuria/urine*; Antigens/urine*; Biological Markers ...

1. Med Lav. 1977 Sep-Oct;68(5):355-63. [Renal indices of acute exposure to chromium and chronic chromium accumulation]. [Article in French]. Borghetti A, Mutti A, Cavatorta A, Falzoi M, Cigala F, Franchini I. PMID: 593212 [PubMed - indexed for MEDLINE]. Publication Types: English Abstract. MeSH Terms. Chromium/adverse effects*; Chromium/metabolism; Humans; Kidney/drug effects; Kidney/metabolism*; Kidney Diseases/chemically induced; Occupational Diseases/chemically induced; Time Factors. Substances. Chromium.

1. Med Lav. 1979 Jul-Aug;70(4):257-65. [Updating on biological monitoring of subjects occupationally exposed to chromium]. [Article in Italian]. Franchini I, Mutti A, Cavatorta A. PMID: 397405 [PubMed - indexed for MEDLINE]. Publication Types: Review. MeSH Terms. Carcinogens; Chromium/metabolism; Chromium/poisoning*; Environmental Exposure; Humans; Occupational Diseases/chemically induced*; Occupational Diseases/metabolism. Substances. Carcinogens; Chromium.

1. Med Lav. 1979 May-Jun;70(3):171-9. Distribution and urinary excretion of chromium. Studies on rats after administration of single and repeated doses of potassium dichromate. Mutti A, Cavatorta A, Borghi L, Canali M, Giaroli C, Franchini I. PMID: 470819 [PubMed - indexed for MEDLINE]. MeSH Terms. Air Pollutants; Animals; Chromates/urine*; Chromium/metabolism*; Chromium/urine; Female; Half-Life; Potassium Dichromate/administration & dosage; Potassium Dichromate/urine*; Rats; Tissue Distribution. Substances. ...

Lung function tests were examined on 28 welders using high chromium alloyed electrode for two years. Respiratory function change seem to be related to the duration of employment as welders. On the contrary, obstructive disease and alveolo-capillary impairment were found with same prevalence in groups of workers differently exposed to chromium. It presumably occurs because the exposure to chromium is quite short.

1. Dev Toxicol Environ Sci. 1980;8:357-61. Behaviour of indicators of dose and effect after cessation of occupational exposure to lead. Alessio L, Castoldi MR, Odone P, Franchini I. PMID: 7308032 [PubMed - indexed for MEDLINE]. Publication Types: Comparative Study. ...

Lung function test performed on 26 chromium plating workers showed a high prevalence of obstructive disease and of change in DLCO. The connection between lung function impairment and occupational exposure to chromium is suggested by the relationship between respiratory changes and biological indices of chromium absorption. The prevalence and the severity of ventilatory impairment also show an increasing trend with the duration of the exposure, while the smoking habitus seems not to be important.

1. Ann Ital Med Int. 1986 Jun;1(2):115-24. [Diagnostic definition of urine albumin isolated by determining tubular antigen excretion using monoclonal antibodies]. [Article in Italian]. Lucertini S, Mutti A, Franchini I, Alinovi R, Fornari M, Borghetti A. PMID: 3275183 [PubMed - indexed for MEDLINE]. Publication Types: English Abstract; Research Support, Non-US Gov't. MeSH Terms. Adult; Albuminuria/diagnosis*; Albuminuria/urine; Animals; Antibodies, Monoclonal ...

1. Contrib Nephrol. 1993;101:164-8. An immunoassay method for the determination of rat retinol-binding protein in serum and urine. Biagini C, Alinovi R, Bergamaschi E, Mutti A, Berni R, Franchini I. Laboratory of Industrial Toxicology, University of Parma, Italy. PMID: 8467671 [PubMed - indexed for MEDLINE]. MeSH Terms. Animals; Enzyme-Linked Immunosorbent Assay; Female; Male; Rats; Retinol-Binding Proteins/analysis*; Retinol-Binding Proteins/urine. Substances. Retinol-Binding Proteins.

The microdialysis technique was applied to the study of norepinephrine (NE) metabolism in white adipose tissue of spontaneously hypertensive (SHR, n = 6) and normotensive Wistar-Kyoto (WKY, n = 6) rats. Mean concentrations of interstitial NE were much higher in SHR as compared to WKY (mean +/- SEM: 980.9 +/- 125.6 pg/ml vs 520.7 +/- 96.1 pg/ml; p = 0.01) over the 180 min experimental period. These results are consistent with the hypothesis that sustained outflow from nerve endings of the peripheral sympathetic system may play a role in the maintenance of arterial hypertension. Owing to its low invasiveness, the microdialysis technique allows to continuously monitor NE extracellular levels in conscious and freely-moving animals.

A case of hypokalaemia due to chronic administration of Clortalydone is reported. The histochemistry of muscle biopsy showed the morphologic changes which are usually found in the muscle fibers of periodic familial paralysis (necrotic fibers, accumulation of PAS positive substance, inflammatory cells, intermyofibrillar network degeneration, increase of lipids content). Such findings suggest some clues to the pathophysiology of the essential hypokalaemic paralysis and the possible practical importance of these histopathologic muscular findings in the diagnosis of secondary hypokalaemia.

Monoamine oxidase B (MAO-B) activity in platelets, serum dopamine-beta-hydroxylase (DBH) activity, and serum prolactin (PRL) were measured during a cross-sectional investigation in workers occupationally exposed to styrene. The study group consisted of 53 workers (33 men and 20 women) employed for 9.3 years on average (range 1-22) in reinforced plastics plants. Sixty industrial workers with no known exposure to chemicals and comparable as to age, sex and confounding variables were recruited as controls. The activities of MAO-B in platelet-rich plasma and of DBH in serum from exposed and control subjects were measured within the same run, using methods based on the liquid-chromatographic determination of the reaction products. Serum PRL was determined by both EIA and RIA. Blood samples had been collected between 8:00 and 9:00 a.m. A lower DBH activity was found in exposed as compared to control workers (GM: 7.25 U/ml serum vs. 10.11 U/ml serum; p < 0.01), whereas MAO-B activity was significantly lower in a heavily exposed subgroup (10.1 vs. 13.8 U/10(7) platelets; p = 0.05), but not in the whole sample (p = 0.07). Serum PRL was higher both in male (GM: 8.90 ng/ml vs. 6.05 ng/ml; p < 0.01) and female (GM: 12.6 ng/ml vs. 9.33 ng/ml; p < 0.05) styrene-exposed workers as compared to their respective controls. Dose-response relationships were found for abnormally low DBH and abnormally high PRL values, with a threshold occurring at metabolite levels corresponding to 8h-TWA styrene concentrations in air around 25 ppm. In summary, this study shows that long-term exposure to relatively low levels of styrene can affect DBH activity and basal serum PRL. Owing to its sensitivity, PRL is a useful biomarker to show impairments of dopaminergic control on pituitary secretion. Since DBH is expression of catecholamine secretion, its decreased activity could represent an indirect index of altered turnover rate of the physiological substrate (i.e.dopamine) at the neuronal level. However, a direct interference by styrene metabolites on enzyme activity cannot be ruled out. Platelet MAO-B activity seems to be less sensitive to styrene exposure.

Introduction. The prevalence of Natural Rubber Latex (NRL) in Health Care Workers (HCW) is estimated to be 5-18%, representing a major health concern. Here we present our specific experience in nurse students of Parma University. Aims. Our aim was to establish (1) the prevalence of NRL allergy and (2) the role of some suspected risk factors. Subjects and Methods. Data about atopy and suspected risk factors for NRL allergy were retrieved from clinical history of nurse students, collected during health surveillance program. We identified 293 subjects: 221 women (mean age 21.9±4.6 years) and 72 males (21.54±2.9 years). Where possible, data from medical records were retrieved. In presence of symptoms when using latex containing devices (pruritus, hands dryness and/or redness, rhinitis) or clinical history suggestive of NRL allergy, diagnosis was ruled out through latex-specific IgE evaluation. Results. A positive familiar history for atopy was identified in 16 subjects (5.5%); 31 (10.6%...

Background Extensive diffusion of video display units (VDU) had led to a growing concern about potential health risks from prolonged VDU work. Actually, symptoms of “eye irritation” and related ocular surface effects (“ocular discomfort”) have been frequently reported as common complaints for VDU workers. Also musculoskeletal disorders affecting dorsal rachides and upper limbs are often reported, and identified as a common cause of work disruption in VDU attendants. Here we present results of health surveillance program for ocular diseases performed in Parma University since 1996. Methods Since 1996, health surveillance program performed at Parma University includes screening for ocular diseases in various job groups: administrative and teaching personnel, laboratory technicians, computer operators, and physicians. As a standard procedure, subjects receive a self-reported questionnaire about working conditions and environment, job schedules, previously diagnosed refractive disorders...

Introduction. Research about silicosis suspects the pathological activation of immune system as a cornerstone of silica-related diseases. We report a case, with previous silica-dust exposure and no history of lung disease, where silicosis and IgA nephropathy were simultaneously diagnosed. Case report. A 68-year-old male, smoker, was admitted to our hospital in October 2005 for proteinuria (2800 mg/24h) and reduced renal function (serum creatinine 2 mg/dL, GFR 35 ml/min). Actually renter, he started working 20-year-old as a miner in a sandstone cave, located near to Parma (Castagneto). Despite high levels of silica dusts in the work environment, he reported no mandatory use of airways protection devices during the first 25 years of activity. He had annual medical examinations, stating no clinical or radiological signs of silicosis or pneumoconiosis until the year of retirement (1997). Lung function tests were unavailable. Urinalysis on admission confirmed nephrosic-range proteinuria,...

Background. Lung fibrosis is usually associated with exposure to inorganic dusts (e.g. asbestos and free silica), but there is increasing evidence that idiopathic pulmonary fibrosis (IPF) occurs more often in subjects previously exposed to wood dusts. Objectives. Here we report a case of suspected IPF after prolonged exposure to high levels of hardwood dusts. Case Report. An 83 year-old male, smoker until 30 years ago, formerly asymptomatic, complains mild shortness of breath at exercise and dry cough. Renter since 1985, he started working 30-year-old in a furniture industry. Despite high levels of mahogany dusts in a working environment poorly aerated, he reported no mandatory use of airways protection devices. Previous radiographic exams and lung function tests were unavailable. A clinical examination was performed reporting inspiratory crackles at lower lung fields. Blood gas evaluation reported normal values. Lung function tests showed a mild restrictive pattern. On the other ha...

In adults, MeHg poisoning is characterized by damage to discrete anatomical areas of the brain (visual cortex, loss of neurons from the granule layer of the cerebellum). However, the immature central nervous system (CNS), which is extremely sensitive to MeHg neurotoxicity, shows a diffuse and widespread damage disorganization of cerebral cortex cytoarchitecture, disappearance of granule cells with narrowing of the molecular layer. While adverse effects have been unequivocally demonstrated in poisoning incidents in humans (visual abnormalities, sensory impairment of the extremities, cerebellar ataxia, hearing loss, muscle weakness, tremor and mental deterioration), the implications of lower level exposures, such as those occurring in fish-eating populations, are still controversial. The high affinity of MeHg for thiol groups makes proteins and peptides bearing cysteines the predominant targets for structural and functional modification by MeHg in all subcellular compartments. The ide...

This document has been prepared by a working group of University Professors belonging to the Italian Society of Occupational Medicine and Industrial Hygiene, with the aim of defining the role of this discipline in the university course on Prevention Techniques in Working and Living Environments. The course trains health professionals to apply risk assessment techniques, preventive measures and legislative tools for safety and health in working and living environments, food and beverages hygiene, and Public Health. The document describes the organization and the structure of the course, general and specific learning objectives, occupational medicine teaching and other organization aspects. Also, training of non-graduate technicians working for local health authorities is discussed.