Alessio L, Apostoli P, Porru S, Clonfero E, Minoia C, Assennato G, Bergamaschi E, Carta P, Cassano F, Dell'Omo M, Fiorentino M L, Foà V, Forni A, Gabbani G, Izzotti A, Mastrangelo G, Pavanello S, Sartorelli P, Valerio F
Cattedra di Medicina del Lavoro, Università di Brescia.
G Ital Med Lav Ergon. 1997 Oct-Dec;19(4):131-6.
These guidelines mainly deal with prevention of carcinogenic effects following occupational exposure to polycyclic aromatic hydrocarbons (PAH). After some toxicological remarks, the guidelines define a possible method to demonstrate and evaluate occupational exposure to PAH. In particular, it is illustrated the strategy of environmental monitoring and indicated which PAH should be measured, with suggestion about the most appropriate analytical techniques. As regards biological monitoring, the 1-OH-pyreneseems to be currently the most useful indicator since it reflects the recent and global exposure to PAH. The guidelines also give elements to interpret monitoring data, taking into account environmental and biological reference and limit values suggested by some authors, Associations, or current regulations. The most important health effects are carcinogenic and excess risks have been described mainly for lung, bladder and skin cancer in some PAH exposed workers. The studies on cytogenetic effects showed contradictory results. On the basis of such information and current regulations, the guidelines show how to perform health surveillance in preventive and periodical examinations and how to proceed for the information and formation of exposed workers. It is not advisable, on the basis of the current scientific data, to screen asymptomatic PAH exposed workers for early diagnosis of lung or bladder cancer, nor it is opportune the use of tumor markers for health surveillance nor is genetic screening applicable for individual susceptibility evaluation outside research programs.
本指南主要涉及职业接触多环芳烃(PAH)后致癌效应的预防。在给出一些毒理学说明后,指南定义了一种可能的方法来证明和评估职业性PAH接触情况。具体而言,阐述了环境监测策略,并指出应测量哪些PAH,还给出了最合适分析技术的建议。关于生物监测,1-羟基芘目前似乎是最有用的指标,因为它反映了近期和总体的PAH接触情况。指南还给出了解释监测数据的要素,同时考虑了一些作者、协会或现行法规建议的环境和生物参考值及限值。最重要的健康影响是致癌性,在一些接触PAH的工人中,主要描述了肺癌、膀胱癌和皮肤癌的额外风险。细胞遗传学效应研究结果相互矛盾。基于这些信息和现行法规,指南展示了如何在预防性和定期检查中进行健康监测,以及如何为接触工人提供信息和开展培训。基于当前科学数据,对无症状的PAH接触工人进行肺癌或膀胱癌早期诊断筛查并不可取,使用肿瘤标志物进行健康监测也不合适,在研究项目之外,基因筛查也不适用于个体易感性评估。