[Show abstract][Hide abstract] ABSTRACT: Recently, a number of reports have been published on silicosis in workers exposed to artificial quartz conglomerates containing high levels of crystalline silica particles (70-90%) used in the construction of kitchen and bathroom surfaces. Three cases of silicosis in workers exposed to artificial quartz conglomerates are reported. The diagnosis was derived from both the International Labour Office and the International Classification of HRCT for Occupational and Environmental Respiratory Diseases (ICOERD) classifications and cytological analysis of bronchoalveolar lavage fluid. In 2 cases, levels of respirable silica greatly in excess of recommended standards were measured in the workplace, and cytological analysis of bronchoalveolar lavage fluid highlighted a prevalence of lymphocytes, meeting criteria for the diagnosis of accelerated silicosis. The prevention of pneumoconiosis caused by the use of innovative materials, such as artificial conglomerates with high crystalline silica content must be addressed.
Archivos de Bronconeumología 09/2015; DOI:10.1016/j.arbres.2014.12.010 · 1.82 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Dermatological risks in supermarkets are largely comparable to those found in other workplaces such as food industry and trade in general Using two Pubmed search strings (one more specific, the other more sensitive) 11 papers were found (5 pertinent). The reasons for the little information may be the particular employment conditions that occur , in large-scale distribution. From this derives the difficulty in defining the epidemiology of skin diseases in the field and the need to refer to the literature on skin diseases in food handlers and cashiers. The most frequent dermatological disease in food handlers is irritant contact dermatitis, while the protein contact dermatitis seems to be more widespread than previously thought. Hand eczema together with nickel contact allergy is not rare in cashiers, but it can be difficult to assess if nickel allergy was occupationally acquired.
Giornale italiano di medicina del lavoro ed ergonomia 10/2014; 36(4):244-7.
[Show abstract][Hide abstract] ABSTRACT: Occupational dermatitis (OD) have always been a significant part of the occupational disease with huge social and economic costs. Traditionally, the standard program of OD prevention takes place in the three phases of protection, cleansing and use of emollient creams and other products able to improve the cutaneous trophism (skincare) at the end of the shiftwork. However, in countries like Germany where protection measures and skincare were widespread, there was not a simultaneous decrease in the OD. In recent years pilot programs for the prevention of OD have been implemented with positive results. In particular the integrated approach that includes three steps of primary, secondary and tertiary prevention (Osnabrueck model) is of great interest. Primary prevention is represented by introduction of technical regulations, pre-employment counselling and specific initiatives to promote health (healthy skin campaign). In the case of initial/minor OD, secondary prevention is accomplished through the dermatological treatment of the patient and 1-2 days outpatient education initiatives/skin protection training. In severe cases of individual OD, tertiary prevention involves the hospitalization of the patient in a dermatology department. In 2009 the European network EPOS (European Initiative for the Prevention of Occupational Skin Diseases) of preventive dermatology has been organized basing on the integrated approach of primary, secondary and tertiary prevention.
Giornale italiano di medicina del lavoro ed ergonomia 02/2013; 34(3 Suppl):136-9.
[Show abstract][Hide abstract] ABSTRACT: The aim of the study was to assess the reliability of the indicators of dose and effect in the health monitoring of asbestos exposed workers. In 49 cases out of 158 studied workers (31%) asbestos-related diseases were diagnosed following ATS criteria (2004). Using nonparametric statistical methods (permutation tests) 6 variables were analyzed with respect to asbestos-related diseases and working sectors, demonstrating a difference in the concentration of amphiboles (p < 0.01), greater in patients with asbestosis and workers involved in asbestos removal from railway carriages. There was not a correlation between mesothelin and amphiboles, chrysotile and total fibers concentrations (Spearman test).
Giornale italiano di medicina del lavoro ed ergonomia 02/2013; 34(3 Suppl):577-80.
[Show abstract][Hide abstract] ABSTRACT: The Italian legislation on chemical agents has undergone significant changes. The aim of the study was to compare the results obatained from an environmental investigation and the use of the ARChi.MEDE model The results of the survey were treated with the UNI EN 689/1997 that showed an acceptable result, while according to the use A.R.Chi.M.E.D.E. a significant risk was obtained. Actually the mathematical model assess workers exposure without considering in the calculation the specific preventive measures (personal protective equipment, training, uptake of pollutants at the source) as contemplated by law. So the mathematical model showed the need of preventive measures in the studied work place.
Giornale italiano di medicina del lavoro ed ergonomia 02/2013; 33(3 Suppl):65-8.
[Show abstract][Hide abstract] ABSTRACT: Most personal exposures to UV radiations occur from outdoor activities and several studies detected a significant association between skin cancer and outdoor occupation.
The aim of the study was to ascertain the prevalence of photoaging signs in a population of Italian farmers and in a population of indoor workers taking account of confounding factors.
169 farmers and 198 indoor workers were classified for skin phototype and for skin photoaging, moreover 13 variables were taken into account. Marginal permutation tests were adopted for statistical analysis.
Farmers were significantly older than the indoor workers. In workers occupationally exposed to UV photoaging increased with increasing age and years of occupational exposure to sunlight The distribution of skin phototype did not show significant differences in the two populations, while farmer showed a higher degree of photoaging than indoor workers.
Even if farmers were older than the in door workers it seems that outdoor work produces a higher degree of photoaging.
La Medicina del lavoro 11/2012; 104(1):24-9. · 0.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Up to now the exposures to hair and skin derivatives of animals have not yet been the subject of systematic studies. The observation of a clinical case has provided the opportunity for a review of the literature. The inpatient was a 49-year-old man, a carder in a textile factory, exposed to angora wool. He noticed the appearance of dyspnea during working hours. There was no eosinophilia in blood, and the results of pulmonary function tests were normal. The nonspecific bronchial provocation test with methacholine demonstrated an abnormal bronchial reactivity. The challenge test with angora wool was positive (decrease in FEV1 of more than 40%) as well as total IGE and specific IgE to rabbit epithelium (433 KU/l and 12.1 KUA/l, resp.). Several sources of allergens were found in the rabbit, and the main allergen was represented by proteins from epithelia, urine, and saliva. Most of these proteins belong to the family of lipocalin, they function as carriers for small hydrophobic molecules (vitamins and pheromones). If the diagnosis of occupational asthma caused by animal hair and skin derivatives may be relatively easy by means of the challenge test, defining etiology is complicated because of the lack of in vitro tests.
[Show abstract][Hide abstract] ABSTRACT: In a previous study EPO values were significantly lower in exposed subjects (PbB > or =30 mcg/dl) than in controls (PbB" 20 mcg/dl). The aim of the study was to verify if high PbB cause the reduction of EPO in connection with the serum concentration of this hormone expected considering the Hct and hemoglobin (Hb) levels. Both in Pb exposed workers and controls blood levels of EPO, PbB, Hb, Hct were measured. It was not observed any line relation between Hct e log EPO (p = 0.01) and any multiple regression relation between log EPO, Hct and PbB into the total studied population. In our subjects PbB does not change physiologic relation between EPO and Hct and between EPO and Hb. Maybe because normal levels of Hct and Hb reduce EPO production in the healthy population. In physiologic condition of erythropoiesis, EPO does not seem influenced by PbB.
Giornale italiano di medicina del lavoro ed ergonomia 01/2011; 33(1):37-40.
[Show abstract][Hide abstract] ABSTRACT: Occupational dermatitis is among the most frequent occupational diseases. Dermal exposure risk affects many professional categories such as healthcare workers, hairdressers, bakers, cleaning and kitchen employees. The economical burden of occupational dermatitis (OD) is huge (greater than 5 billion Euro per year in Europe), comprising direct costs (treatment, compensation), as well as indirect costs due to sick leave and lack of productivity. A scientifically based preventive program consisting of skin protection during work, cleaning and skin care after work has generally been recommended to prevent occupational contact dermatitis. However the rate of reported occupational skin diseases seems unchanged in the recent years. In cases of impaired skin condition the secondary prevention (i.e. therapeutic treatment by dermatologists and health-educational intervention seminars) is fundamental. For cases of occupational dermatoses in which these outpatient prevention measures are not successful, interdisciplinary inpatient rehabilitation measures have been developed (tertiary individual prevention). In the past years, various pilot-concepts to improve occupational dermatitis prevention have been successfully put into practice focussing on interdisciplinary (dermatological and educational) skin protection training programmes for high-risk professions. Currently a multi-step intervention approach is implemented which is aiming at offering quick preventive help at all levels of severity of occupational contact dermatitis. Recent data reveals that there are reliable evidence-based options for multidisciplinary prevention and patient management of occupational dermatitis using a combined approach by a network of clinics, practices and statutory social insurance bodies. At this stage, it seemed reasonable to form a European joint initiative for skin prevention. Recently a European network of preventive dermatology (European Initiative for the Prevention of Occupational Skin Diseases-EPOS) has been organized based on the German experience in the specific field.
International journal of immunopathology and pharmacology 01/2011; 24(1 Suppl):89S-93S. · 1.62 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Craft industries are the backbone of the Italian manufacturing system and in this sector the leather trade plays a crucial role.
The aim of the study was to experiment with a risk pre-mapping data sheet in leather bag manufacture by analyzing the production cycle.
The prevalence of biomechanical, organizational and physical factors was demonstrated in tanneries. With regard to chemical agents the lack of any priority of intervention could be due to the lack of information on the chemicals used. In the 2 enterprises that used mechanical processes the results showed different priorities for intervention and a different level of the extent of such intervention. In particular in the first enterprise biomechanical overload was a top priority, while in the second the results were very similar to those of the tannery. The analysis showed in both companies that there was a high prevalence of risk of upper limb biomechanical overload in leather bag manufacture. Chemical risk assessment was not shown as a priority because the list of chemicals used was neither complete nor sufficient.
The risk pre-mapping data sheet allowed us to obtain a preliminary overview of all the major existing risks in the leather industry. Therefore the method can prove a useful tool for employers as it permits instant identification of priorities for intervention for the different risks.
La Medicina del lavoro 01/2011; 102(1):29-42. · 0.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Occupationally, there are a number of work processes that constitute a long-term risk as sources of exposure to lead. In these processes the presence of lead is not evident but represents a hidden risk of poisoning.
Study of two cases of hidden exposure to lead that were discovered during renovation work on a historical building.
Acute lead poisoning symptoms appeared in the 2 workers. The current protocol for treatment of lead poisoning was applied, which consisted in administration of a chelating agent (EDTA), with subsequent monitoring of indicators of dose (PbB. blood lead level, PbU: urinary lead level) and indicators of effect (erythrocyte Protoporphyrin IX, urinary delta-aminolevulinic acid (ALA-U), urinary coproporphyrins).
The lead colic and anaemia appeared at PbB values (102 microg/dl e 104 microg/dl) that were higher than the PbB action value (40 microg/dl) and higher than the limit value (60 microg/dl).
The gravity of the symptoms, the high number of persons potentially involved, the difficulty of reclamation and probable urban contamination, with relative consequences concerning particularly infants and women infertile age, are sufficient grounds to require effective legislative action and improvement in the services available at the hospitals involved.
La Medicina del lavoro 09/2010; 101(5):335-40. · 0.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Chloramine T is used in hospitals as a disinfectant and for sterilization of endoscopy instruments.
A case of a nurse suffering from asthma due to Chloramine T is presented in order to focus attention on this occupational disease.
The patient (male, 43 years) had been a nurse since 1993, working in various departments and operating rooms where he was exposed to glutaraldehyde and Chloramine T to disinfect surgical and endoscopy instruments. In 2007 he noticed the beginning of asthmatic reactions after exposure to the disinfectant. Skin tests with common allergens gave positive reactions and a skin test with Chloramine T gave a positive result. An inhalation test with glutaraldehyde gave negative results for both asthma and rhinitis. During the inhalation test with Chloramine T 0.5%, a significant biphasic decrease in FEVI was observed. The score of subjective symptoms for rhinitis was negative,
The case confirms the current difficulty in diagnosing occupational asthma due to Chloramine T in health care workers, which is due to the frequent presence of late reactions and to exposure to several respiratory allergens and irritants in the workplace. The specific inhalation challenge is thus confirmed as the gold standard for the diagnosis of asthma induced by Chloramine T and in occupational asthma in general. It may very well be that the frequency of occupational asthma due to sensitization to Chloramine T in nurses is underestimated.
La Medicina del lavoro 03/2010; 101(2):134-8. · 0.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Interventions of health promotion (HP) with the best evidence of effectiveness are reported in literature. However nothing is said about how to apply these interventions in the local specific situations. On the other hand in literature the role of the occupational physician in workplace HP is not highlighted. Currently there is a substantial amount of knowledge on effective HP interventions that meets internationally accepted criteria, but at least in our country it is not systematically applied. While several databases provide useful information on different HP programs, the Cochrane Collaboration systematic reviews should be considered the most reliable source.
Giornale italiano di medicina del lavoro ed ergonomia 01/2010; 32(4 Suppl):448-51.
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: On 29 March 2008 the International Commission on Occupational Health (ICOH) Scientific Committee on Occupational and Environmental Dermatoses organized a Skin Notation Workshop hosted by the 11th International Percutaneous Penetration Perspectives Conference (La Grande Motte, France). Skin notation (S) was chosen as a topic for discussion because this is the only example of existing regulation in the field of dermal risk assessment. The issue was discussed in a previous workshop held in Siena, Italy in 2006 with the objective of focussing on the problems related to S, the different assignment criteria and the attempts to improve the S system made by various international and governmental agencies. A position paper was subsequently published. OBJECTIVES: The workshop in France was a continuation of this activity with the aim of evaluating how the different strategies can improve S. METHODS AND DISCUSSION: The Workshop was divided into two sessions. The first was dedicated to lectures focused on different aspects of S. In the second session participants discussed key issues with the aim of exploring the actions needed to improve international S. systems.
La Medicina del lavoro 01/2010; 101(1):3-8. · 0.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Craft features a strong link with tradition which preserves and perpetuates techniques created and consolidated over time, in a particular historical, cultural and geographical situation. Italy is home to excellent craftsmanship: fashion, furniture, giftware, design. The framework law for the craft n. 433/1985 defines the craft business carried on by the craftsman for a predominant objective of producing goods, including semi-finished or services. The D.L.gs 81/2008 defines the manner in which the employer must conduct risk assessment in the workplace and process the risk assessment document. The aim of the study is to provide employers with a simple methodology that allows the drafting of the first mapping of hazards/dangers identificating risk sources in the working process. The developed methodology is expressed as a model of information gathering, which brings to a first overview of all major risk indicators that may arise in the craftsmanship.
Giornale italiano di medicina del lavoro ed ergonomia 07/2009; 31(3):297-302.
[Show abstract][Hide abstract] ABSTRACT: WORKING HYPOTHESIS OF SIMPLIFIED TECNIQUES FOR THE FIRST MAPPING OF OCCUPATIONAL HAZARDS IN HANDICRAFTS . PART TWO: PHYSICAL AND CHEMICAL RISKS. Craft features a strong link with tradition which preserves and perpetuates techniques created and consolidated over time, in a particular historical, cultural and geographical situation. Italy is home to excellent craftsmanship: fashion, furniture, giftware, design. The framework law for the craft n. 433/1985 defines the craft business carried on by the craftsman for a predominant objective of producing goods, including semi-finished or services. The D.L.gs 81/2008 defines the manner in which the employer must conduct risk assessment in the workplace and process the risk assessment document. The aim of the study is to provide employers with a simple methodology that allows the drafting of the first mapping of hazards/dangers identificating risk sources in the working process. The developed methodology is expressed as a model of information gathering, which brings to a first overview of all major risk indicators that may arise in the craftsmanship.
[Show abstract][Hide abstract] ABSTRACT: The ICOH Scientific Committee on Occupational and Environmental Dermatoses organized an International Workshop on "Dermal risk assessment at workplace" with the aim of focussing on the different ways of approaching the concept of skin notation (S) for chemicals. The Workshop participants presented their ideas on several aspects of S such as the problems related to the absorption through the compromised skin, the different approaches to S and models that can be used as alternatives to S. Participants agreed to produce a position paper with the goal of exploring the actions needed to improve the S system towards international harmonization. They consider that further discussions are needed to obtain an international consensus, but at the same time they believe that by improving and harmonizing systems for setting S we can make an important contribution to improving health of people with potential dermal exposure to chemicals at work.
[Show abstract][Hide abstract] ABSTRACT: In this study the past professional exposure and the health state of sugar refinery workers in Arezzo (Italy) are reviewed. The medical examinations, confirmed by chest CT, showed asbestos pleural thickening and one asbestosis case. Mineralogical analysis of bronchoalveolar lavage fluid (BALF) was carried out in this population to measure the pulmonary burden. Total fiber's concentration was not different in either subjects with or without asbestos-related disease. Notably, comparison between total fiber's concentration in sugar refinery workers and subjects employed in other industries, revealed a lower professional exposure of the former with respect to shipyard workers and electric plants. In other groups of Italian sugar refinery workers, a concentration of asbestos fibers higher than in the studied population was found. Thus, the study highlights the necessity to develop standardized methodologies to carry out health intervention programmes in workers previously exposed to asbestos.
Giornale italiano di medicina del lavoro ed ergonomia 07/2007; 29(3 Suppl):644-6.