Post-occupational health surveillance of asbestos workers.

BACKGROUND: Italian law requires an extensive health surveillance of workers after cessation of their employment status in the case of occupational exposure to carcinogens, including asbestos. Nonetheless, Italian law does not specify the timeframe of these clinical checks, nor who has financial and organizational responsibility for this surveillance. A literature search confirmed a lack of consensus around the objectives and methods to follow up workers with past occupational exposure to asbestos. OBJECTIVES: To develop an updated evidence-based methodology for an appropriate health surveillance programme. METHODS: We present an overview of the field experience developed by the Veneto Region from 2000 to 2011, and new studies that could contribute to establishing a national policy for the medical surveillance of workers with past asbestos exposure. RESULTS: There were three specific topics: (1) definition of a reliable method to identify asbestos workers (through multiple sources and procedures that meet current confidentiality regulations); (2) detection of asbestos fibres in biological media (to support the etiological diagnosis of asbestos-related diseases); (3) creation of a national protocol of health surveillance (through the assessment of policies developed by other Regions in this field, and recruiting from these regions a cohort of past-exposed workers: the epidemiological study should offer relevant suggestions for specific surveillance approaches, based on either estimated cumulative asbestos exposure or detection of x-ray patterns of pleural plaques and/or asbestosis). CONCLUSIONS: These studies will support the Regions in setting up health care policies directed at workers with past asbestos exposure.

[Breath alcohol test in construction sites in the Province of Belluno: a campaign in favour of health promotion and surveillance and against drinking]. / Controlli alcolimetrici nei cantieri edili: un intervento di promozione della salute e di vigilanza nella provincia di Belluno.

BACKGROUND AND OBJECTIVES: Health impairment due to alcohol use and abuse is well known, in terms of relationship with traffic accidents and work accidents. In Italy almost 10 per cent of accidents at work involve intoxicated people injuring themselves and innocent victims. Alcohol abuse is a factor involved in determining severe accidents in the construction industry and epidemiological studies demonstrated a relationship between an elevated alcohol use and severity of accidents. Since in the Province of Belluno alcohol consumption may be elevated also at work, the two Occupational Health Units (SPISAL) in the province organized a campaign of information and surveillance against alcohol consumption at work in the construction industry. This report shows the campaign results, mainly in terms of breath alcohol tests performed in construction workers. DISCUSSION AND CONCLUSIONS: After an extensive information campaign we inspected 50 sites, where 105 construction companies were at work, and tested 294 workers by breath alcohol test. No-one refused the test. Only 2.7% construction workers were positive for the breath alcohol test, and the levels were not elevated. This study shows that the construction workers in Belluno Province are responsible drinkers and are well aware of the policy of prohibition of alcohol consumption at work.

Prevalence of second-hand smoke exposure after introduction of the Italian smoking ban: the Florence and Belluno survey.

AIMS AND BACKGROUND: A law banning smoking in enclosed public places was implemented in Italy on January 10, 2005. The aim of this paper is to present a cross-sectional survey on two representative samples of non-smokers of two Italian towns (Florence and Belluno), conducted one year after the introduction of the ban, in order to assess prevalence of second-hand smoke exposure, to record the attitudes towards the ban, and the perception about its compliance in a representative sample of non-smokers. METHODS: Computer-assisted telephone interviews were carried out in March 2006, from a random sample of households from telephone registries. Respondents were 402 non-smokers from Belluno and 1,073 from Florence. RESULTS: About 12% of Florentines and 7% of Belluno respondents were exposed at home; 39% and 19%, respectively, at work; 10% and 5% in hospitality venues; 20% and 10% in cars. The smoke-free law was almost universally supported (about 98%) even if a smaller proportion of people (about 90%) had the perception that the ban was observed. CONCLUSIONS: Second-hand smoke exposure at home and in hospitality premises has dropped to < or = 10%, whereas exposure at work remained higher. These results suggest the need for more controls in workplaces other than hospitality venues.

[Second-hand smoke exposure in Florence and Belluno before and after the Italian smoke-free legislation]. / Esposizione a fumo o passivo a Firenze e a Belluno prima e dopo l'entrata in vigore del divicto di fumo in Italia.

INTRODUCTION: a law banning smoking in enclosed public places entered into force in Italy on January 10th 2005. OBJECTIVE: to compare the SHS exposure before and after the coming into force of the new anti-smoking law, with direct measurements in public venues and workplaces. METHODS: vapour-phase nicotine was measured using passive samplers, with personal and environmental sampling. SETTING: samples were collected in 10 municipality offices, 10 industry buildings and 11 public venues (4 discos and 7 pubs) in two towns (Florence and Belluno) from november 2004 to march 2005. RESULTS: during the pre-ban period a wide range of nicotine concentrations was observed. Offices and industry sector exhibited very low concentrations, 0,47 e 0,40 microg/m3 in median, respectively. Highest concentrations were measured in pubs and discos (35,59 and 127,16 microg/m3). After the smoking ban, a noteworthy reduction in nicotine concentrations was found with a stronger effect in pubs and discos (95% of decrease). DISCUSSION: the introduction of a national smoking ban led to a clear reduction in SHS exposure, with stronger results in environments less protected by previous regulations.

Mesotheliomas among Italians, returned to the home country, who worked when migrant at a cement-asbestos factory in Switzerland.

OBJECTIVES: To report the occurrence of mesotheliomas in Italy among subjects who worked, when migrant, at a cement-asbestos factory in Niederurnen, Switzerland, and had resettled to the home country. METHODS: Information about the disease and on the working history of subjects was collected by regional mesothelioma registries. Only cases diagnosed by means of histo-pathological examinations have been considered here. RESULTS: 15 mesotheliomas (13 pleural, 2 perithoneal; 12 among males, 3 among females) have been identified among Italians, who had worked at the factory. None of them had other occupational exposure to asbestos. The majority was living in the Veneto Region (North East of Italy), and in Puglia (Southern Italy). CONCLUSIONS: Exposure to asbestos at this factory has already caused an important number of occupational cancers among the employees, a large fraction being constituted of migrants. In order to avoid under-estimation of risks and to allow compensation, diseases which occur among foreign workers returned to their home country should be evaluated. Migration for work is at the genesis of asbestos-related mesotheliomas now occurring in Italy.