Analysis of appeals against the ruling of occupational physicians lodged with the Prevention and Occupational Epidemiology Operative Unit, ASP Palermo (Palermo Health Authority), from 2008-2010.

INTRODUCTION: The responsibility of the Department for Prevention and Safety at the workplace of the Palermo Health Authority (ASP) is to monitor and coordinate the activity of occupational physicians operating in Palermo and its province. One of its obligations is to examine appeals "against the judgment of occupational physicians", "..and, after carrying out further investigation, confirm, modify or reverse the ruling itself" (art. 41, par. 6, legislative Decree 81/08). OBJECTIVES: The purpose of this study was to analyze the appeals lodged against a judgment of fitness for work" submitted to the "Health Prevention and Occupational Epidemiology Operative Unit" of the Department of Prevention and Safety at the Workplace of the ASP Palermo, from 2008 to 2010. METHODS: The total number of appeals lodged during the three-year period was 211, 174 of which were finalized. RESULTS: The most frequent job category among the appellants was that of blue-collar workers, in various sectors, covering 44.5% of the subjects under study (93 cases). In 64.2% of the processed appeals (131 cases), the judgment of the physician was modified, while in the remaining 36.8% (73 cases) it was confirmed. The work fitness judgment with restrictions was the category against which most appeals were lodged, and the diseases in question mostly concerned the osteoarticular and cardiovascular systems. CONCLUSION: In a context of continuous change in the labour field and the related risks to the health and safety of workers, the occupational physician must approach the worker in a comprehensive manner, through an assessment of the possible health problems and the working environment in which he/she operates.

[An analysis of appeals against the ruling of the occupational physician's lodged to the Department of Prevention and Safety in the Working Environment--Health Prevention and Occupational Epidemiology Operative Unit within the A.S.P. Palermo (Palermo Health Authority), years 2008-2010]. / Analisi dei ricorsi "avverso giudizio del Medico Competente (M.C.)" inoltrati all'U.O.S. "Prevenzione Sanitaria e Epidemiologia occupazionale" del Servizio di Prevenzione e Sicurezza negli Ambienti di Lavoro" dell'ASP di Palermo nel periodo 2008-2010.

The purpose of this study is to analyze the appeals against a "suitability judgment for work" lodged to the U.O.S. "Health Prevention and Occupational Epidemiology Operative Unit" of Department of Prevention and Safety in the Working Environment within the ASP Palermo (U.O.S.), from 2008 to 2010. Studying the appeals gives an indirect view on the occupational physician activity and allows to monitor their actions, analysis aims at highlighting those issues around which any planning and implementation of coordination activities should be focused.

[Professional exposure to hardwood dusts in a group of Sicilian joiners]. / Esposizione professionale a polveri di legno duro in un gruppo di falegnami siciliani.

Wood is a system of vegetable tissues chemically formed by biopolymers (90-99%) and phenolic substances, alkaloids, glucosides and saponins (1-10%). There are two botanical groups of wood: hardwood and softwood. Aim of present study was the research of possible work related diseases with professional exposure to hardwood about 25 joiners of Palermo in 2006; in fact wood dust inhalation is very dangerous for workers health because it is cancerogenous for nasal and paranasal sinus (1 IARC). We studied beech and fraxinus dusts (hardwood) and mahogany and teak dusts (exotic hardwood) in the environmental air of joiners during wood cutting and finishing touch. We also analysed exposed workers registry to know joiners duties, exposure values to wood dust, inhalatory exposure, wood type, chemical components, individual protection safety devices, environmental protection means. Then we examined workers medical case and risk histories. At the end we noticed that particle material in environmental air was regular according law reference values (D.Lgs. 66/2000: TLV-TWA 5 mg/m3); but although environmental dust values were normal, we found nasal haemorrhages in 3 workers and vasomotory headache in other 3; we also diagnosed one paranasal sinus polypus and then irritative contact dermatitis in 3 workers. So there is an answer: "can current TLV-TWA be protective and sure? And can it guarantee health of hardwood exposed workers?".

[Occupational exposure to environmental pollution: observational study about a newspaper-agents group]. / Esposizione professionale ad agenti inquinanti ambientali: studio osservazionale su un gruppo di edicolanti della città di Palermo.

UNLABELLED: Environmental pollution constantly menaces urban people's health. This public-health question has a remarkable interest in occupational medicine, because some professions require operations outdoor for most of the day. Therefore airborne pollutants could be considered occupational risk factors. Our object is health evaluation of a newspaper-agents group of Palermo, in association with pollution level monitored during the 2006. We examined these subjects regarding especially lung, ear, kidney, liver and cardiovascular system, with particular consideration for endothelial structure. RESULTS: high prevalence of carotid artery damage can't exclude a concausal role of airborne pollutants.

[Observational study on a group of health care workers assigned to antiblastic drugs manipulation in three Sicilian hospitals]. / Studio osservazionale su un gruppo di operatori sanitari addetti alla manipolazione di farmaci antiblastici di tre nosocomi siciliani.

UNLABELLED: Neoplastic disease therapy problems, e.g. antiblastic drugs manipulation, is developing. We suggested correlation assessment between the lasting professional workers' exposition of three city hospital and disease development. We selected 43 exposed workers; we gave a questionnaire regarding the modality of activity; then we examined this sample with a protocol including clinical examination and special tests (blood tests, ECG, audiometry and spirometry). RESULTS: over 55% of the workers reported aspecific complaint related to antiblastic exposure (headache, nausea, vertigo, dermatitis, alopecia, rhino-conjunctivitis, asthenia, parageusia, fauces dryness); we registered, instead, the absence of significant diseases related to antiblastic drugs exposure, because of both environmental and personal prevention, and clinical surveillance co-ordinated by occupational physician.

[Considerations on correct diagnosis of atypical electrocardiographic T-wave findings in young subjects]. / Considerazioni per un corretto inquadramento diagnostico delle atipie elettrocardiografiche giovanili dell'onda T.

An analysis is made of the significance of the occasional observation of asymptomatic T-wave changes (inversion). The authors maintain that only an overall evaluation of the anamnestic, clinical and laboratory findings will enable the physician to make a correct diagnosis and exclude from the start, via coordinated protocols, any silent ischaemic disease, and also a series of clinical conditions that the ECG can reveal as this disease. In this connection the authors report a clinical case that is deemed interesting due to the finding of ECG anomalies in an asymptomatic young, athletic subject observed during a periodical medical examination for the purpose of certifying fitness for a specific type of work.

[The epidemiological trend of brucellosis in the provinces of Sicily]. / Considerazioni sull'andamento epidemiologico della brucellosi nelle province siciliane.

The epidemiological trend of brucellosis in Italy has been uneven over the last few years since there was a decrease in incidence in some regions and an increase in others, including Sicily. The peak was reached in 1997 when 59% of the cases were reported in Sicily alone. Appropriate intervention strategies are therefore needed both as regards the general population and exposed workers in order to reduce the spread of this disease.