[Promoting the quality of health surveillance of workers exposed to wood dust, with particular care to NPSC, in the territory of the Health Agency of Florence]. / Promozione della qualità della sorveglianza sanitaria dei lavoratori esposti a polvere di legno, con particolare riferimento ai TuNS, nel territorio di competenza della Azienda Sanitoria di Firenze.

Wood dust can cause occupational-related naso-sinusal cancer, characterized by a latency period of about 40 years. The Tuscany Cancer Registry estimates that cases of NPSC are from 20-25 per year into the Region (33% related to wood dust). These neoplasms are surgically treatable at early-stage and, for this reason, a rapid endoscopic diagnosis is considered to be reasonably useful for prognostic issues. We used a questionnaire to investigate nasal symptoms and NOSQ and SOLAR questionnaires to highlight respiratory/skins diseases, and a spirometry for each worker. Subjects with a working-age of more than 15 years, and those that were positive to the questionnaire and/or to the medical history were were referred to a specialist in otolaryngology. The prevalence of endoscopic positive findings--detected especially in subjects with a working age of more than 15 years--confirms the significance of the problem.

[Collaboration between occupational doctors in the public prevention services and qualified occupational doctors: description of an experience in the sandstone sector of Alto Mugello]. / Il rapporto tra medico del lavoro nei servizi pubblici di prevenzione e medico competente: descrizione di un'esperienza nel comparto lapideo dell'Alto Mugello.

BACKGROUND: The present course of work-related injuries imposes an effective collaboration among public service's doctors and qualified occupational doctors. We refer to a positive interaction in a prevention plan of hand-arm vibrations exposure during phases of dressing in the sandstone sector of Alto Mugello. METHODS: Both were acquired data on exposition (risk assessment, measures on tools, times and levels of exposition, etc.) and data on workers' health (an high number of workers showed suspect angioneurotic disorders). The symptomatic workers were subjected to a clinical-instrumental examination that highlighted a clear correlation between high hand-arm vibrations exposition and functional injury. RESULTS: Sharing informations is a precious tool both for Public Prevention Services, it enables in fact to realize an accurate representation of workers' health state, and for qualified occupational doctors to manage risk with employers and to carry out an effective health surveillance.

Respiratory risks in tunnel construction workers.

Respiratory diseases are frequent in tunnel construction workers. A group of 144 subjects randomly selected from the population of 2516 workers engaged in the construction of the railway tunnel under the Appennine Mountains, from Bologna to Firenze was investigated. A group of 69 males comparable for age, living area and habits was studied as a control group. Assessment of air pollutants (NO, NO2, SO2, total dust, silica %) was carried out by means of fixed monitoring stations as well as personal monitors. All the subjects included in the study were examined with a standardised protocol which included physical examination, lung function tests (before and after shift work) and a questionnaire to college respiratory symptoms. Low concentrations of environmental pollutants were evidenced. Significantly lower values of FEV1 and PEF were determined in the worker group pared to controls. A significant decrease in respiratory parameters was shown after shift work. Variables capable of influencing the decrease in parameters include smoking habits, work activity, presence of cough and expectoration, period of the year (spirometries resulted worse in the winter time). Significantly lower values of FEV1 and PEF were evidenced in the workers compared to controls. In spite of the present low work environmental exposure conditions, some physiologic parameters appear altered in tunnel construction workers. This may depend on a variety of noxious agents present in the working environment.