[The safety data sheets of the paint and coatings sector: analysis of the items of most interest to health and safety in the workplace]. / Le schede di dati di sicurezza del comparto vernici e rivestimenti: analisi degli elementi di maggior interesse per la salute e sicurezza nei luoghi di lavoro.

INTRODUCTION: The interlinked REACH-CLP regulations promote the sharing of knowledge regarding the risks and hazards of chemicals throughout the supply chain. The safety data sheet (SDS) is the main instrument to achieve this goal. OBJECTIVE: to study 100 SDS of paints and coatings sector in order to highlight major criticisms related to health and safety of workers. MATERIALS AND METHODS: Using the criteria prescribed by Regulation 453/2010/EC and preparing a suitable check list, some items of the sections 1 "Identification of the substance/mixture and of the company", 2 "Hazards identification", 3 "Composition/information on ingredients", the first part of section 7 "Precautions for safe handling", sections 8 "Exposure controls/personal protection" and 16 "Other information", were therefore evaluated for their appropriateness. RESULTS: Seven SDS were written in a foreign language and were excluded from further analysis. Of the remaining 93 SDS, only 23% had a proportion of adequate items greater than 80%, 49 % had adequate items between 60 and 80%, and 28% had less than 60% adequate items. The most critical sections were those relating to workers' safe handling and exposure controls and protection. CONCLUSION: In conclusion, from the analysis of SDS we found high percentages of inadequacy, especially in sections 7 and 8, the most relevant for the protection of the health and safety of workers.

[The Lombardy Mesothelioma Register, Regional Operating Centre (ROC) of National Mesothelioma Register: organizational aspects]. / Il Registro mesoteliomi Lombardia, Centro Operativo Regionale (COR) del Registro nazionale mesoteliomi: aspetti organizzativi .

The Lombardy Mesothelioma Register (LMR) collects all incident cases of Malignant Mesothelioma (MM) occurring since January 1, 2000 in residents of the Lombardy Region. For each "possible case" reported to the Registry by Lombardy hospitals, diagnosis is ascertained through examination of clinical records (including histology reports) according to ISPESL Guidelines. For confirmed cases, a standardized questionnaire is administered to the subject or next-of-kin in order to verify the possible sources of asbestos exposure in his/her lifetime. A panel composed of industrial hygienists, occupational health physicians and occupational epidemiologists evaluate asbestos exposure in the workplace and environmental settings. Case ascertainment completeness is routinely verified using other sources such as hospital discharge records and death certificates coded as 163 (ICD IX). In the period 2000-2004, 1563 cases were collected, of whom 887 have been evaluated: the diagnosis was confirmed for 626 (70.6%) 9 out of 887 evaluated cases. The age and gender standardized incidence rate for pleural mesothelioma in the Lombardy Region, in the year 2000 (the only one with completed data), was 2.4 (males 3.7; females 1.4) per 100,000 residents/year The 70.5% of certain and probable MM has an asbestos exposure, in particular the 64.5% of cases has an occupational exposure. The experience gathered over the years by the LMR has allowed to implement an efficient information network among different institutions and health services. In addition practical skills have been gained in processing epidemiological data, a useful tool to address new scientific hypothesis and to plan ad-hoc researches. In our experience the LMR represents a potential resource transferable to the epidemiological surveillance of different occupational tumours (i.e. sino-nasal cancers).

[Asbestos exposure in the non-asbestos textile industry: the experience of the Lombardy Mesothelioma Registry]. / Esposizioni professionali nel settore tessile non-amianto in Lombardia: i dati del Registro Regionale.

The Lombardy Mesothelioma Registry, activated in 2000, receives more than 300 cases per year of suspected malignant mesothelioma; the standardized (age and gender) incidence rate of pleural mesothelioma is 2.4/100,000 inhabitants (CI 95% 2.0-2.7). The finding of an increasing number of cases among workers of the non-asbestos-textile industry, classified as "unknown exposure to asbestos", upheld the suspect of presence of asbestos in this compartment. Specific information about a possible asbestos exposure were collected by technicians, maintenance personnel and other experts; industrial machinery utilized in the past was thoroughly examined; direct inspections were carried out in several workplaces that had not yet undergone significant changes with respect to the past. A large amount of asbestos had been regularly used on the ceilings and also to the walls of factories in order to avoid both condensation of steam and reflection of noise. In addition, asbestos had also been widely used to insulate water and steam pipes. The braking systems of most of machines also had asbestos gaskets, and on several looms some brakes operated continuously. The population in study was composed of 119 subjects, 27 males and 92 females, median age of 72 years. Asbestos exposure was ascribed to work in 106 cases (89%). The system devised by the Lombardy Registry had brought to light an occupational hazard in a professional area previously never believed as a source of asbestos exposure. In consideration of the described experience, both environmental and clinical, it seems reasonable to consider the non-asbestos-textile as a new department at risk for asbestos exposure.

[Malignant mesothelioma of the pleura in a truck driver]. / Mesotelioma maligno della pleura in un autotrasportatore.

BACKGROUND: Among the responsibilities of the health operators in the occupational health and safety services of the local health units in Lombardy (Italy) is the administration of standardized questionnaires for the investigation of possible occupational exposure to asbestos fibres in subjects diagnosed with malignant mesothelioma. OBJECTIVES: To describe a case of malignant mesothelioma in a truck driver suspected of being occupationally exposed to asbestos during the course of administration of the questionnaire. METHODS: Analysis of the literature regarding asbestos contamination of truck cabs. Some years ago Italian authors described a case of asbestosis in a truck-driver and findings of pollution by asbestos fibres in the cabs of some models of trucks. RESULTS: The subject had worked for more than 30 years as a truck driver operating on long distances on truck models described in literature as contaminated by asbestos fibres. He had not transported materials made of asbestos, and had not carried out maintenance on the trucks, nor had he any non-occupational sources of exposure to asbestos. Thus the mesothelioma was related to occupational exposure and procedures were initiated for reporting a suspected occupational disease.

[Cluster cases of malignant pleural mesothelioma in an oil factory]. / Cluster di casi di mesotelioma maligno della pleura in un oleificio.

BACKGROUND: The traditional occupational hazards of the productive cycle of oils are attributable to chemicals (use of solvents, pesticides and other agents), dusts, labour accidents (trauma, ignition, explosion), noise, manual lifting, work organization and hot-wet microclimate. The latest risk is due to the use of high temperatures (from 50 up to 250 degrees C) during the processes of extraction with solvent and refining. No cases are reported in literature of asbestos related disease in subjects who worked in oil factories. Nevertheless the structure and organization of the workplace, which is similar to that of sugar refineries, where cases of malignant mesothelioma have been described (moreover in workers employed in running and maintenance of the plants), led to the assumption that even in oil factories asbestos for the insulation of pipes and boilers could be present. OBJECTIVES: To describe 3 cases of Malignant Mesothelioma that occurred in workers of the same oil factory. METHODS: Since this occupational sector is not conventionally known for asbestos exposure the Local Health Unit and the Lombardy Mesothelioma Registry decided to investigate this industrial plant. RESULTS: Following examination of the archives of the Local Health Unit and inspection of the plant, an environmental asbestos contamination (pipes and boilers) was found. The 3 cases were defined as occupational disease and the required legal procedures were initiated. This underlines the importance of close cooperation with Local Health Units of occupational medicine and the Regional Mesothelioma Registry in the study and acknowledgment of cases which would otherwise not have been recognized, with consequent loss of precious information.

[Malignant mesothelioma of the pleura in a worker with brief atypical exposure to chrysotile asbestos]. / Mesotelioma maligno della pleura in un lavoratore con breve esposizione atipica ad amianto crisotilo.

BACKGROUND: The appearance of malignant mesothelioma in workers exposed to asbestos dusts even for relatively short periods of time is amply demonstrated in the literature. The workers however were usually exposed to amphiboles in jobs well known as involving exposure, that are characterized by high levels of dusts. OBJECTIVES: To describe a clinical case of pleural mesothelioma that occurred in a patient exposed to chrysotile, in a job (driver) that cannot be directly linked to such high exposure, and which moreover he only did for a few months. METHODS: The clinical history was reconstructed by analyzing the clinical files of the hospital admittances from May 2002 to August 2003, during which the patient underwent radiological examinations (chest x-rays, chest and abdomen TC), cytological examination of the pleural fluid, videothoracoscopic surgery with histological examination (including immunohistochemical coloration) of the tissue taken in biopsy. The job history, as well as any possible non-occupational exposures to asbestos, was examined via a standardised questionnaire, which the patient himself answered, as used in the Lombardy Mesothelioma Register, in operation at the "Clinica del Lavoro" in Milan. RESULTS: Examination of all clinical files confirmed the diagnosis of malignant pleural mesothelioma. Analysis of job history was found appropriate for defining as certain an occupational aetiology due to inhalation of asbestos fibres which occurred for few months as a truck driver in a chrysotile mine.