Post-traumatic stress disorder among bank employee victims of robbery.

BACKGROUND: Post-traumatic stress disorder (PTSD) in the occupational context, especially following workplace robbery, is still under-investigated. AIMS: To evaluate PTSD incidence and risk factors among bank employee victims of robbery voluntarily joining an employer-sponsored post-robbery support programme. METHODS: The programme entailed a structured support interview with robbery victims within 15 days of the robbery and a follow-up psychological assessment 45 days after. A self-reported questionnaire on personal variables and robbery characteristics was administered to participants at the first support session (T1). Interviews on employees' psychophysical health and their opinion about the support programme were administered individually at follow-up (T2). The Impact of Event Scale (IES) was administered both at T1 and T2. RESULTS: There were 383 participants. At T2, 13% of subjects had an IES score >34, a cut-off suggestive of PTSD. In a multi-variate model, feelings of helplessness and terror during the robbery and the number of previous robberies were associated with a PTSD diagnosis. After including IES score at T1, other variables lost statistical significance. CONCLUSIONS: Our findings showed that PTSD is common among employee victims of workplace robbery. Our results also suggest the importance of subjective variables, such as personal perception of robbery severity and early emotional reaction, in identifying people at higher risk of developing PTSD.

[Bus drivers' biomechanical risk assessment in two different contexts]. / La valutazione del carico biomeccanico degli arti superiori nella conduzione di autobus e tram: primi risultati di due esperienze in contesti differenti.

The application of standardize methods for the biomechanical risk assessment in non-industrial cycled activity is not always possible. A typical case is the public transport sector, where workers complain of suffering for shoulder more than elbow and wrist pains. The Authors present the results of two studies involving two public transport companies and the risk of biomechanical overload of upper limbs for bus and tram drivers. The analysis has been made using three different approaches: focus groups; static analysis by using anthropometric manikins; work sampling technique by monitoring worker's activity and posture at each minute, for two hours and for each binomial vehicle-route, considering P5F e P95M drivers and assessing the perceived efforts thorough the Borg's CR10 Scale. The conclusive results show that the ergonomic analysis managed by multiple non-standardized techniques may reach consistent and repeatable results according to the epidemiological evidences.

[Psychiatric disability and work: assessment of a group of patients examined at the Occupational Medicine Outpatient Department of the Turin University in the period 2000-2012]. / Disabilità psichica e lavoro: la valutazione di un gruppo di pazienti esaminati presso l'Ambulatorio di Medicina del lavoro del Dipartimento dell'Università di Torino nel periodo 2000-2012.

Problems at workplace with psychiatric subjects are increasing and the role of occupational physicians is basic to achieve a suitable job role. The purpose of this study is to assess the main occupational factors and to evaluate the judgement of fitness to work in 1109 patients with psychiatric diseases examined in our outpatients department during the period 2000-2012. These subjects were sent to our service by family doctors or, more frequently, by the companies seeking for judgement of the working residual capacities. The psychiatric diseases were classified according to the DSM IV; for each group considered, we evaluated the production sector, the specific job role, the pharmacological therapy as compared to the final judgement. The most frequent diagnoses were depressive and anxious disorders. The pharmacological therapy does not seem to be related to the final judgement but the small number of subjects defined as unfit to work does not allow a final evaluation. The study suggests the relevance of team work among the different actors of prevention to achieve a successful management of these workers in a specific job role.

[Silica classification and labelling under REACH and CLP regulation]. / Il problema della classificazione ed etichettatura della silice cristallina alla luce del REACH e del regolamento CLP.

Following literature data the evaluation CLP classification and labelling criteria doesn't support the decision to classify respirable crystalline silica (RCS) as carcinogen and suggests to consider RCS as:--STOT (Specific Target Organ Toxicant) RE (Repeated Exposure) cat.l by inhalation in case of concentration > or = 10%--STOT RE cat. 2 by inhalation in case of concentration 1 divided by 10%--Not classifiable as dangerous for human in case of concentration < 1%.

[The issue of medico-legal assessment of noise induced hearing loss: comparison of methods]. / II problema della valutazione medico-legale della ipoacusia da trauma acustico cronico: confronto tra metodi.

Audiogram classification is crucial for hearing protection of workers occupationally exposed to noise. The methods that have been proposed are based on two principles: the morphological evaluation of the audiometric curve (eg. Merluzzi-Pira-Bosio--MPB) or the average hearing loss on different frequencies (eg. Albera-Beatrice--AB). The purpose of this study was to classify audiograms compatible with chronic acoustic trauma performed at the Occupational Medicine Outpatient Clinic of CTO Hospital in Turin from 2004 to 2011 with the methods outlined in Guidelines published by SIMLII. A substantial agreement among the methods was observed. While MPB is the most appropriate method for secondary prevention, the AB would seem more appropriate for the verification of a permanent weakening that has to be reported to the competent legal authorities.

[Exposure talc effects on lung function: longitudinal study on variability of respiratory parameters in talc workers]. / Effetti dell'esposizione a polvere di talco sull'apparato respiratorio: studio longitudinale delle modificazioni delle prove di funzionalità respiratoria nei lavoratori dell'industria del talco.

The study analyzes the variability of respiratory parameters in 59 workers exposed to talc at least 5 years. Cigarettes smoke seems to be the only one variable causing a FEV1 decrease while cumulative exposure doesn't influence any variable analyzed. The talc dust exposure below TLV ACGIH value has not effects on lung function. The function alterations showed are not correlated to task and to cumulative exposure.

[The radon exposure in mine: risk evaluation, risk assessment and health effects]. / L'esposizione a radon in miniera: valutazione del rischio, misure di prevenzione ed effetti sulla salute.

In mining sector, the natural presence of radon determines an exposition which deserves substantive consideration. The results of radon measure from '90 years in a talc mining show levels of radon below to the threshold limit of 400 Bq/m3, values influenced from air forced systems. The epidemiologic studies updated in a cohort of talc workers between 1946 and 1995 showed no excess for lung cancer mortality. No excess was found for lung cancer mortality in miners exposed to low dose of radon.

[Progress of PTSD symptoms following workplace robbery: gender and age differences in a sample of bank employees]. / Decorso della sintomatologia psichica post-traumatica conseguente a rapina sul lavoro: differenze di genere e di età in un campione di bancari esposti.

This study is aimed at assessing gender-and age-related differences in PTSD symptoms in bank employees exposed to robbery and subsequently involved in Psychological Debriefing (PD). The study included 49 females and 51 males (average age 40.9). Impact of Event Scale (IES) was administered before PD (T0) and after 45 days (T1); Post-traumatic Checklist (PCL) only at T1. The sample exhibited a significant decrease in IES score regardless of gender. Female employees obtained higher IES and PCL scores. No age differences were observed. Consistent with most studies, our results may be explained by a higher susceptibility in women.

[Assessment of comfort and health status of Call Center's workers]. / La valutazione del comfort e dello stato di salute in lavoratori di un Call Center.

BACKGROUND: Call Centers are workplaces in which there are a lot of occupational health hazards. METHODS: The aim of the study was to investigate Call Center operators' health status, using: "Ambiente/Salute" questionnaire, VHI questionnaire, health surveillance data analysis. RESULTS: "Negative" Microclimate rating: 68%; "negative" noise rating: 51%. "Negative" eye symptoms rating: 30%; "negative" postural disorders rating: 21%. "Negative" VHI value (over the limit of 30): 6%. CONCLUSIONS: It's necessary to develop and validate an appropriate health surveillance protocol

[Early lung cancer detection in an occupational asbestos exposed population: clinical impact of low-dose computed tomography screening]. / Diagnosi precoce del tumore al polmone in una popolazione esposta professionalmente ad amianto--impatto clinico dello screening con TC spirale.

Lung cancer is the primary cause of cancer mortality in developed countries. Early detection and surgical resection is essential for the treatment of lung cancer. The introduction of low-dose spiral computed tomography (LDCT) is considered one of the most promising clinical research developments in early diagnosis of lung cancer. Our study is aimed at the evaluation of spiral CT in a cohort of subjects with a past occupational exposure to asbestos at high risk of developing lung cancer. 149 subjects were enrolled between 2007 and 2009 (the criteria for enrollment were date of birth between 1930-1961, no previous cancer and general good health, latency from the beginning of exposure > 10 years, exposure duration > 1 year, possibility to undergo to surgery). A helical low-dose CT (LDCT) of the chest was performed yearly and an evaluation protocol derived from IEO with a morphological analysis of nodules have been adopted. 13 nodules were diagnosed in the first CT, 7 in the second and 3 in the third but no invasive procedures have been taken and no lung cancer have been detected. Our early follow-up data aren't able yet to evaluate the effect of screening with LDCT on mortality but have do not confirm some of the literature initial results such as the Increase in cases of overdiagnosis (false positive) due to the high prevalence of benign lesions.

[Occupational cardiovascular diseases diagnosis]. / La diagnosi delle cardiovasculopatie da lavoro.

In Italy cardiovascular diseases (CD) are the main cause of death. On the number of cardiovascular diseases attributable to occupational exposure is very limited. The INAIL list of occupational diseases identifies four types of exposure able to cause a specific CD while the list of DM 19.12.2009 cites two CD with high probability to be linked to occupational exposure and two as possible occupational origin. The literature analysis shows that only the noise occupational exposure (possible origin) could cause a high prevalence of CD and that there are two different relevant occupational risk factors as stress and shift work. Consequently also CD are classifiable as work related diseases. In consequence of the difficulty to identify a good tool to evaluate the weight of occupational exposure on origin of CD, it could be advisable to focus mainly on the identification of specific activities of health prevention and promotion and to define a standard strategy of cardiopathic patient's fitness to work evaluation.

[Alimentation, health promotion and work: a strategy for alimentary education and food quality promotion]. / Alimentazione, promozione della salute e lavoro: un modello integrato di educazione alimentare e promozione della qualità del cibo.

As health promotion activity have been started two alimentary education projects for CTO Turin Hospital and LntesaSanpaolo bank group employers. Both projects have been co-ordinated by structure of Occupational Health of CTO Hospital and Turin University. The first step of the projects provided information and formation by using a brochure containing good alimentation tips. In the next step each participant at projects registered daily the food choice on specific software. At the end of observational period (six months) each participant received a final report containing quali-quantitative evaluation on the food choice uprightness. At the same time in IntesaSanpaolo bank group it have been proceeded, following Slow Food indication, on introducing a new menu based on using localfood products.

[Risk assessment of manual handling of loads: the choice of reference values in light of Leg. 81/2008]. / Valutazione del rischio da movimentazione manuale dei carichi: la scelta dei valori di riferimento alla luce del D.Lgs. 81/2008.

Italian law on safety at work does not clarify specific levels of load for safe manual material handling. For this reason professionals appointed for safety need to define new target range value for the correct application of D.Lgs. 81/2008 law. Authors, discussing about indication of the national laws and international rules, suggest the assumption of a load of 25 and 20 kg as reference values for male and female adult and healthy workers. They also examine the graduation of the acceptable loads in relation to workers' age and the Lifting Index values to be adopted as action limit and exposure limit.

[The role of occupational physician in the application of the 2006 "agreement on workers' health protection through the good handling and use of crystalline silica and products containing it": the experience in mining sector]. / Il ruolo del medico competente nell'applicazione dell'accordo europeo sulla silice: l'esperienza nel settore estrattivo.

The 2006 "Agreement on Workers' Health Protection Through the Good Handling and Use of Crystalline Silica and Products Containing it" between social parts defines a standardization of exposition control methods and medical surveillance. The Occupational Physician is integral part in exposition evaluation process and risk stratification in which derives the medical surveillance program. This study presents a first application of the European agreement in mining sector and the role of Occupational Physician in the evaluation of the risk to define methods of prevention. In particular it will be precised the choice of homogenous groups, the classification of exposed workers from results of workplace monitoring, the choice of technical prevention and individual protection equipments, and then the strategy of medical surveillance.

[The evaluation of workplace visual characteristics and ophthalmologic requirements to define fitness to work]. / Valutazione delle esigenze visive del posto di lavoro e requisiti oftalmologici per l'idoneità alla mansione specifica.

It's necessary to proceed to an evaluation of visual function to define principal ophthalmologic requirements and fitness to work in relation of workplace characteristics. We also have to consider the effects of age on visual function, the specific work risks on eyes and sight care especially for near sight. The evaluation of these parameters permits to verify the compatibility between the psychophysics characteristics of workers and the requests of tasks and then to define fitness to its work. Moreover to the visual functions we have to consider organic visual conditions like conjunctivitis, blepharitis, stenosis of lacrimal gland, dacriocystitis, retinic diseases, muscular motility alteration of the eyes, glaucoma. Our study shows the relation between ophthalmologic requirements of workers and some job groups like professional drivers, technical clerks, precision work, height level workers and proposes a standard method to define fitness to work. Our standard method permits a specific and homogeneous evaluation of fitness to work.

[Application of a protocol for assessing occupational fitness of workers with UE-WMSDS in a second-level hospital center: first results]. / Applicazione di un protocollo di valutazione dell'idoneità lavorativa di soggetti affetti da UE-WMSDS in un centro ospedaliero di secondo livello: primi risultati.

It's presented a cluster of 99 workers affected by UEWMSDs examinated in the Occupational Medicine Department--University of Turin. The object of the evaluation is the critical exam of ergonomic informations, the evalution of the fitness to work and the customed return to work.

[A rapid model of risk assessment of the biomechanical overload to the whole skeletal system]. / Metodo semplificato per l'individuazione del rischio di sovraccarico biomeccanico del sistema osteoarticolare.

A tool easy to apply is presented that can be used in ergonomic analysis of 1st level to identify the risk factors of biomechanical overload of the skeletal structures. The model is an evolution of a previous proposal, published in 2001, which was aimed at evaluation of the only upper arms: the present model also permits the evaluation of the spine (cervical and torso-lumbar tract) and of the inferior arms. A red flag judgement criterion has been maintained and, if an item is marked, there is the possibility to recognise the cause of the ergonomic criticality and to plan the correction according to a scale of ergonomic priority. The aim of this communication is to stimulate a wide participation in the project to develop a model for the risk assessment of biomechanical overload to the whole skeletal system.

[Criteria to notify to the authorities the occupational lumbar trait diseases]. / Criteri per la denuncia ex D.M. 27/4/04 delle spondilodiscopatie del tratto lombare e dell'ernia discale lombare.

To carry out the requirement of notification according to the Italian law D.M. 27/4/04 in relation to the item "Manual handling of loads made continuously during working shift" it is necessary to clarify some quantitative and chronological aspects regarding the exposure and to precise the nature of the diseases to be notified. To fulfil their choices doctors at the moment can not rely on quantitative referrings based on the evidence and wide spread accepted, but they basically have operative indications partly taken from literature and stil under validation. However, to carry out the requirement of the law and to avoid choices not based on considered criteria, we propose some operative criteria deriving from the knowledge that at the moment seems more consolidated and accepted in the occupational and previdential medicine.

Congener-specific detection of dioxins using jet-REMPI.

Although 210 chemically different polychlorinated dibenzo-p-dioxin and dibenzofuran congeners can be produced during combustion, it is currently believed that fewer than 20 are toxic enough to warrant monitoring. SRI is developing a continuous emissions monitor to study the emission levels of these most toxic dioxins, leading eventually to an improved understanding of the formation of these molecules and to improved means of monitoring and control. We report here the first results of performing congener-specific detection for two dichloro dibenzo-p-dioxins present in low ppt concentrations in a mixture using the supersonic jet/resonantly enhanced multiphoton ionization time-of-flight mass spectrometer technique. In addition, we present preliminary data on the detection of chlorinated aromatic compounds using a two-color REMPI scheme with the same instrument.

[Hearing disability in relation to audiometric threshold values: hypothesis on the determination of the onset of hearing loss]. / Disability uditiva in rapporto alla soglia audiometrica: ipotesi sulla determinazione di insorgenza dell'indebolimento del senso dell'udito.

BACKGROUND: The term auditory disability (AD) means the presence of auditory symptoms due to hearing loss. Until now the audiometric threshold cut-off between the presence or absence of AD was not clear. OBJECTIVES: In this study we attempted to define the value of audiometric threshold that could be considered as the limit between the presence or absence of weakness of auditory function, considered as the threshold as the 95th percentile of subjects that did not report AD. METHODS: The study group consisted of 1641 males, 891 normally hearing and 750 affected by noise-induced hearing loss (NIHL) Each subject was submitted to a questionnaire specifically created in order to determine the presence of AD. RESULTS: Statistical analysis confirmed the reliability of answers to items. AD was present in 577 subjects, not all affected by NIHL. Audiometric threshold and age correlated significatively with the degree of AD. CONCLUSIONS: The results obtained allowed the audiometric threshold values to be determined at the 95th percentile of subjects who did not report AD, in relation to the average of frequencies normally used in hearing loss evaluation.