RESUMO
OBJECTIVE: Psychological suffering in patients with Malignant Mesothelioma (MM) is different from the one experienced by patients with other cancers due to its occupational or environmental etiology and its peculiar symptomatology and prognosis (i.e., poor prognosis, reduced effectiveness of the therapies, poor quality of residual life, and advanced age at the time of diagnosis). Therefore, the Mesothelioma Psychological Distress Tool-Patients (MPDT-P) has been developed to evaluate the specific profile of psychological suffering in this population. This paper describes the item selection, factor analysis, and psychometric evaluation of the revised MPDT-P. METHODS: The analyses of the current work aimed to confirm the factorial structure found in the first version of the MPDT-P. In the case of nonfit, it aimed to find an alternative structure and causes of nonfit in the model. The search for the fit of the factorial model was conducted using a Bayesian approach. RESULTS: The two-factor model reported in the first version of the instrument did not fit the data. Confirmatory Bayesian analyses showed adequate fit for the three-factor solution. Based on the content of the items, we labeled the factors as dysfunctional emotions, claims for justice, and anxieties about the future. CONCLUSIONS: Integrating the MPDT-P into clinical practice could help clinicians gain insight into the specific suffering related to MM and investigate potential differences related to different occupational and environmental exposure contexts.
Assuntos
Mesotelioma Maligno , Medidas de Resultados Relatados pelo Paciente , Angústia Psicológica , Psicometria , Humanos , Mesotelioma Maligno/psicologia , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Análise Fatorial , Teorema de Bayes , Mesotelioma/psicologia , Neoplasias Pulmonares/psicologia , Inquéritos e Questionários , Estresse Psicológico/psicologia , Adulto , Reprodutibilidade dos Testes , Qualidade de Vida/psicologiaRESUMO
Climate change is increasingly affecting human well-being and will inevitably impact on occupational sectors in terms of costs, productivity, workers' health and injuries. Among the cooling garment developed to reduce heat strain, the ventilation jacket could be considered for possible use in workplaces, as it is wearable without limiting the user's mobility and autonomy. In this study, simulations with a sweating manikin are carried out to investigate the effects of a short-sleeved ventilation jacket on human thermophysiological responses in a warm-dry scenario. Simulations were performed in a climatic chamber (air temperature = 30.1 °C; air velocity = 0.29 m/s; relative humidity = 30.0 %), considering two constant levels of metabolic rate M (M1 = 2.4 MET; M2 = 3.2 MET), a sequence of these two (Work), and three levels of fan velocities (lf = 0; lf=2; lf=4). The results revealed a more evident impact on the mean skin temperature (Tsk) compared to the rectal temperature (Tre), with significant decreases (compared to fan-off) at all M levels, for Tsk from the beginning and for Tre from the 61st minute. Skin temperatures of the torso zones decreased significantly (compared to fan-off) at all M levels, and a greater drop was registered for the Back. The fans at the highest level (lf=4) were significantly effective in improving whole-body and local thermal sensations when compared to fan-off, at all M levels. At the intermediate level (lf=2), the statistical significance varied with thermal zone, M and time interval considered. The results of the simulations also showed that the Lower Torso needs to be monitored at M2 level, as the drop in skin temperature could lead to local overcooling and thermal discomfort. Simulations showed the potential effectiveness of the ventilation jacket, but human trials are needed to verify its cooling power in real working conditions.
Assuntos
Regulação da Temperatura Corporal , Sudorese , Humanos , Regulação da Temperatura Corporal/fisiologia , Temperatura Alta , Manequins , Temperatura Cutânea , Condições de Trabalho , Local de Trabalho , RespiraçãoRESUMO
INTRODUCTION: The epidemiological surveillance of mesothelioma incidence is a crucial key for investigating the occupational and environmental sources of asbestos exposure. The median age at diagnosis is generally high, according to the long latency of the disease. The purposes of this study are to analyse the incidence of mesothelioma in young people and to evaluate the modalities of asbestos exposure. METHODS: Incident malignant mesothelioma (MM) cases in the period 1993-2018 were retrieved from Italian national mesothelioma registry and analysed for gender, incidence period, morphology and exposure. Age-standardised rates have been calculated and the multiple correspondence analysis has been performed. The association between age and asbestos exposure has been tested by χ2 test. RESULTS: From 1993 to 2018, 30 828 incident MM cases have been collected and 1278 (4.1%) presented diagnosis at early age (≤50 years). There is a substantial association between age at diagnosis and the type of asbestos exposure and a significantly lower frequency of cases with occupational exposure to asbestos (497 cases vs 701 expected) in young people has been documented. Paraoccupational and environmental exposure to asbestos have been found more frequent in young MM cases (85 and 93 observed cases vs 52 and 44 expected cases, respectively). CONCLUSIONS: Mesothelioma incidence surveillance at population level and the anamnestic individual research of asbestos exposure is a fundamental tool for monitoring asbestos exposure health effects, supporting the exposure risks prevention policies. Clusters of mesothelioma incident cases in young people are a significant signal of a potential non-occupational exposure to asbestos.
Assuntos
Amianto , Mesotelioma Maligno , Mesotelioma , Exposição Ocupacional , Neoplasias Pleurais , Humanos , Adolescente , Pessoa de Meia-Idade , Mesotelioma Maligno/complicações , Incidência , Mesotelioma/epidemiologia , Mesotelioma/etiologia , Amianto/efeitos adversos , Exposição Ocupacional/efeitos adversos , Itália/epidemiologia , Sistema de Registros , Neoplasias Pleurais/epidemiologia , Neoplasias Pleurais/etiologiaRESUMO
OBJECTIVE: To develop a short, flexible, and comprehensive tool to measure psychological distress in caregivers of malignant mesothelioma (MM) patients: the Mesothelioma Psychological Distress Tool-Caregivers version (MPDT-C). METHODS: Based on a systematic review of the relevant literature, aspects associated with caregiver distress were derived. Expert researchers/clinicians developed a pool of items for each identified aspect. Content validity was assessed through a multiple mixed-methods approach. A multicenter study was conducted to explore the factorial structure of the 47-item MPDT-C through Bayesian factor analysis. RESULTS: The Bayesian exploratory factor analysis revealed an underlying three-factor structure. Factors were labeled Secondary Traumatic Stress, Engagement in Caring, and Meaningful Cognitive Restructuring. All scales showed sufficient reliability and corrected item-total correlations. Females scored higher than males for Engagement in Caring. CONCLUSIONS: Taking care of malignant mesothelioma patients is a stressful process that influences the caregiver's physical, emotional, and social wellbeing. Our study offers preliminary evidence in support of the adequate psychometric properties of the MPDT-C, and these should now be replicated. Results suggest that the MPDT-C is a reliable tool with which to detect the psychological distress of this traumatized population.
Assuntos
Mesotelioma Maligno , Mesotelioma , Angústia Psicológica , Teorema de Bayes , Cuidadores/psicologia , Feminino , Humanos , Masculino , Estudos Multicêntricos como Assunto , Psicometria , Reprodutibilidade dos Testes , Estresse Psicológico/diagnóstico , Inquéritos e QuestionáriosRESUMO
The increase in average seasonal temperatures has an impact in the occupational field, especially for those sectors whose work activities are performed outdoors (agricultural, road and construction sectors). Among the adaptation measures and solutions developed to counteract occupational heat strain, personal cooling garments represent a wearable technology designed to remove heat from the human body, enhancing human performance. This study aims to investigate the effectiveness and the cooling power of a specific cooling garment, i.e. a ventilation jacket, by quantifying the evaporative heat losses and the total evaporative resistance both when worn alone and in combination with a work ensemble, at three adjustments of air ventilation speed. Standardised "wet" tests in a climatic chamber were performed on a sweating manikin in isothermal conditions considering three clothing ensembles (single jacket, work ensemble and a combination of both) and three adjustments of fan velocity. Results showed a significant increase (p < 0.001) in evaporative heat loss values when the fan velocity increased, particularly within the trunk zones for all the considered clothing ensembles, showing that fans enhanced the dissipation by evaporation. The cooling power, quantified in terms of percent changes of evaporative heat loss, showed values exceeding 100% when fans were on, in respect to the condition of fans-off, for the trunk zones except for the Chest. A significant (p < 0.01) decrease (up to 42.3%) in the total evaporative resistance values of the jacket, coupled with the work ensemble, was found compared to the fans-off condition. Results confirmed and quantified the cooling effect of the ventilation jacket which enhanced the evaporative heat losses of the trunk zones, helping the body to dissipate heat and showing the potential for a heat adaptation measure to be developed.
Assuntos
Temperatura Alta , Dispositivos Eletrônicos Vestíveis , Regulação da Temperatura Corporal , Humanos , Roupa de Proteção , Sudorese , Local de TrabalhoRESUMO
BACKGROUND: as a legacy of the large asbestos consumption until the definitive ban in 1992, Italy had to tackle a real epidemic of asbestos related diseases. The Italian National Registry of Malignant Mesotheliomas (ReNaM) is a permanent surveillance system of mesothelioma incidence, with a regional structure. Aims, assignments and territorial network of ReNaM are described, as well as data collection, recording and coding procedures. OBJECTIVES: to describe the Italian epidemiological surveillance system of mesothelioma incidence, to provide updated data about occurrence of malignant mesothelioma in Italy, and to discuss goals, attainments, and expectations of registering occupational cancer. DESIGN: analysis of data by malignant mesothelioma incident cases surveillance system. SETTING AND PARTICIPANTS: Italy, network of regional surveillance system, all Italian regions. MAIN OUTCOME MEASURES: a Regional Operating Centre (COR) is currently established in all the Italian regions, actively searching incident malignant mesothelioma cases from health care institutions. Occupational history, lifestyle habits, and residential history are obtained using a standardized questionnaire, administered to the subject or to the next of kin by a trained interviewer. The extent of dataset, epidemiological parameters, and occupations involved are reported updated at 31.12.2016, and standardized incidence rates are calculated. RESULTS: at December 2016, ReNaM has collected 27,356 malignant mesothelioma cases, referring to the period of incidence between 1993 and 2015. The modalities of exposure to asbestos have been investigated for 21,387 (78%) and an occupational exposure has been defined for around 70% of defined cases (14,818). CONCLUSIONS: the Italian experience shows that epidemiological systematic surveillance of asbestos related diseases incidence has a key importance for assessing and monitoring the public health impact of occupational and/or environmental hazards, programming preventive interventions, including remediation plans and information campaigns, and supporting the efficiency of insurance and welfare system. Monitoring the incidence of malignant mesothelioma through a specialized cancer registry is essential to follow-up the health effects of changing modalities and extent of occupational exposures over years and of environmental contamination. Such consolidated surveillance system is recommended also for occupational cancers with low aetiological fraction.
Assuntos
Mesotelioma Maligno/epidemiologia , Adulto , Feminino , Humanos , Incidência , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Vigilância da População , Sistema de RegistrosRESUMO
BACKGROUND: Growing evidence indicates that the exposure to high heat levels in the workplace results in health problems in workers. A meta-analysis was carried out to summarize the epidemiological evidence of the effects of heat exposure on the risk of occupational injuries. METHODS: A search strategy was conducted to retrieve studies on the effects of climate change on occupational injury risk. Among the 406 identified, 5 time-series and 3 case-crossover studies were selected for meta-analysis. RESULTS: Pooled risk estimates for time-series and case-crossover studies combined, and then separated, were 1.005 (95%CI: 1.001-1009), 1.002 (95%CI: 0.998-1.005), and 1.014 (95%CI: 1.012-1.017), respectively. Subgroup analyses found increased risks (not statistically significant) for male gender, age <25 years and agriculture. CONCLUSIONS: The present findings can orient further research to assess the effects of heat at workplace and consequently to establish better health policies for managing such exposure in at-risk regions.
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Temperatura Alta/efeitos adversos , Exposição Ocupacional/efeitos adversos , Traumatismos Ocupacionais/epidemiologia , Fatores Etários , Agricultura , Mudança Climática , Indústria da Construção , Humanos , Estudos Observacionais como Assunto , Fatores SexuaisRESUMO
INTRODUCTION: The epidemiology of gender differences for mesothelioma incidence has been rarely discussed in national case lists. In Italy an epidemiological surveillance system (ReNaM) is working by the means of a national register. METHODS: Incident malignant mesothelioma (MM) cases in the period 1993 to 2012 were retrieved from ReNaM. Gender ratio by age class, period of diagnosis, diagnostic certainty, morphology and modalities of asbestos exposure has been analysed using exact tests for proportion. Economic activity sectors, jobs and territorial distribution of mesothelioma cases in women have been described and discussed. To perform international comparative analyses, the gender ratio of mesothelioma deaths was calculated by country from the WHO database and the correlation with the mortality rates estimated. RESULTS: In the period of study a case list of 21 463 MMs has been registered and the modalities of asbestos exposure have been investigated for 16 458 (76.7%) of them. The gender ratio (F/M) was 0.38 and 0.70 (0.14 and 0.30 for occupationally exposed subjects only) for pleural and peritoneal cases respectively. Occupational exposures for female MM cases occurred in the chemical and plastic industry, and mainly in the non-asbestos textile sector. Gender ratio proved to be inversely correlated with mortality rate among countries. CONCLUSIONS: The consistent proportion of mesothelioma cases in women in Italy is mainly due to the relevant role of non-occupational asbestos exposures and the historical presence of the female workforce in several industrial settings. Enhancing the awareness of mesothelioma aetiology in women could support the effectiveness of welfare system and prevention policies.
Assuntos
Amianto/efeitos adversos , Neoplasias Pulmonares/epidemiologia , Mesotelioma/epidemiologia , Exposição Ocupacional/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Itália/epidemiologia , Neoplasias Pulmonares/induzido quimicamente , Masculino , Mesotelioma/induzido quimicamente , Mesotelioma Maligno , Pessoa de Meia-Idade , Exposição Ocupacional/estatística & dados numéricos , Sistema de Registros , Fatores de Risco , Fatores SexuaisRESUMO
BACKGROUND: The aim of this study was to evaluate the occupational health risks in the Italian National Priority Contaminated Sites (NPCSs). METHODS: Established cases of occupational diseases in 2010-2014 were extracted from the Italian National Institute for Insurance against Accidents at Work (INAIL) archives. Standardized incidence ratios with 95% confidence intervals were estimated by site and by disease group separately for genders. RESULTS: In the 44 NPCSs evaluated, 11 015 cases of occupational diseases (8877 in men and 2138 in women) were ascertained. Overall, an excess of occupational diseases with respect to expected cases of 24.2% was found in men residing in NPCSs. An increased occurrence was detected in 21 NPCSs for men and in eight for women. CONCLUSIONS: The findings suggest a role of occupational diseases in the health profile of NPCSs, reinforcing the need for a permanent surveillance system.
Assuntos
Doenças Cardiovasculares/epidemiologia , Locais de Resíduos Perigosos , Transtornos Mentais/epidemiologia , Doenças Musculoesqueléticas/epidemiologia , Neoplasias/epidemiologia , Doenças do Sistema Nervoso/epidemiologia , Doenças Profissionais/epidemiologia , Doenças Respiratórias/epidemiologia , Otopatias/epidemiologia , Poluição Ambiental , Oftalmopatias/epidemiologia , Feminino , Humanos , Incidência , Itália/epidemiologia , Masculino , Dermatopatias/epidemiologia , Poluição da ÁguaRESUMO
BACKGROUND: The purpose of this study is to present the results of a systematic review of published research that focuses on psychological aspects of malignant mesothelioma patients and asbestos-exposed people. METHODS: Our research includes primary studies published between 1980 and 2016, using information from the Cochrane Library, the Psychology Behavioral Sciences Collection, PsychINFO, PubMed, PubGet, PubPsych, and Scopus, in compliance with PRISMA guidelines. RESULTS: We identified 12 papers that investigated the psychological distress and care needs of mesothelioma patients, and nine papers for asbestos-exposed subjects. CONCLUSIONS: This paper highlights the paucity of studies on the psychological distress and care needs of mesothelioma patients and asbestos-exposed subjects. It confirms that malignant mesothelioma is associated with the physical, emotional, and social functioning of patients, while also suggesting that the risk of developing asbestos-related diseases among asbestos-exposed subjects is associated with high levels of psychological distress, despair, and mental health difficulties.
Assuntos
Amianto/efeitos adversos , Neoplasias Pulmonares/psicologia , Mesotelioma/psicologia , Exposição Ocupacional/efeitos adversos , Estresse Psicológico , Adaptação Psicológica , Depressão/psicologia , Feminino , Humanos , Neoplasias Pulmonares/epidemiologia , Masculino , Mesotelioma/epidemiologia , Mesotelioma Maligno , Qualidade de Vida , Apoio SocialRESUMO
BACKGROUND: Occupational Safety and Health (OSH) Services, with inspections and support activities to workers and to enterprises, have a relevant role in the field of safety and health in the workplace. OBJECTIVES: The aim of this study, part of the INSuLa Project, is to realize a national survey about risk perception of OSH and awareness about OSH issues in the context of the Italian OSH legislative framework (Legislative Decree 81/08 and subsequent modifications and integrations) implementation, with involvement of the OSH Services operators. METHODS: The Survey involved a representative national sample of the OSH Services operators. After an analysis of background literature and a comparison with Operating Units involved in the Project, an ad hoc questionnaire was developed and administered to the sample to evaluate the topics of the Survey. RESULTS: The study has been conducted on a sample of 678 OSH Services operators. The Survey showed in Italy an important organizational and procedural inhomogeneity perceived by OSH Services operators. CONCLUSIONS: This study highlighted the relevance perceived by OSH Services operators to develop a system of safety culture dissemination to reduce accidents at work and improve the management of occupational risks (traditional and emerging).
Assuntos
Saúde Ocupacional , Serviços Preventivos de Saúde , Feminino , Inquéritos Epidemiológicos , Humanos , Itália , Masculino , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: Italy produced and imported a large amount of raw asbestos, up to the ban in 1992, with a peak in the period between 1976 and 1980 at about 160,000 tons/year. The National Register of Mesotheliomas (ReNaM, "Registro Nazionale dei Mesoteliomi" in Italian), a surveillance system of mesothelioma incidence, has been active since 2002, operating through a regional structure. METHODS: The Operating Regional Center (COR) actively researches cases and defines asbestos exposure on the basis of national guidelines. Diagnostic, demographic and exposure characteristics of non-occupationally exposed cases are analysed and described with respect to occupationally exposed cases. RESULTS: Standardised incidence rates for pleural mesothelioma in 2008 were 3.84 (per 100,000) for men and 1.45 for women, respectively. Among the 15,845 mesothelioma cases registered between 1993 and 2008, exposure to asbestos fibres was investigated for 12,065 individuals (76.1%), identifying 530 (4.4%) with familial exposure (they lived with an occupationally exposed cohabitant), 514 (4.3%) with environmental exposure to asbestos (they lived near sources of asbestos pollution and were never occupationally exposed) and 188 (1.6%) exposed through hobby-related or other leisure activities. Clusters of cases due to environmental exposure are mainly related to the presence of asbestos-cement industry plants (Casale Monferrato, Broni, Bari), to shipbuilding and repair activities (Monfalcone, Trieste, La Spezia, Genova) and soil contamination (Biancavilla in Sicily). CONCLUSIONS: Asbestos pollution outside the workplace contributes significantly to the burden of asbestos-related diseases, suggesting the need to prevent exposures and to discuss how to deal with compensation rights for malignant mesothelioma cases induced by non-occupational exposure to asbestos.
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Amianto/efeitos adversos , Exposição Ambiental/efeitos adversos , Poluentes Ambientais/efeitos adversos , Neoplasias Pulmonares/etiologia , Mesotelioma/etiologia , Neoplasias Pleurais/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Itália/epidemiologia , Neoplasias Pulmonares/epidemiologia , Masculino , Mesotelioma/epidemiologia , Mesotelioma Maligno , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Neoplasias Pleurais/epidemiologia , Vigilância da População , Saúde Pública , Fatores Sexuais , Adulto JovemRESUMO
INTRODUCTION: Peritoneal mesothelioma, a very rare and lethal malignancy, has not been investigated as extensively as pleural mesothelioma, although the role of asbestos exposure in its occurrence is well-known. Data from Italy are relevant, as it was the largest European asbestos producer, and asbestos was widely used in many economic activities. METHODS: A population-based mortality and incidence analysis was performed in Italy. Data sources were the National Multiple-causes-of-death Database (1995-2010) and the Italian Mesothelioma Register (1993-2008). RESULTS: We found an increasing trend of age standardized mortality rates in men, but no clear trend in women; moreover, we showed significant risks of death in several northern regions, formerly heavy asbestos users; finally, mortality/incidence ratios similar for both genders (about 0.8) were estimated. CONCLUSIONS: The study, based on national data, showed a higher risk of mortality from and incidence of peritoneal mesothelioma in areas with formerly heavy exposure to asbestos.
Assuntos
Mesotelioma/epidemiologia , Doenças Profissionais/epidemiologia , Neoplasias Peritoneais/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Humanos , Incidência , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Adulto JovemRESUMO
Occupational cancer is an important public health concern in Italy and in many industrialized countries. The difficulties in monitoring and the complexity in retrieving occupational cancer cases have required the enrolment of a national epidemiologic sureveillance system at national scale with active search methods. A structured system for the registration of occupational cancer cases is normed by the Decree No. 81/2008, that accounts for the previous legislative procedures and experiences. Research activities and prevention of occupational cancer should be integrated with insurance policies to the purpose of an efficient protection of workers health.
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Neoplasias/epidemiologia , Doenças Profissionais/epidemiologia , Vigilância da População , Sistema de Registros , Amianto/efeitos adversos , Pesquisa Biomédica , Carcinógenos/toxicidade , Coleta de Dados , Órgãos Governamentais , Humanos , Itália/epidemiologia , Mesotelioma/epidemiologia , Mesotelioma/etiologia , Mesotelioma/prevenção & controle , Programas Nacionais de Saúde/organização & administração , Neoplasias/etiologia , Neoplasias/prevenção & controle , Doenças Profissionais/etiologia , Doenças Profissionais/prevenção & controle , Exposição Ocupacional , Indenização aos Trabalhadores/organização & administraçãoRESUMO
According to Italian Legislative Decree 81/2008 and subsequent modifications the Regions and Autonomous Provinces have a innovative and complex role: 1) to regulate and coordinate the total prevention system and 2) to develop interventions/initiatives through regional/local occupational safety and health (OSH) department using not only inspections and controls but education, training and support. Recommendations also include consolidating the role of actors involved in preventing risks to occupational health throughout occupational safety and health education and training, keys for a successful process to improve prevention system. As result of changing world of work and OSH legislation the INSuLa project has creating a national survey involving of all Italian prevention system actors, in order to evaluate implementation and impact of the actual regulations. According to overall objective of the INSuLA project, for the first time in Italy, we studied about operators in regional/local OSH department. The purpose of this paper is to show and recognize the individual learning paths, the perception of adequacy education degree, the exploring criticalities andthe training needs.
Assuntos
Programas Governamentais/organização & administração , Pessoal de Saúde/educação , Inquéritos Epidemiológicos , Saúde Ocupacional/educação , Serviços Preventivos de Saúde/organização & administração , Medicina Preventiva/educação , Participação da Comunidade , Educação Continuada , Programas Governamentais/legislação & jurisprudência , Necessidades e Demandas de Serviços de Saúde , Humanos , Itália , Doenças Profissionais/prevenção & controle , Saúde Ocupacional/legislação & jurisprudência , Saúde Ocupacional/normas , Ocupações/classificação , Serviços Preventivos de Saúde/legislação & jurisprudência , Medicina Preventiva/legislação & jurisprudência , Medicina Preventiva/normas , Gestão de Riscos , Comportamento de Redução do Risco , Fatores Socioeconômicos , Local de Trabalho/normasRESUMO
In the framework of the INSuLa project, supported by Italian Ministry of Health, a national survey was conducted to evaluate the perceptions of employers about Occupational Safety and Health (OSH) activities. Main findings of this survey are presented in this paper. The survey was conducted on a sample of 1,010 employers weighted by economic activity sector, company size and geographic area. An ad hoc questionnaire was administered through Computer Assisted Telephone Interviewing methodology. Most of employers "mostly" or "completely" agree with the usefulness of OSH activities and the efficacy of specific prevention and protection measures. Around 37.7% of employers consider OSH management a shared responsibility with workers and 56.1% of them feel the OSH level to be increased following the implementation of Legislative Decree no. 81/08. The findings of this survey provide a picture of Italian employers' point of view about OSH and identify gaps and needs, thus contributing to choose proper actions for the improvement of OSH
Assuntos
Emprego , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos , Saúde Ocupacional , Medicina Preventiva , Pessoal Administrativo/psicologia , Comunicação , Humanos , Comportamento de Busca de Informação , Itália , Responsabilidade Legal , Doenças Profissionais/etiologia , Doenças Profissionais/prevenção & controle , Doenças Profissionais/psicologia , Saúde Ocupacional/educação , Saúde Ocupacional/legislação & jurisprudência , Saúde Ocupacional/normas , Ocupações/classificação , Cultura Organizacional , Medicina Preventiva/educação , Medicina Preventiva/legislação & jurisprudência , Medicina Preventiva/normas , Risco , Comportamento de Redução do Risco , Gestão da Segurança/legislação & jurisprudência , Gestão da Segurança/organização & administração , Responsabilidade Social , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
Objective: High risk of degraded quality of life and psychological distress is observed in patients diagnosed with sinonasal, nasopharyngeal, and laryngeal cancers, which could be caused by exposure to carcinogens in workplaces. This review aimed to investigate the psychological impact of diagnosis associated with the possible occupational etiology of such neoplasms and to explore the instruments that evaluate the quality of life (QoL), anxiety, and depression in these patients. Methods: Studies were considered for the review only if they described aspects of the psychological impact of the diagnosis of sinonasal, nasopharyngeal, and laryngeal cancers and reported results distinguished by the tumor site. The psychological impact was assessed in terms of health-related QoL, anxiety, and depression using reliable psychometric questionnaires administered at the time of diagnosis and 1 year later. Results: In more than 5,900 records identified, 442 studies fulfilled the eligibility criteria and 436 were excluded after full-text screening, resulting in six studies to be finally included in the review. The EORTC Core Quality of Life questionnaire (EORTC QLQ-C30), EORTC QLQ-H&N35, and Functional Assessment of Cancer Therapy (FACT) were used to evaluate the QoL, whereas the Hospital Anxiety and Depression Scale (HADS) and Center for Epidemiologic Studies Depression Scale (CES-D) questionnaires were employed to assess anxiety and depression. QoL scores were similar to those of the general population at the time of diagnosis and remained unchanged or slightly improved at 1 year since diagnosis. In contrast, a higher prevalence of anxiety and depression was observed compared with the general population, although the results were inconsistent across the very few studies identified. No study investigating the association between the potential occupational etiology and QoL or distress was found. Conclusion: Exploring the existing scientific literature on emotional distress in sinonasal, nasopharyngeal, and laryngeal cancer patients was prompted by concerns over the disfiguring nature of treatment and the additional emotional burden resulting from their occupational etiology. Unfortunately, neither a crucial element nor other risk factors (lifestyle, smoking, drinking, etc.) were examined in any study. Patients' employment history should be considered in order to assess the possible impact of believing they are affected by an occupational exposure disease in the evaluation of their psychological distress. This history would support evidence-based recommendations about dedicated psychological interventions.