[The role of the occupational physician in disabled return to work]. / Il Ruolo del Medico del Lavoro nel reinserimento lavorativo del disabile.

Workers, former workers or unemployed workers with disabilities of various kinds often come to the Occupational Health Hospital Department (UOOML), requiring a report on their fitness for work that often is generic or not suitable for specific situations: a detailed knowledge of both working and health conditions, mainly disabilities and job items are needed. The UOOML was never directly involved in the proceedings of targeted fitting-up of the disabled people, while some Doctors of the Department of Prevention of ASL have an advisory role participating in the Technical Committee under Law 68 and the 'Disabled Commission'. INAIL (the National Insurance Institute for Occupational Accidents and Diseases), in case of allocation of percentages of disability higher than 33% (necessary requirement for the targeted employment) provides an assessment of the 'residual capacity'. The Company Occupational Physician cooperates and intervenes in the management of the employment of the disabled worker in very different ways and at several stages of the path of integration or reintegration. Considering the prolonged and effective cooperation among the Doctors of the UOOML and the Psysiatrists of our Hospital, we are developing a specific out-patients' department where a report on the fitness for job, as close as possible to the patient/work-task compliance, is provided to the disabled.

Occupational exposure to metallic cobalt in the Province of Bergamo. Results of a 1991 survey.

The results of a survey on workers potentially exposed to cobalt in the Bergamo Province are reported. Its aim is to assess the number of workers at risk of developing respiratory disease due to the inhalation of metallic cobalt. Interest was shown after an examination of 11 cases of 'hard metal disease', which we diagnosed, in workers who came from different production areas and had different degrees of exposure. A first group of 45 factories with potential cobalt exposure was identified by consulting the archives of the Local Sanitary Units (USSL) and of the Chamber of Commerce, and by use of the telephone directory and requesting information from the producers and users of Widia tools. A second group of 2039 factories was selected from those industrial activities where we had previously ascertained the presence of grinding operations using hard metal tools with diamond wheels. This study is related to all the factories in the first group and 10% of the factories in the second group. More than 304 inspections were carried out. In this context 403 exposed workers were identified. Workplace air measurements (250 samples) and biological monitoring (> 600 samples) to determine the exposure levels to cobalt were performed. The results show an unexpected diffuse occupational exposure in different production areas where the airborne cobalt is frequently underestimated and higher than the TLV.

[Clinico-anamnestic survey in health professionals exposed to volatile anesthetics]. / Indagine clinico-anamnestica in operatori sanitari professionalmente esposti ad anestetici volatili.

The authors describe the results of a preliminary clinical survey of a group of 220 health workers, physicians and 151 nursing and auxiliary staff members of a large regional hospital in Lombardia, who are exposed to volatile anaesthetics. Contact dermatitis, varices of the legs and arthrosis, particularly that of the cervical and lumbar tract, are the most frequently reported disease in our population. In 75% of cases these disturbances arose after the beginning of the job working in the operating-theatres. When compared with a control group there was a statistically significant difference for contact dermatitis (p less than 0.01) and cervical tract arthrosis (p less than 0.02). The statistical comparison among the subjects exposed to the anaesthetics gases, who were stratified on the basis of the level of exposure and of seniority, confirms a higher prevalence of symptoms due to a reduction of alertness and of psychological and psychomotorial performances in the more exposed personnel. The comparison between female staff exposed and not-exposed to the gases did not show an increase of abortivity, while a statistically significant difference was evident between the female staff (either exposed or not-exposed) and the wives of male workers not exposed to the anaesthetics gases.