[Role of ECG screening and cardiologic examinations in occupational health prevention program for construction workers; results of study in the Province of Bergamo]. / Utilità dell'elettrocardiogramma e degli approfondimenti cardiologici nella sorveglianza sanitaria di una popolazione di operatori edili della Provincia di Bergamo.

Aim of this study was to estimate prevalence of resting electrocardiogram (ECG) abnormalities in men with high physical work demand, like construction workers and the prevalence of secondary related cardiovascular examinations. Several guidelines for cardiovascular risk management recommend an ECG in patients with cardiovascular risk but there are no clear indications about the frequency of resting ECG during evaluation for fitness for work. The results of our study confirm the presence of age-related ECG abnormalities with a similar stratified prevalence distribution in all age-classes. Our fundings intend to contribute to further discussion in occupational health policies and periodical medical evaluations.

[Energy expenditure in construction industry]. / Il dispendio energetico in edilizia.

The aim of this study is to show the results obtained from measuring energy expenditure (EE) during work, through portable devices, in a group of male construction workers. After defining cardio-respiratory parameters in laboratory, authors applied to all subjects an heart rate monitor for measuring the heart rate (HR) and, at the same time, a calorimeter for measuring energy expenditure (EE). To analyse data obtained, authors calculate the Relative Aerobic Strain (RAS), both for the measurements of EE and for HR detected. Results confirm that in many of the typical activities of construction industry, in particular in those characterised by an higher component of manual engagement compared to foreman, workloads are exceeding limits of the probable threshold fatigue (33% of RAS), both for energy expenditure than for HR measured.

[Return to work of the cardiac patient: work fitness evaluation in Occupational Medicine Division including an Occupational Cardiology Unit and Work-Physiology Lab in Bergamo]. / Unità Semplice di Cardiologia del Lavoro ed Ergometria degli Ospedali Riuniti di Bergamo: percorso per la valutazione dell'idoneità lavorativa del cardiopatico.

Cardiovascular disease in working age still represent a major cause of morbidity and account for a number of fitness to work certificates expressing several limitations and prescriptions. To present the medical assessment conducted in an Occupational Medicine Division including an Occupational Cardiology Unit and work-physiology lab. It is described the history and the structure of the Occupational Cardiology Unit. Our almost forty years long-lasting experience allow us to point out the precious contribution of the Occupational Cardiology Unit to the Occupational Medicine Division, due to a highly specialised and qualified assessment of cardiac patients.

[Syncope and work: role of the occupational physician and global risk stratification]. / Sincope e rischio lavorativo: ruolo del medico del lavoro e stratificazione globale del rischio.

Safety risk for subjects suffering from syncope while working has not been as yet addressed by occupational medicine. The present study was aimed at evaluating a new developed methodology for job tasks risk stratification in patients with syncope. During a work-shop on syncope and occupational risk, 149 occupational physicians (OP) with about 10 years of clinical experience were asked to fulfil a Visual Analogue Scale (VAS) concerning the doctor's estimated potential damage (D) to the worker and the probability of a damage to occur (P) should syncope take place during the job task. Five job tasks characterized by different risk for safety (1, driving; 2, toxic products handling; 3, job performed closed to hot surfaces o free flames; 4, surgical activity; 5, office job) were identified. OP correctly stratified the risk associated to the different job tasks in patients with syncope. Unexpectedly, task #3 was given a risk similar to that obtained in drivers. This might be of paramount clinical and social importance when patients with syncope have to return to their job tasks.

[Syncope and occupational risk survey: the role of continuing education and multidisciplinary approach]. / Indagine conoscitiva sulla percezione del problema sincope in relazione al rischio lavorativo nella pratica clinica: ruolo della formazione e dell'approccio multidisciplinare.

Syncope is a common disorder characterized most of the times by a positive clinical outcome. However, it may turn to a life threatening event even for working colleagues and third party when occurring during an high risk job. We have recently found that, out of 670 patients admitted to the Emergency Department (ED) for syncope, about 50% were potential workers, being their age between 18 and 65 years. Also, we found that in this group of patients syncope recurrence was as high as 11% at 6 months. It is unknown how physicians address the problem of the occupational risk in patients suffering from syncope and how occupational aspects are taken into account in the clinical judgment before work readmission. One hundred eighty five doctors (149 occupational physicians, OP), participating in a work-shop on syncope, were asked to fulfill a questionnaire about their clinical experience and their attention to the occupational aspects in patients after syncope. Despite long lasting clinical experience, 41% of OP did not scrutinize syncope as a relevant symptom in their daily activity. 65% of the other specialists were used to address the occupational risk aspects in their syncope patients. A multidisciplinary approach involving continuing education on safety at work might reduce work accidents due to syncope relapse and promote a safe and suitable re-employment of patients with syncope. scrutinize syncope as a relevant symptom in their daily activity. 65% of the other specialists were used to address the occupational risk aspects in their syncope patients. A multidisciplinary approach involving continuing education on safety at work might reduce work accidents due to syncope relapse and promote a safe and suitable re-employment of patients with syncope.

[Measurement of energy expenditure in a group of construction workers during work]. / Valutazione del dispendio energetico durante l'attività lavorativa in un gruppo di lavoratori edili.

The aim of this study is to show the results obtained from measuring energy expenditure (EE) during work in a group of male construction workers through a new portable device of practical use and low cost. The instrument consists of an electronic bracelet multisensor system for measuring EE, which is called Armband Sensewear Pro2 and is produced by Body Media. The disposal has 5 steel hypoallergenic sensors which detect the skin and the near body temperature, the environment temperature, the electrical skin conductance, and an internal two axes accelerometer which detects the transverse and longitudinal acceleration. The analysis of these parameters through software allows you to derive the individual EE. The study describes the results obtained by applying Armband to a group of 10 construction workers performing the following jobs: bricklayer, tiler, crane driver and "rock climber". The results allow to assess and confirm the high EE related to the work of the subjects enrolled in the study. In conclusion the authors argue that Armband, already validated experimentally in several areas of Medicine, can be a useful tool available to the Occupational Physician, in order to determine the EE for workers who perform heavy tasks, such as those that exist in the construction industry, which are characterised by high levels of EE and poor reproducibility of tasks. Moreover, Armband appears to be an useful tool in connection with the dual possibility on the one hand to assess fatigue related to certain skills and jobs, and on the other side to contribute to the metabolic evaluation of cardiac patients during rehabilitation at work.

[Prevalence of risk factors and prevention of coronary disease in a population of construction workers of the Province of Bergamo]. / Prevalenza dei fattori di rischio e prevenzione della coronaropatia in una popolazione di lavoratori edili della provincia di Bergamo.

Authors describe the prevalence of cardiovascular risk factors among 1.348 construction workers, enrolled in a five years lasted health surveillance program. Our results confirm both the high prevalence of cardiovascular risk factors and the need of further examinations other the clinical, laboratory, electrocardiogram and chest X, in order to point out a correct diagnosis and evaluate the fitness to job. Furthermore, we underline the usefulness of training in health education for the prevention of cardiovascular disease, considering the low extent to which individuals perceive their own risk.

[Occupational disease in construction work]. / Le malattie da lavoro in edilizia.

BACKGROUND: There are very few studies in the Italian and international literature concerning occupational diseases and their prevention in the building industry. OBJECTIVES: The aim of this study was risk assessment in the building industry. METHODS: We analyzed the international literature and the results of our cross-sectional study, which involved more than 1000 workers. RESULTS: The analysis of several studies and of our experience suggests a high occupational risk in this field and shows as main risk factors: noise, dusts, fibers, manual lifting, prolonged static positions, repetitive motions, hand-shoulder and whole-body vibrations, chemicals and weather conditions. In addition, non-occupational risk factors can influence health: e.g., habits and lifestyle, like hypercaloric diet, cigarette smoking and alcohol consumption. CONCLUSIONS: Preventive measures and training initiatives are urgently needed to improve the safety and the health among building workers.

[Cardiovascular assessment in building activities using an ergospirometer]. / Valutazione dell'impegno cardio-vascolare in alcune attività di cantiere edile mediante l'impiego di un ergospirometro portatile.

We report preliminary results of a current study aimed to evaluated peak oxygen consumption and others cardiopulmonary exercise test parameters, in some common and tiring building activities, with the use of a portable ergospirometer stress test (Metamax 3B, Cortex Biophysik). We tested 3 Building School's Teachers of Seriate (Bergamo): the materials handling and transport of cement bricks and to dig with pick and shovel reaches peak anaerobic threshold into few minutes while the activity of make molter permits an aerobic metabolism in all building workers tested.

[Health surveillance in construction]. / La sorveglianza sanitaria in edilizia.

In the Italian and international literature there are very few studies about work diseases and their prevention in the construction's compartment. The analysis of the most recent articles about this theme, however, suggests the presence of an high professional risk in the compartment and indicates as the most relevant risk factors noise, dusts, fibres, manual lifting, prolonged fixed postures, cumulative trauma disorders, vibrations, chemical substances and climatic conditions. The role that extra-lavorative risk factors can play on health is also relevant; those risks are due to the workers' peculiar life-style: hyper caloric diet, smoke and use of alcohol. Interventions of medical hygienic prevention, formation and information are therefore necessary. Lombardy Region, which from many years is careful to the problems about the prevention in building yards, has created a Working party who has elaborated the "Guide Lines for the sanitary surveillance in the building industry". The indications reported in the Guide Lines could represent, even for the occupational-doctors of the building contractors of the New Hospital, a good base for the working out of the workers' health care activity, in the respect of the dues of the law in force.

Cobalt myocardiopathy. A critical review of literature.

Cobalt is regarded as being responsible for a form of myocardiopathy whose pathogenesis and clinical description must still find a specific place in the range of congestive myocardiopathies. In spite of this, epidemiological studies are not sufficient to prove the role of cobalt in inducing myocardiopathy in hard metal workers. This critical review intends to evaluate if hard metal exposure may induce toxic effects on the heart. In this context, the literature considered ranges from pioneer reports on 'beer drinkers' to the more recent papers concerning cases of patients occupationally exposed; subjects who, after a surgical operation died of fulminant heart failure and, lastly, hard metal workers who were examined for their cardiac function. Various pathogenetic mechanisms related to possible cardiac effects in hard metal workers have been analyzed. The most likely should be the inhibition of cellular respiration due to inhibition of the mitochondrial dehydrogenase.

Cardiac function study in hard metal workers.

The induction of cardiac effects in hard metal workers is uncertain. This study investigates cardiac function of a group of 31 hard metal workers with or without pulmonary disease. The average duration of exposure to cobalt containing dusts was 10.4 years (range 1-30), while the environmental levels of cobalt exposure ranged from 0.09 to 13.6 mg/m3 Co. Cardiac function has been studied by: ECG (electrocardiogram), exercise test (ET), ECG 24 h according to Holter (ECGH), echocardiogram (ECHO) and radionuclide angiocardiography with 99Tc (RNA). The aims of this work were (i) to show the existence of cobalt myocardiopathy in the workers analyzed and, (ii) to find an early indicator of cardiac dysfunction which could be used in the clinical examination of hard metal workers. Within the group of patients with hard metal lung disease, cases of myocardiopathy of doubtful aetiology have been found. The cardiac indexes obtained through RNA show ventricular dysfunction in healthy hard metal workers which could be a manifestation of initial pulmonary artery hypertension or of an early occult cor pulmonale due to an unknown fibrotic lung disease.