[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.

[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.

[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.

[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.

[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.

[Work-related musculoskeletal disorders of the upper extremity in spinning: lack of risk or of adequate methods for assessing risk?]. / Patologie muscoloscheletriche dell'arto superiore in addetti alla filatura: assenza di rischio o carenza di metodi per valutare in modo adeguato il rischio?

The existence of a risk of musculoskeletal disorders work-related of the upper extremity (UEWMSDs) in the textile industry, specifically in particular working phases as spinning, appears today controversial. The upper limb disorders, sometimes described, have not a location ever plausible with the level of the biomechanical overload, as when carpal tunnel syndromes are signalled during activities in which the shoulder is the only segment eventually interested. Moreover these findings are shown in workers appointed at tasks or actions not clearly identified at risk. For example the spinning activity, that requires the movement of shuttles of modest weight, sometimes on levels above the shoulder line, is organized with cyclical cadences sometimes as repetitive tasks concentrated in a short period, sometimes in longer during the entire shift. Distribution and number of the actions, would however allow a sufficient biomechanical recovery. The identification of the single technical action may result difficult, due to interindividual variability of actions, of their speed and complexity. Furthermore the other possible activities, alternate with specific spinning activities, can require strength or not correct posture even if they may have short duration. In this paper we present and discuss the results of the ergonomic survey for risk assessment of musculoskeletal disorders work-related of the upper limb. These analysis have been carried out in two textile plants, in which some cases of disorders of the upper limb in workers employed in spinning activities have been described by occupational health physicians. In addition to assessment of possible risk for UEWMSDs in spinning activities, we founded the capability of usual methods for ergonomic analysis to adequately examine work situations like spinning, in which the hazardous actions are diluted over the entire shift or concentrate in a short period and in which there is a specific biomechanically overloaded segment i.e. the shoulder. Finally attention was paid to evaluate psychosocial factors which appear to be important when biomechanical factors are low-lying.

[Comparative analysis of the use of 4 methods in the evaluation of the biomechanical risk to the upper limb]. / Analisi comparata dell'applicazione di quattro metodi per la valutazione del rischio biomeccanico per l'arto superiore.

In the last years notices of Work Related Musculo-Skeletal Disorders are significantly increased, for a much widespread mechanism of disease and risk identification. About the last, the methods of assessment, even if in great number, are not universally recognized. This study reports the application of four methods (Check list OCRA, OREGE, Strain Index, ACGIH) to evaluate 12 work emplacements at a different biomechanical overload level. The comparison revealed variability between the methods in situations of middle risk, while the methods substantially gave similar results in situations without any risk or with high risk. Methods could not reveal every component of the risk in a reproducible and univocal way also when the risk assessment was accordant. It is necessary a following analytical evaluation of each risk factor contributing to define the sintetic index. In the complex of biomechanical risk factors these ones might not be considered able to define unequivocally "accettable" or "not accettable" components.

[Hapten selection for patch tests in the diagnosis of allergic contact dermatitis: epidemiologic data]. / La scelta degli apteni per i test epicutanei nella dignosi delle dermatiti allergiche da contatto: osservazioni epidemiologiche.

Aim of the study was to verify the reliability in clinical practice of patch testing with "standard" series and additional series of haptens for the diagnosis of occupational and non-occupational allergic contact dermatitis, evaluating positive reactions and relating those reactions to professional categories. A total of 392 out of 937 patients (41.8%) showed at least one positive reaction to "standard" series testing; the hapten most frequently noted as the cause of positive reaction was nickel sulphate. Professional categories that showed positive reactions to "standard" series most frequently were clerks, hairdressers and hospital auxiliary workers. Among 897 patients tested with nonstandard allergens, only 124 (13.8%) elicited at least one positive reaction, ammonium persulphate being the most frequently positive hapten. A dominant percentage of positive results was seen in hairdressers and cleaning personnel. No positive reactions were observed in a large number of haptens, tested more than 200 times. Haptens of "standard series" elicited a higher number of positive reaction than the additional series, even though there was a high specificity of few additional series haptens in some professional categories. Data suggest some caution in systematically testing additional series, despite a higher accuracy and diagnostic efficacy in some job categories.