[Occupational safety and health risks in seaport: an update of narrative review]. / I rischi per la salute e la sicurezza nel lavoro portuale: aggiornamento della revisione narrativa della letteratura.

SUMMARY: Seaports are complex systems in which workers can be exposed to a large variety of safety and health risks. Nevertheless, a little literature is available concerning this topic, if we exclude the specific area of shipbuilding industry. Objectives. The aim of this paper is to update the review of the scientific literature previously published as result of a project concerning the occupational risks in seaports. Methods. Literature on this theme, obtained consulting the main databases (PubMed, Scholar and CCOHS) from 2012 and up to April 2019, was reviewed. Results. 5 of 8 articles published after 2012 were related to risk of release or formation of volatile compounds in restricted and poorly ventilated areas or inhalation of particles from specific goods. Three papers specifically debated musculoskeletal disorders related to loading/unloading procedures, occupational diseases and injuries. Conclusions. The update of the literature highlighted intrinsically dangerous goods, toxic volatile compounds and emissions as critical aspects of seaport activities related to goods handling. Recently, the literature shows a growing interest in occupational health, especially work-related musculoskeletal diseases. Prevention measures and implementation of worker's training and information are identified by all authors as the more effective action to increase health and safety..

[The organisation of prevention among Ravenna's seaport.] / L'organizzazione della prevenzione nel porto di Ravenna.

SUMMARY: The port work presents specific risk factors in relation to the types of production which take place in it, and to the specific organisation it is managed by. The port of Ravenna is a big commercial one and it has a canal-port structure. Objectives. This work is intended to illustrate the interventions of prevention led by AUSL Romagna within the port. Methods. The methodology of research and presentation of the interventions is inspired to the criteria of prevention based on evidence. Results. Among all the activities conducted, those that associate actions of control with actions of promotion of change are presented: the procedure of planning the interventions for the enhancement of safety in the port of Ravenna; the assessment all'ondeggiaof the risk linked to the movements of the ships, because of the undulation during the operations of loading and unloading; the innovative ways of surveillance; the interventions of promotion and control on of the asssessment and management of silica risk; the surveillance in the cargo holds, as places with scarce ventilation and danger of contamination; the specific plan for safety. Conclusions. As it correlates actions of control and frequent moments of discussion with the spokesmen of the factories, and the shared definition and diffusion of the tools for the assessment of risk, the model of prevention presented in this review proves to be one of the most apt to guarantee the endurance of the measures of prevention and protection adopted, aiming at the health and safety of the workers in the port.

[Mortality study update of workers exposed to vinyl chloride in plants located in Ferrara and Ravenna (Emilia-Romagna Region, Northern Italy)]. / Aggiornamento dello studio di mortalità nelle coorti di lavoratori ex esposti a cloruro di vinile monomero a Ferrara e Ravenna.

OBJECTIVES: to update the mortality study of subjects exposed to vinyl chloride in the phases of synthesis of the monomer and polymerization in the plants of Ferrara and Ravenna (Emilia-Romagna Region, Northern Italy). DESIGN: both for the whole cohort and for the two plants, standardized mortality ratios (SMRs), with 95% confidence intervals (95%CI), were calculated for different death causes, then stratified by duration and latency, periods of the beginning of work and cumulative exposure (ppm-years). SETTING AND PARTICIPANTS: the cohort includes 1,540 subjects (469 in Ferrara hired from 1953 to 1999; 1,071 in Ravenna hired from 1959 to 2000), with at least six months of work. RESULTS: by the end of the follow-up (31.12.2013), 348 deaths occurred. Overall observed mortality, contrasted to that expected based on Emilia-Romagna Region mortality rates, appeared to be lower than expected in the whole cohort (348 cases, SMR: 0.85; 95%CI 0.77-0.95) and in Ravenna (173 cases, SMR: 0.71; 95%CI 0.61-0.83). Mortality for all neoplasms was in excess in Ferrara (79 cases, SMR: 1.27; 95%CI 1.02-1.58), but lower than expected in Ravenna (83 cases, SMR: 0.80; 95%CI 0.64-0.99). An excess in mortality was observed in the whole cohort (16 cases, SMR: 1.74; 95%CI 1.07-2.85) and in Ferrara for liver cancer (7 cases, SMR: 2.12; 95%CI 1.02-4.46), and only in Ferrara for respiratory tract cancer (30 cases, SMR: 1.45; 95%CI 1.02-2.07) and larynx cancer (4 cases, SMR: 3.35; 95%CI 1.26-8.92). In the whole cohort, SMR for liver cancer was in excess since a cumulative exposure of 5,000 ppm-year and 12 cases belong to the job title of autoclave workers (12 cases, SMR 4.6; 95%CI 2.6-8.0), duration of work higher than 20 years (8 cases, SMR 2.4; 95%CI 1.2-4.9), and latency higher than 40 years (7 cases, SMR 2.5; 95%CI 1.2-5.2). The excess in mortality for lung cancer is statistically significant for and with cumulative exposure higher than 7,330 ppm-years (6 cases, SMR 3.2 95%CI 1.4-7.0). There are not excesses among subjects hired after 1971. CONCLUSIONS: the study findings confirm and expand the ones of previous studies. It was not possible to apply a best evidence approach to the study of liver cancer, and consequently it is not possible to distinguish between hepatic angiosarcoma and hepatocellular carcinoma. The evidence of a causal link between vinyl chloride exposure and liver cancer is anyhow confirmed. The causal link between vinyl chloride exposure and lung cancer must be further investigated.

[Occupational safety and health risks in dock work: a narrative literature review. ]. / I rischi per la salute e la sicurezza nel lavoro portuale: revisione narrativa della letteratura.

BACKGROUND: Seaports are complex systems where workers can be exposed to a large variety of safety and health risks. Nevertheless, the literature available on this topic is scarce, if we exclude the specific area of the shipbuilding industry. OBJECTIVES AND METHODS: The aim of this paper is to provide a review of the scientific evidence concerning the occupational risks in seaports. Literature on this theme, obtained consulting the main databases (PubMed, Scholar and CCOHS) up to 2012, was reviewed. RESULTS: Loading/unloading procedures, transport and storage of goods in docks are identified as the major causes of injuries (such as falls, crushing and entrapments) and accidents (release of chemicals, fires or explosions). Moreover, attention is drawn to the risks related to goods handled: in particular, authors described risks of asphyxia or intoxication in restricted and poorly ventilated areas such as containers or ship holds. CONCLUSIONS: The following main prevention measures were identified by all authors as those most effective: implementation of workers' training and information and intensification of controls on ships, particularly concerning loading/unloading procedures and documents accompanying the goods.

[Efficiency of health surveillance in occupational medicine]. / Efficacia della sorveglianza sanitaria in Medicina del Lavoro.

Medical surveillance is one of the primary instruments in occupational health activities and is considered essential to maintain employees' good health. However, the efficacy of medical surveillance has not been sufficiently tested. The aim of this review was to evaluate the usefulness of medical surveillance, using available literature on Pubmed for the period 2005 to 2014. Although on the basis of a small number of studies, our conclusion is that medical surveillance could be considered effective. Apart from the case of occupational asthma, it must be emphasised that the number of evaluation studies is small, especially in some areas, as well as the one of biomechanical overload.

Hidden effectiveness? Results of hand-searching Italian language journals for occupational health interventions.

OBJECTIVE: To compare the yield of hand-searching with optimised electronic search strategies in retrieving occupational health (OH) intervention studies published in a language other than English. METHODS: The authors systematically hand-searched and screened reports of OH intervention studies published in Italian in peer-reviewed scientific journals between 1990 and 2008. The authors evaluated how many of them met the Cochrane Occupational Safety and Health Review Groups (OSHRG) definition of being an OH intervention study and how many potentially relevant studies retrieved by hand-searching would not be found by PubMed alone using the OSHRG's most specific and most sensitive search strings. RESULTS: Hand-searching retrieved 25 articles (reporting 27 studies), including nine not indexed in MEDLINE. Most studies (81%, 22/27) had a before-after design and only one was a randomised trial. The OSHRG's most sensitive search string retrieved all 16 articles published in the Italian language journals that were indexed in MEDLINE, while the most specific search strategy retrieved nine articles (56%, 9/16). The most specific search string showed a lower 'number needed to read' value than the most sensitive one (60 vs 132). CONCLUSIONS: These findings suggest that a sensitive electronic search strategy may be able to find most of the OH interventions published in languages other than English that are indexed in MEDLINE. Hand-searching of important national journals not indexed in MEDLINE should be considered when conducting particularly in-depth research.

Search strings for the study of putative occupational determinants of disease.

OBJECTIVE: To identify efficient PubMed search strategies to retrieve articles regarding putative occupational determinants of conditions not generally considered to be work related. METHODS: Based on MeSH definitions and expert knowledge, we selected as candidate search terms the four MeSH terms describing 'occupational disease', 'occupational exposure', 'occupational health' and 'occupational medicine' (DEHM) alongside 22 other promising terms. We first explored overlaps between the candidate terms in PubMed. Using random samples of abstracts retrieved by each term, we estimated the proportions of articles containing potentially pertinent information regarding occupational aetiology in order to formulate two search strategies (one more 'specific', one more 'sensitive'). We applied these strategies to retrieve information on the possible occupational aetiology of meningioma, pancreatitis and atrial fibrillation. RESULTS: Only 20.3% of abstracts were retrieved by more than one DEHM term. The more 'specific' search string was based on the combination of terms that yielded the highest proportion (40%) of potentially pertinent abstracts. The more 'sensitive' string was based on the use of broader search fields and additional coverage provided by other search terms under study. Using the specific string, the numbers of abstracts needed to read to find one potentially pertinent article were 1.2 for meningioma, 1.9 for pancreatitis and 1.8 for atrial fibrillation. Using the sensitive strategy, the numbers needed to read were 4.4 for meningioma, 8.9 for pancreatitis and 10.5 for atrial fibrillation. CONCLUSIONS: The proposed strings could help health care professionals explore putative occupational aetiology for diseases that are not generally thought to be work related.

Risk factors for operated carpal tunnel syndrome: a multicenter population-based case-control study.

BACKGROUND: Carpal tunnel syndrome (CTS) is a socially and economically relevant disease caused by compression or entrapment of the median nerve within the carpal tunnel. This population-based case-control study aims to investigate occupational/non-occupational risk factors for surgically treated CTS. METHODS: Cases (n = 220) aged 18-65 years were randomly drawn from 13 administrative databases of citizens who were surgically treated with carpal tunnel release during 2001. Controls (n = 356) were randomly sampled from National Health Service registry records and were frequency matched by age-gender-specific CTS hospitalization rates. RESULTS: At multivariate analysis, risk factors were blue-collar/housewife status, BMI > or = 30 kg/m2, sibling history of CTS and coexistence of trigger finger. Being relatively tall (cut-offs based on tertiles: women > or =165 cm; men > or =175 cm) was associated with lower risk. Blue-collar work was a moderate/strong risk factor in both sexes. Raised risks were apparent for combinations of biomechanical risk factors that included frequent repetitivity and sustained force. CONCLUSION: This study strongly underlines the relevance of biomechanical exposures in both non-industrial and industrial work as risk factors for surgically treated CTS.