[Risk assessment: use of the SOBANE model at the Health Authority of Lodi province]. / La valutazione del rischio: applicazione del modello SOBANE nell'ASL di Lodi.

The evaluation of the risks for the health safeguard within the workplace, represents a fundamental moment of the intervention planning. During the years it has been enriched by experiences, improvements and techniques essentially introduced by a set of laws; in particular the 626/94 Legislative Decree. This was the first well-organized expression of the new strategies identified on the basis of the assigned responsibilities and the protection of the production process. With the 81/08 L.D. such strategies have been once again highlighted but with a particular emphasis on the partecipation of the workers in the risk detection. This work just deals with such aspect by means of the experimentation of a specific method represented by the so called SOBANE pattern. The results point out some aspects that are positive in terms of satisfaction and handiness. These aspects may contribute to the employment of the method to a wide range of services with important effects on the drawing up of the evaluation document of the business risks

[Occupational health surveillance in agriculture: the experience of the International Centre for Rural Health]. / Sorveglianza sanitaria in agricoltura: l'esperienza del Centro Internazionale per la Salute Rurale dell'Azienda Ospedaliera San Paolo di Milano.

The results of the activities of occupational health surveillance in agriculture carried out by the International Centre for Rural Health since 2008 are described. The activities involve 800 workers employed in 260 farms in the Region of Lombardy (Italy). The types of farms reflect the vocation toward agricultural sector of the Po Valley and the most representative tasks are related to animal care and use of agricultural machinery. Based on the specific risks, workers are provided with preventive and periodic examinations, and complementary laboratory and instrumental evaluations (hearing and respiratory functions, electrocardiography), related to the different risk factors present in the enterprises. The occupational health priorities identified are, for the time being, noise-induced hearing loss and insufficient immunization against tetanus.

[The occupational health physician and the health surveillance in agriculture]. / Il medico del Lavoro Competente e la Sorveglianza Sanitaria in Agricoltura.

Despite the underreporting of occupational diseases in agriculture, available data clearly show a significant health risk, and therefore the need of health surveillance at the workplace. The implementation of health surveillance programs for agricultural workers relies on the possibility of creating a system able to reach the workers at their workplaces, with the collaboration of employers' associations, able to support enterprises in several issues, including risk assessment and management. The health surveillance program can be organized in a component common for all workers, based on physical examination, chemistry, electrocardiography, hearing and lung functions examinations, and on tests addressing specific risks, if present: vibration, physical overload, chemicals, biological agents, allergens. The frequency of examinations must be decided based on risk assessment and health surveillance outcomes.

[The activity of local health units in agriculture: promotion, prevention, control]. / Attività di promozione, prevenzione e controllo delle ASL/AUSL in ambito agricolo.

Agriculture shows an high proportion of injuries, mostly by machineries and instruments, and the highest proportion between fatal and total injuries. The Conference of Regions has adopted the National Agriculture and Forestry Prevention Plan, in application of the "Pact for health and safety in workplaces". The plan gives priority to actions improving the safety of agricultural machines, specially if more frequently involved in serious and fatal injuries. Goal is to achieve an homogenous intervention standard all over in the country, composed by a mix of information, support and control, addressed to farms and agricultural machines traders. Public prevention organizations of Local Health Units moreover will record homogenously the happen modality of fatal and serious accidents, will collaborate in joining prevention objectives with Rural Develop Plans and in drawing up good practices. At another level in some regions have been developed prevention activities for other risk factors: definition of exposition profiles of pesticides, development of professionally exposed workers formation, control of buildings and cattle breeding, medical and epidemiological periodic survey of employees.

[Evaluation and management of pesticide risk in agriculture: the experience of the Region of Lombardy (Italy)]. / Valutazione e gestione del rischio da antiparassitari in agricoltura: l'esperienza della Regione Lombardia.

The evaluation of chemical risk in agriculture is complicated because of difficulties in obtaining measures representative of working conditions. This is the reason why experiences finalized at producing risk estimates are running. In this frame, a Regional working group has developed the project "Pesticide exposure and risk profiles in agriculture". Priority scenarios have been selected and the main variables correlated with pesticide exposure have been pointed out. A value for each variable has been defined. The sum of these values allows the definition of "Exposure Indices" (EI), which can be reduced by multiplication for a coefficient calculated based on use of personal protective devices, training and education and equipment conditions. A Risk Index is calculated as the product of EI per a toxicity index, calculated based on the risk phrases of the substances used ("Risk Profile"). Risk Profiles allow the production of risk estimates and the definition of the appropriate preventive interventions. Next phase will be addressed at the validation of the model, to be carried out through the determination of the levels of concordance between the risk class allocation obtained from the model and the one obtained from environmental and biological measures, in the same groups of workers.

[Assessment of exposure to organic aromatic compounds and PAH in asphalt industry: the PPTP-POPA Study results]. / Valutazione dell'esposizione a composti organici aromatici e IPA nelle opere di asfaltatura: i risultati dello Studio PPTP-POPA.

Asphalt is a mixture of mineral matter and bitumen, its fumes contain about 1% of Polycyclic Aromatic Hydrocarbons (PAH), some of which are carcinogens. In the PPTP-POPA Study of Lombardy Region, a group of 100 asphalt workers (exposed to bitumen fumes and diesel exhausts) and a group of 47 ground construction operators (exposed only to diesel exhausts) were investigated to assess PAH exposure in Italy, by means of environmental-air monitoring (the 16 most relevant, according to the American Environmental Protection Agency, EPA) and biological monitoring (urinary 1-hydroxypyrene excretion). Our results show that PAH exposure in these workers is not higher than that observed in traffic policemen working in urban areas. Since dermal exposure has been suggested as a major determinant of the total PAH dose absorbed by road pavers from bitumen fumes, we assessed skin contamination by organic aromatic compounds and by sixteen PAH: in both groups, six pads were applied to each subject in different parts of the body, during the workshift. The results show that the dermal contamination in road pavers is higher than in ground construction operators and that cutaneous dose rate is higher than respiratory dose rate, whereas the amount of absorption the ratio is inverted.

[Lombardy regional project: prevention of occupational tumors]. / Progetto regione lombardia: prevenzione dei tumori professionali.

In Lombardy, the regional project "Prevention of occupational cancers" is ongoing. The main objectives of this project are to identify work environments in which there might be a possible exposure to carcinogenic substances and to elaborate preventive measures. A casual sample of 250 working settings representing the different economic activities has been selected and evaluated. The 10% of the examined workplaces showed a possible exposure to chemical carcinogens. The most common carcinogens were trichloroethylene, preparation of plastics materials containing acrylonitrile-butadiene-stirene, formaldehyde, wood dust, hexavalent chromium, silica and polycyclic aromatic hydrocarbons. Galvanic industries, Bitumen production and placing companies and Plastics processing plants will be studied for environmental and biological monitoring and for the development of preventive measures.

[Risk profiles in agriculture: activities in the region of Lombardy]. / Profili di rischio in agricoltura: attività in Regione Lombardia.

Agriculture represents a very complex scenario that needs proper tools. To this aim, in the frame of Special Project "La Prevenzione nell'impiego di Antiparassitari in Agricoltura" promoted by the Region of Lombardy, profiles of exposure and/or risk have been identified as valid approach able to define particular conditions of exposure and risk for the operator in particular settings. The evaluation necessarily needs to identify the most important parameters affecting exposure and their extent on magnitude of exposure. Therefore, field studies should be further performed in order to confirm and improve the profile. The identification of profiles of exposure and risk is an activity still in progress that need to be carefully set up and standardised. The team involved in the study identified priorities deserving much attention in Lombardy, and planned a three years programme aimed at define the profile of exposure and risk in viticulture, maize crop, rice growing, nursery gardening, horticulture in greenhouses, maintenance of gardens, and poplar growing.