[The list of the occupational disease and medical surveillance: the function of preventive medicine doctor]. / L'elenco delle nuove malattie professionali e sorveglianza sanitaria: il ruolo del medico competente.

The recent revision of tables of occupational diseases according to the article 3 and 211 of TU 1124/65 is helpful to working physician. This revision established the necessity of explain the link between the causative agent and disease and inserted the disease caused by biomechanics overload of upper limbs. The previous absence of these disease was in contrast to the duty of declaration according to the article 139 of TU 1124/65. The new decree allowed to define better the link between the causative agent and the target organ of neoplastic occupational disease. Even if the decree set in order the duties of working physician a simplification is needed. In short about health supervision, it's necessary to clarify the link between the duty of health supervision and working activities that can cause occupational disease inserted in the tables. For this reason the intervention of the new Consultative Commission, according to article 6 of decree 81/2008, is desirable.

[The demonstration of the connection of cause in the professional allergic pathology not tabulated. Utility and limits of the allergometric tests]. / La dimostrazione del nesso di causa nella patologia allergica professionale non tabellata. Utilità e limiti dei test allergometrici.

The Sentences of the Constitutional Court no 179/88 and 206/88 have of done modified the system insurance of the professional illnesses. To the old tabular system to the pathologies for which the legal conceitedness of origin is in force they are added those pathologies that need to be shown with burden of test of the applicant. And necessary to resort to the criterion pathogenetic for the geneses pathologies plurifactorialy or to non certain etiology. These innovations determine the necessity of a methodological iter forced for the recognition of the professional illness not table. The authors therefore they propose an iter diagnostic that passes through the recognition of the connection of cause. To such intention the authors examine meaning and limits of the suggested investigations.

[The risk of manual handling loads in the hotel sector]. / Il rischio da movimentazione manuale dei carichi nel settore alberghiero.

The aim of our study is to evaluate the manual handling risk and the incidence of muscle-skeletal pathologies in the hotel compartment. Our study is conducted on 264 workers of the hotel compartment. The sample is divided on the base of the working turn in the following groups: porter (both to the plans and in the kitchen); waiters to the plans; services (gardeners and workers). The duties have been valued according to the method NIOSH. The presence of muscle-skeletal pathologies has been verified on the base to the accused symptomology, and on the presence of clinical objectivity and to the reports of checks. The data has been compared to a control group. The application of the NIOSH method has showed for each working profile an elevated synthetic index, > 3, and for porter the index is 5. The clinical data has shown an elevated incidence of pathologies of the spine, especially lumbar spine, with a high prevalence in the group of male porters. In conclusion we believe that the manual handling represents a particularly remarkable risk for the workers in the hotel compartment.

[Malignant pleuric mesothelioma in Sicily. Epidemiologic observations during the time 1998-2005]. / Mesotelioma pleurico maligno in Sicilia. Note epidemiologiche nel periodo 1988-2005.

Pleural malign mesothelioma is the only one to which we can straight attribute to an exposition, in professional and ambient ambit, to a good identified agent and, precisely, to the fibres of asbestos. Objective of our work has been to verify the incidence of the pleural malign mesothelioma in Sicily and in particular in the Messina's area, during the period 1988-2005. We have examined the epidemiologic data of the period 1988-1997 and 1998-2005 through the consultation of the Mesothelioma Sicilian Register; Mesothelioma Italian Register and of the available documentation in the Health Superior Institute. The study showed that the pleural malign mesothelioma in sicily and in Messina's area is reduced for the elimination of the asbestos and for the low use of asbestos in the sicilian industry.

[Work related disease in radiation exposed? Case report]. / Malattia professionale in radioesposto? Case report.

In the present work we analysed the possible recognition of professional disease in a subject exposed to ionizing radiation. Haematic parameters were evaluated during the working activity and after the risk's avoidance. Normal haematic values after the pathogenic noxa's avoidance exclude a chronic damage, which in an indispensable datum for professional disease recognition.

[Evaluation of direct occupational ocular trauma using electrophysiological techniques]. / Valutazione del trauma oculare diretto occupazionale con tecniche elettrofisiologiche.

The most recent data from National Institute Insurance Work Accident (INAIL) confirm the high incidence of ocular injury as accident work. In this work the authors analyse the most common clinical form of occupational ocular trauma with the purpose to evaluate the use of electrophysiological tests in the diagnosis and in the follow up of these accidents. Authors admit the importance of more recent techniques as TC and MR in the diagnosis of these injuries; however, they conclude that electrophysiological tests can be considered as a first choice for the evaluation of the evolution and sequelae of ocular traumatism, for their low cost and easy application.

Affective correlates of occupational exposure to whole-body vibration. A case-control study.

BACKGROUND: Exposure to whole-body vibrations (WBV) represents a highly diffuse occupational risk. Some studies report that chronic exposure to WBV induces a significant increment in the modifications of the cognitive and emotional area. The aim of this study was to investigate the long-term effects of WBV exposure on the neuropsychic and behavioural system. METHODS: The study population consisted of 137 male subjects, mean age 45.7 years, working as drivers of mechanical trolleys and occupationally exposed to WBV of a frequency below 2 m/s2. The Profile of Mood States was administered to all subjects in a maximum time of 10 min and in the same operative conditions. The results were compared with those of a homogeneous control group by means of an innovative statistical technique. RESULTS: The results show a significant difference in the response to the neurobehavioural test. The exposed group showed, in fact, a higher score compared with the controls for all 6 factors. In particular, the scores for factors F (fatigue-inertia), D (depression-dejection) and T (tension-anxiety) were more elevated, expressing a significant alteration of the psycho-affective status. Moreover, statistical analysis showed a correlation between exposure time and the score obtained for all factors in the exposed group. CONCLUSION: This study indicates that occupational exposure to WBV is associated with alterations of mood status and that these modifications are directly proportional to exposure time. Furthermore, our results show that psychological tests commonly used in psychopathologic diagnostics can be useful in monitoring alterations of psycho-emotional status determined by physical stressors.

Spirometric function in non-smoking workers exposed to aluminum.

BACKGROUND: Exposure to aluminum (Al) causes the onset of respiratory disorders. This study is aimed at providing further information on how occupational exposure to Al affects the respiratory apparatus in healthy non-smokers, with particular attention to respiratory function. METHODS: A group of 50 male shipyard workers who were exposed to Al underwent medical examination, standard chest X-rays and spirometry in accordance with the C.E.C.A. protocol. The data were compared with those of a homogeneous group of controls, all with blood aluminum (AlB) levels below 7.5 ng/ml. Statistical analysis was performed on the following spirometric parameters: vital capacity (VC), forced vital capacity (FVC), maximum forced expiratory volume in 1 s (FEV1), and mean forced expiratory flow during mid-half of FVC (FEF(25-75%)). Environmental Al levels were also measured at the various workstations. RESULTS: Fifty male workers with an average age 31.82 +/- 5.05 years, occupational exposure of 11.81 +/- 3.71 years, presented with average AlB levels of 32.64 +/- 8.69 ng/ml. Environmental monitoring displayed Al levels higher than TLV TWA for all the workstations studied. None of the sample displayed significant pathological conditions. Statistical comparison of the spirometric parameters showed a decrease in the examined values in exposed workers. This decrease was found to be directly proportional to the AlB level. CONCLUSION: The authors conclude that Al affects respiratory function and that limit values should be reassessed.

[Cognitive disorders among welders exposed to aluminum]. / Disturbi cognitivi in saldatori esposti ad alluminio.

In order to evaluate the relationship between exposure to aluminum and cognitive functions, a group of 50 aluminum welders underwent to the following neuropsychological tests: Wechsler Memory Scale, Color-Word Test and Raven Progressives Matrices test. The results of the tests showed a reduction of memory, of concentration and a slight reduction of attention. The authors conclude that aluminum exposure leads cognitive changes.

[Test of pharmacologic bronchial stimulation in the assessment of work suitability]. / Il test di broncostimolazione farmacologica nella valutazione dell'idoneità al lavoro.

The suitability to the work is one of the main items of occupational medical doctor's activity, often developed with very few informations about the effective features a worker is about to carry out. Consequently, every appraisal of work suitability is based almost exclusively on clinical analysis. A peculiarity of the problem is the one strictly connected with the Allergic Pathology, since it brings a condition in which the subject under medical exams don't present any operative-limiting pathological condition; he could, anyway, presents a slight limitation connected to a subjective response toward a eventually workplace-based specific allergenic agent. It's important, therefore, the need to show, in case of workers exposed to potentially allergenic substances, that subjective conditions who could cause an abnormal reactivity in presence of a potentially efficient stimulation. The main intention of this piece of work is to develop a study about the utility of bronchial challenge with methacoline in a context of evaluation of work suitability for those allergenic substances exposed jobs.

Effects of noise on functional cardiovascular parameters: a follow-up study.

The aim of this follow-up design study is to give a contribution to the knowledge of the controversial relations between noise and functional cardiovascular parameters. The study population consisted of 757 male employees working for 5 different firms in the oil chemical area (refining and distribution of fuel) with different qualifications--345 workers, 212 drivers, 200 clerks--and thus exposed to 3 different levels of noise (85-90 dBA, 80-85 dBA and < 80 dBA respectively). Heart rate, systolic and diastolic blood pressure were monitored 3 days a week at the beginning of the working shift, for a period of 12 years. The analysis of the data obtained indicates that all the 3 parameters under observation tend to increase progressively with the age and working age of the subjects. In the comparison between the 3 levels of exposure, heart rate results not affected by the exposure to noise; systolic blood pressure results sensitive only for the discrimination of the effects due to exposure, showing a statistically significant difference only between clerks on one side and workers and drivers on the other; diastolic blood pressure is highly influenced by the level of exposure to noise, showing significantly different slopes for the 3 groups. In conclusion, blood pressure is a parameter definitely more reliable for the correlation to the level of exposure, while heart rate cannot be considered a marker of exposure to noise.

Neurotoxicity induced by exposure to toluene. An electrophysiologic study.

The object of the present study was to evaluate, with the aid of electrophysiologic techniques, the alterations induced in the auditory nervous system by exposure to toluene in a group of rotogravure workers. From 300 workers who were apparently in good health but were professionally exposed to toluene, we selected a sample of 40 workers of normal hearing ability. They were examined with an adaptation test studied by the brainstem auditory evoked potential technique with 11 and 90 stimulus repetitions a second. The results were compared with those in a group of workers of the same age but not professionally exposed to solvents. Our study demonstrates that exposure to toluene is able to induce a statistically significant alteration in the electric responses with both 11 and 90 stimuli repetitions. This alteration can be explained as a toluene exposure-induced modification, of physiologic stimulus conduction mechanisms, even in the absence of any clinical sign of neuropathy. Furthermore, such a modification could be observed in the electric responses of the entire auditory system, from peripheral receptors to brainstem nuclei.

[Inhaled substances in the home and perennial allergic rhinitis: the role of Dermatophagoides pteronyssinus]. / Inalanti "domestici" e riniti allergiche perenni: ruolo del dermatophagoides pteronyssinus.

In this study, the authors evaluate the inhalant substances of the house, emphasizing the importance of Dermatophagoides pteronyssinus to cause perennial allergic rhinitis. They report the incidence of this and other allergens in 140 patients with perennial allergic rhinitis and the pertinent precautionary measures.