[Analysis of a case series of workers with mobbing syndrome]. / Analisi di una casistica di lavoratori con patologia da mobbing.

Mobbing represents nowadays a major challenge for Occupational Medicine. We examined, during the last seven years, 253 patients who asked medical assistance for psychopathological problems by them ascribed to mobbing in the working environment. All patients underwent occupational health visit, psychological counselling (including personality tests administration), and psychiatric evaluation. A clinical picture probably due to mobbing was diagnosed in 37 workers: 2 cases of Post-Traumatic Stress Disorder (PTSD), 33 of Adjustment Disorder (AD), and 2 of anxiety disorder. Regarding mobbing typology, we found 19 cases of vertical mobbing (by an employer/manager to employees), 14 cases of strategic mobbing, 3 cases of horizontal mobbing (among colleagues), and one non intentional mobbing. In conclusion, a pure mobbing syndrome was diagnosed in a lower proportion than that reported by other investigators. The described interdisciplinary approach appears useful for the diagnostic assessment of suspect mobbing cases, that in turn is crucial for prognosis and treatment, as well as in relation to medico-legal issues and work-related compensation claims.

[Ergonomy and videoterminals]. / Ergonomia e videoterminali.

After defining some concepts relative to ergonomy and videoterminals (VDT), the paper describes the main health risks for VDT workers (visual, muscle-skeletal and stress disorders). The ergonomic requirements established by the Italian legislation for VDT work are then examined, including illumination, the working environment, the working desk and seat, the video-screen, the keyboard, the upper body position, pauses and physical exercise, training and information. Recent regulations (in particular the law 422/2000) on the sanitary surveillance of VDT workers are finally reported.

[Mobbing: analysis of an ambulatory case load]. / Mobbing: analisi di una casistica ambulatoriale.

We present twenty outpatients (11 males; 9 females) who asked medical assistance, during the last two years, for psychopathological problems by them ascribed to "mobbing" in the work environment. Six subjects were employed in public institutions, 14 in private companies. All patients underwent occupational health specialistic visit, psychological counselling (including personality tests administration), and psychiatric evaluation. A psychopathological picture reasonably correlable to "mobbing" was diagnosed in four subjects only (20% of the cases), i.e. in a lower proportion than that reported by other investigators.

[Disability and occupational medicine: definitions, scope, and operative examples]. / Disabilità e medicina del lavoro: definizioni, ambiti, esempi operativi.

2003 is the year of disability. This paper briefly illustrates the multiform relationships between occupational medicine and disability, discussing the complex legislation on this matter. A historiographic account is presented of the image of the disabled individual through the centuries. The main terms regarding disability are defined according to current legislation. Current Italian laws are difficult to interpret and to be put into effect. In this process, the occupational physician may be asked to perform several duties, including diagnosis and certification, fitting the disabled to work, safeguarding his/her moral and legislative rights, prevention and sanitary surveillance. Some professional experiences of the authors (regarding certification of the working capability, medico-legal recognition, and adaptation to work) are finally presented.

[Burn-out risk in health workers at Alzheimer's units]. / Il rischio di burn-out negli operatori sanitari dei Nuclei Alzheimer.

On the basis of their personal experience, the Authors try to identify the salient aspects of the occupational stress and of the consequent burn-out syndrome in the health personnel of the Alzheimer Units of Lombardy. In these structures, the initial motivations, the emotional involvement, and the effort required by the job make the staff at high risk. The syndrome generally evolves through four stages (idealistic enthusiasm, stagnation, frustration, apathy) and may easily become a collective problem, with worsening of the quality of care and dispersion of economical resources. The occupational physician, possibly with the collaboration of the psychologist, should adopt adequate preventive, therapeutic, and rehabilitative measures, regarding both the work organization (stress reduction, creation of a group consciousness) and the single (professional training, psychological support, health surveillance).

[Apolipoprotein(a) phenotypes as markers of genetic susceptibility for cardiovascular risk in occupational medicine]. / Fenotipi di apolipoproteina(a) come indicatori di suscettibilità genetica per rischio cardiovascolare in medicina del lavoro.

Several agents (e.g. chemical or physical) present in the work environment may be harmful for the cardiovascular system. Recent studies on the cardiovascular diseases linked to hyperlipidemia have demonstrated a strong correlation between high lipoprotein(a) [Lp(a)] levels and Coronary Heart Disease (CHD). In particular, the severity of this pathological condition correlates well with the molecular weight (MW) of the apolipoprotein(a) [apo(a)] isoforms supporting Lp(a) (low MW = high risk; high MW = low risk), which are characterized by a high degree of individual variability. Since apo(a) isoforms are genetically determined, a genetic predisposition for CHD has been identified, i.e. the apo(a) phenotype is considered a marker of genetic susceptibility for cardiovascular risk. After a brief presentation of the main occupational cardiovascular risk factors (e.g. carbon disulfide, carbon monoxide, noise, psycho-physical stress) and of the most updated theories on atherogenesis, the present review proposes to utilize the measurement of the plasmatic Lp(a) level to screen for occupational cardiovascular risk susceptibility. Apo(a) phenotype characterization of workers with medium-high Lp(a) levels is then suggested. Our proposal may be realized by means of simple and relatively unexpensive laboratory methods.