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2.
Pneumologie ; 74(9): 603-610, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32643765

RESUMO

Occupational diseases are certain diseases designated as such by law. Whereas the medical conditions are described in guidelines, their recognition is based on judicial administrative procedures. Establishing causality is based on requirements of social law. The basic socio-legal concepts are mentioned and the principles of causality in asbestos-related occupational diseases are listed. Exemplary social court judgments are cited. Judgements may not infrequently differ from the medical point of view. The aim of this article is to describe the correct use of social medical understanding in order to carry out adequate assessment of occupational diseases, which implements the legal requirements.


Assuntos
Asbestos/efeitos adversos , Asbestose , Dermatologia/legislação & jurisprudência , Doenças Profissionais , Medicina do Trabalho/legislação & jurisprudência , Justiça Social/legislação & jurisprudência , Asbestose/diagnóstico , Asbestose/terapia , Humanos , Doenças Profissionais/diagnóstico , Doenças Profissionais/terapia
7.
Med Lav ; 111(2): 87-98, 2020 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-32352422

RESUMO

In the past, science has had a conflicting relationship with the philosophy from which it has detached itself due to the scientific method of Galileo Galilei, but anti-scientific atti-tudes and thoughts still persist in every field of knowledge. Occupational Medicine, like other medical disciplines, increasingly needs to have a scientific foundation that guaran-tees evidence and appropriateness for its varied professional activities. Guidance tools for occupational physicians and, in particular, the Guidelines of Scientific Societies repre-sent an indispensable contribution to correct professional practice. In many countries, in addition to the International Society of Reference and International Commission of Occu-pational Health (ICOH), there are National Societies of Occupational Medicine and many of these, such as the Italian Society of Occupational Medicine, regularly publish policy tools and guidelines for the occupational physician. It is not always possible to base the Guidelines in the field of occupational medicine exclusively on consolidated scientific ev-idence but it is still necessary to increase research and publications aimed at evaluating the effectiveness of specific interventions in the preventive, clinical and rehabilitative field of occupational medicine in order to guide occupational physicians to an increasingly appropriate practice. In Italy, a recent law allows the production of Guidelines that partially exempt criminal lia-bility for inexperience through a System of Guidelines produced by accredited Scientific Societies.


Assuntos
Medicina Baseada em Evidências , Medicina do Trabalho , Itália , Guias de Prática Clínica como Assunto
12.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(1): 26-40, ene.-feb. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-191482

RESUMO

El eccema de manos es una patología frecuente con un fuerte impacto en la calidad de vida de los pacientes y un alto coste social y laboral. Su manejo por los médicos de atención primaria y de medicina del trabajo es complejo debido a la variedad de etiologías, la evolución difícilmente predecible de la enfermedad y la respuesta al tratamiento. El diagnóstico precoz y las medidas protectoras adecuadas son esenciales para evitar la cronificación, que es mucho más difícil de tratar. Una correcta derivación a un especialista y la valoración de una baja laboral en el momento adecuado resultan cruciales para un buen manejo de estos pacientes. En esta guía sobre el eccema crónico de manos analizamos el proceso diagnóstico, las medidas preventivas y los tratamientos, con especial énfasis en el papel del médico de atención primaria y de medicina del trabajo en los estados iniciales de su manejo


Hand eczema is a common condition associated with significantly impaired quality of life and high social and occupational costs. Managing hand eczema is particularly challenging for primary care and occupational health physicians as the condition has varying causes and both disease progression and response to treatment are difficult to predict. Early diagnosis and appropriate protective measures are essential to prevent progression to chronic eczema, which is much more difficult to treat. Appropriate referral to a specialist and opportune evaluation of the need for sick leave are crucial to the good management of these patients. These guidelines cover the diagnosis, prevention, and treatment of chronic hand eczema and highlight the role that primary care and occupational health physicians can play in the early management of this disease


Assuntos
Humanos , Eczema/diagnóstico , Eczema/terapia , Atenção Primária à Saúde/normas , Medicina do Trabalho/normas , Eczema/prevenção & controle , Diagnóstico Precoce , Doença Crônica/prevenção & controle , Sociedades Médicas/normas , Qualidade de Vida , Fatores de Risco , Prevenção Primária , Prevenção Secundária , Fototerapia
13.
Arch Environ Occup Health ; 75(1): 45-55, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30896340

RESUMO

Occupational health in Israel is unique as it was originally established as a socialized service which anchored in extensive legislation and is accessible to all employees and employers without copayment. We review historical processes and legal basis that led to current structure of public occupational medicine services in Israel. Some of these go back a century and others extend way back to biblical times. Representative case studies from the field are used to illustrate its scope of practice. Legislative changes that exempted the employers from participation in financing occupational health have led to severe budget cuts, jeopardizing the future provision and key principles of occupational healthcare. We discuss future aspects of recommended development vectors for policy making that will preserve the structure of occupational health services and benefits it offers to all workers in Israel.


Assuntos
Saúde do Trabalhador/legislação & jurisprudência , Medicina do Trabalho/história , Medicina Estatal/história , História do Século XX , História do Século XXI , Humanos , Israel , Saúde do Trabalhador/economia , Medicina do Trabalho/legislação & jurisprudência , Medicina Estatal/legislação & jurisprudência
15.
Rev. Asoc. Esp. Espec. Med. Trab ; 28(4): 288-289, dic. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-187676

RESUMO

Introducción: Mediante la realización de este estudio se pretende conocer las condiciones en las que trabajan los especialistas en medicina del trabajo en España. Metodología: Desarrollo de una encuesta con 57 preguntas contestadas de manera anónima, que tratan aspectos generales de las condiciones socioeconómicas, demográficas, organizativas, formativas y del entorno psicosocial, en formato digital distribuida mediante correo electrónico entre los especialistas en medicina del trabajo a nivel nacional a través de las diferentes sociedades científicas. Resultados: Obtenidas n = 478 encuestas completas, con reparto homogéneo en relación al sexo (mujeres 51% vs. Hombre 49%) con una edad media de 50,72 años, siendo más del 45% mayor de 55 años. Remuneración media entre 45-50 mil euros bruto/año con distribución en SPA (41%) vs SPP (37%) y con contratos por cuenta ajena estable y fijo en el 84%. En cuanto a las condiciones de trabajo, en más del 27% se han recibido amenazas, vejaciones o exclusión laboral, y un 55% considera que tiene una carga excesiva de trabajo. En relación a la formación, el 64% ha recibido al menos 20 h en el último año, pero solo 21% ha publicado en los últimos 3 años. Conclusiones: Los especialistas en Medicina del trabajo conforman un colectivo envejecido con una edad media de 50 años y con la tasa de reposición más baja de todas las especialidades médicas, que cuenta con condiciones laborales estables y retribuciones medias entre 45-50 mil euros anuales. Encontramos diferencias según la modalidad de servicio de prevención en donde se trabaja. y con contratos por cuenta ajena estable y fijo en el 84%. En cuanto a las condiciones de trabajo, en más del 27% se han recibido amenazas, vejaciones o exclusión laboral, y un 55% considera que tiene una carga excesiva de trabajo. En relación a la formación, el 64% ha recibido al menos 20 h en el último año, pero solo 21% ha publicado en los últimos 3 años. Conclusiones: Los especialistas en Medicina del trabajo conforman un colectivo envejecido con una edad media de 50 años y con la tasa de reposición más baja de todas las especialidades médicas, que cuenta con condiciones laborales estables y retribuciones medias entre 45-50 mil euros anuales. Encontramos diferencias según la modalidad de servicio de prevención en donde se trabaja


Introduction: By perfoming this study it is intended to know the conditions in which Specialists in Occupational Medicine work in Spain. Methodology: Development of a survey with 57 questions answered anonymously, dealing with general aspects of socio-economic, demographic, organizational, training and psychosocial environment, in digital format distributed by email among specialists in occupational medicine nationwide of the different scientific societies. Results: Obtained n = 478 complete surveys, with homogeneous distribution in relation to sex (women 51% vs. Man 49%) with an average age of 50,72 years, being more than 45% over 55 years. Average compensation between 45-50 thousand euros gross / year with distribution in SPA (41%) vs SPP (37%) and with contracts for stable and fixed third-party accounts in 84%. Threats, harassment or labor exclusion have been received in more than 27%, and 55% consider that they have an excessive workload. In relation to training, 64% have received at least 20 hours in the last year, but only 21% have published in the last 3 years. Conclusion: The specialists in Occupational Medicine make up an aged group with an average age of 50 years and with the lowest replacement rate of specialist training, which has stable working conditions and average salaries between 45-50 thousand euros per year. We found differences according to the type of prevention service where you work


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Adolescente , Condições de Trabalho , Medicina do Trabalho/estatística & dados numéricos , Impacto Psicossocial , Inquéritos e Questionários , Fatores Socioeconômicos
16.
Med Lav ; 110(S1): 13-23, 2019 Dec 06.
Artigo em Italiano | MEDLINE | ID: mdl-31846443

RESUMO

The first Congress of the Italian Association of Industrial Hygienists was held in 1977. Nevertheless, at the end of the 19th century some issues concerning industrial hygiene had been discussed during the 3rd International Congress on Accidents and Social Insurance (Milan, October 1-6, 1894). A year later, the Milanese trade Unions held another Congress on this theme. In 1902 Leopoldo Sconfietti, an engineer, proposed a new system of air conditioning to be used in textile factories. After the EXPO 1906 in Milan, a museum devoted to Industrial Hygiene was opened in the city, but unfortunately it is now lost. Soon after the opening in 1910 of the Milanese "Clinica del Lavoro", the oldest Occupational Health Institute in the world, an International technical Congress devoted to Industrial Hygiene was held in Milan in May 1912, when the discipline became autonomous from Occupational Medicine and Social Insurance.


Assuntos
Saúde do Trabalhador , Medicina do Trabalho , Academias e Institutos , História do Século XX , Indústrias , Itália , Medicina do Trabalho/história
17.
Med Lav ; 110(S1): 24-35, 2019 Dec 06.
Artigo em Italiano | MEDLINE | ID: mdl-31846444

RESUMO

INTRODUCTION: The Clinica del Lavoro, the first clinic for occupational diseases of the world, was inaugurated in Milan on 20 March 1910; its first director was Luigi Devoto, who was in charge until 1935. The purpose of this work is to review the activities of industrial hygiene and toxicology carried out at the Clinica del Lavoro under the guidance of Devoto. METHODS: Documents published by the Istituti Clinici di Perfezionamento, a group of clinics of which the Clinica del Lavoro was part, record the birth and organization of this structure and the presence of a laboratory of chemistry; documents by Devoto and other authors were also retrieved to extrapolate specific information on activities of industrial hygiene and toxicology. RESULTS: The Clinica del Lavoro, at the time of its inauguration, included four laboratories: of chemistry, clinical physics, histopathology and bacteriology. The chemistry lab was located on the first floor and was composed of 6 well-lit rooms, modernly equipped with work benches that could accommodate 12 people. In Devoto's view, the chemistry laboratory, supported by that of clinical physics, had to assess the toxicological properties of chemicals commonly found in the workplace and to reveal the mechanisms of induction of damage to humans. In the first 30 years of activity, the Clinica del Lavoro investigated various diseases deriving from exposure to chemical agents, including saturnism, or lead intoxication, mercurialism, phosphorism, benzolism, sulfocarbonism, dust diseases. Several assays were developed and applied to measure toxicants in different biological and environmental mean as evidenced by scientific publications starting from 1920. CONCLUSION: In Devoto's view, industrial hygiene and toxicology were essential tools for the research and prevention of occupational diseases since the first years of activity of the Clinica del Lavoro.


Assuntos
Intoxicação por Chumbo , Doenças Profissionais , Saúde do Trabalhador , Medicina do Trabalho , História do Século XX , Humanos , Itália , Saúde do Trabalhador/história , Medicina do Trabalho/história , Local de Trabalho
18.
Med Lav ; 110(S1): 36-48, 2019 Dec 06.
Artigo em Italiano | MEDLINE | ID: mdl-31846445

RESUMO

BACKGROUND: The Clinica del Lavoro of Milan provided several contributions to industrial hygiene and occupational toxicology during the twentieth century. OBJECTIVES: Describe the first years of the laboratory of industrial hygiene of Milan through three figures who played a leading role: Enrico Carlo Vigliani, Nicola Zurlo and Gianmario Cavagna. METHODS: Scientific literature of the period 1948-1970 was investigated, also interviewing first-hand witnesses of that period. RESULTS: Enrico Vigliani was the first European scholar to understand the importance of a laboratory of industrial hygiene within his institution. Thanks to the support of private (Montecatini) and public (INAIL) institutions he succeeded in creating a laboratory in 1948. Nicola Zurlo, who directed this structure in the first thirty years, conducted innovative studies on chronic mercury intoxication, lead intoxication and silicosis, designing and creating instruments for capturing and analyzing atmospheric dust and protection devices. He conducted analysis of the health effects of organophosphorus insecticides and started to study the air pollution. Zurlo also provided an epistemological and methodological content to the discipline. Gianmario Cavagna, one of the first Italian toxicologists, contributed to the discovery of the origin of fevers caused by the inhalation of metal fumes and to the studies on the pathogenesis of byssinosis, hypothesizing a role of bacterial endotoxins in the genesis of this disease. CONCLUSIONS: The contributions provided by these three protagonists to industrial hygiene and occupational toxicology were relevant and made in those years the Clinica del Lavoro of Milan as a landmark, not only in Italy but also abroad.


Assuntos
Intoxicação por Chumbo , Saúde do Trabalhador , Medicina do Trabalho , História do Século XX , Humanos , Itália , Laboratórios , Intoxicação por Chumbo/história , Saúde do Trabalhador/história , Medicina do Trabalho/história
19.
Med Lav ; 110(S1): 49-56, 2019 Dec 06.
Artigo em Italiano | MEDLINE | ID: mdl-31846446

RESUMO

In 1969, the Italian Association of Industrial Hygienists (AIDII) was founded in Milan by Academics working at the Clinica del Lavoro, one of the oldest institutions for work prevention in the world and within the most prolific institutes in the world on Occupational Medicine and Industrial Hygiene. AIDII was founded as a scientific association with the primary purpose of promoting the development, deepening and dissemination of Industrial Hygiene, the scientific discipline aimed at identifying, assessing and controlling chemical, physical and biological risk factors (as well as transversal risks) either inside or outside the workplace, which can alter the health and wellbeing status of workers and/or the general population, for the purpose of effective prevention and protection of human health. Over the decades, the activities of AIDII have evolved to meet some of the current needs and challenges, while remaining consistent with the basics set by the founders.


Assuntos
Saúde do Trabalhador , Medicina do Trabalho , Academias e Institutos , História do Século XX , Humanos , Itália , Saúde do Trabalhador/história , Medicina do Trabalho/história , Local de Trabalho
20.
Med Lav ; 110(6): 459-485, 2019 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-31846450

RESUMO

The Position Paper (PP) on asbestos of the Italian Society of Occupational Medicine (SIML) aims at providing a tool to the occupational physician to address current diagnostic criteria and results of epidemiological studies, and their consequences in terms of preventive and evaluation actions for insurance, compensation and litigation. The PP was based on an extensive review of the scientific literature and was compiled by a Working Group comprising researchers who have contributed to the international literature on asbestos-related diseases, as well as occupational physicians with extensive experience in the evaluation of risks and the medical surveillance of workers currently and formerly exposed to asbestos. The PP was drafted and reviewed between 2017 and 2018; its final version was prepared according to the guidelines of AGREE Reporting Checklist. All the members of the Working Group subscribed to the document, which was eventually approved by SIML's Executive Committee. The first section addresses industrial hygiene issues, such as methods for environmental monitoring, advantages and limitations of different microscopy techniques, the potential role of microfibers and approaches for retrospective assessment of exposure, in particular in epidemiological studies. The second section reviews the biological effects of asbestos with particular attention to the diagnostic aspects of asbestosis, pleural changes, mesothelioma and lung cancer. In the following section the criteria of causal attribution are discussed, together with different hypotheses on the form of the risk functions, with a comparison of the opinions prevalent in the literature. In particular, the models of the risk function for mesothelioma were examined, in the light of the hypothesis of an acceleration or anticipation of the events in relation to the dose. The last section discusses topics of immediate relevance for the occupational physician, such as health surveillance of former exposed and of workers currently exposed in remediation activities.


Assuntos
Asbestos , Asbestose , Neoplasias Pulmonares , Mesotelioma , Exposição Ocupacional , Medicina do Trabalho , Neoplasias Pleurais , Humanos , Itália , Estudos Retrospectivos
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