Giornale italiano di medicina del lavoro ed ergonomia最新文献

Summary: The Authors examine developments in Italian legislation concerning compulsory work placements for disabled people, comparing them to those of other countries, and focusing in particular on the operational aspects of the assessment committees set up under Italian legislative decree 68/1999; these commissions are tasked with a global assessment of the disabled individual, using multiple socio-health and occupational medicine perspectives, as well as through a conclusive medico-legal assessment. The work focuses on the delicate role played by these committees in adequately weighing up the residual working capacity of the disabled individual in order to place him/her in the most appropriate and least aggravating workplace in terms of the disorders they are affected by; this is possible by transferring the socio-work profile drawn up by the evaluation committee into the context of the labour market. Finally, the Authors try to highlight how this task has become even more difficult due to the economic and labour crises that have affected several of the employment sectors in Italy in recent years.

Summary: Purpose. Currents methods for the evaluation and control of optical radiation hazards at workplaces are presented. Methods. Safe exposure criteria that may be readily applied to practical situations are discussed. Hazard evaluation techniques are discussed for a number of intense optical radiation sources. Examples include arc welding, germicidal lamps in medical and laboratories activities, metal and glass melting. Results. Hazard data and PPE choice criteria are provided, taking account of varied critical aspects from the case studies discussed. Conclusions. Some critical aspects in the optical radiation safety management have been discussed. The improvement of protection programmes is needed to raise awareness of the health hazards of optical radiation, and to achieve the application of simple engineering controls and/or administrative controls aimed at ensuring that workers are made aware of the presence of potentially harmful optical radiation and providing information to avoid such harmful exposure, according to AOR Directive.

Summary: The paper aims to present the methodology applied by the Port System Authority of the Eastern Adriatic Sea from 2016 on to tackle aspects threatening the old and no-more replicable "rules" governing the Trieste Port Community social and economic equilibrium and which had generated an endemic reporting of occupational diseases. The methodology is based on the integration between port operation models and occupational health and safety requirements, in particular occupational ergonomics. By consolidating synergies with all Port stakeholders, the Authority carried out document and on-site surveys which detected the most relevant weaknesses of the system, considered already outdated. Thus, the Authority defined and adopted regulations to promote Port workers' welfare and protect marginalized workers' dignity; furthermore, the Authority applied technical measures to stop the process which would have caused new cases of the same occupational diseases. The Authority improvement action plan provides for a central role for occupational health physicians who will be asked to define shared minimum requirements to develop sanitary protocols for those port jobs exposed to similar risks in terms of quality and magnitude.

Summary: The paper reviews allergy to green coffee bean and castor bean in dock workers and in coffee processing workers from '80 to nowadays in Trieste (NE of Italy). The avoidance of use of jute sacks contaminated with castor bean caused a decrease in sensitization to castor bean and the better work practices to handle jute sacks permitted to reduce airborne exposure to green coffee been powders, that resulted below occupational exposure limits. However, the measurement of ultrafine particles emitted during the handling of sacks showed exposure to high level of particles below 40 nm and permitted to identify some work tasks that can cause a more elevated exposure. Moreover, some sacks, coming from Tanzania, are still contaminated with castor bean, causing mild allergic symptoms. The work condition in dock workers in Trieste improved in years with a reduction of exposure to these allergens. However, the adoption of protective measures as well as periodical medical surveillance are needed to prevent sensitization or to detect the early onset of new cases.

Summary: Several decades of research provides compelling evidence that exposure to air pollution causes various diseases. Time series studies in Europe and the USA examined the short term effects on mortality and found about 1% increase for cardiovascular mortality per 10 μg/m3 increase in daily PM2.5 concentration. A comprehensive analysis of 12 European cohort studies addressing the long term effects found a 13% increased risk of coronary events per 5 μg/m3 increase in estimated annual mean PM2.5. Noise exposure triggers an increase in sympathetic responses (fight-flight reactions) and increased release of corticoids (defeat reactions). In 2018 the World Health Organization has published new Environmental Noise Guidelines reporting an 8% increase in risk of incident ischemic heart disease per 10 dB(A) increase in road traffic noise exposure. Transportation noise and air pollution impact health through different pathways, though they also share many biologic pathways. In a recent cohort study, we did not find indications for synergistic or antagonistic effects from combined exposure to noise and air pollution. A study estimating the Environmental Burden of Disease in Europe concluded that ambient air pollution and transportation noise are the two most relevant environmental stressors for the population living in Europe.

Summary: Cardiovascular diseases are the leading cause of morbidity and mortality in developed countries and about 50% of myocardial infarctions occur in working age individuals. Return to work rates are determined by cardiovascular parameters as well as by psychosocial factors and a Cardiac Rehabilitation program after an acute coronary syndrome or coronary revascularization has shown to improve the cardiovascular outcome, occupational recovery and professional reintegration through a multidisciplinary intervention including physical exercise, lipid and blood pressure control, smoking cessation program, nutritional advice, psychological counselling and target-driven pharmacological therapies. The collaboration between cardiologist and occupational physician is crucial in the transition from illness to an active social position defining the work eligibility with the assessment of cardiological profile, comorbidities, psychological functions, worker's ability and functional capacity.

Summary: Research laboratories represent peculiar employment realities, generally characterized by the use of reduced volumes of several chemicals, often used in mixture, thus defining a potential exposure to multiple chemical agents. Methods. The aim of the study is to provide a brief review of the most widely used methods for assessing chemical risk in laboratories, with particular emphasis on their limits and advantages. Results. The approach most often used for assessing chemical risk in research laboratories involves the use of a qualitative modeling approach for risk assessment or quantitative exposure assessment tools. Conclusions. Chemical risk assessment algorithms represent a useful solution for the purposes of the initial screening for the assessment of chemical risk in research laboratories: their ease of use makes them easily accessible, but on the other hand does not allow to take into proper consideration the particularities of the assessed exposure scenarios. Regarding the exposure estimation models, although these instruments have a wide range of applicability, there is no solid and complete validation, which evaluates the accuracy and reliability for this peculiar type of exposure scenarios.

Summary: Purpose. The work illustrates useful elements for the risk assessment for workers exposed to electromagnetic fields, also in reference to sensitive subjects such as those with active implantable medical devices (AIMD). Methods. The approach introduced by Legislative Decree 81/08 for risk assessment does not explicitly include operational criteria and specific measures for the protection of sensitive subjects. In the case of workers with DMIA, the employer may refer to relevant harmonized technical standards. Results. They are shown the results of in vitro tests performed on pacemakers following the indications of the technical reference standard and employing sources of electromagnetic fields that, due to the type of signal emitted, do not allow to exclude an a priori influence on the operation of the device. Conclusions. Workers at particular risk are generally protected if the requirements established for the population are respected. This measure may, under certain conditions, not be sufficient,making it necessary to carry out more in-depth and individual assessments. However, the cases illustrated here for AIMD showed interference phenomena only in limited experimental configurations despite the levels of the electric and magnetic fields generated by the sources exceeding the limits for the general population.

Summary: This report summarises some of the crucial and critical aspects on the enforcement of the Italian regulations on port and maritime work and fishing, following the activity of the Interregional Coordination Working Group on OHS in Ports and Ships from September 2017 until September 2019. The discussions have been organised in fine main topics. First of all, the complex relationships between the different Institution and Social Partners dealing with the subject at local and national level. Some specific topics are then analysed in depth: the limits of regulations on health surveillance for maritime workers; the difficult management of work interference during loading and unloading ships, the transport of dangerous chemicals and the port road and rail safety; the critical aspects of the enforcement of precautions for hot work in ship repair and asbestos removal. Finally, we describe a complex national training on the field project, organized for the inspectors by the Working Group on OHS in Loading and Unloading ships, Shipyards and Ship Repair, Fishing work.

Summary: Aims. A growing number of workers are employed in research laboratories where nanomaterials (NMs) are synthesized, characterized, processed and investigated for their physico-chemical and toxicological properties. To adequately evaluate occupational risks in such contexts, a suitable exposure assessment is necessary. Methods. A critical review of the scientific and grey literature on NM exposure in laboratories has been performed. Results. The evaluation of the exposure, in general, includes a preliminary analysis of the working processes and of the features of NMs employed. Environmental and personal monitoring can be used for a quantitative assessment of the exposure, although the current uncertainties relating to the metrological parameters to be measured and the occupational exposure limits to be compared with collected data make the interpretation of the results and the definition of shared sampling strategies a challenging issue. Conclusions. To date, qualitative information on NM exposure can be used in "control banding" instruments useful for the precautionary assessment and management of risks in research laboratories involved with NMs. Future NM environmental and personal exposure assessments should be pursued to define appropriate monitoring strategies and guide the adoption of appropriate preventive measures to protect the health of workers.