Giornale italiano di medicina del lavoro ed ergonomia最新文献

Summary: In 2013, IARC classified the radiofrequency emitted by mobile phones exposure as possibly carcinogenic to humans (Group 2B). After this classification, several studies were carried out to confirm and to robust or to reject IARC conclusions. Aim of this work was to draw a synthesis of principal scientific evidencies published till September 2019. The analysis of published results could not indicate clear risk profiles, nor surely confirm or reject the hypothesis that exposures to radiofrequency from mobile phones can threat human health. Despite the prevalence of negative studies, some methodological and temporal limitations prevent to draw firm conclusions about the potential health risks for humans, especially for heavy exposed subjects or particular categories such as children or adolescents. Thus, further studies are needed, as well as some methodological improvements, to fully respond to the question about health threats of radiofrequency emitted by mobile phones.

Summary: No abstract available.

Summary: A complex particle accelerator has been built at the Italian National Centre for Oncological Adrotherapy in Pavia, called synchrotron, which is able to decompose atoms and create beams of particles to be directed to tumour cells in order to destroy them. It is the hadrontherapy, a very advanced radiation therapy for the treatment of X-ray resistant or inoperable tumours. In particular, the CNAO synchrotron in Pavia is the only one in Italy capable of extracting carbon ions from the atom, which are the most powerful particles capable of destroying the DNA of cancer cells while preserving the surrounding healthy tissues. Hadrontherapy has been recently included by the Italian Ministry of Health into the essential levels of assistance, recognizing its scientific validity. All Italian citizens can access treatments within the National Health System, according to defined modalities. More than 50 patients are treated at CNAO every day and to date more than 2300 cancer patients from all over Italy have been able to benefit from hadrontherapy. The article will illustrate the technological innovation of the centre in Pavia and will focus on the most interesting research and development projects.

Summary: The term monoclonal gammopathy refers to a clinical condition characterized by the presence in serum and/or urine of clonal immunoglobulins, i.e. homogeneous immunoglobulins, structurally identical both as a heavy chain and as a light chain, produced by a B cell clone (1). The prevalence of MGUS is low in young subjects (less than 2% of patients with MGUS are less than 40 years of age, while in the population aged over 50 years it is relatively high (3.2%) and increases considerably with age. Although historically considered to be a benign condition, patients with MGUS are at risk to develop multiple myeloma over time. Therefore, MGUS may be framed as a preneoplastic stage of the plasma cell that precedes the possible development of a multiple myeloma. In a limited percentage of cases, it can be considered the asymptomatic pre-malignant stage preceding multiple myeloma (MM) on a probabilistic basis. Few studies have assessed the prevalence of MGUS in people occupationally exposed to pesticides. Several other studies on atomic bomb survivors in Hiroshima and Nagasaki have revealed a possible association with exposure to ionizing radiation (IR). Routine laboratory tests performed on the subjects exposed to the risk factors studied appear to be indicated for workers from the age of 50 years. The finding of a GMUS in the absence of further laboratory alterations is the most frequent finding and does not require further action, if it is not to plan include blood chemistry tests at least every two years. In this situation, no restrictions appear to be justified on the work activity involving the risk of exposure to IR or pesticides. In case of concurrent presence of alterations that may be indicative or suggestive of an increased risk of evolution in a neoplastic way a close periodicity - every 3-6 months - of haematological checks is recommended. In such cases, it appears justified to move away from activities involving exposure to ionizing radiation for a period of time which should be evaluated on the basis of the evolution of the picture and the progress of laboratory tests during the monitoring period.

Summary: This report illustrates some points relating to the health surveillance of workers exposed to electromagnetic fields (EMF) contained in the new Guidelines on EMFs. A working group from AIRM (Italian Association of Medical Radiation Protection) is currently implementing these guidelines. The report focus in particular on two specific aspects, critical to set up and carry out a correct Health Surveillance (HS): 1. Identification of the exposed workers (who will undergo Health Surveillance). 2. Health Surveillance contents. Considering the peculiar characteristic of the agents at risk, the identification of workers to undergo health surveillance (not specified in the legislation), should involve an assessment of the exposure levels as well as the specific health condition of each "worker at particular risk". Health surveillance programs, to be applied in case of greater exposure, will be focus on identifying sensitive risk groups who should undergo more frequent health checks.

Summary: Several measures in a response to a nuclear or radiological emergency have in common the aim of protecting human life and health, among these: to save lives; to avoid or to minimize severe deterministic effects; to provide fist aid, critical medical treatment and to manage the treatment of radiation injuries; to reduce the risk of stochastic effects. In the phase of the urgent response (the first hours or few days from the declaration of the emergency) mitigatory actions have to be taken by the operating personnel of a nuclear facility to prevent the escalation of the emergency and mitigate the consequences of radioactive releases and exposure; along with these, urgent protective actions have to be implemented. Examples of urgent protective actions are: sheltering, evacuation of people residing near the plant and iodine thyroid blocking (ITB): these actions can be also precautionary if taken before or immediately after the beginning of the radioactive release. In the second phase of the emergency (the early response phase) which can last days or weeks, early protective actions, like relocation, restrictions on the food chain and on water supply etc., should be taken. The mitigatory and protective actions should be part of a general protective strategy of the population, based on generic criteria and generic guidance values for restricting exposure of the emergency workers and of the general population.

Summary: In the last years nanotechnologies and nanoproducts are constantly growing up thanks to their promising benefits for social and economic development. Nanomaterials are increasingly used in our daily life, finding application in many sectors such as textile, automotive, electronic, food, etc. In 2012, the European Commission included nanotechnologies among the Key Enabling Technologies (KETs), which provide the basis for innovation in the present century. In parallel to the growing interest at industrial and production level (estimated at about 11 million of tons per year) the number of workers potentially exposed in all nanomaterials life cycle has increased. Concurrently, concerns about the potential effects on human health arose, attracting the attention by the scientific community, in particular on health and safety issues in workplaces. In Italy the industrial market has evolved in the same direction with important economic investments both public and private. Consequently, numerous research groups belonging to the University, Institutions and Research Centers were involved in the study of the main issues to promote a responsible development of nanomaterials. In this framework, the main aim of this study is to highlight the commitment of Italian research in the field of health and safety of engineered nanomaterials, through the initiatives of Italian Workers Compensation Authority (INAIL) for sustainable development of nanotechnologies.

Summary: Introduction. The formulation of the suitability for risk assessment from exposure to ionizing radiation in workers diagnosed with malignant tumor disease entails important implications of a professional, human, social, but also medical-legal, nature. By now, the management of such situations is an event anything but infrequent in the activity of the Authorized Physician: the increase in the number of people staying in wore and the rise in the incidence and prevalence of malignant neoplastic diseases in the working-age population make the problem more relevant than ever. This is not only because of the improvement of the diagnostic and treatment capacity but also for the increased survival that follows from them. The result is therefore an increase in the cases that can potentially reach the antention of the Authorized Physician/Competent Physician who - in compliance with the provisions of current legislation - will be thus called to express the suitability assessment for the specific task by applying criteria that respect the highest and current scientific evidence in this field. Materials and Methods. Through the guided illustration of two clinical cases, it is intended to propose here a - practical and reasoned - path towards the formulation of the assessment on the occupational reintegration of the worker with diagnosis of neoplastic disease. This methodology is applied and developed through the systematic recourse to objective and specific orientation criteria, able to guide the decision-making process of the Authorized Doctor/Competent Doctor. Results. The proposed criteria were applied to workers operating in the healthcare sector and assigned to different types of activities who were at risk from exposure to ionizing sources. Conclusions. The proposed evaluation path is intended to represent a clinical and rational methodology of approach and management to the problem of assessing the suitability of workers with previous neoplastic diseases, all that by fully safeguarding the decision-making autonomy - variable from case to case - which is characteristic of the activity of the Authorized Physician/Competent Physician.

Summary: Radiation therapy increasingly plays a fundamental role in the treatment of cancer. Since the survival of cancer patients is continuously improving, the late effects of treatments, including those related to radiation treatment, can affect the quality of life and health and of the patients themselves to a greater extent. Especially in the last 20 years, with the implementation of new techniques/forms of radiation therapy, the risk of developing radiation-induced tumors following radiation therapy has become a hotly debated topic. Malignant tumors induced by radiation therapy represent a particularly important problem for pediatric patients, who are intrinsically more sensitive to carcinogens than adults and have a longer life expectancy. To date, there is only one study in the literature, from 2019, which analyzes the risk of secondary tumors after carbon ion radiation compared to surgery or photon treatment and refers to patients treated for prostate cancer. Despite the high degree of uncertainty, the data acquired so far suggest that particle radiation therapy, especially with protons delivered with active scanning, carries a lower risk of radiation-induced tumors than conventional photon therapies. This is largely due to the lower doses to which healthy tissues are exposed and the low relative risk associated with exposure to neutrons throughout the body, especially when active scanning beams are used.