Giornale italiano di medicina del lavoro ed ergonomia最新文献

Summary: The study aimed to evaluate, through the use of the EA-RfitTM Validation System, the real reduction (PAR) for the right ear (AuD), for the left ear (AuS) and biaural reduction related to each of the seven earplugs currently produced by 3M. In addition, we wanted to verify any difference between the aforementioned PARs in consideration of the tendency to predominantly use the right hand (right-handed) or the left hand (left-handed) and in relation to gender. Finally, for each insert and for each subject, an audiometric examination was conducted with the insert worn, to compare the average PAR value obtained by the EA-RfitTM system for each of the seven inserts and for all selected subjects, with the determined abatement curve through the audiometric measurement of the hearing threshold with the insert worn. The use of the E-ARfitTM system for the choice of the ear insert leads to important advantages in the protection of all workers. Moldable acoustic PPE generally proved to be more efficient than non-moldable, so much so that the higher SNRs (provided by the manufacturer), especially when referring to non-moldable inserts, were found to be misleading as to the real personal abatement capacity of the inserts. The average audiometric curves, obtained with the different inserts worn, confirmed that all of them guarantee a higher reduction for high frequencies than for "social" ones.

Summary: In the last decade, at the conclusion of some civil proceedings concerning appeals against INAIL (the Italian workers' compensation authority), some Italian courts have recognised the occupational origin of tumours in workers exposed to radiofrequency electromagnetic fields (RF EMFs) emitted by wireless phones, despite the fact that a causal role of electromagnetic fields in oncogenesis has not been demonstrated. In some cases, workers' exposures were combined with those due to other RF EMF sources or with exposures to extremely low frequency magnetic fields (ELF MFs). For the sake of completeness, the case of exposure of a worker to ELF MFs only is also considered. These judgements have been widely covered by the media which, on the contrary, have virtually ignored those in which the causal link between occupational exposure to electromagnetic fields and tumours has not been recognised. The author of this communication is aware of two of these "negative" judgements in that he was, in both cases, one of the court-appointed expert witnesses. A key point to understand the scientific bases for the Judges' decisions is how the IARC classifications of ELF magnetic fields (ELF MFs) and radio frequency electromagnetic fields (RF EMFs) as "possibly carcinogenic to humans", and more generally the body of scientific evidence on electromagnetic fields and tumours, have been taken into account in the judgements and court- appointed expert witnesses' reports. The 2009 judgement of the Court of Appeal of Brescia preceded the IARC classification of radio frequency electromagnetic fields in 2011. The judgement of Brescia was confirmed by the Court of Cassation in 2012, but since the Court of Cassation decides on the legitimacy of the judgements without entering into their merits, the fact that this decision was taken after the IARC classification is irrelevant. All other judgements, subsequent to the publication of the IARC monographs, cited the IARC classifications. The bases for the two "negative" judgements of the Courts of Cremona and Milan were as follows: 1) when an agent is classified as "possibly carcinogenic to humans", a causal link between exposure and cancer has not been generally demonstrated, therefore 2) it is not possible to conclude that a tumour was "more likely than not" (as required in civil litigation (4) ), caused by the agent in question whatever the worker's level of exposure. On the contrary, the court appointed expert witnesses' report on the Ivrea proceeding states that "in the present case there is an association between a rare tumour and an exposure as rare as the use since 1995 of high-emission cellular telephony. The rarity of the circumstance is indicative of a causal association". This and other arguments underlying the "positive" judgements.

Summary: No abstract available.

Summary: Less than five years after the "Atoms for Peace" speech by US President Dwight D. Eisenhower to the United Nations General Assembly in December 1953, TRIGA® (acronym for Training, Research, Isotopes, General Atomics), a new inherently safe type reactor developed for nuclear research, training and isotope production, was conceived, built and operated at the General Atomic Division in San Diego. Over the years, the TRIGA industry has soon evolved into the most widely used research reactor in the world with operating power levels up to 14 MW and designs up to 25 MW. Since 1965 the Laboratory of Applied Nuclear Energy (LENA) of the University of Pavia has been operating a TRIGA research reactor with thermal power levels of 250 kW. The installation is used to support education and training programs, neutron activation analysis activities, medical research, industrial applications, and is mainly dedicated to applied nuclear science in general. These activities will be presented together with the historical and technical aspects of the Nuclear Research Reactor.

Summary: No abstract available.

Summary: The radiological risk assessment and the definition of the radioprotection physical surveillance program applied to a 250 kW (thermal power) research nuclear reactor operated by a large Italian public body. Useful elements for the prevention of personnel exposures, classification criteria for workers, risk reduction methods and optimization of exposures, most common criticalities in plant activities. Analysis of the main operations related to the activities of irradiation and scientific research with an eye to the needs of researchers and one to the indications of prevention. Consolidated intervention methods for ordinary activities and for emergency situations. Detailed examination of the possible unforeseen events or accidents initiators, stopping the assessment at the definition of the source terms related to emergencies inside the plant. Nuclear and conventional causes of accidents and analysis of the radiological consequences. Indications for in-depth-defense and long-term monitoring of the safety of workers, individuals of population and the environment.

Summary: The thyroid gland is one of the most radiosensitive human organs. There are two major unwanted consequences from radiation to the thyroid in humans: hypothyroidism and neoplasia. In the system of dose limitation medical surveillance undoubtedly acquires obligations with regard to early tumor diagnosis (secondary prevention). On the basis of the risk coefficient of radioinduction of tumors established by international organizations, thyroidology should not be neglected. Following a wide range of doses of ionizing radiation, an increased risk of thyroid adenomas and nodules has been also observed in a variety of populations and settings, continuing for decades following exposure. Considerably less findings are available regarding functional thyroid disease including autoimmune diseases. In general, associations for these outcomes were fairly weak and significant radiation effect were most observed following high dose, particularly for hypothyroidism. Considerably less consistent findings are available regarding functional thyroid diseased including autoimmune diseases. The medical surveillance of exposed workers with thyroid pathology frequently involves delicate problems in particular concerning the differential diagnosis between benign and malignant nodules. In contrast to rare thyroid cancer, thyroid nodules are extremely common particularly among women. Thus, most thyroid nodules are benign, and it is important for a better outcome to identify those are likely to be malignant especially at an early stage. Therefore screening of all exposed workers is proposed since the beginning of their thyroid radiation exposure and an up to date diagnostic protocoI is discussed. As a consequence of this justified strategy of secondary prevention a huge amount of thyroid nodules, mostly benign, is found involving problems of management especially from the point of view of medical surveillance of radiation protection. In this paper the author: - 1) Discusses the issues and suggests an up to date approach to diagnosis and management of nodular and functional thyroid diseases - 2) Identifies conditions which representing particular problems require a more restrictive judgement of fitness - 3) Intends to demonstrate that the proposed diagnostic protocol conciliates with due economy providing the right balance between effectiveness and costs, the real requirement of medical surveillance, reducing as far as possible undesirable effects such as damage from excessive protection and patient/physician delay, which is extremely dangerous in the early diagnosis of tumors.

Summary: The presence of nanoparticles in the environment is mainly attributed to outdoor sources but sub-10 nm particles may also form indoor as effect of domestic activities such as cooking, heating, air freshening. Today, due to the COVID-19 pandemic, people are staying home for longer periods of times, thus being exposed to a poor indoor air quality. Due to elevated numerical concentration and large surface area, the health effect of sub-10 nm particles can go beyond what expected from their low mass concentration in the atmosphere. The objective of this study is to find, based on analysis of recent in vitro studies, a dose-effect correlation based on particle size/surface more than on particle mass. Such a correlation cold be useful to assess the health effects of people exposed to very low mass doses of nanoparticles either indoor or outdoor.

Summary: In the last few years a wide dissemination of hadrontherapy facilities is taking place. In these facilities, proton or heavy ion (mainly carbon) accelerators are used to treat cancers in peculiar positions (i.e. close to critical organs), or with peculiar biological features that make them not eligible for conventional radiation therapy with photons. During the design, the commissioning and the use of these facilities many radiation safety issues are to be addressed, that are different from the ones that the professionals in the field are used to facing. Many problems need to be solved, among which the characterization of the radiations fields produced by the accelerators, the shielding design, the design of the interlock systems, and the management of the activated materials (PE11). Both the personal and environmental dosimetry systems need to be set up and implemented, taking into consideration the peculiarities of the involved radiation fields, that are often made of many different high energy particles. So, the approach to this kind of problems is usually much more complex than the one that is required for lower energy machines, and the adopted techniques are much more similar to the ones used for the high energy research accelerators. Due to the complexity of the physics involved in the radiation/matter interaction at these energies, the radiation safety calculations are often based on Monte Carlo simulations (that take into account all the physical processes for all the particles involved), and the data should be cross-checked with the experimental data available in literature (e.g. Na06). Moreover, all the radiation measurements must be carried out with instruments conceived for this kind of radiation fields, or anyway with instruments whose behavior can be foreseen also when measuring in high energy mixed fields (Na04). The shielding design and the activation evaluations obviously depend on the different accelerator technologies (e.g. if synchrotrons, or cyclotrons, are used) and on the energy and nature of the accelerated beam. On the other hand, while the technologies used for the interlock safety systems are well known, a big research and development effort is still ongoing about the technologies adopted for personal or environmental dosimetry. Anyway, while the state-of-the-art of instrumentation is still far from being completely satisfactory, many detectors are available, that can be a good option to solve some of the measurement problems found in such environments.

Summary: An up-to-date knowledge on the occupational risk related to electromagnetic fields (EMF) exposure and its prevention, and on the criteria and methods for an appropriate health surveillance (HS) of exposed workers are highly important, as: EMF are almost ubiquitous; in recent years, relevant changes and advancements in the technologies applied have been observed, e.g. the introduction of new equipment for Magnetic Resonance, involving potentially higher exposures for operators, and the development of the 5G technology, using also EMF bands with millimetric wavelengths, not often applied previously; in Italy the new Legislative Decree 159/2016 has been promulgated, implementing the Directive 2013/35/EU and, accordingly, introducing several substantial changes to the Legislative Decree 81/2008 on safety and health at work, in particular to its fourth chapter of the eight section ("Physical Agents"), entitled "The protection of workers from the risks related to electromagnetic fields exposure". For these reasons, the Italian Association of Medical Radioprotection (AIRM) has fully revised the "Guidelines for the health surveillance of workers exposed to non-ionizing radiation", published in 2012 together with the Italian Society of Occupational Medicine (SIML). Therefore, AIRM involved a multidisciplinary panel of experts, working in accordance to a rigorous scientific methodology, based on the recognized international indications for the development of guidelines (GL) in the medical field, as those proposed by the Guidelines International Network (GIN), the Grading of Recommendations Assessment, Development and Evaluation (GRADE), the National Institute for Health and Care Excellence (NICE) and the Appraisal of Guidelines for Research and Evaluation (AGREE) collaboration. Furthermore, the multidisciplinary panel conducted a systematic review of the scientific literature according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyzes" (PRISMA) criteria, aimed at answering to specific research questions, including the "PECO" (Populations of interest, Exposures, Comparators, and Outcomes) questions. The final stages of the GL include the revision of the GL-draft from an external group of independent experts, giving also an overall evaluation and opinions on the Recommendations elaborated, so that the panel group can elaborate a final document to be shared again, after agreement among all the experts, with a consensus reached by Delphi method in case of disagreement. The main GL objective is to guide occupational physicians in charge for the HS of EMF exposed workers, providing up-to-date indications on the contents and methods for an adequate HS of the workers, but also on the regulations and standards applicable, on the relevant occupational EMF exposure sources, on the possible adverse effects to be considered, including indications on the biological mechanisms involved, on the conditions of particular