Medicina Del Lavoro最新文献

Dr. Livia Lollini, a physician and an early pioneer in women's occupational health, authored a paper published as the lead article in the inaugural issue of La Medicina del Lavoro, which adopted its current title in 1925. Her work, La protezione della donna e del fanciullo sul lavoro (The Protection of Women and Children at Work), constitutes one of her contributions to labor protections for women and children in early 20th-century Italy. Born into a family distinguished by socialist and feminist ideals, she completed her medical education in 1913. Subsequently, she served as an assistant at the Clinica del Lavoro in Milan, where she addressed various issues related to occupational health. Drawing from international labor laws, Dr. Lollini critiqued the inadequate enforcement of existing legislation in Italy and emphasized the notable disparities in maternity protections. Her analysis highlighted the need to safeguard women's health at the workplace and called for systemic reforms, including implementing regular medical examinations, female labor inspectors, and industrial nursing services. Her work, grounded in gender-sensitive approaches to occupational health, continues to resonate with contemporary principles of gender medicine. Although substantial advancements in labor legislation have been realized, many of the challenges she addressed-such as child labor, maternity rights, and workplace safety-remain central to global discussions surrounding decent work and equitable labor practices.

Diesel exhaust (DE) is recognized as a carcinogen for the lungs, although evidence linking it to adult brain tumors is limited. We aimed to systematically review the evidence regarding the association between occupational DE exposure and adult brain and other central nervous system (CNS) tumors. A systematic literature review was conducted to identify cohort studies on occupational DE exposure and the risk of adult cancers other than lung cancer. We meta-analyzed relative risks (RRs) and 95% confidence intervals (CIs) for brain or CNS tumors using the DerSimonian and Laird random-effects model. Fourteen studies were included in the meta-analysis. The results showed no in-creased risk of brain or CNS tumors among workers exposed to DE (RR: 0.99; 95% CI: 0.91, 1.07). Findings were consistent when analyzing studies based on incidence (RR: 0.96; 95% CI: 0.90, 1.03; six studies) and mortality (RR: 1.09; 95% CI: 0.87, 1.37; nine studies) separately, as well as in subgroup analyses based on sex, publication year, geographic region, and study quality score. No evidence of publication bias was found (p=0.244). The findings of our meta-analysis suggest that occupational DE exposure is not associated with adult brain or CNS tumors. Given the limitations of the included studies, these results should be interpreted with caution.

Background: Healthcare workers (HCWs) in developed countries can be exposed to a wide range of hazards. The systematic identification of working conditions associated with the risk of occupational injury can significantly reduce this risk.

Methods: From January 2000 to December 2021, a scoping review was performed using PCC (Population, Concept, and Context) criteria and searching major scientific databases. Studies conducted in Western Countries, defined as member countries of the Organisation for Economic Co-operation and Development (OECD), were selected.

Results: We identified 282 studies for the present review. Studies focused more frequently on biological injuries (59%). Musculoskeletal injuries and injuries due to aggression and violence followed, based on the frequency of the investigated topic.

Conclusions: Most studies focused on the risk of bloodborne infections, while a knowledge gap emerged on the epidemiology of accidental exposure to other transmission pathways. Although the proportion of injured workers is not negligible in most studies, the most common determinants and risk factors of injury are entirely preventable.

Background: Like other European systems, the Spanish national health system (NHS) is reaching a critical point. This article analyses sickness absence (SA) trends, as a direct indicator of this crisis, among healthcare workers (HCWs) in Spain, comparing the pre-pandemic, pandemic, and post-pandemic periods.

Methods: This study was based on a retrospective cohort of HCWs (n=7.918) hired at Hospital del Mar in Barcelona for at least three months during 2018-2023. The primary outcome was incident SA episodes. Incidence rates (IR) per 1,000 persons-day and 95% confidence intervals (95% CI) were calculated by sex, period, and occupational variables. Longitudinal entropy regression models were estimated to identify the factors influencing the frequency of transitions between the different HCWs' employment states (active or on SA).

Results: Increasing trends in IR (95%CI) were observed, rising from 1.77 (1.71; 1.83) episodes of SA per 1,000 workers-day during the pre-pandemic period to 5.04 (4.93; 5.15) during the post-pandemic among women, and from 1.23 (1.14; 1.31) to 3.79 (3.64; 3.95), respectively, among men. Nurses, nurse aides, orderlies/technicians, workers under 30, and those in intensive care units and emergency rooms showed the highest IR during and after the pandemic, with longitudinal entropy analysis revealing increased state changes, primarily affecting these groups.

Conclusions: This study demonstrates a significant rise in SA incidence among HCWs during and after the pandemic and identifies vulnerable groups with higher incidence. Several hypotheses, such as poor working conditions, burnout, and patient complexity, have been suggested to explain these results. Urgent interventions are needed to safeguard HCWs' health, thus maintaining the sustainability and safety of the NHS.

Background: The criteria for diagnosing and compensating for occupational diseases vary significantly between countries. The lists of occupational diseases often include diagnostic and attribution criteria that are usually not very specific. As a result, the quality of occupational disease reports is frequently subpar. The aims of this study were to assess the quality of diagnosis and reporting, as well as to evaluate the causal link between reported occupational diseases and occupational risk factors.

Methods: Four occupational physicians assessed the quality of diagnosis by blindly applying Spreeuwers' performance indicators for diagnosis and reporting. Following Violante's criteria, the four evaluators also tested the levels of evidence to evaluate the quality (and associated likelihood) of the diagnosis and the quality of exposure to occupational risk factors in a sample of 104 occupational disease reports, grouped by diagnosis and examined by the local Workplace Safety Prevention Service. Separate scores for each performance indicator and the Total Quality Score (TQS, ranging from 0 to 10), along with the progressive levels of evidence, were then assigned for each occupational disease report.

Results: The mean TQS was below the threshold of sufficiency (<6) for 28% of the diagnoses, while an almost sufficient score (>6) emerged for 72% of the diagnoses, primarily including musculoskeletal disorders, pulmonary silicosis, and noise-induced occupational hearing loss. When applying Violante's criteria for the level of evidence of the diagnosis, it was insufficient for 13.5% of the reported cases, while the level of evidence for exposure to occupational risk factors was deemed insufficient for 19% of the cases, and no cases demonstrated a level of evidence that was highly probable or nearly certain.

Conclusions: Despite the overall quality of the reported cases of occupational diseases being reasonably good, improvements in the quality of diagnosis and reporting could be achieved through strict adherence to standardized diagnostic criteria and by training health personnel to collect data regarding occupational and non-occupational risk factors properly.

Background: The COVID-19 pandemic compelled changes to the structure and organization of many occupational sectors that may impact workers' well-being and work-related symptoms.

Objective: Evaluate the effects of working modifications related to the COVID-19 pandemic on occupational health outcomes and work ability (WA) among a large group of Italian banking employees.

Methods: 2,859 employees visited during health surveillance in 2021 were divided into two job groups: front-office (FO) and back-office workers (BO). Data on conditions associated with office work, psychological distress, WA, and fitness-to-work judgment were analyzed and compared with available data from the pre-pandemic period (2018-2019).

Results: The prevalence of analyzed outcomes was lower than in pre- and post-COVID evaluation literature. After COVID-19, a 28% increase in asthenopin was found in BO, while musculoskeletal symptoms increased about 22% in BO and 9% in FO. Post-COVID showed a 28% rise in stress-related symptoms and a 17% increase in psychotropic drug consumption in both groups. After the lockdown, the prevalence of moderate/poor scores decreased by 13% in each group. Fitness-to-work judgment without limitations prevalence was unchanged.

Conclusion: The slight worsening in all examined outcomes at post-lockdown evaluation and the outcomes' prevalence consistently lower than the literature data could be linked to the measures the Institute took to support employees during the COVID-19 pandemic. In this context, a comprehensive integration between occupational safety and health promotion practices is recommended to ensure the highest level of safeguarding for workers' well-being.

Background: The Work-Related Questionnaire for Upper Extremity Disorders (WORQ-UP) serves as a patient-reported outcome measure to identify work-related limitations in individuals with upper extremity musculoskeletal disorders. This study aims to adapt the WORQ-UP into Turkish and subsequently evaluate its validity and reliability.

Methods: The Turkish WORQ-UP, along with the previously validated Turkish Quick DASH, were administered to 136 patients. The Turkish WORQ-UP was applied twice within a 7-14 day interval to assess test-retest reliability. Reliability was assessed using measures of internal consistency and intraclass correlation coefficient (ICC). For validity assessment, Spearman correlation coefficients were calculated between the Turkish WORQ-UP and Quick DASH, and Explanatory (EFA) and Confirmatory factor analysis (CFA) were conducted.

Results:  In the reliability analysis, items 11, 12, 13, 15, and 16, which did not meet the criterion of item total score correlation >30, were excluded, resulting in a 12-item Turkish WORQ-UP with satisfactory validity and reliability outcomes. The Cronbach's alpha and ICC were calculated as 0.895 and 0.879, respectively, while the SEM and MDC were determined to be 0.93 and 1.85. In the EFA, the Kaiser-Meyer-Olkin measure (0.895) and Bartlett's tests were both significant (p < 0.001). Additionally, the CFA indicated an acceptable fit with two factors. The goodness of fit indices, including χ2/df = 2.09, CFI = 0.934, TLI = 0.918, and RMSEA = 0.08, confirmed the adequacy of the model. The 12-item Turkish WORQ-UP showed a significant and strong correlation (r = 0.754; p < 0.001) with Quick DASH.

Conclusion: The Turkish version of WORQ-UP with 12 items had proper psychometric properties to identify work-related limitations in individuals with upper extremity musculoskeletal disorders.

Background: The assessment of work-related stress is mandatory in Italy, according to Legislative Decree 81/2008. The Academic Teacher Stress Indicator Tool (ATS-IT) was developed to address stress in academic teaching staff by adapting the Health and Safety Executive Management Standards Indicator Tool (HSE-MS IT).

Methods: An online ATS-IT survey was administered to all teaching staff at the University of Trieste, yielding 334 valid responses. The survey also included a measure of psychosomatic complaints and demographic questions. Confirmatory factor analysis (CFA) was performed to test the six-factor structure, and reliability was assessed using Cronbach's alpha.

Results: CFA confirmed an excellent fit for the six-factor structure (CFI = .99; TLI = .99; RMSEA = .034). Reliability analysis mainly showed acceptable values (Cronbach's α ranging from .66 to .91). Significant gender differences were found in the Demands and Control scales, with additional differences based on age and academic role across multiple scales. The ATIS-IT scales were significantly intercorrelated and negatively correlated with psychosomatic complaints.

Conclusions: The ATS-IT demonstrates good potential as a valid and reliable instrument for assessing work-related stress among Italian academic teaching staff. Its use can facilitate better stress management and intervention strategies in educational institutions.