Medicina Del Lavoro最新文献

Background: The present study aims to investigate neural synchrony, as measured by Auditory Steady State Response (ASSR), in individuals with normal hearing who are exposed and not exposed to occupational noise, thereby providing insights into hidden hearing loss within the central auditory nervous system, and justifying the importance of exploring auditory neural function in populations at risk.

Methods: A cross-sectional study involved 30 noise-exposed individuals in the Study Group and 30 unexposed individuals in the Control Group, all paired by an average age of 35 years. The following procedures were performed on all individuals: clinical and occupational history, meatoscopy, immitanciometry, pure tone audiometry, speech audiometry, and ASSR (40Hz). We analyzed the audiometric hearing thresholds at frequencies of 1 kHz and 4 kHz, the electrophysiological thresholds estimated by ASSR, and the comparison of the differences between them: the thresholds estimated by ASSR and the audiometry thresholds. The data were analyzed using both descriptive and inferential statistics. P-values ≤ 0.05 were considered significant.

Results: When comparing hearing thresholds at 1 kHz and 4 kHz between groups, we found significant differences, with the SG showing higher hearing thresholds than the CG bilaterally. No significant differences were seen in the electrophysiological thresholds estimated by ASSR, nor in the comparison between the ASSR-estimated threshold and the psychoacoustic hearing threshold groups.

Conclusions: The results of this study suggest that workers exposed to occupational noise did not show detectable changes in neural synchrony in the midbrain, thalamus, or primary auditory cortex when compared to individuals without occupational noise exposure.

Background: This study aimed to evaluate the effectiveness of workplace-based health promotion programs targeting cardiometabolic risk factors.

Methods: We conducted a systematic review and three-level random-effects meta-analysis following PRISMA guidelines, covering studies published from January 2019 to September 2024. Eligible studies included randomized controlled trials (RCTs) and quasi-experimental (QE) designs assessing workplace interventions to reduce cardiometabolic risks in adult workers. Twelve outcomes were considered. Subgroup analyses and meta-regressions were performed to explore sources of heterogeneity. Certainty of evidence was evaluated using GRADE assessment tool.

Results: Forty-four studies (30 RCTs, 14 QE) involving 49,813 participants were included. Significant improvements were found in nine of twelve outcomes. These included reductions in BMI (-0.61kg/m²; [-0.93; -0.29]), body weight (-2.43kg; [-3.48; -1.38]), waist circumference (-3.46cm; [-5.21; -1.71]), body fat (-1.58%; [-2.40; -0.76]), systolic (-3.75mmHg: [-5.67; -1.82]) and diastolic (mmHg; [-3.58; -1.29]) blood pressure, LDL cholesterol (-5.9 mg/dL; [-11.6; -0.12]), and an increase in HDL cholesterol (2.76 mg/dL; [0.42; 5.09]). All significant outcomes were supported by moderate-to-high certainty evidence except LDL cholesterol, which was rated very low. Non-significant results were observed for total cholesterol, triglycerides and FBG. High heterogeneity was observed. Pre-existing health conditions, author and duration of intervention partially explained between-study heterogeneity.  Conclusions: Workplace health promotion programs were associated with improvements in various cardiometabolic health indicators. Greater effectiveness was observed in interventions targeting high-risk populations, delivered by physicians or qualified health professionals, and implemented over shorter durations. Findings support the integration of such programs into occupational health policies and broader public health strategies. Future research should optimize intervention designs, extend follow-up, and consider integrated approaches to maximize long-term benefits.

Background: Prevention of headache disorders (HDs) among healthcare workers in hospital settings remains a challenge for organizations and employees worldwide. The goals of the present retrospective study were both to analyze the 1-year prevalence of any primary HDs among female registered nurses (RNs) employed in hospital settings and to investigate the relationship between occupational risk factors and HDs.

Methods: We analyzed the occupational medicine database of RNs employed in a large hospital. The sample included 975 female RNs; the diagnostic criteria were based on the International Classification of Headache Disorders, 3rd edition (beta version).

Results: One-year prevalence of any HD was 45.9%; tension-type headache (TTH) was the most commonly reported headache type (by 25.6% of participants), followed by migraine (17.5%). No association was found between the different headache types and work schedules; TTH was linked to age ≥40 years (OR=1.91; 95% CI=1.41-2.72), duration of service ≥15 years (OR=1.61; 95% CI=1.24-2.38), and number of night shifts >5 per month (OR=1.71; 95% CI=1.09-2.68). A high level of WRS was a significant predictor of TTH.

Conclusions: We found a link between TTH and modifiable risk factors at both the individual and organizational levels. These findings suggest interventions in occupational settings to minimize the occurrence of TTH among RNs. Policy-makers and employers should implement preventive measures to reduce the incidence of HDs among RNs by minimizing modifiable risk factors associated with increased occupational risk.

Background: This cross-sectional study aims to assess cumulative loads affecting the lower back, shoulders, and distal upper extremities among automotive mechanics.

Methods: The survey was conducted in automotive repair workshops in Shiraz, involving 157 independent mechanics selected through convenience sampling. Data were collected using a multiple-questionnaire including the Persian Cornell Musculoskeletal Discomfort Questionnaire (P-CMDQ), the Lifting Fatigue Failure Tool (LiFFT), the Shoulder Work Assessment Tool (SWAT), and the Distal Upper Extremity Tool (DUET). Descriptive statistics were used to assess musculoskeletal discomfort, and Partial correlation analyses, adjusted for age and Body Mass Index (BMI), examined the relationships between risk levels from LiFFT, SWAT, and DUET and discomfort reported in the P-CMDQ.

Results: The results showed a high level of musculoskeletal discomfort, especially in the lower back, shoulders, and hands. Risk assessments indicated that the cumulative loads are in the high range for the lower back in 42.7% of cases, the shoulders in 40.8%, and the distal upper extremities in 36.3%. A strong correlation was observed between cumulative load on the lower back and perceived discomfort in this region (r = 0.730), whereas the correlations for the shoulders (r = 0.611) and distal upper extremities (r = 0.537) were moderate.

Conclusions: The findings highlight the significant influence of workplace factors on the musculoskeletal health of automotive mechanics, emphasizing the importance of preventive measures and ergonomic solutions to enhance their health and productivity.

Butylated hydroxytoluene (BHT) is an antioxidant which is used in a vast array of consumer products. The most sensitive toxicological endpoints of BHT are hepatic enzyme induction and reproductive effects. Because of its wide dispersive use and its potential relevance for human health, BHT was included in the human biomonitoring (HBM) cooperation between the German Federal Ministry for the Environment and the German Chemical Industry Association. An analytical method for the sensitive determination of 3,5‑di‑tert‑butyl‑4‑hydroxybenzoic acid (BHT acid)-an oxidized metabolite of BHT which is excreted in urine-was developed. This method was then applied in several environmental and occupational HBM surveys, and BHT acid was detected in the vast majority of samples. Health-based guidance values as well as reference values for the interpretation of HBM results were derived for BHT acid. Thus, a fine-grained picture of the current state of BHT exposure in different populations in Germany is now available. Uncertainties arise from large variability in the fraction of dose excreted as BHT acid and incomplete understanding of human metabolism, which limits reverse dosimetry and risk assessment, particularly for children.

Background: This study was conducted to determine whether occupational exposure to high sound levels, typical of an opera orchestra, can cause hearing loss.

Methods: The orchestra professors at Teatro alla Scala in Milan underwent ear examinations, pure-tone audiometry, and other audiological tests. The hearing thresholds of these musicians were compared with those of populations not exposed to occupational noise and with populations exposed to industrial noise. Noise exposure levels were estimated through a phonometric survey conducted at our theater in 2011, which largely confirmed the exposure levels outlined in European guidelines.

Results: The average audiometric thresholds of the orchestra musicians were slightly worse than the median thresholds of a healthy, non-noise-exposed population. In three subjects (2.8%), bilateral hearing impairment (PTA 0.5, 1, 2, 3, 4 kHz > 25 dB HL) was observed; in four violinists (3.7%) left unilateral hearing impairment was found. This rate is lower than the expected risk from similar industrial noise exposures. Comparing these audiometries with those from about ten years earlier shows that the hearing threshold decline in the study group is comparable to that caused by presbycusis.

Conclusions: The risk of noise-induced hearing loss among professional orchestra musicians appears lower than predicted by the UNI ISO 1999:2015 standard. A few cases of hearing loss due to chronic acoustic trauma were noted, particularly among violinists who demonstrated a higher incidence of left unilateral hearing loss. The high levels of sound exposure and the presence of some hearing loss cases highlight the need for targeted preventative measures in this work activity.

Background: Workplace violence is steadily rising, and the healthcare sector is one of the most impacted areas. Several studies have shown that patients' long management times are a key factor in workplace violence in this setting.

Objective: This study aims to analyze the prevalence and characteristics of aggressions against healthcare workers (HCWs) that occurred in 2023 in the Emergency Rooms (ER) of a large university hospital and to evaluate the potential relationship between the management time of a patient in the ER and the risk of violence incidents.

Methods: To evaluate the prevalence and characteristics of aggressive events against HCWs that occurred in 2023, data from the "incident reporting" form were analyzed. Then, using the 2023 report on daily ER accesses, the management time of a patient at the ER was calculated. Finally, the average management times of patients on days when there were no aggressions were compared with those on days when there was one or more assaults against HCWs to evaluate the potential relationship between the average length of stay of a patient at the ER and the risk of aggression.

Results: In 2023, 271 violent incidents were reported. Verbal aggressiveness was the most common (82.7%), and working the night shift was riskier (42.8%). In 36.2% of cases, patient management time was identified as a potential predictor of aggression. Other identified potential predictors included the patient and/or caregiver relationship with HCW (30.6%), the refusal to accept diagnostic-therapeutic protocols (27.3%), and the cultural background and temperamental traits of the patient or caregiver (18.8% and 11.8%, respectively). According to the logistic regression analysis, the likelihood of a violent incident during a 150-minute stay was less than 10%; it increased to 53% after 650 minutes.

Conclusion: Workplace violence in healthcare settings results from a complex interaction of internal and external factors. Understanding how these elements interact and contribute to the development of incidents is essential for identifying key actions to reduce and mitigate violence.

Background: Accidents in underground coal mining can cause deaths, serious injuries, and material losses.

Methods: This study examined 10,334 work accidents that occurred between 2011 and 2021, resulting in injuries, and evaluated the causes, severity, and types of injuries. The accidents were investigated under the following subheadings: location of accidents, causes of accidents, work shifts when the accidents occurred, accident time, accident days, distribution of accidents by months and years, age of workers, occupational groups, educational status of workers, working day losses, and body parts that were injured. The severity of accidents was categorized into three levels: mild, moderate, and severe, based on the workday losses incurred by the workers after the accident. The severity of accidents and factors affecting their severity were analyzed using multinomial logistic regression.

Results: There is a significant statistical relationship between the severity of accidents and factors such as experience, workplace, accident cause, age, education status, occupational category, and the affected body part, work shift, according to the analysis. The findings indicate that accident severity is influenced not only by the immediate circumstances of the incident but also by broader individual and occupational factors, such as the employee's level of experience, the work environment, the occupational group, and the specific body part affected. The analysis revealed that the occupational group variable had statistically significant interaction effects with multiple other variables.

Conclusions: The study presents all aspects of the hazards faced by the workers and suggests measures to reduce the number and severity of accidents that occur in underground coal mining.