Medicina Del Lavoro最新文献

We report the first confirmed case in Italy of occupational asthma caused by subtilisin in a healthcare worker involved in cleaning surgical instruments. The diagnosis was confirmed through a specific inhalation challenge (SIC) performed one year after the last exposure and after stopping inhaled corticosteroid therapy. An immediate reaction was observed after three minutes of exposure to diluted Neogiozym ™, with a 30% decrease in FEV1. This case highlights the diagnostic importance of SIC even for high-molecular-weight (HMW) agents and emphasizes the need to reconsider occupational asthma as a complex, evolving disease influenced by both host and environmental factors. The patient exhibited a Type-2-high phenotype despite negative skin prick tests and normal IgE levels, reinforcing the value of dynamic, multi-marker assessment in occupational endotyping. This case supports the broader use of SIC in occupational settings where allergen-specific IgE testing is limited.

This study aims to shed light on the largely understudied history of girls and women working in Italian mines during the 19th and 20th centuries. Giovanni Loriga authored an outstanding paper on Pneumoconiosis in 1930 at the Johannesburg Conference. By examining his sources from earlier surveys, travel records, and congressional proceedings, the research uncovers data on women and girls in slate (Liguria), asbestos (Piedmont), zinc-lead (Sardinia and Lombardy), and sulfur mines (Sicily), along with their working conditions. The research findings reveal that girls and women were integral to the mining industry throughout Italy, despite being underrepresented and relegated to specific tasks. Ultimately, the paper explores the development of protective Italian legislation, its inadequate enforcement, and suspension during World War I. The paper concludes by highlighting the ongoing global issue of girls' labour in mines, drawing a parallel between the historical situation in Italy and the contemporary reality denounced by organizations like the ILO and UNICEF.

Background: The association between diesel exhaust and cancer other than the lung is not well established. We aimed to conduct a systematic review and meta-analysis on the association between diesel and kidney cancer in workers.

Methods: Two trained researchers conducted a systematic review to identify cohort studies examining the relationship between occupational exposure to diesel exhaust and the risk of cancer other than lung cancer. Of the 43 retained studies, 15 reported information on kidney cancer. We performed random-effects meta-analyses for ever-exposure to diesel exhaust. Summary relative risks (RR) and 95% confidence intervals (CI) were calculated for the association between diesel exhaust exposure and kidney cancer.

Results: Overall, the RR of kidney cancer was 1.08 (95% CI=1.01-1.15, heterogeneity p=0.1, I2=28.6%). The summary RR was 1.08 for incidence (95% CI=1.01-1.16; I2=36.7%) and 1.09 for mortality (95% CI=0.92-1.30, I2=14.5%), p of heterogeneity=0.914. The summary RR of European studies was 1.08 (95% CI=1.00-1.16, I2=37.8 %), that of USA/Canada studies was 1.10 (95% CI=0.94-1.29, I2=8.5%), p of heterogeneity=0.837. Publication bias was not detected.

Conclusions: Workers exposed to diesel exhaust may experience an increased risk of developing kidney cancer, although the evidence is not entirely consistent, and residual confounding cannot be excluded.

Background: To investigate the current status, morbidity, and risk factors of functional dry eye disease (DED) in Shanghai's working-class population and explore measures to fundamentally cure and prevent functional DED.

Methods: A questionnaire form was used to record the data of the diagnosed functional DED working-class subjects in Shanghai, the results were recorded and analyzed. Additionally, the subjective symptoms of DED subjects and the respective clinical results were also recorded. The classification and corneal staining between subjects who wear contact lens or without were compared. The correlation of classification and corneal staining with their risk factors were also analyzed.

Results: The risk factors of functional DED showed much in common though their works have professional particularity. Evaporative dry eye (EDE) accounts for a large proportion of DED (45.35%), many subjects co-exist symptoms and signs of mixed DED (32.64%). The age of 21-40 is the peak year range (70.4%). Contact lens, visual terminals, air-conditioner, decoration, stay up later, sleep disorder, smoking were risk factors in most functional DED subjects. Notably, contact lens is a leading risk factor to cause functional DED and ocular surface complications (both were p<0.01), while deep sleep seems to be a protective factor (p<0.01%).

Conclusion: The incidence of functional DED in Shanghai is kept in a high level. Most risk factors are closely related to daily work and life, while they are almost reversible. Exploring and eradicating these daily risk factors seems to be a more preferable way to fundamentally control and prevent functional DED.

Background: Work-related musculoskeletal disorders pose a significant burden on the population. The OCRA method plays a key role in assessing the risk associated with repetitive actions of the upper limbs. In this method, muscular force is evaluated based on the rate of perceived effort (RPE) reported by the worker, which can introduce subjective bias into the assessment. This study aims to determine whether testing the worker's handgrip strength can improve the accuracy of the force assessment in the OCRA method.

Methods: Handgrip strength was measured during the risk assessment process following the OCRA method. Data were divided into specific percentile ranks based on age, gender, height, and handedness.

Results: 903 workers from 43 different Italian companies were surveyed. There was a significant difference in handgrip strength percentiles stratified by report of an RPE > 2 and those without (p = 0.047). Additionally, significant differences were found in perceived effort rates (based on the OCRA method) among workers with different levels of stratified handgrip strength (dominant hand: p = 0.04, non-dominant hand: p = 0.02).

Conclusions: Workers performing repetitive upper limb actions at various strength levels experience different perceived effort rates during tasks. These findings suggest that measuring handgrip strength is a crucial component of risk assessments using the OCRA method. To date, this study's sample size is among the largest for this evaluation method; we believe these results could be a significant step forward in improving the risk assessment process for biomechanical overload.

Introduction: Upper Crossed Syndrome (UCS) is a musculoskeletal disorder that mainly occurs due to awkwardposture in a static position. Considering the impact of musculoskeletal disorders on individual and social life, and the limited studies carried out in metal industries, this study evaluated the effect of ergonomic interventions using engineering controls on work-related postures and skeletal abnormalities caused by UCS in one of the metal industries.

Methods: In this interventional study, 132 welders, press, and warehouse workers who had symptoms related to UCS were included. There were 78 participants in the experimental group (43 welders and 35 press operators) and 54 warehouse workers in the control group. Sitting and standing workstations were evaluated using the RULA and REBA methods, respectively. Then, with the technical committee's decision, the necessary ergonomics interventions were carried out. After three months of applying the interventions, the postures were re-evaluated. The paired t-test method was used for intra-group evaluation, and the independent t-test was used to compare the experimental and control groups using SPSS.

Result: This study showed that ergonomic interventions can significantly reduce the risk score of musculoskeletal disorders in different body segments in sitting and standing workstations. Examining the UCS of the experimental group with sitting activities after the intervention, the average angle of the forward head, round shoulder, and kyphosis was reduced by 3.89, 4.05, and 3.73 degrees, and with standing activities by 3.27, 2.70, and 3.10 degrees, respectively.

Conclusion: The results of the study revealed that modifying the workstation has a significant role in reducing the UCS.

Background: Workplace violence (WPV) is a prevalent issue globally among Healthcare Workers (HCWs). Moreover, WPV may disproportionately impact marginalized groups within the healthcare workforce, such as women and gender minorities. This study aims to examine the prevalence of WPV experienced by HCWs through a gender-focused lens and to investigate factors influencing the risk of WPV.

Methods: A cross-sectional observational study was conducted over a month in Apulia, Italy, involving employees from major healthcare institutions, including hospitals, Local Health Authorities, selected correctional facilities, and Residences for Execution of Security Measures. The study used the Italian-validated WHO Workplace Violence in the Health Sector questionnaire, modified to include 'Other' in the gender definition.

Results: 3,259 HCWs participated, representing 88.8% of the 3,670 invited participants. The prevalence of violence incidents within the last 12 months was 29.6% in the HAW group and 57.1% in the CRW group. Within the HAW group, transgender and gender expansive (TGE) workers exhibited a higher prevalence of verbal, physical, and sexual harassment. Logistic regression analysis identified gender, job type, night shifts, interactions with specific patients, and the type of medical settings as significant predictors of experiencing various kinds of violence.

Conclusions: The study underscores the vulnerability of TGE and female HCWs to workplace violence. These findings underscore the imperative for comprehensive yet gender-sensitive interventions promoting safety, equity, and inclusion in the healthcare workplace.

Background: Food handlers may have an increased risk of developing occupational skin and respiratory diseases.

Methods: This retrospective study was based on examinations, skin prick testing, and patch testing performed at the Unit of Occupational Medicine at the University of Trieste (N-E Italy) between 2002 and 2022 in food-handler workers referred to the unit for suspected occupational allergic diseases.

Results: More than half of the population (58.1%) experienced occupational skin diseases, with a higher prevalence among women (OR 3.3, 95% CI 1.5-7.6). Irritant contact dermatitis was the most prevalent skin condition (22.9%), followed by allergic contact dermatitis (20%) and protein contact dermatitis (15.1%). Pastry makers and bakers exhibited a high rate of protein contact dermatitis (20.6 and 17.7%, respectively), which was primarily attributed to wheat flour. Of the participants, 47.8% reported having rhinitis, and 17.6% reported having asthma. Positive SPT results were observed in 34.4% of workers with rhinitis and 58.3% of those with asthma, with bakers and pastry makers being more frequently sensitized to wheat flour (22.8% and 20.6%, respectively). Cooks reported rhinitis (43.2%) and asthma (12.3%) with sensitization to soy, scampi, peanuts, and other foods. Atopy determined by prick test was significantly linked to respiratory symptoms. Bakers and pastry makers showed significantly higher sensitivity to wheat flour (OR 3.3, 95% CI 1.3-7.8).

Conclusions:  Food handlers can experience occupational skin and respiratory diseases, and more efforts are needed to prevent such diseases by improving preventive habits and avoiding exposure to allergens.

Background: As the workforce ages, older employees face increasing challenges in adapting to changing job demands, including technological advances and ongoing occupational risks such as shift work and physically demanding tasks. Work ability is a reliable indicator of older workers' capacity to meet both physical and mental requirements of their jobs. The ProAgeing study, a multicenter investigation specifically focused on workers over 50 years old, examined long-term patterns in work ability, perceived health, and psychosocial risk factors, along with their interactions across this demographic.

Methods: Participants completed self-reported questionnaires at baseline and after one year, including the Work Ability Index (WAI), technostress, sleep quality, perceived stress, health, and psychosocial risk factors. A first-difference linear regression model was used to assess predictors of changes in WAI. Subgroup analyses examined differences across occupational roles (bank employees, administrative employees, and manual workers).

Results: Of the 470 workers enrolled, 356 (76%) completed the follow-up. A significant decline in average WAI score was observed over 12 months (-1.2 points, p<0.001), mainly in subscales related to work demands and physical illness. Technostress levels slightly decreased, suggesting adaptation over time. Bank employees showed less favorable trends than manual workers, indicating that digitalization and higher job demands significantly affected employees' well-being, especially older workers. Improvements in perceived health and reduced stress mostly contributed to enhanced work ability.

Conclusions: These findings highlight the importance of targeted interventions to enhance health and lower stress among aging workers, supporting their well-being and subsequently their work ability.

Background: To assess the association between rotator cuff  tendinitis (RCT) occurrence and socio-professional constraints among a sample of professionally active patients.

Methods: This study was based on a questionnaire that collected information on sociodemographic, occupational characteristics, and medical information about shoulder injuries. The assessment of psychosocial constraints at work was performed using the Karasek Job Content Questionnaire.

Results: A total of 100 patients participated in this study. The population was predominantly female (89%), with a mean age of 45±9.5 years. Sixty-five percent of the patients worked in the manufacturing sector, and working as a machine operator was the most common occupation (48%). The average job seniority was 22±9 years. Regarding organization, the most common constraints were the need to respect production standards and deadlines (93%), to work quickly in 96% of cases, and Repeatability (92%). Eighty-eight percent of the patients reported high psychological demands, and 96% had low social support at work. Most of the patients (83%) were under occupational stress or had been subjected to a job-strain situation.

Discussion: In this study, high psychological demand, low decision latitude, and low social support were predominantly reported in the population with percentages of 88%, 93%, and 96%, respectively.