Medicina Del Lavoro最新文献

Background: The association between welding fumes and cancers other than lung cancer remains undefined. We conducted a systematic review and meta-analysis on occupational exposure to welding fumes and the risk of head and neck cancer (HN, comprising oral, pharynx, and larynx) and gastrointestinal cancer (GI, comprising esophagus, stomach, colorectal, liver, and pancreas).

Methods: A systematic search was performed in PubMed, Scopus, and Embase using PRISMA guidelines. Cohort studies on occupational exposure to welding fumes were identified. Study quality was assessed through the CASP score. Data were analyzed in random-effects models to calculate the relative risks (RR) and 95% confidence intervals (CI) of HN and GI cancer overall and stratified by cancer site.

Results: Seven independent studies with data on oral, pharynx, larynx, esophagus, stomach, colorectal, liver, or pancreas cancer were identified. We observed the following associations: HN RR=1.10 (95% CI 1.00-1.22); GI RR= 1.03 (95% CI 0.97-1.10); oral and pharynx RR=1.06 (95%, CI 0.93-1.20, eleven risk estimates); larynx RR=1.17 (95%, CI 1.01-1.37, nine risk estimates); esophagus RR=0.98 (95%, CI 0.83-1.15, three risk estimates); stomach RR= 1.10 (95%, CI 1.02-1.19, five risk estimates); colorectal RR=0.99 (95%, CI 0.85-1.15, seven risk estimates); liver RR=1.23 (95%, CI 0.79-1.90, five risk estimates); and pancreas cancer RR=1.05 (95%, CI 0.94-1.16, three risk estimates).

Conclusions: We observed an association between occupational exposure to welding fumes and larynx and stomach cancer. No association was found for other HN or GI cancers. Our study stresses the need to investigate the risk of cancers other than lung following occupational exposure to welding fumes.

Background: Several studies have highlighted the role of environmental exposures in malignant hemopathies etiology. Some patients with malignant hemopathies can be compensated as occupational diseases. The Prolymphome research aimed to assess a systematic screening of occupational exposures in patients with lymphoma or myeloma treated in three hospitals in the Rhône-Alpes region.

Methods: Patients received a self-administered questionnaire to fill in at home to collect their job history and potential occupational exposures to carcinogens. A physician assessed the questionnaire to determine if a dedicated consultation was required and the possibility of claiming compensation. Patients were systematically assisted by a social worker for administrative procedures.

Results: In 12 months, 754 patients were enrolled in the study, and 361 (48%) returned the questionnaire. A specialized consultation was proposed for 123 patients, and 98 patients attended the consultation. Overall, a compensation claim was proposed to 18 patients: 11 have been occupationally exposed to pesticides and seven to trichloroethylene.

Conclusions: Our results confirmed the feasibility of the systematic screening procedure. Barriers were observed at every step of the process, and it underlined that patients are rarely  nformed about occupational exposures. As the prevalence of occupational exposures in malignant hemopathies remains scarce, a systematic targeted screening could be relevant in this population.

Background: Workplace (WPW) violence is a significant issue among healthcare workers (HCWs) in hospitals and negatively impacts the healthcare workforce. WPW can have more severe consequences, especially in tertiary hospitals with a concentrated, specialised workforce. In this regard, the study aimed to identify the dynamics of workplace violence exposure among HCWs in a tertiary hospital. It also investigated its impact on job engagement.

Methods: The study was designed as a descriptive cross-sectional study conducted between June and September 2023. The study involved 3,526 HCWs at a tertiary hospital in Turkey, all invited, with 390 participating. The study examined healthcare workers' ability to handle WPV. It also examined their exposure to violence, their perception of safety against violence at work, and their engagement in their jobs.

Results: Exposure to WPV among HCWs included in the study significantly predicts job engagement, with a negative relationship (β: -0.473). Additionally, as HCWs' skills in managing WPV increase, job engagement also increases (β: -0.279). Among younger and less experienced HCWs, WPV exposure and job engagement scores were significantly lower (p<0.05).

Conclusions: WPV, common among health workers, is an essential factor that reduces work engagement. Identifying and controlling the dynamics of WPV is critical to enhancing job engagement among healthcare workers and preventing related adverse outcomes.

Background: This study aimed to investigate the impact of asthma on work productivity among adults receiving asthma therapy.

Methods: A cross-sectional study involving 101 asthmatic patients treated at the Pulmonology Department of University Hospital in Mahdia (Tunisia) who had been employed for at least six months was conducted over the course of a year. Recruited patients were asked to complete a self-administered questionnaire that consisted of the Simplified Medication Adherence Questionnaire (SMAQ), the Work Productivity and Activity Impairment (WPAI), and the Pichot questionnaire.

Results: The study's participants had a sex ratio of 0.51 and a mean age of 44.1±13.2 years. Exposure to aerocontaminants was high among 64.4% of patients. The majority of the patients were treated with inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) (54.4%), and nearly half were classified as having moderate asthma. Our findings revealed significant challenges faced by these patients, with 62.4% experiencing poorly controlled or uncontrolled asthma. Additionally, 69.3% were non-adherent to treatment, and 71.3% reported worsening symptoms while at work. They worked an average of 38.3±16.4 hours per week. The impact of general health status on work productivity was measured at 3.3±2.5. Absenteeism and presenteeism rates were 4.2% and 33.1%, respectively, resulting in a productivity loss of 30.4%. Activity impairment was associated with factors such as gender, alcohol consumption, and uncontrolled asthma.

Conclusion: Addressing asthma control, working conditions, and mental health emerges as essential strategies to enhance workplace productivity. When evaluating the effectiveness of interventions among active asthmatic patients, presenteeism, absenteeism, and productivity loss should be considered.

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: 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.