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Introduction Systemic sclerosis is a potentially devastating disease in which the aetiology and pathogenesis has not yet been fully understood. It has been associated with occupational exposure to silica, vinyl chloride, solvents and other chemical agents. Case summary In this paper, we present the case of an anaesthetist who developed scleroderma after an occupational exposure to volatile anaesthetic gases (halothane, sevoflurane, isoflurane and enflurane) in operating theatres with poor scavenging systems and we discuss the possible causal link between occupational exposure and the disease. Conclusions The case reported is the second that we are aware of in recent years. Reporting scleroderma cases in workers may be the first step in assessing the causal link between occupational exposure to anaesthetic gases and the disease. [ABSTRACT FROM AUTHOR]

Purpose: Several studies suggest that work-related stress in police officers may be associated with an increased risk of cardiovascular diseases. A systematic review of studies is, however, still lacking.Method: According to PRISMA statement, a systematic search of PubMed, ISI Web of Science, Cinahl and PsychInfo electronic databases was undertaken. Studies published in English between 1/1/2000 and 31/12/2016 were included. A studies quality assessment was performed using the Newcastle Ottawa scale (NOS).Results: The preliminary search retrieved 752 records. After selection, 16 studies (total population 17,698) were retrieved. The average quality of studies was low. Exposure to stress in cross-sectional studies was inconstantly associated with hypertension, obesity, dyslipidaemia, and impaired glucose metabolism. In addition, there was a prevalence of positive studies showing an association between stress and cardiovascular disease morbidity. Studies of higher quality, such as longitudinal studies on large sample size, were more supportive of a significant positive association between stress and cardiovascular risk factors. Results were, however, often conflicting and inconsistent with regard to definitions and measurement of stress, features of individual study design, study conduct, and conclusions drawn.Conclusions: A sound precautionary principle would be to adopt worksite health promotion programs designed to implement stress management strategies in this category of workers. [ABSTRACT FROM AUTHOR]

Background An Italian version of the Health & Safety Executive’s (HSE) Management Standards Revised Indicator Tool (MS-RIT) has been used to monitor the working conditions that may lead to stress.Aims To initially examine the factor structure of the Italian version of the MS-RIT, in comparison with the original UK tool, and to investigate its validity and reliability; second, to study the association between occupational stress and psychological distress.Methods Workers from 17 companies self-completed the MS-RIT and the General Health Questionnaire used to measure the psychological distress while they waited for their periodic examination at the workplace. Factor analysis was employed to ascertain whether the Italian version maintained the original subdivision into seven scales. Odds ratios were calculated to estimate the risk of impairment associated with exposure to stress at the workplace.Results In total, 748 workers participated; the response rate was 91%. The factor structure of the Italian MS-RIT corresponded partially to the original UK version. The ‘demand’, ‘control’, ‘role’, ‘ relationship’ and ‘colleague-support’ scales were equivalent to the UK ones. A principal factor, termed ‘ elasticity’, incorporated the UK ‘management-support’ and ‘change’ scales. Reliability analysis of the sub-scales revealed Cronbach’s alpha values ranging from 0.75 to 0.86.Conclusions Our findings confirmed the usefulness of the Italian version of the HSE MS-RIT in stress control. [ABSTRACT FROM PUBLISHER]

Background Special police forces are exposed to periods of intense work stress in ensuring public order.Aims To explore the relationship between the work context (routine work or special event) of special force policemen and psychological measures of job strain (demand–control) and effort–reward imbalance.Methods All policemen assigned to the G8 meeting in L’Aquila, Italy, in July 2009 were invited to complete a questionnaire while engaged in routine work in January 2009 (Time A) and in June 2009 (Time B), while preparing for the special event.Results Participation rate in the questionnaire study was 292/294 (99%) members of the special police force. Measures of job strain (−0.39, P < 0.001) and effort–reward imbalance (−0.37, P < 0.001) decreased significantly from Time A to Time B. On average, demand decreased from 14.2 ± 1.9 to 12.6 ± 2.7 (P < 0.001), control increased from 11.8 ± 2.5 to 14.4 ± 3.4 (P < 0.001) and social support increased from 17.8 ± 2.9 to 19.0 ± 3.1 (P < 0.001). At the same time, effort decreased from 17.4 ± 3.2 to 11.8 ± 3.8 (P < 0.001), reward grew from 37.6 ± 5.5 to 45.5 ± 7.4 (P < 0.001) and overcommitment dropped from 7.1 ± 2.1 to 6.6 ± 1.7 (P < 0.001).Conclusions In special police forces, routine work may be significantly more stressful than a single critical event. [ABSTRACT FROM PUBLISHER]

Musculoskeletal disorders (MSDs) are common among hospital workers. This cross-sectional study on 1744 hospital workers showed strong interaction between temperature complaints (OR 2.73), other environmental complaints (OR 3.12) and upper limbs disorders. A significant interaction between temperature and strain for upper limbs disorders (F = 9.52, p = 0.023) was also found. Environmental and psychosocial factors can interact increasing significantly the risk of MSDs. [ABSTRACT FROM AUTHOR]

The recent emergence of new democracies in North Africa results in a massive wave of immigration in Europe with thousands landing in recent months on the coast of southern Italy. This phenomenon has caused major problems of public order (PO), worsened by the presence of ever-increasing numbers of immigrants and multiculturalism, exposing the Special Forces of the Italian State Police in periods of intense work-related stress. Aims: To explore the relationship between work context (OP routine i.e. mass migration control vs. OP extraordinary i.e. the G8 summit) of special force policemen and psychological measures of job strain (demand-control, JCQ and effort-reward imbalance, ERI) related to objective measure (sickness absences). Conclusions: data showed that in special police forces routine work as migration control is significantly more stressful than a single special event that presents a very high risk for law enforcement, probably due to positive changes in psychosocial work environment among special police force. [ABSTRACT FROM AUTHOR]

Background Musculoskeletal disorders (MSDs) are the most common occupational disease in Europe, with high prevalence among hospital workers. Both environmental and psychosocial work factors may impact significantly on the development and exacerbation of MSDs.Aims To evaluate whether environmental factors at work are associated with MSDs in hospital workers and to investigate potential interactions between environmental and psychosocial risk factors in the workplace that are associated with MSDs.Methods A cross-sectional investigation was performed using the Nordic questionnaire to assess MSDs, the IAQ/MM-040 indoor air questionnaire for environmental factors, the demand–control model for job strain and the Goldberg questionnaire for anxiety and depression. The association between environmental factors and MSDs was studied using logistic regression analysis. In addition, the interactions of environmental factors with strain, anxiety and depression for MSDs were examined.Results Environmental complaints were associated with MSDs. The strongest associations were found between temperature complaints (OR 2.73), noise and light complaints (OR 2.22), other environmental complaints (OR 3.12) and upper limb disorders. A significant interaction between temperature complaints and strain for upper limb disorders (F = 9.52, P < 0.05) was found.Conclusions To prevent MSDs, a multi-level approach is needed, including environmental measures and interventions directed to both psychosocial and organizational factors. [ABSTRACT FROM AUTHOR]

Examines the cacosmia in health workers in Italy. Percentage of workers with feeling ill from the smell of chemical materials; Symptom scores of the subjects on anxiety and depression; Relation of cacosmia to multiple chemical sensitivity, sick-building syndrome, and psychopathology.

Scopo: Il lavoro ha la finalità di valutare se lo stress lavoro-correlato (alto carico, basso controllo, basso sostegno sociale, strain e isostrain) sia associato con la presenza di disturbi cutanei nei lavoratori ospedalieri e se i problemi psicologici, come l'ansia e la depressione, intervengano in questa relazione. Metodo: 1744 lavoratori ospedalieri, nell'intervallo di attesa delle visite periodiche, sono stati invitati a rispondere a un questionario sui disturbi cutanei e sui fattori psicosociali (stress, ansia, depressione). Risultato: Il 25% dei lavoratori dichiarava di aver sofferto di disturbi cutanei alle mani nei 12 mesi precedenti. Le condizioni di elevato carico psicosociale sul lavoro (OR=1.09 CI95% 1.05-1.14), basso sostegno sociale (OR=0.90, CI95% 0.87-0.93), elevato strain (OR=1.54 CI95% 1.20-1.98) ed elevato iso-strain (1.66 CI95% 1.27-2.19) erano tutte associate con elevata prevalenza di disturbi cutanei alle mani. Anche la depressione (OR=2.50 CI95% 1.99-3.14) e l'ansia (OR=2.29 CI95% 1.81-2.89) si associavano ai disturbi cutanei. L'associazione tra stress e disturbi cutanei restava significativa anche dopo correzione per I problemi psicologici. Conclusioni: Lo stress da lavoro gioca un ruolo significativo nella comparsa dei disturbi cutanei nei lavoratori ospedalieri e tale rapporto non sembra essere mediato da problemi psicologici. La prevenzione delle dermatiti cosiddette "da guanti" deve tenere conto di questa significativa associazione. [ABSTRACT FROM AUTHOR]

We report the case of a policeman who suffered a severe head injury to the right temporoparietal lobe while driving a police car. Four years later, the patient developed a neoplasm at the precise site of the meningocerebral scar. Histological examination confirmed a glioblastoma multiforme adjacent to the dural scar. Radiological documentation of the absence of tumor at the time of injury, exact localization of the neoplasm in the injured cerebral area, and latency of the cancer supported the hypothesis of a causal relationship with brain trauma. Physicians faced with brain neoplasms in adults should carefully investigate the patient's personal history of head trauma. When a relationship with occupational head injury is probable, reporting of suspect occupational illness is compelling. [ABSTRACT FROM AUTHOR]

Purpose: The police work is particularly stressful. The aim of this work was to clarify whether the personality factors are associated with perceived stress levels or reactivity to environmental stressors in a special body of police. Methods: The police officers in charge of guaranteeing public order at the L'Aquila G8 meeting were subjected to a control of their levels of work-related stress in anticipation of the event. Personality was assessed by the Italian version of the Five-Factor Model questionnaire, while stress was measured three times (during routine work in January 2009, preparation and imminence of the event, in April and July 2009, respectively) with the demand/control/support model of Karasek and the effort/reward imbalance model of Siegrist. A total of 289 of 294 officers took part in the survey. Results: Some personality traits of the Five-Factor Model were associated with stress levels and stress reactivity. Neuroticism (low emotional stability) showed the strongest associations with job strain (demand/control ratio) ( β = 0.115, p < 0.05) and effort/reward imbalance ( β = 0.270, p < 0.001) and was associated with most of the stress variables. High agreeableness was associated with low effort/reward imbalance ( β = −0.157, p < 0.01). Conclusions: Personality factors may mitigate or increase the strain induced by environmental stressors. [ABSTRACT FROM AUTHOR]

Con l'entrata in vigore del D.Lgs. 81/08, lo spettro dei compiti e delle responsabilità in carico al medico competente è stato esteso alle problematiche riguardanti la prevenzione ed il contrasto delle dipendenze nei luoghi di lavoro. Oltre agli obblighi connessi agli accertamenti tossicologici e clinici di assenza di alcoldipendenza e di assunzione di sostanze stupefacenti e psicotrope sui lavoratori addetti a mansioni che comportano particolari rischi per la sicurezza, l'incolumità e la salute di terzi, infatti, il medico competente è tenuto a collaborare all'interno delle aziende anche riguardo alla formazione, informazione e promozione della salute in tema di uso di droghe e abuso di alcolici. Pertanto, nell'ambito delle attività di medicina del lavoro in materia di comportamenti d'abuso, si sta delineando sempre più la necessità di acquisire specifiche competenze di tossicologia clinica e analitica, biochimica clinica, medicina delle dipendenze, medicina legale e bioetica. Negli USA ed in alcuni Paesi europei il delicato compito di gestire le attività di workplace drug testing e di drug and alcohol free workplace programs è affidato ad una figura professionale specializzata, il Medical Review Officer (MRO). Il MRO ha la responsabilità di interpretare i risultati positivi dei test di conferma effettuati dal laboratorio e stabilire se sussiste una motivazione medica che giustifichi tale esito. Oltre ai test positivi, anche i test negativi 'sospetti" vengono sottoposti al vaglio del MRO, al fine smascherare eventuali interventi di adulterazione e/o sostituzione del campione. Sulla base della propria valutazione il MRO ha la facoltà di sovvertire l'esito delle analisi di conferma. Il MRO rappresenta dunque un'importante risorsa per l'azienda in quanto garantisce il mantenimento di elevati standard scientifici, la riservatezza di dati sensibili riguardanti il lavoratore e la tutela del datore di lavoro contro eventuali contenziosi. Questo modello organizzativo e gestionale offre un'interessante prospettiva di sviluppo anche in Italia, dove è palese l'esigenza di simili profili professionali in grado di supportare in maniera qualificata l'attività dei medici competenti e di interagire attivamente con i datori di lavoro ed i lavoratori nell'attuazione di una valida ed efficace policy aziendale contro le dipendenze nei luoghi di lavoro. [ABSTRACT FROM AUTHOR]

Our aim was to propose a tool for tackle work-related stress (WRS) among Italian Police Special Force officers (SF). Event-related potential associated with error processing (error-related negativity – ERN) is considered a marker of internal and external feedback for processing conflict information. 290 male SF were investigated and selected in two groups (stress group – S, no stress group – NS) based on psychological assessment, evaluation of WRS with questionnaires, behavioral and clinical outcomes throughout 4years. ERN during a modified Eriksen Flanker task preceded by subliminal neutral and threat scenes, were measured in two subgroups (40S; 40NS). ERN mean latency was 27ms for S and 29ms for NS. For error trials, the ERN was more negative for S than NS (p <0,0001) and for S, for errors preceded by threat than neutral scenes (p <0,0001, p <0,02 on frontal derivations). These data supported the response-conflict view of ERN. The observed relationship between high level of WRS and ERN amplitude suggested the excessive activation of anterior cingulated cortex in S than in NS. For the first time, ERN was employed in SF to verify predictions regarding the control behavior in situations inducing high level of WRS. ERN evaluation could be helpful to design suitable training tools to increase operational efficiency based on individual WRS. [Copyright &y& Elsevier]