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The study considered all patients admitted to the 1st Division of Occupational Medicine, Department of Preventive, Occupational and Community Medicine of the University of Pavia between January 1st 1989 and December 31st 1995 with a diagnosis of occupational disease. It was useful in illustrating the evolution of occupational disease as regards both changes in etiology and in the symptoms and systems involved. A decrease in the number of occupational diseases diagnosed from 1993 to 1995 was revealed, but it is difficult to draw any significant conclusions from these data since the need for hospitalization when diagnosing this type of disease has diminished greatly. Changes in legislation which have obliged employers to take precise preventive measures could also be partly responsible for this downward trend. The patients were, in almost all cases, at an initial stage of their disease. This is reassuring as far as the therapeutic and legal need for an early diagnosis is concerned. However, it remains unknown how often the causal relationship between work and disease was not suspected and therefore how many cases did not arrive to observation. Finally, the study confirmed the disappearance of some occupational diseases, such as benzene intoxication, common in the past, and the increase in "emerging" pathologies like allergies.

The relationship between alcohol and work was studied in a group of 537 voluntary patients (393 male and 144 female) admitted to the department of Medicina del Lavoro, Pavia University for alcohol rehabilitation. The highest incidence of alcohol abuse was found in non-working subjects (pensioners, unemployed, housewives) although the start of excessive drinking takes place after beginning a working activity; a cause-effect relationship between these two factors can not be clearly determined, however. It is true that the stress provoked by this new condition (introduction to the work experience) can, in certain subjects, be a contributing factor in alcohol abuse. The increasingly lower age of initiation to alcohol reconfirms the need for prevention and instruction even at scholastic level. We can deduce how no working condition, low age and low education can constitute makers of risk for alcohol abuse.

51 workers, occupationally exposed to anaesthetic gases and vapours (nitrous oxide, halothane, and isoflurane), were studied monitoring their environmental and biological exposure. Moreover, they were tested for visual reaction times and neurobehavioural batteries. There was no evidence of important neurotoxic effects nor of neurobehavioural problems with low concentrations of anaesthetics.

Several hemorheologic and plasma proteic features were analyzed in workers exposed to acoustic defilement. Whole-blood viscosity was significantly increased (at every shear-rate considered) in patients with severe sensorineural hearing impairment; whereas plasma, serum and relative viscosity remained unchanged. These variations were independent of erythrocyte deformability and aggregation, and of plasma fibrinogen levels, resulted indeed in the normal range. On the contrary plasma fibronectin was significantly increased in patients with sensorineural hearing impairment, suggesting a microvascular endothelial damage in these subjects. The exposition to acoustic defilement during work activity may be considered as aetiological factor for the development and progression of sensorineural hearing impairment, and more extensively for the occurrence of cardiovascular complications.

The relationship between alcohol and work was studied in a group of 260 voluntary patients (186 male and 74 female) admitted to the unit of Medicina del Lavoro, Pavia University for alcohol rehabilitation. The highest incidence of alcohol abuse was found in non-working subjects (pensioners, unemployed, housewives) although the start of excessive drinking takes place after beginning a working activity; a cause-effect relationship between these two factors can not be clearly determined, however. It is true that the stress provoked by this new condition (introduction to the work experience) can, in certain subjects, be a contributing factor in alcohol abuse. The increasingly lower age of initiation to alcohol reconfirms the need for prevention and instruction even at scholastic level.

In this study effects on psyche caused by a protract exposure to radiofrequency are examined. 13 women, occupationally exposed to radiofrequency, were subjected to a series of psychological tests in order to verify possible psychological troubles. Results seem to demonstrate a significant presence of troubles concerning social relations, anxiety and depression.

Because of increasing interest for electromagnetic fields biological effects we examined possible effects on behaviour produced by prolonged exposition to radiofrequencies on some wood industry workers. The results of psychological tests seem to prove a significant difference between exposed and control groups in the answers concerning social relations and anxiety. However these results have to be confirmed by other and more complete studies.

Because of the growing national and international spreading of devices producing non-ionizing radiations, the AA consider the possibility of a deep study on some of the most precious and interesting effects, though controversial at the same time, described in occupationally exposed subjects: the psychological ones. Such a study, however, presents considerable difficulties because of the great deal of personal, domestic and social factors responsible for the arising of such a symptomatology. Therefore the AA suggest the use of a set of tests particularly aiming at leaving out such factors in the genesis of the psychological troubles; this set must be previously administered to a carefully selected sample in order to verify its accuracy, reliability, sensitivity and specificity, so that it will be possible to extend afterwards the research to larger samples of population.

Alcoholism is a very important social problem in our Country. Nevertheless our knowledge about the frequency and the features of alcoholism in the household environment is poor; until recently this kind of alcoholism was considered a female problem. The authors studied two homogeneous groups of male and female alcoholics. Females have a greater tendency to drink in the household. This behaviour is due to socio-cultural condition rather than to different psychological features. The authors also reported the importance of the family in the etiology, evolution and treatment of alcoholism.

Wearing work is an old problem of occupational medicine which seems to be resolved by technological progress and progressive disappearance of physical fatigue. On the contrary in these new working conditions new physical and psychical possibilities of wearing work take place and they are less conspicuous but not less important than old conditions. Some examples of such conditions are provided and some possible solutions are proposed.

Because of new increase of coal use as energy source, hazards for environment and human health of coal cycle are debated, from its extration to its combustion, taking particularly care of this last stage. At last specific hazard of coal power station workers are briefly discussed.