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Introduzione. La violenza nei luoghi di lavoro è oggi riconosciuta come un rilevante fattore di rischio occupazionale. L’International Labour Organization, con la Convenzione 190 del 2019, ratificata in Italia il 29/10/21, ha fornito una definizione riconosciuta a livello internazionale di violenze e molestie nel mondo del lavoro, specificando i soggetti protetti, gli ambiti lavorativi di applicazione, le misure di prevenzione e contrasto da adottare e i soggetti responsabili per la loro attuazione, nel contesto di un approccio inclusivo, sensibile al genere e ai soggetti vulnerabili (1). Analizzare e caratterizzare il fenomeno è necessario per mettere in campo adeguate strategie di controllo e prevenzione con particolare riguardo ad alcuni settori lavorativi. Obiettivi. Fornire un inquadramento generale sulla violenza e le molestie nel mondo del lavoro con particolare riferimento a dimensione, caratteristiche demografiche e lavorative, e impatto che tale fenomeno produce in diversi settori lavorativi. Metodi. Vengono analizzati i principali risultati di prevalenza relativi a violenze e molestie nei luoghi di lavoro riportati in revisioni della letteratura e documenti di organismi europei pubblicati negli ultimi 10 anni selezionati attraverso ricerca su PubMed. Risultati e Conclusioni. Il fenomeno della violenza nei luoghi di lavoro è indagato mediante survey periodicamente condotte in Europa da vari organismi, ma l’uso di differenti approcci metodologici limita molto la confrontabilità dei risultati. Secondo il Report Eurofound 2015 i casi di violenze e minacce nei luoghi di lavoro sono aumentati fino agli anni 2000, mentre nel periodo 2005-2010 emerge un trend divergente: le violenze fisiche calano (dal 5% al 2%) mentre altre forme di violenza rimangono sostanzialmente stabili (2). Esiste inoltre il problema della sotto-notifica, anche superiore al 50% degli eventi, quando si vogliano analizzare dati amministrativi, es. da ispettorati del lavoro, enti assicuratori, corti di giustizia. In generale le donne sono più esposte a molestie sessuali, gli uomini a violenze fisiche. Tra gli altri fattori con rischio maggiore sono l’età più giovane (16,1% < 35 anni vs 13,8% e 12,2% per le fasce 35-49 e > 50 anni), l’essere nato in un paese straniero (17,5% vs 13,7%, autoctoni), un basso livello d’istruzione (24% vs 16%, alto livello), l’assunzione con contratti atipici (22% vs 14,5%, contratti a tempo indeterminato) (2). Sanità, servizi sociali, trasporti, turismo, pubblica amministrazione e istruzione sono i settori con maggior rischio da parte di terzi. Tra le condizioni lavorative associate a segnalazioni di atti violenti, una maggiore evidenza esiste per alcuni indicatori “soggettivi” (es. conflitto tempi vita-lavoro) o nel contesto di ambienti di lavoro stressanti. Nei servizi una recente rassegna ha evidenziato l’associazione tra violenza psicologica e cattiva salute mentale e assenze per malattia, e tra violenza fi sica e cattiva salute mentale (3). Strategie di contrasto e prevenzione sono importanti per tutelare la salute fisica e mentale e la capacità lavorativa dei lavoratori, riducendo nel contempo i costi associati ad assenteismo, turnover e perdita di produttività.

Healthcare workers (HCWs) can be considered at an increased risk of developing occupational contact dermatitis (OCD) due to repetitive hand washing with soaps and disinfectants and extended use of gloves for many hours during the day. The aim of this study was to summarize the incidence of OCD in HCWs. We searched the databases PubMed/Medline (1980-present), EMBASE (1980-present) and Cochrane Library (1992-present) through May 2020 using the search term "incidence of contact dermatitis in healthcare workers" according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Overall, 16 studies (six cohort; 10 register-based) with follow-up periods between 1987-2013 fulfilled the inclusion criteria. The incidence of OCD reported in studies using registers of occupational diseases ranged from 0.6 to 6.7 per 10,000 person-years. The cohort studies reported incidence from 15.9 to 780.0 per 10,000 person-years; the incidence was higher in studies which included apprentice nurses. A higher incidence was also observed amongst dental practitioners, particularly dental technicians and nurses, compared to other HCWs. Studies reporting incidence data are very scarce and results differed by study design, type of contact dermatitis, and investigated HCWs. Our study highlighted the dearth of high-quality data on the incidence of OCD and the possible underestimation of disease burden. Prospective cohort studies with harmonized designs, especially exposure assessment and outcome ascertainment, are required to provide more accurate, valid, and recent estimates of the incidence of OCD. A high incidence amongst specific occupational groups suggests the need to undertake intervention studies with a focus on prevention, particularly during pandemics such as COVID-19.

Background Health care workers (HCWs) are on the frontline, playing a crucial role in the prevention of infection and treatment of patients. Aims This study was aimed to evaluate the prevalence of hospital-acquired coronavirus disease 2019 (COVID-19) infection at work and related factors at the University Hospital of Trieste workers exposed to COVID-19 patients. Methods From March 1 to May 31, of 4216 employees, 963 were in contact with COVID-19 patients or colleagues and were followed up. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in nasopharyngeal swabs was determined every 3 days, by RT-PCR. Results During the follow-up period, 193 workers were positive for COVID-19 (5%), and 165 of these (86%) were symptomatic. We identified five major cluster outbreaks of COVID-19 infection in Trieste Hospitals, four of which occurred before the implementation of universal masking for HCWs and patients (1–14 March 2020). COVID-19 infection was significantly higher in high-risk ward workers (Infectious Diseases, and Geriatric and Emergency Medicine, odds ratio [OR] 13.4; 95% confidence interval [CI] 5.8–31), in subjects with symptoms (OR 5.4; 95% CI 2.9–10) and in those with contacts with COVID-19 patients and colleagues (OR 2.23; 95% CI 1.01–4.9). Conclusions Hospital workers were commonly infected due to contact with COVID-19 patients and colleagues, mainly in the first 15 days of the pandemic, before the implementation of universal mask wearing of HCWs and patients. Repetitive testing and follow-up permitted the identification of COVID-19 cases before symptom onset, obtaining better infection prevention and control.

BACKGROUND: Methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) (Kathon® CG) is a common preservative used in industrial products, owing to its strong biocide effect. Contact allergy to MCI/MI has been reported in different occupations, including mechanics, hairdressers and healthcare workers. OBJECTIVE: To retrospectively analyse the temporal trend of MCI/MI sensitization in north-eastern Italy and to evaluate the associations with occupations in our geographical area. METHODS: From 1996 to 2016, 27 381 patients with suspected allergic contact dermatitis were patch tested in eight departments of Dermatology or Occupational Medicine in north-eastern Italy. Individual characteristics were collected through a standardized questionnaire. RESULTS: The overall prevalence of MCI/MI sensitization was 4.2%, with the highest prevalence found in women and in patients younger than 25 years. MCI/MI sensitization was significantly associated with atopic eczema (OR: 1.34, 95% CI: 1.10-1.70), hand/forearm dermatitis (OR: 1.20, 95% CI: 1.05-1.36) and face dermatitis (OR 1.30, 95% CI: 1.10-1.40). There was a significant association between MCI/MI sensitization and chemical processing workers (OR 1.74, 95% CI: 1.03-2.94), while mechanics and healthcare workers resulted more sensitized to this hapten only in the last 3 years. CONCLUSIONS Sensitization to MCI/MI is rising in the last years in Triveneto region, the 'epidemic' of sensitization to MCI/MI is mainly driven by extra-occupational dermatitis, and sensitization in some occupational groups is emerging only in the last years. A full labelling is compulsory for all products that contain isothiazolinones, to permit to identify the culprit agent.

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BACKGROUND Work-related skin diseases (WSD) are caused or worsened by a professional activity. Occupational skin diseases (OSD) need to fulfil additional legal criteria which differ from country to country. OSD range amongst the five most frequently notified occupational diseases (musculoskeletal diseases, neurologic diseases, lung diseases, diseases of the sensory organs, skin diseases) in Europe. OBJECTIVE To retrieve information and compare the current state of national frameworks and pathways to manage patients with occupational skin disease with regard to prevention, diagnosis, treatment and rehabilitation in different European countries. METHODS A questionnaire-based survey of the current situation regarding OSD patient management pathways was carried out with experts on occupational dermatology and/or occupational medicine from 28 European countries contributing to the European Cooperation in Science and Technology (COST) Action TD 1206 (StanDerm) (www.standerm.eu). RESULTS Besides a national health service or a statutory health insurance, most European member states implemented a second insurance scheme specifically geared at occupational diseases [insurance against occupational risks (synonyms: insurance against work accidents and occupational injuries; statutory social accident insurance)]. Legal standards for the assessment of occupationally triggered diseases with a genetic background differ between different countries, however, in most European member states recognition as OSD is possible. In one-third of the countries UV light-induced tumours can be recognized as OSD under specific conditions. CONCLUSION OSD definitions vary between European countries and are not directly comparable, which hampers comparisons between statistics collected in different countries. Awareness of this fact and further efforts for standardization are necessary.

Background The serum level of dehydroepiandrosterone sulphate (DHEA-S) has been suggested as a biological marker of stress. Aims To assess the association between serum DHEA-S, psychosocial factors and musculoskeletal (MS) pain in university workers. Methods The study population included voluntary workers at the scientific departments of the University of Trieste (Italy) who underwent periodical health surveillance from January 2011 to June 2012. DHEA-S level was analysed in serum. The assessment tools included the General Health Questionnaire (GHQ) and a modified Nordic musculoskeletal symptoms questionnaire. The relation between DHEA-S, individual characteristics, pain perception and psychological factors was assessed by means of multivariable linear regression analysis. Results There were 189 study participants. The study population was characterized by high reward and low effort. Pain perception in the neck, shoulder, upper limbs, upper back and lower back was reported by 42, 32, 19, 29 and 43% of people, respectively. In multivariable regression analysis, gender, age and pain perception in the shoulder and upper limbs were significantly related to serum DHEA-S. Effort and overcommitment were related to shoulder and neck pain but not to DHEA-S. The GHQ score was associated with pain perception in different body sites and inversely to DHEA-S but significance was lost in multivariable regression analysis. Conclusions DHEA-S was associated with age, gender and perception of MS pain, while effort-reward imbalance dimensions and GHQ score failed to reach the statistical significance in multivariable regression analysis.

At the 8th conference of Occupational and Environmental Exposure of the Skin to Chemicals (OEESC) (16–18 September 2019) in Dublin, Ireland, several researchers performing skin permeation assays convened to discuss in vitro skin permeability experiments. We, along with other colleagues, all of us hands-on skin permeation researchers, present here the results from our discussions on the available OECD guidelines. The discussions were especially focused on three OECD skin absorption documents, including a recent revision of one: i) OECD Guidance Document 28 (GD28) for the conduct of skin absorption studies (OECD, 2004), ii) Test Guideline 428 (TGD428) for measuring skin absorption of chemical in vitro (OECD, 2004), and iii) OECD Guidance Notes 156 (GN156) on dermal absorption issued in 2011 (OECD, 2011). GN156 (OECD, 2019) is currently under review but not finalized. A mutual concern was that these guidance documents do not comprehensively address methodological issues or the performance of the test, which might be partially due to the years needed to finalize and update OECD documents with new skin research evidence. Here, we summarize the numerous factors that can influence skin permeation and its measurement, and where guidance on several of these are omitted and often not discussed in published articles. We propose several improvements of these guidelines, which would contribute in harmonizing future in vitro skin permeation experiments.

Introduction In recent years, nano-based pesticides formulation are developing with the aim to obtain a product that can release the active ingredients only in contact with the target, prolong the effective duration and reduce the dispersion of chemicals in the environment. Big efforts are spend to develop products that can enter in the market, but concern is rising about safety measures to adopt during usage. United States Environmental Protection Agency and European Commission are enacted rules on the management and usage of nano pesticides. Nano formulations can be more active on pests because of the enhancement of penetration, but for the same reason they can penetrate easily into human body mainly through skin route. Methods a web base survey on pesticides in nano-form tested was done, reviewing scientific literature, technical data and patents on new pesticides formulations with the aim to find information about safety profile comparison between traditional and nano-form. Results literature is focusing mainly on advantages of nano pesticides in term of reduction of active ingredient to be used in association with less use of chemical agents to disperse it. Very few are data on comparative toxicity on cells line between nano and traditional formulations, showing mainly a lower toxicity for the first one. No animal or human data are available in literature in our best knowledge that compares toxicity between nano and traditional formulation. Due to high surface/mass ratio nano formulations can be more active on the target but for the same reason can enter quickly into human body via skin contact and inhalation route. Discussions nano pesticides can offer many advantages from the theoretical point of view but their use need to be evaluated considering the higher permeation into human body that they can have, mainly through the skin route.

BACKGROUND: Contact allergy is a common condition and can severely interfere with daily life or professional activities. Due to changes in exposures, a consequence of introduction of new substances, new products or formulations, and regulatory intervention, the spectrum of contact sensitisation changes. OBJECTIVE: To evaluate the current spectrum of contact allergy to allergens present in the European baseline series (EBS) across Europe. METHODS: Retrospective analysis of data collected by the European Surveillance System on Contact Allergies (ESSCA, www.essca-dc.org) in consecutively patch tested patients, 2013/14, in 46 departments in 12 European countries. RESULTS: Altogether, 31689 patients were included in the analysis. Compared to a similar analysis in 2004, the prevalence of contact allergy to methylisothiazolinone went up to around 20% in several departments. In comparison, contact allergy to the metals nickel, cobalt and chromium remained largely stable, at 18.1, 5.9 and 3.2%, respectively, similar to mostly unchanged prevalences with fragrance mix I, II and Myroxylon pereirae (Balsam of Peru) at 7.3, 3.8 and 5.3%, respectively. In the subgroup of departments diagnosing (mainly) patients with occupational contact dermatitis, the prevalence of work-related contact allergies such as to epoxy resin or rubber additives was increased, compared to general dermatology departments. CONCLUSION: Continuous surveillance of contact allergy based on network data offers the identification of time trends or persisting problems, and thus enables focussing in-depth research (subgroup analyses, exposure analysis) on areas where it is needed. This article is protected by copyright. All rights reserved.

BACKGROUND: Working in healthcare is regarded as a risk factor for occupational skin disease. Workers are exposed to disinfectants, soaps, detergents and latex and need to wash their hands frequently and thoroughly. AIMS: To investigate the association between healthcare work and patch test reactions to various potential sensitizers in a population of contact dermatitis patients in various dermatology and occupational medicine units in north-eastern Italy. METHODS: Patients with suspected allergic dermatitis underwent patch testing. Odds ratios (ORs) and 95% confidence intervals (CIs), adjusted by age and sex, were calculated for healthcare workers (HCWs), using white-collar workers as control group. RESULTS: HCWs represented 14% of the sample of 19088 patients (68% women, 32% men). Among HCWs, both sexes had a higher risk of developing hand/forearm dermatitis (females: OR 2.1, 95% CI 1.8-2.5; males: OR 1.6, 95% CI 1.3-2.1). HCWs had an increased risk of sensitization to formaldehyde (OR 1.65; 95% CI 1.2-2.3) and to p-phenylenediamine (OR 1.6; CI 1.1-2.3). CONCLUSIONS: Our study suggests a significant association between healthcare work, hand/forearm dermatitis and sensitization to formaldehyde and p-phenylenediamine.

Background Occupational skin diseases are often responsible for sick leave or job changes, affect mostly young subjects, are costly to society and have been reported as significant predictor of unemployment. Objectives To assess, over time, the course of occupational hand dermatitis (OHD) after a specific training, by means of follow-up visits and TEWL measurement, to evaluate skin barrier integrity and if preventive measures for hand skin care provided may influence the course of the disease. Methods Workers with a diagnosis of OHD from January 2011 to December 2013 were contacted by telephone, filled in a questionnaire (NOSQ-2002) and were invited to a training course on prevention of skin dermatitis, and to a new clinical evaluation with TEWL measurement. Workers who joined the training programme were asked to undergo a new evaluation after 3 months. A total of 65 subjects without contact dermatitis were recruited as control group. Results One hundred and one subjects from 143 workers, who were contacted, filled in the questionnaire. Sixty-five of them followed the training course and underwent a new clinical evaluation withTEWL measurements. Ongoing symptoms of subjects decreased from 60.0% to 42.3% 3 months after the training, and the subgroup which strictly adhered to the recommendations given achieved better results (61.9% of symptoms improvement when compared to 29.0% obtained in subjects with partial adhesion to the protocol). TEWL values changed from 21.3 ± 9.6 to 18.6 ± 7.2 g/m²/h (P = 0.001) on the hands and from 16.6 ± 9.0 to 10.5 ± 4.6 g/m²/h (P = 0.001) on the forearm, confirming the skin barrier improvement. Conclusions Our secondary prevention intervention was effective, leading to a reduction in clinical signs of dermatitis. TEWL measurement is a useful tool to evaluate skin integrity, mostly in apparently healthy skin, which may have a compromised barrier function, resulting in an exacerbation of the dermatitis.

The incidence of OCD (occupational contact dermatitis) in different European Countries and USA ranges between 0.5 and 1.9 cases per 1000 workers per year. 1,2,3 OCD is lowering in the last 10-15 years, with incidence rate that varies between 1.2 to 0.56 cases per 1000 person-years from 1993 to 1996 in Germany 1,3 and from 0.29 to 0.1 cases per 1000 from 1997 to 2008 in a Czech study.4 Incidence of notified occupational skin diseases for health care workers (HCWs) was 3.1 cases per 1000 workers per year in USA, 1.5 in Bavaria, 1.5 in Denmark (only nurses), 0.4 in Northem Bavaria and 0.1-0.29 in Czech Republic.4 This article is protected by copyright. All rights reserved.

stract BACKGROUND: The Health & Safety Executive Management Standards Indicator Tool (HSE-MS IT) is a questionnaire commonly used to assess work-related stress risks at an organizational level. A critical factor in determining whether this instrument is actually useful is that higher levels of stress risk in the work-design domains should predict higher levels of stress and stress-related outcomes in workers. Only a few studies, however, have addressed this issue. AIMS: To test both the concurrent and construct validity of the HSE-MS IT, by relating it with another widely used instrument, the Job Content Questionnaire (JCQ), and by examining its relationships with a set of work-related stress outcomes. METHODS: An anonymous cross-sectional questionnaire was administered to a sample of employees in an Italian municipality. The questionnaire included the HSE-MS IT, self-reported measures of job satisfaction, job motivation and stress at work, the Satisfaction with Life Scale and the reduced form of the JCQ. RESULTS: A total of 760 out of 779 employees completed the questionnaire. Results showed moderate to strong correlation among the corresponding HSE-MS IT and JCQ scales. Hierarchical regression highlighted the specific contribution of each of the HSE-MS IT scales in predicting three relevant work-related stress outcomes (self-reported stress, job satisfaction and job motivation), after controlling for gender, age and life satisfaction. CONCLUSIONS: Our findings consolidated the HSE-MS IT validity and showed the specific sensitivity of its scales to assess different aspects of work-related distress, including self-perception of stress at work. These results can have practical implications for the occupational well-being of employees.

Shipbuilding industry exhibits higher injury rates at the workplace than those reported in other industrial sectors. Work-related injuries (n = 6714) occurred from 2000 to 2010 at the shipyard of Monfalcone (Gorizia-Italy) were considered. Injury frequency incidence (IF = number of accidents/number of workers x 1000) and injury severity rate were estimated. Among permanent (directly employed) shipyard workers, the IF ranged from 294.6 in 2000 to 113.7 in 2010. Injury severity rates showed the same decreasing trend. The IF for contract workers was unchanged over the calendar period (110.5 in 2000 to 110.9 in 2010) with no significant change in the injury severity rate. These findings suggest an improvement of the working condition for permanent shipyard workers as a result of prevention policies (education and surveillance) and the automation of production processes. Further preventative interventions are suggested to minimize work-related injuries and to promote health and safety in the shipbuilding industry.

Nine hundred building trade workers and 4372 office workers (from a database of 16267 patients) with suspected allergic dermatitis, underwent patch tests. The associations between patch test results and occupations were assessed by multivariate logistic regression analysis. As expected, building trade work was significantly associated with chromium sensitization (OR 1.55; 95% IC 1.22-1.97), a well known occupational hapten in this occupational group. An increased risk for epoxy resin sensitization (OR 3.80; 95% IC 2.11-6.86) and thiuram mix sensitization (OR 1.69; 95% IC 1.07-2.65) was also found in the construction workers. Epoxy resin is a strong skin sensitizer widely used in building trade, while thiuram mix is often present as an additive in the rubber gloves used by construction workers. These findings suggest that effective measures to prevent allergic contact dermatitis are needed in the construction workers.

In the health sector, the theme of work-related stress is a major issue, representing a significant risk factor on health-care providers which can also affect the quality of health services provided. It is therefore important to adopt a multidimensional evaluation system of work-related stress in order to integrate the results of the analysis of objective and subjective stress indicators. The adoption of a multidimensional validated tool as the one proposed by Inail, allows an integrated analysis of sentinel indicators, objective factors of context and content jointly to direct analysis of the subjective perception of workers through the analysis of the Management Standards developed by Health and Safety Executive. The comparison between three Healthcare Districts, three Mental Health Centers and Administrative Offices of an Healthcare Organization (652 workers involved) revealed the most critical areas which need urgent improvement intervention.

Contact allergy surveillance networks provide information that permits a better evaluation of the role of different haptens in allergic contact dermatitis work related. The Triveneto region network is active since 1996 and comprises 12 center of dermatology and occupational medicine: all centers use a standardized protocol to perform patch test and a questionnaire to obtain information on skin diseases, atopy, occupations. All data are collected from Padua and Trieste and used to evaluate sensitization trends and occupation relevance of haptens. The Triveneto region network participates to the European Network on Contact Dermatitis. Data analysis permit to confirm the increase in sensitization in some occupational groups: construction workers has higher risk to be sensitized to chromium, hairdressers to be sensitized to p-phenilendiamine, mechanics to be sensitized to nickel, epoxy resin and mercaptobenzothiazol. Trend analysis of sensitization permit to evaluate in large scale the benefits of preventive measure and the needs for future.

A review of neck and upper limb disorders caused by combined exposures to hand-transmitted vibration and ergonomic risk factors (repetitiveness, force, posture) suggested the following conclusions: (1) hand-transmitted vibration has a dominant role in the etiopathogenesis of Raynaud's phenomenon and various forms of peripheral neuropathy with sensory impairment (digital, multifocal) in users of vibrating tools; (2) vibration of low frequency and high amplitude from percussive tools concur, together with adverse ergonomic factors, to produce degenerative changes in the bones and joints of the upper limbs, mainly in the wrist and elbow; (3) there is strong epidemiological and experimental evidence that combined exposures to hand-transmitted vibration and physical load are associated with an excess risk of carpal tunned syndrome; (4) there is limited evidence for an association between Dupuytren's contracture and vibration exposure owing to the small number of currently available epidemiological studies; (5) there is insufficient evidence for a contribution of hand-transmitted vibration to the development of chronic pain and clinical syndromes in the neck and upper limb, while excessive physical load and ergonomic stress have a primary role in the etiopathogenesis of these disorders.

Background: Natural rubber latex allergy can cause skin and respiratory symptoms The aim of this study was to evaluate the prevalence and incidence of latex related symptoms and sensitisation among a large group of healthcare workers in Trieste hospitals, followed for three years before and after the introduction of powder-free gloves with low latex release. Methods: In the years 1997-99 the authors evaluated 1040 healthcare workers exposed to latex allergen for latex related symptoms and sensitisation by means of a questionnaire, a medical examination, skin prick tests, and IgE specific antibody assay. The second evaluation was carried out in the years 2000-02, subsequent to the changeover to a powder-free environment. Results: Glove related symptoms were seen in 21.8% of the nurses (227), mostly consisting of mild dermatitis: 38 (3.6%) complaining of contact urticaria and 24 (2.3%) of asthma and/or rhinitis. These symptoms were significantly related to skin prick tests positive to latex (OR = 9.70; 95% CI 5.5 to 17) and to personal atopy (OR = 2.29; 95% CI 1.6 to 3.2). Follow up was completed in 960 subjects (92.3%): 19 new subjects (2.4%) complained of itching erythema when using gloves, but none was prick positive to latex. Symptoms significantly improved and in most cases disappeared (p,0.0001). Conclusions: Simple measures such as the avoidance of unnecessary glove use, the use of non-powdered latex gloves by all workers, and use of non-latex gloves by sensitised subjects can stop the progression of latex symptoms and can avoid new cases of sensitisation.

Exposure to urban pollution may cause respiratory diseases in traffic policemen, especially in very polluted cities. The aim of this study was to investigate respiratory symptoms and pulmonary function in traffic police officers in a 5-year follow-up.A 5-year follow-up on FEV1 (forced expiratory volume in one second), FVC (forced vital capacity), and respiratory symptoms was performed on 290 traffic policemen (90.9% of participation rate, mean age 39 +/- 8.3 years, seniority of work 11.4 +/- 8.2 years).Upper respiratory symptoms were reported by the 28% of traffic policemen assigned to traffic control and by the 11% of administrative workers (p = 0.006). Neither in the 1st control (ORc 1.1; IL 95% 0.6-2.3) nor in the follow-up, did ORL evaluation show any difference between the two groups, after having controlled for smoking habits (Mac Nemar test p0.05). The follow up on FEV1 and FVC did not show an accelerated decline in traffic policemen assigned to traffic control as compared to administrative police workers. These data suggest the need to follow-up this cohort, evaluating symptoms and respiratory function for a longer period of time, in order to better understand the role of road traffic pollution in inducing respiratory diseases.

Laboratory animal allergy (LAA) is a well known occupational hazard for workers employed in biological and medical research institutes, but few Italian data on this disease exist.The aim of our study was to evaluate the prevalence of LAA in 45 workers in Trieste (NE-Italy) and in 80 workers in Perugia (Central Italy) and to assess factors predisposing to sensitisation among subjects occupationally exposed to animals.All subjects underwent a physical examination and responded to a standardized questionnaire for the evaluation of allergic respiratory symptoms and exposure data. Skin prick tests with common allergens and with hair extract from laboratory animals were performed and specific IgE was measured. Atopy was defined as positive skin prick test to common allergens.There were 60% atopic subjects in Trieste and 55% in Perugia and sensitisation to laboratory animal hair was found in 24.4% subjects in Trieste and in 35% in Perugia. The prevalence rates of LLA were respectively 11.1% and 11.2%; 2.3% and 3.7% complained of asthma while 8.9% and 7.5% complained of rhinitis. The resulting symptoms were significantly related to skin prick tests that were positive to laboratory animal hair (odds ratio (OR) = 7.64; 1.83-44.5), to skin prick test positivity to common inhalant allergens (OR = 5.29; 1.09-50.2), to common allergic symptoms (OR = 3.95; 1.05-18.2) and to exposure time exceeding 5 hours per day (OR = 5.45; 1.31-22.0).The role of atopy and of exposure time in causing LLA was confirmed and the need of prevention measures to reduce exposure in people at risk was discussed.

Background: Natural rubber latex has become an important occupational health concern, particularly among health care workers, who for protection are required to wear latex gloves when at work. This study evaluated the prevalence of latex-related symptoms and sensitisation among a large group of health care workers in Trieste hospitals. Methods: We evaluated the prevalence of latex-related symptoms in 1,165 health care workers, by means of a questionnaire, a medical examination, skin prick tests and IgE-specific evaluation. We determined atopy and latex sensitivity by skin prick tests using a battery of common inhalant allergens, a commercial latex extract (Lofarma Allergeni, Milan) and individual skin puncture tests for each of the vegetables immunologically related to latex (potato, tomato, chestnut, banana, kiwi fruit). Associations between potential risk factors for latex allergy were assessed. Results: Glove-related symptoms were noticed on 17.2% of the nurses (200) the majority of symptoms being mild dermatitis with itching and erythema (120 subjects, 11.1%). Symptoms suggestive of IgE-mediated latex allergy were found in 51 subjects: 35 (3%) complained of contact urticaria and 16 (2.2%) complained of asthma and/or rhinitis. The resulting symptoms were significantly related to skin prick tests that were positive to latex (odds ratio (OR)=11.89; 6.40–22.2), to personal atopy (OR=2.15; 1.47–3.12), to familiar atopy (OR=2.12; 1.48–3.03), to skin prick test positivity to related fruit (OR=2.01; 1.16–3.46) but not to prick test positivity to common inhalant allergens (OR=1.00; 0.71–1.39). Symptoms increased as a direct function of the time-usage of latex gloves and were more prevalent in operating room staff. Conclusion: In this large cross-sectional study, glove-related symptoms and latex skin sensitisation appear to be substantial among health care workers, and are related to common signs of atopy. We stress the need of preventive measures to avoid latex exposure when health care workers are at risk of developing allergy symptoms.

Objectives: The increased use of glycol ethers (GEs) for water-based paints and cleaning products, combined with a lack of information about many of these products, particularly with regard to the effects of percutaneous exposure, led us to evaluate the skin absorption rates of a group of glycol ethers in vitro. Methods: Skin permeation was calculated using the Franz cell method with human skin. A physiological solution was used as the receiving phase. The amount of solvent passing through the skin was analysed with a gas chromatographic technique employing flame ionization detection. A permeation profile was obtained and steady state, lag time and permeation constant flux was calculated for each of the following solvents: ethylene glycol monoethyl ether (EGMEE), propylene glycol mono-methyl ether (PGMME); propylene glycol mono-methyl ether acetate (PGMMEac); 2-propylene glycol 1-butyl ether (2PG1BE), ethylene glycol dimethyl ether (EGDME), ethylene glycol diethyl ether (EGDEE) and diethylene glycol dimethyl ether (DEGDME). All solvents were tested in their pure form and with 70% acetone. Results: For all solvents tested the lag time was less than 2 h, and for the majority of them was about 60 min. Flux at steady state ranged between 0.017 ± 0.005 and 3.435 ± 1.897 mg/cm2/h and permeation rate was from 0.0192 to 1.02 × 10−3 cm/h. The presence of acetone in the solution caused a reduction in lag time and an increase in permeation rate, higher for EGMEE, lower for EGDEE, indicating the enhancing effect of this mixture of solvents. Conclusions: Our results confirm the high percutaneous absorption of the GEs tested. The Franz method might be helpful for obtaining a grading of skin notation for hydrophilic substances: in the case of glycol ethers, it can give us precise information about permeation risk, particularly important in the evaluation of exposure. In the case of solvents with high dermal absorption, the air concentration is no longer a sufficient measure of the total exposure to workers, and therefore merely respecting threshold limit values (TLVs) in the air is not necessarily enough to protect them.

L’epidemiologia occupazionale può essere intesa in termini etiologici come lo studio degli effetti delle esposizioni lavorative sulla frequenza e distribuzione delle malattie e infortuni nella popolazione. In termini di epidemiologia clinica include anche lo studio dei determinanti e degli effetti delle attività di prevenzione sul luogo di lavoro. Pertanto i principali obiettivi degli studi epidemiologici in campo occupazionale sono di due ordini: (a) stimare un'associazione tra un fattore di rischio in ambito occupazionale e una o più malattie; (b) valutare gli effetti di attività che mirano a ridurre il rischio.