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A Baldasseroni

Publications and source records attributed to A Baldasseroni.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

[Fatal occupational accidents: updating of data from a mortality register].

BACKGROUND: In Italy, almost one thousand deaths due to occupational accidents are usually registered by INAIL each year. Case registration by INAIL has merely administrative purposes and therefore it is necessary to use other sources for case ascertainment in order to better estimate the real number of deaths related to occupational accidents, as shown also by previous papers. OBJECTIVES: Evaluation of the contribution of another data source, namely the Tuscany Regional Mortality Registry, to obtain the correct figure for occupational accident deaths through the use of a place-of-occurrence notation on the death certificate. METHODS: Cases that occurred in residents in Tuscany in 2000-2001 were considered. They were identified from : a) the Tuscany Regional Mortality Registry (RMR) using the E code of the ICD LX code of death, the year and place of occurrence; b) the INAIL archive using the year of event, the type of definition and management. RESULTS: The INAIL source was without doubt the most informative but was only 51% complete, whereas the RMR source, although less informative, was more complete (82.4%) and allowed identification of cases not registered by INAIL, that had occurred for instance in the Armed Forces and in the National Railway Company. However, the vast majority of RMR extra-cases occurred in subjects aged 65+, in agriculture and in the building industry. CONCLUSION: It is currently possible to plan a systematic linkage of the two sources due to the new possibilities that are available: the place-of-occurrence in the death certificate and the availability of individual data in the INAIL source.

Accidents, Occupational↗
PubMedDate not supplied

[Efficacy evidence in occupational medicine].

The author shows an overview of the most relevant features that characterize the development of the so-called "Evidence Based Occupational Health" (EBOH). After a short introduction dealing with the origin of the movement towards an evidence based medicine and health services, attributed to Donabedian and Vuori for WHO during the '80s on one hand, and, of course, fuelled by the most comprehensive Cochrane Collaboration, the most recent developments of EBOH both in Europe and in our country are discussed.

Evidence-Based Medicine↗
PubMedDate not supplied

[Occupational exposure to nickel in Tuscany: analysis of a biological monitoring register for the period 1991-1998].

OBJECTIVE: The study assesses the time trend in exposure to nickel among factory workers in Florence, via data on biological monitoring. A data-base of nickel in urinary samples (Ni-U mg/l) was created for the period 1991 to 1998. METHODS: The data-base contained 2.138 samples, measured by atomic absorption (GF-AAS),from 893 workers. Subjects came from 157 factories in various manufacturing sectors, especially electroplating, mechanical workshops, jewellery. RESULTS: Ni-U levels were correlated with manufacturing sector. The highest levels were found among workers from electroplating industries, where exposure was mainly due to water-soluble nickel compounds. The eight-year time trend showed a statistically significant decrease in Ni-U values, with a sharper drop during the last two-year period. Age, sex and number of samples per subject were not statistically related to this trend. CONCLUSION: The observed Ni-U decrease could be related to the efficacy of new legislation introduced in Italy during the study period (Law 626/94 and subsequent laws), but also to the intense labour inspection activities that officials of National Health Service performed, which were rightly focused on nickel exposure in different manufacturing sectors. This study confirms the usefulness for occupational risk evaluation of a biological monitoring data-base of routinely collected data.

Adult↗
PubMedDate not supplied

[Effectiveness studies in the Italian Society of Occupational Medicine and Industrial Hygiene congresses (1989-2003)].

BACKGROUND: Knowledge of the results of studies on effectiveness of preventive interventions is a fundamental requirement in occupational medicine. OBJECTIVES: The aim of this review was to identify Italian scientific production regarding this issue in the proceedings of the Italian Society of Occupational Medicine and Industrial Hygiene congresses over the last fifteen years. METHODS: An initial selection of the communications on intervention effectiveness studies was performed on the basis of titles, aims, tables and figures of each single presentation. A further selection was made via full reading of the previously selected communications. The selected articles were classified by type of strategy discussed, production sector, study design and several other criteria. RESULTS: 108 studies were selected out of the 3215 papers (3.4%) published in the congress proceedings examined (1989-2003). More than half of these discussed technical control strategies. In the vast majority of cases, the study design was a pre- and post-evaluation of effectiveness, and the 6 (non-randomised) trials concerned vaccination programmes. Almost a quarter of the studies on accident prevention regarded the effectiveness of training programmes. Only 5 studies could be detected in Medline as articles later published in international journals. CONCLUSIONS: On the basis of the Italian Society of Occupational Medicine congress proceedings over the last 15 years, the percentage of communications concerning effectiveness of preventive interventions in occupational health was 3.4%. Intervention effectiveness papers published in congress proceedings seem to reveal a quite unexpected production of effectiveness evaluation studies. Nonetheless, recommendations need to be made to improve study design and to promote effective prevention and control strategies.

Accidents, Occupational↗
PubMedDate not supplied

[Exertion-induced low back pain: a case-control study of health service workers in a local health unit].

Data concerning all accidents with absence from work exceeding three days were analysed in a cohort of 5000 workers (all employees of a Local Health Unit). A total of 1062 accidents were recorded in the file from 1987 to 1989, 118 coded as "low-back injury". A case-control study design was used to detect the main causes of these accidents, using accidents coded as other than low-back injury as controls. The odds ratios and related confidence limits were calculated in order to assess the degree of association, taking account of potentially confounding factors. A significant relationship was observed between hospital wards and other health service departments rated as "high exposure" and low-back injury (OR high exposure versus low exposure = 2.13; 95% C.L. 1.06-4.29). Selection bias and its influence on the results is also discussed.

Adolescent↗
PubMedDate not supplied

[Preventive measures in shoe and leather industry].

The paper presents the results of a survey of the organization and implementation of preventive medicine programmes in the shoe and leather industries 10 years after the introduction of the National Health Service in Italy. There was a marked difference between the resources available in central and northern Italy where, although unevenly, prevention at the workplace has improved, and the regions of southern Italy were the situation is decidedly less comforting. The methods used by the Occupational Health Services in the territories under study are described, which are characterised by programmed or planned activities (according to industrial sector) mainly aimed at acquiring better knowledge of the risk factors and their effective elimination.

Humans↗
PubMedDate not supplied

Behaviour of urinary nickel in low-level occupational exposure.

The study tested the feasibility of using urinary nickel (Ni-U) as a biological indicator to assess exposure to soluble nickel compounds in electroplating departments at concentrations well below the current TLV-TWA. Two groups of workers were studied: Group A, consisting of 13 subjects and Group B consisting of 10 subjects, with an average weekly nickel exposure of nickel in air (Ni-A) greater than or equal to 10 micrograms/m3 (Group A) and less than 10 micrograms/m3 (Group B). Air samples and urine specimens were taken on 4 consecutive days from Monday to Thursday. The mean Ni-U levels in both groups were significantly higher than in the reference group. The Ni-U levels in end-of-shift spot samples showed a tendency to increase over the week; this trend was more marked in Group A. Closer correlations between Ni-A and Ni-U were found using the postshift Ni-U values of Thursday: the test was well correlated both with the Ni-A levels of the same day and with the mean levels of the previous days. The results suggest that Ni-U is a sufficiently sensitive indicator for use in monitoring low-level occupational exposure, especially if Ni-A concentrations are above 10 micrograms/m3.

Adolescent↗
PubMedDate not supplied

[The risk of the carpal tunnel syndrome in some work activities].

The aim of the study was to generate hypotheses on what could be the ISTAT (National Institute of Statistics) job classes with a major risk of carpal tunnel syndrome in order to plan more specific analytic epidemiology studies and apply more correct ergonomic solutions. A case-control cross-sectional survey without matching was carried out. The source of data were the computerized medical records of a large regional hospital: 833 carpal tunnel syndrome cases (mean age 48, SD 9.33) and 3222 controls (mean age 43.5, SD 13.22) hospitalized for other diseases, were selected. The odds ratio (OR) and 95% confidence limits, controlled for age and gender by a logistic linear regression model, were calculated as measures of association for the comparison between non-exposed managerial/administrative staff and industrial workers. The analysis showed a statistically significant risk for some ISTAT job classes, in particular class 53 (spinners, weavers, dyers and similar jobs) (OR = 2.65; C.L. 1.52-4.62) class 54 (knitters, tailors, hatmakers, upholsterers and similar jobs) (OR = 1.69; C.L. 1.06-2.71), 55 (tanners, shoemakers, leather manufacture workers and similar jobs) (OR = 2.74; C.L. 1.66-4.53) and group 742 (Hotel and restaurant cooks) (OR = 2.99; C.L. 1.45-6.13). Job classes 45 (carpenters, welders and similar jobs). 62 (electricians, electrotechnicians, radio engineers and similar jobs), 63 (gasfitters, plumbers, heating engineers and similar jobs) and 85 (porters and other jobs involving manual handling of loads) showed ORs higher than 2 but without statistical significance. The results are valid for planning further studies, especially in the textile and shoe and leather manufacturing sectors.

Adult↗
PubMedDate not supplied

[The epidemiological aspects of eye screening in occupational medicine].

The wide-spread use of video display units in many work places has led to an increase in ophthalmologic examinations of the operators. For this reason, instruments for visual test screening (for example Visotest) have become widely used. Nevertheless, the literature does not seem to offer any clarification about the utility of these instruments as epidemiological tools. The costs and benefits of visual screening programmes were estimated in relation to specific visual deficit prevalence in a differently age-structured population. Via epidemiological calculation, it was demonstrated that positive and negative predictive values, which are directly related to deficit prevalence, are more important than sensitivity and specificity calculations. In view of the disorders screened, a visual test with a low positive predictive value is more expensive than one with a low negative predictive value. A visual test for visual deficits screening does not appear to be advisable in young populations, where the true positives/false positives ratio is 1:4, whereas in older populations the ratio is 2:1.

Adult↗
PubMedDate not supplied

[Back pain in health care workers].

Back pain is a major health and economic problem for preventive medicine. It has been found to be significantly associated with nursing. The present paper reviews a number of epidemiological studies on back pain in nurses and examines the main confounding factors. The different approaches to back pain prevention are briefly discussed.

Back Pain↗
PubMedDate not supplied

[Quality control in a system for the biological surveillance of exposure to n-hexane].

The paper reports the results of a quality assurance programme for routine biological monitoring of n-hexane exposure via measurement of its urinary metabolite 2.5-hexanedione. The programme involved a number of local occupational health services and was coordinated by the industrial toxicology laboratory in Florence. The analytical results show good agreement (68.6%, i.e., 46/67) between high urinary levels of 2.5-hexanedione (equal to or higher than an action level of 3.2 mg/l) and a relatively poor environmental situation at the workplace as reported by the local occupational health services. The fall in the number of 2.5-hexanedione values equal to or higher than the action level in the course of the study period (1990-1991) could be a result of the prevention measures taken. To confirm this hypothesis, 69 enterprises with at least 3 determinations in both 1990 and 1991 were selected. A 58% decrease in the mean 2.5-hexanedione value between 1990 and 1992 was observed in the group of enterprises (24) with at least one sentinel health event in 1990 (a value equal to or higher than 3.2 mg/l). In the group of enterprises with no sentinel health event in 1990, the mean 2.5-hexanedione values were practically unchanged. The authors stress the need for further studies to test the hypotheses based on the data obtained in this study.

Chromatography, Gas↗
PubMedDate not supplied

[Exposure to carcinogens in work environment today. State of the art, problems and prospects raised by the Law 626/94].

The implementation in our country of recent legislation on carcinogenic risk assessment and management (VIIth title of Law 626/94) is considered. The authors describe potentialities and limits of the new legislation and of the derived Guidelines issued by the Regions. The health policy in this field and possible evolution in the near future are outlined, bearing in mind the experience of other countries. A short list of questions is suggested as a contribution to the discussion on the future scenario: whether exposure to carcinogens should be lower in the working environment than in the general environment; what is the relative importance of multifactoriality, individual biological variability, individual life-style in the genesis of cancers; whether medical health surveillance is worthwhile in terms of primary prevention; is it always true that there is no threshold limit value for carcinogens; what is the role of individual attitudes to prevention in exposure to carcinogens compared to "objective" protection; which balance between costs and benefits should be aimed at.

Carcinogens, Environmental↗