The authors analyse the data connected with chronic pulmonary diseases (mainly bronchitis) of two groups of workers, both belonging to the same metallurgical factory. The data is taken in two different periods, before and after the introduction of measures for primary prevention in the factory. The results confirm that the overall cases of pulmonary diseases are greatly reduced by a correct improvement in the working environment. Moreover, they confirm that a dangerous working environment affects the breathing system more prominently then other factors such as smoking, etc.
Risk assessment (the characterization of potential adverse health effects of human exposure to environmental hazards) has been used by FDA and EPA for at least 30 yr, and many regulations currently rely on this procedure in USA and other european countries. RA method has been adopted for determinating of the exposure standards for relevant chemical and physical hazards. RA application shall become an important practice in Occupational Health and Industrial Hygiene, also in view of specific international and national regulations and recommendations. In this paper are discussed the main theoretical aspects of RA procedure in Occupational Health activities. Emphasis is given to the role of the Occupational Medicine Physician, who have a formal training and experience in toxicology epidemiology and industrial hygiene as well as in human physiology and clinical medicine. For these reasons the Occupational Medicine Physicians are in a unique position not only to give specific contributions in some steps of RA (mainly in risk identification and in risk characterization) but also to bridge the gaps between the various technical figures involved in the RA procedure and therefore to guarantee the adoption of correct and accurate preventive measures.
UNLABELLED:For more than two decades many studies have been published searching for a link between exposure to volatile anaesthetic agents and health damage even if it is noteworthy that many other chemical substances can be found in the Operating Room. Purpose of this study was to demonstrate that the Operating Room is not a totally confined environment and that it is possible to perform an, at least qualitative, evaluation of many different polluting contaminants, even unexpected, to whom the working staff is exposed.MATERIAL AND METHODS:The study has been performed in the Operating Rooms of the Departments of Urology and Orthopaedics. Two methods have been employed: a long-casting sampling of volumes of air (with a sampling device composed of an enrichment system and a low flow aspirating pump) and an anaesthetic vapours and gas continuous analyzer. Results. We never recorded environmental levels of anesthetic higher than the currently accepted ones. Many other organic compounds of different kind have been found (irritants, cancer-organs). Their presence, not desirable in a place where a demanding work is performed, deserve further investigation and a quantitative evaluation of these compounds.
The Authors report their experience in a patient with Multiple Sclerosis. The planning and the follow up of rehabilitative treatment were based on clinical, functional, electrophysiological and posturographic evaluation. The impairment degree was evaluated by Kurtzke's Expanded Disability Status Scale. The electrophysiological evaluation showed an abnormal recruitment flexor pattern at exteroceptive stimulus and posturography confirmed postural control disorder. The treatment was based on PNF techniques and postural feedback on standing balance platform. After rehabilitative treatment the clinical and functional improvement has been confirmed by normal exteroceptive flexion reflex and better stabilometric parameters.
With the intent of estimating the proprioceptive sensitivity of the cervical rachis, the Authors subjected 17 healthy volunteers and 20 patients suffering from various cervical disorders to a clinical head positioning test, which was previously experimented upon by several french Authors was modified under certain aspects by our equipe. The test, consists in flexion and extension of the head after maximal rotations to the left and right, then repositioning the head at the starting point "0" which corresponds to the crossing point of two orthogonal axis of a target. The positions are marked on the target by a laser beam situated on the helmet worn by the subject undergoing testing. The results obtained corresponding to the errors committed regarding point "0", permit us to confirm the reliability of the test and significant definitions between the control group and the patients suffering from cervical disorders.
Juvenile behaviour in front of health hazards is often based on irrational choices. In the attempt to form a prevention-oriented consciousness, ten years ago the University of Pavia and the Salvatore Maugeri Foundation organized an experimental prevention course in the local high schools. The intervention was effective and prompted the publication of a book describing the contributions, results and impressions of the experience. Utilizing this book as a teaching aid, the Authors have carried out a further four-year educative intervention, involving approximately 600 first- and second-year high school students. The lectures have illustrated the concepts of health, prevention and risk, and have briefly discussed the risk factors which are most relevant for the youth. The educative intervention has been performed with the cooperation of the school teachers. The answers to a questionary administered at the end of the course have confirmed that this kind of efforts promote a more rational behaviour aimed at health maintenance. The opportunity to introduce health education in the high school teaching programs has also been confirmed.
A bilateral evaluation of the trapezius muscle was carried out, clinically and by surface electromyography, in 11 stroke patients, in order to compare the activation amplitude of the upper trapezius muscle in different movements of upper limb, using the healthy side as comparison parameter. At our request of analytical activation of the trapezius (consisting in raising their shoulders), we noted in all of them a contraction, both clinically and by EMG valuable. On the contrary at our request of the fixation activity of the shoulder girdle by the trapezius (humeral flexion) we couldn't notice a considerable activation in 4 patients. These data suggest that the trapezius is more active during voluntary movements than in postural fixation, and suggest the use of rehabilitation techniques focusing on the voluntary control.
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.
Indoor air is a complex mixture of chemicals and airborne particles. Volatile Organic Compounds (VOC), a broad class of chemicals including diverse compounds such as Aldehydes, Terpenes, Aromatic and Aliphatic Hydrocarbons and Halogenated Volatile Organics, are an important category of indoor air pollutants. The evaluation of exposure to low doses of Chloroform and Benzene through the measurement of Chloroform and Benzene in urine was performed. Results show that biological monitoring may be helpful in indoor environmental studies in non occupational situations.
