Prevention of silica health effects in Italy: current challenges for the Occupational Health and Safety Unit of the Italian National Health Service.

BACKGROUND: Since its foundation in 2002, the Italian Silica Network (NIS), a collaborative network of professionals and public authorities, has been engaged in several aspects of research, control, and prevention of silica exposure and effects, and also in support for compensation claims for silica-related occupational health effects in Italy. METHODS: We start with a report on the NIS point of view concerning the recent scientific results (from epidemiology and laboratory studies), including those carried out by NIS in cooperation with Italian universities and other public agencies. This is followed by a description of the data on silica exposure in different Italian workplaces and guidelines for the management of occupational exposure to silica, as developed by two model regional programmes for the ceramics industry, metal foundries and tunnel excavation. RESULTS: The NIS initiatives highlighted the persistence of workplace conditions posing a significant risk for silica-related health effects, particularly in small industries and workshops. Experimental work has also shown that a number of physical and chemical factors affect the bioreactivity of silica particles. CONCLUSION: Based on NIS experience, it appears clear that currently conditions exist in Italy so as to positively contribute to the WHO Programme for the eradication of silicosis and the other diseases related to silica exposure. In order to achieve this goal, a coordinated and wide-ranging effort is required to reduce the wide gap in specific prevention activities, particularly in small industries and workshops, where high levels of silica exposure sometimes occur.

[Male breast tumors in railway engine drivers: investigation of 5 cases]. / Tumori mammari maschili in macchinisti delle ferrovie: indagine su cinque casi.

The paper describes the results of the investigation carried out on five cases of male breast tumours in railway engine drivers notified to the public Occupational Health Service of Florence in 1999. The aim was to evaluate the possibility of professional extremely low frequency electromagnetic fields (ELF) exposure etiology. The extent of this exposure is described with particular care to engine drivers, comparing the one measured in Italy with those reported in other countries.

[Activities of the industrial physician in a state preventive health service. The case of Italy]. / Attività del medico del lavoro in un servizio pubblico di prevenzione. Un caso italiano.

We analyzed the occupational health activities of physicians in a public occupational health service using the Method of Organizational Congruences (MOC). Occupational health activities are changing in Italy with the application of the European Community Directives (Decreto Legislativo 626/94). We identified four major organizational constraints: a lack and difficult in interdisciplinary work, absence of worker control on the activities, limitations in planning specific industrial area studies, increased conflict between prevention and control activities. We predict for the future an increase of these constraints with a reduction in the professional level of the physicians employed in the state system of local occupational health units.

Circadian rhythms in dynamic electrocardiography.

A group of ten healthy subjects aged 32-58 years was studied by dynamic electrocardiography. An electrocardiogram (ECG) was recorded on CM 5 lead for 14 seconds every 15 minutes during the 24 hours. All the subjects were under a similar nyctohemeral schedule, sleeping between 23.30 and 06.45, and all followed their spontaneous diet without any restriction. "Mean Cosinor" analysis of the data revealed statistically significant circadian rhythms of heart rate (HR), R and T-wave voltages, duration of the QT interval and ST segment displacement, but not of the duration of the corrected QT (QTc).