[Sleep disorders in cement workers]. / I disturbi del sonno nei lavoratori dell'industria del cemento.

Obstructive Sleep Apnea Syndrome (OSAS) and Excessive Daytime Sleepiness (EDS) are sleep disorders which can increase cardiovascular risk. An health survey was performed on the cement workers to estimate the prevalence of sleep disorders and to investigate occupational, personal and health risk factors that could influence it. A total of 761 male workers, employed at 10 different cement plants of South Italy and Sicily, were examined. All subjects gave informed consent to take part in the survey. The following questionnaires were administered: Berlin Questionnaire to estimate the high risk of OSAS, Epworth Sleepiness Scale for EDS, a questionnaire posing questions about working conditions, personal characteristic, lifestyle, past history of disease and present illness. Statistical analysis was performed with the statistical package SPSS. The prevalence of high risk of OSAS and of EDS resulted respectively in 24.2% and 3.4% of workers. Sleep disorders detected with the two questionnaires were significantly associated. A positive and significant association between OSAS and respectively age, time of employment, BMI, ex-smoker status, neck, waist or hip circumferences, chronic fatigue and arterial hypertension was observed. Subjective variables regarding working conditions (job interest, evaluation oforganization of work and job satisfaction) and alcohol consumption were not associated with the high risk of OSAS. Shift work (2 and 3 shifts) was not associated with the high risk of OSAS. An healthy worker effect was observed for workers who changed from shift work (2 or 3 shifts) to fixed daytime work. For them, this change to fixed daytime work was conditioned by chronic disease like hypertension and obesity. EDS was not dependent, associated or correlated with any of the occupational, personal or pathologic variables investigated in the study. In conclusion the research showed no relationship between working conditions, particularly shift work, and the high risk of OSAS, and the influence of obesity in determining the high risk of OSAS, itself a potential cardiovascular risk factor. The interest of occupational physician has been focused on introducing in health surveillance also measures of health promotion regarding sleep disorders with the aim of preserving health condition in workers.

[Extended high frequency audiometry in the prevention of noise-induced hearing loss]. / Uso delle alte frequenze nella prevenzione precoce della ipoacusia da rumore.

An early detection of noise induced hearing loss (NIHL) may allow more effective protection measures. Our aim was to investigate the usefulness of high-frequency audiometry to evaluate the possibility of a future use of the high frequencies audiometry as an early indicator for noise induced hearing loss. A cross-sectional study was performed involving 204 industrial noise exposed and 100 non-industrial noise-exposed workers. Each subject was tested with both conventional-frequency (0.25-8 kHz) and high-frequency (9-18 kHz) audiometry during the annually health surveillance campaign conducted in two Italian cement factories. As expected, noise exposed workers were found to have significantly higher hearing thresholds (P < 0.05) at both conventional and extended high frequencies. Marked differences were found for EHFA. Moreover, significant differences at EHFA were detected also in the subgroup of noise-exposed workers with normal findings at conventional audiometry. Our finding indicate that the use of the extended high frequency test may represent a useful tool for detecting early changes of hearing impairment and that it could be used in addition to the conventional test to better prevent the progression of noise hearing loss.