[Methodological aspects in the evaluation of turn-over and up/down sizing as indicators of work-related stress]. / Aspetti metodologici per la valutazione di turn-over e up/down-sizing quali indicatori di stress da lavoro.

We discuss the methodological aspects related to the evaluation of turn-over and up-down sizing as indicators of work-related stress, in complex organizations like a university hospital. To estimate the active workers population we developed an algorithm which integrated several administrative databases. The indicators were standardized to take into account some potential confounders (age, sex, work seniority) when considering different hospital structures and job mansions. Main advantages of our method include flexibility in the choice of the analysis detail (hospital units, job mansions, a combination of both) and the possibility to describe over-time trends to measure the success of preventive strategies.

[Transitional bladder cancer and occupational exposure. Accuracy assessment of a screening method based on structured interview]. / Neoplasie transizionali della vescica ed esposizione professionale. Valutazione della accuratezza di un metodo di screening basato su intervista strutturata.

The transitional bladder cancer is the most frequent urinary malignant neoplasm. The main risk factors are cigarette smoking, recurrent inflammatory diseases of the urinary tract, assumption of some drugs, familiarity and occupational exposure to aromatic amines and polycyclic aromatic hydrocarbons. The aim of this study is to assess the screening efficacy of a short structured interview to detect the possible occupational bladder cancer, to submit to the specialists evaluation. The sample of the study is represented by 100 subjects, hospitalized for transitional bladder cancer in the years 2004 and 2005 at the Department of Urology of the Ospedale di Circolo - Fondazione Macchi in Varese. Through the structured interview was possible to estimate two occupational exposure indexes: Length-Field Index (DS) and Length-Field-Job Index (DSM). The specialist's evaluation allowed to establish the occupational cancer origin. The analysis of the indexes' accuracy showed good operating characteristics with higher specificity and equal sensitivity for DSM in comparison to DS. Therefore the short structured interview should be considered as a valuable tool to identify urothelial carcinomas worthy of further evaluation of occupational specialist.