[A simplified occupational health and safety management system designed for small enterprises. Initial validation results]. / Modello semplificato di sistema di gestione della sicurezza sul lavoro per piccole imprese. Primi risultati della sperimentazione.

BACKGROUND: Occupational Health and Safety Management Systems (OHSMS) are known to be effective in improving safety at work. Unfortunately they are often too resource-heavy for small businesses. OBJECTIVES: The aim of this project was to develop and test a simplified model of OHSMS suitable for small enterprises. METHODS: The model consists of 7 procedures and various operating forms and check lists, that guide the enterprise in managing safety at work. The model was tested in 15 volunteer enterprises. RESULTS: In most of the enterprises two audits showed increased awareness and participation of workers; better definition and formalisation of respon sibilities in 8 firms; election of Union Safety Representatives in over one quarter of the enterprises; improvement of safety equipment. The study also helped identify areas where the model could be improved by simplification of unnecessarily complex and redundant procedures.

[Study on prevalence of upper and lower airways disorders in woodworkers, using data from medical surveillance reports and exposure registers]. / Indagine sulla presenza di alterazioni delle vie respiratorie superiori ed inferiori in esposti a polveri di legno, utilizzando i dati della sorveglianza sanitaria e dei registri di esposizione.

OBJECTIVES: To evaluate correlations between exposure to wood dust, upper airways symptoms and lung function. METHODS: We have analysed medical surveillance reports of 197 woodworkers with a median wood dust TWA exposure of 2.1 mg/m3. Every worker was examined by an otorhinolaryngologist and had a spirometric test. The results have been analysed with logistic regression to correlate prevalence of symptoms and spirometric data with occupational exposure to wood dust, length of service, regular use of respiratory protection and smoking habits. RESULTS: Epistaxis (prevalence: 10.1%) correlates with no smoking habits (OR = 6.4; p = 0.01); subacute or chronic rhinitis (prevalence: 41.6%) correlates with exposure to wood dust (O = 1.37; p = 0.01) and no use of respirstory protection (OR = 1.68; p = 0.09); subacute or chronic pharyngitis (prevalence: 17.2%) has a weak but significant correlation with length of service (OR = 1.03; p = 0.05); decrease in FEF25-75 (prevalence: 19.8%) correlates with no use of respiratory protection (OR = 2.56; p = 0.02) and exposure to wood dust (OR = 1.29; p = 0.09); pathologic decrease of VC (prevalence: 5.1%) correlates with exposure to wood dust (OR = 1.69; p = 0.05). CONCLUSIONS: this study seems to confirm that chronic irritation of upper and lower respiratory tract are caused by exposure to wood dust below the european 8 hours exposure legal limit of 5 mg/m3.

Arterial revascularization by laser angioplasty: first Italian experiences.

Eighty-seven laser angioplasty procedures were performed on 85 patients (73 men and 12 women). In the first phase (54 patients) a broad selection process included long occlusions (23.9 cm avg) and vessels with heavy calcification; in the second phase (31 patients) the authors treated vessels with shorter occlusions (10 cm avg) and less calcific. The primary success rate, based on number of procedures (73.5% overall) was 69% in the first phase but reached 81.3% in the second phase. There were 14 perforations (16%), 8 dissections (9.4%), and 4 peripheral emboli (4.7%). Six-month follow-up shows that the Winsor index maintained its initial improvement in 76.5% of all patients, or 62% in just the long occlusions. These data and a review of the cases suggest that no more of 10-20% of patients with claudication in lower extremities can be treated by laser angioplasty; the authors consider ideal candidates those patients who noncalcific lesions in the common iliac or superficial femoral arteries at the III medium level with obstructions shorter than 8 cm and good runoff.

[Subclavian and innominate steal syndrome (our experience with 29 patients)]. / Il furto della succlavia e dell'anonima (nostra esperienza in 29 pazienti).

Subclavian steal syndrome and innominate steal syndrome are well-known reasons of cerebral vascular insufficiency. Today this pathology can be corrected by extra-anatomic by-passes. In our experience in recent years (1980-1986) these by-pass (in our patients carotid-subclavian and subclavian-subclavian by-pass) gave very good outcomes. These are simple and poor-risk operations. Their patent after many years is very good.

[Arterial aneurysms of the upper limbs (our experience and review of the literature)]. / Gli aneurismi delle arterie degli arti superiori (nostra esperienza e revisione della letteratura).

The authors discuss about the very low incidence of the upper extremities aneurysms and about their post-traumatic etiology. They show their experience in 6 cases with a Follow up from 2 to 17 years. All the patients were operated on; in 2 cases the authors performed aneurysmectomy only and in 4 cases an axillo-brachial by-pass. The results are very good in every patient.