[Exposure to the risk of the manual lifting of patients and the results of a clinical study in 4 hospital establishments of northern Italy]. / Esposizione al rischio di movimentazione manuale dei pazienti e risultati dell'indagine clinica in quattro aziende ospedaliere del Nord Italia.

The paper reports the results of a study carried out in four hospitals in northern Italy to assess exposure to patient handling and the consequent risks for the lumbar region of the spine. The methods proposed by the EPM Research Unit were used. Altogether, in the four hospitals there were 148 wards and 5596 staff. Of these, 34 wards and 510 workers were examined. The results of exposure assessment showed that the obstetrics departments had negligible risk (MAPO Index 0-1.5), urology and general surgery departments an intermediate risk (MAPO Index 1.51-5.0), while the departments of medicine, orthopaedics, neurology and rehabilitation had high risks (MAPO Index > 5.0). Of the 510 workers who underwent physical and anamnestic assessment for spinal disorders, 44% worked in the departments of medicine, which are known to have a high risk The prevalence of subjects who reported episodes of acute low back pain in the last 12 months (11.4%) was 5 times that of a group of workers not exposed to manual load handling (2.3%). Analysis of the same disorder referred to each job showed higher prevalences in the non-nursing staff (technical 25%, general 27%). The frequency of degenerative disorders of the lumbar spine was slightly lower than the figure for the country as a whole (6.7%). It is clear that measures for improvement of the environment are required aimed particularly at installing aids and staff training (for the specific risk factor), also so as to better manage the reallocation of workers judged unfit for patient handling who, in the group under study, were 5%.

Detection of prognostic factors for oral allergy syndrome in patients with birch pollen hypersensitivity.

To determine why a significant proportion of birch pollen-sensitive patients do not have the oral allergy syndrome (OAS), possible predictive in vivo or in vitro tests for OAS were sought in a large retrospective and prospective follow-up study performed in 283 patients with clinical evidence of birch pollen hypersensitivity. OAS was associated with more severe respiratory symptoms and with higher birch-specific and total IgE levels; moreover, its onset was clearly related to duration of birch pollinosis. The prospective part of this study, performed in 63 patients without OAS, confirmed these findings and highlighted the very high negative predictive value of both skin prick tests with fresh foods and RAST with food allergens. This work suggests that about 15% of patients with birch pollen hypersensitivity are not prone to OAS and that their anti-birch IgE might be directed against determinants that do not crossreact with food allergens.