[Cardiovascular disease and professional activities]. / Malattie cardiovascolari e attività professionali.

Cardiovascular diseases occurrence in the industrial countries is very high and represents one of the major cause of invalidity and mortality. Studies show the close connection between cardiovascular diseases and other risk factors. In Italy heart diseases prevention is one of the main goals of the National Centre for Disease Prevention and Control. Coronary disease increased by 40% among shift-workers and those workers exposed to vibrations and microclimate; extra-auditory effects of noise have also proved to be relevant. Reintegration into labour market and work eligibility certificate can be a problem for patients with coronary diseases, after pathological events. A record of the cardiovascular system could be useful for a readmission to work, in particular after acute episodes. The PreSAL service on the basis of the 2009 data provided by qualified doctors did not show professional diseases but the undervalue may be due to the limited use of specific complementary tests.

Follicle-stimulating hormone levels in male workers exposed to urban chemical, physical, and psychosocial stressors.

The aim of this study is to evaluate whether occupational exposure to urban stressors could cause alterations in the follicle-stimulating hormone (FSH) levels in traffic policemen compared to a control group. After excluding the subjects with main confounding factors, traffic policemen and male controls were matched by age, working life, body mass index (BMI), drinking habit, cigarette smoking history, and daily consumption of Italian coffee, 166 traffic policemen and 166 controls were included into the study. FSH levels were significantly higher in traffic policemen compared to male controls (P < 0.05). The distribution of FSH values in traffic policemen and controls was significant (P < 0.05). Our results suggest that occupational exposure to low doses of chemical and psychosocial stressors may alter plasma levels of FSH in traffic policemen more than in the control group. If the results obtained are confirmed by further research, the plasma levels of FSH may be used as early biological markers, valuable for the group, used in occupational set even before the appearance of disorders of male fertility.

[Register of exposed to carcinogens]. / Registro di esposizione a cancerogeni.

Law Decree 626/94 already provided for the "register of exposed subjects" to be implemented by employer once the presence of cancerogenic agents falling into the definition of the norm itself have been assessed in working activities. The lack of an effective decree identifying the models and modalities of register keeping has led so far to an exposure under-evaluation. Of course the coming into force of Ministerial Decree 155/2007, almost at the same time as the new body of regulations made up by Law Decree 81/2008, stimulated the addressees to proceed with setting an exposure register to be forwarded to the National Institute for Occupational Safety and Prevention (ISPESL) and to the competent inspection authority. Starting for the regulations, the authors will go through the register forms and information flow management.

[The occupational and active research, diagnosis and reporting of occupational diseases]. / Il Medico Competente e la ricerca attiva, diagnosi e denuncia delle malattie professionali.

The Occupational Doctor plays a key role on the protection of workers safety and prevention of occupational and work-related disease. His training and his need of updating, due to the constant transformation of work, the evolution of technology and the medical progress, set him in the center of all activities carried out to protect health in workplaces. The Occupational Doctor should devote special attention to the working anamnesis as well as to the pathological anamnesis both close and remote. He should also pay attention to semeiotics. Another important element is the relationship between the Occupational Doctor and the Doctor of General Medicine (MMG); this synergy is of vital importance in protecting health and in investigating diseases whether occupational or not. D.Lgs. 81/08 emphasizes this synergy, in fact name and phone number of Doctor of General Medicine is compulsory in Case History. Major source of information for all form of prevention is the survey of occupational disease which is a tool for epidemiological control. The use of a systematic collection of data, of protocols, of guidelines and of scientific evidence is the basis for identifying occupational diseases, their diagnosis and subsequent denunciations. This is the line suggested in MAL PROF informative system, made for registration of work-related diseases, and which is important, with other instruments, in realizing an integrated informative system for prevention in workplace. The Covenant for the Protection of Health and Prevention in Workplaces (DPCM 17/12/2007) indicates the strategic objectives of the National Health System for the consolidation and development of the existing system and of the programs promoting health and safety. These include the growth of the culture of prevention and of the epidemiological control of occupational diseases. The Occupational Doctor has an important role because he can identify the early onset of diseases during the working age and start all forms of prevention and health promotion. In the case of diagnosis of a suspected professional disease the Occupational Doctor has three distinct obligations. The first is to report to the legal authority (C.P.P. art. 365). The second requirement is the declaration of the occupational disease (D.P.R. 1124/65 art. 139) and the third is to issue the first certificate of occupational disease for compensation insurance (D.P.R. 1124/65 artt. 53, 251).

Exposure to benzene in urban workers: environmental and biological monitoring of traffic police in Rome.

OBJECTIVES: To evaluate the contribution of traffic fumes to exposure to benzene in urban workers, an investigation on personal exposure to benzene in traffic police from the city of Rome was carried out. METHODS: The study was performed from December 1998 to June 1999. Diffusive Radiello personal samplers were used to measure external exposures to benzene and alkyl benzenes during the workshift in 139 policemen who controlled medium to high traffic areas and in 63 office police. Moreover, as biomarkers of internal exposure to benzene, blood benzene, and urinary trans, trans-muconic and S-phenyl mercapturic acids were measured at the beginning and at the end of the workshift in 124 traffic police and 58 office police. RESULTS: Time weighted average (TWA) exposure to benzene was consistently higher among traffic police than among indoor workers (geometric mean 6.8 and 3.5 microg/m(3), respectively). Among the traffic police, the distribution of individual exposures was highly asymmetric, skewed toward higher values. Mean ambient benzene concentrations measured by municipal air monitoring stations during workshifts of traffic police were generally higher (geometric mean 12.6 microg/m(3)) and did not correlat with personal exposure values. In particular, no association was found between highest personal exposure scores and environmental benzene concentrations. Among the exposure biomarkers investigated, only blood benzene correlated slightly with on-shift exposure to benzene, but significant increases in both urinary trans, trans-muconic and S-phenylmercapturic acids were found in active smokers compared with non-smokers, irrespective of their job. CONCLUSION: The exposure to traffic fumes during working activities in medium to high traffic areas in Rome may give a relatively greater contribution to personal exposure to benzene than indoor sources present in confined environments. Smoking significantly contributed to internal exposure to benzene in both indoor and outdoor workers.