An Evidence-Based Multidisciplinary Practice Guideline to Reduce the Workload due to Lifting for Preventing Work-Related Low Back Pain.

We developed an evidence-based practice guideline to support occupational safety and health (OSH) professionals in assessing the risk due to lifting and in selecting effective preventive measures for low back pain (LBP) in the Netherlands. The guideline was developed at the request of the Dutch government by a project team of experts and OSH professionals in lifting and work-related LBP. The recommendations for risk assessment were based on the quality of instruments to assess the risk on LBP due to lifting. Recommendations for interventions were based on a systematic review of the effects of worker- and work directed interventions to reduce back load due to lifting. The quality of the evidence was rated as strong (A), moderate (B), limited (C) or based on consensus (D). Finally, eight experts and twenty-four OSH professionals commented on and evaluated the content and the feasibility of the preliminary guideline. For risk assessment we recommend loads heavier than 25 kg always to be considered a risk for LBP while loads less than 3 kg do not pose a risk. For loads between 3-25 kg, risk assessment shall be performed using the Manual handling Assessment Charts (MAC)-Tool or National Institute for Occupational Safety and Health (NIOSH) lifting equation. Effective work oriented interventions are patient lifting devices (Level A) and lifting devices for goods (Level C), optimizing working height (Level A) and reducing load mass (Level C). Ineffective work oriented preventive measures are regulations to ban lifting without proper alternatives (Level D). We do not recommend worker-oriented interventions but consider personal lift assist devices as promising (Level C). Ineffective worker-oriented preventive measures are training in lifting technique (Level A), use of back-belts (Level A) and pre-employment medical examinations (Level A). This multidisciplinary evidence-based practice guideline gives clear criteria whether an employee is at risk for LBP while lifting and provides an easy-reference for (in)effective risk reduction measures based on scientific evidence, experience, and consensus among OSH experts and practitioners.

[Adenocarcinoma of the nose after occupational exposure to wood dust: description of a case]. / Esposizione lavorativa a polvere di legno ed adenocarcinoma primitivo dei seni paranasali: descrizione di un caso.

UNLABELLED: The occupational exposure to wood dust, classified by IARC as carcinogenic certain may determine the onset of epithelial tumors of the mass graves and nasal sinuses. The symptoms of these malignancies are aspecific (nasal obstruction, rhinorrhea), the diagnosis is often delayed. CLINICAL CASE: Worker of 59 years occupied, from 1960 to 2005, in carpentry (construction of coffins), who died in 2006 for a nasal adenocarcinoma of the mass graves extended to the cranial base, initially considered intracranial cancer given the wide cranial fossae prior to the histological diagnosis. The case is emblematic to late diagnosis and long survival (the worker has survived for more than three years after TAC diagnosis of intracranial mass occurred in 2003). CONCLUSION: Extending the cranial base of a cancer of the nose and sinuses occurred in a worker exposed to wood dust is a serious critical in the system of health surveillance in the company. This rare neoplasm is a "sentinel event" that highlights a problem of underestimation of this occupational tumor and consequent failure of occupational disease complaint is therefore required a careful accounting and reporting of cases.