[Radon risk evaluation in a hospital context]. / Valutazione del rischio da Radon in una realtà ospedaliera.

Italian legislation imposes radon concentration in occupational, underground premises as to not exceed the annual action level of 500 Bq/m3. A survey in a hospital of Milan founded concentrations never exceeding the action level, distribute around the median concentration of 16 Bq/m3, ranging between 6 e 214 Bq/m3 (Cmean = 38 +/- 50 Bq/m3). However, a pavilion, characterized by higher levels (C = 103 divided by 214 Bq/m3), was better studied by short-term monitoring, during summer and winter, confirming concentrations not exceeding legislative level, even if not negligible. Results underlines the importance of a monitoring strategy as punctual as possible. Moreover, shortterm measurements can represent a valid tool for premises screening in radon monitoring.

[Evaluation of radon levels in bank buildings: results of a survey on a major Italian banking group]. / Valutazione delle concentrazioni di radon nel settore bancario: risultati di una indagine condotta in un gruppo bancario di rilevanza nazionale.

UNLABELLED: Radon, the second cause of lung cancer after smoking, is a natural, radioactive gas, which originates from the soil and pollutes indoor air, especially in closed or underground spaces. Italian legislation recommends an action level of 500 Bq/m3 per year for occupational exposure in underground premises. OBJECTIVES: Since banks usually use various underground premises (archives, safe-deposit room), a study was made of the radon levels on such premises with the aim of identifying useful monitoring strategies. METHODS: 134 branches of a major Italian banking group were examined using 1817 nuclear track dosimeters at ground level and underground level premises. The branches were located in 7 Italian regions in the north (Piedmont, Lombardy, Veneto), centre (Lazio) and south (Campania, Apulia, Sicily). Information on measurement points was recorded in a technical sheet and statistical analysis was carried out. RESULTS: Annual underground measurements gave an average concentration of 157 Bq/m3, with 5.1% for 400 < C < 500 Bq/m3 and 2.9%for C > 500 Bq/m3. Seasonal variability was reflected in a significant decrease in concentrations between winter and spring (delta(mean)% = -47.3%) and good stability between autumn and winter (delta(mean)% = 3%); moreover quarterly concentrations account for 85% of the variability of the corresponding annual level. A multiple linear regression model (R2 = 0.33) indicated geographic location as the principal factor in radon accumulation, followed by underground level, humidity, use, lack of windows, heating and natural ventilation, and direct contact of at least one wall with ground rock; whereas the safe-deposit room structure seems to protect from radon accumulation. Moreover, the ground level measurement results were significantly associated with the corresponding underground average concentrations (p < 0.001). CONCLUSIONS: The results could be a useful tool in planning a monitoring strategy for assessment of bank worker exposure, especially for banking groups with a large number of branches.

[Management of "complicated" work fitness judgements among health care workers]. / La gestione delle "idoneità difficili" negli operatori della sanità.

The occupational physician, performing health surveillance within a hospital, may face to some difficulties due to the variety and complexity of the tasks and the health risk factors of the health care workers. One of the hardest issue for occupational physician is to provide judgement on worker's fitness. Moreover, this task could be more complicated when a impaired worker could represent an hazard for his patients and colleagues. The authors will illustrate three critical clinical cases examined in Occupational Health Unit of Luigi Sacco Hospital, Milan; furthermore, the authors will show the difficulties and the applied solutions in order to provide the judgement on worker's fitness.

[Implementation of a safety and health planning system in a teaching hospital]. / Implementazione di un sistema di gestione per la salute e la sicurezza (SGSS) in un'Azienda Ospedaliera Polo Universitario.

University Hospital "L. Sacco" had started in 2006 a two-year project in order to set up a "Health and Safety Management System (HSMS)" referring to the technical guideline OHSAS 18001:1999 and the UNI and INAIL "Guidelines for a health and safety management system at workplace". So far, the following operations had been implemented: Setting up of a specific Commission within the Risk Management Committee; Identification and appointment of Departmental Representatives of HSMS; Carrying out of a training course addressed to Workers Representatives for Safety and Departmental Representatives of HSMS; Development of an Integrated Informative System for Prevention and Safety; Auditors qualification; Inspection of the Occupational Health Unit and the Prevention and Safety Service: reporting of critical situations and monitoring solutions adopted. Short term objectives are: Self-evaluation through check-lists of each department; Sharing of the Improvement Plan among the departments of the hospital; Planning of Health and Safety training activities in the framework of the Hospital Training Plan; Safety audit.

[Risk profiles in agriculture: activities in the region of Lombardy]. / Profili di rischio in agricoltura: attività in Regione Lombardia.

Agriculture represents a very complex scenario that needs proper tools. To this aim, in the frame of Special Project "La Prevenzione nell'impiego di Antiparassitari in Agricoltura" promoted by the Region of Lombardy, profiles of exposure and/or risk have been identified as valid approach able to define particular conditions of exposure and risk for the operator in particular settings. The evaluation necessarily needs to identify the most important parameters affecting exposure and their extent on magnitude of exposure. Therefore, field studies should be further performed in order to confirm and improve the profile. The identification of profiles of exposure and risk is an activity still in progress that need to be carefully set up and standardised. The team involved in the study identified priorities deserving much attention in Lombardy, and planned a three years programme aimed at define the profile of exposure and risk in viticulture, maize crop, rice growing, nursery gardening, horticulture in greenhouses, maintenance of gardens, and poplar growing.

Aesthetics with lingual orthodontics: resolving Class II malocclusions with molar distalization.

This work emphasizes the most recent aspects and innovations in the field of lingual orthodontics. Proper case selection and the advantages and disadvantages of these innovations are outlined, and cases are discussed in which the lingual approach seems to have been faster and more efficient. Among the nonextraction cases, a method of distalizing the second maxillary molars is described. This biomechanical procedure is well suited for the Class II malocclusions, solving the problem without bicuspid extraction. The objective of this article is to present these innovations in lingual orthodontics to a larger segment of the profession. A clinical case is used to illustrate the molar distalization procedure.

[Relationship of orthodontics and periodontal support]. / Rapporti tra ortodonzia e supporto parodontale.

The Authors, in the light of available data in the published literature and using their own personal experience as a basis, examine the relationship existing between orthodontia and periodontology, giving prominence to the more immediate and dynamic aspects of the comparison. An obvious cause-and-effect relationship often links the position of the teeth and the periodontal pathology; if this relationship is understood by the orthodontist, it can guide him in his choice of treatment, both where curative treatment is required but also, and more importantly, where prevention can be provided. Emphasis is placed on how serious can be the damages caused to the periodontium where the monitoring of the bacterial plaque and of the inflammation which it brings about is not sufficiently constant. Certain programs of treatment are proposed which, using orthodontal methods, can make a substantial contribution to solving periodontal problems, the kind of problems which are hard to control when traditional methods are used.

[Clinical protocol for orthodontic treatment of patients with different stages of periodontal disease]. / Protocollo clinico per il trattamento ortodontico nei pazienti affetti da malattia parodontale di diverso grado.

The Authors after a review of literature suggest a clinical approach to orthodontic treatment of patient with different degree of periodontal disease. They use this kind of clinical approach to guarantee the integrity and the stability of periodontal tissues.

[Splinting technique for traumatic luxation of anterior permanent teeth]. / Tecniche di splintaggio nelle lussazioni traumatiche dei denti permanenti anteriori.

Extrusive luxations of both, upper and lower incisors, represent a frequent event in dental traumatology. The Authors present some cases in which elastic splints have been used. In fact recent researches show that, even soon after a traumatic event, is not indicated to immobilize teeth with rigid fixed splints because they don't allow any dental function. It is therefore preferable the use of elastic splints for 2-4 weeks, instead of rigid splints for long periods. The Authors then describe the techniques, the methods and the radiographic controls and pulp tests used in this kind of traumatic pathology, showing the positive long term results obtained by using elastic splints instead of rigid splints which often present as result root resorptions or pulp necrosis. In fact with elastic splints is possible to replace and maintain luxated teeth, allowing at the same time a certain function of teeth and their support tissues.

[Dyslalia and orofacial dysmorphism]. / Dislalie e dismorfismi oro-facciali.

In the light of reported data and personal experience, relations between malocclusions and dyslalias are examined. Although the coexistence of malocclusions and dyslalia is a frequent clinical observation, correlations between the two conditions do not appear to be closely linked by any clearly identifiable cause-effect relationship. Considering the high number of aetiological factors involved, stress is laid on the need for a multidisciplinary approach to cases that present contemporaneously malocclusions and dyslalias in the interests of correct diagnosis and rational therapeutic orientation.

[Mortality among lead-zinc miners in Val Seriana]. / Studio di mortalità dei minatori di piombo-zinco della Val Seriana.

The mortality experience of 1392 lead-zinc-silver miners (Gorno, Northern Italy) employed in the period 1/1/1950-31/12/1980 and followed-up to 31/12/1986 was examined. Two separate estimates of the radon exposure level are available: 0.60 and 0.36 working levels respectively. The silica exposure level was not assessed. Vital status was ascertained for 95.6% of the cohort members and their mortality was compared with expected deaths based on national rates. Significant excess mortality from esophageal cancer, stomach cancer, lung cancer, respiratory tuberculosis, respiratory diseases and deaths from external causes was found among underground miners. Surface workers show significantly increased mortality from liver and bile ducts cancer, hepatic cirrhosis, respiratory tuberculosis and respiratory diseases. Based on the 16.4 excess lung cancer cases among underground miners and their cumulative radon exposure, an attributable risk estimate ranging from 9.78 and 16.31 cases per million person-years and WLM (Working Level Month) was calculated.

[Documentation file of orthodontic clinical records. Plaster study models. 3]. / Dossier sulla documentazione dei casi clinici ortodontici. I modelli di studio in gesso. Parte III.

Cast models are to be considered a basic element of analysis in orthodontics. This work aims at describing the various operating phases which are necessary for obtaining successful results when preparing these diagnostic records. In fact the various steps are concurrently shown developing from the initial impressions to the polishing and final labelling especially emphasizing Tweeds' trimming method.

[Documentation of orthodontic clinical cases. Photography in orthodontics. 2]. / Sulla documentazione dei casi clinici ortodontici. La fotografia in ortognatodonzia dossier parte II.

We have analysed the bases of information about the feasibility of orthodontic photography. After giving details about the photographic equipment and the field lighting we gave a thorough description of the operative modalities of intra and extraoral photos. We have given special emphasis to the framing phase which is of great importance for successful photograms. This is important both for projection and setting together of case display. Eventually the most frequent mistakes are pointed out. A useful dialogue for daily clinical practice is given hereby.