• Dario Consonni1

  1. Clinica del lavoro, Milano
Dario Consonni -

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Ricerca bibliografica periodo dal 16 settembre 2014 – 01 dicembre 2014

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Stringa: ("occupational exposure"[MeSH Terms] OR "occupational diseases"[MeSH Terms]) OR "occupational health"[MeSH Terms]) OR "workplace"[MeSH Terms]) OR "accidents, occupational"[MeSH Terms]) OR "employment"[MeSH Terms]) OR occupation[Title/Abstract]) OR occupational[Title/Abstract]) OR worker[Title/Abstract]) OR workers[Title/Abstract]) AND ("italy"[MeSH Terms] OR "italy"[All Fields]) AND ("2014/09/16"[PDat] : "2014/12/01"[PDat])
1. Mensi C(1), Riboldi L(2), De Matteis S(3), Bertazzi PA(4), Consonni D(5). Impact of an asbestos cement factory on mesothelioma incidence: Global assessment of effects of occupational, familial, and environmental exposure. Environ Int. 2015 Jan;74:191-9. doi: 10.1016/j.envint.2014.10.016. Epub 2014 Oct 31.
Author information: (1)Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: (2)Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: (3)National Heart & Lung Institute, Respiratory Epidemiology, Occupational Medicine and Public Health, Imperial College London, London, UK. Electronic address: (4)Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. Electronic address: (5)Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address:

Few studies have examined the incidence of malignant mesothelioma (MM) associated with distinct sources of asbestos exposure (occupational, familial, or environmental). We assessed the impact of asbestos exposure-global and by source-on the incidence of MM in Broni, an Italian town in which an asbestos cement factory once operated (1932-1993). Based on data collected by the Lombardy Mesothelioma Registry, we calculated the number of observed and expected MM cases among workers, their cohabitants, and people living in the area in 2000-2011. We identified 147 MM cases (17.45 expected), 138 pleural and nine peritoneal, attributable to exposure to asbestos from the factory. Thirty-eight cases had past occupational exposure at the factory (2.33 expected), numbering 32 men (26 pleural, six peritoneal) and six women (four pleural, two peritoneal). In the families of the workers, there were 37 MM cases (4.23 expected), numbering five men (all pleural) and 32 women (31 pleural, one peritoneal). Among residents in Broni or in the adjacent/surrounding towns, there were 72 cases of pleural MM (10.89 expected), numbering 23 men and 49 women. The largest MM excess was found in the towns of Broni (48 observed, 3.68 expected) and Stradella (16 observed, 1.85 expected). This study documents the large impact of the asbestos cement factory, with about 130 excess MM cases in a 12-year period. The largest MM burden was among women, from non-occupational exposure. Almost half of the MM cases were attributable to environmental exposure.

Breve commento a cura di D. Consonni
questo studio presenta i dati aggiornati sull’impatto della fabbrica di cemento-amianto Fibronit di Broni sull’incidenza di mesotelioma. Utilizzando i dati del Registro Mesoteliomi Lombardia, dopo aver escluso 57 casi con esposizione occupazionale ad amianto in varie industrie, sono stati identificati 147 casi di mesotelioma associati all’esposizione ad amianto derivante dalla Fibronit. Di questi, un quarto hanno riguardato lavoratori della Fibronit, un quarto i loro familiari, mentre ben il 50% ha interessato la popolazione residente nei paesi vicini (a Broni e Stradella in particolare).

2. Scarselli A(1), Di Marzio D. Estimating number of workers potentially at risk of exposure to hardwood dust in certain industrial sectors in Italy using a national register. Med Lav. 2014 Nov 24;105(6):405-12.
[Article in Italian] Author information: (1)INAIL.

BACKGROUND: Hardwood dust is a well-known human carcinogen and its use is common in several economic activities. OBJECTIVES: The aim of this study was to assess the extent of occupational exposure to hardwood dust in certain sectors of Italian industry. METHODS: Information on occupational exposures was collected from enterprise exposure registers that must by law be reported to the National Workers' Compensation Authority, as at 31 December 2011. Data stored in the database included economic activity sector, work force size and exposed workers. The number of workers potentially exposed was estimated for some of the industrial sectors from national occupational statistics in Italy. RESULTS: The economic sector with the highest number of potentially exposed workers to hardwood dust was that classified as the manufacture of other wooden furniture with 15,760 men and 2,771 women, while the highest percentage of enterprises that had sent data (according to the ISTAT 2001 census) was in building and repair of non-metallic ships (21%). CONCLUSIONS: The systematic recording of occupational exposures is a source of data that permits recognition of high risk situations and aids exposure assessment for epidemiological studies.

3. Nemo A(1), Silvestri S(2). Mesothelioma in a wine cellar man: detailed description of working procedures and past asbestos exposure estimation. Ann Occup Hyg. 2014 Nov;58(9):1168-74. doi: 10.1093/annhyg/meu062. Epub 2014 Oct 8.
Author information: (1)1.Department of Prevention-Livorno Area, Health and Safety Unit, Azienda USL 6 di Livorno, Via della Bastia 12, 57122 Livorno, Italy. (2)2.Department of Environmental-Occupational Epidemiology, Institute for Study and Prevention of Cancer, Via delle Oblate, 2, 50141 Florence, Italy

A pleural mesothelioma arose in an employee of a wine farm whose work history shows an unusual occupational exposure to asbestos. The information, gathered directly from the case and from a work colleague, clarifies some aspects of the use of asbestos in the process of winemaking which has not been previously reported in such details. The man had worked as a winemaker from 1960 to 1988 in a farm, which in those years produced around 2500 hectoliters of wine per year, mostly white. The wine was filtered to remove impurities; the filter was created by dispersing in the wine asbestos fibers followed by diatomite while the wine was circulating several times and clogging a prefilter made of a dense stainless steel net. Chrysotile asbestos was the sole asbestos mineralogical variety used in these filters and exposure could occur during the phase of mixing dry fibers in the wine and during the filter replacement. A daily and annual time weighted average level of exposure and cumulative dose have been estimated in the absence of airborne asbestos fiber monitoring performed in that workplace. Since 1993, the Italian National Mesothelioma Register, an epidemiological surveillance system, has recorded eight cases with at least one work period spent as winemaker. Four of them never used asbestos filters and presented exposures during other work periods, the other four used asbestos filters but had also other exposures in other industrial divisions. For the information hitherto available, this is the first mesothelioma case with exclusive exposure in the job of winemaking.

4. Cancer Epidemiol. 2014 Dec;38(6):686-94. doi: 10.1016/j.canep.2014.09.007. Epub 2014 Oct 1. Risk of neuroblastoma, maternal characteristics and perinatal exposures: The SETIL study. Parodi S(1), Merlo DF(2), Ranucci A(3), Miligi L(4), Benvenuti A(4), Rondelli R(5), Magnani C(6), Haupt R(7); SETIL Working Group.
Author information: (1)Institute of Electronics, Computer and Telecommunication Engineering, National Research Council of Italy, Via De Marini 6, Genoa, Italy. (2)Epidemiology, Biostatistics and Clinical Trials, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy. (3)Cancer Epidemiology Unit, Department of Translational Medicine, CPO Piemonte and University of Eastern Piedmont, Novara, Italy. (4)Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy. (5)Paediatric Oncology-Haematology, Lalla Seràgnoli, Policlinico S. Orsola-Malpighi, Bologna, Italy. (6)Cancer Epidemiology Unit, Department of Translational Medicine, CPO Piemonte and University of Eastern Piedmont, Novara, Italy. Electronic address: (7)Epidemiology and Biostatistics Unit, Istituto Giannina Gaslini, Genoa, Italy.

PURPOSE: Neuroblastoma (NB) is the most common extra-cranial paediatric solid tumour. Incidence peaks in infancy, suggesting a role of in-utero and neonatal exposures but its aetiology is largely unknown. The aim of the present study is to evaluate the association between maternal characteristics and perinatal factors with the risk of NB, using data from the SETIL database. METHODS: SETIL is a large Italian population-based case-control study established to evaluate several potential cancer risk factors in 0-10 year olds. Information about maternal characteristics, reproductive history, environmental and occupational exposures during pregnancy, as well as newborns' characteristics were obtained using a structured questionnaire. Extremely low frequency magnetic field (ELF-MF) home exposure was measured. The study included 1044 healthy controls and 153 NB cases, diagnosed between 1998 and 2001. RESULTS: A twofold risk was associated to exposure in pregnancy to chemical products for domestic work and to hair dye. The risk associated with the latter was higher among 0-17 month old children (OR=5.5, 95%CI: 1.0-29.3). Risk was increased for children whose mothers had suffered work related exposure in the preconception period to solvents (OR=2.0 95%CI: 1.0-4.1) and in particular to aromatic hydrocarbons (OR=9.2, 95%CI: 2.4-34.3). No association was observed with ELF-MF exposure. A higher risk was found among children with congenital malformations (OR=4.9, 95%CI: 1.8-13.6) or neurofibromatosis (2 cases and 0 controls, p=0.016). CONCLUSIONS: Our study suggests maternal exposure to hair dyes and aromatic hydrocarbons plays a role and deserves further investigation. The association with congenital malformations might also be explained by over-diagnosis. External exposure, in particular during and before pregnancy might contribute to NB occurrence.

Breve commento a cura di D. Consonni
ancora un interessante contributo dallo studio SETIL (Studio sull’Eziologia dei Tumori Infantili), uno studio multicentrico caso-controllo di popolazione su leucemie, linfomi non Hodgkin e neuroblastoma in bambini con età inferiore a 10 anni, che ha coinvolto 15 centri in varie regioni italiane. In questo lavoro è stato evidenziata una associazione tra rischio di neuroblastoma ed esposizione a sostanze chimiche in gravidanza (coloranti e idrocarburi aromatici), mentre non è stato evidenziato un ruolo dell’esposizione a campi elettromagnetici.

5. Int Arch Occup Environ Health. 2014 Sep 27. [Epub ahead of print] Is musculoskeletal pain a consequence or a cause of occupational stress? A longitudinal study. Bonzini M(1), Bertu' L, Veronesi G, Conti M, Coggon D, Ferrario MM.
Author information: (1)Epidemiology and Preventive Medicine Research Centre, University of Insubria, Varese, Italy,

OBJECTIVES: Longitudinal studies have linked stress at work with a higher incidence of musculoskeletal pain. We aimed to explore the extent to which musculoskeletal pain is a cause as opposed to a consequence of perceived occupational stress. METHODS: As part of the international cultural and psychosocial influences on disability study, we collected information from 305 Italian nurses, at baseline and again after 12 months, about pain during the past month in the low-back and neck/shoulder, and about effort-reward imbalance (ERI) (assessed by Siegrist's ERI questionnaire). Poisson regression was used to assess the RR of ERI >1 at follow-up according to the report of pain and of ERI >1 at baseline. RESULTS: Among nurses with ERI ≤1 at baseline, ERI >1 at follow-up was associated with baseline report of pain in the low-back (RR 2.7, 95 % CI 1.4-5.0) and neck/shoulder (RR 2.6, 95 % CI 1.3-5.1). However, there was no corresponding association with persistence of ERI in nurses who already had ERI >1 at baseline. Associations of ERI at baseline with pain at follow-up were weak. CONCLUSION: Our results suggest that the well-documented association between job stress and musculoskeletal pain is not explained entirely by an effect of stress on reporting of pain. It appears also that workers who report musculoskeletal pain are more likely to develop subsequent perceptions of stress. This may be because pain renders people less tolerant of the psychological demands of work. Another possibility is that reports of pain and stress are both manifestations of a general tendency to be aware of and complain about symptoms and difficulties.

6. World J Gastroenterol. 2014 Sep 21;20(35):12431-44. doi: 10.3748/wjg.v20.i35.12431. Occupational exposures and colorectal cancers: a quantitative overview of epidemiological evidence. Oddone E(1), Modonesi C(1), Gatta G(1).
Author information: (1)Enrico Oddone, Department of Public Health, Experimental and Forensic Medicine, Occupational Medicine Unit, University of Pavia, 27100 Pavia, Italy.

A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer. In more recent times, however, a growing evidence has shown that other determinants can be very important in increasing (or reducing) incidence of this malignancy. The hypothesis that environmental and occupational risk factors are associated with colorectal cancer is gaining ground, and high risks of colorectal cancer have been reported among workers in some industrial branches. The aim of this study was to investigate the epidemiologic relationship between colorectal cancer and occupational exposures to several industrial activities, by means of a scientific literature review and meta-analysis. This work pointed out increased risks of colorectal cancer for labourers occupied in industries with a wide use of chemical compounds, such as leather (RR = 1.70, 95%CI: 1.24-2.34), basic metals (RR = 1.32, 95%CI: 1.07-1.65), plastic and rubber manufacturing (RR = 1.30, 95%CI: 0.98-1.71 and RR = 1.27, 95%CI: 0.92-1.76, respectively), besides workers in the sector of repair and installation of machinery exposed to asbestos (RR = 1.40, 95%CI: 1.07-1.84). Based on our results, the estimated crude excess risk fraction attributable to occupational exposure ranged from about 11% to about 15%. However, homogeneous pattern of association between colorectal cancer and industrial branches did not emerge from this review.

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