Todaro A, Bordini L, Rubagotti M, Mensi C, Riboldi L
Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milano
G Ital Med Lav Ergon. 2007 Jul-Sep;29(3 Suppl):641-2.
The medical surveillance of the previously exposed to asbestos like method of retrospective appraisal of the exposure. The medical surveillance of the previously exposed to asbestos is effected on indication of the Competent Physician by the DL 257/2006. An aspect that often countersigns such typology of surveillance is the lack of relative data about past environmental asbestos exposure. There've been submitted to sanitary controls 140 subject employees in a steel metal company where in past activity of heavy carpentry has been developed. All the subjects have been submitted in the period 1998-2007 to medical visit, PFR with DLCO, radiography of the chest, in some cases TC and BAL. The past exposure has been resulted inclusive between 1962 and 1981. None of these workers has developed asbestosis, while the 10% of the subjects have showed bilateral pleural plaques. 12 subjects have been submitted to close examination through BAL for the determination of the internal dose of asbestos with comparison of middle values of 3.9 ca /ml. Four cases of pulmonary neoplasm and any case of mesothelioma have been diagnosed. This experience shows as the medical surveillance of a homogeneous group of workers can furnish useful data also to frame previous asbestos exposure in absence of environmental data.
对先前接触石棉者的医学监测采用回顾性评估接触情况的方法。根据2006年第257号法令,由主管医生指示对先前接触石棉者进行医学监测。这种监测类型经常遇到的一个问题是缺乏关于过去环境中石棉接触的相关数据。一家钢铁金属公司的140名在职员工接受了卫生检查,该公司过去曾进行过繁重的木工活动。所有这些受试者在1998年至2007年期间都接受了医疗检查、肺功能残气量(PFR)与一氧化碳弥散量(DLCO)检查、胸部X光检查,在某些情况下还进行了胸部CT扫描(TC)和支气管肺泡灌洗(BAL)。过去的接触时间范围在1962年至1981年之间。这些工人中没有一人患石棉肺,而10%的受试者出现了双侧胸膜斑。12名受试者通过支气管肺泡灌洗接受了仔细检查,以确定石棉内部剂量,并与3.9 ca/ml的中位数进行比较。已诊断出4例肺部肿瘤,未发现任何间皮瘤病例。这一经验表明,在缺乏环境数据的情况下,对一组同质工人的医学监测也可以提供有用的数据,以确定先前的石棉接触情况。