Spigno F, Gentile R, Valente T, Capannelli G
DIMEL, Sezione di Medicina del Lavoro--Università degli Studi di Genova, Italy.
G Ital Med Lav Ergon. 2008 Oct-Dec;30(4):324-8.
In our country the rate of asbestos-related neoplasia, in particular pleural mesothelioma and lung cancer, is increasing; the data provided by INAIL concerning the complaints for occupational diseases filed in 2006 ex table D.P.R. 336/1994 (neoplastic diseases caused by asbestos: pleural, pericardial and peritoneal mesothelioma; lung cancer) are significant. The total number of such complaints in our country amounts to 753 (135 in Liguria and 384 in the north-western regions). As the issue of health following up of former exposed workers is actually an important concern of occupational medicine, some protocols have recently been proposed with the aim to early diagnose asbestos related neoplasia, thus getting a better prognosis. Under the medico-legal aspect, the need for fixing the proper criteria for aetiological attribution to asbestos of lung cancer in subjects previously exposed to that substance is a controversial issue, being the various approaches quite different; the incidental finding of a lung "coin lesion" in a subject who had been holding an annuity for years, as an indemnity granted by INAIL for asbestosis, has prompted the authors both to go over such a clinical case and to review the literature on the topic, in particular as to the complex medico-legal implications.
在我国，与石棉相关的肿瘤发病率，尤其是胸膜间皮瘤和肺癌的发病率正在上升；国家工伤事故保险协会（INAIL）提供的关于2006年根据总统令336/1994（石棉所致肿瘤疾病：胸膜、心包和腹膜间皮瘤；肺癌）提交的职业病投诉数据意义重大。我国此类投诉总数达753起（利古里亚大区135起，西北地区384起）。鉴于对既往接触石棉工人的健康随访问题实际上是职业医学的一个重要关注点，最近有人提出了一些方案，旨在早期诊断与石棉相关的肿瘤，从而获得更好的预后。从法医学角度来看，为曾接触石棉的个体确定肺癌病因归属的适当标准是一个有争议的问题，因为各种方法差异很大；一名多年来一直领取国家工伤事故保险协会因石棉肺发放的年金的个体偶然发现肺部有“硬币病灶”，促使作者对这一临床病例进行了回顾，并对该主题的文献进行了综述，特别是关于复杂的法医学影响方面。
