Barbieri Pietro Gino
Servizio Prevenzione e sicurezza ambienti di lavoro, ASL Provincia di Brescia, Brescia, Italia.
Epidemiol Prev. 2009 Jul-Oct;33(4-5 Suppl 2):94-105.
While the progressive improvement of hygiene situations in the workplaces has taken to a reduction of chemical carcinogens exposure, in recent years in Italy the number of compensated occupational cancer resulting from carcinogens exposures of distant decades, has been increasing. Nevertheless, several experiences suggest that the proportion of occupational cancers unrecognised and not notified, as required by law, still remains important. This contribution concerns some experiences, performed between 2004-2008 by the Local Occupational Health Service (SPSAL) located in a highly industrialised province, on the working sector of rubber, iron and steel industry, the asphalt working and the poultry stock-breeders. This work concerns the following issues: - the evaluation of carcinogens exposure; - technical preventive measures and personal protection; - the level of workers' information and formation and the registration of exposed workers; - the characterization of work-related cancer. The results of the 5 years of activity allow us to underline that, in the most of 49 plants involved in the study, the carcinogens exposure evaluation and the prevention and protection measures were lacking. Information of workers was largely deficient and the registration of exposed workers was absent. A major attention to detect and to evaluate the work-related cancer has allowed us to recognize 50 new cases in the iron-steel industries and 21 new cases in a rubber industry. Although this experience concerns only few occupational fields, it provides the basis to call for a greater commitment of SPSAL addressed to companies and general practitioners to both, the promotion and surveillance of the correct procedures of carcinogens exposure evaluation and his prevention, and the active detection of occupational cancer, still missing.
虽然工作场所卫生状况的逐步改善已使化学致癌物暴露量有所减少,但近年来在意大利,因数十年前致癌物暴露导致的获得赔偿的职业性癌症数量一直在增加。然而,一些经验表明,未被识别且未依法通报的职业性癌症比例仍然很高。本报告涉及2004年至2008年间,位于一个高度工业化省份的地方职业健康服务机构(SPSAL)在橡胶、钢铁行业、沥青作业和家禽养殖等工作领域开展的一些工作。这项工作涉及以下问题:- 致癌物暴露评估;- 技术预防措施和个人防护;- 工人的信息和培训水平以及暴露工人的登记;- 与工作相关癌症的特征描述。5年的活动结果使我们能够强调,在参与研究的49家工厂中的大多数,致癌物暴露评估以及预防和保护措施都很欠缺。工人信息严重不足,且没有对暴露工人进行登记。对检测和评估与工作相关癌症的高度关注使我们在钢铁行业识别出50例新病例,在一家橡胶行业识别出21例新病例。尽管这项经验仅涉及少数职业领域,但它为呼吁SPSAL加大对公司和全科医生的投入提供了依据,以促进和监督致癌物暴露评估及其预防的正确程序,并积极检测仍然缺失的职业性癌症。