Taino Giuseppe, Buonocore Concetta R P, Mongiovi Maria C, Oddone Enrico, Imbriani Marcello
Unità Operativa Ospedaliera di Medicina del Lavoro (UOOML) - IRCCS Istituti Clinici Scientifici Maugeri,Pavia.
Scuola di Specializzazione in Medicina del Lavoro - Università degli Studi di Pavia.
G Ital Med Lav Ergon. 2017 Dec;39(4):224-229.
The suspension trauma syndrome is a clinical condition that could lead to death, also in short time, by coupling the suspension with loss of consciousness and multiorgan failure. Health risks linked to temporary work in suspension are characterized both by infortunistic ones (for instance: trauma, falls, etc.) and by clinical ones, like the suspension trauma syndrome or compressive issues due to different fall protection systems.
This study deal with the technical and medical meseasures devoted to the prevention of the suspension trauma syndrome. Italian 81/08 and 164/56 laws prescribes that, when no collective protection systems could be used, any single worker has to used personal safety equipment like energy absorbers, anchoring devices, lanyards, retractable devices, flexible life guides or lines, guides or rigid life lines, harnesses. Persons working in height have to undergo a medical surveillance, devoted in particular to identify such illnesses (frequently cardiologic or muscleskeletal disorders, both temporary or chronical) that prevent the exposures possibly leading to the suspension syndrome.
In some cases, the occupational physician could express a judgement of fitness to work in which only specific personal protection devices are allowed and/or the time to dedicate to work in suspension is limited, to efficiently protect the workers' health.
Qualora emergano quadri patologici (in particolare cardiologici ed osteomuscolari) con caratteristiche di cronicità e irreversibilità, è indicato esprimere un giudizio di inidoneità permanente alle attività che prevedono il lavoro in sospensione con imbracatura. In casi specifici, è possibile formulare giudizi di idoneità con limitazioni/prescrizioni rispetto al tempo di sospensione o rispetto alla tipologia di DPI impiegati, in maniera tale da garantire lo svolgimento dell'attività in sospensione minimizzando il rischio di insorgenza della sindrome.
悬吊创伤综合征是一种临床病症,即使在短时间内,也可能因意识丧失和多器官功能衰竭与悬吊相结合而导致死亡。与临时悬吊作业相关的健康风险既有意外性风险(例如:创伤、跌倒等),也有临床风险,如悬吊创伤综合征或不同防坠落系统导致的压迫问题。
本研究涉及预防悬吊创伤综合征的技术和医学措施。意大利第81/08号和164/56号法律规定,当无法使用集体防护系统时,任何单个工人都必须使用个人安全设备,如能量吸收器、锚固装置、系索、伸缩装置、柔性救生导向装置或绳索、导向装置或刚性救生绳索、安全带。高处作业人员必须接受医学监测,尤其致力于识别那些可能导致悬吊综合征的暴露情况的疾病(常见的有心脏病或肌肉骨骼疾病,包括临时或慢性疾病)。
在某些情况下,职业医生可以做出工作适宜性判断,其中仅允许使用特定的个人防护设备和/或限制悬吊作业时间,以有效保护工人健康。
如果出现具有慢性和不可逆特征的病理情况(特别是心脏病和肌肉骨骼疾病),建议对涉及使用安全带进行悬吊作业的活动做出永久不适宜的判断。在特定情况下,可以针对悬吊时间或所使用的个人防护设备类型做出有限制/规定的适宜性判断,以便在尽量降低悬吊综合征发生风险的情况下确保悬吊作业的进行。