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曾接触石棉工人的临床调查:意大利某大学医院的健康监测经验。

Clinical investigation of former workers exposed to asbestos: the health surveillance experience of an Italian University Hospital.

机构信息

University of Bari, Interdisciplinary Department of Medicine, Occupational Medicine Unit, Bari, Italy.

出版信息

Front Public Health. 2024 Jun 17;12:1411910. doi: 10.3389/fpubh.2024.1411910. eCollection 2024.

Abstract

BACKGROUND

The need for health surveillance of former workers exposed to asbestos was provided by law in Italy after the asbestos ban in 1992.

OBJECTIVES

We describe the results of the health surveillance of former workers exposed to asbestos, conducted over 27 years, from 1994 to 2020, at the Operative Unit of Occupational Medicine of the University Hospital of Bari.

MATERIALS AND METHODS

We adopted the health surveillance protocol, which was validated at the national level in 2018.

RESULTS

A total of 1,405 former workers exposed to asbestos were examined. We proceeded with diagnosing pathologies in 339 cases (24% of the cohort subjected to surveillance), with diagnoses of some cases involving multiple pathologies. Specifically, pleural plaques were diagnosed in 49.2% of the 339 cases, asbestosis in 35.9%, malignant pleural mesothelioma (MPM) in 20.3%, mesothelioma of the vaginal tunic of the testis (MTVT) in 9.1%, lung cancer in 5.8%, and laryngeal cancer in 0.8%.

CONCLUSION

Despite the 1992 asbestos ban, asbestos-related diseases remain a serious public health issue. It is important to establish criteria that ensure the health surveillance of formerly exposed workers minimizes costs, reduces the number of invasive examinations, and optimizes achievable results.

摘要

背景

1992 年石棉禁令后,意大利法律规定需要对曾接触石棉的前工人进行健康监测。

目的

我们描述了从 1994 年到 2020 年在巴里大学医院职业医学科进行的长达 27 年的曾接触石棉的前工人健康监测结果。

材料和方法

我们采用了 2018 年在全国范围内验证过的健康监测方案。

结果

共检查了 1405 名曾接触石棉的前工人。我们对 339 例(接受监测队列的 24%)进行了病理学诊断,一些病例涉及多种病理学。具体来说,在 339 例中诊断出胸膜斑 49.2%,石棉肺 35.9%,恶性胸膜间皮瘤(MPM)20.3%,睾丸鞘膜间皮瘤(MTVT)9.1%,肺癌 5.8%,喉癌 0.8%。

结论

尽管 1992 年石棉禁令已经实施,但与石棉相关的疾病仍然是一个严重的公共卫生问题。确定确保对曾接触石棉的工人进行健康监测的标准非常重要,这些标准可以最大限度地降低成本、减少侵入性检查的数量,并优化可实现的结果。

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