Protecting hospitals from SARS-CoV-2 infection: A review-based comprehensive strategy for COVID-19 prevention and control.

SARS-CoV-2-related infection can determine hospital-acquired infections among patients and healthcare workers. Aim of this paper was to review the literature for developing a strategy for protecting healthcare workers, patients, and visitors by COVID-19 hospital infection. A critical and rapid revision of the literature and international standards and Regulations on this topic allowed us to propose an evidencebased strategy in the framework of the workplace risk assessment for preventing nosocomial COVID-19 outbreaks.

[Cell Phones, Radio Frequencies (RF) and Health: IARC classification and epidemiological updates].

In 2013, IARC classified the radiofrequency emitted by mobile phones exposure as possibly carcinogenic to humans (Group 2B). After this classification, several studies were carried out to confirm and to robust or to reject IARC conclusions. Aim of this work was to draw a synthesis of principal scientific evidencies published till September 2019.

[Fit for work judgment and ionizing radiation: discussion of clinical cases].

Introduction. The formulation of the suitability for risk assessment from exposure to ionizing radiation in workers diagnosed with malignant tumor disease entails important implications of a professional, human, social, but also medical-legal, nature. By now, the management of such situations is an event anything but infrequent in the activity of the Authorized Physician: the increase in the number of people staying in wore and the rise in the incidence and prevalence of malignant neoplastic diseases in the working-age population make the problem more relevant than ever.

[Monoclonal gammopathy of uncertain significance (MGUS) and ionizing radiation].

The term monoclonal gammopathy refers to a clinical condition characterized by the presence in serum and/or urine of clonal immunoglobulins, i.e. homogeneous immunoglobulins, structurally identical both as a heavy chain and as a light chain, produced by a B cell clone (1).

[Health surveillance of workers exposed in a hadrontherapy center].

The Centro Nazionale di Adroterapia Oncologica (CNAO) of Pavia is the only Italian structure capable of administering therapeutic radiotherapy treatments with heavy particles (carbon ions, protons) accelerated; in addition to this, it hosts significant research activity, both as basic research and for health-related applications. From the perspective of radioprotection, the most significant risk profile is that linked to external irradiation, from three categories of sources: accelerated external beams (in addition to the treatment beams there are conventional linear accelerators), materials activated following irradiation during treatment or during research activities, unstable isotopes used for diagnostic purposes. The CNAO building has been designed and built to guarantee maximum safety both to the operator and to the patient or visitor, with widely redundant systems in order to exclude the occurrence of accidental irradiation, and to minimize the risk of exposure to activated materials.

Position Paper on Asbestos of the Italian Society of Occupational Medicine.

The Position Paper (PP) on asbestos of the Italian Society of Occupational Medicine (SIML) aims at providing a tool to the occupational physician to address current diagnostic criteria and results of epidemiological studies, and their consequences in terms of preventive and evaluation actions for insurance, compensation and litigation. The PP was based on an extensive review of the scientific literature and was compiled by a Working Group comprising researchers who have contributed to the international literature on asbestos-related diseases, as well as occupational physicians with extensive experience in the evaluation of risks and the medical surveillance of workers currently and formerly exposed to asbestos. The PP was drafted and reviewed between 2017 and 2018; its final version was prepared according to the guidelines of AGREE Reporting Checklist.

Macular degeneration: peculiar sunlight exposure in an agricultural worker.

Background: Occupational exposure to sunlight, in particular to blue light (wavelength of 380-550 nm), is a risk factor for several pathologies, including chronic retinal photochemical damage and, more specifically, age-related macular degeneration (AMD). Moreover, in addition to the effect of blue light, there is evidence about the role of near ultraviolet light (UV-A) as a risk factor for AMD since, given the wavelength, a precise "turning point" between effect and no effect is not definable.

Methods And Results: This work reports the case of a woman employed in the agricultural sector from 15 to 25 years of age, with no significant occupational exposure to other risk factors for AMD, who later developed this pathology.

[Work on a building site at high altitude: physiopathological features and entailments for the occupational medicine].

Introduction. From a physiological perspective the high altitude is defined by altitudes higher than 3000 meters above sea level: at this altitude the atmospheric pressure is reduced to 525 mmHg and the partial pressure of Oxygen drops to 110 mmHg in the ambient air follows and 60 mmHg in the alveolar air. To stay at altitudes above 3000 m s.

[Proposal of a method for assessing the risk of burnout in teachers: the VA.RI.B.O strategy].

Introduction. Burnout syndrome (BOS) can be defined as a chronic work strain characterized by three dimensions: emotional exhaustion, depersonalization (or cynicism), reduced professional effectiveness. BOS typically strikes the helping professions like the teachers.

[Monoclonal gammopathy of uncertain significance (MGUS) and occupational risk factors: criteria to carry out the health surveillance].

Monoclonal gammopathy of uncertain significance (MGUS) identifies a clinically asymptomatic and laboratory-based situation characterized by a modest monoclonal component (MC). In a limited percentage of cases, on a probabilistic basis, the asymptomatic genepremalignant stage could lead to multiple myeloma (MM). Materials and Methods.

[Active population aging, ICD-ICF clinical model and Occupational and Rehabilitation Medicine].

The aging of the active population is more and more increasing in advanced western societies. This phenomenon also implies a constant increase in the average age of workers in various productive sectors, not least that of health. In this, in fact, alongside the known occupational risks, more and more frequently we are witnessing the emergence of chronic-degenerative pathologies connected with aging, even with symptoms that do not determine an unsuitability for work.

[Commuting and work: health effects on an exposed occupational population].

Objectives: Commuting is generally described as a modern society issue; despite the relevance of this phenomenon, only few studies investigated occupational and health effects of commuting on workers exposed to it. According to the 15th census of the Italian population, in Italy about 29 millions of people (48,6% of total resident population) daily moved to reach their work. During last ten years, this number increased of about 2.

[The Italian version of the "Claustrophobia Questionnaire": validation study and perspectives of use for the occupational physician.].

Objectives: Aim of our study was to adapt the Claustrophobia Questionnaire (CLQ) to the Italian context.

Methods: In our study, a sample of 50 claustrophobic patients was compared to 50 healthy people (control group). All of them answered the Claustrophobia Questionnaire and the Stait-Trait Anxiety Inventory Form Y1 and Y2, as well as demographic questions.

[The complaint of suspected occupational disease: news, critical issues and applicative suggestions].

Objectives: The Legislative Decree n. 151 of 14 September 2015 lays down new provisions concerning the DPR 1124/65. The major developments occur with Article 53 of Presidential Decree 1124/65, which transfer the obligation to send the medical certificate, attached to the report of accident and occupational disease, from the employer to the physician - "every physician lends immediate assistance to an injured worker or to a worker that suffers from an occupational disease" - using telematic systems, either directly or through the health facilities.

[Oncological disease: dimensions of the phenomenon and role ionizing radiation].

Objectives: The continuous scientific advances against neoplastic diseases affecting all areas of oncology biomedical research. Age is an extremely important factor in cancer development, since the incidence of cancer increases significantly with age. Because of aging of the Italian population, although the incidence is kept constant, the number of cancer diagnosis is inevitably going to increase over time only to increasing age.

[Stochastic effects of ionizing radiations].

Objectives: Stochastic effects induced by exposure to ionizing radiation rapresent a relevance radioprotection aspect.

Methods: Actually most of the information about radiation-induced oncogenic risk arise from the follow-up of the atomic bombs survivors (Life Span Study, LSS); at this information sources have been added over the last decades also data derived from medical, occupational and environmental studies conducted in various parts of the world and their contribution about number of cases and duration of follow-up period is of great relevance. These sources of information, in fact, provide important data related to very different exposure models compared to the historical of the LSS and closer to those who characterize the employment context in the last decades.

[Risk assessment and its appropriateness supporting the physician in the certification of a suspected occupational disease.].

Objectives: The topic of appropriateness was defined as the new frontier of development of health interventions. RH Brook in an Editorial published in the BMJ in 1994 defines the appropriateness "… an intervention for which the expected benefits are greater (with a sufficient margin) the possible negative consequences … excluding economic considerations". In workplaces the goal of appropriateness should cover not only the actions of health surveillance and health protocols, but also and primarily all stages of the risk assessment process.

[The suspension trauma syndrome: preventive features.].

Objectives: 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.

[Not Available].

Primary headaches are characterized by an high prevalence, especially among workers. This issue entails remarkable costs, both direct and indirect. For a great amount, the latter consist in the loss of work days for this disease and in a decrease of occupational efficiency among these patients.

[The health surveillance of workers previously exposed to asbestos: criticality of intervention protocols].

The health surveillance of former-exposed asbestos workers is today a current theme, as well as a social and healthcare need. The long latency periods of asbestos related diseases have determined and determine a constant development of cases of these pathologies. To face with these issues, it is necessary to have available adequate diagnostic, clinical and epidemiological tools, that allow efficient health interventions as well as an acceptance of social and medico-legal requests, claimed by workers exposed to asbestos during their work career.

[The occupational medicine specialist advice in support of the competent physician in the elaboration of the judgement of suitability to the job specification: evaluation method and analysis of case studies].

Introduction: Still today, one of the most problematic, qualified and awkward assignments for the occupational physician, also for its ethical and socio-economic involvements, is to provide for each worker a fitness judgment to a specific work task.

Aim: The aim of this study is to describe and to support results and effectiveness of a "second level" expert advice in occupational medicine, among workers with a "problematic" judgment of fitness to work.

Materials And Methods: We considered 80 requests for a "second level" advice.

[Health surveillance for employees who work in "areas suspected of pollution" or confined].

About medical aspects related to the work involving confined spaces Neil McManus, one of the leading world expert on the topic, points out that now a days, besides what is required for general work environmental, no specific data can be found in the literature on health surveillance programs for workers engaged in activities in confined environments. Although there are activities in confined environments, which may include the adoption of operating procedures and protection systems similar to those one used in manufacturing jobs (e.g.

[The INSuLa Project: the knowledge survey of company physicians].

The technological advancements, the occurrence of new emerging occupational risks and diseases, and the changes in the regulatory framework for occupational health and safety induce a constant evolution of occupational medicine. Consequently, the skills and training needs of the occupational physicians should be periodically revalued and upgraded in order to identify technical and operational issues and problems of this discipline. In this context, the aim of this national survey, carried out using a self-administered questionnaire submitted to a sample of 1,237 occupational physicians, has been to gain helpful information to ensure a continuous improvement of the quality and effectiveness of measures aimed at protecting the health and safety of workers.