[Campaign of labour inspections on the implementation of protection measures against carcinogenic agents in fuel station workers].

Following the reduction in levels of exposure to benzene over the last few decades, the cancer risk of refuelers currently represents an occupational hygiene issue potentially underestimated by employers and workers themselves. Based on the literature data, the occurrence of adverse effects of neoplastic nature can not actually be excluded in this professional category, since it is not possible to define a threshold dose. In the period 2016 - 2019, an extensive focused campaign of labour inspections was conducted in the province of Bari by the OSH inspection services of the Health Local Authority in order to verify the compliance with the legislation on the workers' protection from carcinogenic agents at fuel stations. In particular, the obligations referring risk assessment, workplace hygiene, environmental monitoring, personal protective equipment (PPE), health surveillance, biological monitoring and recording of exposure to carcinogens were verified. Although these obligations were documentarily fulfilled by almost all the 162 plants inspected in the province of Bari, several critical issues were found in the approach to carcinogenic risk, including, more frequently, the lack of suitable changing rooms with relative lockers for clothing, the scarce use of gloves when dispensing fuel, the absence or incompleteness of the carcinogenic risk assessment documents, the failed or incorrect execution of biological monitoring. Data of the environmental monitoring carried out by the companies confirm that the current exposures to benzene of fuel distributors are considerably below the limit values set by the Italian legislation. The most frequently used biological exposure indicator was trans, trans-muconic urinary acid (TTMA-U). In order to reduce as much as possible the health risks for refuelers, it is needed that employers, workers and occupational physicians pay more attention to their respective duties, ensuring corrective or ameliorative interventions focused on assessment of the risk of carcinogens, supply and use of PPE, design of workplaces, health surveillance and biological monitoring of workers. The poor value of the end-of-shift TTMA-U as a biological indicator of exposure to low-dose benzene is also confirmed.