Medicina Del Lavoro最新文献

{"title":"The Micronucleus Test for Occupational Safety.","authors":"Ion Udroiu, Claudia Giliberti, Antonella Sgura","doi":"10.23749/mdl.2026.17996","DOIUrl":"10.23749/mdl.2026.17996","url":null,"abstract":"<p><p>Although less commonly used than internal dose indicators, biological effect indicators can be valuable for Risk Assessment. Among the numerous biomarkers used to date, those that indicate DNA damage could be especially useful for occupational safety, as they predict the risk of carcinogenesis. The most common among these assays is the micronucleus test. Unfortunately, this test cannot be performed on human erythrocytes; to apply it to lymphocytes, it requires invasive blood sampling, limiting its use to scientific research. We have developed a new method that enables the micronucleus test to be conducted in a rapid, non-invasive, and cost-effective manner. The test is performed on immature erythrocytes (reticulocytes) in human blood smears collected via a finger prick and stained with Acridine Orange. This new protocol allows the micronucleus test to be applied to human blood samples in a manner compatible with occupational safety procedures.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 2","pages":"17996"},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Effects of Aluminum Exposure in Cement Factory Workers: A Mini-Mental State Examination (MMSE) Assessment.","authors":"Fatma Bozdağ, Sultan Pınar Çetintepe, Mümüne Bozdağ Kiraz, Sevgi Suna Karatay-Rassmus, Mustafa Necmi İlhan","doi":"10.23749/mdl.2026.18002","DOIUrl":"10.23749/mdl.2026.18002","url":null,"abstract":"<p><strong>Background: </strong>Aluminum (Al) is a widely encountered heavy metal with known neurotoxic effects. Occupational exposure, particularly in industrial settings, may impair cognitive functions. This study aimed to evaluate the relationship between Al exposure and cognitive function.</p><p><strong>Methods: </strong>A retrospective study was conducted at Gazi University Faculty of Medicine Hospital, Occupational Diseases Outpatient Clinic, between December 5, 2024, and January 5, 2025. The exposed group consisted of 20 male cement factory workers with elevated urinary Al expressed as a function of creatinine, and the control group included 40 age-matched males without occupational Al exposure (1:2 matching). Cognitive status was assessed using the Mini Mental State Examination (MMSE). Urinary Al levels were measured by inductively coupled plasma mass spectrometry (ICP-MS). Statistical analyses were performed with SPSS 29.0.</p><p><strong>Results: </strong>The mean MMSE score was significantly lower in the exposed group compared with controls (24.3±3.7 vs. 28.5±2.3, p<0.001). Subscale scores for orientation, attention/calculation, recall, and language were also lower in exposed workers. All such workers had elevated aluminum (mean 42.3±21.4 mcg/g creatinine). Urinary Al was positively correlated with working duration (r=0.453, p=0.045) and negatively correlated with MMSE (r=-0.486, p=0.030) and orientation scores (r=-0.494, p=0.027).</p><p><strong>Conclusion: </strong>Workers occupationally exposed to aluminum exhibited significantly lower cognitive performance than non-exposed controls. Higher urinary Al levels were associated with poorer cognitive outcomes, suggesting neurotoxic effects of aluminum and underscoring the importance of preventive strategies and cognitive monitoring in exposed populations.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 2","pages":"18002"},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference Values for Maximal Isometric Handgrip and Pinch Strength in Healthy Italian Adults Without Occupational Biomechanical Overload.","authors":"Emma Sala, Nicola Riolfi, Alessandro De Bellis, Andrea Bisioli, Cesare Tomasi, Francesco Romagnoli, Giuseppe De Palma","doi":"10.23749/mdl.2026.18834","DOIUrl":"10.23749/mdl.2026.18834","url":null,"abstract":"<p><p>  Background: Handgrip strength (HGS) and pinch strength are key indicators of hand function with relevant clinical and ergonomic implications. In Italy, normative reference values based on combined measurements of grip and pinch strength in healthy adults not exposed to upper-limb biomechanical overload are currently lacking. The primary aim of this cross-sectional study was to provide descriptive reference values for HGS and three pinch types, stratified by sex and age group, in a healthy Italian adult population (18-65 years) not exposed to occupational biomechanical overload. The secondary aim was to investigate the influence of sex, age, body mass index (BMI), and hand dominance, as well as the relationships among strength measures.</p><p><strong>Methods: </strong>A total of 813 participants (319 men and 494 women) were evaluated. Measurements were performed using a calibrated Baseline® hand dynamometer and pinch gauge according to the standardized protocol of the American Society of Hand Therapists (ASHT).</p><p><strong>Results: </strong>Men showed higher strength values than women across all measures. The association between body mass index (BMI) and strength was more pronounced and consistent in women than in men, reaching statistical significance only for selected pinch measures in males. Strength values showed a non-linear distribution across age groups, with peak levels observed between 30 and 49 years in men and between 40 and 49 years in women. Hand dominance showed a selective effect in both sexes, influencing specific pinch tasks but not handgrip strength.</p><p><strong>Conclusions: </strong>This study provides the first national joint normative dataset for intergrip and pinch strength in healthy Italian adults aged 18-65 years not exposed to occupational biomechanical overload. These findings may support clinical and occupational assessments and contribute to the development of broader Italian normative reference tables.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 2","pages":"18834"},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Occupational Medicine: Upholding Disciplinary Integrity and Editorial Standards.","authors":"Antonio Mutti","doi":"10.23749/mdl.2026.18996","DOIUrl":"10.23749/mdl.2026.18996","url":null,"abstract":"","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 2","pages":"18996"},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol Consumption at Work in Construction Workers Employed in Small Italian Companies.","authors":"Ivan Borrelli, Luca Fontana, Antongiulio Perrotta, Paolo Zita, Mauro Fedele, Ivo Iavicoli","doi":"10.23749/mdl.2026.18756","DOIUrl":"10.23749/mdl.2026.18756","url":null,"abstract":"<p><strong>Background: </strong>Alcohol consumption is an important occupational risk factor, especially in safety-sensitive sectors such as construction. Alcohol-related psychomotor impairment may increase the risk of workplace injuries and may also affect the safety of third parties. However, data on alcohol-related behaviors, workers' risk perception, and alcohol-focused health surveillance among Italian construction workers are still limited.  Methods: We conducted a cross-sectional survey between September 2023 and June 2024 in 315 construction workers employed in small Italian companies. All participants performed work activities for which local legislation mandates alcohol-use and alcohol-dependence checks as part of occupational health surveillance. Data were collected through an anonymous 27-item questionnaire exploring sociodemographic characteristics, alcohol consumption (AUDIT-C; cut-off ≥5 for men and ≥4 for women), alcohol use at work, knowledge of national regulations, alcohol-related risk perception, and accident/injury indicators. Nonparametric tests and multivariable linear regression were used to identify factors associated with AUDIT-C scores. Logistic regression analyses examined associations between perceived alcohol-related risks and awareness of, and exposure to, alcohol-dependence checks during health surveillance.</p><p><strong>Results: </strong>The sample was predominantly male (274/315; 86.98%), and 26.03% of workers were aged 46-55 years. The mean AUDIT-C score was 2.85±2.49 (3.13±2.47 in men; 0.95±1.75 in women); 32.7% of workers screened positive, mainly men. Alcohol consumption during the work shift was reported by 1.9% of participants (7.94% occasionally), and during breaks by 5.08% (19.37% occasionally). Most workers were aware of the workplace alcohol ban (90.48%), and 83.49% reported having undergone alcohol-related checks. Higher AUDIT-C scores were associated with alcohol consumption during the work shift and occasional drinking during breaks.</p><p><strong>Conclusions: </strong>Although average AUDIT-C scores were not high, a relevant subgroup of workers showed risky drinking patterns and some alcohol consumption at work.  These findings highlight the need to strengthen prevention strategies and ensure consistent alcohol-related health surveillance in construction settings.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 2","pages":"18756"},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Occupational Health Surveillance: Evaluating AI-Assisted ILO Classification of Radiographs of Pneumoconioses.","authors":"Antonio Baldassarre, Martina Padovan, Alessandro Palla, Augusto Quercia, Rita Leonori, Stefano Dugheri, Nicola Mucci, Veronica Traversini","doi":"10.23749/mdl.2026.18371","DOIUrl":"10.23749/mdl.2026.18371","url":null,"abstract":"<p><strong>Background: </strong>Pneumoconioses remain an important occupational health issue, particularly in low- and middle-income countries. The International Labour Organization (ILO) Classification standardizes chest radiograph interpretation but requires trained readers and is affected by inter-reader variability. This study evaluated whether generative multimodal artificial intelligence (AI) models can approximate ILO-based diagnostic reasoning.</p><p><strong>Methods: </strong>Eighty-two chest radiographs from the official NIOSH B Reader syllabus were analysed using four AI systems (GPT-4o, GPT-5, MedGemma-4B, MedGemma-27B). Each image was evaluated with a standardized prompt based on the 2022 revised ILO guidelines using deterministic settings. Model outputs were mapped to ILO codes and compared with the official answer keys of the ILO Standard Radiograph Set used for B Reader training and examination. Performance metrics included balanced accuracy, sensitivity, specificity, precision, and Matthews correlation coefficient (MCC). Bootstrap 95% confidence intervals, McNemar's test, and Cohen's κ assessed performance variability and agreement.</p><p><strong>Results: </strong>All four AI models showed moderate diagnostic performance, with balanced accuracy ranging from 60.8% to 70.3%. Sensitivity remained limited (35.5%-54.9%), while specificity was consistently high (84.6%-86.2%). MedGemma-27B performed best for small opacities, GPT-5 for pleural abnormalities and for technical quality. Large opacities and rare findings were systematically under-detected. Statistical comparisons showed significant differences between models, although agreement patterns were broadly similar.</p><p><strong>Conclusion: </strong>All AI models partially followed structured ILO radiographic criteria but did not achieve expert-level performance, confirming that they cannot replace certified B Readers. Larger, real-world datasets are needed to assess their potential clinical utility as supportive tools in occupational health surveillance programs.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 2","pages":"18371"},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Reported Non-Auditory Effects of High Sound Pressure Levels Exposure in Academic Musicians in Uruguay.","authors":"Alice Elizabeth González, Fernando Tomasina, Julián D Ortiz Umaña, Lady Carolina Ramírez, Bettina Tellechea, Adriana Pisani","doi":"10.23749/mdl.2026.18730","DOIUrl":"10.23749/mdl.2026.18730","url":null,"abstract":"<p><strong>Background: </strong>While hearing loss is the most emblematic effect of exposure to high sound pressure levels, it is not neither the first nor the only one. This article explores self-reported effects of exposure to high sound pressure levels among a population of 306 academic musicians (singers, choir members and instrumentalists) in Uruguay.</p><p><strong>Methods: </strong>A special anamnesis form was prepared for use in interviews of each of the participants. The collected information was anonymized and processed. Some interesting results were found, both through direct processing and PCA analysis.</p><p><strong>Results: </strong>Most participants reported several non-auditory effects. These were classified by sex, age, and role (singer or instrumentalist, voice type, or played instrument).</p><p><strong>Conclusions: </strong>Among the reported effects, the most prevalent were muscle contractures, fatigue/tiredness, difficulty sleeping, and noise sensitivity, followed by arthralgia and headaches. The most frequent effects in women were muscle contracture (86%), followed by tiredness/fatigue, noise susceptibility, and tinnitus. The most frequent effects in men were muscle contracture (68%), followed by tinnitus, noise susceptibility, and irritability after musical activity. It was possible to establish some \"effects profiles\" according to instrument and gender. For example, woodwind players experience muscle contracture, tinnitus, post-musical activity irritability, noise susceptibility, and decreased performance, while soprano singers have a higher prevalence of muscle contracture, tiredness/fatigue, noise sensitivity, difficulty sleeping, arthralgia, digestive disorders, headache, tinnitus, and vertigo. They are the second most affected category of musicians, according to their effect profile.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 2","pages":"18730"},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Utility of Serum Krebs von den Lungen-6 (KL-6) and Surfactant Protein-D (SP-D) Levels in Hypersensitivity Pneumonitis.","authors":"Asuman Aslan Kara, Adem Koyuncu, Gülden Sarı, Tuğçe Şahin Özdemirel, Berna Akıncı Özyürek, Cebrail Şimşek","doi":"10.23749/mdl.2026.18283","DOIUrl":"10.23749/mdl.2026.18283","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the diagnostic and prognostic values of serum Krebs von den Lungen-6 (KL-6) and  ve Surfactant Protein-D (SP-D) levels in patients with hypersensitivity pneumonitis (HP).</p><p><strong>Methods: </strong>Serum samples were collected from patients diagnosed with HP and from a healthy control group. KL-6 and SP-D levels were measured using the ELISA method. HP cases were further compared according to fibrotic and non-fibrotic subgroups, as well as whether they were receiving treatment or not. The relationships between respiratory function tests (DLCO, FEV₁, FVC) and biomarker levels were examined.</p><p><strong>Results: </strong>Both KL-6 (median 5.95 ng/ml vs 5.4 ng/ml, p<0.001) and SP-D (median 14.87 ng/ml vs 14.72 ng/ml, p<0.05) levels were significantly higher in HP patients than in the control group. In non-fibrotic HP patients, KL-6 levels were higher than in the fibrotic group (median 6.07 ng/ml vs 5.62 ng/ml, p<0.05), while no significant difference was observed for SP-D (p=0.71). KL-6 levels were significantly higher in untreated cases compared to treated cases (median 6.30 ng/ml vs 5.65 ng/ml, p<0.01), while the difference in SP-D was not significant (p=0.26).</p><p><strong>Conclusion: </strong>KL-6 emerges as a sensitive biomarker in the diagnosis of HP, assessing of disease activity, and monitoring treatment response. SP-D, although reflecting inflammatory processes, seems to be have limitations in evaluating fibrotic progression.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 2","pages":"18283"},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breathing the Job: Impaired Pulmonary Function in Hairdressers due to Occupational Chemical Exposure.","authors":"Zeliha Demir Giden, Elif Demir, Ramazan Giden, Hasret Yağmur Sevinç Akın","doi":"10.23749/mdl.2026.18075","DOIUrl":"10.23749/mdl.2026.18075","url":null,"abstract":"<p><strong>Background: </strong>Hairdressers are occupationally exposed to harmful factors in the working environment and many cosmetic products. During the professional use of these products, there is exposure to many irritating, allergic, and carcinogenic chemicals, mainly through the skin and respiratory tract, and it is known that these occupational exposures are much more frequent and long-lasting than personal exposures. Hairdressing is one of the occupational groups with a high risk of respiratory diseases. In this study, we aimed to determine the extent to which the hairdressing profession affects respiratory functions.</p><p><strong>Methods: </strong>The present study included 50 people who had worked in hairdressing for at least three years, especially with hair products, had not been diagnosed with respiratory disease before this job, and did not smoke, and 50 healthy people with similar demographic characteristics. All respiratory complaints and sociodemographic information of the hairdressers were determined. Pulmonary function tests (PFTs) were performed on hairdressers and a healthy group, including FEV1, FVC, PEF, and FEV1/FVC ratio.</p><p><strong>Results: </strong>In the present study, we found that the hairdressing profession significantly increased the risk of respiratory symptoms. In addition, the increase in working hours as a hairdresser was associated with increased respiratory complaints, while hairdressers showed a statistically significant decrease in PFT values compared to the healthy group.</p><p><strong>Conclusions: </strong>Exclusion of smoking in our study reveals the occupational exposure more clearly. Our study provides additional evidence of a possible significant association between chemical exposure and increased respiratory symptom prevalence and decreased lung function.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 1","pages":"18075"},"PeriodicalIF":2.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General and Toxicologic Aspects of Occupational Fatalities in the Metropolitan Area of Lyon From 2000 to 2020, a Retrospective Study.","authors":"Céline Lamouroux, Guillaume Pouliquen, Emmanuel Fort, Marie Epain, Florent Marfaing, Barbara Charbotel, Laurent Fanton","doi":"10.23749/mdl.2026.17546","DOIUrl":"10.23749/mdl.2026.17546","url":null,"abstract":"<p><p>Over the past two decades, fatal workplace accidents have accounted for between 300,000 and 400,000 deaths a year worldwide. The aim of this study was to investigate the general characteristics and the toxicological profile of work-related deaths. A descriptive retrospective study was carried out on occupational-related deaths occurred in the Lyon metropolitan area from 2000 to 2020 from the autopsy reports of the University Institute of Legal Medicine. A total of 476 cases of work-related deaths were identified, of which 91% were men. The median age was 48 years, 44% of the deaths were due to cardiac origin, 34% to mechanical accidents and 18% to suicide. 16 homicides were also recorded. The cause of death differed significantly between socio-professional categories: suicide was the main cause of death among managers & intellectual occupations (50%), cardiovascular death among non-manual elementary workers (53%), manual elementary workers (49%) and craftsmen, shop keepers & business owners (33%), and physical accidents among farmers (50%) and manual elementary workers (48%). The main cause of death varied by sector: physical accidents in construction (61%), cardiovascular events in transportation and storage (67%) and manufacturing (51%). 27% (n = 130) tested positive for at least one psychoactive substance, including 75 for alcohol, 43 for sedative anxiolytics and 33 for cannabis. These results may help occupational health professionals to design policies and campaigns to prevent deaths among the workers concerned. Specific studies to assess the proportion of fatal accidents attributable to the use of alcohol, cannabis or benzodiazepines could contribute to reducing work-related deaths.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 1","pages":"17546"},"PeriodicalIF":2.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}