Medicina Del Lavoro最新文献

{"title":"Cadmium Exposure and Risk of Pancreatic Cancer: A Systematic Review and Meta-Analysis.","authors":"Monireh Sadat Seyyedsalehi, Lorenzo Ciaccio, Rosa Francesca Marra, Paolo Boffetta","doi":"10.23749/mdl.2026.19093","DOIUrl":"10.23749/mdl.2026.19093","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic cancer is a highly lethal malignancy with poor prognosis and limited treatment options. Environmental exposures, particularly to heavy metals such as cadmium, may contribute to its etiology. This systematic review and meta-analysis evaluated the association between cadmium exposure from different sources and pancreatic cancer incidence or mortality.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we searched PubMed, EMBASE, and Scopus. Eighteen studies comprising 20 risk estimates were included. Random-effects meta-analyses were conducted overall and stratified by exposure source, gender, region, study design, and outcome. Dose-response relationships were assessed using meta-regression of cadmium exposure measures. Publication bias was evaluated using funnel plots and Egger's test.</p><p><strong>Results: </strong>Overall, cadmium exposure was associated with an increased risk of pancreatic cancer [relative risk (RR) = 1.69, 95% confidence interval (CI): 1.28-2.22]. Occupational exposure showed the most consistent association (RR = 1.38, 95% CI: 1.19-1.61), followed by urinary and blood/serum biomarkers. Risk was higher in men than in women, and in case-control than in cohort studies. Dose-response analysis did not reveal a linear trend. There was limited evidence of publication bias overall, though some asymmetry was observed for urinary cadmium studies (P = 0.045).</p><p><strong>Conclusion: </strong>Cadmium exposure was associated with pancreatic cancer risk, particularly in occupational and biomarker-based studies. While findings support a potential causal link, heterogeneity, residual confounding, and limited dose-response data necessitate cautious interpretation.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 3","pages":"19093"},"PeriodicalIF":2.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310321","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":"Multiple Fatal Accidents at Work in Italy: How They Occur and Causal Factors for Identifying Specific Prevention Measures.","authors":"Vanessa Manni, Giuseppe Campo, Armando Guglielmi","doi":"10.23749/mdl.2026.18027","DOIUrl":"10.23749/mdl.2026.18027","url":null,"abstract":"<p><strong>Background: </strong>Workplace accidents represent a significant health problem for workers. In 2022, the EU recorded over 3,000 workplace deaths and nearly 3 million non-fatal accidents. The aim of this paper is to provide an in-depth analysis of multiple fatal accidents in Italy in recent years, analyzing their occurrence patterns and causal factors to increase useful information for risk management.</p><p><strong>Methods: </strong>The statistics come from the INAIL Database and the Infor.MO National Surveillance System, which collects detailed information on accident dynamics and uses a multifactorial model to analyze the causes of injuries. In this system, the in-depth analysis of multiple fatal accidents was conducted on a cluster of 181 events that occurred between 2008 and 2022.</p><p><strong>Results: </strong>Data sources show that road accidents are a significant cause of multiple injuries. Other recurring accidents include collapses, fires, explosions, and asphyxiation in confined spaces. The construction and manufacturing sectors are the most affected. The main causes, highlighted particularly in the Infor.MO system, include poor worker training, inadequate workplace organization, and a lack of safety devices.</p><p><strong>Conclusions: </strong>To reduce workplace accidents, especially those with dramatic consequences such as multiple accidents, the importance of a stronger organizational safety culture is reiterated, in which training enables workers to understand risk analysis and gain greater awareness of hazards.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 3","pages":"18027"},"PeriodicalIF":2.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310259","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":"Work Ability and Associated Factors Among Nurses in a Teaching Hospital: A Cross-Sectional Study.","authors":"Paola Ferri, Angela Contri, Loretta Casolari, Alberto Modenese, Sergio Rovesti, Elena Righi, Lucia Rampino, Domenico Cannizzaro, Annalisa Bargellini","doi":"10.23749/mdl.2026.18637","DOIUrl":"10.23749/mdl.2026.18637","url":null,"abstract":"<p><strong>Background: </strong>Preserving nurses' work ability (WA) is essential for healthcare sustainability, especially given the current global workforce crisis and an ageing population. This study aims to assess the prevalence of inadequate WA among hospital nurses and to identify the personal, domestic, and organisational predictors that influence it, focusing on modifiable factors to inform targeted retention strategies.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at an Italian university hospital (August-October 2022). Data from 182 nurses were collected during mandatory health surveillance visits using the Work Ability Index (WAI), alongside assessments of socio-demographic, occupational, and extra-work responsibilities (caregiving/education). Multivariable binary logistic regression was performed to identify independent predictors of WA, adjusting for confounders such as BMI and lifestyle factors.</p><p><strong>Results: </strong>Inadequate WA was reported by 44.5% of participants (mean age 45.8±11.1 years). A significant health burden was observed, with 41.8% suffering from musculoskeletal disorders. The regression model (χ2(9)=31.026; p<0.001) revealed that the likelihood of adequate WA decreased significantly with advancing age (OR=0.93 per year; p<0.001) and high extra-work burdens (OR=0.97 per hour; p=0.041). Conversely, satisfaction with working conditions emerged as the primary modifiable protective factor, significantly increasing the likelihood of adequate WA (OR=2.41; p=0.010). No significant associations were found for sex, BMI, or smoking status.</p><p><strong>Conclusions: </strong>Nearly half of the nursing workforce exhibits vulnerable work ability. Findings suggest a detrimental 'double duty' effect where domestic responsibilities and age intersect. Organisational interventions should prioritise work-life balance and improved work climates to mitigate the impact of demographic shifts and preserve workforce sustainability.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 3","pages":"18637"},"PeriodicalIF":2.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310261","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":"Effects of Breathing Exercises Applied to Intensive Care Nurses on Fatigue and Perceived Stress: A Randomized Controlled Trial.","authors":"Yasemin Sazak, Meltem Kalaycı, Nermin Olgun","doi":"10.23749/mdl.2026.18426","DOIUrl":"10.23749/mdl.2026.18426","url":null,"abstract":"<p><strong>Background: </strong>Fatigue and stress are common challenges for intensive care nurses. Reducing stress and fatigue among nurses is important for improving nurse and patient safety. Breathing exercises are a nonpharmacological approach that effectively reduces fatigue and stress. This study aimed to evaluate the effects of breathing exercises on fatigue and stress among intensive care nurses.  Methods: The research was conducted as a randomized controlled trial between October and December 2024. The study included 66 nurses, 33 in the control group and 33 in the intervention group. Nurses in the intervention group performed breathing exercises lasting approximately 20 minutes for 30 days. No intervention was performed in the control group. Data were collected using the Piper Fatigue Scale and Perceived Stress Scale at the beginning of the study, on the 15th day, and on the 30th day.</p><p><strong>Results: </strong>A statistically significant difference was identified in the group effect, time effect, and group-time interaction for the mean scores on the Piper Fatigue Scale and the Perceived Stress Scale (p<0.01). The fatigue and stress scores of nurses in the intervention group decreased on the 15th and 30th days.</p><p><strong>Conclusions: </strong>This study shows that breathing exercises positively affect fatigue and stress among intensive care nurses. The breathing exercise protocol can be applied to intensive care nurses, and these exercises can be taught to nurses through in-service training.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 3","pages":"18426"},"PeriodicalIF":2.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310232","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":"Clinical Characteristics and Interstitial Findings on High-Resolution Computed Tomography in Patients with Coal Workers' Pneumoconiosis.","authors":"Merve Acun Pınar, Gülden Sarı, Adem Koyuncu, Rabia Ezber, Hakan Ertürk, Cebrail Şimşek","doi":"10.23749/mdl.2026.18244","DOIUrl":"10.23749/mdl.2026.18244","url":null,"abstract":"<p><strong>Background: </strong>Coal workers' pneumoconiosis (CWP) is a parenchymal lung disease resulting from the prolonged inhalation of coal dust. Coal dust exposure may also lead to a spectrum of airway and parenchymal disorders. This study aimed to investigate the clinical characteristics, radiological and functional findings of CWP, as well as the presence of interstitial changes and associated risk factors.</p><p><strong>Methods: </strong>Patients with CWP who were admitted to the occupational diseases clinic of a tertiary hospital between 2017 and 2023 were included. Demographic, radiological, and pulmonary functional data were analyzed. High-resolution computed tomography scans were reviewed for interstitial lung abnormalities (ILA) and interstitial lung disease (ILD). Factors associated with ILD were assessed using logistic regression analysis. Statistical significance was defined as p<0.05.</p><p><strong>Results: </strong>A total of 100 male patients with CWP (mean age, 61.7 ± 11.7 years) were evaluated. Large opacities were present in 37% of cases. Pulmonary function testing revealed restrictive impairment in 35% and obstructive impairment in 38%of patients. Compared with those working lignite mines, bituminous coal miners exhibited a significantly higher prevalence of large opacities and lower lung function values. ILAs were identified in 63% of patients and ILD in 42%. ILD prevalence was significantly higher among those with exposure durations exceeding 10 years, working in bituminous coal mines, and with predominant small opacities larger than 3 mm.</p><p><strong>Conclusions: </strong>Coal dust exposure represents a major risk factor not only for CWP but also for lung function impairment, ILA, and ILD. Comprehensive surveillance of coal workers is essential for early detection and timely management of these conditions.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 3","pages":"18244"},"PeriodicalIF":2.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310240","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":"Validation of the Italian Version of the Perception of Aggression Scale (POAS): A Cross-Sectional Study.","authors":"David Shaholli, Beatrice Bottini, Stefan Muhulica, Giorgia Mantione, Adolfo Bei, Shizuka Kibi, Giuseppe La Torre","doi":"10.23749/mdl.2026.17620","DOIUrl":"10.23749/mdl.2026.17620","url":null,"abstract":"<p><strong>Background: </strong>Aggression in healthcare settings is a persistent occupational hazard that affects staff well-being, the quality of patient care, and organizational dynamics. Understanding healthcare professionals' perceptions of aggression is crucial for designing effective interventions and improving workplace safety. This study aimed to validate the Italian version of the short-form Perception of Aggression Scale (POAS) and to examine how demographic and professional variables influence staff attitudes toward aggression in clinical settings..</p><p><strong>Methods: </strong>The POAS was administered to a heterogeneous sample of 475 healthcare professionals across multiple hospital departments and educational settings. Psychometric properties, including internal consistency and test-retest reliability, were evaluated. Bivariate and multivariate analyses assessed associations between perceptions of aggression and sociodemographic variables.</p><p><strong>Results: </strong>The Italian POAS demonstrated strong psychometric performance, with high internal consistency (α = 0.82 for dysfunctional; α = 0.76 for functional aggression) and temporal stability. While dysfunctional interpretations of aggression were prevalent across the sample, functional perceptions, viewing aggression as contextually meaningful or communicative, were more common among male participants and physicians. Multivariate analysis revealed a strong inverse relationship between functional and dysfunctional perceptions, suggesting a polarized interpretive schema.</p><p><strong>Conclusions: </strong>The validated Italian POAS is a reliable tool for assessing healthcare workers' attitudes toward aggression. Its integration into clinical training, audits, and risk management systems could facilitate early identification of negative attitudes and support the development of targeted de-escalation strategies. Future research should investigate longitudinal shifts in perception and the tool's adaptability across diverse healthcare settings.</p>","PeriodicalId":49833,"journal":{"name":"Medicina Del Lavoro","volume":"117 3","pages":"17620"},"PeriodicalIF":2.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310236","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":"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":2.1,"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":"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":2.1,"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":"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":2.1,"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":"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":2.1,"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}