[更新。石棉职业接触清单,特别是托斯卡纳工人]。

IF 1.2 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Alessia Angelini, Andrea Martini, Giovanna Masala
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引用次数: 0

摘要

本《目录》收集了多个行业和职业活动中使用的未加工石棉和含石棉材料的相关信息,尤其关注意大利中部托斯卡纳大区的情况。这项工作是在佛罗伦萨癌症研究、预防和临床网络研究所(ISPRO)开展的,该研究所自 1988 年以来一直在开展流行病学研究和监测活动,2016 年开始协调和评估为过去的石棉工人提供的地区健康监测计划,目前仍在进行中。该目录旨在成为所有卫生专业人员的工作工具,用于检查和分类受职业石棉暴露影响的受试者,这些受试者既患有可能与这种致癌物质有关的疾病,也在地区健康监测计划内接受检查。从事上述活动的医务人员有必要了解或有可能找到有关各职业部门石棉暴露的准确和详细的数据。这些数据在本《目录》的 29 份概况介绍中作了简要说明。 在每份概况介绍中,都针对一个确切的职业部门,描述了石棉的存在和各种用途。由于在石棉暴露方面存在类比关系,因此可以将多个职业部门放在一起考虑。考虑职业的依据是现有的关于使用未加工石棉或含石棉材料(作为半成品或成品,或作为生产过程中的辅助材料)的证据。除了石棉的存在和使用外,还报告了工人可能接触石棉的情况。信息来源包括科学文献和灰色文献,以及托斯卡纳特定登记处登记的 8097 例间皮瘤职业史。一些概况介绍已经过意大利石棉暴露专家的修订和完善,这些专家在所审查的行业中具有特定的能力。每份概况介绍还包括向工人提出的问题,以便深入研究他们可能接触石棉的情况。对于那些希望扩展相关知识的人,每份概况介绍的末尾和全卷末尾都提供了参考资料。在所有工业化国家,包括那些尚未禁止使用石棉的国家,自七十年代末以来,在科学界对石棉的致癌性达成普遍共识几年后,这种材料的使用量和相对接触量一直在下降。自八十年代末以来,这种减少的趋势越来越明显,因为当时批准并实施了更严格的规定,特别是在职业环境中。尽管如此,尽管在下一个十年中,恶性间皮瘤(与这种致癌物质关系最密切的癌症,其特点是预后极差,潜伏期最长)的发病率有所下降,但现在仍然可以诊断出与石棉有关的疾病是由于过去的接触所致。含石棉旧建筑的翻新工作和净化活动将受到特别关注。总之,对于所有从事石棉风险预防活动的专业人员,如卫生保健人员、保险公司人员、雇主和雇员代表而言,本《目录》是一个工作工具,尽管它并不详尽,而且可以根据新的信息进行更新。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Update. Inventory of occupational exposure to asbestos with particular reference to Tuscan worker].

This Catalogue is a collection of information on the use of raw asbestos and asbestos-containing materials used in several industries and occupational activities, with particular attention to the situation of Tuscany, a region of Central Italy. The work was developed at the Institute for Cancer Research, Prevention and Clinical Network (ISPRO) of Florence, where epidemiologic research and surveillance activities have been developing since 1988 and where the coordination and evaluation of the regional health surveillance programme provided to past asbestos workers started in 2016 and is still ongoing. The Catalogue aims at being a working tool for all health professionals engaged in examining and classifying the occupational asbestos exposures of subjects both affected by diseases that could be associated to this carcinogen and examined within the regional health surveillance programme. It is necessary for the health personnel engaged in the above-mentioned activities to know or to have the possibility to find exact and detailed data on asbestos exposure by occupational sector. These data are briefly described in the 29 factsheets this Catalogue consists of.  In each factsheet, the presence and every use of asbestos are described, with reference to a precise occupational sector. Several occupational sectors can be considered together because of analogies on asbestos exposure. Occupations are considered on the basis of existing evidence on the use of raw asbestos or asbestos-containing materials (as semi-finished or finished products or as auxiliary materials in production processes). Besides the presence and use of asbestos, a description of the possible exposures of workers is reported. Sources of information were scientific and grey literature as well as the 8,097 occupational histories of mesothelioma registered by the specific Tuscan registry. Some factsheets have been revised and enhanced by Italian experts on the asbestos exposure with a specific competence in the examined sectors. Each factsheet includes also questions to be addressed to workers in order to examine in depth their possible asbestos exposure. For those who would like to expand their knowledge on this topic, references are reported both at the end of each factsheet and at the end of the volume. In all industrialized countries, also in those which have not already banned asbestos use, a decrease in the use of this material and in the relative exposure have been observing since the end of the Seventies, few years after the general consensus within the scientific community on asbestos carcinogenicity. This decreasing trend has been becoming greater and greater since the end of the Eighties, when more restrictive regulations have been approved and applied, especially in occupational settings. Nevertheless, nowadays asbestos-related diseases are still diagnosed due to past exposures, although during next decade a decreasing incidence of malignant mesothelioma - the cancer most specifically related to this carcinogen and characterized by a very bad prognosis and the longest latency - could be observed. Particular attention will be paid to jobs regarding renovation of old buildings containing asbestos and to decontamination activities. In conclusion, this Catalogue is a working tool - although it is not exhaustive and could be upgraded with new information - for all professionals engaged in asbestos risk prevention activities as health personnel, personnel of insurance companies, employers, and employee representatives.

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来源期刊
Epidemiologia & Prevenzione
Epidemiologia & Prevenzione 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.60
自引率
14.30%
发文量
0
审稿时长
>12 weeks
期刊介绍: Epidemiologia & Prevenzione, oggi organo della Associazione italiana di epidemiologia, raccoglie buona parte delle migliori e originali esperienze italiane di ricerca epidemiologica e di studio degli interventi per la prevenzione e la sanità pubblica. La rivista – indicizzata su Medline e dotata di Impact Factor – è un canale importante anche per la segnalazione al pubblico internazionale di contributi che altrimenti circolerebbero soltanto in Italia. E&P in questi decenni ha svolto una funzione di riferimento per la sanità pubblica ma anche per i cittadini e le loro diverse forme di aggregazione. Il principio che l’ha ispirata era, e rimane, che l’epidemiologia ha senso se è funzionale alla prevenzione e alla sanità pubblica e che la prevenzione ha ben poche possibilità di realizzarsi se non si fonda su valide basi scientifiche e se non c’è la partecipazione di tutti i soggetti interessati. Modalità di comunicazione aggiornate, metodologia statistica ed epidemiologica rigorosa, validità degli studi e solidità delle interpretazioni dei risultati sono la solida matrice su cui E&P è costruita. A questa si accompagna una forte responsabilità etica verso la salute pubblica, che oggi ha ampliato in forma irreversibile il suo orizzonte, e include in forma sempre più consapevole non solo gli esseri umani, ma l’intero pianeta e le modificazioni che l’uomo apporta all’universo in cui vive. L’ambizione è che l’offerta di nuovi strumenti di comunicazione, informazione e formazione, soprattutto attraverso l''uso di internet, renda la rivista non solo un tradizionale veicolo di contenuti e analisi scientifiche, ma anche un potente strumento a disposizione di una comunità di interessi e di valori che ha a cuore la salute pubblica.
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