La Medicina del Lavoro is a bimonthly magazine founded in 1901 by L. Devoto, and then directed by L. Preti, E. Vigliani, V. Foà, P.A. Bertazzi (Milan), and now by A. Mutti (Parma). It is owned by and is the official journal of the Italian Society of Occupational Medicine (SIML), aimed at training and updating professionals concerned with Occupational Health. Language: English Frequency: Bi-monthly (6 issues per year) Format: 20 x 27 cm ISSN: 0025-7818 eISSN: 2532-1080 La Medicina del Lavoro is indexed by: Index Medicus/MEDLINE; Embase/Excerpta Medica; the Elsevier BioBASE, Abstracts on Hygiene; Industrial Hygiene Digest; Securitè et Santè au Travail Bit-CIS; Sociedad Iberoamericana de Informaciòn Cientifica (SIIC); Science Citation Index Expanded (SciSearch); Journal Citation Report/Science Edition; ISI Web of Science; Scopus; PubMed/Medline; Portico. 2024 IMPACT FACTOR 2.0 2024 Cite Score (Scopus) 4.3 last updated 23 June 2025
All Journal's articles are Open Access papers distributed under the terms of the Creative Commons Attribution License CC BY-NC 4.0 Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Reproductions with commercial intent will require written permission and payment of royalties.
Where Are We Going by Applying AI Tools? Are We Going to Lose Our Jobs?
Copyright (c) 2025 Antonio Mutti https://creativecommons.org/licenses/by-nc/4.0
Effectiveness of Occupational Health Promotion Programs on Cardiometabolic risk factors: A Systematic Review and Three-Level Meta-Analysis
Background: This study aimed to evaluate the effectiveness of workplace-based health promotion programs targeting cardiometabolic risk factors. Methods: We conducted a systematic review and three-level random-effects meta-analysis following PRISMA guidelines, covering studies published from January 2019 to September 2024. Eligible studies included randomized controlled trials (RCTs) and quasi-experimental (QE) designs assessing workplace interventions to reduce cardiometabolic risks in adult workers. Twelve outcomes were considered. Subgroup analyses and meta-regressions were performed to explore sources of heterogeneity. Certainty of evidence was evaluated using GRADE assessment tool. Results: Forty-four studies (30 RCTs, 14 QE) involving 49,813 participants were included. Significant improvements were found in nine of twelve outcomes. These included reductions in BMI (–0.61kg/m²; [–0.93; –0.29]), body weight (–2.43kg; [–3.48; –1.38]), waist circumference (–3.46cm; [–5.21; –1.71]), body fat (–1.58%; [–2.40; –0.76]), systolic (–3.75mmHg: [–5.67; –1.82]) and diastolic (mmHg; [-3.58; -1.29]) blood pressure, LDL cholesterol (–5.9 mg/dL; [–11.6; –0.12]), and an increase in HDL cholesterol (2.76 mg/dL; [0.42; 5.09]). All significant outcomes were supported by moderate-to-high certainty evidence except LDL cholesterol, which was rated very low. Non-significant results were observed for total cholesterol, triglycerides and FBG. High heterogeneity was observed. Pre-existing health conditions, author and duration of intervention partially explained between-study heterogeneity. Conclusions: Workplace health promotion programs were associated with improvements in various cardiometabolic health indicators. Greater effectiveness was observed in interventions targeting high-risk populations, delivered by physicians or qualified health professionals, and implemented over shorter durations. Findings support the integration of such programs into occupational health policies and broader public health strategies. Future research should optimize intervention designs, extend follow-up, and consider integrated approaches to maximize long-term benefits.
Copyright (c) 2025 Alessandro Godono, Veruscka Leso, Ettore Paradisi, Elisa Carena, Maria Vittoria Picciaiola, Anna Schneider-Kamp, Catalina Ciocan, Fabrizio Bert, Franco Veglio, Paolo Boffetta, Ivo Iavicoli https://creativecommons.org/licenses/by-nc/4.0
Human Biomonitoring of Butylated Hydroxytoluene (BHT) in Germany: Methods, Exposure Levels, and Health-Based Interpretation
Butylated hydroxytoluene (BHT) is an antioxidant which is used in a vast array of consumer products. The most sensitive toxicological endpoints of BHT are hepatic enzyme induction and reproductive effects. Because of its wide dispersive use and its potential relevance for human health, BHT was included in the human biomonitoring (HBM) cooperation between the German Federal Ministry for the Environment and the German Chemical Industry Association. An analytical method for the sensitive determination of 3,5‑di‑tert‑butyl‑4‑hydroxybenzoic acid (BHT acid)—an oxidized metabolite of BHT which is excreted in urine—was developed. This method was then applied in several environmental and occupational HBM surveys, and BHT acid was detected in the vast majority of samples. Health-based guidance values as well as reference values for the interpretation of HBM results were derived for BHT acid. Thus, a fine-grained picture of the current state of BHT exposure in different populations in Germany is now available. Uncertainties arise from large variability in the fraction of dose excreted as BHT acid and incomplete understanding of human metabolism, which limits reverse dosimetry and risk assessment, particularly for children.
Copyright (c) 2025 Christoph Schmidtkunz, Isabell Schönrath, Aline Murawski, Katja Küpper, Nora Lemke, Till Weber, Gabriele Leng, Marike Kolossa-Gehring https://creativecommons.org/licenses/by-nc/4.0
From Subjects to Partners: Rethinking Research Methodologies through Citizen Science
The article will first introduce a general definition of Citizen Science (section 1), followed by an excursion of its foundations and of the different understandings and ways of applying it, with examples drawn from diverse research and policy areas (section 2). It will then focus more closely on the field of health and the environment (section 3), including occupational medicine (subsection 3.1), community response to environmental risks (section 3.2), biomonitoring (sub-section 3.3), and human biomonitoring (subsection 3.4). Section 4 will address some of the advantages (section 4.1) and challenges (section 4.2) of adopting CS in research and policy. Finally, section 5 will trace the legislative and normative background of participatory approaches and points to the challenges ahead.
Citizen Science, participation, integration, inter-disciplinarity, trans-disciplinarity, occupational medicine, biomonitoring, human biomonitoring.
Copyright (c) 2025 Bruna De Marchi https://creativecommons.org/licenses/by-nc/4.0
Occupational Risk for Headache Disorders in Female Registered Nurses. A Retrospective Study
Background: Prevention of headache disorders (HDs) among healthcare workers in hospital settings remains a challenge for organizations and employees worldwide. The goals of the present retrospective study were both to analyze the 1-year prevalence of any primary HDs among female registered nurses (RNs) employed in hospital settings and to investigate the relationship between occupational risk factors and HDs. Methods: We analyzed the occupational medicine database of RNs employed in a large hospital. The sample included 975 female RNs; the diagnostic criteria were based on the International Classification of Headache Disorders, 3rd edition (beta version). Results: One-year prevalence of any HD was 45.9%; tension-type headache (TTH) was the most commonly reported headache type (by 25.6% of participants), followed by migraine (17.5%). No association was found between the different headache types and work schedules; TTH was linked to age ≥40 years (OR=1.91; 95% CI=1.41-2.72), duration of service ≥15 years (OR=1.61; 95% CI=1.24-2.38), and number of night shifts >5 per month (OR=1.71; 95% CI=1.09-2.68). A high level of WRS was a significant predictor of TTH. Conclusions: We found a link between TTH and modifiable risk factors at both the individual and organizational levels. These findings suggest interventions in occupational settings to minimize the occurrence of TTH among RNs. Policy-makers and employers should implement preventive measures to reduce the incidence of HDs among RNs by minimizing modifiable risk factors associated with increased occupational risk.
Headache disorder; Shift-work; Work-related stress;
Copyright (c) 2025 Gabriele d'Ettorre; Roberta Tornese; Andrea Baldassarre https://creativecommons.org/licenses/by-nc/4.0
Evaluation of the Hearing Function in the Orchestra Professional Musicians of the Teatro alla Scala in Milan
Background: This study was conducted to determine whether occupational exposure to high sound levels, typical of an opera orchestra, can cause hearing loss. Methods: The orchestra professors at Teatro alla Scala in Milan underwent ear examinations, pure-tone audiometry, and other audiological tests. The hearing thresholds of these musicians were compared with those of populations not exposed to occupational noise and with populations exposed to industrial noise. Noise exposure levels were estimated through a phonometric survey conducted at our theater in 2011, which largely confirmed the exposure levels outlined in European guidelines. Results: The average audiometric thresholds of the orchestra musicians were slightly worse than the median thresholds of a healthy, non-noise-exposed population. In three subjects (2.8%), bilateral hearing impairment (PTA 0.5, 1, 2, 3, 4 kHz > 25 dB HL) was observed; in four violinists (3.7%) left unilateral hearing impairment was found. This rate is lower than the expected risk from similar industrial noise exposures. Comparing these audiometries with those from about ten years earlier shows that the hearing threshold decline in the study group is comparable to that caused by presbycusis. Conclusions: The risk of noise-induced hearing loss among professional orchestra musicians appears lower than predicted by the UNI ISO 1999:2015 standard. A few cases of hearing loss due to chronic acoustic trauma were noted, particularly among violinists who demonstrated a higher incidence of left unilateral hearing loss. The high levels of sound exposure and the presence of some hearing loss cases highlight the need for targeted preventative measures in this work activity.
Opera; Music; Orchestral Professional Musicians; Musicians Hearing Threshold; Hypoacusis; Hearing Disorders; Occupational Workers; Noise-Induced Hearing Loss
Copyright (c) 2025 Terenzio Cassina, Alessia Tomasin, Orietta Calcinoni, Umberto Ambrosetti, Eliana Filipponi, Valeria Castelli, Riccardo Bianchin, Valentina Teodorani, Laura Magnoni, Leonardo Braga, Linda Parati, Federica Di Berardino https://creativecommons.org/licenses/by-nc/4.0
Call for Applications for the Enrico C. Vigliani Award
La SIML – Società Italiana di Medicina del Lavoro è lieta di annunciare l’apertura delle candidature per il prestigioso Premio Vigliani, riconoscimento annuale riservato a giovani ricercatori che si siano distinti per l’impegno e la qualità della propria attività scientifica nel campo della Medicina del Lavoro. SCADENZE IMPORTANTI Candidatura: data limite 31 agosto 2025, ore 18 COMUNICAZIONE DEL VINCITORE: 15 settembre 2025 Premiazione ufficiale: 1 ottobre 2025, Bologna – 87° Congresso Nazionale SIML Scarica il PDF per saperne di più...
Workplace Violence and Patient Management Time in the Emergency Department: An Observational Study
Background: Workplace violence is steadily rising, and the healthcare sector is one of the most impacted areas. Several studies have shown that patients’ long management times are a key factor in workplace violence in this setting. Objective: This study aims to analyze the prevalence and characteristics of aggressions against healthcare workers (HCWs) that occurred in 2023 in the Emergency Rooms (ER) of a large university hospital and to evaluate the potential relationship between the management time of a patient in the ER and the risk of violence incidents.Methods: To evaluate the prevalence and characteristics of aggressive events against HCWs that occurred in 2023, data from the “incident reporting” form were analyzed. Then, using the 2023 report on daily ER accesses, the management time of a patient at the ER was calculated. Finally, the average management times of patients on days when there were no aggressions were compared with those on days when there was one or more assaults against HCWs to evaluate the potential relationship between the average length of stay of a patient at the ER and the risk of aggression. Results: In 2023, 271 violent incidents were reported. Verbal aggressiveness was the most common (82.7%), and working the night shift was riskier (42.8%). In 36.2% of cases, patient management time was identified as a potential predictor of aggression. Other identified potential predictors included the patient and/or caregiver relationship with HCW (30.6%), the refusal to accept diagnostic-therapeutic protocols (27.3%), and the cultural background and temperamental traits of the patient or caregiver (18.8% and 11.8%, respectively). According to the logistic regression analysis, the likelihood of a violent incident during a 150-minute stay was less than 10%; it increased to 53% after 650 minutes. Conclusion: Workplace violence in healthcare settings results from a complex interaction of internal and external factors. Understanding how these elements interact and contribute to the development of incidents is essential for identifying key actions to reduce and mitigate violence.
Copyright (c) 2025 Chiara Di Giorgio, Isabella Cucchi, Marco Mendola, Maria Cristina Costa, Fabio Tonelli, Elisa Turchet, Matteo Marrazzo, Paolo Carrer https://creativecommons.org/licenses/by-nc/4.0
Strength and Perceived Effort in Repetitive Upper-Limb Tasks: An OCRA Method Analysis of 900 Workers
Background: Work-related musculoskeletal disorders pose a significant burden on the population. The OCRA method plays a key role in assessing the risk associated with repetitive actions of the upper limbs. In this method, muscular force is evaluated based on the rate of perceived effort (RPE) reported by the worker, which can introduce subjective bias into the assessment. This study aims to determine whether testing the worker’s handgrip strength can improve the accuracy of the force assessment in the OCRA method. Methods: Handgrip strength was measured during the risk assessment process following the OCRA method. Data were divided into specific percentile ranks based on age, gender, height, and handedness. Results: 903 workers from 43 different Italian companies were surveyed. There was a significant difference in handgrip strength percentiles stratified by report of an RPE > 2 and those without (p = 0.047). Additionally, significant differences were found in perceived effort rates (based on the OCRA method) among workers with different levels of stratified handgrip strength (dominant hand: p = 0.04, non-dominant hand: p = 0.02). Conclusions: Workers performing repetitive upper limb actions at various strength levels experience different perceived effort rates during tasks. These findings suggest that measuring handgrip strength is a crucial component of risk assessments using the OCRA method. To date, this study's sample size is among the largest for this evaluation method; we believe these results could be a significant step forward in improving the risk assessment process for biomechanical overload
Copyright (c) 2025 Stefano Gobbo, Valentina Bullo, Francesco Favro, Davide Pavan, Beatrice Doro, Alessandro Bortoletto, Giuseppe De Palma, Emma Sala, Stefano Mattioli, Andrea Di Blasio, Marco Bergamin https://creativecommons.org/licenses/by-nc/4.0
Occupational Asthma Due to Subtilisin: The Power of Specific Inhalation Challenge
We report the first confirmed case in Italy of occupational asthma caused by subtilisin in a healthcare worker involved in cleaning surgical instruments. The diagnosis was confirmed through a specific inhalation challenge (SIC) performed one year after the last exposure and after stopping inhaled corticosteroid therapy. An immediate reaction was observed after three minutes of exposure to diluted Neogiozym ™, with a 30% decrease in FEV1. This case highlights the diagnostic importance of SIC even for high-molecular-weight (HMW) agents and emphasizes the need to reconsider occupational asthma as a complex, evolving disease influenced by both host and environmental factors. The patient exhibited a Type-2-high phenotype despite negative skin prick tests and normal IgE levels, reinforcing the value of dynamic, multi-marker assessment in occupational endotyping. This case supports the broader use of SIC in occupational settings where allergen-specific IgE testing is limited.
Copyright (c) 2025 Filippo Liviero, Laura Fabris, Marco Biasioli, Francesco Favretto, Paola Mason https://creativecommons.org/licenses/by-nc/4.0
Steady-State Auditory Evoked Potentials in Workers Exposed to Occupational Noise
Background: The present study aims to investigate neural synchrony, as measured by Auditory Steady State Response (ASSR), in individuals with normal hearing who are exposed and not exposed to occupational noise, thereby providing insights into hidden hearing loss within the central auditory nervous system, and justifying the importance of exploring auditory neural function in populations at risk. Methods: A cross-sectional study involved 30 noise-exposed individuals in the Study Group and 30 unexposed individuals in the Control Group, all paired by an average age of 35 years. The following procedures were performed on all individuals: clinical and occupational history, meatoscopy, immitanciometry, pure tone audiometry, speech audiometry, and ASSR (40Hz). We analyzed the audiometric hearing thresholds at frequencies of 1 kHz and 4 kHz, the electrophysiological thresholds estimated by ASSR, and the comparison of the differences between them: the thresholds estimated by ASSR and the audiometry thresholds. The data were analyzed using both descriptive and inferential statistics. P-values ≤ 0.05 were considered significant. Results: When comparing hearing thresholds at 1 kHz and 4 kHz between groups, we found significant differences, with the SG showing higher hearing thresholds than the CG bilaterally. No significant differences were seen in the electrophysiological thresholds estimated by ASSR, nor in the comparison between the ASSR-estimated threshold and the psychoacoustic hearing threshold groups. Conclusions: The results of this study suggest that workers exposed to occupational noise did not show detectable changes in neural synchrony in the midbrain, thalamus, or primary auditory cortex when compared to individuals without occupational noise exposure.
Copyright (c) 2025 Mariana Keiko Kamita, Clayton Henrique Rocha, Liliane Aparecida Fagundes Silva, Alessandra Giannella Samelli, Carla Gentile Matas https://creativecommons.org/licenses/by-nc/4.0
Longitudinal Changes in Work Ability, Well-Being, and Psychosocial Risk Factors Among Older Workers: The ProAgeing Study
Background: As the workforce ages, older employees face increasing challenges in adapting to changing job demands, including technological advances and ongoing occupational risks such as shift work and physically demanding tasks. Work ability is a reliable indicator of older workers’ capacity to meet both physical and mental requirements of their jobs. The ProAgeing study, a multicenter investigation specifically focused on workers over 50 years old, examined long-term patterns in work ability, perceived health, and psychosocial risk factors, along with their interactions across this demographic. Methods: Participants completed self-reported questionnaires at baseline and after one year, including the Work Ability Index (WAI), technostress, sleep quality, perceived stress, health, and psychosocial risk factors. A first-difference linear regression model was used to assess predictors of changes in WAI. Subgroup analyses examined differences across occupational roles (bank employees, administrative employees, and manual workers). Results: Of the 470 workers enrolled, 356 (76%) completed the follow-up. A significant decline in average WAI score was observed over 12 months (-1.2 points, p<0.001), mainly in subscales related to work demands and physical illness. Technostress levels slightly decreased, suggesting adaptation over time. Bank employees showed less favorable trends than manual workers, indicating that digitalization and higher job demands significantly affected employees’ well-being, especially older workers. Improvements in perceived health and reduced stress mostly contributed to enhanced work ability. Conclusions: These findings highlight the importance of targeted interventions to enhance health and lower stress among aging workers, supporting their well-being and subsequently their work ability.
Copyright (c) 2025 Alice Fattori, Teresa Barnini, Anna Comotti, Pasquale Bufano, Marco Laurino, Simone Russo, Luca Ferrari, Catalina Ciocan, Matteo Bonzini https://creativecommons.org/licenses/by-nc/4.0
Neurosensory Response of the Hand and Foot to Vibration Exposure
Background: This study investigated the vibrotactile perception threshold (VPT) changes in the fingers and toes of twenty-eight healthy subjects (15 males and 13 females aged 20 to 62 years) exposed to hand- and foot-transmitted vibration. Methods: The VPT was measured before and after the exposure of the hands and feet to 5 minutes of triaxial white noise pseudorandom vibration. The post-vibration VPT was measured immediately after and 15 minutes after the end of the exposure to assess the temporary threshold shift (TTS) of vibration perception. The effects of the anatomical district (index finger and big toe), measurement time (before and after vibration exposure), test frequency (8, 31.5, and 125 Hz), age group (Under30s and Over 40s), and gender (male and female) on the changes in VPT were investigated. Results: The findings revealed that the index finger and the big toe exhibited comparable profiles in the vibrotactile sensitivity at the low-middle vibration frequencies and in the recovery of the perception threshold after vibration exposure. The big toe showed a higher perception threshold than the index finger, and the difference increased with the test frequency. In addition to vibration frequency, age and skin temperature influenced the results of VPT and TTS measurements. Conclusions: The findings of this study can contribute to outlining alternative frequency weighting functions for the neurosensory response of the hand and foot to vibration exposure, and to update the current guidelines for evaluating human vibration exposure.
Copyright (c) 2025 Flavia Marrone, Nicole Sanna, Julio Sánchez García , Federico Ronchese, Enrico Marchetti, Angelo Tirabasso, Massimo Bovenzi, Marco Tarabini https://creativecommons.org/licenses/by-nc/4.0
Evaluation of the Workplace Accident Severity in an Underground Coal Mine By Logistic Regression Analysis
Background: Accidents in underground coal mining can cause deaths, serious injuries, and material losses.Methods: This study examined 10,334 work accidents that occurred between 2011 and 2021, resulting in injuries, and evaluated the causes, severity, and types of injuries. The accidents were investigated under the following subheadings: location of accidents, causes of accidents, work shifts when the accidents occurred, accident time, accident days, distribution of accidents by months and years, age of workers, occupational groups, educational status of workers, working day losses, and body parts that were injured. The severity of accidents was categorized into three levels: mild, moderate, and severe, based on the workday losses incurred by the workers after the accident. The severity of accidents and factors affecting their severity were analyzed using multinomial logistic regression. Results: There is a significant statistical relationship between the severity of accidents and factors such as experience, workplace, accident cause, age, education status, occupational category, and the affected body part, work shift, according to the analysis. The findings indicate that accident severity is influenced not only by the immediate circumstances of the incident but also by broader individual and occupational factors, such as the employee’s level of experience, the work environment, the occupational group, and the specific body part affected. The analysis revealed that the occupational group variable had statistically significant interaction effects with multiple other variables. Conclusions: The study presents all aspects of the hazards faced by the workers and suggests measures to reduce the number and severity of accidents that occur in underground coal mining.
Copyright (c) 2025 ilknur Erol https://creativecommons.org/licenses/by-nc/4.0
A 21-Year Perspective on Occupational Skin and Respiratory Diseases Among Food Handlers
Background: Food handlers may have an increased risk of developing occupational skin and respiratory diseases. Methods: This retrospective study was based on examinations, skin prick testing, and patch testing performed at the Unit of Occupational Medicine at the University of Trieste (N-E Italy) between 2002 and 2022 in food-handler workers referred to the unit for suspected occupational allergic diseases. Results: More than half of the population (58.1%) experienced occupational skin diseases, with a higher prevalence among women (OR 3.3, 95% CI 1.5-7.6). Irritant contact dermatitis was the most prevalent skin condition (22.9%), followed by allergic contact dermatitis (20%) and protein contact dermatitis (15.1%). Pastry makers and bakers exhibited a high rate of protein contact dermatitis (20.6 and 17.7%, respectively), which was primarily attributed to wheat flour. Of the participants, 47.8% reported having rhinitis, and 17.6% reported having asthma. Positive SPT results were observed in 34.4% of workers with rhinitis and 58.3% of those with asthma, with bakers and pastry makers being more frequently sensitized to wheat flour (22.8% and 20.6%, respectively). Cooks reported rhinitis (43.2%) and asthma (12.3%) with sensitization to soy, scampi, peanuts, and other foods. Atopy determined by prick test was significantly linked to respiratory symptoms. Bakers and pastry makers showed significantly higher sensitivity to wheat flour (OR 3.3, 95% CI 1.3-7.8). Conclusions: Food handlers can experience occupational skin and respiratory diseases, and more efforts are needed to prevent such diseases by improving preventive habits and avoiding exposure to allergens.
Copyright (c) 2025 Jessica Granzotto, Ilaria Lazzarato, Marcella Mauro, Luca Cegolon, Francesca Larese Filon https://creativecommons.org/licenses/by-nc/4.0
Beyond the Balance Sheet: The Human Cost of Neglecting Occupational Health
Occupational-Related Exposure to Diesel Exhaust and Kidney Cancer: Systematic Review and Meta-Analysis of Cohort Studies
Background: The association between diesel exhaust and cancer other than the lung is not well established. We aimed to conduct a systematic review and meta-analysis on the association between diesel and kidney cancer in workers.Methods: Two trained researchers conducted a systematic review to identify cohort studies examining the relationship between occupational exposure to diesel exhaust and the risk of cancer other than lung cancer. Of the 43 retained studies, 15 reported information on kidney cancer. We performed random-effects meta-analyses for ever-exposure to diesel exhaust. Summary relative risks (RR) and 95% confidence intervals (CI) were calculated for the association between diesel exhaust exposure and kidney cancer. Results: Overall, the RR of kidney cancer was 1.08 (95% CI=1.01-1.15, heterogeneity p=0.1, I2=28.6%). The summary RR was 1.08 for incidence (95% CI=1.01-1.16; I2=36.7%) and 1.09 for mortality (95% CI=0.92-1.30, I2=14.5%), p of heterogeneity=0.914. The summary RR of European studies was 1.08 (95% CI=1.00-1.16, I2=37.8 %), that of USA/Canada studies was 1.10 (95% CI=0.94-1.29, I2=8.5%), p of heterogeneity=0.837. Publication bias was not detected. Conclusions: Workers exposed to diesel exhaust may experience an increased risk of developing kidney cancer, although the evidence is not entirely consistent, and residual confounding cannot be excluded.
Copyright (c) 2025 Giulia Collatuzzo, Federica Teglia, Paolo Boffetta https://creativecommons.org/licenses/by-nc/4.0
Girls and Women in Mines: an Invisible Path of Forced Labour in Italy
This study aims to shed light on the largely understudied history of girls and women working in Italian mines during the 19th and 20th centuries. Giovanni Loriga authored an outstanding paper on Pneumoconiosis in 1930 at the Johannesburg Conference. By examining his sources from earlier surveys, travel records, and congressional proceedings, the research uncovers data on women and girls in slate (Liguria), asbestos (Piedmont), zinc-lead (Sardinia and Lombardy), and sulfur mines (Sicily), along with their working conditions. The research findings reveal that girls and women were integral to the mining industry throughout Italy, despite being underrepresented and relegated to specific tasks. Ultimately, the paper explores the development of protective Italian legislation, its inadequate enforcement, and suspension during World War I. The paper concludes by highlighting the ongoing global issue of girls' labour in mines, drawing a parallel between the historical situation in Italy and the contemporary reality denounced by organizations like the ILO and UNICEF.
Copyright (c) 2025 Silvana Salerno https://creativecommons.org/licenses/by-nc/4.0
When Occupational Cancer Recognition Falters
There are differences between epidemiology and legal medicine in addressing the problem of under-reporting occupational cancers. Epidemiology focuses on systematically gathering data and identifying patterns of under-reporting, which is not deemed to pose ethical dilemmas, as its goal is to improve public health outcomes. Conversely, legal medicine investigates individual cases and ensures compliance with legal standards, presenting more complex ethical challenges. Considering workers' frustrations when dealing with unrecognized occupational diseases is essential. These workers experience significant physical and emotional distress and should not have to face a complicated compensation claims process. There is a need for ethical approaches that support workers in navigating their rightful claims for compensation, not challenging their mental and emotional well-being.
Copyright (c) 2025 Giorgio Assennato, Chiara De Giampaulis https://creativecommons.org/licenses/by-nc/4.0
Assessing Cumulative Musculoskeletal Strain in Automotive Mechanics: Insights from Real-World Occupational Analysis
Background: This cross-sectional study aims to assess cumulative loads affecting the lower back, shoulders, and distal upper extremities among automotive mechanics. Methods: The survey was conducted in automotive repair workshops in Shiraz, involving 157 independent mechanics selected through convenience sampling. Data were collected using a multiple-questionnaire including the Persian Cornell Musculoskeletal Discomfort Questionnaire (P-CMDQ), the Lifting Fatigue Failure Tool (LiFFT), the Shoulder Work Assessment Tool (SWAT), and the Distal Upper Extremity Tool (DUET). Descriptive statistics were used to assess musculoskeletal discomfort, and Partial correlation analyses, adjusted for age and Body Mass Index (BMI), examined the relationships between risk levels from LiFFT, SWAT, and DUET and discomfort reported in the P-CMDQ. Results: The results showed a high level of musculoskeletal discomfort, especially in the lower back, shoulders, and hands. Risk assessments indicated that the cumulative loads are in the high range for the lower back in 42.7% of cases, the shoulders in 40.8%, and the distal upper extremities in 36.3%. A strong correlation was observed between cumulative load on the lower back and perceived discomfort in this region (r = 0.730), whereas the correlations for the shoulders (r = 0.611) and distal upper extremities (r = 0.537) were moderate. Conclusions: The findings highlight the significant influence of workplace factors on the musculoskeletal health of automotive mechanics, emphasizing the importance of preventive measures and ergonomic solutions to enhance their health and productivity.
Copyright (c) 2025 Hadi Daneshmandi, Reyhane Sadeghian, Niloofar Rahgoshay, Nahideh Sartavi, Fardin Negahdari, Laleh Golkari https://creativecommons.org/licenses/by-nc/4.0
Differences in Risk Perception Between the Construction and Agriculture Sectors: An Exploratory Study with a Focus on Carcinogenic Risk
Background: Risk perception is crucial in occupational health and safety, particularly in high-risk sectors like agriculture and construction. This study investigates the influence of personality traits, emotional states, and socio-demographic variables on perceived risks, explicitly focusing on carcinogenic exposure. The aim is to identify key factors shaping risk perception to inform safety interventions. Methods: Using a correlational research design, 91 Italian workers (49 from construction and 42 from agriculture) completed a comprehensive questionnaire assessing personality (Big Five model), emotional state, self-perceived safety knowledge, and risk perception across 14 dimensions. Statistical analyses included correlations, ANOVA, and regression models to explore relationships between variables. Results: Open-mindedness, emotional stability and extraversion were inversely related to perceived risk levels, while conscientiousness and friendliness correlated positively. Workers in agriculture reported higher awareness of carcinogenic risks than construction workers, though no significant differences emerged in perceived risk levels. Negative emotional states predicted higher risk perception, while self-perceived safety knowledge had only minor correlations with specific risk dimensions. Gender, age, and service length did not significantly influence risk perception. Conclusion: Personality traits, particularly openness and emotional stability, strongly influence risk perception, highlighting the importance of considering individual psychological profiles in occupational safety interventions. Although emotional state plays a notable role, self-perceived safety knowledge showed limited impact, suggesting a need for targeted education.
Copyright (c) 2025 Massimiliano Barattucci, Tiziana Ramaci, Serena Matera, Francesca Vella, Valentino Gallina, Ermanno Vitale https://creativecommons.org/licenses/by-nc/4.0
A 7-Year Active Surveillance Experience for Occupational Lung Cancer in Bologna, Italy (2017-2023)
Background: In Italy, lung cancer is the second most frequent neoplasm in men and the third in women. Exposure to carcinogens in workplaces plays a significant role. Still, cases attributable to occupational exposure are currently under-reported as occupational diseases: the current National Prevention Plan also encourages active research projects for the detection of cancers attributable to occupational exposure. Methods: The Unit of Prevention and Safety in the Workplace of Bologna Local Health Authority (Azienda Unità Sanitaria Locale-AUSL-)created a network for active surveillance of occupational lung cancer cases with the dedicated Diagnostic and Therapeutic Care Pathways(PDTA). Possible occupational exposure cases were selected within all incident PDTA cases using a self-completed patient filter form. Only patients selected through the form were interviewed; occupational physicians collected personal, occupational, and clinical history. Definition of a cooperation system with the local office of the National Institute for Insurance(INAIL)for monitoring the process during the medico-legal assessments conducted by the insurance institute up to resolution. Results: 453 cases completed the filter form, 177 had a potential occupational exposure. Of these, 140 accepted the direct interview with occupational physicians. One hundred eleven cases interviewed were assessed with sure or suspect occupational origin: for 82, a claim for recognition was sent to the INAIL, while for the other 29 was sent to INAIL a report for epidemiological purposes. Out of 82 compensation claims, 18 individuals (4 females and 14 males) received compensation, while 4 cases remain under investigation. A total of 53 claims were rejected: 54.7% for lack of exposure to risk factors, 24.5% for insufficient exposure, 9.4% due to inadequate administrative documentation, 7.5% because of insufficient clinical documentation, and 3.8% for the absence of causal association. Conclusions: Several occupational lung cancers were found that otherwise would have been unrecognized. Asbestos was the most frequent agent occurring in the most widespread work sectors—construction and manufacture of metalworking products—and in the period of exposure from 1970 to 1980. Other relevant agents were welding fumes and polycyclic aromatic hydrocarbons. Active surveillance, direct patient interviews, and claims for recognition integrated by a complementary report are essential to increase the INAIL compensation rate.
occupational lung cancer, occupational carcinogens, active systematic search
Copyright (c) 2025 Monica Bogni, Daniela Cervino, Manuela R. Rossi, Paolo Galli https://creativecommons.org/licenses/by-nc/4.0
Copyright (c) 2025 Canzio Romano https://creativecommons.org/licenses/by-nc/4.0
Copyright (c) 2025 La Redazione https://creativecommons.org/licenses/by-nc/4.0
Gender Disparities in Workplace Violence Among Italian Healthcare Workers: A Cross-Sectional Study
Background: Workplace violence (WPV) is a prevalent issue globally among Healthcare Workers (HCWs). Moreover, WPV may disproportionately impact marginalized groups within the healthcare workforce, such as women and gender minorities. This study aims to examine the prevalence of WPV experienced by HCWs through a gender-focused lens and to investigate factors influencing the risk of WPV. Methods: A cross-sectional observational study was conducted over a month in Apulia, Italy, involving employees from major healthcare institutions, including hospitals, Local Health Authorities, selected correctional facilities, and Residences for Execution of Security Measures. The study used the Italian-validated WHO Workplace Violence in the Health Sector questionnaire, modified to include 'Other' in the gender definition. Results: 3,259 HCWs participated, representing 88.8% of the 3,670 invited participants. The prevalence of violence incidents within the last 12 months was 29.6% in the HAW group and 57.1% in the CRW group. Within the HAW group, transgender and gender expansive (TGE) workers exhibited a higher prevalence of verbal, physical, and sexual harassment. Logistic regression analysis identified gender, job type, night shifts, interactions with specific patients, and the type of medical settings as significant predictors of experiencing various kinds of violence. Conclusions: The study underscores the vulnerability of TGE and female HCWs to workplace violence. These findings underscore the imperative for comprehensive yet gender-sensitive interventions promoting safety, equity, and inclusion in the healthcare workplace.
Copyright (c) 2025 Angela Stufano, Luigi De Maria, Giuseppe Delvecchio, Gianfranco Sifanno, Gianluca Maffione, Gianmarco Giannelli, Valentina Schino, Riccardo Ravallese, Antonio Caputi, Donato Sivo, Piero Lovreglio, Luigi Vimercati https://creativecommons.org/licenses/by-nc/4.0
The Protection of Women and Children at Work
Copyright (c) 2025 Livia Lollini https://creativecommons.org/licenses/by-nc/4.0
Forward-Thinking: How a Century Ago Protecting Women and Children in the Workplace Laid the Groundwork for Gender Medicine and Decent Work
Dr. Livia Lollini, a physician and an early pioneer in women’s occupational health, authored a paper published as the lead article in the inaugural issue of La Medicina del Lavoro, which adopted its current title in 1925. Her work, La protezione della donna e del fanciullo sul lavoro (The Protection of Women and Children at Work), constitutes one of her contributions to labor protections for women and children in early 20th-century Italy. Born into a family distinguished by socialist and feminist ideals, she completed her medical education in 1913. Subsequently, she served as an assistant at the Clinica del Lavoro in Milan, where she addressed various issues related to occupational health. Drawing from international labor laws, Dr. Lollini critiqued the inadequate enforcement of existing legislation in Italy and emphasized the notable disparities in maternity protections. Her analysis highlighted the need to safeguard women's health at the workplace and called for systemic reforms, including implementing regular medical examinations, female labor inspectors, and industrial nursing services. Her work, grounded in gender-sensitive approaches to occupational health, continues to resonate with contemporary principles of gender medicine. Although substantial advancements in labor legislation have been realized, many of the challenges she addressed—such as child labor, maternity rights, and workplace safety—remain central to global discussions surrounding decent work and equitable labor practices.
Women’s Occupational Health; Livia Lollini; History; Labor Legislation; Gender Medicine; Decent Work
Copyright (c) 2025 Michele Augusto Riva, Maria Emilia Paladino https://creativecommons.org/licenses/by-nc/4.0
Celebrating the Legacy of a Century of Scientific Research Published by La Medicina del Lavoro
New Prospects for Rural Health Collaboration
Copyright (c) 2024 Claudio Colosio, Petar Bulat https://creativecommons.org/licenses/by-nc/4.0
Occupational Injuries and Their Determinants Among Healthcare Workers in Western Countries: A Scoping Review
Background: Healthcare workers (HCWs) in developed countries can be exposed to a wide range of hazards. The systematic identification of working conditions associated with the risk of occupational injury can significantly reduce this risk. Methods: From January 2000 to December 2021, a scoping review was performed using PCC (Population, Concept, and Context) criteria and searching major scientific databases. Studies conducted in Western Countries, defined as member countries of the Organisation for Economic Co-operation and Development (OECD), were selected. Results: We identified 282 studies for the present review. Studies focused more frequently on biological injuries (59%). Musculoskeletal injuries and injuries due to aggression and violence followed, based on the frequency of the investigated topic. Conclusions: Most studies focused on the risk of bloodborne infections, while a knowledge gap emerged on the epidemiology of accidental exposure to other transmission pathways. Although the proportion of injured workers is not negligible in most studies, the most common determinants and risk factors of injury are entirely preventable.
Copyright (c) 2025 Guglielmo Dini, Alborz Rahmani, Alfredo Montecucco, Bruno Kusznir Vitturi, Sonia Zacconi, Alessia Manca, Carlo Blasi, Roberta Linares, Mauro Morganti, Nicola Luigi Bragazzi, Angela Razzino, Paolo Durando https://creativecommons.org/licenses/by-nc/4.0