Luciano Marchiori1, Gianluca Marangi2, Nicoletta Ballarin3, Flavio Valentini4, Mauro D'Anna5, Paolo Barbina6, Alberto Franchi7, Giuseppe Mastrangelo8. 1. Servizio prevenzione, igiene e sicurezza degli ambienti di lavoro, Unità locale socio sanitaria 20 Verona. 2. Servizio prevenzione, igiene e sicurezza degli ambienti di lavoro, Unità locale socio sanitaria 20 Verona. gianluca_marangi@yahoo.it. 3. Servizio prevenzione, igiene e sicurezza degli ambienti di lavoro, Unità locale socio sanitaria 12 Mestre (VE). 4. Servizio prevenzione, igiene e sicurezza degli ambienti di lavoro, Unità locale socio sanitaria 13 Dolo (VE). 5. Unità operativa ospedaliera di medicina del lavoro, Azienda ospedaliera "Istituti ospitalieri" di Cremona. 6. Centro regionale unico amianto, Azienda per l'assistenza sanitaria 2 Bassa Friulana-Isontina. 7. Unità operativa prevenzione e sicurezza degli ambienti di lavoro, Azienda unità sanitaria locale di Bologna. 8. Dipartimento di scienze cardiologiche, toraciche e vascolari, Università degli Studi di Padova.
Abstract
OBJECTIVES: to define an Italian national protocol of post-occupational health surveillance for asbestos workers according to effectiveness, appropriateness, saving, and social utility. DESIGN: data for 1,071 former asbestos workers from several Italian Regions were collected and analysed. For these workers, a retrospective estimate of asbestos exposure was carried out. A cohort study of 1,588 asbestos workers recruited from 2000 onward during statutory health examinations in Veneto and followed-up for lung cancer mortality until December 2010 was executed. A literature search on methods of follow-up of asbestos workers (imaging, spirometry, and questionnaires) and diagnosis of non-malignant (asbestosis and pleural plaques) and malignant (lung cancer) asbestos disease was done. A consensus, i.e., a process of agreeing on one result among the participants, was made. SETTING AND PARTICIPANTS: 19 Italian Regions (North: Veneto, Emilia-Romagna, Lombardia, Piemonte, Valle d'Aosta, Autonomous Province of Trento, Autonomous Province of Bolzano, Friuli Venezia Giulia, Liguria; Centre:Toscana, Umbria; South and Islands: Calabria, Abruzzo, Puglia, Campania, Basilicata,Marche, Sicilia, Sardegna), Department of Occupational Medicine at Italian National Institute for Compensation ofWork-Related Diseases and Accidents (INAIL), and Department of Cardiac, Thoracic, and Vascular Sciences at University of Padova. MAIN OUTCOME MEASURES: analysis of current regional experiences on health surveillance; retrospective estimate of asbestos exposure; data collection and analysis of a cohort of asbestos workers; search of the relevant literature; final report with the consensus document. RESULTS: the results obtained in each of the above areas of research, along with the relevant findings of the literature, were presented and discussed among the participants. The several phases of expression and evaluation of the participants' opinions were conducted according to an iterative method of investigation (Delphi method), which allows a progressive converging of different views into one shared result. CONCLUSION: based on all the above, a consensus has been reached on a proposal for an Italian national protocol of health surveillance for asbestos workers.
OBJECTIVES: to define an Italian national protocol of post-occupational health surveillance for asbestos workers according to effectiveness, appropriateness, saving, and social utility. DESIGN: data for 1,071 former asbestos workers from several Italian Regions were collected and analysed. For these workers, a retrospective estimate of asbestos exposure was carried out. A cohort study of 1,588 asbestos workers recruited from 2000 onward during statutory health examinations in Veneto and followed-up for lung cancer mortality until December 2010 was executed. A literature search on methods of follow-up of asbestos workers (imaging, spirometry, and questionnaires) and diagnosis of non-malignant (asbestosis and pleural plaques) and malignant (lung cancer) asbestos disease was done. A consensus, i.e., a process of agreeing on one result among the participants, was made. SETTING AND PARTICIPANTS: 19 Italian Regions (North: Veneto, Emilia-Romagna, Lombardia, Piemonte, Valle d'Aosta, Autonomous Province of Trento, Autonomous Province of Bolzano, Friuli Venezia Giulia, Liguria; Centre:Toscana, Umbria; South and Islands: Calabria, Abruzzo, Puglia, Campania, Basilicata,Marche, Sicilia, Sardegna), Department of Occupational Medicine at Italian National Institute for Compensation ofWork-Related Diseases and Accidents (INAIL), and Department of Cardiac, Thoracic, and Vascular Sciences at University of Padova. MAIN OUTCOME MEASURES: analysis of current regional experiences on health surveillance; retrospective estimate of asbestos exposure; data collection and analysis of a cohort of asbestos workers; search of the relevant literature; final report with the consensus document. RESULTS: the results obtained in each of the above areas of research, along with the relevant findings of the literature, were presented and discussed among the participants. The several phases of expression and evaluation of the participants' opinions were conducted according to an iterative method of investigation (Delphi method), which allows a progressive converging of different views into one shared result. CONCLUSION: based on all the above, a consensus has been reached on a proposal for an Italian national protocol of health surveillance for asbestos workers.