La Medicina del Lavoro

Call for Applications for the Enrico C. Vigliani Award

2026-06-24T13:37:15+00:00

The Impact of Robotization on Employees' Mental and Physical Health: A Qualitative Study in the Czech and Slovak Republics

2026-08-03T13:45:40+00:00

Background: This study aimed to explore the impact of introducing robotic technologies on employees' mental and physical health across three Czech and one Slovak manufacturing company. It sought to understand employees’ subjective experiences and perceptions of organizational support during the robotization process. Methods: A qualitative study was conducted between 2023 and 2025 in four companies. 27 semi-structured interviews with employees (15 women, 12 men) and 19 unstructured interviews with managers (3 women, 16 men) were conducted on-site during working hours. Data were analyzed using thematic analysis with open and axial coding. Results: Nine thematic areas were identified: general perceptions, change, fear, problems, support, social relations and communication, employee characteristics, physical health, and mental health. Employees generally perceived robotization positively, noting reduced physical workload and less monotonous or hazardous work. Initial adaptation was challenging, especially due to technical demands and workflow changes. Technical staff experienced higher stress than operators, related to responsibility, troubleshooting, and learning new skills. Technical malfunctions, elevated noise and vibration, and cognitive demands were reported as stressors. Personifying robots and informal knowledge sharing facilitated adaptation. No significant sleep disturbances or substance use linked to robotization were reported. Managers faced a high mental workload due to coordination and supervision responsibilities. Conclusions: When the implementation process is well designed, robotization does not necessarily negatively affect employees’ mental health. The findings highlight the importance of actively addressing organizational and human factors that influence the success of technological change in the workplace. Attention should focus on monitoring cognitive and psychological demands, particularly for technical and managerial staff.

A Portable Heat-Exchange-Based System for Assessing Digital Vascular Response to Cold

2026-08-03T13:45:40+00:00

Background: Digital vascular assessment is relevant in occupational medicine, but current measurement methods may be complex and poorly portable. Objective: To validate a portable heat-exchange-based system for assessing cold-induced digital vascular response, using strain-gauge plethysmography as the reference method. Methods: Twenty healthy volunteers, 10 males and 10 females, underwent five subsequent sessions. Finger blood flow (FBF) was assessed by strain-gauge plethysmography, while simultaneously, fingertip thermal power (TP) was recorded with a portable thermoflowmeter. FBF was measured at baseline, while both FBF and TP were measured during application of 1-N contact force alone and during 1-N force combined with local cooling at 10 °C. The relationship between TP and FBF, after adjustment for covariates (age, sex, body mass index (BMI), and room temperature), was evaluated in the cooled condition using a linear mixed model including fixed and random effects. Results: Local cooling induced a significant vascular response, with FBF decreasing from 1.23 to 0.98 ml/100 ml/s (p<0.0001). In the cooled-condition model, TP was significantly associated with FBF, with each 1 ml/100ml/s increase in FBF corresponding to a 39.6 mW increase in TP (p<0.0001). Under cooling, TP showed lower within-subject variability than FBF (wsCV ≈0.19 vs ≈0.64). BMI was positively associated with TP (4.40 mW per kg/m², p=0.007), whereas age and sex were not significant predictors. Conclusions: These findings support the interpretation of TP as a perfusion-related thermal descriptor with potential applicability in occupational health surveillance. Further validation in subjects with digital vascular disorders is needed.

Bridging Two Gaps: A Roadmap for Collaboration Between Occupational Physicians and General Practitioners

2026-08-03T13:45:40+00:00

Occupational physicians (OPs) and general practitioners (GPs) manage overlapping aspects of the same patient’s health yet rarely communicate with one another. By assigning OPs a role in promoting cancer screening, Law 198/2025 has created in Italy a regulatory link between occupational surveillance and public health prevention—a link that cannot function without a structured exchange of data between the two professional roles. This commentary argues that the new regulatory framework, together with Legislative Decree 135/2024 on carcinogens, mutagens, and substances toxic to reproduction, and Legislative Decree 29/2024 on active aging, offers an unprecedented—yet narrow—window of opportunity to build formal collaboration between OPs and GPs in Italy. Another argument concerns the growing presence of foreign-born workers, who may carry undiagnosed endemic conditions and face language barriers that make OP–GP coordination essential for safe fitness-for-work assessments. Drawing on documented challenges from similar initiatives in the Netherlands, Germany, France, and Finland, we identify the main structural obstacles in the Italian context and propose a three-tiered roadmap for implementation, progressing from immediate consensus-based models to the long-term integration of occupational health data into the Electronic Health Record 2.0.

Cadmium Exposure and Risk of Pancreatic Cancer: A Systematic Review and Meta-Analysis

2026-06-24T13:37:15+00:00

Introduction: 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. Methods: 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.Results: 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). Conclusion: 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.

Women's Work and its Effects on Personal Wellbeing and Satisfaction with Life: A Cross-Sectional Comparative Study

2026-08-03T13:45:40+00:00

Background: Women’s participation in the workforce has increased substantially, raising important questions about how employment is associated with their subjective well-being and satisfaction with life. This study aimed to assess differences in personal well-being and life satisfaction between working and non-working women and to identify their significant socio-demographic and occupational predictors. Methods:A cross-sectional comparative study was conducted among 402 women (192 working, 210 non-working) attending outpatient clinics at Mansoura University and primary healthcare centers. Data were collected using an interviewer-administered questionnaire covering sociodemographic factors, occupational characteristics, the Personal Well-being Index–Adult (PWI-A), and the Life Satisfaction Scale(LSS). Bivariate and binary logistic regression analyses identified the independent predictors. Results: Working women reported significantly higher well-being (PWI-A: 72.06 ± 13.03) and life satisfaction (LSS: 21.52 ± 5.76) than non-working women (PWI-A: 67.42 ± 10.14; LSS: 17.55 ± 5.91). University education (AOR = 2.81) and sufficient income (AOR = 2.94) were strong predictors of higher wellbeing. Subjective well-being (AOR = 21.67) was a significant predictor of life satisfaction. Among working women, professional (AOR = 4.76) and administrative/technical occupations (AOR = 7.40), and absence of shift work (AOR = 6.53) were associated with better wellbeing. Shorter working hours (≤40 h/week; AOR = 14.34) were linked to higher life satisfaction. Conclusion: In Mansoura, working women exhibit higher subjective well-being and life satisfaction than non-working women. These outcomes were associated with education, income, and occupational conditions. Improving work conditions may contribute to better well-being among working women.

Artificial Intelligence in Occupational Medicine: Upholding Disciplinary Integrity and Editorial Standards

2026-04-22T13:45:40+00:00

The Evolving Landscape of Contact Dermatitis Diagnosis: A Critical Appraisal of Recent Regulatory Constraints

2026-06-24T13:37:16+00:00

The current limited availability of patch tests for diagnosing Allergic contact dermatitis (ACD) and occupational or non-professional diseases, in accordance with AIFA regulations, has significantly affected the diagnostic approach for patients and affected workers. The issue is even more severe for haptens of occupational origin. In occupational medicine, the patch test is crucial for establishing the causal link between the skin disease and the patient's work activities. Accurate diagnosis is essential for occupational physicians both to determine the need for a job change and to assess workers' compensation. Due to limited diagnostics and regulatory restrictions, it remains impossible to diagnose occupational ACD. In this context, occupational doctors will focus on primary prevention by avoiding risk products and replacing them with non-sensitizing or non-cross-reactive alternatives. This paper addresses the challenges posed by the new AIFA (Italian Medicines Agency) diagnostic restrictions and explores potential solutions and future perspectives.

Combined Occupational Exposure to Lead and Other Metals and Risk of Lung Cancer

2026-08-03T13:45:40+00:00

Background: The evidence linking occupational exposure to lead and cancer in humans is suggestive. Existing studies examine individual exposure to lead, ignoring the potential joint effects of mixed metal exposure. Methods:We analyzed the data of a case-control study of lung cancer conducted in seven European countries and comprising 2,861 cases and 2,936 controls, with a detailed assessment of occupational exposure to arsenic, cadmium, chromium (VI), and lead, to estimate the odds ratio (OR) of lung cancer for combined exposure to lead and these other carcinogenic metals, after adjustment for potential confounders. Results: The results suggested a synergism between lead and arsenic or cadmium: ORs were around 1.0 for lead alone and above 2.0 for combined exposure. No interaction was suggested between lead and chromium (VI). Conclusion: Our results provide suggestive evidence of a possible interaction between occupational exposure to lead, arsenic, or cadmium and lung cancer risk, and highlight the importance of considering mixed metal exposures in occupational epidemiology.

Artificial Intelligence in Occupational Health Surveillance: Evaluating AI-Assisted ILO Classification of Radiographs of Pneumoconioses

2026-04-22T13:45:41+00:00

Background: 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. Methods: 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. Results: 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. Conclusion: 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.

Sleep Quality and Physiological Stress in Emergency Physicians During 24‑Hour Shifts: A Wearable‑Based Occupational Health Assessment

2026-08-03T13:45:40+00:00

Background: Shift-based work schedules may disrupt circadian rhythm and adversely affect sleep and stress regulation among healthcare workers. Emergency physicians are particularly exposed to high-intensity workloads and prolonged 24-hour shifts, which can increase occupational strain. Methods: This study was conducted between April and December 2024 in a tertiary emergency department. Participants wore a smartwatch continuously for 30 days to record sleep architecture and heart rate variability–based stress indicators. Physiological parameters obtained during 24-hour shifts and at home were compared. Analyses were performed across four professional-experience groups. Results: Sleep duration, deep sleep percentage, deep sleep continuity score, breathing quality score, and overall sleep score were lower during 24-hour shifts, whereas light sleep percentage, nighttime awakenings, and stress levels were higher (all p < 0.001). Physicians with greater professional experience had longer sleep duration and lower stress levels during 24-hour shifts compared with early-career residents. Multiple linear regression analysis indicated that professional experience was the only independent predictor of stress levels during shifts. Conclusions: Shift work in emergency medicine is associated with impaired sleep quality and increased physiological stress. Professional experience appears to mitigate stress responses but does not fully restore sleep quality. These findings support the need for targeted occupational strategies, including optimized workload distribution and structured support for early-career physicians, to improve well-being and ensure patient safety in high-intensity clinical environments.

Reference Values for Maximal Isometric Handgrip and Pinch Strength in Healthy Italian Adults Without Occupational Biomechanical Overload

2026-04-22T13:45:40+00:00

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.

Methods: 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).

Results: 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.

Conclusions: 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.

Objective Assessment of Visual Workload in Video Display Terminal Workers Using a Non-Invasive Monitoring System

2026-06-24T13:37:15+00:00

Background: The risk assessment for video display terminal (VDT) operators in occupational settings often relies on indirect estimates, such as self-reported screen time, which may not accurately reflect the true visual workload. The objective is to assess visual workload in VDT workers by measuring active screen fixation time with a non-invasive monitoring system and to explore its relationship with ocular surface alterations and fatigue-related indicators. Methods: An observational cross-sectional study was conducted on 38 administrative workers employed at a hospital booking center. Active VDT screen fixation, as well as shift duration and time spent in front of the VDT screen, were objectively measured using a patented video-based monitoring system. Ophthalmological evaluation included the Ocular Surface Disease Index (OSDI^®), tear break-up time (BUT), and slit-lamp examination. Other investigated markers included blink rate, the Percentage of Eyelid Closure over the Pupil over Time (PERCLOS), and the Fatigue Assessment Scale (FAS). Results: Active screen fixation accounted for approximately 60% of the total recorded working time. Ophthalmological assessment identified alterations of the ocular surface in a substantial proportion of workers, with pathological BUT values observed in nearly half (47%) of the study population. No statistically significant associations were found between objectively measured fixation time and ocular or fatigue-related outcomes. PERCLOS80 and blink rate values remained within physiological ranges across the work shift. Conclusions: Objective measurement of screen fixation provides a more accurate characterization of visual workload among VDT workers than indirect exposure estimates and may support occupational health surveillance and risk assessment in VDT-exposed workers.

Interstitial Lung Disease in a Dental Technician Diagnosed Through an Integrated Multidisciplinary Approach

2026-08-03T13:45:40+00:00

Evidence from the literature indicates that workers in the dental care sector are routinely exposed to hazardous airborne agents, particularly mineral and metal dusts. This occupational risk is further amplified in settings with inadequate ventilation and insufficient use of personal protective equipment. We discuss the case of a dental technician with a significant history of occupational exposure who presented to our clinic with exertional dyspnea. High-resolution computed tomography revealed fibrosing nonspecific interstitial pneumonia associated with emphysema, and spirometry showed a severe reduction in carbon monoxide diffusion capacity. After a multidisciplinary evaluation, we performed bronchoscopy with bronchoalveolar lavage (BAL), which revealed an abundance of macrophages. Scanning electron microscopy with energy-dispersive spectrometry of the BAL detected silicon oxide, calcium, iron, and traces of metals typical of dental alloys (titanium, aluminum), as well as rare earth elements and toxic pollutants. These findings supported the diagnosis of interstitial lung disease due to long-term occupational exposure in dental laboratories, enabling a minimally invasive diagnostic approach. This strategy obviated the need for transbronchial biopsy, thereby avoiding a procedure associated with a high risk of pneumothorax in this patient.

Alcohol Consumption at Work in Construction Workers Employed in Small Italian Companies

2026-04-22T13:45:40+00:00

Background: 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. Results: 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. Conclusions: 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.

Self-Reported Non-Auditory Effects of High Sound Pressure Levels Exposure in Academic Musicians in Uruguay

2026-04-22T13:45:41+00:00

Background: 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. Methods: 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. Results: Most participants reported several non-auditory effects. These were classified by sex, age, and role (singer or instrumentalist, voice type, or played instrument). Conclusions: 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.

Thanks to our Reviewers

2026-02-24T15:10:25+00:00

Work Ability and Associated Factors Among Nurses in a Teaching Hospital: A Cross-Sectional Study

2026-06-24T13:37:15+00:00

Background: 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.

Methods: 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. Results: 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. Conclusions: 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.

Occupational Exposure to Inhalation Anesthetics in Operating Room and Adverse Health Outcomes: A Systematic Review

2026-02-24T15:10:25+00:00

Summary: Volatile anesthetics (VA) are essential agents for inducing and maintaining unconsciousness during specific surgical procedures, but they pose several health risks for exposed workers. The aim of the systematic review was to assess the effects of long-term VA occupational exposure in operating rooms. The review was conducted in accordance with the PRISMA Statement, and the search was conducted in PubMed, Scopus, and Web of Science to identify articles published between January 1, 1994, and December 31, 2024, that reported data from observational, quasi-experimental, and experimental studies. The protocol was registered in PROSPERO (ID: CRD42024500838). The quality of the studies was assessed using the standard Newcastle-Ottawa Scale versions for cohort and case–control studies, and an adapted version for cross-sectional studies. A total of 65 studies were included. Adverse effects were categorized into four groups: reproductive and Adverse pregnancy or offspring outcomes, neurotoxic alterations, laboratory parameter changes, and cyto- and genotoxicity. Overall, no significant associations were found between VA exposure and reproductive or pregnancy outcomes. One study reported neurological alterations (prolonged reaction times). Additionally, some studies have documented impairments in immune function and minor alterations in renal and hepatic function parameters. Finally, several studies indicated an increased risk of genotoxicity and oxidative stress. Given this evidence, protective measures and health surveillance for exposed workers remain crucial preventive measures.

General and Toxicologic Aspects of Occupational Fatalities in the Metropolitan Area of Lyon From 2000 to 2020, a Retrospective Study

2026-02-24T15:10:25+00:00

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.

Breathing the Job: Impaired Pulmonary Function in Hairdressers due to Occupational Chemical Exposure

2026-02-24T15:10:25+00:00

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Effects of Breathing Exercises Applied to Intensive Care Nurses on Fatigue and Perceived Stress: A Randomized Controlled Trial

2026-06-24T13:37:16+00:00

Background: 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 15^th day, and on the 30^th day. Results: 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 15^thand 30^th days. Conclusions: 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.

Headaches in Hospital Nurses - Authors' Reply

2026-02-24T15:10:25+00:00

Diagnostic Utility of Serum Krebs von den Lungen-6 (KL-6) and Surfactant Protein-D (SP-D) Levels in Hypersensitivity Pneumonitis

2026-04-22T13:45:41+00:00

Background: 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). Methods: 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. Results: 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). Conclusion: 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.

Where Are We Going by Applying AI Tools? Are We Going to Lose Our Jobs?

2025-12-16T09:08:40+00:00

Clinical Characteristics and Interstitial Findings on High-Resolution Computed Tomography in Patients with Coal Workers’ Pneumoconiosis

2026-06-24T13:37:16+00:00

Background: 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. Methods: 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. Results: 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.

Conclusions: 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.

Validation of the Italian Version of the Perception of Aggression Scale (POAS): A Cross-Sectional Study

2026-06-24T13:37:16+00:00

Background: 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.. Methods: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. Results: 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. Conclusions: 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.

Effectiveness of Occupational Health Promotion Programs on Cardiometabolic risk factors: A Systematic Review and Three-Level Meta-Analysis

2025-12-16T09:08:40+00:00

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.

Prevalence and Multivariate Impact of Musculoskeletal Disorders on General Health, Occupational Fatigue, and Productivity in an Industrial Workforce

2026-02-24T15:10:25+00:00

Background: Musculoskeletal disorders represent a leading occupational health challenge in heavy‐industry settings, yet their combined impact on workers’ general health, fatigue, and productivity remains underexplored. This study aims to quantify the relationship between multisite musculoskeletal symptom burden and key health and performance outcomes among copper‐industry employees. Methods: A cross-sectional survey of 585 workers used the Standardized Nordic Musculoskeletal Questionnaire, the 28-item General Health Questionnaire, the SOFI-20 fatigue inventory, and the HPQ-26 productivity survey. Spearman’s rank correlation was used to examine bivariate relationships, and multivariable linear regression models adjusting generally for demographic, work-related, and psychosocial factors were employed to estimate the independent effect of the number of painful sites on health, fatigue, and productivity outcomes. Results: Fifty-seven percent of workers reported pain in at least one region during the preceding 12 months, with an average of 2.6 painful sites per person (standard deviation 2.4). The number of painful sites showed a moderate positive correlation with poorer general health scores (ρ = 0.43, p < 0.001) and higher fatigue scores (ρ = 0.53, p < 0.001), and a moderate negative correlation with productivity ratings (ρ = –0.30, p < 0.001). In adjusted regression analyses, each additional painful site was associated with a 1.9-point worsening in general health score (95% CI 1.5 to 2.2), an 8.4-point increase in fatigue score (95% CI 7.3 to 9.6), and a 1.6-point decrease in productivity score (95% CI –2.0 to –1.2), all with p-values < 0.001. Conclusions: There is a clear dose–response relationship between the number of painful anatomical sites and declines in health, increases in fatigue, and reductions in productivity among copper-industry workers. To address this multifaceted impact, interventions should integrate ergonomic workstation design, task rotation, optimized break schedules, and comprehensive health-promotion services targeting both physical and psychosocial risk factors.

The Micronucleus Test for Occupational Safety

2026-04-22T13:45:41+00:00

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.