Sorveglianza sanitaria in ex esposti ad asbesto: osservazioni su 24 lavoratori di uno zuccherificio pavese [Health surveillance for formerly exposure to asbestos: observations on 24 workers of a sugar refinery]

Although the Italian law 257/1992 has banned asbestos, workers formerly exposed to this material continue to require health surveillance. We present 24 outpatients (1 woman and 23 men) with a history of occupational exposure to asbestos (mean 303,6 months), who have worked at a sugar refinery as mainteiners, mechanics and electricians. Their job involved testing, maintenance and repair of factory machinery: asbestos gaskets were cut, replaced and milled by hand, resulting in significant dispersion of fibres; additionally, the workers shattered asbestos insulation material covering pipes, boilers and electrical panels. An amount of asbestos-cement was produced directly in the workplace, saturating the environment with airborne dust. Since 1992, 20 subjects participated in the dismantling of deteriorating asbestos-cement wavy roofs. After an occupational medicine visit with careful occupational and environmental history, the patients underwent chest x-ray with ILO classification and complete spirometric test. No asbestos-related diseases, such as pleural plaques, mesothelioma or pneumoconiosis, were disclosed. Considering the lag time from the start of exposure, the subjects were enrolled in a specific follow-up program. In spite of the current negative findings, our observations draw attention to the risk of asbestos-related diseases in the sugar industry: a business sector usually not regarded as a potential source of exposure.