Aspetti attuali della patologia professionale: analisi di una casistica clinica

The 2001-2005 occupational diseases record of our institute is presented. In this period, 238 diagnoses were formulated in 158 patients (95 males, 63 females; age 17-81 years, mean 45), with a clear decreasing trend in comparison with the previous years. Respiratory diseases (n = 119) were the most frequent, with a preponderance of allergic pathology (rhinitis/rhinoconjunctivtis: 31 cases; bronchial asthma: 34 cases). Still common were the clinical pictures caused by inorganic dusts and fibres: 5 cases of silicosis, one of silicotuberculosis, 9 of mixed dust pneumoconiosis, and 32 asbestos-related diseases (7 asbestosis, 13 pleural plaques, 6 lung carcinomas, 6 pleural mesotheliomas). The other diseases were mostly skin diseases (30 cases of allergic contact dermatitis, one of irritative contact dermatitis, 3 of angioedema, 9 of contact urticaria), musculoskeletal disorders (10 cases of low back pain and 20 of upper extremity cumulative trauma disorders), noise-induced hypoacusia (22 cases), and psychopathological conditions due to mobbing at work (one case of post-traumatic stress disorder and 19 of adjustment disorder). The record also includes two cases of occupational bladder cancer (one due to aromatic amines, the other caused by combustion products), one patient with toxic hepatopathy (due to organic solvents) and a battery recycling worker with chronic lead poisoning. Overall, the study suggests that diagnosed occupational diseases are gradually decreasing, probably thanks to the improvement of workplace hygienic conditions, and that the pictures coming to observation change with time, as a consequence of the partial substitution of the classic risk factors with new ones.