Nursing staff members of a urban general hospital (GH) and a small oncological department (OD) were surveyed to determine the prevalence of occupational related musculoskeletal disorders (MSDs), the specific disabilities, accidents at work, and working time lost. All subjects had a medical examination to evaluate osteoarthicular disease and selected cases were invited to X-ray examinations. The purpose of this study was to compare MSDs in the two groups of nurses working in two hospitals with different work organization in the same geographical area, Pordenone in Italy. In the previous year 48% GH and 33% OD nurses reported back pain due to work, 29.4 and 16.1% respectively have had X-ray or orthopaedic examinations, 19.2% and 9.1% had been away from work because of back pain. All these differences are statistically significant. The analysis of musculoskeletal pain sites and working tasks in the two hospital workers shows no differences in distribution. Great difference exists when analysing the numbers of patients assisted by a nurse: 0.57 and 1.27 nurse/patients respectively in GH and OD. Our data indicate a high overall frequency of occupational back pain, similar to other studies in Europe. The comparison between the two hospitals suggests factors associated with the disorder: work tasks and particularly nurses/patients ratio are more important factors than age and length of exposure. Different work distribution, shift organization, a better ratio between nurses and patients, an improvement of equipment provision, and specific nurse-training with application of ergonomic methods could improve work efficiency radically and decrease injury rates.

X-ray examinations of the wrists, the elbows and the shoulders were carried out on 67 vibration-exposed foundry workers and on 46 comparable referents performing heavy manual work. Both groups had a mean age of 39.6 years. Musculoskeletal symptoms, such as arthralgias of the wrist and elbow joints, muscle pain and decreased muscular force, were found to be significantly increased in the chipping and grinding workers compared with the referents. After adjustment for age, the prevalence of cysts in the metacarpal and carpal bones was almost the same in the two groups, whereas radiological signs of osteoarthritis in the wrist joint were more frequent among the vibration-exposed workers (P less than 0.025). The overall prevalence of radiographic abnormalities in the elbow joint was higher in the vibration group than in the reference group (P less than 0.025). Olecranon spurs were observed in 50.7% of the exposed operators and in 28.2% of the referents (P less than 0.025). No difference in the prevalence of radiological changes in the should could be demonstrated between the populations studied. In both groups injuries of bones and joints were not associated with age. Among the chipping and grinding operators, a slight but not significant trend in the prevalence of skeletal abnormalities with increasing vibration exposure was observed. The results of this study indicate that the foundry workers using vibrating tools were affected with bone and joint disorders in the elbow and, to a lesser extent, in the wrist, which occurred more frequently than was observed in unexposed referents, who performed solely heavy manual activity. Among the vibration-exposed workers, no relationship between radiological changes in the upper limbs and symptoms of vibration white finger was found, pointing out that different pathogenic mechanisms are involved.

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Haemopoietic effects of ethylene glycol monomethyl ether (EGME) are described in three young women employed in a frame factory where the substance was applied under apparently safe hygienic conditions. In a ventilated room they used a mixture of acetone (70%) and EGME (30%) to glue together cellulose acetate frame components. During a periodic medical examination their white blood cell count was found to be abnormally low, with a relative lymphocytosis, macrocytosis with red blood cells, and haemoglobin at borderline normal values. These findings persisted over the exposure period but the haematological parameters returned to normal on stopping exposure. The subjects remained clinically healthy during the exposure period. This exposure to EGME occurred in an industry where such toxicity had not been previously reported and describes a situation in which the risk did not come from the exposure to vapour but most likely from an insufficient skin protection.Ethylene glycol monomethyl ether (EGME; meticellosolve) is a volatile and almost odourless solvent used primarily as an industrial solvent for resins, paints, dyes, and lacquers.'The first report describing acute effects of short term exosure concerns its use as a cleaning solvent in the production of fused shirt collars.23 Later reports have determined its toxicity for several animal species: the main actions are on the brain, blood, and kidney.45 Some cases of acute or subacute poisoning have been described in human subjects, due to ingestion or to high environmental exposure,"' but recently some authors have suggested that cutaneous absorption may play a significant part in poisoning in humans. '3 14 We describe haemopoietic effects of EGME in three workers employed in a glasses frame factory where the substance was used under apparently hygienic safe conditions. Work environment and exposure The affected workers were employed by a factory where celluloid glasses frames were made. They dipped the pieces to be fixed together in a kettle containing a mixture of acetone (70%) and EGME (30%); then glued them by cold pressing the two melted edges. They worked in a ventilated room standing directly over an aspirated table. Thin rubber gloves were worn but sometimes they handled the smallest pieces with bare hands, getting the solvent on their fingertips.Unfortunately the EGME was replaced before we could measure the concentration the workers were exposed to, but the environmental concentrations of acetone, which is much more volatile than EGME and which was the main component (70%) of the solvent mixture, were unremarkable.As the amount of the substance used was 1 1/day and we did not find excessive acetone in the environment, we assumed that EGME concentrations in the air were also negligible.Case reports Three young women employed in assembling glasses frames had their first periodic medical examination in 1987, two years after beginning their jobs.The clinical histories of the patients were negative; they did not suffer from virus infections, did not ...

Background Occupational respiratory allergy to green coffee beans (GCB) and to castor beans (CB) was studied in 112 workers in a modern coffee manufacturing plant of Trieste (Italy), where the process is completely automatic, the environmental conditions are good and where exposure to CB can be considered absent because since 1970, only new sacks have been used for coffee transportation. Methods All subjects were interviewed by a trained doctor using a questionnaire to investigate allergic symptoms and predisposing factors. Sensitization to GCB and to common allergens (pollens, molds, house dust mites) were evaluated by the skin‐prick test. The serum of subjects with a positive skin‐prick test to CGB or who had symptoms at work was tested for specific IgE (RAST) for GCB and CB. Lung function was evaluated by a Ponigraph spirometer. Results Sensitization to GCB was found in 25.8% of green coffee workers (31 cases), in 2.7% of roasted coffee workers (37 cases) and in 4.5% of the clerks (44 cases), p < 0.01. The evaluation of IgE specific for CB gave positive results only in 3 of 10 subjects sensitized to GCB. A total of 20% of GCB workers (6 cases) complained of work‐related respiratory symptoms (asthma and/or rhinitis) compared with only one subject in the roasted coffee group and one in the control group (p < 0.01). Asthma was reported by 2/31 of the green coffee workers and by 1/44 of roasted coffee workers. Conclusions There was a significant correlation between sensitization to GCB and work related symptoms (p < 0.01), common allergic symptoms (p < 0.05) and atopy by prick test (<0.01). These results point to the need to evaluate atopic status in workers and identify the most susceptible subjects, with the aim of informing them of their at‐risk status and monitoring their progress. This makes it possible to diagnose sooner those symptoms possibly indicative of a work‐related disease, because even in presence of good environmental conditions and even when symptoms are mild, it is almost always the atopic subjects who are affected. Am. J. Ind. Med. 34:623–627, 1998. © 1998 Wiley‐Liss, Inc.