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ALBERTO MODENESE

Professore Associato
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze Sede ex Sanità Pubblica

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Pubblicazioni

2024 - Protective role of SARS-CoV-2 anti-S IgG against breakthrough infections among European healthcare workers during pre and post-Omicron surge—ORCHESTRA project [Articolo su rivista]
Spiteri, Gianluca; D’Agostini, Marika; Abedini, Mahsa; Ditano, Giorgia; Collatuzzo, Giulia; Boffetta, Paolo; Vimercati, Luigi; Sansone, Emanuele; De Palma, Giuseppe; Modenese, Alberto; Gobba, Fabriziomaria; Liviero, Filippo; Moretto, Angelo; Dell’Omo, Marco; Fiordi, Tiziana; Larese Filon, Francesca; Mauro, Marcella; Violán, Concepción; Mates, Dana; Oravec Bérešová, Jana; Monaco, Maria Grazia Lourdes; Carta, Angela; Verlato, Giuseppe; Porru, Stefano
abstract

Purpose Anti SARS-CoV-2 vaccination initially showed high effectiveness in preventing COVID-19. However, after the surge of variants of concern, the effectiveness dropped. Several studies investigated if this was related to the decrease of the humoral response over time; however, this issue is still unclear. The aim of this study was to understand whether SARS-CoV-2 anti-S IgG levels can be used to predict breakthrough infection risk and define the timing for further booster doses administration. Method Within the framework of the ORCHESTRA Project, over 20,000 health workers from 11 European centers were enrolled since December 2020. We performed two Cox proportional hazards survival analyses regarding pre-Omicron (from January to July 2021) and Omicron (December 2021-May 2022) periods. The serological response was classified as high (above the 75th percentile), medium (25th-75th), or low (< 25th). Results Seventy-four (0.33%) and 2122 (20%) health workers were infected during the first and second periods, respectively. Both Cox analyses showed that having high anti-S titer was linked to a significantly lower risk of infection as compared to having medium serological response [HR of high vs medium anti-S titer = 0.27 (95% CI 0.11-0.66) during the first phase, HR = 0.76 (95% CI 0.62-0.93) during the second phase]. Conclusion Vaccine effectiveness wanes significantly after new variants surge, making anti-S titer unsuitable to predict optimal timing for further booster dose administration. Studies on other immunological indicators, such as cellular immunity, are therefore needed to better understand the mechanisms and duration of protection against breakthrough infection risk.

2023 - A Multi-Center Study Investigating Long COVID-19 in Healthcare Workers from North-Eastern Italy: Prevalence, Risk Factors and the Impact of Pre-Existing Humoral Immunity—ORCHESTRA Project [Articolo su rivista]
Cegolon, L.; Mauro, M.; Sansone, D.; Tassinari, A.; Gobba, F. M.; Modenese, A.; Casolari, L.; Liviero, F.; Pavanello, S.; Scapellato, M. L.; Taus, F.; Carta, A.; Spiteri, G.; Monaco, M. G. L.; Porru, S.; Larese Filon, F.
abstract

: Introduction: The impact of long-COVID-19 syndrome is rather variable, since it is influenced by several residual confounders. This study aimed to investigate the prevalence of long COVID-19 in healthcare workers (HCWs) from four university hospitals in north-eastern Italy: Trieste, Padua, Verona, and Modena-Reggio Emilia. Methods: During the period June 2022-August 2022, HCWs were surveyed for past COVID-19 infections, medical history, and any acute as well as post-COVID-19 symptoms. The prevalence of long COVID-19 was estimated at 30-60 days or 61+ days since first negative swab following first and second COVID-19 episode. Furthermore, the risk of long COVID-19 was investigated by multivariable logistic regression. Results were expressed as the adjusted odds ratio (aOR) with a 95% confidence interval (95%CI). Results: 5432 HCWs returned a usable questionnaire: 2401 were infected with SARS-CoV-2 at least once, 230 were infected at least twice, and 8 were infected three times. The prevalence of long COVID-19 after a primary COVID-19 infection was 24.0% at 30-60 days versus 16.3% at 61+ days, and 10.5% against 5.5% after the second SARS-CoV-2 event. The most frequent symptoms after a first COVID-19 event were asthenia (30.3%), followed by myalgia (13.7%), cough (12.4%), dyspnea (10.2%), concentration deficit (8.1%), headache (7.3%), and anosmia (6.5%), in decreasing order of prevalence. The risk of long COVID-19 at 30-60 days was significantly higher in HCWs hospitalized for COVID-19 (aOR = 3.34; 95%CI: 1.62; 6.89), those infected with SARS-CoV-2 during the early pandemic waves-namely the Wuhan (aOR = 2.16; 95%CI: 1.14; 4.09) or Alpha (aOR= 2.05; 95%CI: 1.25; 3.38) transmission periods-and progressively increasing with viral shedding time (VST), especially 15+ days (aOR = 3.20; 95%CI: 2.07; 4.94). Further determinants of long COVID-19 at 30-60 days since primary COVID-19 event were female sex (aOR = 1.91; 95%CI: 1.30; 2.80), age >40 years, abnormal BMI, or administrative services (reference category). In contrast, HCWs vaccinated with two doses before their primary infection (aOR = 0.57; 95%CI: 0.34; 0.94), undergraduate students, or postgraduate medical trainees were less likely to experience long COVID-19 at 30-60 days. Apart from pandemic waves, the main determinants of long COVID-19 at 30-60 days were confirmed at 61+ days. Conclusions: The risk of long COVID-19 following primary infection increased with the severity of acute disease and VST, especially during the initial pandemic waves, when more virulent viral strains were circulating, and susceptibility to SARS-CoV-2 was higher since most HCWs had not been infected yet, COVID-19 vaccines were still not available, and/or vaccination coverage was still building up. The risk of long COVID-19 therefore decreased inversely with humoral immunity at the individual level. Nevertheless, the prevalence of long COVID-19 was remarkably lower after SARS-CoV-2 reinfections regardless of vaccination status, suggesting that hybrid humoral immunity did not increase protection against the syndrome compared to immunity mounted by either natural infection or vaccination separately. Since the risk of long COVID-19 is currently low with Omicron and patients who developed the syndrome following SARS-CoV-2 infection in the early pandemic waves tend to return to a state of full health with time, a cost-effective approach to screen post-COVID-19 symptoms during the Omicron time could be restricted to vulnerable individuals developing severe disease and/or with prolonged VST.

2023 - A quantitative solar ultraviolet radiation job-exposure matrix for the general working population of Europe (UVR EuroJEM) [Abstract in Atti di Convegno]
Würtz, Else Toft; Pugdahl, Kirsten; Berglind, Ina A; Cherrie, Mark PC; Dahlman-Höglund, Anna; Grandahl, Kasper; Macan, Jelena; Modenese, Alberto; Notø, Hilde; Solovieva, Svetlana; Straif, Kurt; Wittlich, Marc; Connemann, Sven; Heepenstrick, Timo; Philipsen, Peter A; Westerhausen, Stephan; Ge, Calvin B; Hansen, Johnni; Peters, Cheryl; Selander, Jenny; Mehlum, Ingrid Sivesind; Schlünssen, Vivi; Kolstad, Henrik A
abstract

2023 - Correlations between SARS-CoV-2 Infections and the Number of COVID-19 Vaccine Doses Administered in Three Italian Provinces [Articolo su rivista]
Modenese, A.
abstract

The aim of this ecological study is to evaluate correlations between the number of COVID-19 vaccine doses administered in three Italian provinces—one in the south, one in the center and one in the north of the country—and the registered numbers of COVID-19 cases in the same areas. The period of January 2021–September 2022 was considered, with specific analysis for fractions of times corresponding to the spread in Italy of the different SARS-CoV-2 variants. The results confirm the reduction of the effectiveness of the vaccines in preventing new COVID-19 cases in Italy, regardless of latitude, after the appearance of the first omicron variants. The new variants omicron 4 and 5 showed an extremely high spread during the Italian summer months; fortunately, the effects of the vaccinations in preventing new cases was improved compared to the previous omicron variants, showing a negative correlation between the new COVID-19 cases and the number of vaccine doses administered.

2023 - COVID-19, long-COVID and return-to-work a questionnaire to investigate the experience of the occupational physicians from an Italian region [Abstract in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

2023 - COVID-19, long-COVID and return-to-work: the experience of Italian occupational physicians on musculoskeletal symptoms and occupational ergonomic risks [Abstract in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

2023 - COVID-19, LONG-COVID E REINSERIMENTO LAVORATIVO: PRIMI RISULTATI DI UNA SURVEY PER MEDICI COMPETENTI DELL’EMILIA-ROMAGNA [Abstract in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

2023 - Digitally measuring solar ultraviolet radiation in outdoor workers: A study protocol for establishing the use of electronic personal dosimeters in Portugal [Articolo su rivista]
Paulo, Ms; Symanzik, C; Maia, Mr; Lapao, Lv; Carvalho, F; Conneman, S; Dias, Jb; Gobba, F; John, Sm; Loney, T; Pinho, C; Rodrigues, A; Strehl, C; Tenkate, T; Wittlich, M; Modenese, A
abstract

IntroductionThe rising incidence of skin cancer over the years has made it a significant public and occupational health issue. However, skin cancer is highly preventable, mainly through reduced exposure to solar ultraviolet radiation (UVR), which can be achieved by a variety of individual and collective protective measures and interventions. The relative risk associated with different patterns of exposure to solar UVR differs for the subtypes of keratinocyte cancers (KC). Specifically, whether the exposure is intermittent or continuous, and occurs in an occupational or leisure/recreational setting. The main aim of the study using this protocol is to contribute to raising public and policy awareness on solar UVR-inflicted occupational skin cancers in Lisbon. This will be achieved by performing direct measurements of the solar UVR dose received by outdoor workers using a digital platform. Results will likely contribute to further understanding the risk estimates for keratinocyte cancer estimations in this population. MethodsA prospective observational study will be conducted in Lisbon, Portugal. Personal electronic dosimeters (GENESIS-UV system) integrated with a digital platform will be used to assess occupational solar UVR doses of gardeners, masons, and gravediggers of the municipality of Lisbon. Two hundred and ten outdoor workers will be selected to wear the dosimeter for 1 month each, between April and October during their daily working hours. A digital web-based platform that offers private access to information through dashboard visualization will provide information for the outdoor workers and facilitate communication with the participants. DiscussionThe expected results of the overall proposal comprise the occupational solar UVR doses, expressed in standard erythemal dose (SEDs) per day of outdoor work for 7 months. Study data will provide outdoor workers with information on their personal solar UVR exposure during their working hours and an estimate of their risk of developing skin cancer. It is expected that the occupational solar UVR doses of the outdoor workers in Portugal will be above the threshold of 1 to 1.33 SED/day, due to the latitude of Lisbon and the nature of the occupations. The results prospectively should flow into the design of adequate prevention campaigns for skin cancer in outdoor workers.

2023 - Editorial: Occupation and cancer: new insights into burden, risk factors, and prevention [Articolo su rivista]
Ádám, Balázs; Modenese, Alberto; Loney, Tom
abstract

2023 - ESPOSIZIONE OCCUPAZIONALE A RADIOFREQUENZE E POSSIBILI RISCHI CANCEROGENI: UNA REVISIONE SISTEMATICA [Abstract in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

2023 - Factors Associated with SARS-CoV-2 Infection Evaluated by Antibody Response in a Sample of Workers from the Emilia-Romagna Region, Northern Italy [Articolo su rivista]
Paduano, Stefania; Granata, Michele; Turchi, Sara; Modenese, Alberto; Galante, Pasquale; Poggi, Alessandro; Marchesi, Isabella; Frezza, Giuseppina; Dervishaj, Giulia; Vivoli, Roberto; Verri, Sara; Marchetti, Simona; Gobba, Fabriziomaria; Bargellini, Annalisa
abstract

Factors associated with SARS-CoV-2 infection risk are still debated. This case-control study aims to investigate the possible relationship between SARS-CoV-2 infection, evaluated through antibody response, and the main sociodemographic, occupational, clinical-anamnestic, and biochemical factors in a population of Modena province (Northern Italy), mainly workers. Both workers who voluntarily joined the screening campaign proposed by companies and self-referred individuals who underwent serological testing were enrolled. Subjects with antibody positivity were recruited as cases (n = 166) and subjects tested negative (n = 239) as controls. A questionnaire on sociodemographic, occupational, and clinical data was administered through telephone interviews. Serum zinc/iron/copper/chromium/nickel, vitamins D/B12, folates, triglycerides, and LDL/HDL/total cholesterol were measured. Cases lived more often in urban areas (61.8% vs. 57%). Cases and controls did not differ significantly by working macrocategories, but the percentage of workers in the ceramic sector was higher among cases. Low adherence to preventive measures in the workplace was more frequent among seropositives. Folate concentration was significantly lower among cases. Therefore, adequate folate levels, living in rural areas, and good adherence to preventive strategies seem protective against infection. Workers in the ceramic sector seem to be at greater risk; specific factors involved are not defined, but preventive interventions are needed.

2023 - Factors Associated with SARS-CoV-2 Infection Evaluated by Antibody Response in a Sample of Workers from the Emilia-Romagna Region, Northern Italy [Articolo su rivista]
Paduano, S; Granata, M; Turchi, S; Modenese, A; Galante, P; Poggi, A; Marchesi, I; Frezza, G; Dervishaj, G; Vivoli, R; Verri, S; Marchetti, S; Gobba, F; Bargellini, A.
abstract

Factors associated with SARS-CoV-2 infection risk are still debated. This case–control study aims to investigate the possible relationship between SARS-CoV-2 infection, evaluated through antibody response, and the main sociodemographic, occupational, clinical-anamnestic, and biochemical factors in a population of Modena province (Northern Italy), mainly workers. Both workers who voluntarily joined the screening campaign proposed by companies and self-referred individuals who underwent serological testing were enrolled. Subjects with antibody positivity were recruited as cases (n = 166) and subjects tested negative (n = 239) as controls. A questionnaire on sociodemographic, occupational, and clinical data was administered through telephone interviews. Serum zinc/iron/copper/chromium/nickel, vitamins D/B12, folates, triglycerides, and LDL/HDL/total cholesterol were measured. Cases lived more often in urban areas (61.8% vs. 57%). Cases and controls did not differ significantly by working macrocategories, but the percentage of workers in the ceramic sector was higher among cases. Low adherence to preventive measures in the workplace was more frequent among seropositives. Folate concentration was significantly lower among cases. Therefore, adequate folate levels, living in rural areas, and good adherence to preventive strategies seem protective against infection. Workers in the ceramic sector seem to be at greater risk; specific factors involved are not defined, but preventive interventions are needed.

2023 - ICOH Scientific Committees “Occupational and Environmental Dermatoses” and “Radiation and Work” collaborate in a national project in Portugal for the prevention of the solar radiation risk and UV-inflicted skin cancers in outdoor workers [Altro]
Hernan ALFONSO, José; Malte JOHN, Swen; Wittlich, Marc; Modenese, Alberto
abstract

2023 - Il progetto BRiC INAIL “Sviluppo di dispositivo multisensore smart dotato di software di funzionamento per il monitoraggio dell’esposizione personale di lavoratori outdoor alla radiazione ultravioletta (UV) solare": risultati preliminari [Articolo su rivista]
Burattini, C.; Modenese, A.; Gobba, F.; Borra, M.; Leccese, F.; Militello, A.; Salvadori, G.; Rocca, M.; Bisegna, F.
abstract

2023 - Il rischio da ROA nell’impiego dei LASER - Problematiche radioprotezionistiche e mediche nell’impiego dei LASER in ospedale [Relazione in Atti di Convegno]
Di Liberto, Riccardo; Modenese, Alberto
abstract

2023 - Neutralizing anti-sars-cov-2 antibody titer after three doses of mrna vaccine in a sample of italian nursing home personnel [Abstract in Rivista]
Bargellini, Annalisa; Modenese, Alberto; Paduano, Stefania; Turchi, Sara; Marchesi, Isabella; Bellucci, Rossana; Marchetti, Simona; Vivoli, Roberto; Bruno, Fulvio; Grazioli, Pietro; Gobba, Fabriziomaria
abstract

2023 - Occupational Exposure to Solar Radiation and the Eye: A Call to Implement Health Surveillance of Outdoor Workers [Articolo su rivista]
Modenese, Alberto; Chou, B Ralph; Ádám, Balázs; Loney, Tom; Silva Paulo, Marilia; Tenkate, Thomas; Gobba, Fabriziomaria
abstract

Globally, hundreds of millions of outdoor workers are exposed to solar radiation (SR) for most of their work. Such occupational exposure is known to induce various adverse health effects on the eyes, mainly related to its ultraviolet (UV) component. The present work is a call to action to raise awareness of the need for health surveillance to prevent chronic ocular diseases in outdoor workers. Photo-chemical chronic damage can induce pterygium at the eye's outer layer and cataracts in the lens. Considering carcinogenic effects, rare squamous-cell tumors of the cornea and/or the conjunctiva and ocular melanomas are associated with UV radiation exposure. Solar UV-related eye diseases should be considered "occupational diseases" when workers have sufficient exposure. Still, they are often not recognized and/ or frequently not reported to the national compensation authorities. Therefore, to prevent the burden of these work -related eye pathologies, an adequate risk assessment with identification of appropriate preventive measures and a provision of periodic health surveillance to the exposed workers, particularly those at higher risk of exposure or with individual susceptibility, should be urgently implemented.

2023 - PREVENTION OF THE OCCUPATIONAL RISK RELATED TO SOLAR UV EXPOSURE OF OUTDOOR WORKERS: THE INTERNATIONAL PROJECT MEAOW@SOLARUV [Relazione in Atti di Convegno]
Silva Paulo, Marília; Modenese, Alberto; Maia, Mélanie R.; Velez Lapão, Luís; Gobba, Fabriziomaria
abstract

2023 - PROGETTARE INTERVENTI DI TOTAL WORKER HEALTH®: LA MISURAZIONE DELLA CAPACITÀ LAVORATIVA DEGLI OPERATORI DELL’AOU DI MODENA [Relazione in Atti di Convegno]
Casolari, Loretta; Rossi, Giorgia; D’Elia, Cristiana; Garavini, Denise; Glieca, Francesca; Mariani, Stefania; Venturelli, Luca; Vivoli, Daniela; Mastroberardino, Michele; Broccoli, Lorenzo; Nicastro, Ottavio; Pistoresi, Barbara; Poma, Erica; Curzi, Ylenia; Fabbri, Tommaso; Modenese, Alberto; Gobba, Fabriziomaria
abstract

2023 - Risk of cutaneous squamous cell carcinoma due to occupational exposure to solar ultraviolet radiation: Protocol for a systematic review and meta-analysis [Articolo su rivista]
Paulo, Marília Silva; Symanzik, Cara; Ádam, Balázs; Gobba, Fabriziomaria; Kezic, Sanja; van der Molen, Henk F; Peters, Cheryl E; Rocholl, Marc; Tenkate, Thomas; John, Swen Malte; Loney, Tom; Modenese, Alberto; Wittlich, Marc
abstract

: Solar ultraviolet radiation (UVR) is the most significant occupational carcinogenic exposure in terms of the number of workers exposed (i.e., outdoor workers). Consequently, solar UVR-induced skin cancers are among the most common forms of occupational malignancies that are potentially expected globally. This systematic review is registered in PROSPERO (CRD42021295221) and aims to assess the risk of cutaneous squamous cell carcinoma (cSCC) associated to occupational solar UVR exposure. Systematic searches will be performed in three electronic literature databases (PubMed/Medline, EMBASE, and Scopus). Further references will be retrieved by a manual search (e.g., in grey literature databases, internet search engines, and organizational websites). We will include cohort studies and case-control studies. Risk of Bias assessment will be conducted separately for case-control and cohort studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) will be used for the certainty of assessment. In case quantitative pooling is not feasible, a narrative synthesis of results will be performed.

2023 - Risk/protective factors associated with anti-SARS-CoV-2 antibody response in a sample of workers from the emilia romagna region, Italy [Abstract in Rivista]
Granata, Michele; Galante, Pasquale; Paduano, Stefania; Modenese, Alberto; Poggi, Alessandro; Marchesi, Isabella; Vivoli, Roberto; Bellucci, Rossana; Verri, Sara; Marchetti, Simona; Gobba, Fabriziomaria; Bargellini, Annalisa; Turchi, Sara
abstract

2023 - The Occupational Health Surveillance of Workers Exposed to Electromagnetic Fields and the Problem of ‘Workers at Particular Risk’ [Capitolo/Saggio]
Modenese, A.; Gobba, F.
abstract

Electromagnetic fields (EMF) represent a recognised occupational risk factor, and the number of potentially exposed workers is huge; but, to date, the problem of an adequate occupational health surveillance (OHS) programme for the protection of EMF-exposed workers is still open. So far, scant agreement is available, especially on the OHS-specific contents to adequately ensure an effective prevention and early detection of adverse effects such as the stimulation of muscles, nerves or sensory organs, and limb currents or thermal effects, generally not expected in the usual working situations, commonly not exceeding exposure limits; but that can appear especially in the case of overexposures. A further problematic aspect of OHS programme is the protection of workers with conditions inducing their higher susceptibility (‘workers at particular risk’) as are, in the case of EMF exposure, for example, subjects with implanted medical devices and pregnant workers. It should be considered that the adverse effects are usually prevented in the case of strict compliance with occupational exposure limit values, but an exceeding of the limits is possible, at least during certain working activities. Furthermore, the current occupational limits may not provide an adequate protection for workers at particular risk. For this reason, an adequate information of the workers on the risk, on exposure levels and on conditions possibly inducing a particular susceptibility to EMF, as well as an early identification and a medical periodical examination of these workers, should be an essential component of any appropriate OHS programme. A last point to be raised here is the fact that the overall results of the OHS should be adequately collected and preserved in a suitable form in order to be consulted at a later date, as required by the European legislation, offering a potential important source of evidence on the possible EMF-related effects; but the unavailability of shared OHS programmes makes it almost impossible. Unfortunately, at our knowledge to date no international effort is ongoing, and apparently none is planned to overcome these challenges.

2022 - A systematic review on occupational exposure to radiofrequency electromagnetic fields and risk of cancer: preliminary results from an Italian research project [Relazione in Atti di Convegno]
Modenese, Alberto; Bravo, Giulia; Grandi, Carlo; Biffoni, Mauro; Gobba, Fabriziomaria
abstract

2022 - Adesione ed esitazione vaccinale in una coorte di operatori di un’Azienda Ospedaliero-Universitaria [Abstract in Atti di Convegno]
Glieca, Francesca; Bertoldi, Chiara; Rossi, Giorgia; Della Vecchia, Elena; D’Elia, Cristiana; Garavini, Denise; Mariani, Stefania; Venturelli, Luca; Vivoli, Daniela; Modenese, Alberto; Gobba, Fabriziomaria; Casolari, Loretta
abstract

2022 - Aggiornamento in tema di sintomatologia soggettiva riferita da operatori di Risonanza Magnetica: principali risultati di un recente studio italiano [Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

2022 - Analisi degli eventi di violenza nei confronti degli operatori sanitari dell’Azienda Ospedaliero-Universitaria di Modena [Abstract in Atti di Convegno]
Bertoldi, Chiara; Glieca, Francesca; Casolari, Loretta; D’Elia, Cristiana; Garavini, Denise; Mariani, Stefania; Rossi, Giorgia; Venturelli, Luca; Vivoli, Daniela; Marchegiano, Patrizia; Mastroberardino, Michele; Modenese, Alberto; Gobba, Fabriziomaria
abstract

2022 - Andamento del titolo anticorpale ad 1 e 3 mesi dal completamento del ciclo vaccinale primario anti-Covid-19 nei lavoratori dell’Azienda USL di Modena [Abstract in Atti di Convegno]
Pedretti, Simona; Gualtieri, Giulia; Rita Tarantini, Anna; Lacirignola, Michele; Abenante, Maria; Modenese, Alberto; Gobba, Fabriziomaria
abstract

2022 - Assessing the quality of evidence in studies estimating prevalence of exposure to occupational risk factors: The QoE-SPEO approach applied in the systematic reviews from the WHO/ILO Joint Estimates of the Work-related burden of disease and Injury [Articolo su rivista]
Pega, Frank; Momen, Natalie C.; Gagliardi, Diana; Bero, Lisa A.; Boccuni, Fabio; Chartres, Nicholas; Descatha, Alexis; Dzhambov, Angel M.; Godderis, Lode; Loney, Tom; Mandrioli, Daniele; Modenese, Alberto; van der Molen, Henk F.; Morgan, Rebecca L.; Neupane, Subas; Pachito, Daniela; Paulo, Marilia S.; Prakash, K. C.; Scheepers, Paul T. J.; Teixeira, Liliane; Tenkate, Thomas; Woodruff, Tracey J.; Norris, Susan L.
abstract

Background: The World Health Organization (WHO) and the International Labour Organization (ILO) have produced the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates). For these, systematic reviews of studies estimating the prevalence of exposure to selected occupational risk factors have been conducted to provide input data for estimations of the number of exposed workers. Acritical part of systematic review methodology is to assess the quality of evidence across studies. In this article, we present the approach applied in these WHO/ILO systematic reviews for performing such assessments on studies of prevalence of exposure. It is called the Quality of Evidence in Studies estimating Prevalence of Exposure to Occupational risk factors (QoE-SPEO) approach. We describe QoE-SPEO’s development to date, demonstrate its feasibility reporting results from pilot testing and case studies, note its strengths and limitations, and suggest how QoE-SPEO should be tested and developed further. Methods: Following a comprehensive literature review, and using expert opinion, selected existing quality of evidence assessment approaches used in environmental and occupational health were reviewed and analysed for their relevance to prevalence studies. Relevant steps and components from the existing approaches were adopted or adapted for QoE-SPEO. New steps and components were developed. We elicited feedback from other systematic review methodologists and exposure scientists and reached consensus on the QoE-SPEO approach. Ten individual experts pilot-tested QoE-SPEO. To assess inter-rater agreement, we counted ratings of expected (actual and non-spurious) heterogeneity and quality of evidence and calculated a raw measure of agreement (Pi) between individual raters and rater teams for the downgrade domains. Pi ranged between 0.00 (no two pilot testers selected the same rating) and 1.00 (all pilot testers selected the same rating). Case studies were conducted of experiences of QoE-SPEO’s use in two WHO/ILO systematic reviews. Results: We found no existing quality of evidence assessment approach for occupational exposure prevalence studies. We identified three relevant, existing approaches for environmental and occupational health studies of the effect of exposures. Assessments using QoE-SPEO comprise three steps: (1) judge the level of expected heterogeneity (defined as non-spurious variability that can be expected in exposure prevalence, within or between individual persons, because exposure may change over space and/or time), (2) assess downgrade domains, and (3) reach a final rating on the quality of evidence. Assessments are conducted using the same five downgrade domains as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach: (a) risk of bias, (b) indirectness, (c) inconsistency, (d) imprecision, and (e) publication bias. For downgrade domains (c) and (d), the assessment varies depending on the level of expected heterogeneity. There are no upgrade domains. The QoE-SPEO’s ratings are “very low”, “low”, “moderate”, and “high”. To arrive at a final decision on the overall quality of evidence, the assessor starts at “high” quality of evidence and for each domain downgrades by one or two levels for serious concerns or very serious concerns, respectively. In pilot tests, there was reasonable agreement in ratings for expected heterogeneity; 70% of raters selected the same rating. Inter-rater agreement ranged considerably between downgrade domains, both for individual rater pairs (range Pi: 0.36–1.00) and rater teams (0.20–1.00). Sparse data prevented rigorous assessment of inter-rater agreement in quality of evidence ratings. Conclusions: We present QoE-SPEO as an approach for assessing quality of evidence in prevalence studies of exposure to occupational risk factors. It has been developed to its current version (as presente

2022 - Assessor burden, inter-rater agreement and user experience of the RoB-SPEO tool for assessing risk of bias in studies estimating prevalence of exposure to occupational risk factors: An analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury [Articolo su rivista]
Momen, N. C.; Streicher, K. N.; da Silva, D. T. C.; Descatha, A.; Frings-Dresen, M. H. W.; Gagliardi, D.; Godderis, L.; Loney, T.; Mandrioli, D.; Modenese, A.; Morgan, R. L.; Pachito, D.; Scheepers, P. T. J.; Sgargi, D.; Paulo, M. S.; Schlunssen, V.; Sembajwe, G.; Sorensen, K.; Teixeira, L. R.; Tenkate, T.; Pega, F.
abstract

Background: As part of the development of the World Health Organization (WHO)/International Labour Organization (ILO) Joint Estimates of the Work-related Burden of Disease and Injury, WHO and ILO carried out several systematic reviews to determine the prevalence of exposure to selected occupational risk factors. Risk of bias assessment for individual studies is a critical step of a systematic review. No tool existed for assessing the risk of bias in prevalence studies of exposure to occupational risk factors, so WHO and ILO developed and pilot tested the RoB-SPEO tool for this purpose. Here, we investigate the assessor burden, inter-rater agreement, and user experience of this new instrument, based on the abovementioned WHO/ILO systematic reviews. Methods: Twenty-seven individual experts applied RoB-SPEO to assess risk of bias. Four systematic reviews provided a total of 283 individual assessments, carried out for 137 studies. For each study, two or more assessors independently assessed risk of bias across the eight RoB-SPEO domains selecting one of RoB-SPEO's six ratings (i.e., “low”, “probably low”, “probably high”, “high”, “unclear” or “cannot be determined”). Assessors were asked to report time taken (i.e. indicator of assessor burden) to complete each assessment and describe their user experience. To gauge assessor burden, we calculated the median and inter-quartile range of times taken per individual risk of bias assessment. To assess inter-rater reliability, we calculated a raw measure of inter-rater agreement (Pi) for each RoB-SPEO domain, between Pi = 0.00, indicating no agreement and Pi = 1.00, indicating perfect agreement. As subgroup analyses, Pi was also disaggregated by systematic review, assessor experience with RoB-SPEO (≤10 assessments versus > 10 assessments), and assessment time (tertiles: ≤25 min versus 26–66 min versus ≥ 67 min). To describe user experience, we synthesised the assessors’ comments and recommendations. Results: Assessors reported a median of 40 min to complete one assessment (interquartile range 21–120 min). For all domains, raw inter-rater agreement ranged from 0.54 to 0.82. Agreement varied by systematic review and assessor experience with RoB-SPEO between domains, and increased with increasing assessment time. A small number of users recommended further development of instructions for selected RoB-SPEO domains, especially bias in selection of participants into the study (domain 1) and bias due to differences in numerator and denominator (domain 7). Discussion: Overall, our results indicated good agreement across the eight domains of the RoB-SPEO tool. The median assessment time was comparable to that of other risk of bias tools, indicating comparable assessor burden. However, there was considerable variation in time taken to complete assessments. Additional time spent on assessments may improve inter-rater agreement. Further development of the RoB-SPEO tool could focus on refining instructions for selected RoB-SPEO domains and additional testing to assess agreement for different topic areas and with a wider range of assessors from different research backgrounds.

2022 - Biological effects induced by EMF exposure and conditions determining a particular risk for the exposed workers [Relazione in Atti di Convegno]
Modenese, Alberto; Wittlich, Marc; Gobba, Fabriziomaria
abstract

2022 - Correction to: Occupational exposure to electromagnetic fields in magnetic resonance environment: an update on regulation, exposure assessment techniques, health risk evaluation, and surveillance (Medical & Biological Engineering & Computing, (2022), 60, 2, (297-320), 10.1007/s11517-021-02435-6) [Articolo su rivista]
Hartwig, V.; Virgili, G.; Mattei, F.; Biagini, C.; Romeo, S.; Zeni, O.; Scarfi, M. R.; Massa, R.; Campanella, F.; Landini, L.; Gobba, F.; Modenese, A.; Giovannetti, G.
abstract

The original article contained a mistake. The original article reports wrong affiliations. The final affiliations have reported below.

2022 - COVID-19-Related Mortality amongst Physicians in Italy: Trend Pre- and Post-SARS-CoV-2 Vaccination Campaign [Articolo su rivista]
Modenese, Alberto; Loney, Tom; Gobba, Fabriziomaria
abstract

2022 - Editorial: Environmental or occupational exposure to optical radiation: Risk evaluation, health effects and prevention - tangible innovation for public and occupational health? [Articolo su rivista]
Modenese, Alberto
abstract

2022 - Esposizione alla radiazione ultravioletta solare e rischio occupazionale nei lavoratori outdoor: risultati preliminari di un progetto BRiC INAIL [Abstract in Atti di Convegno]
Modenese, Alberto; Burattini, Chiara; Bisegna, Fabio; Borra, Massimo; Leccese, Francesco; Militello, Andrea; Salvadori, Giacomo; Gobba, Fabriziomaria
abstract

2022 - Evaluation of an Online Course Promoting Health and Wellbeing for University Students and Employees. [Articolo su rivista]
Ricci, F.; Modenese, A.; Gobba, F.; Morlini, I.
abstract

Published studies dealing with health promotion activities, such as the improvement of physical activity and healthy eating, for workers and students prove the effectiveness of these preventive interventions. The consequent benefits include better prevention of cardiovascular risk and an improvement in quality of life. Considering this, an intervention aimed at promoting healthy eating and non-sedentary lifestyles has been implemented within an Italian university: the aim of the present research is to evaluate its effectiveness. The intervention consisted of a targeted asynchronous e-learning two-hour course on healthy eating and non-sedentary lifestyles. The attendants were 2004 university students and employees. We conducted two surveys before and after the training intervention, and, through the responses obtained, we evaluated the effectiveness of the intervention. We applied different statistical methods, including unpaired t-tests and nonparametric tests, principal components and cluster analysis. Our results indicate that the post-training knowledge has been significantly improved, compared to that pre-training (7.3 vs. 8.7, p < 0.001). Moreover, the whole sample showed an improved awareness of the importance of healthy behaviors, and perception of the University as an institution promoting a healthy lifestyle. Through the principal components analysis, we identified a unidimensional latent factor named “health and behaviors”. The cluster analysis highlighted that the sub-group reporting the lowest scores at the survey before the training was the one with the highest improvement after the intervention. To the best of our knowledge, this is the first Italian study testing, before and after a health promotion intervention, the knowledge and the attitudes and behaviors towards healthy lifestyles of a group of students and workers. Moreover, we also evaluated the pre- and post-intervention perceived health status, as well as the level of engagement of the attendants, with respect to their colleagues and management in an educational institution promoting wellbeing. The conclusions of our study support the need for further adoption of health promotion training interventions, similar to the one we performed, in order to improve healthy eating and non-sedentary behaviors among workers and students.

2022 - Exposición laboral a radiación solar: ¿un riesgo tan evidente como desestimado? [Occupational exposure to solar radiation: an obvious but undervalued risk?] [Relazione in Atti di Convegno]
Modenese, Alberto
abstract

2022 - Il percorso per la stesura delle Linee Guida [Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

2022 - Investigation of Possible Factors Influencing the Neutralizing Anti-SARS-CoV-2 Antibody Titer after Six Months from the Second Vaccination Dose in a Sample of Italian Nursing Home Personnel [Articolo su rivista]
Modenese, Alberto; Paduano, Stefania; Bellucci, Rossana; Marchetti, Simona; Bruno, Fulvio; Grazioli, Pietro; Vivoli, Roberto; Gobba, Fabriziomaria; Bargellini, Annalisa
abstract

2022 - OCCUPATIONAL EXPOSURE TO ELECTROMAGNETIC FIELDS AND HEALTH SURVEILLANCE OF WORKERS [Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

2022 - Occupational exposure to electromagnetic fields in magnetic resonance environment: an update on regulation, exposure assessment techniques, health risk evaluation, and surveillance [Articolo su rivista]
Hartwig, V.; Virgili, G.; Mattei, F.; Biagini, C.; Romeo, S.; Zeni, O.; Scarfi, M. R.; Massa, R.; Campanella, F.; Landini, L.; Gobba, F.; Modenese, A.; Giovannetti, G.
abstract

Magnetic resonance imaging (MRI) is one of the most-used diagnostic imaging methods worldwide. There are ∼50,000 MRI scanners worldwide each of which involves a minimum of five workers from different disciplines who spend their working days around MRI scanners. This review analyzes the state of the art of literature about the several aspects of the occupational exposure to electromagnetic fields (EMF) in MRI: regulations, literature studies on biological effects, and health surveillance are addressed here in detail, along with a summary of the main approaches for exposure assessment. The original research papers published from 2013 to 2021 in international peer-reviewed journals, in the English language, are analyzed, together with documents published by legislative bodies. The key points for each topic are identified and described together with useful tips for precise safeguarding of MRI operators, in terms of exposure assessment, studies on biological effects, and health surveillance. Graphical abstract: [Figure not available: see fulltext.]

2022 - Occupational exposure to solar UV radiation: methods and first results of a multi-disciplinary expert assessment within the EPHOR project [Relazione in Atti di Convegno]
Würtz, Else Toft; Modenese, Alberto; Cherrie, Mark; Grandahl, Kasper; Dahlman-Höglund, Anna; Macan, Jelena; Notö, Hilde; Selander, Jenny; Berglind, Ina Anveden; Solvieva, Svetlana; Straif, Kurt; Wittlich, Marc; Kolstad, Henrik
abstract

2022 - Occupational Health and Safety in the Healthcare Sector [Curatela]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

Healthcare workers are exposed to several different occupational risk factors, and they pay an important tribute in terms of occupational diseases and work-related injuries. Currently, the COVID-19 pandemic has focused the attention on the problem of the infectious risk, which is certainly among the risks typically expected and specifically recognized for the health personnel, but also other occupational risks should not be overlooked, as, e.g., the risks associated with work-organization factors and with the exposure to chemical and physical agents. The health consequences associated with the exposure to all these factors have relevant impacts in terms of induced diseases, DALYs, sickness absence from work and costs for the health systems. According to these premises, this reprint has collected manuscripts addressing topics related to the prevention of the occupational risks in the healthcare sector, including original articles and reviews on the prevention of work-related illnesses and injuries of the health personnel, as well as on the evaluation of the risks in the healthcare workplaces, and on the topics of risk perception and of the knowledge and attitudes of the workers towards the preventive procedures and the use of protections. The themes of the prevention of occupational infectious risk, biomechanical overload of the musculoskeletal system and work-related psychosocial factors are specifically discussed in the papers collected.

2022 - Occupational health surveillance of workers exposed to electromagnetic fields according to the current Italian legislation [Relazione in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

Summary—The health surveillance (HS) of workers exposed to electromagnetic fields (EMF) aims at the prevention of known EMF adverse effects. No specific lab tests or medical investigations are useful for routine monitoring of exposure and/or in the prevention of adverse effects occurrence. The main HS scopes are the recognition of workers at particular risk and/or of the occurrence of unexpected symptoms.

2022 - Prevention of Health Risks Related to Occupational Solar Ultraviolet Radiation Exposure in Times of Climate Change and COVID-19 Pandemic [Articolo su rivista]
Modenese, Alberto
abstract

2022 - Risposta anticorpale neutralizzante anti-SARS-CoV-2 in operatori di una RSA del nord-Italia a 1 mese dalla vaccinazione e suo andamento a 6 mesi, e possibili fattori associati [Abstract in Atti di Convegno]
Modenese, Alberto; Paduano, Stefania; Bargellini, Annalisa; Bellucci, Rossana; Marchetti, Simona; Bruno, Fulvio; Grazioli, Pietro; Vivoli, Roberto; Gobba, Fabriziomaria
abstract

2022 - SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers [Articolo su rivista]
Porru, Stefano; Monaco, Maria Grazia Lourdes; Spiteri, Gianluca; Carta, Angela; Pezzani, Maria Diletta; Lippi, Giuseppe; Gibellini, Davide; Tacconelli, Evelina; Dalla Vecchia, Ilaria; Sala, Emma; Sansone, Emanuele; De Palma, Giuseppe; Bonfanti, Carlo; Lombardo, Massimo; Terlenghi, Luigina; Pira, Enrico; Mansour, Ihab; Coggiola, Maurizio; Ciocan, Catalina; Godono, Alessandro; Tardon, Adonina; Rodriguez-Suarez, Marta-Maria; Fernandez-Tardon, Guillermo; Jimeno-Demuth, Francisco-Jose; Castro-Delgado, Rafael-Vicente; Iglesias Cabo, Tania; Scapellato, Maria Luisa; Liviero, Filippo; Moretto, Angelo; Mason, Paola; Pavanello, Sofia; Volpin, Anna; Vimercati, Luigi; Tafuri, Silvio; De Maria, Luigi; Sponselli, Stefania; Stefanizzi, Pasquale; Caputi, Antonio; Gobba, Fabriziomaria; Modenese, Alberto; Casolari, Loretta; Garavini, Denise; D’Elia, Cristiana; Mariani, Stefania; Filon, Francesca Larese; Cegolon, Luca; Negro, Corrado; Ronchese, Federico; Rui, Francesca; De Michieli, Paola; Murgia, Nicola; Dell’Omo, Marco; Muzi, Giacomo; Fiordi, Tiziana; Gambelunghe, Angela; Folletti, Ilenia; Mates, Dana; Calota, Violeta Claudia; Neamtu, Andra; Perseca, Ovidiu; Staicu, Catalin Alexandru; Voinoiu, Angelica; Fabiánová, Eleonóra; Bérešová, Jana; Adamčáková, Zora Kľocová; Nedela, Roman; Lesňáková, Anna; Holčíková, Jana; Boffetta, Paolo; Abedini, Mahsa; Ditano, Giorgia; Asafo, Shuffield Seyram; Visci, Giovanni; Violante, Francesco Saverio; Zunarelli, Carlotta; Verlato, Giuseppe
abstract

2022 - Seroprevalence Survey of Anti-SARS-CoV-2 Antibodies in a Population of Emilia-Romagna Region, Northern Italy [Articolo su rivista]
Paduano, Stefania; Galante, Pasquale; Berselli, Nausicaa; Ugolotti, Luca; Modenese, Alberto; Poggi, Alessandro; Malavolti, Marcella; Turchi, Sara; Marchesi, Isabella; Vivoli, Roberto; Perlini, Paola; Bellucci, Rossana; Gobba, Fabriziomaria; Vinceti, Marco; Filippini, Tommaso; Bargellini, Annalisa
abstract

taly was the first Western European country to be severely hit by the COVID-19 pandemic. Variations in seroprevalence rates were reported according to geographical and temporal differences of previous surveys, as well as depending on demographic and occupational factors. In this cross-sectional study, we evaluated the prevalence of anti-SARS-CoV-2 antibodies in a population of the Emilia-Romagna region in Northern Italy after the first wave in the period from 26 September 2020–26 March 2021. We included 5128 subjects who voluntarily underwent serological tests to determine anti-SARS-CoV-2 antibody positivity, including both self-referred individuals (24.2%) and workers adhering to company screening programs (76.8%). Overall, seroprevalence was 11.3%, higher in self-referred (13.8%) than employed-referred (10.5%) individuals. A slightly higher seroprevalence emerged in women compared to men (12.3% and 10.7%), as well as in the extreme age categories (18.6% for 60–69 years, 18.0% for ≥70 years, and 17.1% for <20 years compared to 7.6% for 20–39 years). Healthcare professionals showed the highest prevalence of seropositivity (22.9%), followed by workers in direct contact with customers, such as the communication, finance, and tourism sectors (15.7%). Overall subgroups seroprevalence increased compared to the first wave data but the trends agreed between the first and subsequent waves, except for an increase in the younger age group and in the sector in direct contact with customers. Among the occupational categories, our study confirms that healthcare workers and workers in the sports sector were at high risk of exposure to SARS-CoV-2.

2022 - Telefoni cellulari e tumori: quali evidenze? [Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

2022 - The effect of occupational exposure to welding fumes on trachea, bronchus and lung cancer: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury [Articolo su rivista]
Loomis, Dana; Dzhambov, Angel M.; Momen, Natalie C.; Chartres, Nicholas; Descatha, Alexis; Guha, Neela; Kang, Seong-Kyu; Modenese, Alberto; Morgan, Rebecca L.; Ahn, Seoyeon; Martínez-Silveira, Martha S.; Zhang, Siyu; Pega, Frank
abstract

2022 - The health surveillance of workers exposed to EMF: an outline of criteria [Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

2022 - UV radiation exposure in occupation and leisure time - detailed knowledge for holistic prevention [Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

2021 - Anti-SARS-CoV-2 antibodies frequency in non-Health Care Workers in a highly industrialized province of northern Italy [Relazione in Atti di Convegno]
Modenese, Alberto; Mazzoli, Tommaso; Berselli, Nausicaa; Ferrari, Davide; Bargellini, Annalisa; Borella, Paola; Filippini, Tommaso; Marchesi, Isabella; Paduano, Stefania; Vinceti, Marco; Gobba, Fabriziomaria
abstract

2021 - Blood cell gene expression profiles: A narrative review of biomarkers and effects of low-dose ionizing radiation exposure [Articolo su rivista]
Panera, Nadia; Camisa, Vincenzo; Brugaletta, Rita; Vinci, Maria Rosaria; Santoro, Annapaola; Coscia, Emanuele; Pastore, Anna; Cannatà, Vittorio; Gobba, Fabriziomaria; Modenese, Alberto; Chirico, Francesco; Magnavita, Nicola; Alisi, Anna; Zaffina, Salvatore
abstract

Ionizing radiation (IR) is a ubiquitous environmental agent whose effects on organisms are well known. This review provides a summary about definitions and man-made low-dose ionizing radiation (LDIR) sources and dosimeters used in radiation protection. Moreover, the main purpose of this article was to overview the pro-oncogenic effects of LDIR, and to provide experimental evidence that reinforce the use of gene expression data as biomarkers of LDIR effects. Our review showed that basic studies on biological response to LDIR are considered priority. Further, understanding occupational exposure to LDIR may provide valuable information to organize the prevention and prevent from the onset of long-term health effects in radiation workers. Currently, the biodosimetry-based assessment in certain high risk occupational groups may be performed by using peripheral blood cells as samples for testing and validation of biomarkers specificity and sensitivity. Most of the studies on this topic are aimed at establishing new biomarkers and approaches to biological dosimetry, for allowing non-invasive monitoring of long-term health effects of LDIR. Analysis on changes in gene-expression, which is an early specific biological response to LDIR, could provide rapid estimates of individual dose in occupational cohorts, improving the management of periodical medical examination in subjects exposed to LDIR sources.

2021 - Environmental safety of the 180-W GreenLight Laser: a pilot study on plume and irrigating fluids [Articolo su rivista]
Ferrari, Giovanni; Ferrari, Anna Maria; Campobasso, Davide; Modenese, Alberto; Rijo, Enrique; Misrai, Vincent; Rosa, Roberto; Cindolo, Luca
abstract

2021 - Evaluation of Personal Solar UV Exposure in a Group of Italian Dockworkers and Fishermen, and Assessment of Changes in Sun Protection Behaviours After a Sun-Safety Training [Articolo su rivista]
Modenese, Alberto; Bisegna, Fabio; Borra, Massimo; Bravo, Giulia; Burattini, Chiara; Grasso, Anna; Gugliermetti, Luca; Filon, Francesca Larese; Militello, Andrea; Ruggieri, Francesco Pio; Gobba, Fabriziomaria
abstract

2021 - Exposure to Optical Radiation and Electromagnetic Fields at the Workplace: Criteria for Occupational Health Surveillance According to Current European Legislation [Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

2021 - Factors associated with SARS-CoV-2 infection risk among healthcare workers of an italian university hospital [Articolo su rivista]
Modenese, A.; Casolari, L.; Rossi, G.; Della Vecchia, E.; Glieca, F.; D'Elia, C.; Garavini, D.; Righi, E.; Mariani, S.; Venturelli, L.; Vivoli, D.; Gobba, F.
abstract

We report the results of a study on the cumulative incidence of SARS-CoV-2 infections in about 6000 workers of the University Hospital of Modena, Northern Italy, in the period March 2020–January 2021, and the relations with some individual and occupational factors. Overall, in healthcare workers (HCW) the cumulative incidence of COVID-19 during the period was 13.8%. Results confirm the role of overweight and obesity as significant risk factors for SARS-CoV-2 infection. Chronic respiratory diseases, including asthma, also proved to be significantly associated with the infection rate. Considering occupational factors, the COVID-19 risk was about threefold (OR: 2.7; 95% CI 1.7–4.5) greater in nurses and nurse aides than in non-HCW, and about double (OR: 1.9; 95% CI 1.2–3.2) in physicians. Interestingly, an association was also observed between infection risk and nightshifts at work (OR: 1.8; 95% CI 1.4–2.3), significantly related to the total number of shifts in the whole eleven-month period. Even if the vaccination campaign has now greatly modified the scenario of SARS-CoV-2 infections among HCW, the results of this study can be useful for further development of health and policy strategies to mitigate the occupational risk related to the new variants of coronavirus, and therefore the evolution of the pandemic.

2021 - Frequency of anti-sars-cov-2 antibodies in various occupational sectors in an industrialized area of northern italy from may to october 2020 [Articolo su rivista]
Modenese, A.; Mazzoli, T.; Berselli, N.; Ferrari, D.; Bargellini, A.; Borella, P.; Filippini, T.; Marchesi, I.; Paduano, S.; Vinceti, M.; Gobba, F.
abstract

The results of a voluntary screening campaign for the presence of anti-SARS-CoV-2 serum antibodies are presented, performed on workers in the highly industrialized province of Modena in northern Italy in the period 18 May–5 October 2020. The employment activities of the subjects that tested positive for anti-SARS-CoV-2 IgM and/or IgG antibodies were determined and classified using the International Standard Industrial Classification of All Economic Activities (ISIC). The distribution across different sectors was compared to the proportion of workers employed in the same sectors in the province of Modena as a whole. Workers with anti-SARS-CoV-2 serum antibodies were mainly employed in manufacturing (60%), trade (12%), transportation (9%), scientific and technical activities (5%), and arts, entertainment and recreation activities (4.5%). Within the manufacturing sector, a cluster of workers with positive serological tests was observed in the meat processing sector, confirming recent data showing a possible increased risk of SARS-CoV-2 infection in these workers.

2021 - Harmonized definition of occupational burnout: A systematic review, semantic analysis, and Delphi consensus in 29 countries [Articolo su rivista]
Guseva Canu, Irina; Marca, Sandy Carla; Dell'Oro, Francesca; Balázs, Ádám; Bergamaschi, Enrico; Besse, Christine; Bianchi, Renzo; Bislimovska, Jovanka; Koscec Bjelajac, Adrijana; Bugge, Merete; Busneag, Carmen Iliana; Çağlayan, Çiğdem; Cernițanu, Mariana; Costa Pereira, Cristiana; Dernovšček Hafner, Nataša; Droz, Nadia; Eglite, Maija; Godderis, Lode; Gündel, Harald; Hakanen, Jari J; Iordache, Raluca Maria; Khireddine-Medouni, Imane; Kiran, Sibel; Larese-Filon, Francesca; Lazor-Blanchet, Catherine; Légeron, Patrick; Loney, Tom; Majery, Nicole; Merisalu, Eda; Mehlum, Ingrid Sivesind; Michaud, Laurent; Mijakoski, Dragan; Minov, Jordan; Modenese, Alberto; Molan, Marija; van der Molen, Henk; Nena, Evangelia; Nolimal, Dusan; Otelea, Marina; Pletea, Elisabeta; Pranjic, Nurka; Rebergen, David; Reste, Jelena; Schernhammer, Eva; Wahlen, Anny
abstract

Objective A consensual definition of occupational burnout is currently lacking. We aimed to harmonize the definition of occupational burnout as a health outcome in medical research and reach a consensus on this definition within the Network on the Coordination and Harmonisation of European Occupational Cohorts (OMEGA-NET). Methods First, we performed a systematic review in MEDLINE, PsycINFO and Embase (January 1990 to August 2018) and a semantic analysis of the available definitions. We used the definitions of burnout and burnout-related concepts from the Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to formulate a consistent harmonized definition of the concept. Second, we sought to obtain the Delphi consensus on the proposed definition. Results We identified 88 unique definitions of burnout and assigned each of them to 1 of the 11 original definitions. The semantic analysis yielded a first proposal, further reformulated according to SNOMED-CT and the panelists` comments as follows: "In a worker, occupational burnout or occupational physical AND emotional exhaustion state is an exhaustion due to prolonged exposure to work-related problems". A panel of 50 experts (researchers and healthcare professionals with an interest for occupational burnout) reached consensus on this proposal at the second round of the Delphi, with 82% of experts agreeing on it. Conclusion This study resulted in a harmonized definition of occupational burnout approved by experts from 29 countries within OMEGA-NET. Future research should address the reproducibility of the Delphi consensus in a larger panel of experts, representing more countries, and examine the practicability of the definition.

2021 - La sorveglianza sanitaria dei lavoratori esposti a campi elettromagnetici: aspetti legislativi, particolare sensibilità al rischio, indicazioni per l’idoneità [Articolo su rivista]
Filosa, Laura; Gobba, Fabriziomaria; Modenese, Alberto
abstract

2021 - LA VALUTAZIONE DEL RISCHIO DA MOVIMENTAZIONE PAZIENTI: RISULTATI DELL’APPLICAZIONE DEL METODO SPOSO-POLETTI [Abstract in Atti di Convegno]
Gualtieri, G.; Dieci, C.; Romiti, E.; Morini, G.; Mineo, F.; Perazzoli, F.; Coriani, S.; Modenese, A.; Gobba, F.
abstract

2021 - Linee Guida per la sorveglianza sanitaria dei lavoratori esposti a campi elettromagnetici [Monografia/Trattato scientifico]
Gobba, Fabriziomaria; Falsaperla, Rosaria; Grandi, Carlo; Moccaldi, Roberto; Modenese, Alberto; Polichetti, Alessandro; Rossi, Paolo; Stanga, Andrea
abstract

2021 - Neutralizing Anti-SARS-CoV-2 Antibody Titer and Reported Adverse Effects, in a Sample of Italian Nursing Home Personnel after Two Doses of the BNT162b2 Vaccine Administered Four Weeks Apart [Articolo su rivista]
Modenese, Alberto; Paduano, Stefania; Bargellini, Annalisa; Bellucci, Rossana; Marchetti, Simona; Bruno, Fulvio; Grazioli, Pietro; Vivoli, Roberto; Gobba, Fabriziomaria
abstract

Background: The immunization of healthcare workers (HCWs) plays a recognized key role in prevention in the COVID-19 pandemic: in Italy, the vaccination campaign began at the end of December 2020. A better knowledge of the on-field immune response in HCWs, of adverse effects and of the main factors involved is fundamental. Methods: We performed a study on workers at a nursing home in Northern Italy, vaccinated in January–February 2021 with two doses of the BNT162b2 vaccine four weeks apart, instead of the three weeks provided for in the original manufacturer protocol. One month after the second dose, the serological titer of IgG-neutralizing anti-RBD antibodies of the subunit S1 of the spike protein of SARS-CoV-2 was determined. The socio-demographic and clinical characteristics of the subjects and adverse effects of vaccination were collected by questionnaire. Results: In all of the workers, high antibody titer, ranging between 20 and 760 times the minimum protective level were observed. Titers were significantly higher in subjects with a previous COVID-19 diagnosis. Adverse effects after the vaccine were more frequent after the second dose, but no severe adverse effects were observed. Conclusions: The two doses of the BNT162b2 vaccine, even if administered four weeks apart, induced high titers of anti-SARS-CoV-2 neutralizing IgG in all the operators included in the study.

2021 - Occupational exposure to electromagnetic fields and health surveillance according to the european directive 2013/35/eu [Articolo su rivista]
Modenese, A.; Gobba, F.
abstract

In the European Union, health surveillance (HS) of electromagnetic fields (EMF)-exposed workers is mandatory according to the Directive 2013/35/EU, aimed at the prevention of known direct biophysical effects and indirect EMF’s effects. Long-term effects are not addressed in the Directive as the evidence of a causal relationship is considered inadequate. Objectives of HS are the prevention or early detection of EMF adverse effects, but scant evidence is hitherto available on the specific procedures. A first issue is that no specific laboratory tests or medical investigations have been demonstrated as useful for exposure monitoring and/or prevention of the effects. Another problem is the existence of workers at particular risk (WPR), i.e., subjects with specific conditions in-ducing an increased susceptibility to the EMF-related risk (e.g., workers with active medical devices or other conditions); exposures within the occupational exposure limit values (ELVs) are usually adequately protective against EMF’s effects, but lower exposures can possibly induce a health risk in WPR. Consequently, the HS of EMF-exposed workers according to the EU Directive should be aimed at the early detection and monitoring of the recognized adverse effects, as well as an early identification of WPR for the adoption of adequate preventive measures.

2021 - O-312 Occupational exposure levels of solar ultraviolet radiation: an EPHOR review [Abstract in Atti di Convegno]
Würtz, Else Toft; Cherrie, Mark; Ge, Calvin; Grandahl, Kasper; Hansen, Johnni; Dahlman-Höglund, Anna; Mehlum, Ingrid Sivesind; Modenese, Alberto; Notö, Hilde; Peters, Cheryl; Selander, Jenny; Solovieva, Svetlana; Schlünssen, Vivi; Wittlich, Marc; Kolstad, Henrik Albert
abstract

2021 - Protocol for a Systematic Review on the Effectiveness of Interventions to Reduce Exposure to Occupational Solar UltraViolet Radiation (UVR) Among Outdoor Workers [Articolo su rivista]
Modenese, A.; Loney, T.; Rocholl, M.; Symanzik, C.; Gobba, F.; John, S. M.; Straif, K.; Silva Paulo, M.
abstract

Background: Solar UltraViolet Radiation (UVR) is considered the most relevant occupational carcinogenic exposure in terms of the number of workers exposed (i.e., outdoor workers) and UVR-induced skin cancers are among the most frequent types of occupational cancers worldwide. This review aims to collect and evaluate all the available preventive interventions conducted on outdoor workers to reduce their solar UVR related risk, with the final purpose of reducing the burden of occupational skin cancers for outdoor workers. Methods: We will search the following databases for peer-reviewed original research published: MEDLINE (through PubMed), Scopus, and EMBASE. We will include only interventional studies, both randomized and non-randomized, with an adequate comparison group, therefore excluding cross-sectional studies, as well as case-reports/series, reviews, and letters/comments. The systematic review will adhere to the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) guidelines for reporting systematic reviews. After the literature search, studies to be included will be independently reviewed by two Authors, first based on title and abstract, then based on the full text, according to the inclusion criteria. Conflicts will be solved by a third Author. Two authors will independently extract the required data from included studies and perform quality assessment according to the relevant domain for Risk of Bias assessment proposed by the Cochrane collaboration group. In case of sufficient homogeneity of interventions and outcomes evaluated, results from subgroups of studies will be pooled together in a meta-analysis. Discussion: Following the principles for the evaluation of interventions for cancer prevention established by the International Agency for Research on Cancer, this systematic review will investigate the effectiveness of the interventions, and consequently it will provide reliable indications for the actual reduction of skin cancer incidence in outdoor workers.

2021 - PROTOCOLLO DI REVISIONE SISTEMATICA DELLA LETTERATURA SU ESPOSIZIONE OCCUPAZIONALE A RADIOFREQUENZE E TUMORI NELL’AMBITO DEL PROGETTO BRIC ID6 2018 [Abstract in Atti di Convegno]
Modenese, A.; Bravo, G.; Gobba, F.; Grandi, C.
abstract

2021 - P-228 Occupational exposure to radiofrequency electromagnetic fields and risk of cancer: preliminary data from the Italian research project BRIC 2018 – ID 06 [Poster]
Modenese, Alberto; Bravo, Giulia; Grandi, Carlo; Biffoni, Mauro; Gobba, Fabriziomaria
abstract

2021 - Risk perception and ethnic background in construction workers: Results of a cross-sectional study in a group of trainees of a vocational school in italy [Articolo su rivista]
Ricci, F.; Bravo, G.; Modenese, A.; De Pasquale, F.; Ferrari, D.; Bello, M.; Favero, G.; Soddu, S.; Gobba, F.
abstract

Risk perception can be influenced by cultural background. The study aims to evaluate risk perception, considering different ethnicities of construction workers from vocational schools in Italy. We administered a questionnaire investigating four different dimensions: Perceived behavioral control (PBC), Danger perception (DP), Safety climate (SC), and Attitude towards safe actions (ATSA). 562 workers answered: 72.4% from Italy, 14.2% from eastern Europe, 9.4% from Balkans, and 3.9% from North Africa. The participants indicated quite low control, attributable to the haste in performing the job. The workers perceived their specific job tasks as riskier compared to the tasks of their colleagues. They reported as fundamental the respecting of safety rules, but indicating that supervisors do not adequately promote safety behaviors. Finally, construction workers judged as “brave” the colleagues working without protective equipment. When compared to Italians, North Africa workers showed a lower perception of the possibility to control their safe behaviors (p = 0.040), while both eastern Europeans and Balkan obtained higher scores at the ATSA dimension, indicating a kind of fatalistic acceptance of the risky situations at work. Eastern Europeans also showed a lower perception of the dangers (p = 0.002), while Balkan demonstrated a perception of SC even better than the Italian group (p = 0.005).

2021 - Risk Perception in the Construction Industry: Differences Between Italian and Migrant Workers Before and After a Targeted Training Intervention [Articolo su rivista]
Ricci, F.; Bravo, G.; Modenese, A.; Pasquale, F. D.; Ferrari, D.; Gobba, F.
abstract

We developed a visual tool to assess risk perception for a sample of male construction workers (forty Italian and twenty-eight immigrant workers), just before and after a sixteen-hour training course. The questionnaire included photographs of real construction sites, and workers were instructed to select pictograms representing the occupational risks present in each photograph. Points were awarded for correctly identifying any risks that were present, and points were deducted for failing to identify risks that were present or identifying risks that were not present. We found: (1) Before the course, risk perception was significantly lower in immigrants compared to Italians (p <.001); (2) risk perception improved significantly (p <.001) among all workers tested; and (3) after the training, the difference in risk perception between Italians and immigrants was no longer statistically significant (p =.1086). Although the sample size was relatively small, the results suggest that the training is effective and may reduce the degree to which cultural and linguistic barriers hinder risk perception. Moreover, the use of images and pictograms instead of words to evaluate risk perception could also be applied to nonconstruction workplaces.

2021 - RISPOSTA ANTICORPALE ED EVENTI AVVERSI A VACCINAZIONE ANTI SARS-COV-2 NEGLI OPERATORI DELL’AZIENDA OSPEDALIERO-UNIVERSITARIA DI MODENA [Abstract in Atti di Convegno]
Casolari, L.; Rossi, G.; Della Vecchia, E.; Glieca, F.; Muscatello, M.; Modenese, A.; Cannizzo, C.; D’Elia, C.; Garavini, D.; Neri, S.; Salvatori, D.; Mariani, S.; Righi, E.; Sarti, M.; Venturelli, L.; Vivoli, D.; Gobba, F.
abstract

2021 - RISULTATI DELLO SCREENING SIEROLOGICO PER SARS-COV-2 IN OPERATORI DELL’AUSL DI MODENA NEL PERIODO 01/04/2020-31/05/2020 [Abstract in Atti di Convegno]
Muscatello, M.; Grasso, A.; Gualtieri, G.; Lacirignola, M.; Pedretti, S.; Tarantini, A. R.; Vaccari, C.; Modenese, A.; Gobba, F.
abstract

2021 - Seroprevalence of anti-SARS-CoV-2 antibodies after the first COVID-19 wave: a cross-sectional study in the province of Modena, city of a Northern Italy region [Abstract in Rivista]
Berselli, N; Filippini, T; Paduano, S; Malavolti, M; Modenese, A; Gobba, F; Borella, P; Marchesi, I; Vivoli, R; Perlini, P; Bellucci, R; Bargellini, A; Vinceti, M
abstract

2021 - Seroprevalence of anti-SARS-CoV-2 antibodies in the Northern Italy population before the COVID-19 second wave [Articolo su rivista]
Berselli, Nausicaa; Filippini, Tommaso; Paduano, Stefania; Malavolti, Marcella; Modenese, Alberto; Gobba, Fabriziomaria; Borella, Paola; Marchesi, Isabella; Vivoli, Roberto; Perlini, Paola; Bellucci, Rossana; Bargellini, Annalisa; Vinceti, Marco
abstract

The COVID-19 pandemic is due to SARS-CoV-2 coronavirus infections. It swept across the world in the spring of 2020, and so far it has caused a huge number of hospitalizations and deaths. In the present study, the authors investigated serum anti-SARS-CoV-2 antibody prevalence in the period of June 1-September 25, 2020, in 7561 subjects in Modena, Northern Italy.

2021 - SORVEGLIANZA SANITARIA DEL RISCHIO DA SARS-COV-2 NELL’AZIENDA OSPEDALIEROUNIVERSITARIA DI MODENA: PRIMI RISULTATI [Abstract in Atti di Convegno]
Rossi, G.; Della Vecchia, E.; Glieca, F.; Venturelli, L.; Casolari, L.; D’Elia, C.; Garavini, D.; Mariani, S.; Pala, F.; Vivoli, D.; Modenese, A.; Gobba, F.
abstract

2021 - Studio di fattori di rischio/protettivi associati alla risposta anticorpale anti-SARS-CoV-2 in un campione di lavoratori della provincia di Modena e province limitrofe [Abstract in Rivista]
Paduano, S; Modenese, A; Filippini, T; Berselli, N; Marchesi, I; Vinceti, M; Borella, P; Gobba, F; Bargellini, A
abstract

2021 - Subjective Symptoms in Magnetic Resonance Imaging Personnel: A Multi-Center Study in Italy [Articolo su rivista]
Bravo, Giulia; Modenese, Alberto; Arcangeli, Giulio; Bertoldi, Chiara; Camisa, Vincenzo; Corona, Gianluca; Giglioli, Senio; Ligabue, Guido; Moccaldi, Roberto; Mucci, Nicola; Muscatello, Martina; Venturelli, Irene; Vimercati, Luigi; Zaffina, Salvatore; Zanotti, Giulio; Gobba, Fabriziomaria
abstract

2021 - The effect of occupational exposure to solar ultraviolet radiation on malignant skin melanoma and non- melanoma skin cancer: a systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury [Monografia/Trattato scientifico]
Boniol, Mathieu; Hosseini, Bayan; Ivanov, Ivan; Náfrádi, Bálint; Neira, Maria; Olsson, Ann; Onyije, Felix; Pega, Frank; Pintado Nunes, Joaquim; Prüss-Üstün, Annette; Schubauer-Berigan, Mary; Schüz, Joachim; Ujita, Yuka; Maria Leon-Roux, Emilie van Deventer.; Momen, Natalie; Ádám, Balázs; Akagwu, Ojochide; Akparibo, Issaka; Al Rifai, Rami; Bazrafshan, Sholeh; Bravo, Giulia; Gobba, Fabriziomaria; Green, Adele; Kezic, Sanja; Loney, Tom; Modenese, Alberto; Paulo, Marilia; Peters, Cheryl; Tenkate, Thomas; Whiteman, David; Wittlich, Marc; John, Swen
abstract

A systematic review and meta-analysis of studies were conducted reporting on the association between occupational exposure to solar ultraviolet radiation (UVR) and both malignant skin melanoma (melanoma) and non-melanoma skin cancer (NMSC), with the aim of enabling the estimation of the numbers of deaths and disability-adjusted life years from melanoma and NMSC attributable to occupational exposure to solar UVR, for the development of the World Health Organization (WHO)/International Labour Organization (ILO) Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates). A protocol was developed and published, applying the Navigation Guide as an organizing systematic review framework where feasible. Electronic bibliographic databases were searched for potentially relevant records; electronic grey literature databases and organizational websites were also searched, reference lists of previous systematic reviews and included study records were hand-searched, and additional experts were consulted. Randomized controlled trials and cohort, case–control and other non-randomized studies were included that estimated the effect of any occupational exposure to solar UVR, compared with no occupational exposure to solar UVR, on melanoma (excluding melanoma of the lip or eye) or NMSC prevalence, incidence or mortality. At least two reviewers independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage. Adjusted relative risks were combined using random-effects meta-analysis. Two or more reviewers assessed the risk of bias, quality of evidence and strength of evidence. Fifty-three (48 case–control, three case–case and two cohort) eligible studies were found, published in 62 study records, including over 457 000 participants in 26 countries of three WHO regions (Region of the Americas, European Region and Western Pacific Region), reporting on the effect on melanoma or NMSC incidence or mortality. No studies on the prevalence of melanoma or NMSC were found. In most studies, exposure was self-reported in questionnaires during interviews and the health outcome was assessed via physician diagnosis based on biopsy and histopathological confirmation. The risk of bias of the body of evidence was judged to be generally “probably low”, although there were some concerns regarding risks of exposure misclassification bias, detection bias and confounding. The main meta-analyses of relevant case–control studies revealed a relative risk (RR) of melanoma and NMSC incidence of 1.45 (95% confidence interval (CI): 1.08–1.94; I2 = 81%) and 1.60 (95% CI: 1.21–2.11; I2 = 91%), respectively. No statistically significant differences in risk of melanoma and NMSC incidence were found when conducting subgroup analyses by WHO region, and no differences in risk of NMSC incidence in a subgroup analysis by sex. However, in a subgroup analysis by NMSC subtype, the increased risk of basal cell carcinoma (RR: 1.50; 95% CI: 1.10–2.04; 15 studies) was probably lower (P = 0.05 for subgroup differences) than the increased risk for squamous cell carcinoma (RR: 2.42; 95% CI: 1.66–3.53; 6 studies). The sensitivity analyses found that effect estimates of NMSC incidence were significantly higher in studies with any risk of bias domain rated as “high” or “probably high” compared with studies with only a “low” or “probably low” risk of bias, and in studies not reporting the health outcome by International Statistical Classification of Diseases and Related Health Problems (ICD) code compared with the two studies reporting ICD codes. The quality of available evidence of the effect of any occupational exposure to solar UVR on melanoma incidence and mortality and on NMSC mortality was rated as “low”, and the quality of evidence for NMSC incidence was rated as “moderate”. The strength of the existing bodies of ev

2021 - The under-reporting of UV induced occupational non-melanoma skin cancers and actinic keratoses in Italy [Poster]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

2021 - UV solar exposure of outdoor workers in Mediterranean area [Relazione in Atti di Convegno]
Burattini, Chiara; Pompei, Laura; Modenese, Alberto; Salvadori, Giacomo; Militello, Andrea; Leccese, Francesco; Borra, Massimo; Gobba, Fabriziomaria; Bisegna, Fabio
abstract

2021 - VALUTAZIONE SOGGETTIVA DEL SONNO IN UN CAMPIONE DI AUTOTRASPORTATORI: DATI PRELIMINARI [Abstract in Atti di Convegno]
Ruggieri, F. P.; Melloni, P.; Modenese, A.; Gobba, F.
abstract

2020 - A One-Month Monitoring of Exposure to Solar UV Radiation of a Group of Construction Workers in Tuscany [Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria; Paolucci, Valentina; John, Swen Malte; Sartorelli, Pietro; Wittlich, Marc
abstract

2020 - Ethnic background and risk perception in construction workers: development and validation of an exploratory tool [Articolo su rivista]
Ricci, Federico; Modenese, Alberto; Bravo, Giulia; De Pasquale, Fabrizio; Ferrari, Davide; Bello, Massimo; Carozza, Lorenzo; Longhi, Francesca; Favero, Gianluca; Soddu, Sergio; Gobba, Fabriziomaria
abstract

Among occupational sectors, construction is still one of the branches with the highest reported numbers of work-related injuries and diseases, which can even lead to death and in many cases induce permanent health consequences. The vast majority of these occupational injuries and diseases are preventable; accordingly, an improvement in preventive strategies, also through a better knowledge of the main factors involved in these events, is one of the most important objectives for better occupational health and safety in the construction sector. Considering the individual factors associated with a higher risk of work-related adverse health effects in workers, an inadequate perception of occupational risks is among the most relevant issues. Risk perception can vary according to different cultural backgrounds, highly influenced by ethnicity, and it affects the relations between workers in the work environment, and the way by with they undergo the specific occupational tasks and manage risky situations frequently occurring on construction sites. Accordingly, the aim of the authors was to develop a new tool for the assessment of risk perception in construction workers with different ethnic backgrounds.

2020 - Global evidence on occupational sun exposure and keratinocyte cancers: a systematic review [Articolo su rivista]
Loney, T.; Paulo, M. S.; Modenese, A.; Gobba, F.; Tenkate, T.; Whiteman, D. C.; Green, A. C.; John, S. M.
abstract

2020 - Incidence of occupational contact dermatitis in health care workers: A systematic review [Articolo su rivista]
Larese Filon, Francesca; Pesce, Marco; Paulo, Marília Silva; Loney, Tom; Modenese, Alberto; John, Swen Malte; Kezic, Sanja; Macan, Jelena
abstract

Healthcare workers (HCWs) can be considered at an increased risk of developing occupational contact dermatitis (OCD) due to repetitive hand washing with soaps and disinfectants and extended use of gloves for many hours during the day. The aim of this study was to summarize the incidence of OCD in HCWs. We searched the databases PubMed/Medline (1980-present), EMBASE (1980-present) and Cochrane Library (1992-present) through May 2020 using the search term "incidence of contact dermatitis in healthcare workers" according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Overall, 16 studies (six cohort; 10 register-based) with follow-up periods between 1987-2013 fulfilled the inclusion criteria. The incidence of OCD reported in studies using registers of occupational diseases ranged from 0.6 to 6.7 per 10,000 person-years. The cohort studies reported incidence from 15.9 to 780.0 per 10,000 person-years; the incidence was higher in studies which included apprentice nurses. A higher incidence was also observed amongst dental practitioners, particularly dental technicians and nurses, compared to other HCWs. Studies reporting incidence data are very scarce and results differed by study design, type of contact dermatitis, and investigated HCWs. Our study highlighted the dearth of high-quality data on the incidence of OCD and the possible underestimation of disease burden. Prospective cohort studies with harmonized designs, especially exposure assessment and outcome ascertainment, are required to provide more accurate, valid, and recent estimates of the incidence of OCD. A high incidence amongst specific occupational groups suggests the need to undertake intervention studies with a focus on prevention, particularly during pandemics such as COVID-19.

2020 - Increased Risk of COVID-19-Related Deaths among General Practitioners in Italy [Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

To date, data on COVID-19-related death cases among physicians from different medical specialties are incomplete and scattered. In Italy, available data highlight that general practitioners (GPs) are, apparently, the most heavily affected group. Indeed, they currently represent 44.1% of the total COVID-19 related death cases occurred among physicians, whereas they constitute about 15% of the total number of doctors. This high proportion is most likely the consequence of a work-related contagion happening especially during the first weeks of the epidemic, and persisting also in the following weeks, after the national lockdown. There are various reasons for these higher contagion rates: GPs perform a lot of medical examinations daily, usually in close contact with patients. Especially at the beginning of the epidemic, GPs might have had scant information on the specific safety procedures for the prevention of SARS-CoV-2 transmission (e.g., there was limited knowledge on the possibility of contagions deriving from asymptomatic patients) and, moreover, the availability of personal protective equipment was insufficient. Furthermore, the risk of infection is highly increased by the virus' characteristics, like its survival for several hours/days on different surfaces and its persistence in the air after an aerosolization process, with possibilities to be transmitted over distances longer than two meters. Following these observations, and considering the high cost in term of GPs' lives, the COVID-19 pandemic will probably revolutionize the approach to patients in general practice. Clear and effective guidelines are absolutely and urgently needed for the refinement of adequate measures to prevent SARS-CoV-2 infections among GPs.

2020 - Occupational Exposure to Non-Ionizing radiation. Main effects and criteria for health surveillance of workers according to the European Directives [Relazione in Atti di Convegno]
Modenese, A.; Gobba, F.
abstract

Occupational exposure to Non-Ionizing radiation (NIR), including Electromagnetic fields (EMF) and Optical radiation (OR), is almost ubiquitous. EMF may induce various effects: in the case of direct short term effects, static and low-frequency fields interact with the biological tissues through the induction of currents, while high frequency fields through thermal mechanisms. EMF can also induce indirect effects, as interference, causing a specific risk e.g. in workers with active medical devices as pacemakers. The induction of various long term effects has also been proposed, but up now data supporting a causal effect are considered insufficient by almost all authoritative international agencies. Moving to OR, sources can be artificial (incoherent or coherent in the case of LASER) or natural; the main source of occupational OR exposure is natural: the Sun, exposing millions of outdoor workers worldwide. The main targets of OR effects are the skin and the eye. Among OR bands, the ultraviolet component is of particular relevance, inducing photochemical alterations in human cells that can cause both acute and long term effects as burns and skin cancers or cataract. For all workers NIR risk should be evaluated and, in case of significant risk, an adequate health surveillance (HS) should be implemented, also considering the possible presence of workers with conditions inducing a higher susceptibility to the risk, as subjects with active medical devices for EMF or subjects with a fair skin photo-type or eye alterations as aphakia or aniridia for OR. Aims of HS of occupational NIR exposure are the prevention and early detection of related health effects. The appropriate specific HS content depends on the NIR band(s) and on the specific work activities but, in general, at least a screening of the conditions inducing a particular risk and an active seeking of symptoms possibly induced by exposure should be performed before of the employment, and periodically repeated.

2020 - Occupational Exposure to Solar UV Radiation in a Group of Dock-workers in North-East Italy [Relazione in Atti di Convegno]
Modenese, A.; Bisegna, F.; Borra, M.; Burattini, C.; Gugliermetti, L.; Filon, F. L.; Militello, A.; Toffanin, P.; Gobba, F.
abstract

Occupational solar ultraviolet radiation (UVR) exposure is a relevant heath risk in dock workers, potentially exposed to both direct and reflected radiation, but apparently was scantly studied up now and few studies on measurements of solar UVR levels are currently available for these workers. Our aim was to provide an evaluation of UVR exposure in 10 longshoremen and 4 port traffic coordinators/goods acceptors of a dock in North-East Italy. During a Summer day, workers' exposure was measured with personal UV dosimeters, and the environmental UV effective radiant exposure with a spectroradiometer. Personal solar UV dose ranged between 257-1975 J/m2 in longshoremen, and between 44-139 J/m2 for port traffic coordinators/goods acceptors. The percentage of personal compared to ambient exposure resulted between 16 and 59% for longshoremen, while were much lower, between 2 and 7%, in port traffic coordinators/goods acceptors. Eye exposure was also estimated using an ocular UV dosimeter placed on a stem of the sunglasses in a subject spending the day close to the longshoremen, resulting in a non-weighted solar UV-A ocular dose between 133.9 and 401.8 J/m2. Our results show an occupational solar UVR exposure of uncovered skin exceeding the suggested occupational limit of 1 - 1.3 standard erythemal dose per day, in all longshoremen. In one case this value was exceeded also in one of the port traffic coordinators /good acceptors, despite the overall lower UVR doses received. In conclusion, our UV measurement campaign in a group of Italian dock-workers support the existence of a significantly high occupational UVR risk at least for longshoremen, possibly inducing long-term UV-related adverse skin effects. Accordingly, an effort for the development of adequate interventions to protect these workers from solar UV risk is highly recommended in Italy.

2020 - Occupational risk related to natural optical radiation exposure and skin cancers [Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

Skin tumors are the most frequent neoplasms worldwide in Caucasian subjects, and UV exposure is one of the most relevant risk factors in their etiology. Cumulative UV exposure is strongly associated with an increased occurrence of both basal and squamous cell carcinomas (i.e. Non melanoma skin cancers - NMSC), while for malignant melanoma the role of UV radiation as risk factors seems more related to intermittent and intense exposures, able to induce repeated sunburns, at young ages. Considering the occupational risk, currently UV radiation, part of the solar radiation (SR) spectrum, is one of the major risks in all jobs including outdoor activities (outdoor work - OW): many studies show high levels of solar UV exposure during OW, nevertheless to date the European, and Italian, legislation on occupational risks prevention does not include specific requirements for SR compleexposure at work, as occupational exposure limits values or workers' health surveillance. This is not coherent with the strong associations showed in scientific literature in particular between the occurrence of NMSC and a history of OW. Accordingly, considering the high exposure levels, the large number of outdoor workers and the strong associations with NMSC, we'd expect a relevant number of occupational skin cancers (OSC) to be reported every year to the national workers' compensation authorities in European countries. Nevertheless, in Italy, as in other European countries, the number of reported UV-induced OSC is much lower than the expected number of OSC, with less than 40 cases reported on average in Italy in last years compared to about a thousand of expected cases incident in outdoor workers per year. An increasing in the reporting of OSC would certainly be important, for the purpose of a better recognition of the real dimension of the phenomenon, and to stimulate the implementation of adequate preventive strategies, in order to guarantee an improved protection of outdoor workers and a more appropriate prevention of the adverse health effects related to solar UV exposure.

2020 - Occupational solar UV exposure in construction workers in Italy: Results of a one-month monitoring with personal dosimeters [Relazione in Atti di Convegno]
Modenese, A.; Gobba, F.; Paolucci, V.; John, S. M.; Sartorelli, P.; Wittlich, M.
abstract

Occupational exposure to solar UV radiation (UVR) is relevant in the construction sector. We performed a one month monitoring period in late spring of direct individual solar UVR exposure measurements in a group of three construction workers from the Tuscany Italian region, using the GENESIS-UV system for personal dosimetry and for the collection of long-term exposure data in a centralized dataset. Then, we compared personal UVR exposure data with the environmental erythemal dose in the same days in clear-sky conditions. The individual solar UVR exposures of the construction workers in the period between 22nd May and 22nd June 2017 in Tuscany varied between 85.5 and 1556.8 J/m2, while the average daily exposure considering all the three workers resulted 573.3 J/m2. The percentage between individual vs environmental exposure varied from 2.7 up to 31.2%, resulting 12.2 on average. Of the total amount of 40 days/worker measured we detected exposure levels above the 100 J/m2 proposed limit value in 39 days/worker, with exceeding of the limit up to ten times per day, more than five times on average. In terms of cumulative UVR exposure, the construction workers received on average a total one month exposure, based on 21 working days, of 12 kJ/m2, and we estimated an annual exposure of about 70 kJ/m2, approximately corresponding to 700 Standard Erythemal Doses. Our data show that the exposure levels of the Italian construction workers are very high in late spring, systematically exceeding the limit values. These UVR exposure levels can be considered potentially dangerous, in particular if associated with relevant cumulative annual UV doses received at the body, which are related to an increased risk of adverse effects, including skin cancers. Accordingly, a big effort is needed, to urgently reduce occupational solar UVR exposure in the construction sector, improving the application of preventive measures.

2020 - Personal solar ultraviolet radiation dosimetry in an occupational setting across Europe [Articolo su rivista]
Wittlich, M; John, Sm; Tiplica, Gs; Sălăvăstru, Cm; Butacu, Ai; Modenese, A; Paolucci, V; D’Hauw, G; Gobba, F; Sartorelli, P; Macan, J; Kovačić, J; Grandahl, K; Moldovan, H
abstract

2020 - Physicians' deaths related to SARS-Cov-2 infections in Italy [Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

2020 - Rischio di cataratta ed esposizione alle radiazioni ionizzanti negli operatori sanitari: un aggiornamento [Articolo su rivista]
Modenese, Alberto; Della Vecchia, Elena; Muscatello, Martina; Rossi, Giorgia; Gobba, Fabriziomaria
abstract

2020 - Risk of cataract in health care workers exposed to ionizing radiation: A systematic review [Articolo su rivista]
Vecchia, E. D.; Modenese, A.; Loney, T.; Muscatello, M.; Paulo, M. S.; Rossi, G.; Gobba, F.
abstract

Background: The eye is an important sensory organ occupationally exposed to ionizing radiation (IR) in healthcare workers (HCWs) engaged in medical imaging (MI). New evidence highlights the possible induction of cataract at IR exposure levels to be much lower than expected in the past. Objective: Conduct an updated review on the current evidence on cataract risk in healthcare workers exposed to IR. Methods: Published scientific studies on cataract risk in IR exposed healthcare workers were collected through a systematic search of two biomedical databases (MEDLINE and Scopus). Data from included studies was extracted and summarized. Study quality was also assessed. Results: All 21 eligible studies reported an increased prevalence of cataract, especially posterior subcapsular cataract, in IR exposed HCWs with a higher prevalence in interventional cardiology staff. Discussion: Our review synthesizes the latest evidence to support the hypothesis of a significantly increased risk of occupational cataract in healthcare workers operating MI and exposed to IR, especially in interventional cardiologists. Data also support a dose-response relationship between IR exposure and the prevalence of opacities, especially posterior subcapsular opacities. Con-clusions: Findings highlight the need for effective control measures including appropriate training, adherence to protective procedures, and a constant use of shields and eye personal protective equipment in healthcare workers with optical exposure to IR. Periodic health surveillance programs, possibly including lens evaluation, are also important to monitor cataract risk in these MI operators.

2020 - RoB-SPEO: A tool for assessing risk of bias in studies estimating the prevalence of exposure to occupational risk factors from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury [Articolo su rivista]
Pega, F.; Norris, S. L.; Backes, C.; Bero, L. A.; Descatha, A.; Gagliardi, D.; Godderis, L.; Loney, T.; Modenese, A.; Morgan, R. L.; Pachito, D.; Paulo, M. B. S.; Scheepers, P. T. J.; Schlunssen, V.; Sgargi, D.; Silbergeld, E. K.; Sorensen, K.; Sutton, P.; Tenkate, T.; Torreao Correa da Silva, D.; Ujita, Y.; van Deventer, E.; Woodruff, T. J.; Mandrioli, D.
abstract

Background: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates). For this, systematic reviews of studies estimating the prevalence of exposure to selected occupational risk factors will be conducted to provide input data for estimations of the number of exposed workers. A critical part of systematic review methods is to assess risk of bias (RoB) of individual studies. In this article, we present and describe the development of such a tool, called the Risk of Bias in Studies estimating Prevalence of Exposure to Occupational risk factors (RoB-SPEO) tool; report results from RoB-SPEO's pilot testing; note RoB-SPEO's limitations; and suggest how the tool might be tested and developed further. Methods: Selected existing RoB tools used in environmental and occupational health systematic reviews were reviewed and analysed. From existing tools, we identified domains for the new tool and, if necessary, added new domains. For each domain, we then identified and integrated components from the existing tools (i.e. instructions, domains, guiding questions, considerations, ratings and rating criteria), and, if necessary, we developed new components. Finally, we elicited feedback from other systematic review methodologists and exposure scientists and agreed upon RoB-SPEO. Nine experts pilot tested RoB-SPEO, and we calculated a raw measure of inter-rater agreement (Pi) for each of its domain, rating Pi < 0.4 as poor, 0.4 ≤ Pi ≥ 0.8 as substantial and Pi > 0.80 as almost perfect agreement. Results: Our review found no standard tool for assessing RoB in prevalence studies of exposure to occupational risk factors. We identified six existing tools for environmental and occupational health systematic reviews and found that their components for assessing RoB differ considerably. With the new RoB-SPEO tool, assessors judge RoB for each of eight domains: (1) bias in selection of participants into the study; (2) bias due to a lack of blinding of study personnel; (3) bias due to exposure misclassification; (4) bias due to incomplete exposure data; (5) bias due to conflict of interest; (6) bias due to selective reporting of exposures; (7) bias due to difference in numerator and denominator; and (8) other bias. The RoB-SPEO's ratings are low, probably low, probably high, high or no information. Pilot testing of the RoB-SPEO tool found substantial inter-rater agreement for six domains (range of Pi for these domains: 0.51–0.80), but poor agreement for two domains (i.e. Pi of 0.31 and 0.33 for biases due to incomplete exposure data and in selection of participants into the study, respectively). Limitations of RoB-SPEO include that it has not yet been fully performance-tested. Conclusions: We developed the RoB-SPEO tool for assessing RoB in prevalence studies of exposure to occupational risk factors. The tool will be applied and its performance tested in the ongoing systematic reviews for the WHO/ILO Joint Estimates.

2020 - Sun protection habits and behaviors of a group of outdoor workers and students from the agricultural and construction sectors in north-Italy [Articolo su rivista]
Modenese, A.; Loney, T.; Ruggieri, F. P.; Tornese, L.; Gobba, F.
abstract

Background: Despite the relevant frequency of ultraviolet induced adverse health effects in workers, solar ultraviolet radiation (UVR) exposure is an occupational risk not adequately minimized in Italy. Objective: To assess the characteristics and prevalence of sun exposure habits and behaviors in a group of students and outdoor workers (OW) from the agricultural and construction sectors of a north-Italian region. Methods: Based on a previously developed standardized questionnaire, we collected full information on individual sun exposure habits at work and during leisure activities. Results: In 2018, 380 high school students and OW from the agricultural and construction sectors participated in a sun-safety campaign. More than a third (39.0%) of OW reported never using sunglasses, 52.8% never applied sunscreens at work, and a quarter never wear a UV protective hat. Considering leisure-time, students reported more frequent sunburns compared to OW: 25.0% vs. 13.8%; half (51.6%) of students and a third (36.4%) of OW reported never wearing a UV protective hat. A third (30.1%) of students and 37.2% of OW never or only seldom applied sunscreens on holidays. Discussion: The majority of OW in our study reported poor protective solar exposure habits. Young students of the construction and agricultural sectors indicated even worse sun-protective behaviors, both during apprenticeship and leisure activities. Our study highlights the low health literacy related to solar UVR in OW and apprentices. Further educational initiatives are required in Italy to improve the adoption of protective behaviors during outdoor activities.

2020 - The development of the new guidelines of the Italian association of medical radioprotection (AIRM) for the protection of the workers exposed to EMF related risks: new approaches and criteria [Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

An up-to-date knowledge on the occupational risk related to electromagnetic fields (EMF) exposure and its prevention, and on the criteria and methods for an appropriate health surveillance (HS) of exposed workers are highly important, as: EMF are almost ubiquitous; in recent years, relevant changes and advancements in the technologies applied have been observed, e.g. the introduction of new equipment for Magnetic Resonance, involving potentially higher exposures for operators, and the development of the 5G technology, using also EMF bands with millimetric wavelengths, not often applied previously; in Italy the new Legislative Decree 159/2016 has been promulgated, implementing the Directive 2013/35/EU and, accordingly, introducing several substantial changes to the Legislative Decree 81/2008 on safety and health at work, in particular to its fourth chapter of the eight section ("Physical Agents"), entitled "The protection of workers from the risks related to electromagnetic fields exposure". For these reasons, the Italian Association of Medical Radioprotection (AIRM) has fully revised the "Guidelines for the health surveillance of workers exposed to non-ionizing radiation", published in 2012 together with the Italian Society of Occupational Medicine (SIML). Therefore, AIRM involved a multidisciplinary panel of experts, working in accordance to a rigorous scientific methodology, based on the recognized international indications for the development of guidelines (GL) in the medical field, as those proposed by the Guidelines International Network (GIN), the Grading of Recommendations Assessment, Development and Evaluation (GRADE), the National Institute for Health and Care Excellence (NICE) and the Appraisal of Guidelines for Research and Evaluation (AGREE) collaboration. Furthermore, the multidisciplinary panel conducted a systematic review of the scientific literature according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyzes" (PRISMA) criteria, aimed at answering to specific research questions, including the "PECO" (Populations of interest, Exposures, Comparators, and Outcomes) questions. The final stages of the GL include the revision of the GL-draft from an external group of independent experts, giving also an overall evaluation and opinions on the Recommendations elaborated, so that the panel group can elaborate a final document to be shared again, after agreement among all the experts, with a consensus reached by Delphi method in case of disagreement. The main GL objective is to guide occupational physicians in charge for the HS of EMF exposed workers, providing up-to-date indications on the contents and methods for an adequate HS of the workers, but also on the regulations and standards applicable, on the relevant occupational EMF exposure sources, on the possible adverse effects to be considered, including indications on the biological mechanisms involved, on the conditions of particular susceptibility to the EMF risk, on the criteria to be considered for the evaluation of "fitness to work" in case of occupational EMF exposure and finally also on the contents of adequate information and training for the workers exposed. As a final objective, the AIRM GL on HS of workers exposed to EMF will be proposed for public consultation to the Italian National Guidelines System, as required according to the Law n. 24/2017, also known as the «Gelli law».

2020 - The effect of occupational exposure to welding fumes on trachea, bronchus and lung cancer: A protocol for a systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury [Articolo su rivista]
Pega, Frank; Chartres, Nicholas; Guha, Neela; Modenese, Alberto; Morgan, Rebecca L; Martínez-Silveira, Martha S; Loomis, Dana
abstract

The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Welding fumes have been classified as carcinogenic to humans (Group 1) by the International Agency for Research on Cancer (IARC); this assessment found sufficient evidence from studies in humans that welding fumes are a cause of lung cancer. In this article, we present the protocol for a systematic review of parameters for estimating the number of deaths and disability-adjusted life years from trachea, bronchus and lung cancer attributable to occupational exposure to welding fumes, to inform the development of the WHO/ILO Joint Estimates.

2019 - CEM: le condizioni che possono comportare una maggiore suscettibilità dei lavoratori e le misure di prevenzione. [Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

2019 - Evaluation of Occupational Exposure to Perchlorethylene in a Group of Italian Dry Cleaners Using Noninvasive Exposure Indices [Articolo su rivista]
Modenese, Alberto; Gioia, Tiziana Concetta; Chiesi, Andrea; Abbacchini, Carlotta; Borsari, Lucia; Ferrari, Davide; De Pasquale, Fabrizio; Di Rico, Renato; Ricci, Raffaella; Sala, Antonella; Gianaroli, Ennio; Predieri, Guerrino; Verri, Sara; Gobba, Fabriziomaria
abstract

Recent data suggest a general trend in decreased occupational exposure to perchlorethylene (PCE) in the dry-cleaning sector. The aims of this study were to confirm this trend to lower exposure levels in a group of Italian dry cleaners and to evaluate the current occupational PCE exposure in these works using noninvasive biological indices. Environmental exposure was assessed by personal sampling in 60 operators working in 21 dry cleaning shops in North Italy. PCE in the exhaled alveolar air (PCEalv), urinary concentration of PCE and of trichloroacetic acid (TCA) (PCEu and TCAu respectively), were measured as biological exposure indices. Median PCE environmental concentration in the whole sample was 10.6 mg/m3 (i.e., less than the 25% of the levels measured in the same area in a previous study). All values were less than 10% of the occupational limits. PCEu measured in samples collected at the end of the work shift resulted the biological markers having the strongest correlation with environmental PCE (r = 0.81). PCEalv also resulted in a high correlation (r = 0.66), while a lower correlation was found for TCAu measured at the end shift (r = 0.32). According to our results, PCEu can be proposed as a valid, noninvasive, and easily reliable exposure index to evaluate PCE exposure at the low levels currently observed in dry cleaners, therefore representing a promising alternative to invasive blood sample collections needed to determine PCE blood concentration.

2019 - L'esposizione al sole dei lavoratori outdoor: un rischio sottostimato. [Relazione in Atti di Convegno]
Borra, Massimo; Burattini, Chiara; Gugliermetti, Luca; Modenese, Alberto
abstract

2019 - Macular degeneration and occupational risk factors: a systematic review [Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

Purpose: Macular degeneration is a multi-factorial disease, leading cause of blindness for people over 50 years old in developed countries. To date, the knowledge on possible occupational factors involved in the development of the disease is scant. Method: We performed a systematic scientific literature search on the association between macular degeneration and occupational risk factors searching the MedLine and Scopus databases. Results: We examined 158 articles and, according to the inclusion criteria, 13 peer-reviewed studies evaluating occupational risk factors for macular degeneration or reporting the frequency of the disease in specific groups of workers were included in the review. Ten on thirteen articles evaluated the presence of macular degeneration in workers exposed to solar radiation. Only one study found that non-specific history of occupational chemical exposure was associated with the disease. Two studies showed an association between macular degeneration and the general category of “blue-collar” workers, but they did not identify the specific risk factors involved. Conclusions: To date few studies have examined occupational risk factors for macular degeneration. Nevertheless, available data indicate that long-term occupational solar radiation exposure, in particular for its blue-light component, is associated with macular degeneration in outdoor workers.

2019 - Occupational exposure to electromagnetic fields and prevention of possible adverse effects in workers: results of 20 years of research at the University of Modena and Reggio Emilia [Capitolo/Saggio]
Modenese, Alberto; Bargellini, Annalisa; Gobba, Fabriziomaria
abstract

The occupational risk related to electromagnetic fields (EMF) exposure in workplaces is one of the main research fields developed in the last 20 years by the Chair of Occupational Medicine and the Chair of Hygiene of the Public Health Section of the Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia. During this period we have approached several topics in the field of exposure and prevention of EMF risk in occupational settings, including: - the occupational and environmental Extremely Low Frequency – Electromagnetic Fields (ELF-EMF) exposure and effects in different groups of workers; - the possible mechanisms of ELF-EMF effects in biological tissues; - the development of best practices to manage and prevent the EMF related occupational risk in workers according to the European Directives, with particular consideration for health surveillance of exposed workers; - the occupational risk and the health surveillance of Magnetic Resonance Imaging operators; - the epidemiology of proposed adverse long-term effects of occupational EMF exposure.

2019 - Occupational Exposure to Solar UV Radiation of a Group of Fishermen Working in the Italian North Adriatic Sea [Articolo su rivista]
Modenese, Alberto; Ruggieri, Francesco Pio; Bisegna, Fabio; Borra, Massimo; Burattini, Chiara; Della Vecchia, Elena; Grandi, Carlo; Grasso, Anna; Gugliermetti, Luca; Manini, Marco; Militello, Andrea; Gobba, Fabriziomaria
abstract

Occupational solar radiation exposure is a relevant heath risk in the fishing sector. Our aim was to provide a detailed evaluation of individual UV exposure in three different fishing activities in Italy, with personal UV dosimeters and a simple formula to calculate the fraction of ambient erythemal UV dose received by the workers. The potential individual UV exposure of the fishermen was between 65 and 542 Joules/m2. The percentages of the ambient exposure were estimated between 2.5% and 65.3%. Workers’ UV exposure was mainly influenced by the characteristics of the work activity, the postures adopted, and the type of boats. Overall, our data showed that 43% of the daily measurements could result largely above the occupational limits of 1–1.3 standard erythemal dose (i.e., 100 Joules/m2) per day, in case of exposure of uncovered skin areas. Measurements of individual UV exposure are important not only to assess the risk but also to increase workers’ perception and stimulate the adoption of preventive measures to reduce solar UV risk. Furthermore, the simple method proposed, linking ambient erythemal UV dose to the workers’ exposure, can be a promising tool for a reliable assessment of the UV risk, as time series of environmental UV dose are widely available

2019 - PREVENZIONE DEL RISCHIO OCCUPAZIONALE DA ESPOSIZIONE A RADIAZIONE SOLARE: UN INTERVENTO FORMATIVO RIVOLTO A LAVORATORI DEL SETTORE MARITTIMO [Abstract in Rivista]
Ruggieri, Francesco Pio; Grasso, Anna; Della Vecchia, Elena; Larese Filon, Francesca; Manini, Marco; Modenese, Alberto; Toffanin, Paolo; Gobba, Fabriziomaria
abstract

2019 - Prevenzione del rischio occupazionale da radiazione solare: realizzazione di un intervento formativo per i lavoratori e gli studenti del comparto agricolo ed edile in provincia di Modena [Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

2019 - PROTEZIONE DEI LAVORATORI DAI CAMPI ELETTROMAGNETICI (CEM) E SORVEGLIANZA SANITARIA: DATI PRELIMINARI DI UNA RICERCA NELL’AMBITO DEL BANDO INAIL RICERCHE IN COLLABORAZIONE (BRiC) 2016 [Relazione in Atti di Convegno]
Modenese, A.; Carlotti, D.; Contessa, G. M.; D’Agostino, S.; Falsaperla, R.; Grandi, C.; Lopresto, V.; Pinto, R.; Polichetti, A.; Pozzi, R.; Gobba, F. M.
abstract

2019 - REVISIONE DI LETTERATURA SULLE CONOSCENZE SCIENTIFICHE RECENTI IN TEMA DI RISCHIO BIOLOGICO E CHIMICO NELLE STRUTTURE SANITARIE: UN’ATTIVITÀ REALIZZATA NELL’AMBITO DI UN PROGETTO CONGIUNTO UNIMORE, INAIL E AUSL DI MODENA, FINALIZZATO ALLA PREDISPOSIZIONE DI INDICAZIONI PRATICHE DI PREVENZIONE PER IL PERSONALE SANITARIO [Abstract in Rivista]
Modenese, Alberto; Glieca, Francesca; Gualtieri, Giulia; Mazzoli, Tommaso; Rossi, Giorgia; Rosa Avino, Maria; Bonetti, Daniela; Bravo, Giulia; Ferrari, Davide; Innocenti, Massimo; Gobba, Fabriziomaria
abstract

2019 - Skin cancer in outdoor workers exposed to solar radiation: a largely underreported occupational disease in Italy [Articolo su rivista]
Gobba, F; Modenese, A; John, S M
abstract

Background Solar UV radiation (sUVR) is one of the main carcinogen exposures in occupational settings, and UV-induced skin cancers are the most frequent tumours in fair-skinned individuals worldwide. Objectives According to this premise, we should expect a high number of occupational skin cancers reported to the national workers' compensation authorities each year, also considering that the incidence of skin cancers has been constantly increased in recent years Methods We examined the data on reported non-melanoma skin cancers (NMSC) and actinic keratoses (AK) to the Italian National Workers Compensation Authority (INAIL) from 2012 to 2017, and we compared the number of reported skin cancers for outdoor workers with the expected numbers, obtained from currently available NMSC incidence rates for the Italian population applied to the occupational sUVR-exposed workers estimated with the CAREX methodology in Italy in 2005. Results The cases of NMSC reported each year to INAIL in Italy are 34 per year on average, while for AK the mean number of reported cases is of only 15/year. We estimated a number of expected NMSC cases in Italy for solar UV-exposed workers ranging between 432 and 983, representing a proportion between reported vs. expected skin cancers of only 3.5-6.2%. Conclusions Our study clearly shows that occupational skin cancers in Italy are largely underreported, and, accordingly, urgent initiatives should be taken to raise appropriate awareness to the problem of occupational sUVR-induced skin cancers, so that adequate preventive measures can be implemented rapidly.

2019 - STUDIO SUGLI EFFETTI SENSORIALI SOGGETTIVI IN OPERATORI DI RISONANZA MAGNETICA [Abstract in Rivista]
Bertoldi, C.; Muscatello, M.; Venturelli, I.; Modenese, A.; Bravo, G.; Arcangeli, G.; Camisa, V.; Corona, G.; Giglioli, S.; Ligabue, G.; Moccaldi, R.; Mucci, N.; Vimercati, L.; Zaffina, S.; Zanotti, G.; Gobba, F.
abstract

2019 - TUMORI PROFESSIONALI DELLA CUTE: ESPOSIZIONI A RISCHIO E ASPETTI EPIDEMIOLOGICI [Abstract in Rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

2019 - WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of occupational exposure to solar ultraviolet radiation and of the effect of occupational exposure to solar ultraviolet radiation on cataract [Articolo su rivista]
Tenkate, Thomas; Adam, Balazs; Al-Rifai, Rami H.; Chou, B. Ralph; Gobba, Fabriziomaria; Ivanov, Ivan D.; Leppink, Nancy; Loney, Tom; Pega, Frank; Peters, Cheryl E.; Prüss-Üstün, Annette M.; Silva Paulo, Marilia; Ujita, Yuka; Wittlich, Marc; Modenese, Alberto
abstract

Background: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. Here, we present the protocol for two systematic reviews of parameters for estimating the number of disability-adjusted life years of cataracts from occupational exposure to solar ultraviolet radiation, to inform the development of the WHO/ILO joint methodology. Objectives: We aim to systematically review studies on occupational exposure to solar ultraviolet radiation (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational exposure to solar ultraviolet radiation on the development of cataract (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework and conducting both systematic reviews in tandem and in a harmonized way. Data sources: Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and Web of Sciences. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand search reference list of previous systematic reviews and included study records; and consult additional experts. Study eligibility and criteria: We will include working-age (≥15 years) workers in WHO and/or ILO Member States, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative studies on the prevalence of relevant levels of occupational exposure to solar ultraviolet radiation and of the total working time spent outdoors from 1960 to 2018, stratified by sex, age, country and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of any occupational exposure to solar ultraviolet radiation (i.e. ≥30 Jm −2 /day of occupational solar UV exposure at the surface of the eye) on the prevalence or incidence of cataract, compared with the theoretical minimum risk exposure level (i.e. <30 Jm −2 /day of occupational solar UV exposure at the surface of the eye). Study appraisal and synthesis methods: At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration: CRD42018098897.

2019 - WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of occupational exposure to solar ultraviolet radiation and of the effect of occupational exposure to solar ultraviolet radiation on melanoma and non-melanoma skin cancer [Articolo su rivista]
Paulo, Marilia Silva; Adam, Balazs; Akagwu, Cyril; Akparibo, Issaka; Al-Rifai, Rami H.; Bazrafshan, Sholeh; Gobba, Fabriziomaria; Green, Adele C.; Ivanov, Ivan; Kezic, Sanja; Leppink, Nancy; Loney, Tom; Modenese, Alberto; Pega, Frank; Peters, Cheryl E.; Prüss-Üstün, Annette M.; Tenkate, Thomas; Ujita, Yuka; Wittlich, Marc; John, Swen M.
abstract

Background: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from melanoma and non-melanoma skin cancer (or keratinocyte carcinoma) from occupational exposure to solar ultraviolet radiation, to inform the development of the WHO/ILO joint methodology. Objectives: We aim to systematically review studies on occupational exposure to solar ultraviolet radiation (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational exposure to solar ultraviolet radiation on melanoma and non-melanoma skin cancer (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework and conducting both systematic reviews in tandem and in a harmonized way. Data sources: Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and Web of Science. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records and consult additional experts. Study eligibility and criteria: We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative studies on the prevalence of relevant levels of occupational exposure to solar ultraviolet radiation (i.e. <0.33 SED/d and ≥0.33 SED/d) and of the total working time spent outdoors, stratified by country, sex, age and industrial sector or occupation, in the years 1960 to 2018. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of any occupational exposure to solar ultraviolet radiation (i.e., ≥0.33 SED/d) on the prevalence of, incidence of or mortality due to melanoma and non-melanoma skin cancer, compared with the theoretical minimum risk exposure level (i.e. <0.33 SED/d). Study appraisal and synthesis methods: At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess the risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42018094817.

2018 - Cataract frequency and subtypes involved in workers assessed for their solar radiation exposure: a systematic review [Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

Cataract is currently the primary cause of blindness worldwide, and one of its main risk factors is solar ultraviolet radiation exposure. According to the localization of lens opacities, three main subtypes of cataract are recognized: nuclear, cortical and posterior subcapsular cataract. One of the main determinants of individual long-term solar radiation exposure is outdoor work. We systematically reviewed scientific literature from the last 20 years to update the recent development of research on the risk of cataract in outdoor workers and on the specific subtypes involved, also investigating the methods applied to evaluate the occupational risk. A total of 15 studies were included in the review, of which 12 showed a positive association. The studies confirm the relationship of long-term occupational solar radiation exposure with cortical cataract and give new support for nuclear cataract, although no substantial new data were available to support a relation with the posterior subcapsular subtype. In most of the studies, the exposure assessment was not adequate to support a representative evaluation of the ocular risk; however, outdoor work is clearly a relevant risk factor for cataract. Further research providing a better evaluation of the relation between solar radiation exposure levels and lens damage in workers is needed and aimed to establish adequate occupational exposure limits and better preventive measures, studying also their effectiveness.

2018 - Criteri di sorveglianza sanitaria dei lavoratori esposti a UV [Relazione in Atti di Convegno]
Modenese, Alberto
abstract

2018 - Developing an algorithm to assess the UV erythemal dose for outdoor workers Validation through direct measures [Relazione in Atti di Convegno]
Borra, M; Grandi, C; Militello, A; Burattini, C; Gugliermetti, L; Mangione, A; Bisegna, F; Modenese, A; Gobba, F
abstract

An algorithm has been developed to determine the annual dose of UV solar radiation for outdoor workers. The dose is indirectly assessed basing on satellite data, mean global irradiance values, workers' data obtained by means of a questionnaire and corrective coefficients provided by a mathematical model. The values obtained by the use of the algorithm are compared with those obtained by measurement records in different environments. Results demonstrated that the algorithm estimates the mean daily erythemal dose with good approximation.

2018 - I RISCHI OCCUPAZIONALI ATTUALI NEL PERSONALE SANITARIO DELLA DIAGNOSTICA PER IMMAGINI: UNA REVISIONE DEI DATI DELLA LETTERATURA [Abstract in Atti di Convegno]
Della Vecchia, Elena; Muscatello, Martina; Rossi, Giorgia; Modenese, Alberto; Gobba, Fabriziomaria
abstract

2018 - LA COPERTURA VACCINALE ANTINFLUENZALE NEGLI OPERATORI SANITARI [Abstract in Atti di Convegno]
Stefani, M.; Corona, G.; Marchegiano, P.; Melloni, P.; Modenese, Alberto; Nikollau, N.; Placidi, D.; Gobba, Fabriziomaria
abstract

2018 - L'esposizione a campi elettromagnetici (CEM) nelle strutture sanitarie: le principali sorgenti, dati attuali sui possibili effetti [Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

2018 - MONITORAGGIO DOSIMETRICO DELL’ESPOSIZIONE A RADIAZIONE SOLARE IN LAVORATORI DEL SETTORE MARITTIMO [Abstract in Atti di Convegno]
Ruggieri, Francesco Pio; Bisegna, Fabio; Borra, Massimo; Burattini, Chiara; Della Vecchia, Elena; Foddis, Rudy; Grandi, Carlo; Grasso, Anna; Gugliermetti, Luca; Larese Filon, Francesca; Manini, Mauro; Militello, Andrea; Modenese, Alberto; Toffanin, Paolo; Gobba, Fabriziomaria
abstract

2018 - Occupational exposure to solar radiation at different latitudes and pterygium: A systematic review of the last 10 years of scientific literature [Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

Pterygium is a chronic eye disease: among its recognized risk factors there is long-term exposure to ultraviolet (UV) radiation. The Sun is the main source of UV exposure: according to the World Health Organization, the Population Attributable Fraction of pterygium due to solar radiation (SR) is 42–74%. Outdoor work can deeply influence the eye exposure to solar UV rays, but, despite this, pterygium is currently not adequately considered as a possible occupational disease in this working category, at least in Europe. For this reason, we performed a systematic review of the scientific literature published in the last ten years (2008–2017) considering the role of outdoor work as a risk factor for pterygium, in order to give new support for the prevention of this UV related disease in workers. We identified 29 relevant papers. Our results show that pterygium prevalence highly increased with latitude and mean annual UV index, and outdoor work is one of the most relevant risk factors, as well as age and male sex, both in high risk and in moderate risk World areas considering the environmental UV levels. Accordingly, pterygium occurring in outdoor workers should be considered an occupational disease. Moreover, our findings clearly support the need of further research on more effective prevention of the occupational risk related to long-term solar radiation exposure of the eye.

2018 - PREVENZIONE DEL RISCHIO DA ESPOSIZIONE OCCUPAZIONALE A RADIAZIONE SOLARE: UN INTERVENTO FORMATIVO RIVOLTO A LAVORATORI, DOCENTI E STUDENTI DEI SETTORI AGRICOLO E EDILE [Abstract in Atti di Convegno]
Modenese, Alberto; Avino, M. R.; Delli Carri, R.; Innocenti, M.; Gobba, Fabriziomaria
abstract

2018 - Solar radiation exposure and outdoor work: An underestimated occupational risk [Articolo su rivista]
Modenese, Alberto; Korpinen, Leena; Gobba, Fabriziomaria
abstract

A considerably high number of outdoor workers worldwide are constantly exposed for the majority of their working life to solar radiation (SR); this exposure is known to induce various adverse health effects, mainly related to its ultraviolet (UV) component. The skin and the eye are the principal target organs for both acute and long-term exposure. Actinic keratosis, non-melanoma skin cancers, and malignant melanoma are the main long-term adverse skin effects, whereas in the eye pterygium, cataracts, and according to an increasing body of evidence, macular degeneration may be induced. Despite this, SR exposure risk is currently undervalued, if not neglected, as an occupational risk factor for outdoor workers. SR exposure is influenced by various environmental and individual factors, and occupation is one of the most relevant. For a better understanding of this risk and for the development of more effective prevention strategies, one of the main problems is the lack of available and adequate methods to estimate SR worker exposure, especially long-term exposure. The main aims of this review were to provide a comprehensive overview of SR exposure risk of outdoor workers, including the UV exposure levels and the main methods recently proposed for short-term and cumulative exposure, and to provide an update of knowledge on the main adverse eye and skin effects. Finally, we also outline here preventive interventions to reduce occupational risk.

2018 - Stakeholders' views on vocational rehabilitation programs: a call for collaboration with Occupational Health Physicians [Articolo su rivista]
Mattei, Giorgio; Sacchi, Valentina; Alfieri, Salvatore; Bisi, Antonella; Colombini, Niccolò; Ferrari, Silvia; Giubbarelli, Giuseppe; Gobba, Fabriziomaria; Modenese, Alberto; Pingani, Luca; Rigatelli, Marco; Rossetti, Marisa; Venturi, Giulia; Starace, Fabrizio; Galeazzi, Gian Maria
abstract

The triple-dip recession taking place in Italy in 2008-2014 impacted negatively on health, mainly by increasing the rate of unemployment. This increased the prevalence of mental health disorders, while reducing the number of available places on vocational rehabilitation programs (VRPs) delivered by the psychiatric services.

2018 - 1334 A simple method to determine the cumulative dose in outdoor workers exposed to solar radiation [Abstract in Rivista]
Borra, M; Bisegna, F; Burattini, C; Gobba, F; Grandi, C; Gugliermetti, F; Militello, A; Modenese, A
abstract

2018 - 1616b Questionnaire based evaluation of the whole-life history of solar uv radiation exposure in a group of patients in italy [Abstract in Rivista]
Modenese, Alberto
abstract

2018 - 1650a Subjective symptoms in magnetic resonance imaging operators: preliminary results of an italian study [Abstract in Rivista]
Zanotti, G; Modenese, A; Bravo, G; Arcangeli, G; Camisa, V; Corona, G; Giglioli, S; Ligabue, G; Moccaldi, R; Mucci, N; Vimercati, L; Zaffina, S; Gobba, F
abstract

2018 - 1651d Occupational uv exposure and the eye [Abstract in Rivista]
Modenese, A
abstract

2018 - 931 Occupational skin cancer in outdoor workers in italy: expected number vs cases recognised by the italian national compensation authority (inail) [Abstract in Rivista]
Modenese, Alberto; Korpinen, Leena; Gobba, Fabriziomaria
abstract

2018 - 934 Gliomas incidence in italy [Abstract in Rivista]
Modenese, Alberto; Korpinen, Leena; Gobba, Fabriziomaria
abstract

2017 - Effetti dei campi elettromagnetici nei lavoratori professionalmente esposti: le evidenze scientifiche, le decisioni della magistratura. [Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto; Zanotti, Giulio
abstract

2017 - Epidemiologia delle neoplasie indotte dall’esposizione a NIR [Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

2017 - Esposizione a radiazione solare e cataratta: un aggiornamento delle conoscenze della letteratura scientifica. [Abstract in Atti di Convegno]
Mazzoli, T; Grasso, A; Gualtieri, G; Carozza, Lm; Modenese, A; Gobba, F.
abstract

Esposizione a radiazione solare e cataratta: un aggiornamento delle conoscenze della letteratura scientifica.

2017 - Esposizione occupazionale ed ambientale a radiazione solare e degenerazione maculare: una revisione dei dati epidemiologici dell’ultimo decennio. [Abstract in Atti di Convegno]
Gualtieri, Giulia; Grasso, Anna; Mazzoli, Tommaso; Carozza, Lm; Modenese, A; Gobba, F.
abstract

Esposizione occupazionale ed ambientale a radiazione solare e degenerazione maculare: una revisione dei dati epidemiologici dell’ultimo decennio.

2017 - Esposizione professionale a radiazione solare: il dosaggio di dimeri di timina urinari per la stima del danno cutaneo da UV. [Abstract in Atti di Convegno]
Loscerbo, Roberto; Modenese, A; Tomasini, Emanuela; Gobba, F.
abstract

Esposizione professionale a radiazione solare: il dosaggio di dimeri di timina urinari per la stima del danno cutaneo da UV.

2017 - Health Risk Assessment per esposizione occupazionale a sostanze chimiche cancerogene e non cancerogene nel riciclo di rifiuti di apparecchiature elettriche e elettroniche (RAEE): dati dal progetto WeeenModels. [Abstract in Atti di Convegno]
Modenese, A; Ferrari, Am; Gamberini, R; Grasselli, L; Neri, P; Pini, M; Rimini, B; Vinceti, M; Violi, F; Gobba, F.
abstract

Health Risk Assessment per esposizione occupazionale a sostanze chimiche cancerogene e non cancerogene nel riciclo di rifiuti di apparecchiature elettriche e elettroniche (RAEE): dati dal progetto WeeenModels.

2017 - La sorveglianza sanitaria dei lavoratori esposti a campi elettromagnetici: obblighi alla luce dei recenti aggiornamenti normativi in Italia [Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

2017 - La valutazione dell’esposizione professionale a radiazione solare negli studi epidemiologici su lavoratori: una revisione della letteratura. [Abstract in Atti di Convegno]
Carozza, Lm; Grasso, A; Mazzoli, T; Gualtieri, G; Modenese, A; Gobba, F.
abstract

La valutazione dell’esposizione professionale a radiazione solare negli studi epidemiologici su lavoratori: una revisione della letteratura.

2017 - Latenza dei disturbi muscolo scheletrici in un campione di personale sanitario [Abstract in Atti di Convegno]
Stefani, Marco; Lanfranchi, Giordano; Modenese, A; Gobba, F.
abstract

Abstract presentato al 80° Congresso Nazionale SIMLII tenutosi a Padova dal 20 al 22 Settembre 2017, riportante dati sulla latenza dell'insorgenza di disturbi muscolo scheletrici in un campione di personale sanitario

2017 - Monitoraggio dosimetrico dell’esposizione a radiazione solare nel settore edile [Abstract in Atti di Convegno]
Modenese, A; Paolucci, V; D’Hauw, G; Gobba, F; Sartorelli, P.
abstract

Monitoraggio dosimetrico dell’esposizione a radiazione solare nel settore edile.

2017 - Work-related eye injuries: A relevant health problem. main epidemiological data from a highly-industrialized area of northern Italy [Articolo su rivista]
Gobba, Fabriziomaria; Dall'Olio, Enrico; Modenese, Alberto; DE MARIA, Michele; Campi, Luca; Cavallini, Gian Maria
abstract

The province of Modena is one of the most industrialized areas of Northern Italy. The medical records of the Ophthalmological Emergency Department (OED) of Modena University Hospital were studied: there were 13, 470 OED accesses in 2014 and in 754 cases that an occupational eye injury occurred. The frequency of work-related eye injuries (3â °) was lower compared to other published studies, but the absolute number is still relevant, showing the need for more adequate prevention, especially in metal work, construction work, and agriculture, where the worst prognoses were observed. Intervention programs must be implemented as early as possible in the working life, considering that the frequency in younger workers is about double that of the oldest age class (3.5â °vs. 1.8â °), and special attention should also be given to foreigners, who have a 50% higher injury risk. Furthermore, the planning of specific interventions for eye-injured workers may be useful, considering that a previous injury does not appear to encourage the adoption of preventive interventions, and a subgroup of eye-injured workers have a potential risk for new injuries. Finally, the data presented here indicates how OED records, integrated with specific occupational information, can be applied for studies on work-related eye injuries.

2017 - Work-related stress and role of personality in a sample of Italian bus drivers [Articolo su rivista]
Bergomi, Margherita; Modenese, Alberto; Ferretti, Enrica; Ferrari, Angela; Licitra, Giuseppe; Vivoli, Roberto; Gobba, Fabriziomaria; Aggazzotti, Gabriella
abstract

BACKGROUND: Several studies have shown that professional drivers are at risk of developing work-related stress. Stress may be responsible for a variety of adverse effects and may also be associated with an increased number of accidents. OBJECTIVE: Perform an integrated, objective and subjective evaluation of work-related stress in bus drivers, that also considered the role of personality traits. METHODS: Salivary α-amylase and cortisol were measured in 42 bus drivers. Subjective stress evaluation was performed with the Perceived Stress Scale (PSS-10) and Driver Stress Inventory (DSI). To evaluate personality traits, we administered the Eysenck Personality Questionnaire-Revised (EPQ-R) and the Impulsivity Inventory (IVE). RESULTS: Salivary biomarkers showed no associations with PSS-10 and personality traits. Cortisol levels were positively correlated with fatigue (r = 0.44) at the middle of the work-shift and with aggression (r = 0.51) at the end of a day off. At the end of the work-shift, cortisol levels were negatively correlated with hazard monitoring (r = -0.37) and salivary α-amylase was positively correlated with thrill-seeking (r = 0.36). Neuroticism (β = 0.44) and impulsiveness (β = 0.38) were predictors of perceived stress by multiple regression. CONCLUSIONS: An integrated method, considering both objective and subjective indicators, seems adequate to evaluate work-related stress in professional drivers. Personality traits are relevant in determining perception of stress.

2016 - Assessing cancer risk from heavy metal exposure in recycling waste of electrical and electronic equipment: preliminary results from the Weeenmodels European Life Programme. [Abstract in Atti di Convegno]
Violi, Federica; Modenese, Alberto; Gobba, Fabriziomaria; Ferrari, Anna Maria; Rimini, Bianca; Gamberini, Rita; Pini, M; Neri, P; Filippini, Tommaso; Grasselli, Luigi; Montanari, P; Vinceti, Marco
abstract

Introduction The growing amount of waste derived from electrical and electronic equipment (WEEE) poses significant challenges to waste management, due to the presence of toxic chemicals with environmental and health implications for the general population and for occupationally-exposed workers. Methods Based on an toxicological and epidemiologic evaluation, we carried out a health risk assessment to evaluate the cancer risk deriving from environmental and occupational exposure to heavy metals released during different WEEE recycling procedures (electronic scrap in blister copper, treatment of metals recovery in copper smelter, treatment of shredding, pyrometallurgical treatment of Li-ion battery). We considered the typical WEEE production in a municipality of 150.0000 inhabitants, carrying out a Life Cycle Assessment. Outdoor (1km2 around a treatment plant) and indoor (for a factory volume of 3200m3) emissions generated during the WEEE recycling procedures were computed. In particular, we estimated the amount of Cd, Ni and As inhaled by the potentially exposed population. We computed the cancer risk due to inhalation of these heavy metals in residents and workers using the methodology proposed by the California Office of Environmental Health and Hazard Assessment Results For the metals considered, our results showed negligible cancer risk (from 2,21x10-11 to 4,31x10-08) for the general population around the plant. On the converse, occupational exposures linked to specific procedures were associated with a cancer risk of 1,42x10-3 for workers in the shredding procedures mainly due to Ni exposure, and of 4,68x10-4 for workers with electronic scrap and exposed to As. Conclusions Based on our preliminary results from an integrated toxicological and epidemiologic approach, WEEE life cycle may be linked to health risks for workers in the recycling procedures, while it does not seem to adversely affect health of the general population around the treatment plants.

2016 - Assessing Cancer Risk from Heavy Metals in Recycling Waste Electrical and Electronic Equipment: Preliminary Results from the WEENMODELS European Life Programme [Abstract in Rivista]
Violi, Federica; Modenese, Alberto; Gobba, Fabriziomaria; Ferrari, Anna Maria; Rimini, Bianca; Gamberini, Rita; Pini, Martina; Neri, Paolo; Filippini, Tommaso; Grasselli, Luigi; Montanari, Pinuccia; Vinceti, Marco
abstract

Introduction The growing amount of waste derived from electrical and electronic equipment (WEEE) poses significant challenges to waste management, due to the presence of toxic chemicals with environmental and health implications for the general population and for occupationally-exposed workers. Methods Based on an toxicological and epidemiologic evaluation, we carried out a health risk assessment to evaluate the cancer risk deriving from environmental and occupational exposure to heavy metals released during different WEEE recycling procedures (electronic scrap in blister copper, treatment of metals recovery in copper smelter, treatment of shredding, pyrometallurgical treatment of Li-ion battery). We considered the typical WEEE production in a municipality of 150.0000 inhabitants, carrying out a Life Cycle Assessment. Outdoor (1 square km around a treatment plant) and indoor (for a factory volume of 3200 m3) emissions generated during the WEEE recycling procedures were computed. In particular, we estimated the amount of Cd, Ni and As inhaled by the potentially exposed population. We computed the cancer risk due to inhalation of these heavy metals in residents and workers using the methodology proposed by the California Office of Environmental Health and Hazard Assessment Results For the metals considered, our results showed negligible cancer risk (from 2,21x10-11 to 4,31x10-08) for the general population around the plant. On the converse, occupational exposures linked to specific procedures were associated with a cancer risk of 1,42x10-3 for workers in the shredding procedures mainly due to Ni exposure, and of 4,68x10-4 for workers with electronic scrap and exposed to As. Conclusions Based on our preliminary results from an integrated toxicological and epidemiologic approach, WEEE life cycle may be linked to health risks for workers in the recycling procedures, while it does not seem to adversely affect health of the general population around the treatment plants.

2016 - CANCER RISK FROM HEAVY METAL EXPOSURE IN RECYCLING WASTE OF ELECTRICAL AND ELECTRONIC EQUIPMENT: PRELIMINARY RESULTS FROM THE WEEENMODELS EUROPEAN LIFE PROGRAM [Abstract in Atti di Convegno]
Violi, Federica; Modenese, Alberto; Gobba, Fabriziomaria; Ferrari, Anna Maria; Rimini, Bianca; Gamberini, Rita; Pini, Martina; Neri, Paolo; Filippini, Tommaso; Grasselli, Luigi; Montanari, Pinuccia; Vinceti, Marco
abstract

Background and objectives: When electrical and electronic equipment reaches its end of life, it becomes ‘Waste Electrical and Electronic Equipment’ (WEEE). The growing amount of this type of waste has posed significant challenges to waste management, since WEEE contains a whole range of toxic chemicals having relevant environmental and health implications. The WEEE life cycle may expose the general population and workers to various toxic chemicals, such as heavy metals. We conducted a health risk assessment to evaluate the cancer risk derived from environmental and occupational exposure to trace elements from different recycling procedures (electronic scrap in blister copper, treatment of metals recovery in copper smelter, treatment of shredding, pyrometallurgical treatment of Li-ion battery). We considered the typical production of WEEE in a municipality of 150.0000 inhabitants, where a Life Cycle assessment (LCA) was carried out. Methods: Outdoor (1km2 around a WEEE treatment plant) and indoor (factory volume of 3200m3) emissions generated from the above-mentioned procedures were computed, to perform a health risk assessment for occupationally-exposed workers and for the general population around the plant. Dose of the heavy metals cadmium, nickel, arsenic inhaled by the potentially exposed population was estimated using the values obtained through a toxicological model. Cancer risk due to inhalation was calculated using the method proposed by the California Office of Environmental Health and Hazard Assessment. Results and Conclusions: For the heavy metals considered, generated from WEEE treatment, these preliminary results show negligible cancer risk for the general population. On the converse, some risks may be present for occupational exposures linked to specific procedures (from cancer risk of 1,42x10-3 for men working in shredding procedure and exposed to nickel to cancer risk of 4,68x10- 4 for women working with electronic scrap and exposed to arsenic).

2016 - Corioretinite acuta da esposizione a ROA nel campo dell’infrarosso in un lavoratore di una acciaieria. [Articolo su rivista]
Taino, Giuseppe; Modenese, Alberto; Zanotti, Giulio; Gobba, Fabriziomaria
abstract

L’esposizione a Radiazione Ottica Artificiale (ROA) incoerente, per quanto concerne l’ambito della radiazione infrarossa (IR), interessa le lunghezze d’onda di radiazione non ionizzante da 780 nm a 1 millimetro, ovvero dell’IR-A (780-1400 nm), IR-B (1400-3000 nm) e IR-C (3000 nm – 1 mm). La radiazione IR, come le altre componenti della ROA, visibile e ultravioletto (UV), ha un potere di penetrazione nei tessuti biologici relativamente basso, e per questo il principale rischio è la possibilità di insorgenza di effetti avversi a livello oculare e cutaneo. Con particolare riferimento all’occhio, si ricorda che le IR sono assorbite da diverse strutture oculari in dipendenza della lunghezza d’onda: la quasi totalità di IR-C e una parte sostanziale di IR-B sono assorbiti a livello corneale; l’IR B è assorbito in buona parte anche da altre strutture quali l’iride ed il cristallino, mentre l’IR-A, o “vicino infrarosso”, in quanto confinante con la regione del visibile, è assorbito dal cristallino, ma in gran parte anche a livello retinico. L’interazione delle IR con le strutture oculari avviene con meccanismi di tipo termico, ovvero l’insorgenza del possibile danno oculare dipende strettamente dall’aumento di temperatura indotto dalla radiazione nell’occhio. Tra gli effetti avversi a breve termine si ricordano le ustioni corneali e retiniche, tra quelli a lungo termine va certamente citata la possibilità di insorgenza di cataratta. Il rischio lavorativo da IR incoerenti è noto già dal XXVII secolo e le prime dettagliate descrizioni delle problematiche oculari a cui potevano andare incontro i lavoratori esposti a IR sono rintracciabili all’interno del De Morbis Artificum Diatriba di Bernardino Ramazzini. Ad oggi l’esposizione occupazionale a IR è rimasta, come da alcuni secoli a questa parte, principalmente determinata dalla lavorazione di materiali, quali metalli e vetro, portati ad elevatissime temperature. Accanto a queste lavorazioni che potremmo definire storiche, attualmente le IR sono ampiamente utilizzate anche in apparecchi ad uso industriale quali ad esempio sistemi per la visione notturna e la termografia. Come le altre bande della ROA, il rischio occupazionale da IR è normato a livello nazionale dal titolo VIII, capo V, del D.Lgs. 81/2008 e s.m.i. e nell’allegato XXXVII sono riportate le tabelle dei Valori Limite di Esposizione (VLE) attualmente vigenti per le IR incoerenti, sia per quanto riguarda il rischio retinico, dove, come per la radiazione visibile troviamo limiti espressi come radianza (L), sia per il rischio delle strutture oculari anteriori, per le quali i limiti sono espressi come irradianza (E). Nonostante le lavorazioni di fusione del vetro e dei metalli, seppur molto diverse rispetto al passato, siano ancora oggi largamente diffuse e i livelli di esposizione a IR in queste attività siano certamente rilevanti, le pubblicazioni della letteratura scientifica recente sull'argomento sono poche e la maggior parte dei casi segnalati di effetti avversi oculari da IR incoerente a probabile eziologia lavorativa risalgono a vari anni orsono. Sulla base di queste premesse viene descritto e discusso il caso di un lavoratore presso una acciaieria andato incontro ad un infortunio riconducibile all’azione fototermica delle IR sulle strutture oculari.

2016 - Effetti precoci della esposizione a percloroetilene nei lavoratori delle lavanderie a secco sulla funzione visiva [Articolo su rivista]
Chiesi, Andrea; Gioia, Tiziana Concetta; Modenese, Alberto; Abbacchini, Carlotta; Borsari, Lucia; Clo', Emanuele; DI RICO, Renato; Ferrari, Davide; Gobba, Fabriziomaria
abstract

Introduzione: Alcuni studi hanno dimostrato la possibile correlazione tra esposizione a percloroetilene (PCE) negli addetti delle lavanderie a secco ed alterazioni della percezione cromatica. Obiettivi: Abbiamo voluto verificare l’eventuale presenza di alterazioni della funzione visiva in un gruppo di lavoratori esposti ai livelli attuali di PCE. Metodi: Lo studio è stato condotto su 38 lavoratori esposti a PCE in 21 lavanderie del distretto di Modena e 60 controlli scelti in base a criteri di confrontabilità. I lavoratori delle lavanderie sono stati sottoposti a monitoraggio ambientale dell’esposizione a PCE (esposizione media pari a 16,9 mg/m3). Ad entrambi i gruppi sono poi stati somministrati un questionario anamnestico ed il test di Ishihara per valutare i criteri di esclusione e, successivamente, i test di Lanthony D15d e di Acuità Visiva a Contrasto Ridotto (VCS) per valutare alterazioni della funzione visiva. I risultati del test di Lanthony sono stati espressi mediante l’Indice di Confusione Cromatica (ICC). Risultati: Nei casi il valore medio di ICC è 1,28 (DS 0,21) e nei controlli è 1,15 (DS 0,21); la differenza risulta statisticamente significativa (p<0.01). I valori di ICC sono tendenzialmente peggiori negli addetti al solo lavaggio, esposti a livelli di PCE più elevati (esposizione media pari a 26,8 mg/m3). I valori di VCS per ciascuna frequenza non mostrano invece differenze significative tra i due gruppi. Conclusioni: I nostri dati indicano che anche esposizioni occupazionali a PCE ben al di sotto degli attuali valori limite possano essere comunque in grado di indurre alterazioni della percezione cromatica e non sarebbero pertanto adeguatamente protettivi almeno nei confronti di questi effetti.

2016 - Esposizione occupazionale negli addetti alle attività di riciclo e riuso dei rifiuti di apparecchiature elettriche e elettroniche (RAEE): dati preliminari dal progetto WEEENMODELS. [Abstract in Atti di Convegno]
Modenese, A.; Violi, F.; Pini, M.; Gioia, T. C.; Ferrari, A. M.; Gamberini, R.; Grasselli, L.; Montanari, G.; Neri, P.; Rimini, B.; Vinceti, M.; Gobba, F.
abstract

Esposizione occupazionale negli addetti alle attività di riciclo e riuso dei rifiuti di apparecchiature elettriche e elettroniche (RAEE): dati preliminari dal progetto WEEENMODELS.

2016 - Health risk related to occupational exposure in WEEE management [Capitolo/Saggio]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

2016 - Outdoor work and solar radiation exposure: Evaluation method for epidemiological studies. [Articolo su rivista]
Modenese, Alberto; Bisegna, Fabio; Borra, Massimo; Grandi, Carlo; Gugliermetti, Franco; Militello, Andrea; Gobba, Fabriziomaria
abstract

Background: The health risk related to an excessive exposure to solar radiation (SR) is well known. The Sun represents the main exposure source for all the frequency bands of optical radiation, that is the part of the electromagnetic spectrum ranging between 100 nm and 1 mm, including infrared (IR), ultraviolet (UV) and visible radiation. According to recent studies, outdoor workers have a relevant exposure to SR but few studies available in scientific literature have attempted to retrace a detailed history of individual exposure. Material and Methods: We propose a new method for the evaluation of SR cumulative exposure both during work and leisure time, integrating subjective and objective data. The former is collected by means of an interviewer administrated questionnaire. The latter is available through the Internet databases for many geographical regions and through individual exposure measurements. The data is integrated into a mathematical algorithm, in order to obtain an esteem of the individual total amount of SR the subjects have been exposed to during their lives. Results: The questionnaire has been tested for 58 voluntary subjects. Environmental exposure data through online databases has been collected for 3 different places in Italy in 2012. Individual exposure by electronic UV dosimeter has been measured in 6 fishermen. A mathematical algorithm integrating subjective and objective data has been elaborated. Conclusions: The method proposed may be used in epidemiological studies to evaluate specific correlations with biological effects of SR and to weigh the role of the personal and environmental factors that may increase or reduce SR exposure.

2016 - Preventing Melanoma with the Help of Occupational Physicians [Articolo su rivista]
Modenese, Alberto
abstract

2016 - Questionnaire-based evaluation of occupational and non-occupational solar radiation exposure in a sample of Italian patients treated for actinic keratosis and other non-melanoma skin cancers [Articolo su rivista]
Modenese, Alberto; Farnetani, Francesca; Andreoli, Alessandro; Pellacani, Giovanni; Gobba, Fabriziomaria
abstract

Background An adequate evaluation of the ultraviolet (UV) cumulative exposure is a major problem in epidemiological studies on chronic skin damage. Questionnaires may be applied as useful tools. Objective We developed an original questionnaire to evaluate individual cumulative exposure to solar radiation (SR) in patients affected by actinic keratosis (AK), basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Method The questionnaire, considering both working and leisure exposure, was applied to evaluate the whole life history of solar UV radiation exposure in a group of patients of the Dermatologic Clinic of UNIMORE. Results In outdoor workers (OW), the co-presence of AK/in situ SCC and invasive non-melanoma skin cancers (NMSCs) was increased compared to indoor workers (IW), as was the frequency of multiple skin lesions. The prevalence of skin lesions of the face was significantly higher in OW. Work 'sometimes' or 'often' in the shades was associated with an absence of skin lesions on the shoulders and neck, while workers adopting 'sometimes' or 'often' a downward bent position were more likely to develop lesions on the top of the head. Considering leisure activities, the use of tanning beds was associated to the presence of skin lesions on the shoulders, neck and chest. Considering vacation periods, subjects spending at least 2 h outdoor in the period 11 am to 1 pm presented earlier diagnoses of skin cancers. Conclusion Results of the original questionnaire developed are coherent with current knowledge and confirm the important role of UV exposure, both occupational and recreational, in the development of AK and NMSCs. Data support the hypothesis that this questionnaire can be applied as useful tool for the evaluation of cumulative UV exposure in future epidemiological studies.

2016 - Rischio sanitario correlato all'esposizione occupazionale nella gestione dei RAEE [Capitolo/Saggio]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

2016 - The European Status Quo in legal recognition and patient-care services of occupational skin cancer [Articolo su rivista]
Ulrich, Claas; Salavastru, CARMEN MARIA; Agner, Tove; Bauer, Andrea; Brans, Richard; Crepy, MARIE NOELLE; Ettler, Karel; Gobba, Fabriziomaria; Goncalo, Margarida; IMKO WALCZUK, Beata; Lear, John; Macan, Jelena; Modenese, Alberto; Paoli, John; Sartorelli, Pietro; Stangeland, Katarina; Weinert, Patricia; Wroblewski, Nora; Wulf, HANS CHRISTIAN; John, SVEN MALTE
abstract

BACKGROUND: Skin cancer is the most common malignancy in Caucasian populations worldwide and ultraviolet radiation (UVR) is known for being the number one carcinogen. As, especially in outdoor workers, UVR is an inevitable carcinogen, the prevention and management of UVR-related skin cancers in these at-risk populations represent a collective challenge for dermatologists and healthcare policymakers likewise. OBJECTIVE: To provide an overview on the current regulations on the acknowledgement and management of work-related skin cancer in 11 European countries. METHODS: Dermatologists from 11 countries networking within the EU Horizon 2020 COST Action TD1206 'StanDerm' contributed to a standardized survey regarding current national regulations, implemented for the recognition, prevention and management as well as possible compensation regulations in their individual country of residence. RESULTS: Ten of 11 participating countries in this survey reported the existence of an established programme available on certain occupational diseases; work-related skin diseases were only specifically recognized in eight countries. Seven of 11 countries recognize cutaneous squamous cell carcinoma in outdoor workers as 'occupational skin cancer'. Basal cell carcinoma (6 of 11), actinic keratosis (5 of 11), Bowen's disease (5 of 11) and malignant melanoma (5 of 11) are not as regularly approved as potentially 'work-induced'. Only a few of the countries included into this survey established a general documentation system (national registry) on occupational skin diseases. So far, representatives of only three countries of this survey referred to a specific established national programme for the prevention, management or compensation of occupational skin cancers acquired during work-related UVR exposure. CONCLUSION: This survey highlights the need for mandatory regulations on the prevention, management and potential compensation of work-related UV-induced skin cancer across Europe. Against the background of a joint European domestic market, equal standards of occupational safety across Europe should include binding regulations for the protection and management of work-related skin cancer. The design of a common regulation to meet the increasing incidence of skin cancers in outdoor workers should become part of the European agenda, ensuring equal working and living conditions in the member states.

2016 - Traduzione in lingua italiana e validazione del questionario Work, Osteoarthritis and joint-Replacement Questionnaire (WORQ): dati preliminari. [Abstract in Atti di Convegno]
Lanfranchi, G.; Rovesta, C.; Chiesi, A.; Modenese, A.; Catani, F.; Gobba, F.
abstract

Traduzione in lingua italiana e validazione del questionario Work, Osteoarthritis and joint-Replacement Questionnaire (WORQ): dati preliminari.

2015 - Esposizione occupazionale a radiazione solare in un campione di pazienti dermatologici. [Abstract in Atti di Convegno]
Modenese, A; Pellacani, G; Farnetani, F; Andreoli, A; Gobba, F.
abstract

Esposizione occupazionale a radiazione solare in un campione di pazienti dermatologici.

2015 - Long-Term Eye Effects And Occupational Exposure To Solar Radiation: A Systematic Review Of The Recent Literature. [Abstract in Atti di Convegno]
Modenese, A.; Zanotti, G.; Gobba, F.
abstract

Long-Term Eye Effects And Occupational Exposure To Solar Radiation: A Systematic Review Of The Recent Literature.

2015 - Metodologia per una valutazione complessiva dell’esposizione a radiazione solare nei lavoratori all’aperto. [Abstract in Atti di Convegno]
Borra, M; Grandi, C; Militello, A; Bisegna, F; Gugliermetti, F; Modenese, A; Gobba, F.
abstract

Metodologia per una valutazione complessiva dell’esposizione a radiazione solare nei lavoratori all’aperto.

2015 - Occupational exposure to solar radiation and age-related macular degeneration: a case control study. [Abstract in Atti di Convegno]
Modenese, A; Gobba, F; Mattioli, S; Violante, Fs; Zanotti, G; Curti, S; Marinelli, Francesco; Campos, Emilio; Fresina, M.
abstract

Occupational exposure to solar radiation and age-related macular degeneration: a case control study.

2015 - Prevalence of subjective symptoms in a group of physicians recently involved in Magnetic Resonance Imaging (MRI) procedures. [Abstract in Atti di Convegno]
Zanotti, G; Modenese, A; Corona, G; Ligabue, G; Gobba, F.
abstract

Prevalence of subjective symptoms in a group of physicians recently involved in Magnetic Resonance Imaging (MRI) procedures.

2015 - Solar radiation: a neglected health risk in exposed workers. [Abstract in Atti di Convegno]
Modenese, A.; Gobba, F.
abstract

Solar radiation: a neglected health risk in exposed workers.

2015 - The incidence of micronuclei in buccal mucosa cells as a possible biomarker in the evaluation of occupational risk for MRI workers. [Abstract in Atti di Convegno]
Sannino, A; Romeo, S; Zeni, O; Massa, R; Scarfì, Mr; Zanotti, G; Modenese, A; Gobba, F.
abstract

The incidence of micronuclei in buccal mucosa cells as a possible biomarker in the evaluation of occupational risk for MRI workers.

2014 - A new method for the evaluation of cumulative solar radiation exposure in outdoor workers. [Abstract in Atti di Convegno]
Modenese, Alberto; Bisegna, Fabio; Borra, Massimo; Grandi, Carlo; Gugliermetti, Franco; Militello, Andrea; Gobba, Fabriziomaria.
abstract

A new method for the evaluation of cumulative solar radiation exposure in outdoor workers.

2014 - Assessing the cumulative solar radiation exposure among outdoor workers: presentation of a method for epidemiological studies [Abstract in Atti di Convegno]
Modenese, Alberto; Bisegna, F; Borra, M; Grandi, C; Gugliermetti, F; Militello, A; Gobba, Fabriziomaria
abstract

So far, few studies on occupational risk related to Solar Radiation (SR) in outdoor workers have attempted to retrace a detailed history of individual exposure. We propose a new method for the evaluation of the SR cumulative exposure both during work and leisure time, integrating subjective and objective exposure data. The former are collected with a questionnaire, which investigates in detail work and leisure activities during life. The latter are available through internet databases for many geographical regions and provide an estimate of the SR on the Earth's surface in specific areas and periods. These data will be integrated in a mathematical model, in order to obtain an esteem of the individual total amount of SR the subjects have been exposed to during their life. This personal exposure index can be used to evaluate specific correlations with the biological effects and to weigh the role of the personal and environmental factors that can increase or reduce SR exposure.

2014 - Esposizione a PCE nei lavoratori delle lavanderie a secco ed alterazioni della funzione visiva [Abstract in Rivista]
Chiesi, Andrea; Gioia, Tiziana Concetta; Modenese, Alberto; Abbacchini, Carlotta; Borsari, Lucia; Clò, E; Di Rico, R; De Pasquale, F; Ferrari, D; Gobba, Fabriziomaria
abstract

Alcuni studi hanno dimostrato la possibile correlazione tra esposizione a percloroetilene (PCE) negli addetti delle lavanderie a secco ed alterazioni della percezione cromatica. L’esposizione a tale solvente si è però progressivamente ridotta nel tempo: abbiamo voluto verificare l’eventuale presenza di alterazioni della funzione visiva in un gruppo di lavoratori esposti ai livelli attuali di PCE.

2014 - Esposizione professionale a Percloroetilene nelle lavanderie a secco [Abstract in Rivista]
Gioia, Tiziana Concetta; Chiesi, Andrea; Modenese, Alberto; Abbacchini, Carlotta; Borsari, Lucia; Clò, E; De Pasquale, F; Di Rico, R; Ferrari, D; Ricci, R; Pugni, S; Sala, A; Gianaroli, E; Predieri, G; Verri, S; Gobba, Fabriziomaria
abstract

Il percloroetilene (PCE) è tuttora il principale solvente in uso nelle lavanderie a secco. Spesso il monitoraggio biologico dei lavoratori si basa sul solo dosaggio dell’acido tricloroacetico (TCA), suo principale metabolita urinario. Abbiamo voluto verificare la correlazione dei valori di tale metabolita con il PCE ambientale ai livelli attuali di esposizione.

2014 - Proposta di una metodologia di valutazione dell'esposizione cumulativa a radiazione solare nei lavoratori all'aperto [Abstract in Atti di Convegno]
Modenese, Alberto; Bisegna, F; Bombarda, M; Borra, M; Grandi, C; Gugliermetti, F; Militello, A; Gobba, Fabriziomaria
abstract

Le attività lavorative all'aperto comportano una significativa esposizione alla radiazione solare (RS), che è anche la principale fonte di radiazione ultravioletta (RUV); i lavoratori outdoor sono quindi a rischio per l'insorgenza di effetti avversi, acuti e cronici, principalmente a carico di occhio e cute, legati a queste radiazioni. Tuttavia, ad oggi vari aspetti della relazione tra esposizione a RS e patologie non sono adeguatamente definiti. Su queste basi, ci siamo proposti di elaborare un metodo per la valutazione dell'esposizione attuale e pregressa a RS, che integri dati soggettivi e oggettivi di esposizione, tenendo conto dei possibili fattori ambientali e individuali che modulano l'esposizione a RS, sia durante l'attività lavorativa che nel tempo libero.

2014 - Revisione di letteratura: degenerazione maculare senile e lavoro [Abstract in Rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

La Degenerazione Maculare Senile (DMS) è la prima causa di ipovisione sopra i 50 anni nei Paesi industrializzati. Tra i fattori di rischio, oltre a familiarità, età e fumo vi è l’esposizione a radiazione ottica (RO) visibile (in particolare luce blu) e ad UV. In questo lavoro si è proceduto ad un’estensione ed aggiornamento dei dati, che tenesse conto anche di altri possibili fattori lavorativi.

2013 - Approccio Metodologico per la valutazione della dose cumulativa di radiazione solare pregressa nei lavoratori outdoor [Abstract in Rivista]
M., Borra; Modenese, Alberto; A., Militello; F., Bisegna; C., Grandi; F., Gugliermetti; Gobba, Fabriziomaria
abstract

Uno dei rischi più significativi del lavoro outdoor è l’esposizione a Radiazione Solare (RS), che può determinare numerosi effetti acuti e cronici a carico di occhio e cute, quali cataratta, pterigio, cheratosi attinica e tumori cutanei (carcinoma squamocellulare, basocellulare e melanoma); la RS è nel gruppo I (IARC) dei “cancerogeni certi per l’uomo”. Tra i limiti più rilevanti degli studi epidemiologici condotti finora sull’associazione tra RS e patologie cutanee e oculari va certamente rilevato quello della stima della dose cumulativa di radiazione all’occhio. Per valutare tale dose stiamo elaborando un metodo innovativo, che integra i dati di un dettagliato questionario su durata e modalità di esposizione pregressa a RS, sia occupazionale che extraoccupazionale, con dati di irraggiamento solare ricavabili da fonti disponibili.

2013 - Esposizione occupazionale a radiazione ottica e pterigio: revisione dei dati della letteratura scientifica negli ultimi 20 anni [Relazione in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

Lo Pterigio è un'anomala crescita del tessuto congiuntivale di forma caratteristicamente triangolare che si espande ad invadere la cornea sul lato nasale e la cui unica terapia definitiva, resta ad oggi, l'asportazione chirurgica. L'eziologia di tale patologia è in parte sconosciuta ma tra i fattori ambientali in grado di determinare un'irritazione cronica della superficie oculare gioca sicuramente un ruolo non trascurabile l'esposizione cronica a radiazioni UVR. In ragione di ciò, e considerato che varie attività lavorative comportano una significativa esposizione ad UVR, abbiamo effettuato una revisione degli studi presenti nella letteratura scientifica riguardo i fattori di rischio occupazionale per l'insorgenza dello Pterigio e la prevalenza di tale patologia nelle varie attività lavorative.

2013 - Esposizione occupazionale a radiazione ottica e rischio di cataratta: revisione dei dati recenti della letteratura [Relazione in Atti di Convegno]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

Secondo dati dell'Organizzazione Mondiale della Sanità, nel 2002 le persone nel mondo affette da visual impairment erano circa 161 milioni, e, in quasi la metà dei casi (47,8%), la causa era la presenza di cataratta. Tra i vari fattori di rischio tipicamente connessi con l'attività lavorativa rientrano, oltre ai traumi oculari, l'esposizione a vari tipi di radiazioni: ionizzanti, infrarossa (IR), ottica naturale (radiazione solare) e ottica artificiale. Scopo di questo lavoro è di effettuare un aggiornamento dei dati della letteratura scientifica più recente sui rapporti tra esposizione occupazionale a radiazione ottica e insorgenza di cataratta.

2013 - Patologie croniche oculari nei lavoratori outdoor: un rischio sottovalutato [Abstract in Rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

Lo pterigio e la cataratta, in particolare la forma corticale (CC), ma anche, seppure con evidenza minore, la nucleare (CN) e sottocapsulare posteriore (CSP), sono patologie croniche oculari correlate con l’esposizione a radiazione solare ultravioletta (RSUV). La RSUV è un importante fattore di rischio del lavoro outdoor: abbiamo effettuato una revisione dei dati della letteratura scientifica su pterigio e cataratta da RSUV in questi lavoratori.

2013 - Radiazione solare e lavoro: esposizione, effetti, prevenzione [Articolo su rivista]
Modenese, Alberto; Gobba, Fabriziomaria
abstract

2012 - Benessere e lavoro: il punto di vista della medicina del lavoro [Capitolo/Saggio]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

Il concetto "benessere dei lavoratori" ha un significato ampio, comprende differenti aspetti, e non è facilmente quantificabile in modo univoco da un punto di vista scientifico, ma, soprattutto, ha seguito un'importante evoluzione nel tempo. Attualmente nel D.Lgs. 81/2008 all'art. 2 la "salute" viene descritta come lo "stato di completo benessere fisico, mentale e sociale" e non solo come una semplice assenza di malattia o di infermità. Per questo motivo lo scopo odierno della medicina del lavoro è quello di tutelare e promuovere il benessere e la salute nei luoghi di lavoro. Al fine di avere un'adeguata comprensione del percorso, della sua difficoltà, e dell'importanza dell'obbiettivo ottenuto, questo volume tratta: una contestualizzazione storica delle conoscenze sui rapporti tra salute e lavoro, il ruolo della disciplina scientifica della medicina del lavoro e la figura professionale del medico del lavoro nella tutela e nella promozione della salute e della sicurezza dei lavoratori.

2012 - Occupational risk related to optical radiation exposure in construction workers [Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto
abstract

Optical Radiation is a relevant occupational risk in construction workers, mainly as a consequence of the exposure to the ultraviolet (UV) component of solar radiation (SR). Available data show that UV occupational limits are frequently exceeded in these workers, resulting in an increased occupational risk of various acute and chronic effects, mainly to skin and to the eye. One of the foremost is the carcinogenic effect: SR is indeed included in Group IIARC (carcinogenic to humans). UV exposure is related to an increase of the incidence of basal cell carcinoma, squamous cell carcinoma of the skin and cutaneous malignant melanoma (CMM). The incidence of these tumors, especially CMM, is constantly increasing in Caucasians in the last 50 years. As a conclusion, an adequate evaluation of the occupational risk related to SR, and adequate preventive measures are essential in construction workers. The role of occupational physicians in prevention is fundamental.

2012 - Rischio da stress lavoro-correlato e disturbi muscolo-scheletrici in operatori socio-sanitari di residenze assistenziali per anziani. [Abstract in Atti di Convegno]
Modenese, A.; Gobba, F.
abstract

Rischio da stress lavoro-correlato e disturbi muscolo-scheletrici in operatori socio-sanitari di residenze assistenziali per anziani.

2011 - Bernardino Ramazzini's intuitions and modern occupational medicine [Articolo su rivista]
Gobba, Fabriziomaria; Modenese, Alberto; Occhionero, Vincenzo
abstract

Bernardino Ramazzini is the recognized father of occupational medicine. His work De morbis artificum diatriba, printed in Modena in 1700, is the first comprehensive treatise on the diseases of workers. Ramazzini was the first physician to investigate systematically the relationship between work and disease. The method applied, including an accurate medical examination, an inspection to workplaces to observe workers' activities, and a collection of existing knowledge, is surprisingly up-to-date. But the most modern part of his method was the acknowledgement of the role of prevention: Ramazzini identified several precautions to limit exposure to hazards, and also recognized the fundamental role of informing and training the workers about the occupational risks and how to protect themselves. As a conclusion, the contribution of Bernardino Ramazzini to occupational medicine is not limited to the recognition of a large number of occupational diseases, but is also, and mainly, in the method developed

2011 - Disturbi muscolo-scheletrici e stress lavoro-correlato nel personale sanitario: indagine pilota in due strutture residenziali per anziani dell’Emilia Romagna [Poster]
Modenese, Alberto; Migliore, Agostino; I., Degli Antoni; S., Pedretti; Gobba, Fabriziomaria
abstract

Gli operatori socio-sanitari (OSS) impiegati in strutture residenziali per anziani sono a rischio per l’insorgenza di stress e disturbi muscolo-scheletrici (DMS) lavoro-correlati. In un campione di 46 OSS, sono state rilevate mediante il Nordic Musculoskeletal Questionnaire elevate prevalenze di disturbi (69,9-41,3%) e impedimenti (39,1-19,6%) a spalle, collo, rachide lombare e polso/mano. Agli stessi operatori, è stato somministrato il “questionario-strumento indicatore” INAIL-HSE. I risultati indicano come aree critiche per l’insorgenza di stress l’autonomia nell’esecuzione della propria attività lavorativa (Controllo=2,96±0,71), il carico di lavoro percepito (Domanda=3,40±0,60) e la gestione dei conflitti (Relazioni=3,38±0,68) e dei cambiamenti organizzativi (Cambiamento=3,54±0,74). Nei lavoratori con disturbi e impedimenti a collo e rachide lombare il questionario ha rilevato un rischio maggiore alle scale Domanda e Relazioni rispetto ai colleghi in cui tali DMS sono assenti (p<0,05 per collo, p<0,01 per rachide lombare). Gli OSS con disturbi e impedimenti del polso/mano giudicano maggiormente critiche le dimensioni Controllo e Supporto rispetto a quelli che non riferiscono tali problematiche (p<0,01). I risultati ottenuti suggeriscono la presenza di un’associazione tra stress e DMS lavoro-correlati.

2010 - Heat stroke in the workplace: description of a case with fatal outcome [Articolo su rivista]
Roccatto, L; Modenese, Alberto; Occhionero, V; Barbieri, Alberto; Serra, D; Miani, E; Gobba, Fabriziomaria
abstract

BACKGROUND: Heat exposure represents an occupational risk factor in various work settings. Adverse effects may range from mild symptoms, like muscular cramps, to life threatening conditions, like heat stroke. Data on the occurrence of work-related adverse effects of heat exposure in Italy are lacking.OBJECTIVES:To highlight the risk of heat stroke in a common working activity.METHODS:The case of a fatal heat stroke in a 19-year-old worker, in apparently good health, employed in maintenance of open park spaces is presented. After working 7 hours outdoors on a sunny day he was found unconscious. He was immediately taken to the local Emergency Department, where he arrived in hyperthermic and comatose conditions, and died due to multiple organ failure after 36 hours. After excluding other main causes of hyperthermia, heatstroke was identified as the initial cause of death.RESULTS:The case presented describes the possible extreme consequences of an underestimation of the risk related to occupational heat exposure, even in young and apparently healthy workers. Heat-related adverse effects may occur in a number of common activities, not necessarily involving heavy workload or extreme temperatures. Different methods, including simplified methods, are available for heat stress risk evaluation. The main preventive measures include adequate acclimatization, periodic interruption of exposure, sufficient fluid intake, adequate clothing and appropriate Personal Protective Equipment. Adequate training and workers' health surveillance are also essential.CONCLUSIONS:Heat exposure may be a significant occupational risk, potentially inducing life-threatening conditions, in a number of common activities but is frequently underestimated. An example of undervaluation of the risk and of the possible consequences, are presented and discussed in this case report.

2010 - Lo stress lavoro-correlato: i recenti documenti regionali e del comitato tecnico interregionale [Relazione in Atti di Convegno]
Modenese, Alberto; A., Migliore; Gobba, Fabriziomaria
abstract

Since May 2009, many Italian Regions and the Interregional Technical Committee have developed guidance for work-related stress risk assessment. These documents have similarities but also differences. Risk assessment is a three steps process in the documents of Lombardia, Veneto, Toscana and Interregional Committee: it implies an objective evaluation, a subjective one and a final report with definition of the hazard level. Only Lombardia asserts that stress perception’s evaluation is necessary even if no risk emerged from the objective investigation. In another document, proposed in Emilia Romagna region, two checklists of objective indicators for risk assessment are proposed. For the “Emilia Romagna work-group –ERPER-“, stress risk assessment is particularly problematic in small companies (less than 10 employees); this group suggests training meetings, each lasting two hours, for both employees and management, to provide knowledge, policy and tools for better dealing with work-related stress. Regarding workers’ health surveillance, the Interregional Committee provides a list of the main disorders correlated with stress, but it doesn’t recommend any specific monitoring procedure, while in other documents the importance of specific health surveillance focused on prevention of stress risk is stressed. Up now an agreement on criteria for an adequate prevention of WR stress are lacking in Italy.

2010 - Stress occupazionale e sottopopolazioni linfocitarie e citochine infiammatorie nei lavoratori. [Abstract in Atti di Convegno]
Modenese, A.; Gobba, F.
abstract

Stress occupazionale e sottopopolazioni linfocitarie e citochine infiammatorie nei lavoratori.

2009 - ANXIETY SYNDROME AND SOMATIC MORBIDITY IN AN ITALIAN ELDERLY POPULATION [Abstract in Atti di Convegno]
Cesano, S; Atti, Ar; Moretti, F; Bernabei, V; Morini, V; Modenese, A; Dalmonte, E; De Ronchi, D
abstract

Aims To evaluate anxiety syndrome prevalence and to investigate the association between anxiety and somatic morbidity in a population-based study of elderly: the “Faenza Project” (De Ronchi, 2005). Methods 6987 cognitively intact subjects living in the Faenza area (mean age 71,88 years; 59,2% women) underwent semi-structured interviews and were clinically assessed in order to evaluate somatic and mental health status (ICD-10 criteria). Multi-morbidity was defined as the presence of two or more somatic diseases (hypertension, diabetes, dyslipidemia, cardiovascular, gastro-intestinal, endocrine diseases, psychiatric disorders, osteoporosis, Parkinson's disease (PD) and stroke). The association between anxiety and somatic morbidity was calculated by Logistic regression analysis estimating Odds Ratios and 95% Confidence Intervals (OR, 95%CI), adjusting for age, education, gender, marital status, socio-economic status, smoking habits and alcohol consumption. Results The prevalence of anxiety syndrome was 11,1% (8,6% women vs 2,5% men, p< 0.001). Taking into account possible confounders, anxiety syndrome was associated with depressive syndrome (OR,95%CI=4.55,3.73-5.54), osteoporosis (OR, 95%CI=1.37,1.13-1.65), Parkinson's disease (OR,95%CI=4.18,2.55-6.85) and multi-morbitidy (OR,95%CI=1.75,1.46-2.10). When all these conditions were included simultaneously in the logistic model, however, only depressive syndrome and PD were still significantly associated with anxiety: OR,95%CI=4.10,3.22-5.23 and OR, 95%CI=3.02,1.73-5.28 respectively. Conclusions The well known association between depression and anxiety is confirmed in our elderly population independently of other medical factors. Furthermore, a strong association between PD and anxiety resulted independently of co-occurrence of depression.

2009 - SUICIDAL IDEATION IN ITALIAN ELDERLY. PRELIMINAR DATA FROM THE "FAENZA PROJECT" [Abstract in Atti di Convegno]
Atti, Ar; Modenese, A; Bellini, M; Moretti, F; Cesano, S; Bernabei, V; Ferrari, B; Dalmonte, E; De Ronchi, D
abstract

Aims To evaluate prevalence rate of suicidal ideation among Italian elderly and to investigate possible socio-demographic and psychopathological features of suicide attempters in a population-based study. Methods 461 subjects (mean age 85 years; 52.9% women; 49.2% widow) were interviewed using the Revised Cambridge Examination for Mental Disorders in the Elderly. The presence of suicidal ideation was assessed by the Scale for Suicide Ideation. The association between suicidal ideation and its correlates was analysed by Logistic Regression Model estimating Odds Ratios and 95% Confidence Intervals (OR, 95%CI). Results Eighteen (3,8%) persons refused to answer to questions concerning suicide thoughts. Only one participant declared to have attempted suicide (a 92 years-old men, widow, living on his own and complaining about depressive feelings). Overall suicidal ideation prevalence was 7.3%: wish to die (3.8%) and not worth living (13%). Gender, age, education, marital and socio-economic status were similar in subjects with and without suicidal ideation. Subjects with suicidal ideation had fewer family contacts, were less satisfied of their general health status and had a higher number of depressive and anxiety symptoms. However, when all these conditions were tested in the same model, only depressive symptoms were still significantly associated with suicidal ideation (OR, 95%CI=9.6, 3.3-27.9). Conclusion The worldwide aging of the population deserves attention to psycho-geriatric medicine. Study on suicide in late-life are of interest to detect elderly at risk and to emphasize this increasing phenomenon.

2009 - THE USE OF MMSE TO IDENTIFY MILD COGNITIVE IMPAIRMENT (MCI). A POPULATION-BASED STUDY [Abstract in Atti di Convegno]
Moretti, F; Atti, Ar; Cesano, S; Morini, V; Forlani, C; Bernabei, V; Modenese, A; Dalmonte, E; De Ronchi, D
abstract

Aims To evaluate the prevalence of MCI and its subtypes in the Faenza Project, using the Mini-Mental State Examination (MMSE). Methods Subjects living in the municipality of Faenza were clinically assessed. The diagnosis of MCI was achieved according to international criteria using a double-step procedure: first, we excluded subjects with dementia, functional impairment and MMSE< 24, leaving 6,745 persons. Then, the performance in different cognitive domains was considered and scores less than 1.5 standard deviations below the age- and education-adjusted norms on MMSE were settled as cut-offs. Four subtypes were identified: amnestic MCI, single non-memory MCI, multidomains non-amnestic, multidomains amnestic MCI. Results 2,720 (40.3%) participants met MCI criteria. Prevalence were 4% (amnestic MCI), 26.5% (single non-memory MCI), 4.4% (multidomains amnestic MCI), and 5.4% (multidomains non-amnestic MCI). Conclusions MCI is common among Italian elderly. In our study prevalence are higher than reported in other population-based studies. The use of MMSE with different operational criteria, diverse sampling and assessment procedure might explain such discrepancy. The role of MMSE to identify persons with mild cognitive deficits deserves concerns. However, MMSE is largely used in both clinical practice and research and has been suggested as a useful screening tool for assessing the degree of cognitive impairment in the guidelines for the Report of the Quality Standards Subcommittee of the American Academy of Neurology.