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The aim of our study is evaluating occupational exposure in a factory named "Poligrafico Zecca dello Stato" in Foggia. The workers had a occupational disease "chlorine related parodontal disease" indemnified by INAIL (Italian Occupational Assurance). The study demonstrated the workers have been indemnified worked as engineer, drying and electrolysis process employed. The study showed that the workers indemnified without legal action were different in respect of workers that take legal action, because the last showed, paradoxically, a chlorine occupational exposure. The explanation of this paradox might be the production cycle non acknowledge by operators.

The authors studied a cohort of 2660 pulp and paper workers in Capitanata, Apulia (Italy). All workers with at least 1 year of employment on January 1 1965 or thereafter until march 30, 2000 where studied. Standardized Mortality Ratios (SMRs) were used to compare the mortality rates of the cohort with those of Apulian population. Ninetyfive percent confidence intervals (CIs) for SMRs were obtained. Cancer risks significantly associated with work where observed: all causes for males (SMR 112.09, 95% CI 104.91-119.77), brain cancer for males (SMR 206.04, 95% CI 103.04-412.01), digestive tract for males (SMR 126.78, CI 100.63-159.73). Association with other malignancies are suggested in this study for Laryngeal and Kidney. These malignancies have been associated with different exposures in the production cycle: biocides (Kidney), Formaldehyde (Kidney, Brain). Unclear is the risk factor for the excess showed in digestive tract cancer.

The review of main scientific investigations about the work related diseases in metallurgy shows that the most studied pathologies regards lung cancer and pneumoconiosis, other cancers and cardiovascular diseases. These evidences are not univocal and have been and are critically evaluated due to the complexity and articulated structure of metals production which makes it very difficult to compare the risks and diseases among the different metallurgical activities and, in the same activity, among the different job tasks. In addition, due to the technological and organizational evolution investigations, appear to be necessary to better define the specific hazards (for example metal species, PAH and PoPs mixtures) and to put into a correct relation these and pathologies diagnosed by health surveillance procedures or epidemiological surveys, surely different from those of past decades.

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The article presents reports on clinical-epidemiologic patterns on chemical and oncogenic risk in the metalworking industry. It focuses on the difficulty in interpreting epidemiological data as far as cancer is concerned due to the papers that refer to past exposure to metalworking fluid (MWF). However, the problems with could be overcome with the elimination of polycyclic aromatic hydrocarbons (PAHs) and some additives in metalworking.

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