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Background: The epidemiological evidence of work-related musculoskeletal disorders (UL-WMSDs) due to repetitive strain and movements in the various industries has been collected in the literature mainly through cross-sectional surveys. In particular there are no contributions so far regarding the upholstered furniture industry with a longitudinal design., Objectives: The aim of the study was to evaluate the incidence rate of WMSDs such as hand-wrist and shoulder tendonitis, carpal tunnel syndrome, and epicondylitis in exposed workers of three large companies of the upholstered furniture industry in a large geographic area of southern Italy., Methods: The OCRA method, recommended by international standard ISO 11228-3 and EN 1005-5, was used for risk assessment. The following work tasks were considered:.filling preparation workers, leather-cutting operators, sewing and upholstery-assembly workers. A total population of 5,278 subjects (exposed n=2927, controls n=2351) was investigated. The person/year at risk parameters were calculated from 1 January 2000, or from the date of engagement if later, until the first diagnosis of WMSD or, in absence of disorders, until the end of the study, i.e. 31 December 2004. Disorders occurring after the first were not considered. A multiple regression analysis was used to evaluate relationships between rates., Results and Conclusions: Incidence rates correlated with risk classes of the OCRA index. An incidence rate of WMSDs higher than 1.2 cases per 100 person/year may be considered as a threshold value to suspect an occupational exposure to repetitive strain and movements warranting further investigation. The analysis of single factors did not show a greater predisposition of the female gender, with the single exception of the carpal tunnel syndrome (RR 2.92; 95% CI 1.57-5.43). Shoulder disorders affected mainly male leather-cutting operators (RR 4.97; 95% CI 2.03-12.16) and among all the factors influencing risk (frequency, force, posture, additional risk factors, pauses) posture seems to play a significant role.

Background: The upholstered furniture industry, the so-called "triangle of the sofa industry", is a geographic area of national and strategic economic importance in southern Italy. The single tasks are carried out mostly manually, with the characteristics of a handicraft approach., Objectives: The aim of the survey was to assess the prevalence of upper limb work-related musculoskeletal disorders (UL-WMSDs) in 30 factories of the sofa industry located in a large geographic area of the Puglia and Basilicata Regions., Methods: In the period 1 January-31 December 2003 a network of occupational physicians investigated a population of 5.477 subjects (exposed n=3481, controls n=1996, M=3865, F=1612) in 30 different factories of the area. More than 60 percent of the total workforce studied was employed in large-sized companies (>500 employees). The following work tasks were considered: filling preparation workers, leather-cutting operators, sewing and upholstery-assembly workers. Case-definition was assessed through standardized procedures: symptoms by questionnaire plus physical and laboratory/imaging findings., Results: Cumulative prevalence rates of UL-WMSDs as at 31 December 2003 reached values of up to 30% in high risk groups. Prevalence rates showed good correlation with the concise OCRA index used for assessment of exposure to repetitive strain and movements of the upper limb. The most frequently occurring disorders were tendon-related cysts and wrist tendonitis. Shoulder disorders were more frequent in male and female leather-cutting operators., Conclusions: This survey showed a significantly high prevalence of UL-WMSDs in sofa industry workers. It did not seem to be confirmed in this study that there was a greater female susceptibility to UL-WMSDs with the exception of carpal tunnel syndrome: gender difference seems to be less relevant at increasing levels of occupational exposure to repetitive movements and exertion of the upper limbs.

Background: In cooperation with the IRCCS Fondazione Maugeri and the IRCCS Fondazione Ospedale Maggiore Policlinico - EPM-CEMOC, of Milan, the Local Health Unit in Bari, Italy carried out a research project, sponsored partly by the Italian Ministry of Health, on upper limb work-related musculoskeletal disorders (UL-WMSDs) in a specific manufacturing sector, the upholstered furniture industry. This "sofa district" is widely represented with approximately 14,000 workers and 500 factories over a wide geographic area of southern Italy. Advanced technology in the manufacturing process is combined with workers performing intensive arm-hand tasks., Objectives: The aim of the study included: a) assessment of exposure to repetitive strain and movements of the upper limb in a representative sample of the factories using the OCRA method, b) analysis of the annual prevalence and incidence rates, c) definition of possible improvement via ergonomic solutions in the various factories., Methods: Via a network of occupational physicians a total of more than 6000 subjects were examined over a 5-year period. Case-definition was assessed through standardized procedures., Results: A detailed description of the manufacturing process of the upholstered furniture industry and of the characteristics of the working population is provided Exposed groups at risk were:filling preparation workers, leather-cutting operators, sewing and upholstery-assembly workers., Conclusions: Data collected in private companies of different size in this extensive industrial "sofa area" emphasize the importance of prevention through adequate ergonomic solutions and the need to improve training programmes covering the whole area.

Background: The Italian 2006-2008 National Health Plan emphasizes synergy and cooperation between the agencies formally involved in the prevention of occupational risks, in agreement with social partners. The so-called 'triangle of the sofa industry' is an interregional geographic area south-west of Bari, Italy. In 2003 this area produced 16% of the world-wide upholstered furniture output, with more than 500 plants of varying size., Objective: The aim was to set up a network of communication and cooperation between the competent Agencies and Regions in order to address the rising trend of upper limb work-related musculoskeletal disorders., Methods: The first step of the National Health Service Unit in Bari was to assess risk via a Ministerial research project and implement various information campaigns involving institutions, occupational physicians, private companies and public opinion. In a subsequent phase a synergy between the local Departmenst ofPrevention of the different Regions, the Italian Institute for Insurance Occupational Accidents and Disease (INAIL), the trade unions and the upholstered furniture industry Association was established., Results and Conclusions: New joint experimental projects (cutting tools, ergonomic table for assemblers, instruments for isokinetic evaluation) were launched together with training programmes for management, safety technicians and workers. This kind of 'participatory prevention' is more appropriate for the goal of a collaborative effort in order to assist the companies, which is a modern interpretation of the mission of public health prevention operators.

Background: One of the most common procedures for risk assessment of upper limb work-related musculoskeletal disorders (UL-WMSDs) in Italy is the OCRA synthetic index, which is recommended as the preferred method in the ISO standard 11228-3., Objective: The aim of the survey was to assess the risk of UL-WMSDs due to repetitive strain and movements in thirty factories of the sofa industry located in a large geographic area of southern Italy., Methods: The most characteristic working tasks of the manufacturing process were studied: filling preparation workers, leather-cutting operators, sewing and upholstery-assembly workers. The single tasks were carried out almost exclusively manually, with features of a handicraft approach. Data were collected through questionnaires and video tape recordings in each factory. The mean value of the OCRA index of every group of factories was calculated by weighting the values of the index of each single task group with the number of the workers., Results: Figures obtained in the different factories showed values of the OCRA index ranging between 4 and 15. A 2,9 OCRA value was attributed to a low exposure group., Conclusions: Even though the work tasks analyzed were characterized by long duration of the manufacturing cycle (between 5 and 60 min), a particular but rigorous application of the OCRA procedures made it possible for a detailed risk assessment to be made for each of the working groups analysed.

Background: The incidence of silicosis has decreased today because of a clear improvement of working conditions. According to recent data from Italian National Compensation Agency (INAIL) silicosis represents more than 5% of occupational diseases claimed for annually. Since silicosis is an evolving chronic disease, it has serious consequences on patient health, modifying the quality of life and increasing public costs. Some studies show a relationship between occupational exposure to silica and radiological and functional deterioration, but the results are not satisfactory because of the variety of clinical patterns and the interference of many risk factors., Objectives: The aim of our investigation was to evaluate silicosis evolution in relation to living habits and to different occupational exposures., Methods: All admissions from 1980 to 2000 in the Occupational Medicine Unit of the Maugeri Foundation in Cassano Murge (Bari), Southern Italy, with final diagnosis of silicosis were examined. From 586 medical records gathered, subjects with double admissions were selected and their chest radiographs and FVC, FEV1 from lung function test were detected. No industrial hygiene data were available and individual exposure was estimated through calculation of a global exposure index., Results: On the basis of data quality control, 106 consecutive male patients were recruited (age at first admission 51.7 +/- 8.3 years, occupational exposure at second admission 23.8 +/- 9.1 years). More than 50% of the subjects had an estimated high risk exposure at work. The first diagnosis of silicosis was made at first admission in 40% of the cases, 33% of the patients had been suffering from silicosis for 10 years while 27% for more than 10 years. Chest radiographs showed mostly p, q nodular pattern, and over a 4. 7 +/- 3.3 year follow-up period they appeared largely unchanged, although 8 radiographs showed confluent areas, 18 subjects showed pleural thickening, 10 calcified opacities, 17 COPD (Chronic Obstructive Pulmonary Disease) with emphysema, 2 tubercolosis lesions, 4 radiographic abnormalities attributable to cancer (3 lung, 1 oesophageal)., Conclusions: The mainly stationary results of chest radiographs and the slight loss of respiratory function we observed confirm the slow evolution over time of silicosis. Multiple logistic regression analysis of main risk factors showed that subjects with radiographic opacities having a diameter greater than 10 mm or conglomerate shadows at the time of diagnosis seem to have a lower risk of progression of the disease after a relatively short period of follow up, even in mining related exposure.