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Copyright of Giornale Italiano di Medicina del Lavoro ed Ergonomia is the property of Giornale Italiano di Medicina del Lavoro ed Ergonomia Editorial Board and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Importance: Occupational therapists often address financial occupations of clients with acquired functional impairments who experience challenges with financial capability (FC)., Objective: To explore the intervention literature aimed at improving FC in five diagnostic adult populations., Data Sources: MEDLINE, CINAHL, PsycInfo, EconLit, and EMBASE; researchers also completed backward and forward citation searching and contacted expert authors., Study Selection and Data Collection: Two independent reviewers completed article screening, selection, and extraction using a scoping review approach; a priori inclusion criteria were peer-reviewed articles, written in English, involving adults with one of five diagnostic conditions, describing any intervention to improve FC., Findings: Twenty-four articles met the inclusion criteria. Most articles were aimed at substance use or mental health populations (n = 20); fewer focused on brain injury (n = 2), multiple sclerosis (n = 1), or mixed-diagnosis (n = 1) populations. Only 4 were randomized controlled trials (RCTs). Interventions were heterogeneous and complex, including components of skills training (n = 21), individualized budgeting (n = 18), representative payeeship (n = 11), education (n = 10), structured goal setting (n = 7), savings building (n = 5), metacognitive strategies (n = 2), and assistive technology (n = 1)., Conclusions and Relevance: Despite growth in the area, the literature regarding FC intervention is limited, with few RCTs and many populations unrepresented. The literature for a systematic review of FC intervention efficacy for these populations is insufficient, particularly because included studies used varied components, limiting comparison. Further research is imperative to guide evidence-based practice. Plain-Language Summary: This study is an overview of literature about interventions to address the financial occupations of clients with acquired functional impairments. The findings give occupational therapy researchers and clinicians the information they need to begin analyzing, using, and building the evidence to support the use of interventions to improve clients' financial capability and well-being., (Copyright © 2024 by the American Occupational Therapy Association, Inc.)

Introduction: Absorbed dose assessment from dermal exposure involves multiplying skin contamination by the dermal absorption coefficient, which is usually defined for the standard workday of 8 h. This strategy may suffer from limitations when the duration of exposure is extremely variable, such as in agricultural exposure to pesticides., Objectives: The aim of this study was to estimate the dose of mancozeb absorbed by agricultural pesticide applicators in a typical working day considering the real duration of exposure, to compare these estimates with those coming from the use of the Fixed Fractional Approach, and to assess the suitability of the dose estimates in the interpretation of biological monitoring results., Methods: In a series of real-life field studies on 29 workers applying mancozeb in vineyards for 38 work days, three sets of data were collected: information regarding work activities for each work day, potential (on clothes) and actual skin exposure using the "patch" methodology, and excretion of ethylenethiourea (ETU) in the 24-h pre-exposure and 24-h post-exposure urine samples. The statistical analyses were done using the R Language and Environment for Statistical Computing., Results: Accounting for the duration of exposure led to a substantial reduction in the absorbed dose estimates, compared to the estimates coming from the Fixed Fractional Approach. In particular, absorbed dose by the body, hands' and total absorbed dose were reduced by 50%, 81%, and 80% respectively. The body dose estimated considering both approaches still correlated better with post-exposure 24-h urine ETU levels than the hands' dose, although more than 90% of the estimated total absorbed dose comes from the hands., Conclusions: An accurate estimate of the absorbed dose, carried out considering the real duration of exposure, can result in a higher correlation with a biomarker of occupational exposure, such as urine ETU, or at least yield more accurate results. This can facilitate the interpretation of biological monitoring data in pesticide-exposed agricultural workers despite the absence of biological exposure limits. ETU should be evaluated as a potentially relevant source of exposure due to ethylenebisdithiocarbamates' (EBDCs) degradation in the formulated product or spray mixture., (Copyright © 2019 Elsevier GmbH. All rights reserved.)

Grapevine is a vulnerable crop to several fungal diseases often requiring the use of ethylenebisdithiocarbamate (EBDC) fungicides, such as mancozeb. This fungicide has been reported to have goitrogenic, endocrine disrupting, and possibly immunotoxic effects. The aim of this study was to assess workers' exposure in two scenarios of mancozeb application and analyse the main determinants of exposure in order to better understand their mechanism of influence. Environmental monitoring was performed using a modified Organisation for Economic Co-operation and Development (OECD) "patch" methodology and by hand-wash collection, while mancozeb's metabolite, ethylenethiourea (ETU), was measured in 24-h preexposure and postexposure urine samples. Liquid chromatography-mass spectrometry was used for determination of mancozeb and ETU in different kinds of samples. Closed tractor use resulted in 40 times lower potential exposure compared with open tractor. Coveralls reduced skin exposure 4 and 10 times in case of open and closed tractors, respectively. Gloves used during application resulted in 10 times lower hand exposure in open but increased exposure in closed tractors. This study has demonstrated that exposure to mancozeb is low if safe occupational hygiene procedures are adopted. ETU is confirmed as suitable biological marker of occupational exposure to mancozeb, but the absence of biological exposure limits significantly reduces the possibility to interpret biological monitoring results in occupationally exposed workers.

Agricultural work submits to high risks for safety and health. In 2009, in execution of "workplace health protection pact" (DPCM 17.12.2007), has been defined the National Plan for prevention in agriculture and forestry, whose first three-year program ended in 2012. Goals were: to Systematize and to standardize direction and control activity, defining the number of factories to control, in most italian regions, for high and ubiquitous risks applying homogeneous standards, spending special attention to risks of fatal and serious injury; to develop agricultural machinery trade control, for new and second-hand machinery, for normalizing the whole fleet; to contribute to monitoring of risk factors and injury dynamics, for a better definition of prevention policies; to increase the knowledge of public health agency officers; to identify and to promote technical solutions, helping to define, in proper way, good practices for complex problems; to promote coordination between economic develop policies and prevention policies for agriculture, breeding and forestry, paying attention also to financial helps. The plan, divided in regional plans, obtained most of defined goals and allowed to build a permanent interregional net of referents and expert officers. Next years perspective is to enhance in developing the faced themes and objectives.

Open field, variability of climatic and working conditions, and the use of complex mixtures of pesticides makes biological and environmental monitoring in agriculture, and therefore risk assessment and management, very complicated. A need of pointing out alternative risk assessment approaches, not necessarily based on measures, but simple, user-friendly and reliable, feasible also in the less advanced situations and in particular in small size enterprises, arises. This aim can be reached through a combination of environmental monitoring, biological monitoring and computational modelling. We have used this combination of methods for the creation of "exposure and risk profiles" to be applied in specific exposure scenarios, and we have tested this approach on a sample of Italian rice and maize herbicide applicators. We have given specific "toxicity scores" to the different products used and we have identified, for each of the major working phases, that is mixing and loading, spraying, maintenance and cleaning of equipment, the main variables affecting exposure and inserted them into a simple algorithm, able to produce "exposure indices". Based on the combination of toxicity indices and exposure indices it is possible to obtain semiquantitative estimates of the risk levels experienced by the workers in the exposure scenarios considered. Results of operator exposure data collected under real-life conditions can be used to validate and refine the algorithms; moreover, the AOEL derived from pre-marketing studies can be combined to estimate tentative biological exposure limits for pesticides, useful to perform individual risk assessment based on technical surveys and on simple biological monitoring. A proof of principle example of this approach is the subject of this article., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Although rice and corn are two main cash crops in Lombardy (North Italy) and their cultivation involves several thousands of farmers, risk assessment of pesticide exposure is rarely done, especially in small and medium sized enterprises. With the use of pads for environmental monitoring (OECD protocol), of pre- and post-exposure 24h urine collection for biological monitoring and of hand wash for hands' exposure, we measured the exposure of 28 agricultural workers to propanil and terbuthylazine in real-life working conditions. In propanil applicators, median daily exposure on the clothes was 73.5μmol per worker, while the exposure on the skin was 22.4μmol. For terbuthylazine, these exposures were 37.2μmol and 0.86μmol per worker, respectively. Median excretion of the propanil metabolite (3,4-dichloroaniline) after exposure was 84nmol in 24h urine, and 13nmol for the metabolite of terbuthylazine. Risk assessment performed by comparing to the AOELs of the applied active ingredients with an estimated internal dose, obtained based on the measured levels of skin and hand exposure and the percentage of dermal absorption of the active ingredients considered showed that 4 propanil workers, and no terbuthylazine workers, were overexposed. Our study helps define and confirm relationships between different exposure determinants, which can be used in the development of tools for risk assessment of exposure to pesticides in small and medium sized enterprises., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

The results of the activities of occupational health surveillance in agriculture carried out by the International Centre for Rural Health since 2008 are described. The activities involve 800 workers employed in 260 farms in the Region of Lombardy (Italy). The types of farms reflect the vocation toward agricultural sector of the Po Valley and the most representative tasks are related to animal care and use of agricultural machinery. Based on the specific risks, workers are provided with preventive and periodic examinations, and complementary laboratory and instrumental evaluations (hearing and respiratory functions, electrocardiography), related to the different risk factors present in the enterprises. The occupational health priorities identified are, for the time being, noise-induced hearing loss and insufficient immunization against tetanus.

The evaluation of the risks for the health safeguard within the workplace, represents a fundamental moment of the intervention planning. During the years it has been enriched by experiences, improvements and techniques essentially introduced by a set of laws; in particular the 626/94 Legislative Decree. This was the first well-organized expression of the new strategies identified on the basis of the assigned responsibilities and the protection of the production process. With the 81/08 L.D. such strategies have been once again highlighted but with a particular emphasis on the partecipation of the workers in the risk detection. This work just deals with such aspect by means of the experimentation of a specific method represented by the so called SOBANE pattern. The results point out some aspects that are positive in terms of satisfaction and handiness. These aspects may contribute to the employment of the method to a wide range of services with important effects on the drawing up of the evaluation document of the business risks

Despite the underreporting of occupational diseases in agriculture, available data clearly show a significant health risk, and therefore the need of health surveillance at the workplace. The implementation of health surveillance programs for agricultural workers relies on the possibility of creating a system able to reach the workers at their workplaces, with the collaboration of employers' associations, able to support enterprises in several issues, including risk assessment and management. The health surveillance program can be organized in a component common for all workers, based on physical examination, chemistry, electrocardiography, hearing and lung functions examinations, and on tests addressing specific risks, if present: vibration, physical overload, chemicals, biological agents, allergens. The frequency of examinations must be decided based on risk assessment and health surveillance outcomes.

Agriculture shows an high proportion of injuries, mostly by machineries and instruments, and the highest proportion between fatal and total injuries. The Conference of Regions has adopted the National Agriculture and Forestry Prevention Plan, in application of the "Pact for health and safety in workplaces". The plan gives priority to actions improving the safety of agricultural machines, specially if more frequently involved in serious and fatal injuries. Goal is to achieve an homogenous intervention standard all over in the country, composed by a mix of information, support and control, addressed to farms and agricultural machines traders. Public prevention organizations of Local Health Units moreover will record homogenously the happen modality of fatal and serious accidents, will collaborate in joining prevention objectives with Rural Develop Plans and in drawing up good practices. At another level in some regions have been developed prevention activities for other risk factors: definition of exposition profiles of pesticides, development of professionally exposed workers formation, control of buildings and cattle breeding, medical and epidemiological periodic survey of employees.

The evaluation of chemical risk in agriculture is complicated because of difficulties in obtaining measures representative of working conditions. This is the reason why experiences finalized at producing risk estimates are running. In this frame, a Regional working group has developed the project "Pesticide exposure and risk profiles in agriculture". Priority scenarios have been selected and the main variables correlated with pesticide exposure have been pointed out. A value for each variable has been defined. The sum of these values allows the definition of "Exposure Indices" (EI), which can be reduced by multiplication for a coefficient calculated based on use of personal protective devices, training and education and equipment conditions. A Risk Index is calculated as the product of EI per a toxicity index, calculated based on the risk phrases of the substances used ("Risk Profile"). Risk Profiles allow the production of risk estimates and the definition of the appropriate preventive interventions. Next phase will be addressed at the validation of the model, to be carried out through the determination of the levels of concordance between the risk class allocation obtained from the model and the one obtained from environmental and biological measures, in the same groups of workers.

Objective: A study called OCCAM (OCcupational CAncer Monitoring) has been carried out in order to establish a nationwide surveillance system for occupational cancer. This project consists of population-based case control studies where information on past occupations are automatically gathered National Institute for Social Security's archive, cancer cases are obtained from Cancer Registries (CR) and controls are sampled from population files of the National Health Service. As previous results obtained using CR were encouraging, we tried to use regional hospital discharge records as a source of incident cases., Design: We have conducted a population based case-control study with 1568 male bladder cancer cases occurred in the years 1999 and 2000 and 18818 controls randomly sampled from resident population in Lombardy region (Italy)., Results: Despite the limits of this approach the following industries were found at increased risk of bladder cancer: leather and shoes industry (OR=1.83; CI 90%: 1.01-3.33; observed: 10); transports (OR=1.28; CI 90%: 0.94-1.76; observed: 37), rubber industry (OR=1.22 CI 90% 0.80-1.85; observed: 19) and printing industry (OR=1.5 CI 90%: 1.10-2.05; observed: 38)., Conclusion: The ability of OCCAM surveillance system to find known associations using routinely available data offers new opportunities to detect cancer cases likely to be of occupational origin.

Asphalt is a mixture of mineral matter and bitumen, its fumes contain about 1% of Polycyclic Aromatic Hydrocarbons (PAH), some of which are carcinogens. In the PPTP-POPA Study of Lombardy Region, a group of 100 asphalt workers (exposed to bitumen fumes and diesel exhausts) and a group of 47 ground construction operators (exposed only to diesel exhausts) were investigated to assess PAH exposure in Italy, by means of environmental-air monitoring (the 16 most relevant, according to the American Environmental Protection Agency, EPA) and biological monitoring (urinary 1-hydroxypyrene excretion). Our results show that PAH exposure in these workers is not higher than that observed in traffic policemen working in urban areas. Since dermal exposure has been suggested as a major determinant of the total PAH dose absorbed by road pavers from bitumen fumes, we assessed skin contamination by organic aromatic compounds and by sixteen PAH: in both groups, six pads were applied to each subject in different parts of the body, during the workshift. The results show that the dermal contamination in road pavers is higher than in ground construction operators and that cutaneous dose rate is higher than respiratory dose rate, whereas the amount of absorption the ratio is inverted.

Agriculture represents a very complex scenario that needs proper tools. To this aim, in the frame of Special Project "La Prevenzione nell'impiego di Antiparassitari in Agricoltura" promoted by the Region of Lombardy, profiles of exposure and/or risk have been identified as valid approach able to define particular conditions of exposure and risk for the operator in particular settings. The evaluation necessarily needs to identify the most important parameters affecting exposure and their extent on magnitude of exposure. Therefore, field studies should be further performed in order to confirm and improve the profile. The identification of profiles of exposure and risk is an activity still in progress that need to be carefully set up and standardised. The team involved in the study identified priorities deserving much attention in Lombardy, and planned a three years programme aimed at define the profile of exposure and risk in viticulture, maize crop, rice growing, nursery gardening, horticulture in greenhouses, maintenance of gardens, and poplar growing.

In Lombardy, the regional project "Prevention of occupational cancers" is ongoing. The main objectives of this project are to identify work environments in which there might be a possible exposure to carcinogenic substances and to elaborate preventive measures. A casual sample of 250 working settings representing the different economic activities has been selected and evaluated. The 10% of the examined workplaces showed a possible exposure to chemical carcinogens. The most common carcinogens were trichloroethylene, preparation of plastics materials containing acrylonitrile-butadiene-stirene, formaldehyde, wood dust, hexavalent chromium, silica and polycyclic aromatic hydrocarbons. Galvanic industries, Bitumen production and placing companies and Plastics processing plants will be studied for environmental and biological monitoring and for the development of preventive measures.