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MALATTIE TRASMESSE DA ZECCHE E RISCHIO PROFESSIONALE: INDAGINE SIEROLOGICA IN LAVORATORI DEL COMPARTO AGRICOLO E ZOOTECNICO.
No full textClimate changes imply an increased zoonotic risk, especially for tick borne diseases, such as Lyme Borreliosis, so far considered of major concern mainly for forestry workers. This study aims to assess the occupational risk of Lyme Disease for: 1) shepherds devoted to mountain pasture and transhumance and 2) workers employed in intensive swine and cattle breeding facilities. All subjects were asked to fulfil an informed consensus. Workers were reached at the workplace. Exclusion criteria were considered those clinical conditions determining immunodeficiency. In the first part of the study, sera for the detection of antibodies to Borrelia burgdorferi were collected from 28 shepherds (exposed) and 22 locals (not exposed). The subjects provided information about health status, age, exposure to tick bites, house location, pets and outdoor activities (hunting, fishing, trekking). Moreover, shepherds were asked about previous ticks’ bites. Significant difference has been found among groups (exposed/not exposed) respect to the number of tick bites; just one subject – from the not exposed group – was found to have IgG against Borrelia burgdorferi s.l., confirmed with Western Blotting. Leisure activities were pointed out as major risk factors. In the second part of the study, sera from 100 workers employed in Po Valley were collected in the frame of the health surveillance programme held by the Occupational health Department of the San Paolo Hospital. A two step detection of IgG against Borrelia burgdorferi was conducted. Nine workers were found positive to the first step of the serological survey. The second step by immunoblotting confirmed just 6 of them. For the confirmation test, workers were addressed to the general practitioner for medical prescription. Results show a statistically significant difference between mountain shepherds and Po Valley breeders with regard to ticks’ bites (60% versus 24%, p< 0,05). This difference was not found between breeders and agricultural workers not devoted to animal care. Interestingly, migrant workers were found to be more often interested by tick bites and by positive results to serological test when compare to Italian workers (32% versus 18%, p< 0,05). Main limitation of the study was the sample size which has not allowed inferential statistics on data. Some suggestions can be taken by these partial results: tick bite is still a threat to working population and general population. Borrelia burgdorferi s.l. diffusion seems to be quite low, in comparison to literature data which, in turn, come mainly by other geographical regions. Data from the second group (Po Valley) are not fully in line with the registry of Local health Unit of Lodi: from 2000 to 2009 no case of Lyme disease was notified to the health authority. Underestimation of cases, due to subclinical patterns and not specific clinical features has to be taken into account. In conclusion, this study, despite the small sample, has the specificity to deal with tick borne diseases risk for breeders: so far, in literature, mainly data from forestry workers were published. This study is part of a more extensive serological survey on agricultural workers focused on biological risk. A more extensive longitudinal prospective study has already started, with the aim of identify possible changing in antibody title during years
Occupational health and safety in agriculture : situation and priorities at the beginning of the third millennium
No full textAgriculture is a human activity, which includes a number of different tasks and occupies a huge number of people worldwide. Estimates of World Bank for 2003 suggest that 51% of globalpopulation lives in rural areas. ILO estimates that 1.3 billion of workers are engaged in agriculture, and they represent almost a half of the total number of economically active subjects (2,838,897,404). In developed countries, agriculture workers are only a small fraction of the whole work force (up to 9% according to ILO data), while in developing countries, especially in Asia, agriculture workers represent up to the 60% of the total work force. Most agriculture workers reside in Asia, in the Pacific (74%) and in Africa (16%). ILO estimates suggest that half of fatal occupational injuries in the world are attributable to agriculture. This means that around 170,000 agriculture workers die every year as a consequence of occupational injuries. Using the same estimate, half of the fatal accidents could be linked to agricultural activities (more than 130 million). Comparing this estimate with the 6.328.217 people injured in war in 2002 or with the 20-50 million injured victims of road accidents, one has a much clearer picture about the importance of preventing agricultural injuries. In a complicated situation such as occupational health and safety problems in agriculture, it is not so easy to select priorities clearly. But "legalization" of agriculture workers could be a key to solving all the other problems. Actual data on fatal and non-fatal occupational injuries in agriculture show that occupational health and safety issues are among the top priorities for that disciplin
Tuberculosis and cattle breeding : the case of an Egyptian milker
No full textOccupational health in breeding activities is strongly embedded with animal health. Tuberculosis (TB) – known for its critical progress and for the long duration of the drug treatment – has the specificity of a bi-directional infectious potential. Tuberculosis is still endemic in Africa, Asia and Balkan Area. Among these, the most risky regions for the disease are North Africa and India. In the Italian agricultural system, about 37000 migrants are legally employed, most of them in seasonal activities (e.g.: harvesting) but if we consider Northern Italy, we can easily find a significant presence of foreign workers also in animal breeding. In our experience, we have observed that people from India and North Africa are often involved in cattle breeding. Case-report This case report deals with a worker from Aegypt, employed as milker in an Italian enterprise since 1990. The worker, a 51 years old man, affected by chronic HCV, showed suddenly symptoms and signs suggesting lung TB (cough, haemoptysis, weight loss and thoracic pain). A diagnosis of lung TB was made in the past and the worker underwent a multidrug therapy. A re-activation of a silent lung TB due to the immunodepression linked to the chronic liver disease or to a new infection have been inquired with questionnaire. The diagnostic approach performed included BK search in the sputum, lung X-ray, Mantoux test, pulmonary evaluation. The worker was held temporarily not suitable for work. Consequences Preventive measures provide to perform Mantoux test to all milker’s colleagues and to perform tuberculin test to all animals reared. The occupational risk of TB to cattle breeders is discussed in light of bovine TB cases in Lombardy Region
Occupational health problems of migrant workers : the Italian situation
No full textMigrant workers are becoming more and more represented in the Italian productive tissue. Among 2,35 million immigrants are assessed by the National Institute for Statistics (ISTAT), in the first three-month period of 2008. Among them, 71,4% are active workers (996,000 men and 682,000 women), mostly living and working in the northern part of the country. According to the annual report of the National Italian Institute for the insurance of Occupational Accidents and Diseases (INAIL), the increase of immigration is accompanied by an increase of the total work accidents, which have grown of 8,7%. Work injuries involving migrants are 15% of the total, which fatalities involving mainly Rumanians, Moroccans and Albanians. 14,5% of the occupational accidents are reported in the construction sector, with more than 20,000 notifications/year; a further sector in which a significant increase of occupational accidents is reported is household work, with an increase of 24% compared with 2005. These figures do not take into account occupational accidents occurred in illegal migrants (no less than 500,000). This makes data from agriculture poorly interpretable, because most of illegal immigrants are employed in this sector. The data on occupational diseases in migrants are sparse and not fully interpretable, but one can assume that, being hardly reaching by training and educational programmes due to linguistic and cultural barriers, they can be at higher risk for the same levels of exposure, compared to Italian workers. On the other hand, the number of foreign workers insured against occupational injuries and diseases is increased of 19,5% from 2006 to 2007, and of 36,9% in comparison to 2003. Another significant trend is the increase of the total amount of foreign entrepreneurs: they are mainly represented in breeding and agriculture (nearly 2.500), but their number is also relevant in other sectors, such as constructions and trade
Agenti biologici in allevamento: un rischio antico e sempre attuale
No full textL'agricoltura e la zootecnia implicano l'esposizione dei lavoratori a rischio biologico, per lo stretto contatto che si verifica con possibili serbatoi di patogeni, quali terreno, animali, deiezioni e prodotti derivati. il contributo descrive i fattori che hanno contribuito da un lato alla riduzione o l'eradicazione di alcune zoonosi, come brucellosi, salmonellosi e tubercolosi bovina (piani di sorveglianza e profilassi delle malattie infettive veterinarie, industrializzazione e meccanizzazione delle attività agro-zootecniche), e dall'altro all'emergenza di nuovi rischi e nuove patologie (capacità di adattamento dei microrganismi, generazione di nuovi ceppi, antibiotico-resistenze, diffusione dei vettori). Il ruolo della Medicina del Lavoro nella prevezione delle zoonosi è discusso.Agricultural activities expose workers to biological risk, due to the close contact that could occur with pathogens' reservoirs, such as soil, animals, manure and animal products.
The paper describes factors that have contributed on the reduction or eradication of zoonoses, such as brucellosis, salmonellosis and bovine tubercolosis (monitoring and prevention of animal infectious diseases, industrialization and mechanization of agricultural activities), and on the other hand the emergence of new risks and new diseases (adaptability of microorganisms, generation of new strains, antibiotic resistance, dissemination of vectors). The role of Occupational Medicine in the prevention of zoonoses is discussed
Lavoratori migranti in agricoltura e zootecnia : esperienze di sorveglianza sanitaria
No full textIn Italia, secondo i dati più aggiornati, sono presenti circa 5,000,000 di migranti. L’immigrazione nel nostro paese è prevalentemente finalizzata alla ricerca di lavoro, come dimostra il tasso di occupazione degli stranieri, pari al 75%, molto superiore rispetto a quello degli italiani in età lavorativa (62%). Questo si accompagna inevitabilmente ad un “effetto migrante sano”: i lavoratori stranieri arrivano cioè in Italia generalmente sani, come dimostrato anche dalle statistiche relative al loro utilizzo delle strutture del Servizio Sanitario Nazionale che vedono gli infortuni, le malattie trasmissibili e la gravidanza come i principali motivi di accesso. Le patologie cronico degenerativo, al contrario, non sembrano rivestire importanza. In generale, gli stranieri sono più frequentemente idonei senza limitazioni, in parte per l’età in parte l’assenza di una esposizione pregressa a noxae patogene in ambito lavorativo, quali il rumore: nel nostro campione, i migranti provengono da storie lavorative nel terziario. In questo quadro, tuttavia, esistono delle nicchie di ipersuscettibilità della popolazione straniera che devono essere tenute in debito conto da parte del Medico Competente: 1) il rischio infortunio correlato anche ad una meno efficace pratica vaccinale, con la conseguente maggiore suscettibilità a contrarre patologie quali, ad esempio, il Tetano; 2) la patologia dismetabolica, in particolare i disturbi del metabolismo glicidico e lipidico, con un conseguente maggior rischio di patologia cardiovascolare
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