To study new disease-exposure associations, we created a pilot network (namely MAREL – MAlattie e Rischi Emergenti sul Lavoro) of occupational disease consultation centres of the Italian national health service to which patients are referred for potentially work-related diseases.Methods
The MAREL network included in 2016 five occupational disease consultation centres of university hospitals located in central-northern Italy. Patients were referred to the MAREL consultation centres by their general practitioners, occupational physicians or other specialists for the investigation of the putative occupational origin of a disease. Each centre collected cases of putative occupational origin through a structured and standardised data collection form. We collected data on: diagnosis; personal habits; occupational history; exposure to risk factors; physician’s opinion on the possible causal relationship between disease and occupation. Data were coded according to national and international classifications.Results
The data collection started in 2016, enrolling 1516 cases of putative occupational diseases. Musculoskeletal disorders were the most represented conditions: intervertebral lumbar disc degeneration (11.2%), spondylitis (6.3%), tendinopathies (4.9%), arthritis (4.8%), upper limb mononeuropathies (4.4%), and shoulder disorders (3.7%). The most frequently reported exposures were related to biomechanical overload: manual material handling (29.5%, out of 1811), hand-arm vibrations (13.9%), repetitive movements of the upper limb (10.9%), whole-body vibrations (7.6%), awkward posture of the upper limb (7.1%), and awkward body posture (4.5%).Discussion
The exposure to biomechanical overload seems to play a role in generating potentially work-related conditions. Expanding the MAREL network to other occupational disease consultation centres in 2017 and 2018, we will contribute to already existing surveillance systems (i.e. MALPROF) by the detection of new and emerging occupational diseases and risks.