PreventionofsilicahealtheffectsinItaly:current challengesfortheoccupationalhealthandsafetyUnitof theItalianNationalHealthService

SUMMARY Background: Since its foundation in 2002, the Italian Silica Network (NIS), a collaborative network of profes sionalsandpublicauthorities,hasbeenengagedinseveralaspectsofresearch,control,andpreventionofsilicaexpo sure and effects, and also in support for compensation claims for silica-related occupational health effects in Italy. Methods:WestartwithareportontheNISpointofviewconcerningtherecentscientificresults(fromepidemiolo gy and laboratory studies), including those carried out by NIS in cooperation with Italian universities and other public agencies.This is followed by a description of the data on silica exposure in different Italian workplaces and guidelines for the management of occupational exposure to silica, as developed by two model regional programmes fortheceramicsindustry,metalfoundriesandtunnelexcavation. Results: TheNISinitiativeshighlighted theper sistenceofworkplaceconditionsposingasignificantriskforsilica-relatedhealtheffects,particularlyinsmallindus tries and workshops. Experimental work has also shown that a number of physical and chemical factors affect the bioreactivityofsilicaparticles . Conclusion:BasedonNISexperience,itappearsclearthatcurrentlyconditionsex ist in Italy so as to positively contribute to theWHO Programme for the eradication of silicosis and the other dis easesrelatedtosilicaexposure.Inordertoachievethisgoal,acoordinatedandwide-rangingeffortisrequiredtore ducethewidegapinspecificpreventionactivities,particularlyinsmallindustriesandworkshops,wherehighlevels ofsilicaexposuresometimesoccur.

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