title: Post-occupational health surveillance of asbestos workers.
abstract: BACKGROUND
  Italian law requires an extensive health surveillance of workers after cessation of their employment status in the case of occupational exposure to carcinogens, including asbestos. Nonetheless, Italian law does not specify the timeframe of these clinical checks, nor who has financial and organizational responsibility for this surveillance. A literature search confirmed a lack of consensus around the objectives and methods to follow up workers with past occupational exposure to asbestos.
  
  
  OBJECTIVE
  To develop an updated evidence-based methodology for an appropriate health surveillance programme.
  
  
  METHODS
  We present an overview of the field experience developed by the Veneto Region from 2000 to 2011, and new studies that could contribute to establishing a national policy for the medical surveillance of workers with past asbestos exposure.
  
  
  RESULTS
  There were three specific topics: (1) definition of a reliable method to identify asbestos workers (through multiple sources and procedures that meet current confidentiality regulations); (2) detection of asbestos fibres in biological media (to support the etiological diagnosis of asbestos-related diseases); (3) creation of a national protocol of health surveillance (through the assessment of policies developed by other Regions in this field, and recruiting from these regions a cohort of past-exposed workers: the epidemiological study should offer relevant suggestions for specific surveillance approaches, based on either estimated cumulative asbestos exposure or detection of x-ray patterns of pleural plaques and/or asbestosis).
  
  
  CONCLUSIONS
  These studies will support the Regions in setting up health care policies directed at workers with past asbestos exposure.
authors.affiliation: Padua University, Department of Molecular Medicine, University of Padua, Padua, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mastrangelo
authors.forename: G
authors.initials: G
authors.lastname: Marangi
authors.forename: Maria Nicoletta
authors.initials: MN
authors.lastname: Ballarin
authors.forename: E
authors.initials: E
authors.lastname: Bellini
authors.forename: Nicoletta
authors.initials: N
authors.lastname: De Marzo
authors.forename: Margit
authors.initials: M
authors.lastname: Eder
authors.forename: A
authors.initials: A
authors.lastname: Finchi
authors.forename: F
authors.initials: F
authors.lastname: Gioffrè
authors.forename: Daniela
authors.initials: D
authors.lastname: Marcolina
authors.forename: Gianna
authors.initials: G
authors.lastname: Tessadri
authors.forename: Federica
authors.initials: F
authors.lastname: Zannol
authors.forename: Ilaria
authors.initials: I
authors.lastname: Altafini
authors.forename: Elena
authors.initials: E
authors.lastname: Belluso
authors.forename: Sara
authors.initials: S
authors.lastname: Zaina
authors.forename: R
authors.initials: R
authors.lastname: Agnesi
authors.forename: L
authors.initials: L
authors.lastname: Scoizzato
authors.forename: U
authors.initials: U
authors.lastname: Fedeli
authors.forename: L
authors.initials: L
authors.lastname: Cegolon
authors.forename: F
authors.initials: F
authors.lastname: Valentini
authors.forename: L
authors.initials: L
authors.lastname: Marchiori
mesh_terms: D001194:Asbestos / Q000009:adverse effects* / Q000032:analysis; D001195:Asbestosis / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D015415:Biomarkers; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods; D005500:Follow-Up Studies; D006291:Health Policy; D006801:Humans; D007558:Italy; D016365:Liability, Legal; D008175:Lung Neoplasms / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D008875:Middle Aged; D019016:Mineral Fibers / Q000032:analysis; D016273:Occupational Exposure; D009790:Occupations; D053495:Osteopontin / Q000097:blood; D010997:Pleural Neoplasms / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D011159:Population Surveillance / Q000379:methods; D015397:Program Evaluation; D015203:Reproducibility of Results; D012129:Respiratory Function Tests; D012179:Retirement; D012189:Retrospective Studies; D012907:Smoking
chemical_list: D015415:Biomarkers; D019016:Mineral Fibers; D053495:Osteopontin; D001194:Asbestos