Un modello originale di follow-up in ex esposti ad amianto applicato ad una grande azienda di trasporto pubblico

In 1997, a health surveillance program for workers with a known past exposure to asbestos started in an important public transport company in Milan (ATM). The investigated group was composed by 800 workers for which a past exposure to asbestos has been proved. This surveillance program was based on a medical evaluation, a questionnaire including questions about a possible past exposure to asbestos and smoke habits, chest X-ray, a spirometry diffusion capacity test and asbestos fiber analysis (this protocol is no longer used). Chest X-ray, first used as part of a screening program, is now performed specifically, according to the sources and the duration of the exposure and can be completed by HRTC. Thanks to this new surveillance program we were able to diagnose two pleural asbestos signs cases. Since screening procedures to diagnose asbestos occupational cancers are not available, the ex-exposed surveillance should be conceived as a cross-sectional surveying, able to define the exposure history of the subject, to inform about the past exposure risks and to give information about diagnosis, therapy and legal medicine aspects.