Sentinel events in occupational medicine: the example of Local Health Unit No. 1 of the Tuscany region [Eventi sentinella in medicina del lavoro: l'esempio dell'USL n. 1 della Regione Toscana]

In order to apply the "sentinel health event" methodology we reviewed the certificates of 4541 deaths occurred in the period 1/01/83-31/12/88 in the USL 1 (Lunigiana) in the Tuscany Region. The histories of 6 work accidents, 6 cases of pleural mesothelioma, and 2 cases of sinunasal cancers have been collected by means of personal interviews and investigation at various workplaces. It should be noted that a case of sinunasal cancer was discovered in a farmer who used lead arsenate as an insecticidal. Furthermore the wife of a shipyard worker died of pleural mesothelioma. The death of a shipyard worker caused by pleural mesothelioma, provoked the critical review of the other workers of the same company who were also exposed to asbestos. Moreover, 73 deaths were recorded as due to silicosis; among them, 29 occurred in quartzite quarrymen. In addition, among 153 total cases of lung cancer, 9 were found to be associated with silicosis.