OCCUPATIONAL EXPOSURE TO IONISING RADIATION AND FITNESS FOR WORK: A CASE SERIES AND COMPARISON WITH LITERATURE.

Introduction The increasing number of healthcare workers (HCWs) occupationally exposed to ionising radiation (IR) and the growing number of cancer disease survivors in the working age, require adopting shared and sustainable management models to protect workers' health and safety. Methods We performed a retrospective analysis of health surveillance activities carried out in the last six years on HCWs working at the University Hospital of Verona. All cancer cases were collected and evaluated, as well as information on the characteristics of the worker and job task. The cases were then appraised and compared with the most recent evidence in the literature. Results Ten cancer cases were recognised: four breast cancer, one gastric lymphoma, two papillary thyroid carcinomas, one melanoma, two leukaemia cases and one colon cancer. For eight workers, it was necessary to appraise the probability of causation regarding occupational exposure and the onset of the disease, as well as fitness for work, which in more than 50% of the cases led to restrictions. Discussion The case series analysis enabled to identify a tailor-made health surveillance protocol for these IR-exposed workers and to facilitate the support of a team of referral physicians so that the worker was quickly taken care of. The literature review revealed insufficient scientific evidence to support the occupational physician in managing these cases. Conclusion The management of cancer workers exposed to IR requires a close multidisciplinary collaboration, in order to take care both of their health and safety protection needs and their professionalism at work.