ATTI 26° CONVEGNO NAZIONALE AIRM
17 February 2025
Vol. 42 No. 4 (2020)
https://doi.org/10.4081/gimle.479

[Judgement of suitability and ionising radiation: discussion of clinical cases]

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Ionizing radiation, fitness to work and cancer, radioprotection.
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Lorenzo Bordini
lorenzo.bordini@policlinico.mi.it
UOC Medicina del Lavoro, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.
Giorgia Malagò
Unità Operativa Ospedaliera di Medicina del lavoro, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy.
Giuseppe Taino
Unità Operativa Ospedaliera di Medicina del lavoro, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy.
Concetta Buonocore
Università degli Studi di Pavia, Pavia, Italy.
Marcello Imbriani
Università degli Studi di Pavia and IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy.

1) Associazione Italiana Radioprotezione Medica, Linee guida AIRM: sorveglianza medica dei lavoratori esposti a radiazion ionizzanti. IPSOA, 2013.
2) Taino G, Giroletti E, Delogu A, Malagò G, Corona G, Businaro J, Imbriani M. Il giudizio di idoneità al rischio da esposizione a radiazioni ionizzanti nei lavoratori con pregressa patologia neoplastica: criteri di valutazione e analisi di una casistica. La Medicina del Lavoro 2014; 105, 6: 445-472.
3) Taino G, Oddone E, Corona G, Foti R, Imbriani M. The fitness to work certificate in a worker exposed to ionizing radiation with an oncological disease: criteria and assessment process. Radioprotection 2019; 54(4): 303-307. DOIhttps://doi.org/10.1051/radiopro/2019036 4) Testo integrale del D.M. della Sanità 488/01 (GU Serie Generale n. 80 del 05-04-2002).
5) Recommendations of the international Commission on Radiological Protection. ICRP 103. 2007 6) IAEA Safety standards series. Occupational Radiation Protection.
2004.
7) Associazione Italiana Registri Tumori - AIRTUM 2018: I numeri del cancro in Italia 2018. https://www.registri-tumori.it/cms/pubblicazioni/i -numeri-del-cancro-italia-2018 8) Institut de France, Accadémie des Sciences. La relation dose-effect et l'estimation des effects cancérogènesdes faibles doses de rayonnements ionisants, Rapport adopté à l'unanimité par l'Accadémie des Sciences, Paris, 2005.
9) National Council on Radiation Protection and Measurements: Evaluation of the linear-non threshold dose-response model for ionizing radiation NRC Report 136, Bethesda Maryland 2001.

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ABSTRACT. Introduction. The formulation of the suitability for risk assessment from exposure to ionizing radiation in workers diagnosed with malignant tumor disease entails important implications of a professional, human, social, but also medical-legal, nature. By now, the management of such situations is an event anything but infrequent in the activity of the Authorized Physician: the increase in the number of people staying in wore and the rise in the incidence and prevalence of malignant neoplastic diseases in the working-age population make the problem more relevant than ever. This is not only because of the improvement of the diagnostic and treatment capacity but also for the increased survival that follows from them. The result is therefore an increase in the cases that can potentially reach the antention of the Authorized Physician/Competent Physician who - in compliance with the provisions of current legislation - will be thus called to express the suitability assessment for the specific task by applying criteria that respect the highest and current scientific evidence in this field.
Materials and Methods. Through the guided illustration of two clinical cases, it is intended to propose here a - practical and reasoned - path towards the formulation of the assessment on the occupational reintegration of the worker with diagnosis of neoplastic disease. This methodology is applied and developed through the systematic recourse to objective and specific orientation criteria, able to guide the decision-making process of the Authorized Doctor/Competent Doctor.
Results. The proposed criteria were applied to workers operating in the healthcare sector and assigned to different types of activities who were at risk from exposure to ionizing sources. Conclusions. The proposed evaluation path is intended to represent a clinical and rational methodology of approach and management to the problem of assessing the suitability of workers with previous neoplastic diseases, all that by fully safeguarding the decision-making autonomy - variable from case to case - which is characteristic of the activity of the Authorized Physician/Competent Physician.

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[Judgement of suitability and ionising radiation: discussion of clinical cases]. (2025). Giornale Italiano Di Medicina Del Lavoro Ed Ergonomia, 42(4), 298-303. https://doi.org/10.4081/gimle.479
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