Col.CSrnCol.CSrn Massimo MANNISIMassimo MANNISICapo Centro Capo Centro AeromedicoAeromedico ProfessionaleProfessionale

RADIAZIONI RADIAZIONI COSMICHECOSMICHE

FISICAFISICANORMATIVANORMATIVAPREVENZIONEPREVENZIONEESPERIENZA DELLESPERIENZA DELL’’ ISTITUTOISTITUTOMEDICO LEGALE DI ROMAMEDICO LEGALE DI ROMA

SCHEMA DELLA PENETRAZIONE SCHEMA DELLA PENETRAZIONE DEI VARI TIPI DI RADIAZIONIDEI VARI TIPI DI RADIAZIONI

RADIAZIONI COSMICHERADIAZIONI COSMICHE

NATURANATURA: : nuclei atomici,elettroni,positroni e nuclei atomici,elettroni,positroni e raggi gamma (raggi cosmici primari) o raggi gamma (raggi cosmici primari) o sciami fotonisciami fotoni--elettroni (raggi cosmici elettroni (raggi cosmici secondari).secondari).SORGENTESORGENTE:: lo spazio.lo spazio.VELOCITAVELOCITA’’: : prossima a quella della luce.prossima a quella della luce.POTERE PENETRANTE E IONIZZANTEPOTERE PENETRANTE E IONIZZANTE: : fortissimo.fortissimo.

NORMATIVA CHE REGOLAMENTA LA NORMATIVA CHE REGOLAMENTA LA SORVEGLIANZA SANITARIA AL SORVEGLIANZA SANITARIA AL PERSONALE AERONAVIGANTEPERSONALE AERONAVIGANTE

D.LgsD.Lgs 241/00241/00

"Attuazione della direttiva "Attuazione della direttiva 96/29/EURATOM in materia 96/29/EURATOM in materia di protezione sanitaria della di protezione sanitaria della popolazione e dei lavoratori popolazione e dei lavoratori contro i rischi derivanti dalle contro i rischi derivanti dalle

radiazioni ionizzanti"radiazioni ionizzanti"

Decreto Legislativo n. Decreto Legislativo n. 230 del 1995230 del 1995

The clinical significance of cosmic The clinical significance of cosmic radiation in aviationradiation in aviation

OttOtt CC, , Huber SHuber S..

FliegerFliegeräärztlichesrztliches InstitutInstitut (FAI)/Swiss Air Force Institute of Aviation Medicine. (FAI)/Swiss Air Force Institute of Aviation Medicine. claudineott@hotmail.comclaudineott@hotmail.com

The possible adverse health effects of cosmic radiation remains The possible adverse health effects of cosmic radiation remains an important topic in the an important topic in the consultation of aviators and frequent flyers. A good number of aconsultation of aviators and frequent flyers. A good number of articles, dealing with this rticles, dealing with this questions have been published recently but produced controversiaquestions have been published recently but produced controversial results. METHODS: l results. METHODS: We performed a Medline database search and identified 20 relevanWe performed a Medline database search and identified 20 relevant articles that were t articles that were published between 1990 and 2003. There were one retropublished between 1990 and 2003. There were one retro--/prospective, 13 retrospective, /prospective, 13 retrospective, 3 prospective cohort studies and 3 3 prospective cohort studies and 3 metaanalysismetaanalysis reviewed. Sixteen studies were set in reviewed. Sixteen studies were set in the civil aviation environment, two studies in the military aviathe civil aviation environment, two studies in the military aviation environment and two tion environment and two studies were set in both environments. RESULTS: Seven out of ninstudies were set in both environments. RESULTS: Seven out of nine studies found an e studies found an identical or decreased overidentical or decreased over--allall--risk for aviators to develop cancer of any kind compared risk for aviators to develop cancer of any kind compared to the general population. In reto the general population. In re-- gardsgards to skin cancer, seven out of eight studies found an to skin cancer, seven out of eight studies found an increased risk for aviators to develop malignant melanoma, increased risk for aviators to develop malignant melanoma, basaliomabasalioma or other kinds of or other kinds of skin cancer. Three studies found an increased risk for the develskin cancer. Three studies found an increased risk for the development of prostate opment of prostate cancer and two studies were able to demonstrate a higher risk focancer and two studies were able to demonstrate a higher risk for the appearance of r the appearance of leukaemia. CONCLUSIONS: Although our review found some studies, leukaemia. CONCLUSIONS: Although our review found some studies, that identified that identified higher risks for pilots to develop cancer of the skin, prostate higher risks for pilots to develop cancer of the skin, prostate cancer or leukaemia, there cancer or leukaemia, there is not enough scientific evidence to support the hypothesis, thais not enough scientific evidence to support the hypothesis, that cosmic radiation is the t cosmic radiation is the cause for these findings. It shows to be important to include otcause for these findings. It shows to be important to include other factors in the her factors in the interpretation of the results, since some of the findings may beinterpretation of the results, since some of the findings may be well explained by lifewell explained by life--style style factors of the aviation community.factors of the aviation community.

PMID: 16485604 [PMID: 16485604 [PubMedPubMed -- indexed for MEDLINEindexed for MEDLINE

Cancer incidence among 10,211 airline pilots: a Cancer incidence among 10,211 airline pilots: a Nordic study.Nordic study.

AviatAviat SpaceSpace Environ Environ MedMed.. 2003 Jul;74(7):6992003 Jul;74(7):699--706.706.

RESULTS: The SIR for cancer overall was 1.01 (95% CI 0.78 to 1.2RESULTS: The SIR for cancer overall was 1.01 (95% CI 0.78 to 1.24) 4) for women and 1.16 (95% CI 0.76 to 1.55) for men. Both men and for women and 1.16 (95% CI 0.76 to 1.55) for men. Both men and women had an increased incidence of malignant melanoma of the skwomen had an increased incidence of malignant melanoma of the skin in (SIR 2.18 and 3.66 respectively) and men of non(SIR 2.18 and 3.66 respectively) and men of non--melanoma skin melanoma skin cancer (SIR 4.42). Female cabin attendants had a noncancer (SIR 4.42). Female cabin attendants had a non--significant significant increase of breast cancer (SIR 1.30; 95% CI 0.85 to 1.74). No clincrease of breast cancer (SIR 1.30; 95% CI 0.85 to 1.74). No clear ear associations were found between length of employment or cumulatiassociations were found between length of employment or cumulative ve block hours and cancer incidence. CONCLUSIONS: Swedish cabin block hours and cancer incidence. CONCLUSIONS: Swedish cabin crew had an overall cancer incidence similar to that of the genecrew had an overall cancer incidence similar to that of the general ral population. An increased incidence of malignant melanoma and nonpopulation. An increased incidence of malignant melanoma and non--melanoma skin cancer may be associated with exposure to UV melanoma skin cancer may be associated with exposure to UV radiation, either at work or outside work. An increased risk of radiation, either at work or outside work. An increased risk of breast breast cancer in female cabin crew is consistent with our results and mcancer in female cabin crew is consistent with our results and may in ay in part be due to differences in reproductive history.part be due to differences in reproductive history.

PMID: 14573710 [PMID: 14573710 [PubMedPubMed -- indexed for MEDLINE]indexed for MEDLINE]

Cancer incidence in airline cabin crew: Cancer incidence in airline cabin crew: experience from Sweden.experience from Sweden.

LinnersjLinnersjöö AA, , HammarHammar NN, , DammstrDammströömm BGBG, , Johansson MJohansson M, , EliaschEliasch HH..

: : OccupOccup Environ Med.Environ Med. 2003 Nov;60(11):8102003 Nov;60(11):810--4. 4. Erratum in:Erratum in:OccupOccup Environ Med. 2004 Jan;61(1):94. Environ Med. 2004 Jan;61(1):94. Comment in:Comment in:OccupOccup Environ Med. 2003 Nov;60(11):805Environ Med. 2003 Nov;60(11):805--6. 6.

METHODS: A questionnaire was used to collect information on hairMETHODS: A questionnaire was used to collect information on hair colour, eye colour, colour, eye colour, freckles, number of freckles, number of naevinaevi, family history of skin cancer and , family history of skin cancer and naevinaevi, skin type, history of , skin type, history of sunburn, sunburn, sunbedsunbed, all sunscreen use, and number of sunny vacations. RESULTS: The, all sunscreen use, and number of sunny vacations. RESULTS: The239 pilots were all males and there were 856 female cabin attend239 pilots were all males and there were 856 female cabin attendants, which were ants, which were compared with 454 males and 1464 females of the same age drawn rcompared with 454 males and 1464 females of the same age drawn randomly from the andomly from the general population. The difference in constitutional and behaviogeneral population. The difference in constitutional and behavioural risk factors for ural risk factors for malignant melanoma between the aircrews and the population samplmalignant melanoma between the aircrews and the population sample was not e was not substantial. The aircrews had more often used sunscreen and had substantial. The aircrews had more often used sunscreen and had taken more sunny taken more sunny vacations than the other men and women. The predictive values fovacations than the other men and women. The predictive values for use of sunscreen r use of sunscreen were 0.88 for pilots and 0.85 for cabin attendants and the prediwere 0.88 for pilots and 0.85 for cabin attendants and the predictive values for sunny ctive values for sunny vacation were 1.36 and 1.34 respectively. CONCLUSION: There was vacation were 1.36 and 1.34 respectively. CONCLUSION: There was no substantial no substantial difference between the aircrew and the random sample of the popudifference between the aircrew and the random sample of the population with respect to lation with respect to prevalence of risk factors for malignant melanoma. Thus it is unprevalence of risk factors for malignant melanoma. Thus it is unlikely that the increased likely that the increased incidence of malignant melanoma found in previous studies of pilincidence of malignant melanoma found in previous studies of pilots and cabin ots and cabin attendants can be solely explained by excessive sun exposure.attendants can be solely explained by excessive sun exposure.

PMID: 14573711 [PMID: 14573711 [PubMedPubMed -- indexed for MEDLINE]indexed for MEDLINE]

JIMMYJIMMY

SCHEMA RIASSUNTIVO DELLE SCHEMA RIASSUNTIVO DELLE SORVEGLIANZE EFFETTUATE IN UN SORVEGLIANZE EFFETTUATE IN UN

ANNO SOLAREANNO SOLARE

CASI CLINICI IML ROMACASI CLINICI IML ROMAPaziente Paziente imgimg. 0054. 0054MaschioMaschioEtEtàà 51 51 aaaa..Sede: dorsoSede: dorsoMisure 8 x 6,5 mm.Misure 8 x 6,5 mm.Diagnosi: MELANOMA Diagnosi: MELANOMA IN SITUIN SITU

CASI CLINICI IML ROMACASI CLINICI IML ROMA

Paziente Paziente imgimg. 0859. 0859MaschioMaschioEtEtàà 52 52 aaaaSede dorsoSede dorsoMisure: 10 x 6 mm.Misure: 10 x 6 mm.Diagnosi: MELANOMA Diagnosi: MELANOMA IIII°° ClarkClark ; 0,4 mm. ; 0,4 mm. Sec.Sec.BreslowBreslow con adiacente con adiacente nevonevo intradermico intradermico

CASI CLINICI IML ROMACASI CLINICI IML ROMA

Paziente Paziente imgimg. 5598. 5598MaschioMaschioEtEtàà 50 50 aaaaSede: Plantare Sede: Plantare Misure Misure neofneof. 7 x 3 . 7 x 3 mm.mm.Diagnosi: MELANOMA Diagnosi: MELANOMA IN SITUIN SITU