Risk Factors for Upper Extremity Musculoskeletal Symptoms among Call Center Employees: Angelo d'ERRICO, et al. Epidemiology Unit ASL TO3-Piedmont Region, Italy-Objectives:To investigate the prevalence of musculoskeletal symptoms in the upper extremity (UE) in a sample of Italian call center (CC) operators, and the relationship between the symptoms and potential workplace risk factors. Methods: During 2005-2006, 775 workers from seven CCs in the Turin area participated in a questionnaire survey of exposure to ergonomic, organizational and psychosocial factors at work, sociodemographics, lifestyle, symptoms and diseases. Musculoskeletal symptoms were defined as selfreported musculoskeletal symptoms in the UE during the previous 28 days, for which a physician was consulted and/or drugs were taken. Relative risks were estimated through Poisson regression models with the Huber-White sandwich estimator of variance. Result: Overall, 45% of workers reported UE symptoms in the last four weeks. Symptoms in the neck were the most prevalent (39%), followed by the shoulder (22%), handwrist (10%) and elbow (4%). Among workplace risk factors, neck-shoulder symptoms were associated with low job control, elevated noise, poor desk lighting and impossibility to lean back while sitting; whereas elbowhand/wrist symptoms were associated with short intervals between calls, insufficient working space, lack of forearm support, job insecurity and long seniority in the CC industry. Conclusions: The high prevalence of UE symptoms in this sample was similar to that reported by other studies conducted in this industry. Our results confirm previously reported associations, such as poor characteristics of the workstation and psychological stressors. The striking difference between the set of risk factors for neck-shoulder and elbow/wrist-hand symptoms indicates that the two regions should be investigated separately.

The evaluation of tongue swellings often represents a diagnostic challenge, because of the wide spectrum of benign and malignant possible lesions. We report a case of a patient presenting a tongue mass. An incisional biopsy was performed. Diagnosis of primary Mantle Cell non-Hodgkin's Lymphoma of the tongue was made by histological, immunohistochemical and cytogenetic studies. Our patient was treated with Rituximab-Cyclophosphamide, Epirubicine, Vincristine, Prednisone polychemotherapy plus Rituximab as single agent maintenance. Complete remission was achieved and no relapse has occurred during a follow-up of 53 months. We emphasize the importance of including also NHL in differential diagnosis of a tongue mass.

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