Benedetta Persechino

Indoor formaldehyde and acetaldehyde levels in the province of Bari, South Italy, and estimated health risk

Indoor and outdoor formaldehyde and acetaldehyde levels were assessed to characterize pollution in dwellings in the city and the Province of Bari, also taking into account seasonal variability, and to investigate health effects of aldehyde exposure on the general population. In 2007, passive environmental monitoring was performed, for 24 hours, in the kitchen of 59 dwellings, as well as outdoors for 27 of them. A questionnaire probing personal and home characteristics was administered to all 182 subjects habitually resident in the homes. During the period January-June 2008, formaldehyde and acetaldehyde levels were monitored monthly in 20 of the investigated dwellings inhabited only by non smokers. Indoor formaldehyde and acetaldehyde concentrations were significantly higher (16.0 +/- 8.0 and 10.7 +/- 8.8 microg m(-3)) than outdoor concentrations (4.4 +/- 1.7 and 3.4 +/- 2.0 microg m(-3)), showing a correlation between indoor levels of the two aldehydes (r = 0.41; p = 0.001). In dwellings inhabited only by non smokers, formaldehyde concentrations were higher in the presence of furniture bought new or restored less than one year before (p = 0.03). Formaldehyde and acetaldehyde levels were significantly higher in winter months than in spring-summer months (F = 2.86, p = 0.02; F = 5.39, p < 0.001) and seemed to be influenced by the time that kitchen windows were kept open. As regards the effects on human health, a low prevalence of allergic disease and no association between any irritant or allergic complaints and indoor levels of the two aldehydes was observed. In conclusion, the results showed low indoor and outdoor concentrations of formaldehyde and acetaldehyde, not generally posing a risk for human health.

The relevance of socio-demographic and occupational variables for the assessment of work-related stress risk

BackgroundWork-related stress is widely recognized as one of the major challenges to occupational health and safety. The correlation between work-related stress risk factors and physical health outcomes is widely acknowledged. This study investigated socio-demographic and occupational variables involved in perceived risk of work-related stress.MethodsThe Italian version of the Health and Safety Executive Management Standards Indicator Tool was used in a large survey to examine the relationship between work-related stress risks and workers’ demographic and occupational characteristics. Out of 8,527 questionnaires distributed among workers (from 75 organizations) 6,378 were returned compiled (74.8%); a set of mixed effects models were adopted to test single and combined effects of the variables on work-related stress risk.ResultsFemale workers reported lower scores on control and peer support and more negative perceptions of relationships and change at work than male workers, most of them with full-time contracts. Age, job seniority, and educational level appeared positively correlated with control at work, but negatively with job demands. Fixed-term workers had positive perceptions regarding job demands and relationships, but more difficulties about their role at work than permanent workers. A commuting time longer than one hour and shift work appeared to be associated with higher levels of risk factors for work-related stress (except for role), the latter having more negative effects, increasing with age.ConclusionsThe findings suggest that the assessment and management of work-related stress risk should consider specific socio-demographic and occupational risk factors such as gender, age, educational level, job status, shift work, commuting time, job contracts.

Hard and soft law approaches to addressing psychosocial risks in Europe: lessons learned in the development of the Italian approach

Psychosocial risks in the workplace have been identified as some of the most significant emerging risks, particularly since issues such as work-related stress, which is closely linked to psychosocial risks, are widely recognised as major challenges in modern occupational safety and health. This paper presents the policy framework and key initiatives that have been implemented for the management of psychosocial risks in the workplace in Europe. It discusses several approaches and initiatives, both from a hard and soft law perspective, that have been implemented at European Union and national level. Within this context, it discusses the key issues that pertain to the development of national approaches, focussing as an example on the Management Standards for work-related stress developed in the UK and their recent adaptation in Italy. The Italian approach is discussed in detail as an example that may highlight key process elements in the development of psychosocial risk management policies, and promote good practice in this area through lessons learned. It is concluded that it is more pressing now than ever for a critical evaluation of efforts employed so far to address psychosocial risks to be conducted, and an approach at European level to be developed that will allow both flexibility and a certain level of benchmarking across members states. Such an approach can be supported by European bodies, responsible for surveillance and promotion of good practice, working in collaboration with similar national bodies.

Stakeholders' perception of the possible implications of "green jobs" for health and safety at work in Italy.

Despite all the emphasis laid today on the green economy, occupational health and safety (OHS) issues have still been talked only limitedly, as already noted in previous studies and literature reviews. The Department of Occupational and Environmental Medicine, Epidemiology and Hygiene of the Italian Workers’ Compensation Authority (INAIL) has conducted a survey among some Italian stakeholders, social partners, institutions and “green” businesses to gather their perceptions of the potential effects of green jobs on OHS, particularly in the renewable energy sector. The survey involved a sample of 61 stakeholders in the following categories: institutions (11), trade unions (11), employers’ organizations (13), businesses (11), research (15). Participation in this survey of national stakeholders who have a central role in the development and management of policies on renewable energy and OHS, allowed to analyze in depth the fundamental aspects for a fair transition towards green economy. Also, the good agreement among respondents brought to light quite clearly the main critical points as regards the OHS implications of green work in Italy, and pointed to the principal policies to be adopted to safeguard workers’ health and safety.

Collaboration of occupational physicians with national health system and general practitioners in Italy

A good cooperation between occupational physicians and other healthcare professionals is essential in order to achieve an overall improvement of workers/patients’ well-being. Unfortunately, collaboration between occupational physicians and other physicians is often lacking or very poor. In this context, using a self-administered questionnaire, we investigated the cooperation of Italian occupational physicians with the National Health System (NHS) facilities and with the general practitioners in order to identify any potential critical issues that may hinder an effective and collaborative relationships between these professionals. The survey was conducted from October 2013 to January 2014. Nearly all of the interviewed occupational physicians have had contacts with colleagues of the Departments for Prevention and Occupational Health and Safety of the NHS. Regarding the relationship between occupational physicians and general practitioners findings showed that their cooperation is quite difficult and it would not seem a two-way collaboration. Cooperation between occupational physicians and NHS would benefit from the development of communication strategies and tools enhancing the support and assistance functions of the NHS facilities. The elaboration and subsequent application of operational guidelines and standardized procedures of communication would also improve collaboration between occupational physicians and general practitioners that is currently considered rather insufficient and incomplete.

Professional activity, information demands, training and updating needs of occupational medicine physicians in Italy: National survey.

OBJECTIVES Occupational medicine is a discipline continually evolving in response to technological advances, changes in workplaces and production processes, emergence of new occupational risks and diseases and modifications in regulatory framework for occupational health and safety. Therefore, the recurrent revaluation of professional activity, information demands and education and training needs of occupational physicians is essential in order to identify methodologies and tools that may contribute to improvement of their professional knowledge and competency. In this regard, we conducted the first large-scale national survey of Italian occupational medicine physicians to define their demographic and professional activity and to assess their information demands, training and updating needs. MATERIAL AND METHODS A random sample of occupational physicians, listed in the national register of the Italian Ministry of Health, was selected to complete a voluntary survey. Subjects recruited in this study were asked to complete 3 different sections (personal and professional information, training and updating needs, professional activity and practice characteristics) of a questionnaire for a total of 35 questions. RESULTS Most of participants were specialized in occupational medicine, worked for a large number of companies and carried out health surveillance on a total number of workers that exceeds 1500. Occupational physicians would like to have a higher training offer towards practical aspects of health surveillance, risks assessment, manual handling of loads, chemical substances and upper limb biomechanical overload. Interestingly, statistically significant differences were observed subdividing the sample into different groups according to the legal requirements to perform the professional activity of occupational physicians in Italy or according to particular aspects of their professional activity. CONCLUSIONS This study has provided interesting findings that may help to guide future discussion on alternative and additional instruments and/or methodologies that may be adopted to implement the quality and effectiveness of occupational medicine practice. Int J Occup Med Environ Health 2016;29(5):837-858.

1174 Risk perception among migrant agricultural workers

Introduction Over the past few years, there has been a progressive increase in foreign labour force in agricultural sector in Italy, which has reached over 1 15 000 units (14.2% of total employment in agriculture), of which 36% coming from EU countries, while 64% from non-EU countries. In case of migrant workers factors such as lack of knowledge of occupational safety and health (OSH) legislation, language knowledge difficulties, young age, lack of information and training and, consequently, reduced perception of work-related risks, could further increase the risk for health due to both specific risks of the activities carried out and the peculiar characteristics of the work organisation. The present study aims at detecting the perception of OSH risk in agriculture in migrant workers as a contribution to the identification of training needs. Methods With the support of cultural mediators, an ad hoc questionnaire was submitted to 402 migrant workers employed in agriculture in Lombardy Region. Results The interviewees have different nationalities (60% Indian, 15% Moroccan, 15% Bengali), with mostly seasonal employment contracts (96%); the age most represented is 25–34 years (41%). Over 56% generally evaluate their health ‘very good’. About 73% of respondents believe that there are no risks for OSH and 80% of them believe that are not personally exposed. Over 62% is very/completely agree that the lack of knowledge and awareness of workers’ dangers in the workplace contributes to an injury. Conclusions Preliminary results of the study requires a secondary analysis in order to contribute to the implementation and optimisation of preventative tools in consideration of the peculiarities that characterise the agricultural sector.

1337 Investigating the effectiveness of organisationallevel interventions for the management of work-related stress through a process evaluation: an italian case study

Introduction Evaluating the effects of organisational level interventions, as those related to work related-stress, is broadly recognised crucial to identify the key steps needed to ensure the efficacy of interventions. The Italian Workers’ Compensation Authority (INAIL) developed a methodology for management of risks associated to work related-stress as an organisational integrated approach useful for OSH professional and companies. This study provides a process evaluation of organizational-level work related stress management interventions in a public administration using the INAIL’s methodology. Methods An Italian Public Administration (more than 4, 000 employees) has carried out a process of risk assessment and management of work-related stress using the INAIL’s approach and tools, with the methodological support of a research team form INAIL. Our support ensured that some key aspects of the process were implemented such as: specific training, the active involvement of workers, and OSH professionals, and raise the awareness of management on the importance of organisational level interventions in managing stress at work. According to the literature, we analysed intervention process using two methodological approaches: quantitative and qualitative. Results Some aspects resulted valuable for the effectiveness of the interventions: the active role played by OSH professionals in implementing the process; 2) the high participation of workers with a 75% of response rate in the risk assessment (3200 questionnaires); 3) The direct involvement of the management; 4) a bottom-up approach through the active involvement of workers by the means of focus groups in identifying concrete actions based on the assessment findings in collaboration with OSH professional and managers. Discussion This study investigates the ways of implementing an effective integrated approach for assessing and managing work related stress using the INAIL’s methodology through a process evaluation of organizational-level interventions. Findings contributes to the international debate on how to verify the effectiveness of processes of intervention planning and implementation.

Improving the job-retention strategies in multiple sclerosis workers: the role of occupational physicians

Several studies evaluated whether a person with multiple sclerosis is employed or not and investigated the main symptoms that hinder the job performance. However, despite occupational physicians are fundamental in managing disabled subjects, there is a serious lack of data regarding their role in improving employability of these workers. In this regard, we assessed occupational physicians’ professional activity and training/updating needs in order to identify and develop management tools, operative procedures and training programs helpful to support and implement adequate job-retention strategies. Four hundred three Italian occupational physicians compiled a self-administered questionnaire to evaluate individual demographics, health surveillance system, fitness for work and training needs. Our findings confirmed the suitability to adopt environmental adjustments at workplace (particularly referring to the ergonomics of workstation, the typology of occupational risk factors and the working time) to accommodate individual’s needs in order to improve working ability among multiple sclerosis workers. Moreover, training events discussing operational guidelines and standardized instruments and/or methodologies to adequately manage the disable workers should be fostered. Therefore, in this regard, occupational physicians could play a key role but they need more high-quality training especially concerning the different tools that are currently available to assess the work issues in multiple sclerosis patients.

L’impatto economico del mesotelioma maligno in Italia: una stima dei costi pubblici e sociali

BACKGROUND Despite their considerable interest for public health policies and for occupational disease management and assessment, the economic costs of asbestos-related diseases (ARDs) for society have not been fully estimated or even frequently discussed. OBJECTIVES The aim of this study was to estimate the economic burden of mesothelioma in Italy by assessing the overall societal cost of the disease, applying an econometric model. METHODS We analyzed two main cost groups, public and social. The first includes expenditure borne by the State and other public bodies (medical care costs, insurance, tax and benefits), while the latter uses the human capital approach to measure the loss of productivity suffered by the economy as a whole. RESULTS We provide an estimate of euro 33,000 per patient for medical care costs and euro 25,000 for insurance and compensation; tax and benefits seem to roughly compensate. We estimated a loss of more than euro 200,000 per patient, in terms of loss of production. CONCLUSIONS This study offers a practical approach for estimating the economic impact of mesothelioma, and provides empirical evidence of the huge economic burden linked to this disease, with its high etiologic fraction.