M D’Orso

Small italian enterprises and their effective application of laws concerning occupational health: a six years study

Introduction Small enterprises are the majority of productive activities in Italy. For a small enterprise activation of regulations prescribed by European law concerning occupational health promotion is difficult and proportionally expensive. This fact could originate a delay in application of preventative laws comparing with what usually happens in bigger firms. Methods State of application of laws concerning occupational health and safety in Italy has been evaluated a first time in 2011 in 1458 small enterprises (less than 50 workers). Evaluation has been repeated in 2017 in same firms to verify the possible differences in application of laws carried out in this six years period. For every enterprise we verified presence of a regular program of occupational medicine carried out by an Occupational Health Doctor according to guidelines of Italian Occupational Health Association. We also evaluated Occupational Doctors’ role in risk assessment. We evaluated adoption of correct personal protective devices, their use and specific individual formation programs. We also studied legal problems eventually found in small firms carrying out these programs. Results Only in 21.8% of firms evaluated we evidenced complete and adequate applications of laws. In 81.9% firms correct occupational health programs were regularly carried out. Occupational Health Doctors have been involved in risk assessment in 71,8% firms. Personal protective devices were adopted and used only in 55,4% firms. Specific individual formation programs for workers were carried out in 48,5% firms. We present data divided for different productive sectors comparing them with data collected in 2011. Discussion Small enterprises respect of laws concerning workers’ health and safety is increased comparing with what resulted in 2011 but it is still not satisfactory. A more active Occupational Health Doctors role could increase workers’ safety and health in these firms. This result could be obtained only increasing employers’ and employees’ cultural specific level.

1688c The contribution of task- and worker-related accommodation to asthenopia: a critical literature review

Introduction Near work is believed to be a key factor in the development of occupational asthenopia as well as being a possible cofactor for the development of adult myopia. Prolonged viewing distances of less than one metre induce visual symptoms by imposing a sustained contraction of ciliary muscles. Small screens on mobile devices are very common in modern work environments, and there are many jobs and tasks that require near work every day. Furthermore, there is an ageing workforce where there is less capacity for visual accommodation. This review critically assesses the published literature on asthenopia attributable to task observation distance and worker-related accommodative capacity. Methods A systematic search of PubMed, Scopus, and Embase was used, and supplemented with forwards, backwards and hand-searching, including by author. The major search terms were ‘observation distance’, ‘near work’ and ‘visual work load’. Results Most published papers reporting on asthenopia in the workplace classify visual effort in broad terms, without objective ‘on site’ measurement of task-determined visual distances/durations. Similarly, few papers separately consider workers over 45 (presbyopia), and those who are long sighted (hyperopia), where there is a greater requirement of accommodation compared to normal sighted (emmetropes). Even fewer papers juxtapose the observation distance with the worker capacity for accommodation, i.e. combining exposure and susceptibility, which is essential for the characterisation of asthenopia risk. Discussion In order to assess and manage risks for asthenopia attributable to visual effort, equal weight should be given to task and individual factors. Future studies should utilise objective measurements of task viewing distance and durations. Currently, there is a need for a personal monitoring device that can continuously measure and datalog these parameters. With regard to an ageing workforce, intervention research is needed to determine whether the provision of larger screens, larger images and less visual demanding software reduces asthenopia.

1688a Office lighting surveys – refocussing on the eye and health

Introduction Current guidance on office lighting tends to be oriented towards illumination engineering, i.e. achieving a certain lighting environment. The selection of lamps and luminaires from a vast array of current lighting options, as well as their layout, often reflects architectural style and energy efficiency, rather than ‘healthy’ lighting – which aims to eliminate or minimise adverse health effects, including visual discomfort, arising from visual tasks and ambient light sources. Methods Firstly, this paper explores the criteria for healthy lighting based on visual anatomy and pathophysiology and characteristics of workers and tasks in office environments. Secondly, survey methods addressing characteristics of light entering the eye are reviewed in the context of outcomes ranging from discomfort to retinal degradation. Results A primary consideration is characterisation of light sources in the occupational visual field, (OVF) which is mainly determined by the visual tasks. Another consideration is how, and for how long, the source(s) are imaged on the retina (especially the macula). Again this depends on the visual requirements of the task. Indeed, directionality is much more important for lighting than other hazards such as noise. Such assessments are not possible with an integrating light measuring instrument such as a lux metre. Finally, in the cases of blue-rich sources, the assessment should be more about radiometry than photometry. Discussion A variety of visual, circadian rhythm and psychological disturbances may arise from inappropriate lighting. The concept of ‘healthy’ lighting serves to integrate the issues, and surveys of lighting should begin with the OVF and systematic consideration of light sources therein. Assessment should involve luminance and where necessary radiance.