[‘Health Surveillance’ of workers: opening a discussion on its theoretical basis and methods of application]

“Sorveglianza Sanitaria” dei lavoratori: aprire una discussione sulle sue basi teoriche e modalità applicative

Our research aims at proposing a reflection on the theoretical and methodological contents that characterize occupational health surveillance (OHS) carried out in Italy by the occupational health physician (OHP), mainly focusing on the shortcomings arose from the transposition of the European framework directives 89/391 in our legislative context. On this matter, we critically analyzed the legislative frame, already discussed in the previous guidelines produced by our professional society (SIMLIl), and the proposals made by SIMLII following the recent developments in Italian legislation (Legislative Decree no. 81/08 and 106/09). The key starting point concerns the need of providing better, comprehensive and referenced definitions of occupational exposure, risk, job task, working activity, often not included in the abovementioned regulations. Also the concept of "fitness to work" should be reviewed to "fitness to a defined job", which must be performed starting from a clear evaluation of the compatibility of a specific health condition and a specific working activity. Moreover, it is necessary to remark that the OH physician must be actively involved in all the activities addressed at assessing and managing both occupational health and safety in the enterprise. This must be done considering the bonds of the quality and of the validity of the whole body of the preventive interventions performed.