[Aging and occupational accidents]. / Invecchiamento e infortuni sul lavoro.

Ageing and occupational accidents is an underestimated issue in Italy. This deals both with shortcomings of data and proper studies in the matter and with safety culture and interventions. Nevertheless, some tables are presented showing a relation between ageing and occupational accidents both in frequency and in severity. These results are discussed in the light of a review of the literature on age-related accidents risks of three decades published in 1995. A framework is reported outlined for the purpose of identifying jobs in which ageing has either a preventive or an aggravating effect on accident occurrence. It is concluded that the safety problems of older workers may well be restricted to activities that are specifically "age-impaired". Age-related accident problems can also be specific in terms of injury type, as also demonstrated by some Italian data. Finally, it is emphasized that further research would benefit greatly from longitudinal designs, proper exposure measurements, intra-occupational investigations, consideration of the positive effect of relevant experience on occupational safety and greater precision about the type of accidents in focus. On the prevention side, a better attention to a global approach to safety problems (not only to technological aspects but also to immaterial ones, like work organization, psychosocial factors and so on) is pointed out.

[Point of view of the trade union]. / Il parere del sindacato.

The goal is "make healthy individuals in healthy organizations". The workers health tutorship isn't in contrast with the business purpose, if the business considers the workers health a development factor. He doesn't agree with so frequent clinical examination, that are useless. However we can't leave the sanitary surveillance, that must involve a lager number of workers indeed. The occupational health physician must be involved in the risk assessment and pay attention to the information coming from the workers. The public service must make the occupational health physician activity more effective, giving them a line.

[Round Table "Role of scientific and professional associations in proposing occupational health programs to regional and national authorities]. / Tavola Rotonda "Ruolo propositivo delle associazioni scientifiche e professionali verso gli organi di governo locale e centrale".

The six participants at the round table were experts in the field of Occupational Prevention working respectively in the Ministry of Health, the National Institute of Occupational Health, the Health Council of Lombardy, the Law-court of Milan, the CGIL Trade Union, and the Lombard Employers Association. All the participants were of one mind on the establishment of working groups within the scientific and professional associations with the aim of preparing and updating occupational exposure limits, diagnostic records, programs of biological and environmental monitoring, etc. Moreover, they stressed the need to establish permanent cooperation between the scientific and professional associations and the regional and national health authorities. These associations can make an important contribution, for example in preparing new preventive guidelines, because they can act faster than the legislative bodies. The validity of these proposals was confirmed by the judge attending the round table. He stated that technical standards proposed by groups of professionals or by scientific associations have usually been taken into consideration when relevant legislation has been applied.

Occupational cancer in Italy.

This article is a discussion of occupational cancer in Italy. The introduction provides the necessary context of Italian industrialization and occupational health regulation. This is followed by a review of Italian epidemiologic studies of occupational cancer risks considered in terms of relative measures of risk and attributable risk of carcinogenic agents or exposure circumstances. We attempt to establish the number of workers exposed to carcinogens in Italy and the intensity of their exposures. Finally, the Italian system of compensation for occupational cancer is discussed. Several cohort and case-control studies have addressed the issue of occupational risks, mostly among male workers. The results of these studies suggest that the growing incidence of and mortality by mesothelioma is explained by the widespread and intense exposure to asbestos in some Italian industrial settings. A high attributable risk of lung tumors among male populations in industrial areas of northern Italy is explained by occupational exposures. However, insufficient data are available for clear definition of the extent and intensity of occupational exposure to carcinogenic substances. In Italy, we must prioritize and maximize resources in occupational cancer epidemiology and revitalize the role of national institutions. Recent legislation has established new regulations on the handling of carcinogenic substances in industrial settings, a new list of occupational diseases, and a national registry of mesothelioma linked to asbestos exposure. These legislative changes are expected to have positive effects.