Emerging problems and novel skills: a qualitative analysis on the role of occupational physicians.

INTRODUCTION: The thorough changes in the world of employment, together with regulatory changes, have made the role of occupational health physicians increasingly complex, with an extension of the prescribing component, linked to the operational aspects of the role, as well as a greater complexity in the discretionary sphere, which also requires a number of "non-technical" skills. OBJECTIVES: This work investigates how occupational physicians experience and represent their role, with special attention paid to the person-context relationship, so as to offer reflections and useful tools for supporting this role within the participatory health and safety system in the workplaces. METHODS: Using a qualitative approach, the survey has been carried out through semi-structured interviews to a sample of 22 Italian occupational health physicians who were asked to talk about their professional experience with regard to the legislative reforms, critical factors in their work, their relationship with other players in the safety system, and satisfaction with Continuous Medical Training (ECM). The interviews were analyzed using content statistics analysis software. RESULTS: Faced with the various context constraints, occupational physicians often remain confined to their healthcare role and in their relationship with the patient-worker. This causes difficulties in intervening as overall health and safety consultants for workers in a preventive context. Traditional technical expertise, delivered through ECM Training and guidelines, is not enough to make a substantial change in practising the profession, but other types of intervention are necessary to facilitate reflection about problems and one's own actions.

Teaching Life-Saving Manoeuvres in Primary School.

Introduction. In the event of sudden cardiac arrest (SCA) early intervention provided by a layperson can be life-saving. Teaching first aid in primary school may increase the lifelong ability and motivation of young people to take action in an emergency. Objective. The aim of this article is to report a training experience on BLSD (Basic Life Support and Defibrillation) designed for a group of pupils in an Italian primary school, with assessment of its effectiveness at a distance. Methods. The assessment was carried out using a multiple choice questionnaire on a sample of 130 pupils aged 11-12, 62 trained in BLSD and 68 as a control group. The trained group also performed an emergency simulation to assess their learning of practical skills. Results. Using the t test, significant differences emerged in the questionnaire scores between the case-control group. The results of the skill test were positive, even for the most difficult manoeuvres such as opening airways, assessing breathing, or using an AED (Automated External Defibrillator). Conclusion. Although there are still some open questions regarding the ability to retain these skills in the medium/long term, the study shows that life-saving manoeuvres can be effectively taught to primary school pupils.

[DIFFERENT APPROACHES FOR CHEMICAL RISK ASSESSMENT IN LABORATORIES]. / Rischio chimico nei laboratori: confronto tra diversi approcci alla valutazione.

The aim of this study was to compare the different approaches used for chemical risk assessment, in relation to the perception of riskfor operators, in some research laboratories of a hospital in Rome. All information regarding the chemicals used for the application of three algorithmic models for chemical risk assessment ("Movarisch", "Inforisk", "Archimede") were collected. An environmental and biological monitoring and a study on the combined exposure to multiple chemicals using the World Health Organization proposed steps were carried out. A questionnaire was prepared for the identification of risk perception. An estimation of chemical risk with algorithms was compared with data from monitoring: findings showed that estimated risk was higher than those identified with airborne or urine concentrations, always under their limit values. The study of multiple exposure showed a possible cumulative risk, in some cases, but the conditions of use (volume and time) often bring to a reduced one. The perception of risk attributed to the monitored hazardous substances showed a correct perception in all laboratories and for all workers, with regard to the substances manipulated.

[The organization and management of First Aid in the workplace: critical issues and innovations to be introduced]. / L'organizzazione e la gestione del Prime Soccorso nei luoghi di lavoro: aspetti critici e innovazioni da introdurre.

Develop an effective First Aid's system in workplaces is significantly important to the outcomes of accidents at work, thus contributing positively to create healthy and safe environments, improving responsible attitude and risk perception by workers. The italian regulation (D. Lgs. 81/08; DM 388/03) gives an important role to First Aid within the system for managing health and safety in workplaces and requires the employers to designate and train workers and organize facilities in the workplace. However, to ensure that First Aid's system actually contributes to increasing health and safety in workplaces, it's necessary to verify its effectiveness, beyond the law compliance. The article stands to evaluate the critical issues and related innovations to be introduced in this context, by analyzing data from literature and field experiences involving actors in the prevention system. The goal is to provide suggestions and action proposals to improve first aid's system in workplaces, paying particular attention to the aiders training (selection, motivation, teaching methods, retraining), as well as introduce to innovations to allow an immediate and timely emergency response (company equipments, other useful devices). On this last aspect, it has given particular emphasis to the introduction of semi-automatic defibrillator (AED), which is essential in case of sudden cardiac arrest with ventricular fibrillation, and special aiders training by means of BLSD (Basic Life Support and Defibrillation) courses based on international guidelines.