[Risk assessment and its appropriateness supporting the physician in the certification of a suspected occupational disease.] / La valutazione dei rischi e la sua appropriatezza a supporto del medico nella certificazione di sospetta tecnopatia.

OBJECTIVES: The topic of appropriateness was defined as the new frontier of development of health interventions. RH Brook in an Editorial published in the BMJ in 1994 defines the appropriateness "… an intervention for which the expected benefits are greater (with a sufficient margin) the possible negative consequences … excluding economic considerations". In workplaces the goal of appropriateness should cover not only the actions of health surveillance and health protocols, but also and primarily all stages of the risk assessment process. METHODS: Only through an assessment of occupational risks that aims to identify, evaluate and measure the real professional risk factors in specific working environments, it is possible to meet the requirements of effectiveness, efficiency and protection of ethical principles in the identification of priorities (according to values of person, community and society) that represent the size of the appropriateness of an intervention. At the same time, the risk assessment should provide to the occupational pyisician instruments to study with scientific, justifiable and reproducible criteria the possible correlation between damage to the worker's health and the occupational risk factors. RESULTS: In the process of reporting of suspected technopathy, both for prevention purposes (according to art. 139 of Presidential Decree 1165/68, art. 10 of Legislative Decree 38/00 and DM 10 June 2014), both for insurance purposes (according to art. 53 of Presidential Decree 1165/68 and Ministerial Decree 9 April 2008), it should be considered two indispensable judgment elements to study the correlation between the disease and the work: on the one hand the level (measured or estimated) of the occupational risk factors; on the other hand the appropriateness of the risks assessment compared to the best and most current scientific evidence (Evidence Based Medicine - EBM), according to technical standards and specific guidelines. CONCLUSIONS: Our study underlines the importance of appropriateness in the risk assessment process to analyze the correlation between the exposure to specific occupational hazards and the suspected technopathy.

Usage and effectiveness of e-learning courses for continuous medical education.

The paper describes the results of an e-learning experimental project for Continuous Medical Education (CME) in Occupational Medicine in terms of: extent of the e-learning courses usage by the healthcare personnel, knowledge acquisition and satisfaction. 11 courses have been available for 11 months during which 2,034 users all over Italy enrolled in 5,183 courses with a success percentage of 72% and a significant difference between test scores performed before and after attending the e-learning courses. Also user's satisfaction, inspected through a questionnaire, has provided good results. Starting from the experience reported, the authors are confident that e-learning will gain ground and evolve as an effective and appreciated educational mean for CME.

Development of an e-learning system for occupational medicine: usability issues.

The aim of the present paper is to describe the process of developing an e-learning system for continuous medical education in the field of occupational medicine, with special focus on usability. The following steps are described: the needs analysis of the potential users; the prototype of the system that has been set up; the usability evaluation of the prototype by a sample of ten users; the analysis of the potential improvements; the evaluation of the revised system. The results of the usability tests point out that investing in improving usability was useful, even when they have not been recommended as mandatory. Only data collected from real active users will provide a more exhaustive evaluation, nevertheless it can be considered that positive results can be expected.