Desempeño ocupacional de una y un superheroe / Occupational performance of one and one superhero

La aparición de las y los superhéroes ha sido a lo largo de la historia una propaganda social que mantiene viva la llama de la esperanza. La realidad se torna incierta cuando una o un superhéroe flaquea. Pero la realidad es que todas y todos los superhéroes a lo largo de su vida han sentido una falta de equilibrio ocupacional que ha roto su sensación de competencia. Esta situación no exenta de ciertas repercusiones mantiene ese punto de cercanía con la sociedad. El desempeño ocupacional de una o un superhéroe va a depender las cruzadas en las que se encuentre. En la sociedad actual más de una y uno se ha enfundado en el traje siendo esa o ese superhéroe para otros y otras

The appearance of superhero has been throughout history a social propaganda that keeps the flame of hope alive. Reality becomes uncertain when one or a superhero falters. But the reality is that each and every superhero throughout their lives has felt a lack of occupational balance that has broken their sense of competence. This situation is not without certain repercussions maintains that point of closeness with society. The occupational performance of one or a superhero will depend on the crusades in which they are. In today's society more than one and one has dressed in the suit being one or a superhero for others and others

[Occupational health and safety in the port and the government of social processes and economic development]. / Salute e sicurezza sul lavoro in ambito portuale e governo dei processi sociali e di sviluppo economico.

SUMMARY: The paper aims to present the methodology applied by the Port System Authority of the Eastern Adriatic Sea from 2016 on to tackle aspects threatening the old and no-more replicable "rules" governing the Trieste Port Community social and economic equilibrium and which had generated an endemic reporting of occupational diseases. The methodology is based on the integration between port operation models and occupational health and safety requirements, in particular occupational ergonomics. By consolidating synergies with all Port stakeholders, the Authority carried out document and on-site surveys which detected the most relevant weaknesses of the system, considered already outdated. Thus, the Authority defined and adopted regulations to promote Port workers' welfare and protect marginalized workers' dignity; furthermore, the Authority applied technical measures to stop the process which would have caused new cases of the same occupational diseases. The Authority improvement action plan provides for a central role for occupational health physicians who will be asked to define shared minimum requirements to develop sanitary protocols for those port jobs exposed to similar risks in terms of quality and magnitude.

[Work ability in workers with heart disease: assessing physical and psycho-social risks]. / Idoneità lavorativa nel cardiopatico: valutare i rischi fisici e psico-sociali.

SUMMARY: Cardiovascular diseases are the main cause of death and disability in all industrialized countries, including Italy. Advances in acute phase treatment and increasingly effective rehabilitation programs have determined higher survival rates and a subsequent rise in disease prevalence in working age population. Hence the need for implementing social reintegration programs, including interventions aimed specifically at aiding the process of returning to work, in which the occupational physician plays a crucial role by means of assessing the compatibility between the workers residual clinical and functional capabilities and the characteristics of their job profile. On the basis of recent literature data, particular attention must be paid to occupational risks towards which cardiopathic patients are particularly susceptible, i.e. environmental risks (physical effort), organizational and psycho-social risks (workload and time pressure, shifts, job demand and control). A close collaboration between the occupation physician and the cardiologist to ensure an effective return to work process is highly recommended, as well as periodic re-evaluations of job placement adequacy that can also include clinical examinations, performed during working hours, of the degree of cardiovascular adaptation to working conditions.

[The suspension trauma syndrome: preventive features.] / Sindrome da sospensione inerte (sindrome da imbracatura): peculiarità preventive.

OBJECTIVES: The suspension trauma syndrome is a clinical condition that could lead to death, also in short time, by coupling the suspension with loss of consciousness and multiorgan failure. Health risks linked to temporary work in suspension are characterized both by infortunistic ones (for instance: trauma, falls, etc.) and by clinical ones, like the suspension trauma syndrome or compressive issues due to different fall protection systems. METHODS: This study deal with the technical and medical meseasures devoted to the prevention of the suspension trauma syndrome. Italian 81/08 and 164/56 laws prescribes that, when no collective protection systems could be used, any single worker has to used personal safety equipment like energy absorbers, anchoring devices, lanyards, retractable devices, flexible life guides or lines, guides or rigid life lines, harnesses. Persons working in height have to undergo a medical surveillance, devoted in particular to identify such illnesses (frequently cardiologic or muscleskeletal disorders, both temporary or chronical) that prevent the exposures possibly leading to the suspension syndrome. RESULTS: In some cases, the occupational physician could express a judgement of fitness to work in which only specific personal protection devices are allowed and/or the time to dedicate to work in suspension is limited, to efficiently protect the workers' health. CONCLUSIONS: Qualora emergano quadri patologici (in particolare cardiologici ed osteomuscolari) con caratteristiche di cronicità e irreversibilità, è indicato esprimere un giudizio di inidoneità permanente alle attività che prevedono il lavoro in sospensione con imbracatura. In casi specifici, è possibile formulare giudizi di idoneità con limitazioni/prescrizioni rispetto al tempo di sospensione o rispetto alla tipologia di DPI impiegati, in maniera tale da garantire lo svolgimento dell'attività in sospensione minimizzando il rischio di insorgenza della sindrome.

[Occupational allergic contact dermatitis: the role of occupational physician in the prevention.] / Dermatite allergica professionale: il ruolo del medico competente nella prevenzione.

OBJECTIVES: Occupational contact dermatitis are the second occupational diseases in industrialized countries and the preventive action and/or early diagnosis done by occupational physician (OP) is of paramount importance. METHODS: OP in the process of risk evaluation must suggest products, detergents and personal protective equipment with low irritant or sensitization potential. During work, the use of skin creams has to be promoted to prevent irritation that is the first step towards impairment of the skin barrier and sensitization. RESULTS: During periodical medical surveillance OP can control skin conditions of workers looking for signs of irritant and contact dermatitis, can give advice about preventive measures and information about products used to permit an early and correct diagnosis. CONCLUSIONS: At the retour to work workers with a diagnosis of occupational dermatitis must avoid direct contact with irritant and sensitizing products.

Birth and development of the SIMLII Guidelines program.

OBJECTIVES: This paper aims to review the steps that the Italian Society Occupational Medicine and Industrial Hygiene (SIMLII) has undertaken over the past two decades in the context of a process of integration with quality systems, resulting in several initiatives including the production of different tools for the updating and professional qualification of the Occupational Health Physician (OHP). METHODS: The choice of focusing on a propositional-formative model such as the guidelines (GL) and the choice of the topics to be dealt with, was based on the need to provide the OHP with appropriate tools in order to face the complexity, specificity and rapidity of knowledge evolution which characterize our discipline. RESULTS: After the release of the first set of instruments (25 GL) over the five-year period 2003-2008, it became necessary to adhere to the guidelines of the GL National Program, distinguishing GL's evidence based, from consensus / orientation documents or technical assessments. CONCLUSIONS: In recent years, the introduction of the AGREE method has been of great interest and importance for assessing the quality of content and recommendations, also considering the recent legislation provisions on the criminal and civil liability of the Physician.

[Gender-sensitive risk assessment and health medical surveillance: some operative tools.] / Valutazione dei rischi e sorveglianza sanitaria in ottica di genere: proposta di strumenti operativi.

OBJECTIVES: A thorough and fully application of the principles of gender mainstreaming, in accordance with the European Community guidelines, to the health and safety at work, implies the systematic review of the whole prevention from the gendered point of view. This means that both biology- and gender-based differences between male and female workers should be conceived not only as determinants of health but also as factors affecting either positively or negatively the health and safety risk prevention. In this evolutionary cultural step the role of the occupational physician is particularly important. METHODS: In this paper we propose some operative tools that can concretely implement gender perspective in all the various areas of prevention, where the occupational physician has a leading, if not even exclusive, role such as risk assessment, training and health medical surveillance.

[The operational role of the occupational health physician in the assessment and management of health risks related to night risks]. / Il ruolo del medico del lavoro nella valutazione e nella gestione dei rischi correlati al lavoro notturno alla luce della disciplina nazionale e comunitaria.

The operational role of the occupational health physician in the assessment and management of health risks related to night work. Night work, in the last 30-40 years, has been extended to almost all areas of employment. The potential effects on workers' health--related to the disruption of circadian rhythms--are now well defined and studied in the Literature. All issues about the protection of safety and health for night workers are governed by the Italian Legislative Decree no. 66/2003 and subsequent amendments. The management of night work hasn't been included into the main Law on Occupational Safety and Health (Italian Legislative Decree no. 81/2008 and subsequent amendments) and a coordination between the two disciplines is desirable. The occupational health physician, as a global consultant for the protection of all health issues into a company, has to evaluate the potential effects of night work on health, both individually and as a group of workers. In this way, the physician may use either traditional tools (history, physical examination, blood tests) or innovative tools (questionnaires, health promotion programs, interventions on shift schedules). In the management of night work is useful to employ schedules that respect both psychophysical integrity and social welfare of workers and the needs of the production. The occupational health physician plays a significant role in information and training of workers, both individually and as a group of workers, and in the organization of health promotion programs (whit a voluntary participation by the workers).

How do Dutch GPs address work-related problems? A focus group study.

BACKGROUND: In the Netherlands, there is a lack of knowledge about general practitioners' (GPs) perception of their role regarding patients' occupation and work related problems (WRP). As work and health are closely related, and patients expect help from their GPs in this area, a better understanding is needed of GPs' motivation to address WRP. OBJECTIVES: To explore GPs' opinions on their role in the area of work and health. METHODS: This is a qualitative study using three focus groups with Dutch GPs from the catchment area of a hospital in the Southeast of the Netherlands. The group was heterogeneous in characteristics such as sex, age, and practice setting. Three focus groups were convened with 18 GPs. The moderator used an interview guide. Two researchers analysed verbatim transcripts using constant comparative analysis. RESULTS: We distinguished three items: (a) work context in a GP's integrated consultation style; (b) counselling about sick leave; (c) cooperation with occupational physicians (OPs). The participants are willing to address the topic and counsel about sick leave. They consider WRP in patients with medically unexplained symptoms (MUS) challenging. They tend to advise these patients to continue working as they think this will ultimately benefit them. CONCLUSION: The participating GPs seemed well aware of the relation between work and health but need more knowledge, communication skills and better cooperation with occupational physicians to manage work-related problems. [Box: see text].

Online reporting and assessing new occupational health risks in SIGNAAL.

BACKGROUND: Changes in work and working conditions continuously give rise to new work-related health risks. Without sufficient knowledge of these, opportunities for prevention and intervention may be missed. AIMS: To develop, implement and evaluate an online tool called SIGNAAL for reporting and assessment of new work-related health risks by occupational health physicians and experts in the Netherlands and Belgium. METHODS: Development and implementation of SIGNAAL to allow both easy and sufficient detailed reporting by occupational health physicians and structured and transparent assessment by occupational health experts. A new work-related health risk is defined as a work-related disease due to specific exposure in a specific work setting not described in the literature before. RESULTS: The online reporting and assessment tool proved to be a feasible means of reporting possible new combinations of health problems and exposures in the work situation. Eleven of the 15 cases reported until October 2014 were fully assessed: one was an entirely new work-related disease, four were known but uncommon work-related diseases, five were known but new in the reported work situation and one was a well-known work-related disease. CONCLUSIONS: An online reporting system used in an occupational health setting can provide insight into new work-related health risks by creating a structured way to gather, report and assess new combinations of health problems and exposure in the workplace.

[Relationship between organisational structure and worksite health management in the information technology and communications sector]. / Zusammenhänge zwischen der Betriebsstruktur und Betrieblichem Gesundheitsmanagement in der Informationstechnologie- und Kommunikationsbranche.

AIM OF THE STUDY: Worksite health management (WHM) can positively influence employee health and performance. However, it has not yet been comprehensively implemented in companies. This study aims to identify the role of organisational structures in the implementation of WHM. METHODS: In this cross-sectional study, data were collected on the companies' WHM and the organisational structure. Out of 522 randomly selected companies within the German information technology and communication (ITC) sector, one managing director for each company was being questioned through telephone interviews. Bivariate and multivariate logistic regression analyses were conducted. RESULTS: The results of the study reveal that the implementation of WHM is positively correlated with a large company size (OR 2.75; 95%-CI 1.10-6.88) and with the existence of an employee representation (OR 2.48; 95%-CI 1.54-3.98). Other structural characteristics, such as the employment of a company physician, the percentage of temporary workers as well as the staff's age and sex distribution do not seem to have a significant impact on the implementation of WHM. CONCLUSIONS: The results indicate that the implementation of WHM can only be explained to a certain degree by organisational structures. However, the findings highlight the fact that companies with few structural resources are in particular need of tailored support when implementing WHM.

Activities of occupational physicians for occupational health services in small-scale enterprises in Japan and in the Netherlands.

OBJECTIVES: Occupational health service (OHS) for small-scale enterprises (SSEs) is still limited in many countries. Both Japan and the Netherlands have universal OHS systems for all employees. The objective of this survey was to examine the activities of occupational physicians (OPs) in the two countries for SSEs and to investigate their proposals for the improvement of service. METHODS: Questionnaires on types and sizes of the industries they serve, allocation of service hours (current and desired), sources of information for occupational health activities etc. were mailed in 2006 to 461 and 335 Japanese and Dutch OPs, respectively, who have served in small- and medium-scale enterprises. In practice, 107 Japanese (23%) and 106 Dutch physicians (32%) replied, respectively. RESULTS AND CONCLUSIONS: Total service time per month was longer for OPs in the Netherlands than OPs in Japan. Japanese OPs spent more hours for health and safety meetings, worksite rounds, and prevention of overwork-induced ill health (14-16% each). Dutch OPs used much more hours for the guidance of absent workers (48%). Thus, service conditions were not the same for OPs in the two countries. Nevertheless, both groups of OPs unanimously considered that employers are the key persons for the improvement of OHS especially in SSEs and their education is important for better OHS. The conclusions should be taken as preliminary, however, due to study limitations including low response rates in both groups of physicians.

[Psychology and psychological examinations in the opinion of occupational medicine physicians]. / Psychologia i badania psychologiczne w ocenie lekarzy sluzby medycyny pracy.

BACKGROUND: The aim of this study was to find out expectations of what psychologists and psychological examinations have to offer physicians and to evaluate the existing cooperation between occupational medicine physicians and psychologists. MATERIALS AND METHODS: A questionnaire was used as a major tool in this study. The data were analyzed in the group of 111 occupational medicine physicians from all over Poland. RESULTS: The collected data show that 61% of physicians evaluated their cooperation with psychologists as good and very good. The interviewed physicians expect improvements in the organization of work and the quality of cooperation. Of the whole study group, over 72% of respondents want to strengthen the cooperation with psychologists in the field of occupational medicine and 79% of physicians want to be trained in work psychology. CONCLUSION: Based on the information collected via the questionnaire, the major directions for and methods of improving and expanding the cooperation between occupational medicine physicians and psychologists were defined.