[Biological agents in animal breeding: an ancient but still relevant risk]. / Agenti biologici in allevamento: un rischio antico e sempre attuale.

Agricultural activities expose workers to biological risk, due to the close contact that could occur with pathogens' reservoirs, such as soil, animals, manure and animal products. The paper describes factors that have contributed on the reduction or eradication of zoonoses, such as brucellosis, salmonellosis and bovine tuberculosis (monitoring and prevention of animal infectious diseases, industrialization and mechanization of agricultural activities), and on the other hand the emergence of new risks and new diseases (adaptability of microorganisms, generation of new strains, antibiotic resistance, dissemination of vectors). The role of Occupational Medicine in the prevention of zoonoses is discussed.

[Occupational health surveillance in agriculture: the experience of the International Centre for Rural Health]. / Sorveglianza sanitaria in agricoltura: l'esperienza del Centro Internazionale per la Salute Rurale dell'Azienda Ospedaliera San Paolo di Milano.

The results of the activities of occupational health surveillance in agriculture carried out by the International Centre for Rural Health since 2008 are described. The activities involve 800 workers employed in 260 farms in the Region of Lombardy (Italy). The types of farms reflect the vocation toward agricultural sector of the Po Valley and the most representative tasks are related to animal care and use of agricultural machinery. Based on the specific risks, workers are provided with preventive and periodic examinations, and complementary laboratory and instrumental evaluations (hearing and respiratory functions, electrocardiography), related to the different risk factors present in the enterprises. The occupational health priorities identified are, for the time being, noise-induced hearing loss and insufficient immunization against tetanus.

[Diet as a key element of health promotion at the workplace in scientific research and practice. First results of the EU project FAHRE]. / La dieta come elemento cardine della promozione della salute ne luoghi di lavoro nella ricerca scientifica e nella pratica. Primi risultati del progetto EU FAHRE.

The globalization of markets have led to rapid changes in diet and lifestyle in the developed countries, where living standards have improved, and availability and variety of food has increased while physical activity decreases have led to an augment in chronic diseases (obesity and diabetes mellitus), cardiovascular diseases and some specific cancers. In this context there is a need to develop health promotion activities. Workers represent a very appropriate group for such activities because they are relatively homogeneous, easily reachable because they can be found together in the same place and time and the occupational physician has good knowledge of the of health status of individual worker. In this scenario, a renew interest must be posed to the relationship between diet and health. In this context our Group is participating at the FAHRE project (Food and Health Research in Europe). The project aims to establish the state of the art of research at the interface of nutrition and health in the European Union, identifying its strengths and weaknesses in order to propose strategies to increase coordination and improve its functioning as a European Research Area.

[Biological risk prevention in agriculture and animal breeding: immunization strategies]. / Strategie vaccinali per la prevenzione del rischio biologico in agricoltura e zootecnia.

Vaccine preventable diseases are, so far, a main focus of Public Health programmes all over the world since people still die in consequence of Dyphteria or Tetanus. Biological risk is widely represented in agriculture and animal breeding, due to environmental characteristics and to injury typology. Moreover, aged people and migrants represent a significant part of the workforce. These two groups are, for instance, more exposed to Clostridium tetani infection because not fully immunized. Among infectious diseases that can affect agricultural workers, just tetanus can be well controlled by immunization programmes. Teaching and training activities are the most important tools to get protection against Leptospira interrogans, Salmonella spp and hepatitis E Virus infection. As for every training activity, linguistic and cultural barriers have to be taken into account.

[The occupational health physician and the health surveillance in agriculture]. / Il medico del Lavoro Competente e la Sorveglianza Sanitaria in Agricoltura.

Despite the underreporting of occupational diseases in agriculture, available data clearly show a significant health risk, and therefore the need of health surveillance at the workplace. The implementation of health surveillance programs for agricultural workers relies on the possibility of creating a system able to reach the workers at their workplaces, with the collaboration of employers' associations, able to support enterprises in several issues, including risk assessment and management. The health surveillance program can be organized in a component common for all workers, based on physical examination, chemistry, electrocardiography, hearing and lung functions examinations, and on tests addressing specific risks, if present: vibration, physical overload, chemicals, biological agents, allergens. The frequency of examinations must be decided based on risk assessment and health surveillance outcomes.