[Experience in risk assessment in variety type of work: reflection on reliability and judgement in method reference to European accord, 2004]. / Esperienze di valutazioni del rischio stress in realtà lavorative di varia tipologia: riflessioni sull'attendibilità e riproponibilità del metodo anche in riferimento all'accordo europeo del 2004.

Interest in problems of work-related stress has been limited, till now, to its effects on health of workers. The aim of our study, lacking valid literature's instruments, is to experiment and to evaluate a risk's evaluation model to identify and prevent or manage problems of work-related stress also according to indications published in "European Framework Agreement on work-related stress" (08/10/2004). Our evaluation model (even according to art. 28 D.Lgs. 81/2008) has been experimented in a sample composed by 1470 employers in 19 Lomabardia's factories. Valued risk's results have been introduced in the risk assessment and they have been used to sanitary surveillance indications.

[Proposal for an evaluation method of the psyco-social risks (stress) and for the orientation of the sanitary surveillance]. / Proposta di un metodo per la valutazione dei rischi psicosociali (stress) e di orientamento per la sorveglianza sanitaria.

The interest for the problematics linked to the stress in work environments has been till now limited to the consideration of its effects on health, even if the D.Lgs 626/94 obliges the employer to evaluate also the psyco-social risk, as has confirmed a sentence of the European Court of Justice. The present survey, lacking valid instruments to be found in literature, aims to experiment and evaluate a principle for the identification of causes, thus creating a model for the evaluation of risk also according to the indications published in the Document for the Consent of SIMLII in 2005, which can be used by Prevention and Protection Services and by Competent Medical Doctors. In the area of risks evaluation and of the attainment deriving from them. The model of evaluation of the risk deriving from work organization (stress), object of the present survey, has been sperimented in a sample composed of 268 employees in 13 municipal administration belonging to biographically known categories for stress risk afferent to 23 homogenuous organizational structures (traffic officers and nursery school teachers). The valued risk has been introduced in the VDR document and the indications for the sanitary surveillance have been formulated.

[Tetanus vaccination and antibody tritation: compulsory vaccination at work and the role of the occupational medicine in the induction of protective effects in the population in general]. / La vaccinazione antitetanica e titolazione anticorpale: obbligo vaccinale in ambito professionale e ruolo del medico competente nell'induzione di effetti protettivi nella popolazione generale.

In Italy in the last ten years tetanus incidence has been considerably decreased. It is a result first of the application of national laws that make compulsory the tetanus vaccine for some workers' group and for the population in general, and on the other hand for the working class as a consequence of D.Lgs 626/94. It was carried out by the U.O.O.M.L. of Garbagnate an activity of sanitary surveillance towards the working class with a tetanus biological risk (i.g. builder, metalworker, cleaning staff policemen, health visitors, cooks, etc.). During this activity it was considered the possibility of a tetanus vaccine cycle for those people that couldn't provide any certification about previous tetanus vaccine. The justification for this propose is to reduce the risk of side effects due to iperimmunization in case of close vaccinations and the safety and low cost of the tritation test of antibody anti-tetanus toxin method. Therefore it was decided to determine the personal condition of tetanus immunization for all those people without a valid certification. It resulted that 38% of people subject to sanitary surveillance were not protected and 55 years people resulted to be the group with highest risk. This result was also confirmed by the Ministry of Health that considers older population the highest risk group. It becomes clear that the vaccination for working purposes protects the population in general too. In conclusion we firmly think the procedure we followed completely accomplish the general principle of healthcare for infectious risk on the application of the tit. VIII of D.Lgs. 626/94.

[Carpal tunnel syndrome and cleaning work: a binomial that should not be overlooked]. / Sindrome del tunnel carpale ed imprese di pulizia: un binomio da non trascurare.

The Carpal tunnel syndrome is a common problem in various jobs, but not in the cleaning farms. A population of 99 women working in hospital cleaning activities was investigated to define if, although the risk assessment was negative for cumulative trauma diseases (CTD), the Occupational physician should search or not the CTS. We found that CTS prevalence in exposed group is higher than the common female population not exposed and the female workers are younger, so we can suppose the occupational risk exist although the negative risk assessment. The age and the working-age seem not to be determinant in the pathology of the disease, nether the different working-risks is, therefore the risk assessment doesn't consider other risk factor of the cleaning activities: strength, duration, frequency and recover time. This study confirms that the CTS seems to be a disease related with the cleaning workers and although the risk assessment is negative for CTD the Occupational physician should perform the health survaillance for CTD.