[The role of the factory doctor in the health promotion of workers: the experience of the "WHP Bergamo" network]. / Il ruolo del medico competente nella promozione della salute dei lavoratori: l'esperienza della rete WHP Bergamasca.

In Bergamo there is a huge network of 46 "health promoting companies" following an accreditation system which requires the implementation of best practices on health promotion in the workplace. For some of these practices, Company Doctor are involved: management of smokers and workers with alcohol consumption; courses for employees about WHP, use of SMS and web-based systems. Local Public Health Authority has created an annual training which also provided tools to Doctors for their activities in the project. Nowadays 55 doctors have been trained. For Accreditation 2012 eight companies will declare as good practice the training of its CD about smoking and three companies their activities on alcohol abuse prevention and control.

[Courses for smoking cessation in the workplaces: results and opportunities]. / Corsi per smettere di fumare in azienda: risultati ed opportunità.

In the context of the "WHP- District Network Project", 6 group-treatments for smoking cessation have been performed in five companies, with the voluntary participation of 88 smokers. Health professionals, with specific training, conducted the groups according to specific guidelines. The quitting rate recorded at the end of the course (and confirmed, in two groups, by measurement of exhaled CO) was on average 49% (range 34-70%). The abstainers at one year, recorded by a telephonic follow-up, mounted to 38% (range 29-50%, 4 courses out of 6). The courses have proved to be a good tool to help people to quit smoking and so reducing smoking-associated risks and its synergism with occupational risk factors.

[Laboratory of construction research - ALS Bergamo - Lombardy Region]. / Laboratorio di approfondimento costruzioni - ASL Bergamo - Regione Lombardia.

The Regional Board of Construction Examination has established guidelines in health and safety matter to be adopted in yards during realization of works to elevated economic and/or strategic importance. The Regional Board's aim was to design an organizational model that can ensure every stage of construction design and realization safeguards the health and safety of workers. This can be achieved by implementing suitable preventive measures and adopting a set of coordinated tools for the safety officers in charge of the yard. Hence, the Regional Board designed an "ideal" model of the prevention and safety system. A significant decrease in the frequency and severity of accidents was observed in the yards, where the above-mentioned safety measures were implemented.

[Safety measures to prevent falls are introduced into the training course for people in charge of planning]. / La sicurezza anticaduta entra nel progetto Corso di formazione per addetti alla progettazione.

For to pursue and to stimulate adequate shapes of prevention of the risk of falls from the high, the ASL of the province of Bergamo has approved of the moderniization of the R.L.I. that it introduces the obligation of the predisposition of structural elements that they favor the successive one rests in work and 1 use of DPI. It has been activated, therefore, a Work group composed from doctors and technicians of the Sanitary Company and graduating of the Faculty of Building Engineering of Bergamo, with the obbiettivo of to create means of support for the been involved figures of system. Us one is prefixed this obbiettivo to useful the aim to predispose and to put into effect course to to answer to the needs formed you of the professional figures of system and not in matter of risk of fall from the high.

[Training individuals of the construction sector in the province of Bergamo: a shared path division and an operative proposal]. / La formazione delle figure di sistema del comparto edilizia nella provincia di Bergamo: un percorso condiviso ed una proposta operativa.

With this presentation it will be introduced the experience of the work group native of Bergamo who is taken care to plan the formation course for the professional figures of system in building. The group is formed from the greater agencies present on the territory, their work is to ensure the protection of the health and the emergency of the workers in the field of the constructions. The objective is to use the formation course in order to diffuse one culture of the emergency. In the specific one they will come to describe the various planning phases of the course of formation for employers that mean to elect himself Responsible of the Service of Prevention and Protection (RSPP).

[Clinical and risk records assessment]. / Verifica cartella sanitaria e di rischio.

In the collaboration between the Hospital Occupational Health Department and Public Occupational Service of Bergamo, it has been elaborated a plan finalised to the verification of the quality and of the appropriateness in the compilation of the Clinical and Risk Record in the firm. The study has been lead by evaluation of 409 clinical and risk records (containing the first visit and, in 277 records, a periodic visit) collected from different productive areas (wood, building, health, agriculture). The analysis of the clinical and risk records have shown many critical aspects in their compilation, for this reason it is necessary to improve vigilance and attention from Public Occupational Service, Hospital Occupational Health Department and the Scientific Associations.

[Health surveillance in noise exposure]. / Sorveglianza sanitaria esposti a rumore.

The Occupational Health Department of Bergamo Ospedali Riuniti and Occupational Health Public Services set up a project in order to check the health surveillance quality in noise exposed workers. 887 hearing threshold tests, performed between 1998 and 2002, were examined; the audiograms concerned 304 workers exposed to industrial noise higher than 85dB(A), employed in 22 textile, mechanical, wood, stone, building and paper industries. After examining the 887 audiograms we noticed that the health surveillance of noise exposed workers up to now, 14 years after the issuing of the Legislative Decree 277/91, reveals many critical situations, showing an inadequate accuracy and possibility of interpretation of the audiometric tests.

[Health surveillance: from risk presumption to risk assessment]. / La sorveglianza sanitaria: dalla presunzione del rischio alla valutazione del rischio.

A working group of the Occupational Medicine and Industrial Hygiene Association of Lombardy, the National Association of Occupational Health Physicians the National Society of Prevention Operators made a paper in order to rationalize the sanitary surveillance, observing the laws in force and following the European Directives. The authors, thinking that everyday experience not very useful health examinations are carried out and that the sanitary surveillance should be planned according to the real working risks, give methodological directives about the way to make the mandatory clinical examinations less frequent, to the firms, to the occupational health physician and to the public occupational health operators of the local health units that must supervise the sanitary surveillance.

[Application of article 35 of the DPR 303/56: experience of the operators of the Public Occupational Services and competent physicians. Sample survey]. / Applicazione dell'art. 35 del DPR 303/56 in Lombardia: esperienze degli operatori delle ASL e dei medici competenti. Indagine campionaria.

In the last three years 450 requests of derogation to the article 35 of legislative decree 303/56 reached one third of the Public Occupational Services, with a clear progressive increase of their number. The working risks derogation is most frequently requested for are: solvents, welding fumes and metallic dusts. The operators of the Public occupational Services employed these criteria to grant the derogation: the effectiveness of the prevention, the low concentrations of the harmful agents, the occasionality of the unhealthy working, the risk lack or scarcity. In the 80% of the cases the operators of the Public Occupational Services made an inspection in only two cases they notified breaches of the law. 350 (70%) of the requested derogation were granted, 10 (20%) are now under evaluation, 90% (20%) were not allowed. In conclusion we point out that the use of the article 35 in industries with an adequate safety organization, by means of the dilution of the periodical clinical examinations, allows to better fit the health surveillance programs to the real working risks.

Colour vision loss in workers exposed to elemental mercury vapour.

We evaluated colour vision in 33 workers exposed to elemental mercury (Hg) vapour and in 33 referents matched for sex, age, alcohol consumption and cigarette smoking. The results were expressed as colour confusion index (CCI). In the workers urinary excretion of Hg (HgU) ranged from 28 to 287 micrograms/g creatinine. Subclinical colour vision loss, mainly in the blue-yellow range, was observed in the workers. This effect was related to exposure, as indicated by the correlation between HgU and CCI (r = 0.488, P < 0.01). In the workers whose HgU exceeded 50 micrograms/g creatinine, mean CCI was significantly increased compared to the matched referents. The results suggest that exposure to elemental Hg inducing HgU values exceeding 50 micrograms/g creatinine can induce a dose-related colour vision loss.