Delphi consensus on the monitoring tools of main individual risk factors for chronic diseases by the company doctor. / Ricerca di consenso Delphi sugli strumenti per il monitoraggio da parte del medico competente dei principali fattori di rischio individuali per malattie croniche.

BACKGROUND: Data on individual risk factors for chronic diseases (smoking, physical activity, body mass) are collected by company physicians in heterogeneous ways. This makes comparisons, researches and evaluations difficult. OBJECTIVES: The aim of the study was to find a consensus on evaluation tools for chronic diseases risk factors and for health promotion programs in workplaces that could be performed by company physicians during their clinical activity. METHODS: A first set of tools, proposed by a working group of occupational physicians in Bergamo, was submitted through the Delphi technique to a national expert panel of 22 persons including recognized national experts in specific fields and occupational physicians skilled in health promotion. RESULTS: In three Delphi rounds, the panel selected a set of tools to monitor the main individual risk factors for chronic diseases (smoking, alcohol, physical activity, nutrition, stress and mental health) as well as general data related to the worker and his job. CONCLUSIONS: The use of these specific tools, collected in a homogeneous format, should be recommended to all Italian company physicians, in particular those who work in WHP-programs, in order to allow analysis, comparison and evaluation of health promotion programs effectiveness at a national level.

[Collaboration of the occupational physician for risk assessment activities in work environment]. / La collaborazione del medico competente alle attività di valutazione dei rischi in azienda.

In Italy, the legislative Decree n. 81/2008 (and further modifications) foresee the obligation, with relative sanction, for the "competent physician" to collaborate with the employer and the person responsible of the service of prevention and protection to the evaluation of the risks in the places of job. Objective of the present job is to give indications that allow the physician to acquit with correctness the obligation, looking for an equilibrium among the dictated normative and the resources to his/her disposition. For small and medium-sized companies, some activities developed by the physician can determine the real collaboration to the evaluation of the risks: periodic inspections; recording of the evaluations of the workers; planning of the biological monitoring; execution of the sanitary overseeing; epidemiological elaboration of the data of the sanitary overseeing; you meet with the employer etc. In the great farms the collaboration of the competent physician to the evaluation of the risks should culminate in the predisposition of a specific document Such document could compose him some followings sections: indication of the working risks; evaluation of the risks for the pregnant workers; evaluation of the risk job-correlated stress; analysis on the problem list alcohol and job; collaboration to the organization of the service of first help; analysis of the accident coarse; collaboration to the realization of programs of information; collaboration to the realization of programs of promotion of the health; layout of the sanitary plan; measures of prevention and protection necessary.