Table of Contents
GIPMEL 2024;4(3):167-170
Editorial in History of Medicine and Occupational Epidemiology
In the footsteps of Ramazzini: Modern occupational medicine and the role of occupational epidemiology
Author: Francesco CHIRICO1*
1 Scuola di Specializzazione in Medicina del Lavoro, Università Cattolica del Sacro Cuore, Roma, Italia. Centro Sanitario
Polifunzionale di Milano, Servizio Sanitario della Polizia di Stato, Milano, Italia. Email: medlavchirico@gmail.com
ORCID: 0000-0002- 8737-4368
* Author for the correspondence
Abstract
This editorial revisits the foundational contributions of Bernardino Ramazzini to occupational medicine and their relevance in today’s context. Ramazzini, born in 1633 in Italy, pioneered occupational neurotoxicology in his 1700 treatise, “De Morbis Artificum Diatriba,” linking heavy metal exposure to neurological disorders in workers. His extensive work spanned various fields, including studies on artesian aquifers, atmospheric impacts on epidemics, and early advocacy for quinine in malaria treatment. A significant part of his legacy was at the University of Modena, where he methodically documented health issues across professions, emphasizing a healthy workforce for societal productivity.
The editorial highlights how modern occupational physicians continue to draw from Ramazzini’s principles, focusing on detailed observation and systematic recording of occupational diseases. The cornerstone of current practice is epidemiological analysis, which aims to identify relationships between workplace exposures and health outcomes. This approach is exemplified by establishing occupational cancer registries and correlating specific cancers with job exposures.
Moreover, the role of technology and collaboration in enhancing data collection and analysis is discussed, alongside the need for continuous learning and advocacy in occupational medicine. Conclusively, Ramazzini’s legacy endures in today’s data-driven healthcare environment, guiding occupational health professionals in protecting workers and evaluating preventive measures’ effectiveness.
Keywords: Epidemiology; occupational physicians; occupational medicine.
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GIPMEL 2024;4(3):171-178
Commentary in Occupational Health
Integrating health promotion into occupational health surveillance: The Italian approach and beyond
Authors: Nicola MAGNAVITA1*, Igor MERAGLIA2
1 Post-graduate School of Occupational Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy. E-mail: nicolamagnavita@gmail.com. ORCID: 0000-0002-0988-7344
2 Post-graduate School of Occupational Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, E-mail: meraglia.igor93@gmail.com
* Corresponding Author
Abstract
Health surveillance in the workplace increasingly integrates health promotion activities alongside traditional occupational risk prevention. The Italian National Prevention Plan (PNP) encourages companies and occupational physicians to adopt health promotion strategies, inspired by the “Total Worker Health” (TWH) model developed by NIOSH in the United States. However, this study highlights the limitations of directly applying the TWH model in Italy without significant adaptations, due to differences in healthcare systems, company structures, and economic contexts. Over the past 15 years, Italian occupational physicians have developed and implemented health promotion models that are integrated into routine surveillance activities, addressing various aspects of workplace health and well-being. These programs, which go beyond the US TWH model, can be executed at no cost to companies and with minimal additional effort from occupational physicians. University researchers play a central role in designing these initiatives, analyzing data, and disseminating results, making these resources freely accessible to interested professionals.
Keywords: Epidemiology; occupational physicians; occupational medicine.
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GIPMEL 2024;4(3):179-190
Original Research in Occupational Health
Workplace violence in Italian healthcare organizations: A multicenter survey on prevention measures and incident reporting
Authors: Jessika CAMATTI1*, Francesco CHIRICO2, Franco PUGLIESE3, Mario GIACOMAZZI4, Piero BORGIA5, Anna Maria MINICUCCI6, Nicola PINELLI7, Eva COLOMBO8, Giovanni MIGLIORE9
1Prevention and Protection Unit – Hospital of Piacenza, Piacenza, Italy. E-mail: jessikacamatti@gmail.com ORCID: 0009-0003-8449-1803
2Post-graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy. E-mail: medlavchirico@gmail.com ORCID: 0000-0002-8737-4368
3 Prevention and Protection Unit – Hospital of Piacenza, Piacenza, Italy. E-mail: frnc.pugliese@gmail.com
4 Human resources unit – Hospital of Piacenza, Piacenza, Italy. E-mail: m.giacomazzi@ausl.pc.it
5 Italian Federation of Health and Hospital Companies – FIASO, Rome, Italy. E-mail: pieroborgia3@gmail.com
6 Italian Federation of Health and Hospital Companies – FIASO, Rome, Italy. E-mail: annamariaminicucci@gmail.com
7 Italian Federation of Health and Hospital Companies – FIASO, Rome, Italy. E-mail: pinelli@fiaso.it
8 Italian Federation of Health and Hospital Companies – FIASO, Rome, Italy. E-mail: direttore.generale@aslvc.piemonte.it
9 Italian Federation of Health and Hospital Companies – FIASO, Rome, Italy. E-mail: migliore@fiaso.it
*Corresponding Author
Abstract
Introduction: Workplace violence in healthcare settings is a growing global concern, particularly for its detrimental effects on workers’ safety and the operational efficiency of healthcare organizations. This study aimed to assess the implementation of violence prevention measures and to analyze the incidence of violent incidents in Italian healthcare organizations.
Methods: A multicenter, descriptive-analytical survey was conducted in 2022 across 47 healthcare organizations affiliated with FIASO. A 12-item questionnaire was developed and validated to assess the adoption of prevention measures, including risk assessment documents, corporate procedures, training, and reporting mechanisms. Additionally, data on violent incidents and sentinel events between 2019 and 2021 were collected and analyzed. Descriptive statistics were used to present the results.
Results: A total of 79% of responses across the 12 items were affirmative, indicating a high degree of compliance with recommended preventive measures. Specifically, 95.7% of organizations had a corporate procedure for violence prevention, and 100% had reporting mechanisms in place. However, 22% of organizations had not drafted a risk assessment document for workplace violence. Regarding violent incidents, 1,419 were reported in 2019, 1,155 in 2020 (an 18.6% decrease), and 1,590 in 2021 (a 37.7% increase from 2020). Sentinel events followed a similar trend, with 59 in 2019, 48 in 2020, and 50 in 2021.
Conclusions: While Italian healthcare organizations have made progress in implementing violence prevention measures, there remain critical gaps, particularly in risk assessment and legal support for victims. Policymakers should prioritize enforcing compliance and enhancing support services. Further research is needed to evaluate the effectiveness of prevention programs and the psychological impact of violence on healthcare workers.
Keywords: Healthcare; healthcare professionals; incident reporting; prevention measures; workplace violence.
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GIPMEL 2024;4(3):191-202
Original Research in Occupational Health
Analysis of the Work Ability Index in workers with previous shoulder injury: An exploratory study
Authors: Luca DI GIAMPAOLO1*, Paola BORRELLI2, Antonella BOZZI3, Piergiorgio ASTOLFI4, Michela ANGELUCCI5
1 Department of Innovative Technologies in Medicine & Dentistry (DTIMO), “G. d’Annunzio” University of Chieti-Pescara, Italy. luca.digiampaolo@unich.it; ORCID: orcid.org/0000-0003-3315-7197
2 Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, “G. d’Annunzio” University of Chieti-Pescara, Italy. paola.borrelli@unich.it; ORCID: orcid.org/0000-0001-9389-627X
3Department of Innovative Technologies in Medicine & Dentistry (DTIMO), “G. d’Annunzio” University of Chieti-Pescara, Italy. dottantonellabozzi@gmail.com
4 Department of Innovative Technologies in Medicine & Dentistry (DTIMO), “G. d’Annunzio” University of Chieti-Pescara, Italy. pierg.astolfi@gmail.com
5 Department of Innovative Technologies in Medicine & Dentistry (DTIMO), “G. d’Annunzio” University of Chieti-Pescara, Italy. michelaangelucci@outlook.it
* Corresponding Author
Abstract
Introduction: Every year in Europe, millions of people are temporarily or permanently unable to work as a result of a work-related injury. [1] To date, the extent to which the latter can change in the worker’s “perceived work well-being in the present and for the future in relation to the demands of his or her task and his or her mental and physical resources,” in terms of Work Ability, is still little investigated. [2]
Aim: To assess the determinants of improved Work Ability in workers who have suffered a shoulder injury, three months after returning to work.
Methods: The study sample consisted of 55 workers who had suffered a shoulder injury, afferent to the outpatient clinics of INAIL in Pescara. A Work Ability Index (WAI) questionnaire was administered at the time the injury event was defined (T0) and after three months (T3). A descriptive and inferential statistical analysis was performed on the collected data to test the relationship between WAI and worker characteristics.
Results: The sample consisted of 75% male workers. According to INAIL management, 48 were in Industry, 4 in Agriculture and 3 in State Account. The mean WAI value at T0 was 29.97±7.08 vs 32.60±7.13 at T3 (p=0.005). Further differences emerged at T3 for gender (p=0.036), age (p=0.035), presence of comorbidities (p=0.049), and objective examination (p=0.002).
Conclusions: The findings highlight the need to implement post-injury programs that take into account the characteristics of workers in order to reduce the incidence of employment disaffection.
Keywords: Shoulder injury; return to work; work ability.
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GIPMEL 2024;4(3):203-220
Original Article in Occupational Health
Noise risk assessment and health surveillance in the Italian state police band musicians: A cross-sectional study
Authors: Gloria ABBRUZZESE1*, Marco MICHELAZZI2, Massimiliano POMPILI3, Salvatore LIRANGI4, Pietro NATALETTI5, Diego ANNESI6, Francesco CHIRICO7, Andrea MAGRINI8, Fabrizio CIPRANI9
1 Direzione Centrale di Sanità, Dipartimento di Pubblica Sicurezza, Ministero dell’Interno, Roma, Italia. E-mail:gloria.abbruzzese@poliziadistato.it
2Direzione Centrale di Sanità, Dipartimento di Pubblica Sicurezza, Ministero dell’Interno, Roma, Italia. E-mail:marco.michelazzi@poliziadistato.it
3 Direzione Centrale di Sanità, Dipartimento di Pubblica Sicurezza, Ministero dell’Interno. Roma, Italia. E-mail:massimiliano.pompili@poliziadistato.it
4 Direzione Centrale di Sanità, Dipartimento di Pubblica Sicurezza, Ministero dell’Interno. Roma, Italia. Email:salvatore.lirangi@poliziadistato.it INAIL, Roma, Italia.
5 INAIL, Roma, Italia. E-mail: p.nataletti@inail.it
6 INAIL, Roma, Italia.. E-mail:d.annesi@inail.it
7 Scuola di Specializzazione in Medicina del Lavoro, Università Cattolica del Sacro Cuore, Roma, Italia. Centro Sanitario Polifunzionale di Milano, Servizio Sanitario della Polizia di Stato, Ministero dell’Interno, Italia. E-mail medlavchirico@gmail.com ORCID: 0000-0002- 8737-4368
8 Scuola di Specializzazione in Medicina del Lavoro, Università Tor Vergata, Roma, Italia
9 Direzione Centrale di Sanità, Dipartimento di Pubblica Sicurezza, Ministero dell’Interno, Roma, Italia. E-mail: fabrizio.ciprani@poliziadistato.it.
*Corresponding Author
Abstract
Introduction: The State Police Band musicians are subjected to high levels of sound exposure during rehearsals and performances. This study assesses the noise risk among these musicians, employing various measurement and calculation methodologies to understand their exposure and propose preventive measures.
Methods: A cross-sectional study was conducted with authorization from the Central Health Directorate of the Italian State Police Health Service. The study population included 93 musicians, divided into Acoustically Homogeneous Groups (GAO). Phonometric and dosimetric measurements were taken on July 25-26 and October 24, 2022, in both combined and separate sections. The methodologies used included evaluations based on GAO, Recurring Week of Maximum Risk (LEX,W), and task-based daily exposure (LEX,8H). The attenuation provided by hearing protection devices (HPDs) was also assessed using the OMB method. Audiometric tests were conducted to evaluate the musicians’ hearing capabilities.
Results: The results indicated that the LEX,W exceeded the exposure limit in all GAOs during the Recurring Week of Maximum Risk. Task-based daily exposure LEX,8H showed that some GAOs in both combined (trombones, euphonium) and separate sections (clarinets, trumpets, oboe, tubas, trombones) exceeded the limit value of 87 dB(A). The HPDs provided to the musicians were found to offer acceptable protection. No values exceeded the lower action peak value of 135 dB(C). Audiometric tests revealed that 28% of musicians had hearing deficits, predominantly sensorineural, with the highest incidences in the trumpet, trombone, percussion, and euphonium GAOs.
Discussion and Conclusion: Task-based daily exposure assessment provided more realistic individual noise exposure values, highlighting the importance of considering the acoustic properties and size of rehearsal spaces. Larger spaces with better acoustics, such as the renovated large music hall, resulted in lower exposure levels compared to smaller practice rooms. Despite acceptable HPD attenuation, some GAOs still experienced high exposure levels, necessitating further preventive measures. Key preventive and protective measures include practicing in larger spaces, reducing the number of activities, increasing breaks, rotating musicians’ positions, and using customized HPDs. Regular phonometric surveys and adequate training and information for musicians are essential for effective noise risk management. Further research is needed to explore the impact of other health factors and improve HPD compliance among musicians.
Keywords: Noise exposure, State Police Band, musicians, hearing protection, phonometric measurements, audiometric tests, task-based strategy, occupational health.
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GIPMEL 2024;4(3): 221-233
Original Article in Occupational Health Psychology
The role of motivations, emotions, strategies, and teaching in burnout experiences among Italian teachers: A cross-sectional study
Authors: Amelia RIZZO1*, Aanuoluwapo AFOLABI2, Alessandro DE CARLO3, Muhammad KAMRAN4, Francesco CHIRICO5
1 Department of Clinical and Experimental Medicine University of Messina, Italy. Department of Cognitive Sciences, Psychological, Educational, and Cultural Studies, University of Messina, Italy. E-mail: amrizzo@unime.it ORCID: 0000-0002-6229-6463
2 Technical Services Directorate, MSI Nigeria Reproductive Choices, Abuja. Nasarawa State University, Keffi, Nigeria. Plus-Circle Community Health Advancement Organization, Nigeria. E-mail: afoannade@gmail.com ORCID: 0000-0001-9928-2252.
4 Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy. E-mail: alessandro.decarlo@unime.it ORCID: 0000-0003-4394-6798
5 Chairperson, Department of Education, University of Loralai, Balochistan, Pakistan. E-mail: Muhammad.kamran@uoli.edu.pk and kamrankundi86@gmail.com. ORCID: 0000-0001-8014-1345.
6 Post-Graduate School of Occupational Health, Catholic University of the Sacred Heart, Rome, Italy.Department of Health Service, Italian State Police, Ministry of the Interior, Milan, Italy. E-mail: medlavchirico@gmail.com ORCID: 0000-0002-8737-4368.
*Corresponding Author
Abstract
Introduction: Teacher burnout is a critical issue in the educational sector, characterized by emotional exhaustion, depersonalization, and diminished professional efficacy. This study aims to investigate the interplay of motivations, emotions, strategies, and teaching in relation to teacher burnout, considering factors like job satisfaction, self-efficacy, and gender differences.
Methods: A descriptive cross-sectional study was conducted among 98 Italian high school teachers in the province of Reggio Calabria. Participants, aged 38 to 64 years, completed a composite questionnaire between September and December 2023, including the Link Burnout Questionnaire (LBQ) and the Motivations, Emotions, Strategies, and Instruction (MESI) suite. Data were analyzed using IBM SPSS version 27.0. Regression analyses assessed the relationships between MESI components and burnout dimensions, with significance set at p < 0.05.
Results: Higher job satisfaction was significantly associated with reduced exhaustion (estimate: -0.165; p = 0.015) and disillusionment (estimate: -0.326; p = <0.001). Emotional stressors in teaching roles predicted higher levels of burnout, while self-efficacy was linked to reduced professional ineffectiveness (estimate: -0.047; p = <0.001). Differences in satisfaction, practices, and self-efficacy were noted between high school and technical schoolteachers and between genders, with female teachers displaying higher levels of job satisfaction and self-efficacy.
Discussion: The findings underscore the protective role of job satisfaction and self-efficacy in mitigating burnout among teachers. Emotional stressors related to teaching roles contribute significantly to burnout, highlighting the need for tailored interventions that support positive emotions and strengthen self-efficacy. Educational institutions should focus on developing comprehensive support systems to enhance teacher well-being and foster a positive work environment.
Conclusion: Effective strategies that improve job satisfaction and self-efficacy can significantly reduce burnout among teachers. This research provides a foundation for targeted interventions to address burnout and promote resilience in educational settings.
Keywords: Burnout; emotions; motivations; strategies; teachers.
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GIPMEL 2024;4(3): 234-237
Technical Commentary in Occupational Health
Normativa in Italia e sorveglianza sanitaria per la movimentazione manuale dei carichi: novità dalla Cassazione e prevenzione dei rischi
Regulations in Italy and health surveillance for manual load handling: New developments from the supreme court and risk prevention
Authors: Angelo SACCO1*
1 Scuola di Specializzazione in Medicina del Lavoro, Università Cattolica del Sacro Cuore, Roma, Italia. U.O.C. Servizio Prevenzione e Sicurezza Ambienti di Lavoro, ASL Roma 4, Civitavecchia, Italia. E-mail: angelo.sacco.@alice.it ORCID: 0000-0002-8429-5314.
* Corresponding Author
Abstract
Italian regulations for protecting workers involved in manual load handling are outlined in Legislative Decree 81/2008. This decree mandates that employers adopt organizational measures and mechanical equipment to prevent or mitigate biomechanical overload risks, especially for the lower back. When manual handling cannot be avoided, employers must provide suitable tools and measures, as indicated in Annex XXXIII. Health surveillance is mandatory for all involved workers to identify hypersusceptibility conditions, such as pregnancy or physiological issues, that could impair physical capability. Rulings by the Italian Supreme Court (2023, 2019) have upheld the obligation for health surveillance even when risks are deemed low. The surveillance protocol should not only focus on biomechanical overload but also consider the functional status of target organs and systems, such as the cardiovascular and respiratory systems, to ensure worker safety and health.
Riassunto
Le norme italiane riguardanti la protezione dei lavoratori che svolgono attività di movimentazione manuale dei carichi sono contenute nel D.Lgs. 81/2008. Questo decreto stabilisce che il datore di lavoro deve adottare misure organizzative e utilizzare attrezzature meccaniche per evitare o ridurre i rischi da sovraccarico biomeccanico, specialmente a livello dorso-lombare. Quando non è possibile evitare tali operazioni, il datore di lavoro deve fornire strumenti e misure adeguate a limitare i rischi, secondo le indicazioni dell’allegato XXXIII. La sorveglianza sanitaria, obbligatoria per tutti i lavoratori esposti, mira a identificare condizioni di ipersuscettibilità al rischio, come gravidanza o condizioni fisiopatologiche, che possano compromettere la capacità fisica. Sentenze della Corte di Cassazione Penale (2023, 2019) hanno confermato l’obbligo della sorveglianza sanitaria anche in presenza di rischi considerati bassi. Il protocollo di sorveglianza deve tenere conto non solo del sovraccarico biomeccanico, ma anche dello stato funzionale di organi e apparati, come il sistema cardiovascolare e respiratorio, per garantire la sicurezza e la salute dei lavoratori.
Parole chiave: movimentazione manuale di carichi; sovraccarico biomeccanico; sorveglianza sanitaria
Keywords: Manual load handling; Biomechanical overload; Health surveillance
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GIPMEL 2024;4(3): 238-242
Technical Note in Biostatistics and Research
The impact of weight bias in forensic medicine: Challenges and implications for objectivity in medical legal practice
Authors: Amelia RIZZO1*
1 Medical-Legal Center of the National Institute of Social Welfare, Messina, Italy. Department of Clinical and Experimental Medicine and Department of Cognitive Sciences, Pedagogical Psychological and Cultural Studies, University of Messina, Messina, Italy. E-mail: amrizzo@unime.it. ORCID: https://orcid.org/0000-0002-6229-6463
* Corresponding Author
Abstract
Weight bias, defined as negative attitudes and stereotypes directed toward individuals based on their weight, has profound implications in healthcare and legal settings. In forensic medicine, where objective assessments are critical to the pursuit of justice, weight bias can distort clinical and legal evaluations. This article examines the prevalence of weight bias in forensic medicine, its impact on disability judgments and medical-legal outcomes, and proposes solutions for mitigating bias to ensure fairness and accuracy. Emphasizing the need for education and standardized guidelines, we argue that addressing weight bias is essential for maintaining the integrity of forensic science and bio-psycho-social evaluation.
Keywords: Weight Bias; Healthcare; Forensic Medicine.
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GIPMEL 2024;4(3): 243-246
Book Review in Occupational Health Psychology
Recensione del libro “Violenza nei luoghi di lavoro e rischio aggressione. Guida pratica alla prevenzione”
Book review: “Violence in the workplace and risk of aggression: a practical guide to prevention”
Authors: Leonardo TAFURI1*
1 SIPISS; Milan, Italy. E mail: tafuri@sipiss.it
*Corresponding Author
Parole chiave: book review; medicina del lavoro; prevenzione e protezione; violenza lavorativa.
Keywords: book review; occupational health; prevention and protection; workplace violence.
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