Original Articles
Vol. 39 No. 2 (2017)
https://doi.org/10.4081/gimle.611

[Risk assessment and its appropriateness to support the physician in certifying a suspected technopathy]

La valutazione dei rischi e la sua appropriatezza a supporto del medico nella certificazione di sospetta tecnopatia

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Published: 13 April 2017
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Authors

Giuseppe Taino
giuseppe.taino@icsmaugeri.it
Unità Operativa Ospedaliera di Medicina del Lavoro, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy.
Franco Pugliese
Dipartimento Sicurezza Ausl di Piacenza, Italy.
Daniela Bonetti
INAIL Sovrintendenza Sanitaria Regionale Emilia Romagna, Bologna, Italy.
Marcello Imbriani
Istituti Clinici Scientifici Maugeri IRCCS, Pavia; Dipartimento di Sanità Pubblica, Medicina Sperimentale e Forense, Università di Pavia, Italy.

The topic of appropriateness was defined as the new frontier of development of health interventions. RH Brook in an Editorial published in the BMJ in 1994 defines the appropriateness"... an intervention for which the expected benefits are greater (with a sufficient margin) the possible negative consequences ... excluding economic considerations". In workplaces the goal of appropriateness should cover not only the actions of health surveillance and health protocols, but also and primarily all stages of the risk assessment process. Only through an assessment of occupational risks that aims to identify, evaluate and measure the real professional risk factors in specific working environments, it is possible to meet the requirements of effectiveness, efficiency and protection of ethical principles in the identification of priorities (according to values of person, community and society) that represent the size of the appropriateness of an intervention. At the same time, the risk assessment should provide to the occupational pyisician instruments to study with scientific, justifiable and reproducible criteria the possible correlation between damage to the worker's health and the occupational risk factors.
In the process of reporting of suspected technopathy, both for prevention purposes (according to art. 139 of Presidential Decree 1165/68, art. 10 of Legislative Decree 38/00 and DM 10 June 2014), both for insurance purposes (according to art. 53 of Presidential Decree 1165/68 and Ministerial Decree 9 April 2008), it should be considered two indispensable judgment elements to study the correlation between the disease and the work: on the one hand the level (measured or estimated) of the occupational risk factors; on the other hand the appropriateness of the risks assessment compared to the best and most current scientific evidence (Evidence Based Medicine - EBM), according to technical standards and specific guidelines.
Our study underlines the importance of appropriateness in the risk assessment process to analyze the correlation between the exposure to specific occupational hazards and the suspected technopathy.

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Citations

1) Brook RH. Editorial BMJ - January 1994, 308: 218.
2) WHO Regional Office for Europe. Appropriateness in health care services, 2000.
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4) ILO convention n. 161, 1985.
5) National Academy of Science. Risk assessment in the Federal Government: managing the process. Chapter 1 The nature of Risk Assessment National Academy of Science, National Academy press, Washington, D.C. 1983, pp. 17- 51.
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1.
[Risk assessment and its appropriateness to support the physician in certifying a suspected technopathy]: La valutazione dei rischi e la sua appropriatezza a supporto del medico nella certificazione di sospetta tecnopatia. G Ital Med Lav Ergon [Internet]. 2017 Apr. 13 [cited 2026 Sep. 15];39(2):100-5. Available from: https://medicine.pagepress.net/gimle/article/view/611
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