[Changes in work organization and management of psychosocial risk factors].

In recent years, major changes have occurred in Italian working conditions and employment patterns due to several concurrent factors: increasing occupation in the tertiary sector, implementation of new technologies, labour market globalization, higher variability of working time arrangements, decrease of traditional physical-chemical risks, ageing of general/working population, access to work of people with disabilities, growing immigration of extra-community workers. Thus, psychosocial risk factors are becoming crucial issues of the present work organization, dealing with job content (complexity, meaning, uncertainties), mental work load, time pressure, variable working hours; career perspectives, role conflicts and ambiguity, education and training, personal relations, social support, work/family conflicts; age and cultural discrimination. The Occupational Health Physician has to deal with these multidimensional and multifaceted aspects of work stress by different and concurrent approaches, at both group and individual levels, with epidemiological and clinical perspectives, enacting preventive and therapeutic strategies. Both "external" work load and individual "responses" have to be properly considered and risk has to be assessed with "relative" rather than "absolute" criteria, addressed not only at fitness to work, but also to corrective actions. Hence, the OHP has to act in closer collaboration with work psychologists, sociologists, human resources managers and work organisation experts.