Silvestri Stefano
U.O. Epidemiologia ambientale-occupazionale, Istituto per lo studio e la prevenzione oncologica, Firenze, Italia.
Epidemiol Prev. 2009 Jul-Oct;33(4-5 Suppl 2):37-42.
In Italy during the last three decades important changes in employment have occurred. During the '70s, thanks to a variety of factors, the hygiene conditions of work have undergone a process of slow, but gradual improvement, which has not been arrested during the following decades. New legislation, partly deriving from European directives, has been introduced, and processes of outsourcing have moved the most burdensome and pollutants industrial productions to developing countries. Nevertheless, the estimates of the number of exposed (or even potentially so) workers, to carcinogens remain quite high. Currently, in absence of the planned National Information System on Prevention, it is impossible to estimate in how many and which workplaces primary prevention plans and facilities have been already installed. This paper aims to describe the situation related to most occupationally diffused carcinogenic agents: asbestos, wood and crystalline silica dusts, each one for its specificity. It also describes the innovations introduced by the most recent legislation, in particular with regard to the asbestos risk control. Finally, it stresses the need for a reform of the insurance premiums in order to introduce a mechanism for rewarding those employers who implement primary prevention facilities and penalizing those who don't. The economic advantages should gradually cover the cost of risk control technology.
在过去三十年里，意大利的就业情况发生了重大变化。在20世纪70年代，由于多种因素，工作场所的卫生条件经历了一个缓慢但逐步改善的过程，在随后的几十年里这一改善过程并未停止。部分源自欧洲指令的新立法已经出台，外包流程已将最繁重和污染性最强的工业生产转移到了发展中国家。然而，接触致癌物（或甚至有可能接触致癌物）的工人数量估计仍然相当高。目前，由于尚未建立规划中的国家预防信息系统，因此无法估计有多少工作场所以及哪些工作场所已经安装了一级预防计划和设施。本文旨在描述与最常见的职业性致癌物相关的情况：石棉、木尘和结晶二氧化硅粉尘，每种致癌物都有其独特性。本文还描述了最新立法引入的创新措施，特别是在石棉风险控制方面。最后，本文强调有必要改革保险费，以便引入一种机制，奖励那些实施一级预防设施的雇主，惩罚那些未实施的雇主。经济优势应逐步覆盖风险控制技术的成本。
