Vigna Luisella, Agnelli Gianna Maria, Tirelli Amedea Silvia, Belluigi Valentina, Aquilina Tatiana, Riboldi L
U.O. Medicina del Lavoro 1, Clinica del Lavoro "L. Devoto", Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano.
Med Lav. 2011 May-Jun;102(3):275-85.
Obesity is often particularly burdensome for subjects at work and leads to hypertension and diabetes preceded by a low grade of inflammation. Measures to promote health at the workplace can be achieved through periodic health surveillance. Simple parameters such as height, weight, body mass index (BMI), waist circumference (CV), blood pressure (BP), as well as taking into account the type of work and tasks, shift work and smoking, are in fact sufficient to identify the most significant features of the working population so as to adequately design the type of intervention required. The paper describes how a health promotion programme aimed at preventing overweight and obesity was implemented based on analysis of the health surveillance data routinely collected by the occupational physician in an engineering plant in northern Italy.
Data on weight, height and BMI were collected for 301 workers with different jobs and shifts in an engineering plant; 32 of these workers, (mean age 44+/-8.4) agreed to undergo a diagnosis and treatment programme at the Obesity and Work Centre of the Clinica del Lavoro in Milan.
A higher incidence of overweight and obesity was found compared to the national average for similar age classes, therefore meetings were organized at the plant on awareness and information on correct lifestyle and diet targeted for shift workers. The workers who had followed the diagnosis and treatment programme had a mean BMI of 32.6 (SD 2.7) and, considering the parameters investigated, the presence of metabolic syndrome was found in a greater proportion of subjects (62.5%) than the average in our practice (46%) and particularly in workers with three day shifts. CONCLUSIONSThe intervention programme began with assessment of the information obtained in the course of routine periodic health surveillance according to the occupational hazards under study. On the basis of this information it was possible to implement the first awareness campaigns. On completion of the multidisciplinary intervention, which was conducted in collaboration with the occupational physician, two major initiatives were taken: one in the canteen with the aim of improving the nutritional content and type of meals offered to suit the dietary needs of overweight or obese workers, and the other consisted of an agreement with local gyms so as to motivate workers to exercise more. A prerequisitefor this type of initiative is the willingness and understanding of the management to recognize the health of the worker as a priority value.
肥胖对于在职人员而言往往负担格外沉重，并会引发低度炎症，进而导致高血压和糖尿病。通过定期健康监测可实现职场健康促进措施。诸如身高、体重、体重指数（BMI）、腰围（CV）、血压（BP）等简单参数，以及考虑工作类型和任务、轮班工作和吸烟情况，实际上足以识别在职人群的最重要特征，从而充分设计所需的干预类型。本文描述了如何基于对意大利北部一家工程工厂职业医生定期收集的健康监测数据的分析，实施一项旨在预防超重和肥胖的健康促进计划。
收集了一家工程工厂301名从事不同工作和轮班的工人的体重、身高和BMI数据；其中32名工人（平均年龄44±8.4岁）同意在米兰职业临床肥胖与工作中心接受诊断和治疗计划。
与同年龄组的全国平均水平相比，超重和肥胖的发生率更高，因此在工厂组织了针对轮班工人的关于正确生活方式和饮食的认识与信息会议。参加诊断和治疗计划的工人平均BMI为32.6（标准差2.7），考虑到所调查的参数，代谢综合征在受试者中的比例（62.5%）高于我们诊所的平均比例（46%），尤其是在三班倒的工人中。结论干预计划始于根据所研究的职业危害对常规定期健康监测过程中获得的信息进行评估。基于这些信息，得以开展首次提高认识活动。在与职业医生合作完成多学科干预后，采取了两项主要举措：一项是在食堂，目的是改善提供的膳食的营养成分和类型，以满足超重或肥胖工人的饮食需求；另一项是与当地健身房达成协议，以激励工人更多地锻炼。这类举措的一个先决条件是管理层愿意并理解将工人的健康视为优先价值。
