Marano G
Ministero della Salute, Via Ribotta 5 Roma - 00.
G Ital Med Lav Ergon. 2012 Jul-Sep;34(3 Suppl):469-70.
The specialist who is appointed by an employer as a competent physician in an occupational medicine service, has been charged of new public legal tasks, as a result of the changes introduced by Legislative Decree No. 81/08, setting him in a direct relationship with the National Health Service; in particular the Article 40 of decree 81 assigns a strategic role for prevention of new occupational diseases and injuries to the competent physician, as a primary source of epidemiological information, able to bring out "sentinel events" in the population of workers undergoing health surveillance, by the communication to the relevant public health services of combined aggregate data as required by Annex 3B. In a second step such information shall be processed and analyzed on a national scale by Italian Workers'Compensation Authority (INAIL), in order to improve the knowledge useful to a more effective and prompt prevention. The new possibility, introduced by Legislative Decree 106/09, to carry out pre-employment visits as a part of health surveillance, allows the competent physician to establish the fitness to the work of involved persons, a task that was previously assigned by law 300/70 to public bodies only, allowing him to check for alcohol and drug addiction at such stage too, provided the involvement of public health facilities of II level (referred to State/Regions Agreement of September 18, 2008) for relevant clinical examinations for verification purposes.
雇主指定的职业医学服务领域的专科医生，由于第81/08号立法令所做的变动，被赋予了新的公共法律任务，这使他与国家卫生服务机构建立了直接关系；特别是该法令第40条赋予了主管医生预防新的职业病和工伤的战略角色，作为流行病学信息的主要来源，主管医生能够通过按照附件3B的要求向相关公共卫生服务机构通报综合汇总数据，在接受健康监测的工人人群中发现“哨点事件”。第二步，此类信息应由意大利工伤事故保险协会（INAIL）在全国范围内进行处理和分析，以增进有助于更有效和迅速预防的知识。第106/09号立法令引入的新可能性，即作为健康监测的一部分进行就业前检查，使主管医生能够确定相关人员是否适合工作，这一任务以前仅由第300/70号法律分配给公共机构，这也使主管医生能够在此阶段检查是否存在酒精和药物成瘾问题，前提是有二级公共卫生机构（参照2008年9月18日国家/地区协议）参与进行相关临床检查以作核实。
