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Tools and aims of occupational medicine
Evaluation and management of occupational risks
Environmental/biological monitoring and Health surveillance
Environmental, collective and personal protection epuipment
Occupational risks in the healthcare facilities: chemical and biological agents, incongruous postures and patients manual handling, shift and night work, cutting and pointy injuries, work-related stress.

CURRENT Diagnosis & Treatment. Occupational & Environmental Medicine. Joseph Ladau, Robert Harrison. McGraw Hill Education, Lange, USA. 5th Edition, 2015

At the end of the course the student will know the main prevention strategies and the measures to safeguard the health and safety of workers exposed to various occupational risk agents, with particular regard to the specific occupational risks to which the students are / will likely be exposed during their working activity.

None

Classroom-taught lessons divided into modules concerning:
- general aspects (basic concepts: occupational risks, risk agents, health surveillance, risk assessment and management, Legislative Decree 81/08 and subsequent amendments)
-health facilities specific risk agents: overall classification (exposure, effects, monitoring and limit values, prevention)

Oral exam. EXAMINATION CRITERIA: passing the exam includes the knowledge of the basic concepts: risk and occupational risk agents; health surveillance
The knowledge and deepening of more topics increases the exam grade.
Praise depends on the correct use of language and the ability to connect among the educational program topics

OCCUPATIONAL MEDICINE: AIMS AND TOOLS
Examples of occupational risks in health facilities (hospitals)
Occupational Medicine fields of interest
Italian Legislation (Legislative Decree n. 81, 2008 9th April
Occupational risk concept and classifications
Occupational accidents and diseases
Occupational physician’s requirements and role
Health Surveillance
Hypersusceptibility
Stakeholders of workers’ safety and health safeguard
Evaluation Risk Document (Documento di Valutazione dei Rischi, DVR)

RISK ASSESSMENT AND RISK MANAGEMENT
the occupational risk determinants components
risk assessment and risk management
risk assessment four step process:
-Hazard identification
-Dose-response assessment
-Exposure assessment
-Risk characterization
-Risk management measures (art. 15)
-structural measure
-signeposting
-protective equipment (PPE)
-health promotion

OCCUPATIONAL RISKS IN HEALTH FACILITIES
-Biological risk and biological agents
-Protection from cutting wounds (chapter X-bis Legislative Decree 81/08)
-Biomechanical overload: incongruous posture and manual handling of loads / patients
-Biomechanical overload risk evaluation method: MAPO
-Shift / night work: health effects
-Work-related stress: stressors and risk evaluation
-Violence in hospital wards


THE CHEMICAL RISK
Classification and hazard
-Classification of chemical substances (physical state, effects, European Regulations)
-Definitions of chemical agents and dangerous substances: Legislative Decree 81/08 (art. 221) -REACH and CLP Regulation: Safety Data Sheets, risk phrases and safety advice, pictograms.
-CLP Regulation: hazard classes and categories, meaning of the alpha-numeric code of the H and P sentences
Interaction between chemicals and the organism
-deterministic/stochastic action mechanism
-local/systemic, acute/chronic effects
-organ toxicity


QUALITATIVE AND QUANTITATIVE CHEMICAL RISK ASSESSMENT
-algorithms and models
-definition, purposes and planning monitoring campaigns
-continuum of events
Environmental Monitoring
-personal and area monitoring
- inhalation and dermal exposure
- sampling methods (personal and area samplers, wipe-tests, pads, ampoules)
Biological Monitoring
- biological indicators of exposure, of effect, of susceptibility
- multiple meaning of biomarkers
- half-life: choice of biological indicators
- biological indicators and matrices
- advantages and disantvantages of biological monitoring
Reference and Occupational Limit Values
-Reference values and Occupational Limit Values
-Occupazional Limit Values defined either by law or by scientific agreement
-Occupational Exposure Levels and Action Levels
-Health based and Risk based limit values
-Italian Legislation (Legislative Decree 81/08)
-European Legislation (SCOEL, Scientific Commetee Occupational Exposure Limits)
-International Agencies (ACGIH, Americal Conference of Governmental Industrial Hygienists)
-Biological monitoring data interpretation: SEG and individuals