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Introduction: During the COVID-19 Pandemic, the use of digital devices during work activities has increased with important re-percussions on the psychological and physical well-being of the employees. The aim of this study was to investigate the prevalence of musculoskeletal and visual disorders related to the use of computers and home workstation. Methods: The study is a cross-sectional study. A checklist, from the National Institute of Health, was administered to white collar workers of a large international pharmaceutical company based in Italy. Results: Our study showed that postural breaks have a protective effect on neck/shoulder pain (OR 0.32, CI 0.16-0.62), back and lower extremity pain (OR 0.35, CI 0.18-0.69), and eye burning (OR 0.50, CI 0.27-0.94) of study participants. Conclusions: The research recommends that remote employees who often change their workstations should establish a suitable work environment and obtaining enough risk training from an occupational physician. This is essential for maintaining their mental and physical well-being.

Objective: Sudden cardiac death (SCD) is a rare and yet unexplained condition. The most frequent cause is myocardial infarction, while a small proportion is due to arrhythmogenic syndromes (e.g., channelopathies). This systematic review and meta-analysis aimed to provide a comprehensive overview of the prevalence and risk factors associated with SCD in workers. Material and methods: A search for eligible studies was performed utilizing three databases (PubMed, ISI Web of Knowledge, and Scopus). The inclusion criteria were fulfilled if sudden cardiac death due to channelopathy in workers was mentioned. Results: Out of the 1408 articles found across three databases, 6 articles were included in the systematic review but the meta-analysis was conducted on 3 studies The total sample included was 23,450 participants. The pooled prevalence of channelopathies in employees was 0.3% (95% CI 0.07-0.43%), of sudden cardiac death in employees was 2.8% (95% CI 0.37-5.20%), and of sudden cardiac death in employees with a diagnosis of cardiac channelopathies was 0.2% (95% CI 0.02- 0.30%). Conclusions: SCD is a serious and potentially preventable condition that can occur among workers. By identifying and addressing work-related risk factors, providing appropriate screening and interventions, and promoting healthy lifestyle behaviors, we can work to reduce the incidence of SCD and improve the cardiovascular health and well-being of workers.

Students in medicine and other health professions are exposed to numerous occupational hazards, primarily biological hazards, during their academic careers at university. The aim of the present study was to investigate the seroprevalence characteristics of anti-HBsAg, anti-Measles, anti-Mumps, anti-Rubella and anti-Varicella IgG antibodies in healthcare students of a large teaching hospital in Rome. Methods: To accomplish the study's aims, antibody serology data were gathered from students of Medicine and Surgery, Dentistry, and Health Professions at the Catholic University of the Sacred Heart (Rome Campus) during their first Health Surveillance visit, that took place from 2013 to 2023. Results: Our study sample included 2523 students, 44.4 % were protected against Hepatitis B, 87.3 % against measles, 85.5 % against mumps, 94.6 % rubella and 95.2 % against varicella. Differences in antibody coverage between age groups were statistically significant (p < 0.001), except for mumps. It found a lower probability of having seronegative anti-HBVs with an older date since the presumed primary vaccination. Conclusion: In our sample, seropositivity rate against vaccine-preventable diseases, especially for Hepatitis B, was often inadequate to prevent possible biological risks connected with the activities carried out on the ward.

The COVID-19 vaccination campaign in Italy started in December 2020, and, due to the Omicron variant's emergence, a second booster dose was recommended for high-risk individuals and healthcare workers from July 2022. The aim of the study was to evaluate the vaccination coverages for the COVID-19 second booster dose and to identify predictors of its acceptance within the population of medical residents (MRs) of the Fondazione Policlinico Universitario "A. Gemelli" IRCCS (FPG) University Hospital. The study was conducted at FPG from October 4th to December 21st, 2022, and COVID-19 second booster dose and influenza vaccines were administered. The study analyzed collected data and conducted multivariate logistic regressions to explore potential predictors of vaccination adherence. The analyses performed were compared with the sample enrolled in FPG residency programs at the start of the COVID-19 vaccination campaign. 1968 MRs were involved in the 2022-2023 vaccination campaign (mean age 28.97, SD 3.44), and the second booster dose of COVID-19 vaccination coverage was low (18.80%). Almost all participants opted for co-administration of COVID-19 and influenza vaccinations, leading to a similar rate of influenza vaccination coverage (16.26%). Being a frontline resident, meaning a direct involvement in managing COVID-19 patients and vaccination campaigns, was the main predictor of vaccination adherence (OR 1.72, 95% CI 1.25-2.17). The dropping in influenza vaccination coverage in 2022-2023 and the low adherence to COVID-19 second booster dose among young physicians is concerning, calling for tailored vaccination campaigns and interventions.

Introduction: The COVID-19 pandemic had a negative impact on the psychological wellbeing of workers worldwide. Certain coping styles may increase burnout risk. To investigate the relationship between burnout and coping styles, a systematic review was performed.Methods: Following the PRISMA statements, three databases were screened up until October 2022, including research articles written in English language and investigating the relationship between burnout and coping strategies in workers. The quality of articles was assessed by the Newcastle-Ottawa Scale.Results: The initial search resulted in 3,413 records, 15 of which were included in this review. Most studies were performed on healthcare workers (n = 13, 86.6%) and included a majority of female workers (n = 13, 86.7%). The most used burnout assessment questionnaire was the Maslach Burnout Inventory (n = 8, 53.3%), and the most used coping assessment tool was the Brief-COPE (n = 6, 40.0%). Task-related coping was a protective factor for burnout in all four studies investigating its correlation with burnout dimensions. Two of the four studies investigating emotion-oriented coping found that it was protective while the other two found that it was predictive of burnout. All five studies investigating avoidance-oriented coping and burnout dimensions found that this coping style was predictive of burnout.Discussion: Task-oriented and adaptive coping were protective for burnout, avoidance-oriented, and maladaptive coping were predictive factors of burnout. Mixed results were highlighted concerning emotion-oriented coping, suggesting that different outcomes of this coping style may depend on gender, with women relying more on it than men. In conclusion, further research is needed to investigate the effect of coping styles in individuals, and how these correlates with their unique characteristics. Training workers about appropriate coping styles to adopt may be essential to enact prevention strategies to reduce burnout

Background: The aim of this paper is to discuss the impact of COVID-19 on patients with urological malignancies (prostate cancer, bladder and upper tract urothelial cancer, kidney cancer, penile and testicular cancer) and to review the available recommendations reported in the literature. Methods: A review was performed, through the PubMed database, regarding available recommendations reported in the literature, to identify studies examining the impact of COVID-19 on treatment and clinical outcomes (including upstaging, recurrence, and mortality) for uro-oncological patients. Results: The COVID-19 pandemic dramatically changed the urological guidelines and patients’ access to screening programs and follow-up visits. Great efforts were undertaken to guarantee treatments to high-risk patients although follow up was not always possible due to recurrent surges, and patients with lower risk cancers had to wait for therapies. Conclusions: Physically and mentally, uro-oncological patients paid a heavy price during the COVID-19 pandemic. Long term data on the “costs” of clinical decisions made during the COVID-19 pandemic are still to be revealed and analyzed.

Introduction: In recent years, due to the COVID-19 Pandemic, an increasing number of people were forced to stay at home. Working from home seems to have resulted in an increase of TElewoRk-RelAted stress (TERRA), defined as physical and mental stress due to telework, including the inability to cope with new information and communication technologies in a healthy manner, recognized as technostress. TERRA is a primary concern for Occupational Health worldwide, affecting psychophysical health and productivity. The aim of this systematic review is to determine if and how telework has actually increased TERRA levels in workers and its impacts, during the COVID-19 Pandemic. Materials and methods: Following the PRISMA statements, a systematic review was performed across three scientific databases (Pubmed, ISI Web of Knowledge and Scopus), using “telework”, “technostress” and “COVID-19” (and relative MeSH terms) as keywords. The research was restricted to articles in Italian and English, published up to August 2021. Results: As results, 518 articles were found; after removing duplicates, and exclusion based on title, abstract, and full text, 36 articles were included in the review. Most of articles demonstrate that women and who work at distance in full time mode show higher TERRA levels. Conclusions: This systematic review highlights some of the emerging psychophysical health issues related to TERRA, and offers an overview into the modern challenges workers have to face, in order to improve Total Worker Health through Occupational Medicine.

Introduction: In recent years, due to the COVID-19 Pandemic, an increasing number of people were forced to stay at home. Working from home seems to have resulted in an increase of TElewoRk-RelAted stress (TERRA), defined as physical and mental stress due to telework, including the inability to cope with new information and communication technologies in a healthy manner, recognized as technostress. TERRA is a primary concern for Occupational Health worldwide, affecting psychophysical health and productivity. The aim of this systematic review is to determine if and how telework has actually increased TERRA levels in workers and its impacts, during the COVID-19 Pandemic. Materials and methods: Following the PRISMA statements, a systematic review was performed across three scientific databases (Pubmed, ISI Web of Knowledge and Scopus), using “telework”, “technostress” and “COVID-19” (and relative MeSH terms) as keywords. The research was restricted to articles in Italian and English, published up to August 2021. Results: As results, 518 articles were found; after removing duplicates, and exclusion based on title, abstract, and full text, 36 articles were included in the review. Most of articles demonstrate that women and who work at distance in full time mode show higher TERRA levels. Conclusions: This systematic review highlights some of the emerging psychophysical health issues related to TERRA, and offers an overview into the modern challenges workers have to face, in order to improve Total Worker Health through Occupational Medicine.

To reduce vaccine-preventable diseases in workers, workplace vaccination campaigns can be implemented on-site. The aim of this systematic review was to evaluate adherence to workplace vaccination campaigns. Three databases, PubMed, ISI Web of Science, and Scopus, were screened systematically for articles in English or Italian addressing participation in an on-site vaccination program by employees. The following data was extracted: authors, year, country, type of vaccine, type of workplace, sample size, vaccination rate. Data on the prevalence of flu vaccination were calculated and pooled using a random-effects model. Thirteen articles were included in the review, ten in the meta-analysis. Most studies were conducted in the USA (30.7%) and most vaccination campaigns were against influenza (69.2%), with a pooled estimate of 42% (95% CI: 0.25–0.60%); participation rate was highly variable, ranging from 88.9% for an influenza vaccination campaign to 5.7% for a Lyme disease vaccination campaign. Offering free on-site vaccination can be a successful tool to ensure adherence to vaccination campaigns and administration of all required doses according to the vaccine administration scheme. The occupational physician can play a key role in implementing workplace campaigns for employee mandatory vaccinations.

The COVID-19 vaccination has proven to be the most effective prevention measure, reducing deaths and hospitalizations and allowing, in combination with non-pharmacological interventions, the pandemic to be tackled. Although most of the adverse reactions to vaccination present mild symptoms and serious effects are very rare, they can be the cause of legal action against the healthcare workers (HCWs) who administered it. To highlight differences in the medical liability systems, we performed a search for the three most populous countries in each continent on vaccine injury compensation programs, new laws or policies to protect HCWs administering vaccinations introduced during the COVID-19 pandemic, and policies on mandatory vaccinations, on literature databases and institutional sites. We found that in seven countries the medical liability system is based on Common Law, while in eleven it is mainly based on Civil Law. Considering the application of specific laws to protect HCWs who vaccinate during the pandemic, only the USA and Canada provided immunity from liability. Among the countries we analyzed, fourteen have adopted compensation funds. From an international perspective, our results highlight that in eleven (61.1%) countries medical liability is mainly based on Civil Law, whilst in seven (38.9%) it is based on Common Law.

Background: The COVID-19 pandemic is still ongoing, with rapidly increasing cases all over the world, and the emerging issue of post COVID-19 (or Long COVID-19) condition is impacting the occupational world. Objective: The aim of this systematic review was to evaluate the impact of lasting COVID-19 symptoms or disability on the working population upon their return to employment. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statements we performed a systematic review in December 2021, screening three databases (PubMed, ISI Web of Knowledge, Scopus), for articles investigating return to work in patients that were previously hospitalized due to COVID-19. A hand-searched was then performed through the references of the included systematic review. A quality assessment was performed on the included studies. Results: Out of the 263 articles found through the initial search, 11 studies were included in this systematic review. The selected studies were divided based on follow-up time, in two months follow-up, follow-up between two and six months, and six months follow-up. All the studies highlighted an important impact of post COVID-19 condition in returning to work after being hospitalized, with differences based on follow-up time, home Country and mean/median age of the sample considered. Conclusions: This review highlighted post COVID-19 condition as a rising problem in occupational medicine, with consequences on workers' quality of life and productivity. The role of occupational physicians could be essential in applying limitations to work duties or hours and facilitating the return to employment in workers with a post COVID-19 condition.

To maintain safety conditions in the provision of care and assistance, and to protect healthcare workers (HCWs) and patients, the Italian government required compulsory COVID-19 vaccination for HCWs, including medical residents (MRs). The aim of this study was to assess COVID-19 vaccination coverage in MRs in a large tertiary hospital in Italy, before and after the introduction of compulsory vaccination, according to demographic characteristics and specific residency. A database on COVID-19 vaccination status and infection of resident medical doctors was created. Descriptive statistics and logistic regressions were carried out on the data. A total of 1894 MRs were included in the study. Being vaccinated in the same hospital as the residency program was significantly related to the year of residency and being enrolled in a frontline residency. A significant association between compliance with the compulsory primary cycle vaccination and vaccination in the hospital residency was observed. Being enrolled in the second, third, and last years of residency, and in a frontline residency, were predictive of being vaccinated in the residency hospital. Almost 100% of the MRs participating in the study were vaccinated against COVID-19. Compulsory vaccination of HCWs, alongside greater and clearer information about the risks and benefits of vaccination, represents an important booster to ensure public health and to promote quality and safety of care.

Managing the COVID-19 pandemic posed several challenges for healthcare professionals, which likely heightened their risk of burnout (Amanullah and Ramesh Shankar, 2020) and, consequently, their general physical and mental health. Although it may not be possible to address and eliminate the causes of burnout, current research informs healthcare organizations about protective strategies to reduce its detrimental consequences. The promotion of compassionate interactions among healthcare professionals may play such a role. Compassion within healthcare organizations positively affects individual performance and well-being. Building on these considerations and within the framework of the Conservation of Resources theory, this study explores the relationships among burnout dimensions, received compassion at work, and general health in 711 Italian healthcare professionals (68.5% female), aged between 21 and 73 years (Mage = 36.4, SD = 11.2). Analyses were conducted to investigate the association between burnout and general well-being (H1) and between burnout symptoms and perceived compassion at work (H2); and the mediational role of compassion in the relationship between burnout symptoms and general well-being. H1 and H2 were confirmed (r < 0.01 for both), and a SEM model showed the mediating role of compassion at work in the association between burnout symptoms and general well-being (RMSEA < 0.08, SRMR < 0.08, CFI and TLI > 0.90). Theoretical and practical implications of the findings are discussed in the paper.

Background: Many workers shifted to working from home due to the COVID-19 pandemic. This review aims to investigate if this sudden change caused an increase in TElewoRk-RelAted stress (TERRA) which is defined as physical and mental stress caused by telework. Methods: A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed of three scientific databases (PubMed, ISI Web of Knowledge, and Scopus), which also included a quality assessment. Articles measuring stress, psychological or physical, in remote workers, published from December 2019 through August 2021 were included in the review. Results were extracted by reporting: authors, country, study design, type of workers, sample, questionnaires and measurements, and outcomes. Data were synthesized quantitatively for country, type of workers, and outcomes. Results: Out of the 518 articles found in the three databases, 19 articles were included in the systematic review (10,012 participants overall), and 78.9% of these highlighted an increase in TERRA levels in remote workers. Among 85.7% of the studies considering gender as a variable, TERRA levels were higher in female workers. Twelve (63.2%) of the studies investigated psychological well-being, two (10.5%) focused on the physical well-being of remote workers, three (15.8%) investigated both, and two studies had other outcomes (10.5%). Conclusions: Considering the redefinition of workplaces dictated by the COVID-19 pandemic, this review highlights the emerging issue of remote work and the use of technology in working from home, emphasizing a rapidly growing occupational health problem. Remote workers need to be provided with emotional and technical support to prevent TERRA in remote workers.

Monkeypox infection is an emerging problem and a new challenge for modern medicine. With an increasing number of new cases worldwide, new data regarding the clinical manifestations, characteristics of the patients, risk factors and treatment options are coming to light. Knowing more about the disease will allow to elaborate new helpful methods to facilitate its diagnosis. Special attention should be paid to the careful dermatologic and dermoscopic examination of the patient. The analysis of available data also suggests possible strategies for the prevention of Monkeypox virus spread; the vaccine against Smallpox seems to be an effective solution. This case report describes the diagnostic approach and management of a non-vaccinated adult patient with several risk factors and a history of sexually transmitted disease. The patient had no history of travel abroad. Even though a clinical diagnose of Monkeypox can be challenging due to its similarities with skin rashes caused by other Orthopoxviral infections, there are fine differences between the rashes which can be helpful in their differentiation, although laboratory analysis is required for a definitive identification. A careful study of the characteristics of the rash, such as diameter, its presence on palms and soles and its evolution in time, provided important clues for the diagnosis of Monkeypox infection. The lack of vaccinations in the history of the patient was another crucial finding in the diagnostic process.

In 2020, the COVID-19 pandemic exhausted healthcare systems around the world, including European Union countries, with healthcare workers at the frontline. Therefore, new health laws and policies have been introduced at the national level in order to offer greater legal protection for health workers. Since the introduction of COVID-19 vaccination, it has led to the development of specific laws to define the compulsoriness for particular categories. This review aimed to evaluate the system of medical liability, focusing on the ten countries of the European Union with the highest rate of vaccination coverage against SARS-CoV-2. A country-by-country analysis was conducted on the different medical liability systems of individual professionals, in general, and with specific focus on the vaccinating doctors. Additional search was conducted to investigate which European states have introduced specific policies in this field, to identify the implementation of any new laws alongside the COVID-19 vaccination campaigns, and to assess which countries have adopted the European Digital COVID Certificate and funded specific compensation programs for COVID-19 vaccination. Our results highlight an extremely fragmented European scenario; therefore, this work could be a starting point to define a common approach for medical liability and related policies in the COVID-19 pandemic.

Introduction: Gender medicine is a new medical approach aimed at the study of the differences between women and men in terms of prevention, diagnosis, and the outcome of all diseases. Migraines are among these. They represent the most common neurological illness; they are most prevalent in adults between 20 and 50 years of age and are three to four times more frequent in woman than in men. Affecting people in working age, migraines are a problem that strongly impacts the psychophysical health and productivity of workers, regardless of the specific job task they have. Methods: A narrative review was performed, searching for the most relevant articles describing gender differences in people suffering from migraines, and particularly in workers. Results: Migraine global prevalence is 20.7% in women and 9.7% in men whereas prevalence in Italy is 32.9% for women and only 13.0% for men. This difference is partly explained by hormonal differences, as well as by differences in brain structure, genetic polymorphisms and neuronal pathways. Sex differences may also play a role in the progression from episodic to chronic migraine. In workers, migraines are mostly associated with strenuous physical work in men, whilst migraines triggered by night shifts, lack of sleep, or irregular sleep patterns are more common in women. Conclusions: To this day, the reasons of sex/gender disparity for migraine are still obscure. However, migraines, chronic migraine in particular, have a negative impact on the lives of all individuals affected by this disease, but particularly in women in which family cares and working activity are often superimposed. Migraine prevention strategies should be planned in workers through the occupational health physician.

Introduction: During the pandemic, the use of personal protective equipment (PPE) has become essential for Healthcare Workers (HCWs) to fight safely against the virus. However, the extensive and prolonged use of PPE may cause various adverse skin reactions due to the use of alcohol hand cleanser and protracted use of masks and goggles. The aim of this study is to evaluate the skin problems caused by PPE in HCWs and the possible consequences on their work. Materials and methods: An online ad hoc questionnaire, composed by 35 questions about sociodemographic characteristics, work related issues and exposure/habits about PPE, was administered to a sample of Italian HCWs. Univariate and multivariate analyses were performed in order to explore possible associations between variables. Results: We tested 3 types of PPE: Gloves, Hair Bonnets and Masks for different time of utilization (<1, 1-3, 3-6, >6 hours). The sample included 1184 participants: 292 workers reported a dermatological pathology nested in four different pathological groups: 45 (15%) had Psoriasis, 54 (19%) Eczema, 38 (13%) Acne, 48 (16%), seborrheic dermatitis and 107 (36%) other. 25 workers had a loss of occupational days due to dermatological illness; 56 occupational physician surveillance visits were asked for; in 30 cases were recognized limitations in working duties. Conclusions: Protecting HCWs requires the use of PPE, but occupational dermatitis is an emerging problem in the midst of the COVID-19 pandemic. National data for affected healthcare professionals could contribute to a better understanding of the problem and prevention initiatives in the workplace.

INTRODUCTION: In Italy annual flu vaccination for health care workers is recommended but coverage is usually unsatisfying. The compliance is even worse among medical residents (MRs) both in literature, both in our experience: in the flu season 2014/ 15 only 0.6% of MRs enrolled at the Università Cattolica del Sacro Cuore (UCSC) were vaccinated. For this reason, during the influenza season 2015/16, the Institute of Public Health of the UCSC, in collaboration with the Health Management of the "Agostino Gemelli" Teaching Hospital (FPG) and with the directive board of the Medical Specialization Schools (SSM) present at the University has tested several strategies to improve awareness and adherence to flu vaccination campaign by its staff. This study aims to analyze the impact of the strategies used during the 2015/16 campaign on flu vaccination coverage among MRs of an important Italian Teaching Hospital. METHODS: The study was conducted among MRs enrolled at the UCSC - FPG in 2015/16. The data was collected by the Occupational Medicine which, during the influenza seasons, immunize MRs against influenza free of charge. For each variable - vaccination, area of specialization (surgical, medical, clinical services), typology of SSM - was measured the absolute and percentage frequency. In order to compare the flu vaccination coverage between seasons 2014/15 and 2015/16 and between areas of specialization in 2015/16 chi-square test was used (statistical significance level of 0.05). The data were analyzed using STATA Software. RESULTS: Were included in the analysis 42 SSM with a total of 1041 MRs. During the vaccination campaign 2015/16, flu vaccine was administered to 99 MRs (9.5%), 8.9% more than in the previous season (p<0.001). There is also a significant difference in vaccine coverage between surgical, medical and clinical services areas in 2015/16 (p <0.001). The highest vaccination coverage was recorded among MRs of Hematology and Urology (54.5%). However, no one MRs

INTRODUZIONE: L' utilizzazione dell'alcol nei luoghi di lavoro è stato oggetto di numerose valutazioni da parte del mondo della prevenzione e vi è stato un variegato e talora difforme orientamento normativo a livello regionale e locale. La normativa vigente nel nostro Paese affida ai datori di lavoro il compito di contrastare l’uso di alcol nei da parte dei lavoratori che svolgono mansioni a rischio di infortuni sul lavoro ovvero per la sicurezza, l’incolumità o la salute dei terzi. Il gruppo LaRA (Lavoratori Rischiosi per gli Altri) si è posto il compito di valutare se quanto disposto garantisca compiutamente la tutela della salute e sicurezza dei lavoratori e dei terzi, senza pregiudizio per i diritti civili dei lavoratori. MATERIALI E METODI: È stato prodotto un documento di consenso nel confronto tra medici del lavoro, igienisti, medici legali, tossicologi, psichiatri , medici di medicina generale, giuristi, bioeticisti, e parti sociali. Il documento è stato compilato valutando in comparazione le numerose norme esistenti e i pareri giurisprudenziali sulla materia , mediante riunioni del network e formali RISULTATI: Si è evidenziata l’importanza di un corretto approccio al problema della utilizzazione dell’alcol in particolare in ambienti di lavoro particolarmente rischiosi per i lavoratori e per terzi . Tuttavia la normativa vigente presenta lacune e incongruenze che rendono difficoltosa l’attuazione uniforme di comportamenti di prevenzione. Di fronte ad una generale condivisione dei concetti preventivi di base, esistono difformità nelle disposizioni delle autorità locali e regionali che non consentono di applicare una strategia unitaria sul territorio nazionale. Diversamente da quanto finora statuito dalle norme, l’obbligo del datore di lavoro di vigilare sull’osservanza del divieto di assunzione di alcolici sul luogo di lavoro non dovrebbe essere espletato “solo” attraverso medico competente, il cui ruolo istituzionale dovrebbe essere di fiducia e non

Aim: Current Italian legislation obliges employers to prevent workers who are occupationally at risk or who perform jobs that may be hazardous for the safety or health of third parties from consuming alcohol. The LaRA Group has set out to assess whether the law fully safeguards the health and safety of both workers and third parties, without impinging upon the civil rights of workers. Method: A written document expressing agreement was produced following discussions between doctors, lawyers, bioethicists and social partners. Results: There are gaps and inconsistencies in current laws; the differences in local and regional provisions prevent authorities from applying a single strategy at national level. There should be a change in existing rules under which the employer’s obligation to enforce the ban on drinking alcohol in the workplace is enacted solely by the “competent” physician whose institutional role is to safeguard and promote health. Some occupational categories that are subject to a ban on alcohol drinking do not currently undergo health surveillance. For example, if road transport drivers are not exposed to a specific occupational risk foreseen under another law, they can be placed under health surveillance only in those regions where the local laws contemplate this type of control. In other cases, the practice of assessing the risk to third parties and providing for compulsory health surveillance in the Risk Assessment Document, is considered by some jurists to be a "consuetudo praeter legem" and therefore acceptable in a field not yet covered by a specific law, but to be "contra legem” or unlawful by other jurists. Moreover, the competent physician who uses a breathanalyser or tests for alcohol addiction faces an ethical dilemma, since by communicating the results to an employer or authorities responsible for the issuing of licenses, he may be violating his professional oath of secrecy. Furthermore, the emphasis placed on testing has induced companies a

L'applicazione della sorveglianza sanitaria nelle Facoltà di medicina e chirurgia richiede la predisposizione di uno schema procedurale che codifichi obblighi e azioni da attivare nelle diverse fasi di definizione dei rischi e profili professionali, focalizzando attività e competenze correlate agli obblighi normativi