A health equity focused National Prevention Plan 2020-2025 and related capacity building (CCM, 201)

In Italy there are significant differences in life expectancy, morbidity and disability between different social groups: the wealthiest and educated people are better off, get sick less and live longer. The poorer Italian Regions show less favourable health indicators. However, Italy aims to reduce health inequalities (HI) among the priorities of its agenda. The 2014-2018 National Prevention Plan (NPP) had already instructed the Regions to include the fight against HI in the guiding principles of the regional prevention plans (RPP). The new NPP 2020-2025 confirms the need to strengthen the fight against HI and the reduction of the main social and geographical inequalities that are observed in our country represents a priority to all the objectives of the NPP, which requires the disclosure of scientific data, validated methods and tools to guarantee equity in the action. In this scenario, there is a project coordinated by the Istituto Superiore di Sanità with the contribution of DORS, the Documentation Centre for Health Promotion of Piedmont Region. The main objective of this project is to support the Ministry of Health (MoH) and the Regions in order to consolidate the introduction of the equity lenses approach in the new NPP, in particular the project aims at: promoting a health equity-oriented approach in priority and target setting, choice of a strategy, and in the design of the monitoring and evaluation system;investing in a capacity building process for regional officers responsible of the elaboration and implementation of the RPP in each Italian region.

20 Italian Regions participate to this two-year project (2019-2020). Two face-to-face training modules and the sharing of a web community of practice have been planned. The project involves developing support tools that provide equity-oriented practices. The main expected result is the increase of the equity-oriented actions and their dissemination across the country.

Get to know to prevent: the Local Health Authority of Cuneo takes care of visual disability

Visual impairment has an important economic weight on our society; in addition to this considerable cost, loss of vision imposes physical, financial and quality of life limitations. Preventing visual impairment is not only a social duty but also an economically convenient activity for the national health system.

On the basis of this concept, a visual impairment disability campaign was carried out in the ASL CN1 (Southern Piedmont Region) taking into account the guidelines recommended by the WHO (1968 screening guidelines but still applicable) in the most disadvantaged territories of the cross-border and rural area, where people have more difficulties to reach territorial services or hospital.

Patients who tested positive for the screening were taken over by the local network for a second-level visit and subsequent follow-up based on the pathology found. In this frame, visual screening represents a promising health policy as it can identify visual disability at an early stage. Through the health information systems (hospital discharge, access to the emergency department and exemptions for pathology), the geographical distribution and demographic characteristics of the subjects with visual disability were described in the ASL CN1 area. The level of detail has reached granularity at the single municipality and single age level.

For the year 2018 among 416.000 residents in ASL CN1, about 4.000 visual impaired subjects were identified (3.188 on the basis of the presence of an exemption for glaucoma, 542 from hospital discharge and 535 at the emergency department). Assessing mortality in this subgroup, the mean age at death is slightly higher than that of general population (82,42 vs 81,39 years respectively). This can be suggestive of an efficient handling the local population with visual disability. The developed indicators can be extended to other periods and new areas.

Key messages

Visual screening represents a promising health policy as it can identify visual disability. Through the health information systems, the geographical distribution and demographic characteristics of the subjects with visual disability were described.

[Integrated use of data bases to map manufacturing processes involving exposure to carcinogens in the Piedmont Region: the example of formaldehyde]

BACKGROUND

Exposure to carcinogens is still widespread in working environments. For the purpose of defining priority of interventions, it is necessary to estimate the number and the geographic distribution of workers potentially exposed to carcinogens. It could therefore be useful to test the use of tools and information sources already available in order to map the distribution of exposure to carcinogens. Formaldehyde is suggested as an example of an occupational carcinogen in this study.

OBJECTIVES

The study aimed at verifying and investigating the potential of 3 integrated databases: MATline, CAREX, and company databases resulting from occupational accident and disease claims (INAIL), in order to estimate the number of workers exposed to formaldehyde and map their distribution in the Piedmont Region.

METHODS

The list of manufacturing processes involving exposure to formaldehyde was sorted by MIATline; for each process the number of firms and employees were obtained from the INAIL archives. By applying the prevalence of exposed workers obtained with CAREX, an estimate of exposure for each process was determined. A map of the distribution of employees associated with a specific process was produced using ArcView GIS software.

RESULTS

It was estimated that more than 13,000 employees are exposed to formaldehyde in the Piedmont Region. The manufacture of furniture was identified as the process with the highest number of workers exposed to formaldehyde (3,130),followed by metal workers (2,301 exposed) and synthetic resin processing (1,391 exposed).

CONCLUSION

The results obtained from the integrated use of databases provide a basis for defining priority of preventive interventions required in the industrial processes involving exposure to carcinogens in the Piedmont Region.

[Working conditions and health problems among call-centre operators: a study on self-reported data in the Piedmont Region (Italy)]

BACKGROUND

Currently, about 250,000 workers are employed in the call-centre sector in Italy. The nature and the organization of the work exposes workers to a variety of psychosocial and ergonomic hazards, with a potential impact on physical and psychological health.

OBJECTIVE

The aim of the study was to investigate working conditions and health status among call-centre operators, in order to estimate the prevalence of exposure to psychosocial and ergonomic risk factors, and of potentially work-related health problems.

METHODS

Workers from seven call-centres operating in the Torino area were invited to participate in the survey. During the period 2005-2006, 775 subjects working in telecommunications (70%), telemarketing (14%) and finance (16%) completed a standardized questionnaire on socio-demographics and lifestyle, working conditions, symptoms and diseases.

RESULTS

Poor microclimatic conditions, elevated noise, high levels of exposure to psychosocial factors and a high prevalence of unfavourable ergonomic working conditions were observed With regard to health conditions, the mental health index was lower than that expected for the Italian population. Overall, 60%, of the subjects reported headache, 57% musculoskeletal symptoms and 46% voice disorders, for which they consulted a physician and/or took medication.

CONCLUSION

A high proportion of call-centre operators were exposed to organizational and psychosocial risk factors, while the self-reported prevalence of potentially work-related health conditions was also high, as has been reported by other authors. Although further epidemiological studies are needed to meaningfully evaluate these associations, it also appears necessary to implement interventions on the most frequently encountered hazards in this sector.