Active search for occupational diseases in agriculture: Our experience

Introduction  Due to the prevalence of family based and self-employed workers ‘run enterprises, remoteness, and distance from health care structures, rural workers are very often not provided with occupational health care at the workplace and usually obtain from rural General Practitioners the only access to health care.  Unfortunately, rural GPs are not usually fully aware about the risks and related diseases present in rural enterprises.  As a consequence, occupational diseases in the sector are very likely underreported, with consequences in term of lack of compensation of occupational diseases and  lack of knowledge on the real burden of disease attributable to specific risk factors, affecting  the identification of priorities for prevention.     Accessibility   For these reasons, we have developed activities addressed at creating a system adequate to increase the access of rural workers to occupational health surveillance. One of the activities is the active search for occupational diseases. This activity is based on the examination of the existing records, an effort toward the interpretation of early signals of disease and the identification of areas of possible underreporting. Based on the indications provided by these activities, we run specific actions addressed at the identifying  occupational diseases. These activities are based on the systematic health surveillance of workers and on the linkage between different administrative data sources.  The use of the new Regional SISS repository is anticipated, and a pilot experience is running.      Some Results  In the first three years of activity, we have significantly increased the number of reports of noise-induced hearing loss, and we have pointed on the existence of a specific biological risk not fully anticipated before. Key aspect of our approach is increase of the activities carried out at the enterprise level, creation of specific data base and collaboration among all the professionals involved, in particular physicians, veterinarians and agronomists.