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Nadia MIRAGLIA

Insegnamento di OCCUPATIONAL MEDECINE

Corso di laurea in INFERMIERISTICA (ABILITANTE ALLA PROFESSIONE SANITARIA DI INFERMIERE)

SSD: MED/44

CFU: 2,00

ORE PER UNITÀ DIDATTICA: 30,00

Periodo di Erogazione: Primo Semestre

Italiano

Lingua insegnamento

Inglese

English

Teaching language

English

Contents

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.

Textbook and course materials

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

Course objectives

At the end of the course the student should know and understand the main prevention strategies and measures to protect the health and safety of workers exposed to occupational risks.
In particular, the primary objective is for students to develop a critical understanding of the examined topics and the conceptual and methodological tools for independent and ongoing study. This will enable them to apply the acquired knowledge to identify and manage occupational risks to which they are/will be potentially exposed during their work.

Prerequisites

None

Teaching methods

Classroom-taught lessons with slides, 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)

Assessment methods

Oral exam. The exam is held concurrently with the evaluation of the various courses of the Integrated Course, and the final grade, expressed collectively by the examining committee, is based on a unified assessment of the entire Integrated Course, taking into account the level of learning demonstrated in each subject area and the weighting of each course.
Specifically, passing the occupational medicine exam requires 1) knowledge of basic concepts: risk and occupational risk agents, risk assessment and management, and health surveillance; 2) comprehensive understanding of at least one specific topic among the risk agents covered. Students must demonstrate the ability to analyze and connect the different topics. Grades are expressed out of 30, with 18 representing the minimum and 30 the maximum; knowledge and in-depth analysis of multiple topics will increase the exam grade. Honors are awarded based on fluency in language and the ability to connect the topics covered.

Detailed syllabus

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

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