[Association between causes of lNPS compensated disability and occupational category (Veneto Region, 1994-2002): a surveillance method for occupational diseases?].
BACKGROUND
According to Italian law, workers are insured against disability through the National Social Security Institute (INPS), whose records contain information on diseases causing disability and occupational histories.


OBJECTIVE
Using the INPS data, our objective was to identify any excess risk of disabling diseases in relation to the occupational categories.


METHODS
Insurance covers all private sector employees, a small proportion of public sector employees, agricultural labourers, domestic workers, self-employed workers (craftsmen, commercial dealers,farmers), and few other occupational categories. For each insured worker, a database was created containing registry data, occupational history and, for compensated workers, the disease code, for each year from 1994 to 2002. A cohort study design was adopted, in which references were self-employed workers (with mixed exposure) to whom different categories of employees in agriculture, industry, crafts, and services were compared. Data were analyzed by means of Poisson regression, estimating the Incidence Rate Ratio (IRR) and confidence interval (CI) at 99.99%, instead of 95%, in order to set the threshold of error for the entire study at 0.05.


RESULTS
In the construction industry there were significantly high risks of disability in both industry and crafts for tumours (industry: IRR = 2.07; IC = 1. 67-2.57; crafts: 2.57; 1.89-3.18), circulatory disorders (industry: IRR = 2.24; IC = 1.65-3.04; crafts.: 3.06; 2.16-4.32), and bone and joint diseases (industry. IRR = 5.0; IC = 3.15-7.94; crafts: 6.58; 5.04-8.59).


CONCLUSIONS
The advantage of this approach is to recruit a large number of subjects at limited cost. The procedure here proposed is a mainly exploratory approach aimed at establishing new study hypotheses: disability, in fact, is acknowledged by INPS when its cause is not occupational according to the current literature.
Mastrangelo
G
G
Dipartimento di Medicina Ambientale e Sanità Pubblica, Università degli Studi di Padova. giuseppe.mastrangelo@unipd.it
Carassai
Patrizia
P
Carletti
Claudia
C
Cattani
F
F
Di Loreto
G
G
Dini
M
M
Mundo
Antonietta
A
Noceta
R
R
Piccioni
M
M
Sereno
Antonella
A
Campo
G
G
Marangi
G
G
Fadda
Emanuela
E
Priolo
G
G
Scoizzato
L
L
Marchiori
L
L
D000328:Adult; D000368:Aged; D003953:Diagnosis-Related Groups; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D009784:Occupational Diseases / Q000191:economics / Q000453:epidemiology*; D009790:Occupations / Q000145:classification* / Q000706:statistics & numerical data; D011159:Population Surveillance / Q000379:methods*; D012306:Risk; D012943:Social Security / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D014942:Workers' Compensation / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*