title: Analysis of appeals against the ruling of occupational physicians lodged with the Prevention and Occupational Epidemiology Operative Unit, ASP Palermo (Palermo Health Authority), from 2008-2010.
abstract: BACKGROUND
  The responsibility of the Department for Prevention and Safety at the workplace of the Palermo Health Authority (ASP) is to monitor and coordinate the activity of occupational physicians operating in Palermo and its province. One of its obligations is to examine appeals "against the judgment of occupational physicians", "..and, after carrying out further investigation, confirm, modify or reverse the ruling itself" (art. 41, par. 6, legislative Decree 81/08).
  
  
  OBJECTIVE
  The purpose of this study was to analyze the appeals lodged against a judgment of fitness for work" submitted to the "Health Prevention and Occupational Epidemiology Operative Unit" of the Department of Prevention and Safety at the Workplace of the ASP Palermo, from 2008 to 2010.
  
  
  METHODS
  The total number of appeals lodged during the three-year period was 211, 174 of which were finalized.
  
  
  RESULTS
  The most frequent job category among the appellants was that of blue-collar workers, in various sectors, covering 44.5% of the subjects under study (93 cases). In 64.2% of the processed appeals (131 cases), the judgment of the physician was modified, while in the remaining 36.8% (73 cases) it was confirmed. The work fitness judgment with restrictions was the category against which most appeals were lodged, and the diseases in question mostly concerned the osteoarticular and cardiovascular systems.
  
  
  CONCLUSIONS
  In a context of continuous change in the labour field and the related risks to the health and safety of workers, the occupational physician must approach the worker in a comprehensive manner, through an assessment of the possible health problems and the working environment in which he/she operates.
authors.affiliation: Sciences for Health Promotion Department, University of Study of Palermo.
authors.forename: Maria Grazia Laura
authors.initials: MG
authors.lastname: Marsala
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Morici
authors.forename: Giovanna
authors.initials: G
authors.lastname: Anastasi
authors.forename: C
authors.initials: C
authors.lastname: Costantino
authors.forename: F
authors.initials: F
authors.lastname: Tramuto
authors.forename: G
authors.initials: G
authors.lastname: Lacca
authors.forename: Loredana
authors.initials: L
authors.lastname: Curcurù
authors.forename: E
authors.initials: E
authors.lastname: Costagliola
authors.forename: Sara
authors.initials: S
authors.lastname: Ilardo
authors.forename: Elisa
authors.initials: E
authors.lastname: Trapani
authors.forename: Rosa
authors.initials: R
authors.lastname: Caracausi
authors.forename: A
authors.initials: A
authors.lastname: Firenze
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006077:Government Agencies; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis; D009787:Occupational Medicine / Q000331:legislation & jurisprudence*; D009790:Occupations; D011247:Pregnancy; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014938:Work Capacity Evaluation