title: [The validity of proofs in demonstrating risk and in research into the causal connection of occupational diseases].
abstract: The verification of the occupational origin of a disease is a forensic medical activity requiring: the confirmation of the existence and of the exact nosographic identification of the disease, as well as the type of work really performed, and the actual exposure to an effective occupational hazard during an adequate time, and finally a reconstruction of the causal relationship based on objective data. Checking the disease is essentially documentary, corroborated by direct survey by medical examination. The assessment of exposure to the occupational hazard must be scrupulous also, not being acceptable the medical history alone: that is, it does require documentary evidence. Finally, the logical process of recognition of causation requires the application of rigorous forensic medical methodology, with references to current scientific knowledge, and the application of legal criteriology from the legal field of law in which you are moving. Indeed, forensic medical methodology is not the same of epidemiological one: probability of occurrence of an event is not a proof, but only a circumstantial element. A forensic medical doctor organizes every evidence and circumstantial evidence in a unique decision-making process, as a result of a logical process, and probabilistic data can be among circumstantial evidence, but they must suit the case in details, in order to reach the so called "logic probability". But this doesn't mean that you have "proven" the occupational origin of a disease. In the "demonstration" of a fact you use the same forensic medical methodology (thus referring to classic criteria: temporality, biological gradient and plausibility, topographical, exclusion, and phenomenal continuity if suitable, too), and also the same general scientific references, nevertheless the law can be different in causality principles admitted (the principles governing the causal link are the same in Criminal Code and Civil law both, but they differ in private insurance), and besides there is a different rule of evidence, that is the "quantum of evidence" required (the amount of evidence needed) and, secondarily, also a different quality of proof required (how reliable such evidence should be considered, and which types of evidence admitted). Therefore in Civil law you can reach a "procedural truth" different from the one in Criminal law, and various from the one needed to prevail in litigation with social security insurance or with private insurance.
authors.affiliation: DM 1° Iivello INAIL Direzione Regionale Emilia Romagna.  d.bonetti@inail.it
authors.forename: Daniela
authors.initials: D
authors.lastname: Bonetti
mesh_terms: D015984:Causality; D005554:Forensic Medicine / Q000331:legislation & jurisprudence / Q000379:methods*; D006801:Humans; D007348:Insurance, Health / Q000331:legislation & jurisprudence; D007558:Italy; D016365:Liability, Legal; D009784:Occupational Diseases / Q000209:etiology*; D009787:Occupational Medicine / Q000331:legislation & jurisprudence / Q000379:methods*; D015985:Precipitating Factors; D011336:Probability; D018570:Risk Assessment / Q000331:legislation & jurisprudence / Q000379:methods*