The surveillance of occupational diseases in Italy: the MALPROF system.
BACKGROUND
Occupational diseases data can guide efforts to improve worker's health and safety.


OBJECTIVE
To describe MALPROF, the Italian system for surveillance of work-related diseases collected by the subregional Department of Prevention.


METHODS
The MALPROF system started in 1999 with contributions from Lombardy and Tuscany and spread in the following years to collect contributions from 14 out of the 20 Italian regions. MALPROF data were explored to follow-up work-related diseases and to detect emerging occupational health risks by calculating proportional reporting ratio (PRR), as in pharmacosurveillance. It classified work-related diseases according to economic sector and job activity in which the exposure occurred. Occupational physicians of the Italian National Health Service evaluate the possible causal relationship with occupational exposures and store the data in a centralized database.


RESULTS
From 1999 to 2012, the MALPROF system collected about 112000 cases of workers' diseases. In 2010, more than 13000 cases of occupational diseases were reported. The most frequently reported diseases were hearing loss (n = 4378, 32%), spine disorders (n = 2394, 17%) and carpal tunnel syndrome (n = 1560, 11%). The PRR calculated for cervical disc herniation, a disease whose occupational origin has to be studied, in 1999-2010 was 2.47 [95% confidence interval (CI) 1.76-3.47] for drivers and 36.64 (95% CI 22.03-60.93) for air transport workers.


CONCLUSIONS
MALPROF is a sensitive system for identifying possible associations between occupational risks and diseases, it can contribute to the development of preventive measures, to evaluate the effectiveness of preventive interventions and to stimulate research on new occupational risks and diseases.
Department of Work and Environmental Medicine, Epidemiology and Hygiene, National Institute for Insurance against Accidents at Work (INAIL), Via Ferruzzi 38-40, 00143 Rome, Italy, g.campo@inail.it.
G
G
Campo
Department of Work and Environmental Medicine, Epidemiology and Hygiene, National Institute for Insurance against Accidents at Work (INAIL), Via Ferruzzi 38-40, 00143 Rome, Italy.
A
A
Papale
CeRIMP-Regional Centre for Occupational Diseases and Injuries, Tuscany Region, Florence, Italy.
A
A
Baldasseroni
Department of Prevention, ASL Bari, Italy.
G
G
Di Leone
Department of Prevention, ASL Milano, Italy.
B
B
Magna
Department of Work and Environmental Medicine, Epidemiology and Hygiene, National Institute for Insurance against Accidents at Work (INAIL), Via Ferruzzi 38-40, 00143 Rome, Italy.
B
B
Martini
Department of Medical and Surgical Sciences, University of Bologna, Italy.
S
S
Mattioli
D002349:Carpal Tunnel Syndrome / Q000453:epidemiology* / Q000517:prevention & control; D034381:Hearing Loss / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007558:Italy / Q000453:epidemiology; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000517:prevention & control; D009313:National Health Programs; D009784:Occupational Diseases / Q000453:epidemiology* / Q000517:prevention & control; D016273:Occupational Exposure / Q000009:adverse effects*; D016272:Occupational Health; D011159:Population Surveillance; D011322:Primary Prevention / Q000458:organization & administration*; D012040:Regional Health Planning; D017751:Safety Management; D013124:Spinal Injuries / Q000453:epidemiology* / Q000517:prevention & control; D014942:Workers' Compensation / Q000706:statistics & numerical data
Aetiology; medical surveillance; occupational disease; occupational epidemiology; population.