Basic Occupational Health Services in Agriculture : an urgent goal for the healthy village campaign

Only part of the Italian agricultural workers are provided with occupational health surveillance at the workplace, with a lack of preventive activities and underreporting of occupational diseases and even mild and moderate acute pesticide poisonings. Among the reasons of this situation, the structural characteristics of agriculture, based on medium and small size family based enterprises, and on the lack of basic occupational health services (BOHSs) in the territory. Since available data highlight a significant presence of health risks in the agricultural sector, together with an unacceptably high incidence of occupational accidents, it is evident the need of actions addressed at improving and widening preventive activities, taking also in account that “prevention” in agriculture means also good quality of food and environmental health promotion. In this frame a project is running in the Region, addressed at the creation of BOHSs for agricultural workers. BOSHs will be disseminated in the territory, with a distribution based on local needs (number of workers and enterprises). BOHSs will host a complex body of activities: health surveillance, education and training; vaccinations; execution of specific laboratory and instrumental examination (electrocardiography; respiratory function examination; hearing function) together with biological specimen collection, and will also be equipped with occupational hygiene instruments, in order to fulfil any possible need of risk assessment at the workplace. Activities will be performed by specifically trained personnel. Since very often Rural GPs are the only health care providers for agricultural workers, the BOHSs project anticipates some experimental activities of collaboration between Occupational Health Physician and Rural GPs. Collaboration will be based on information exchange, with some pilot experience of electronic files sharing. The possibility of creating BOHSs in selected rural GPs services, and of asking Rural GPs to perform specific instrumental examinations will be explored. A further field of collaboration will be the conduction of health promotion activities.