Basic occupational health services for rural workers : dream or reality?

Only part of the Italian agricultural workers is provided with occupational health surveillance. They have a lack of preventive activities and underreporting of occupational diseases and accidents. Typical characteristics of agriculture are small and family based enterprises, not covered by OHS legislation and health care facilities neither at the enterprise level nor in the territory. Since significant health and safety risks are present in the sector, actions addressed at improving and widening preventive activities are strongly needed. In this frame a project is running in the Region, addressed at the creation of BOHSs for agricultural workers. BOHSs will be spread in the territory, depending on local needs, and a complex body of activities will be there carried out; health surveillance with specific laboratory and instrumental examinations (electrocardiography; respiratory function examination; hearing function evaluation, biological specimen collection, vaccinations and education and training). Services should preferably be equipped also with occupational hygiene instruments, to fulfil any need of occupational risk assessment. 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, in some cases also through electronic files sharing. The possibility of creating BOHSs in selected rural GPs\u2019 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, such as campaigns for the prevention of cardiovascular risk. The preliminary results of our experience show that providing rural and agricultural workers with health surveillance at the workplace is a fully reachable objective and that, where BOHSs exist and are active, notifications of occupational disease increases and workers are healthier