Atti del 52° Congresso Nazionale: Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI)

eir activity, through a global, coherent and progressive approach implemented by the company. On an international level, DM is widely used in the public field, such as, for example, in the Canadian government, where this method is implemented to prevent and manage absences from work due to illness or injury, with tools such as sick leave, but also planning of benefits and adjustments of professional duties when returning to work. The possibility for the workers to be assigned a different duty, in order to work to the best of their abilities, besides being a shared value, in this country is a legal obligation. The professional profile responsible for the overall process of the socio-working integration of people with disabilities, in charge of planning, research and selection, insertion and retention in the company, up to the professional and organizational development, is known as Disability Manager. Its origin has to be considered within the Public Administration in which, especially within the Italian Municipalities, it finds its specific location. In comparison with countries in which this professional profile has existed for the past 30 years, the Lombardia Region has recently recognized the professional profile of the Disability Manager (Regional Decree No. 2922 of March 1, 2018) . Beyond the regulatory evolution and the recognition of professionalism, the Disability Manager profile has already been introduced in several large companies that have by now many years of experience in the field. In the health field there are also different experiences carried out in some hospitals, i.e. health agencies such as the Local Health Unit 4 of eastern Veneto and private companies. In this regard, the experience and the company role of the competent physician make her/him as one of the most authoritative candidates to hold such position within the companies. A DM program started in 2011 within IRCCS Bambino Gesù Children's Hospital, which serves as a national and international reference for its clinical excellence and translational research. In this context, the distribution of work restrictions by risk factor highlights how the main causes are the ergonomic factors and the organizational risks, on which the main preventive actions have been focused. In fact, the improvement actions have concentrated on limiting the risk from biomechanical overload/manual patient movement (MPM) and on the activities necessary for the organizational well-being. In this regard, health and safety promotion initiatives have been implemented together with the Health Department (HD) (ad example, food education courses, on-the-job training on correct maneuvers in the MPM, anti-flu vaccination campaign). Occupational Medicine (OM) has collaborated in developing proposals for the ergonomic requalification of spaces (ceiling lifts, robotization systems for drugs preparation, corporate back school, etc.). Furthermore, in 2011 an ad hoc Working Group (WG) was set-up starting managing the so-called "difficult suitability", with the aim of replacing the cases with limitation and, at the same time, identifying the "full" suitability for the assigned task. The WG, coordinated by the Head of OM, is constituted by competent physicians, members of Human Resources (HR) Department and the HD; it meets periodically on a monthly basis. During the last two years, through DM programs, 700 assessments have been carried for about 150 workers (5% of health personnel), mostly women (about