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

The analysis of the national and international reference context provided by Eurostat, Eurofound and INAIL reports on workrelated diseases in recent years shows a prospective increase correlated to seniority and a more significant incidence in healthcare facilities, in particular due to the risk factors of biomechanical overload and work-related stress. These reports launch an alert for the significant increase in the working population aged over 55 by 2030, which is more significant in Italy due to the recent changes to the social security system. In this context, complex healthcare authorities have to face relevant organizational and managerial problems, also in the light of the turn-over policies implemented in recent years, as a result of the overall resources reduction in the healthcare system. This causes a considerable difficulty for healthcare authorities in maintaining the right balance between the need to protect the workers' health and that of guaranteeing business functionality and containment of public spending, with possible repercussions also on the quality of care and patient safety. In order to reduce the impact of diseconomies, inefficiencies and negative consequences on the work atmosphere, it is increasingly necessary to operate through the prevention strategies on the most important risk factors, the main causes of work restrictions, through the integrated Workplace Health Promotion (WHP) approach and Total Worker Health (TWH), aimed at combining and integrating interventions for work well-being, health promotion, disability management and safety at the workplace. The work well-being must be considered as the authorities' ability to promote and maintain the highest degree of the workers' physical, psychological and social well-being, connected to several variables linked to the risks that working activities involve, including the organizational ones. Since the human factor is a fundamental asset of the Hospital, it is necessary to always pay much attention to the workers, as persons called to cooperate with the authorities' objectives, through actions aimed at meeting the individuals' specificities and needs on the same wavelength of the authorities' needs and which can affect the improvement of the internal social system, interpersonal relationships and, in general, "the organization health". Therefore, it seems appropriate to promote the coordination of the integrated WHP activities, within a complex reality such as that of a hospital, where different areas with specific purposes can develop. To this purpose, in addition to the activities already implemented in the field of assessment and management of occupational risks and health surveillance, it cannot no longer be delayed the implementation of other activities aimed at prevention and health promotion, considered in its broadest sense, and their evaluation in order to measure their effectiveness through a set of shared indicators. In this sense, three specific lines of action have been adopted in recent years at Bambino Gesù Pediatric Hospital (OPBG), IRCCS: the first aimed at eliminating organizational constraints, a cause of personnel discomfort, a conflictual climate and, in the long term, the system inefficiency; the second concerns the health promotion actions aimed at reaching the workers' wellbeing, such as attention to correct lifestyles, oncologic prevention and chronic-degenerative pathologies, cause of most of the personnel invalidity and unsuitabili