The challenges of managing patients with cancer in the workplace: Needs, opportunities and perspectives of occupational physicians

Cancer is a global major public health problem since it is a leading cause of death, accounting for nearly 10 million deaths in 2020 worldwide and the most recent epidemiological data suggested that its global impact is growing significantly. In this context, cancer survivors have to live for a long time often in a condition of disability due to the long-term consequences, both physical and psychological. These difficulties can seriously impair their working ability, limiting the employability. In this context, the occupational physician plays a key role in the implementation and enforcement of measures to support the workers affected by cancer, to address issues such as the information on health promotion, the analysis of work capacity and the management of disability at work and also promoting a timely and effective return to work and preserving their employability. Therefore, the aim of this study was to gather useful information to support the occupational physicians in the management of workers affected by cancer, through a survey on 157 Italian occupational physicians. Based on the interviewees' opinions, the most useful occupational safety and health professionals in terms of job retention and preservation of workers affected by cancer are the employers and the occupational physicians themselves, whose role is crucial in identifying and applying the most effective reasonable accommodations that should be provided to the workers affected by cancer. The provision of these accommodations take place on the occasion of mandatory health surveillance medical examination to which the worker affected by cancer is subjected when he returns to work. Results on training and information needs showed that the management of the workers affected by cancer is essentially centered on an appropriate fitness for work judgment and on the correct performance of health surveillance. However, an effective and successful management model should be based on a multidisciplinary and integrated approach that, from the earliest stages of the disease, involves the occupational physicians and employers

Correlations Between Gender, Age, and Occupational Factors on the Work Ability Index Among Healthcare Professionals

Background: The Work Ability Index (WAI) measures how well employees' abilities match their job demands. This study assessed the WAI among health workers and explored how age, gender, and job roles affected it. The research was conducted in a central Italian hospital, with a focus on health workers undergoing health surveillance between September 2020 and April 2021. Methods: Data were collected using validated questionnaires that assessed the WAI and risk factors for metabolic syndrome among participants. Demographic information, including age, gender, and occupation, was also obtained. The study involved 1847 health workers, with an average age of 43 years, predominantly women (67.6%). Occupational categories included administrative staff, nurses/healthcare workers (HCWs)/midwives, physicians, and healthcare technicians. Statistical analyses, such as t-tests, ANOVA, and chi-squared tests, were performed to explore the relationships between WAI scores and demographic/occupational variables. Results: The study suggested a relationship between WAI scores and gender, age, and occupation. Men workers exhibited higher mean WAI scores than women workers, while older workers (>55 years) had lower WAI scores compared with their younger counterparts. WAI scores varied by job role, with physicians scoring the highest. Conclusions: The findings suggested that demographic and occupational factors were associated with variations in work ability among health workers. These findings can help improve workforce management, occupational health, and research on aging workers. However, it is important to acknowledge the limitations of this study. Given its cross-sectional design, causal inferences cannot be established, and further longitudinal research is needed to confirm these findings and explore potential causal relationships

Recent progress in understanding and predicting Atlantic decadal climate variability

Recent Atlantic climate prediction studies are an exciting new contribution to an extensive body of research on Atlantic decadal variability and predictability that has long emphasized the unique role of the Atlantic Ocean in modulating the surface climate. We present a survey of the foundations and frontiers in our understanding of Atlantic variability mechanisms, the role of the Atlantic Meridional Overturning Circulation (AMOC), and our present capacity for putting that understanding into practice in actual climate prediction systems

Reconstructing extreme AMOC events through nudging of the ocean surface: a perfect model approach

While the Atlantic Meridional Overturning Circulation (AMOC) is thought to be a crucial component of the North Atlantic climate, past changes in its strength are challenging to quantify, and only limited information is available. In this study, we use a perfect model approach with the IPSL-CM5A-LR model to assess the performance of several surface nudging techniques in reconstructing the variability of the AMOC. Special attention is given to the reproducibility of an extreme positive AMOC peak from a preindustrial control simulation. Nudging includes standard relaxation techniques towards the sea surface temperature and salinity anomalies of this target control simulation, and/or the prescription of the wind-stress fields. Surface nudging approaches using standard fixed restoring terms succeed in reproducing most of the target AMOC variability, including the timing of the extreme event, but systematically underestimate its amplitude. A detailed analysis of the AMOC variability mechanisms reveals that the underestimation of the extreme AMOC maximum comes from a deficit in the formation of the dense water masses in the main convection region, located south of Iceland in the model. This issue is largely corrected after introducing a novel surface nudging approach, which uses a varying restoring coefficient that is proportional to the simulated mixed layer depth, which, in essence, keeps the restoring time scale constant. This new technique substantially improves water mass transformation in the regions of convection, and in particular, the formation of the densest waters, which are key for the representation of the AMOC extreme. It is therefore a promising strategy that may help to better constrain the AMOC variability and other ocean features in the models. As this restoring technique only uses surface data, for which better and longer observations are available, it opens up opportunities for improved reconstructions of the AMOC over the last few decades

IMPAcT-RLS2: Indagine nazionale sulla salute e la sicurezza sul lavoro: il ruolo dei Rappresentanti dei Lavoratori per la Sicurezza

L’Indagine IMPAcT-RLS2 si inserisce nel più ampio programma di ricerca INSuLa2, la cui prima edizione, condotta nel 2014 e rivolta a tutti gli attori della prevenzione, ha approfondito aspetti della tutela della salute e sicurezza sul lavoro (SSL) secondo il punto di vista delle varie figure intervistate. La survey indirizzata ai Rappresentanti dei lavoratori per la sicurezza (RLS), focalizzata inizialmente su tre contesti regionali, è stata implementata grazie all’indagine IMPAcT-RLS, realizzata nel 2016, che ha coinvolto un campione di circa 2.100 soggetti, rappresentativo a livello nazionale, per dimensione aziendale e settore di attività economica. L’indagine ha evidenziato l’importanza di disporre di informazioni sempre più approfondite sul ruolo dei RLS e di monitorarne l’andamento nel tempo. Il presente studio ribadisce l’importanza di istituire rilevazioni periodiche e replicabili, finalizzate ad aumentare le conoscenze e la consapevolezza sui sistemi di prevenzione e promuovere interventi sempre più mirati per il miglioramento della tutela della SSL.The IMPAcT-RLS2 survey is part of a larger context of INSuLa2 research program; its first edition was conducted in 2014 and targeted to all prevention professionals, investigating occupational health and safety (OSH) protection issues perceived by the various professionals’ point of view. The survey addressed to Health and Safety Representatives (HS reps.), focused on three regional contexts, was further implemented in 2016 through the IMPAcT-RLS survey, which involved a sample representative at national level, by company size and economic activity sector consisting of about 2,100 subjects. The survey highlighted the importance of having ever more in-depth information on the role of HS reps. and monitoring their evolution over time. This study arises from the need to create periodic and replicable surveys, aimed at increasing knowledge and awareness of prevention systems and promoting increasingly targeted interventions for improving the protection of OS