Epidemiological surveillance of occupational pathology: a program of the Piedmont region (PRiOR). The PRiOR Protection Group

A surveillance programme of exposures and health impairment from work (PRiOR) was developed in Piedmont Region during 1996-97, aiming to: (i) experiment and make available to the health and safety at work services methods and tools to detect currently under-reported cases of work related diseases (disease surveillance); (ii) and build up tools to predict exposure to occupational hazards (hazard surveillance). Within the framework of the disease surveillance system, an active search was carried out in hospital departments for sino-nasal cancer, pleuro-pericardial malignant mesotheliomas, bronchial asthma, and contact dermatitis (the last two diseases only when associated with hypersensitivity to agents possibly entailing occupational exposure). The programme tested and showed the feasibility of such a detection system on a regional basis; a pilot system was set up in order to collect the cases, assess them, and bring them to the attention of the health and safety at work services of the local health authorities. Case detection seems to have been rather complete, and time elapsed from first diagnosis has been kept to a minimum. The exposure histories of the collected cases show exposure patterns not only of historical, but also of current relevance. Evaluating the exposure status either by the occupational histories (neoplastic diseases) or by the hypersensitivity pattern and job title (allergic diseases), the proportion of occupationally exposed cases was remarkably high. At the end of the PRiOR programme, the active search procedures were considered to have yielded positive results. and are going to become a permanent surveillance system.