[Occupational diseases: when unity does not make strength]

The operating model of health and safety protection in the workplace is a complex system made up of multiple integrated layers of intervention, achieved by various parties, organizations and institutions. The objective in this study was to verify the congruity and appropriateness of these specific interventions in the Genoa area, starting from a sample of reports of musculoskeletal diseases pursuant to Art. 139 TU 1124/1965 and to Art. 365 CP received in ASL3 between years 2004 and 2014. In order to process the dossiers related to the sample, all the documentation about the companies and the workers concerned was collected and analyzed to extrapolate data relevant for evaluation of the quality of the DVR, the appropriateness and effectiveness of health surveillance and coherency of the data collected in the different computerized archives/ records containing informations for the examination of cases of occupational disease. The results show how much work remains to be done culturally in order to acquire adequate sensibleness on prevention, the poor quality of the DVR, the weakness of health surveillance intended solely as preventive and periodic examination and the inhomogeneities of information from territory to institutions and of data processing in the different databases used by local health authorities and INAIL. All this in a scenario in which the phenomenon of under-notification significantly limits the potential of information flows.