Stress at Work: Risk Evaluation and Prevention / Le stress au travail : évaluation du risque et prévention / Lo stress nel lavoro: valutazione del rischio e prevenzione

The “psychological” definition of stress, in which cognitive evaluation is the triggering element, and the “psychoneuroendocrine” definition (by Hans Selye) in which the triggering element is made up of complex biochemical and humoral events, among which the cognitive component, are compared to each other. The references to Selye's studies, the definition of health as a perfectible process of physical, mental and social well being, and the analysis of work processes according to the Theory of Organizational Action, allow a complete risk evaluation and the primary prevention of work stress. Many of the studies of the Organization and Well-being Programme, conducted in the manufacturing, artisanal, tertiary services, hospital and local health care sectors, before the EU norms and the 2004 European Agreements on stress were implemented, make this point clear

Theories on stress / Teorie sullo stress

Two theories on stress are introduced. The first one proposes the unification of the two great research traditions on stress, biological and psychological, within a systemic science, psychoneuroendocrineimmunologic, aimed at both explaining the complex interaction between different levels of stress incidence on health and disease, and integrating the care of the others and the care of oneself. The other theory, oriented towards the study and the improvement of human being's condition, especially well-being at work, criticizes the psychological interpretative perspectives. According to this theory, stress is conceived as a psychoneuroendocrineimmune process, while health and prevention are seen as perfectible processes. Several differences, compatible elements as well as synergies between the two theories emerge

Work analysis for prevention according to the "Organization and Well-being" Program / L’analyse du travail pour la prévention selon le Programme « Organization and Well-being » / L’analisi del lavoro per la prevenzione secondo il Programma “Organization and Well-being”

A case study concerns a public health service where work analysis, oriented towards primary prevention, is repeatedly performed over a long period of time. The goal is to present the approach of the Interdisciplinary Research Program “Organization and Well-Being”, that has been active for three decades. This approach is based on the Organizational Action Theory and concerns the analysis of work processes’ regulation. It takes care of the well-being of people at work and implies that the analysis, carried out by the workers themselves, coincides with the transformation of the work processes. The debate is open about the possible connections between this approach and the ones that share the same epistemological premises

Le travail de soudure pour l’ingénierie nucléaire / Il lavoro di saldatura per l’ingegneria nucleare

A welding work process in a plant for the production of heavy components for the nuclear industry is analyzed through two different methodologies. The first analysis concerns the work of welders, according to the Méthode de l’Auto-confrontation, proposed by Daniel Faïta and widely utilized in France. An organizational analysis, extended to a biomedical analysis of health and safety conditions of workers, concerns the whole welding process, according to the Method of Organizational Congruences, proposed by Bruno Maggi, and adopted for three decades within the Interdisciplinary Research Program “Organization and Well-being”. The two methods’ complementarity and synergy, already discussed in previous publications, are emphasized both in diagnostic terms and in relation to possible work transformations aimed at improving effectiveness, efficiency and workers’ well-being

Lavoro organizzato e salute in un laboratorio di analisi cliniche

This contribution presents the main results of a research aimed at interpreting the relationships between organized work and workers' health in a clinical analysis laboratory. The analysis has been carried out in the biomedical laboratory of the Desio hospital, by adopting the Method of Organizational Congruencies. All units operating within the laboratory were studied in detail by means of MOC. The analysis allowed to identify, for each technical action, the typical elements of organizational constraint, and to suggest different organizational choices. It was also possible to plan detailed biomedical analysis to assess operators’ distress and to prearrange specific measures of primary and secondary prevention

Well-being, Prevention, Risk / Benessere, Prevenzione, Rischio / Bien-être, Prévention, Risque / Bienestar, Prevención, Riesgo / Bem-estar, Prevenção, Risco / Wohlbefinden, Vorbeugung, Risiko

The etymology and the development of the meanings of well-being, prevention and risk, as well as their relationships, are presented and discussed. It is reminded that the World Health Organization defined health as physical, mental and social well-being, and that the European Union prescribed a general and programmed primary prevention, integrated with the design of work situations. However, current interpretations and practices mistake well-being with wellness, and prevention with the management of existing risks, while usually attributing the responsibility to the acting subjects in the workplace. The Interdisciplinary Research Program “Organization and Well-being”, for over three decades, has interpreted well-being as a perfectible process, and outlined pathways of work analysis that actually carry out primary prevention

Prevention at work and stress evaluation in France and in Italy / La prévention sur les lieux de travail et l’évaluation du stress en France et en Italie / Prevenzione nei luoghi di lavoro e valutazione dello stress in Francia e in Italia

A European directive, transposed into the legal systems of the member States, steers towards an idea of prevention that is primary, general, programmed and integrated in work design. The interpretation of norms and the guidelines of institutions devoted to health and safety in the workplace direct, however, towards the management of existing risks. This is particularly evident as far as stress and the so called psycho-social risks are concerned. Even the approaches of disciplines regarding work follow the same trend. A real and effective protection of well-being appears to be neglected, and this is confirmed by statistics about physical and psychological damages to workers. The contributions in this collection concern France and Italy, where, however, internationally recognized approaches, allowing primary prevention interventions on work, have been developed

Ventilation, oxidative stress and risk of brain injury in preterm newborn

Preterm infants have an increased risk of cognitive and behavioral deficits and cerebral palsy compared to term born babies. Especially before 32 weeks of gestation, infants may require respiratory support, but at the same time, ventilation is known to induce oxidative stress, increasing the risk of brain injury. Ventilation may cause brain damage through two pathways: localized cerebral inflammatory response and hemodynamic instability. During ventilation, the most important causes of pro-inflammatory cytokine release are oxygen toxicity, barotrauma and volutrauma. The purpose of this review was to analyze the mechanism of ventilation-induced lung injury (VILI) and the relationship between brain injury and VILI in order to provide the safest possible respiratory support to a premature baby. As gentle ventilation from the delivery room is needed to reduce VILI, it is recommended to start ventilation with 21-30% oxygen, prefer a non-invasive respiratory approach and, if mechanical ventilation is required, prefer low Positive End-Expiratory Pressure and tidal volume

Ergonomic analysis and organizational analysis for prevention / Analyse ergonomique et analyse organisationnelle pour la prévention / Analisi ergonomica e analisi organizzativa per la prevenzione

The ergonomic analysis of work activities, typical of the francophone tradition, may usefully benefit from the organizational analysis that considers the well-being of the subjects of the action processes. According to the theory of organizational action, this encounter is possible: the method it proposes allows the integration of biomedical analysis and ergonomic analysis for the purpose of prevention in the workplace. A seminar of the Interdisciplinary Research Program “Organization and Well-being”, with the example of an ergonomic analysis of airline pilots’ activity and an organizational analysis of a work situation in large archives, shows the compatibility and the possible synergies between the two research paths

Decreto Legislativo 81/2008. Quale prevenzione nei luoghi di lavoro?

A contribution in the medical field illustrates the historical evolution of the concepts of prevention and health to which it is necessary to refer for a discussion about health and safety in the workplace. Some contributions in the fields of labor law and organizational theory interpret the norms currently effective in Italy and the guidelines for the assessment of risks in work situations. What conception of prevention is implicitly assumed by the norms, and by the guidelines that the norms indicate? Are the current norms adequate to stimulate organizational choices aimed at preventing risks and discouraging harmful choices? Limits and contradictions hindering a real, effective, primary prevention are emphasized