Fitness for work in health care workers across ethics, science and good practices: introductory remarks

Fitness for work (FfW) judgement is the final task of both risk assessment and health surveillance, aimed at protecting workers’ health and working capacity. Numerous are the specific concerns regarding health care workers. In particular: i) the frequent difficulty to determine at pre-employment/pre-placement examinations the specific task that the individual worker will perform; ii) the prevalence of female workers and the contemporary presence of numerous occupational risk factors that are potential cause of harmful effects on women's reproductive health; iii) the progressive aging of the staff, especially nurses; iv) the risk to third parties, with particular reference to the issues of biological risk and abuse of substances, also in relation to shift work, fatigue and occupational stress; v) the increasing number of immigrant workers among support staff.In such cases the occupational physician, in respect of both ethical principles and regulations and with an appropriate balance between scientific evidence and the precautionary principle, should express a FfW judgement that allows both the adaptation of work to the worker and vice versa, as recommended by the World Health Organization (WHO) and the International Commission on Occupational Health (ICOH). Proper FfW judgement allows also to achieve the expected benefits, not only for the workers but also for employers, companies and the society.