[Health surveillance and prevention in the service industries: the problems and outlook]

The great expansion of the services industry in the developed countries of the world is producing profound changes in the composition of the work force and, consequently, also in the health needs that are traditionally part of occupational medicine. Of all the medical disciplines, occupational medicine is most strongly affected by social and economic changes. In recent years experience has been acquired both at national and international level that can identify the new health needs in practical terms. The aim of this paper is to describe such experience with particular reference to the situation in Italy. The authors describe the shift of prevalent diseases from occupational to work-related diseases, the problems concerning the human, social and economic cost of these diseases, prevention and control strategies, relationships between company health services and the national health service and possible synergic action of the public and private sectors.