[Relations of the competent physician, the dependent or independent professional and the S.S.N]

The specialist who is appointed by an employer as a competent physician in an occupational medicine service, has been charged of new public legal tasks, as a result of the changes introduced by Legislative Decree No. 81/08, setting him in a direct relationship with the National Health Service; in particular the Article 40 of decree 81 assigns a strategic role for prevention of new occupational diseases and injuries to the competent physician, as a primary source of epidemiological information, able to bring out "sentinel events" in the population of workers undergoing health surveillance, by the communication to the relevant public health services of combined aggregate data as required by Annex 3B. In a second step such information shall be processed and analyzed on a national scale by Italian Workers'Compensation Authority (INAIL), in order to improve the knowledge useful to a more effective and prompt prevention. The new possibility, introduced by Legislative Decree 106/09, to carry out pre-employment visits as a part of health surveillance, allows the competent physician to establish the fitness to the work of involved persons, a task that was previously assigned by law 300/70 to public bodies only, allowing him to check for alcohol and drug addiction at such stage too, provided the involvement of public health facilities of II level (referred to State/Regions Agreement of September 18, 2008) for relevant clinical examinations for verification purposes.