[The experiences and outlook of occupational epidemiology in Italy]

Occupational epidemiology has been developed and established in Italy thanks mainly to cancer risk studies. From these studies contributions have been derived for the identification of occupational carcinogenic agents which have received wide international recognition. However, an opportunity was missed when the question of "subjectivity" was abandoned since this is still topical and important for the identification and evaluation of exposure and notification of risk. Significant investigations have estimated the proportion of tumours that could be ascribed to occupational exposure in Italy. Another area where epidemiology in Italy has made significant contributions is the retrospective conversion of jobs in exposures to specific substances. The situation in Italy is still favourable for "record linkage" studies using census data. The main challenges awaiting occupational epidemiology in Italy concern method (for example, the use of molecular dosimetry for the assessment of internal dose or the choice of the most appropriate reference populations), the interpretation of the effects of exogenous exposure in terms of biological mechanisms (including the role of individual susceptibility), evaluation of the predictability of cytogenetic alterations, comparison with bioethical aspects, the ever closer link between occupational and environmental problems in the study of effects on industrial activity and products.