Disability and work: fitness for work judgement

The role of physicians, in particular those dealing with health promotion in the workplace, takes on a specific meaning in relation to the difficulties that disabled people encounter both in order to reach the workplace and to reconcile their working activity with the difficulties that result from their condition. Observing the data concerning employment of disabled persons in Italy, it becomes dramatically evident that among the disabled subjects of working age only 17% are employed. OBJECTIVE: The objective of the occupational health physician is to recognise the impairment, study the disability and, possibly, eliminate or reduce the handicap. Achieving this target is difficult, and there is often a lack in understanding the discomforts experienced by disabled people in their working activity. Expression of a judgement of work fitness for a specific task is a particularly delicate matter, all the more so if the worker is a disabled person. A judgement of work fitness of a disabled person should include evaluation of the person's ability and an analysis of the working task and the workplace. CONCLUSIONS: Based on our experience, one can safely say that working inclusion and integration in work is possible, without any decrease in productivity, if an appropriate position is found for disabled workers. The occupational health physician has a primary role in the entire process of inclusion of disabled people at work, since he/she knows the company, the tasks, and the associated risks, and furthermore is able to assess the capabilities and abilities of the worker and can thus identify the most suitable and safe working situation.