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These days, so-called “fragile” workers, who have pathologies such as being at risk in the event of a COVID contraction, are at the center of media interest. Along with them there are also students with fragility. For both categories, the ISS has provided precise indications in the document containing “Operational indications for the management of cases and outbreaks of SARS-CoV-2 in schools and in early childhood education services”. For its part, the Ministry has already announced that operational guidelines are being defined and will be disseminated to schools.
See also
Frail Workers: CTS Restriction, Serious Illness Only Exemption
Children and students with frailty
In this context, it is necessary to guarantee the protection of students with frailty, in collaboration with the socio-sanitary structures, family medicine (eg PLS, GPs, etc.), families and the associations that represent them. The possibility of active surveillance of these students must be agreed between the school referent for COVID-19 and DdP, in accordance with / with the PLS and GPs, (remember that patients with chronic diseases in adolescence may continue to be dependent on the PLS until the age of 18. Hence the need for a primary agreement with the PLS who are in charge of most frail patients up to this age) in terms of privacy but with the aim of guaranteeing greater prevention through early identification of COVID-19 cases. Therefore, special attention should be paid to highlighting the need for priority detection in case of case reports in the same school that you attended. Special attention should be paid to students who cannot wear a mask or who have a frailty that places them at greater risk, adopting the appropriate measures to ensure the prevention of the possible spread of the SARS-CoV-2 virus and guaranteeing priority access to any screening / diagnostic tests.
The protection of the health and safety of school workers.
The protection of the health and safety of school workers is guaranteed, as for all sectors of activity, private and public, by Legislative Decree 81/08 and subsequent modifications and additions, as well as by the provisions of specific ministerial regulations ( Ministerial Decree September 29, 1998, no 382).
In the “ordinary”, if the employer, through the risk assessment process, highlights and reports in the Risk Assessment Document (DVR) the presence of one of the risks “regulated” by Legislative Decree 81/08 that , time, provides for the obligation of health surveillance, you must designate the competent doctor to carry out the medical examinations referred to in art. 41 of the aforementioned decree, intended to express the judgment of suitability for the position.
This prognosis has not changed in the current pandemic context; However, any employer in the school context must integrate the DVR with all identified measures to be implemented to contain the risk of SARS-CoV-2.
Instead, an element of novelty is art. 83 of Decree Law May 19, 2020 n. 34 and its conversion into Law July 17, 2020, n. 77 that introduced an “exceptional health surveillance”, insured by the employer, for “workers most exposed to the risk of contagion, due to their age or risk condition derived from immunosuppression, including the COVID-19 disease, or due to outcomes of oncological pathologies or by carrying out life-saving therapies or in any case due to morbidity that may characterize a greater risk ”.
As also highlighted in the Technical Document on the possible remodeling of measures to contain SARS-CoV-2 infection in the workplace and the prevention strategies approved by the CTS, from the beginning of the pandemic, epidemiological data showed clearly greater frailty in older age groups of the population in the presence of some types of chronic degenerative diseases (for example, cardiovascular, respiratory and metabolic diseases) or in the presence of diseases that affect the immune system or oncological (regardless of age) which, in case of comorbid with SARS-CoV-2 infection, can negatively affect the severity and outcome of the disease.
Therefore, the concept of frailty must be identified in the health conditions of the worker with respect to pre-existing pathologies (two or more pathologies) that could determine, in case of infection, a more serious or unfortunate outcome, also with regard to risk of exposure to contagion.
For this reason, and therefore for these so-called “fragile workers”, the employer guarantees exceptional health surveillance, at the request of the worker in question:
to. through the competent doctor if he is already designated for health surveillance in accordance with art. 41 of Legislative Decree 81/08:
yes. through a designated ad hoc competent doctor, for the emergency period, also, for example, by providing a consortium of several schools;
C. Through application to local Inail services that provide it with their own occupational doctors.
Frail Workers: CTS Restriction, Serious Illness Only Exemption
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