key: cord-0968950-x9ji7x3x
authors: Mutti, Antonio
title: Tailored prevention in occupational and environmental health
date: 2020-11-25
journal: Med Lav
DOI: 10.23749/mdl.v111i6.11021
sha: 90c1ea020fac525db2ed8c299ba827314a41cb13
doc_id: 968950
cord_uid: x9ji7x3x

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mutti 424 tion by SARS-CoV-2, and for age-related differences in COVID-19 prevalence and especially outcome. Telemedicine is also expected to benefit from constraints imposed by COVD-19 pandemic. Occupational telemedicine should be worker-centric, and should provide tools for multidisciplinary assessment by occupational health physicians, general practitioners, and specialists as needed by a tailored approach. A safe return to work after a severe infectious disease such as COVID-19 could require a collegial examination, which is easier to organise relying on telemedicine. The need for a multidisciplinary assessment, however, will not reduce the role and the responsibility of occupational physicians, who are expected to be compliant with their ethically binding mandate consisting of workers' health protection.

Mixing exposure settings can give rise to spurious findings, which increase with the number of variables. Extrapolation to individual health will always be challenging, even if assisted by artificial intelligence. Moreover, observed changes in patterns (omics) are transient, and timing is tricky.

For diagnostic purposes, the strength of associations is perhaps more critical than their causality, the probability of a correct classification being more important than the underlying pathophysiological mechanism. On the contrary, primary prevention can only be effective is relevant causal agents are removed. This is why genomics and proteomics and all other "omics" are promising for diagnosis, and perhaps for therapy. For prevention, the recognition of the actual causes of diseases would be crucial for subsequent intervention aimed at removing them, as our primary objective remains ensuring that the workplace and the environment are safe for all.

Antonio Mutti

Personalised Medicine: implication and perspectives in the field of occupational health

Precision Public Health for the Era of Precision Medicine

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