CONTROL AND SURVEILLANCE

The National Center for Chemicals, Cosmetics and Consumer Protection (in Italian CNSC) at the National Institute of Health was entrusted with the surveillance of chemicals by the Decree of the Italian Ministry of Health of March 2, 2016 “Approvazione del regolamento di organizzazione e funzionamento dell’Istituto Superiore di Sanità, ai sensi dell’articolo 3 del decreto legislativo 28 giugno 2012, n. 106, Gazzetta Ufficiale [Official Gazette of Italian Republic] n. 88, 15 aprile 2016. The Decree on Registries and Surveys of March 3, 2017 “Identificazione dei sistemi di sorveglianza e dei registri di mortalità, di tumori e di altre patologie”, Gazzetta Ufficiale [Official Gazette of Italian Republic] n.109, 12 maggio 2017, entrusted the ISS as the site of the National Informative System for Surveillance of Toxic Exposures and Poisonings (in Italian SIN-SEPI) and as the national contact for prevention and surveillance activities on chemical exposures and intoxications. Through these activities the CNSC provides scientific evidences to the Ministry of Health in order to promote prevention strategies. 

The surveillance activity is based on the collaboration of the Italian Poison Centers (PCs) whose rules and activities are defined by the Agreement of the Permanent Conference “Italian State-Regions”, 28th February 2008. 

The SIN-SEPI activity is essential to identify chemical products on the market which are more involved in intoxication cases. These products require the adoption of preventive measures (e.g. modification of the packaging or revision of methods of use) in order to reduce their related risk of exposure. Data collected by the National PCs also make it possible to monitor exposures within groups of population by studying the association between different age classes, gender and environments (occupational and domestic), in order to differentiate the risk assessment and to identify Evidence Based Prevention strategies. Furthermore, it is possible to propose risk management measures and to verify the compliance to the requirements established by European provisions. In particular, the requirements concerning the hazard of the mixtures, their classification and the information needed to ensure their correct use, must be verified (REACH and CLP regulations). 

To collect data two ways were followed:  
•    collecting data yearly. It includes the consultancies managed year by year by each PC for the elaboration of annual reports useful to support health professionals;  
•    collecting data in real time through the Online Surveillance Card. PC toxicologists can  report cases for prompt surveillance actions in order to identify  potentially dangerous events of exposure/intoxication to chemicals. The impact of these events on the general population can be tested by analysing annual data.