Alessandro Lesma - Head of Corporate Health

The promotion of health is one of the areas in which Eni is ahead of the pack. Can you explain Eni's strategy in this area?
The promotion of health is a primary commitment for which the company has selected to valorise its resources. For this reason, for many years now, a program of Health Promotion has been in operation that is focused principally on the concept of prevention.
By Health Promotion we don't just mean the diagnosis and cure of professional illnesses which, thanks to the preventative measures put in place by our health surveillance structure and the rigorous application of existing norms, have diminished substantially. Today the primary aim of the health management system at Eni is prevention. The company doctor deals every day with a range of chronic pathologies that are not directly related to work but are uniformly distributed through the population: cardiovascular and metabolic diseases, tumours, etc. In fact, at every company, there is an increase in the incidence of such illnesses. A consequence of inappropriate behaviours (such as poor diet and smoking) and the continuous stresses of everyday life. The challenge facing Health Promotion is the primary and secondary prevention of these pathologies.
Primary prevention involves the elimination of the risk factors that contribute to the main illnesses and can be achieved by promoting more appropriate life styles, such as: physical activity, a healthy diet, moderate consumption of alcohol and not smoking.
In fact, an appropriate lifestyle can reduce by 60% the risk of developing chronic cardiovascular and metabolic disease, as well as cancers. At Eni prevention involves the promotion of training and information campaigns on the Health Promotion intranet site and the involvement of competent physicians. Also in the area of primary prevention, are the annual campaigns to fight against flu, online medicine, a Health Card, and a Health Manual for employees who travel and the First Aid Manual.
Secondary prevention, meanwhile, means the activation of projects aimed at the early diagnosis of disease. In recent years a number of targeted projects have involved numerous employees. Among the most important was the Early Diagnosis Program, conceived to discover cancers at the initial stage where they can be effectively treated.

Among the projects that Eni has developed in this area, which, in your opinion, have been the most important?
Certainly the Early Diagnosis Programme which aims at the permanent secondary prevention of the sort of cancers for which it has been proved that there is a real advantage in mass screening to ensure early diagnosis. Such screening, as recommended in the latest national health plan, are for cancers of the breast, uterus, colon-rectum and skin.
The program, which is available to all Eni employees around the country, is conducted in cooperation with the Italian Anti-Cancer League (Lega Italiana per la Lotta ai tumori - LILT) . Screenings for each type of cancer are carried out, free of charge and through preferential channels, at the facilities of the Institution and, where the League is not present, with local health facilities or the company's own structures that have been specially equipped, such as at Priolo in Sicily. Participation in the program is voluntary and regular internal promotional campaigns promote and encourage participation.
risk factors related to cardiovascular, metabolic and chronic illnesses among Eni employees and to activate a series of initiatives to reduce the impact on the most affected individuals, such as encouraging and facilitating physical activity and providing information on how to combine in the best way the food provided by company canteens.

In 2008, the healthcare management system was implemented in all foreign Countries
where the E&P sector is operational.

 The most important initiatives include:

• the implementation of new "Occupational Medicine and Healthcare Checks" in 5 Countries (Angola, Tunisia, Algeria, Kazakhstan – KPO, Libya);

• studies on the evaluation and updating of care plans and emergency health schemes in Croatia, Qatar, USA (Alaska) and Saudi Arabia;

• implementation of emergency health plans (MERP – Medical Emergency Response Plan) in Mozambique, Congo (IPP and M'Boundi), Mali and Kazakhstan (KPO);

• new assessments and updating of health risk management programs in 6 Countries (Angola, Libya, Mali, Pakistan, Indonesia and Russia). The implementation also continued of the GIPSI program for the IT management of individual health services relating to occupational medicine through its application in Angola, Egypt, Russia, Congo, Kazakhstan (KCO) and Italy.

As part of the "Monitoring project for cardiac risk factors in remote areas", an initial health protocol was proposed relating to the evaluation of the cardio-circulatory apparatus for people travelling abroad to work in extreme working conditions (heat, cold, humidity) and for people operating in highly stressful situations (e.g. emergencies). The "Fleet On-Line Medical Assistance" tele-medicine system was started in the gas transmission sector to support the healthcare of employees working on-board the LNG Shipping fleet and improve their medical monitoring conditions.

The Eni in Forma project is part of a program for primary preventive care that aims to encourage and provide incentives for the adoption of healthy behaviours and lifestyles that are able to reduce and/or eliminate risk factors responsible for certain illnesses such as: cardiovascular disease, metabolism and muscular deficiencies and certain forms of cancer.
According to the World Health Organisation data, 86% of deaths, 77% of loss of years of good health and 75% of health expenditure
 in Europe and in Italy are caused by pathologies that share common modifiable risk factors such as smoking, obesity and overweight, sedentary lifestyles and the abuse of alcohol.
Projects for the management and reduction of such factors, through structured programs, have shown that  there is a clear link with a decrease in the probability of contracting these degenerative illnesses and an improvement in the prognosis when the illness is already present.

Objectives of the project:

• To identify the main risk factors for cardiovascular and metabolic diseases among Eni personnel who have signed up to the initiative
• To promote, through corporate tools, (intranet, canteen, etc.) guidelines for healthy behaviour and lifestyle
• To strengthen, within the company, a culture of health that employees can make use of in their private lives

Project structure:

• Investigation phase

During 2008, through the corporate intranet, all employees received an online questionnaire, elaborated by the Neuro-Vegetative Therapy Research Centre of the Department of Clinical Science, at the University of Milan.
The replies to the questionnaires allowed to have an overview of the state of risk and of the improvement areas among Eni's employees. The same questionnaire will be sent out again after about a year in order to assess the improvements made.

• Data analysis

The questionnaire was managed directly and completely by the University of Milan, which guaranteed data privacy, anonymity as well as the statistical data processing of the results which were delivered anonymously and collectively to the company.

• Specific actions

Two types of actions have been implemented:
- Training and information actions have been developed on the company's intranet site, through the publication of articles, advice, quizzes, tests, film clips of good relaxation exercises, relating to the issues to be examined, highlighted by the replies to the questionnaire.

- Actions have also been taken to encourage physical exercise and a healthy diet (Welfare Project)

The results of the project

The survey involved 973 employees, a representative sample from across Eni, in terms of categories and age bands. 
With regard to lifestyle, 52.3% of participants have a completely sedentary life, and a good 49.2% of them would like to change and take regular exercise. Only 17.9% of the sample has a sufficient dose of physical activity.
81.7% of the sample is made up of non-smokers. Among smokers, 43.7% claim to want to give up now. 24.2% say that they do not drink alcohol, and around 60% state that they do not drink more than one glass of wine per day.
The area in which the majority would like to see their lifestyle improve is in the quantity of physical exercise (49.6%), followed by a greater ability to manage life's priorities (24%), to have a more appropriate diet (20.4%) and by stopping smoking (6%).