Abstract

Background: Endometriosis is a chronic condition affecting a substantial proportion of women of reproductive age and leading to impaired quality of life. Despite its potential occupational implications, evidence on how occupational physicians (OPs) manage workers affected by endometriosis remains scarce. This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding endometriosis among Italian OPs. Methods: A cross-sectional web-based survey was conducted between 1 and 18 April 2026 by recruiting a convenience sample of 155 occupational physicians. The questionnaire was specifically designed and investigated knowledge status, risk perception, perceived barriers to workplace management, and previous experience of participating professionals. Results: Most respondents considered themselves adequately informed about endometriosis (78.1%) and reported previous professional experience with affected workers (81.3%). Knowledge gaps were identified, particularly regarding disease prevalence (26.5% correct responses), familial predisposition (34.8%), and diagnostic pathways (31.6%). Overall, 65.8% of participants reported having previously issued conditioned fitness-for-work appraisals, most frequently recommending increased work breaks, avoidance of night shifts, or limitations on shift work. In multivariable analysis, male gender (adjusted odds ratio [aOR] 5.69, 95% confidence interval [95% CI] 1.84–17.58), participation in continuing medical education activities (aOR 85.72, 95% CI 6.60–1114.21), information obtained from colleagues (aOR 4.67, 95% CI 1.23–17.77), and employment in healthcare settings (aOR 5.91, 95% CI 1.92–18.16) were independently associated with having previously issued restricted fitness-for-work judgments, whereas relying exclusively on undergraduate medical education was negatively associated with this outcome (aOR 0.07, 95% CI 0.01–0.39). Conclusions: Among the sampled Italian OPs, endometriosis was recognized as a clinically relevant condition frequently encountered in daily practice. Continuous professional education, interdisciplinary exchange, and practical experience were more strongly associated with occupational decision-making than undergraduate training alone. These findings support the development of targeted educational interventions and shared occupational recommendations aimed at improving workplace management and promoting the inclusion and retention of women affected by endometriosis in the workforce.

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