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BACKGROUND: Occupational biomonitoring is essential for assessing health risks linked to workplace exposures. The use of 'omics' technologies, such as metabolomics and proteomics, has become crucial in detecting subtle biological alterations induced by occupational hazards, thereby opening novel avenues for biomarker discovery. AIMS: This systematic review aims to evaluate the application of metabolomics and proteomics in occupational health. METHODS: Following the PRISMA guidelines, we conducted a comprehensive search on PubMed, Scopus, and Web of Science for original human studies that use metabolomics or proteomics to assess occupational exposure biomarkers. The risk of bias was assessed by adapting the Cochrane Collaboration tool and the Newcastle-Ottawa Quality Assessment Scale. RESULTS: Of 2311 initially identified articles, 85 met the eligibility criteria. These studies were mainly conducted in China, Europe, and the United States of America, covering a wide range of occupational exposures. The findings revealed that metabolomics and proteomics approaches effectively identified biomarkers related to chemical, physical, biomechanical, and psychosocial hazards. Analytical methods varied, with mass spectrometry-based techniques emerging as the most prevalent. The risk of bias was generally low to moderate, with specific concerns about exposure measurement and confounding factors. CONCLUSIONS: Integrating metabolomics and proteomics in occupational health biomonitoring significantly advances our understanding of exposure effects and facilitates the development of personalized preventive interventions. However, challenges remain regarding the complexity of data analysis, biomarker specificity, and the translation of findings into preventive measures. Future research should focus on longitudinal studies and biomarker validation across diverse populations to improve the reliability and applicability of occupational health interventions.
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Introduction: The increasing prevalence ofsedentary behavior at work, which has been exacerbated by technological advancement and remote work models, can compromise worker health, leading to both physical and mental problems. Increasing research on sedentary behavior has resulted in interventions such as active breaks. Objectives: This study addresses the impact of sedentary behavior at work and the effects of active breaks. Methods: This descriptive-exploratory study with a mixed-methods approach included 70 professionals of both sexes, 86% women (35.2 [SD, 10.2] years) and 14% men (33.5 [SD, 11] years), who worked remotely in administrative roles. The intervention was a 25-week active break protocol involving lectures, a questionnaire, and an app. Results: At the end of the intervention, 64% of participants were taking active breaks. Spending > 10 hours a day in sedentary behavior reduced significantly (from 31% to 14%), as did the proportion of workers who did not exercise (from 43% to 26%; p = 0.002). There were also reductions in post-lunch sleepiness, perceived stress (p < 0.01), and pain/discomfort (p < 0.01). Conclusions: Management programs for sedentary behavior should consider the use of active breaks, since they can reduce sedentary behavior and perceived sleepiness, stress, and pain. This will result in a healthier work environment, increasing employee quality of life as well as company productivity.
Introdução: Com a predominância do sedentarismo ocupacional, agravado pelo avanço tecnológico e pelo trabalho remoto, a saúde dos trabalhadores pode ser comprometida, incluindo problemas físicos e mentais, o que faz com que estudos sobre o comportamento sedentário e intervenções como pausas ativas ganhem destaque. Objetivos: O estudo aborda o impacto do sedentarismo no ambiente de trabalho e a relevância das pausas ativas para mitigar seus efeitos. Métodos: Tratou-se de estudo descritivo-exploratório com abordagem qualiquantitativa, realizado com 70 profissionais de ambos os sexos, 86% mulheres (35,2±10,2 anos) e 14% homens (33,5±11 anos). Todos trabalhavam remotamente em funções administrativas. Os participantes foram orientados a seguir uma rotina de pausas ativas durante 25 semanas. O estudo usou palestras, um questionário e um aplicativo para a prática. Resultados: Dos participantes, 64% adotaram as pausas ativas após a intervenção. Foi observada uma redução significativa no tempo sedentário (superior a 10 horas), de 31 para 14%, e no número de trabalhadores que não se exercitavam, de 43 para 26% (p = 0,002). Notou-se também uma redução na sonolência após o almoço, na percepção do estresse (p < 0,01) e nas dores e/ou desconforto no corpo (p < 0,01). Conclusões: A rotina de pausas ativas parece ser uma estratégia para diminuir o comportamento sedentário e melhorar a percepção quanto a sonolência, estresse e dores. Portanto, a implementação de programas de gestão ativa do comportamento sedentário, por meio de pausas ativas, pode proporcionar um ambiente de trabalho mais produtivo e saudável, beneficiando a qualidade de vida dos funcionários e a produtividade da empresa.
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Reflecting on the complexity and impacts of determination of the causal relationship between health problems of workers and the exercise of their work activities, there is a need to learn about scientific articles that expose techniques to determine this type of causal relationship. There is also a need to reveal whether any article exposes multicriteria decision analysis technique. The aim is to quantify the techniques used to determine the causal relationship between health problems of workers and the exercise of their work activities. Bibliometric analysis was performed, searching for articles in Portuguese, Spanish and English. An advanced search was performed on the website of the ministerial journals portal and then on the Gale Academic OneFile, SciVerse Scopus, Scientific Electronic Library Online (SciELO) and PubMed Central collections. In summary, 38 articles were selected from portal, 50 from Gale Academic OneFile, 20 from SciVerse Scopus, 37 from SciELO and 5 from PubMed Central, totaling 150 articles of interest for analysis of their contents. Among these 150 articles, 33.33% addressed the causal relationship between illness and work, 3.33% described some process related to occupational diagnostic investigation and 0.66%, which represents only one article, exhibited a technique to determine this type of causal relationship: the probability of causality in neoplastic diseases. No article described multicriteria decision analysis method as a technique for determine this type of causal relationship. Therefore, there is a need to carry out and disseminate scientific research on methods to help determine a causal relationship between illness and work.
Ao refletir sobre a complexidade e os impactos do estabelecimento do nexo causal entre o agravo à saúde dos trabalhadores e o exercício de suas atividades laborais, surge a necessidade de conhecer artigos científicos que expõem técnicas para estabelecer esse tipo de nexo. Surge também a necessidade de revelar se algum artigo expõe auxílio multicritério à decisão. O objetivo foi quantificar as técnicas utilizadas no estabelecimento do nexo causal entre o agravo à saúde dos trabalhadores e o exercício de suas atividades laborais. Foi realizada uma análise bibliométrica, buscando artigos em português, espanhol e inglês. Realizou-se uma busca avançada no site do portal ministerial de periódicos e, em seguida, nas coleções Gale Academic OneFile, SciVerse Scopus, Scientific Electronic Library Online (SciELO) e PubMed Central. Em síntese, foram selecionados 38 artigos do portal ministerial de periódicos, 50 da Gale Academic OneFile, 20 da SciVerse Scopus, 37 do SciELO e 5 da PubMed Central, totalizando 150 artigos para análise de conteúdo. Entre esses 150 artigos, 33,33% abordavam o nexo causal entre doença e trabalho, 3,33% descreviam algum processo relacionado à investigação diagnóstica ocupacional, e 0,66%, o que representa apenas um artigo, exibia uma técnica para se estabelecer esse tipo de nexo causal: a probabilidade de causalidade em doenças neoplásicas. Nenhum artigo descrevia o auxílio multicritério à decisão como técnica para estabelecer esse tipo de nexo causal. Portanto, nota-se a necessidade da realização e divulgação de pesquisas científicas sobre métodos de auxílio ao estabelecimento de nexo causal entre doença e trabalho.
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Background: Chronic obstructive pulmonary disease (COPD) is associated with subclinical atherosclerosis and endothelial dysfunction, which can be assessed non-invasively through flow-mediated dilation (FMD). In this study, we evaluated the potential impact of inhaled corticosteroid (ICS) therapy on FMD of COPD patients undergoing pulmonary rehabilitation (PR). Methods: Medical records of COPD patients undergoing FMD assessment upon admission to our Pulmonary Rehabilitation Unit were reviewed in this retrospective post hoc analysis. Results: A total of 46 patients with COPD (median age 71.5 years, 28.3% postmenopausal females) were included in the final analysis. Among these, 27 participants were currently receiving ICS therapy, while 19 were not. At baseline, the two groups showed no difference in the main clinical and functional variables. Similarly, no significant difference was observed in vascular reactivity parameters, with a median FMD of 3.12% (IQR: 2.23-4.45) in ICS users and 3.39% (IQR: 2.45-4.08) in ICS nonusers (p = 0.544). After PR, a significant improvement in the main rehabilitation and patient-reported outcomes was observed in all groups, with a significant improvement in FMD documented in both patients treated with steroids (from 3.12%; IQR: 2.23-4.45 to 4.77%; IQR: 3.25-5.63, p = 0.022) and in those who were not (from 3.39%; IQR: 2.45-4.08 to 5.04%; IQR: 3.98-6.06, p = 0.005). FMD changes were of comparable magnitude among groups. Conclusions: Our preliminary findings do not indicate a significant impact of medications containing ICS on the endothelial function of COPD patients, suggesting that the potential beneficial effect of PR on this surrogate marker of cardiovascular risk is independent of inhaled therapy.
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Regular and long-term shift work is associated with a number of chronic diseases. There is some evidence that shift work also has an influence on the autonomous nervous system. Studies that have examined the effect of shift work on heart rate variability (HRV) have not taken into account age and gender. Therefore, the aim of this study was to investigate the influence of night shift based on 24 h long-term analyses carried out on non-night shift days with a matched control group for age and gender. In total, 172 (128 male, 44 female) healthy shift night workers were compared with subjects from a non-night shift worker group at a ratio of 1:1, forming matched pairs based on the subjects' sex and age. HRV parameters were analyzed based on 24 h ECG recording. An analysis of the HRV parameters showed only a small difference but without statistical significance between the two groups with regard to all of the HRV parameters examined (SDNN, RMSSD, NN50, pNN50, VLF, LF, HF, LF/HF, DFA1, and DFA2). An analysis of the subgroup of subjects who had only worked night shifts for a minimum of 10 or 20 years, with the respective pairs matched by age and gender, did not reveal any significant differences between the HRV parameters of employees working night shifts and those not working night shifts. Taking into account qualitative aspects of HRV analysis, this study was thus able to show that working night shifts for many years may not have as big an influence on HRV as had been assumed so far.
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The set up of new healthcare models by taking into account diagnosis and health education of the viral infection, aims to achieve the goals of the World Health Organization Global Health Sector Strategy on viral diseases for 2022-2030. In comparison to Europe, Poland is ranked among countries with an moderate prevalence of hepatitis B and C virus (HBV and HCV), also human immunodeficiency virus (HIV). An additional challenge is the changing epidemiological situation due to the impact of immigrants, resulting mainly from the war in Ukraine. The article presents current guidance for HCV and HIV diagnosis and presents the role of occupational health service (OHS) for primary and secondary prevention of the infectious diseases. It was considered to expand the scope of periodic examinations to include diagnosis of HBV, HCV and HIV infections among health care workers, who have not had it performed so far. In the case of abnormal level of alanine aminotransferase (ALT), aspartate aminotransferase (AST) or γ-glutamyl transpeptidase (GGT) found during routine pre-employment or periodic examinations for specific occupational exposures and it is considered crucial to implement further measures to exclude or confirm HBV or HCV infection, with indications for further management in primary care, and followed by subsequent periodic examinations. The need to pay attention to any symptoms that may indicate HBV, HCV and/or HIV infection, to perform additional diagnostic tests (e.g., point of care), and to determine the next steps in case of positive result was indicated. It emphasized the need to tailor the delivery of information to the patient, including taking care to ensure that immigrants' workers understand the next steps. It was recommended that the OHS conduct educational activities to raise health awareness of HIV, HCV, HBV infections, both through health policy programs as well as through broader activities in cooperation with the employer. Med Pr Work Health Saf. 2024;75(5).
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INTRODUCTION: Although the number of cancer survivors has increased, the role of physical therapy in return to work (RTW) for employed patients with cancer remains unclear. CASE PRESENTATION: The patient is a 50-year-old man diagnosed with cholangiocarcinoma who worked as a liquefied petroleum gas station filler. He started perioperative rehabilitation and underwent pancreaticoduodenectomy for cholangiocarcinoma. He developed a postoperative pancreatic fistula, which improved with conservative treatment over 40 days. Although he achieved independence regarding day-to-day activities, his physical condition and workability worsened, as his skeletal muscle index decreased from 8.7 to 7.7, 6-min walk distance from 518 to 460 m, and work ability index (WAI) from 37 to 20 points. His physical therapist was concerned about his RTW and recommended that he receive RTW support from the Department of Occupational Medicine (DOM). The DOM employed a team approach for the RTW strategy, and the primary physician, occupational physician, and company collaborated to support the patient. After the outpatient treatment protocol and RTW support plans were formulated, the patient was discharged. The physical therapist reported declining physical performance and WAI at the DOM's multidisciplinary conference. After consulting with multiple professionals, the team recommended work resumption in stages: part-time for three months and full-time for four months after surgery while undergoing oral adjuvant chemotherapy. The WAI improved to 35 points after RTW. CONCLUSION: This case report suggests that physical therapists are vital in providing continuous patient support, from perioperative rehabilitation to DOM intervention, to build physical strength for return to work.
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Introduction: In recent decades there has been a growth in the demand for tattoos and in the number of tattoo artists. Objectives: A study was designed to compare the results obtained in the application of risk assessment instruments by the Occupational Safety and Health team with those of the risk perception of the same variable in a sample of tattoo artists. Methods: A risk chart was prepared and the William Fine method, the integrated risk assessment approach, and the methodology for risk assessment and accidents at work were applied for general risk assessment, whereas the Ovako Working Posture Analysis System and Rapid Entire Body Assessment were applied for ergonomic risk assessment. Tattoo artists' perception was registered in an online questionnaire. Results: The most valued risk factors by tattoo artists were forced/maintained postures and repetitive movements; conversely, interaction with old machines and/or in poor condition and monotonous work. Divergences were found when comparing the results of risk assessment with those of risk perception, since the first highlights chemical and biological agents. This may be justified by the fact that tattoo artists give more relevance to issues capable of causing faster and/or more intense semiology. Conclusions: If the Occupational Safety and Health team is attentive and prepared to deal with these differences, it will achieve better performance.
Introdução: Nas últimas décadas, houve um crescimento na procura por tatuagens e no número de tatuadores. Objetivos: Projetou-se um estudo para comparar os resultados obtidos na aplicação de instrumentos para avaliação de risco pela equipe de Saúde e Segurança Ocupacionais com a percepção da mesma variável em uma amostra de tatuadores. Métodos: Elaborou-se uma carta de riscos, e foram aplicados os métodos de William Fine, a metodologia integrada de avaliação de risco, bem como e de avaliação do risco e acidentes de trabalho para risco geral e o Ovako Working Posture Analysis System e Rapid Entire Body Assessment para o risco ergonômico. A percepção dos tatuadores foi registrada em um questionário on-line. Resultados: Os fatores de risco mais valorizados pelos tatuadores foram as posturas forçadas/mantidas e os movimentos repetitivos; por sua vez, entre os fatores de risco menos valorizados, estavam a interação com máquinas antigas e/ou em mau estado e o trabalho monótono. Comparando os resultados da avaliação de risco com a percepção de risco, constata-se que existem divergências, uma vez que a primeira realça os agentes químicos e biológicos. Isso pode se justificar por eventualmente os tatuadores darem mais relevância às questões com capacidade para originar semiologia mais rápida e/ou intensa. Conclusões: Se a equipe de Saúde e Segurança Ocupacionais estiver atenta e preparada para lidar com essas diferenças, terá maior capacidade de obter melhor desempenho.
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Based on personal experience over several years, we carried out a comparative analysis of two different European health systems, in Portugal and France, from a perspective comparing occupational medicine and use of telemedicine in a postpandemic context. This analysis addressed four aspects: Health System; Occupational Medicine; Telemedicine/Telework; and Future and Suggestions. The study employed searches and review of recent articles, guidelines, and recommendations from the authorities responsible for regulation (Medical Doctors Order, Labor Legislation, and Medical Collegiate Recommendations) and analysis of some statistical indicators from recent studies. Three tables on Occupational Health and Medicine present some relevant data and facilitate comparisons. Despite the difficulties of comparison, given the basic differences between these two systems (Beveridge vs. Bismark), it can be concluded that there is a greater acceptance of judicious use of teleconsultation in France (from 15 to 35%). This includes its use by occupational nurses, in the context of the "Visite de Information et Prevention", with good acceptance among employers and employees. There are still some difficulties to be resolved concerning security, conducting biometrics, and objective examinations. We expect that these issues will be overcome with improved biosensing, adequate training, and proper regulation. Given the shortage of occupational physicians and the customary overrunning of legal deadlines, we believe that these possibilities and suggestions should be explored and adopted by the specialty's Collegiates. Certain recommendations to this effect are made.
Com base na experiência pessoal de vários anos, foi realizada uma análise comparativa de dois sistemas de saúde europeus diferentes, de Portugal e da França, em uma perspectiva direcionada a uma comparação da medicina do trabalho e a utilização da telemedicina no contexto pós-pandêmico, em que ela se normalizou. Esta análise comparativa incide em quatro aspectos: sistema de saúde; medicina do trabalho; telemedicina/teletrabalho; e futuro e sugestões. Foram incluídas pesquisa e revisão documental de vários artigos recentes, normativas e recomendações das autoridades responsáveis pela tutela (Recomendações Colegiais, Ordem dos Médicos, Código do Trabalho), e foram feitas comparações de alguns indicadores estatísticos e estudos recentes. Três tabelas sobre a saúde, a medicina do trabalho e a telemedicina apresentam alguns dados relevantes e facilitam a comparação. Apesar da comparação difícil dadas as diferenças de base dos dois sistemas (modelo Beveridge versus Bismarck), parece ser possível concluir que existe uma maior abertura para a utilização criteriosa da teleconsulta na França (entre 15 e 35%), incluindo o seu uso por enfermeiras no contexto da visite d'information et de prévention, com uma boa aceitação pelos empregadores e trabalhadores. Ainda existem dificuldades por resolver, nomeadamente sobre a segurança e as dificuldades na sua utilização ou na realização da biometria ou exame objetivo. Por meio de melhorias no biosensing e de uma formação adequada, essas questões serão ultrapassadas. Dada a falta de médicos do trabalho e a habitual dilação dos prazos legais, essa possibilidade e as sugestões deveriam ser exploradas e enquadradas pelo Colégio da especialidade. Realizam-se algumas sugestões nesse sentido.
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This article explores the impact and potential applications of large language models in Occupational Medicine. Large language models have the ability to provide support for medical decision-making, patient screening, summarization and creation of technical, scientific, and legal documents, training and education for doctors and occupational health teams, as well as patient education, potentially leading to lower costs, reduced time expenditure, and a lower incidence of human errors. Despite promising results and a wide range of applications, large language models also have significant limitations in terms of their accuracy, the risk of generating false information, and incorrect recommendations. Various ethical aspects that have not been well elucidated by the medical and academic communities should also be considered, and the lack of regulation by government entities can create areas of legal uncertainty regarding their use in Occupational Medicine and in the legal environment. Significant future improvements can be expected in these models in the coming years, and further studies on the applications of large language models in Occupational Medicine should be encouraged.
Este artigo explora o impacto e as possíveis aplicações dos grandes modelos de linguagem na Medicina do Trabalho. Os grandes modelos de linguagem têm a capacidade de fornecer suporte durante a tomada de decisão médica, a triagem de pacientes, a sumarização e confecção de documentos técnicos, científicos e jurídicos, o treinamento e educação de médicos e da equipe de saúde ocupacional, bem como a educação de pacientes, potencialmente levando a menores custos, menor gasto de tempo e menor incidência de erros humanos. Apesar dos resultados promissores e da grande variabilidade de aplicações, os grandes modelos de linguagem apresentam também limitações significativas em relação à sua acurácia, ao risco de geração de informações falsas e a recomendações errôneas. Também devem ser considerados diversos aspectos éticos ainda não bem elucidados pela comunidade médica e acadêmica, e a falta de regulamentação pelas entidades governamentais pode gerar áreas de incerteza jurídica sobre o seu uso na Medicina do Trabalho e no ambiente judicial. Melhorias futuras significativas podem ser esperadas nesses modelos nos próximos anos, e mais estudos das aplicações dos grandes modelos de linguagem na Medicina do Trabalho devem ser encorajados.
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OBJECTIVES: This study aimed to adapt and validate the Occupational Health Literacy Scale (OHLS) for the Italian workforce, assessing its psychometric properties and ensuring its relevance and applicability within this specific cultural setting. STUDY DESIGN: Validation process by observational and descriptive study. METHODS: Initially, two members of the research team independently translated the original OHLS into Italian. Subsequent comparisons and syntheses of these translations produced a unified Italian document. To ensure translation accuracy, this document was then retranslated back into English. An expert committee with specialized knowledge in occupational safety and health evaluated the retranslations to finalize the Italian version. This version underwent a preliminary test using a pilot group, followed by anonymous administration to a sample of 398 workers. RESULTS: The adaptation of the OHLS into Italian demonstrated outstanding psychometric characteristics. The scale exhibited an excellent model fit and strong internal consistency. Furthermore, the factorial structures were congruent with theoretical expectations, underscoring the scale's robust construct validity. CONCLUSIONS: The Italian version of the OHLS has been validated as a reliable and effective instrument for quantifying occupational health literacy among Italian workers. This tool's demonstrated validity and reliability suggest its potential for broader application in promoting occupational health awareness and interventions within Italian-speaking populations.
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BACKGROUND: Occupational medicine (OM) faces considerable challenges today, one of them related to the university training of future physicians considered suboptimal at a global level as it has been pointed out in many studies. The aim of this study is to update the state of OM medical education in European universities. METHODS: Between March and August 2022, an e-mail survey regarding OM training to undergraduate medical students was conducted among OM professors at European universities in 28 countries (n = 347). RESULTS: Of the 347 universities, 53 medical schools from 19 countries responded (response rate = 15.3%). In 89% of cases, OM was taught. The average number of hours per academic year was 24.3, with significant variation within the same country. Lectures were the most popular teaching technique (98%), with a considerable use of modern approaches such as problem-based learning (61%), and e-learning (57%). While occupational diseases and principles of prevention were covered, other subjects such as the environmental impact or collaboration with an OM physician were poorly represented in the educational program. CONCLUSION: According to data, several European medical schools may provide insufficient OM education and training to their students. The education of undergraduate occupational medicine students in European medical schools should be designed to equip them with the knowledge and skills required to meet today's challenges. It is critical that undergraduate OM education in European medical schools be enhanced, harmonized, and standardized.
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Curriculum , Education, Medical, Undergraduate , Occupational Medicine , Schools, Medical , Europe , Humans , Occupational Medicine/education , Surveys and Questionnaires , Students, MedicalABSTRACT
Background: Severe eosinophilic asthma (SEA) is often linked to a dysregulation in the Interleukin-(IL)-5 axis. Mepolizumab, a humanized monoclonal antibody, reduces eosinophils by directly binging to IL-5, potentially restoring homeostatic eosinophil biology, with a significant impact on quality of life, acute exacerbations and oral corticosteroids (OCS) elimination in SEA patients. While its short- and middle-term effects are well described, no study has so far investigated its long-lasting effects in SEA patients. The aim of our study was therefore to explore the effects of a long-term, six-year continuous treatment with mepolizumab on clinical control and clinical remission in a cohort of SEA patients. Methods: We conducted a retrospective review of clinical records of patients who were prescribed mepolizumab between June 2017 and April 2018. We collected demographical, functional, and clinical data from visits performed at baseline and then at the specified timepoints and checked if patients had reached clinical remission after 6 years. We assessed asthma control test (ACT), exacerbation rate, and OCS elimination dose at 6 years. Clinical Remission (CR) was defined on the basis of the elimination of OCS and the contemporary presence of all the following: 1) stable lung function; 2) no exacerbation in the previous 12 months; 3) acceptable symptom control (ACT ≥ 20). Results: Of 86 patients screened, 62 were included in the final analysis. Our study suggests that mepolizumab is effective and well tolerated after a six-year course of continuous treatment in patients with SEA. We reported a prevalence of 28 (46.8%) patients who reached complete CR at 72 months from the treatment start. 75% of patients eliminated the maintenance OCS already after 1 year of treatment; this proportion reached the 87% within the sixth year of treatment. Conclusion: Mepolizumab proved to be effective in real-life after 6 years of treatment, inducing a complete clinical remission in the 46.8% of patients, with sustained improvements in quality of life, exacerbation rate, OCS intake and lung function.
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Pertussis is a vaccine-preventable respiratory disease. Pertussis vaccination is currently mandatory for all children in Italy, and is administered in three doses at the beginning of the third, fifth, and twelfth month of life, respectively. Booster doses are also recommended at five-six years, at eleven-twelve years, and then once every ten years. Healthcare workers (HCWs) are a high-risk population for pertussis. Strategies to increase HCWs' compliance to this vaccination have not been investigated in depth. Our study investigates the determinants of acceptance of a "soft nudge" vaccination campaign in a large hospital in Apulia (Southern Italy). HCWs from the Gynaecology and Neonatology Units of Bari's Policlinico General Hospital were screened in June 2023 for pertussis vaccination. Non-vaccinated subjects were offered a vaccination appointment. Vaccination determinants were studied, and a logistic regression model was built to identify determinants that significantly influence vaccination acceptance. At the time of screening, only 31.34% of target HCWs (68/217) had already been vaccinated. After the active call intervention, vaccine coverage rose to 70.00% (152/217). Significantly higher coverage was found in the Neonatology Unit (30/43, 69.77%) than in the Gynaecology unit (54/106, 50.94%) (Chi2: 4.41; p-value: 0.036). A logistic regression model confirmed a higher compliance to vaccination in HCWs staffed in the Neonatology Unit (Chi2: 2.08; 95%CI: 1.04 - 4.73; p-value: 0.038). Our intervention increased vaccination coverage in a high-risk cohort. The solicitation was effective, as communication with a trained specialist might have improved the subjects' perception of vaccination and individual risk of contagion and transmission to others. A synergistic approach, mixing active call with a vaccination mandate, might have greater effectiveness.
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Background: The need for health surveillance of former workers exposed to asbestos was provided by law in Italy after the asbestos ban in 1992. Objectives: We describe the results of the health surveillance of former workers exposed to asbestos, conducted over 27 years, from 1994 to 2020, at the Operative Unit of Occupational Medicine of the University Hospital of Bari. Materials and methods: We adopted the health surveillance protocol, which was validated at the national level in 2018. Results: A total of 1,405 former workers exposed to asbestos were examined. We proceeded with diagnosing pathologies in 339 cases (24% of the cohort subjected to surveillance), with diagnoses of some cases involving multiple pathologies. Specifically, pleural plaques were diagnosed in 49.2% of the 339 cases, asbestosis in 35.9%, malignant pleural mesothelioma (MPM) in 20.3%, mesothelioma of the vaginal tunic of the testis (MTVT) in 9.1%, lung cancer in 5.8%, and laryngeal cancer in 0.8%. Conclusion: Despite the 1992 asbestos ban, asbestos-related diseases remain a serious public health issue. It is important to establish criteria that ensure the health surveillance of formerly exposed workers minimizes costs, reduces the number of invasive examinations, and optimizes achievable results.
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Asbestos , Asbestosis , Hospitals, University , Occupational Exposure , Humans , Italy/epidemiology , Occupational Exposure/adverse effects , Male , Female , Middle Aged , Asbestosis/epidemiology , Aged , Mesothelioma, Malignant , Adult , Lung Neoplasms/epidemiology , Lung Neoplasms/etiology , Population Surveillance , Pleural Neoplasms/epidemiology , Pleural Neoplasms/etiology , Mesothelioma/epidemiology , Mesothelioma/etiologyABSTRACT
OBJECTIVES: The underreporting of occupational diseases in many countries significantly hampers the development of intervention programs, posing a significant public health problem. Our study aimed to contribute to the occupational diseases surveillance by examining the data of hospitals authorized to issue reports throughout Turkey. MATERIAL AND METHODS: This cross-sectional study was conducted using medical diagnoses of occupational diseases reported to the General Directorate of Public Health from 81 provinces in Turkey between 1 January 2018 and 31 December 2022. The study evaluated hospitals that made medical diagnoses of occupational diseases and compared age groups, genders, occupational disease diagnosis groups and provinces of work regarding legal and medical diagnoses. RESULTS: The top three disease groups in terms of medical diagnosis are musculoskeletal disorders with 38.8%, respiratory diseases with 14.4% and hearing defects with 10.9%. Regarding legal diagnoses, respiratory system diseases ranked first with 26.4%, followed by musculoskeletal disorders with 8.2% and hearing defects with 5.5%. While the provinces where most cases of medical occupational diseases are diagnosed share similarities, the majority of affected individuals in Karabük and Batman have not received a legal recognition of the occupational disease. Two-thirds of Turkey's medical occupational disease diagnoses were made in two hospitals. CONCLUSION: This study is reflecting national data in Turkey and is the country's first nationwide study. The number of occupational diseases in Turkey is lower than expected. It would be more accurate to express the data in a way that includes medical diagnoses instead of using the number of compensated files corresponding to legal diagnoses.
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Occupational Diseases , Humans , Turkey/epidemiology , Cross-Sectional Studies , Occupational Diseases/epidemiology , Occupational Diseases/diagnosis , Male , Female , Adult , Middle Aged , Musculoskeletal Diseases/epidemiology , Musculoskeletal Diseases/diagnosis , Respiratory Tract Diseases/epidemiology , Respiratory Tract Diseases/diagnosis , Young Adult , Hearing Disorders/epidemiology , Hearing Disorders/diagnosisABSTRACT
BACKGROUND: Cardiologists will commonly assess patients who hold an aviation medical certificate and require unique assessments and communications with national civil aviation authorities (in Australia, the Civil Aviation Safety Authority [CASA] and in New Zealand, the Civil Aviation Authority of New Zealand [CAA NZ]). Cardiac conditions are the most common reason for disqualification from holding an aviation licence, and coronary artery disease is considered a high-risk condition for pilot incapacitation. AIM: To provide a contemporary update on the aeromedical approach to the evaluation, detection, and management of coronary artery disease in an Australasian context. METHODS: A narrative view of current and historical practice in the area of aeromedical evaluation of coronary disease was undertaken. RESULTS: This review highlights the aeromedical approach to risk stratification and specific challenges of the aviation environment for patients with coronary artery disease. Scenarios of coronary artery disease screening, common and rare acute coronary syndromes, and the assessment of established coronary artery disease are examined in detail. Suggestions to facilitate communications between specialists and CASA or CAA NZ to facilitate patient re-certification are also provided. CONCLUSION: Patients who are pilots have unique requirements in terms of their coronary assessment, management, and follow-up to maintain eligibility to fly. It is important for cardiologists to be aware of relevant occupational requirements to provide optimal care to their patients.
Subject(s)
Cardiology , Coronary Artery Disease , Humans , New Zealand/epidemiology , Australia/epidemiology , Coronary Artery Disease/diagnosis , Coronary Artery Disease/therapy , Coronary Artery Disease/epidemiology , Aerospace Medicine/methods , Aviation , PilotsABSTRACT
BACKGROUND: Immunization against vaccine-preventable diseases prior to pregnancy is an important measure of primary prevention both for the mother and the unborn child. We analyzed immunity rates against measles, mumps, rubella, varicella, and pertussis in pregnant employees in Germany prior to significant changes in legal conditions in 2020, to provide a basis of comparison for future research. METHODS: We analyzed occupational-medical routine data in three collectives of pregnant women with an occupational risk of infection in the years 2018 and 2019: 1: hospital staff with regular access to an in-house company physician (n = 148); 2: employees in childcare with regular access to external occupational-health services (n = 139); 3: teachers with no regular access to occupational healthcare (n = 285). Immune status was assessed by a physician based on vaccination certificates, laboratory results, and medical documentation on prior infections. We compared immunity rates against measles, rubella, varicella, and pertussis as well as full immunity against all targeted vaccine-preventable diseases. RESULTS: Altogether, n = 572 pregnant women were included in our study. Of these women, 96.5 % were immune to rubella, 95.8 % to varicella, 88.3 % to measles, 82.7 % to mumps, and 67.8 % to pertussis. Only 56.2 % of the women had full immunity against all targeted vaccine-preventable diseases. Collective 1 showed the highest immunity rates against measles and pertussis as well as the highest rate of full immunity against all targeted vaccine-preventable diseases. The immunity rates against rubella and varicella did not differ significantly between the collectives. With the exception of rubella, the lowest immunity rates during pregnancy were found in Collective 3. CONCLUSION: We found pregnancy-relevant immunity gaps in all our study groups with significant differences between the collectives. Considering the potentially devastating consequences of infections during pregnancy, all medical professionals and health-policy makers should be involved in an increased effort to improve vaccination rates prior to pregnancy.