Measles vaccine in the school settings: a cross-sectional study about knowledge, personal beliefs, attitudes and practices of schoolteachers in northern Italy.

BACKGROUND: School teachers (STs) might have a crucial role in countering students' and parents' hesitancy towards immunization. Such role is associated with STs own knowledge, attitudes and practices (KAP) towards vaccines. In this cross-sectional study we assess measles vaccine KAP in a sample of Italian STs. METHODS: Between January 2012 and August 2015, 376 STs from the Lombardy region were enrolled in the study; data were retrieved on socio-demographic characteristics, KAP towards MeV, including immunization status. The association between knowledge, practices and a favorable attitude towards MeV was assessed calculating Odds Ratio (OR) and respective 95% confidence intervals (95% CIs) through multivariate regression analysis. RESULTS: 16.7% of STs in Italy know national recommendations on MeV and 16.0% were favorable to MeV and 12.8% of STs reported to have been vaccinated against MeV as adults and only 5.9% reported fears of MeV side effects (e.g. autisms). MeV propensity was associated with previous vaccination as adults (OR=5.222; 95% CI: 1.752-15.567), knowledge of national recommendations, and the understanding that MeV prevents natural infection and disease transmission (OR=2.274; 95% CI: 1.246-4.149, OR=14.061; 95% CI: 7.048-28.063, and OR=2.085; 95% CI: 1.125-3.864, respectively). CONCLUSIONS: The share of STs holding false beliefs and misconceptions towards MeV was lower than expected. STs might actively contribute to fight parents' vaccine hesitancy and such social role should be further acknowledged and promoted by policy makers and the wider public health community.

Occurrence of SARS-CoV-2 infection among healthcare personnel: results from an early systematic review and meta-analysis.

BACKGROUND: SARS-CoV-2 infection has become a global public health concern globally. Even though Healthcare Workers (HCWs) are supposedly at increased risk for SARS-CoV-2 infection, to date no pooled evidence has been collected. MATERIALS AND METHODS: We searched online electronic databases (PubMed, Embase, medRxiv.org for pre-prints) for all available contribution (up to May 20, 2019). Two Authors independently screened articles and extracted the data. The pooled prevalence of SARS-CoV-2 was analyzed using the random-effects model. The possible sources of heterogeneity were analyzed through subgroup analysis, and meta-regression. RESULTS: The overall pooled prevalence of SARS-CoV-2 was 3.5% (95%CI 1.8-6.6) for studies based on molecular assays, 5.5% (95%CI 2.1-14.1) for studies based on serological assays, and 6.5% (95%CI 2.5-15.6) for point-of-care capillary blood tests. Among subgroups, serological tests identified higher risk for SARS-CoV-2 seropositivity in physicians than in nurses (OR 1.436, 95%CI 1.026 to 2.008). Regression analysis indicated the possible presence of publication bias only for molecular tests (t -3.3526, p-value 0.002648). CONCLUSIONS: The overall pooled prevalence of SARS-CoV-2 was lower than previously expected, but available studies were affected by significant heterogeneity, and the molecular studies by significant publication bias. Therefore, further high-quality research in the field is warranted.

Occupational Injuries and Use of Benzodiazepines: A Systematic Review and Metanalysis.

Background: Benzodiazepines have been widely used in clinical practice for over four decades and continue to be one of the most consumed and highly prescribed class of drugs available in the treatment of anxiety, depression, and insomnia. The literature indicates that Benzodiazepine users at a significantly increased risk of Motor Vehicle accidents compared to non-users but the impact on injuries at workplace is not well-defined. We aimed to investigate whether use of benzodiazepine is associated with increased risk of occupational injuries (OI). Methods: PubMed, Embase, and Scopus databases were searched. A meta-analysis was performed to calculate odds ratio (OR) and 95% confidence interval (CI) among case controls, cross-sectional studies, either questionnaire or laboratory exams based. Results: A total of 13 studies met inclusion criteria, involving 324,168 OI from seven different countries, with an estimated occurrence of benzodiazepine positivity of 2.71% (95% CI 1.45-4.98). A total of 14 estimates were retrieved. Of them, 10 were based on laboratory analyses, three on institutional databases, while one study was based on questionnaires. Regarding the occupational groups, three estimates focused on commercial drivers (0.73%, 95% CI 0.12-4.30), that exhibited a reduced risk ratio for benzodiazepine positivity compared to other occupational groups (RR 0.109, 95% CI 0.063-0.187). Eventually, no increased risk for benzodiazepine positivity was identified, either from case control studies (OR 1.520, 95% CI 0.801-2.885, I 2 76%), or cross sectional studies, when only laboratory based estimates were taken in account (OR 0.590, 95% CI 0.253-1.377, I 2 63%). Conclusions: Even though benzodiazepines have the potential to increase injury rates among casual and chronic users, available evidence are insufficient to sustain this hypothesis, particularly when focusing on laboratory-based studies (i.e., studies the characterized the benzodiazepine immediately before the event).

Personal beliefs and misconceptions, not evidence guide general practitioners in the managing of travelers' diarrhea: Results from a pilot study (North-Western Italy, 2019).

BACKGROUND: The present study aims to characterize knowledge, attitudes and practices in a sample of general practitioners (GPs) on management of travelers' diarrhea (TD). METHODS: A total of 158 GPs (44.3% males; mean age 40.2±12.4 years) completed a web questionnaire on antibiotic prophylaxis (AP) and/or an antibiotic treatment (AT) in TD cases. Participants were inquired on knowledge status (KS), risk perception and effectively applied recommendations for AP/AT through a specifically designed questionnaire. Multivariate odds ratios (OR) for predictors of AP/AT were calculated through regression analysis. RESULTS: All in all, while 15 (9.5%) participants recommended AP for TD, 61 of them (39.4%) recommended AT. KS was largely unsatisfying as participants extensively ignored the most recent AP/AT recommendations. Acknowledgment of TD as a severe disorder was predictive for recommendation of AP (OR 37.843, 95%CI 4.752-301.4). As for AT, it was relatively elevated in GPs≥10 years (OR 2.653, 95%CI 1.169-6.019), but more rarely reported in participants with higher KS (OR 0.056, 95%CI 0.021-0.153). CONCLUSIONS: Adherence of GPs to official recommendations for TD management was unsatisfying, particularly in older participants. Continuous Education of GPs should be improved by sharing up-to-date official recommendations on AT/AP for TD.

Prevalence of Parkinson Disease in Italy: a systematic review and meta-analysis.

INTRODUCTION: Parkinson's disease (PD) is a common disease of unknown etiology. Even though accurate information on the epidemiology of PD is critical for defining appropriate health policies, epidemiological data on Parkinson's disease (PD) in Italy are often defined as scant or conflicting. Our study attempted to provide an overview on the prevalence of (PD) by means of a systematic review and metanalysis of existing data.   Material and methods. We searched into two different databases (PubMed and EMBASE), focusing on studies reporting the prevalence of PD in Italy. Data were extracted using a standardized assessment form, and results of such analyses were systematically reported, summarized and compared.   Results. A total of 16 studies were eventually included in the analyses, with a prevalence rate of 193.7/100,000. Available reports were heterogeneous both in design and in eventual figures, and also prevalence estimates were affected by substantial heterogeneity. Interestingly, prevalence rates ranged from 37.8/100,000 inhabitants in subjects aged 0 to 64 years, to 578.7 in age group 65 to 75 years, and 1235.7 in age group 75 years or older. PD was significantly associated with male sex, but only in older age groups (i.e. Odds Ratio, OR 1.37 95%CI 1.22-1.53, and OR 1.31, 95%CI 1.21-1.42 for age groups 65-74 years and 75 years or more, respectively).   Discussion and conclusion. While the observed variations in prevalence rates may result from environmental or genetic factors, differences in methodologies for case ascertainment and diagnostic criteria may have significantly affected our estimates. As a consequence, the comparability of existing studies is limited.

Knowledge, Attitudes, Practices (KAP) of Italian Occupational Physicians towards Tick Borne Encephalitis.

Tick-Borne Encephalitis (TBE) is an occupational health threat with increasing incidence in the geographic area of Italy. Despite this, TBE vaccination rates have ranged from 10% to 40% in Italy, even in at-risk workers. The reasons for this low rate are investigated in this present study of the knowledge, attitudes, and practices of occupational physicians (OP) regarding TBE disease and vaccination in at-risk workers. A total of 229 OP participated in an internet-based survey by completing a structured questionnaire. Adequate general knowledge of TBE disease was found in 58% of OP. Accurate perception of TBE risk in occupational settings was found in 20%. TBE vaccination for at-risk workers was recommended by 19%. Willingness to recommend TBE vaccination was more likely by OP practicing in endemic areas (Odds Ratio 3.10, 95% confidence intervals 1.47-6.55), who knew the existence of the term "arboviruses" (3.10, 1.29-7.44), or exhibited a better understanding of TBE (2.38, 1.11-5.12)-and were positive predictors for promoting TBE vaccine, while acknowledging that TBE as a severe disease was a negative one. Tick-borne disorders in Italy are a still rare (but increasing) occupational health threat, and vaccination gaps for TBE virus may find an explanation in OP incomplete knowledge of evidence-based recommendations.

Point-of-Care diagnostic of SARS-CoV-2: knowledge, attitudes, and perceptions (KAP) of medical workforce in Italy.

INTRODUCTION: The present study aims to characterize knowledge, attitudes and beliefs in a sample of medical professionals towards point-of-care (POC) rapid tests for SARS-CoV-2 in Italy (April 2020). MATERIAL AND METHODS: A total of 561 professionals (42.6% males, 26.9% ≥ 50-year-old) compiled a specifically designed web questionnaire on characteristics of POC rapid tests. They were asked whether they would change daily practice and make clinical decisions according to POC tests. Multivariate odds ratios (aOR) for predictors of propensity towards the aforementioned behavioral outcomes were calculated through regression analysis. RESULTS: Overall, only 51.9% knew the official recommendations of the Italian Health Authorities for POC tests, while 26.0% of respondents considered POC tests for COVID-19 highly reliable. Still, 40.3% of respondents would change daily practice because of such tests, and 38.5% would make clinical decisions based of their results. Actual understanding of specificity and sensitivity of POC tests was not associated with assessed behavioral outcomes: main positive effectors were identified in perceived reliability and usefulness of rapid tests, acknowledging the existence of official recommendations, understanding the limited clinical implications of POC tests, and working as occupational physicians were characterized as negative effectors.  Conclusions. Propensity of sampled professionals towards POC tests for COVID-19 was diffusely unsatisfying. While actual understanding of accuracy of such tests was not a main effector of propensity, previous experiences with other POC tests in daily practice, particularly among occupational physicians may have impaired overall acceptance of such instruments.

Stop playing with data: there is no sound evidence that Bacille Calmette-Guérin may avoid SARS-CoV-2 infection (for now).

Since the beginning of the COVID-19 epidemic, a possible explanation for the high heterogeneity of infection/mortality rates across involved countries was hinted in the prevalence of tuberculosis vaccination with Bacille Calmette-Guérin (BCG). A systematic review was therefore performed on May 2, 2020. A total of 13 articles were ultimately retrieved, 12 of them as preprint papers. All articles were ecological studies of low quality. Most of them did not include main confounding factors (i.e. demographic of the assessed countries, share of peo- ple residing in urban settings, etc.), and simply assessed the differences among incidence/mortality of COVID-19 with vaccination rates or by having vs. having not any vaccination policy for BCG. Even though all studies shared the very same information sources (i.e. international registries for BCG vaccination rates and open source data for COVID-19 epidemics), results were conflicting, with later studies apparently denying any true correlation between COVID-19 occurrence and BCG vaccination rates and/or policies. As a consequence, there is no sound evidence to recommend BCG vaccination for the prevention of COVID-19.

Point-of-Care Diagnostic Tests for Detecting SARS-CoV-2 Antibodies: A Systematic Review and Meta-Analysis of Real-World Data.

SARS-CoV-2 is responsible for a highly contagious infection, known as COVID-19. SARS-CoV-2 was discovered in late December 2019 and, since then, has become a global pandemic. Timely and accurate COVID-19 laboratory testing is an essential step in the management of the COVID-19 outbreak. To date, assays based on the reverse-transcription polymerase chain reaction (RT-PCR) in respiratory samples are the gold standard for COVID-19 diagnosis. Unfortunately, RT-PCR has several practical limitations. Consequently, alternative diagnostic methods are urgently required, both for alleviating the pressure on laboratories and healthcare facilities and for expanding testing capacity to enable large-scale screening and ensure a timely therapeutic intervention. To date, few studies have been conducted concerning the potential utilization of rapid testing for COVID-19, with some conflicting results. Therefore, the present systematic review and meta-analysis was undertaken to explore the feasibility of rapid diagnostic tests in the management of the COVID-19 outbreak. Based on ten studies, we computed a pooled sensitivity of 64.8% (95%CI 54.5-74.0), and specificity of 98.0% (95%CI 95.8-99.0), with high heterogeneity and risk of reporting bias. We can conclude that: (1) rapid diagnostic tests for COVID-19 are necessary, but should be adequately sensitive and specific; (2) few studies have been carried out to date; (3) the studies included are characterized by low numbers and low sample power, and (4) in light of these results, the use of available tests is currently questionable for clinical purposes and cannot substitute other more reliable molecular tests, such as assays based on RT-PCR.

Vaccines are underused in pregnancy: what about knowledge, attitudes and practices of providers?

INTRODUCTION: To investigate actual knowledge of official recommendations towards seasonal influenza (SID), and Tetanus-diphtheria acellular-pertussis (Tdap) vaccines in obstetrics/gynecologists (OBGYN). METHODS: PubMed and EMBASE databases were searched. A meta-analysis was performed to calculate odds ratio (OR) and 95% confidence interval (CI) among case controls, cross-sectional studies, either questionnaire or laboratory exams based.  Results. A total of 6 studies met inclusion criteria, including 1323 OBGYN from 5 different countries. Overall, around 99% of sampled professionals were aware that official recommendations towards SID in pregnancy do exist, compared to 92% for Tdap, with significant heterogeneity (I2 > 95%, p < 0.001). Concerns about vaccine safety was reported by 10% of respondents for Tdap, and by 6.0% for SID, but again available studies were substantially heterogenous (I2 = 86.7% and 86.0%, p < 0.001). Eventually, 93% of respondents actively recommended SID in pregnancy, compared to 88% for Tdap (I2 98.8% and I2 95.9%, respectively p < 0.001). The evidence of significant publication bias was initially subjectively identified from the funnel plot, and then objectively confirmed through the regression test for all analyses. CONCLUSIONS: These results suggest an appropriated understanding of official recommendation among sampled OBGYN, with high shares of professionals actively promoting vaccination practices among their patients. Despite the high heterogeneity and the significant publication bias we identified, our results also hint towards extensive knowledge gaps of OBGYN, and particularly regarding unmotivated concerns about vaccine safety. As a consequence, appropriate information and formation campaigns should be appropriately tailored.

Prevalence of Huntington Disease in Italy: a systematic review and meta-analysis.

Worldwide prevalence of Huntington's disease (HD) is quite heterogenous. As Italy is characterized by significant genetic heterogeneity, with presumptive differences between Italian regions, this review was undertaken to define available data of HD prevalence in Italy, to assess geographic heterogeneity, and reconcile possible variation in HD prevalence rates with the availability of genetic testing. METHODS: In total, 14 relevant studies were identified from Medline/Embase, and analysis of available Italian regional reports on rare diseases. RESULTS: A cumulative prevalence of 3.9/100,000 inhabitants (95% Confidence Interval 3.0 - 5.0) was identified, with apparently higher rates in the last decades (4.1/100,000 vs. 3.0/100,000). The lowest rates were among the resident of the Oristano province in Sardinia, while the highest were reported in three mountainous and rather isolated areas (i.e. Molise, San Marino, Varese; all well over 10 cases/100,000 inhabitants). These differences cannot be not fully explained by varying approaches to case-ascertainment or diagnosis, and a possible "founder effect" may therefore be extensively advocated. DISCUSSION: The prevalence of HD in retrieved Italian reports varied up to almost tenfold between different geographical regions. Even though such variation can in part be attributed to differences in case-ascertainment and/or diagnostic criteria, there is consistent evidence of significant founder effects in certain areas such as the provinces of Varese, the Republic of San Marino, and the region od Molise - all of them with estimates > 10/100,000 cases. As our estimates suggest that up to half of Italian HD cases may be still waiting, Public Health approach should improve diagnostic rates in order to guaranteeing palliative and symptomatic interventions (antidepressants, antipsychotics, anti-choreiform medications) to all individuals and their families.

Air temperatures and occupational injuries in the agricultural settings: a report from Northern Italy (Po River Valley, 2013-2017).

INTRODUCTION: High environmental temperatures are associated with an increased risk for occupational injuries (OIs), particularly where environmental exposure and heat sources in the workplace, are associated with internal heat generation by strenuous muscular work. As a consequence, Agricultural Workers (AWs) are among the most heavily affected occupational groups. METHODS AND AIMS: The aim of this study was to assess the relationship between environmental temperatures and OIs in AWs from the Po River Valley in the Northern Italy (27,736,158 total inhabitants; mean agricultural workforce of 312,195.6 individuals). Data about OIs from 2013 to 2017, and daily weather for the administrative unit of occurrence were retrieved. Days were classified by a) mininum (Tmin) / maximum (Tmax) air temperatures; b) average day temperature (Tday); c) daily temperature variation (TV), d) relative humidity. Risk for daily OIs was calculated as correspondent Odds Ratios (OR) through a Poisson regression model. RESULTS: Estimated incidence for OIs was 66.3/1,000 workers-year. In regression analysis, for every Tday percentile increase equal to 2.5, an OR 1.007 (95% CI, 1.003 to 1.010) was reported. More precisely, higher risk for OIs was associated to Tmax > 25°C (OR 1.143, 95%CI 1.125-1.160) and to Tmax > 25°C + Tmin > 20°C (OR 1.158, 95%CI 1.138-1.179), Tmin < 0°C were associated with a significantly reduced risk (OR 0.879, 95%CI 0.850-0.910), with the notable exception of older age groups (OR 1.348, 95%CI 1.254; 1.449). During timeframes characterized by Tmax > 35°C (i.e. HW time period), the risk was higher during the first day (OR 1.266; 95%CI 1.206-1.330), and again from the fourth day onwards (OR 1.090; 95%CI 1.048 - 1.133). Analysis of TV identified an increased risk for occupational injuries in days characterized by higher variability, and particularly for TV ranging 4.0 - 4.9 (OR 1.042, 95%CI 1.017 - 1.068), and equals to 5.0 or greater (OR 1.143, 95%CI 1.118 - 1.167). Also increased relative humidity was associated with higher risk for OIs (OR 1.096, 95%CI 1.081-1.126, and OR 1.154, 95%CI 1.135-1.173 for relative humidity 70 - 89%, and ≥ 90%). CONCLUSIONS: Our findings recommend policymakers to develop appropriate procedures and guidelines, in particular for the HW time periods.

Factors influencing the willingness to perform bystander cardiopulmonary resuscitation on the workplace: a study from North-Eastern Italy.

BACKGROUND: Early bystander cardiopulmonary resuscitation (CPR) improves the chances of successful resuscitation and survival. However, few data are available regarding the willingness to perform CPR among First Aid Attendants on the Workplace (FAAWs) in Italy. The present study was performed in order to identify current attitudes of Italian FAAWs towards CPR. METHODS: Between February and June 2017, FAAWs from the Autonomous Province of Trento were asked about their willingness to perform CPR through a structured questionnaire assessing their knowledge about CPR, and the reasons for hesitancy. A cumulative knowledge score (KS) was eventually calculated. RESULTS: A total of 123 FAAWs (male 57.7%, mean age 45.2 years ± 10.1) completed the questionnaire. About 1/3 of participants (32.5%) had previously performed First Aid procedures. Overall, 77.2% exhibited willingness to perform CPR, and such attitude was more frequently reported by subjects younger than 40 years (29.5% vs. 10.7% in older subjects; p = 0.045), perceiving First Aid training as useful (98.9% vs. 84.7%, p = 0.002), and exhibiting a better knowledge of CPR (KS ≥ 75%: 47.4% vs. 15.3%). The reasons for the unwillingness were inadequate knowledge and doubt regarding whether they could perform the techniques effectively. Eventually, KS was identified as the main predictor for willingness to perform CPR (OR 4.450, 95%CI 1.442 - 14.350). CONCLUSIONS: Willingness to perform CPR was seemingly high, and knowledge of CPR techniques was its main predictor. These findings emphasize the importance for an accurate CPR training, as well as for the surveillance of the quality of qualification courses.

Knowledge, attitudes, beliefs and practices of obstetrics-gynecologists on seasonal influenza and pertussis immunizations in pregnant women: preliminary results from North-Western Italy.

BACKGROUND: Italian National Immunization Plan (NIP) 2017-2019 has introduced new recommendations regarding immunization practices during pregnancy. In this cross-sectional study, we documented specific knowledge, attitudes, and practices (KAP) in a sample of obstetrician-gynecologists (OBGYN). METHODS: A total of 68 OBGYN (39.7% of males, mean age of 47.7±9.3 years old) compiled a structured online questionnaire. Participants were asked about: knowledge of vaccine issues (both in general and regarding NIP recommendations for pregnant women); actual performance/recommendation of seasonal influenza (SID) and tetanus-diphtheria-acellular pertussis vaccinations (Tdap); risk perception about SID and pertussis. Eventually, a regression analysis was performed in order to identify predictive factors for vaccine propensity. RESULTS: Although most OBGYN were aware of official recommendations, only 57.4% and 55.9% correctly recalled the appropriate timing for vaccinations shots for SID and Tdap. Overall, 79.4% and 67.6% of participants usually delivered or recommended SID and Tdap to pregnant women, respectively. Main perceived barriers were identified by OBGYN in patients' fear of side effects (89.7%), their low risk perception (82.3%), insufficient awareness of official recommendations among pregnant women (75.0%). Significant predictors of Tdap practice were identified in higher risk perception (OR 6.466, 95% CI: 1.077; 38.803) and better knowledge of official recommendations (OR 7.310, 95% CI: 1.195; 44.704), whereas SID was apparently unrelated with individual characteristics of participants. CONCLUSIONS: Sampled OBGYN were largely favorable towards vaccination of pregnant women. As knowledge of official recommendations was identified as a main predictor of appropriate behavior at least for Tdap practice, future educational interventions could eventually improve immunization rates.

Knowledge, attitudes, and practices of influenza and pneumococcal vaccines among agricultural workers: results of an Italian a cross-sectional study.

BACKGROUND: Working age is increasing across Europe. Seasonal influenza (SID) and pneumococcal disease (PND) immunization programmes might be successfully implemented at the workplace. We conducted a cross-sectional survey among to assess SID and PND vaccine status, as well as knowledge, attitudes and practices (KAP) in a representative sample of agricultural workers (AWs) aged ≥55 years in North-Eastern Italy. METHODS: A structured questionnaire was administered in person by trained personnel. Bivariate and multivariate logistic regression analyses were carried out to identify behavioral and work-related factors associated with SID and PND vaccine uptake. RESULTS: Among 707 participants, 238 were aged 55 years or more (33.7% of total). Of them, 39.1% had an up-to-date immunization status towards influenza, and 17.6% towards pneumococcus. Factors associated with inadequate immunization were doubts about influenza vaccine safety (40.0%) and the confidence in natural immunity towards pneumococcus (30.8%). Attitude towards vaccinations was somehow favorable in 44.5% of participants for SID, and 37.8% for PND. Overall, 37.4% and 21.8% workers were aware of national recommendations on SID and PND immunization, respectively. This factor was characterized as a significant predictor for SID vaccination (multivariated Odds Ratio, OR 32.688 95%CI 12.015-88.930), as well as the perception of SID as a severe disease (OR 7.539 95%CI 3.312-17.164), and the perceived value of preventing new infections (OR 3.215 95%CI 1.205-8.578). A somehow favorable attitude towards vaccinations was the main predictor (OR 39.214 95%CI 10.179-151.1) for PND vaccination. CONCLUSIONS: Our study indicates that older workers lack appropriate knowledge of national recommendations and correct risk perception of SID and PND infections, but also vaccines' side effects. As the latter has been recognized as predictive factor for SID vaccination, our results stress the importance for tailored informative interventions in the workplaces aimed to increase risk perception and vaccine acceptance. (www.actabiomedica.it).

Knowledge, attitudes, beliefs and practices of occupational physicians towards vaccinations of health care workers: A cross sectional pilot study in North-Eastern Italy.

OBJECTIVES: This study aims to characterize personal attitudes and knowledge of a sample of Italian occupational physicians (OPhs) towards immunization practice in the case of healthcare workers (HCWs). MATERIAL AND METHODS: A total of 90 OPhs (42.2% of males, 57.8% of females, mean age of 50.1±8.3 years old) compiled a structured questionnaire through a telephonic interview. They were asked about the official Italian recommendations for HCWs, their general knowledge of vaccine practice, their propensity towards vaccines (both in general and about specific immunizations), their risk perception about the vaccine-preventable infectious diseases. Eventually, a regression analysis was performed in order to identify factors predictive for vaccine propensity. RESULTS: Only 12 out of 90 subjects correctly identified all the 7 recommended immunizations. The hepatitis B virus (HBV) vaccine was correctly identified by 95.6% of the sample, and was also associated with the more positive attitude and the more accurate risk perception. Influenza vaccine had the lowest acceptance (75.9%). Eventually, pertussis, measles, parotitis and varicella vaccines were insufficiently recognized as recommended ones (all cases < 50% of the sample). General knowledge of vaccine and knowledge of official recommendations were significantly correlated with the attitude towards immunization practice (r = 0.259, p = 0.014 and r = 0.438, p < 0.0001). In the regression analysis general knowledge (unstandardized coefficient (B) = 0.300, 95% confidence interval (CI): 0.090-0.510, p = 0.006) and risk perception (B = 0.579, 95% CI: 0.155-1.003, p = 0.008) were significant predictors of the propensity to vaccinate. CONCLUSIONS: Vaccinations gaps in HCWs may found their roots in OPhs incomplete knowledge of evidence-based recommendations. Specific training programs and formations courses should then be planned. Int J Occup Med Environ Health 2017;30(5):775-790.

Work with visual display units and musculoskeletal disorders: A cross-sectional study.

BACKGROUND: Epidemiological studies have shown that employees working with visual display units (VDU) are more likely to complain about musculoskeletal disorders (MSDs). The aim of this study has been to evaluate associations among MSDs and individuals and work-related factors. MATERIAL AND METHODS: A total of 1032 VDU workers were assessed about their personal (i.e., age, working history, smoking history, physical activity) and work-related factors (i.e., predominant job tasks performed, work posture). Work environment was evaluated regarding fulfillment of the standard ISO 9241-5:1998. The investigation required a direct observation of participants (in order to accurately assess the prevalence of MSDs) and workstations. Adjusted odds ratios (ORa) were calculated by means of the logistic regression model. RESULTS: Prevalence of MSDs was relatively high (53%). In general, MSDs were significantly associated with female sex (OR = 2.832, 95% confidence interval (CI): 2.178-3.683), age ≥ 50 years old (OR = 2.231, 95% CI: 1.236-4.026), longer exposure to VDU, both as working history (10-14 years: OR = 1.934, 95% CI: 1.301-2.875; ≥ 15 years: OR = 2.223, 95% CI: 1.510-3.271) and working time (30-39 h/week: OR = 1.537, 95% CI: 1.087-2.273). Inappropriate workstation design was confirmed by the multivariate analysis as a risk factor for MSDs (ORa = 2.375, 95% CI: 1.124-5.018). CONCLUSIONS: Musculoskeletal disorders were significantly associated with individual factors as well as characteristics of work environment. An appropriate design of workstations may significantly reduce their prevalence amongst VDU workers. Med Pr 2016;67(6):707-719.