Protective role of SARS-CoV-2 anti-S IgG against breakthrough infections among European healthcare workers during pre and post-Omicron surge-ORCHESTRA project.

PURPOSE: Anti SARS-CoV-2 vaccination initially showed high effectiveness in preventing COVID-19. However, after the surge of variants of concern, the effectiveness dropped. Several studies investigated if this was related to the decrease of the humoral response over time; however, this issue is still unclear. The aim of this study was to understand whether SARS-CoV-2 anti-S IgG levels can be used to predict breakthrough infection risk and define the timing for further booster doses administration. METHOD: Within the framework of the ORCHESTRA Project, over 20,000 health workers from 11 European centers were enrolled since December 2020. We performed two Cox proportional hazards survival analyses regarding pre-Omicron (from January to July 2021) and Omicron (December 2021-May 2022) periods. The serological response was classified as high (above the 75th percentile), medium (25th-75th), or low (< 25th). RESULTS: Seventy-four (0.33%) and 2122 (20%) health workers were infected during the first and second periods, respectively. Both Cox analyses showed that having high anti-S titer was linked to a significantly lower risk of infection as compared to having medium serological response [HR of high vs medium anti-S titer = 0.27 (95% CI 0.11-0.66) during the first phase, HR = 0.76 (95% CI 0.62-0.93) during the second phase]. CONCLUSION: Vaccine effectiveness wanes significantly after new variants surge, making anti-S titer unsuitable to predict optimal timing for further booster dose administration. Studies on other immunological indicators, such as cellular immunity, are therefore needed to better understand the mechanisms and duration of protection against breakthrough infection risk.

Sensitization to ethylenediamine dihydrochloride in patients with contact dermatitis in northeastern Italy from 1996 to 2021.

BACKGROUND: Ethylenediamine dihydrochloride is a versatile aliphatic amine found in numerous medications and industrial compounds and is a known sensitiser. The sensitization prevalence is affected by geographical and socio-cultural factors. OBJECTIVES: The objectives are to analyse the temporal trend of sensitization to ethylenediamine dihydrochloride in northeastern Italy and to investigate associations with occupations. METHODS: Between 1996 and 2021, 30 629 patients with suspected allergic contact dermatitis were patch tested with the Triveneto baseline series. Individual characteristics were collected through a standardised questionnaire. RESULTS: The overall prevalence of ethylenediamine dihydrochloride sensitization was 1.29% with percentages similar in both sexes. We observed a significant decreasing trend over time (p < 0.001), yielding a sensitization prevalence <1% in recent years. Among departments, residence in Pordenone area was protective for sensitization. No significant associations were observed with specific occupations. We found significant associations between ethylenediamine dihydrochloride sensitization and being 26-35 years old (odds ratio [OR], 1.47; 95% confidence interval [CI]: 1.05-2.08), and sensitization for many haptens, such as paraben mix (OR, 5.3; 95% CI: 3.3-8.5), epoxy resin (OR, 5.1; 95% CI: 3.0-8.7), neomycin sulphate and mercaptobenzothiazole. CONCLUSIONS: Our study showed a downward time trend of ethylenediamine dihydrochloride sensitization in northeastern Italian population and pointed to an update of the Triveneto baseline series.

Probing the effectiveness of barrier creams against human skin penetration of nickel powder.

OBJECTIVE: Barrier creams (BCs) are marketed as locally applied medical devices or cosmetic products to protect the skin from exposure to chemicals and irritants. Generally, the mechanism of action of such products is mainly due to the formation of a superficial thin film between the skin and the irritant or sensitizer, thus reducing or totally blocking the cutaneous penetration of such agents. Specifically, studies focusing on the effectiveness of commercial protective creams to prevent nickel cutaneous penetration are extremely scarce. The aim of the current work, therefore, is to evaluate the protective role of a commercially available barrier cream for nickel and compare the results with a simple moisturizing, following exposure to Ni powder. METHODS: Marketed BCs were evaluated and tested. Human skin absorption of Ni was studied in vitro using static Franz diffusion cells. RESULTS: Our results demonstrate that the application of both formulations caused a reduction of Ni inside the skin (8.00 ± 3.35 µg cm-2 for the barrier cream and 22.6 ± 12.6 µg cm-2 for the general moisturizing product), with the specialized barrier cream being statistically (p = 0.015) more efficient on forming a protective barrier, thus evidencing the importance of some ingredients in such formulations on the nickel dermal accumulation. CONCLUSIONS: The composition of the formulations based on film-forming or chelating agents may play an imperative role in reducing the cutaneous penetration of Ni.

OBJECTIF: Les crèmes de barrière (CB) sont commercialisées en tant que dispositifs médicaux ou produits cosmétiques appliqués localement pour protéger la peau contre l'exposition aux produits chimiques et irritants. En général, le mécanisme d'action de ces produits est principalement dû à la formation d'un film mince superficiel entre la peau et l'irritant ou le sensibilisant, réduisant ainsi ou bloquant totalement la pénétration cutanée de ces agents. Plus précisément, les études portant sur l'efficacité des crèmes protectrices commercialisées pour prévenir la pénétration cutanée du nickel sont extrêmement rares. L'objectif du projet en cours est donc d'évaluer le rôle protecteur d'une crème barrière disponible dans le commerce contre le nickel et de comparer les résultats à un simple hydratant après une exposition à la poudre de Ni. MÉTHODES: Des CB commercialisées ont été évaluées et testées. L'absorption cutanée du Ni dans la peau humaine a été étudiée in vitro à l'aide de cellules de diffusion statiques de Franz. RÉSULTATS: Nos résultats démontrent que l'application des deux formulations a entraîné une réduction du taux de Ni à l'intérieur de la peau (8,00 ± 3,35 µg·cm-2 pour la crème barrière et 22,6 ± 12,6 µg·cm-2 pour le produit hydratant ordinaire), la crème barrière spécialisée étant statistiquement (p = 0,015) plus efficace pour former une barrière protectrice, démontrant ainsi l'importance de certains ingrédients dans ces formulations sur l'accumulation dermique du nickel. CONCLUSIONS: La composition des formulations basées sur des agents de formation de film ou de chélation peut jouer un rôle nécessaire pour réduire la pénétration cutanée du Ni.

Assessing Workplace Violence: Methodological Considerations.

The risk of violence is present in all workplaces. It must be accurately assessed to establish prevention and protection measures tailored to the features of each situation. The risk management process requires compliance in a sequential order: 1) risk identification, 2) quantitative risk assessment, and 3) impact assessment. Gathering workers' experiences using lists, focus groups, or participatory ergonomics groups is necessary to identify the phenomenon. For risk assessment, spontaneous reporting of events is often insufficient. It may be complemented with two methods: systematic recording of violent events that occurred in the past year during periodic medical examinations of workers and targeted surveys. The epidemiological analysis of data from individual interviews and surveys provides the phenomenon's prevalence, incidence, and evolution. Moreover, reporting the harm suffered by victims of violence allows constructing impact matrices to allocate resources where they are most needed.

Incidence of shoulder disorders in a cohort of healthcare workers from 2009 to 2020.

PURPOSE: To estimate the incidence of shoulder disorders in a cohort of Health Care Workers (HCWs). METHODS: 4406 workers employed from 2009 to 2020, were included in the study. Occupational risk factors and jobs were assessed according to working history. Incident cases were defined in case of shoulder pain associated with functional limitations during the medical examination. The Cox regression model was used to calculate the Hazard Ratio (HR) for different work activities, adjusted for age, sex, body mass index, and previous musculoskeletal injuries, using clerks as the reference category. RESULTS: The incidence rates of shoulder musculoskeletal disorder for men and women were 13.1 for 1000 person-years (CI 95% 10.6-16.3) and 20.1 for 1000 person-years (CI 95% 17.8-22.6) respectively. The adjusted HR was significantly increased with age (1.06, CI 95% 1.05-1.07), outpatient health activities (2.82, CI 95% 1.89-4.219), and wards health activity (2.37, CI 95% 1.68-3.33). CONCLUSION: HCWs with high biomechanical risk such as nurses and healthcare assistants had a higher incidence of shoulder disorders. Actions are needed for better prevention in health care assistance.

Occupational contact allergy: The European perspective-Analysis of patch test data from ESSCA between 2011 and 2020.

BACKGROUND: Occupational skin diseases have led the occupational disease statistics in Europe for many years. Especially occupational allergic contact dermatitis is associated with a poor prognosis and low healing rates leading to an enormous burden for the affected individual and for society. OBJECTIVES: To present the sensitization frequencies to the most relevant allergens of the European baseline series in patients with occupational contact dermatitis (OCD) and to compare sensitization profiles of different occupations. METHODS: The data of 16 022 patients considered having OCD after patch testing within the European Surveillance System on Contact Allergies (ESSCA) network between January 2011 and December 2020 were evaluated. Patients (n = 46 652) in whom an occupational causation was refuted served as comparison group. RESULTS: The highest percentages of OCD were found among patients working in agriculture, fishery and related workers, metal industry, chemical industry, followed by building and construction industry, health care, food and service industry. Sensitizations to rubber chemicals (thiurams, carbamates, benzothiazoles) and epoxy resins were associated with at least a doubled risk of OCD. After a decline from 2014 onwards, the risks to acquire an occupation-related sensitization to methyl(chloro)isothiazolinone (MCI/MI) and especially to methylisothiazolinone (MI) seem to increase again. Sensitization rates to formaldehyde were stable, and to methyldibromo glutaronitrile (MDBGN) slightly decreasing over time. CONCLUSIONS: Among allergens in the European Baseline Series, occupational relevance is most frequently attributed to rubber accelerators, epoxy resins and preservatives.

Recognized Occupational Diseases in Italy's Friuli-Venezia Giulia and Liguria Regions (2010-2021).

BACKGROUND: The study of recognized occupational diseases trend is important to understand the preventive approach needed in the future, however, while numbers of occupational diseases are available on web, data on incidence are missing. The aim of our study was to analyze the trend and the incidence rate ratio (IRR) of recognized occupational diseases in Italy, in Friuli-Venezia Giulia region (FVG) and Liguria region from 2010 to 2021. METHODS: Numbers of recognized occupational diseases by the Italian National Insurance for Occupational Diseases (INAIL) were analyzed and incidence were calculated considered the total number of workforces in the area. A Poisson regression model was used to estimate incidence trends. RESULTS: FVG region presented a higher incidence of all occupational diseases compared to Italy and to Liguria in the period considered. The overall incidence in 2019 was 175, 91.8 and 108 cases for 100,000 workers, for FVG, Liguria and Italy respectively. Musculoskeletal disorders (MSDs) were the majority of occupational diseases with 100, 51 and 82.8 cases per 100,000 workers, in FVG, Liguria and Italy, respectively. Incidence of occupational cancers was 16, 10 and 4.9 cases per 100,000 workers, in FVG, Liguria and Italy, respectively. The annual change of incidence from 2010 to 2019 was positive for MSDs (IRR 1.06; 95%CI 1.06 to 1.07) and decreasing for the other causes in Italy. In FVG region the trend was positive for MSDs (IRR 1.05;95%CI 1.04 to 1.06), for respiratory diseases (IRR 1.03; 95%CI 1.00 to 1.05) and pleural plaques (IRR 1.03; 95%CI 1.00 to 1.06). In Liguria the trend was positive for MSDs (IRR 1.17; 95% CI 1.15-1.19) and for pleural plaques (IRR 1.07; 95%CI 1.03-1.12). Stable trends were found for cancers. Declining trend was shown for noise induced hearing loss and skin diseases. CONCLUSIONS: FVG region presented a higher incidence of recognized occupational diseases compared to Liguria region and Italian data. Results that can be explained by a higher propensity of claiming for occupational diseases in workers, mainly for MSDs disorders. For cancers and asbestos-related diseases the higher incidence can be attributable to high exposure to asbestos in FVG and Liguria workers mainly in shipyard and dock activities.

Trends in Occupational Diseases in Italian Industry and Services From 2006 To 2019.

BACKGROUND: There is a paucity of data on occupational disease incidence in Italy, and we analyzed the trend on time as an incidence rate ratio (IRR). METHODS: Occupational diseases reported to the Italian National Insurance for Occupational Diseases (INAIL) in industrial and services sectors from 2006 to 2019 were considered and analyzed. Annual case counts were analyzed using a Poisson regression model to estimate incidence trends. RESULTS: The incidence of occupational diseases in the industrial and services sectors in 2019 was 261 cases for 100,000 workers, with musculoskeletal disorders (MSDs) representing 65% of the total cases, their incidence being 169.5 cases per 100,000 workers. The incidence of ear diseases (ED) decreased to 20.8 cases for 100,000 workers. The annual change in incidence (IRR) was 1.08 (CI 95% 1.07-1.11) for MSDs, 1.08 (CI 95% 1.06-1.10) for cancers, and 1.04 (CI 95% 1.03-1.06) for respiratory diseases. The trend was significantly negative for ear diseases, 0.96 (CI 95% 0.96-0.97), and skin diseases 0.93 (CI 95% 0.92-0.93). No changes were found for asbestos and mental diseases. CONCLUSIONS: During the study period, occupational diseases increased in Italy, mainly for MSDs, due to a changeover in eligibility criteria from 2008. However, the overall incidence was lower than in other EU Countries. More efforts are needed to harmonize the legislation for joint action in the prevention and recognition of occupational diseases.

Prevalence of work-related musculoskeletal symptoms among young orthopedics during the surgical practice: an intervention study.

BACKGROUND: Work-related muscle-skeletal symptoms (WRMS) represent a substantial social and economic impact on the way of work and have a high incidence in surgeons. In the literature, several studies address the impact of WRMS in surgeons performing gynecological, laparoscopic, and robotic surgery, but there are no studies in the field of orthopedic surgery. This pilot study aims to assess the effectiveness of a preventive program to reduce pain. METHODS: All workers filled in a standardized questionnaire, and postoperative pain in the operating room was quantified using a numeric scale (NAS). The intervention group followed ergonomic principles in the operating room supervised by a physiotherapist and specific physical exercises before and after surgery. Data were analyzed using the statistical program STATA rel. 14.0. RESULTS: Twenty-one surgeons were assigned to intervention groups and thirty-three to controls. At baseline, the two groups were homogeneous for anthropometric factors, and controls were older and with higher work seniority. Pain perception resulted in high in both groups in many body districts. At follow-up, after three months, the intervention group significantly reduced pain perception in all body districts for the lumbar back, knees, ankles and feet (p<0.05). In the control group, pain perception increased in all body districts investigated. CONCLUSIONS: We found a high prevalence of WRMS in young orthopedic surgeons, and we demonstrated the effectiveness of a preventive program through targeted ergonomic education and exercises for the most affected body districts.

Tailored physiotherapeutic intervention study for musculoskeletal disorders among video display terminal users.

BACKGROUND: Musculoskeletal disorders represent one of the most common complains among video display terminal (VDT) users and are responsible for an important burden of disease in white collars. METHODS: From May 2017 to March 2018, 69 VDT users working at Trieste hospitals were recruited for a training session aimed to reduce musculoskeletal disorders in white collars workers. Thirty-three were assigned to the intervention group, whereas 36 comprised the control group. The intervention group received three personalized 1-hour-one-to-one sessions with a physiotherapist and a thorough evaluation of their workstation. Data were collected at baseline (T0), at 2 months (T1) and at 6 months (T2) using a standardized questionnaire and analyzed with the software STATA. RESULTS: Overall pain significantly decreased in cases at T1 and T2 (p < 0.05). Headache significantly decreased in cases at T1 (p < 0.05). Body awareness significantly increased in cases both at T1 and T2 (p < 0.05). Headache was positively correlated with an increased perception of pain (Coef 6.85, CI95% 3.2-10.5; p < 0.001), while the intervention determined a significant reduction of overall pain during the follow up (OR 0.97, IC 0.95-0.99, p = 0.013). Cases showed a significant increase of the cranial-vertebral angle at the 6 months follow up (p < 0.05). CONCLUSION: A tailored physiotherapeutic intervention has showed a statistically significant decrease in osteoarticular pain and an increased body awareness in VDT users undergoing a personalized training session.v.

Occupational contact dermatitis in a gender perspective: North East Italian data 1996-2016.

BACKGROUND: Occupational contact dermatitis (OCD) ranks high among occupational diseases in Europe, but little is known as regards OCD and jobs in a gender perspective. OBJECTIVES: To evaluate sex prevalence of OCD according to occupational sectors and agents involved. 27381 patients (1996-2016) with suspected irritant/allergic contact dermatitis (ICD-ACD) were evaluated in North-Eastern Italy. Each patient underwent: a standardized questionnaire, a dermatologist/occupational physician evaluation and a patch test. RESULTS: Females were younger at diagnosis (35.2 ± 11.6 years vs 37.7 ± 12.6 in males, p< 0.001) and had a lower ICD prevalence (OR 0.58, C.I. 95% 0.51 - 0.66, p < 0.001). Job categories most involved differed between sexes, with highest rank for healthcare professionals in females and machinery mechanics and filters for males. In females ACD percentage was higher in all job categories. CONCLUSIONS: OCD characteristics differ between sexes, according to intrinsic and extrinsic factors. Use of personal care products, housekeeping products and outdoor work activities may account for different sensitization profiles.

Epidemiology of SARS-CoV-2 among healthcare workers in North-Eastern Italy from March 1, 2020 to May 10, 2020.

BACKGROUND: During major epidemic outbreaks, the preparedness of public health systems is challenged and -healthcare workers (HCWs) are at the frontline. Italy was among the first- and worst-hit countries by COVID-19. AIM: To analyze the prevalence and incidence of infection among HCWs in Friuli Venezia Giulia region (north-eastern Italy) from March 1 to the end of the Italian lock-down, May 10, 2020. METHODS: HCWs exposed to COVID-19 patients were actively surveyed and all HCWs were routinely tested with nasopharyngeal and oropharyngeal swab for RNA virus detection (n. 54,670). RESULTS: Infected HCWs (n. 595) represented the 32.3% of all COVID-19 cases in the region under 65 years of age, and incidence of infection was 11.4 cases/1000 workers. HCWs accounted for a significant proportion of coronavirus infection and experienced high infection incidence after unprotected contact. CONCLUSIONS: HCWs' knowledge of SARS-CoV-2 epidemiology and proper infection control practices are critical to the control of the disease.

Low sensitivity of rapid tests detecting anti-CoV-2 IgG and IgM in health care workers' serum for COVID-19 screening.

BACKGROUND: the sensitivity and specificity of a rapid antibody test were investigated for the screening of healthcare workers. METHODS: the serum of 389 health care workers exposed to COVID-19 patients or with symptoms, were analysed. All workers underwent monthly the screening for SARS-CoV-2 with detection of viral RNA in nasopharyngeal swabs by RT-PCR. IgG antibody detection in serum was performed by Chemiluminescence Immunoassay (CLIA) and by the Rapid test (KHB diagnostic kit for SARS CoV-2 IgM/IgG antibody after a median of 7.6 weeks (25°-75° percentiles 6.6-11.5). RESULTS: the rapid test resulted positive in 31/132 (23.5%), 16/135 (11.8%) and 0/122 cases in COVID-19 positive individuals, in those with only SARS-CoV-2 IgG antibodies and in those negative for both tests, respectively. Sensitivity was 17.6% (CI95% 13.2-22.7) and 23.5% (CI95% 16.5-31.6), and specificity was 100% (CI95% 97-100) and 100% (CI95% 97-100) considering Rapid test vs CLIA IgG or Rapid test vs SARS-CoV-2 positive RNA detection, respectively. CONCLUSION: the KHB Rapid test is not suitable for the screening of workers with previous COVID-19 infection.

Characteristics and incidence of contact dermatitis among hairdressers in north-eastern Italy.

BACKGROUND: Hairdressers are at high risk of contact dermatitis (CD) due to skin exposure to numerous irritants and haptens in hair products in combination with frequent wet work. OBJECTIVES: To investigate the characteristics and incidence of CD among hairdressers in north-eastern Italy. METHODS: A total of 324 hairdressers who had been examined and patch tested in north-eastern Italy from 1996 to 2016 were retrospectively identified, and compared with 9669 matched controls. Sensitization to allergens of the hairdressing series was analysed among hairdressers attending an occupational medicine clinic in Trieste, Italy. Incidence data were calculated from 1999 to 2016. RESULTS: Sensitization to p-phenylenediamine, thiuram mix, and N-isopropyl-N'-phenyl-p-phenylenediamine was significantly associated with hairdressing and with hand/forearms dermatitis. Frequent sensitizers from hairdressing series were ammonium persulfate, toluene-2,5-diamine, and p-aminobenzene. The overall incidence of CD declined from 2003 (31.7 cases/10 000 workers) to 2016 (20.8 cases/10 000 workers). CONCLUSIONS: Sensitization to several haptens was significantly associated with hairdressing. The incidence of CD among hairdressers in north-eastern Italy has declined in recent years, but is still high. Preventive efforts are needed to reduce the burden of CD in this professional group.

Occupational contact dermatitis in Triveneto: Analysis of patch test data of the North Eastern Italian Database from 1996 to 2016.

BACKGROUND: Occupational contact dermatitis (OCD) is frequent in the workplace. OBJECTIVES: To provide recent data on the epidemiology of OCD in Italy. METHODS: This multicenter retrospective study, conducted from 1996 to 2016, included patients with suspected allergic contact dermatitis (ACD) patch tested in the departments comprising the North-East Italy Contact Dermatitis Group. RESULTS: We studied 18 859 workers with a diagnosis of contact dermatitis (CD), of which 10.4% were recognized as being of professional origin. OCD declined from 1996 to 2011-2013 and increased in 2014-2016. The overall prevalence of both CD and OCD was higher in women compared to men, but the share of OCD of the total CD was greater for men compared to women. A history of atopic dermatitis was less frequent in workers with OCD than in non-OCD patients (5.8% vs 8.6%). Hairdressers were the youngest profession (27.1 ± 11.7 years). Hands were the primary site of involvement in patients with OCD (76.6%). The five highest risk occupations for OCD were hairdressers, cooks, metalworkers, chemical industry workers, and construction workers. CONCLUSIONS: OCDs have a relevant impact in our region, mainly for five job categories, and the increase in the last 3 years suggests the need to improve preventive measures.

Sensitization to nickel in the Triveneto region: Temporal trend after European Union regulations.

Highlights After the introduction of the EU regulatory interventions, nickel sensitization decreased significantly in the group of females aged ≤25 years. Women born between 1966 and 1975 presented the higheest prevalence of sensitization to nickel, then prevalence of sensitization gradually decreased with a minimum in more recent years. Nickel sensitization is higher in Italian patients compared to people living in other EU coutries. Additional interventions are needed to address nickel sensitization.

UV exposure, preventive habits, risk perception, and occupation in NMSC patients: A case-control study in Trieste (NE Italy).

BACKGROUND: UV exposure is strongly associated with the incidence of non melanoma skin cancers (NMSCs), both basal and squamous cell carcinomas. The aim of our study was to analyze risk perception, UV exposure, preventive habits, and occupation in 126 subjects affected by NMSC and 187 controls. METHODS: Consecutive cases with incident NMSC were recruited in Dermatologic Unit at University of Trieste; controls were recruited in Unit of Occupational Medicine. All had a medical examination to define Fitzpatrick skin type and skin lesions, and filled a standardized questionnaire on sun exposure habits, sun protection, occupational exposures, and sunburns in adulthood and childhood. RESULTS: In multivariate regression analysis, NMSC resulted significantly associated with age (OR: 1.03; 95% CI 1.01-1.05), with a positive feeling for tan (OR: 1.10; 95% CI 1.01-1.20), and sunbath numbers per year (OR: 1.02; 95% CI: 1.001-1.03). A protective effect was demonstrated for Fitzpatrick phototypes III-IV compared to I and II (OR: 0.31; 95% CI: 0.18-0.55), sunscreen use (OR: 0.35; 95% CI: 0.22-0.58), and risk perception (OR: 0.98; 95% CI: 0.97-0.99). In univariate analysis, we demonstrated an increased risk for fishermen, sailors, and lifeguards (OR: 4.3; 95% CI: 1.1-16.4); foundry and metallurgy workers (OR: 5.58; 95% CI: 1.14-27.3); and mechanics, fixers, and welders (OR: 8.2; 95% CI: 1.76-37.9). CONCLUSIONS: Our study demonstrated that protective behavior must be implemented in people living in Trieste. Workers must avoid direct UV exposure and must use protective equipment. More efforts are needed to increase knowledge on this risk and to raise awareness among at-risk people.

[Green coffee bean allergy and ultrafine particles exposure in Trieste dock workers]. / Allergia a caffè verde ed esposizione a particelle ultrafini nei lavoratori del porto di Trieste.

SUMMARY: The paper reviews allergy to green coffee bean and castor bean in dock workers and in coffee processing workers from '80 to nowadays in Trieste (NE of Italy). The avoidance of use of jute sacks contaminated with castor bean caused a decrease in sensitization to castor bean and the better work practices to handle jute sacks permitted to reduce airborne exposure to green coffee been powders, that resulted below occupational exposure limits. However, the measurement of ultrafine particles emitted during the handling of sacks showed exposure to high level of particles below 40 nm and permitted to identify some work tasks that can cause a more elevated exposure. Moreover, some sacks, coming from Tanzania, are still contaminated with castor bean, causing mild allergic symptoms. The work condition in dock workers in Trieste improved in years with a reduction of exposure to these allergens. However, the adoption of protective measures as well as periodical medical surveillance are needed to prevent sensitization or to detect the early onset of new cases.

The gender gap in Italian academic medicine from 2005 to 2015: still a glass ceiling.

BACKGROUND: Although women make up half of the population of medical students and residents, they are still under-represented in prominent leadership positions in academia. The disparity is greatest at the highest levels and represents a loss of talent for academic health centers, showing that women must choose between career advancement and personal life. OBJECTIVES: The aim of this study was to analyze gender distribution in Italian medical academia in all hierarchical roles (researchers in tenure track positions, associate and full professors) in different disciplinary scientific fields (SSD) in 2015 compared to 2005. METHODS: Medical faculties were considered at 31/12/2005 and 30/09/2015, and analyzed using Excel data sheet (Office for Windows 2007). Database was analyzed using STATA software (Texas, Inc. 2014). RESULTS: Women are under-represented in all careers: in 2005 they made up 36.2% of researchers, 21.7% of associate professors and only 9.4% of full professors. The percentage of women researchers increased significantly (p<0.0001) in 2015 to 41.9%, but the percentages of female associate professors (25.3%) and full professors (14.2%) were still extremely low. DISCUSSION: Our study shows that women are under-represented in Italian academia, with only a slight increase in presence in 2015 compared to ten years before. More action is needed to create a supportive environment, increase awareness and monitor potential discrimination.

Pilot study on a new concept of documenting the clinical relevance of patch test results in contact dermatitis patients.

BACKGROUND: Assessment of the clinical relevance of patch test reactions is an essential part of the diagnostic work-up of patients with (occupational) contact dermatitis. However, final diagnostic information, particularly the clinical relevance of allergic patch test reactions, has hitherto been ill-represented in clinical documentation systems (patch test software) and surveillance registries based on these. OBJECTIVES: To develop, implement as a pilot study, and analyse concerning feasibility and contents a new concept of representing the full scope of diagnostic information utilized in the diagnosis of patients with (occupational) contact dermatitis. METHODS: On the basis of a European working group discussion on items to document and catalogue lists to use for this purpose, an online documentation system to collect data was set up, followed by pilot use involving 9 dermatology departments across Europe. RESULTS: Data on 176 patients with suspected occupational hand dermatitis were included; among these, work-relatedness was confirmed in 150, and in 53 non-occupational aetiology was the sole or a contributory cause. Data were further analysed with regard to occupations, product categories, substances (haptens), source of information on which the evaluation was based, and various combinations of these factors, to illustrate the usefulness of the proposed data representation. CONCLUSIONS: An improved method of data collection is presented that more accurately links allergen to exposure and to clinical disease and patient history, and thus better represents clinical relevance. This enables more precise analysis of the causation of contact dermatitis, occupational or non-occupational, and thereby better targeting of prevention. The development of future databases should incorporate the above considerations to record the results of investigation.