Vaccination status among COVID-19 patients and duration of Polymerase Chain Reaction test positivity: evaluation of immunization schedule and type of vaccine.

Background: The introduction of the vaccine against SARS-CoV-2 has represented a cornerstone in the containment of the pandemic. Our aim was to assess the vaccination schedules in relation to the infection free interval and to the duration of positivity in case of infection. Study design: This study involves the SARS-CoV-2 infected people managed by the Local Health Authority ASL 1 Abruzzo. The data collected included: vaccine administration date, vaccine type, information on the Polymerase Chain Reaction test positivity, and demographic variables, such as age and sex. Methods: The duration of Polymerase Chain Reaction test positivity was assessed in relation to the vaccination status, the vaccine type and the time interval between the last vaccination dose and the first nasopharyngeal positive swab over the considered period. Results: The infection duration (DAYS) was significantly shorter in subjects vaccinated with a booster dose than unvaccinated subjects (12.8 vs 14.6; p<0.0001) and subjects vaccinated with the primary series only (12.8 vs 14.1; p<0.0001). Duration of PCR positivity was shorter with heterologous immunisation than with other vaccination schedules (p=0.0317). Conclusions: This study highlights, in a large cohort of patients, the association between vaccination schedule and the response to infection.

Occupational risk perception of construction workers: a cross sectional study.

Introduction: Construction workers are often exposed to significant injury risk. The aim of our study is to assess their occupational hazards and injury risk perception. Methods: We administered 256 questionnaires to construction workers. The survey was aimed at collecting information regarding occupational risk and hazard exposure perception, risk control and behavioral self-assessment. We analyzed the data obtained in order to highlight any associations between injury risk perception and anamnestic, occupational, behavioral or perceptual factors. Results: Participants were prevalently males (92.37%) aged 21-60 years (94%). They showed a job seniority level of 21.3 (11.51) on average and, ranging from a 1 to 10 score, a danger awareness of 6.8 (2.9), a lack of prevention measures 6.0 (3.3), an improper behavior of 7.3 (2.7), an unpredictable fate of 6.0 (2.9). These factors resulted significantly associated with the injury risk perception. Multivariable analysis highlighted that the injury risk perception was associated with the lack of prevention measure and unpredictable fate. On the other hand, we found a negative association with the workers' improper behaviors. Conclusion: Workers' perception showed fairly uniform average values even when occupational risk was demonstrated. Our analysis suggests a positive correlation between injury risk perception and the idea that injuries are due both to fate and to chance; it also shows a negative correlation between injury risk perception and the idea that injuries are due to improper behavior. A lack of fully comparable studies confirms the need for further studies on the injury risk perception of construction workers.

Implementation of community health care services to counter the SARS-CoV2 pandemic.

BACKGROUND: The COVID-19 pandemic has ravaged many countries worldwide since December 2019. The high infection rates, and the need for health care assistance for individuals with comorbidities, strained the national health care systems around the world. Outbreak peaks increased the burden on hospitals that where perceived as high-risk places by people, who often decided to cancel or defer hospital visits. Thus, Italian Local Health Authorities had to develop new organizational models to meet the increased health care needs of the population. The aim of this study is to assess the impact of strengthened community health services on the hospital burden. METHODS: We analysed the number of Emergency Department access at the Hospital De Lellis covered by the Local Health Authority in Rieti, from March 2020 to November 2021. We then assessed the effects of community health services: the Special District Continuing Care Units (SDCUs) and the the COVID hub, on the COVID-19-related ED access, admission and mortality rates. A Chi-squared test for trend and three multivariable logistic regression models were used to investigate the trends and the possible predictors of COVID ED access, COVID hospital admissions, and deaths. RESULTS: Being male (OR = 1.41, CI95% 1.05-1.90; p = 0.022) and older age (OR = 1.03, CI95% 1.02-1.04; p < 0.0001) increase the likelihood of hospitalisation for Sars-CoV-2. The implementation of the nursing and medical SDCUs contributed to reducing COVID-19-related deaths (OR = 0.09, CI95% 0.03-0.29; p < 0.0001). The simultaneous implementation of the COVID hub and of the nursing SDCUs had a synergistic effect in reducing the likelihood of hospitalisation (OR = 0.24, CI95% 0.09-0.65; p = 0.005). The subsequent implementation of the medical SDCUS has further contributed to lowering the admission rates. These protective effects persisted also after potential cofounders, such as age, sex, clinical condition on admission, and the immunisation status, were adjusted. CONCLUSIONS: These measures have helped in the management of patients in a complex context such as that of a pandemic by reducing the hospital load and playing an important role in the management of the pandemic. Further studies could assess the transferability of this model in a non-pandemic context.

Exposure assessment to inhalable and respirable dust in the post - earthquake construction sites in the city of l'Aquila.

OBJECTIVES: Following an earthquake that occurred in middle Italy in 2009, the involved territory hosted in 10 years thousands of construction sites. The aim of this study is to assess inhalable, respirable, and respirable crystalline silica exposure of the construction workers involved in the rebuilding activities. METHODS: Six construction companies joined the study and hosted the air sampling activities. We identified four work tasks: bricklayer and similar; scaffolder and carpenter; manual demolition; other tasks. We reported 8-h time-weighted concentrations. RESULTS: The "All tasks" geometric mean concentration of inhalable dust was 4.73 mg/m3 and the higher, TLV exceeding exposure was observed for "Manual demolition workers" (13.92 mg/m3 , GM). The "All tasks" geometric mean concentration of respirable dust was 0.25 mg/m3 and no TLV-exceeding exposure (geometric mean values) was observed among the work-related groups. About the respirable crystalline silica dust exposure, the "All tasks" average concentration was 0.004 mg/m3 . No TLV-exceeding exposure was observed among the whole data sample. CONCLUSIONS: The comparison of the results shows that manual demolition workers are exposed to high levels of inhalable dust, exceeding the TLV-TWA (Threshold Limit Values-Time Weighted Average) limit of 10 mg/m3 . About the respirable dust concentration, none of the analyzed work task dust concentrations exceeded the TLV-TWA limit of 3 mg/m3 (geometric mean values). Measurements of respirable crystalline silica dust have shown levels below the threshold limit value of 0.025 mg/m3 . Our findings overall match with the available scientific data.

Environmental status of an Italian site highly polluted by illegal dumping of industrial wastes: The situation 15 years after the judicial intervention.

In 2008 the Italian government classified the Bussi sul Tirino area (Central Italy) as Site of National Interest destined to remediation which, unfortunately, has not yet begun. The decision followed >20 years of illegal dumping of industrial wastes, lasting from 1984 to 2005, that generated the biggest illegal toxic waste disposal site in Europe. The contamination profile of the site was mainly characterized by PCDD/Fs, PCBs, PAHs, chlorinated solvents, Hg, and Pb. Due to the health concern of the population and local authorities, an extensive monitoring and biomonitoring campaign was carried out in 2017-2018, checking the site-specific pollutants in local food (free-range hens' eggs, milk from grazing sheep and goats, wild edible mushrooms, and drinking water), environmental (air and freshwaters) and biological (human urine) matrices. A total of 314 samples were processed, obtaining 3217 analytical data that were compared with regulatory limits, when available, and values reported by international literature. The sum PCDD/Fs and DL-PCBs ranged from 0.24 to 3.6 pg TEQ g-1 fat, and from 0.46 to 8.3 pg TEQ g-1 fat, respectively in milk in eggs, in line with the maximum levels established by CE Regulations except for an egg sample. As regards PAHs, all our results were lower than the literature data, as well as for Hg and Pb. Outdoor air showed levels of chlorinated solvents ranging from

Experimental Application of Semi-Quantitative Methods for the Assessment of Occupational Exposure to Hazardous Chemicals in Research Laboratories.

PURPOSE: The aim of this study was to evaluate the application of some chemical risk assessment semi-quantitative methods and also to identify potential bias or differences originated by applying different methods to the same activities. METHODS: We collected the data related to the chemical agents used in three different activities of three laboratories of an Italian university; the methods we compared were: MoVaRisCh, COSHH Essentials, LaboRisCh and Datarisch. RESULTS: The input parameters requested by each method are shown for each activity and for each used chemical. We collected the results obtained since the application of the four different tools in three tables. The use of some chemicals (especially of the activity n° three) shows a not irrelevant risk for the users. CONCLUSION: Our findings show that COSHH Essentials, MoVaRisCh and Datarisch tools are consistent in the identification of a risk level; the small differences are related to risk rating, to be considered in relation with the specific structure of the method applied. The differences detected in the risk rating may be overcome by applying, for each working activity we want to assess, two or more different semi-quantitative tools. This strategy can allow to reduce the exposure to chemicals of the workers.

Early genotoxic damage through micronucleus test in exfoliated buccal cells and occupational dust exposure in construction workers: a cross-sectional study in L'Aquila, Italy.

AIM: The city of L'Aquila (central Italy) was hit by a strong earthquake in 2009 that caused the collapse of several buildings, deaths and injured people. In the following years, a great number of building sites were activated, building workers resulted intensely exposed and represent a relevant target for research on environmental mutagenesis and epidemiological surveillance. Cells of buccal mucosa are considered an appropriate site for early detecting of cytogenetic damage, since it represents the first barrier in inhalation or ingestion and can metabolize carcinogenic agents into reactive chemicals. Our study is aimed 1) at comparing the early genotoxic damage as measured by the buccal mucosa micronucleus test in two subgroups of workers defined by different occupational exposure and 2) at evaluating possible confounding variables such as lifestyle factors. METHODS AND RESULTS: A cross-sectional study was conducted in L'Aquila, on 24 outdoor workers (OWs) highly exposed on the construction sites and 26 indoor workers (IWs), all subjected to the compulsory occupational surveillance system, in the period 2017-2018. Buccal cells samples were collected and, based on the Micronucleus test, the exfoliated cells were classified in respect of nuclear changes observed. Moreover, a self-report questionnaire composed of 84 items, was administered to the workers. RESULTS: Significant differences were observed between Exp+ (OWs) and Exp- (IWs) in the number of the analyzed cells (expressed as mean value out of 1000 cells): respectively 954.46 vs 990.06 normal cells, (p < 0.001); 19.79 vs 4.95 micronucleated cells, as marker of chromosomal damage (p < 0.001); 13.93 vs 8.96 binucleated cells, as marker of failed cytokinesis (p < 0.001); 2.09 vs 1.18 karyolytic cells, as marker of cell death and damaged DNA (p < 0.05). According with a multivariate regression analysis, in addition to the job exposure (OW vs IW, beta = 12.221, p < 0.001), the only variable independently associated with an increase in Micronuclei (MNs) is the smoking habit (OWs vs IWs, beta = 6.683, p < 0.001) which, even if not associated with dust exposure, worsens cell integrity. Moreover, this worsening effect is weaker in workers not exposed to the site dust (moderation effect). Within social demographic factors, the high educational level only apparently seems to affect MNs number: even if unbalanced in favor of IWs vs OWs, this variable resulted a confounder, since its effect disappears when the interaction between these two factors is considered, because it is a covariate of smoking habit as well as of the job condition. CONCLUSION: Despite some limitation, our findings clearly confirm the role of occupational exposure as a marker of cytogenetic damage associated with MNs number in construction workers. Moreover, smoking status appears as the only other investigated factor independently associated to the outcome. The statistical model, in addition, highlights possible moderation and confounding effects, such as interaction between smoking and occupational exposure and the unbalanced school education level in workers. Micronucleus test in exfoliated buccal cells would be considered a suitable method for studying the early genotoxic damage in the construction occupational setting as well as in evaluating the efficacy of preventive practices.