Occupational Medicine and Prevention of Chronic and Infectious Diseases.

Occupational medicine is a clinical discipline that draws attention to the health of workers and their ability to work [...].

Evaluation of the Factors Associated with Reinfections towards SARS-CoV-2 Using a Case Control Design.

OBJECTIVE: The risk of reinfection with SARS-CoV-2 has been rapidly increased with the circulation of concerns about variants. So, the aim of our study was to evaluate the factors that increase the risk of this reinfection in healthcare workers compared to those who have never been positive and those who have had only one positivity. METHODS: A case-control study was carried out at the Teaching Hospital Policlinico Umberto I in Rome, Sapienza University of Rome, in the period between 6 March 2020 and 3 June 2022. Cases are healthcare workers who have developed a reinfection with the SARS-CoV-2 virus, while controls were either healthcare workers who tested positive once or those who have never tested positive for SARS-CoV-2. RESULTS: 134 cases and 267 controls were recruited. Female gender is associated with a higher odds of developing reinfection (OR: 2.42; 95% CI: 1.38-4.25). Moreover, moderate or high alcohol consumption is associated with higher odds of reinfection (OR: 1.49; 95% CI: 1.19-1.87). Diabetes is also associated with higher odds of reinfection (OR: 3.45; 95% CI: 1.41-8.46). Finally, subjects with increased red blood cell counts have higher odds of reinfection (OR: 1.69; 95% CI: 1.21-2.25). CONCLUSION: From the prevention point of view, these findings indicate that particular attention should be paid to subjects with diabetes mellitus, women and alcoholic drinkers. These results could also suggest that contact tracing represents a fundamental approach model against the SARS-CoV-2 pandemic, together with the health information of participants.

Assessment of the Impact of Low-dose Ionizing Radiation Exposure on Health Care Workers: A Study of Methods Used from a Scoping Review.

ABSTRACT: Healthcare workers may be exposed to ionizing radiation. Ionizing radiations are an important occupational risk factor for the potential damage they can cause to workers' health. Actually, the attention is focused on diseases caused by damage to radiosensitive organs. The aim of our study is to evaluate the methods used for the assessment of the impact of exposure to low-dose ionizing radiation in a population of healthcare workers (HCWs). The electronic database PubMed was searched by title, abstract, and medical subheadings (MeSH) terms. The extracted data were arranged into tables by dividing bibliographic reference, exposure, and statistical analysis information. The quality assessment was performed with the use of the Newcastle-Ottawa Quality Assessment Scale. The search strategy involved retrieving 15 studies (eight cohorts and seven cross-sectional studies). The univariate tests have been performed in 14 studies (93.3%), and Chi-square and T-test were the most commonly used. Multivariate tests have been performed in 11 studies (73.3%), and the most commonly performed were Logistic and Poisson Regressions. The most rated organ was the thyroid gland (six studies). The annual cumulative effective dose was the most used method to assess the dose rate (seven studies). Due to the characteristics of pathologies involved, a retrospective cohort study with an adequate control group and use of the annual cumulative effective dose to account for exposure could be useful features to obtain the best possible evidence. All the elements were found rarely in studies considered. The need is highlighted for more in-depth studies to investigate this topic.

Mindfulness as a tool for reducing stress in healthcare professionals: An umbrella review.

BACKGROUND: Health care providers (HCPs) and health care students experience a huge amount of stress due to high workloads and pressure to perform and are likely to develop anxiety, depression and burnout. OBJECTIVE: The objective was to carry out an umbrella review of systematic and narrative reviews on the effectiveness of mindfulness-based interventions in reducing stress and improving well-being in HCPs and health care students. METHODS: Systematic and narrative reviews that examined the impact of mindfulness-based interventions on HCPs and healthcare students' perceived stress were identified through a systematic search of three electronic databases: PubMed, Scopus and Web of Science. RESULTS: Fifteen articles were included in the analysis: eleven systematic and four narrative reviews. Studies' quality varied from critically low to high. The different interventions showed positive results in reducing stress in both HCPs and students, with mindfulness-based stress reduction (MBSR) course having the major impact. CONCLUSIONS: MBSR techniques and other mindfulness based interventions resulted to be potentially effective in reducing stress. However, despite the vast amount of data collected by the studies and the promising results, several limitations affected the validity of the studies. Therefore, more research that considers the critical aspects of this field is required, in order to provide more reliable results.

Prevalence and Risk Factors of Bullying and Sexual and Racial Harassment in Healthcare Workers: A Cross-Sectional Study in Italy.

BACKGROUND: This cross-sectional study aims to evaluate the prevalence and socio-demographic factors associated with workplace bullying, sexual harassment and racial harassment among Italian health workers. METHODS: We recruited 3129 participants using an online Italian translation of the 'Workplace Violence in the Health Sector Country Case Studies Research Instruments Survey' (WVHS) questionnaire. Data were analyzed with univariate (chi-square) and multivariate (multiple logistic regression) analysis. RESULTS: Univariate analysis shows that females are significantly more affected by bullying (16.4% vs. 12.3%) and sexual harassment (2.4% vs. 1.3%). On the other hand, males are significantly more affected by racial harassment (3.1% vs. 2.0%). Multivariate analysis shows higher odds of being affected by bullying (OR = 1.30; 95% CI (1.03, 1.64)) and sexual harassment (OR = 2.08; 95% CI (1.04, 4.00)) for females, and higher odds of undergoing racial harassment (OR = 1.55; 95% CI (0.95, 2.53)) for males. CONCLUSION: This analysis of work situations looks to identify those risk factors, existing or potential, that increase the probability of episodes of violence. A group of work or other subjects identified by direction will have to evaluate the vulnerability of workplaces and establish more effective preventive actions to be adopted.

Thyroid parameters variations in healthcare workers and students exposed to low-dose ionizing radiations.

SUMMARY: Background. Ionizing Radiations (IR) are an important occupational risk factor for the potential damage that can cause to workers' health and for their presence in numerous professional settings. Health care workers (HCW) can be exposed to IR from various sources, in particular from x-rays using radiological equipment, and represent the largest group of workers occupationally at risk, despite increased regulation and protection which caused exposure to low dose radiations. The thyroid gland is one of the most sensitive organs to damage and an important target of IR, leading to functional and organic diseases. The aim of this study is to assess the variations in thyroid hormones, in a population of HCW exposed to low-dose IR. Methods. 121 individuals of the Teaching Hospital Policlinico Umberto I in Rome exposed to low-dose of IR (78 HCW, 17 Residents and 26 Radiology Technicians Students) were observed assessing serum levels of different thyroid function parameters as free triiodothyronine, free thyroxine and thyroid stimulating hormone at T1, T2 and DeltaT. Age, gender, history of thyroid diseases, BMI and smoke were analyzed as possible influencing factors using linear and multiple logistic regression analysis. Results. Analyzing TSH, fT3 and fT4 serum levels, in two different measurement (T1 and T2) and considering Delta between them, adjusting for different confounding factors, data showed no variation of TSH levels related to occupational exposure, a decrease of fT3 hormone values in HCW and residents, and an increase of fT4 in HCW. Discussion. The analysis of our results revealed that hospital occupation has an impact on thyroid hormones variations, with an increase of fT4 and a decrease of fT3 and no variations of TSH. These results are in conflict with previous studies evidences, in which both free hormones decreased with a concomitant increase of TSH. Conclusion. Exposure to low dose IR influences levels of free thyroid hormones, with no variation in TSH, which could result in a functional or organic disease. For this reason it is recommended continuous surveillance through a periodic check of all the thyroid hormones for an overall view of each HCW. However, further studies are necessary to confirm hormones trend and assess any related thyroid diseases.

[Workplace injuries in micro and small enterprises in the period 2013-2015 in the province of Rome (Italy)]. / Infortuni sul lavoro nelle micro e piccole imprese nel periodo 2013-2015 in provincia di Roma.

SUMMARY: Background. Micro and small enterprises (MSE) have fewer than 10 and 50 employees, and an annual balance sheet total that does not exceed € 2million and 10 million, respectively. Aim. To assess injuries in the micro and small enterprises in the Province of Rome in the period 2013-2015. Methods. In this study MSEs of the Confederazione Nazionale dell'artigianato piccole e medie imprese (CNA) of Rome were randomly selected. Results. In 290 MSEs sampled, 7 workplace injuries occurred, 3 in the same enterprise (PVC window frames, one injury per year) and the others occurred in an orthopaedic laboratory, in a store for building construction, in a cleaning company and in a company plant. The injury rate was 5.93‰ in three years (i.e., 1.97‰ per year on average). Conclusions. Workplace injuries in MSEs in the Province of Rome is not relevant (almost 2‰ per year), if compared to the injury rates in the Lazio region and the national level.

{Perception of alcohol problem among workers of the transportation, healthcare and building sectors in the Lazio Region]. / La percezione del problema alcol fra I lavoratori in aziende dei settori trasporti, sanità ed edilizia nella regione Lazio.

AIM: To perform an analysis of the perception of alcohol use among workers of the transportation, healthcare and building sectors. METHODS: A survey was carried out on alcohol consumption and knowledge of deriving health effects. Socio-demographic characteristics of the workers were collected. Risk indexes for habitual alcohol and binge consumption were calculated. RESULTS: The number of workers entering the survey is 3,914 (57% males; 58% married). Two-thirds of the sample reported good knowledge of alcohol-related risks that could occur at the workplace, and 55% of alcohol-related health risks. Binge drinking is inversely associated with female gender, good perceived health and good knowledge of alcohol-related risks at the workplace and of alcohol-related health risks. People who are single, young and working in the building sector show higher odds for binge drinking. The habitual use is positively associated with marital status (OR=1.51 for single) and working sector (in the building sector OR=3.28; in the healthcare OR=1.90); and inversely associated with good health (OR=0.70), good knowledge of alcohol-related risks at the workplace (OR=0.54) and of alcohol-related health risks (OR=0.41). CONCLUSIONS: Socio-demographic factors, such as age, gender and marital status are associated with different patterns of alcohol consumption, that in turn are inversely associated with good knowledge of alcohol-related risks at the workplace and of alcohol-related health risks. These results suggest the need to increase knowledge of alcohol-related issues among the workers, both at the workplace and in everyday life.

Are Bank Employees Stressed? Job Perception and Positivity in the Banking Sector: An Italian Observational Study.

Background: The epidemiology of stress on bank workers in Europe is only at the introductory stages. This study investigated for the first time the association between occupational stress level in bank-employees using the BEST8, Karasek-Model and socio-demographic and working factors in Italy. Methods: The observational pilot study involved 384 employees. Three questionnaires were adopted to collect data: Karasek-Model, BEST8 (p < 0.001) and Positivity-Scale. Results: 25% of the sample belonged to high stress group. The workers more stressed were older with a commercial role and consumer of antidepressants/sedatives. Women were much more likely to agree with the perception of feeling unsafe in a possible robbery (OR = 2.42; 95% CI: 1.50-3.91) and with that sales requests were in conflict with one's own personal moral code (OR = 2.31; 95% CI: 1.38-3.87). Older employees declared feeling inadequate in the workplace (OR = 1.97; 95% CI: 1.07-3.65) and younger employees referred to be anxious about meeting financial budget goals. Workers who had a low positivity had a lower probability of adaptation (OR = 0.88; 95% CI: 0.83-0.93). Conclusions: The occupational stress level in the banking sector involves many aspects: gender, type of bank, role, personal morals, high job-demands, low level of decision-making. This study recommended that banks should implement strategic interventions for well-being of employees, and consequently for their productivity.

Association between Work Related Stress and Health Related Quality of Life: The Impact of Socio-Demographic Variables. A Cross Sectional Study in a Region of Central Italy.

The aim of this work is investigate relationship between health-related quality of life and work-related stress and the impact of gender, education level, and age on this relationship. A cross-sectional study was conducted among workers of various setting in Rome and Frosinone. Work-related stress was measured with a demand-control questionnaire and health-related functioning by SF (short form)-12 health survey. There were 611 participants. Men reported high mental composite summary (MCS) and physical composite summary (PCS). In multivariate analysis age, gender (p < 0.001) and job demand (0.045) predicted low PCS. Low MCS predicted poor PCS. Job demand and educational level resulted negatively associated with MCS. In an analysis stratified for age, gender, and educational level, gender and age resulted effect modifier for MCS, gender and education level for PCS. In women increase of decision latitude predict (p = 0.001) an increase in MCS; a low job demand predict high MCS in male (p ≤ 0.001). In younger workers, a lower level of job demand predicted high MCS (<0.001). For PCS, gender and education level resulted effect modifier. In women, high decision latitude predicted higher PCS (p = 0.001) and lower level of job demand results in higher PCS (p ≤ 0.001). Higher educational level resulted predictor of low PCS. Management of risk about work-related stress should consider socio-demographic factors.

[Employee Wellbeing in a University Department, Italy]. / Il benessere organizzativo in un dipartimento universitario.

A serene workplace environment can provide significant benefits to employees. The aim of the present study was to assess wellbeing of employees in a university department, by administering validated questionnaires (Karasek and INAIL) and to determine any similarities and / or differences. The sample consisted of 48 employees (22.9 % male and 77.1% female) in various job categories including doctors, biologists, nurses, and technical and administrative staff. Results obtained from the Karasek questionnaire allowed us to calculate the values of Decision latidude and Job demand. The intersection of the medians of the two components, respectively 56 and 30, allowed us to divide participants into four quadrants consisting of high "strain" workers, active and passive and low "strain" workers. Thirty seven percent of the sample was found to be at high risk of stress. Significant differences in responses were identified in relation to gender, age, job seniority and educational level. Responses to the two questionnaires compared favorably. Seventeen questions were compared, and for eleven of these there was sufficient agreement, with kappa test values comprised between 0.194 and 0.408 (p<0.05). Results confirm that work-related stress is a relevant issue. Karasek and INAIL questionnaires, while investigating similar issues, should not be used alternatively but rather administered simultaneously.

Prevalence of major cardiovascular risk factors among oil and gas and energy company workers.

INTRODUCTION: Cardiovascular diseases (CVD) remain the biggest cause of disability and premature death throughout the world. AIM: The aim of this study was to describe and determine the prevalence of major cardiovascular risk factors emerged at the first medical examination carried out by a group of an oil and gas contractor company workers in the observation period 2000-2010. METHODS: An observational cross-sectional study was conducted on 1073 workers (mean age 41 years, SD = 9.5) presenting overweight BMI (body mass index) values, hypertension and cholesterol problems. RESULTS: In particular, we found that workers > 45 years had significant higher risk to have obesity (OR = 3.8, CI 95% = 2.5-5.7), hypertension (OR = 2.7, CI 95% = 2.1-3.6), high blood fasting glucose (OR = 2.6, CI 95% = 1.2-5.5), high cholesterol (OR = 2.7, CI 95% = 2.0-3.6), high triglycerides (OR = 1.8, CI 95% = 1.4-2.4) compared to younger (< 45 years).

Levels of anti-HBs antibody in HBV-vaccinated students enrolled in the faculty of medicine, dentistry and health professions of a large Italian University.

BACKGROUND: Prophylaxis against hepatitis B virus (HBV) addressed to students of the faculties of health professions has received great attention. Objectives. The present study aims to assess vaccination coverage against hepatitis B in healthcare professionals in training. MATERIALS AND METHODS: A retrospective study was carried out using data from the students of medicine, dentistry, and health professions. RESULTS: 4180 vaccination certifications were examined through the internal database. Significant differences (<0.0001) emerge between the number of doses applied and the antibody level. 50.4% of the students have nonprotective antibody levels (<10 IU). The age of the first dose significantly influences the level of coverage, resulting in more coverage in those vaccinated with earlier onset (1-10 years). Antibody levels are not significantly different by type of course; the levels of noncoverage are present in 44.4% of the students of medicine and dentistry and in 50.6% among those belonging to the health professions. CONCLUSIONS: This study represents one of the first experiences in Italy on vaccination against HBV and the relationship between doses of vaccination and antibody titer in the biomedical students that can configure a step forward in the real-time monitoring in order to establish a register of vaccination.

[Latent tuberculosis infection: prevalence amongst healthcare students at the Sapienza University of Rome (Italy)]. / Infezione tubercolare latente: analisi su una popolazione di studenti della Sapienza Università di Roma.

Healthcare workers, including medical, dentistry and nursing students, have an increased risk of Mycobacterium tuberculosis infection. In this study the prevalence of tuberculin skin test (TST) positivity (defined as induration ≥ 5 mm) among healthcare students enrolled at the Sapienza University of Rome (Italy) in the years 2011-2012 was evaluated. Overall, 2,519 students with a mean age of 20.6 years were tested, of whom 62.4% were female, 0.4% were vaccinated with BCG and 4.6% were foreign-born. Eighty-two students (3.3%) were found to have a positive TST. Prevalence varied by age and geographical place of birth. A baseline evaluation of medical and other healthcare students' TST status at the beginning of their training is essential to better implement infection and control measures for tuberculosis infection.

[Control and prevention of tuberculosis in healthcare facilities]. / Protocollo per la Prevenzione e il Controllo del Rischio di Tubercolosi nelle strutture sanitarie.

Tuberculosis remains the leading cause of death by a single infectious agent. Healthcare workers who for professional reasons are exposed to infectious patients and to potentially contaminated materials are at high risk of infection. This article provides a review of existing regulations and summarizes national and international guidelines and operational protocols for tuberculosis surveillance in clinical settings.