Patch Test Positivity to Palladium: A 5-Year Retrospective Study in Triveneto Region, Italy.

BACKGROUND: The use of palladium (Pd) is increasing in metal objects after the banning of nickel in items in prolonged contact with the skin. The properties of Pd make this metal useful in various industrial fields. OBJECTIVE: The aim of the study was to evaluate the prevalence of Pd sensitization in patients who underwent patch tests for suspected allergic contact dermatitis in the Triveneto region from 2013 to 2018. METHODS: A total of 4816 patients with symptoms and/or signs of suspected contact allergic dermatitis were patch tested. Individual characteristics were assessed using a standardized questionnaire. RESULTS: The overall prevalence of Pd sensitization was 7.6% and 10.8% using PdCl2 1% or 2% petrolatum, respectively, with a higher prevalence in women (odds ratio, 2.6; 95% confidence interval, 1.9-3.7) and in 26- to 55-year-old patients. Monosensitization occurred in 1%-1.5% of the patients tested. Health care workers and technicians were more sensitized to Pd than clerks, but the data did not reach statistical significance. CONCLUSIONS: Palladium sensitization was high, but it was mainly associated with nickel sensitization. A possible occupational role was found for workers with potential contact with Pd-containing objects, but more data are needed to reach statistical significance.

SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers.

BACKGROUND: The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers. METHODS: A multicentric retrospective cohort study, involving 12 European centers, was carried out within the ORCHESTRA project, collecting data up to 18 November 2021 on fully vaccinated health workers. The cumulative incidence of SARS-CoV-2 breakthrough infections was investigated with its association with occupational and social-demographic characteristics (age, sex, job title, previous SARS-CoV-2 infection, antibody titer levels, and time from the vaccination course completion). RESULTS: Among 64,172 health workers from 12 European health centers, 797 breakthrough infections were observed (cumulative incidence of 1.2%). The primary analysis using individual data on 8 out of 12 centers showed that age and previous infection significantly modified breakthrough infection rates. In the meta-analysis of aggregated data from all centers, previous SARS-CoV-2 infection and the standardized antibody titer were inversely related to the risk of breakthrough infection (p = 0.008 and p = 0.007, respectively). CONCLUSION: The inverse correlation of antibody titer with the risk of breakthrough infection supports the evidence that vaccination plays a primary role in infection prevention, especially in health workers. Cellular immunity, previous clinical conditions, and vaccination timing should be further investigated.

COVID-19 susceptibility and vaccination coverage for measles, rubella and mumps in students and healthcare workers in Trieste hospitals (NE Italy).

BACKGROUND: Measles, mumps, and rubella (MMR) vaccines have been suggested as preventive measures to protect subjects from the worst sequelae of COVID-19 infection because neutralizing antibodies can cross-react with other viruses. AIM: To verify COVID-19 infection in MMR vaccinated and non-vaccinated healthcare workers and medical students in Trieste Hospitals. RESULTS: Nurse aids resulted in significantly more infections than structured physicians (OR 1.80; 95% CI 1.14-2.80) while students resulted in less infections (OR, 0.66; 95% CI 0.43-1.01). The presence of an MMR vaccination was inversely associated with COVID-19 (OR, 0.77; 95% CI 0.61-0.96) but only in univariate analysis. In the multivariable logistic regression analysis, MMR vaccination lost statistical significance (OR, 0.86; 95%CI 0.62-1.20).On 13 HCWs hospitalized for COVID-19, 11 resulted not vaccinated for MMR. DISCUSSION: Our study found a mild, non-significant reduction in SARS-CoV-2 infections in workers vaccinated with MMR.

Incidence of COVID-19 infection in hospital workers from March 1, 2020 to May 31, 2021 routinely tested, before and after vaccination with BNT162B2.

To evaluate the incidence of COVID-19 infection in health care workers from the start of the COVID-19 pandemic in NE Italy, vaccination with BNT162b2. This was a retrospective cohort study. Healthcare workers were routinely tested for SARS-CoV-2 infection using real-time polymerase chain reaction tests in nasopharyngeal swabs. Logistic regression was used to calculate the incidence rate ratios (IRRs) of the factors associated with COVID-19. A total of 4251 workers were followed up, and the prevalence of COVID-19 was 13.6%. In March 2021 the incidence of infection was 4.88 and 103.55 cases for 100,000 person-days in vaccinated and non-vaccinated workers, respectively, with an adjusted IRRs of 0.05 (95% CI 0.02-0.08). Our study evaluated the monthly incidence in health care workers in Trieste hospitals before and after vaccination, finding an estimated vaccine effectiveness of 95% in health care workers routinely tested.

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.

Pleural and peritoneal mesotheliomas in the Friuli Venezia Giulia register: data analysis from 1995 to 2015 in Northeastern Italy.

BACKGROUND: The Friuli Venezia Giulia Mesothelioma Register contains a case-list of 1,109 mesotheliomas (1,034 pleural, 75 peritoneal) during 1995-2015. Exposure data are available for almost all cases. The aim was to assess mesothelioma incidence in the Region, an area with several shipyards, and to investigate determinants of mesothelioma latency among occupational cases. METHODS: Incidence rates were calculated. Univariate and multivariate analyses were performed to estimate latency time by anatomical site, gender, diagnostic period and industry sector. RESULTS: Mesothelioma incidence rates among men were higher than among women during the overall period. The incidence of pleural mesothelioma in men leveled off until 2009 (6.50 per 100,000) with a slight decrease thereafter. For women, the rate increased until 2006 (1.31 per 100,000) and then remained relatively stable. The incidence of peritoneal mesothelioma in men was constant whereas rate among women increased during 2010-2015. The number of cases diagnosed during three-year periods remained level. In multivariate model, site and gender were not relevant for latency period whereas construction workers had a shorter latency than shipyard workers. CONCLUSIONS: Despite the asbestos ban since 1992, occupational exposure is still at risk. This highlights the need to assess exposure levels and to find a reliable health surveillance tool.

Pleural mesothelioma in household members of asbestos-exposed workers in Friuli Venezia Giulia, Italy.

OBJECTIVES: Malignant mesothelioma is closely associated to asbestos exposure. One such exposure may occur through contact with occupationally exposed household members and their belongings. This study examines the features of pleural mesothelioma attributable only to asbestos brought home by another family member. MATERIAL AND METHODS: The data sources were 1063 mesothelioma cases diagnosed between 1995 and 2014, from the Friuli Venezia Giulia Mesothelioma Register. In all cases the diagnosis of mesothelioma was based on the pathology report. Exposure information and demographic data were acquired by an occupational medical standardized questionnaire/interview. RESULTS: Household-exposure mesothelioma cases included 33 women and 2 men. Relationships were: wives (N = 22), daughters (N = 9), sons (N = 2), and mothers (N = 2). Asbestos exposure in the workers predominantly occurred in shipyards. Out of the 35 pleural cases, 19 were epithelial, 9 biphasic, 3 sarcomatoid, and 4 not specified. The mean age at diagnosis was 77 years old. The mean latency was 59 years, with wives having a significant shorter latency than offspring. Latency was not significantly related to morphology and asbestosis. The overall mean survival was 16 months (median 11 months) but treatment was beneficial (mean 16 months vs. 7 months). Biphasic/sarcomatoid histology and presence of asbestosis were associated with a decreased survival, although not with statistical significance. CONCLUSIONS: Our data confirms that household exposure increases the risk for pleural mesothelioma amongst women with no history of occupational asbestos exposure. This is an ongoing problem in many countries, as well as in Italy, where the evaluation of a framework for the compensation of these cases is under debate. Int J Occup Med Environ Health 2017;30(3):419-431.

[Asbestos related cancers in seamen]. / Rischio cancerogeno da amianto nella marineria civile.

Seamen and marine engineers were formerly exposed to asbestos used in gasket, pipes, valves and machinery. Ship motion and vibration can release asbestos in the surrounding space. Asbestos fibres may also be inhaled by workers involved in maintenance operations of vessels built before 1992 in Italy. History of asbestos exposure has been reported by workers and confirmed by a higher prevalence of pleural abnormalities and a significant excess of mesothelioma with a Standardized Incidence Ratio (SIR) ranging between 1.83 and 4.8 as a function of years of exposure. SIR for lung cancer ranged between 1.10 and 1.62. Mesothelioma in seamen and marine engineers represents about 2.5% of the overall Italian mesothelioma cases with a very long latency period (47.6 +/- 9.6 years). There is no epidemiological evidence for an excess risk of mesothelioma in fishermen.