Trends in thyroid function testing, neck ultrasound, thyroid fine needle aspiration, and thyroidectomies in North-eastern Italy.

PURPOSE: Evidence of an increased diagnostic pressure on thyroid has emerged over the past decades. This study aimed to provide estimates of a wide spectrum of surveillance indicators for thyroid dysfunctions and diseases in Italy. METHODS: A population-based study was conducted in North-eastern Italy, including 11.7 million residents (20% of the total Italian population). Prescriptions for TSH testing, neck ultrasound or thyroid fine needle aspiration (FNA), surgical procedures, and drugs for hypo- or hyperthyroidism were extracted from regional health databases. Proportions and rates of selected examinations were calculated from 2010 to 2017, overall and by sex, calendar years, age, and region. RESULTS: Between 2010 and 2017 in North-eastern Italy, 24.5% of women and 9.8% of men received at least one TSH test yearly. In 2017, 7.1% of women and 1.5% of men were prescribed drugs for thyroid dysfunction, 94.6% of whom for hypothyroidism. Neck ultrasound examinations were performed yearly in 6.9% of women and 4.6% of men, with a nearly two-fold variation between areas. Thyroid FNA and thyroidectomies were three-fold more frequent in women (394 and 85 per 100,000) than in men (128 and 29 per 100,000) with a marked variation between areas. Both procedures decreased consistently after 2013. CONCLUSIONS: The results of this population-based study describe recent variations over time and between surrounding areas of indicators of 'diagnostic pressure' on thyroid in North-eastern Italy. These results emphasize the need to harmonize practices and to reduce some procedures (e.g., neck ultrasound and total thyroidectomies) in certain areas.

Risk perception of heat related disorders on the workplaces: a survey among health and safety representatives from the autonomous province of Trento, Northeastern Italy.

INTRODUCTION: This study will investigate knowledge, attitude and practices towards heat-related health issues in a sample of safety representatives from Northern Italy (H&SRs). METHODS: A cross-sectional questionnaire survey was conducted in 2016-2017 among 298 H&SR. Knowledge status was measured both in general but as well and focusing on first-aid issues. Assessment of risk perception included severity and frequency of heat-related events. Multivariate logistic regression analysis assessed individual and work-related characteristics associated with H&SRs' risk perception. RESULTS: 258 questionnaires were retrieved (participation rate 86.6%; mean age 48.2 ± 8.4 years). Knowledge status was relatively good on technical/preventive issues (62.3% ± 16.8) and first aid measures (72.6% ± 27.2), but a large share of respondents ignored the risk from exertional heat stroke (35.9%), and for heat strokes elicited by non-environmental heat (e.g. machineries, use of protective equipment, etc. 47.9%). The majority of respondents acknowledged the high frequency of extreme events like heat waves (62.0%), but only 44.6% agreed on their potential health threat, with an unsatisfying cumulative risk perception score (55.4% ± 23.5). A specific first-aid formation course was reported by 49.2% of respondents, while 10.9% had any previous interaction with heat-related disorders. Specific countermeasures for heat waves had been put in place by parent company in 20.1% of cases. Eventually, higher educational achievements (mOR 2.239, 95% CI 1.184-4.233) and a better general knowledge status (mOR 1.703, 95% CI 1.073-2.979) were positive predictors for higher risk perception. CONCLUSIONS: Although H&SRs exhibited a good understanding of heat-related health issues, stakeholders should improve the implementation of specific countermeasures on the workplaces.

Knowledge, Attitudes and Practices of Agricultural Workers towards Tetanus Vaccine: a Field Report.

BACKGROUND: Agricultural Workers are both more exposed to tetanus and at higher risk to be inadequately immunized than other usual recipients of the same vaccine. STUDY DESIGN: Our cross-sectional questionnaire-based study aimed to evaluate tetanus vaccination status, knowledge, attitudes and practices in Agricultural Workers in North-Eastern Italy. METHODS: Bivariate and multivariate logistic regression analyses were used to identify, from individual and work-related characteristics, factors significantly associated with appropriate vaccination status. RESULTS: Among 707 participants, 58.4% had an up-to-date immunization status. In 33.1%, last booster was performed by an Emergency Department. The main reason for inadequate immunization was having forgotten the recommended periodic booster (146/707; 20.7%). Attitude towards tetanus vaccination was somehow favourable in 79.5% of participants, and 72.7% correctly identified tetanus vaccination as mandatory for Agricultural Workers. A lower degree of false beliefs and better knowledge of official recommendations were significant predictors of vaccine propensity. The main predictor for an appropriate vaccination status was interaction with a healthcare provider, in general (adjusted Odds Ratio, adjOR 2.516 95%CI 1.707-3.710), and specifically regarding vaccine counseling, (adjOR 6.275 3.184-12.367 and adjOR 9.739 95%CI 3.933-24.111 for general practitioners and occupational physicians, respectively). CONCLUSIONS: Our study enlightens the key role of healthcare providers in recalling and promoting vaccination policies, as well in increasing the general awareness of Agricultural Workers regarding vaccines and official recommendations.