Tuberculosis screening in outpatient healthcare workers: lessons from a high-income, low TB burden country.

SETTING: Early diagnosis of latent tuberculous infection (LTBI) should be pursued in healthcare workers (HCWs). While HCWs in hospitals are screened for LTBI, HCWs in outpatient settings are usually not. In 2017, in Italy, a tuberculosis (TB) infected paediatrician working in an outpatient vaccination service infected 15 adults and nine children. The investigation involved 2490 children and 151 adults. Among children, nine were tuberculin skin test-positive, and four developed active TB. Among 123 adult contacts with longer exposure, seven were interferon-gamma release assay (IGRA) positive and none had active TB. Among 28 close contacts, eight had a positive IGRA, and three had pulmonary TB. The total outbreak cost €1 017 903.OBJECTIVE: To compare the outbreak cost with those of potential screening programme strategies.RESULTS: Regular screening of paediatric outpatient HCWs would have cost between €2592 and €11 373. Extending the screening to all outpatient HCWs (caring for adults and children) would have cost between €66 384 and €155 043. Investigating only close contacts would have cost €42 857.CONCLUSION: Each of these screening strategies would have been cost-effective compared with the outbreak investigation occurring in real life with a cut-off of 474 for the maximum number of tested outpatient HCWs needed for the screening strategy to be cost-saving.

[Geografic epidemiology of soft tissue sarcomas, Trieste (1995 -2005)]. / Epidemiologia geografica dei tumori del connettivo a Trieste (1995-2005).

Exposure to dioxin has been associated with the development of various kind of cancer. In the town of Trieste there is a contaminated site of national interest (according to law) and the incidence rate of cancer is the highest in Friuli Venezia Giulia. Using "main residence" it was possible to map soft tissues sarcomas (ICD-IX-171), in order to detect possible clusters or incidence gradients. Available data do not point out any statistically significant difference between observed and expected cases, applying pooled means from North Italy Cancer Registers. This work did not highlighted a correlation between residence in supposed polluted areas and rates of incidence of Soft tissue sarcomas.

[Freedom from smoking for health care workers. A project from Trieste]. / Operatori della sanità liberi dal fumo. Attivazione di un progetto in Provincia di Trieste.

A tree years interventional study to modify smoking habits in health workers in Trieste province was planed in the collaboration of occupational health unit and Tobacco's Dependence Study Center. The aim of this paper is refer about preliminary data of the project started in 2007 regarding smoking habits in health workers of the Azienda per i Servizi Sanitari n.1 "Triestina" (ASS1) and the Azienda Ospedaliera Universitaria Ospedali Riuniti di Trieste (AOUTS). The project consist of several actions. i) information about risks and opportunities of project; ii) pursuance of the law 51 L 3/2003; iii) Occupational Health Unit and Tobacco's Dependence Study Center collaboration; iv) follow-up of the subjects that choose the disaccustom program. During occupational medical surveillance we collected the data related to 492 workers, 37% of the cases were smokers (180). The results of test of dependence to smoke (test di Fagestrom) showed an high dependence in 19% and an high motivation to stop smoke (test di Richmond) in 39% of the smokers. More than fifty percent of this subjects gave their adhesion to the disaccustom program.