Risk Factors Associated with Severe Systemic Allergic Reaction after Wasp Sting in Subjects with a History of European Hornet Sting Allergy.

Aim: To make the treatment approach in patients suffering a European hornet sting allergy reaction more personalized, preparing them also for possible future risks. Methods: In Slovenia an extended retrospective observational cohort epidemiological study about the natural history of Hymenoptera venom sensitivity is in progress. The study is based on data from the healthcare records of the University Clinic Golnik (UCG) and data collected by a questionnaire sent to patients from May 2019 to April 2021. For a pilot study, we selected patients who were referred to UCG because of an allergic reaction to European hornet sting and had been re-stung later by a wasp (n=68). The association between severe systemic allergic reactions (SSAR) after wasp sting and potential risk factors in subjects with a history of hornet sting allergy was assessed univariately using the likelihood ratio test. Results: Among 68 European hornet allergic patients 27 reacted with an SSAR and 41 reacted with a mild SAR. Among 27 patients with SSAR, 4 reacted with an SSAR also to a subsequent wasp sting. Among 41 patients with a mild European hornet sting SAR nobody reacted with an SSAR to a subsequent wasp sting. The association between the severity of the wasp SAR reaction in European hornet allergic patients was statistically significant (p=0.022). Conclusion: Our results suggest that patients with severe European hornet SAR should be considered for wasp venom immunotherapy or prophylactic prescription of epinephrine auto-injector as they are at risk for an SSAR also after wasp string.

Factors Influencing the Degree of Employee Involvement in Preventive Nutrition and Physical Activity Web-Based Programs in Medium and Small Enterprises.

This cross-sectional study was part of a comprehensive workplace health promotion program (WHPP) implemented in the work environment of small- and medium-sized enterprises (SMEs) in Western Slovenia, which included web-based educational campaigns aimed at promoting positive lifestyle changes among workers, including healthy eating habits and physical activity. As part of this program, which included campaigns in the areas of stress management, ergonomics, sleep hygiene, communication, work climate, and absenteeism, we developed and examined the engagement frequency in web-based content on healthy eating and physical activity for the companies included in the WHPP. This part of the project lasted from 2020 to 2022. Prior to the educational campaign, participants voluntarily completed a screening questionnaire. We analyzed the patterns of 370 workers in terms of their job classification (predominantly sedentary, predominantly standing, or predominantly physical), body mass index (BMI), gender, age, and selected indicators of diet and physical activity. Of the 88 companies participating in the WHPP, 26 took part in our web-based educational campaigns on nutrition and physical activity. Through an empirical analysis using descriptive and inferential statistics and a linear regression, we found that, on average, the engagement frequency (i.e., proportion of educational personal e-mails read) was highest among men with sedentary work, with older employees participating more actively than expected. Moreover, workers with good dietary habits and a favorable BMI proved to be the most avid readers of the web-based campaigns. Despite the overall low participant engagement frequency, it is clear that web-based educational campaigns are more appealing to workers with sedentary jobs and good dietary habits. This study provides valuable information on the potential effectiveness of appropriate workplace health promotion campaigns for SMEs and public health practices.

Natural History of the Hymenoptera Venom Sensitivity Reactions in Adults: Study Design.

BACKGROUND: Allergic reactions to Hymenoptera stings can have varying levels of severity, according to the Müller grading system. METHODS: By an epidemiological concept, this is a retrospective cohort study. The observed cohort was represented by patients referred to the University Clinic Golnik due to Hymenoptera allergic reaction in the period from 1997 to 2015. From the immunological database of the University Clinic Golnik, we obtained laboratory data (sIgE, skin tests and basophil activation test). The clinical characteristics of patients were obtained from BIRPIS. With the help of a questionnaire, which was sent to each patient in the period from May 2019 to April 2021, we obtained epidemiological data. For the assessment of the association between the severity of allergic reaction for the observed outcome, the severity of the first allergic reaction after Hymenoptera sting was used. Other variables were grouped according to risk factors. DISCUSSION: We will identify the risk factors that could play an important role in a severe systemic reaction: the aetiology of the Hymenoptera sting, sex, age, history and severity of previous systemic reactions, being re-stung in an interval of two months, the frequency of re-stings, atopy, genetic predisposition, preventive medication use, other medication use, beekeeping or living next to beehives and why immunotherapy was not taken. Laboratory data will also be analysed to determine if there is any association with laboratory tests and the severity of the allergic reactions after Hymenoptera stings. CONCLUSIONS: Several new approaches are introduced in the study design. The most important is that the protocol covers epidemiological data gained from the questionnaire, as well as clinical data gained from the Immunological database and BIRPIS database. We expect to obtain significant results that will explain the risk factors for the natural history of Hymenoptera sting allergic reactions and will help allergologists, as well as general doctors, when facing those patients allergic to Hymenoptera venom without immunotherapy.

STAR-VITAL, a Four Year Comprehensive Workplace Health Promotion Program: Study Design.

Background: Premature death, chronic disease, and productivity loss can be reduced with the help of programs that promote a healthy lifestyle. Workplace health promotion programs have been shown to be an efficient way of improving employee health. These can also benefit employers by improving retention, reducing worker turnover, and lowering healthcare costs. In Slovenia, a workplace health promotion program called "STAR-VITAL-Joint Measures for the Vitality of Older Workers" targeting small- and medium-sized enterprises has been ongoing since September 2017. We hypothesize that this workplace health promotion program will yield long-term health changes for the included employees and employers. Methods/Design: The manuscript presents a workplace health promotion program design that introduces some novel approaches and solutions to workplace health promotion program implementation. It also introduces a measurement of their effects that address the problem of low participation rates and the effectiveness of workplace health promotion programs, as follows: (1) the multifaceted and individualised approach to implementation, (2) customer relationship management (CRM) -based interaction management with program participants, and (3) impact evaluation based on employee health and labour market data observing both intermediate outcomes and the final outcomes based on national micro administrative data. Discussion: Although the novel approaches introduced with the STAR-VITAL program proved to be effective during the COVID-19 pandemic, they deserve the attention of scholars and practitioners. Further research is called for to further explore the potential of CRM in health promotion contexts, the effectiveness of multifaceted and individualised workplace health promotion program interventions, and micro administrative data-based impact evaluations. Conclusions: The STAR-VITAL program introduces several new approaches addressing the problem of low participation rates and the effectiveness of WHPPs. Further research is called for to discover and explore the potential of those novel approaches.

Number of Heat Wave Deaths by Diagnosis, Sex, Age Groups, and Area, in Slovenia, 2015 vs. 2003.

Background: Number of deaths increases during periods of elevated heat. Objectives: To examine whether differences in heat-related deaths between 2003 and 2015 occurred in Slovenia. Materials and Methods: We estimated relative risks for deaths for the observed diagnoses, sex, age, and area, as well as 95% confidence intervals and excess deaths associated with heat waves occurring in 2015 and 2003. For comparison between 2015 and 2003, we calculated relative risks ratio and 95% confidence intervals. Results: Statistically significant in 2015 were the following: age group 75+, all causes of deaths (RR = 1.10, 95% CI 1.00-1.22); all population, circulatory system diseases (RR = 1.14, 95% CI 1.01-1.30) and age group 75+, diseases of circulatory system (RR = 1.17, 95% CI 1.01-1.34). Statistically significant in 2003 were the following: female, age group 5-74, circulatory system diseases (RR = 1.69, 95% CI 1.08-2.62). Discussion: Comparison between 2015 and 2003, all, circulatory system diseases (RRR = 1.25, 95% CI 1.01-1.55); male, circulatory system diseases (RRR = 1.85, 95% CI 1.41-2.43); all, age group 75+ circulatory system diseases (RRR = 1.34, 95% CI 1.07-1.69); male, age group 75+, circulatory system diseases (RRR = 1.52, 95% CI 1.03-2.25) and female, age group 75+, circulatory system diseases (RRR = 1.43, 95% CI 1.08-1.89). Conclusions: Public health efforts are urgent and should address circulatory system causes and old age groups.