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Introduzione. Durante il percorso universitario, gli studenti della Facoltà di infermieristica sono esposti a diversi fattori di rischio per l’attività svolta nel tirocinio pratico ospedaliero, in particolare se riferito al rischio biologico. Risulta, pertanto, importante, nel corso della sorveglianza sanitaria ex D.lgs. 81/08, la valutazione della risposta anticorpale individuale per le malattie infettive per le quali è prevista la vaccinazione obbligatoria durante l’infanzia e che possono avere rilevanza in termini di rischio di contagio e trasmissione per lo studente stesso oltre che per il personale sanitario ed i pazienti (Epatite B, Morbillo, Parotite, Rosolia e Varicella). Obiettivi. L’obiettivo del presente studio è quello di indagare le caratteristiche di sieroprevalenza degli anticorpi IgG anti-HBsAg, anti-Morbillo, anti-Parotite, anti- Rosolia ed anti-Varicella, negli studenti della Facoltà di infermieristica di un “Teaching Hospital” in Roma. L’analisi comprende, inoltre, lo studio descrittivo dei fattori demografici del campione osservato. Materiali e Metodi. È stato effettuato uno studio osservazionale trasversale su 357 studenti della Facoltà di infermieristica, sottoposti a visita preventiva di sorveglianza sanitaria per rischio biologico potenziale. È stata valutata la risposta immunitaria ai virus in relazione al range di riferimento: Epatite B (positivo ≥10 mUI/ml, negativo <10 mUI/ml), Morbillo (positivo ≥150 mUI/ml, negativo <150 mUI/ml), Parotite (positivo ≥230 UA/ml, negativo <230 UA/ml), Rosolia (positivo ≥10 UI/ml, negativo <10 UI/ml), Varicella (positivo ≥50 mUI/ml, negativo <50 mUI/ml). È stata poi eseguita, con software STATA 17, un’analisi statistica descrittiva delle variabili qualitative e quantitative prese in esame ed un’analisi bivariata per studiare l’associazione tra copertura vaccinale e variabili rilevanti. Risultati. Il campione osservato è composto da 357 studenti, età media 21,2 (SD 4,1), dei quali 6

Introduzione. Le “Linee guida per la valutazione e la gestione del rischio per la sicurezza dell’acqua nei sistemi di distribuzione interni degli edifici prioritari e non prioritari e in talune navi ai sensi della Direttiva (UE) 2020/2184”, trasposta con D. L.vo 18/2023, pubblicate all’interno del RAPPORTO ISTISAN 22/32, permettono di valutare, individuare e monitorare le potenziali fonti di pericoli chimici e microbiologici legati al sistema idrico, nonché sviluppare programmi di ispezione o verifiche per specifici parametri, come piombo e Legionella, riconosciuti anche all’interno del D.lgs. 81/2008 tra i composti e gli agenti biologici per cui è prevista la sorveglianza sanitaria. Obiettivi. Le Linee Guida intendono essere uno strumento per realizzare adeguate misure di gestione e controllo dei rischi legati al sistema di distribuzione idrico interno agli edifici, a partire dai “locali prioritari” sottoposti agli obblighi normativi, ovvero immobili di grandi dimensioni con numerosi utenti: ospedali, strutture assistenziali, navi, stazioni, aeroporti, ecc. Metodi. In una fase iniziale le linee guida sono state redatte da un gruppo multidisciplinare di esperti nei settori dell’acqua, della prevenzione sanitaria, igiene e salute pubblica, e impianti idraulici. Successivamente, al fine di garantire l’adeguatezza e la sostenibilità delle azioni e delle misure di controllo raccomandate, è stato condotto un confronto con esperti del Terzo settore. Sulla base di un’analisi complessiva dei rischi sono state definite cinque classi di edifici con diverse priorità di adozione di adeguati sistemi di gestione e controllo dei rischi: prioritari (classi A-D) e non prioritari (classe E). Risultati. Le Linee Guida permettono di individuare i “locali prioritari” in cui la valutazione del rischio e la gestione della sicurezza idrica nei sistemi di distribuzione interna è resa obbligatoria ai sensi del DL.vo 18/2023 e descrive i relativi sistemi di gestione e controllo dei risc

Introduction: In recent years, due to the COVID-19 Pandemic, an increasing number of people were forced to stay at home. Working from home seems to have resulted in an increase of TElewoRk-RelAted stress (TERRA), defined as physical and mental stress due to telework, including the inability to cope with new information and communication technologies in a healthy manner, recognized as technostress. TERRA is a primary concern for Occupational Health worldwide, affecting psychophysical health and productivity. The aim of this systematic review is to determine if and how telework has actually increased TERRA levels in workers and its impacts, during the COVID-19 Pandemic. Materials and methods: Following the PRISMA statements, a systematic review was performed across three scientific databases (Pubmed, ISI Web of Knowledge and Scopus), using “telework”, “technostress” and “COVID-19” (and relative MeSH terms) as keywords. The research was restricted to articles in Italian and English, published up to August 2021. Results: As results, 518 articles were found; after removing duplicates, and exclusion based on title, abstract, and full text, 36 articles were included in the review. Most of articles demonstrate that women and who work at distance in full time mode show higher TERRA levels. Conclusions: This systematic review highlights some of the emerging psychophysical health issues related to TERRA, and offers an overview into the modern challenges workers have to face, in order to improve Total Worker Health through Occupational Medicine.

Le infezioni correlate all’assistenza (ICA) e la resistenza agli antibiotici (Antimicrobial Resistance, AMR) rappresentano una vera e propria emergenza sanitaria, con un impatto rilevante in termini clinici, sociali ed economici [1]. L’utilizzo eccessivo e inappropriato di farmaci antimicrobici è uno dei principali fattori di insorgenza della resistenza agli antibiotici nei patogeni umani, a causa di mutazioni o scambi genetici che ne facilitano la sopravvivenza. Gli effetti della resistenza, ovvero l’incapacità di un antibiotico, somministrato alle dosi terapeutiche, di ridurre la sopravvivenza o inibire la replicazione di un batterio patogeno, comportano gravi rischi di salute pubblica a livello globale, con aumento di mortalità per infezioni e ingenti costi sanitari e sociali. L’antibioticoresistenza è un fenomeno multifattoriale e multisettoriale, contro il quale interventi singoli e sporadici mostrano un impatto limitato [1, 2]. Una delle più importanti conseguenze derivanti da tale fenomeno è rappresentata dalle ICA che, assenti al momento del ricovero, si manifestano in un individuo durante la degenza in ospedale o in un qualsiasi contesto assistenziale, con una sempre più crescente selezione di ceppi di patogeni Multi-Drug Resistant (MDR). A livello europeo, ogni anno, le ICA colpiscono circa 4 milioni di pazienti e sono causa di oltre 37.000 decessi, di cui solo 10.000 in Italia. I costi per la gestione di queste infezioni, inoltre, superano il miliardo di €/anno, con un impatto economico notevole anche in termini di prolungamento dei tempi di degenza e maggior impiego di antibiotici. I dati provenienti dagli ospedali italiani mostrano un’incidenza di ICA del 5 ± 10%, con un tasso di mortalità fino al 20 ± 30% [1-6]. L’Organizzazione per la Cooperazione e lo Sviluppo Economico (OCSE) ha inoltre stimato che, tra il 2015 e il 2050, circa 2.4 milioni di persone potrebbero morire in Europa, Nord America e Australia a causa di infezioni da superbatteri

Personalized medicine, and particularly gender medicine, is becoming essential in daily medical practice. This narrative review aims to assess sex and gender differences in occupational risks among workers. We point out that female workers are more exposed to biological risks (i.e., 70% of healthcare workers during the COVID-19 pandemic were women), but also seem to be more protected against microorganisms (i.e., for HBV vaccination: OR 1.21, p = 0.0023); with regard to physical risks, women are more susceptible to radiations (the estimated incidence of solid tumors for 0.1 Gy of exposure is 0.013% in females and 0.008% in males), while men are more susceptible to heat (infertility prevalence was 22.7% in exposed workers vs 3.0% in controls); female video terminal workers are more susceptible to both computer vision syndrome (aOR 2.57 and aOR 2.35) and musculoskeletal symptoms (OR 3.6). From a psychological point of view, women are more at risk for work-related stress and burnout, as well as workplace mobbing (65% of affected workers are women) and verbal violence, while physical violence was more common among men. In conclusion, important sex and gender differences are present with regard to occupational risks and hazards, thus showing the necessity to improve medical surveillance and to allow occupational physicians to personalize health surveillance.

To reduce vaccine-preventable diseases in workers, workplace vaccination campaigns can be implemented on-site. The aim of this systematic review was to evaluate adherence to workplace vaccination campaigns. Three databases, PubMed, ISI Web of Science, and Scopus, were screened systematically for articles in English or Italian addressing participation in an on-site vaccination program by employees. The following data was extracted: authors, year, country, type of vaccine, type of workplace, sample size, vaccination rate. Data on the prevalence of flu vaccination were calculated and pooled using a random-effects model. Thirteen articles were included in the review, ten in the meta-analysis. Most studies were conducted in the USA (30.7%) and most vaccination campaigns were against influenza (69.2%), with a pooled estimate of 42% (95% CI: 0.25–0.60%); participation rate was highly variable, ranging from 88.9% for an influenza vaccination campaign to 5.7% for a Lyme disease vaccination campaign. Offering free on-site vaccination can be a successful tool to ensure adherence to vaccination campaigns and administration of all required doses according to the vaccine administration scheme. The occupational physician can play a key role in implementing workplace campaigns for employee mandatory vaccinations.

The COVID-19 vaccination has proven to be the most effective prevention measure, reducing deaths and hospitalizations and allowing, in combination with non-pharmacological interventions, the pandemic to be tackled. Although most of the adverse reactions to vaccination present mild symptoms and serious effects are very rare, they can be the cause of legal action against the healthcare workers (HCWs) who administered it. To highlight differences in the medical liability systems, we performed a search for the three most populous countries in each continent on vaccine injury compensation programs, new laws or policies to protect HCWs administering vaccinations introduced during the COVID-19 pandemic, and policies on mandatory vaccinations, on literature databases and institutional sites. We found that in seven countries the medical liability system is based on Common Law, while in eleven it is mainly based on Civil Law. Considering the application of specific laws to protect HCWs who vaccinate during the pandemic, only the USA and Canada provided immunity from liability. Among the countries we analyzed, fourteen have adopted compensation funds. From an international perspective, our results highlight that in eleven (61.1%) countries medical liability is mainly based on Civil Law, whilst in seven (38.9%) it is based on Common Law.

Background: The COVID-19 pandemic is still ongoing, with rapidly increasing cases all over the world, and the emerging issue of post COVID-19 (or Long COVID-19) condition is impacting the occupational world. Objective: The aim of this systematic review was to evaluate the impact of lasting COVID-19 symptoms or disability on the working population upon their return to employment. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statements we performed a systematic review in December 2021, screening three databases (PubMed, ISI Web of Knowledge, Scopus), for articles investigating return to work in patients that were previously hospitalized due to COVID-19. A hand-searched was then performed through the references of the included systematic review. A quality assessment was performed on the included studies. Results: Out of the 263 articles found through the initial search, 11 studies were included in this systematic review. The selected studies were divided based on follow-up time, in two months follow-up, follow-up between two and six months, and six months follow-up. All the studies highlighted an important impact of post COVID-19 condition in returning to work after being hospitalized, with differences based on follow-up time, home Country and mean/median age of the sample considered. Conclusions: This review highlighted post COVID-19 condition as a rising problem in occupational medicine, with consequences on workers' quality of life and productivity. The role of occupational physicians could be essential in applying limitations to work duties or hours and facilitating the return to employment in workers with a post COVID-19 condition.

Background: Many workers shifted to working from home due to the COVID-19 pandemic. This review aims to investigate if this sudden change caused an increase in TElewoRk-RelAted stress (TERRA) which is defined as physical and mental stress caused by telework. Methods: A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed of three scientific databases (PubMed, ISI Web of Knowledge, and Scopus), which also included a quality assessment. Articles measuring stress, psychological or physical, in remote workers, published from December 2019 through August 2021 were included in the review. Results were extracted by reporting: authors, country, study design, type of workers, sample, questionnaires and measurements, and outcomes. Data were synthesized quantitatively for country, type of workers, and outcomes. Results: Out of the 518 articles found in the three databases, 19 articles were included in the systematic review (10,012 participants overall), and 78.9% of these highlighted an increase in TERRA levels in remote workers. Among 85.7% of the studies considering gender as a variable, TERRA levels were higher in female workers. Twelve (63.2%) of the studies investigated psychological well-being, two (10.5%) focused on the physical well-being of remote workers, three (15.8%) investigated both, and two studies had other outcomes (10.5%). Conclusions: Considering the redefinition of workplaces dictated by the COVID-19 pandemic, this review highlights the emerging issue of remote work and the use of technology in working from home, emphasizing a rapidly growing occupational health problem. Remote workers need to be provided with emotional and technical support to prevent TERRA in remote workers.

In 2020, the COVID-19 pandemic exhausted healthcare systems around the world, including European Union countries, with healthcare workers at the frontline. Therefore, new health laws and policies have been introduced at the national level in order to offer greater legal protection for health workers. Since the introduction of COVID-19 vaccination, it has led to the development of specific laws to define the compulsoriness for particular categories. This review aimed to evaluate the system of medical liability, focusing on the ten countries of the European Union with the highest rate of vaccination coverage against SARS-CoV-2. A country-by-country analysis was conducted on the different medical liability systems of individual professionals, in general, and with specific focus on the vaccinating doctors. Additional search was conducted to investigate which European states have introduced specific policies in this field, to identify the implementation of any new laws alongside the COVID-19 vaccination campaigns, and to assess which countries have adopted the European Digital COVID Certificate and funded specific compensation programs for COVID-19 vaccination. Our results highlight an extremely fragmented European scenario; therefore, this work could be a starting point to define a common approach for medical liability and related policies in the COVID-19 pandemic.

Introduction: Working during the Sars-CoV-2 pandemic healthcare workers (HCWs) had to wear Personal Protective Equipment (PPEs) for extended periods of time, leading to an increase in dermatological reactions. The study evaluates the prevalence of adverse skin reactions to PPEs among Italian healthcare workers during the COVID-19 pandemic, and aims to determine whether prolonged PPEs usage poses a significant occupational health risk, by measuring the loss of work days and the eligibility of workers that requested health surveillance due to dermatological PPEs reactions. Materials and Methods: An online ad hoc questionnaire was administered to a sample of Italian HCWs. Questions verted on sociodemographic characteristics, PPEs usage, and occupational well-being. Descriptive analyses and logistic regressions were performed to explore possible associations between variables. Results: Two types of PPEs, Gloves and Masks, were tested. The sample included 1,223 interviewed HCWs, 1,184 gave their consent for participation. A total of 90 medical surveillance visits were requested due to PPEs related dermatological issues: in 30 cases were recognized limitations in working duties and in one case the worker was deemed not fit to keep working. Furthermore, 25 workers had a loss of occupational days due to dermatological issues. A statistically significant correlation was observed with being a nurse or midwife (OR = 1.91, IC = 1.38–2.63, p < 0.001), and being female (OR = 2.04, IC = 1.49–2.78, p < 0.001), which acted as risk factors. Discussion: The enhanced protection measures put in place during the COVID-19 pandemic, highlight the importance of occupational dermatology. This study could contribute to assess the issue, aiming to develop better prevention strategies in the workplace in order to improve well-being of HCWs and reduce the impact of dermatological adverse reactions to PPEs.

Worldwide, the management of health emergencies requires a high degree of preparedness and resilience on the part of governments and health systems. Indeed, disasters are becoming increasingly common, with significant health, social, and economic impacts. Living in a globalized world also means that emergencies that occur in one country often have an international, in some cases global, spread: the COVID-19 pandemic is a cogent example. The key elements in emergency management are central governance, coordination, investment of resources before the emergency occurs, and preparedness to deal with it at all levels. However, several factors might condition the response to the emergency, highlighting, as for Italy, strengths and weaknesses. In this context, policies and regulation of actions to be implemented at international and national level must be up-to-date, clear, transparent and, above all, feasible and implementable. Likewise, the allocation of resources to develop adequate preparedness plans is critical. Due to COVID-19 pandemic, the European Commission proposed the temporary recovery instrument NextGenerationEU, as well as a targeted reinforcement of the European Union’s long-term budget for the period 2021–2027. The pandemic highlighted that it is necessary to interrupt the continuous defunding of the health sector, allocating funds especially in prevention, training and information activities: indeed, a greater and more aware public attention on health risks and on the impacts of emergencies can help to promote virtuous changes, sharing contents and information that act as a guide for the population.

Introduction: During the pandemic, the use of personal protective equipment (PPE) has become essential for Healthcare Workers (HCWs) to fight safely against the virus. However, the extensive and prolonged use of PPE may cause various adverse skin reactions due to the use of alcohol hand cleanser and protracted use of masks and goggles. The aim of this study is to evaluate the skin problems caused by PPE in HCWs and the possible consequences on their work. Materials and methods: An online ad hoc questionnaire, composed by 35 questions about sociodemographic characteristics, work related issues and exposure/habits about PPE, was administered to a sample of Italian HCWs. Univariate and multivariate analyses were performed in order to explore possible associations between variables. Results: We tested 3 types of PPE: Gloves, Hair Bonnets and Masks for different time of utilization (<1, 1-3, 3-6, >6 hours). The sample included 1184 participants: 292 workers reported a dermatological pathology nested in four different pathological groups: 45 (15%) had Psoriasis, 54 (19%) Eczema, 38 (13%) Acne, 48 (16%), seborrheic dermatitis and 107 (36%) other. 25 workers had a loss of occupational days due to dermatological illness; 56 occupational physician surveillance visits were asked for; in 30 cases were recognized limitations in working duties. Conclusions: Protecting HCWs requires the use of PPE, but occupational dermatitis is an emerging problem in the midst of the COVID-19 pandemic. National data for affected healthcare professionals could contribute to a better understanding of the problem and prevention initiatives in the workplace.