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We analysed the impact of several strategies aimed at increasing influenza immunisation rates among Medical Residents (MRs) of an Italian teaching Hospital. During the 2015–16 and 2016–17 influenza seasons we carried out several interventions: ambulatory doubling where vaccination was offered, ambulatory opening hour extension, email invitations, informative materials, forum theatre and vaccination campaign conference. In addition, during the 2016–17 the OSV was carried out: MRs who go to specific wards where they perform influenza immunisation counselling and eventually vaccinate the personnel. 99/1041 (9.5%) and 184/1013 (18.2%) MRs received the vaccine in 2015–16 and in 2016–17 respectively (p < 0.0001). Significant difference was found among three specialisation areas (medicine, surgery, “services”; p < 0.001) and among years of residency (p < 0.001). The highest coverage was found among Infectious Diseases, Paediatrics, Haematology and Hygiene MRs (80%, 67%, 52% and 52% respectively) in 2016–2017 season. The highest coverage increase was found among MRs in Pneumology and Geriatrics (566% and 268%, respectively). The coverage rate has increased even though important differences among specialties persist. The study shows a significant increase in immunisation rate among MRs after the implementation of these strategies.

INTRODUCTION: In Italy annual flu vaccination for health care workers is recommended but coverage is usually unsatisfying. The compliance is even worse among medical residents (MRs) both in literature, both in our experience: in the flu season 2014/ 15 only 0.6% of MRs enrolled at the Università Cattolica del Sacro Cuore (UCSC) were vaccinated. For this reason, during the influenza season 2015/16, the Institute of Public Health of the UCSC, in collaboration with the Health Management of the "Agostino Gemelli" Teaching Hospital (FPG) and with the directive board of the Medical Specialization Schools (SSM) present at the University has tested several strategies to improve awareness and adherence to flu vaccination campaign by its staff. This study aims to analyze the impact of the strategies used during the 2015/16 campaign on flu vaccination coverage among MRs of an important Italian Teaching Hospital. METHODS: The study was conducted among MRs enrolled at the UCSC - FPG in 2015/16. The data was collected by the Occupational Medicine which, during the influenza seasons, immunize MRs against influenza free of charge. For each variable - vaccination, area of specialization (surgical, medical, clinical services), typology of SSM - was measured the absolute and percentage frequency. In order to compare the flu vaccination coverage between seasons 2014/15 and 2015/16 and between areas of specialization in 2015/16 chi-square test was used (statistical significance level of 0.05). The data were analyzed using STATA Software. RESULTS: Were included in the analysis 42 SSM with a total of 1041 MRs. During the vaccination campaign 2015/16, flu vaccine was administered to 99 MRs (9.5%), 8.9% more than in the previous season (p<0.001). There is also a significant difference in vaccine coverage between surgical, medical and clinical services areas in 2015/16 (p <0.001). The highest vaccination coverage was recorded among MRs of Hematology and Urology (54.5%). However, no one MRs

Objective: The purpose of the study is to evaluate whether low-dose exposure to benzene, an environmental pollutant to which male and female traffic policemen are daily exposed to could cause alterations in plasma luteinizing hormone (LH) levels. Methods: From an initial sample of 1594 workers, we only selected 95 workers of whom study we knew the values of late-shift benzene and LH hormone. All subjects underwent biological monitoring (final blood benzene evaluation) and luteinizing hormone dosing. Excluding subjects with the main confounding factors, the final sample included 76 workers. The normal distribution of the variables was evaluated using the Kolmogorov - Smirnov test, followed by the logarithmic transformation of the LH and benzene values. The comparison among means was performed by using the t-test for the independent samples. The ANOVA test was performed for variables with more than 2 modes (ages and seniority) and Pearson correlation index between variables in the total sample and after subdivision as to sex, job, sports activity and smoking. The results were considered significant when p values were less than 0.05. Results/ Conclusion: The study did not show a correlation between benzene levels and LH plasma levels in outdoor workers.

We analysed the impact of several strategies aimed at increasing influenza immunisation rates among Medical Residents (MRs) of an Italian teaching Hospital. During the 2015–16 and 2016–17 influenza seasons we carried out several interventions: ambulatory doubling where vaccination was offered, ambulatory opening hour extension, email invitations, informative materials, forum theatre and vaccination campaign conference. In addition, during the 2016–17 the OSV was carried out: MRs who go to specific wards where they perform influenza immunisation counselling and eventually vaccinate the personnel. 99/1041 (9.5%) and 184/1013 (18.2%) MRs received the vaccine in 2015–16 and in 2016–17 respectively (p < 0.0001). Significant difference was found among three specialisation areas (medicine, surgery, “services”; p < 0.001) and among years of residency (p < 0.001). The highest coverage was found among Infectious Diseases, Paediatrics, Haematology and Hygiene MRs (80%, 67%, 52% and 52% respectively) in 2016–2017 season. The highest coverage increase was found among MRs in Pneumology and Geriatrics (566% and 268%, respectively). The coverage rate has increased even though important differences among specialties persist. The study shows a significant increase in immunisation rate among MRs after the implementation of these strategies.

BACKGROUND: In the assessment of work-related stress it is crucial to find the factors that generate and increase it in order to identify categories of individuals at risk, to plan interventions for prevention, elimination or reduction of risk. The aim of the study is to assess the subjective stress in 68 workers of a large Italian company dealing with human health, through the use of a questionnaire-indicating tool, elaborated by the Italian National Institute for insurance against accidents at work (INAIL) and developed by the Health and Safety Executive (HSE). METHODS: We studied a final sample of 68 individuals (34 drivers/rescuers and 34 video display unit (VDU) operators). The questionnaire consists of 35 items (divided into six areas) with five possible answers each, that cover working conditions considered potential causes of stress. RESULTS: The drivers/rescuers had a better performance than the VDU operators, especially in the areas "demand", "relationships" and "role". We compared men and women in the two groups, finding that, in VDU operators, women had a better performance than men in all areas, except "role" and "changes", in which the overall scores were the same in men and women. In the drivers/rescuers women showed more critical scores in the items "relationships" and "change". CONCLUSION: The results show that: the questionnaire-indicating tool is useful, with a demonstrated effectiveness for the occupational physician during the visits and proven validity; additional future efforts should focus on understanding the psycho-social, organizational and individual problems related to stress and the consequent implementation of preventive measures. KEYWORDS: Health workers; Psychophysical health; Questionnaire; VDU operators; Work-related

Objectives: The aim of this study is to evaluate whether exposure to low concentrations of cadmium (Cd) can have effects on the thyroid hormone level of outdoor workers exposed to urban pollutants. Methods: The study was conducted on a final sample of 277 individuals (184 males and 93 females). The environmental monitoring of Cd was evaluated through the use of portable dosimeters, while the biological monitoring was achieved through the assessment of urinary Cd and thyroid hormones. The total sample was divided according to sex and task. The Pearson's correlation coefficient among the variables was calculated after subdivision on the basis of sex and task. The multiple linear regression was performed to take into account the major confounding factors. Results: Statistical tests showed a negative correlation between urinary Cd levels and free triiodothyronine and free thyroxine and a positive correlation between urinary Cd and thyroid-stimulating hormone levels. Conclusions: Our early results seem to point out that occupational exposure to low concentrations of Cd present in urban air affects the thyroid hormone levels in exposed workers.

Nell'ambito dei diversificati comparti lavorativi si evidenzia costantemente la necessità di modelli applicativi di valutazione dei rischi adeguati alla realtà produttiva. Di conseguenza sono spesso disponibili diverse metodologie nell'ambito di alcuni comparti tradizionali (industriale, terziario ecc.) mentre, al contrario, sono carenti i modelli applicativi per altri settori pur ad elevato tasso di complessità in termini di rischi. In questa prospettiva, lo studio ha effettuato una ricognizione su un'attività articolata, quella marittima portuale.IL LAVORO NEI PORTI COMMERCIALI DELLA TIPOLOGIA DEL " TERMINAL-CONTAINER" PRESENTA NUMEROSI RISCHI PER LE MOLTEPLICI ATTIVITA' SVOLTE E PROFILI DI MANSIONE.SONO VALUTATI TUTTI I RISCHI PRESENTI IN QUESTO PARTICOLARE SETTORE LAVORATIVO IN RAPPORTO ALLE SINGOLE MANSIONI. IL MODELLO DI VALUTAZIONE DEI RISCHI E' STATO EFFETTUATO ATTRAVERSO UNA METODOLOGIA OPERATIVA STANDARDIZZATA E APPLICABILE A TUTTI GLI ANALOGHI CONTESTI.

IL LAVORO ALL'ESTERO CONFIGURA UN SETTORE PER IL QUALE SI IMPONE LA VALUTAZIONE DEL RISCHIO AI FINI DELLA TUTELA DELLA SALUTE DEI LAVORATORI CHE SVOLGONO LA PROPRIA MANSIONE IN AREE DI DESTINZAIONE DIVERSE DA QUELLE DI PROVENIENZA. AI RISCHI COSIDDETTI TRADIZIONALI SI AGIUNGONO DIVERSIFICATI RISCHI IN RAPPORTO ALL'AREA GEOGRAFICA DI DESTINAZIONE, TRA QUESTI RILEVANTE E' IL RISCHIO BIOLOGICO CHE IMPONE MISURE DI PREVENZIONE ADEGUATE QUALI: SORVEGLIANZA SANITARIA, VACCINAZIONI, FORMAZIONE E INFORMAZIONE.

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Le meningiti batteriche rappresentano una patologia rilevante per il lavoratore viaggiatore, in rapporto alla gravità e alle sequele neurologiche. La cosomministrazione del vaccino antimeningococcico quadrivalente coniugato negli schemi vaccinali risulta pratica sicura ed efficace, come dimostrato dai dati di programmi vaccinali in lavoratori di diversi comparti produttivi , nell'anno 2011-2012.

L'applicazione della sorveglianza sanitaria nelle Facoltà di medicina e chirurgia richiede la predisposizione di uno schema procedurale che codifichi obblighi e azioni da attivare nelle diverse fasi di definizione dei rischi e profili professionali, focalizzando attività e competenze correlate agli obblighi normativi

INTRODUZIONE: In Italia la vaccinazione antinfluenzale è raccomandata per medici in formazione specialistica (MFS), ma la copertura presso l’Università Cattolica del Sacro Cuore (UCSC) – Fondazione Policlinico Universitario “A. Gemelli” (FPG) è insoddisfacente: nella stagione 2014/15 si sono vaccinati lo 0,6% dei MFS; nel 2015/16 il 9,5% grazie a strategie messe in atto per migliorare la consapevolezza e l’adesione alla campagna vaccinale. Nel corso del 2016/17 tali novità sono state mantenute ed è stata introdotta la vaccinazione “on site”: la possibilità di vaccinarsi direttamente in alcuni reparti della FPG senza doversi recare presso le sedi usualmente preposte. Questo studio ha l’obiettivo di analizzare l’impatto delle strategie utilizzate durante la campagna 2016/17 sulla copertura vaccinale tra MFS dell’UCSC. MATERIALI E METODI: Lo studio è stato condotto tra MFS delle Scuole di Specializzazione Mediche (SSM) dell’UCSC nell’anno 2016/17. I dati sono stati raccolti dall’Istituto di Sanità Pubblica e analizzati tramite STATA. Per le variabili considerate – vaccinazione, area della SSM (chirurgica, medica, servizi), anno di corso – sono state misurate la frequenza assoluta e percentuale. Per confrontare le coperture vaccinali tra stagioni influenzali, tra anni di corso e tra singole scuole e aree di afferenza delle SSM nella stagione 2016/17 è stato utilizzato il test del chi quadrato (livello di significatività statistica pari a 0.05). RISULTATI: Sono state incluse 42 SSM per un totale di 1013 MFS. Nel corso della campagna 2016/17 il vaccino è stato somministrato a 184 MFS (18,2%), circa il doppio rispetto alla precedente (p<0,001) e 30 volte maggiore rispetto al 2014/15 (p<0,001). È presente una eterogenea distribuzione delle coperture vaccinali antinfluenzali tra SSM, nonché una differenza statisticamente significativa nell’adesione tra MFS delle 3 aree (p<0,001) e tra anni di corso (p<0,001). CONCLUSIONI: Questo studio evidenzia un incoraggiante

Background: Biological risk is a significant issue in workplaces due to continuous modification of work organization and condition. Objectives: In this pilot study, perception and knowledge of biological risk, as well as adoption of prevention measures were evaluated among construction and agriculture workers. Methods: A structured questionnaire was administered to workers to collect socio-demographic and employment information, in addition to data on risk perception and knowledge, and adoption of preventive measures, including those related to work activities. Results: Fifty-three workers aged 45.3 +/- 9.8 years participated in the study, 81% were male, and 70% were construction workers. Approximately 80% of participants declared that infectious diseases are neither frequent nor health-threatening in their occupational activity. The majority of workers considered some diseases, such as hepatitis A and B, leptospirosis and listeriosis, as posing a low risk to their health. Forty-seven % claimed to be unexposed to biohazards at their workplace, and 72% were not worried about them. Ninety-six % of the workers knew about vaccination for tetanus, but only 74% and 36% knew about the availability of vaccination for Hepatitis A and B, respectively. During lifetime, 94% of the workers received at least one vaccination. All workers had undergone tetanus vaccination, but only few received vaccine for influenza, hepatitis B and tuberculosis. Conclusions: This pilot study in occupational settings revealed a poor perception of biological risk and a limited awareness of the severity of infectious diseases. Major knowledge gaps existed about the available preventive measures. It is essential to promote safety culture at the workplace also with regard to biological hazards. This requires improving information and education, conducting appropriate studies, and prompting health and safety professional actors to focus on occupational infectious disease problems.

Work capacity of an epileptic patient receiving pharmacological therapy