rubrica

Lavoro

  • Dario Consonni1

  1. Clinica del lavoro, Milano

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Ricerca bibliografica periodo 2 agosto – 15 ottobre 2011

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Database: Pubmed/MEDline
Stringa:
("occupational exposure"[MeSH Terms] OR "occupational diseases"[MeSH Terms]) OR "occupational health"[MeSH Terms]) OR "workplace"[MeSH Terms]) OR "accidents, occupational"[MeSH Terms]) OR "employment"[MeSH Terms]) OR occupation[Title/Abstract]) OR occupational[Title/Abstract]) OR worker[Title/Abstract]) OR workers[Title/Abstract]) AND ("italy"[MeSH Terms] OR "italy"[All Fields]) AND ("2011/08/02"[PDAT] : "2011/10/15"[PDAT])

Di ogni articolo è disponibile l'abstract. Per visualizzarlo basta cliccare sul titolo.

1. Warner M, Mocarelli P, Samuels S, Needham LL, Brambilla P, Eskenazi B. Dioxin Exposure and Cancer Risk in the Seveso Women's Health Study. Environ Health Perspect. 2011 Aug 2. [Epub ahead of print]
University of California.
Abstract
Background: 2,3,7,8-Tetrachlorodibenzo-para-dioxin (TCDD), a widespread environmental contaminant, disrupts multiple endocrine pathways. The International Agency for Research on Cancer classified TCDD as a known human carcinogen, based upon predominantly male occupational studies of increased mortality from all cancers combined. Objectives: After a chemical explosion on July 10, 1976, in Seveso, Italy, residents experienced some of the highest levels of TCDD exposure in a human population. In 1996, we initiated the Seveso Women's Health Study (SWHS), a retrospective cohort study of the reproductive health of the women. We previously reported a significant increased risk for breast cancer and a non-significant increased risk for all cancers combined with individual serum TCDD, but the cohort averaged only 40 years old in 1996. Herein we report results for risk of cancer from a subsequent follow-up of the cohort in 2008. Methods: In 1996, we enrolled 981 women who were 0 to 40 years in 1976, lived in the most contaminated areas, and had archived sera collected near the explosion. Individual TCDD concentration was measured in archived serum by high-resolution mass spectrometry. A total of 833 women participated in the 2008 follow-up study. We examined the relation of serum TCDD with cancer incidence using Cox proportional hazards models. Results: In total, 66 (6.7%) women had been diagnosed with cancer. The adjusted hazard ratio (adj-HR) associated with a ten-fold increase in serum TCDD for all cancers combined was significantly increased (adj-HR=1.80 (95% CI 1.29, 2.52)). For breast cancer, the HR was increased, but not significantly ((adj-HR=1.44 (95% CI 0.89, 2.33)). Conclusions: Individual serum TCDD is significantly positively related with all cancer incidence in the SWHS cohort, more than 30 years later. This all-female study adds to the epidemiologic evidence that TCDD is a multi-site carcinogen.

Breve commento a cura di Dario Consonni
Aggiornamento del follow-up (al 2009) dello studio sulle donne di Seveso. Al contrario del precedente follow-up (1976-1998), si evidenzia un rischio chiaramente aumentato per tutti i tumori e un rischio aumentato ma che lascia spazio a incertezze per i tumori della mammella. Rispetto ad altre indagini sugli effetti a lungo a termine nell’area di Seveso ha il vantaggio di poter usufruire dei dati sui livelli individuali di TCDD nel siero, misurato su campioni di siero congelato raccolto nei mesi-anni dopo l’incidente. I potenziali limiti stanno nel fatto che si tratta di un campione selezionato per i seguenti motivi: 1) sono state incluse solo le donne residenti nell’area di Seveso nel 1976 con almeno un campione di siero valido; 2) sono escluse le donne decedute, non rintracciate, ecc.: hanno partecipato allo studio 833 donne, pari ai 2/3 delle 1271 donne idonee al primo follow-up); 3) l’accertamento della diagnosi di tumore è basato sull’intervista (non è stato effettuato un formale follow-up di incidenza).

2. Talini D, Novelli F, Melosini L, Bacci E, Bartoli ML, Cianchetti S, Dente FL, Di Franco A, Vagaggini B, Paggiaro PL. May the Reduction of Exposure to Specific Sensitizers Be an Alternative to Work Cessation in Occupational Asthma? Results from a Follow-Up Study. Int Arch Allergy Immunol. 2011 Oct 7;157(2):186-193. [Epub ahead of print]
Cardiothoracic and Vascular Department, University of Pisa, Pisa, Italy.
Abstract
Background: Few data are reported on the effects of a reduction of exposure to specific sensitizers in occupational asthma (OA). The objective of this study was to evaluate the clinical outcome of subjects with OA, comparing the effect of a reduction with that of the persistence or cessation of occupational exposure to the specific sensitizer. Subjects and Methods: Forty-one subjects with OA due to different sensitizers were diagnosed via a specific inhalation challenge. After a follow-up interval of 3.5 years, subjects were reexamined by clinical assessment, bronchial hyperresponsiveness (BH) and induced sputum. Results: At follow-up, subjects who had reduced occupational exposure (n = 22) showed a significant improvement in BH and a nonsignificant improvement in sputum eosinophilia (from 5.3 to 1.1%, n.s.), while subjects still exposed (n = 10) showed a significant decrease in FEV(1). Subjects who ceased work (n = 9) showed a trend of improvement in BH and sputum eosinophilia. Logistic analysis showed that the major determinant of improvement in BH at follow-up was the severity of BH at diagnosis, with a minimal contribution from the duration of exposure and treatment with inhaled corticosteroids during follow-up; reduction of work exposure did not enter into any model. Conclusion: The reduction of occupational exposure could not be considered to be as effective as work cessation, which remained the best treatment for OA. However, it was not associated with a deterioration of FEV(1) as observed in subjects with persistent exposure.

Breve commento a cura di Dario Consonni
La gestione del paziente con patologie occupazionali o condizionanti una ridotta idoneità lavorativa è sempre complessa, essendovi implicazioni non solo di tipo sanitario ma anche occupazionale (cambio lavoro, licenziamento). Lo studio, nonostante sia piccolo, è perciò interessante. La forte relazione con la gravità all’inizio fa sospettare un problema di “regressione verso la media” (o “regressione spuria”), un errore che ciclicamente si ripresenta in letteratura e di cui non sempre viene tenuto adeguato conto.

3. Gioffrè A, Marramao A, Iannò A. Airborne Microorganisms, Endotoxin, and Dust Concentration in Wood Factories in Italy. . Ann Occup Hyg. 2011 Oct 5. [Epub ahead of print]
Istituto Nazionale per l'Assicurazione contro gli Infortuni sul Lavoro (INAIL), Centre of Research, Laboratory Biological Agents, 88046 Zona Industriale Area ex SIR, Lamezia Terme (CZ), Italy.
Abstract
Exposure to biological agents and dusts occurs in homes and occupational environments and it is known to cause adverse health effects. There is limited information concerning the occupational exposure levels of airborne biohazard during wood processing, but this exposure is associated with a range of adverse health effects. Control of exposure to microbiological hazards and dust in woodworking is not easy. In fact, various types of wood are commonly used and they generate complex mixtures of dusts and biological agents with various health risks. The aim of this study was to investigate the concentration of dust, bacteria, and endotoxins encountered in six different wood factories. These people were exposed to between 0.05 and 12.00 mg inhalable dust m(-3) and between 0.40 and 6.93 ng inhalable endotoxins m(-3). Total bacteria concentrations in the air of the factories examined were within a range of 130-2000 CFU m(-3), the value of Gram negative was within a 0-164 CFU m(-3), and the concentration of Gram positive was within 1-104 CFU m(-3). In conclusion, people working in wood factories may be exposed to high levels of inhalable dust and endotoxins.
4. Di Renzi S, Tomao P, Martini A, Capanna S, Rubino L, D'Amico W, Tomei F, Visca P, Vonesch N. Screening for tuberculosis among homeless shelter staff. Am J Infect Control. 2011 Sep 28. [Epub ahead of print]
Italian Workers' Compensation Authority (INAIL), Department of Occupational Medicine, Rome, Italy.
Abstract
The prevalence of tuberculosis (TB) among homeless shelter staff was assessed using the tuberculin skin test (TST) and the Quantiferon TB-Gold in tube interferon-γ release assay (QFT-TB). Investigation of 51 participants for whom both QFT-TB and TST results were available showed 47.1% and 43.1% positivity, respectively, with excellent (92%) concordance between the 2 tests. The high risk for acquiring occupational TB necessitates the development of TB surveillance protocols for homeless shelter staff in Italy.
5. Forcella L, Bonfiglioli R, Cutilli P, Siciliano E, Di Donato A, Di Nicola M, Antonucci A, Di Giampaolo L, Boscolo P, Violante FS. Analysis of occupational stress in a high fashion clothing factory with upper limb biomechanical overload. Int Arch Occup Environ Health. 2011 Sep 23. [Epub ahead of print]
Occupational Health Unit, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.
Abstract
PURPOSE: To study job stress and upper limb biomechanical overload due to repetitive and forceful manual activities in a factory producing high fashion clothing. METHODS: A total of 518 workers (433 women and 85 men) were investigated to determine anxiety, occupational stress (using the Italian version of the Karasek Job Content Questionnaire) and perception of symptoms (using the Italian version of the Somatization scale of Symptom Checklist SCL-90). Biomechanical overload was analyzed using the OCRA Check list. RESULTS: Biomechanical assessment did not reveal high-risk jobs, except for cutting. Although the perception of anxiety and job insecurity was within the normal range, all the workers showed a high level of job strain (correlated with the perception of symptoms) due to very low decision latitude. CONCLUSION: Occupational stress resulted partially in line with biomechanical risk factors; however, the perception of low decision latitude seems to play a major role in determining job strain. Interactions between physical and psychological factors cannot be demonstrated. Anyway, simultaneous long-term monitoring of occupational stress features and biomechanical overload could guide workplace interventions aimed at reducing the risk of adverse health effects.
6. Dipalma N, Luisi V, Di Serio F, Fontana A, Maggiolini P, Licchelli B, Mera E, Bisceglia L, Galise I, Loizzi M, Pizzigallo MA, Molinini R, Vimercati L. Biomarkers in malignant mesothelioma: diagnostic and prognostic role of soluble mesothelin-related peptide. Int J Biol Markers. 2011 Sep 5;26(3):160-165. doi: 10.5301/JBM.2011.8614. [Epub ahead of print]
Department of Occupational Medicine, "Policlinico" University Hospital, Bari - Italy.
Abstract
Soluble mesothelin-related peptide (SMRP) is a biomarker that has been proposed for differential diagnosis from pleural metastatic cancer, as well as prognosis and treatment monitoring of malignant pleural mesothelioma (MM). The aim of this study was to evaluate the role of SMRP in clinic management of MM. We assayed the SMRP concentrations in 354 subjects: 109 healthy volunteers with no history of exposure to asbestos, 26 patients with previous occupational asbestos exposure but who were free from pleural or parenchymal disease, 48 patients with asbestosis, 110 patients with pleural plaques, 25 patients with lung cancer, and 36 patients with MM. We also tested SMRP titers in 2 patients with MM at 5 different times of the disease, to evaluate the trend of the biomarker in the course of therapy. Our data confirm previous experiences with the use of SMRP as a diagnostic marker of MM. Low SMRP levels at diagnosis seem to have a positive prognostic significance.
7. Papaleo B, Caporossi L, Bernardini F, Cristadoro L, Bastianini L, De Rosa M, Capanna S, Marcellini L, Loi F, Battista G. Exposure to Styrene in Fiberglass-Reinforced Plastic Manufacture: Still a Problem. J Occup Environ Med. 2011 Sep 15. [Epub ahead of print]
. From the INAIL, ex ISPESL Department of Occupational Medicine (Drs Papaleo, Caporossi, De Rosa, Capanna, and Marcellini), Monte Porzio Catone; University Center for the Study of Systems of Prevention and Protection of Workers (Drs Bernardini, Cristadoro, and Loi), University of Siena, Siena; Department of Prevention, Unit of Preventive Medicine of Work (Dr Bastianini), Grosseto; and Department of Surgery and Bioengineering, University Center for the Study of Systems of Prevention and Protection of Workers (Dr Battista), University of Siena, Siena, Italy.
Abstract
OBJECTIVE:: The aim of the work is to define occupational exposure to styrene in fiberglass manufacture; the phase of stretching styrene resins needs some manual handling and leads workers to be exposed to styrene. METHODS:: We surveyed 20 workers in two companies manufacturing fiberglass, checking environmental levels and urinary concentrations of mandelic acid (MA), and phenylglioxylic acid (PGA). Workers completed a questionnaire collecting their medical history. RESULTS:: Environmental monitoring showed some styrene concentrations higher than the threshold limit value-time-weighted average. Biological monitoring confirmed these findings and four workers had levels of urinary PGA and MA concentrations higher than the Biological Exposure Indices of the American Conference of Governmental Industrial Hygienists. CONCLUSIONS:: This picture confirms that, even though the risk is known and the manufacturing cycle is well-defined, workers nevertheless risk exposure. More research is needed to optimize the work processes and the protection systems to lower this risk.
8. Aprea MC. Environmental and biological monitoring in the estimation of absorbed doses of pesticides. Toxicol Lett. 2011 Sep 12. [Epub ahead of print]
Public Health Laboratory, Department of Occupational Toxicology and Industrial Hygiene, National Health Service, Local Health Unit 7, Siena, Italy.
Abstract
Exposure to pesticides affects most of the population, not only persons occupationally exposed. In a context of high variability of exposure, biological monitoring is important because of the various routes by which exposure can occur and because it assesses both occupational and non-occupational exposure. The main aim of this paper was to critically compare estimates of absorbed dose measured by environmental and biological monitoring in situations in which they could both be applied. The combination of exposure measurements and biological monitoring was found to provide extremely important information on the behaviour of employees, and on the proper use and effectiveness of personal protection equipment.
9. Panizza C, Bai E, Oddone E, Scaburri A, Massari S, Modonesi C, Contiero P, Marinaccio A, Crosignani P. Lung cancer risk in the electroplating industry in Lombardy, Italy, using the Italian occupational cancer monitoring (OCCAM) information system. Am J Ind Med. 2011 Sep 14. doi: 10.1002/ajim.21004. [Epub ahead of print]
Service for Occupational Safety and Prevention, Local Health Unit (ASL), Brescia, Italy.
Abstract
BACKGROUND: Occupational Cancer Monitoring (OCCAM) is an Italian organization that monitors occupational cancers, by area and industrial sector, by retrieving cases and employment history from official databases. OCCAM previously estimated a relative risk (RR) of lung cancer of about 1.32 among "metal treatment" workers in Lombardy, northern Italy, potentially exposed to chrome and nickel. In the present study, lung cancer risk was estimated among electroplating workers only. METHODS: Lombardy electroplating companies were identified from descriptions in Social Security files. Lung cancer risk was evaluated from 2001 to 2008 incident cases identified from hospital discharge records. RESULTS: The RR for lung cancer among electroplating workers was 2.03 (90% CI 1.33-3.10, 18 cases) for men; 3.00 (90% CI 1.38-9.03, 4 cases) for women. CONCLUSIONS: Electroplaters had higher risks than "metal treatment" workers. Although the risks were due to past exposure, case histories and recent acute effects indicate a present carcinogenic hazard in some Lombardy electroplating factories.
10. Colosio C, Rubino FM, Alegakis A, Ariano E, Brambilla G, Mandic-Rajcevic S, Metruccio F, Minoia C, Moretto A, Somaruga C, Tsatsakis A, Turci R, Vellere F. Integration of biological monitoring, environmental monitoring and computational modelling into the interpretation of pesticide exposure data: Introduction to a proposed approach. Toxicol Lett. 2011 Aug 27. [Epub ahead of print]
Department of Occupational and Environmental Health of the University of Milan and International Centre for Rural Health of the University Hospital San Paolo, S. Paolo Hospital Unit, Via San Vigilio 43, 20142 Milan, Italy.
Abstract
Open field, variability of climatic and working conditions, and the use of complex mixtures of pesticides makes biological and environmental monitoring in agriculture, and therefore risk assessment and management, very complicated. A need of pointing out alternative risk assessment approaches, not necessarily based on measures, but simple, user-friendly and reliable, feasible also in the less advanced situations and in particular in small size enterprises, arises. This aim can be reached through a combination of environmental monitoring, biological monitoring and computational modelling. We have used this combination of methods for the creation of "exposure and risk profiles" to be applied in specific exposure scenarios, and we have tested this approach on a sample of Italian rice and maize herbicide applicators. We have given specific "toxicity scores" to the different products used and we have identified, for each of the major working phases, that is mixing and loading, spraying, maintenance and cleaning of equipment, the main variables affecting exposure and inserted them into a simple algorithm, able to produce "exposure indices". Based on the combination of toxicity indices and exposure indices it is possible to obtain semiquantitative estimates of the risk levels experienced by the workers in the exposure scenarios considered. Results of operator exposure data collected under real-life conditions can be used to validate and refine the algorithms; moreover, the AOEL derived from pre-marketing studies can be combined to estimate tentative biological exposure limits for pesticides, useful to perform individual risk assessment based on technical surveys and on simple biological monitoring. A proof of principle example of this approach is the subject of this article.
11. Cresci M, Foffa I, Ait-Ali L, Pulignani S, Gianicolo EA, Botto N, Picano E, Andreassi MG. Maternal and Paternal Environmental Risk Factors, Metabolizing GSTM1 and GSTT1 Polymorphisms, and Congenital Heart Disease. I Am J Cardiol. 2011 Sep 3. [Epub ahead of print]
National Research Council (CNR) Institute of Clinical Physiology, Massa, Italy.
Abstract
Congenital heart defects (CHDs) are the most prevalent of all birth malformations arising from the complex interplay of environmental exposures and genes. Modifiable environmental risk factors are still largely unknown, especially for paternal exposure. The aim of the present study was to examine the association between the environmental exposures of both parents and CHD risk and to explore the modification effect of metabolizing gene polymorphisms in children who lack the genetic capacity to produce the glutathione S-transferase (GST) GSTM1 and GSTT1 enzymes. A total of 330 parents of a child with CHD and 330 parents of a child without any congenital malformations were compared in terms of lifestyle habits and toxicant exposure. GST gene polymorphisms were investigated in 180 patients with CHD (104 males, age 4.9 ± 5.8 years). Paternal smoking (≥15 cigarettes/day) was significantly associated with CHD risk (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.3 to 3.5, p = 0.002). Both maternal (OR 2.6, 95% CI 1.6 to 4.2, p <0.0001) and paternal (OR 2.5, 95% CI 1.6 to 3.8, p <0.0001) occupational/environmental exposures increased the risk of CHD. Also, a significant additive risk (OR 4.5, 95% CI 2.5 to 8.3, p <0.0001) was found when both parents were exposed to toxicants. Both maternal (OR 3.6, 95% CI 1.1 to 11.2, p = 0.03) and paternal (OR 3.3, 95% CI 1.0 to 10.8, p = 0.03) exposure to toxicants increased the CHD risk in children who carried the combined null GST genotypes. The effect for the combined null GST genotypes was also stronger (OR 6.5, 95% CI 1.5 to 28.0) when both parents were exposed. In conclusion, paternal smoking and exposure to toxicants for both parents affect the risk of children with CHD. Polymorphisms in GST genes can modify a person's risk of toxicant exposure-induced disease.
12. Sghedoni R, Grassi E, Fioroni F, Asti M, Piccagli V, Versari A, Iori M. Personnel exposure in labelling and administration of (177)Lu-DOTA-D-Phe1-Tyr3-octreotide. Nucl Med Commun. 2011 Oct;32(10):947-53.
Department of Medical Physics, Nuclear Medicine, Arcispedale S. Maria Nuova, Reggio Emilia, Italy. roberto.sghedoni@asmn.re.it
Abstract
OBJECTIVE: The introduction of peptide receptor radionuclide therapy, mainly performed with (90)Y and (177)Lu-labelled somatostatin analogues, has widened the therapeutic horizon of nuclear medicine. The handling of (177)Lu-labelled pharmaceuticals implies an increase of the personnel exposure and this aspect is evaluated in this paper, in comparison with personal exposure in (90)Y manipulation. MATERIALS AND METHODS: Personal dose measurements were performed during 26 (177)Lu-DOTATOC preparations by using a series of thin active layer LiF: Mg,Cu,P thermoluminescence dosimeters fixed at the operator's fingertips to evaluate the skin equivalent dose and by means of direct reading dosimeters positioned at the chest to evaluate the personal effective dose. Individual protection devices, such as shielded aprons and anti-X gloves, were also used. RESULTS: The 95th percentile of the skin equivalent dose distribution for (177)Lu operations by using 0.20-mm anti-X gloves was 0.080 mSv/GBq for the chemist and 0.011 mSv/GBq for the physician, whereas the 75th percentile was 0.058 mSv/GBq for the chemist and 0.006 mSv/GBq for the physician. The use of the 0.25 mm Pb-equivalent anti-X apron halved the personal equivalent dose measured over the apron by a direct reading dosimeter. Skin doses were compared with (90)Y-DOTATOC procedures: no relevant exposure reduction is observed for chemists, whereas doses are considerably lower during administration procedures performed by physicians. CONCLUSION: In this study, an evaluation of the skin equivalent doses during (177)Lu-DOTATOC labelling and administration is presented. These data can be useful to assess the risk for workers in centres that are starting to implement PRRT using (177)Lu. The use of appropriate protection devices and procedures allows the observance of International Commission for Radiological Protection dose limits for exposed workers.
13. Dominici L, Villarini M, Fatigoni C, Monarca S, Moretti M. Genotoxic hazard evaluation in welders occupationally exposed to extremely low-frequency magnetic fields (ELF-MF). Int J Hyg Environ Health. 2011 Aug 20. [Epub ahead of print]
Department of Medical-Surgical Specialties and Public Health (Section of Public Health), University of Perugia, Via del Giochetto, 06122 Perugia, Italy.
Abstract
Electric arc welding is known to involve considerable exposure to extremely low-frequency magnetic fields (ELF-MF). A cytogenetic monitoring study was carried out in a group of welders to investigate the genotoxic risk of occupational exposure to ELF-MF. This study assessed individual occupational exposure to ELF-MF using a personal magnetic-field dosimeter, and the cytogenetic effects were examined by comparing micronuclei (MN) and sister chromatid exchange (SCE) frequencies in the lymphocytes of the exposed workers with those of non-exposed control subjects (blood donors) matched for age and smoking habit. Cytogenetic analyses were carried out on 21 workers enrolled from two different welding companies in Central Italy and compared to 21 controls. Some differences between the groups were observed on analysis of SCE and MN, whereas replication indices in the exposed were found not to differ from the controls. In particular, the exposed group showed a significantly higher frequency of MN (group mean±SEM: 6.10±0.39) compared to the control group (4.45±0.30). Moreover, the increase in MN is associated with a proportional increase in ELF-MF exposure levels with a dose-response relationship. A significant decrease in SCE frequency was observed in exposed subjects (3.73±0.21) compared to controls (4.89±0.12). The hypothesis of a correlation between genotoxic assays and ELF-MF exposure value was partially supported, especially as regards MN assay. Since these results are derived from a small-scale pilot study, a larger scale study should be undertaken.
14. Amodio E, Tramuto F, Maringhini G, Asciutto R, Firenze A, Vitale F, Costantino C, Calamusa G. Are medical residents a "core group" for future improvement of influenza vaccination coverage in health-care workers? A study among medical residents at the University Hospital of Palermo (Sicily). Vaccine. 2011 Oct 19;29(45):8113-7. Epub 2011 Aug 19.
Department for Sciences of Health Promotion "G. D'Alessandro", University of Palermo, Via Del Vespro n 133, cap 90127, Palermo Italy.
Abstract
Despite international recommendations, vaccination coverage among European healthcare workers, including physicians, is widely recognized as unsatisfactory. In order to plan tailored vaccination campaigns and increase future coverage, we investigated reasons for refusing vaccination and determinants associated with influenza vaccine uptake among young health care workers. A survey was carried out during September and October 2010 on medical residents attending post-graduate Schools of the Medical Faculty at the University of Palermo (Italy). Each participant completed an anonymous web-based questionnaire including items on demographic and occupational characteristics, knowledge, attitudes and behaviours with regard to influenza and influenza vaccination, and main sources of information. A total of 202 (66.9%) out of 302 medical residents participated in the survey. During the 2009-2010 influenza vaccine campaign, 44 residents (21.8%) were vaccinated against seasonal influenza and 84 (41.6%) against pandemic influenza A (H1N1) 2009. For the impending 2010-2011 influenza season, 45 (22.3%) stated their intention to get vaccinated against seasonal influenza, 40 (19.8%) were uncertain and 117 (57.9%) were opposed. Considering themselves to be a high risk group for developing influenza was significantly associated with vaccination against both 2009-2010 seasonal (adj-OR=1.46; 95% CI=1.05-2.04) and pandemic A (H1N1) influenza (adj-OR 1.38; 95% CI=1.08-1.75). Intention to get vaccinated against 2010-2011 seasonal influenza was significantly more frequent in participants who had a high perception of efficacy/safety (adj-OR=1.49; 95% CI=1.05-2.12). After adjusting for confounding, vaccinations against seasonal 2009-2010 influenza, pandemic influenza A (H1N1) 2009 and seasonal 2010-2011 influenza were significantly more frequent in residents who were vaccinated against influenza at least once in the previous five influenza seasons. Influenza vaccination among medical residents appears to be habitual, with little comprehension of the rationale and logic for vaccination, including the need to be vaccinated to protect patients from nosocomial influenza infection. Our study suggests the importance of prioritizing residents for vaccination campaigns, as they represent "the future" and include a core group that habitually accepts vaccination.
15. Apostoli P, Sala E, Curti S, Cooke RM, Violante FS, Mattioli S. Loads of housework? Biomechanical assessments of the upper limbs in women performing common household tasks. Int Arch Occup Environ Health. 2011 Aug 4. [Epub ahead of print]
Dipartimento di Medicina Sperimentale ed Applicata, Medicina del Lavoro e Igiene Industriale, Università degli Studi di Brescia, Brescia, Italy.
Abstract
PURPOSE: Housework is a form of regular manual work that is often performed by women. Little is known about the entity of biomechanical exposure to the upper limbs during typical housework tasks. This study aims to make an initial quantitative estimate of some such exposures. METHODS: We conducted objective assessments of biomechanical exposure to the upper limbs during nine frequent housework tasks performed by 12 women without domestic help. For the main evaluations, we implemented five instruments: the OCRA (Occupational Repetitive Actions) checklist; OREGE (Outil de Repérage et d'Evaluation des Gestes); the American Conference of Governmental Industrial Hygienists (ACGIH) assessment of hand activity levels (HAL); RULA (Rapid Upper Limb Assessment); and the full checklist of the Washington State Department of Labor and Industries. RESULTS: The ACGIH evaluation suggested light/moderate biomechanical exposure levels, as did the RULA. For the OCRA checklist and OREGE, time-weighted average scores (not adjusted by a duration multiplier because women may also routinely undergo biomechanical loads in other domestic or professional settings) were: OCRA checklist, 12.0 ("mild risk", light red) and OREGE, 10.2 ("not recommended"). The full checklist of Washington State Department of Labor and Industries showed that repetitive/similar movements (for >2 h/day) accompanied by other risk factors such as >=30° bending of the wrists, >=45° stretched wrists, >=30° ulnar stretches, and manual force. CONCLUSIONS: Housework commonly entails light-moderate biomechanical loads that nevertheless could conceivably contribute to the genesis/worsening of musculoskeletal disorders. Biomechanical loads experienced by women during housework deserve greater consideration in epidemiologic studies of musculoskeletal disorders.
16. Solano P, Pizzorno E, Gallina AM, Mattei C, Gabrielli F, Kayman J. Employment status, inflation and suicidal behaviour: An analysis of a stratified sample in Italy. Int J Soc Psychiatry. 2011 Aug 3. [Epub ahead of print]
Department of Neurosciences, Ophtalmology and Genetics, Section of Psychiatry, San Martino Hospital, University of Genova, Italy.
Abstract
BACKGROUND: There is abundant empirical evidence of a surplus risk of suicide among the unemployed, although few studies have investigated the influence of economic downturns on suicidal behaviours in an employment status-stratified sample. AIMS: We investigated how economic inflation affected suicidal behaviours according to employment status in Italy from 2001 to 2008. METHODS: Data concerning economically active people were provided by the Italian Institute for Statistical Analysis and by the International Monetary Fund. The association between inflation and completed versus attempted suicide with respect to employment status was investigated in every year and quarter-year of the study time frame. We considered three occupational categories: employed, unemployed who were previously employed and unemployed who had never worked. RESULTS: The unemployed are at higher suicide risk than the employed. Among the PE, a significant association between inflation and suicide attempt was found, whereas no association was reported concerning completed suicides. No association was found between completed and attempted suicides among the employed, the NE and inflation. Completed suicide in females is significantly associated with unemployment in every quarter-year. CONCLUSION: The reported vulnerability to suicidal behaviours among the PE as inflation rises underlines the need of effective support strategies for both genders in times of economic downturns.

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