SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers

The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers

Hymenoptera venom allergy: work disability and occupational impact of venom immunotherapy

ABSTRACT Objectives: Little is known about the Hymenoptera venom allergy impact on work ability and the effect of venom immunotherapy (VIT) on work. The objective of this study was to evaluate the prevalence and predictors of work disability in patients treated with VIT and the effects of VIT on occupational functioning. Methods: 181 patients, aged 18–71 years, treated with VIT while working, were investigated by questionnaire. Participants were classified into employed and self-employed and, based on work exposure to Hymenoptera, into three risk categories: high risk, occasionally high risk and low risk. Work disability was defined as having to have changed jobs/ tasks and/or suffered economic loss because of Hymenoptera venom allergy. Predictors of work disability were assessed in logistic regression models. Results: 31 (17%) patients reported work disability. Being self-employed and having the severe reaction at work were associated with work disability ( p<0.01). Having a high-risk job for exposure to Hymenoptera was a significant predictor of work disability (OR 2.66, 95% CI 1.04 to 6.75). 24% of patients referred a positive effect of VIT on work. Determinants of the positive effect of VIT on work were having a high-risk job for exposure to hymenoptera (OR 3.60, 95% CI 1.52 to 8.51) and having already concluded VIT (OR 2.82, 95% CI 1.30 to 6.14). Conclusions: Hymenoptera venom allergy could determine work disability. Patients with Hymenoptera venom allergy having a high-risk job for exposure to Hymenoptera seem to have higher risk of work disability and refer more frequently a positive effect of VIT on work

Non‐industrial Indoor Environments and Work‐Related Asthma

Work-related asthma is one of the most relevant work-related diseases worldwide, causing a high socio-economical burden. In the last decades, many countries experienced huge modifications in work organisations. These changes made people to move from traditional sectors to the tertiary sectors and non-industrial indoor working environments. Non-industrial indoor workplaces are characterised by a new concept of building, with a new structure, new materials, forced ventilation, tight construction and a potential exposure to new risk factors for work-related asthma, such as new chemicals and biological agents able to cause or exacerbate asthma. The actual scientific evidence suggests an increased risk of asthma among workers exposed to cleaning agents in indoor working environment and moulds in damp buildings. Also volatile organic compounds (VOCs) and environmental tobacco smoke could be considered triggers of asthma, even if their role is still under debate. Because of the increasing numbers of subjects working in non-industrial indoor environments and the scientific evidence of an increased risk of asthma in indoor environment, there is a need of public health intervention towards the prevention of work-related asthma, also in this specific setting

Medico-legal implications of mobbing: a case law [Riflessioni medico-legali su un caso giudiziario di mobbing]

Lo stress e le violenze morali nei luoghi di lavoro, come indicato dai dati epidemiologici, sono in costante aumento e rappresentano una causa di alterazione dello stato di salute dei lavoratori, con importanti ricadute negative sui soggetti, sulle aziende e sulla società. Nel caso descritto qui di seguito, le violenze morali e la disfunzionalità organizzativa, una delle principali fonti di stress correlato al lavoro, sono state intenzionalmente impiegate quale mezzo mobbizzante nei confronti di un lavoratore da parte dei suoi superiori (mobbing verticale). Attraverso il procedimento giudiziario, intrapreso dal lavoratore per vedersi riconosciuto vittima di mobbing, è stato possibile ripercorrere e identificare le ragioni e le modalità dell'azione mobbizzante, l'eziopatogenesi della conseguente psicopatologia, la sua strutturazione e la manifestazione sintomatologica. L'esame del caso permette di formulare delle considerazioni riguardo la necessità che i casi di mobbing siano trattati all'interno di un team multidisciplinare (medico di famiglia, medico del lavoro, psichiatra e medico legale) al fine di garantire un efficace trattamento terapeutico e la tutela del lavoratore nei diversi ambiti previsti dalla legge.Epidemiological data indicate that distress and psychological violence in the workplace are steadily increasing and have negative health effects for employees. Aside from the damages to the victims of violence, organizations are finding that workplace violence, bullying and mobbing may severely damage companies as well, for instance in terms of reduced productivity, absenteeism, excessive employees' turnover, impact to the company's reputation, medical and legal costs. We report of a case where psychological violence and organizational dysfunction, which represent the main sources of work related distress, have been intentionally used as a mean of vertical mobbing. An analysis of the information that was presented in Court to prove a case of mobbing permitted to track and identify the reasons and modalities of mobbing, as well as the etiopathogenesis of the resulting psychopathology and of the consequent somatic symptoms. This case description highlights the need to involve a multidisciplinary team (family doctor, occupational physician, psychiatrist and forensic physician) in order to ensure a fair analysis and - when appropriate - to suggest an appropriate treatment for individuals who file a mobbing claim

Occupational risk factors for idiopathic pulmonary fibrosis in Southern Europe: a case-control study

Abstract Background Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia of unknown cause associated with the histopathologic and/or radiologic pattern of usual interstitial pneumonia (UIP). Occupational risk factors have been proposed to be associated with UIP. The aim of this case-control study is to evaluate the relationship between UIP pattern and occupational exposure in Southern Europe. Methods Sixty nine cases with a UIP radiological pattern at CT-scan were selected from a clinical database of the University Hospital of Perugia, Umbria, between January 2010 and December 2013. Controls (n = 277) not reporting doctor diagnosed pulmonary fibrosis, were ascertained casually among general population from the same catching area of cases. Data were collected by a questionnaire used previously in a similar study. Logistic regression models, adjusted for gender, age and smoking, were performed to evaluate the association between UIP and occupational exposure. Results Farmers, veterinarians and gardeners (OR = 2.73, 95%CI = 1.47–5.10), metallurgical and steel industry workers (OR = 4.80, 95%CI = 1.50–15.33) were occupations associated with UIP. Metal dust and fumes and organic dust were risk factors for UIP. Increasing the length of occupational exposure in jobs at risk of pulmonary fibrosis, increased the risk of having UIP. Conclusions This case control study confirm partially the results from previous similar studies. Some discrepancies could be explained by the different geographical origins of the population under study, reflecting also different occupational exposures

Exposure to additives or multigrain flour is associated with high risk of work-related allergic symptoms among bakers

Wheat flour exposure in bakers can elicit respiratory and skin symptoms. Scarce data are available on the prevalence of such conditions in bakers. We investigated the prevalence of work-related rhinitis, asthma-like symptoms and dermatitis in bakers according to job task and type of allergens involved

Chronic use of Datura stramonium cigarettes and late diagnosis of bullous emphysema in a smoker of marijuana and tobacco

Unconventional inhaled therapy as a treatment for respiratory diseases became very common during the 19th century. Here, we present the case of a 52-year-old patient who smoked Datura stramonium cigarettes, tobacco cigarettes, and cannabis, with only an early diagnosis of asthma. The patient was admitted to our hospital with acute respiratory syndrome, characterized by worsening dyspnea, cough, and an acute episode of dyspnea and chest tightness. The combined chronic use of both D. stramonium cigarettes and cannabis masks the progression of chronic obstructive lung damage due to tobacco cigarette smoking because of the lack of clinical signs and symptoms