Evidence-based approach for continuous improvement of occupational health

Introduction. It was recognized early on that an Evidence-Based Medicine (EBM) approach could be applied to Public Health (PH), including the area of Occupational Health (OH). The aim of Evidence-Based Occupational Health (EBOH) is to ensure safety, health, and well-being in the workplace. Currently, high-quality research is necessary in order to provide arguments and scientific evidence upon which effective, efficient, and sustainable preventive measures and policies are to be developed in the workplace in Western countries. Occupational physicians need to integrate available scientific evidence and existing recommendations with a framework of national employment laws and regulations. Objective. This paper addresses the state of the art of scientific evidence available in the field (i.e., efficacy of interventions, usefulness of education and training of workers, and need of a multidisciplinary strategy integrated within the national PH programs) and the main critical issues for their implementation. Conclusions. Promoting good health is a fundamental part of the smart, inclusive growth objectives of Europe 2020 - Europe's growth strategy: keeping people healthy and active for longer has a positive impact on productivity and competitiveness. It appears clear that health quality and safety in the workplace play a key role for smart, sustainable, and inclusive growth in Western countries

Coronavirus disease 2019: the second wave in Italy

Purpose: This paper describes how Italy addressed the first Coronavirus disease 2019 (COVID-19) wave and analyzes the possible causes of the current second wave. Design/methodology/approach: Descriptive analysis of critical points and differences in the containment strategies between the first and the second waves in Italy. Findings: Italy's strict lockdown has been credited with getting the initial major outbreak under control. Furthermore, the way Italy handled the first wave was considered a lesson for other countries. On the contrary, a decentralized and highly bureaucratic political system with low coordination and political conflicts between government, regions and stakeholders led to a relaxation of individual health behaviors, poor and conflicting communication to the general public, poor management of the public transport and the reopening of schools and companies after the summer, that in turn generated the second wave, which is showing signs of becoming worse than the first. Originality/value: This is a commentary piece

Common Occupational Trauma: Is There a Relationship with Workers’ Mental Health?

Exposure to major trauma can have significant consequences for workers’ mental health, but common trauma may also result in poor mental health outcomes. This cross-sectional study retrospectively investigated the occurrence of common physical or psychological workplace trauma in 901 health, social service, and trading company workers and studied these experiences in relation to occupational stress, anxiety, and depression. Stress was measured with the effort/reward imbalance (ERI) model while anxiety and depression were evaluated with the Goldberg Anxiety and Depression Scale (GADS). Healthcare workers reported a high frequency of trauma and significantly higher levels of stress, anxiety, and depression than other workers. Even in the entire population of workers of the various professional categories, verbal violence (harassment and threats), traffic accidents, home injuries, and family bereavement were significantly associated with high levels of stress, anxiety, and depression. Major trauma survivors are known to be at increased risk of mental disorders and require support in the workplace, however, even minor repeated emotional trauma and injuries can affect mental health. During mandatory health surveillance, the occupational physician should systematically collect information on minor trauma and mental health outcomes when assessing the occupational fitness of the workers assigned to him

Need for psychological support and disability management programs during and after the COVID-19 pandemic in Italy: Preliminary findings from a hospital-based occupational health surveillance program

Introduction: Since the beginning of COVID-19 pandemic, healthcare workers (HCWs) have undoubtedly experienced overwhelming levels of strain associated with social and occupational stressors. This study aimed to investigate the potential psychological effects experienced by hospital workers and HCWs and their associated demographical and occupational characteristics during the COVID-19 pandemic. Methods: A cross-sectional study was carried out in a public hospital in Rome, Italy, from June 2020 to July 2021. 635 hospital workers (HCWs, administrative and technicians) were enrolled in the study. The “Psychological Injury Risk Indicator” questionnaire was used. Statistical analyses have been made using Student’s T test for categorical binomial variables and analysis of variance for multi-categorical variables. Logistic regression analysis was then performed. Results: 30.6% of the sample was at risk for general psychological impairment; reduced energy recovery was found in 48.0% and sleep problems in 44.7% of them. Female workers reported a two-fold risk for potential psychological impairment compared to male colleagues. Nurses presented a three-fold risk while physicians a two-fold risk for the overall score. Additionally, physicians had a four-fold risk to develop a lack of energy recovery and a three-fold risk for chronic fatigue. Technicians showed a significant double risk for sleep problems and chronic fatigue as well as a three-fold risk for reduced energy recovery. Administrative personnel reported a tendency on sleep problems. Interestingly, agile working was a two-fold protecting factor. No-night shifters have a half risk for reporting problems in energy recovery. Discussion and Conclusion: The measure of agile working is effective to mitigate the impacts of COVID-19 on mental health by protecting and promoting the psychological wellbeing of HCWs during and after the outbreak

Effectiveness of psychological support to healthcare workers by the occupational health service: a pilot experience

Work-related stress is a significant risk for healthcare workers (HCWs). This study aims aevaluating the effectiveness of an individual psychological support programme for hospital workersIn all, 35 workers participated (n). A control group of 245 workers (7n) was set. Occupationadistress was measured by the General Health Questionnaire, (GHQ-12), the quality of life by the Short Form-36 health survey, (SF-36), and sickness absence was recorded. Costs and benefits of the service were evaluated and the return on investment (ROI) was calculated. The level of distress was significantly reduced in the treated group at the end of the follow-up (p < 0.001). Quality of life had significantly improved (p < 0.003). A 60% reduction of sickness absence days (SADs) following the intervention was recorded. After the treatment, absenteeism in cases was significantly lower than in controls (p < 0.02). The individual improvement of mental health and quality of life was significantly correlated with the number of meetings with the psychologist (p < 0.01 and p < 0.03, respectively)The recovery of direct costs due to reduced sick leave absence was significantly higher than the costs of the programme; ROI was 2.73. The results must be examined with caution, given the very limited number of workers treated; this first study, however, encouraged us to continue the experience

Evolution of Human Memory B Cells From Childhood to Old Age

High quality medical assistance and preventive strategies, including pursuing a healthy lifestyle, result in a progressively growing percentage of older people. The population and workforce is aging in all countries of the world. It is widely recognized that older individuals show an increased susceptibility to infections and a reduced response to vaccination suggesting that the aged immune system is less able to react and consequently protect the organism. The SARS-CoV-2 pandemic is dramatically showing us that the organism reacts to novel pathogens in an age-dependent manner. The decline of the immune system observed in aging remains unclear. We aimed to understand the role of B cells. We analyzed peripheral blood from children (4-18 years); young people (23-60 years) and elderly people (65-91 years) by flow cytometry. We also measured antibody secretion by ELISA following a T-independent stimulation. Here we show that the elderly have a significant reduction of CD27dull memory B cells, a population that bridges innate and adaptive immune functions. In older people, memory B cells are mostly high specialized antigen-selected CD27bright. Moreover, after in vitro stimulation with CpG, B cells from older individuals produced significantly fewer IgM and IgA antibodies compared to younger individuals. Aging is a complex process characterized by a functional decline in multiple physiological systems. The immune system of older people is well equipped to react to often encountered antigens but has a low ability to respond to new pathogens

Prevalence, risk factors and prevention of burnout syndrome among healthcare workers: An umbrella review of systematic reviews and meta-analyses

Introduction: Burnout syndrome (BOS) is a psychological syndrome characterized by emotional exhaustion, depersonalization, and low personal accomplishment. This umbrella review aimed to investigate BOS among healthcare workers (HCWs). Methods: An umbrella review of systematic reviews and meta-analyses concerning the prevalence of BOS among physicians, nurses, medical students and other HCWs, and its associated factors was conducted across PubMed Central/Medline, Cochrane Library, PROSPERO and Epistemonikos databases. Only systematic reviews and meta-analyses from inception to 15 January 2020 and restricted to English language documents were included. Results: A total of 43 studies met the full inclusion criteria and were included. Among them, there were 3 meta-analyses, 26 systematic reviews, and 14 systematic reviews with meta-analysis. The prevalence of BOS was highest among nurses, younger persons, and trainees. The most frequent risk factors associated with BOS included stress, lack of family support, and organizational risk factors such as prolonged night shifts, length of experience, and exposure to traumatic events. Individual coping strategies such as exercise and communication with peers, and organizational strategies such as periodic review of shift schedule should be undertaken. Discussion: BOS has profound effects on the mental health states of HCWs. Individuals and the hospital authority need to pay specific attention to work-related stress risk factors to improve the psychological well-being of HCWs

The origins and development of Zuwīla, Libyan Sahara: an archaeological and historical overview of an ancient oasis town and caravan centre

Zuwīla in southwestern Libya (Fazzān) was one of the most important early Islamic centres in the Central Sahara, but the archaeological correlates of the written sources for it have been little explored. This paper brings together for the first time a detailed consideration of the relevant historical and archaeological data, together with new AMS radiocarbon dates from several key monuments. The origins of the settlement at Zuwīla were pre-Islamic, but the town gained greater prominence in the early centuries of Arab rule of the Maghrib, culminating with the establishment of an Ibāḍī state ruled by the dynasty of the Banū Khaṭṭāb, with Zuwīla its capital. The historical sources and the accounts of early European travellers are discussed and archaeological work at Zuwīla is described (including the new radiocarbon dates). A short gazetteer of archaeological monuments is provided as an appendix. Comparisons and contrasts are also drawn between Zuwīla and other oases of the ash-Sharqiyāt region of Fazzān. The final section of the paper presents a series of models based on the available evidence, tracing the evolution and decline of this remarkable site

Methylated HBHA Produced in M. smegmatis Discriminates between Active and Non-Active Tuberculosis Disease among RD1-Responders

A challenge in tuberculosis (TB) research is to develop a new immunological test that can help distinguish, among subjects responsive to QuantiFERON TB Gold In tube (QFT-IT), those who are able to control Mtb replication (remote LTBI, recent infection and past TB) from those who cannot (active TB disease). IFN-\u3b3 response to the Heparin-binding-hemagglutinin (HBHA) of Mtb has been associated with LTBI, but the cumbersome procedures of purifying the methylated and immunological active form of the protein from Mtb or M. bovis Bacillus Calmette et Guerin (BCG) have prevented its implementation in a diagnostic test. Therefore, the aim of the present study was to evaluate the IFN-\u3b3 response to methylated HBHA of Mtb produced in M. smegmatis (rHBHAms) in individuals at different stages of TB who scored positive to QFT-IT