Professional activity, information demands, training and updating needs of occupational medicine physicians in Italy: National survey.

Objectives: Occupational medicine is a discipline continually evolving in response to technological advances, changes in workplaces and production processes, emergence of new occupational risks and diseases and modifications in regulatory framework for occupational health and safety. Therefore, the recurrent revaluation of professional activity, information demands and education and training needs of occupational physicians is essential in order to identify methodologies and tools that may contribute to improvement of their professional knowledge and competency. In this regard, we conducted the first large-scale national survey of Italian occupational medicine physicians to define their demographic and professional activity and to assess their information demands, training and updating needs. Material and Methods: A random sample of occupational physicians, listed in the national register of the Italian Ministry of Health, was selected to complete a voluntary survey. Subjects recruited in this study were asked to complete 3 different sections (personal and professional information, training and updating needs, professional activity and practice characteristics) of a questionnaire for a total of 35 questions. Results: Most of participants were specialized in occupational medicine, worked for a large number of companies and carried out health surveillance on a total number of workers that exceeds 1500. Occupational physicians would like to have a higher training offer towards practical aspects of health surveillance, risks assessment, manual handling of loads, chemical substances and upper limb biomechanical overload. Interestingly, statistically significant differences were observed subdividing the sample into different groups according to the legal requirements to perform the professional activity of occupational physicians in Italy or according to particular aspects of their professional activity. Conclusions: This study has provided interesting findings that may help to guide future discussion on alternative and additional instruments and/or methodologies that may be adopted to implement the quality and effectiveness of occupational medicine practice. Int J Occup Med Environ Health 2016;29(5):837–85

Factors Affecting Indoor Radon Levels in Buildings Located in a Karst Area: A Statistical Analysis

In this paper, the averages annual radon concentrations in buildings placed in a karst area are analyzed in order to understand which factors may affect the occurrence of high levels of radon indoor. Statistical analysis on the radon dataset is performed using analytical factors described by two or three levels according to the characteristic of the measured buildings. The factors that determine higher radon levels in terms of arithmetic mean (AM) at ground floor (GF) are mainly the presence of sedimentary calcareous rock (SCR) in walls and the direct attack or crawl space as type of foundation. At first floors (FF), the presence of walls of only SCR showed radon levels higher (in terms of AM) than the one found for walls of mixed typology. These outcomes suggest that in karstic area buildings with SCR as the main construction material and direct attack or crawl space as the type of foundation, can be considered as radon-prone buildings. Moreover, this study confirms the need to measure radon levels not only at below ground floor and at GF, but also at FF and above for buildings in karst areas with construction materials including SCR blocks

Spatial and temporal distribution of the prevalence of unemployment and early retirement in people with multiple sclerosis: A systematic review with meta-analysis

BackgroundWe aimed to summarise the prevalence of unemployment and early retirement among people with MS and analyze data according to a spatio-temporal perspective.MethodsWe undertook a systematic search of PubMed/MEDLINE, Scopus, SciVerse ScienceDirect, and Web of Science. We included any peer-reviewed original article reporting the prevalence of unemployment and early retirement in the working-age population with MS. We excluded articles off-topic, with other study designs, whose study sample were unlikely to be representative of the MS population and in case of unavailability of the full text or essential information. A random-effects meta-analysis was used to measure overall prevalence estimates of unemployment and early retirement. We used meta-regression and subgroup analysis to evaluate potential moderators of prevalence estimates and the leave-one-out method for sensitivity analyses.ResultsOur research identified 153 studies across 29 countries encompassing 188436 subjects with MS. The pooled overall effect size for unemployment and early retirement was 35.6% (95% CI 32.8-38.4; I-2 = 99.31) and 17.2% (95% CI 14.6-20.2; I-2 = 99.13), respectively. The prevalence of unemployment varied according to the year of publication (p < 0.001) and there was a statistically significant decrease in the prevalence of unemployment over time (p = 0.042). Regarding early retirement, only seven (31.8%) estimates obtained from studies that were published before 2010 were below the overall effect size in comparison to 27 (60.0%) estimates extracted from data published between 2010 and 2021 (p = 0.039). There was a significant difference in prevalence according to countries (p < 0.001). Psychiatric illness was an important clinical feature responsible for patients leaving the workforce in regions with a high MS prevalence.ConclusionsUnemployment and early retirement due to MS remain highly prevalent, despite a slight decline in the last decade. The prevalence of unemployment and early retirement varies globally

Occupational outcomes of people with multiple sclerosis: a scoping review

Objectives To update the knowledge on the occupational outcomes associated with multiple sclerosis (MS), systematically examine the extent, scope and nature of the pre-existing literature and identify research gaps in the existing literature. Design Scoping review. Data sources A comprehensive database search of PubMed/MEDLINE, Scopus, SciVerse ScienceDirect and Web of Science was performed. There were no time limits. Eligibility criteria We included any peer-reviewed original article reporting the occupational outcomes of people with MS between the ages of 18 and 65 years. We excluded those off-topic and with insufficient information. Methods This review was conducted following the Joanna Briggs Institute recommendations and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping review checklist. Screening, reading of full-texts and data extraction was performed in a standardised way by expert reviewers from 14 July 2021 to 31 October 2021. We provided a narrative synthesis and an overview of findings. Results The initial systematic search yielded 104 228 results. After removing duplicates and applying the exclusion criteria, 403 articles were included in the review. In total, the studies evaluated 492 062 subjects with MS. One hundred fifty-four (38.2%) articles were published in the last 5 years, mostly from Europe and North America (50.9% and 33.0%, respectively). Concerning the occupational outcomes, studies mostly addressed unemployment (311, 77.2%), early retirement (120, 29.8%), disability pension (117, 29.0%), sick leave (77, 19.1%), the indirect cost of MS (74, 18.4%) and work characteristics (57, 14.1%). The results were categorised into seven subtopics: 'Changes in work and occupational status due to MS', 'work-related socio-economic consequences of MS', 'risk factors for unfavourable occupational outcomes', 'reported barriers to employment', 'reported job accommodations and vocational rehabilitation strategies', 'job satisfaction, stigma, and disclosing the diagnosis in the workplace' and 'rating clinical scales'. Conclusions There are several issues that deserve further in-depth study by the scientific community in order to improve the occupational outcomes of people with MS

Monitoraggio sugli operatori sanitari risultati positivi a COVID-19 dall’inizio dell’epidemia fino al 30 aprile 2020: studio retrospettivo in sette regioni italiane

Il documento affronta il tema del contagio tra il personale sanitario che, fin dalle primissime fasi, ha svolto un ruolo cruciale nella gestione dell'epidemia sia per la cura in prima linea dei pazienti infetti, con il conseguente maggior rischio di esposizione, sia nell’assicurare la piena implementazione delle misure di prevenzione e controllo per il contenimento del contagio. Questo ha determinato un'elevata diffusione di contagi tra gli operatori sanitari con percentuali molto elevate rispetto ai casi registrati nella popolazione generale

Radon levels in dwellings and workplaces: a comparison with data from some European countries

Background: According to 2013 European Basic Safety Standards (EU BSS), legal and administrative consequences of having an area declared as radon priority area (RPA) concern workplaces (WP) and public buildings, as well as dwellings (DW). However, RPAs in many cases are defined as higher levels of indoor radon in DW. The reason is that most data are available for DW. So far, indoor radon data for WP (except for schools) and public buildings are scarce. Objective: The objective of this study was to compare indoor radon levels in DW and WP in a given area and to evaluate whether they have different distributions and different average levels. Design: Austria, Finland, Germany, and Italy provided indoor radon data on DW and WP. Data related to WP were aggregated in the same grid, as already done for data on DW, to update the European Indoor Radon Map. Based on 10 km × 10 km grid cells, the same statistics are computed for both datasets. Thus, two structurally equal datasets for each country were generated to be statistically compared. Results and conclusions: Generally, there are numerous indoor radon data on DW than data on WP. Statistical analysis suggests that in all the countries, indoor radon levels – in terms of arithmetic mean (AM) of the natural logarithm-transformed data – in WP and DW are statistically different (P < 0.05), as well as from those referring to schools. The difference in distributions is neither attributable to the effect of geology nor to the effect of different sample sizes. The correlation between aggregated data is positive in the sense that if the mean (over grid cells) radon concentration increases in DW, it increases in WP as well. Compared with DW, in all countries indoor radon levels in WP seem to be statistically different, but the results are not enough to draw final conclusions: on-purpose designed surveys could be a useful tool to better understand this phenomenon

The Impact of the First Wave of the COVID-19 Pandemic on Healthcare Workers: An Italian Retrospective Study

Healthcare workers (HCWs) played an essential role in managing the COVID-19 pandemic. The Italian Workers&rsquo; Compensation Authority (INAIL) and the Italian National Institute of Health (ISS) developed a retrospective study to analyze and understand trends and characteristics of infections among HCWs during the first wave of the pandemic. Between May and September 2020, Italian Regions retrospectively collected anonymous data regarding HCWs infected from the beginning of the pandemic until 30 April 2020 from their administrative sources through a questionnaire asking for socio-demographic and occupational information about the characteristics of contagion and disease outcome. Almost 16,000 valid questionnaires were received. Logistic regression was performed to ascertain the effect of age, gender, geographical macro area, profession, and pre-existing health conditions on the likelihood of HCWs developing more severe forms of COVID-19 (at least hospitalization with mild symptoms). All predictor variables were statistically significant. HCWs at higher risk of developing a more severe disease were males (OR: 1.90; 95% CI: 1.44&ndash;2.51), older than 60 years of age (OR: 6.00; 95% CI: 3.30&ndash;10.91), doctors (OR: 4.22; 95% CI: 2.22&ndash;9.02), working in Lombardy (OR: 55.24; 95% CI: 34.96&ndash;87.29) and with pre-existing health conditions (OR: 1.90; 95% CI: 1.43&ndash;2.51). This study analyses the main reasons for the overload put on the National Health Service by the first wave of the pandemic and the risk of infection for HCWs by age, gender, occupational profile and pre-existing health conditions. Improved knowledge, availability of personal protective equipment (PPE) and a tight vaccination campaign for HCWs strongly changed the trend of infections among HCWs, with substantial elimination of serious and fatal cases

Young Workers’ Access to and Awareness of Occupational Safety and Health Services: Age-Differences and Possible Drivers in a Large Survey of Employees in Italy

Young workers are in particular need of occupational safety and health (OSH) services, but it is unclear whether they have the necessary access to such services. We compared young with older workers in terms of the access to and awareness of OSH services, and examined if differences in employment conditions accounted for age-differences. We used survey data from Italy (INSuLA 1, 2014), with a sample of 8000 employed men and women aged 19 to 65 years, including 732 young workers aged under 30 years. Six questions measured access to services, and five questions assessed awareness of different OSH issues. Several employment conditions were included. Analyses revealed that young workers had less access and a lower awareness of OSH issues compared with older workers. For instance, odds ratios (OR) suggest that young workers had a 1.44 times higher likelihood [95%&mdash;confidence interval 1.21&ndash;1.70] of having no access to an occupational physician, and were more likely (2.22 [1.39&ndash;3.38]) to be unaware of legal OSH frameworks. Adjustment for selected employment conditions (company size, temporary contract) substantially reduced OR&rsquo;s, indicating that these conditions contribute to differences between older and younger workers. We conclude that OSH management should pay particular attention to young workers in general and, to young workers in precarious employment, and working in small companies in particular