Empowering workplace and wellbeing among healthcare professionals: the buffering role of job control

Health care workers are exposed to several job stressors that can adversely affect their wellbeing. Workplace incivility is a growing organizational concern with the potential to create workplaces harmful to individuals' wellbeing and increase occupational health risks. Based on the Job Demands-Resources (JD-R) model, the purpose of the present study was to investigate the role of two resources (organizational empowerment and job control) on individuals' well-being (emotional exhaustion) and attitude at work (unit affective commitment)

Time trend and Bayesian mapping of multiple myeloma incidence in Sardinia, Italy

A few reports have described increasing trends and spatial distribution of multiple myeloma (MM). We used a validated database including the 1606 cases of MM diagnosed in Sardinia in 1974–2003 to explore its time trend, and we applied Bayesian methods to plot MM probability by administrative unit on the regional map. Over the 30 years of observation, the MM standardized incidence rate (standard world population, all ages) was 2.17 × 10(–5) (95% CI 2.01–2.34), 2.29 (95% CI 2.06–2.52) among men, and 2.06 (95% CI 1.83–2.28) among women. MM incidence increased by 3.3%/year in 1974–2003, in both males and females, particularly among the elderly and in the high incidence areas. Areas at risk tended to cluster in the north-eastern part of the region. A higher proportion of elderly in the resident population, but not socioeconomic factors, nor livestock farming, was associated with higher incidence rates. The steep upward time trend and the spatial clustering of MM suggest interactions between genetic and environmental determinants that might be more efficiently investigated in the areas at risk

Haemolymphatic cancer among children in Sardinia, Italy: 1974–2003 incidence

Objectives To explore the time trend and geographical distribution of childhood leukaemia incidence over the territory of the Italian region of Sardinia.Setting All hospitals departments, diagnostic centres and social security agencies in Sardinia were regularly screened in 1974–2003 to identify, register and review the diagnoses of incident cases of haematological malignancies (HM).Participants The whole child population aged 0–14 resident in Sardinia.Primary and secondary outcome measures Incidence and time trend of childhood HM and childhood acute lymphoblastic leukaemia (ALL) over the study period, and use of Bayesian methods to plot the probability of areas with excess incidence on the regional map.Results Overall, 675 HM cases, including 378 ALL cases, occurred among children aged 0–14 years resident in Sardinia in 1974–2003, with an incidence rate of 6.97×10-5 (95% CI 6.47 to 7.51) and 3.85×10-5 (95% CI 3.48 to 4.26), respectively. Incidence of HM and ALL showed an upward trend along the study period especially among females. Three communes out of the 356 existing in 1974, namely Ittiri, Villa San Pietro and Carbonia, stand out as areas with excess incidence of HM and ALL in particular and another, Carloforte, for ALL only.Conclusions Our results might serve as convincing arguments for extending the coverage of routine cancer registration over the whole Sardinian population, while prompting further research on the genetic and environmental determinants in the areas at risk

Metabolomic patterns associated to QTc interval in shiftworkers: an explorative analysis

Objectives: 1H NMR-metabolomic approach was used to investigate QTc interval correlation with plasma metabolic profiles in shiftworkers. Methods: Socio-demographic data, electrocardiographic QTc interval and plasma metabolic profiles from 32 male shiftworkers, were correlated by multivariate regression analysis. Results: We found a positive correlation between QTc interval values, body mass index, glycemia and lactate level and a negative correlation between QTc interval and both pyroglutamate and 3-hydroxybutyrate plasma level. Conclusions: Our analysis provides evidence of the association between clinical, metabolic profiles and QTc interval values. This could be used to identify markers of early effects and/or susceptibility in shiftworker

Occupational exposure to ionizing radiation and risk of lymphoma subtypes: results of the Epilymph European case-control study

Background: Evidence linking risk of lymphoma and B-cell lymphoma subtypes to ionizing radiation is inconclusive, particularly at low exposure levels. Methods: We investigated risk of lymphoma (all subtypes), B-cell lymphomas, and its major subtypes, associated with low-level occupational exposure to ionizing radiation, in 2346 lymphoma cases and 2463 controls, who participated in the multicenter EpiLymph case-control study. We developed a job-exposure matrix to estimate exposure to ionizing radiation, distinguishing between internal and external radiation, and we applied it to the lifetime occupational history of study subjects, We calculated the Odds Ratio (OR) and its 95% confidence interval (95% CI) for lymphoma (all subtypes combined), B-cell lymphoma, and its major subtypes using unconditional, polytomous logistic regression adjusting for age, gender, and education. Results: We did not observe an association between exposure metrics of external and internal radiation and risk of lymphoma (all subtypes), nor with B-cell lymphoma, or its major subtypes, at the levels regularly experienced in occupational settings. An elevated risk of diffuse large B cell lymphoma was observed among the most likely exposed study subjects with relatively higher exposure intensity, which would be worth further investigation. Conclusions: Further investigation is warranted on risk of B cell lymphoma subtypes associated with low-level occupational exposure to external ionizing radiation, and to clarify whether lymphoma should be included among the cancer outcomes related to ionizing radiation

Occupational exposure to organic dust and risk of lymphoma subtypes in the EPILYMPH case-control study

Objectives: This study aimed to estimate the risk of lymphoma and its major subtypes in relation to occupational exposure to specific organic dusts. Methods: We explored the association in 1853 cases and 1997 controls who participated in the EpiLymph case–control study, conducted in six European countries in 1998–2004. Based on expert assessment of lifetime occupational exposures, we calculated the risk of the major lymphoma subtypes associated with exposure to six specific organic dusts, namely, flour, hardwood, softwood, natural textile, synthetic textile, and leather, and two generic (any types) groups: wood and textile dusts. Risk was predicted with unconditional regression modeling, adjusted by age, gender, study center, and education. Results: We observed a 2.1-fold increase in risk of follicular lymphoma associated with ever exposure to leather dust [95% confidence interval (CI) 1.01–4.20]. After excluding subjects who ever worked in a farm or had ever been exposed to solvents, risk of B-cell lymphoma was elevated in relation to ever exposure to leather dust [odd ratio (OR) 2.2, 95% CI 1.00–4.78], but it was not supported by increasing trends with the exposure metrics. Risk of Hodgkin lymphoma was elevated (OR 2.0, 95% CI 0.95–4.30) for exposure to textile dust, with consistent upward trends by cumulative exposure and three independent exposure metrics combined (P=0.023, and P=0.0068, respectively). Conclusions: Future, larger studies might provide further insights into the nature of the association we observed between exposure to textile dust and risk of Hodgkin lymphoma

Occupational Exposure to Fine Particles and Ultrafine Particles in a Steelmaking Foundry

Several studies have shown an increased mortality rate for different types of tumors, respiratory disease and cardiovascular morbidity associated with foundry work. Airborne particles were investigated in a steelmaking foundry using an electric low-pressure impactor (ELPI+™), a Philips Aerasense Nanotracer and traditional sampling equipment. Determination of metallic elements in the collected particles was carried out by inductively coupled plasma mass spectrometry. The median of ultrafine particle (UFP) concentration was between 4.91 × 103 and 2.33 × 105 part/cm3 (max. 9.48 × 106 part/cm3). Background levels ranged from 1.97 × 104 to 3.83 × 104 part/cm3. Alveolar and deposited tracheobronchial surface area doses ranged from 1.3 × 102 to 8.7 × 103 mm2, and 2.6 × 101 to 1.3 × 103 mm2, respectively. Resulting inhalable and respirable fraction and metallic elements were below limit values set by Italian legislation. A variable concentration of metallic elements was detected in the different fractions of UFPs in relation to the sampling site, the emission source and the size range. This data could be useful in order to increase the knowledge about occupational exposure to fine and ultrafine particles and to design studies aimed to investigate early biological effects associated with the exposure to particulate matter in the foundry industries

The X-ray Polarization Probe mission concept

The X-ray Polarization Probe (XPP) is a second generation X-ray polarimeter following up on the Imaging X-ray Polarimetry Explorer (IXPE). The XPP will offer true broadband polarimetery over the wide 0.2-60 keV bandpass in addition to imaging polarimetry from 2-8 keV. The extended energy bandpass and improvements in sensitivity will enable the simultaneous measurement of the polarization of several emission components. These measurements will give qualitatively new information about how compact objects work, and will probe fundamental physics, i.e. strong-field quantum electrodynamics and strong gravity.Comment: submitted to Astrophysics Decadal Survey as a State of the Profession white pape

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients