Editorial: Occupational risks of healthcare personnel

Healthcare personnel (HCP), and especially those working in front-line roles, are at increased risk for occupational exposure to a variety of infections, including vaccine-preventable diseases. At the same time, HCP are exposed not only to environmental risks (e.g., biological, physical, and chemical risks) but also to psychological stress, which was exceptionally intensified during the coronavirus disease 2019 (COVID-19) pandemic. As such, ensuring safety within healthcare facilities and creating health-promoting workplaces is becoming increasingly relevant in a globalizing workplace..

Vibration transmitted to operator’s back by machines with back-pack power unit: a case study on blower and spraying machines

To correctly evaluate the vibration transmitted to the operators, it is necessary to consider each body’s point interested by the vibratory stimulus produced by machines. All the body’s part in contact to the vibration, when a portable device with internal combustion engine is used, are: hands, back and shoulders. Some information for wholebody vibration are available in the ISO 2631-1997 standard, which otherwise refers to a seated operator. ‘C’ type standards for the vibration analysis exist for some portable machines with an internal combustion engine which is comprehensive in the machine (chainsaw, brush-cutter, blower). If the engine is not inside the machine, but it is on the operator’s back, ‘C’ type standards on vibration measurements are quite incomplete. The IMAMOTER institute of CNR, the DISAFA Department (University of Turin) and the Occupational Medicine Department of the University of Catania started some tests to verify the vibration levels transmitted to an operator working with backed engine devices. Two machines have been examined: a blower and a spraying machine. Two operative conditions have been considered during all the tests: idling and full load. Three operators have been involved and each test has been repeated three times. The spraying machine has been tested both with the empty tank and with 10 litres of water, to simulate the load to be caused by the presence of liquid inside the tank. In this work the comfort condition of ISO 2631-1 standard was considered, using the frequency weighting Wc curve with the weighting factor 0.8 for X axis (back-ventral direction) and the Wd curve for Y and Z axis (shoulder - shoulder and buttocks - head) with weighting factors 0.5 and 0.4 (respectively for Y and Z axis). Data were examined using IBM SPSS Statistics 20 software package. The statistical analysis underlined that the running condition is the main factor to condition the vibration levels transmitted to the operator’s back, while the ballast and the operators are influent when the running conditions are distinguished. Concerning medical investigation, lower back and shoulders are the main critical part of the body interested by vibration transmitted to each operator

Work-related stress in the italian banking population and it's association with recovery experience

Objectives: Over the past decade, there has been a markedly growing interest in issues involving work-related stress in Europe. In Italy, according to Eurofound, research has demonstrated high levels of stress in the banking sector. With this in mind, a study was conducted to evaluate the peculiarities of hindrance and challenge stressors, and their links with recovery in the Italian banking population. Material and Methods: The health and safety managers of a major Italian banking group were contacted and invited to participate in a stress assessment procedure, not only for research purposes but also to help them fulfill their obligations with regard to work-related stress. In total, 6588 bank workers took part in the study (57.5% males and 42.5% females) in 2012–2018. Work-related stress was measured with the Stress Questionnaire (SQ) that assesses several psychosocial working variables. Recovery was measured using a scale based on the SQ. The analysis and tabulation of the study results were performed using the Statistical Package for Social Sciences (SPSS). Results: The results have demonstrated that female respondents lack more job control and colleagues’ support as compared to male respondents. Employees aged > 50 lack their supervisors’ support while employees with the shortest job seniority experience the greatest role ambiguity, as well as the lack of job control and colleagues’ support. The results of hierarchical regression analysis have demonstrated that the lack of colleagues and supervisors’ support, as well as job demands and job control, contribute to explaining the recovery experience. The greatest contribution to the explained variance could be attributed to job demands and the lack of colleagues’ support. Conclusions: This study has demonstrated an important contribution of the so-called traditional stressors to predicting recovery for the banking population in Italy. These findings suggest that banks should adopt corporate policies containing activities for the prevention of and protection against stress, with a more general objective of improving the mental health of their workers

How the Heart Was Involved in COVID-19 during the First Pandemic Phase: A Review

Coronavirus disease (COVID-19) was first observed in Wuhan, Hubei Province (China) in December 2019, resulting in an acute respiratory syndrome. Only later was COVID-19 considered a public health emergency of international concern and, on 11 March 2020, the WHO classified it as pandemic. Despite being a respiratory virus, the clinical manifestations are also characterized by cardiological involvement, especially in patients suffering from previous comorbidities such as hypertension and diabetes mellitus, its complications being potentially serious or fatal. Despite the efforts made by the scientific community to identify pathophysiological mechanisms, they still remain unclear. A fundamental role is played by the angiotensin 2 converting enzyme, known for its effects at the cardiovascular level and for its involvement in COVID-19 pathogenesis. The goal of this paper was to highlight the mechanisms and knowledge related to cardiovascular involvement during the first pandemic phase, as well as to emphasize the main cardiological complications in infected patients

Increased serum chemerin level to predict early onset of aortic valve stenosis

Publisher Copyright: © 2018, Spandidos Publications. All rights reserved.Inflammation appears to be the cause of aortic valve (AoV) stenosis and identification of predictive biomarkers is therefore imperative. The aim of the current study was to evaluate the potential role of serum chemerin and fibroblast growth factor-21 (FGF-21) in the pathogenesis of the disease. A total of 102 patients were selected based on certain criteria and divided into an aortic stenosis group and a control group. Patients with AoV stenosis were subdivided into three groups depending on the severity according to the echocardiography criteria: Aortic jet velocity, Vmax (m/ sec); mean pressure gradient, PG (mmHg); aortic valve area (AVA), cm2; and indexed AVA, cm2/m2. Patients were graded as: Severe: Vmax >4 m/sec, PG >40 mmHg, AVA 1.5 cm2, indexed AVA >0.85. ELISA was used for the detection of chemerin and FGF-21. Post-hoc analysis with Tukey's correction was performed. The highest chemerin levels were found in mild and moderate AoV stenosis and decreased along with the grade of severity, compared with the control group. The FGF-21 level was increased in all the stenosis groups, reaching the highest level at severe stenosis. Receiver-operating characteristic analysis of chemerin in all the AoV stenosis groups without grading the severity included, area under the curve (AUC)=0.76; 0.70-0.80= fair; P<0.001 and for mild AoV stenosis was AUC=0.82; 0.80-0.90= good; P<0.001. In conclusion, chemerin is a good diagnostic biomarker for mild AoV stenosis, while FGF-21 is a moderate diagnostic marker.publishersversionPeer reviewe

Acute Glomerulonephritis in a Child with Chlamydia pneumoniae Infection: A Case Report.

Background. Infectious diseases seem to be an important and independent risk factor for renal failure, but the underlying mechanism of renal involvement during some kinds of infectious diseases is still unclear, even if the literature data report immunomediated and/or autoimmune mechanisms to explain the pathogenic relationship between the two diseases. In paediatric patients, Chlamydia pneumoniae is a rare cause of renal complications and it may manifest in several ways, mainly involving the respiratory system, even if also renal and glomerulalr complications, have been described. Case Diagnosis/Treatment. Herein we report a case of a 3-year-old child who developed an acute glomerulonephritis that was chronologically, clinically, and biologically related to a previous Chlamydia pneumoniae infection. On our knowledge, in the literature it is the youngest patient with renal involvement during course of Chlamydia pneumoniae infection ever reported. Conclusions. The present case supports the hypothesis of a rather close causal relationship between this infective agent and renal and glomerular symptoms occurred in this child, during an acute episode of respiratory disease

Management of High-Pressure Injection Hand Injuries: A Multicentric, Retrospective, Observational Study

Hand injuries after high-pressure injection are a medical emergency. These events occur frequently in workers during industrial cleaning, painting, and lubrication, and may have devastating consequences, leading to eventual amputation and poor functional outcomes. The authors have investigated the evolution, management, and outcome. Medical records of occupational medicine units and hand surgery units were collected in order to spot the high-pressure gear accident cases. Records were analyzed by dividing the subjects into two groups: those treated within 6 h and after 6 h of the trauma. A follow-up was carried out at least 1 year after treatment; the post-treatment outcomes were assessed. Of the 71 (100%) subjects, 26 (37%) were treated ≤6 h and 45 (63%) >6 h. A total of 28% (n = 20) underwent amputation. In 61% of cases, accidents had occurred in the iron and steel sector. High viscosity materials with a delayed treatment beyond 6 h seemed to determine compartmental syndrome and following amputation. A significantly better outcome was reported among subjects treated ≤6 h compared to those treated >6 h, 20% (n = 7) versus 26% (n = 9), respectively. Early management of this type of injury is crucial. The results of this study may contribute to providing guidelines to occupational physicians in order to best manage this type of emergency

Prevalence of anti-nuclear autoantibodies in subjects exposed to natural asbestiform fibers: a cross-sectional study.

Fluoro-edenite (FE) is an asbestiform mineral fiber spotted in the lava rocks excavated from a stone quarry in Biancavilla (Italy). The derived material had been employed locally for building purposes. Previous studies found evidence that exposure to asbestos may induce autoimmunity, with frequency of anti-nuclear autoantibodies (ANA). The aim of this study was to explore the relationship between FE exposure and autoimmune responses in an exposed population. For the study, 60 subjects living in the area of Biancavilla and 60 subjects as control group were randomly invited to participate. A free medical check, including spirometry and a high-resolution computer tomography chest scan, was given to all participants. ANA were determined by indirect immunofluorescence. On medical check, no subject showed any sign and/or symptoms of illness. Prevalence for samples positive to ANA were 70% (n = 42) and 25% (n = 15), respectively, for exposed and non-exposed subjects (p < 0.05). The presence of pleural plaques (PP) was found in 21 (30%) of the exposed subjects and in 2 (3%) of the non-exposed participants. PP subjects were always ANAs positive. In conclusion, as already it was observed with exposure to asbestos fibers, levels of ANA seemed to significantly increase in subjects who had been exposed to FE. Furthermore, all subjects showing PP were also ANA-positive. This first finding in subjects exposed to FE should encourage researchers to further investigate associations between autoimmune unbalance and environmental exposure to asbestiform fibers

Correlation of the risk of breast cancer and disruption of the circadian rhythm (Review)

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Impact of several proinflammatory and cell degradation factors in patients with aortic valve stenosis

Aortic valve (AoV) stenosis is the third most common cardiovascular disease. The pathogenesis of AoV stenosis is associated with an inflammatory process where MMPs serve important roles. The aim of the present study was to determine the association between matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs) and inflammatory factors, and AoV stenosis at various degrees of severity compared with the control. A total of 18 patients with mild, 19 with moderate and 15 with severe AoV stenosis were included in the present stud, and 50 individuals were enrolled in the control group. The severity of stenosis was determined by echocardiography. The expression levels of chemerin, fibroblast growth factor 21, MMP‑1, ‑3, and ‑9, and TIMP‑1 and ‑3 were analyzed by ELISA. Data were analyzed using GraphPad Prism7 software. The expression levels of MMP‑1 was increased in patients with stenosis compared with the control group (P=0.0043). Distribution of the trimodal MMP‑1 values was obtained in the stenosis group and monomodal in the control group. A total of 80% of patients in the stenosis group presented significantly increased expression levels of MMP‑1 compared with the control group (P=0.0002). Expression of MMP‑1 was significantly higher in all stenosis groups compared with the control. The highest expression level of MMP‑1 appeared in patients with moderate stenosis (P<0.0001). There was no significant difference in the expression of MMP‑3, MMP‑9 and TIMP‑1 in the aortic stenosis group, compared with the control group. A positive correlation between MMP‑1 and MMP‑9 expression levels was identified (r=0.37; P=0.017). The increase of MMP‑1 was correlated with the increase of MMP‑9, but not with the level of MMP‑3. The expression levels of chemerin was significantly elevated in patients with stenosis compared with healthy patients. The highest expression levels of chemerin were determined in patients with mild (P=0.0001) and moderate (P=0.0007) stenosis and decreased with the grade of severity compared with the control group. The expression of FGF‑21 was significantly different between the control and mild (P=0.013), moderate (P=0.015) and severe stenosis (P=0.003) groups. The expression levels of FGF‑21 increased with the increase in severity grade, reaching the maximum for severe stenosis. The results of the present study indicated that the inflammatory process is predominantly occurring at the early, mild stage of stenosis and the most prominent extracellular matrix remodeling occurs in moderate stenosis (demonstrated by MMP‑1 levels). In patients with severe stenosis, the levels of MMP‑1 and chemerin (which are lower than in a case of mild or moderate stenosis) could indicate the development of calcinosis and the reduction in activity or inactivation of the inflammatory process.Peer reviewe