DOES STILL EXIST A CORRELATION BETWEEN X-RAYS OCCUPATIONAL EXPOSURE AND BENIGN NODULAR THYROID DISEASE?

Objective: The prevalence of benign nodular thyroid disease in the general population is high, as shown by various studies, and the diagnosis is eased by the improved diagnostic capacity of the instruments used. The aim of the present study is the evaluation of occupational exposure to ionizing radiation as a possible significant risk factor in the determinism of this pathology. Method: A cross-sectional observational study in “A category” X-ray exposed workers (doctors, nurses, technicians) of the University Hospital of Palermo, compared with a sample of the general population, was carried out from June 2016 to June 2017. We evaluated data obtained from the Personal Health Records, including thyroid sonographic reports, assessed by 10-MHz neck ultrasonography: then were analyzed on the basis of statistical significance (p-value < 0.05, Odd ratios and 95% confidence interval), in order to identify possible relations with conditions who may become real risk factors, such as: occupational exposure, considering years and accumulated dose, age, gender, smoking habit. Result: Nodules were detected in 32/85 (37.6%) workers and in 31/90 (34.4%) subjects of the control group. None of the parameters examined in the two groups reached statistical significance as a risk factor, therefore not playing major role in the determinism of thyroid nodularitye. Conclusion: In this study, X-rays work-related exposure does not represent a risk factor of thyroid nodularity, although it would be opportune to know the reasons of the high prevalence of this pathology in general population

Immunization against Hepatitis B Surface Antigen (HBsAg) in a Cohort of Nursing Students Two Decades after Vaccination: Surprising Feedback

Health-care students can be exposed to biological risks during university training. The persistence of long-term immunogenicity against hepatitis B virus (HBV) was analyzed in a cohort of nursing students two decades after primary vaccination. A total of 520 students were enrolled at the University of Palermo and were evaluated for levels of anti-HBsAg antibodies. ThestudentswereexaminedduringthefirstyearoftheirDegreeCourseandwerecheckedtwoyears later. All students with anti-HBsAg <10 mIU/mL during their first or third year were boosted within onemonth. Theproportionofstudentsthatwerevaccinatedduringadolescenceshowinganti-HBsAg ≥10 mIU/mL was higher than that observed in students who were vaccinated during infancy (69% versus31.7%;p-value<0.001). ReceivingHBVvaccinationatadolescencewassignificantlyassociated with a fourfold increased possibility of having anti-HBsAg titers≥10 mIU/mL (adj-OR = 4.21, 95% CI: 2.43–7.30). Among the students who were checked at the third year and boosted after the first year (n = 279), those who were vaccinated during infancy showed a higher percentage of antibody titers <10 mIU/mL (20.3% versus 8.7% among vaccinated during adolescence; p < 0.01). This study confirms that HBV vaccination at adolescence might determine a higher long-term persistence of anti-HBsAg titers≥10 mIU/mL and that anti-HBV booster could increase levels of anti-HBsAg over a relatively short period, especially in subjects who were vaccinated during infancy

Latent Tuberculosis Infection among Healthcare Students and Postgraduates in a Mediterranean Italian Area: What Correlation with Work Exposure?

Background: Tuberculosis screening is part of the standard protocol for evaluating the risk of infection in healthcare workers. The aim of this study was to evaluate the prevalence of latent tuberculosis infection (LTBI) among students attending various healthcare profession degree courses and postgraduate medical courses at the School of Medicine of the University of Palermo, Italy, and assess the possible professional origin of infection. Methods: In total, 2946 students (2082 undergraduates and 864 postgraduates) took part in a screening program for LTBI between January 2014 to April 2019 using the tuberculin skin test (TST). Students with a positive TST result underwent a Quantiferon-TB test (QFT). Results: Among the 2082 undergraduates, 23 (1.1%) had a positiveTST;theresultwasconfirmedwithQFTfor13(0.62%)ofthem. Amongthe864postgraduate students,24(2.78%)hadapositiveTSTandonly18(2.08%)showedapositiveQTF.Latenttuberculosis infectionsweresignificantlymorefrequentamongpostgraduatesthanundergraduates(2.08% > 0.62%, p < 0.0001). There was a higher number of subjects previously vaccinated for TB (18.87% > 0.24%, p < 0.0001), and of vaccinated subjects found positive for TST and QTF (66.67% > 7.69%, p = 0.001) in the postgraduate group. Conclusion: Latent TB is relatively low among medical school students in our geographic area. Nevertheless, this infectious disease must be regarded as a re-emerging biohazard for which preventive strategies are required to limit the risk of infection, especially among exposed workers