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

Study of Cytotoxic and Genotoxic Effects of Hydroxyl-Functionalized Multiwalled Carbon Nanotubes on Human Pulmonary Cells

Chemical functionalization of multiwalled carbon nanotubes (MWCNTs) increases their solubility, dispersion, and biological applications. Since there are only a few studies on the toxicity of functionalized MWCNTs, we investigated the cytotoxic and genotoxic-oxidative effects of OH-functionalized MWCNTs on human lung epithelial cells (A549) in order to obtain information on their biological effects. We exposed the cells to 10, 20, 40, and 100 μg/mL of commercial MWCNT-OH for 24 h. Cytotoxicity was then evaluated as the reduction in cell viability, membrane damage, and apoptosis, assessed by MTT and LDH assays and fluorescence microscopic analysis, respectively. The Fpg-modified comet assay was used to assess direct/oxidative DNA damage. We found a concentration-dependent reduction in cell viability and an increase of percentage of apoptotic cells, with no significant cellular LDH release. There was also concentration-dependent direct DNA damage but no oxidative DNA damage. These findings demonstrate the cytotoxicity of MWCNT-OH, through reduction of cell viability and induction of apoptosis without cell membrane damage, and the genotoxicity, by direct DNA damage induction, suggesting that the MWCNTs enter the cell without damaging its membrane and directly interact with the nucleus. This preliminary study highlights the need for further research to examine the potential toxicity of functionalized MWCNTs before starting to use them in biological applications

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

Risk assessment at work and prevention strategies on COVID-19 in Italy.

The COVID-19 pandemic has spread worldwide, with considerable public health and socio-economic impacts that are seriously affecting health and safety of workers, as well as their employment stability. Italy was the first of many other western countries to implement extended containment measures. Health workers and others employed in essential sectors have continued their activity, reporting high infection rate with many fatalities. The epidemiological trend highlighted the importance of work as a substantial factor to consider both when implementing strategies aimed at containing the pandemic and shaping the lockdown mitigation strategy required for sustained economic recovery. To support the decision-making process, we have developed a strategy to predict the risk of infection by SARS-CoV-2 in the workplace based on the analysis of the working process and proximity between employees; risk of infection connected to the type of activity; involvement of third parties in the working processes and risk of social aggregation. We applied this approach to outline a risk index for each economic activity sector, with different levels of detail, also considering the impact on mobility of the working population. This method was implemented into the national epidemiological surveillance model in order to estimate the impact of re-activation of specific activities on the reproduction number. It has also been adopted by the national scientific committee set up by the Italian Government for action-oriented policy advice on the COVID-19 emergency in the post lockdown phase. This approach may play a key role for public health if associated with measures for risk mitigation in enterprises through strategies of business process re-engineering. Furthermore, it will make a contribution to reconsidering the organization of work, including also innovation and fostering the integration with the national occupational safety and health (OSH) system