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Background: In the context of Infections Prevention and Control activities, the training of healthcare-associated infection control figures is crucial; the COVID-19 pandemic further emphasized the necessity of ensuring a widespread and stable level of skills over time for such professionals. The present work aims to identify the number and training needs of the personnel working in the Emilia-Romagna Region's healthcare facilities as "healthcare-associated infection control figures"., Methods: Data were collected through a survey created by experts from the Regional Group "Training in the prevention and control of antibiotic resistance". The questionnaire explored the number, professional and educational background, and training requirements of Healthcare-associated infections control figures in Emilia-Romagna., Results: With 73 figures dedicated to Healthcare-associated infections control, the Emilia-Romagna Region appears to be in line with the European standard ratio (1 professional every 125 beds). Professionals with a nursing background, over 50 years old and of female sex prevail in the group, while the training needs expressed include both theoretical and practical aspects., Conclusions: Healthcare assistants and nursing staff represent a fundamental resource for the implementation of infection prevention and control programs in our healthcare facilities; continuous, multidisciplinary and targeted training of these professionals is confirmed as necessary.

Background: Modena's Local Health Authority (AUSL) is a public service with more than 5,000 employees. In its facilities, drinking water is available as tap water. However, disposable plastic bottles are also widely used, thus increasing plastic waste., Study Design and Methods: In the present study, we aimed to investigate employees' drinking habits through an ad hoc 10-item online questionnaire, which was administered in spring 2023., Results: Of the 584 participants (10.8% response rate), 75% of workers reported drinking less than 1.5 liters of water per day. In addition, 74% of workers brought water from home, while 62% used disposable plastic containers bought in the workplace or outside. When asked if they would appreciate a water refilling station in the workplace, whether that would induce them to consume less plastic and to drink more water, 91%, 82%, and 72% of workers said "yes", respectively. By installing water coolers, the estimated mean number of plastic bottles spared every day at the AUSL would be about 6,000., Conclusions: Our data shed light on most employees' perceived need for alternative sources of drinking water, not only in order to drink more for health benefits, but also to reduce plastic usage in favor of reusable, more environmentally friendly materials.

Background: During the COVID-19 pandemic, telemedicine had the opportunity to demonstrate its potential. In Italy, after an initial period of mistrust, it became clear that remote medicine can provide significant benefits for both healthcare professionals and patients. In the Local Health Unit of Modena (Emilia Romagna region, Northern Italy), great importance was placed on developing, promoting, and managing all telemedicine activities. In particular, it was decided to prioritize the activation of tele-visit services in accordance with the guidelines of the Emilia-Romagna region., Study Design: This case study aims to illustrate the activities planned and developed at the Local Health Authority of Modena for the implementation of the first service of this kind, the tele-visit service for outpatients suffering from type 1 diabetes mellitus, and to analyze data from the first 12 months of activity (from May 2023 to April 2024) to share reflections on the strengths and critical points encountered., Method: For the activation of tele-visits at the Local Health Authority of Modena, a dedicated working group was established with the mandate to manage all clinical, organizational, and IT aspects. Before starting the service, various preliminary activities were carried out, including selecting the clinical specialty to be activated, defining patient inclusion criteria, implementing IT systems, assessing clinical risks, preparing and distributing information materials, training healthcare personnel, and planning outpatient activities., Results: During the first year of experimental activation of the service (May 2023-April 2024), a total of 72 patients were enrolled in the project, with 103 tele-visits provided. The patients were predominantly women (67%), and the most represented age groups were 30-39 (26%) and 40-49 (21%). Half of the specialists in the Diabetology Service (9/19) participated in the initiative by providing tele-visits, most of whom were young and all of whom were women. The main issues identified through regularly scheduled meetings with professionals, to which the working group is seeking the most appropriate solutions, include poor adherence by many patients who still have doubts about this modality, the habit of many patients rescheduling appointments multiple times, a habit not diminished by this visit method, the non-uniform adherence of professionals, and uneven territorial diffusion of the service. Lastly, professionals reported various IT difficulties. Although the number of tele-visits was not high, the initiative has sparked the interest of several specialists, some of whom have already proposed activating other telemedicine services, with some even suggesting innovative new projects. The next steps will involve extending diabetes monitoring to pregnant women with gestational diabetes and developing tele-visit services for endocrinology, neurology, hematology, and gastroenterology., Conclusions: Implementing a tele-visit service in a Local Health Unit is a complex process. A thorough evaluation of the issues that emerged during the development phases and the initial delivery period can help us to act proactively to prevent the failure of future projects. Our evaluations suggest a need to act on two fronts: on one hand, we must organize further activities to promote telemedicine to both patients and healthcare providers, while on the other hand, we must work to resolve IT issues.

Background: A key renovation of doctoral programs is currently ongoing in Italy. Public health and its competencies may play a pivotal role in high-level training to scientific research, including interdisciplinary and methodological abilities., Methods: As a case study, we used the ongoing renovation of the Clinical and Experimental Medicine doctoral program at the University of Modena and Reggio Emilia. We focused on how the program is designed to meet national requirements as well as students' needs, thus improving educational standards for scientific research in the biomedical field, and on the specific contribution of public health and epidemiology in such an effort., Results: The renovation process of doctoral programs in Italy, with specific reference to the biomedical field, focuses on epidemiologic-statistical methodology, ethics, language and communication skills, and open science from an interdisciplinary and international perspective. In the specific context of the doctoral program assessed in the study and from a broader perspective, public health appears to play a key role, taking advantage of most recent methodological advancements, and contributing to the renovation of the learning process and its systematic quality monitoring., Conclusions: From a comparative assessment of this case study and Italian legislation, the key role of public health has emerged in the renovation process of doctoral programs in the biomedical field.

Background: The World Health Organization's Action Framework for tuberculosis elimination in low-tuberculosis incidence countries includes the screening for active and latent tuberculosis in selected high-risk groups, including health care workers. In this context, medical and health profession students, exposed to nosocomial tuberculosis transmission during training and clinical rotations, are target populations for tuberculosis screening. No updated data are available on tuberculosis screening practice and knowledge of medical and health profession students in Italy., Methods: Within the activities Italian Study Group on Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine and Public Health, we carried out a multicentre cross-sectional study to assess knowledge, attitude and practices on tuberculosis prevention and control among Medical, Dentistry, Nursing and other health professions' students. Students were enrolled in the study on a voluntary basis and were administered a previously piloted structured questionnaire. Logistic regression models were applied to explore knowledge on tuberculosis prevention by selected socio-demographic variables and University-based tuberculosis prevention practice., Results: Students of seventeen Universities across Italy participated in the study, and 58.2% of them received compulsory tuberculin skin test either at enrollment or while attending clinical practice. A total of 5,209 students filled the questionnaire. 37.7% were medicine and dentistry students (Group 1), 44.9% were nursing students (Group 2) and 17.4% were other health professions' students (Group 3). Age and gender had different distributions by groups, as well as knowledge and practice on tuberculin skin test. 84.4% of the study population (95% CI = 83.3-85.3) was aware of the existence of the tuberculin skin test, 74.4% (95% CI = 73.2-75.6) knew what is the first-level screening test for latent tuberculosis and only 22.5% (95% CI = 21.4-23.6) knew how to proceed after a positive tuberculin skin test result. Overall, knowledge on tuberculosis prevention was higher in Group 2 and lower Group 3, as compared to Group 1., Conclusion: In Italy, the knowledge on tuberculosis screening among University students is generally good. To reduce some of the criticalities found among the different study courses, it would be appropriate to harmonize both the regulations on tuberculosis screening practices for admission to University courses, and the educational activities on the topic of tuberculosis, to be extended to all workers involved in health care setting.

Background: Lack of knowledge is the major reason for non-compliance with correct healthcare-associated infections (HAI) prevention procedures. The aim of this study was to evaluate knowledge of the Dental School (DSS) and Dental Hygiene (DHS) students with regard to the prevention of HAI, as basic knowledge for improving and harmonizing the educational content in the different Italian Universities., Methods: A cross-sectional study was carried out using an anonymous questionnaire that was completed by DSS (I, II, III, IV, and V year) in seven Universities and DHS (I, II, and III year) in three Universities. The questions dealt with three specific areas: healthcare-associated infections, standard precautions and hand hygiene. Factors associated with an unacceptable level of knowledge (score <17.5) were analyzed using a logistic regression model. A p value <0.05 was considered to be significant., Results: Five hundred and four questionnaires were collected: 81.5% for DSS and 18.5% for DHS. Mean overall score (±DS) achieved by the total number of students was 18.2±2.93 on an overall perfect score of 25; 18.2±3.04 for DSS and 17.8±2.31 for DHS. Stratifying by area, the average score 2.7±1.07 (53%) for HAI, 10.3±1.61 (85.9%) for standard precautions, and 5.2±1.44 (64.8%) for hand hygiene was observed. A significantly different level of knowledge (p<0.001) between DSS and DHS was observed only for HAI (2.8±1.07 for DSS vs 2.1±0.96 for DHS). Significant differences among the academic years were found only for DSS concerning HAI and standard precautions. The logistic regression model showed that an age <23 years was a risk factor for lack of knowledge on HAI, but a protective factor for lack of knowledge about standard precautions and hand hygiene; attending DH degree course was associated with lack of knowledge on HAI., Conclusions: Although the overall score obtained both by DSS and DHS indicated an acceptable level of knowledge, lack of knowledge was highlighted, in particular, for hand hygiene. Therefore, it is necessary to implement and validate effective teaching models in undergraduate courses in order to provide the scientific basis and the theoretical and practical preparation for the prevention and control of HAI.

The aim of the present study was to investigate the environmental and healthy aspects from a representative sample of indoor swimming pools located in the Emilia Romagna region. During the sampling sessions, the occupational environment was evaluated in terms of microclimate parameters and thermal comfort/discomfort conditions. Moreover the chemical risk was assessed by analyzing from the pool water the presence of disinfection by-products (DBPs), such as: trihalomethanes (THMs), haloacetic acids (HAAs), chlorite, chlorate and bromate. The analytical results are in agreement with the Italian legislation (Accordo Stato-Regioni; 2003) even if in some of the sampled indoor swimming pools, the dosed combined chlorine levels, were greater than the Italian limit. With the regard to the microclimate conditions evaluation, the considered thermal indices, Predicted Mean Vote (PMV) and Predicted Percentage of Dissatisfied (PPD%), described a satisfactory occupational environment. Among DBPs, the THMs mean levels (41.4 +/- 30.0 microg/l) resulted close to the values of the current Italian drinking water legislation, and seem to not represent an health issue. The pool waters chlorate levels (range: 5 - 19537 microg/l) need further investigations as recent epidemiological studies on drinking water hypothesized a potential genotoxicity effect of these compounds which are involved in cellular oxidative processes.

This study investigated the exposure to organohalogens compounds in drinking water from 9 Italian towns (Udine, Genova, Parma, Modena, Siena, Roma, L'Aquila, Napoli and Catania). Overall, 1199 samples collected from 72 waterworks were analyzed. THMs, trichloroethylene and tetrachloroethylene were evaluated using the head-space gas chromatographic technique (detection limit of 0.01 microg/l; chlorite and chlorate analysis was performed by ion chromatography (detection limit of 20 microg/l). THMs were evidenced in 925 samples (77%) (median value: 1.12 micro/l; range: 0.01-54 mciro/l) and 7 were higher than the THMs Italian limit of 30 microg/l. Chlorite and chlorate levels were higher than the detection limit in 45% for chlorite and in 34% for chlorate samples; median values were 221 microg/l and 76 microg/l, respectively. Chlorite values were higher than the chlorite Italian limit (700 microg/l) in 35 samples (8.7%). Trichloroethylene and tetrachloroethylene were measured in 29% and 44% of the investigated samples and showed values lower than the Italian limit (highest levels of 6 microg/l and 9 microg/l, respectively). The low levels detected of THMs, trichloroethylene and tetrachloroethylene have no potentials effects on human health, whereas, the levels of chlorite and chlorates should be further evaluated and their potential effects for the populations using these drinking waters, better understood.

74 mineral natural water samples and 56 samples of different commercial drinks have been analysed by head-space chromatography in order to evidence the presence of volatile halogenated organic compounds (VHO). Trihalomethanes (THM) as drinking water chlorination by-products and trichloroethane, carbon tetrachloride, trichloroethylene and tetrachloroethylene as ubiquitarious substances have been investigated. The presence of VHO has been evidenced in 20,3% of mineral natural water samples and in the 58,9% of the commercial soft drinks: this latest group has usually shown higher levels of the investigated compounds. The results of the present study has been compared with a similar study performed in 1991 in the same area: the VHO values observed in the present study appear to be lower than those obtained in the previous study.

The Authors report data about the presence of Disinfection By-Products (DBPs) and other halogenated compounds in drinking water samples collected in the areas of Modena and Parma (20 water supplies). Trihalomethanes, chlorite and chlorate (only in water samples treated with chlorine dioxide), and halogenated compounds were investigated. On the whole, trihalomethanes were evidenced in the 85% of the samples (n. 285) at low levels, while chlorite and chlorate were present in the 67% and 63% of the treated samples with chlorine dioxide (257 samples). Chlorite mean and median values were 225.70 microg/l and 136.75 microg/l respectively, ranging from 20 to 2000 microg/l. Chlorate concentrations were lower than chlorite: the mean value was 102.93 mg/l, while median level was 50 microg/l (range: 20-1500 microg/l). The high concentrations of chlorite and the wide range of values within each municipality plant in Modena and Parma suggest to investigate further in order to evaluate the human exposure in drinking water thoroughly.

Authors report data about microbiological characterization of solid wastes and aerosol in the municipal solid waste landfill site in Poiatica (RE). In solid waste samples high values of total coliform and fecal coliform were observed (10(5)-10(6) CFU/g): total bacterial counts at 22 degrees, at 36 degrees and at 44 degrees ranged from 10(7) to 10(9) CFU/g. Aerosol samples collected during waste movement in the landfill site showed values of total and fecal bacterial ranging from 10(3)-10(4) CFU/m3. Staphylococci and fungi reported the same values while streptococci, total and fecal coliform and spore evidenced lower values. Municipal solid wastes and aerosol have to be considered as an infective substrate: it is necessary to adopt protective barriers in occupationally exposed subjects.

Chlorination By Products (CBPs) in drinking water have been associated with an increased risk of adverse pregnancy outcomes, such as small term birth (STB) and preterm delivery. Up to date epidemiological evidence is weakened by a generally inaccurate exposure assessment, often at an ecological level: in this study the exposure is evaluated at the individual level. A case control study with incident cases was performed in Modena between October 1999-September 2000. 332 subjects were enrolled: 93 preterm births (26th-37th week of pregnancy), 73 STB (from 38th week, and weight less than the lowest 10th percentile) and 166 controls. Exposure was assessed both by applying a questionnaire on personal habits and by personal water sampling directly at subjects' home. THMs were analysed in all samples, chlorite and chlorate in water samples treated with chlorine dioxide. Subjects usually drinking tap water were few (5.2%): most of them were living in areas supplied by water treated with chlorine dioxide (87%). Levels of THMs were low (mean: 0.73 microgram/l), while chlorite and chlorate concentrations were relatively high (mean: 217.8 microgram/l for chlorites and 95.2 microgram/l for chlorates). Preterm birth did not show any significant association with CBPs, while STB appeared significantly associated, after adjusting for many potential confounders, with CBPs induced by chlorine dioxide treatment, especially with levels of chlorate higher than 200 microgram/l (OR: 4.7; 95%CI: 1.15-19.72). The association between STB and chlorate must be investigated further as the number of water utilities applying chlorine dioxide as disinfection treatment is increasing.

Work related injuries, above all those involving young people, are an important health and social issue, even though up to now small attention has been deserved in spite of the presence of about 68 workers per 1000 young people and the occurrence of 27400 injures in young people in 2000 in Italy. This study was aimed at improving the knowledge on work related injures occurring in Modena in 14-17 year old subjects in the period January-June 2000. A descriptive epidemiological study was carried out. Information was collected at the two emergency departments operating in Modena by checking hospital and INAIL records. Injures were defined as events caused by a violent external cause producing one or more lesions. Injuries were defined as work related when occurring during working activities or "in itinere". Work related injures and other injures were compared using the different statistical methods. Work related injuries occurring in young people during January-June 2000 in Modena were 76 (6-month incidence: 1.5 per 100 subjects of the same age) and represent 8.5% of all injuries. The most involved subjects were 17 year old males working in the industrial field, and in most cases prognoses were lasting less than 8 days. A Cluster Analysis identified two types of injures: the "in itinere" ones which resulted similar to the road accidents, both for body sites involved and for the way of occurrence and the injuries occurring at the working place characterised by a high frequency of lesions concerning hand, head, above all eyes. The study showed a remarkable incidence of work related injuries among 14-17 year old subjects in Modena in the first 6 months of 2000. Nevertheless many difficulties in finding information raised during the survey: a higher accuracy and completeness in collecting and recording of the data is needed to better define the epidemiological aspects of this issue.