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Objective: The development of a vaccine against hepatitis B virus (HBV) is one of the improvements in strategy prevention during the last decades. Aim: To evaluate HBV-related vaccine status in healthcare workers (HCW) exposed to biological risk. Methods: The serum markers for HBV were collected from HCWs in two tertiary care hospitals in Naples (Italy). Multivariate statistical analysis was then performed to identify associated factors linked to the long-term immunogenicity of the HCWs. Results: All HBV vaccinated individuals were screened for whole marker patterns; all were HBsAg/anti-HBc negative. Of individuals, 20% had an anti-HB antibody titre < 10 IU/L. Multivariate statistical analysis highlighted that women were more protected than men (73.6% vs. 26.4%, P < 0.05). Additionally, nurses seem to maintain a higher antibody titre than doctors and other staff, such as auxiliary technicians ( P < 0.05). Conclusions: Our data support the evidence of a strong immunogenicity against HBV, assessed through the circulating antibody titre, when prophylactic vaccination is conducted in non-infantile age, particularly for women. The outcome of the study supports the central role of occupational physicians within the hospital districts in terms of primary prevention and maximum protection of HCWs.

Manual patient handling (MPH) is a major occupational risk in healthcare settings. The aim of this study was to propose an MPH training model involving interdisciplinary aspects. A scheduled training program was performed with 60 healthcare workers (HCWs) from a hospital in Naples, Italy, providing training divided into three sections (occupational health&mdash, section one, physical therapy&mdash, section two, psychosocial section&mdash, section three) and lasting six hours. Fifty-two HCWs performed the training session. In section one, a questionnaire about risk perception related to specific working tasks was administered. Section two provided specific exercises for the postural discharge of the anatomical areas most involved in MPH. The last section provided teamwork consolidation through a role-playing exercise. The training program could also be useful for risk assessment itself, as they can examine the perceptions of the specific risk of the various workers and incorrect attitudes and therefore correct any incorrect procedures, reducing exposure to specific risks in the field. This pilot study proposes a training model that explores all aspects related to MPH risk exposure and also underlines the need for standardization of this formative model, which could represent a useful tool for studying the real effectiveness of training in workplaces.

The authors conducted a work-related stress surveillance study in 2013 on 6,558 public-sector employees in Italy, examining how they perceived their jobs, via the Job Content Questionnaire, and their mental health status, via the General Health Questionnaire 12 (GHQ-12). Of the 2,094 employees completing the questionnaires, 60% were male, 52% had a medium-level education, and 76% had a medium-level job. Three hundred and eighty-five employees (18%) had a GHQ-12 score >3 and were classified as GHQ-12 cases: these were more often female (54%), medium-to-highly educated (54%), and had more often reported health problems over the previous year (51%). Thus, GHQ-12 cases represented a significant percentage of the examined population, indicating that work-related stress surveillance programs are needed for the planning of psychosocial interventions aimed at the reintegration of individuals with mental health problems.

Objective A systematic review and meta-analysis was conducted to evaluate the agreement between Tuberculin Skin Test (TST) and Quantiferon (QFT) in screening for tuberculosis (TB) infection among healthcare workers (HCWs) and to estimate associations between TST and QFT agreement and variables of interest, such as Bacillus Calmette-Guérin (BCG) vaccination and incidence of TB. Methods Cross-sectional and longitudinal studies on HCWs, published in English until October 2013, comparing TST and QFT results, were selected. For each study Cohen’s κ value and a 95% confidence interval were calculated. Summary measures and indexes of heterogeneity between studies were calculated. Results 29 studies were selected comprising a total of 11,434 HCWs. Cohen’s κ for agreement between TST and QFT for 24 of them was 0.28 (95% CI 0.22 to 0.35), with the best value in high TB incidence countries and the lowest rate of BCG vaccination. Conclusion Currently, there is no gold standard for TB screening and the most-used diagnostic tools show low agreement. For evidence-based health surveillance in HCWs, occupational physicians need to consider a number of factors influencing screening results, such as TB incidence, vaccination status, age and working seniority.

OBJECTIVES: To study aluminum (Al), manganese (Mn), and lead (Pb) influence on amyotrophic lateral sclerosis (ALS) development. METHODS: A total of 34 patients (10% of the regional ALS population) and 25 controls of an Italian region were enrolled. Metal concentrations were determined by atomic absorption spectroscopy. RESULTS: Serum Al concentrations in patients and controls were similar and lower than those provided by the Italian Society of Reference Values. No differences were observed in serum Mn concentrations, while, as expected, blood Pb levels were significantly higher in patients with ALS than those in controls. CONCLUSIONS: Results confirmed the association between high Pb blood levels and ALS; on the contrary, Al and Mn did not differ significantly in patients and controls, suggesting that Mn and especially Al may play a less important role in the ALS pathogenesis.