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Background Ethical climate in the workplace has been highlighted to have an important impact on workers' mental health; the evaluation of workplace ethics and its impact on workers' health should be considered an occupational health issue.Aims The present study aims to investigate ethical climate as perceived by workers, and its correlation with mental health outcomes, in particular, symptoms of depression, anxiety and stress.Methods A cross-sectional study was performed by administering an online survey, investigating socio-demographic variables, workplace ethics (through the Italian short version of the Corporate Ethical Virtues questionnaire) and mental health outcomes (using the short version of the Depression, Anxiety and Stress Scale). Descriptive analyses, analyses of variance and regression models were performed; P-values were considered significant for values <= 0.05.Results The sample included 176 workers; the mean age of participants was 46.22 years and 44% were males. The most represented job sector was health care (37%), and 42% of participants had college-level education. Ethical climate was significantly correlated with all mental health outcomes investigated in the study: anxiety (P <= 0.001), depression (P <= 0.05) and stress (P <= 0.05).Conclusions Results from this study highlighted a significant correlation between workplace ethical climate and depression, anxiety and stress. This study underlines the importance of evaluating and improving ethical climate to prevent the onset of psychological distress in workers. Furthermore, results from this study should be a starting point for future research investigating the role of ethics and mental health in employees' turnover intention and job satisfaction.This cross-sectional study was performed by investigating through an online survey of the relationship between results from the Italian short version of the Corporate Ethical Virtues questionnaire and the Depression, Anxiety and Stress Scal

Background In recent years many tools have been developed for the objective assessment of the impact of ethics in the occupational world; in the Italian context, many different methods have been used to assess ethical values in the occupational context, which presents difficulties for the occupational physician in the interpretation of the results. To standardize the evaluation of ethical standards in the workplace, the short version of a questionnaire based on the Corporate Ethical Virtues Model, which was recently validated in Italian, was used to evaluate ethical climate in a population of office workers. Methodology The questionnaire was administered to a large population of Italian office workers. Descriptive statistical analysis, as well as a logistic regression model, were performed to evaluate variables acting as predictors of ethical standards. P-values < 0.05 were considered statistically significant. Results/discussion In all, 3706 workers were included in the study; 1710 were males (46.14%). The total score obtained on the questionnaire by the workers participating in the study ranged from 31 to 96 points, with a mean of 72.16 (SD ± 11.01) points (higher values indicate better ethical standards). Job role and length of service were highlighted as statistically significant (P < 0.01) predictors of ethical standards. Conclusion/perspectives Role and length of service are predictors of ethical standards. The questionnaire may be used to evaluate ethical climate in the workplace, allowing the harmonization of the evaluation of ethical standards performed by the occupational physician. Further studies are needed to evaluate the impact of ethical climate on workers’ well-being.

Background: Unemployment impacts people's physical and psychological well-being, and gender and age affect mental health among the unemployed. Despite the correlation between unemployment and negative mental health outcomes being largely investigated in scientific literature, research on voluntarily unemployed individuals is scarce. A systematic review was performed on studies evaluating mental health outcomes in voluntarily unemployed adults. Methods: Following the PRISMA statements, three databases were screened; research articles written in English investigating the relationship between mental health outcomes and employment status were included. The quality of articles was assessed using the Newcastle-Ottawa Scale. Results: The initial search yielded 727 records; 4 studies were included in this systematic review. One study reported voluntarily unemployed people as less depressed than employed and unemployed people, one as more depressed than employed but less than unemployed people, one reported voluntarily unemployed people as less anxious but more depressed than employed and less anxious and depressed than unemployed people, one study reported voluntarily unemployed men as depressed and anxious more often than employed men. Further research should investigate mental health outcomes in voluntarily unemployed people and strategies to bring back these individuals into the workforce.

Background. Paternity leave is a right that allows fathers to take care of their newborns in the first days of life; however, parental leave for fathers is still not recognized equally in European Union countries, with important consequences on the occupational wellbeing of employees. This review aimed to research the current legislation on paternity leave in 27 European Union countries. Material and methods. A review of the legislative framework for all 27 European Union member states was conducted through desk research on the online institutional repositories of the European Union, ministries, or National Institutes of Health of the selected countries to screen information on paternity leave legislation, population size, gross domestic product, gross domestic product per capita, unemployment rate and number of average children per family. Results. Our analysis shows that the duration of paternity leave and the daily allowance for absence from work vary significantly within the European Union. Cyprus and the Netherlands still fall short of the minimum 10 days required by the European directive. Disparities are even more pronounced concerning the period of uptake, as while in Romania, it must be taken within the first 56 days of the child’s life, in Sweden, there is the option to take it within the first 12 years. Conclusion. A unified vision of the issue is needed, since effective paternity leave regulations could have a positive effect on reducing the risk of parental stress and enhancing the birth rate, ensuring the psychological wellbeing of employees during the initial period of parenthood.

Background: Healthcare university students are exposed to a range of risk factors during their hospital practical training, particularly in relation to biological hazards. Despite being students, they must be paid the same attention as health professionals in relation to the same possibility of transmitting infections to fellow colleagues, patients, and the wider community.The primary aim of this study is to investigate the seroprevalence characteristics of IgG antibodies against main infectious diseases in students enrolled in medical and health-related degree programs in an Italian university. Methods: We conducted a retrospective epidemiological study of health professions students of a university hospital in Rome, collecting sociodemographic information and serology of antibody titers under study (hepatitis B, measles, mumps, rubella and varicella) from 2013 to 2023. After initial description of the study population, bivariate and multivariate analyses were performed to study the association between presence of antibodies with relevant variables. Results: Our study sample included 2523 students (68.5% females; mean age 22.2, SD 3.8), of which 44.4% were protected against HBV, 87.3% against measles, 85.5% against mumps, 94.6% rubella and 95.2% against varicella. Differences in antibody coverage between age groups were statistically significant (p < 0.001), with the exception of mumps. Surprisingly, the prevalence of HBV antibody titer below the seropositivity cutoff appeared to have an inverse correlation with older age (1998-99 OR 0.75 CI 0.61-0.93, 2000-01 OR 0.50 CI 0.41-0.62, 2002-04 OR 0.40 CI 0.31-0.52). Conclusions: Despite several recommendations and campaigns to promote vaccinations, the goal of achieving high immunization rates among healthcare workers still represents a challenge. Public health policies should focus on improving prevention strategies, including serological screening and workplace vaccination for non-immune individuals, especially fo

Introduction: The COVID-19 pandemic has determined a radical change in workplace dynamics, with a reported increase in voluntary resignation from employment at a global level, especially among the young-est workers. The aim of this study is to investigate the social, demographic, and cultural characteristics of young people aged between 25 and 45 years who voluntarily resigned from their previous jobs during the COVID-19 pandemic. Methods: This is a cross-sectional observational study; an ad hoc questionnaire was designed and admin-istered via an online link. Descriptive analyses were performed to describe the sample, and the Pearson analysis was performed to investigate statistically significant correlations; p values ≤ 0.05 were considered statistically significant. Results: A total of 72 valid responses were gathered. Mean age was 32.6 years; 43.1% participants were males, 54.2% were married, and 80.6% had no children; most participants (68.1%) had a college level education. The most reported cause of job resignation was work dissatisfaction (38.9%), followed by inadequate remuneration (27.8%). The most reported perspective for people who had resigned or were planning on resigning, was a better salary (27.8%), followed by the pursuit of a higher work-life balance (25.0%). The perception that having resigned was the right choice was significantly correlated with the timeframe of resignation (p<0.01), with having suffered from COVID-19 (p<0.05), and with a close relative having suffered from COVID-19 (p<0.01). Conclusion: This study highlighted that voluntarily resigning was significantly correlated to having suffered from COVID-19, or a close relative having suffered from it; 84.9% of participants who had resigned thought that it had been the right choice. The COVID-19 pandemic could have changed workplace perception, making employees feel more at risk; the indirect impact of the pandemic should be further investigated, and prevention strategies should be

Introduction: Work-related psychosocial risks have been identified as significant occupational health and safety risks; the occupational physicians must assess and monitor the health status of workers in order to verify that work is not a source of harm to exposed operators. The aim of the study was to investigate the outcomes related to anxiety and depression traits in workers exposed to stress-related work. Methods: A questionnaire was administered to a large population of Italian public administration workers; the Centre for Epidemiologic Studies - Depression Scale questionnaire was used to measure depression, the Self rating Anxiety Scale was used to measure anxiety, the UK Management Standards Indicator tool questionnaire was used to assess work adjustment. A descriptive analysis, a multivariate analysis, as well as logistic regression models were used to assess the health outcomes related to stress. Results: A total of 292 workers participated in the study; 100% of participants had a Centre for Epidemiologic Studies - Depression Scale score over the cut-off; 41.78% had a Self rating Anxiety Scale score over the cut-off; the results support a correlation between the Centre for Epidemiologic Studies - Depression Scale results and the UK Management Standards Indicator tool results; and a correlation between Self-rating Anxiety Scale results and the UK Management Standards Indicator tool results. Conclusions: The Demand, Management, Support and Relationship results were associated with mental health outcomes, and it could be a useful tool in occupational medicine, to identify workers at risk for negative mental health outcomes, becoming an essential tool in workers' health assessment and for prevention of mental health disorders.

Background: Human papillomavirus (HPV) infection is the most common sexually transmitted viral infection in the world. HPV vaccination adherence rates in men are generally lower than in women. The aim of this systematic review and meta-analysis was to assess adherence to HPV vaccination in young working-age males (18-30 years old). Methods: A systematic review was performed using three databases: PubMed, Scopus, and Web of Science, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: After duplicate removal, the initial search resulted in 478 eligible papers. With the exclusion of 425 papers after screening the abstracts, full texts of 53 articles were reviewed. Subsequently, 45 were excluded. Among the eight studies included, four (50%) examined the vaccination adherence in young adults through data registered in nationwide insurance or private companies' databases, three (37.5%) in young adults in different settings through data collected from surveys and questionnaires, and one (12.5%) an HPV vaccination campaign in a family medicine residency practice. Conclusion: Adherence to HPV vaccination in men of working age (18-30 years) does not appear to be adequate (pooled prevalence 11%). In order to achieve a higher level of compliance, it is important to place an emphasis on vaccination campaigns in schools as well as in the workplace, after consultation with and approval from local, regional, and federal public health agencies.

Objectives: The aim of this umbrella review of systematic reviews and meta-analyses was to address workplace violence (WPV) against healthcare workers (HCWs). Several systematic reviews exist in the literature, but the diversity of settings, population considered, and type of violence investigated make it difficult to gain insight and use the vast amount of available data to implement policies to tackle WPV. With this in mind, we conducted an umbrella review of systematic reviews and meta-analyses on WPV against HCWs to examine the global prevalence of the phenomena and its features. Study design and methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, Scopus, and ISI Web of Science were searched for relevant systematic reviews and meta-analyses published in English up to November 2022. Data on authors, year, country, violence type, prevalence (pooled and not), setting, population, and specific considerations were extracted. Results: A total of 32 systematic reviews were included, 19 of which performed a meta-analysis, investigating overall, physical, and non-physical violence. Even considering the variability of the data, the COVID-19 pandemic has exacerbated the scale of the problem. From our review, we found that overall violence prevalence among HCWs was reported to be as high as 78.9%, and nurses working in psychiatric wards were the professionals most impacted. Conclusion: In conclusion, this umbrella review revealed a high prevalence of WPV among HCWs, which varies between countries, population subgroups, and detection methods. Strengthening recognition of the problem could lead to appropriate local and international strategies to address it.

LEGAL RESPONSIBILITY OF VACCINATING DOCTOR. The legal responsibility of the vaccinating doctor is one of the central issues in the current setting of the Covid-19 pandemic. The aim of this statement is to outline the profiles of the medical legal liability, with a focus on the figure of the vaccinating physician, in criminal, civil, and disciplinary terms, based on the Italian legislation in force. The vaccinating doctor responds for his work in the field of vaccination in the same way as any other health service should perform (diagnostic, therapeutic, etc.). Helpful in this context is the adoption of the L. 76/2021; it was developed to find a balance between safeguarding the person privacy and greater guarantees for the doctor. This law introduces a criminal shield that can put a limit to litigation, curbing the phenomenon of so-called defensive medicine. The climate of uncertainty and fear of legal repercussions for the doctors, and the constant updating and redefinition of the indications of operability in the vaccination campaigns, underline the need to focus on the knowledge of the responsibilities and the safeguard of the vaccinating doctors. In addition to the regulatory cornerstones, the statement also addresses the issue of informed consent and the role of the occupational doctor as a central figure in the vaccination campaign in the workplace.

Background: Alcohol use is an ever-growing phenomenon in the population, consumption data indicate that 5-20% of the European working population have serious problems related to alcohol. The use of alcohol constitutes a risk to the health and safety of workers as well as to the safety of the general population. The present work aims to address the problem of alcohol intake in occupational settings by comparatively analyzing alcohol consumption behavior within the 27 countries of the European Union. Methods: The purpose of this research is to analyze the differences between the 27 countries of the European Union in the application of measures to assess and manage the risk of alcohol intake in occupational settings. Results: An examination of the legislation and guidelines of the different countries reveals profound differences in the management of the problem of alcohol in the workplace. The discrepancy is very wide that it ranges from the complete absence of legislative restrictions on a national level in some countries to highly restrictive measures with severe sanctions in others. Conclusions: It would be appropriate-also for the purpose of ease of movement of workers within the European Community-to find shared management models useful for protecting the health and safety of workers and the general population.

Long COVID-19 is a term used to describe the symptomatic sequelae that develop after suffering from COVID-19. Very few studies have investigated the impact of COVID-19 sequelae on employment status. The aim of this research was to characterise sequelae of COVID-19 in a population of workers who tested positive for COVID-19, with a follow-up within one year of the acute illness, and to analyse the possible association between this and changes in the workers' occupational status. In this retrospective cohort study, a questionnaire was administered to 155 workers; descriptive, univariate (chi-square tests), and multivariate (logistic regression model) analyses were carried out. The mean age was 46.48 years (SD +/- 7.302); 76 participants were males (49.7%), and 33 participants reported being current smokers (21.3%). Overall, 19.0% of patients reported not feeling fully recovered at follow-up, and 13.7% reported a change in their job status after COVID-19. A change in occupational status was associated with being a smoker (OR 4.106, CI [1.406-11.990], p = 0.010); hospital stay was associated with age > 46 years in a statistically significant way (p = 0.025) and with not feeling fully recovered at follow-up (p = 0.003). A persistent worsening in anxiety was more common in women (p = 0.028). This study identifies smoking as a risk factor for workers not able to resume their job; furthermore, occupational physicians should monitor mental health more closely after COVID-19, particularly in female workers.

To avoid exposure to SARS-COV-2, healthcare professionals must use personal protective equipment (PPE). Their use has been related to a series of adverse effects; the most frequent adverse events were headache, dyspnoea, and pressure injuries. Skin adverse effects are very common, including contact dermatitis, itching, erythema, and acneiform eruptions. The objective of this study is to evaluate the skin problems caused by personal protection equipment (PPE) in health care workers (HCWs) and to individuate eventual risk factors. From May to June 2020 a retrospective observational multi-centric study conducted by an online survey sent by email, involving 10 hospital centers, was performed. We considered as independent variables gender and age, occupational group and sector, time of utilization, type and material of PPE. We tested 3 types of PPE: gloves, bonnet, and mask for different time of utilization (<1, 1–3, 3–6, >6 h). We performed a multiple logistic regression model to correlate them with skin adverse events occurrence. Among all the 1184 participants, 292 workers reported a dermatological pathology: 45 (15.41%) had psoriasis, 54 (18.49%) eczema, 38 (13.01%) acne, 48 (16.44%) seborrheic dermatitis, and 107 (36.64%) other. In our sample previous inflammatory dermatological conditions, female sex, prolonged use of PPE were significant risk factors for developing skin related adverse events considering all the PPE considered. The use of PPE is still mandatory in the hospital setting and skin adverse reactions still represent a global problem. Although data from Europe are limited, our study highlighted the importance of the problem of PPE skin reactions in a large sample of Italian healthcare professionals.

Background: Healthcare workers (HCWs) represents one of the highest-risk population to develop burnout symptoms. Recently, a new tool has been designed to measure several dimensions that capture an exhaustive expression of burnout symptoms by six dimensions (i.e., exhaustion; mental distance; cognitive impairment; emotional impairment; psychological distress; psychosomatic complaints). Methods: The current study aims to adapt the Burnout Assessment Tool (BAT) to an Italian Healthcare workers’ sample confirming the original second-order factorial structure. Furthermore, we expected to find good indexes of reliability and validity tests. Participants were 697 Italian Health Care Workers (Female = 68.44%; mean age = 36.47; SD = 11.20). Data were collected by self-report questionnaires submitted by the snowball method. Results: Findings show a good fit of the BAT’s structure, confirming the hypothesized second-order factorial model. Furthermore, good reliability has been established with the study’s measures. Conclusions: The BAT for HCWs is eligible as a new tool to evaluate burnout in the at-risk HCWs as a multi-facet constellation of symptoms.

Introduction: Working during the Sars-CoV-2 pandemic healthcare workers (HCWs) had to wear Personal Protective Equipment (PPEs) for extended periods of time, leading to an increase in dermatological reactions. The study evaluates the prevalence of adverse skin reactions to PPEs among Italian healthcare workers during the COVID-19 pandemic, and aims to determine whether prolonged PPEs usage poses a significant occupational health risk, by measuring the loss of work days and the eligibility of workers that requested health surveillance due to dermatological PPEs reactions. Materials and Methods: An online ad hoc questionnaire was administered to a sample of Italian HCWs. Questions verted on sociodemographic characteristics, PPEs usage, and occupational well-being. Descriptive analyses and logistic regressions were performed to explore possible associations between variables. Results: Two types of PPEs, Gloves and Masks, were tested. The sample included 1,223 interviewed HCWs, 1,184 gave their consent for participation. A total of 90 medical surveillance visits were requested due to PPEs related dermatological issues: in 30 cases were recognized limitations in working duties and in one case the worker was deemed not fit to keep working. Furthermore, 25 workers had a loss of occupational days due to dermatological issues. A statistically significant correlation was observed with being a nurse or midwife (OR = 1.91, IC = 1.38–2.63, p < 0.001), and being female (OR = 2.04, IC = 1.49–2.78, p < 0.001), which acted as risk factors. Discussion: The enhanced protection measures put in place during the COVID-19 pandemic, highlight the importance of occupational dermatology. This study could contribute to assess the issue, aiming to develop better prevention strategies in the workplace in order to improve well-being of HCWs and reduce the impact of dermatological adverse reactions to PPEs.

RA is a systemic autoimmune disorder primarily involving the joints. Extra-articular manifestations of RA often include lung involvement with heterogeneous clinical presentation and radiological findings. Autopsy studies reveal that the percentage of RA patients with pathological changes in the lung is significantly higher than that of patients with clinical manifestations. Lung alterations in RA may be primary or secondary to pharmacological treatments and may involve the alveoli, the interstitium, the airways and/or the pleura. These alterations may significantly impair lung function and some of them are potentially life-threatening. Thus, clinical examination and lung function testing should be performed in all patients with RA at the time of diagnosis and during follow-up. Those patients with clinical alterations and/or impaired lung function should undergo a complete radiological study.