Search

The emergence of antimicrobial resistance (AMR) is a complex problem driven by many interconnected factors regarding human, animal and environmental health sectors. An interdisciplinary effort within the One Health approach is necessary to face the phenomenon, as further evidenced by the Council conclusions of the 23 July 2016. In the occupational field, farmers are at risk of acquiring from animals and farm environment AMR agents. The aim of the present study, which represent the first part of a project funded by the National Institute for Insurance against Accidents at Work (INAIL) and focused on prevention purposes, is to identify farming practices associated to the risk of exposure to AMR. We adopted a mixed methods research design, integrating qualitative and quantitative techniques. By using fattening turkey production as a case study, we reconstructed farming phases, as well as corresponding working practices, based upon semi-structured interviews of public and private veterinarians and farmers in Northern Italy. Working practices were classified and ordered in terms of the probability of exposure of farmers to AMR, by a modified FMEA (Failure Modes and Effect Analysis), based upon information on prevalence of agents in animals and in the farming environment, and on AMR transmission routes. Scientific evidence to estimate prevalence of AMR in poultry farming and associations between working practices and the transmission to farmers was obtained by a systematic literature review. Preliminary results showed that vaccination of turkeys was characterized by the highest risk of exposure to AMR, due to direct and repeated contact with animals, by workers without personal safety devices. Removal and milling of litter ranked second in the risk prioritization, given the exposure of farmers to high dust level. Appropriate risk communication and risk mitigation measures will be produced, and communication of preventive measures to farmers and other stakeholders will be implemented by means of a website. [ABSTRACT FROM AUTHOR]