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The socio-emotional wealth perspective is a framework widely used to examine managerial decisions, particularly within the field of family business. We evaluate, refine, and validate the FIBER 27-item scale developed by Berrone et al. (2012) as a psychometric instrument to measure the socioemotional wealth construct (SEW), defined as affective endowment embedded by family owners in their business. The findings suggest that SEW is a superordinate multidimensional construct that captures socioemotional utilities in family firms and their impact on financial performance.

Introduction: Burnout syndrome (BOS) is a psychological syndrome characterized by emotional exhaustion, depersonalization, and low personal accomplishment. This umbrella review aimed to investigate BOS among healthcare workers (HCWs). Methods: An umbrella review of systematic reviews and meta-analyses concerning the prevalence of BOS among physicians, nurses, medical students and other HCWs, and its associated factors was conducted across PubMed Central/Medline, Cochrane Library, PROSPERO and Epistemonikos databases. Only systematic reviews and meta-analyses from inception to 15 January 2020 and restricted to English language documents were included. Results: A total of 43 studies met the full inclusion criteria and were included. Among them, there were 3 meta-analyses, 26 systematic reviews, and 14 systematic reviews with meta-analysis. The prevalence of BOS was highest among nurses, younger persons, and trainees. The most frequent risk factors associated with BOS included stress, lack of family support, and organizational risk factors such as prolonged night shifts, length of experience, and exposure to traumatic events. Individual coping strategies such as exercise and communication with peers, and organizational strategies such as periodic review of shift schedule should be undertaken. Discussion: BOS has profound effects on the mental health states of HCWs. Individuals and the hospital authority need to pay specific attention to work-related stress risk factors to improve the psychological well-being of HCWs.

Despite the advent of modern technologies, biological risks still cause concern in workplaces. Healthcare workers (HCWs) are exposed to a wide range of occupational risks including biological and psychosocial ones. During the COVID-19 pandemic, HCWs experienced unprecedented levels of distress, especially due to the risk of SARS-CoV-2 contagion and the fear of spreading the virus in the work and social community. This emotional overload led to an increase in mental health disorders (e.g., anxiety, depression, and burnout) that can hinder patients' safety and the quality of care. After outlining the international safety regulation on biological risks, we discussed the interplay between biohazard and psychosocial risk, focusing on how to prevent occupational infections in healthcare using comprehensive action strategies that aim to ensure a healthy work environment to improve, protect, and promote the health and safety of all workers. Occupational infections, particularly those caused by emerging agents and/or responsible for epidemics, still cause concern in health care workers globally and require prompt action to implement health and safety programs.

Introduction: Workplace violence (WV) against healthcare workers (HCWs) is a widespread phenomenon, which contributes to increasing occupational stress. The COVID-19 pandemic has exposed the world's population to intense stress. It is therefore questionable whether there is a correlation between the two phenomena, violence and COVID-19. This systematic review aimed to investigate the prevalence and risk factors of WV against HCWs during the COVID-19 pandemic. Methods: A systematic review was conducted across PubMed Central/Medline, Cochrane Library, PROSPERO and Epistemonikos databases using predefined search criteria. Only studies containing quantitative and mixed-method research from the inception of the pandemic to 22 February 2022 and published in English language were included. Results: Overall, 61 articles were retrieved, and a total of 15 studies met the full inclusion criteria and were included. Most of the studies reported both physical and psychological (verbal and non-verbal) WV, which was perpetrated by personal (family members, friends, neighbors) and/or professional relationships (bosses, co-workers, patients’ relatives, strangers). The overall prevalence of WV ranged from 18.5% to 84.5%. In many cases, victims of WV during the COVID-19 pandemic included frontline HCWs and staff working in emergency departments. Discussion: Our findings showed a high prevalence of WV against HCWs during the COVID-19 pandemic. Males, young people, those with less working experience, and those working in direct contact with patients infected by the virus were the most relevant risk factors for WV, that was mostly perpetrated by caregivers and COVID-19 patients’ family members. Occupational health services, hospital management and policymakers should cooperate to address these psychosocial risk factors to protect the mental health of HCWs during the COVID-19 pandemic. Take-home message: This systematic review showed a high prevalence of workplace violence against healthca

OH plays a new and insightful role in helping society achieve higher levels of health. In this regard, WHP programs offer an invaluable and inclusive chance to support workers and a cost-saving prospect for employers.

Lyme disease (LD) can have significant consequences for the health of workers. The frequency of infection can be estimated by using prevalence and incidence data on antibodies against Borrelia Burgdoferi (BB). A systematic search of studies published in English between 2002 and 2021 and a meta-analysis were conducted in PubMed/Medline, Web of Science, Scopus, and Google Scholar databases. Out of a total of 1125 studies retrieved, 35 articles were included in the systematic review. Overall, in these studies, outdoor workers showed a 20.5% BB seroprevalence rate. Meta-analysis, performed on 15 studies (3932 subjects), revealed a significantly increased risk in outdoor activities (OR 1.93 95%CI 1.15–3.23), with medium-level heterogeneity (I2 = 69.2%), and non-significant publication bias. The estimated OR in forestry and agricultural workers was 2.36 (CI95% 1.28; 4.34) in comparison with the controls, while a non-significant increase in risk (OR = 1.05, CI95% 0.28; 3.88) was found in the remaining categories of workers (veterinarians, animal breeders, soldiers). The estimated pooled risk was significantly higher in the studies published until 2010 (OR 3.03 95% CI 1.39–6.61), while in more recent studies the odds became non-significant (OR 1.08 95% CI 0.63–1.85). The promotion of awareness campaigns targeting outdoor workers in endemic areas, and the implementation of local programs aimed at controlling range expansion of vectors, are key strategies for protecting workers.

Occupational exposure to elemental mercury still represents a significant risk in the workplace. The sensitivity of the exposed subjects varies considerably. This study aims to summarize the literature on the role of genetic factors in occupationally exposed cohorts. A systematic search of the literature was carried out on PubMed Central (PMC), MEDLINE, and Google Scholar databases in accordance with the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) guidelines, from 1946 to July 2020. Ten cross-sectional studies were included in the review. All studies referred to the polymorphisms that can favour some neurotoxic effects of the metal in occupational cohorts. Some genetic variants may be associated with an increase in the occupational effects of mercury. Given the limited evidence, genetic screening of all mercury-exposed workers is not recommended. However, a personalized search for polymorphisms could be taken into consideration if exposed workers report early neurotoxic symptoms.

Exposure to major trauma can have significant consequences for workers’ mental health, but common trauma may also result in poor mental health outcomes. This cross-sectional study retrospectively investigated the occurrence of common physical or psychological workplace trauma in 901 health, social service, and trading company workers and studied these experiences in relation to occupational stress, anxiety, and depression. Stress was measured with the effort/reward imbalance (ERI) model while anxiety and depression were evaluated with the Goldberg Anxiety and Depression Scale (GADS). Healthcare workers reported a high frequency of trauma and significantly higher levels of stress, anxiety, and depression than other workers. Even in the entire population of workers of the various professional categories, verbal violence (harassment and threats), traffic accidents, home injuries, and family bereavement were significantly associated with high levels of stress, anxiety, and depression. Major trauma survivors are known to be at increased risk of mental disorders and require support in the workplace, however, even minor repeated emotional trauma and injuries can affect mental health. During mandatory health surveillance, the occupational physician should systematically collect information on minor trauma and mental health outcomes when assessing the occupational fitness of the workers assigned to him.

Ionizing radiation (IR) is a ubiquitous environmental agent whose effects on organisms are well known. This review pro-vides a summary about definitions and man-made low-dose ionizing radiation (LDIR) sources and dosimeters used in radiation protection. Moreover, the main purpose of this article was to overview the pro-oncogenic effects of LDIR, and to provide experimental evidence that reinforce the use of gene expression data as biomarkers of LDIR effects. Our review showed that basic studies on biological response to LDIR are considered priority. Further, understanding occupational exposure to LDIR may provide valuable information to organize the prevention and prevent from the onset of long-term health effects in radiation workers. Currently, the biodosimetry-based assessment in certain high-risk occupational groups may be performed by using peripheral blood cells as samples for testing and validation of biomarkers specificity and sensi-tivity. Most of the studies on this topic are aimed at establishing new biomarkers and approaches to biological dosimetry, for allowing non-invasive monitoring of long-term health effects of LDIR. Analysis on changes in gene-expression, which is an early specific biological response to LDIR, could provide rapid estimates of individual dose in occupational cohorts, improving the management of periodical medical examination in subjects exposed to LDIR sources.

Purpose: This paper describes how Italy addressed the first Coronavirus disease 2019 (COVID-19) wave and analyzes the possible causes of the current second wave. Design/methodology/approach: Descriptive analysis of critical points and differences in the containment strategies between the first and the second waves in Italy. Findings: Italy's strict lockdown has been credited with getting the initial major outbreak under control. Furthermore, the way Italy handled the first wave was considered a lesson for other countries. On the contrary, a decentralized and highly bureaucratic political system with low coordination and political conflicts between government, regions and stakeholders led to a relaxation of individual health behaviors, poor and conflicting communication to the general public, poor management of the public transport and the reopening of schools and companies after the summer, that in turn generated the second wave, which is showing signs of becoming worse than the first. Originality/value: This is a commentary piece.

The coronavirus-19 (COVID-19) pandemic is putting a severe strain on all healthcare systems. Several occupational risk factors are challenging healthcare workers (HCWs) who are at high risk of mental health outcomes, including Burnout Syndrome (BOS). BOS is a psychological syndrome characterized by emotional exhaustion, depersonalization, and low personal accomplish-ment. An umbrella review of systematic reviews and meta-analyses concerning BOS and coronavirus (SARS/MERS/SARS-CoV-2) outbreaks was carried out on PubMed Central/Medline, Cochrane Library, PROSPERO, and Epistemonikos databases. Data relating to COVID-19 is insufficient, but in previous SARS and MERS outbreaks about one-third of HCWs manifested BOS. This prevalence rate is similar to the figure recorded in some categories of HCWs exposed to chronic occupational stress and poor work organization during non-epidemic periods. Inadequate organization and worsening working conditions during an epidemic appear to be the most likely causes of BOS. Preventive care and workplace health promotion programs could be useful for protecting healthcare workers during pandemics, as well as during regular health activities.

Michele Usuelli1 raised two questions to the international scientific community. First, whether there were errors in the management of the COVID-19 health emergency in Lombardy, Italy. Second, whether having 20 regional health services across Italy is useful in controlling a pandemic. The answer to the first question will be useful to medical science and the civil conscience (by improving the decision making process) in Italy. Unfortunately, the process of a commission of inquiry is much slower than that of a pandemic, and therefore it is unlikely that the evidence gained will be useful during this pandemic. The answer to the second question is self-evident. Unfortunately, a strong political movement is pressing to accentuate the transfer of fiscal resources from the national level to the regions where income is produced. If the tax income remained in the region that produced it, then there would be no national budget. This transfer would increase health inequity, with an unfair burden of this pandemic on people who are disadvantaged2 and an inevitable negative effect on the health of the population.3 In the meantime, emergency conditions have changed the traditional way that doctors operate. Intensivists who treat patients with COVID-19 have high levels of compassion fatigue and occupational stress; they do not have daily contact with the patients’ relatives anymore and can inform families only at the end of therapy if the treatment has not been successful.4 The scarcity of interaction with relatives could increase misunderstandings and the risk of malpractice litigation, which is already high in Italy.5 We reasonably expect that the pandemic, in addition to many grievances, will leave many claims for compensation

we believe it is more prudent that in case of emergency, both lay and medical rescuers use respirators without EV, except when hospital HCWs assist patients with highly suspected or confirmed COVID-19 infection. Educational efforts, implementing fit testing and seal checking of masks, organizational measures as well as using appropriate PPEs are needed to offer safe emergency interventions to rescuer and casualty for this and other airborne-transmitted diseases.

We should discourage dishonest publications so that published scientific literature can be relied upon. The research outcome should not be the only criterion of a clinician’s dedication to his field

An editorial on the role of health surveillance in the workplace during the SARS/CoV-2 pandemic

Workplace health and safety is constantly evolving both in developed and developing countries. Under the tumultuous development of technology, working environments are changing, leading to the onset of new occupational hazards and unprecedented risk conditions deriving from the new ways of organizing work. At the same time, progress in medical science, with the knowledge in the fields of genetics, metabolomics, big data, and smart technologies, makes it possible to promptly identify and treat risk conditions that would have escaped notice in the past. Personalized occupational medicine represents the frontier of prevention in the workplace, from the perspective of total worker health and the sustainability of resources. The contributions to this Special Issue range from chemical, physical, and biological to psychosocial risks, and from the search for new ways to control long-known risks, such as mercury toxicity, to observations of the most frequent pathologies in the workplace in the last twenty years, such as repetitive trauma diseases, immunodeficiency transmitted as a result of biological injuries, and violence and psychological trauma in the workplace. New insights are needed in occupational health and safety practice to address the new challenges in this field.

Healthcare workers employed in the COVID19 emergency are at high risk of stress, burnout and post-traumatic stress disorders. The most important occupational risk factors that employers should address include insufficient staff training and resources available, and lack of training and treatment protocols. In Italy, recent guidelines were released for providing all healthcare workers who are employed in this emergency with psychological support services based on coping strategies for managing stress. We suggest that preventive measures and a psychological intervention plan should be framed within the mandatory occupational health surveillance programme, and carried out by occupational physicians in cooperation with mental healthcare providers in the workplace.

In workplaces, where no pollution problems are reported, a significant share of indoor workers (6% of males, 9% of females) suffer “often, at least once a week” from headaches attributed to the working environment.2 This symptom is significantly associated with occupational stress.3 The individual characteristics of workers, in particular anxiety and depression, significantly influence the reporting of headache.4 Among health care workers, headache is associated with occupational stress5 and with sleep problems,6 as well as with anxiety and depression that were significantly increased during the COVID-19 pandemics.7 This study did not take into account these variables. This may be a major limitation because the study population was drawn from high-risk hospital areas such as isolation wards (designated as “pandemic wards”), the emergency rooms and medical intensive care unit. In these settings, workers are highly likely to experience emotional overload. The association between Personal Protective Equipment (PPE) and headache could be, therefore, spurious and the real factor should be sought among the psychosocial factors associated with the pandemic. Furthermore, the study is entirely based on what workers remember of the situation before the epidemic, and this inevitably exposes to a possible recall bias. We are convinced that the association between PPE and headache is worthy of controlled longitudinal studies, which compare different types of PPE and take into account all confounding factors.

Chronic exposure to low levels of mercury is involved in the development of motor neuron diseases (MND). Genetic alterations may have a crucial role in the onset and progression. We presented a case of a TANK-binding kinase 1 (TBK1)-mutated 54-year-old male worker who developed a MND due to chronic mercury exposure at work. He was employed in a chlor-alkali plant in Central Italy. After two years of employment he had acute mercury intoxication with suggestive neurological symptoms and a high urinary level of the metal. Through years, many episodes of intoxication occurred, but he continued to perform the same job and be exposed to mercury. After yet another episode of intoxication in 2013, he showed fasciculations of the upper limbs and trunk, and electromyographic activity patterns were consistent with amyotrophic lateral sclerosis (ALS). In 2016, a genetic test revealed a mutation of TBK1, an ALS-related gene. This case highlights the important role of genetics in personalized occupational medicine. Occupational physicians should use genetic tests to identify conditions of individual susceptibility in workers with documented frequent episodes of mercury intoxication recorded during health surveillance programs to customize prevention measures in the workplace and act before damage appears.

Methods of estimating case fatality ratio

The airborne transmission of SARS-CoV-2 is still debated. The aim of this rapid review is to evaluate the COVID-19 risk associated with the presence of air-conditioning systems. Original studies (both observational and experimental researches) written in English and with no limit on time, on the airborne transmission of SARS-CoV, MERS-CoV, and SARS-CoV-2 coronaviruses that were associated with outbreaks, were included. Searches were made on PubMed/MEDLINE, PubMed Central (PMC), Google Scholar databases, and medRxiv. A snowball strategy was adopted to extend the search. Fourteen studies reporting outbreaks of coronavirus infection associated with the air-conditioning systems were included. All studies were carried out in the Far East. In six out the seven studies on SARS, the role of Heating, Ventilation, and Air Conditioning (HVAC) in the outbreak was indirectly proven by the spatial and temporal pattern of cases, or by airflow-dynamics models. In one report on MERS, the contamination of HVAC by viral particles was demonstrated. In four out of the six studies on SARS-CoV-2, the diffusion of viral particles through HVAC was suspected or supported by computer simulation. In conclusion, there is sufficient evidence of the airborne transmission of coronaviruses in previous Asian outbreaks, and this has been taken into account in the guidelines released by organizations and international agencies for controlling the spread of SARS-CoV-2 in indoor environments. However, the technological differences in HVAC systems prevent the generalization of the results on a worldwide basis. The few COVID-19 investigations available do not provide sufficient evidence that the SARS-CoV-2 virus can be transmitted by HVAC systems.

Since the beginning of the COVID-19 pandemic, Italy was one of the worst-affected European countries. The rapid surge of cases and the limited capacity of intensive care unit departments have posed a serious threat to the Italian national health system. In this paper we describe the first response and the main measures carried by Italian policy makers, as coordinated by a governmental committee of public health experts, which have succeeded in preventing the pandemic from turning into a disaster. Early closure of the school, quarantine measures and lockdown were put in place and the response of the population has been good overall. Despite the Italian health care system of universal coverage is considered the second-best in the world, during phase 1, the Italian decentralisation and fragmentation of health services probably restricted timely interventions and effectiveness. In northern Italy, Lombardy, Emilia Romagna, Piedmont, and Veneto, which reported most of the Italian cases, carried out different strategies against COVID-19, with great differences in testing, quarantine, and public health procedures. The improvement of the epidemiological situation has allowed an easing of the restrictive measures, with a progressive restarting of work activities. The government and technical-scientific bodies have prepared health strategies to support a possible second epidemic wave in the autumn.

Objective: Workplace violence against nurses is a widespread phenomenon that has been associated with many unfavorable individual and organizational outcomes. The aim of this study was to analyze the relationship between violence and work functioning in a sample of Italian nurses. Design: Cross-sectional, with retrospective analysis of exposure. Methods: All nurses from a local hospital were invited to complete a questionnaire assessing violent experiences that occurred in the previous 12 months. The questionnaire also measured job strain (with the Demand-Control-Support questionnaire), organizational justice (with Colquitt’s Questionnaire), and work impairment (with the Nurses Work Functioning Questionnaire). The associations were examined with logistic regression analyses. Findings: Of the 302 nurses who were invited, 275 (91.1%) agreed to participate. The total work impairment score was significantly higher among the nurses exposed to violence compared with the nonexposed nurses (42.2 ± 27.8 vs. 31.9 ± 31.6, respectively; p <.001). Exposed nurses also reported significantly higher levels of job strain (0.96 ± 0.25 vs. 0.8 ± 0.21; p =.003) and lower levels of perceived organizational justice (56.6 ± 12.6 vs. 62.5 ± 14.8; p =.001) than nonexposed nurses. Nurses who had experienced violence had a significantly higher risk for impairment of work functioning than their colleagues (crude odds ratio [OR] = 2.33; 95% confidence interval [CI 95%] = 1.42–3.83). The association between violence and impairment remained significant after adjusting for demographic variables, occupational stress, and perceived organizational justice (OR = 1.83; 95% CI 95% = 1.06–3.17). Conclusions: Workplace violence is associated with impaired work function in nurses. Job strain and perceived organizational injustice are associated with impairment. Clinical Relevance: Violence prevention programs in healthcare activities should include training for violent behavior identification and d

This study examines family firms’ propensity to protect their intellectual property through patents. Building on the mixed gamble logic of the behavioral agency model, we theorize that family ownership has a U-shaped relationship with firm propensity to patent. Specifically, we argue that family firms’ desire to prevent losses of current socioemotional wealth (SEW) inhibits their propensity to patent until a threshold level of family ownership, beyond which the family’s SEW is secured and a greater focus on prospective financial gains attainable through patents is possible. We also suggest that environmental munificence moderates this nonlinear relationship such that a low-munificent environment accentuates the potentially detrimental (beneficial) effects of low-to-medium (medium-to-high) levels of family ownership on patents. We test our hypotheses on a sample of 4,198 small- and medium-sized family firms.

We investigate how perceived parents’ performance in entrepreneurship (PPE) affects the entrepreneurial career intentions of offspring. We argue that while perceived PPE enhances offspring’s perceived entrepreneurial desirability and feasibility because of exposure mechanisms, it inhibits the translation of both desirability and feasibility perceptions into entrepreneurial career intentions due to upward social comparison mechanisms. Thus, perceived PPE acts as a double-edged sword for the intergenerational transmission of entrepreneurship. Our predictions are tested and confirmed on a sample of 21,895 individuals from 33 countries. This study advances the literature on intergenerational transmission of entrepreneurship by providing a foundation for understanding the social psychological conditions necessary for such transmission to occur.