35 results on '"Monaco, Mgl"'
Search Results
2. L’esposizione professionale ai metalli e lo sviluppo di patologie neurodegenerative: valutazione delle varie metodologie utilizzate negli studi di ricerca
- Author
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Garzillo EM, Feola D, PEDATA, Paola, Muoio M, Monaco MGL Miraglia N, LAMBERTI, Monica, SANNOLO, Nicola, Garzillo, Em, Feola, D, Pedata, Paola, Muoio, M, Monaco MGL Miraglia, N, Lamberti, Monica, and Sannolo, Nicola
- Published
- 2014
3. La gestione di casi di tubercolosi in un’Azienda Ospedaliera Campana
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UCCELLO R, MONACO MGL, FEOLA D, GARZILLO EM, MUOIO M, LAMBERTI, Monica, SANNOLO, Nicola, Uccello, R, Monaco, Mgl, Feola, D, Garzillo, Em, Muoio, M, Sannolo, Nicola, and Lamberti, Monica
- Published
- 2012
4. SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers
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Stefano Porru, Maria Grazia Lourdes Monaco, Gianluca Spiteri, Angela Carta, Maria Diletta Pezzani, Giuseppe Lippi, Davide Gibellini, Evelina Tacconelli, Ilaria Dalla Vecchia, Emma Sala, Emanuele Sansone, Giuseppe De Palma, Carlo Bonfanti, Massimo Lombardo, Luigina Terlenghi, Enrico Pira, Ihab Mansour, Maurizio Coggiola, Catalina Ciocan, Alessandro Godono, Adonina Tardon, Marta-Maria Rodriguez-Suarez, Guillermo Fernandez-Tardon, Francisco-Jose Jimeno-Demuth, Rafael-Vicente Castro-Delgado, Tania Iglesias Cabo, Maria Luisa Scapellato, Filippo Liviero, Angelo Moretto, Paola Mason, Sofia Pavanello, Anna Volpin, Luigi Vimercati, Silvio Tafuri, Luigi De Maria, Stefania Sponselli, Pasquale Stefanizzi, Antonio Caputi, Fabriziomaria Gobba, Alberto Modenese, Loretta Casolari, Denise Garavini, Cristiana D’Elia, Stefania Mariani, Francesca Larese Filon, Luca Cegolon, Corrado Negro, Federico Ronchese, Francesca Rui, Paola De Michieli, Nicola Murgia, Marco Dell’Omo, Giacomo Muzi, Tiziana Fiordi, Angela Gambelunghe, Ilenia Folletti, Dana Mates, Violeta Claudia Calota, Andra Neamtu, Ovidiu Perseca, Catalin Alexandru Staicu, Angelica Voinoiu, Eleonóra Fabiánová, Jana Bérešová, Zora Kľocová Adamčáková, Roman Nedela, Anna Lesňáková, Jana Holčíková, Paolo Boffetta, Mahsa Abedini, Giorgia Ditano, Shuffield Seyram Asafo, Giovanni Visci, Francesco Saverio Violante, Carlotta Zunarelli, Giuseppe Verlato, Porru, S, Monaco, Mgl, Spiteri, G, Carta, A, Pezzani, Md, Lippi, G, Gibellini, D, Tacconelli, E, Dalla Vecchia, I, Sala, E, Sansone, E, De Palma, G, Bonfanti, C, Lombardo, M, Terlenghi, L, Pira, E, Mansour, I, Coggiola, M, Ciocan, C, Godono, A, Tardon, A, Rodriguez-Suarez, Mm, Fernandez-Tardon, G, Jimeno-Demuth, Fj, Castro-Delgado, Rv, Iglesias Cabo, T, Scapellato, Ml, Liviero, F, Moretto, A, Mason, P, Pavanello, S, Volpin, A, Vimercati, L, Tafuri, S, De Maria, L, Sponselli, S, Stefanizzi, P, Caputi, A, Gobba, F, Modenese, A, Casolari, L, Garavini, D, D'Elia, C, Mariani, S, Filon, Fl, Cegolon, L, Negro, C, Ronchese, F, Rui, F, De Michieli, P, Murgia, N, Dell'Omo, M, Muzi, G, Fiordi, T, Gambelunghe, A, Folletti, I, Mates, D, Calota, Vc, Neamtu, A, Perseca, O, Staicu, Ca, Voinoiu, A, Fabiánová, E, Bérešová, J, Adamčáková, Zk, Nedela, R, Lesňáková, A, Holčíková, J, Boffetta, P, Abedini, M, Ditano, G, Asafo, S, Visci, G, Violante, F, Zunarelli, C, Verlato, G, Porru S., Monaco M.G.L., Spiteri G., Carta A., Pezzani M.D., Lippi G., Gibellini D., Tacconelli E., Dalla Vecchia I., Sala E., Sansone E., De Palma G., Bonfanti C., Lombardo M., Terlenghi L., Pira E., Mansour I., Coggiola M., Ciocan C., Godono A., Tardon A., Rodriguez-Suarez M.-M., Fernandez-Tardon G., Jimeno-Demuth F.-J., Castro-Delgado R.-V., Iglesias Cabo T., Scapellato M.L., Liviero F., Moretto A., Mason P., Pavanello S., Volpin A., Vimercati L., Tafuri S., De Maria L., Sponselli S., Stefanizzi P., Caputi A., Gobba F., Modenese A., Casolari L., Garavini D., D'Elia C., Mariani S., Filon F.L., Cegolon L., Negro C., Ronchese F., Rui F., De Michieli P., Murgia N., Dell'Omo M., Muzi G., Fiordi T., Gambelunghe A., Folletti I., Mates D., Calota V.C., Neamtu A., Perseca O., Staicu C.A., Voinoiu A., Fabianova E., Beresova J., Adamcakova Z.K., Nedela R., Lesnakova A., Holcikova J., Boffetta P., Abedini M., Ditano G., Asafo S.S., Visci G., Violante F.S., Zunarelli C., and Verlato G.
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Pharmacology ,health worker ,COVID-19 ,SARS-CoV-2 vaccination ,breakthrough infections ,health workers ,occupational and socio-demographic determinants ,Immunology ,breakthrough infection ,Infectious Diseases ,occupational and socio-demographic determinant ,Drug Discovery ,Pharmacology (medical) - Abstract
European Commission, H2020 [101016167]; Regional Health Authority (Azienda Zero), Veneto Region, Italy; Health Research Institute of Asturias (ISPA), Spain, Porru S, Monaco MGL, Spiteri G, Carta A, Pezzani MD, Lippi G, Gibellini D, Tacconelli E, Dalla Vecchia I, Sala E, Sansone E, De Palma G, Bonfanti C, Lombardo M, Terlenghi L, Pira E, Mansour I, Coggiola M, Ciocan C, Godono A, Tardon A, Rodriguez-Suarez MM, Fernandez-Tardon G, Jimeno-Demuth FJ, Castro-Delgado RV, Iglesias Cabo T, Scapellato ML, Liviero F, Moretto A, Mason P, Pavanello S, Volpin A, Vimercati L, Tafuri S, De Maria L, Sponselli S, Stefanizzi P, Caputi A, Gobba F, Modenese A, Casolari L, Garavini D, D'Elia C, Mariani S, Filon FL, Cegolon L, Negro C, Ronchese F, Rui F, De Michieli P, Murgia N, Dell'Omo M, Muzi G, Fiordi T, Gambelunghe A, Folletti I, Mates D, Calota VC, Neamtu A, Perseca O, Staicu CA, Voinoiu A, Fabiánová E, Bérešová J, Adamčáková ZK, Nedela R, Lesňáková A, Holčíková J, Boffetta P, Abedini M, Ditano G, Asafo SS, Visci G, Violante FS, Zunarelli C, Verlato G
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- 2022
5. Determinants of Anti-S Immune Response at 9 Months after COVID-19 Vaccination in a Multicentric European Cohort of Healthcare Workers-ORCHESTRA Project
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Giulia Collatuzzo, Vittorio Lodi, Daniela Feola, Giuseppe De Palma, Emanuele Sansone, Emma Sala, Christian Janke, Noemi Castelletti, Stefano Porru, Gianluca Spiteri, Maria Grazia Lourdes Monaco, Francesca Larese Filon, Corrado Negro, Luca Cegolon, Jana Beresova, Eleonora Fabianova, Lucia A. Carrasco-Ribelles, Pere Toràn-Monserrat, Marta Maria Rodriguez-Suarez, Guillermo Fernandez-Tardon, Shuffield S. Asafo, Giorgia Ditano, Mahsa Abedini, Paolo Boffetta, Collatuzzo, G, Lodi, V, Feola, D, De Palma, G, Sansone, E, Sala, E, Janke, C, Castelletti, N, Porru, S, Spiteri, G, Monaco, Mgl, Larese Filon, F, Negro, C, Cegolon, L, Beresova, J, Fabianova, E, Carrasco-Ribelles, La, Toràn-Monserrat, P, Rodriguez-Suarez, Mm, Fernandez-Tardon, G, Asafo, S, Ditano, G, Abedini, M, and Boffetta, P.
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Infectious Diseases ,temporal trends ,antibody level ,temporal trend ,Virology ,COVID-19 ,vaccine ,serology ,immunization - Abstract
This project has received funding from the EU Horizon 2020 research and innovation program under the ORCHESTRA project Grant Agreement No. 101016167. The cohort from Verona is funded by the Regional Health Authority (Azienda Zero), Veneto Region, Italy., Collatuzzo G., Lodi V., Feola D., De Palma G., Sansone E., Sala E., Janke C., Castelletti N., Porru S., Spiteri G., Monaco M.G.L., Larese Filon F., Negro C., Cegolon L., Beresova J., Fabianova E., Carrasco-Ribelles L.A., Toràn-Monserrat P., Rodriguez-Suarez M.M., Fernandez-Tardon G., Asafo S.S., Ditano G., Abedini M., Boffetta P.
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- 2022
6. Interleukin-2-mediated CD4 T-cell activation correlates highly with effective serological and T-cell responses to SARS-CoV-2 vaccination in people living with HIV.
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Gupta A, Righi E, Konnova A, Sciammarella C, Spiteri G, Van Averbeke V, Berkell M, Hotterbeekx A, Sartor A, Mirandola M, Malhotra-Kumar S, Azzini AM, Pezzani D, Monaco MGL, Vanham G, Porru S, Tacconelli E, and Kumar-Singh S
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- Humans, Male, Middle Aged, Female, Adult, CD4 Lymphocyte Count, Vaccination, Immunoglobulin G blood, Antibodies, Neutralizing blood, Antibodies, Neutralizing immunology, CD4-Positive T-Lymphocytes immunology, HIV Infections immunology, HIV Infections drug therapy, Interleukin-2, COVID-19 immunology, COVID-19 prevention & control, SARS-CoV-2 immunology, Antibodies, Viral blood, Lymphocyte Activation, COVID-19 Vaccines immunology
- Abstract
People living with HIV (PLWH) despite having an appreciable depletion of CD4
+ T-cells show a good severe acute respiratory syndrome coronavirus 2 vaccination response. The underlying mechanism(s) are currently not understood. We studied serological and polyfunctional T-cell responses in PLWH receiving anti-retroviral therapy stratified on CD4+ counts as PLWH-high (CD4 ≥ 500 cells/mm3 ) and PLWH-low (<500 cells/mm3 ). Responses were assessed longitudinally before the first vaccination (T0), 1-month after the first dose (T1), 3-months (T2), and 6-months (T3) after the second dose. Expectedly, both PLWH-high and -low groups developed similar serological responses after T2, which were also non-significantly different from age and vaccination-matched HIV-negative controls at T3. The immunoglobulin G titers were also protective showing a good correlation with angiotensin-converting enzyme 2-neutralizations (R = 0.628, p = 0.005). While surface and intracellular activation analysis showed no significant difference at T3 between PLWH and controls in activated CD4+ CD154+ and CD4+ memory T-cells, spike-specific CD4+ polyfunctional cytokine expression analysis showed that PLWH preferentially express interleukin (IL)-2 (p < 0.001) and controls, interferon-γ (p = 0.017). CD4+ T-cell counts negatively correlated with IL-2-expressing CD4+ T-cells including CD4+ memory T-cells (Spearman ρ: -0.85 and -0.80, respectively; p < 0.001). Our results suggest that the durable serological and CD4+ T-cell responses developing in vaccinated PLWH are associated with IL-2-mediated CD4+ T-cell activation that likely compensates for CD4+ T-cell depletion in PLWH., (© 2024 The Author(s). Journal of Medical Virology published by Wiley Periodicals LLC.)- Published
- 2024
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7. Protective role of SARS-CoV-2 anti-S IgG against breakthrough infections among European healthcare workers during pre and post-Omicron surge-ORCHESTRA project.
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Spiteri G, D'Agostini M, Abedini M, Ditano G, Collatuzzo G, Boffetta P, Vimercati L, Sansone E, De Palma G, Modenese A, Gobba F, Liviero F, Moretto A, dell'Omo M, Fiordi T, Larese Filon F, Mauro M, Violán C, Mates D, Oravec Bérešová J, Monaco MGL, Carta A, Verlato G, and Porru S
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- Humans, Europe epidemiology, Female, Adult, Male, Middle Aged, Immunization, Secondary, Spike Glycoprotein, Coronavirus immunology, Breakthrough Infections, COVID-19 prevention & control, COVID-19 immunology, Health Personnel statistics & numerical data, SARS-CoV-2 immunology, Immunoglobulin G blood, Antibodies, Viral blood, COVID-19 Vaccines immunology, COVID-19 Vaccines administration & dosage
- Abstract
Purpose: Anti SARS-CoV-2 vaccination initially showed high effectiveness in preventing COVID-19. However, after the surge of variants of concern, the effectiveness dropped. Several studies investigated if this was related to the decrease of the humoral response over time; however, this issue is still unclear. The aim of this study was to understand whether SARS-CoV-2 anti-S IgG levels can be used to predict breakthrough infection risk and define the timing for further booster doses administration., Method: Within the framework of the ORCHESTRA Project, over 20,000 health workers from 11 European centers were enrolled since December 2020. We performed two Cox proportional hazards survival analyses regarding pre-Omicron (from January to July 2021) and Omicron (December 2021-May 2022) periods. The serological response was classified as high (above the 75th percentile), medium (25th-75th), or low (< 25th)., Results: Seventy-four (0.33%) and 2122 (20%) health workers were infected during the first and second periods, respectively. Both Cox analyses showed that having high anti-S titer was linked to a significantly lower risk of infection as compared to having medium serological response [HR of high vs medium anti-S titer = 0.27 (95% CI 0.11-0.66) during the first phase, HR = 0.76 (95% CI 0.62-0.93) during the second phase]., Conclusion: Vaccine effectiveness wanes significantly after new variants surge, making anti-S titer unsuitable to predict optimal timing for further booster dose administration. Studies on other immunological indicators, such as cellular immunity, are therefore needed to better understand the mechanisms and duration of protection against breakthrough infection risk., (© 2024. The Author(s).)
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- 2024
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8. SARS-CoV-2 Positivity in Foreign-Born Adults: A Retrospective Study in Verona, Northeast Italy.
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Lotti V, Spiteri G, Caliskan G, Monaco MGL, Gibellini D, Verlato G, and Porru S
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We compared SARS-CoV-2 positivity between the foreign-born adult working population and Italians living in the Verona area to investigate whether being a foreign-born adult could confer an increased risk of infection or lead to a diagnostic delay. The present study included 105,774 subjects, aged 18-65 years, tested for SARS-CoV-2 by nasopharyngeal swabs and analyzed at the University Hospital of Verona between January 2020 and September 2022. A logistic regression model was used, controlling for gender, age, time of sampling, and source of referral. A higher proportion of SARS-CoV-2 positivity in Italian (30.09%) than in foreign-born (25.61%) adults was reported, with a higher proportion of SARS-CoV-2 positivity in men than women in both cohorts analyzed. The difference in swab positivity among Italian and foreign-born adults was the highest in people aged 18-29 years (31.5% vs. 23.3%) and tended to disappear thereafter. Swab positivity became comparable between Italian and foreign-born adults during the vaccination campaign. Multivariable analysis confirmed the lower risk of swab positivity among foreign-born adults (OR = 0.85, 95% CI 0.82-0.89). In the Verona area, foreign-born adults showed a lower rate of SARS-CoV-2 positivity than the native population, likely because of underdiagnosis. Hence, public health should increase attention toward these particularly vulnerable populations., Competing Interests: The authors declare no conflicts of interest.
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- 2024
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9. Risk of obstructive sleep apnea among health workers: results of a screening in a large Italian University Hospital.
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Spiteri G, Monaco MGL, Carta A, Taus F, Torroni L, Verlato G, and Porru S
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- Humans, Male, Quality of Life, Polysomnography, Surveys and Questionnaires, Hospitals, Italy epidemiology, Mass Screening methods, Sleep Apnea, Obstructive diagnosis, Sleep Apnea, Obstructive epidemiology
- Abstract
Purpose: Obstructive sleep apnea (OSA) is a common respiratory sleep disorder, related to increased mortality, poor quality of life, and higher risk of work accidents and injuries. Studies on the risk of OSA (rOSA) among health workers (HW) are scant. The aims of this study were to investigate this issue in a large University Hospital and to assess the effectiveness of a screening program., Methods: The STOP-BANG questionnaire (SBQ) was sent via e-mail to the 5031 HW employed at the University Hospital of Verona. HW who completed the SBQ were classified at low, moderate, and high rOSA. HW at high rOSA were invited to undergo nocturnal polygraphy. The determinants of rOSA were studied by non-parametric Kruskal-Wallis test, Pearson's chi-squared, and multinomial logistic model., Results: Of 5031 HW, 1564 (31.1%) completed the online questionnaire. Responders with low, moderate, and high rOSA were 72.7%, 13.7%, and 13.6%. Male gender, older age, and higher body mass index (BMI) were significant predictors of high rOSA, as expected. Physicians had the lowest probability of being in the high-risk category. Polygraphy was performed in 64 subjects. The positive predictive value of the self-administered SBQ was 68.8% (95%C.I. 55.9-79.8%) but raised to 96.9% (95%C.I. 89.2-99.6%) when re-administered by medical staff., Conclusion: SBQ showed its effectiveness as a screening tool in detecting undiagnosed OSA in HW. Systematic screening for OSA in work settings could allow early diagnosis and treatment, reducing short- and long-term health effects of OSA., (© 2023. The Author(s).)
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- 2024
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10. A Multi-Center Study Investigating Long COVID-19 in Healthcare Workers from North-Eastern Italy: Prevalence, Risk Factors and the Impact of Pre-Existing Humoral Immunity-ORCHESTRA Project.
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Cegolon L, Mauro M, Sansone D, Tassinari A, Gobba FM, Modenese A, Casolari L, Liviero F, Pavanello S, Scapellato ML, Taus F, Carta A, Spiteri G, Monaco MGL, Porru S, and Larese Filon F
- Abstract
Introduction: The impact of long-COVID-19 syndrome is rather variable, since it is influenced by several residual confounders. This study aimed to investigate the prevalence of long COVID-19 in healthcare workers (HCWs) from four university hospitals in north-eastern Italy: Trieste, Padua, Verona, and Modena-Reggio Emilia. Methods: During the period June 2022-August 2022, HCWs were surveyed for past COVID-19 infections, medical history, and any acute as well as post-COVID-19 symptoms. The prevalence of long COVID-19 was estimated at 30-60 days or 61+ days since first negative swab following first and second COVID-19 episode. Furthermore, the risk of long COVID-19 was investigated by multivariable logistic regression. Results were expressed as the adjusted odds ratio (aOR) with a 95% confidence interval (95%CI). Results: 5432 HCWs returned a usable questionnaire: 2401 were infected with SARS-CoV-2 at least once, 230 were infected at least twice, and 8 were infected three times. The prevalence of long COVID-19 after a primary COVID-19 infection was 24.0% at 30-60 days versus 16.3% at 61+ days, and 10.5% against 5.5% after the second SARS-CoV-2 event. The most frequent symptoms after a first COVID-19 event were asthenia (30.3%), followed by myalgia (13.7%), cough (12.4%), dyspnea (10.2%), concentration deficit (8.1%), headache (7.3%), and anosmia (6.5%), in decreasing order of prevalence. The risk of long COVID-19 at 30-60 days was significantly higher in HCWs hospitalized for COVID-19 (aOR = 3.34; 95%CI: 1.62; 6.89), those infected with SARS-CoV-2 during the early pandemic waves-namely the Wuhan (aOR = 2.16; 95%CI: 1.14; 4.09) or Alpha (aOR= 2.05; 95%CI: 1.25; 3.38) transmission periods-and progressively increasing with viral shedding time (VST), especially 15+ days (aOR = 3.20; 95%CI: 2.07; 4.94). Further determinants of long COVID-19 at 30-60 days since primary COVID-19 event were female sex (aOR = 1.91; 95%CI: 1.30; 2.80), age >40 years, abnormal BMI, or administrative services (reference category). In contrast, HCWs vaccinated with two doses before their primary infection (aOR = 0.57; 95%CI: 0.34; 0.94), undergraduate students, or postgraduate medical trainees were less likely to experience long COVID-19 at 30-60 days. Apart from pandemic waves, the main determinants of long COVID-19 at 30-60 days were confirmed at 61+ days. Conclusions: The risk of long COVID-19 following primary infection increased with the severity of acute disease and VST, especially during the initial pandemic waves, when more virulent viral strains were circulating, and susceptibility to SARS-CoV-2 was higher since most HCWs had not been infected yet, COVID-19 vaccines were still not available, and/or vaccination coverage was still building up. The risk of long COVID-19 therefore decreased inversely with humoral immunity at the individual level. Nevertheless, the prevalence of long COVID-19 was remarkably lower after SARS-CoV-2 reinfections regardless of vaccination status, suggesting that hybrid humoral immunity did not increase protection against the syndrome compared to immunity mounted by either natural infection or vaccination separately. Since the risk of long COVID-19 is currently low with Omicron and patients who developed the syndrome following SARS-CoV-2 infection in the early pandemic waves tend to return to a state of full health with time, a cost-effective approach to screen post-COVID-19 symptoms during the Omicron time could be restricted to vulnerable individuals developing severe disease and/or with prolonged VST.
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- 2023
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11. Determinants of Anti-S Immune Response at 12 Months after SARS-CoV-2 Vaccination in a Multicentric European Cohort of Healthcare Workers-ORCHESTRA Project.
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Leomanni L, Collatuzzo G, Sansone E, Sala E, De Palma G, Porru S, Spiteri G, Monaco MGL, Basso D, Pavanello S, Scapellato ML, Larese Filon F, Cegolon L, Mauro M, Lodi V, Lazzarotto T, Noreña I, Reinkemeyer C, Giang LTT, Fabiánová E, Strhársky J, Dell'Omo M, Murgia N, Carrasco-Ribelles LA, Violán C, Mates D, Rascu A, Vimercati L, De Maria L, Asafo SS, Ditano G, Abedini M, and Boffetta P
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Background: The effectiveness of the immunity provided by SARS-CoV-2 vaccines is an important public health issue. We analyzed the determinants of 12-month serology in a multicenter European cohort of vaccinated healthcare workers (HCW)., Methods: We analyzed the sociodemographic characteristics and levels of anti-SARS-CoV-2 spike antibodies (IgG) in a cohort of 16,101 vaccinated HCW from eleven centers in Germany, Italy, Romania, Slovakia and Spain. Considering the skewness of the distribution, the serological levels were transformed using log or cubic standardization and normalized by dividing them by center-specific standard errors. We fitted center-specific multivariate regression models to estimate the cohort-specific relative risks (RR) of an increase of one standard deviation of log or cubic antibody level and the corresponding 95% confidence interval (CI) for different factors and combined them in random-effects meta-analyses., Results: We included 16,101 HCW in the analysis. A high antibody level was positively associated with age (RR = 1.04, 95% CI = 1.00-1.08 per 10-year increase), previous infection (RR = 1.78, 95% CI 1.29-2.45) and use of Spikevax [Moderna] with combinations compared to Comirnaty [BioNTech/Pfizer] (RR = 1.07, 95% CI 0.97-1.19) and was negatively associated with the time since last vaccine (RR = 0.94, 95% CI 0.91-0.98 per 30-day increase)., Conclusions: These results provide insight about vaccine-induced immunity to SARS-CoV-2, an analysis of its determinants and quantification of the antibody decay trend with time since vaccination.
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- 2023
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12. Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project.
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Porru S, Monaco MGL, Spiteri G, Carta A, Caliskan G, Violán C, Torán-Monserrat P, Vimercati L, Tafuri S, Boffetta P, Violante FS, Sala E, Sansone E, Gobba F, Casolari L, Wieser A, Janke C, Tardon A, Rodriguez-Suarez MM, Liviero F, Scapellato ML, dell'Omo M, Murgia N, Mates D, Calota VC, Strhársky J, Mrázová M, Pira E, Godono A, Magnano GC, Negro C, and Verlato G
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- Female, Humans, Incidence, SARS-CoV-2, BNT162 Vaccine, Breakthrough Infections, Longitudinal Studies, COVID-19 epidemiology, COVID-19 prevention & control
- Abstract
Background: SARS-CoV-2 breakthrough infections (BI) after vaccine booster dose are a relevant public health issue., Methods: Multicentric longitudinal cohort study within the ORCHESTRA project, involving 63,516 health workers (HW) from 14 European settings. The study investigated the cumulative incidence of SARS-CoV-2 BI after booster dose and its correlation with age, sex, job title, previous infection, and time since third dose., Results: 13,093 (20.6%) BI were observed. The cumulative incidence of BI was higher in women and in HW aged < 50 years, but nearly halved after 60 years. Nurses experienced the highest BI incidence, and administrative staff experienced the lowest. The BI incidence was higher in immunosuppressed HW (28.6%) vs others (24.9%). When controlling for gender, age, job title and infection before booster, heterologous vaccination reduced BI incidence with respect to the BNT162b2 mRNA vaccine [Odds Ratio (OR) 0.69, 95% CI 0.63-0.76]. Previous infection protected against asymptomatic infection [Relative Risk Ratio (RRR) of recent infection vs no infection 0.53, 95% CI 0.23-1.20] and even more against symptomatic infections [RRR 0.11, 95% CI 0.05-0.25]. Symptomatic infections increased from 70.5% in HW receiving the booster dose since < 64 days to 86.2% when time elapsed was > 130 days., Conclusions: The risk of BI after booster is significantly reduced by previous infection, heterologous vaccination, and older ages. Immunosuppression is relevant for increased BI incidence. Time elapsed from booster affects BI severity, confirming the public health usefulness of booster. Further research should focus on BI trend after 4th dose and its relationship with time variables across the epidemics., (© 2023. The Author(s).)
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- 2023
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13. Multimorbidity and Serological Response to SARS-CoV-2 Nine Months after 1st Vaccine Dose: European Cohort of Healthcare Workers-Orchestra Project.
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Violán C, Carrasco-Ribelles LA, Collatuzzo G, Ditano G, Abedini M, Janke C, Reinkemeyer C, Giang LTT, Liviero F, Scapellato ML, Mauro M, Rui F, Porru S, Spiteri G, Monaco MGL, Carta A, Otelea M, Rascu A, Fabiánová E, Klöslová Z, Boffetta P, and Torán-Monserrat P
- Abstract
Understanding antibody persistence concerning multimorbidity is crucial for vaccination policies. Our goal is to assess the link between multimorbidity and serological response to SARS-CoV-2 nine months post-first vaccine. We analyzed Healthcare Workers (HCWs) from three cohorts from Italy, and one each from Germany, Romania, Slovakia, and Spain. Seven groups of chronic diseases were analyzed. We included 2941 HCWs (78.5% female, 73.4% ≥ 40 years old). Multimorbidity was present in 6.9% of HCWs. The prevalence of each chronic condition ranged between 1.9% (cancer) to 10.3% (allergies). Two regression models were fitted, one considering the chronic conditions groups and the other considering whether HCWs had diseases from ≥2 groups. Multimorbidity was present in 6.9% of HCWs, and higher 9-months post-vaccine anti-S levels were significantly associated with having received three doses of the vaccine (RR = 2.45, CI = 1.92-3.13) and with having a prior COVID-19 infection (RR = 2.30, CI = 2.15-2.46). Conversely, lower levels were associated with higher age (RR = 0.94, CI = 0.91-0.96), more time since the last vaccine dose (RR = 0.95, CI = 0.94-0.96), and multimorbidity (RR = 0.89, CI = 0.80-1.00). Hypertension is significantly associated with lower anti-S levels (RR = 0.87, CI = 0.80-0.95). The serological response to vaccines is more inadequate in individuals with multimorbidity.
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- 2023
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14. Corrigendum: Temporal trends of COVID-19 antibodies in vaccinated healthcare workers undergoing repeated serological sampling: an individual-level analysis within 13 months in the ORCHESTRA cohort.
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Collatuzzo G, De Palma G, Violante FS, Porru S, Filon FL, Fabianova E, Violán C, Vimercati L, Leustean M, Rodriguez-Suarez MM, Sansone E, Sala E, Zunarelli C, Lodi V, Monaco MGL, Spiteri G, Negro C, Beresova J, Carrasco-Ribelles LA, Tafuri S, Asafo SS, Ditano G, Abedini M, and Boffetta P
- Abstract
[This corrects the article DOI: 10.3389/fimmu.2022.1079884.]., (Copyright © 2023 Collatuzzo, De Palma, Violante, Porru, Filon, Fabianova, Violán, Vimercati, Leustean, Rodriguez-Suarez, Sansone, Sala, Zunarelli, Lodi, Monaco, Spiteri, Negro, Beresova, Carrasco-Ribelles, Tafuri, Asafo, Ditano, Abedini and Boffetta.)
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- 2023
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15. Reduction of Excessive Dietary Sodium Consumption: Effectiveness of a Prevention Intervention among Health Workers in a Large Italian Hospital.
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Spiteri G, Monaco MGL, Carta A, Torroni L, Taus F, Verlato G, and Porru S
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- Male, Humans, Sodium Chloride, Dietary, Blood Pressure, Obesity epidemiology, Obesity prevention & control, Obesity complications, Hospitals, Sodium, Dietary, Hypertension epidemiology, Hypertension prevention & control, Hypertension etiology
- Abstract
Excessive salt consumption is one of the leading causes of high blood pressure. Worldwide salt intake largely exceeds the WHO recommended amount. This study aimed to evaluate the prevalence of high salt consumers and the effectiveness of a short-term workplace educational intervention among health workers. An online survey, assessing daily salt consumption through the MINISAL-SIIA questionnaire, was sent to the 4911 health workers employed by the University Hospital of Verona, Italy. Health workers who had a high (total score ≥ 10) or moderate (total score = 8/9) salt consumption associated with obesity or arterial hypertension were invited to undergo a medical examination and a short individual counselling session. A total of 1665 health workers (34.0%) completed the online questionnaire; 40.9% and 12.6% had moderate and high salt intake, respectively. High salt intake was more prevalent in men, current and past smokers, and obese and overweight subjects. In 95 participants completing the clinical phase, median daily salt consumption decreased from 10 (p25-p75 8-11) to 7 g (6-8) ( p < 0.001), systolic blood pressure from 130 (120-140) to 120 (120-130) mmHg and weight from 78 (62-87) to 75 (62-86) kg. More than half of health workers had an excessive salt intake. However, a brief educational intervention in the healthcare working setting can substantially reduce unhealthy dietary habits, fostering weight loss and blood pressure control. Studies with a longer follow-up are needed to evaluate the persistence over time of these effects.
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- 2023
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16. Vasovagal Syncope at Work: A Narrative Review for an Occupational Management Proposal.
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Corvino AR, Russo V, Monaco MGL, Garzillo EM, Guida D, Comune A, Parente E, Lamberti M, and Miraglia N
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- Humans, Syncope complications, Transportation, Syncope, Vasovagal etiology, Syncope, Vasovagal diagnosis, Pacemaker, Artificial adverse effects, Occupational Health
- Abstract
Syncope is a complex clinical manifestation that presents considerable diagnostic difficulties and, consequently, numerous critical issues regarding fitness for work, especially for high-risk tasks. To date, it is impossible to quantify the exact impact of syncope on work and public safety since it is highly improbable to identify loss of consciousness as the fundamental cause of work or driving-related accidents, especially fatal injuries. Working at high-risk jobs such as public transport operators, in high elevations, or with exposure to moving parts, construction equipment, fireworks, or explosives demand attention and total awareness. Currently, no validated criteria or indicators are available for occupational risk stratification of a patient with reflex syncope to return to work. By drawing inspiration from the updated literature, this narrative review intends to summarise the leading knowledge required regarding the return to work for subjects affected by syncope. According to the available data, the authors highlighted some key findings, summarised in macro-items, such as defined risk stratification for vasovagal accidents, return to work after a critical event, and a focus on pacemaker (PM) implementation. Lastly, the authors proposed a flowchart for occupational physicians to help them manage the cases of workers affected by syncope and exposed to levels of risk that could represent a danger to the workers' health.
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- 2023
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17. SARS-CoV-2 Emergency Management in the ASL 1 Abruzzo Companies, Italy: An Autumn 2022 Cross-Sectional Investigation.
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Mastrodomenico M, Monaco MGL, Spacone A, Inglese E, Cioffi A, Fabiani L, and Garzillo EM
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- Humans, Cross-Sectional Studies, Italy epidemiology, Workplace, SARS-CoV-2, COVID-19 epidemiology
- Abstract
Background: The SARS-CoV-2 pandemic still represents a public health emergency that affects workplaces and forces employers to develop technical, organizational and procedural measures safeguarding workers' health, particularly 'fragile' ones. This research aimed to assess employers' adherence to the emergency measures planned by the Italian government to hinder COVID-19 during Autumn 2022., Methods: A cross-sectional study was conducted in Autumn 2022, with an 18-item questionnaire derived from the Italian State's governmental indications, sent by email to 51 companies of Marsica and Peligna Valley, L'Aquila, Southern Italy., Results: A total of 20 recruited companies (65% were micro-enterprises, belonging to the food and financial sector) responded to the questionnaire within a mean time of 18 days (±11.64), which was lower for medium- and large-sized companies as well as for banking sector ones ( p < 0.05). As regards intervention strategies, sanitization (92.7% of positive answers) and specific training (83.3%) showed almost full compliance in contrast to working organization (47.5%) and social distancing (61.7%). The companies that reported managing fragility (50%) belong almost exclusively to the banking sector, with predominantly office-based tasks., Conclusions: The study provided insight into critical issues relating to compliance with national legislative directives and the crucial role of occupational physicians as global advisors for all workplaces.
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- 2023
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18. Temporal trends of COVID-19 antibodies in vaccinated healthcare workers undergoing repeated serological sampling: An individual-level analysis within 13 months in the ORCHESTRA cohort.
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Collatuzzo G, De Palma G, Violante FS, Porru S, Larese Filon F, Fabianova E, Violán C, Vimercati L, Leustean M, Rodriguez-Suarez MM, Sansone E, Sala E, Zunarelli C, Lodi V, Monaco MGL, Spiteri G, Negro C, Beresova J, Carrasco-Ribelles LA, Tafuri S, Asafo SS, Ditano G, Abedini M, and Boffetta P
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- Humans, Infant, Antibodies, Health Personnel, Italy, COVID-19 Vaccines, COVID-19 prevention & control
- Abstract
Short Summary: We investigated changes in serologic measurements after COVID-19 vaccination in 19,422 subjects. An individual-level analysis was performed on standardized measurements. Age, infection, vaccine doses, time between doses and serologies, and vaccine type were associated with changes in serologic levels within 13 months., Background: Persistence of vaccine immunization is key for COVID-19 prevention., Methods: We investigated the difference between two serologic measurements of anti-COVID-19 S1 antibodies in an individual-level analysis on 19,422 vaccinated healthcare workers (HCW) from Italy, Spain, Romania, and Slovakia, tested within 13 months from first dose. Differences in serologic levels were divided by the standard error of the cohort-specific distribution, obtaining standardized measurements. We fitted multivariate linear regression models to identify predictors of difference between two measurements., Results: We observed a progressively decreasing difference in serologic levels from <30 days to 210-240 days. Age was associated with an increased difference in serologic levels. There was a greater difference between the two serologic measurements in infected HCW than in HCW who had never been infected; before the first measurement, infected HCW had a relative risk (RR) of 0.81 for one standard deviation in the difference [95% confidence interval (CI) 0.78-0.85]. The RRs for a 30-day increase in time between first dose and first serology, and between the two serologies, were 1.08 (95% CI 1.07-1.10) and 1.04 (95% CI 1.03-1.05), respectively. The first measurement was a strong predictor of subsequent antibody decrease (RR 1.60; 95% CI 1.56-1.64). Compared with Comirnaty, Spikevax (RR 0.83, 95% CI 0.75-0.92) and mixed vaccines (RR 0.61, 95% CI 0.51-0.74) were smaller decrease in serological level (RR 0.46; 95% CI 0.40-0.54)., Conclusions: Age, COVID-19 infection, number of doses, time between first dose and first serology, time between serologies, and type of vaccine were associated with differences between the two serologic measurements within a 13-month period., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Collatuzzo, De Palma, Violante, Porru, Larese Filon, Fabianova, Violán, Vimercati, Leustean, Rodriguez-Suarez, Sansone, Sala, Zunarelli, Lodi, Monaco, Spiteri, Negro, Beresova, Carrasco-Ribelles, Tafuri, Asafo, Ditano, Abedini and Boffetta.)
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- 2023
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19. Determinants of Anti-S Immune Response at 9 Months after COVID-19 Vaccination in a Multicentric European Cohort of Healthcare Workers-ORCHESTRA Project.
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Collatuzzo G, Lodi V, Feola D, De Palma G, Sansone E, Sala E, Janke C, Castelletti N, Porru S, Spiteri G, Monaco MGL, Larese Filon F, Negro C, Cegolon L, Beresova J, Fabianova E, Carrasco-Ribelles LA, Toràn-Monserrat P, Rodriguez-Suarez MM, Fernandez-Tardon G, Asafo SS, Ditano G, Abedini M, and Boffetta P
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- Female, Humans, Antibodies, Viral, Health Personnel, Immunity, Vaccination, COVID-19 prevention & control, COVID-19 Vaccines
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Background: The persistence of antibody levels after COVID-19 vaccination has public health relevance. We analyzed the determinants of quantitative serology at 9 months after vaccination in a multicenter cohort. Methods: We analyzed data on anti-SARS-CoV-2 spike antibody levels at 9 months from the first dose of vaccinated HCW from eight centers in Italy, Germany, Spain, Romania and Slovakia. Serological levels were log-transformed to account for the skewness of the distribution and normalized by dividing them by center-specific standard errors. We fitted center-specific multivariate regression models to estimate the cohort-specific relative risks (RR) of an increase of one standard deviation of log antibody level and the corresponding 95% confidence interval (CI), and combined them in random-effects meta-analyses. Finally, we conducted a trend analysis of 1 to 7 months' serology within one cohort. Results : We included 20,216 HCW with up to two vaccine doses and showed that high antibody levels were associated with female sex ( p = 0.01), age (RR = 0.87, 95% CI = 0.86-0.88 per 10-year increase), 10-day increase in time since last vaccine (RR = 0.97, 95% CI 0.97-0.98), previous infection (3.03, 95% CI = 2.92-3.13), two vaccine doses (RR = 1.22, 95% CI = 1.09-1.36), use of Spikevax (OR = 1.51, 95% CI = 1.39-1.64), Vaxzevria (OR = 0.57, 95% CI = 0.44-0.73) or heterologous vaccination (OR = 1.33, 95% CI = 1.12-1.57), compared to Comirnaty. The trend in the Bologna cohort, based on 3979 measurements, showed a decrease in mean standardized antibody level from 8.17 to 7.06 (1-7 months, p for trend 0.005). Conclusions: Our findings corroborate current knowledge on the determinants of COVID-19 vaccine-induced immunity and declining trend with time.
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- 2022
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20. SARS-CoV-2 and Its Variants in Thrice-Infected Health Workers: A Case Series from an Italian University Hospital.
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Monaco MGL, Spiteri G, Caliskan G, Lotti V, Carta A, Gibellini D, Verlato G, and Porru S
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- Humans, Retrospective Studies, Hospitals, SARS-CoV-2 genetics, COVID-19 epidemiology
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Background: We described a SARS-CoV-2 thrice-infected case series in health workers (HW) to evaluate patient and virus variants and lineages and collect information on variables associated with multiple infections., Methods: A retrospective analysis of clinical and laboratory characteristics of SARS-CoV-2 thrice-infected individuals was carried out in Verona University Hospital, concurrent with the ORCHESTRA project. Variant analysis was conducted on a subset of available specimens., Results: Twelve HW out of 7368 were thrice infected (0.16%). Symptomatic infections were reported in 63.6%, 54.5% and 72.7% of the first, second and third infections, respectively. Nine subjects were fully vaccinated at the time of the third infection, and five had an additional booster dose. The mean time to second infection was 349.6 days (95% CI, 138-443); the mean interval between the second and third infection was 223.5 days (95% CI, 108-530) ( p = 0.032). In three cases, the second and third infections were caused by the Omicron variant, but different lineages were detected when the second vs third infections were sequenced., Conclusions: This case series confirms evidence of multiple reinfections with SARS-CoV-2, even from the same variant, in vaccinated HW. These results reinforce the need for continued infection-specific prevention measures in previously infected and reinfected HW.
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- 2022
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21. Determinants of anti-S immune response at 6 months after COVID-19 vaccination in a multicentric European cohort of healthcare workers - ORCHESTRA project.
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Collatuzzo G, Visci G, Violante FS, Porru S, Spiteri G, Monaco MGL, Larese Fillon F, Negro C, Janke C, Castelletti N, De Palma G, Sansone E, Mates D, Teodorescu S, Fabiánová E, Bérešová J, Vimercati L, Tafuri S, Abedini M, Ditano G, Asafo SS, and Boffetta P
- Subjects
- Antibodies, Viral, Female, Health Personnel, Humans, Immunity, Immunoglobulin G, Infant, Vaccination, COVID-19 prevention & control, COVID-19 Vaccines
- Abstract
Background: The duration of immune response to COVID-19 vaccination is of major interest. Our aim was to analyze the determinants of anti-SARS-CoV-2 IgG titer at 6 months after 2-dose vaccination in an international cohort of vaccinated healthcare workers (HCWs)., Methods: We analyzed data on levels of anti-SARS-CoV-2 Spike antibodies and sociodemographic and clinical characteristics of 6,327 vaccinated HCWs from 8 centers from Germany, Italy, Romania and Slovakia. Time between 1
st dose and serology ranged 150-210 days. Serological levels were log-transformed to account for the skewness of the distribution and normalized by dividing them by center-specific standard errors, obtaining standardized values. We fitted center-specific multivariate regression models to estimate the cohort-specific relative risks (RR) of an increase of 1 standard deviation of log antibody level and corresponding 95% confidence interval (CI), and finally combined them in random-effects meta-analyses., Results: A 6-month serological response was detected in 99.6% of HCWs. Female sex (RR 1.10, 95%CI 1.00-1.21), past infection (RR 2.26, 95%CI 1.73-2.95) and two vaccine doses (RR 1.50, 95%CI 1.22-1.84) predicted higher IgG titer, contrary to interval since last dose (RR for 10-day increase 0.94, 95%CI 0.91-0.97) and age (RR for 10-year increase 0.87, 95%CI 0.83-0.92). M-RNA-based vaccines (p<0.001) and heterologous vaccination (RR 2.46, 95%CI 1.87-3.24, one cohort) were associated with increased antibody levels., Conclusions: Female gender, young age, past infection, two vaccine doses, and m-RNA and heterologous vaccination predicted higher antibody level at 6 months. These results corroborate previous findings and offer valuable data for comparison with trends observed with longer follow-ups., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Collatuzzo, Visci, Violante, Porru, Spiteri, Monaco, Larese Fillon, Negro, Janke, Castelletti, De Palma, Sansone, Mates, Teodorescu, Fabiánová, Bérešová, Vimercati, Tafuri, Abedini, Ditano, Asafo, Boffetta and Orchestra WP5 Working Group.)- Published
- 2022
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22. Usefulness and Limitations of Anti-S IgG Assay in Detecting Previous SARS-CoV-2 Breakthrough Infection in Fully Vaccinated Healthcare Workers.
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Spiteri G, Monaco MGL, Caliskan G, Carta A, Pezzani MD, Lippi G, Gibellini D, Verlato G, and Porru S
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Introduction: The anti-spike (S) IgG assay is the most widely used method to assess the immunological response to COVID-19 vaccination. Several studies showed that subjects with perivaccination infection have higher anti-S IgG titers. However, a cut-off has not yet been identified so far for distinguishing infected subjects after vaccination. This study thus evaluates the performance of the anti-S IgG assay in identifying subjects with breakthrough infections (BIs) and its potential usefulness for screening healthcare workers (HCWs). Methods: Out of 6400 HCWs of the University Hospital of Verona vaccinated with two doses of BNT162b2, 4462 never infected before subjects who had completed primary vaccination were tested for IgG anti-S 6 to 9 months after the second dose. Of these, 59 (1.3%) had a BI. The discriminant power of IgG anti-S in detecting previous breakthrough infection was tested by constructing receiver operating characteristic (ROC) curves. Results: The discriminant power for BI was rather good (area under the curve (AUC), 0.78) and increased with decreasing time elapsed between antibody titer assessment and previous SARS-CoV-2 infection. Accuracy (AUC) sensitivity increased from 0.78 (95% CI 0.70−0.85) for BI in the previous six months to 0.83 (95% CI 0.67−0.99) for those in the previous two months, and from 0.68 to 0.80, respectively. The specificity (0.86) and optimal cut-off (935 BAU/mL) remained unchanged. However, BI were rather rare (1.3%), so the positive predictive value (PPV) was low. Only 40 of the 664 HCWs with antibody titer > 935 BAU/mL had previously confirmed BI, yielding a PPV of only 6.0%. When adopting as cut-off the 90th percentile (1180 BAU/mL), PPV increased to 7.9% (35/441). Conclusions: The anti-S IgG assay displayed good sensitivity and specificity in discriminating subjects with BI, especially in recent periods. However, BIs were rare among HCWs, so that the anti-S IgG assay may have low PPV in this setting, thus limiting the usefulness of this test as a screening tool for HCWs. Further studies are needed to identify more effective markers of a previous infection in vaccinated subjects.
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- 2022
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23. Smoking Habits and Workplace Health Promotion among University Students in Southern Italy: A Cross-Sectional Pilot Investigation.
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Garzillo EM, Monaco MGL, Corvino AR, Giardiello A, Arnese A, Napolitano F, Di Giuseppe G, and Lamberti M
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- Adult, Cross-Sectional Studies, Female, Health Promotion, Humans, Italy epidemiology, Male, Pilot Projects, Prevalence, Surveys and Questionnaires, Workplace, Cigarette Smoking epidemiology, Smoking Cessation, Students, Medical
- Abstract
The study aimed to investigate the tobacco smoking prevalence, habits and awareness among a cohort of healthcare students from a university hospital in southern Italy and the associations with socio-demographic determinants. A secondary outcome was to estimate the educational needs to receive information on smoking-related risk factors. Five hundred and forty-nine students completed a self-administered questionnaire (180 male and 369 female, average age 25 yo, ±5.9 SD), enrolled from October 2018 to November 2019 at the University of Naples 'Luigi Vanvitelli', and the collected data were analysed by descriptive and inferential statistical analysis. The sample's prevalence of current smokers was 25.3%, without a significant sex difference. The multiple logistic regression model showed the link between smoking habits and alcoholic beverage consumption ( p < 0.001) and living with smokers ( p = 0.003). The enrolled cohort does not seem to need more information about the risks of cigarette smoking ( p = 0.028). The data analysis and the comparison with the current literature allowed the authors to hypothesise a training model to be adopted within a workplace health promotion programme managed by an occupational physician. This model included targeted training for smoking dissuasion, focusing on sex and gender, cohabitant's influence, and combined addiction management. Further research will focus on the effectiveness of these proposed models.
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- 2022
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24. SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers.
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Porru S, Monaco MGL, Spiteri G, Carta A, Pezzani MD, Lippi G, Gibellini D, Tacconelli E, Dalla Vecchia I, Sala E, Sansone E, De Palma G, Bonfanti C, Lombardo M, Terlenghi L, Pira E, Mansour I, Coggiola M, Ciocan C, Godono A, Tardon A, Rodriguez-Suarez MM, Fernandez-Tardon G, Jimeno-Demuth FJ, Castro-Delgado RV, Iglesias Cabo T, Scapellato ML, Liviero F, Moretto A, Mason P, Pavanello S, Volpin A, Vimercati L, Tafuri S, De Maria L, Sponselli S, Stefanizzi P, Caputi A, Gobba F, Modenese A, Casolari L, Garavini D, D'Elia C, Mariani S, Filon FL, Cegolon L, Negro C, Ronchese F, Rui F, De Michieli P, Murgia N, Dell'Omo M, Muzi G, Fiordi T, Gambelunghe A, Folletti I, Mates D, Calota VC, Neamtu A, Perseca O, Staicu CA, Voinoiu A, Fabiánová E, Bérešová J, Adamčáková ZK, Nedela R, Lesňáková A, Holčíková J, Boffetta P, Abedini M, Ditano G, Asafo SS, Visci G, Violante FS, Zunarelli C, and Verlato G
- Abstract
Background: The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers., Methods: A multicentric retrospective cohort study, involving 12 European centers, was carried out within the ORCHESTRA project, collecting data up to 18 November 2021 on fully vaccinated health workers. The cumulative incidence of SARS-CoV-2 breakthrough infections was investigated with its association with occupational and social-demographic characteristics (age, sex, job title, previous SARS-CoV-2 infection, antibody titer levels, and time from the vaccination course completion)., Results: Among 64,172 health workers from 12 European health centers, 797 breakthrough infections were observed (cumulative incidence of 1.2%). The primary analysis using individual data on 8 out of 12 centers showed that age and previous infection significantly modified breakthrough infection rates. In the meta-analysis of aggregated data from all centers, previous SARS-CoV-2 infection and the standardized antibody titer were inversely related to the risk of breakthrough infection ( p = 0.008 and p = 0.007, respectively)., Conclusion: The inverse correlation of antibody titer with the risk of breakthrough infection supports the evidence that vaccination plays a primary role in infection prevention, especially in health workers. Cellular immunity, previous clinical conditions, and vaccination timing should be further investigated.
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- 2022
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25. SARS-CoV-2 emergency in the workplace: are companies ready to protect their workers? A cross-sectional survey.
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Garzillo EM, Monaco MGL, Spacone A, Inglese E, Lamberti M, and Pompei D
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- Cross-Sectional Studies, Humans, Italy epidemiology, SARS-CoV-2, COVID-19 epidemiology, COVID-19 prevention & control, Occupational Health
- Abstract
Purpose. The SARS-CoV-2 pandemic has affected all aspects of everyday life worldwide, including the entire working sector. This study aims to evaluate the response capacity of some Italian companies to the emergency about workers' health and safety. Methods. Data were cross-sectional, collected by a specially drafted 19-item checklist sent to 60 enterprises located in the province of L'Aquila, Abruzzo, Italy. Results. Forty-one companies (68%) responded by filling in the checklist; more than 50% have fewer than 50 employees each and most of the companies belong to the food industry and the financial services. Adherence to the containment measures for the COVID-19 emergency was analysed, especially relating to job organization, social distancing, sanitization and specific training. Large enterprises and the banking sector showed ductile work reorganization according to the containment measures compared to small companies and the food sector. Conclusions. Italian companies have shown a good response to the regulatory restrictions resulting from the SARS-CoV-2 emergency. This is a worthy premise for the imminent management of Phase 2, with the progressive reopening of Italian companies.
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- 2022
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26. Returning to Work after the COVID-19 Pandemic Earthquake: A Systematic Review.
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Garzillo EM, Cioffi A, Carta A, and Monaco MGL
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- Humans, Pandemics, Return to Work, SARS-CoV-2, COVID-19 epidemiology, Earthquakes
- Abstract
Background: The ongoing SARS-CoV-2 pandemic has disrupted life and work habits and has produced landmark changes worldwide. This systematic review aimed to analyse the management of Return to Work (RTW) by work organisations following the virus spread., Methods: A selection of 2477 papers, using string research on PubMed, Embase, Web of Science and Scopus from January 2020 to October 2021, were analysed., Results: Fifty-one articles were finally included, and the results obtained were discussed from three different points of view. Twenty articles concerning 'Remodelling of Work Organization' proposed some model strategies for resumption to work. Twenty-one papers, including 'Clinical Evaluation of Workers', mostly explored the psychosocial impact of returned workers. Finally, twelve articles explored the best 'Testing Strategies related to RTW'. Despite the heterogeneity of included articles, several interesting approaches have emerged in managing RTW., Conclusions: The reported experiences could help to develop an RTW model for COVID-19 and future pandemics.
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- 2022
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27. Post-Vaccination SARS-CoV-2 Infections among Health Workers at the University Hospital of Verona, Italy: A Retrospective Cohort Survey.
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Porru S, Spiteri G, Monaco MGL, Valotti A, Carta A, Lotti V, Diani E, Lippi G, Gibellini D, and Verlato G
- Abstract
Background: The SARS-CoV-2 vaccination campaign began on 27 December 2020 in Europe, primarily involving health workers. This study aimed to assess the SARS-CoV-2 vaccination effectiveness, as assessed by reductions in incidence, symptom severity, and further infection spreading., Methods: A retrospective cohort study was conducted on 9811 health workers operating at the Verona University Hospital, Italy, from 27 December 2020 to 3 May 2021. All health workers were offered vaccination with Comirnaty (BNT162b2, BioNTech/Pfizer, Mainz, Germany/New York, United States), and a health surveillance program was implemented with periodical swab testing. Vaccination status and clinical data were collected using an ad hoc semi-structured questionnaire and health surveillance charts., Results: As of 3rd of May, 82.5% of health workers had been vaccinated against SAR-CoV-2, and 177 (1.8%) had tested positive for SARS-CoV-2. Vaccination more than halved the cumulative incidence of SARS-CoV-2 infection and reduced by two-thirds the cumulative incidence of symptomatic subjects. In detail, most unvaccinated HWs were symptomatic; 50% reported fever, 45% reported ageusia/anosmia, and nearly 20% reported dyspnea. These percentages were much lower in HWs who had been vaccinated for at least 14 days (18% for fever and anosmia, 6% for dyspnea and ageusia). Moreover, cases of vaccine breakthrough were sixfold less likely to further spread the infection than unvaccinated HWs., Conclusions: SARS-CoV-2 vaccination reduced the infection frequency among HWs, further spreading of the infection, and the presence, severity, and duration of COVID-19-related symptoms.
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- 2022
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28. SARS-CoV-2 Infection in Health Workers: Analysis from Verona SIEROEPID Study during the Pre-Vaccination Era.
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Porru S, Monaco MGL, Carta A, Spiteri G, Parpaiola M, Battaggia A, Galligioni G, Ferrazzi B, Lo Cascio G, Gibellini D, Peretti A, Brutti M, Tardivo S, Ghirlanda G, Verlato G, Gaino S, Peserico D, Bassi A, and Lippi G
- Subjects
- Antibodies, Viral, Humans, Immunoglobulin M, Italy epidemiology, Seroepidemiologic Studies, Vaccination, COVID-19, SARS-CoV-2
- Abstract
Background: To report the baseline phase of the SIEROEPID study on SARS-CoV-2 infection seroprevalence among health workers at the University Hospital of Verona, Italy, between spring and fall 2020; to compare performances of several laboratory tests for SARS-CoV-2 antibody detection., Methods: 5299 voluntary health workers were enrolled from 28 April 2020 to 28 July 2020 to assess immunological response to SARS-CoV-2 infection throughout IgM, IgG and IgA serum levels titration by four laboratory tests. Association of antibody titre with several demographic variables, swab tests and performance tests (sensitivity, specificity, and agreement) were statistically analyzed., Results: The overall seroprevalence was 6%, considering either IgG and IgM, and 4.8% considering IgG. Working in COVID-19 Units was not associated with a statistically significant increase in the number of infected workers. Cohen's kappa of agreement between MaglumiTM and VivaDiagTM was quite good when considering IgG only (Cohen's kappa = 78.1%, 95% CI 74.0-82.0%), but was lower considering IgM (Cohen's kappa = 13.3%, 95% CI 7.8-18.7%)., Conclusion: The large sample size with high participation (84.7%), the biobank and the longitudinal design were significant achievements, offering a baseline dataset as the benchmark for risk assessment, health surveillance and management of SARS-CoV-2 infection for the hospital workforce, especially considering the ongoing vaccination campaign. Study results support the national regulator guidelines on using swabs for SARS-CoV-2 screening with health workers and using the serological tests to contribute to the epidemiological assessment of the spread of the virus.
- Published
- 2021
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29. Tuberculosis Infection Screening in 5468 Italian Healthcare Students: Investigation of a Borderline Zone Value for the QFT-Test.
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Corvino AR, Monaco MGL, Garzillo EM, Grimaldi E, Donnarumma G, Miraglia N, Di Giuseppe G, and Lamberti M
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- Delivery of Health Care, Female, Humans, Italy epidemiology, Male, Mass Screening, Students, Health Personnel, Tuberculosis diagnosis, Tuberculosis epidemiology
- Abstract
Healthcare workers are at an increased risk of contracting Mycobacterium tuberculosis infection. Tuberculin skin test (TST) and interferon gamma release assay (IGRA) represent the available tests most used for the diagnosis of latent tuberculosis infection (LTBI). Different borderline zones have been proposed for defining conversions and reversions to improve the interpretation of the IGRA test results as part of serial testing. From 2012 to 2017, 5468 health students of an Italian University Hospital were screened for tuberculosis infection through the execution of the TST and, in case of positivity, of the QuantiFERON-TB
® Gold In-Tube assay (QFT-GIT). The QFT-GIT is considered "borderline" with values from 0.35 to 0.99 IU/mL. Among the students who performed the QFT-GIT assay, 27 subjects presented a range of values defined as borderline. The QFT-GIT was repeated after 90 days on 19 subjects with borderline values and showed a negativization of the values in 14 students and a positive conversion in three cases, while for two students, a borderline value was also found for the second test, with a 74% regression of the borderline cases. The introduction of QuantiFERON borderline values is a useful assessment tool to bring out LTBI case candidates for chemoprophylaxis.- Published
- 2020
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30. Anti-X Apron Wearing and Musculoskeletal Problems Among Healthcare Workers: A Systematic Scoping Review.
- Author
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Monaco MGL, Carta A, Tamhid T, and Porru S
- Subjects
- Adult, Case-Control Studies, Cross-Sectional Studies, Ergonomics, Female, Humans, Male, Middle Aged, Health Personnel, Musculoskeletal Diseases epidemiology, Musculoskeletal Diseases prevention & control, Occupational Diseases epidemiology, Occupational Diseases prevention & control
- Abstract
Interventional radiology activities and other medical practices using ionising radiation have become increasingly prevalent. In this context, the use of anti-X aprons, in association with awkward postures and non-ergonomic working conditions, might cause the onset of musculoskeletal disorders (MSDs). This research aims to evaluate the evidence about the correlation between wearing anti-X aprons and work-related MSDs. A systematic scoping review of articles published between 1990 and 2020 was conducted by searching the PubMed, Scopus, Embase, and Web of Science databases. Twelve cross-sectional studies, conducted among interventional physicians, nurses, and technicians, were finally included. Five studies primarily investigated the association between use of anti-X aprons and MSDs, showing that a higher prevalence of disorders was not always associated with the use of protective aprons. No studies investigated the impact of anti-X aprons on fitness for work assessment, particularly in subjects with MSDs. There is no complete agreement about the correlation between anti-X apron-wearing and the occurrence of MSDs, although the possible discomfort of workers using anti-X aprons appears more evident. Further studies are needed to objectify the role of these protective devices in the genesis of MSDs and to offer specific ergonomic solutions for healthcare workers.
- Published
- 2020
- Full Text
- View/download PDF
31. Health Surveillance and Response to SARS-CoV-2 Mass Testing in Health Workers of a Large Italian Hospital in Verona, Veneto.
- Author
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Porru S, Carta A, Monaco MGL, Verlato G, Battaggia A, Parpaiola M, Lo Cascio G, Pegoraro M, Militello V, Moretti F, and Tardivo S
- Subjects
- Adult, Betacoronavirus, COVID-19, Coronavirus Infections epidemiology, Coronavirus Infections virology, Female, Humans, Incidence, Italy epidemiology, Male, Pandemics, Pneumonia, Viral epidemiology, Pneumonia, Viral virology, Polymerase Chain Reaction, Risk Assessment, SARS-CoV-2, Coronavirus Infections diagnosis, Mass Screening methods, Personnel, Hospital, Pneumonia, Viral diagnosis
- Abstract
Italy presented the first largest COVID-19 outbreak outside of China. Veneto currently ranks fourth among the Italian regions for COVID-19 confirmed cases (~19,000). This study presents health surveillance data for SARS-CoV-2 in 6100 health workers (HW) employed in a large public hospital. Workers underwent oropharyngeal and nasopharyngeal swabs, with a total of 5942 participants (97.5% of the population). A total of 11,890 specimens were tested for SARS-CoV-2 infection using PCR, identifying the viral genes E, RdRP, and N. Positive tests were returned for 238 workers (cumulative incidence of 4.0%, similar in both COVID and nonCOVID units). SARS-CoV-2 risk was not affected by gender, age, or job type, whereas work setting and occupation were both predictors of infection. The risk was higher in medical wards (OR 2.7, 95% CI 1.9-3.9) and health services (OR 4.3, 95% CI 2.4-7.6), and lower in surgical wards and administration areas. To our knowledge, this study represents the largest available HW case list swab-tested for SARS-CoV-2, covering almost the total workforce. Mass screening enabled the isolation of HW, improved risk assessment, allowed for close contacts of and infected HW to return to work, provided evidence of SARS-CoV-2 diffusion, and presented solid ground to prevent nosocomial SARS-CoV-2 infections. The ongoing concurrent sero-epidemiological study aims to enable the improvement of health surveillance to maintain the safety of HWs and the communities they serve.
- Published
- 2020
- Full Text
- View/download PDF
32. Healthcare Workers and Manual Patient Handling: A Pilot Study for Interdisciplinary Training.
- Author
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Garzillo EM, Monaco MGL, Corvino AR, D'Ancicco F, Feola D, Della Ventura D, Miraglia N, and Lamberti M
- Subjects
- Humans, Italy, Pilot Projects, Health Personnel, Moving and Lifting Patients, Occupational Health
- Abstract
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-section one; physical therapy-section two; psychosocial section-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.
- Published
- 2020
- Full Text
- View/download PDF
33. HBV vaccination status among healthcare workers: A cross-sectional study.
- Author
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Garzillo EM, Arnese A, Coppola N, Corvino A, Feola D, Monaco MGL, Signoriello G, Marsella LT, Arena P, and Lamberti M
- Abstract
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., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2019.)
- Published
- 2020
- Full Text
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34. Work-related upper limb disorders and risk assessment among automobile manufacturing workers: A retrospective cohort analysis.
- Author
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Monaco MGL, Uccello R, Muoio M, Greco A, Spada S, Coggiola M, Pedata P, Caputo F, Chiodini P, and Miraglia N
- Subjects
- Adult, Automobiles, Biomechanical Phenomena, Cohort Studies, Ergonomics methods, Female, Humans, Longitudinal Studies, Male, Middle Aged, Retrospective Studies, Risk Assessment, Upper Extremity, Manufacturing Industry statistics & numerical data, Musculoskeletal Diseases epidemiology, Occupational Diseases epidemiology
- Abstract
Objective: To estimate the three-year cumulative risk of work-related upper limb disorders (WRULDs) in a cohort of automotive industry workers and to provide a first test of the ability of the European Assembly Worksheet (EAWS) methodology to predict WRULDs., Methods: 292 workers were investigated by reviewing workers' medical records during the period from 2012-2015 to determine their exposure to biomechanical overload according to EAWS risk scores (0-25, low risk, Green zone; 26-50, medium risk, Yellow zone; >50, High risk; Red zone)., Results: The risks were 0.83%, 5.71%, and 11.88% for the Control (unexposed), Green and Yellow Groups, respectively. Only the comparison between the Yellow/Control Groups was significant (p = 0.0014). In total, we observed 17 cases of musculoskeletal disorders (MSDs) (14 symptomatic and 3 cases detected by physical examination)., Conclusions: The EAWS is a useful tool for the preliminary risk assessments of biomechanical overload among automotive industry workers. The finding of mainly non-specific disorders highly suggests that health surveillance should aim to identify not only full-blown diseases but also symptomatic cases.
- Published
- 2019
- Full Text
- View/download PDF
35. Tuberculin skin test and Quantiferon test agreement and influencing factors in tuberculosis screening of healthcare workers: a systematic review and meta-analysis.
- Author
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Lamberti M, Uccello R, Monaco MGL, Muoio M, Feola D, Sannolo N, Nienhaus A, and Chiodini P
- Abstract
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.
- Published
- 2015
- Full Text
- View/download PDF
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