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We analysed the impact of several strategies aimed at increasing influenza immunisation rates among Medical Residents (MRs) of an Italian teaching Hospital. During the 2015–16 and 2016–17 influenza seasons we carried out several interventions: ambulatory doubling where vaccination was offered, ambulatory opening hour extension, email invitations, informative materials, forum theatre and vaccination campaign conference. In addition, during the 2016–17 the OSV was carried out: MRs who go to specific wards where they perform influenza immunisation counselling and eventually vaccinate the personnel. 99/1041 (9.5%) and 184/1013 (18.2%) MRs received the vaccine in 2015–16 and in 2016–17 respectively (p < 0.0001). Significant difference was found among three specialisation areas (medicine, surgery, “services”; p < 0.001) and among years of residency (p < 0.001). The highest coverage was found among Infectious Diseases, Paediatrics, Haematology and Hygiene MRs (80%, 67%, 52% and 52% respectively) in 2016–2017 season. The highest coverage increase was found among MRs in Pneumology and Geriatrics (566% and 268%, respectively). The coverage rate has increased even though important differences among specialties persist. The study shows a significant increase in immunisation rate among MRs after the implementation of these strategies.

We analysed the impact of several strategies aimed at increasing influenza immunisation rates among Medical Residents (MRs) of an Italian teaching Hospital. During the 2015–16 and 2016–17 influenza seasons we carried out several interventions: ambulatory doubling where vaccination was offered, ambulatory opening hour extension, email invitations, informative materials, forum theatre and vaccination campaign conference. In addition, during the 2016–17 the OSV was carried out: MRs who go to specific wards where they perform influenza immunisation counselling and eventually vaccinate the personnel. 99/1041 (9.5%) and 184/1013 (18.2%) MRs received the vaccine in 2015–16 and in 2016–17 respectively (p < 0.0001). Significant difference was found among three specialisation areas (medicine, surgery, “services”; p < 0.001) and among years of residency (p < 0.001). The highest coverage was found among Infectious Diseases, Paediatrics, Haematology and Hygiene MRs (80%, 67%, 52% and 52% respectively) in 2016–2017 season. The highest coverage increase was found among MRs in Pneumology and Geriatrics (566% and 268%, respectively). The coverage rate has increased even though important differences among specialties persist. The study shows a significant increase in immunisation rate among MRs after the implementation of these strategies.

Salute e sicurezza sul lavoro dei lavoratori anziani

Inappropriate lighting is one of the most common causes of visual disturbances in office workers. Visual demand can also lead to musculoskeletal problems such as tension neck syndrome. On the other hand, appropriate location of light sources and a suitable level of illumination can enhance visual capacity. A rational approach to visual risk assessment of tasks and workstations involves measurements in the occupational visual field, and in particular luminance measurement. We report a large scale photometric evaluation in six companies in northern and central Italy. Operator tasks were predominantly administrative with some computer aided design activity. Occupational visual field luminance ratios were found to be excessively high (>1:250 cd/m2) in 19% of workstations (n = 100), moderately high (1:100-1:250 cd/m2) in 20% and considered satisfactory (<1:100 cd/ m2) in 61%. Illuminance in the working plane ranged from 100-2500 lux and correlated poorly with luminance. Parameters were highly dependent on light fitting position and window location. The survey demonstrated shortcomings in lighting design and workstation layout, both from artificial and natural sources. It is recommended that photometric assessment incorporate both luminance (occupational visual field) and illuminance measurements

Introduzione: Con l’entrata in vigore delle disposizioni di cui al Capo V del Titolo VIII del D.Lgs. 81/08 viene ad essere garantita dal legislatore la piena tutela della sicurezza e della salute dei lavoratori esposti a radiazioni ottiche artificiali (ROA). Obiettivi e metodi: Gli autori prendono in esame, sulla base dei dati della letteratura sull’argomento, gli effetti sulla salute conseguenti all’esposizione occupazionale a ROA. Risultati: Le patologie croniche correlate con esposizione a ROA nel range dello spettro fra 220 e 310 nm (UV) sono rappresentate da congiuntiviti e cheratocongiuntiviti croniche. Le patologie oncologiche della cute correlabili con l’esposizione a RUV sono rappresentate dai carcinomi cutanei basocellulari e spinocellulari e dai melanomi cutanei. L’effetto biologico delle radiazioni ottiche infrarosse (lunghezza d’onda compresa fra 780 nm e 1 mm) è essenzialmente di natura termica. L’esposizione a luce blu (lunghezza d’onda compresa fra 380 e 550 nm) causa danni esclusivamente retinici ed è considerata responsabile dello sviluppo di quadri di Degenerazione Maculare Senile (AMD). Pur in presenza di dati sperimentali di laboratorio, non esistono tuttavia al momento dati epidemiologici che documentino i danni retinici da luce blu. Conclusioni: Nello studio vengono illustrati i criteri medico-legali per lo studio del nesso di causalità fra esposizione professionale a ROA e danno, nonché la metodologia e i momenti procedurali necessari per l’iter valutativo. Vengono quindi presi in esame gli elenchi delle malattie professionali attribuite all’esposizione a ROA presenti nel DM9 aprile 2008 e nel DM13 dicembre 2009. Infine gli autori propongono, sulla base di Linee Guida e dati della letteratura scientifica sull’argomento, protocolli di sorveglianza sanitaria per la tutela della salute dei lavoratori esposti al rischio specifico., «Occupational diseases caused by artificial optical radiations (AOR)». Background: Italian national legislation guarantees safety and health for workers exposed to Artificial Optical Radiations (AOR) by Legislative Decree 81/2008. Objectives and methods: Effects and damages to health resulting from AOR exposure were analyzed from literature data. Results: Ultraviolet Radiations (UV), particularly those in the wavelength range between 220 and 310 nm, causes chronic conjunctivitis and kerato-conjunctivitis. Skin cancer caused by UV exposure included Basal Cell Carcinoma, Squamous Cell Carcinoma and Melanoma. As regards Infrared Radiations (portion of the spectrum between 780 nm and 1 mm), the biological effect is essentially of thermal nature. Exposure to Blue Light (portion of the spectrum of visible light radiation in a wavelength range between 380 and 550 nm) causes exclusively retinal damage and is considered to be responsible for the development of situations of Age-relatedMacular Degeneration (AMD). Even if experimental data are available, at the present time there is still no epidemiological evidence of retinal damage caused by blue light. Conclusions: The forensic criteria for investigating the causality link between occupational exposure to AOR and damage, and the methodology necessary for the assessment process, are reported.Two lists of occupational diseases which were included in the ItalianMinisterial Decrees, issued respectively on April 2008 and 11 December 2009, are also considered. Lastly, on the basis of the current existing guidelines and scientific evidence, the authors propose occupational health surveillance protocols for workers exposed to AOR risk.

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