Search

Theoretical background. The link between well-being at work and leadership relationships has received considerable attention in the literature. However, these two topics have become more crucial for healthcare workers, considering the pandemic. The study is an investigation of leadership and its effects on work well-being, that considers both parties in the relationship, i.e., leaders and followers, and a fundamental characteristic of leaders that impacts on how they enact leadership, i.e., leader identity. Drawing on the Crossover model (Westman, 2001), this study investigates whether leaders’ work-related positive attitudes (i.e., work engagement) cross over to followers’ positive attitudes (i.e., job satisfaction) through the latter’s perception of transformational leadership. In addition, the study analyzes whether leader identity acts as a personal resource (Job Demands-Resources theory; Bakker & Demerouti, 2017) for leaders increasing their work engagement. Methodology. The study has a multilevel cross-sectional design that involves nurse managers and their nurses in four Italian hospitals. Questionnaires were administered paper-and-pencil, and care was taken in matching nurses’ questionnaires with their nurse managers’ questionnaires to guarantee the formers’ anonymity and confidentiality of the data collected. First, using SPSS, we performed a multiple hierarchical regression with leader identity and other personal and job resources on work engagement in a sample of 156 nurse managers. We then tested a multilevel mediation using Mplus8, to investigate leaders’ work engagement crossover to followers’ job satisfaction using a sample of 1505 nurses divided into 156 teams. Results. 1) Leader identity acts as a personal resource for leaders by increasing nurse managers’ work engagement even after controlling for a number of other classical antecedents of work engagement (i.e., occupational self-efficacy, independence at work, role clarity; Bakker & Demerouti, 2017); 2) Nurse managers’ work engagement crosses over to nurses’ job satisfaction through transformational leadership. There is also a significant indirect effect from leaders’ leader identity to followers’ perception of transformational leadership via leaders’ work engagement. Conclusions. The analysis of crossover presented adds something new to the literature, since this is the first time to our knowledge that crossover from leaders’ work engagement to followers’ job satisfaction through transformational leadership has been tested. Future studies could add moderators or compare this model with a dyadic one analyzing pairs of nurse managers and nurses. Leaders’ leader identity is a significant antecedent for outcomes linked to leaders’ well-being and motivation at work. Leaders’ work engagement shows its powerful impact on followers, bearing out the importance of supporting leaders’ work motivation. This model offers a number of suggestions to improve leaders’ training that can “cross over” their benefits to the leader’s team. This study adds the important leadership construct of leader identity to the leaders’ and followers’ well-being process. In addition, even though positive crossover between leaders and followers had already been tested (see Gutermann et al., 2017), this model shows some meaningful differences in terms of the variables considered.

Background: Descriptive epidemiology identifies associations between environmental exposures and health effects that require results from methodologically stronger studies before causation can be considered. Objective: To critically review the methodology and results of Sentieri, a descripitive study on residence in areas with one or more industrial source of pollution. Methods: We systematically reviewed the literature quoted by Sentieri for the selection of health effects of nine types of pollution sources of a-priori interest. We also reviewed and meta-analyzed the results of the first report of Sentieri, that analyzed mortality in 44 polluted sites (PS), and 17 causes of deaths during 1995-2002. Results: Among 159 study results quoted by Sentieri, 23.9 % were supportive of an association between residence near a pollution source and a health effect, 30.2 % were partially supportive, 10.7 % were not supportive, and 35.2 % were not relevant. Among 653 standardized mortality ratios for associations between PS-specific pollution sources and causes of death, 14.4% were significantly above 1.02, and 9.0% were significantly below 0.98. Among 48 meta-analysis, seven were significantly above 1.0, including five on exposure to asbestos. Conclusions: Sentieri exemplifies the limitations of descriptive environmental epidemiology studies, in which most hypotheses have limited prior support, most results do not show associations, data on potential confounders and other sources of bias are not available. Such studies tend to replicate well-known associations and occasionally can identify critical situations requiring more investigation, but cannot be used to infer causality either in general or in specific circumstances.

BackgroundHealthcare workers (HCW) are at increased risk of being infected with SARS-CoV-2, yet limited information is available on risk factors of infection.MethodsWe pooled data on occupational surveillance of 10,654 HCW who were tested for SARS-CoV-2 infection in six Italian centers. Information was available on demographics, job title, department of employment, source of exposure, use of personal protective equipment (PPE), and COVID-19-related symptoms. We fitted multivariable logistic regression models to calculate odds ratios (OR) and 95% confidence intervals (CI).FindingsThe prevalence of infection varied across centers and ranged from 3.0% to 22.0%, being strongly correlated with that of the respective areas. Women were at lower risk of infection compared to men. Fever, cough, dyspnea and malaise were the symptoms most strongly associated with infection, together with anosmia and ageusia. No differences in the risk of infection were detected between job titles, or working in a COVID-19 designated department. Reported contact with a patient inside or outside the workplace was a risk factor. Use of a mask was strongly protective against risk of infection as was use of gloves. The use of a mask by the source of exposure (patient or colleague) had an independent effect in reducing infection risk.

Purpose: We report a case of a 30 years old Indian sailor with microcytic anemia (Hb 9.9), persistent abdominal pain, emesis, dark stool, hyperchromic urine, latent jaundice and asthenia. Lead intoxication was confirmed (blood lead value of 102 µg/dL). The patient assumed Ayurvedic medicines in the previous months. Ayurveda is an ancient form of Indian traditional popular medicine aiming to re-establish health and body function through herbal preparations, heavy metals are often added. Our purpose was to treat the patient and to establish the source of poisoning. Methods: After testing blood and urine lead concentration of other 3 crew members and analyzing over than 150 products used on the ship professional exposure was excluded. We analyzed the two Ayurvedic drugs assumed by the patient with an Inductively Coupled Plasma Mass Spectrometry. The patient underwent three chelation cycles with Calcium Disodium Ethylenediaminetetraacetic acid (EDTA) while monitoring blood and urinary lead levels. Results: The final blood lead level at discharge, after three chelation cycles, was 36.27 µg/dL. One of the two drugs contained extremely high concentrations of lead and mercury. The three different mixtures of this preparation showed lead concentrations of 12,638.54 mg/kg (Sample 2A), 23,043.02 mg/kg (Sample 2B), 21,352.97 mg/kg (Sample 2C); these levels are much higher than the highest values reported in literature for the indian soil (32 mg/kg). Conclusions: This case and similar cases raise the safety alert on complementary and alternative medicines; Ayurvedic medicine users should be carefully informed about potential risks and signs of poisoning.

Background: Severe Acute Respiratory Syndrome - Coronavirus – 2 (SARS-CoV-2) is a virus, primarily transmitted through droplets, able to persist on different surfaces and in the air for several hours. During the COVID-19 pandemic, Health Care Workers should be considered a high risk profession. Beside social distancing rules and the proper use of Personal Protective Equipment, sanitization measures and ventilation system disinfection are essential to reduce viral transmission. Objectives: This is the first Italian study aiming to assess the magnitude of environmental contamination in a COVID-19 non-Intensive Care Unit. Methods: In addition to ordinary cleaning procedures, surface and air samplings have been performed before and after the application of two different sanitization devices. Samples have been analyzed with Real Time-Polymerase Chain Reaction in order to find viral RNA. Results: All samples obtained from surfaces and air before and after extra-ordinary sanitization procedures turned out negative for viral detection. Discussion: These findings highlight the efficiency of ordinary cleaning procedures in guaranteeing a safer workplace. The adoption of additional sanitization protocols should be considered in order to further reduce environmental viral contamination.

The Position Paper (PP) on asbestos of the Italian Society of Occupational Medicine (SIML) aims at providing a tool to the occupational physician to address current diagnostic criteria and results of epidemiological studies, and their consequences in terms of preventive and evaluation actions for insurance, compensation and litigation. The PP was based on an extensive review of the scientific literature and was compiled by a Working Group comprising researchers who have contributed to the international literature on asbestos-related diseases, as well as occupational physicians with extensive experience in the evaluation of risks and the medical surveillance of workers currently and formerly exposed to asbestos. The PP was drafted and reviewed between 2017 and 2018; its final version was prepared according to the guidelines of AGREE Reporting Checklist. All the members of the Working Group subscribed to the document, which was eventually approved by SIML’s Executive Committee. The first section addresses industrial hygiene issues, such as methods for environmental monitoring, advantages and limitations of different microscopy techniques, the potential role of microfibers and approaches for retrospective assessment of exposure, in particular in epidemiological studies. The second section reviews the biological effects of asbestos with particular attention to the diagnostic aspects of asbestosis, pleural changes, mesothelioma and lung cancer. In the following section the criteria of causal attribution are discussed, together with different hypotheses on the form of the risk functions, with a comparison of the opinions prevalent in the literature. In particular, the models of the risk function for mesothelioma were examined, in the light of the hypothesis of an acceleration or anticipation of the events in relation to the dose. The last section discusses topics of immediate relevance for the occupational physician, such as health surveillance of former exposed and of workers currently exposed in remediation activities.

Background: Soft tissue sarcoma (STS) is a heterogeneous group of rare neoplasms whose aetiology is largely unknown. Dioxin and dioxin-like compounds, including 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD) and polychlorinated biphenyls (PCBs), are potential risk factors for STS. Objectives: To investigate the relation of 17 PCBs congeners, assessed in human plasma, with STS risk. Methods: We conducted a case-control study in Italy, including 52 STS cases and 99 hospital-based controls. Selected PCB were extracted by high-performance liquid chromatography (HPLC) and measured with gas chromatography-mass spectrometry (GC-MS). Odds ratios (OR), and the corresponding 95% confidence intervals (CI), were estimated through multivariate logistic regression models. Results: The most frequently detected PCB congeners were 138, 170, 180 and 149 (detected in 40-77% of controls). The OR for the sum of all 17 PCB congeners was 1.20 (95% CI 0.50-2.92). In categorical analysis no consistent association was found for individual congeners and for groups based on Wolff ’s classification or the degree of chlorination. For continuous estimates, borderline positive associations emerged for Wolff ’s groups 2A (OR 1.23, 95% CI 0.97-1.55), 2B (OR 1.34, 95% CI 1.00-1.77, and 3 (OR 1.19, 95% CI 0.96-1.49), for moderately (OR 1.20, 95% CI 0.96-1.51) and highly (OR 1.18, 95% CI 0.99-1.41) chlorinated PCBs, and for congeners 170 (OR 1.26, 95% CI 0.98-1.63), 180 (OR 1.26, 95% CI 0.97-1.64) and 138 (OR 1.45, 95% CI 1.02-2.04). Discussion: Most associations between PCBs and STS risk were not significant, but, given the limited sample size, we cannot exclude moderate associations.

Il Position Paper SIML dedicato all’asbesto si propone di offrire uno strumento che consenta al Medico Competente un rapido orientamento sui criteri diagnostici attuali e sui risultati della ricerca epidemiologica con le conseguenti indicazioni per l’azione preventiva e di valutazione in contesti previdenziali, assicurativi e medico-legali. Par- tendo da una ampia revisione della letteratura scientifica in argomento e, nel corso delle riunioni del Gruppo di lavoro, costituito sia da ricercatori che hanno fornito un apporto di livello internazionale sul tema delle patologie asbesto-correlate sia da Medici del Lavoro con ampia esperienza nella valutazione del rischio e nella sorveglianza sanitaria di esposti ed ex-esposti ad amianto, sono stati discussi tra il 2017 ed il 2018 i diversi argomenti trattati con ampie e ripetute revisioni del testo. La versione definitiva è stata sottoposta alla valutazione abituale per le Linee Guida secondo lo standard metodologico AGREE. Il documento, su cui si è registrato l’unanime consenso del Gruppo di Lavoro ed è stato successivamente approvato dal Direttivo Nazionale della Società, si articola in alcune principali sezioni. La prima riguarda gli argomenti propri dell’Igiene Industriale quali le metodiche per il monitoraggio ambientale, i vantaggi e i limiti delle tecniche microscopiche disponibili, il potenziale ruolo delle mi- crofibre e gli approcci per la valutazione retrospettiva dell’esposizione, specialmente a fini epidemiologici. La secon- da gli effetti biologici da amianto con particolare attenzione agli aspetti diagnostici dell’asbestosi, delle alterazioni pleuriche, del mesotelioma e del tumore del polmone. La terza i criteri di attribuzione causale e discusse le diverse ipotesi sulla forma delle funzioni di rischio, vengono confrontate le principali posizioni al riguardo disponibili in letteratura. In particolare sono stati approfonditi i modelli della funzione di rischio per il mesotelioma ed affron- tato il tema dell’ipotesi di un effetto acceleratore e anticipazione della frequenza degli eventi in relazione alla dose. Infine sono stati trattati gli argomenti di attualità applicativa per il Medico Competente quali la sorveglianza sanitaria degli ex esposti ad amianto e di quella degli operatori attualmente esposti in attività di bonifica.

No abstract available.

Questo documento è stato predisposto da un gruppo di lavoro del Collegio dei Docenti Universitari della Società Italiana di Medicina del Lavoro e Igiene Industriale, con lo scopo di definire il ruolo di questa disciplina nel Corso di Laurea in Tecniche della Prevenzione nell'Ambiente e nei Luoghi di Lavoro. Il Corso di Laurea in Tecniche della Prevenzione nell' Ambiente e nei Luoghi di Lavoro forma un laureato in grado di applicare i criteri valutativi, le misure preventive e gli strumenti legislativi per l'igiene e la sicurezza nei luoghi di vita e di lavoro l’igiene degli alimenti e delle bevande e l’igiene e la sanità pubblica e veterinaria. Il documento descrive l'organizzazione e la struttura del corso, gli obiettivi formativi generali e specifici, l'insegnamento di Medicina del Lavoro e alcuni altri aspetti organizzativi. Viene infine affrontato il problema della formazione dei Tecnici della Prevenzione nell'Ambiente e nei Luoghi di Lavoro non laureati in servizio presso le Aziende Sanitarie.

We previously investigated bladder cancer risk in a cohort of dyestuff workers who were heavily exposed to aromatic amines from 1922 through 1972. We updated the follow-up by 14 years (through 2003) for 590 exposed workers to include more than 30 years of follow-up since last exposure to aromatic amines. Expected numbers of deaths from bladder cancer and other causes were computed by use of national mortality rates from 1951 to 1980 and regional mortality rates subsequently. There were 394 deaths, compared with 262.7 expected (standardized mortality ratio = 1.50, 95% confidence interval = 1.36 to 1.66). Overall, 56 deaths from bladder cancer were observed, compared with 3.4 expected (standardized mortality ratio = 16.5, 95% confidence interval = 12.4 to 21.4). The standardized mortality ratio for bladder cancer increased with younger age at first exposure and increasing duration of exposure. Although the standardized mortality ratio for bladder cancer steadily decreased with time since exposure stopped, the absolute risk remained approximately constant at 3.5 deaths per 1000 man-years up to 29 years after exposure stopped. Excess risk was apparent 30 years or more after last exposure. © 2010 The Author. Published by Oxford University Press. All rights reserved.

OBJECTIVE: To examine cancer mortality in continuous glass filament workers. METHODS: A cohort of 936 continuous glass filament workers employed in a plant from northern Italy since January 1976 was followed-up through December 2003, for a total of 19,987 man-years. RESULTS: Overall, 144 deaths were observed compared with 160.8 expected based on regional death rates (standardized mortality ratio [SMR] = 0.90, 95% CI = 0.76 to 1.05). There were 53 deaths from all cancers (SMR = 1.01, 95% CI = 0.75 to 1.32), and 21 from lung cancer (SMR = 1.23, 95% CI = 0.76 to 1.89). There was no consistent relation with risk for age at first employment, time since first or last employment, or duration of employment for any of the causes considered. CONCLUSIONS: Although limited in size, this study provides no evidence that continuous glass filament workers experience a significant increased risk of cancer, including respiratory cancer. ©2009The American College of Occupational and Environmental Medicine.

Cold storage is a well-known strategy to limit concerns about seasonality for sheep dairy productions. The aim of this study was to investigate the effect of long-term freezing on milk renneting properties from the Sarda sheep, an autochthonous breed from Italy. Two-hundred milk samples from 50 pluriparous Sarda ewes were collected at monthly intervals throughout the lactation from April to July. Each sample of fresh milk was analysed for composition and subsamples were obtained and frozen for one, three and five months. Renneting properties, both from the fresh and frozen subsamples, were achieved using the Formagraph instrument and results were submitted to a mixed model statistical analysis. The storage effect significantly affected (P