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Gariazzo C, Taiano L, Bonafede M, Leva A, Morabito M, De' Donato F, Marinaccio A. Association between extreme temperature exposure and occupational injuries among construction workers in Italy: An analysis of risk factors. ENVIRONMENT INTERNATIONAL 2023; 171:107677. [PMID: 36495676 DOI: 10.1016/j.envint.2022.107677] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/10/2022] [Accepted: 12/03/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND/AIM Extreme temperatures have impact on the health and occupational injuries. The construction sector is particularly exposed. This study aims to investigate the association between extreme temperatures and occupation injuries in this sector, getting an insight in the main accidents-related parameters. METHODS Occupational injuries in the construction sector, with characteristic of accidents, were retrieved from Italian compensation data during years 2014-2019. Air temperatures were derived from ERA5-land Copernicus dataset. A region based time-series analysis, in which an over-dispersed Poisson generalized linear regression model, accounting for potential non-linearity of the exposure- response curve and delayed effect, was applied, and followed by a meta-analysis of region-specific estimates to obtain a national estimate. The relative risk (RR) and attributable cases of work-related injuries for an increase in mean temperature above the 75th percentile (hot) and for a decrease below the 25th percentile (cold) were estimated, with effect modifications by different accidents-related parameters. RESULTS The study identified 184,936 construction occupational injuries. There was an overall significant effect for high temperatures (relative risk (RR) 1.216 (95% CI: (1.095-1.350))) and a protective one for low temperatures (RR 0.901 (95% CI: 0.843-0.963)). For high temperatures we estimated 3,142 (95% CI: 1,772-4,482) attributable cases during the studied period. RRs from 1.11 to 1.30 were found during heat waves days. Unqualified workers, as well as masons and plumbers, were found to be at risk at high temperatures. Construction, quarry and industrial sites were the risky working environments, as well as specific physical activities like working with hand-held tools, operating with machine and handling of objects. Contact with sharp, pointed, rough, coarse 'Material Agent' were the more risky mode of injury in hot conditions. CONCLUSIONS Prevention policies are needed to reduce the exposure to high temperatures of construction workers. Such policies will become a critical issue considering climate change.
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Affiliation(s)
- Claudio Gariazzo
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy.
| | - Luca Taiano
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Antonio Leva
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Marco Morabito
- CNR-IBE, National Research Council of Italy, Institute of Bioeconomy, Sesto Fiorentino (Florence), Italy
| | - Francesca De' Donato
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
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Alangari HM, Alrashed AM. Analytical illustration of occupational injuries between 2019 and 2020 in the Kingdom of Saudi Arabia. Work 2022; 74:1563-1576. [PMID: 36530120 DOI: 10.3233/wor-211424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND: In recent times, Saudi Arabia has experienced growing industrialisation and more opportunities for business requires more human capital if it is to become one of the largest economies in the world and Such growth brings with it some health issues. OBJECTIVE: The study aimed to provide analytical illustration of occupational injuries among the workforce in Saudi Arabia. To accomplish the study purpose, four measurements were carried out, the occurrence of occupational injuries, the severity of occupational injuries, the patterns in occupational injuries, and the occupational injuries in relation to the demography of the injured employees. METHODS: A retrospective study was designed based on a secondary data of occupational injuries(OI) that was obtained from The General Organization for Social Insurance. Descriptive analysis was used to describe the occurrence and the outcome of OI. Multivariate regression was applied to the patterns in OI and to those injuries in relation to the demography of the injured employees. RESULTS: Within two years, Riyadh Province had the highest occurrence of OI (30.6%). Construction and Elementary occupations had the highest occurrence of OI (36.3%, and 45.7% respectively). Injuries’ occurrence differed significantly between months. Fridays significantly associated with low injuries. Among demography, injuries differed significantly in relation to the employees’ age. CONCLUSIONS: There was no noticeable decrease in death cases from an earlier local study while they were less compared to other nations (Turkey and South Korea). Compared to other nation, Islamic holidays that are characterized by heat waves were not associated with increased OI. Preventive measures are insufficient.
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Affiliation(s)
- Hessa M. Alangari
- College of Business Administration, King Saud University, Riyadh, Saudi Arabia
| | - Abeer M. Alrashed
- College of Business Administration, King Saud University, Riyadh, Saudi Arabia
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Dethlefsen R, Orlik L, Müller M, Exadaktylos AK, Scholz SM, Klukowska-Rötzler J, Ziaka M. Work-Related Injuries among Insured Construction Workers Presenting to a Swiss Adult Emergency Department: A Retrospective Study (2016-2020). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811294. [PMID: 36141566 PMCID: PMC9517430 DOI: 10.3390/ijerph191811294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 06/02/2023]
Abstract
Occupational injuries are one of the main causes of Emergency Department visits and represent a substantial source of disability or even death. However, the published studies and reports on construction-occupational accidents in Switzerland are limited. We aimed to investigate the epidemiology of fatal and non-fatal injuries among construction workers older than 16 years of age over a 5-year period. Data were gathered from the emergency department (ED) of Bern University Hospital. A retrospective design was chosen to allow analysis of changes in construction accidents between 2016-2020. A total of 397 patients were enrolled. Compared to studies in other countries, we also showed that the upper extremity and falling from height is the most common injured body part and mechanism of injury. Furthermore, we were able to show that the most common age group representing was 26-35 years and the second common body part injured was the head, which is a difference from studies in other countries. Wound lacerations were the most common type of injury, followed by joint distortions. By stratifying according to the season, occupational injuries among construction workers were found to be significant higher during summer and autumn. As work-related injuries among construction workers are becoming more common, prevention strategies and safety instructions must be optimized.
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Affiliation(s)
- Ralf Dethlefsen
- Department of Orthopedics, Thun General Hospital, 3600 Thun, Switzerland
| | - Luisa Orlik
- Department of Internal Medicine, Thun General Hospital, 3600 Thun, Switzerland
| | - Martin Müller
- Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern University, 3010 Berne, Switzerland
| | - Aristomenis K. Exadaktylos
- Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern University, 3010 Berne, Switzerland
| | - Stefan M. Scholz
- Department of Statistics, Suva (Swiss National Accident Insurance Fund), 6002 Lucerne, Switzerland
- Central Office for Statistics in Accident Insurance (SSUV), 6002 Lucerne, Switzerland
| | - Jolanta Klukowska-Rötzler
- Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern University, 3010 Berne, Switzerland
| | - Mairi Ziaka
- Department of Internal Medicine, Thun General Hospital, 3600 Thun, Switzerland
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Jawarneh S, Talib WH. Combination of Ashwagandha Water Extract and Intermittent Fasting as a Therapy to Overcome Cisplatin Resistance in Breast Cancer: An in vitro and in vivo Study. Front Nutr 2022; 9:863619. [PMID: 35859750 PMCID: PMC9290527 DOI: 10.3389/fnut.2022.863619] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Breast cancer is considered a universal public health dilemma in women. Due to the high toxicity and low selectivity of conventional anticancer therapies, there is a growing trend of using plant-derived natural products in cancer prevention and therapy. Ashwagandha (Withania somnifera, WS) has been used in the Mediterranean region and Ayurvedic medicine for millennia as a functional food and a medicinal plant with anticancer activity. Besides, intermittent fasting (IF) has been engaged recently in cancer treatment. Hence, the combination of WS and IF provides possible solutions to treat cancer and reduce chemoresistance when combined with chemotherapy. In this study, WS root (WSR), IF, and cisplatin were tested on cisplatin-sensitive (EMT6/P) and cisplatin-resistant (EMT6/CPR) mouse mammary cell lines. The phytochemical content of the WSR extract was analyzed using liquid chromatography–mass spectrometry (LC-MS) analysis. Antiproliferative and apoptotic effects were assessed for WSR extract, cisplatin, and their combination in vitro using [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide] (MTT) and caspase-3 assays. An in vivo study was used to assess the effect of WSR extract, IF, cisplatin, and their combinations in mice inculcated with EMT6/P and EMT6/CPR cells. The safety profile was also investigated using liver enzymes and creatinine assays. In vitro, WSR extract and cisplatin had a synergistic effect in both cell lines. The same combination induced an apoptotic effect higher than the single treatment in both cell lines. In vivo, several combinations of WSR extract, IF, or cisplatin caused significant tumor size reduction and improved the cure rate in mice implanted with EMT6/P and EMT6/CPR cell lines. IF-treated groups showed a significant reduction in serum glucose and an elevation in β-hydroxybutyrate (BHB) levels. In the safety profile, WSR extract, IF, and their combinations were safe. Overall, the combination of WSR extract and IF provides a promising solution for breast cancer treatment besides cisplatin by reducing the proliferation of cancer cells through induction of apoptosis. Moreover, they minimize cisplatin toxicity to the liver and kidney.
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Dengue Fever in Italy: The "Eternal Return" of an Emerging Arboviral Disease. Trop Med Infect Dis 2022; 7:tropicalmed7010010. [PMID: 35051126 PMCID: PMC8782038 DOI: 10.3390/tropicalmed7010010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/04/2022] [Accepted: 01/12/2022] [Indexed: 01/27/2023] Open
Abstract
Enhanced surveillance for dengue virus (DENV) infections in Italy has been implemented since 2012, with annual reports from the National Health Institute. In this study, we summarize available evidence on the epidemiology of officially notified DENV infections from 2010–2021. In total, 1043 DENV infection cases were diagnosed, and most of them occurred in travelers, with only 11 autochthonous cases. The annual incidence rates of DENV infections peaked during 2019 with 0.277 cases per 100,000 (95% confidence interval [95% CI] 0.187–0.267), (age-adjusted incidence rate: 0.328, 95% CI 0.314–0.314). Cases of DENV were clustered during the summer months of July (11.4%), August (19.3%), and September (12.7%). The areas characterized by higher notification rates were north-western (29.0%), and mostly north-eastern Italy (41.3%). The risk for DENV infection in travelers increased in the time period 2015–2019 (risk ratio [RR] 1.808, 95% CI 1.594–2.051) and even during 2020–2021 (RR 1.771, 95% CI 1.238–2.543). Higher risk for DENV was additionally reported in male subjects compared with females subjects, and aged 25 to 44 years, and in individuals from northern and central Italy compared to southern regions and islands. In a multivariable Poisson regression model, the increased number of travelers per 100 inhabitants (incidence rate ratio [IRR] 1.065, 95% CI 1.036–1.096), the incidence in other countries (IRR 1.323, 95% CI 1.165–1.481), the share of individuals aged 25 to 44 years (IRR 1.622, 95% CI 1.338–1.968), and foreign-born residents (IRR 2.717, 95% CI 1.555–3.881), were identified as effectors of annual incidence. In summary, although the circulation of DENV remains clustered among travelers, enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.
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Riccò M. Excess mortality in Mountain Areas of Emilia Romagna Region during the first months of SARS-CoV-2 pandemic: a "canary in the coal mine"? ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022247. [PMID: 36043963 PMCID: PMC9534250 DOI: 10.23750/abm.v93i4.13190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Because of their remoteness, Mountain Communities (MC) have been considered at advantage when dealing with infectious diseases. However, earlier reports have identified MC among the hotspots for early spreading of COVID-19 pandemic. METHODS Crude mortality rates (CMR) and Excess mortality rates (EMR) were calculated for 97 municipalities from MC in the Emilia Romagna Region, and resulting estimates were compared to the Parent Provinces. Notification and mortality rates for COVID-19 were also retrieved, and correlated with EMR estimates. RESULTS During 2020, a CMR of 150.3/100,000 (95% Confidence Interval [95%CI] 117-185.4) was identified, with substantial heterogeneities between the 8 provinces of Emilia Romagna Region that were included in the analyses. A pooled EMR of +20.3% (95%CI 10.6-30.1) for MC and 19.9% (95%CI 9.5-30.3) was identified. The monthly estimates were quite heterogenous across the various provinces, ranging between -79.7% and +307.4% during the assessed timeframe. Higher estimates were identified in the months of March and April in MC, and during the months of April and May for Parent Provinces. In bivariate analysis, EM in MC was positively correlated with estimates in the parent province (Spearman's r = 0.201, p = 0.049), and also with notification rates for COVID- (i.e. Piacenza, Parma, Reggio Emilia, Modena, Bologna, Ravenna, Rimini, and Forlì Cesena) (r = 0.225, p = 0.045), and particularly with mortality rates for COVID-19 at provincial level (r = 0.372, p < 0.001). CONCLUSIONS In summary, the study highlights that small geographical and population size, along with remoteness, did not play a substantial advantage for MC against the spread and mortality rate of COVID-19. On the other hand, as the surge of EM in MC anticipated a similar habit in Parent Provinces of several weeks, improved surveillance interventions are also urgently in need. (www.actabiomedica.it).
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Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio EmiliaV.le Amendola n.2 - 42122 REServizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione.
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Riccò M, Peruzzi S, Ranzieri S, Giuri PG. Epidemiology of Legionnaires' Disease in Italy, 2004-2019: A Summary of Available Evidence. Microorganisms 2021; 9:microorganisms9112180. [PMID: 34835307 PMCID: PMC8624895 DOI: 10.3390/microorganisms9112180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 01/11/2023] Open
Abstract
Legionnaires’ disease (LD) incidence has been increasing in several European countries since 2011. Currently, Italy is experiencing high notification rates for LD, whose cause still remains scarcely understood. We sought to summarize the available evidence on the epidemiology of LD in Italy (2004–2019), characterizing the risk of LD by region, sex, age group, and settings of the case (i.e., community, healthcare, or travel-associated cases). Environmental factors (e.g., average air temperatures and relative humidity) were also included in a Poisson regression model in order to assess their potential role on the annual incidence of new LD cases. National surveillance data included a total of 23,554 LD cases occurring between 2004 and 2019 (70.4% of them were of male gender, 94.1% were aged 40 years and older), with age-adjusted incidence rates increasing from 1.053 cases per 100,000 in 2004 to 4.559 per 100,000 in 2019. The majority of incident cases came from northern Italy (43.2% from northwestern Italy, 25.6% from northeastern Italy). Of these, 5.9% were healthcare-related, and 21.1% were travel-associated. A case-fatality ratio of 5.2% was calculated for the whole of the assessed timeframe, with a pooled estimate for mortality of 0.122 events per 100,000 population per year. Poisson regression analysis was associated with conflicting results, as any increase in average air temperature resulted in reduced risk for LD cases (Incidence Rate Ratio [IRR] 0.807, 95% Confidence Interval [95% CI] 0.744–0.874), while higher annual income in older individuals was associated with an increased IRR (1.238, 95% CI 1.134–1.351). The relative differences in incidence between Italian regions could not be explained by demographic factors (i.e., age and sex distribution of the population), and also a critical reappraisal of environmental factors failed to substantiate both the varying incidence across the country and the decennial trend we were able to identify.
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Affiliation(s)
- Matteo Riccò
- Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), AUSL—IRCCS di Reggio Emilia, Via Amendola n.2, I-42022 Reggio Emilia, Italy
- Correspondence: or ; Tel.: +39-3392-994-343 or +39-522-837-587
| | - Simona Peruzzi
- Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, AUSL—IRCCS di Reggio Emilia, I-42016 Guastalla, Italy;
| | - Silvia Ranzieri
- Department of Medicine and Surgery, School of Occupational Medicine, University of Parma, Via Gramsci n.14, I-43123 Parma, Italy;
| | - Pasquale Gianluca Giuri
- Dipartimento Internistico Interaziendale, Struttura Operativa Semplice Dipartimentale “Medicina Infettivologica”, AUSL—IRCCS di Reggio Emilia, Ospedale “Sant’Anna”, I-42035 Castelnovo ne’ Monti, Italy;
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Riccò M, Peruzzi S, Ranzieri S, Balzarini F, Valente M, Marchesi F, Bragazzi NL. Hantavirus infections in Italy: not reported doesn't mean inexistent. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021324. [PMID: 34487097 PMCID: PMC8477108 DOI: 10.23750/abm.v92i4.10661] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 12/03/2022]
Abstract
BACKGROUND Hantaviruses can cause serious human diseases including hemorrhagic fever with renal syndrome (HFRS) and Hantavirus Cardiopulmonary Syndrome (HCPS). European Hantavirus are usually associated with HFRS, and their geographical distribution mirrors the ecology of reservoir host species. Epidemiology of HFRS is well-studied in Western Europe, but data from Italy are fragmentary. METHODS We searched into two different databases (PubMed and EMBASE), focusing on studies reporting the prevalence of Hantaviruses in Italy. Data were extracted using a standardized assessment form, and results of the analyses were systematically reported, summarized and compared. RESULTS We identified a total of 18 articles, including 12 reports (total population: 5,336 subjects, 1981-2019) and 6 case reports (1984-2019). In total, 200 subjects exhibited some degree of seropositivity, with a pooled seroprevalence of 1.7% (95% confidence interval 0.7%-4.0%) in the general population. Higher occurrence was reported in selected subgroups, i.e. acute (28.7%, 95%CI 22.1-36.2) and chronic (6.6%, 95%CI 4.7-9.1) renal failure, forestry workers (3.0%, 95%CI 1.4-6.5, actual range 0.0 to 10.8%). CONCLUSIONS In the last decade, no human cases of hantavirus infection have been officially reported in Italy. However, our analysis stresses the actual occurrence of Hantavirus among general population and in selected population groups. Further studies on hantavirus infection rates in reservoir host species (rodents, shrews, and bats) and virus transmission to humans are needed to prevent outbreaks in the future.
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Affiliation(s)
- Matteo Riccò
- AUSL - IRCCS di Reggio Emilia, Servizio di Prevenzione e Sicurezza negli ambienti di Lavoro (SPSAL), Via Amendola n.2, I-42122 Reggio Emilia (RE), Italy .
| | - Simona Peruzzi
- AUSL-IRCCS di Reggio Emilia, Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, Via Donatori di Sangue n.1, I-42016 Guastalla (RE), Italy;.
| | - Silvia Ranzieri
- University of Parma, Department of Medicine and Surgery, School of Occupational Medicine; Via Gramsci n.14, 43126; Parma (PR), Italy.
| | - Federica Balzarini
- University "Vita e Salute", San Raffaele Hospital; Via Olgettina n. 58, 20132; Milan (MI), Italy.
| | - Marina Valente
- University of Parma, Department of Medicine and Surgery, School of General Surgery; Via Gramsci n.14, 43126; Parma (PR), Italy .
| | - Federico Marchesi
- University of Parma, Department of Medicine and Surgery, School of General Surgery; Via Gramsci n.14, 43126; Parma (PR), Italy .
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, University of York, Toronto (ON), Canada.
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Pega F, Govindaraj S, Tran NT. Health service use and health outcomes among international migrant workers compared with non-migrant workers: A systematic review and meta-analysis. PLoS One 2021; 16:e0252651. [PMID: 34106987 PMCID: PMC8189512 DOI: 10.1371/journal.pone.0252651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/20/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The review aimed to synthesise recent evidence on health service use and health outcomes among international migrant workers, compared with non-migrant workers. METHODS A search was carried out in MEDLINE, PubMed, Embase, and CINAHL for studies published between Jan 1, 2010, and Feb 29, 2020. Included outcomes were: occupational health service use, fatal occupational injury, HIV, and depression. Two authors independently screened records, extracted data, assessed risk of bias and judged quality of evidence. We meta-analysed estimates and conducted subgroup analyses by sex, geographical origin, geographical destination, and regularity of migration. RESULTS Twenty-one studies were included comprising >17 million participants in 16 countries. Most studies investigated regular migrant workers in high-income destination countries. Compared with non-migrant workers, migrant workers were less likely to use health services (relative risk 0·55, 95% confidence interval 0·41 to 0·73, 4 studies, 3,804,131 participants, I2 100%, low quality of evidence). They more commonly had occupational injuries (1·27, 95% confidence interval 1·11 to 1·45, 7 studies, 17,100,626 participants, I2 96%, low quality of evidence). Relative risks differed by geographical origin and/or destination. There is uncertainty (very low quality of evidence) about occupational health service use (0 studies), fatal occupational injuries (5 studies, N = 14,210,820), HIV (3 studies, N = 13,775), and depression (2 studies, N = 7,512). CONCLUSIONS Migrant workers may be less likely than non-migrant workers to use health services and more likely to have occupational injuries. More research is required on migrant workers from and in low- and middle-income countries, across migration stages, migrating irregularly, and in the informal economy.
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Affiliation(s)
- Frank Pega
- Environment, Climate Change and Health Department, World Health Organization, Geneva, Switzerland
| | - Srinivasan Govindaraj
- Environment, Climate Change and Health Department, World Health Organization, Geneva, Switzerland
| | - Nguyen Toan Tran
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology, Sydney, NSW, Australia
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Fatima SH, Rothmore P, Giles LC, Varghese BM, Bi P. Extreme heat and occupational injuries in different climate zones: A systematic review and meta-analysis of epidemiological evidence. ENVIRONMENT INTERNATIONAL 2021; 148:106384. [PMID: 33472088 DOI: 10.1016/j.envint.2021.106384] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/09/2020] [Accepted: 01/05/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND The link between heat exposure and adverse health outcomes in workers is well documented and a growing body of epidemiological evidence from various countries suggests that extreme heat may also contribute to increased risk of occupational injuries (OI). Previously, there have been no comparative reviews assessing the risk of OI due to extreme heat within a wide range of global climate zones. The present review therefore aims to summarise the existing epidemiological evidence on the impact of extreme heat (hot temperatures and heatwaves (HW)) on OI in different climate zones and to assess the individual risk factors associated with workers and workplace that contribute to heat-associated OI risks. METHODS A systematic review of published peer-reviewed articles that assessed the effects of extreme heat on OI among non-military workers was undertaken using three databases (PubMed, Embase and Scopus) without temporal or geographical limits from database inception until July 2020. Extreme heat exposure was assessed in terms of hot temperatures and HW periods. For hot temperatures, the effect estimates were converted to relative risks (RR) associated with 1 °C increase in temperature above reference values, while for HW, effect estimates were RR comparing heatwave with non-heatwave periods. The patterns of heat associated OI risk were investigated in different climate zones (according to Köppen Geiger classification) based on the study locations and were estimated using random-effects meta-analysis models. Subgroup analyses according to workers' characteristics (e.g. gender, age group, experience), nature of work (e.g. physical demands, location of work i.e. indoor/outdoor) and workplace characteristics (e.g. industries, business size) were also conducted. RESULTS A total of 24 studies published between 2005 and 2020 were included in the review. Among these, 22 studies met the eligibility criteria, representing almost 22 million OI across six countries (Australia, Canada, China, Italy, Spain, and USA) and were included in the meta-analysis. The pooled results suggested that the overall risk of OI increased by 1% (RR 1.010, 95% CI: 1.009-1.011) for 1 °C increase in temperature above reference values and 17.4% (RR 1.174, 95% CI: 1.057-1.291) during HW. Among different climate zones, the highest risk of OI during hot temperatures was identified in Humid Subtropical Climates (RR 1.017, 95% CI: 1.014-1.020) followed by Oceanic (RR 1.010, 95% CI: 1.008-1.012) and Hot Mediterranean Climates (RR 1.009, 95% CI: 1.008-1.011). Similarly, Oceanic (RR 1.218, 95% CI: 1.093-1.343) and Humid Subtropical Climates (RR 1.213, 95% CI: 0.995-1.431) had the highest risk of OI during HW periods. No studies assessing the risk of OI in Tropical regions were found. The effects of hot temperatures on the risk of OI were acute with a lag effect of 1-2 days in all climate zones. Young workers (age < 35 years), male workers and workers in agriculture, forestry or fishing, construction and manufacturing industries were at high risk of OI during hot temperatures. Further young workers (age < 35 years), male workers and those working in electricity, gas and water and manufacturing industries were found to be at high risk of OI during HW. CONCLUSIONS This review strengthens the evidence on the risk of heat-associated OI in different climate zones. The risk of OI associated with extreme heat is not evenly distributed and is dependent on underlying climatic conditions, workers' attributes, the nature of work and workplace characteristics. The differences in the risk of OI across different climate zones and worker subgroups warrant further investigation along with the development of climate and work-specific intervention strategies.
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Affiliation(s)
| | - Paul Rothmore
- School of Allied Health Science and Practice, The University of Adelaide, Australia
| | - Lynne C Giles
- School of Public Health, The University of Adelaide, Australia
| | | | - Peng Bi
- School of Public Health, The University of Adelaide, Australia.
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Ricci F, Bravo G, Modenese A, Pasquale FD, Ferrari D, Gobba F. Risk Perception in the Construction Industry: Differences Between Italian and Migrant Workers Before and After a Targeted Training Intervention. New Solut 2021; 31:65-71. [PMID: 33632012 DOI: 10.1177/1048291121998364] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We developed a visual tool to assess risk perception for a sample of male construction workers (forty Italian and twenty-eight immigrant workers), just before and after a sixteen-hour training course. The questionnaire included photographs of real construction sites, and workers were instructed to select pictograms representing the occupational risks present in each photograph. Points were awarded for correctly identifying any risks that were present, and points were deducted for failing to identify risks that were present or identifying risks that were not present. We found: (1) Before the course, risk perception was significantly lower in immigrants compared to Italians (p < .001); (2) risk perception improved significantly (p < .001) among all workers tested; and (3) after the training, the difference in risk perception between Italians and immigrants was no longer statistically significant (p = .1086). Although the sample size was relatively small, the results suggest that the training is effective and may reduce the degree to which cultural and linguistic barriers hinder risk perception. Moreover, the use of images and pictograms instead of words to evaluate risk perception could also be applied to nonconstruction workplaces.
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Ricci F, Bravo G, Modenese A, De Pasquale F, Ferrari D, Bello M, Favero G, Soddu S, Gobba F. Risk Perception and Ethnic Background in Construction Workers: Results of a Cross-Sectional Study in a Group of Trainees of a Vocational School in Italy. Eur J Investig Health Psychol Educ 2021; 11:96-109. [PMID: 34542452 PMCID: PMC8314337 DOI: 10.3390/ejihpe11010008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/13/2021] [Accepted: 01/24/2021] [Indexed: 11/25/2022] Open
Abstract
Risk perception can be influenced by cultural background. The study aims to evaluate risk perception, considering different ethnicities of construction workers from vocational schools in Italy. We administered a questionnaire investigating four different dimensions: Perceived behavioral control (PBC), Danger perception (DP), Safety climate (SC), and Attitude towards safe actions (ATSA). 562 workers answered: 72.4% from Italy, 14.2% from eastern Europe, 9.4% from Balkans, and 3.9% from North Africa. The participants indicated quite low control, attributable to the haste in performing the job. The workers perceived their specific job tasks as riskier compared to the tasks of their colleagues. They reported as fundamental the respecting of safety rules, but indicating that supervisors do not adequately promote safety behaviors. Finally, construction workers judged as “brave” the colleagues working without protective equipment. When compared to Italians, North Africa workers showed a lower perception of the possibility to control their safe behaviors (p = 0.040), while both eastern Europeans and Balkan obtained higher scores at the ATSA dimension, indicating a kind of fatalistic acceptance of the risky situations at work. Eastern Europeans also showed a lower perception of the dangers (p = 0.002), while Balkan demonstrated a perception of SC even better than the Italian group (p = 0.005).
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Affiliation(s)
- Federico Ricci
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41125 Modena, Italy; (F.R.); (G.B.); (A.M.); (M.B.)
| | - Giulia Bravo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41125 Modena, Italy; (F.R.); (G.B.); (A.M.); (M.B.)
- Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41125 Modena, Italy; (F.R.); (G.B.); (A.M.); (M.B.)
| | - Fabrizio De Pasquale
- Department of Public Health, National Health Service, 41126 Modena, Italy; (F.D.P.); (D.F.)
| | - Davide Ferrari
- Department of Public Health, National Health Service, 41126 Modena, Italy; (F.D.P.); (D.F.)
| | - Massimo Bello
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41125 Modena, Italy; (F.R.); (G.B.); (A.M.); (M.B.)
| | | | - Sergio Soddu
- Department of Public Health, National Health Service, 40068 San Lazzaro di Savena, Italy;
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41125 Modena, Italy; (F.R.); (G.B.); (A.M.); (M.B.)
- Correspondence:
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Riccò M, Vezzosi L, Balzarini F, Gualerzi G, Valente M, Bragazzi NL. Air temperatures and occupational injuries in the agricultural settings: a report from Northern Italy (Po River Valley, 2013-2017). ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020094. [PMID: 33525259 PMCID: PMC7927534 DOI: 10.23750/abm.v91i4.10035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 01/17/2023]
Abstract
Introduction: High environmental temperatures are associated with an increased risk for occupational injuries (OIs), particularly where environmental exposure and heat sources in the workplace, are associated with internal heat generation by strenuous muscular work. As a consequence, Agricultural Workers (AWs) are among the most heavily affected occupational groups. Methods and aims: The aim of this study was to assess the relationship between environmental temperatures and OIs in AWs from the Po River Valley in the Northern Italy (27,736,158 total inhabitants; mean agricultural workforce of 312,195.6 individuals). Data about OIs from 2013 to 2017, and daily weather for the administrative unit of occurrence were retrieved. Days were classified by a) mininum (Tmin) / maximum (Tmax) air temperatures; b) average day temperature (Tday); c) daily temperature variation (TV), d) relative humidity. Risk for daily OIs was calculated as correspondent Odds Ratios (OR) through a Poisson regression model. Results: Estimated incidence for OIs was 66.3/1,000 workers-year. In regression analysis, for every Tday percentile increase equal to 2.5, an OR 1.007 (95% CI, 1.003 to 1.010) was reported. More precisely, higher risk for OIs was associated to Tmax > 25°C (OR 1.143, 95%CI 1.125-1.160) and to Tmax > 25°C + Tmin > 20°C (OR 1.158, 95%CI 1.138-1.179), Tmin < 0°C were associated with a significantly reduced risk (OR 0.879, 95%CI 0.850-0.910), with the notable exception of older age groups (OR 1.348, 95%CI 1.254; 1.449). During timeframes characterized by Tmax > 35°C (i.e. HW time period), the risk was higher during the first day (OR 1.266; 95%CI 1.206-1.330), and again from the fourth day onwards (OR 1.090; 95%CI 1.048 – 1.133). Analysis of TV identified an increased risk for occupational injuries in days characterized by higher variability, and particularly for TV ranging 4.0 – 4.9 (OR 1.042, 95%CI 1.017 – 1.068), and equals to 5.0 or greater (OR 1.143, 95%CI 1.118 – 1.167). Also increased relative humidity was associated with higher risk for OIs (OR 1.096, 95%CI 1.081-1.126, and OR 1.154, 95%CI 1.135-1.173 for relative humidity 70 – 89%, and ≥ 90%). Conclusions: Our findings recommend policymakers to develop appropriate procedures and guidelines, in particular for the HW time periods. (www.actabiomedica.it)
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Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio EmiliaV.le Amendola n.2 - 42122 REServizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione.
| | - Luigi Vezzosi
- Agenzia di Tutela della Salute (ATS) della Val Padana; Via Toscani n.1; Mantova (MN), Italy.
| | - Federica Balzarini
- University "Vita e Salute", San Raffaele Hospital; Via Olgettina n. 58, 20132; Milan (MI), Italy.
| | - Giovanni Gualerzi
- University of Parma, Department of Medicine and Surgery, School of Medicine; Via Gramsci n.14, 43123; Parma (PR), Italy.
| | - Marina Valente
- Department of Medicine and Surgery, Unit of Clinical Surgery, University of Parma, I-43123 Parma (PR), Italy.
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, University of York, Toronto (ON), Canada.
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Riccò M, Vezzosi L, Balzarini F, Gualerzi G, Ranzieri S. Prevalence of Huntington Disease in Italy: a systematic review and meta-analysis. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:119-127. [PMID: 32275276 PMCID: PMC7975892 DOI: 10.23750/abm.v91i3-s.9441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 01/24/2023]
Abstract
Worldwide prevalence of Huntington’s disease (HD) is quite heterogenous. As Italy is characterized by significant genetic heterogeneity, with presumptive differences between Italian regions, this review was undertaken to define available data of HD prevalence in Italy, to assess geographic heterogeneity, and reconcile possible variation in HD prevalence rates with the availability of genetic testing.
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Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio EmiliaV.le Amendola n.2 - 42122 REServizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione.
| | - Luigi Vezzosi
- Agenzia di Tutela della Salute (ATS) della Val Padana; Via Toscani n.1; Mantova (MN), Italy.
| | - Federica Balzarini
- University "Vita e Salute", San Raffaele Hospital; Via Olgettina n. 58, 20132; Milan (MI), Italy.
| | - Giovanni Gualerzi
- University of Parma, Department of Medicine and Surgery, School of Medicine; Via Gramsci n.14, 43123; Parma (PR), Italy.
| | - Silvia Ranzieri
- University of Parma, Department of Medicine and Surgery, School of Occupational Medicine; Via Gramsci n.14, 43123; Parma (PR), Italy.
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RICCÒ M, VEZZOSI L, BALZARINI F, ODONE A, SIGNORELLI C. Air temperatures and occupational injuries in the construction industries: a report from Northern Italy (2000-2013). INDUSTRIAL HEALTH 2020; 58:182-192. [PMID: 31548469 PMCID: PMC7118059 DOI: 10.2486/indhealth.2018-0268] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 09/18/2019] [Indexed: 05/13/2023]
Abstract
The aim of this study was to assess the relationship between environmental temperatures and occupational injuries (OIs) in construction workers (CWs) from a subalpine region of North-Eastern Italy. Data about OIs from 2000 to 2013, and daily weather for the specific site of the events were retrieved. Risk for daily OIs was calculate through a Poisson regression model. Estimated daily incidence for OIs was 5.7 (95%CI 5.5-5.8), or 2.8 OIs/10,000 workers/d (95%CI 2.7-2.9), with higher rates for time periods characterized by high temperatures (daily maximum ≥35°C), both in first 2 d (3.57, 95%CI 3.05-4.11) and from the third day onwards (i.e. during Heat Waves: 3.43, 95%CI 3.08-3.77). Higher risk for OIs was reported in days characterized temperatures ≥95th percentile (OR 1.145, 95%CI 1.062-1.235), summer days (daily maximum ≥25°C , OR 1.093, 95%CI 1.042-1.146). On the contrary, no significant increased risk was found for OIs having a more severe prognosis (≥40 d or more; death). In conclusion, presented findings recommend policymakers to develop appropriate procedures and guidelines, in particular aimed to improve the compliance of younger CWs towards severe-hot daily temperatures.
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Affiliation(s)
- Matteo RICCÒ
- AUSL-IRCCS di Reggio Emilia, Italy
- Department of Prevention, Provincial Agency for Health
Services (APSS) of the Autonomous Province of Trento, Italy
| | - Luigi VEZZOSI
- Prevention of Infectious Disease Unit, Health Protection
Agency Val Padana, Italy
| | | | - Anna ODONE
- School of Medicine, Vita-Salute San Raffaele University,
Italy
- Clinical Epidemiology and HTA Unit, IRCCS San Raffaele
Scientific Institute, Italy
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RICCò M, RAZIO B, POLETTI L, PANATO C, BALZARINI F, MEZZOIUSO A, VEZZOSI L. Risk perception of heat related disorders on the workplaces: a survey among health and safety representatives from the autonomous province of Trento, Northeastern Italy. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E48-E59. [PMID: 32490269 PMCID: PMC7225649 DOI: 10.15167/2421-4248/jpmh2020.61.1.727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 01/14/2020] [Indexed: 01/04/2023]
Abstract
Introduction This study will investigate knowledge, attitude and practices towards heat-related health issues in a sample of safety representatives from Northern Italy (H&SRs). Methods A cross-sectional questionnaire survey was conducted in 2016-2017 among 298 H&SR. Knowledge status was measured both in general but as well and focusing on first-aid issues. Assessment of risk perception included severity and frequency of heat-related events. Multivariate logistic regression analysis assessed individual and work-related characteristics associated with H&SRs’ risk perception. Results 258 questionnaires were retrieved (participation rate 86.6%; mean age 48.2 ± 8.4 years). Knowledge status was relatively good on technical/preventive issues (62.3% ± 16.8) and first aid measures (72.6% ± 27.2), but a large share of respondents ignored the risk from exertional heat stroke (35.9%), and for heat strokes elicited by non-environmental heat (e.g. machineries, use of protective equipment, etc. 47.9%). The majority of respondents acknowledged the high frequency of extreme events like heat waves (62.0%), but only 44.6% agreed on their potential health threat, with an unsatisfying cumulative risk perception score (55.4% ± 23.5). A specific first-aid formation course was reported by 49.2% of respondents, while 10.9% had any previous interaction with heat-related disorders. Specific countermeasures for heat waves had been put in place by parent company in 20.1% of cases. Eventually, higher educational achievements (mOR 2.239, 95% CI 1.184-4.233) and a better general knowledge status (mOR 1.703, 95% CI 1.073-2.979) were positive predictors for higher risk perception. Conclusions Although H&SRs exhibited a good understanding of heat-related health issues, stakeholders should improve the implementation of specific countermeasures on the workplaces.
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Affiliation(s)
- M. RICCò
- AUSL- IRCCS di Reggio Emilia, Department of Public Health, Service for Health and Safety in the Workplace, Reggio Emilia (RE), Italy
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento; Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN), Italy
- Correspondence: Matteo Riccò, Department of Public Health, Service for Health and Safety in the Workplace, via Amendola 2, 42122 Reggio Emilia (RE), Italy - Tel. +39 0522 837 587 - E-mail: /
| | - B. RAZIO
- University of Trento, First cycle degree in Environment and Workplace Prevention Techniques, Trento (TN), Italy
| | - L. POLETTI
- University of Trento, First cycle degree in Environment and Workplace Prevention Techniques, Trento (TN), Italy
| | - C. PANATO
- University of Trento, First cycle degree in Environment and Workplace Prevention Techniques, Trento (TN), Italy
| | - F. BALZARINI
- University “Vita e Salute”, San Raffaele Hospital, Milan (MI), Italy
| | - A.G. MEZZOIUSO
- University “Vita e Salute”, San Raffaele Hospital, Milan (MI), Italy
| | - L. VEZZOSI
- ASST di Cremona; Direzione Medica di Presidio, Cremona (Italy)
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Marinaccio A, Scortichini M, Gariazzo C, Leva A, Bonafede M, De' Donato FK, Stafoggia M, Viegi G, Michelozzi P. Nationwide epidemiological study for estimating the effect of extreme outdoor temperature on occupational injuries in Italy. ENVIRONMENT INTERNATIONAL 2019; 133:105176. [PMID: 31654985 DOI: 10.1016/j.envint.2019.105176] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/12/2019] [Accepted: 09/09/2019] [Indexed: 05/04/2023]
Abstract
BACKGROUND Despite the relevance for occupational safety policies, the health effects of temperature on occupational injuries have been scarcely investigated. A nationwide epidemiological study was carried out to estimate the risk of injuries for workers exposed to extreme temperature and identify economic sectors and jobs most at risk. MATERIALS AND METHODS The daily time series of work-related injuries in the industrial and services sector from the Italian national workers' compensation authority (INAIL) were collected for each of the 8090 Italian municipalities in the period 2006-2010. Daily air temperatures with a 1 × 1 km resolution derived from satellite land surface temperature data using mixed regression models were included. Distributed lag non-linear models (DLNM) were used to estimate the association between daily mean air temperature and injuries at municipal level. A meta-analysis was then carried out to retrieve national estimates. The relative risk (RR) and attributable cases of work-related injuries for an increase in mean temperature above the 75th percentile (heat) and for a decrease below the 25th percentile (cold) were estimated. Effect modification by gender, age, firm size, economic sector and job type were also assessed. RESULTS The study considered 2,277,432 occupational injuries occurred in Italy in the period 2006-2010. There were significant effects for both heat and cold temperatures. The overall relative risks (RR) of occupational injury for heat and cold were 1.17 (95% CI: 1.14-1.21) and 1.23 (95% CI: 1.17-1.30), respectively. The number of occupational injuries attributable to temperatures above and below the thresholds was estimated to be 5211 per year. A higher risk of injury on hot days was found among males and young (age 15-34) workers occupied in small-medium size firms, while the opposite was observed on cold days. Construction workers showed the highest risk of injuries on hot days while fishing, transport, electricity, gas and water distribution workers did it on cold days. CONCLUSIONS Prevention of the occupational exposure to extreme temperatures is a concern for occupational health and safety policies, and will become a critical issue in future years considering climate change. Epidemiological studies may help identify vulnerable jobs, activities and workers in order to define prevention plans and training to reduce occupational exposure to extreme temperature and the risk of work-related injuries.
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Affiliation(s)
- Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy.
| | - Matteo Scortichini
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Claudio Gariazzo
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Antonio Leva
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | | | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Giovanni Viegi
- Italian National Research Council (CNR), Institute of Biomedical Research and Innovation (IRIB) (previously Institute of Biomedicine and Molecular Epidemiology "Alberto Monroy"), Palermo, Italy
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
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Tocci G, Presta V, Schiavello F, Miceli F, Citoni B, Battistoni A, Coluccia R, Ferrucci A, Geraci S, Volpe M. Immigration Emergency in Italy: The Impact of Socioeconomic Status on Blood Pressure Levels and Control. High Blood Press Cardiovasc Prev 2019; 26:467-473. [PMID: 31741338 DOI: 10.1007/s40292-019-00349-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/11/2019] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Nowadays there are more than 5 millions of immigrants (8.3% of general adult population) in Italy. AIM To evaluate the potential impact of immigration and the possession of a permanent residence on blood pressure (BP) levels and control in a low income population of immigrants from different countries. METHODS We evaluated clinical characteristics and social status of adult individuals with known diagnosis of hypertension afferent to the Poliambulatorio della Caritas Diocesana in Rome, Italy, between 2010-2016. Subjects were stratified according to their macro-areas of origin (Europe, Asia, Africa, South-America), housing (with or without house), and immigration status (presence or absence of residence permit). BP levels were measured in three consecutive visits according to recommendations from current European Guidelines. RESULTS From an overall population sample of 9827 adult individuals, we initially identified 994 patients with a diagnosis of hypertension (10.1%), among whom 536 (5.4%) had valid BP data. Among these, 50.6% came from Europe, 21.6% from Africa, 24.1% from Asia, and 3.7% from South-America. They were predominantly male (54.7%), middle aged (42.8 ± 12.1 years at arrival and 51.6 ± 10.6 years at first visit) and untreated (72.8%) individuals with baseline systolic/diastolic BP levels of 156.9 ± 22.2/97.3 ± 12.4 mmHg). BP levels remained higher in homeless than in housed people at both visit 2 (150.0 ± 21.8/92.6 ± 12.9 mmHg vs. 142.9 ± 19.3/89.9 ± 11.6 mmHg; P < 0.001) and visit 3 (147.9 ± 22.2/91.7 ± 12.5 mmHg vs. 141.8 ± 19.4/89.2 ± 12.0 mmHg; P = 0.013). We also observed reductions of both systolic and diastolic BP levels compared to baseline values in immigrants stratified according to residence permit, although without relevant differences among groups. CONCLUSIONS Beyond conventional risk factors, socio-economic issues, including lack of residence permit or habitation, may affect BP levels and control in frail populations of immigrants, which have been marginally considered before.
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Affiliation(s)
- Giuliano Tocci
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy.
| | - Vivianne Presta
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Francesca Schiavello
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Francesca Miceli
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Barbara Citoni
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Allegra Battistoni
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | | | - Andrea Ferrucci
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Salvatore Geraci
- Poliambulatorio, Area Sanitaria, Caritas Diocesana di Roma, Rome, Italy
| | - Massimo Volpe
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
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Riccò M, Vezzosi L, Balzarini F, Mezzoiuso AG, Ranzieri S, Vaccaro FG, Odone A, Signorelli C. Epidemiology of leprosy in Italy (1920 - 2019): a comprehensive review on existing data. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:7-14. [PMID: 31517884 PMCID: PMC7233659 DOI: 10.23750/abm.v90i9-s.8695] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND AIMS Incidence of leprosy in Italy has declined steadily over the last century, but available evidence remains fragmentary. Our review aims to summarize available data on the epidemiology of leprosy cases in Italy. METHODS The following keywords were used to explore PubMed and Embase: leprosy, Hansen's disease, (Mycobacterium) leprae, Italy, without any chronological restriction. RESULTS We identified a total of 39 reports, including 7 national reports, 11 international reports, 20 case reports. Notified leprosy cases were: 839 between 1925 and 1948; 434 between 1955 and 1979; 76 cases for the decade 1980-1989; 112 between 1990 and 1999; 62 between 2000 and 2009, and a total of 25 cases since 2009. Since 2003, 53% of all cases occurred in illegal residents. Focusing on individual cases, latency between early signs/symptoms and a proper diagnosis ranged between 2 and 20 years in 52.1% of individual cases. CONCLUSION Imported cases of leprosy are responsible for most leprosy incidence in Italy, and social stigma, the unfamiliarity of healthcare professionals with such disorders, and difficulties of some high-risk groups to be appropriately assessed hint to a possible under-diagnosis. Professionals should be made more aware of the potential for leprosy incidence among patients from countries where the disease is endemic.
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Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio EmiliaV.le Amendola n.2 - 42122 REServizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione.
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Riccò M, Bragazzi NL, Vezzosi L, Balzarini F, Colucci ME, Veronesi L. Knowledge, Attitudes, and Practices on Tick-Borne Human Diseases and Tick-Borne Encephalitis Vaccine among Farmers from North-Eastern Italy (2017). J Agromedicine 2019; 25:73-85. [PMID: 31456505 DOI: 10.1080/1059924x.2019.1659204] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Tick-borne diseases (T-BD) represent a potential health threat for outdoor workers in endemic areas, such as the Autonomous Province of Trento (APT). We conducted a questionnaire-based survey to assess T-BD knowledge, attitudes, and preventive practices among APT farmers, specifically focusing on the use of protective habits and the uptake of the tick-borne encephalitis (TBE) vaccine.Methods: A convenience sample of 106 farmers (all males, mean age 47.3 ± 13.6 years) attending pesticide training courses (12/2016-03/2017) completed the anonymous survey. Binary regression analysis, calculations of multivariate odds ratios (mOR) and 95% confidence intervals were used to assess knowledge, attitudes, and risk perceptions as predictors of preventive measures.Results: Though general understanding of T-BD was fairly low, the majority of the participants perceived TBE infection as a frequent (73.6%) and severe disease (61.3%). Overall, 43.3% of participants knew a TBE vaccine was available, and 24.5% had been vaccinated. Protective habits were reported by 53.8% of respondents, with self-checks for tick bites particularly low at 2.8% of participants. Better knowledge of T-BD and favorable attitudes toward vaccinations were associated with TBE immunization (mOR 4.708; 95%CI 1.273-17.409 and mOR 3.555; 95%CI 1.175-10.760, respectively), while previous history of tick bite and any interaction with T-BD significantly predicted adherence to protective measures (mOR 4.458; 95%CI 1.808-10.991, and mOR 9.433; 95%CI 1.127-78.973, respectively).Conclusions: Adherence to preventive measures (TBE vaccine) and protective habits was unsatisfactory in our sampled group, being a possible consequence of significant knowledge gaps. Public health communication on T-BD in farmers should, therefore, target understanding of health issues and appropriate preventive measures.
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Affiliation(s)
- Matteo Riccò
- Department of Public Health, AUSL- IRCCS di Reggio Emilia, Service for Health and Safety in the Workplace, Reggio Emilia (RE), Italy.,Autonomous Province of Trento Department of Prevention, Provincial Agency for Health Services (APSS), Operative Unit for Health and Safety in the Workplaces, Trento, Italy
| | - Nicola Luigi Bragazzi
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Luigi Vezzosi
- Azienda Sanitaria dell'Alto Adige -Comprensorio di Brunico, Servizio di Igiene e Sanità Pubblica, Brunico, BZ
| | | | | | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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21
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Morabito M, Messeri A, Noti P, Casanueva A, Crisci A, Kotlarski S, Orlandini S, Schwierz C, Spirig C, Kingma BRM, Flouris AD, Nybo L. An Occupational Heat-Health Warning System for Europe: The HEAT-SHIELD Platform. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162890. [PMID: 31412559 PMCID: PMC6718993 DOI: 10.3390/ijerph16162890] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 12/20/2022]
Abstract
Existing heat–health warning systems focus on warning vulnerable groups in order to reduce mortality. However, human health and performance are affected at much lower environmental heat strain levels than those directly associated with higher mortality. Moreover, workers are at elevated health risks when exposed to prolonged heat. This study describes the multilingual “HEAT-SHIELD occupational warning system” platform (https://heatshield.zonalab.it/) operating for Europe and developed within the framework of the HEAT-SHIELD project. This system is based on probabilistic medium-range forecasts calibrated on approximately 1800 meteorological stations in Europe and provides the ensemble forecast of the daily maximum heat stress. The platform provides a non-customized output represented by a map showing the weekly maximum probability of exceeding a specific heat stress condition, for each of the four upcoming weeks. Customized output allows the forecast of the personalized local heat-stress-risk based on workers’ physical, clothing and behavioral characteristics and the work environment (outdoors in the sun or shade), also taking into account heat acclimatization. Personal daily heat stress risk levels and behavioral suggestions (hydration and work breaks recommended) to be taken into consideration in the short term (5 days) are provided together with long-term heat risk forecasts (up to 46 days), all which are useful for planning work activities. The HEAT-SHIELD platform provides adaptation strategies for “managing” the impact of global warming.
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Affiliation(s)
- Marco Morabito
- Institute of BioEconomy-National Research Council, 50019 Florence, Italy.
- Centre of Bioclimatology-University of Florence, 50144 Florence, Italy.
| | | | - Pascal Noti
- Federal Office of Meteorology and Climatology, MeteoSwiss, Zurich Airport, 8058 Zurich, Switzerland
| | - Ana Casanueva
- Federal Office of Meteorology and Climatology, MeteoSwiss, Zurich Airport, 8058 Zurich, Switzerland
- Meteorology Group, Dept. Applied Mathematics and Computer Sciences, University of Cantabria, 39005 Santander, Spain
| | - Alfonso Crisci
- Institute of BioEconomy-National Research Council, 50019 Florence, Italy
| | - Sven Kotlarski
- Federal Office of Meteorology and Climatology, MeteoSwiss, Zurich Airport, 8058 Zurich, Switzerland
| | - Simone Orlandini
- Centre of Bioclimatology-University of Florence, 50144 Florence, Italy
- Department of Agricultural, Food, Environmental and Forestry Sciences and Technologies, University of Florence, 50144 Florence, Italy
| | - Cornelia Schwierz
- Federal Office of Meteorology and Climatology, MeteoSwiss, Zurich Airport, 8058 Zurich, Switzerland
| | - Christoph Spirig
- Federal Office of Meteorology and Climatology, MeteoSwiss, Zurich Airport, 8058 Zurich, Switzerland
| | - Boris R M Kingma
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 2100 Copenhagen, Denmark
- Unit Defense, Safety and Security, The Netherlands Organisation of Applied Scientific Research, 3769DE Soesterberg, The Netherlands
| | - Andreas D Flouris
- FAME Laboratory, Department of Exercise Science, University of Thessaly, 42100 Karies, Greece
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 2100 Copenhagen, Denmark
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22
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Messeri A, Morabito M, Bonafede M, Bugani M, Levi M, Baldasseroni A, Binazzi A, Gozzini B, Orlandini S, Nybo L, Marinaccio A. Heat Stress Perception among Native and Migrant Workers in Italian Industries-Case Studies from the Construction and Agricultural Sectors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071090. [PMID: 30934675 PMCID: PMC6479923 DOI: 10.3390/ijerph16071090] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 03/22/2019] [Accepted: 03/25/2019] [Indexed: 01/16/2023]
Abstract
Climate change will increase the frequency and severity of hazard events such as heat waves, with important effects in several European regions. It is of importance to consider overall effects as well as specific impact on vulnerable population groups such as outdoor workers. The agricultural and construction sectors represent two strategic occupational fields that in relatively recent years involve an increasing number of migrant workers, and therefore require a better management of cultural aspects, that may interact with and impact on heat-related health risk. For this reason, the present study evaluated heat-stress perception and management among native and immigrant workers in Europe. As part of the EU’s Horizon 2020 HEAT-SHIELD project (grant agreement No. 668786), two agricultural and one construction companies, traditionally employing migrant workers, were evaluated with a questionnaire survey during the summer months of 2017. The data collected (104 case studies) were analyzed using descriptive statistics (Chi-squared tests) and the analysis of variance was performed with ANOVA test. From the results, migrant workers declared that work required greater effort than do native Italian workers (χ2 = 17.1, p = 0.001) but reported less impact from heat on productivity (χ2 = 10.6; p = 0.014) and thermal discomfort. In addition, migrant workers were mainly informed through written or oral communications, while native workers received information on heat-health issues through training courses. These findings are of importance for future information and mitigation actions to address socio-cultural gaps and reduce heat-stress vulnerability.
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Affiliation(s)
- Alessandro Messeri
- Centre of Bioclimatology (CIBIC), University of Florence (UNIFI), 50144 Florence, Italy.
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence (UNIFI), 50144 Florence, Italy.
| | - Marco Morabito
- Centre of Bioclimatology (CIBIC), University of Florence (UNIFI), 50144 Florence, Italy.
- Institute of Biometeorology, National Research Council (IBIMET-CNR), 50145 Florence, Italy.
| | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), 00143 Rome, Italy.
| | - Marcella Bugani
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), 00143 Rome, Italy.
| | - Miriam Levi
- Tuscany Regional Centre for Occupational Injuries and Diseases (CeRIMP), 50135 Florence, Italy.
| | - Alberto Baldasseroni
- Tuscany Regional Centre for Occupational Injuries and Diseases (CeRIMP), 50135 Florence, Italy.
| | - Alessandra Binazzi
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), 00143 Rome, Italy.
| | - Bernardo Gozzini
- Tuscany Region, LaMMA Consortium, Weather Forecaster and Researcher at Laboratory of Monitoring and Environmental Modelling for Sustainable Development, Sesto Fiorentino, 50019 Florence, Italy.
| | - Simone Orlandini
- Centre of Bioclimatology (CIBIC), University of Florence (UNIFI), 50144 Florence, Italy.
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence (UNIFI), 50144 Florence, Italy.
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, 2100 Copenhagen, Denmark.
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), 00143 Rome, Italy.
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