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Pattavina F, Barbara A, Cruciani I, Calabrese AC, Mazzetta E, Sezzatini R, Tuti F, Laurenti P. Evaluation of a food safety training intervention in an asylum-seeking population in Rome. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
The integration of asylum seekers is a public health issue in various contexts, including food, where they often work. According to European legislation, every food operator is obliged to follow training courses on food safety knowledge in order to prevent food-borne diseases. This study aims to evaluate a food safety training intervention in a population of asylum seekers in Rome through the use of a specific tool validated by the WHO, to introduce them in of catering.
The 'Five Key Points for Safer Food' manual was used to deliver the course. An evaluation test for participants to assess the impact of the food safety training is included, divided into 4 categories: General Information, Knowledge (11 items), Attitudes (10) and Behavior (10). The involved food handlers received the same test before and after training. In order to evaluate the effectiveness of the training intervention, the difference in the average of correct pre and post-test answers, overall and by category, was analyzed.
Overall, the 69 food handlers comprised 34 (49.3%) females and 35 (50.7%) males, from different continents (36.2% from Africa, 30.5% Central-South America and 33.3% Asia). The 57.3% has previously worked as cook or waiter. The average age was 36.6 (±12.5) with 11.4 (±3.9) years of education. Overall, the average of correct answers increases of 11.6% (from 76.4% to 88.0% correct answers pre and post-test; p < 0.0001). Knowledge pre test was 7.7 (±1.4), while post test was 8.9 (±1.7) (p < 0.0001). Attitude pre test was 8.3 (±2.2), post test was 9.6 (±0.9) (p < 0.0001). Behavior pre test was 7.7 (±2.2), post test 8.8 (±1.9) (p < 0.0001).
Despite cultural and linguistic differences, our training intervention has been effective in improving knowledge, attitudes and behaviors on food safety in the target population. The food safety in these contexts cannot be understood only as the fulfilment of a regulatory obligation, but also as an opportunity for aggregation and social integration.
Key messages
Food cooking represents a social integration tool: asylum seekers from the most disadvantaged countries could prepare safe multi-ethnic dinners based on the typical courses of their country of origin. WHO training intervention on food safety was effective in improving knowledge, attitudes and behaviors in the target population.
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Affiliation(s)
- F Pattavina
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - A Barbara
- Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | | | - R Sezzatini
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - F Tuti
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - P Laurenti
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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Sezzatini R, Sapienza M, D'Ambrosio F, Moscato U, Laurenti P. [Transmission of Sars-Cov-2 and ventilation of indoor environments. Technical notes and preventive measures]. Ig Sanita Pubbl 2020; 76:107-118. [PMID: 32877395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Knowledge about the new infectious disease COVID-19, which first spread in the city of Wuhan in China, in December 2019, is based on the evidence retrieved from coronaviruses previously known to humans. The main transmission ways of the new SARS-CoV-2 virus are respiratory droplets and direct and close contact with infected individuals and contaminated surfaces. To date, some scientific publications provide initial evidence that SARS-CoV-2 can be detected in the air, thus assuming a further route of infection, that airborne, although these results are to be considered preliminary and they need careful interpretation. In support of this hypothesis, ventilation systems, aimed to improve indoor air, could represent an easy way to spread and promote the virus infection especially in hospitals and in all health facilities where the presence of infected individuals is potentially high as well as the possibility of infection by air. Indeed, by generating jets of air at different speeds, they can interfere with the mission of respiratory particles and determine an environmental diffusion of the potentially contaminating droplet. Therefore, ventilation systems could provide a potential transmission channel for the viral load able to spread out in indoor air. Nonetheless, good management, technical and operational practices may lead to a low risk of contagion, both in community and health environments.
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Affiliation(s)
- Romina Sezzatini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | | | | | - Umberto Moscato
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
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Quaranta G, Sezzatini R, Turnaturi C, Bresa B, Mandolini A, Giovannetti G, Boldrin A, Berloco F, La Milia DI, Cambieri A, Laurenti P. [Hospital foodservice through the Cook Chill system: a two-year experience in a University teaching hospital, Italy]. Ig Sanita Pubbl 2019; 75:51-61. [PMID: 31185490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The Authors present their two-year experience regarding an evaluation of the hygienic quality of ready-to-eat foods in a hospital foodservice, both for patients' meals and hospital staff, prepared by using the Cook Chill system. According to the microbiological parameters provided by International Guidelines, 23 of 27 food samples that were collected and analyzed were found to be satisfactory, one was acceptable and only three were unsatisfactory (two for aerobic colony count and one both for aerobic colony count and hygienic procedure). Escherchia coli, Staphylococcus aureus, Salmonella, Listeria monocytogenes, and Clostridium perfringens were absent in all of the analyzed products, The study results are encouraging and confirm the need to always verify that the different phases of production of hospital meals are correctly implemented, even when the foodservice is out-sourced. This has always been considered a priority in the study hospital, where the Health Department is at the forefront both in control and verification of food safety practices and in offering training activities, especially in view of the increased susceptibility of hospitalized patients.
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Affiliation(s)
| | - Romina Sezzatini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Cinzia Turnaturi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Benedetto Bresa
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | | | | | | | - Filippo Berloco
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | | | - Andrea Cambieri
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
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Vincenti S, Raponi M, Sezzatini R, Giubbini G, Laurenti P. Enterobacteriaceae Antibiotic Resistance in Ready-to-Eat Foods Collected from Hospital and Community Canteens: Analysis of Prevalence. J Food Prot 2018; 81:424-429. [PMID: 29457919 DOI: 10.4315/0362-028x.jfp-17-317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Foodborne diseases and antibiotic resistance are serious widespread health problems in the contemporary world. In this study, we compared the microbiological quality of ready-to-eat (RTE) foods found in community canteens versus hospital canteens in Rome, Italy, focusing on detection and quantification of Enterobacteriaceae and the antibiotic resistance of these bacteria. Our findings show a remarkable difference in Enterobacteriaceae contamination between RTE foods distributed in community canteens (33.5% of samples) and those distributed in hospital canteens (5.3% of samples). This result highlights greater attention to good manufacturing practices and good hygiene practices by the food operators in hospitals compared with food operators in community canteens. As expected, a higher percentage of cold food samples (70.9%) than of hot food samples (10.8%) were positive for these bacteria. Excluding the intrinsic resistance of each bacterial strain, 92.3% of the isolated strains were resistant to at least one antibiotic, and about half of the isolated strains were classified as multidrug resistant. The prevalence of multidrug-resistant strains was 50% in the community samples and 33.3% in hospital canteens. Our results indicate that approximately 38% of RTE foods provided in community canteens is not compliant with microbiological food safety criteria and could be a special risk for consumers through spread of antibiotic-resistant strains. Hygienic processing and handling of foods is necessary for both hospital and community canteens.
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Affiliation(s)
- Sara Vincenti
- 1 Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; and
| | - Matteo Raponi
- 2 Istituto di Sanità Pubblica, Sezione Igiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Romina Sezzatini
- 1 Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; and
| | - Gabriele Giubbini
- 2 Istituto di Sanità Pubblica, Sezione Igiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Patrizia Laurenti
- 1 Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; and.,2 Istituto di Sanità Pubblica, Sezione Igiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
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Quaranta G, Marruco R, Posteraro B, Cambieri A, Berloco F, Sezzatini R, Boninti F, Turnaturi C, Laurenti P. [Hygienic suitability of food and food-contact surfaces in a hospital canteen: the experience of a University Hospital in Italy]. Ig Sanita Pubbl 2017; 73:579-593. [PMID: 29573385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The Authors present the results of a study performed during a time-period of two years, to evaluate the hygienic quality of ready-to-eat foods, prepared and served in a hospital catering service, and the microbiological status of food-contact surfaces. Food hygiene was evaluated using non-pathogenic indicator microorganisms. The study was part of the verification activities that the hospital Health Department considers as a priority in order to guarantee patient safety. Only one of 52 food samples tested was considered unsatisfactory; the examined surfaces were not fully satisfactory in one of four cases. The study results, although encouraging as a whole, especially with respect to the hygienic safety of food prepared and served in the hospital, confirm the need to continuously verify that the appropriate environmental sanitation procedures are applied, even in the case of outsourcing. Considering the increased susceptibility of hospitalized patients, this remains a priority in the hospital where the study was performed.
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Affiliation(s)
- Gianluigi Quaranta
- Sezione di Igiene dell'Istituto di Sanità Pubblica - Università Cattolica del Sacro Cuore, Roma - Unità Operativa Complessa "Igiene Ospedaliera", Fondazione Policlinico Universitario A. Gemelli, Roma, Italia
| | - Roberta Marruco
- Tecnico della Prevenzione nell'Ambiente e nei Luoghi di Lavoro
| | - Brunella Posteraro
- Sezione di Igiene dell'Istituto di Sanità Pubblica - Università Cattolica del Sacro Cuore, Roma - Unità Operativa Complessa "Igiene Ospedaliera", Fondazione Policlinico Universitario A. Gemelli, Roma, Italia
| | - Andrea Cambieri
- Direzione Sanitaria, Fondazione Policlinico Universitario A. Gemelli, Roma, Italia
| | - Filippo Berloco
- Direzione Sanitaria, Fondazione Policlinico Universitario A. Gemelli, Roma, Italia
| | - Romina Sezzatini
- Sezione di Igiene dell'Istituto di Sanità Pubblica - Università Cattolica del Sacro Cuore, Roma - Unità Operativa Complessa "Igiene Ospedaliera", Fondazione Policlinico Universitario A. Gemelli, Roma, Italia
| | - Federica Boninti
- Sezione di Igiene dell'Istituto di Sanità Pubblica - Università Cattolica del Sacro Cuore, Roma - Unità Operativa Complessa "Igiene Ospedaliera", Fondazione Policlinico Universitario A. Gemelli, Roma, Italia
| | - Cinzia Turnaturi
- Sezione di Igiene dell'Istituto di Sanità Pubblica - Università Cattolica del Sacro Cuore, Roma - Unità Operativa Complessa "Igiene Ospedaliera", Fondazione Policlinico Universitario A. Gemelli, Roma, Italia
| | - Patrizia Laurenti
- Sezione di Igiene dell'Istituto di Sanità Pubblica - Università Cattolica del Sacro Cuore, Roma - Unità Operativa Complessa "Igiene Ospedaliera", Fondazione Policlinico Universitario A. Gemelli, Roma, Italia
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Boccia S, Laurenti P, Leoncini E, Amore R, Vincenti S, Arzani D, Berloco F, Boninti F, Bruno S, Celani F, Damiani G, Di Giannantonio P, Moscato U, Posteraro B, Sezzatini R, Vecchioni A, Wachocka M, Ricciardi W, Quaranta G, Ficarra MG. [Comparison of conventional culture methods and quantitative real-time PCR methods for the detection of Legionella pneumophila in water samples in a large University teaching hospital in Rome, Italy]. Ig Sanita Pubbl 2015; 71:569-576. [PMID: 26847270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aims of this study were to identify the best threshold value for the real-time PCR method in detecting the presence of Legionella pneumophila in water samples, and to evaluate the prognostic significance of negative results obtained with the molecular method. From 2011 to 2014, 77 water samples were collected from hospital wards of a large University teaching hospital in Rome (Italy) and screened for L.pneumophila by the standard culture method and by real-time PCR. The high sensitivity and negative predictive value of real-time PCR make this method suitable as a quick screening tool to exclude the presence of L. pneumophila in water samples in the hospital setting.
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Affiliation(s)
- Stefania Boccia
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Patrizia Laurenti
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Emanuele Leoncini
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Rosarita Amore
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Sara Vincenti
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Dario Arzani
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Filippo Berloco
- Direzione Rischio Clinico e Igiene, Policlinico Universitario "Agostino Gemelli, Roma, Italia
| | - Federica Boninti
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Stefania Bruno
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Fabrizio Celani
- Direzione Rischio Clinico e Igiene, Policlinico Universitario "Agostino Gemelli, Roma, Italia
| | - Gianfranco Damiani
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Paolo Di Giannantonio
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Umberto Moscato
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Brunella Posteraro
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Romina Sezzatini
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Alessia Vecchioni
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Malgorzata Wachocka
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Walter Ricciardi
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Gianluigi Quaranta
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Maria Giovanna Ficarra
- Istituto di Sanità Pubblica, sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
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Laurenti P, Raponi M, De Meo C, Corsaro A, Sezzatini R, Vincenti S, Popovic D, Ricciardi W. Antimicrobial resistant bacteria in ready-to-eat foods from hospital and community in Rome, Italy. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv172.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Laurenti P, Raponi M, Sezzatini R, de Waure C, De Meo C, Ricciardi W. Antibiotic resistance strains in ready to eat foods from hospital and community in Rome, Italy: where are more widespread and what implications? Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Quaranta G, Vincenti S, Ferriero AM, Boninti F, Sezzatini R, Turnaturi C, Gliubizzi MD, Munafò E, Ceccarelli G, Causarano C, Accorsi M, Del Nord P, Ricciardi W, Laurenti P. Legionella on board trains: effectiveness of environmental surveillance and decontamination. BMC Public Health 2012; 12:618. [PMID: 22870945 PMCID: PMC3519711 DOI: 10.1186/1471-2458-12-618] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 07/30/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Legionella pneumophila is increasingly recognised as a significant cause of sporadic and epidemic community-acquired and nosocomial pneumonia. Many studies describe the frequency and severity of Legionella spp. contamination in spa pools, natural pools, hotels and ships, but there is no study analysing the environmental monitoring of Legionella on board trains. The aims of the present study were to conduct periodic and precise environmental surveillance of Legionella spp. in water systems and water tanks that supply the toilet systems on trains, to assess the degree of contamination of such structures and to determine the effectiveness of decontamination. METHODS A comparative pre-post ecological study was conducted from September 2006 to January 2011. A total of 1,245 water samples were collected from plumbing and toilet water tanks on passenger trains. The prevalence proportion of all positive samples was calculated. The unpaired t-test was performed to evaluate statistically significant differences between the mean load values before and after the decontamination procedures; statistical significance was set at p ≤ 0.05. RESULTS In the pre-decontamination period, 58% of the water samples were positive for Legionella. Only Legionella pneumophila was identified: 55.84% were serogroup 1, 19.03% were serogroups 2-14 and 25.13% contained both serogroups. The mean bacterial load value was 2.14 × 10(3) CFU/L. During the post-decontamination period, 42.75% of water samples were positive for Legionella spp.; 98.76% were positive for Legionella pneumophila: 74.06% contained serogroup 1, 16.32% contained serogroups 2-14 and 9.62% contained both. The mean bacterial load in the post-decontamination period was 1.72 × 10(3) CFU/L. According to the t-test, there was a statistically significant decrease in total bacterial load until approximately one and a half year after beginning the decontamination programme (p = 0.0097). CONCLUSIONS This study indicates that systematic environmental surveillance could be a useful approach for assessing the risk of exposure to Legionella bacteria, which still represents a public health threat. According to the study results, an environmental surveillance programme, followed by decontamination procedures where necessary, would decrease the total bacterial count, protecting the health of travellers and workers.
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Affiliation(s)
- Gianluigi Quaranta
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Sara Vincenti
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Anna Maria Ferriero
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Federica Boninti
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Romina Sezzatini
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Cinzia Turnaturi
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Maria Daniela Gliubizzi
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Elio Munafò
- RFI (Italian Railway) Health Service, Via F. A. Pigafetta 3, 00154, Rome, Italy
| | - Gianluca Ceccarelli
- RFI (Italian Railway) Health Service, Via F. A. Pigafetta 3, 00154, Rome, Italy
| | - Carmelo Causarano
- RFI (Italian Railway) Health Service, Via F. A. Pigafetta 3, 00154, Rome, Italy
| | - Massimo Accorsi
- RFI (Italian Railway) Health Service, Via F. A. Pigafetta 3, 00154, Rome, Italy
| | - Pasquale Del Nord
- Trenitalia Environmental Work Quality and Safety, Via F. A. Pigafetta 3, 00154, Rome, Italy
| | - Walter Ricciardi
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Patrizia Laurenti
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
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