[Phenomenon of occupational accidents in hospitals: a retrospective study with reference to introduction of preventive measures and safety specified by D.Lgs 626/94]. / Il fenomeno infortunistico in ospedale: studio retrospettivo con riferimento all'introduzione delle misure preventive e di sicurezza previste dal D.Lgs 626/94.

The work analyzes the phenomenon of the professional accidents in the Policlinico S. Matteo in Pavia, in the quadrenium 1995-1998 to appraise the effects of the application of the D. Lgs 626/94. The obtained data highlight an aggregative diminution of the number of accidents in the biennium 1997-1998 in comparison with the previous biennium 1995-1996. The reduction of the phenomenon of professional accidents is linked substantially with a diminution of the number of accidents with biologic risk. In the quadrennium considered no case of serum conversion has been recorded. It doesn't result significantly altered the number of events of professional accidents linked with the manual handling of loads and with different traumatisms without biological risk. It is highlighted the necessity of more and more close collaboration between the operators of the prevention and the workers.

Incidence of, and risk factors for, nosocomial infections among hematopoietic stem cell transplantation recipients, with impact on procedure-related mortality.

OBJECTIVES: To determine the incidence of, and risk factors for, nosocomial infections (NIs) occurring among hematopoietic stem cell transplantation (HSCT) recipients during hospitalization and to evaluate the impact of these NIs on patient outcome. DESIGN: A two-year prospective observational study in two HSCT units. PATIENTS: All patients admitted to the HSCT units between February 1997 and March 1999. SETTING: A teaching hospital. METHODS: After admission to the HSCT units, the patients were followed prospectively on a daily basis to collect all pertinent variables for the development of NIs. RESULTS: 49 NIs were identified in 34 of the 143 patients screened. The incidence of NIs and infected patients was 34.2% and 23.7%, respectively. The incidence density of NI was 8.96 per 1,000 patient-days. The most frequent NIs were bloodstream infections ([BSIs], 42.8%) and respiratory tract infections (28.6%). Other sites involved were as follows: eye (8.2%), urinary tract (6.1%), gastrointestinal tract (6.1%), skin (4.1%), ear (2%), and central venous catheter ([CVC], 2%). Because of the predominance and clinical relevance of BSIs, we examined both intrinsic and extrinsic risk factors associated with these infections. Independent risk factors for BSIs were allograft from matched unrelated or partially matched family donor, graft-versus-host disease (GVHD) prophylaxis without methotrexate (MTX), type of CVC, and duration of total parenteral nutrition. Four variables were independently associated with mortality occurring during hospitalization: culture-proven BSIs, advanced disease phase at transplant, type of transplant, and absence of MTX for GVHD prophylaxis. CONCLUSIONS: The study identified several factors associated with increased risk of BSIs among HSCT patients. Because BSIs are life-threatening complications for HSCT recipients, preventive measures aimed at reducing the incidence of these infections among patients given HSCT should be adopted.

[Epidemiologic study on the prevalence of low back pain in health personnel exposed to manual handling tasks]. / Studio epidemiologico sulla prevalenza della lombalgia nel personale sanitario esposto a movimentazione manuale dei carichi.

An epidemiological study on the prevalence rate of low back pain among health care workers exposed to manual handling tasks and physical work load was performed. A representative sample (n. 1053) of nursing staff working at the San Matteo Hospital in Pavia was studied using a questionnaire with the purpose of evaluating the prevalence rate of low back pain and related risk factors. 86.4% of the subjects admitted having suffered from back pain at some stage in their life and 71.0% complained of back pain in the 3 months prior to answering the questionnaire. Multivariate logistic regression analysis revealed a significant correlation between low back pain, female gender and specific nursing activities. A significant correlation was found between smoking (> 20 cigarettes per day) and the presence of low back pain, due to intervertebral disk pathology. A statistically significant difference (p < 0.0001) was found in the average degree of disability between healthy nurses (1.3), those with low back pain taking analgesic drugs (5.9) and nurses suffering from low back pain without taking drugs (3.8).