Influenza vaccination and absenteeism among healthy working adults: a cost-benefit analysis.

BACKGROUND: Seasonal influenza is a highly contagious infection that might lead to serious clinical complications and incurs a conspicuous socio-economic impact. Influenza vaccination is currently recommended only for specific groups of healthy adults (such as healthcare workers) even though it was demonstrated to be effective in reducing absenteeism and decreased workers' productivity during flu epidemic period. The main purpose of this study is to analyse the extent of absences due to illness following a voluntary flu immunization program among the Komatsu Italia Manufacturing company's personnel during the flu season 2017-2018. Secondly, we aimed at performing a cost-benefit analysis of the vaccination campaign from the company's perspective. STUDY DESIGN: This is an observational cohort study conducted during the period between the 14th week of 2017 and the 13th week of 2018 (from 03/04/2017 to 01/04/2018). The study population was the personnel of Komatsu Italia Manufacturing S.p.A. on duty during the study period. METHODS: For each subject the following data were collected: sex, date of birth, professional profile, seasonal influenza immunization status and sick-leave days. Sick-leave days were compared among the influenza epidemic period and the previous one between vaccinated and unvaccinated and any difference in days of absence was considered to be caused by seasonal influenza. RESULTS: Out of 408 employees, 60 (14.7%) accepted the voluntary influenza vaccination. In multivariate analysis (logistic model) an age ≥ 50 years was the only predictor for vaccination acceptance (ORM 3.11 p<0.001). During the flu period, the monthly mean of sick-leave days per employee was significantly lower among the vaccinated than the unvaccinated, respectively of 0.328 days/person vs 0.752 days/person (p = 0.022). Unvaccinated employees reported a higher average of sick-leave days during the flu period compared to the previous non-influenza period (0.752 days/month/person vs 0.337 days/month/person p <0.001). The monthly mean cost for sickness absences per employee was significantly higher for an unvaccinated subject compared to one vaccinated, respectively € 129.00 and € 54.00 (p = 0.028). The overall net saving estimated was € 314.00 per person vaccinated. CONCLUSIONS: Influenza vaccination proved to be an extraordinary preventive tool and a cost-effective intervention. However, influenza immunization seems to be unappealing among healthy adults and higher flu vaccination coverages could be achieved through educational interventions possibly addressing young employees who showed little interest in vaccination. Finally, among health promotion interventions, companies should point out the importance of flu vaccination both for the individual wellbeing and the company environment.

Chronic obstructive pulmonary disease: the Disability Adjusted Life Years in northern Italy.

AIM: The DALY measure represents a new tool for improving the capacity of local health unit to assess population health needs and priorities. Our study aimed to increase the validity of the Disability Adjusted Life Years (DALY), by incorporating local estimates of the disease incidence and applying population-specific disability weights. METHODS: This is a prospective cohort study enrolling subjects aged 45+ years, first-time admitted to the hospital with principal diagnosis of 490-492, 496 ICD IX-CM codes and followed for one year to evaluate the vital status. A subset was administered the Saint George Respiratory Questionnaire to estimate the distribution of the chronic obstructive pulmonary disease (COPD)-related disability. RESULTS: Estimates of total DALY (per 1000) for COPD varied between 2.1 to 3.4 years among men and between 1.0 to 2.3 years among women; percentages of years of life lost due to a premature mortality were between 60 and 70%. CONCLUSION: The DALY represents a new tool for improving the capacity to assess population health needs and priorities. Policy makers owning such a further element of evaluation may be better oriented in allocating resources for COPD among the different health care chapters: prevention, emergency, chronicity and rehabilitation.

[Effectiveness trial for prevention of occupational injuries in the wood processing industry]. / Un trial di efficacia nella prevenzione degli infortuni nel settore del legno.

BACKGROUND: Training is a key tool to improve prevention and safety management at the workplace. Few studies have aimed at assessing quality of training and its outcomes. OBJECTIVES AND METHODS: This paper describes the rationale, design, content, and evaluation of an ongoing randomized controlled trial aimed at assessing the effectiveness of a training programme designed to reduce the risk of occupational injuries among employees of the wood processing industry. DISCUSSION AND CONCLUSIONS: Well designed, targeted training programmes could represent a feasible means of reducing work injuries by improving employers' behaviour and attitudes towards safety; nevertheless, these kinds of interventions have a considerable impact both in terms of human resources and in terms of cost. For these reasons, assessment of effectiveness and knowledge-sharing should be considered as essential phases of injury prevention programmes.

Oral health inequalities in preschool children in North-Eastern Italy as reflected by caries prevalence.

AIM: To investigate dental caries experience among preschool children aged 3-5 years living in 2 Health Districts in North- Eastern Italy and to compare caries experience between indigenous and immigrant children. STUDY DESIGN: Cross-sectional observational survey. METHODS AND STATISTICS: In this study 4,198, 3-5-year-old children, drawn from a total population of 9,829 were asked to participate. The examinations were performed at school between October 2004 and June 2005 and only lesions that penetrate the dentine were recorded (according to the BASCD criteria, 1997), by 2 calibrated examiners using artificial light, mouth mirrors and dental probes. The participants were categorised into 2 subgroups according to the country of origin of their mothers: indigenous mothers, almost all born in Italy, plus a very small number of mothers born in other highly developed western countries--"western origin"--(Nordic countries, Western Europe, North America, New Zealand and Australia), and immigrant mothers from Eastern Europe, Asia, Africa, Turkey, South and Central America, "non-western origin". Comparisons between groups were made using Pearson chi-squared test. Caries risk estimation was established by logistic regression analysis to assess the influence of gender, age and ethnicity on caries experience. Risk was summarised as odds ratio plus 95% CI. RESULTS: A total of 3,401 pre-school children were examined. The overall prevalence of dentinal caries was: 15.4% in 3-year-olds, 24.2% in 4-year-olds and 31.1% in 5-year-olds. At the same ages, children of immigrant mothers ("non-western origin") showed a significantly higher prevalence of caries compared with their counterparts of "western origin". As expected, older children had more caries. "Non-western origin" had a negative effect on caries experience. CONCLUSIONS: Inequalities associated with mothers with an immigrant background were observed in the distribution of caries experience among the children. These children represent the first generation settling in and growing up in Italy, and their dental status-related data are comparable to those observed at the same ages in first generation "non-western" children living in other industrialised countries.