Preparing for future waves and pandemics: a global hospital survey on infection control measures and infection rates in COVID-19.

A survey of hospitals on three continents was performed to assess their infection control preparedness and measures, and their infection rate in hospital health care workers during the COVID-19 pandemic. All surveyed hospitals used similar PPE but differences in preparedness, PPE shortages, and infection rates were reported.

Antibody response to SARS-CoV-2 vaccination is extremely vivacious in subjects with previous SARS-CoV-2 infection.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic calls for rapid actions, now principally oriented to a world-wide vaccination campaign. In this study we verified if, in individuals with a previous SARS-CoV-2 infection, a single dose of messenger RNA (mRNA) vaccine would be immunologically equivalent to a full vaccine schedule in naïve individuals. Health care workers (184) with a previous SARS-CoV-2 infection were sampled soon before the second dose of vaccine and between 7 and 10 days after the second dose, the last sampling time was applied to SARS-CoV-2 naïve individuals, too. Antibodies against SARS-CoV-2 were measured using Elecsys Anti-SARS-CoV-2 S immunoassay. The study was powered for non-inferiority. We used non parametric tests and Pearson correlation test to perform inferential analysis. After a single vaccine injection, the median titer of specific antibodies in individuals with previous coronavirus disease 2019 was 30.527 U/ml (interquartile range [IQR]: 19.992-39.288) and in subjects with previous SARS-CoV-2 asymptomatic infection was 19.367.5 U/ml (IQR: 14.688-31.353) (p = .032). Both results were far above the median titer in naïve individuals after a full vaccination schedule: 1974.5 U/ml (IQR: 895-3455) (p < .0001). Adverse events after vaccine injection were more frequent after the second dose of vaccine (mean: 0.95; 95% confidence interval [CI]: 0.75-1.14 vs. mean: 1.91; 95% CI: 1.63-2.19) (p < .0001) and in exposed compared to naïve (mean: 1.63; 95% CI: 1.28-1.98 vs. mean: 2.35; 95% CI: 1.87-2.82) (p = .015). In SARS-CoV-2 naturally infected individuals a single mRNA vaccine dose seems sufficient to reach immunity. Modifying current dosing schedules would speed-up vaccination campaigns.

Occupational health and safety of road haulage company employees.

BACKGROUND: This paper follows up on a project that was launched in 2008 and contributed to the development of the new Italian Society of Occupational Medicine (SIML) guidelines for the road haulage industry. OBJECTIVE: To reach a better understanding of occupational illness amongst truck drivers, in order to define appropriate health monitoring protocols and promote a healthy life-style. METHODS: We assessed 673 male drivers (mean age 43.85 years, SD 9.56; mean working seniority 27.28 years, SD 10.59), employed by 46 different companies. The drivers, who were gradually recruited in the study over the years, had a maximum of 8 re-assessments each, for a total of 2608 examinations. We applied a survey protocol consisting in a medical examination, questionnaires for the most common risks and instrumental and laboratory tests in compliance with SIML guidelines. RESULTS: We identified a total of 44 work-related diseases: 22 cases of noise-induced hearing loss (NIHL) and 22 cases of lumbar degenerative disc disease. As regards metabolic disorders, we observed 28 cases of diabetes mellitus, in most cases (71.4%) as a first diagnosis or under poor therapeutic control. We observed poorly-controlled hypertension in 103 drivers, the majority of whom (54%) were diagnosed for the first time. Over 30% of the workers in our study were obese and approximately 40% were tobacco smokers. We identified just 9 individuals (1.3%) with a positive toxicological screening for use of recreational drugs. Our data confirm a high prevalence of occupational illness amongst truck drivers. Cardiovascular and metabolic conditions require close monitoring.

[Not Available]. / Diabetes mellitus in critical jobs.

BACKGROUND: Diabetes is a disease with high social impact and it is important to consider how work may be influenced by it or whether work itself may promote or accelerate its course. OBJECTIVES: The objective was to investigate the prevalence of diabetes in four critical categories of workers. The survey involved construction workers, truck drivers, bus drivers and shift workers in the manufacturing sector. METHODS: In the years 2012-14 we investigated 2034 males workers, through personal history, physical examination, laboratory tests. The subjects with fasting glucose >125 mg/dl underwent a second control and haemoglobin A1c determination. Positive cases were referred to specialist control. Expected prevalence and standardized prevalence ratio (SPR) were calculated using official data regarding diabetes prevalence in Italy. RESULTS: The prevalence of diabetes in 608 truck drivers was 4.4% (expected 2.6%, SPR 1.69, IC95% 1.08 to 2.31); in 860 construction workers 1.9% (expected 2.1%, SPR 0.90, IC95% 0.48 to 1.33); in 378 bus drivers 2.6% (expected 3.5%, SPR 0.74, IC95% 0.29 to 1.20); in 188 shift workers 3.2% (expected 2.1%, SPR 1.52, IC95% 0.33 to 2.71). In the age range 35-59 years the prevalence in 467 truck drivers was 5.1% (expected 2.4%, SPR 2.13, IC 95% 1.29 to 2.96). DISCUSSION: Diabetes was confirmed to be highly prevalent at working ages. The study highlighted an increased diabetes prevalence among truck drivers, whereas other jobs might represent protective factors; this hypothesis, however, needs further investigation.