COVID-19 outbreaks in hospital workers during the first COVID-19 wave.

BACKGROUND: Health care workers (HCWs) are on the frontline, playing a crucial role in the prevention of infection and treatment of patients. AIMS: This study was aimed to evaluate the prevalence of hospital-acquired coronavirus disease 2019 (COVID-19) infection at work and related factors at the University Hospital of Trieste workers exposed to COVID-19 patients. METHODS: From March 1 to May 31, of 4216 employees, 963 were in contact with COVID-19 patients or colleagues and were followed up. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in nasopharyngeal swabs was determined every 3 days, by RT-PCR. RESULTS: During the follow-up period, 193 workers were positive for COVID-19 (5%), and 165 of these (86%) were symptomatic. We identified five major cluster outbreaks of COVID-19 infection in Trieste Hospitals, four of which occurred before the implementation of universal masking for HCWs and patients (1-14 March 2020). COVID-19 infection was significantly higher in high-risk ward workers (Infectious Diseases, and Geriatric and Emergency Medicine, odds ratio [OR] 13.4; 95% confidence interval [CI] 5.8-31), in subjects with symptoms (OR 5.4; 95% CI 2.9-10) and in those with contacts with COVID-19 patients and colleagues (OR 2.23; 95% CI 1.01-4.9). CONCLUSIONS: Hospital workers were commonly infected due to contact with COVID-19 patients and colleagues, mainly in the first 15 days of the pandemic, before the implementation of universal mask wearing of HCWs and patients. Repetitive testing and follow-up permitted the identification of COVID-19 cases before symptom onset, obtaining better infection prevention and control.

[Risks of repetitive movements in health personnel]. / Rischi da movimenti ripetitivi nel personale sanitario.

To date, scant attention has been devoted to the occupational risk related to repetitive movements in health personnel. Using three database, PubMed, Scopus, and EMBASE, we found 57 papers on this topic, and on possibly related upper limb symptoms and diseases. In these studies, evaluation of the risk, e.g. using the methods currently applied in industry, are lacking. Although in several studies data on the prevalence of upper limb symptoms and disorders are presented, a comparison of results is difficult as different methods were applied. Furthermore, a comparison with adequate controls is frequently lacking, and/or correlation with the risk was not studied. Despite these limitations, an overall evaluation of the results shows that in health personnel the prevalence of upper limb symptoms/disorders is generally high. Highest prevalences were observed for the neck, shoulder, wrist/hand symptoms and for Carpal Tunnel Syndrome (CTS) in dental personnel, for symptoms to the neck, shoulder and wrist/hand in sonographers, and to the neck, shoulder, elbow, and, especially, wrist/hand in laboratory technicians using manual pipettes. In the nursing personnel highly variable prevalences were observed; this is possibly due to the variability of the tasks performed by this occupational group. Repetitive movements of upper limb are a known risk factor for symptoms to the neck, shoulder, elbow, and wrist/hand, and some disorders, as CTS: the high prevalences observed in health workers may be related to this risk. Nevertheless, other factors such as effort, posture and precision work may play an important role too. As a conclusion, available data are insufficient for an adequate evaluation of the occupational risk related to repetitive movements in health workers.

[Freedom from smoking for health care workers. A project from Trieste]. / Operatori della sanità liberi dal fumo. Attivazione di un progetto in Provincia di Trieste.

A tree years interventional study to modify smoking habits in health workers in Trieste province was planed in the collaboration of occupational health unit and Tobacco's Dependence Study Center. The aim of this paper is refer about preliminary data of the project started in 2007 regarding smoking habits in health workers of the Azienda per i Servizi Sanitari n.1 "Triestina" (ASS1) and the Azienda Ospedaliera Universitaria Ospedali Riuniti di Trieste (AOUTS). The project consist of several actions. i) information about risks and opportunities of project; ii) pursuance of the law 51 L 3/2003; iii) Occupational Health Unit and Tobacco's Dependence Study Center collaboration; iv) follow-up of the subjects that choose the disaccustom program. During occupational medical surveillance we collected the data related to 492 workers, 37% of the cases were smokers (180). The results of test of dependence to smoke (test di Fagestrom) showed an high dependence in 19% and an high motivation to stop smoke (test di Richmond) in 39% of the smokers. More than fifty percent of this subjects gave their adhesion to the disaccustom program.