Blood and body fluids exposure of healthcare workers in a university hospital of Palermo, Italy: a fourteen years long surveillance.

BACKGROUND: Healthcare workers are habitually in direct contact with patients, possible carriers of infectious diseases and with potentially infectious biological materials; therefore, the implementation of standard precautions and good working practices represent an intervention strongly recommended by the Centers for Disease Control and Prevention, and required by Italian law, for the prevention of professional cut wounds. The study focused on assessing the exposure frequency and factors related to biological injuries among healthcare workers in a teaching hospital in Palermo, Italy. METHODS: We performed a 14-years retrospective descriptive analysis on blood and body fluids exposures in healthcare workers, documented by questionnaires administered at the time of injury and by data collected during the follow-up period. The questionnaire included questions concerning personal data (age, sex), job position (role, employment contract, ward), biological exposure (type of exposure, devices used and circumstance of blood and body fluids exposure), precautions adopted (personal protecting equipment, safety devices) and vaccination status. RESULT: A total amount of 899 healthcare workers was investigated. The incidence rate per 100 beds was 10.7. Frequency of exposure to blood and body fluids among healthcare workers was 35.3% in nurses, 31.7% in physicians, 17.6% in students. The mean age of injured healthcare workers was 36 years. The most common blood and body fluids exposures were represented by needlestick injury (76.2%), splash and spill (15.0%) and sharp (8.3%). 585 out of 685 percutaneous exposures were caused by needles (syringe, peripheral venous catheter, butterfly needles, etc.) and occurred mainly to nurses (N=224, 38.3%), physicians (N=184, 31.4% of whom resident physicians=122, 20.1% and hospital doctors=62, 10.6%), students (N=96, 16.4%) and auxiliary personnel (N=77, 13.1%). No seroconversion among exposed healthcare workers was recorded in the whole survey period. Twenty-four healthcare workers (2.6%) received post-exposure prophylaxis against Hepatitis B Virus. CONCLUSION: To our knowledge, this is the first long-term survey on blood and body fluids exposure in Southern Italy. Nurses are the most commonly affected group by biological injuries. Resident physicians and students follow the nurses probably due to a lack of training and experience about biological risk. These last two groups, however, seem to have more awareness of blood and body fluids exposures to which they are susceptible during their training cycle; in fact, they mostly use personal protective equipment compared to other healthcare workers. The blood and body fluids exposures are a preventable and a major occupational hazard in healthcare. This focus highlights the need for interventions to enhance the occupational safety of workers and students.

Digital epidemiology: assessment of measles infection through Google Trends mechanism in Italy.

INTRODUCTION: The primary aim of this study is to evaluate the temporal correlation between Google Trends and the data on measles infection arising from the conventional surveillance system, reported by the Istituto Superiore di Sanità's (ISS) bulletin. Moreover, this study is also aimed at forecasting the trends of the reported infectious diseases cases over time. MATERIAL AND METHODS: The reported cases of measles were selected from January 2013 until October 2018. The data on Internet searches have been obtained from Google Trends; the research data referred to the first 48 weeks of year 2017 have been aggregated on a weekly basis. The search volume provided by Google Trends has a relative nature and is calculated as a percentage of query related to a specific term in connection with a determined place and time-frame. The statistical analyses have been performed by using the Spearman's rank correlation coefficient (rho). The statistical significance level for such analyses has been fixed in 0.05. OUTCOMES: We have observed a strong correlation at a lag of 0 to -4 weeks (rho > 0.70) with the cases reported by ISS with the strongest correlation at a lag of -3 weeks (rho > 0.80 both for measles than for the symptoms of the measles). The database containing monthly data has shown a moderate correlation at a lag of -1 to +1 months and a strongest correlation at a lag of -1 (rho = 0.6152 for measles and rho = 0.5039 for symptoms of the measles). CONCLUSIONS: The surveillance systems based on Google Trends have a potential role in public health in order to provide near real-time indicators of the spread of infectious diseases. Therefore the huge potential of this approach could be used in the immediate future as a support of the traditional surveillance systems.

[Abolishing mandatory routine medical and laboratory examination of food handlers may have influenced the reporting trends of foodborne diseases? Frequency of notified foodborne illnesses in Southern Italy from 1996 to 2009]. / L'abolizione del libretto di idoneità sanitaria per alimentaristi può aver influenzato il trend di notifica delle tossinfezioni alimentari? Analisi delle notifiche delle principali tossinfezioni alimentari nelle Regioni meridionali ed insulari nel periodo 1996-2009.

The aim of this study is to compare notifications of foodborne diseases in Southern Italy, before and after abolishing mandatory medical and laboratory examination routine. Data were obtained from the National Epidemiological Report of Health Ministry, that includes the annual summaries of foodborne infectious illnesses notified in Italy. The average number of foodborne diseases per million inhabitants per year decreased after the abolishment of health card for all examined conditions. There was a statistically significant reduction in all Regions for Salmonellosis and in Basilicata, Calabria, Campania and Sicily for Brucellosis. Abolishing health card of food handlers workers did not increase trends of foodborne illnesses and foodborne epidemics in Southern Italy. Examined data confirm the substantial effectiveness of food handlers self-control and training as essentials instruments of Evidence Based Prevention.

A proposal for an evidence-based model of the screening for the colorectal carcinoma in an Italian setting.

INTRODUCTION: The aim of this paper is to improve the feasibility perception of policymakers, health care workers and target population about the cost-effectiveness of the implementation of colorectal screening as Public Health strategy. METHODS: Retrospective study by application of a three-step model designed for a local setting in Sicily (Palermo and its Province) in order to distribute Fecal Occult Blood Tests (FOBTs), offer colonoscopy and surgery, by district allocation of pharmacies, public digestive endoscopic centres and oncologic and general surgery units. Mean adherence to consolidated colorectal screening programs in Italy was applied in order to evaluate the feasibility of an operative model in our area. RESULTS: Applying the model to the target population (269,368 individuals of both sexes), it can be expected a mean percentage of 79% delivered invitation and a mean participation rate of 46.3% accounting for a total of 213,070 invited individuals and 98,651 participating in the first round of the program. Furthermore, considering the national mean of 6% positive FOBT, 82% of colonscopy adhesion and 7% CRC detection rate, it can be scheduled a burden for health care structures involved in the program accounting for 49,325 FOBTs, 2,338 colonscopies and 141 surgeries for each year. DISCUSSION: This work demonstrates the feasibility of a colorectal screening project in our area, showing a sustainable impact for local health care involved structures. Furthermore, this program may be spread as an applicative model to other areas, adapting the project to the needs of the local setting in which the colorectal screening will be organized.