Smoking at the workplaces in Italy after the smoking ban in the Lazio Region.

BACKGROUND: In Italy, an anti-smoking law was issued in 2003, with the aim of reducing tobacco smoking inside public places. OBJECTIVES: The aim of the study was to assess the observance of the smoking ban in Italy, during the period 2010-2014, in several workplaces and to evaluate the perception of workers, both smokers and non-smokers, on this issue. METHODS: This cross-sectional study analyzed data resulting from a self-administered questionnaires in 59 companies, from several working sectors (transport, healthcare and building), in the Latium Region in Italy. RESULTS: Out of 7200 questionnaires, 6996 were included in the analysis: 43.7% of the employees think that the smoking ban is respected in the workplace; women are more prone to think that the ban is not observed. Smokers tend to perceive the ban to be respected (AOR: 0.69; 95% CI: 0.62-0.77) while non-smokers feel more exposed to second-hand smoke (AOR: 1.57; 95% CI: 1.39-1.77). Workers in intellectual and highly specialized professions (AOR: 1.63; 95% CI: 1.25-2.13), technical professions (AOR: 1.64; 95% CI: 1.28-2.10) and craftsmen, skilled workers and farmers (AOR: 1.42; 95% CI: 1.09-1.85) tend to perceive the smoking ban not to be observed and the last two classes are the ones who feel the most exposed to second-hand smoke (AOR: 6.68; 95% CI: 0.50-0.90; AOR: 0.52; 95% CI: 0.38-0.70). DISCUSSION: The results of this study can be used as a starting point for the implementation of new strategies to reduce tobacco addiction, beginning from the compliance with the ban on smoking in the workplace and the promotion of a healthy lifestyle.

Assessing knowledge, attitude, and practice of healthcare personnel regarding biomedical waste management: a systematic review of available tools.

Biomedical waste (BMW) management is an important commitment of hospitals both in terms of the possible infectious risk and from the financial point of view. Monitoring the knowledge, attitude, and practice (KAP) of healthcare professionals on this topic represents a source of information on BMW management. The aim of this study is to perform a systematic review to identify the reliable and valid tools able to assess the KAP of professionals in healthcare centers to manage BMW. Two databases (PubMed and Scopus) were searched on 10 May 2018 for cross-sectional studies with tools on BWM management, including original research studies from peer-reviewed journals, case studies, and review studies. Information on validation and reliability were collected. Methodological quality was assessed using the Newcastle-Ottawa scale for cross-sectional studies. Fifty-three articles were included, of which 19 presented a questionnaire on BMW for healthcare workers. Nine proposed a validated questionnaire: four reported Cronbach's alpha, which ranged from 0.62 to 0.86. Results further emphasize the prevalence of Asian studies facing the problem of assessing KAP about BMW management using specific tools. Overall, 14 questionnaires were designed in Asia, two in Africa, one in America, one in Australia, and one questionnaire was elaborated in Europe, in Spain. This systematic review highlighted the need of creation of validated and methodologically high-quality questionnaires. Therefore, there is the need of new cross-sectional studies to investigate these problems, improving generalization, and facilitating international comparison of research findings.

Towards elimination of measles and rubella in Italy: Progress and challenges.

INTRODUCTION: In the WHO European Region, endemic transmission of measles and rubella had been interrupted by 37 and 42 of the 53 member states (MSs), respectively, by 2018. Sixteen MSs are still endemic for measles, 11 for rubella and nine for both diseases, the latter including Italy. Elimination is documented by each country's National Verification Committee (NVC) through an annual status update (ASU). OBJECTIVE: By analysing data used to produce the ASUs, we aimed to describe the advances made by Italy towards elimination of measles and rubella. Moreover, we propose a set of major interventions that could facilitate the elimination process. METHODS: A total of 28 indicators were identified within the six core sections of the ASU form and these were evaluated for the period 2013-2018. These indicators relate to the incidence of measles/rubella; epidemiological investigation of cases; investigation of outbreaks; performance of the surveillance system; population immunity levels; and implementation of supplemental immunization activities (SIAs). RESULTS: From 2013 to 2018, epidemiological and laboratory analyses of measles cases in Italy improved substantially, allowing timely investigation in 2017 and 2018 of most outbreak and sporadic cases and identification of the majority of genotypic variants. Moreover, since 2017, vaccination coverage has increased significantly. Despite these improvements, several areas of concern emerged, prompting the following recommendations: i) improve outbreak monitoring; ii) strengthen the MoRoNet network; iii) increase the number of SIAs; iv) reinforce vaccination services; v) maintain regional monitoring; vi) design effective communication strategies; vii) foster the role of general practitioners and family paediatricians. CONCLUSIONS: The review of national ASUs is a crucial step to provide the NVC with useful insights into the elimination process and to guide the development of targeted interventions. Against this background, the seven recommendations proposed by the NVC have been shared with the Italian Ministry of Health and the Technical Advisory Group on measles and rubella elimination and have been incorporated into the new Italian Elimination Plan 2019-2023 as a technical aid to facilitate the achievement of disease elimination goals.