Network analysis of posttraumatic stress disorder in a treatment-seeking sample of US firefighters and emergency medical technicians.

BACKGROUND: First responders, including firefighters and emergency medical technicians (EMTs), are under extreme stress from repeated exposure to potentially traumatic events. To optimize treatment for this population, it is critical to understand how the various posttraumatic stress disorder (PTSD) symptom factors are associated with one another so these relations may be targeted in treatment. METHOD: Using a sample of treatment-seeking firefighters/EMTs (N = 342), we conducted a partial correlation network analysis of the eight-factor model. A Bayesian directed acyclic graph (DAG) was used to estimate causal associations between clusters. RESULTS: Approximately 37 % of the sample screened positive for probable PTSD. Internal re-experiencing and external re-experiencing had the strongest edges. In the DAG, internal re-experiencing was the parent node and was potentially predictive of external re-experiencing, negative affect, dysphoric arousal, and avoidance. LIMITATIONS: Data were drawn from a treatment-seeking sample that may not generalize to all firefighters/EMTs. CONCLUSIONS: The current findings are consistent with prior research suggesting re-experiencing plays a critical role in developing and maintaining PTSD symptoms. Future research should investigate non-treatment-seeking first responders, as well as EMTs and firefighters as individual populations.

Protecting hospitals from SARS-CoV-2 infection: A review-based comprehensive strategy for COVID-19 prevention and control.

SUMMARY: SARS-CoV-2-related infection can determine hospital-acquired infections among patients and healthcare workers. Aim of this paper was to review the literature for developing a strategy for protecting healthcare workers, patients, and visitors by COVID-19 hospital infection. A critical and rapid revision of the literature and international standards and Regulations on this topic allowed us to propose an evidencebased strategy in the framework of the workplace risk assessment for preventing nosocomial COVID-19 outbreaks. The virus' high transmissibility, the high prevalence of asymptomatic carriers and false-negative Covid-19 rates on naso- and oropharingeal swabs, put hospitals at high-risk of COVID-19 outbreaks. A comprehensive strategy based on standard precautions, administrative, environmental, and engineering controls, a screening protocol for patients on their admission to hospital, and a testing-based strategy for HCWs within health surveillance programs may prevent the onset of hospital outbreaks, which are a threat to community, patients and HCWs, compromising the sustainability of healthcare facilities.

Prevalence of burnout syndrome among Italian volunteers of the Red Cross: a cross-sectional study.

Burnout syndrome (BOS) is a work-related constellation of symptoms characterized by emotional exhaustion, depersonalization, and personal accomplishment. A cross-sectional survey was performed to study the prevalence of BOS among a randomly selected sample of 280 Italian Red Cross volunteers. A socio-demographic questionnaire and the Maslach Burnout Inventory (MBI)-HSS were used to collect data. 241 volunteers participated (response rate: 86.1%). A significant proportion of the workers had BOS subscale scores in the highest tertile: emotional exhaustion 8.0%, depersonalization 35.9% and perceived lack of accomplishment 23.5%, respectively. Volunteers in emergency care reported higher levels of emotional exhaustion (p=0.004) and depersonalization (p=0.001), and lower level of personal accomplishment (p=0.042) than volunteers engaged in non-healthcare social and administrative duties. These findings support the opportunity of a set of administrative, organizational and individual preventive interventions for emergency volunteers' mental health.

First aid and basic life support resuscitation in occupational settings in COVID-19 pandemic.

The risk of transmission of COVID-19 or other serious respiratory infections during a pandemic event can dissuade lay rescuers from practicing resuscitation maneuvers; this may result in a reduction in efficacy in the treatment of the subject with cardiorespiratory arrest; this can also happen in occupational settings for the "designed first aid worker". In this letter we propose some considerations on the adaptation of the guidelines for cardiopulmonary resuscitation to pandemic events and on the protection of workers designated to first aid.

Can Air-Conditioning Systems Contribute to the Spread of SARS/MERS/COVID-19 Infection? Insights from a Rapid Review of the Literature.

The airborne transmission of SARS-CoV-2 is still debated. The aim of this rapid review is to evaluate the COVID-19 risk associated with the presence of air-conditioning systems. Original studies (both observational and experimental researches) written in English and with no limit on time, on the airborne transmission of SARS-CoV, MERS-CoV, and SARS-CoV-2 coronaviruses that were associated with outbreaks, were included. Searches were made on PubMed/MEDLINE, PubMed Central (PMC), Google Scholar databases, and medRxiv. A snowball strategy was adopted to extend the search. Fourteen studies reporting outbreaks of coronavirus infection associated with the air-conditioning systems were included. All studies were carried out in the Far East. In six out the seven studies on SARS, the role of Heating, Ventilation, and Air Conditioning (HVAC) in the outbreak was indirectly proven by the spatial and temporal pattern of cases, or by airflow-dynamics models. In one report on MERS, the contamination of HVAC by viral particles was demonstrated. In four out of the six studies on SARS-CoV-2, the diffusion of viral particles through HVAC was suspected or supported by computer simulation. In conclusion, there is sufficient evidence of the airborne transmission of coronaviruses in previous Asian outbreaks, and this has been taken into account in the guidelines released by organizations and international agencies for controlling the spread of SARS-CoV-2 in indoor environments. However, the technological differences in HVAC systems prevent the generalization of the results on a worldwide basis. The few COVID-19 investigations available do not provide sufficient evidence that the SARS-CoV-2 virus can be transmitted by HVAC systems.

[Actuality and originality in the scientific thought of Angelo Iannaccone (1925 - 1982).] / Attualità e originalità nel pensiero e nell'azione scientifica del Prof. Angelo Iannaccone (1925 - 1982).

SUMMARY: Background. Angelo Iannaccone is certainly one of the most important personalities in the field of occupational medicine of the last century. Aims. The fiftieth anniversary of the Post-graduate School of Occupational Medicine of the Catholic University of Rome gives us the opportunity to define this extraordinary figure of man and scientist, at over 35 years from his death. Results. Prof. Iannaccone was among the very first, if not the first to deal with chronobiology and occupational ergonomics in Italy, adopting the modern perspective of "upstream" prevention, since the design phase, which had to be based on the adaptation of work to man and not vice versa. He carried out important and pioneering studies on the effects of benzene on the hematopoietic apparatus and of various industrial toxicants on the neuroendocrine system. In establishing the formative principles for the occupational physician, he devoted a significant space to industrial hygiene, in the interdisciplinary perspective of prevention sciences. He gave a significant contribution to the scientific society of occupational medicine, first as a member of the board, then as the president of the Italian Society of Occupational Medicine and Industrial Hygiene. He realized the Institute of Occupational Medicine of the Catholic University of Rome and founded the post-graduate school. Conclusions. Prof. Iannaccone's contribution to occupational health and industrial hygiene emphasized applied research and prevention in the workplace.