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Liviero F, Volpin A, Furlan P, Battistella M, Broggio A, Fabris L, Favretto F, Mason P, Cocchio S, Cozzolino C, Baldo V, Moretto A, Scapellato ML. The impact of SARS-CoV-2 on healthcare workers of a large University Hospital in the Veneto Region: risk of infection and clinical presentation in relation to different pandemic phases and some relevant determinants. Front Public Health 2023; 11:1250911. [PMID: 38098828 PMCID: PMC10720910 DOI: 10.3389/fpubh.2023.1250911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/07/2023] [Indexed: 12/17/2023] Open
Abstract
Aim The aim of this study is to evaluate the incidence of SARS-CoV-2 infection and the prevalence of COVID-19-related symptoms in relation to pandemic phases and some relevant variables in a cohort of 8,029 HCWs from one of the largest Italian University Hospitals. Methods A single-center retrospective study was performed on data collected during SARS-CoV-2 infection surveillance of HCWs. Cox's multiple regression was performed to estimate hazard ratios of SARS-CoV-2 infection. Logistic multivariate regression was used to assess the risk of asymptomatic infections and the onset of the most frequent symptoms. All analyses were adjusted for sociodemographic and occupational factors, pandemic phases, vaccination status, and previous infections. Results A total of 3,760 HCWs resulted positive (2.0%-18.6% across five study phases). The total incidence rate of SARS-CoV-2 infection was 7.31 cases per 10,000 person-days, significantly lower in phase 1 and higher in phases 4 and 5, compared to phase 3. Younger HCWs, healthcare personnel, and unvaccinated subjects showed a higher risk of infection. Overall, 24.5% were asymptomatic infections, with a higher probability for men, physicians, and HCWs tested for screening, fully vaccinated, and those with previous infection. The clinical presentation changed over the phases in relation to vaccination status and the emergence of new variants. Conclusion The screening activities of HCWs allowed for the early detection of asymptomatic cases, limiting the epidemic clusters inside the hospital wards. SARS-CoV-2 vaccination reduced infections and symptomatic cases, demonstrating again its paramount value as a preventive tool for occupational and public health.
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Affiliation(s)
- Filippo Liviero
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Anna Volpin
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Patrizia Furlan
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Monica Battistella
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Alessia Broggio
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Laura Fabris
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Francesco Favretto
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Paola Mason
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Silvia Cocchio
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Preventive Medicine and Risk Assessment Unit, University Hospital of Padova, Padova, Italy
| | - Claudia Cozzolino
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Vincenzo Baldo
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Preventive Medicine and Risk Assessment Unit, University Hospital of Padova, Padova, Italy
| | - Angelo Moretto
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
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Cegolon L, Mauro M, Sansone D, Tassinari A, Gobba FM, Modenese A, Casolari L, Liviero F, Pavanello S, Scapellato ML, Taus F, Carta A, Spiteri G, Monaco MGL, Porru S, Larese Filon F. A Multi-Center Study Investigating Long COVID-19 in Healthcare Workers from North-Eastern Italy: Prevalence, Risk Factors and the Impact of Pre-Existing Humoral Immunity-ORCHESTRA Project. Vaccines (Basel) 2023; 11:1769. [PMID: 38140174 PMCID: PMC10747427 DOI: 10.3390/vaccines11121769] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
Introduction: The impact of long-COVID-19 syndrome is rather variable, since it is influenced by several residual confounders. This study aimed to investigate the prevalence of long COVID-19 in healthcare workers (HCWs) from four university hospitals in north-eastern Italy: Trieste, Padua, Verona, and Modena-Reggio Emilia. Methods: During the period June 2022-August 2022, HCWs were surveyed for past COVID-19 infections, medical history, and any acute as well as post-COVID-19 symptoms. The prevalence of long COVID-19 was estimated at 30-60 days or 61+ days since first negative swab following first and second COVID-19 episode. Furthermore, the risk of long COVID-19 was investigated by multivariable logistic regression. Results were expressed as the adjusted odds ratio (aOR) with a 95% confidence interval (95%CI). Results: 5432 HCWs returned a usable questionnaire: 2401 were infected with SARS-CoV-2 at least once, 230 were infected at least twice, and 8 were infected three times. The prevalence of long COVID-19 after a primary COVID-19 infection was 24.0% at 30-60 days versus 16.3% at 61+ days, and 10.5% against 5.5% after the second SARS-CoV-2 event. The most frequent symptoms after a first COVID-19 event were asthenia (30.3%), followed by myalgia (13.7%), cough (12.4%), dyspnea (10.2%), concentration deficit (8.1%), headache (7.3%), and anosmia (6.5%), in decreasing order of prevalence. The risk of long COVID-19 at 30-60 days was significantly higher in HCWs hospitalized for COVID-19 (aOR = 3.34; 95%CI: 1.62; 6.89), those infected with SARS-CoV-2 during the early pandemic waves-namely the Wuhan (aOR = 2.16; 95%CI: 1.14; 4.09) or Alpha (aOR= 2.05; 95%CI: 1.25; 3.38) transmission periods-and progressively increasing with viral shedding time (VST), especially 15+ days (aOR = 3.20; 95%CI: 2.07; 4.94). Further determinants of long COVID-19 at 30-60 days since primary COVID-19 event were female sex (aOR = 1.91; 95%CI: 1.30; 2.80), age >40 years, abnormal BMI, or administrative services (reference category). In contrast, HCWs vaccinated with two doses before their primary infection (aOR = 0.57; 95%CI: 0.34; 0.94), undergraduate students, or postgraduate medical trainees were less likely to experience long COVID-19 at 30-60 days. Apart from pandemic waves, the main determinants of long COVID-19 at 30-60 days were confirmed at 61+ days. Conclusions: The risk of long COVID-19 following primary infection increased with the severity of acute disease and VST, especially during the initial pandemic waves, when more virulent viral strains were circulating, and susceptibility to SARS-CoV-2 was higher since most HCWs had not been infected yet, COVID-19 vaccines were still not available, and/or vaccination coverage was still building up. The risk of long COVID-19 therefore decreased inversely with humoral immunity at the individual level. Nevertheless, the prevalence of long COVID-19 was remarkably lower after SARS-CoV-2 reinfections regardless of vaccination status, suggesting that hybrid humoral immunity did not increase protection against the syndrome compared to immunity mounted by either natural infection or vaccination separately. Since the risk of long COVID-19 is currently low with Omicron and patients who developed the syndrome following SARS-CoV-2 infection in the early pandemic waves tend to return to a state of full health with time, a cost-effective approach to screen post-COVID-19 symptoms during the Omicron time could be restricted to vulnerable individuals developing severe disease and/or with prolonged VST.
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Affiliation(s)
- Luca Cegolon
- Occupational Medicine Unit, Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (M.M.); (D.S.); (A.T.); (F.L.F.)
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
| | - Marcella Mauro
- Occupational Medicine Unit, Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (M.M.); (D.S.); (A.T.); (F.L.F.)
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
| | - Donatella Sansone
- Occupational Medicine Unit, Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (M.M.); (D.S.); (A.T.); (F.L.F.)
| | - Alice Tassinari
- Occupational Medicine Unit, Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (M.M.); (D.S.); (A.T.); (F.L.F.)
| | - Fabrizio Maria Gobba
- Department of Biomedical, Metabolic and Neurological Sciences, University of Modena and Reggio-Emilia, 41125 Modena, Italy; (F.M.G.); (A.M.)
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neurological Sciences, University of Modena and Reggio-Emilia, 41125 Modena, Italy; (F.M.G.); (A.M.)
| | - Loretta Casolari
- Health Surveillance Service, Modena University Hospital, 41125 Modena, Italy;
| | - Filippo Liviero
- Occupational Medicine Unit, Padua University Hospital, 35128 Padua, Italy; (F.L.); (S.P.)
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padua, Italy
| | - Sofia Pavanello
- Occupational Medicine Unit, Padua University Hospital, 35128 Padua, Italy; (F.L.); (S.P.)
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padua, Italy
| | - Maria Luisa Scapellato
- Occupational Medicine Unit, Padua University Hospital, 35128 Padua, Italy; (F.L.); (S.P.)
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padua, Italy
| | - Francesco Taus
- Department of Diagnostics and Public Health, Section of Medical Statistics, University of Verona, 37134 Verona, Italy;
| | - Angela Carta
- Occupational Medicine Unit, Verona University Hospital, 37134 Verona, Italy; (A.C.); (G.S.); (M.G.L.M.); (S.P.)
- Department of Diagnostics and Public Health, Section of Occupational Medicine, University of Verona, 37134 Verona, Italy
| | - Gianluca Spiteri
- Occupational Medicine Unit, Verona University Hospital, 37134 Verona, Italy; (A.C.); (G.S.); (M.G.L.M.); (S.P.)
| | - Maria Grazia Lourdes Monaco
- Occupational Medicine Unit, Verona University Hospital, 37134 Verona, Italy; (A.C.); (G.S.); (M.G.L.M.); (S.P.)
| | - Stefano Porru
- Occupational Medicine Unit, Verona University Hospital, 37134 Verona, Italy; (A.C.); (G.S.); (M.G.L.M.); (S.P.)
- Department of Diagnostics and Public Health, Section of Occupational Medicine, University of Verona, 37134 Verona, Italy
| | - Francesca Larese Filon
- Occupational Medicine Unit, Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (M.M.); (D.S.); (A.T.); (F.L.F.)
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
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Leomanni L, Collatuzzo G, Sansone E, Sala E, De Palma G, Porru S, Spiteri G, Monaco MGL, Basso D, Pavanello S, Scapellato ML, Larese Filon F, Cegolon L, Mauro M, Lodi V, Lazzarotto T, Noreña I, Reinkemeyer C, Giang LTT, Fabiánová E, Strhársky J, Dell’Omo M, Murgia N, Carrasco-Ribelles LA, Violán C, Mates D, Rascu A, Vimercati L, De Maria L, Asafo SS, Ditano G, Abedini M, Boffetta P. Determinants of Anti-S Immune Response at 12 Months after SARS-CoV-2 Vaccination in a Multicentric European Cohort of Healthcare Workers-ORCHESTRA Project. Vaccines (Basel) 2023; 11:1527. [PMID: 37896931 PMCID: PMC10610704 DOI: 10.3390/vaccines11101527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The effectiveness of the immunity provided by SARS-CoV-2 vaccines is an important public health issue. We analyzed the determinants of 12-month serology in a multicenter European cohort of vaccinated healthcare workers (HCW). METHODS We analyzed the sociodemographic characteristics and levels of anti-SARS-CoV-2 spike antibodies (IgG) in a cohort of 16,101 vaccinated HCW from eleven centers in Germany, Italy, Romania, Slovakia and Spain. Considering the skewness of the distribution, the serological levels were transformed using log or cubic standardization and normalized by dividing them by center-specific standard errors. We fitted center-specific multivariate regression models to estimate the cohort-specific relative risks (RR) of an increase of one standard deviation of log or cubic antibody level and the corresponding 95% confidence interval (CI) for different factors and combined them in random-effects meta-analyses. RESULTS We included 16,101 HCW in the analysis. A high antibody level was positively associated with age (RR = 1.04, 95% CI = 1.00-1.08 per 10-year increase), previous infection (RR = 1.78, 95% CI 1.29-2.45) and use of Spikevax [Moderna] with combinations compared to Comirnaty [BioNTech/Pfizer] (RR = 1.07, 95% CI 0.97-1.19) and was negatively associated with the time since last vaccine (RR = 0.94, 95% CI 0.91-0.98 per 30-day increase). CONCLUSIONS These results provide insight about vaccine-induced immunity to SARS-CoV-2, an analysis of its determinants and quantification of the antibody decay trend with time since vaccination.
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Affiliation(s)
- Ludovica Leomanni
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
| | - Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
| | - Emanuele Sansone
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Emma Sala
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Giuseppe De Palma
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37129 Verona, Italy
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37100 Verona, Italy
| | - Gianluca Spiteri
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37100 Verona, Italy
| | | | - Daniela Basso
- Department of Medicine-DIMED, University of Padova, 35128 Padova, Italy
- Laboratory Medicine Unit, University Hospital of Padova, 35128 Padova, Italy
| | - Sofia Pavanello
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, 35128 Padova, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, 35128 Padova, Italy
| | - Francesca Larese Filon
- Occupational Medicine Unit, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34100 Trieste, Italy
| | - Luca Cegolon
- Occupational Medicine Unit, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34100 Trieste, Italy
| | - Marcella Mauro
- Occupational Medicine Unit, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34100 Trieste, Italy
| | - Vittorio Lodi
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
- SSD Health Surveillance, IRCCS University Hospital, 40139 Bologna, Italy
| | - Tiziana Lazzarotto
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
- Microbiology Unit, IRCCS University Hospital, 40139 Bologna, Italy
| | - Ivan Noreña
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, 81377 Munich, Germany
| | - Christina Reinkemeyer
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, 81377 Munich, Germany
| | - Le Thi Thu Giang
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospital, 81377 Munich, Germany
| | - Eleonóra Fabiánová
- Occupational Health Department, Regional Authority of Public Health, 497556 Banská Bystrica, Slovakia
| | - Jozef Strhársky
- Medical Microbiology Department, Regional Authority of Public Health, 497556 Banská Bystrica, Slovakia
| | - Marco Dell’Omo
- Unit of Occupational Medicine, Department on Medicine and Surgery, University of Perugia, 06125 Perugia, Italy
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Lucía A. Carrasco-Ribelles
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, 08007 Barcelona, Spain
- Grup de Recerca en Impacte de les Malalties Cròniques i les seves Trajectòries (GRIMTra), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), 08303 Barcelona, Spain
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Concepción Violán
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, 08007 Barcelona, Spain
- Grup de Recerca en Impacte de les Malalties Cròniques i les seves Trajectòries (GRIMTra), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), 08303 Barcelona, Spain
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Germans Trias i Pujol Research Institute (IGTP), 08916 Badalona, Spain
- Universitat Autónoma de Barcelona, 08193 Bellaterra, Spain
| | - Dana Mates
- National Institute of Public Health, 050463 Bucharest, Romania
| | - Agripina Rascu
- Department of Internal Medicine-Occupational Medicine, Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70121 Bari, Italy
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70121 Bari, Italy
| | - Shuffield S. Asafo
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
| | - Giorgia Ditano
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
| | - Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
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Porru S, Monaco MGL, Spiteri G, Carta A, Caliskan G, Violán C, Torán-Monserrat P, Vimercati L, Tafuri S, Boffetta P, Violante FS, Sala E, Sansone E, Gobba F, Casolari L, Wieser A, Janke C, Tardon A, Rodriguez-Suarez MM, Liviero F, Scapellato ML, dell'Omo M, Murgia N, Mates D, Calota VC, Strhársky J, Mrázová M, Pira E, Godono A, Magnano GC, Negro C, Verlato G. Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project. J Epidemiol Glob Health 2023; 13:577-588. [PMID: 37480426 PMCID: PMC10468456 DOI: 10.1007/s44197-023-00139-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/05/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND SARS-CoV-2 breakthrough infections (BI) after vaccine booster dose are a relevant public health issue. METHODS Multicentric longitudinal cohort study within the ORCHESTRA project, involving 63,516 health workers (HW) from 14 European settings. The study investigated the cumulative incidence of SARS-CoV-2 BI after booster dose and its correlation with age, sex, job title, previous infection, and time since third dose. RESULTS 13,093 (20.6%) BI were observed. The cumulative incidence of BI was higher in women and in HW aged < 50 years, but nearly halved after 60 years. Nurses experienced the highest BI incidence, and administrative staff experienced the lowest. The BI incidence was higher in immunosuppressed HW (28.6%) vs others (24.9%). When controlling for gender, age, job title and infection before booster, heterologous vaccination reduced BI incidence with respect to the BNT162b2 mRNA vaccine [Odds Ratio (OR) 0.69, 95% CI 0.63-0.76]. Previous infection protected against asymptomatic infection [Relative Risk Ratio (RRR) of recent infection vs no infection 0.53, 95% CI 0.23-1.20] and even more against symptomatic infections [RRR 0.11, 95% CI 0.05-0.25]. Symptomatic infections increased from 70.5% in HW receiving the booster dose since < 64 days to 86.2% when time elapsed was > 130 days. CONCLUSIONS The risk of BI after booster is significantly reduced by previous infection, heterologous vaccination, and older ages. Immunosuppression is relevant for increased BI incidence. Time elapsed from booster affects BI severity, confirming the public health usefulness of booster. Further research should focus on BI trend after 4th dose and its relationship with time variables across the epidemics.
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Affiliation(s)
- Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
- Occupational Medicine Unit, University Hospital of Verona, 37134, Verona, Italy
| | | | - Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, 37134, Verona, Italy.
| | - Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
- Occupational Medicine Unit, University Hospital of Verona, 37134, Verona, Italy
| | - Gulser Caliskan
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
| | - Concepción Violán
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Unitat de Suport a la Recerca Metropolitana Nord, Mare de Déu de Guadalupe 2, Planta 1ª, Mataro, 08303, Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, S/N, Badalona, 08916, Barcelona, Spain
| | - Pere Torán-Monserrat
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Unitat de Suport a la Recerca Metropolitana Nord, Mare de Déu de Guadalupe 2, Planta 1ª, Mataro, 08303, Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, S/N, Badalona, 08916, Barcelona, Spain
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124, Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124, Bari, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | - Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25123, Brescia, Italy
| | - Emanuele Sansone
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Occupational Health and Industrial Hygiene, University of Brescia, 25123, Brescia, Italy
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy
| | - Loretta Casolari
- Health Surveillance Service, University Hospital of Modena, 41125, Modena, Italy
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
- German Center for Infection Research (DZIF), Partner Site , 81377, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, 80799, Munich, Germany
- Max Von Pettenkofer Institute, Faculty of Medicine, LMU Munich, 80336, Munich, Germany
| | - Christian Janke
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Adonina Tardon
- University of Oviedo, Health Research Institute of Asturias (ISPA) and CIBERESP, Asturias, Spain
| | | | - Filippo Liviero
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padua, Italy
- University Hospital of Padova, 35128, Padua, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padua, Italy
- University Hospital of Padova, 35128, Padua, Italy
| | - Marco dell'Omo
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123, Perugia, Italy
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121, Ferrara, Italy
| | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | | | - Jozef Strhársky
- Medical Microbiology Department, Regional Authority of Public Health, 97556, Banská Bystrica, Slovakia
| | - Mariana Mrázová
- Public Health Institute, St. Elizabeth University of Health and Social Work, 81106, Bratislava, Slovakia
| | - Enrico Pira
- Department of Public Health and Pediatrics, University of Torino, 10126, Turin, Italy
| | - Alessandro Godono
- Department of Public Health and Pediatrics, University of Torino, 10126, Turin, Italy
| | - Greta Camilla Magnano
- Department of Medical Sciences, Unit of Occupational Medicine, University of Trieste, 34129, Trieste, Italy
| | - Corrado Negro
- Department of Medical Sciences, Unit of Occupational Medicine, University of Trieste, 34129, Trieste, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
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Violán C, Carrasco-Ribelles LA, Collatuzzo G, Ditano G, Abedini M, Janke C, Reinkemeyer C, Giang LTT, Liviero F, Scapellato ML, Mauro M, Rui F, Porru S, Spiteri G, Monaco MGL, Carta A, Otelea M, Rascu A, Fabiánová E, Klöslová Z, Boffetta P, Torán-Monserrat P. Multimorbidity and Serological Response to SARS-CoV-2 Nine Months after 1st Vaccine Dose: European Cohort of Healthcare Workers-Orchestra Project. Vaccines (Basel) 2023; 11:1340. [PMID: 37631908 PMCID: PMC10459685 DOI: 10.3390/vaccines11081340] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/25/2023] [Accepted: 08/03/2023] [Indexed: 08/29/2023] Open
Abstract
Understanding antibody persistence concerning multimorbidity is crucial for vaccination policies. Our goal is to assess the link between multimorbidity and serological response to SARS-CoV-2 nine months post-first vaccine. We analyzed Healthcare Workers (HCWs) from three cohorts from Italy, and one each from Germany, Romania, Slovakia, and Spain. Seven groups of chronic diseases were analyzed. We included 2941 HCWs (78.5% female, 73.4% ≥ 40 years old). Multimorbidity was present in 6.9% of HCWs. The prevalence of each chronic condition ranged between 1.9% (cancer) to 10.3% (allergies). Two regression models were fitted, one considering the chronic conditions groups and the other considering whether HCWs had diseases from ≥2 groups. Multimorbidity was present in 6.9% of HCWs, and higher 9-months post-vaccine anti-S levels were significantly associated with having received three doses of the vaccine (RR = 2.45, CI = 1.92-3.13) and with having a prior COVID-19 infection (RR = 2.30, CI = 2.15-2.46). Conversely, lower levels were associated with higher age (RR = 0.94, CI = 0.91-0.96), more time since the last vaccine dose (RR = 0.95, CI = 0.94-0.96), and multimorbidity (RR = 0.89, CI = 0.80-1.00). Hypertension is significantly associated with lower anti-S levels (RR = 0.87, CI = 0.80-0.95). The serological response to vaccines is more inadequate in individuals with multimorbidity.
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Affiliation(s)
- Concepción Violán
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Mataró, Spain; (L.A.C.-R.); (P.T.-M.)
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, s/n, 08916 Badalona, Spain
- Grup de REcerca en Impacte de les Malalties Cròniques i les Seves Trajectòries (GRIMTra) (2021 SGR 01537), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) (RD21/0016/0029), Insitituto de Salud Carlos III, Av. de Monforte de Lemos, 5, 28029 Madrid, Spain
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, Ctra. de Barcelona, 473, Sabadell, 08204 Barcelona, Spain
- Universitat Autónoma de Barcelona, Plaça Cívica, 08193 Bellaterra, Spain
| | - Lucía A. Carrasco-Ribelles
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Mataró, Spain; (L.A.C.-R.); (P.T.-M.)
- Grup de REcerca en Impacte de les Malalties Cròniques i les Seves Trajectòries (GRIMTra) (2021 SGR 01537), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) (RD21/0016/0029), Insitituto de Salud Carlos III, Av. de Monforte de Lemos, 5, 28029 Madrid, Spain
| | - Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (G.C.); (G.D.); (M.A.); (P.B.)
| | - Giorgia Ditano
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (G.C.); (G.D.); (M.A.); (P.B.)
| | - Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (G.C.); (G.D.); (M.A.); (P.B.)
| | - Christian Janke
- Division of Infectious Diseases and Tropical Medicine, LMU Klinikum, Leopoldstraße 5, 80802 Munich, Germany; (C.J.); (C.R.)
| | - Christina Reinkemeyer
- Division of Infectious Diseases and Tropical Medicine, LMU Klinikum, Leopoldstraße 5, 80802 Munich, Germany; (C.J.); (C.R.)
| | - Le Thi Thu Giang
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich, Lindwurmstrasse 4, 80337 Munich, Germany;
| | - Filippo Liviero
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy;
| | | | - Marcella Mauro
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, 34129 Trieste, Italy; (M.M.); (F.R.)
| | - Francesca Rui
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, 34129 Trieste, Italy; (M.M.); (F.R.)
| | - Stefano Porru
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (S.P.); (G.S.); (M.G.L.M.); (A.C.)
- Section of Occupational Health, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (S.P.); (G.S.); (M.G.L.M.); (A.C.)
| | - Maria Grazia Lourdes Monaco
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (S.P.); (G.S.); (M.G.L.M.); (A.C.)
| | - Angela Carta
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (S.P.); (G.S.); (M.G.L.M.); (A.C.)
- Section of Occupational Health, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Marina Otelea
- University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (M.O.); (A.R.)
| | - Agripina Rascu
- University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (M.O.); (A.R.)
| | - Eleonóra Fabiánová
- Occupational Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia; (E.F.); (Z.K.)
- Public Health Department, Faculty of Health, Catholic University, 03401 Ružomberok, Slovakia
| | - Zuzana Klöslová
- Occupational Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia; (E.F.); (Z.K.)
- Public Health Department, Faculty of Health, Catholic University, 03401 Ružomberok, Slovakia
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (G.C.); (G.D.); (M.A.); (P.B.)
| | - Pere Torán-Monserrat
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Mataró, Spain; (L.A.C.-R.); (P.T.-M.)
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, s/n, 08916 Badalona, Spain
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, Ctra. de Barcelona, 473, Sabadell, 08204 Barcelona, Spain
- Department of Medicine, Faculty of Medicine, Universitat de Girona, 17001 Girona, Spain
- Multidisciplinary Research Group in Health and Society (GREMSAS) (2021 SGR 01484), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Barcelona, Spain
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6
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Mason P, Rizzuto R, Iannelli L, Baccaglini F, Rizzolo V, Baraldo A, Melloni B, Maffione F, Pezzoli C, Chiozza ML, Rupolo G, Biasioli M, Liviero F, Scapellato ML, Trevisan A, Merigliano S, Scuttari A, Moretto A, Scarpa B. Comparison of Adverse Effects of Two SARS-CoV-2 Vaccines Administered in Workers of the University of Padova. Vaccines (Basel) 2023; 11:vaccines11050951. [PMID: 37243055 DOI: 10.3390/vaccines11050951] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Introduction: In Italy, on December 2020, workers in the education sector were identified as a priority population to be vaccinated against COVID-19. The first authorised vaccines were the Pfizer-BioNTech mRNA (BNT162b2) and the Oxford-AstraZeneca adenovirus vectored (ChAdOx1 nCoV-19) vaccines. Aim: To investigate the adverse effects of two SARS-CoV-2 vaccines in a real-life preventive setting at the University of Padova. Methods: Vaccination was offered to 10116 people. Vaccinated workers were asked to voluntarily report symptoms via online questionnaires sent to them 3 weeks after the first and the second shot. Results: 7482 subjects adhered to the vaccination campaign and 6681 subjects were vaccinated with ChAdOx1 nCoV-19 vaccine and 137 (fragile subjects) with the BNT162b2 vaccine. The response rate for both questionnaires was high (i.e., >75%). After the first shot, the ChAdOx1 nCoV-19 vaccine caused more fatigue (p < 0.001), headache (p < 0.001), myalgia (p < 0.001), tingles (p = 0.046), fever (p < 0.001), chills (p < 0.001), and insomnia (p = 0.016) than the BNT162b2 vaccine. After the second dose of the BNT162b2 vaccine, more myalgia (p = 0.033), tingles (p = 0.022), and shivers (p < 0.001) than the ChAdOx1 nCoV-19 vaccine were elicited. The side effects were nearly always transient. Severe adverse effects were rare and mostly reported after the first dose of the ChAdOx1 nCoV-19 vaccine. They were dyspnoea (2.3%), blurred vision (2.1%), urticaria (1.3%), and angioedema (0.4%). Conclusions: The adverse effects of both vaccines were transient and, overall, mild in severity.
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Affiliation(s)
- Paola Mason
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Rosario Rizzuto
- Department of Biomedical Sciences, University of Padova, Via Ugo Bassi 58/B, 35131 Padova, Italy
| | - Luca Iannelli
- Central Administration, University of Padova, Via VIII Febbraio 2, 35122 Padova, Italy
| | - Flavio Baccaglini
- Central Administration, University of Padova, Via VIII Febbraio 2, 35122 Padova, Italy
| | - Valerio Rizzolo
- Central Administration, University of Padova, Via VIII Febbraio 2, 35122 Padova, Italy
| | - Andrea Baraldo
- Central Administration, University of Padova, Via VIII Febbraio 2, 35122 Padova, Italy
| | - Barbara Melloni
- Central Administration, University of Padova, Via VIII Febbraio 2, 35122 Padova, Italy
| | - Francesca Maffione
- Central Administration, University of Padova, Via VIII Febbraio 2, 35122 Padova, Italy
| | - Camilla Pezzoli
- Central Administration, University of Padova, Via VIII Febbraio 2, 35122 Padova, Italy
| | - Maria Laura Chiozza
- Italian Red Cross, Padua Committee, Via della Croce Rossa, 130, 35129 Padova, Italy
| | - Giampietro Rupolo
- Italian Red Cross, Padua Committee, Via della Croce Rossa, 130, 35129 Padova, Italy
| | - Marco Biasioli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Filippo Liviero
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Andrea Trevisan
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Stefano Merigliano
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Alberto Scuttari
- Central Administration, University of Padova, Via VIII Febbraio 2, 35122 Padova, Italy
| | - Angelo Moretto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Bruno Scarpa
- Department of Statistical Sciences, University of Padova, Via Battisti 241, 35121 Padova, Italy
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7
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Liviero F, Scapellato ML, Folino F, Moretto A, Mason P, Pavanello S. Persistent Increase of Sympathetic Activity in Post-Acute COVID-19 of Paucisymptomatic Healthcare Workers. Int J Environ Res Public Health 2023; 20:830. [PMID: 36613152 PMCID: PMC9820028 DOI: 10.3390/ijerph20010830] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/09/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Healthcare workers (HCWs) represent a population with a significant burden of paucisymptomatic COVID-19, as the general population. We evaluated autonomic nervous system activity by means of heart rate variability (HRV) in HCWs during health surveillance visits. Short-term electrocardiogram (ECG) recordings were obtained 30 days (IQR 5.25-55.75) after a negative naso-pharyngeal swab for SARS-CoV-2 in 44 cases and compared with ECGs of 44 controls with similar age and sex distribution. Time and frequency domain HRV were evaluated. HCWs who used drugs, had comorbidities that affected HRV, or were hospitalized with severe COVID-19 were excluded. Frequency domain HRV analysis showed a significantly higher low/high-frequency power ratio (LF/HF) in the case study compared with controls (t = 2.84, p = 0.006). In time domain HRV analysis, mean standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive RR interval differences (RMSSD) were significantly lower for cases compared with controls (t = -2.64, p = 0.01 and t = -3.27, p = 0.002, respectively). In the post-acute phase of infection, SARS-CoV-2 produces an autonomic imbalance mirrored by a reduction in HRV. These results are consistent with epidemiological data that suggest a higher risk of acute cardiovascular complications in the first 30 days after COVID-19 infection.
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Affiliation(s)
- Filippo Liviero
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani 2, 35128 Padova, Italy
- University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani 2, 35128 Padova, Italy
- University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Franco Folino
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani 2, 35128 Padova, Italy
- University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Angelo Moretto
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani 2, 35128 Padova, Italy
- University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Paola Mason
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani 2, 35128 Padova, Italy
- University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Sofia Pavanello
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani 2, 35128 Padova, Italy
- University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
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8
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Porru S, Monaco MGL, Spiteri G, Carta A, Pezzani MD, Lippi G, Gibellini D, Tacconelli E, Dalla Vecchia I, Sala E, Sansone E, De Palma G, Bonfanti C, Lombardo M, Terlenghi L, Pira E, Mansour I, Coggiola M, Ciocan C, Godono A, Tardon A, Rodriguez-Suarez MM, Fernandez-Tardon G, Jimeno-Demuth FJ, Castro-Delgado RV, Iglesias Cabo T, Scapellato ML, Liviero F, Moretto A, Mason P, Pavanello S, Volpin A, Vimercati L, Tafuri S, De Maria L, Sponselli S, Stefanizzi P, Caputi A, Gobba F, Modenese A, Casolari L, Garavini D, D’Elia C, Mariani S, Filon FL, Cegolon L, Negro C, Ronchese F, Rui F, De Michieli P, Murgia N, Dell’Omo M, Muzi G, Fiordi T, Gambelunghe A, Folletti I, Mates D, Calota VC, Neamtu A, Perseca O, Staicu CA, Voinoiu A, Fabiánová E, Bérešová J, Adamčáková ZK, Nedela R, Lesňáková A, Holčíková J, Boffetta P, Abedini M, Ditano G, Asafo SS, Visci G, Violante FS, Zunarelli C, Verlato G. SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers. Vaccines (Basel) 2022; 10:vaccines10081193. [PMID: 36016081 PMCID: PMC9415790 DOI: 10.3390/vaccines10081193] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 12/23/2022] Open
Abstract
Background: The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers. Methods: A multicentric retrospective cohort study, involving 12 European centers, was carried out within the ORCHESTRA project, collecting data up to 18 November 2021 on fully vaccinated health workers. The cumulative incidence of SARS-CoV-2 breakthrough infections was investigated with its association with occupational and social–demographic characteristics (age, sex, job title, previous SARS-CoV-2 infection, antibody titer levels, and time from the vaccination course completion). Results: Among 64,172 health workers from 12 European health centers, 797 breakthrough infections were observed (cumulative incidence of 1.2%). The primary analysis using individual data on 8 out of 12 centers showed that age and previous infection significantly modified breakthrough infection rates. In the meta-analysis of aggregated data from all centers, previous SARS-CoV-2 infection and the standardized antibody titer were inversely related to the risk of breakthrough infection (p = 0.008 and p = 0.007, respectively). Conclusion: The inverse correlation of antibody titer with the risk of breakthrough infection supports the evidence that vaccination plays a primary role in infection prevention, especially in health workers. Cellular immunity, previous clinical conditions, and vaccination timing should be further investigated.
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Affiliation(s)
- Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (M.G.L.M.); (G.S.)
- Correspondence: ; Tel.: +39-0458124294
| | | | - Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (M.G.L.M.); (G.S.)
| | - Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (M.G.L.M.); (G.S.)
| | - Maria Diletta Pezzani
- Infectious Diseases Unit, University Hospital of Verona, 37134 Verona, Italy; (M.D.P.); (E.T.)
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Davide Gibellini
- Section of Microbiology, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Evelina Tacconelli
- Infectious Diseases Unit, University Hospital of Verona, 37134 Verona, Italy; (M.D.P.); (E.T.)
- Section of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Ilaria Dalla Vecchia
- Section of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25121 Brescia, Italy; (E.S.); (G.D.P.)
| | - Emanuele Sansone
- Unit of Occupational Health and Industrial Hygiene, Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy;
| | - Giuseppe De Palma
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25121 Brescia, Italy; (E.S.); (G.D.P.)
- Unit of Occupational Health and Industrial Hygiene, Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy;
| | - Carlo Bonfanti
- Department of Molecular and Translational Medicine, Institute of Microbiology, University of Brescia-ASST Spedali Civili, 25121 Brescia, Italy; (C.B.); (L.T.)
| | - Massimo Lombardo
- Chief Executive Office, ASST Spedali Civili di Brescia, 25121 Brescia, Italy;
| | - Luigina Terlenghi
- Department of Molecular and Translational Medicine, Institute of Microbiology, University of Brescia-ASST Spedali Civili, 25121 Brescia, Italy; (C.B.); (L.T.)
| | - Enrico Pira
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.P.); (I.M.); (C.C.); (A.G.)
- Occupational Medicine Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy;
| | - Ihab Mansour
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.P.); (I.M.); (C.C.); (A.G.)
| | - Maurizio Coggiola
- Occupational Medicine Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy;
| | - Catalina Ciocan
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.P.); (I.M.); (C.C.); (A.G.)
- Occupational Medicine Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy;
| | - Alessandro Godono
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.P.); (I.M.); (C.C.); (A.G.)
| | - Adonina Tardon
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Marta-Maria Rodriguez-Suarez
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Guillermo Fernandez-Tardon
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Francisco-Jose Jimeno-Demuth
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Rafael-Vicente Castro-Delgado
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Tania Iglesias Cabo
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Filippo Liviero
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Angelo Moretto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Paola Mason
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Sofia Pavanello
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Anna Volpin
- University Hospital of Padova, 35128 Padova, Italy;
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Stefania Sponselli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41125 Modena, Italy; (F.G.); (A.M.)
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41125 Modena, Italy; (F.G.); (A.M.)
| | - Loretta Casolari
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy; (L.C.); (D.G.); (C.D.); (S.M.)
| | - Denise Garavini
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy; (L.C.); (D.G.); (C.D.); (S.M.)
| | - Cristiana D’Elia
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy; (L.C.); (D.G.); (C.D.); (S.M.)
| | - Stefania Mariani
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy; (L.C.); (D.G.); (C.D.); (S.M.)
| | - Francesca Larese Filon
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Luca Cegolon
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Corrado Negro
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Federico Ronchese
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Francesca Rui
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Paola De Michieli
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Nicola Murgia
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Marco Dell’Omo
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Giacomo Muzi
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Tiziana Fiordi
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Angela Gambelunghe
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Ilenia Folletti
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Dana Mates
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Violeta Claudia Calota
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Andra Neamtu
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Ovidiu Perseca
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Catalin Alexandru Staicu
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Angelica Voinoiu
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Eleonóra Fabiánová
- Occupational Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia;
| | - Jana Bérešová
- Epidemiology Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia;
| | - Zora Kľocová Adamčáková
- Health Promotion Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia;
| | - Roman Nedela
- Health Informatics Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia;
| | - Anna Lesňáková
- Infectology Clinic, Central Military Hospital, 03426 Ružomberok, Slovakia;
| | - Jana Holčíková
- Occupational Medicine Clinic, University Hospital, 83105 Bratislava, Slovakia;
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
| | - Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Giorgia Ditano
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Shuffield Seyram Asafo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Giovanni Visci
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Francesco Saverio Violante
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
- IRCCS, Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
| | - Carlotta Zunarelli
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
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9
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Basso D, Padoan A, D'Incà R, Arrigoni G, Scapellato ML, Contran N, Franchin C, Lorenzon G, Mescoli C, Moz S, Bozzato D, Rugge M, Plebani M. Peptidomic and proteomic analysis of stool for diagnosing IBD and deciphering disease pathogenesis. Clin Chem Lab Med 2021; 58:968-979. [PMID: 32229654 DOI: 10.1515/cclm-2019-1125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 03/02/2020] [Indexed: 12/12/2022]
Abstract
Background The sensitivities and specificities of C-reactive protein (CRP) and faecal calprotectin (fCal), as recommended for inflammatory bowel diseases (IBD) diagnosis and monitoring, are low. Our aim was to discover new stool protein/peptide biomarkers for diagnosing IBD. Methods For peptides, MALDI-TOF/MS (m/z 1000-4000) was performed using stools from an exploratory (34 controls; 72 Crohn's disease [CD], 56 ulcerative colitis [UC]) and a validation (28 controls, 27 CD, 15 UC) cohort. For proteins, LTQ-Orbitrap XL MS analysis (6 controls, 5 CD, 5 UC) was performed. Results MALDI-TOF/MS spectra of IBD patients had numerous features, unlike controls. Overall, 426 features (67 control-associated, 359 IBD-associated) were identified. Spectra were classified as control or IBD (absence or presence of IBD-associated features). In the exploratory cohort, the sensitivity and specificity of this classification algorithm were 81% and 97%, respectively. Blind analysis of the validation cohort confirmed 97% specificity, with a lower sensitivity (55%) paralleling active disease frequency. Following binary logistic regression analysis, IBD was independently correlated with MALDI-TOF/MS spectra (p < 0.0001), outperforming fCal measurements (p = 0.029). The IBD-correlated m/z 1810.8 feature was a fragment of APC2, homologous with APC, over-expressed by infiltrating cells lining the surface in UC or the muscularis-mucosae in CD (assessed by immunohistochemistry). IBD-associated over-expressed proteins included immunoglobulins and neutrophil proteins, while those under-expressed comprised proteins of the nucleic acid assembly or those (OLFM4, ENPP7) related to cancer risk. Conclusions Our study provides evidence for the clinical utility of a novel proteomic method for diagnosing IBD and insight on the pathogenic role of APC. Moreover, the newly described IBD-associated proteins might become tools for cancer risk assessment in IBD patients.
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Affiliation(s)
- Daniela Basso
- Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Andrea Padoan
- Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Renata D'Incà
- Department of Surgical, Oncological and Gastroenterological Sciences - DISCOG, University Hospital, Padova, Italy
| | - Giorgio Arrigoni
- Department of Biomedical Sciences - BIOMED, University of Padova, Padova, Italy.,Proteomic Center, University of Padova, Padua, Italy
| | - Maria Luisa Scapellato
- Department of Cardiologic, Thoracic and Vascular Sciences, Preventive Medicine and Risk Assessment Unit, University Hospital of Padova, Padova, Italy
| | - Nicole Contran
- Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Cinzia Franchin
- Department of Biomedical Sciences - BIOMED, University of Padova, Padova, Italy.,Proteomic Center, University of Padova, Padua, Italy
| | - Greta Lorenzon
- Department of Surgical, Oncological and Gastroenterological Sciences - DISCOG, University Hospital, Padova, Italy
| | - Claudia Mescoli
- Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Stefania Moz
- Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Dania Bozzato
- Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Massimo Rugge
- Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Mario Plebani
- Department of Medicine - DIMED, University of Padova, Padova, Italy
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10
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Buja A, Fonzo M, Sperotto M, De Battisti E, Baldovin T, Cocchio S, Furlan P, Saia M, Scapellato ML, Viel G, Baldo V, Bertoncello C. Education level and hospitalization for ambulatory care sensitive conditions: an education approach is required. Eur J Public Health 2021; 30:207-212. [PMID: 31321416 DOI: 10.1093/eurpub/ckz122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Studies in several different countries and settings suggest that ambulatory care-sensitive conditions (ACSCs)-related hospitalizations could be associated more with socioeconomic variables than with the quality of primary healthcare services. The aim of the present study was to analyze the potential links between education levels or other social determinants and ACSC-related hospitalization rates. METHODS We analyzed a total of 467 504 records of ordinary discharges after acute hospitalization in 2015-16 for patients 20-74 years old residing in the Veneto Region. We calculated the prevention quality indicators (PQIs) developed by the Agency for Healthcare Research and Quality. Rate ratios (RRs) and 95% confidence intervals (95% CIs) were estimated with a set of Poisson regressions to measure the relative risk by sociodemographic level. RESULTS Hospitalizations for ACSCs accounted for 3.9% of all hospital admissions (18 436 discharges), and the crude hospitalization rate for ACSCs among 20- to 74-year-olds was 26.6 per 10 000 inhabitants (95% CI, 25.8-27.4). For all conditions, we found a significant association with formal education. In the case of the overall composite PQI#90, e.g. poorly educated people (primary school or no schooling) were at significantly higher risk of hospitalization for ACSCs than the better educated (RR, 4.50; 95% CI, 4.13-4.91). CONCLUSIONS Currently available administrative data regarding ACSCs may be used effectively for reveal equity issues in the provision of health care. Our results indicate that an educational approach inside Primary Health Care could address the extra risk for preventable healthcare demands associated with poorly educated patients.
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Affiliation(s)
- Alessandra Buja
- Department of Cardiological, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padova, Italy
| | - Marco Fonzo
- School of Specialization in Hygiene, Preventive Medicine and Public Health, University of Padua, Padova, Italy
| | - Milena Sperotto
- Department of Cardiological, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padova, Italy
| | - Elisa De Battisti
- School of Specialization in Hygiene, Preventive Medicine and Public Health, University of Padua, Padova, Italy
| | - Tatjana Baldovin
- Department of Cardiological, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padova, Italy
| | - Silvia Cocchio
- Department of Cardiological, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padova, Italy
| | - Patrizia Furlan
- Department of Cardiological, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padova, Italy
| | - Mario Saia
- ULSS 6 Euganea, Veneto Region, Padova, Italy
| | - Maria Luisa Scapellato
- Department of Cardiological, Thoracic and Vascular Sciences, Occupational Medicine Unit, University of Padua, Padova, Italy
| | - Guido Viel
- Department of Cardiological, Thoracic and Vascular Sciences, Legal Medicine Unit, University of Padua, Padova, Italy
| | - Vincenzo Baldo
- Department of Cardiological, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padova, Italy
| | - Chiara Bertoncello
- Department of Cardiological, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padova, Italy
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11
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Trevisan A, Mason P, Nicolli A, Maso S, Scarpa B, Moretto A, Scapellato ML. Vaccination and Immunity toward Measles: A Serosurvey in Future Healthcare Workers. Vaccines (Basel) 2021; 9:377. [PMID: 33924547 PMCID: PMC8069293 DOI: 10.3390/vaccines9040377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/08/2021] [Accepted: 04/10/2021] [Indexed: 11/18/2022] Open
Abstract
Measles is a very contagious infectious disease, and vaccination is the only medical aid to counter the spread of the infection. The aim of this study was to evaluate the influence of vaccination schedule and type of vaccine, number of doses, and sex on the immune response. In a population of Italian medical students (8497 individuals born after 1980 with certificate of vaccination and quantitative measurement of antibodies against measles), the prevalence of positive antibodies to measles and antibody titer was measured. Vaccination schedule such as number of doses and vaccine type (measles alone or combined as measles, mumps and rubella (MMR)) and sex were the variables considered to influence the immune response. The vaccination schedule depends on the year of birth: students born before 1990 were prevalently vaccinated once and with measles vaccine alone (not as MMR). One dose of vaccine induces a significantly (p < 0.0001) higher positive response and antibody titer than two doses, in particular when measles alone is used (p < 0.0001). Females have a significantly higher percentage of positive response (p = 0.0001) than males but only when the MMR formulation was used. Multiple linear regression confirms that sex significantly influences antibody titer when only MMR is used, after one (p = 0.0002) or two (p = 0.0060) doses. In conclusion, vaccination schedule and, partially, sex influence immune response to measles vaccination. Most notably, the measles vaccine alone (one dose) is more effective than one and two doses of MMR.
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Affiliation(s)
- Andrea Trevisan
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (A.M.); (M.L.S.)
| | - Paola Mason
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (A.M.); (M.L.S.)
| | - Annamaria Nicolli
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (A.M.); (M.L.S.)
| | - Stefano Maso
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (A.M.); (M.L.S.)
| | - Bruno Scarpa
- Department of Statistical Sciences, University of Padova, 35128 Padova, Italy;
- Department of Mathematics “Tullio Levi-Civita”, University of Padova, 35128 Padova, Italy
| | - Angelo Moretto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (A.M.); (M.L.S.)
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (A.M.); (M.L.S.)
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12
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Cocchio S, Baldo V, Volpin A, Fonzo M, Floreani A, Furlan P, Mason P, Trevisan A, Scapellato ML. Persistence of Anti-Hbs after up to 30 Years in Health Care Workers Vaccinated against Hepatitis B Virus. Vaccines (Basel) 2021; 9:vaccines9040323. [PMID: 33915763 PMCID: PMC8067181 DOI: 10.3390/vaccines9040323] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 12/20/2022] Open
Abstract
The burden of hepatitis B virus (HBV) infection is a serious public health problem all over the world. Vaccination remains the most effective prevention measure, and safe and effective HBV vaccines have been available since 1982. Health care workers (HCWs) vaccinated against HBV and prospectively followed up for at least 14 years were classified by their antibody titers after primary vaccination as: poor responders (10–99 mIU/mL); moderate responders (100–999 mIU/mL); and good responders (≥1000 mIU/mL). The incidence of antibody loss was calculated for 1000 person-years and the anti-HBs persistence was calculated. The analysis concerned 539 HCWs: 494 good responders (91.7%); 37 moderate responders (6.9%); and eight poor responders (1.5%). The incidence of anti-HBs loss was 52.1 per 1000 person-years for the poor responders, 11.3 per 1000 person-years for the moderate responders, and 1.4 per 1000 person-years for the good responders. The mean persistence of anti-HBs differed significantly between the three groups, being: 19.2 years (95% CI: 15.6–22.8), 25.4 years (95% CI: 23.0–27.9), and 31.0 years (95% CI: 30.5–31.5) for the poor, moderate and good responders, respectively. In conclusion, our findings demonstrate a good persistence of protective anti-HBs titers in HCWs exposed to occupational risk for up to 30 years after a primary vaccination cycle (even without a booster dose) if their titer was initially higher than 100 mIU/mL.
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Affiliation(s)
- Silvia Cocchio
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Vincenzo Baldo
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
- Correspondence:
| | - Anna Volpin
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Marco Fonzo
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Annarosa Floreani
- Scientific Institute for Research, Hospitalization and Healthcare Negrar, 37024 Negrar, Italy;
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, 35124 Padova, Italy
| | - Patrizia Furlan
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Paola Mason
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Andrea Trevisan
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
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13
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Di Liddo R, Piccione M, Schrenk S, Dal Magro C, Cosma C, Padoan A, Contran N, Scapellato ML, Pagetta A, Romano Spica V, Conconi MT, Parnigotto PP, D'Incà R, Michetti F. S100B as a new fecal biomarker of inflammatory bowel diseases. Eur Rev Med Pharmacol Sci 2021; 24:323-332. [PMID: 31957846 DOI: 10.26355/eurrev_202001_19929] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE S100 proteins are demonstrated to exert a protective role in the gastrointestinal tract. In the present study, we investigated whether S100B protein, that is typically expressed by enteroglial cells, is detectable in feces and could be a useful noninvasive indicator of gut chronic inflammation. PATIENTS AND METHODS This clinical prospective study included n=48 patients suffering Crohn's disease (CD) or ulcerative colitis (UC) and non IBD-controls. The clinical disease activity was evaluated using Harvey-Bradshaw or Mayo Score Index while the diagnosis of IBD was defined based on standard endoscopic and histological criteria. S100B and calprotectin were extracted and analyzed using commercial enzyme-linked immunosorbent assay (ELISA) kits. RESULTS Unlike calprotectin, S100B was significantly decreased in both CD and UC compared to non IBD-patients. The strongest quantitative alterations of S100B were detected concomitantly with signs of active or quiescent disease, including high/normal expression of fecal calprotectin, mucosal damage/cryptitis, mucin depletion and inflammatory infiltrate, as defined by endoscopic evaluation and histological analysis. At the onset of disease and under no Infliximab-based therapy, the lowest was detected suggesting that S100B in feces could have a potential diagnostic value for IBD. CONCLUSIONS Testing for S100B and calprotectin could be a useful screening tool to better predict IBD activity.
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Affiliation(s)
- R Di Liddo
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padua, Italy.
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14
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Cester G, Giraudo C, Causin F, Boemo DG, Anglani M, Capizzi A, Carretta G, Cattelan A, Cecchin D, Cianci V, Crisanti A, De Conti G, Donato D, Flor L, Gabrieli JD, Munari M, Navalesi P, Ponzoni A, Scapellato ML, Tiberio I, Vianello A, Stramare R. Retrospective Analysis of a Modified Organizational Model to Guarantee CT Workflow during the COVID-19 Outbreak in the Tertiary Hospital of Padova, Italy. J Clin Med 2020; 9:E3042. [PMID: 32967312 PMCID: PMC7563301 DOI: 10.3390/jcm9093042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/16/2020] [Indexed: 01/19/2023] Open
Abstract
At the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) outbreak in Italy, the cluster of Vò Euganeo was managed by the University Hospital of Padova. The Department of Diagnostic Imaging (DDI) conceived an organizational approach based on three different pathways for low-risk, high-risk, and confirmed Coronavirus Disease 19 (COVID-19) patients to accomplish three main targets: guarantee a safe pathway for non-COVID-19 patients, ensure health personnel safety, and maintain an efficient workload. Thus, an additional pathway was created with the aid of a trailer-mounted Computed Tomography (CT) scanner devoted to positive patients. We evaluated the performance of our approach from February 21 through April 12 in terms of workload (e.g., number of CT examinations) and safety (COVID-19-positive healthcare workers). There was an average of 72.2 and 17.8 COVID-19 patients per day in wards and the Intensive Care Unit (ICU), respectively. A total of 176 high-risk and positive patients were examined. High Resolution Computed Tomography (HRCT) was one of the most common exams, and 24 pulmonary embolism scans were performed. No in-hospital transmission occurred in the DDI neither among patients nor among health personnel. The weekly number of in-patient CT examinations decreased by 27.4%, and the surgical procedures decreased by 29.5%. Patient screening and dedicated diagnostic pathways allowed the maintenance of high standards of care while working in safety.
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Affiliation(s)
- Giacomo Cester
- Department of Diagnostic Imaging and Interventional Radiology, Neuroradiology, Padua University Hospital, 35128 Padua, Italy; (G.C.); (M.A.); (J.-D.G.)
| | - Chiara Giraudo
- Department of Medicine–DIMED, Institute of Radiology, Padua University Hospital, 35128 Padua, Italy; (C.G.); (R.S.)
| | - Francesco Causin
- Department of Diagnostic Imaging and Interventional Radiology, Neuroradiology, Padua University Hospital, 35128 Padua, Italy; (G.C.); (M.A.); (J.-D.G.)
| | - Deris Gianni Boemo
- Department of Directional Hospital Management, Padua University Hospital, 35128 Padova, Italy; (D.G.B.); (A.C.); (G.C.); (D.D.); (L.F.)
| | - Mariagiulia Anglani
- Department of Diagnostic Imaging and Interventional Radiology, Neuroradiology, Padua University Hospital, 35128 Padua, Italy; (G.C.); (M.A.); (J.-D.G.)
| | - Alfio Capizzi
- Department of Directional Hospital Management, Padua University Hospital, 35128 Padova, Italy; (D.G.B.); (A.C.); (G.C.); (D.D.); (L.F.)
| | - Giovanni Carretta
- Department of Directional Hospital Management, Padua University Hospital, 35128 Padova, Italy; (D.G.B.); (A.C.); (G.C.); (D.D.); (L.F.)
| | - Annamaria Cattelan
- Department of Internal Medicine, Infectious and Tropical Diseases, Padua University Hospital, 35128 Padua, Italy;
| | - Diego Cecchin
- Department of Medicine–DIMED, Nuclear Medicine Unit, Padua University Hospital, 35128 Padua, Italy;
| | - Vito Cianci
- ER Unit, Emergency-Urgency Department, Padua University Hospital, 35128 Padua, Italy;
| | - Andrea Crisanti
- Department of Molecular Medicine, Microbiology and Virology, Padua University Hospital, 35128 Padua, Italy;
| | - Giorgio De Conti
- Radiology Unit, Department of Diagnostic Imaging and Interventional Radiology, Padua University Hospital, 35128 Padua, Italy; (G.D.C.); (A.P.)
| | - Daniele Donato
- Department of Directional Hospital Management, Padua University Hospital, 35128 Padova, Italy; (D.G.B.); (A.C.); (G.C.); (D.D.); (L.F.)
| | - Luciano Flor
- Department of Directional Hospital Management, Padua University Hospital, 35128 Padova, Italy; (D.G.B.); (A.C.); (G.C.); (D.D.); (L.F.)
| | - Joseph-Domenico Gabrieli
- Department of Diagnostic Imaging and Interventional Radiology, Neuroradiology, Padua University Hospital, 35128 Padua, Italy; (G.C.); (M.A.); (J.-D.G.)
| | - Marina Munari
- Anesthesia and Intensive Care Unit, Department of Medicine–DIMED, Padua University Hospital, 35128 Padua, Italy; (M.M.); (P.N.)
| | - Paolo Navalesi
- Anesthesia and Intensive Care Unit, Department of Medicine–DIMED, Padua University Hospital, 35128 Padua, Italy; (M.M.); (P.N.)
| | - Alberto Ponzoni
- Radiology Unit, Department of Diagnostic Imaging and Interventional Radiology, Padua University Hospital, 35128 Padua, Italy; (G.D.C.); (A.P.)
| | - Maria Luisa Scapellato
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Preventive Medicine and Risk Assessment, Padua University Hospital, 35128 Padua, Italy;
| | - Ivo Tiberio
- Emergency-Urgency Department, Intensive Care Unit, Padua University Hospital, 35128 Padua, Italy;
| | - Andrea Vianello
- Respiratory Pathophysiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padua University Hospital, 35128 Padua, Italy;
| | - Roberto Stramare
- Department of Medicine–DIMED, Institute of Radiology, Padua University Hospital, 35128 Padua, Italy; (C.G.); (R.S.)
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15
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Martinelli A, Salamon F, Scapellato ML, Trevisan A, Vianello L, Bizzotto R, Crivellaro MA, Carrieri M. Occupational Exposure to Flour Dust. Exposure Assessment and Effectiveness of Control Measures. Int J Environ Res Public Health 2020; 17:ijerph17145182. [PMID: 32709123 PMCID: PMC7399869 DOI: 10.3390/ijerph17145182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 11/16/2022]
Abstract
The adverse effects associated with exposure to flour dust have been known since the 1700s. The aim of the study was to assess the occupational exposure to flour dust in Italian facilities, identify the activities characterized by the highest exposure, and provide information to reduce workers’ exposure. The study was performed in different facilities such as flourmills (n = 2), confectioneries (n = 2), bakeries (n = 24), and pizzerias (n = 2). Inhalable flour dust was assessed by personal and area samplings (n = 250) using IOM (Institute of Occupational Medicine) samplers. The results showed personal occupational exposure to flour dust over the American Conference of Governmental Industrial Hygiene (ACGIH) and the Scientific Committee on Occupational Exposure Limit (SCOEL) occupational limits (mean 1.987 mg/m3; range 0.093–14.055 mg/m3). The levels were significantly higher for dough makers in comparison to the dough formers and packaging area subjects. In four bakeries the industrial hygiene surveys were re-performed after some control measures, such as installation of a sleeve to the end of pipeline, a lid on the mixer tub or local exhaust ventilation system, were installed. The exposure levels were significantly lower than those measured before the introduction of control measures. The exposure level reduction was observed not only in the dough making area but also in all bakeries locals.
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Affiliation(s)
- Andrea Martinelli
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (F.S.); (M.L.S.); (A.T.); (M.A.C.); (M.C.)
- Correspondence:
| | - Fabiola Salamon
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (F.S.); (M.L.S.); (A.T.); (M.A.C.); (M.C.)
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (F.S.); (M.L.S.); (A.T.); (M.A.C.); (M.C.)
| | - Andrea Trevisan
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (F.S.); (M.L.S.); (A.T.); (M.A.C.); (M.C.)
| | - Liviano Vianello
- SPISAL, Azienda ULSS7 Pedemontana, 36061 Bassano del Grappa (VI), Italy;
| | | | - Maria Angiola Crivellaro
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (F.S.); (M.L.S.); (A.T.); (M.A.C.); (M.C.)
| | - Mariella Carrieri
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (F.S.); (M.L.S.); (A.T.); (M.A.C.); (M.C.)
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16
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Trevisan A, Giuliani A, Scapellato ML, Anticoli S, Carsetti R, Zaffina S, Brugaletta R, Vonesch N, Tomao P, Ruggieri A. Sex Disparity in Response to Hepatitis B Vaccine Related to the Age of Vaccination. Int J Environ Res Public Health 2020; 17:ijerph17010327. [PMID: 31906550 PMCID: PMC6981715 DOI: 10.3390/ijerph17010327] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/24/2019] [Accepted: 12/31/2019] [Indexed: 12/27/2022]
Abstract
Hepatitis B virus (HBV) infection is one of the major infectious hazards for health-care workers (HCWs) because of the frequency of percutaneous exposures to blood or body fluids. For this reason, all HCWs should be vaccinated, including students in medicine and health professional degree programs. The aim of this study was to assess the immune coverage to anti-HBV vaccine and long-lasting protective titres of anti-HBs antibodies in female and male students to evaluate gender-related differences in response to HBV vaccination. Data relative to anti-HBs antibody titre, sex, age, and age at vaccination were collected and analyzed from 5291 Italian students (1812 males and 3479 females) of the graduate courses at the School of Medicine, who underwent the mandatory health surveillance of workers exposed to biological risk. The results indicated that gender affects the immune response to HBV vaccine, particularly evident in the case of females vaccinated after one year of age who exhibited a statistically significant (p = 0.0023) 1.21-fold increase in median antibody titre with respect to males. Our findings could contribute to the optimization of HBV vaccination schedules in health surveillance of HCWs.
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Affiliation(s)
- Andrea Trevisan
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy;
- Correspondence: (A.T.); (A.R.)
| | - Alessandro Giuliani
- Environment and Health Department, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy;
| | - Simona Anticoli
- Istituto Superiore di Sanità, Center for Gender Specific Medicine, 00161 Rome, Italy;
| | - Rita Carsetti
- Diagnostic Immunology Unit, Department of Laboratories and B cell Pathophysiology Unit, Immunology Research Area, Bambino Gesù Children Hospital, 00165 Rome, Italy;
| | - Salvatore Zaffina
- Occupational Medicine, Health Directorate, Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (S.Z.); (R.B.)
| | - Rita Brugaletta
- Occupational Medicine, Health Directorate, Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (S.Z.); (R.B.)
| | - Nicoletta Vonesch
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian National Workers Compensation Authority, Monte Porzio Catone, 00078 Rome, Italy; (N.V.); (P.T.)
| | - Paola Tomao
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian National Workers Compensation Authority, Monte Porzio Catone, 00078 Rome, Italy; (N.V.); (P.T.)
| | - Anna Ruggieri
- Istituto Superiore di Sanità, Center for Gender Specific Medicine, 00161 Rome, Italy;
- Correspondence: (A.T.); (A.R.)
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17
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Trevisan A, Frasson C, De Nuzzo D, Nicolli A, Scapellato ML. Significance of anti-HB levels below 10 IU/L after vaccination against hepatitis B in infancy or adolescence: an update in relation to sex. Hum Vaccin Immunother 2019; 16:460-464. [PMID: 31487228 PMCID: PMC7062447 DOI: 10.1080/21645515.2019.1656483] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Hepatitis B vaccination (three-dose series) induces long-term immunity, but it is not uncommon to find antibody levels below 10 IU/L long after vaccination. However, the majority of the subjects with low antibody levels have a prompt response to a booster dose. A population of 10,294 students at Padua University Medical School, who were subjected to hepatitis B vaccination during infancy or adolescence according to the law, was tested for the presence of anti-HBs, usually during the first year of matriculation. Among the students offered a booster dose, 1,030 were vaccinated, and the antibody titre was re-tested. The present research provides further evidence from a larger number of students (1,030) that an anti-HB level higher than 2 IU/L is predictive of a prompt response to a booster. There are also differences related to sex. The results clearly confirm that an antibody titre equal to or greater than 2 IU/L is enough to prompt a response after a booster dose, even several years after the initial vaccination cycle, and to predict effective immune protection. The length of the interval between the booster/post-booster analyses increases the probability of finding a low response to the booster; furthermore, females show a more rapid response to the booster than males. The importance for healthcare workers of measuring the antibody titre four weeks after a booster is highlighted, and the results suggest that females have a better response than males to booster vaccination.
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Affiliation(s)
- Andrea Trevisan
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Preventive Medicine and Risk Assessment, University of Padova, Padova, Italy
| | - Clara Frasson
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Preventive Medicine and Risk Assessment, University of Padova, Padova, Italy
| | - Davide De Nuzzo
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Preventive Medicine and Risk Assessment, University of Padova, Padova, Italy
| | - Annamaria Nicolli
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Preventive Medicine and Risk Assessment, University of Padova, Padova, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Preventive Medicine and Risk Assessment, University of Padova, Padova, Italy
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18
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Emanuelli E, Comiati V, Cazzador D, Schiavo G, Alexandre E, Fedeli U, Frasson G, Zanon A, Martini A, Scapellato ML, Mastrangelo G. Malignant Versus Benign Tumors of the Sinonasal Cavity: A Case-Control Study on Occupational Etiology. Int J Environ Res Public Health 2018; 15:E2887. [PMID: 30562946 PMCID: PMC6313789 DOI: 10.3390/ijerph15122887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/13/2018] [Accepted: 12/15/2018] [Indexed: 11/16/2022]
Abstract
Case-control studies on malignant sinonasal tumors and occupational risk factors are generally weakened by non-occupational confounders and the selection of suitable controls. This study aimed to confirm the association between sinonasal malignant tumors and patients' occupations with consideration for sinonasal inverted papillomas (SNIPs) as a control group. Thirty-two patients affected by adenocarcinoma (ADC) and 21 non-adenocarcinoma epithelial tumors (NAETs) were compared to 65 patients diagnosed with SNIPs. All patients were recruited in the same clinical setting between 2004 and 2016. A questionnaire was used to collect information on non-occupational factors (age, sex, smoking, allergies, and chronic sinusitis) and occupations (wood- and leather-related occupations, textile industry, metal working). Odds ratios (OR) with 95% confidence intervals (CI) associated with selected occupations were obtained by a multinomial and exact logistic regression. Between the three groups of patients, SNIP patients were significantly younger than ADC patients (p = 0.026). The risk of NAET increased in woodworkers (OR = 9.42; CI = 1.94⁻45.6) and metal workers (OR = 5.65; CI = 1.12⁻28.6). The risk of ADC increased in wood (OR = 86.3; CI = 15.2⁻488) and leather workers (OR = 119.4; CI = 11.3⁻1258). On the exact logistic regression, the OR associated to the textile industry was 9.32 (95%CI = 1.10⁻Inf) for ADC, and 7.21 (95%CI = 0.55⁻Inf) for NAET. Comparing sinonasal malignant tumors with controls recruited from the same clinical setting allowed demonstrating an increased risk associated with multiple occupations. Well-matched samples of cases and controls reduced the confounding bias and increased the strength of the association.
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Affiliation(s)
- Enzo Emanuelli
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Vera Comiati
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Preventive Medicine and Risk Assessment Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Diego Cazzador
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Gloria Schiavo
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Enrico Alexandre
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Ugo Fedeli
- Epidemiological Department, Veneto Region. Passaggio Gaudenzio 1, 35131 Padova, Italy.
| | - Giuliana Frasson
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Alessia Zanon
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Alessandro Martini
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Preventive Medicine and Risk Assessment Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Giuseppe Mastrangelo
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Preventive Medicine and Risk Assessment Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
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19
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Scapellato ML, Comiati V, Buja A, Buttignol G, Valentini R, Burati V, La Serra L, Maccà I, Mason P, Scopa P, Volpin A, Trevisan A, Spinella P. Combined Before-and-After Workplace Intervention to Promote Healthy Lifestyles in Healthcare Workers (STI-VI Study): Short-Term Assessment. Int J Environ Res Public Health 2018; 15:ijerph15092053. [PMID: 30235849 PMCID: PMC6164287 DOI: 10.3390/ijerph15092053] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/07/2018] [Accepted: 09/14/2018] [Indexed: 12/23/2022]
Abstract
Health care workers (HCWs) are prone to a heavy psycho-physical workload. Health promotion programs can help prevent the onset of chronic and work-related diseases. The aim of the STI-VI ‘before-and-after’ study, with assessments scheduled at 6 and 12 months, was to improve the lifestyle of HCWs with at least one cardiovascular risk factor. A tailored motivational counseling intervention, focusing on dietary habits and physical activity (PA) was administered to 167 HCWs (53 males; 114 females). BMI, waist circumference, blood pressure, and cholesterol, triglyceride, and blood glucose levels were measured before and after the intervention. The 6-month results (total sample and by gender) showed a marked effect on lifestyle: PA improved (+121.2 MET, p = 0.01), and diets became more similar to the Mediterranean model (+0.8, p < 0.001). BMI dropped (−0.2, p < 0.03), and waist circumference improved even more (−2.5 cm; p < 0.001). Other variables improved significantly: total and LDL cholesterol (−12.8 and −9.4 mg/dL, p < 0.001); systolic and diastolic blood pressure (−4.4 and −2.5 mmHg, p < 0.001); blood glucose (−1.5 mg/dL, p = 0.05); and triglycerides (significant only in women), (−8.7 mg/dL, p = 0.008); but HDL cholesterol levels dropped too. If consolidated at 12 months, these results indicate that our intervention can help HCWs maintain a healthy lifestyle and work ability.
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Affiliation(s)
- Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Vera Comiati
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Alessandra Buja
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Giulia Buttignol
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Romina Valentini
- Department of Medicine, University of Padova, 35128 Padova, Italy.
- Dietetic and Clinical Nutrition Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Valentina Burati
- Department of Medicine, University of Padova, 35128 Padova, Italy.
| | - Lucia La Serra
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Isabella Maccà
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Paola Mason
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Pasquale Scopa
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Anna Volpin
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Andrea Trevisan
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Paolo Spinella
- Department of Medicine, University of Padova, 35128 Padova, Italy.
- Dietetic and Clinical Nutrition Unit, Padova University Hospital, 35128 Padova, Italy.
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20
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Carrieri M, Spatari G, Tranfo G, Sapienza D, Scapellato ML, Bartolucci GB, Manno M. Biological monitoring of low level exposure to benzene in an oil refinery: Effect of modulating factors. Toxicol Lett 2018; 298:70-75. [PMID: 30086327 DOI: 10.1016/j.toxlet.2018.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/25/2018] [Accepted: 08/02/2018] [Indexed: 10/28/2022]
Abstract
The aim of the study was to investigate the effect of various factors that modulate the metabolism of benzene, including smoking habits, metabolic genotype of GST and co-exposure to toluene, on the levels of three biomarkers, i.e. urinary benzene (UB), S-phenylmercapturic acid (SPMA) and t,t-muconic acid (t,t-MA), in 146 refinery workers exposed to low levels of air benzene (AB) in the range <1.5-529.2 μg/m3 (mean value 32.6 μg/m3). The study confirmed the validity of SPMA as a good biomarker of benzene exposure even at low levels of exposure. It was also confirmed that cigarette smoking is the main confounding factor when assessing biological monitoring data of occupational exposure to AB. Our data indicate that the GSTT1, but not the GSTM1 genotype, significantly increases the urinary levels of SPMA, even at low levels of exposure. It is not known, though, whether subjects with a GSTT1 "null" genotype may be more susceptible to the effects of benzene. Finally, environmental toluene appears to inhibit the metabolism of benzene to SPMA even at low concentrations, also resulting in an underestimation by SPMA levels of the actual exposure of workers to benzene.
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Affiliation(s)
- Mariella Carrieri
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani 2, Padova, Italy.
| | - Giovanna Spatari
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via C. Valerio 1, 98125 Messina, Italy.
| | - Giovanna Tranfo
- Italian Workers' Compensation Authority (INAIL), Via di Fontana Candida 1, 00040 Monteporzio Catone, RM, Italy.
| | - Daniela Sapienza
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via C. Valerio 1, 98125 Messina, Italy.
| | - Maria Luisa Scapellato
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani 2, Padova, Italy.
| | - Giovanni Battista Bartolucci
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani 2, Padova, Italy.
| | - Maurizio Manno
- Department of Public Health, University of Napoli Federico II, Via S. Pansini, 5, 80131 Napoli, Italy.
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21
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Padoan A, D’Incà R, Scapellato ML, De Bastiani R, Caccaro R, Mescoli C, Moz S, Bozzato D, Zambon CF, Lorenzon G, Rugge M, Plebani M, Basso D. Improving IBD diagnosis and monitoring by understanding preanalytical, analytical and biological fecal calprotectin variability. ACTA ACUST UNITED AC 2018; 56:1926-1935. [DOI: 10.1515/cclm-2018-0134] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 04/03/2018] [Indexed: 12/12/2022]
Abstract
Abstract
Background:
The appropriate clinical use of fecal calprotectin (fCal) might be compromised by incomplete harmonization between assays and within- and between-subjects variability. Our aim was to investigate the analytical and biological variability of fCal in order to provide tools for interpreting fCal in the clinical setting.
Methods:
Experiments were conducted to investigate the effects of temperature and storage time on fCal. Thirty-nine controls were enrolled to verify biological variability, and a case-control study was conducted on 134 controls and 110 IBD patients to compare the clinical effectiveness of three different fCal assays: ELISA, CLIA and turbidimetry.
Results:
A 12% decline in fCal levels was observed within 24 h following stool collection irrespective of storage temperature. Samples were unstable following a longer storage time interval at room temperature. Within- and between-subjects fCal biological variability, at 31% and 72% respectively, resulted in a reference change value (RCV) in the region of 100%. fCal sensitivity in distinguishing between controls and IBD patients is satisfactory (68%), and the specificity high (93%) among young (<65 years), but not among older (≥65 years) subjects (ROC area: 0.584; 95% CI: 0.399–0.769). Among the young, assays have different optimal thresholds (120 μg/g for ELISA, 50 μg/g for CLIA and 100 μg/g for turbidimetry).
Conclusions:
We recommend a standardized preanalytical protocol for fCal, avoiding storage at room temperature for more than 24 h. Different cutoffs are recommended for different fCal assays. In monitoring, the difference between two consecutive measurements appears clinically significant when higher than 100%, the fCal biological variability-derived RCV.
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Affiliation(s)
- Andrea Padoan
- Department of Medicine – DIMED , University of Padova , Padova , Italy
| | - Renata D’Incà
- Division of Gastroenterology , University Hospital , Padova , Italy
| | - Maria Luisa Scapellato
- Department of Cardiologic, Thoracic and Vascular Sciences , Preventive Medicine and Risk Assessment Unit , University Hospital of Padova , Padova , Italy
| | - Rudi De Bastiani
- Italian Association for Gastroenterology in Primary Care (GICA-CP) , Feltre , Italy
| | - Roberta Caccaro
- Division of Gastroenterology , University Hospital , Padova , Italy
| | - Claudia Mescoli
- Department of Medicine – DIMED , University of Padova , Padova , Italy
| | - Stefania Moz
- Department of Medicine – DIMED , University of Padova , Padova , Italy
| | - Dania Bozzato
- Department of Medicine – DIMED , University of Padova , Padova , Italy
| | | | - Greta Lorenzon
- Division of Gastroenterology , University Hospital , Padova , Italy
| | - Massimo Rugge
- Department of Medicine – DIMED , University of Padova , Padova , Italy
| | - Mario Plebani
- Department of Medicine – DIMED , University of Padova , Padova , Italy
| | - Daniela Basso
- Department of Medicine – DIMED , University of Padova , Padova , Italy
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Comiati V, Scapellato ML, Alexandre E, Volo T, Borsetto D, Carrieri M, Emanuelli E, Cazzador D. Sinonasal cancer in a worker exposed to chromium in an unusual industrial sector. Med Lav 2017; 108:477-481. [PMID: 29240044 DOI: 10.23749/mdl.v108i6.6606] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/23/2017] [Accepted: 11/08/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Occupational exposure to chromium is carcinogenic for human respiratory system. Due to the low incidence of sinonasal malignancies, there is still a paucity of evidence to confirm that chromium(VI) exposure is a cause of nasal cancer. OBJECTIVES To report on a sinonasal cancer (SNC) of rare occupational origin, increasing the awareness on epidemiological knowledge of occupational exposures to chromium compounds. METHODS We describe a case of a 64-year-old chrome plater who worked in the galvanic industry in the early 1970s. After a latency period of 39 years, he was diagnosed with sinonasal undifferentiated carcinoma (SNUC). A brief review of the literature was conducted. RESULTS A thorough occupational history revealed a 4-year-long occupational exposure to chromium(VI) during a magnesium cylinder plating process involved in computer production. The patient underwent endoscopic endonasal removal of the SNUC. He is alive with no evidence of disease at 40-month follow-up. Our literature review identified 8 papers concerning 40 cases of chrome-induced sinonasal tumors. The maximum relative risk of SNC developing in chromium-exposed workers was 15.4. CONCLUSIONS When dealing with patients diagnosed with SNC, the possibility of an underlying occupational risk is worth further investigation. Because chromium exposure is rare, and the incidence of SNUC is low, any information emerging on clinical and exposure-related aspects of SNCs in chrome plating workers can contribute to adding evidence on the possible causal relationship between chromium and sinonasal malignancies.
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Foddis R, Ficini G, Cristaudo A, Pistelli A, Carducci A, Caponi E, Biancheri R, Ninci A, Breschi C, Cristaudo A, Basso A, Bonfiglioli R, Larese Filon F, Simonini S, Spatari G, Tomao P, Verso MG, Scapellato ML. [Gender-sensitive risk assessment and health medical surveillance: some operative tools.]. G Ital Med Lav Ergon 2017; 39:214-217. [PMID: 29916592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/09/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES A thorough and fully application of the principles of gender mainstreaming, in accordance with the European Community guidelines, to the health and safety at work, implies the systematic review of the whole prevention from the gendered point of view. This means that both biology- and gender-based differences between male and female workers should be conceived not only as determinants of health but also as factors affecting either positively or negatively the health and safety risk prevention. In this evolutionary cultural step the role of the occupational physician is particularly important. METHODS In this paper we propose some operative tools that can concretely implement gender perspective in all the various areas of prevention, where the occupational physician has a leading, if not even exclusive, role such as risk assessment, training and health medical surveillance.
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Affiliation(s)
- Rudy Foddis
- Dipartimento di Ricerca Traslazione e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa
- Gruppo di ricerca del progetto "Salute e Sicurezza sul lavoro, una questione anche di genere", Università di Pisa-INAIL Regione Toscana
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Giulia Ficini
- Dipartimento di Ricerca Traslazione e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa
- Gruppo di ricerca del progetto "Salute e Sicurezza sul lavoro, una questione anche di genere", Università di Pisa-INAIL Regione Toscana
| | - Alfonso Cristaudo
- Dipartimento di Ricerca Traslazione e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa
| | - Alessandra Pistelli
- Dipartimento di Ricerca Traslazione e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa
- Gruppo di ricerca del progetto "Salute e Sicurezza sul lavoro, una questione anche di genere", Università di Pisa-INAIL Regione Toscana
| | - Annalaura Carducci
- Dipartimento di Biologia, Università di Pisa
- Gruppo di ricerca del progetto "Salute e Sicurezza sul lavoro, una questione anche di genere", Università di Pisa-INAIL Regione Toscana
| | - Elisa Caponi
- Dipartimento di Biologia, Università di Pisa
- Gruppo di ricerca del progetto "Salute e Sicurezza sul lavoro, una questione anche di genere", Università di Pisa-INAIL Regione Toscana
| | - Rita Biancheri
- Dipartimento di Scienze Politiche, Università di Pisa
- Gruppo di ricerca del progetto "Salute e Sicurezza sul lavoro, una questione anche di genere", Università di Pisa-INAIL Regione Toscana
| | - Antonella Ninci
- INAIL, sede Regionale Toscana, Firenze
- Gruppo di ricerca del progetto "Salute e Sicurezza sul lavoro, una questione anche di genere", Università di Pisa-INAIL Regione Toscana
| | - Chiara Breschi
- INAIL, sede Regionale Toscana, Firenze
- Gruppo di ricerca del progetto "Salute e Sicurezza sul lavoro, una questione anche di genere", Università di Pisa-INAIL Regione Toscana
| | - Andrea Cristaudo
- Dipartimento di Ricerca Traslazione e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa
| | - Antonella Basso
- Dipartimento Interdisciplinare di Medicina-Sezione Medicina del Lavoro Vigliani - Università degli Studi di Bari Aldo Moro
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Roberta Bonfiglioli
- Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum, Università di Bologna
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Francesca Larese Filon
- Unità Clinico Operativa di Medicina del Lavoro, Università di Trieste
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Silvia Simonini
- Servizio di Medicina Preventiva Asl 5 Spezzino, La Spezia
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Giovanna Spatari
- Dipartimento BIOMORF, Università di Messina
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Paola Tomao
- INAIL, Dipartimento di Medicina, Epidemiologia, Igiene del Lavoro ed Ambientale, Monte Porzio Catone - Roma
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Maria Gabriella Verso
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile "G. D'Alessandro", Università degli Studi di Palermo
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Maria Luisa Scapellato
- UOC Medicina Preventiva e Valutazione del Rischio, Azienda Ospedaliera-Università di Padova
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
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24
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Manno M, Iavicoli I, Scapellato ML, Leso V. [Relevance and role of guideline values for chemical risk assessment.]. G Ital Med Lav Ergon 2017; 39:155-158. [PMID: 29916578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/09/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Guideline values have been defined by the ad hoc S.I.M.L.I.I. Working Group as "the level of a risk factor, previously established for an environmental or biological context, to which the levels actually measured for/in the workers should be compared, in order to assess their degree of exposure". METHODS Guideline values include limit values, action levels and reference values, and may refer to an environmental or biological matrix. RESULTS The present paper aims to discuss the methodologies currently used for the definition of the most relevant guideline and limit values at the national and international level, with a particular attention to those used in the European Union (OEL). CONCLUSIONS It is concluded that a correct use of guideline values represents a fundamental tool for both the assessment and the management of chemical risk in workers exposed to toxic and/or carcinogenic substances.
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Affiliation(s)
- Maurizio Manno
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Napoli
| | - Ivo Iavicoli
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Napoli
| | - Maria Luisa Scapellato
- UOC di Medicina Preventiva e Valutazione del Rischio, Azienda Ospedaliera - Università degli Studi di Padova
| | - Veruscka Leso
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Napoli
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25
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Scapellato ML, Basso A, Bonfiglioli R, Foddis R, Larese Filon F, Simonini S, Spatari G, Tomao P, Verso MG. [Health and work in a gender perspective.]. G Ital Med Lav Ergon 2017; 39:203-210. [PMID: 29916590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/09/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES A literature review was performed to highlight which work-related diseases express sex/gender differences in health outcomes and focus the main limits of studies in this field. METHODS The research, carried out on PubMed by specific search string, identified 4828 articles (1997-2017 period) of which 381 are eligible for review (4-22%, depending on the disease). RESULTS Among them, 68% reported sex/gender differences in health outcomes, which in most cases appear to be due to different exposure and/or work segregation rather than to biological differences. However, few studies place this assessment among the research goals and results are almost never discussed and hypothesis are seldom formulated about any observed differences. CONCLUSIONS It seems necessary to use research methodologies and study design that can detect and explain the described complexity and useful in defining appropriate preventive strategies.
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Affiliation(s)
- Maria Luisa Scapellato
- UOC Medicina Preventiva e Valutazione del Rischio, Azienda Ospedaliera-Università di Padova
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Antonella Basso
- Dipartimento Interdisciplinare di Medicina-Sezione Medicina del Lavoro Vigliani - Università degli Studi di Bari Aldo Moro
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Roberta Bonfiglioli
- Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum, Università di Bologna
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Rudy Foddis
- Dipartimento di Ricerca Traslazione e Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Francesca Larese Filon
- Unità Clinico Operativa di Medicina del Lavoro, Università di Trieste
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Silvia Simonini
- Servizio di Medicina Preventiva Asl 5 Spezzino, La Spezia
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Giovanna Spatari
- Dipartimento BIOMORF, Università di Messina
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Paola Tomao
- INAIL, Dipartimento di Medicina, Epidemiologia, Igiene del Lavoro ed Ambientale, Monte Porzio Catone - Roma
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
| | - Maria Gabriella Verso
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile "G. D'Alessandro", Università degli Studi di Palermo
- Gruppo di Lavoro Permanente sui Temi di Genere, SIMLII
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26
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Aprea MC, Scapellato ML, Valsania MC, Perico A, Perbellini L, Ricossa MC, Pradella M, Negri S, Iavicoli I, Lovreglio P, Salamon F, Bettinelli M, Apostoli P. Methodology to define biological reference values in the environmental and occupational fields: the contribution of the Italian Society for Reference Values (SIVR). Med Lav 2017; 108:138-148. [PMID: 28446741 DOI: 10.23749/mdl.v108i2.5574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 11/07/2016] [Accepted: 12/15/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Biological reference values (RVs) explore the relationships between humans and their environment and habits. RVs are fundamental in the environmental field for assessing illnesses possibly associated with environmental pollution, and also in the occupational field, especially in the absence of established biological or environmental limits. OBJECTIVES The Italian Society for Reference Values (SIVR) determined to test criteria and procedures for the definition of RVs to be used in the environmental and occupational fields. METHODS The paper describes the SIVR methodology for defining RVs of xenobiotics and their metabolites. Aspects regarding the choice of population sample, the quality of analytical data, statistical analysis and control of variability factors are considered. The simultaneous interlaboratory circuits involved can be expected to increasingly improve the quality of the analytical data. RESULTS Examples of RVs produced by SIVR are presented. In particular, levels of chromium, mercury, ethylenethiourea, 3,5,6-trichloro-2-pyridinol, 2,5-hexanedione, 1-hydroxypyrene and t,t-muconic acid measured in urine and expressed in micrograms/g creatinine (μg/g creat) or micrograms/L (μg/L) are reported. CONCLUSIONS With the proposed procedure, SIVR intends to make its activities known to the scientific community in order to increase the number of laboratories involved in the definition of RVs for the Italian population. More research is needed to obtain further RVs in different biological matrices, such as hair, nails and exhaled breath. It is also necessary to update and improve the present reference values and broaden the portfolio of chemicals for which RVs are available. In the near future, SIVR intends to expand its scientific activity by using a multivariate approach for xenobiotics that may have a common origin, and to define RVs separately for children who may be exposed more than adults and be more vulnerable.
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27
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Emanuelli E, Alexandre E, Cazzador D, Comiati V, Volo T, Zanon A, Scapellato ML, Carrieri M, Martini A, Mastrangelo G. A case-case study on sinonasal cancer prevention: effect from dust reduction in woodworking and risk of mastic/solvents in shoemaking. J Occup Med Toxicol 2016; 11:35. [PMID: 27453718 PMCID: PMC4957368 DOI: 10.1186/s12995-016-0124-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/29/2016] [Indexed: 11/25/2022] Open
Abstract
Background and aims Sinonasal cancers (SNCs) are rare neoplasms, accounting for about 3 % of head and neck cancers, with squamous cell carcinoma (SCC) and adenocarcinoma (ADC) as the most common subtypes. ADCs present strong associations with occupational wood dust exposure. Preventive measures have progressively reduced wood dust concentrations in workplaces but no study has evaluated the effectiveness of such interventions. Few studies indicate associations between ADC and exposure to solvents, which is common in the shoe industry, but this hypothesis still needs confirmation. Methods In a case-case study, we contrasted 32 ADCs against 21 Non-Adenocarcinoma Epithelial Tumors (NAETs) – all recruited from the same clinical setting (Padua’s University Hospital; period 2004–2015) – using questionnaires and clinical records to collect information on potential predictors. Non-occupational factors were age, sex, smoking, allergy and chronic sinusitis. Occupational factors were intensity and frequency of wood dust exposure, protection from wood dust, type of wood (in woodworking); frequency of exposure to leather dust or mastic/solvent (in shoemaking). Odds-ratio (OR), 95 % confidence interval (95 % CI) and two-tail p-values were obtained through stepwise backward logistic regression for each industry, always using as reference patients never employed in either trade and adjusting for non-occupational risk factors. Results Adjusted OR was 22.5 (95 % CI = 3.50–144; p = 0.001) and 9.37 (95 % CI = 1.29–67.6; p = 0.026), respectively, in patients with low or high degree of protection against wood dust. In the shoe industry, adjusted OR was 1 and 18.8 (95 % CI = 1.29–174; p = 0.030), respectively, in patients with low or high exposure to only mastic/solvent; and 1 and 22.5 (95 % CI = 2.07–244; p = 0.011), respectively, in patients with low or high exposure to only leather dust. Discussion and conclusions The questionnaire used was able to estimate with simple algorithms past exposures in wood and footwear industries. The case-case design considerably increased the validity of this small study. Results in this study were always consistent with the extant literature; this could support reliability of novel findings. In woodworking, respiratory protective equipment and local exhaust ventilation reduced the risk of occupational SNC; in footwear manufacture, where preventive interventions were seldom adopted, SNC risk was significantly greater for high exposure from mastic/solvent and leather dust. Electronic supplementary material The online version of this article (doi:10.1186/s12995-016-0124-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Enzo Emanuelli
- Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Enrico Alexandre
- Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Diego Cazzador
- Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Vera Comiati
- Department of Occupational Medicine, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Tiziana Volo
- Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Alessia Zanon
- Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Maria Luisa Scapellato
- Department of Occupational Medicine, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Mariella Carrieri
- Department of Occupational Medicine, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Alessandro Martini
- Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Giuseppe Mastrangelo
- Department of Occupational Medicine, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
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28
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Staffieri C, Lovato A, Aielli F, Bortoletto M, Giacomelli L, Carrieri M, Romeo S, Boscolo-Rizzo P, Da Mosto MC, Bartolucci GB, Marioni G, Scapellato ML. Investigating nasal cytology as a potential tool for diagnosing occupational rhinitis in woodworkers. Int Forum Allergy Rhinol 2015; 5:814-9. [DOI: 10.1002/alr.21562] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 04/11/2015] [Accepted: 05/02/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Claudia Staffieri
- Department of Neurosciences; Otolaryngology Section; Treviso Regional Hospital Branch; University of Padova; Treviso Italy
| | - Andrea Lovato
- Department of Neurosciences; Otolaryngology Section; University of Padova; Padova Italy
| | - Federica Aielli
- Department of Neurosciences; Otolaryngology Section; Treviso Regional Hospital Branch; University of Padova; Treviso Italy
| | - Martina Bortoletto
- Department of Cardiologic; Thoracic and Vascular Sciences; Preventive Medicine and Risk Assessment Unit; University of Padova; Padova Italy
| | | | - Mariella Carrieri
- Department of Cardiologic; Thoracic and Vascular Sciences; Preventive Medicine and Risk Assessment Unit; University of Padova; Padova Italy
| | - Salvatore Romeo
- Department of Pathology; Treviso Regional Hospital; Treviso Italy
| | - Paolo Boscolo-Rizzo
- Department of Neurosciences; Otolaryngology Section; Treviso Regional Hospital Branch; University of Padova; Treviso Italy
| | - Maria Cristina Da Mosto
- Department of Neurosciences; Otolaryngology Section; Treviso Regional Hospital Branch; University of Padova; Treviso Italy
| | - Giovanni Battista Bartolucci
- Department of Cardiologic; Thoracic and Vascular Sciences; Preventive Medicine and Risk Assessment Unit; University of Padova; Padova Italy
| | - Gino Marioni
- Department of Neurosciences; Otolaryngology Section; University of Padova; Padova Italy
| | - Maria Luisa Scapellato
- Department of Cardiologic; Thoracic and Vascular Sciences; Preventive Medicine and Risk Assessment Unit; University of Padova; Padova Italy
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Carrieri M, Scapellato ML, Salamon F, Gori G, Trevisan A, Bartolucci GB. Assessment of exposure to oak wood dust using gallic acid as a chemical marker. Int Arch Occup Environ Health 2015; 89:115-21. [PMID: 25940655 DOI: 10.1007/s00420-015-1056-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/22/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The American Conference of Governmental Industrial Hygienists (ACGIH) has classified oak dust as a human carcinogen (A1), based on increased sinus and nasal cancer rates among exposed workers. The aims of this study were to investigate the use of gallic acid (GA) as a chemical marker of occupational exposure to oak dusts, to develop a high-performance liquid chromatography-diode array detector method to quantify GA and to apply the method in the analysis of oak dust samples collected in several factories. METHODS A high-performance liquid chromatography method was developed to detect GA in oak wood dust. The method was tested in the field, and GA was extracted from inhalable oak wood dust collected using the Institute of Occupational Medicine inhalable dust sampler in the air of five woodworking plants where only oak wood is used. RESULTS A total of 57 samples with dust concentrations in the range of 0.27-11.14 mg/m(3) were collected. Five of these samples exceeded the Italian threshold limit value of 5 mg/m(3), and 30 samples exceeded the ACGIH TLV of 1 mg/m(3). The GA concentrations were in the range 0.02-4.18 µg/m(3). The total oak dust sampled was correlated with the GA content with a correlation coefficient (r) of 0.95. CONCLUSIONS The GA in the tannic extracts of oak wood may be considered a good marker for this type of wood, and its concentration in wood dust sampled in the work environment is useful in assessing the true exposure to carcinogenic oak dust.
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Affiliation(s)
- Mariella Carrieri
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani, 2, 35127, Padova, Italy.
| | - Maria Luisa Scapellato
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani, 2, 35127, Padova, Italy
| | - Fabiola Salamon
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani, 2, 35127, Padova, Italy
| | - Giampaolo Gori
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani, 2, 35127, Padova, Italy
| | - Andrea Trevisan
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani, 2, 35127, Padova, Italy
| | - Giovanni Battista Bartolucci
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani, 2, 35127, Padova, Italy
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30
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Scapellato ML, Carrieri M, Maccà I, Salamon F, Trevisan A, Manno M, Bartolucci GB. Biomonitoring occupational sevoflurane exposure at low levels by urinary sevoflurane and hexafluoroisopropanol. Toxicol Lett 2014; 231:154-60. [PMID: 25455444 DOI: 10.1016/j.toxlet.2014.10.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 09/30/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
Abstract
This study aimed to correlate environmental sevoflurane levels with urinary concentrations of sevoflurane (Sev-U) or its metabolite hexafluoroisopropanol (HFIP) in order to assess and discuss the main issues relating to which biomarker of sevoflurane exposure is best, and possibly suggest the corresponding biological equivalent exposure limit values. Individual sevoflurane exposure was measured in 100 healthcare operators at five hospitals in north-east Italy using the passive air sampling device Radiello(®), and assaying Sev-U and HFIP concentrations in their urine collected at the end of the operating room session. All analyses were performed by gas chromatography-mass spectrometry. Environmental sevoflurane levels in the operating rooms were also monitored continuously using an infrared photoacoustic analyzer. Our results showed very low individual sevoflurane exposure levels, generally below 0.5 ppm (mean 0.116 ppm; range 0.007-0.940 ppm). Sev-U and HFIP concentrations were in the range of 0.1-17.28 μg/L and 5-550 μg/L, respectively. Both biomarkers showed a statistically significant correlation with the environmental exposure levels (Sev-U, r=0.49; HFIP, r=0.52), albeit showing fairly scattered values. Sev-U values seem to be influenced by peaks of exposure, especially at the end of the operating-room session, whereas HFIP levels by exposure on the previous day, the data being consistent with the biomarkers' very different half-lives (2.8 and 19 h, respectively). According to our results, both Sev-U and HFIP are appropriate biomarkers for assessing sevoflurane exposure at low levels, although with some differences in times/patterns of exposure. More work is needed to identify the best biomarker of sevoflurane exposure and the corresponding biological equivalent exposure limit values.
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Affiliation(s)
- Maria Luisa Scapellato
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani, 2, Padova 35128, Italy.
| | - Mariella Carrieri
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani, 2, Padova 35128, Italy.
| | - Isabella Maccà
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani, 2, Padova 35128, Italy.
| | - Fabiola Salamon
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani, 2, Padova 35128, Italy.
| | - Andrea Trevisan
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani, 2, Padova 35128, Italy.
| | - Maurizio Manno
- Department of Public Health, University of Napoli Federico II, Via Pansini, 5, Napoli 80131, Italy.
| | - Giovanni Battista Bartolucci
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani, 2, Padova 35128, Italy.
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Maccà I, Scapellato ML, Carrieri M, Maso S, Trevisan A, Bartolucci GB. High-frequency hearing thresholds: effects of age, occupational ultrasound and noise exposure. Int Arch Occup Environ Health 2014; 88:197-211. [PMID: 24923465 DOI: 10.1007/s00420-014-0951-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 05/30/2014] [Indexed: 12/26/2022]
Abstract
PURPOSE It has been suggested that high-frequency audiometry (HFA) could represent a useful preventive measure in exposed workers. The aim was to investigate the effects of age, ultrasound and noise on high-frequency hearing thresholds. METHODS We tested 24 industrial ultrasound-exposed subjects, 113 industrial noise-exposed subjects and 148 non-exposed subjects. Each subject was tested with both conventional-frequency (0.125-8 kHz) and high-frequency (9-18 kHz) audiometry. RESULTS The hearing threshold at high frequency deteriorated as a function of age, especially in subjects more than 30 years old. The ultrasound-exposed subjects had significantly higher hearing thresholds than the non-exposed ones at the high frequencies, being greatest from 10 to 14 kHz. This hearing loss was already significantly evident in subjects with exposure <5 years and increased with years of exposure and advancing age. The noise exposure group had significantly higher hearing thresholds than the non-exposed group at the conventional frequencies 4 and 6 kHz and at the high frequency of 14 kHz. After stratification for age, there was a significant difference between the two groups at 9-10 and 14-15 kHz only for those under 30 years of age. CONCLUSION Multivariate analysis indicated that age was the primary predictor, and noise and ultrasound exposure the secondary predictors of hearing thresholds in the high-frequency range. The results suggest that HFA could be useful in the early diagnosis of noise-induced hearing loss in younger groups of workers (under 30 years of age).
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Scapellato ML, Aprea MC, Moretto A, Bartolucci GB, Manno M. [Considerations on the limit values for benzene]. G Ital Med Lav Ergon 2013; 35:268-271. [PMID: 24303709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Occupational exposure limits and guideline values for the general population proposed for benzene by several international bodies are discussed and compared with the Italian and EU occupational limit values, taking also into account the criteria used for their derivation. Benzene is an environmental pollutant, and the EU guideline value for ambient air is 5 microg/m3, based on carcinogenic risk. Presently, occupational exposures are greatly reduced, and in many instances close to those of the general population. Consequently, it does not seem to be appropriate to maintain the Italian and the EU occupational exposure limits of 1 ppm (3.2 mg/m3), which are inconsistent with the ALARA principle and not justified by technological constraints. It should be pointed out that, in any case, preventive interventions should be carried out, beyond the compliance with the established limit values, in order to ensure the lowest exposure and by carrying out biological monitoring as a tool to verify the appropriateness of risk management measures.
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Affiliation(s)
- Maria Luisa Scapellato
- U.O.C. di Medicina del Lavoro, Azienda Ospedaliera di Padova, Università di Padova, Padova, Italy.
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Macca I, Carrieri M, Scapellato ML, Scopa P, Trevisan A, Bartolucci GB. Biological monitoring of exposure to perchloroethylene in dry cleaning workers. Med Lav 2012; 103:382-393. [PMID: 23077798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Perchloroethylene (PCE) is the most widely used solvent in dry cleaning. OBJECTIVES The aim was to evaluate PCE pollution and to identify the most reliable biological indicators for the assessment of workers' exposure. METHODS The study was performed in 40 dry cleaning shops covering a total of 71 subjects. Environmental monitoring was carried out with personal diffusive samplers (Radiello) for the entire work shift; biological monitoring was performed by measuring PCE in urine and blood and trichloroacetic acid (TCA) in urine on Thursday evening at end-of shift and on Friday morning pre-shift. RESULTS The mean concentration of PCE in air was 52.32 mg/m3, about 30% of the TLV-TWA and the mean value of the PCE inpre-shift blood samples was 0.304 mg/l, slightly more than 50% of the BEI. In dry cleaning shops employing less than 3 persons PCE in air exceeded the TLV-TWA in 7.8% of cases; the size of the shops was inversely related to pollution. Statistically significant correlations were found between PCE exposure and PCE in blood end-of-shift (r = 0.67) and pre-shift (r = 0.70), and PCE in urine end-of-shift (r = 0.68); no correlation was found between exposure and PCE in urine pre-shift and urinary TCA. CONCLUSIONS Dry cleaning shops still register conditions of exposure and pollution by PCE, although to a lesser extent than in the past. The most reliable indicators for biological monitoring are CE in end-of-shift urine and PCE in blood both at end-of-shift and pre-shift at the end of the workweek.
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Affiliation(s)
- Isabella Macca
- Department of Molecular Medicine, Unit of Occupational Medicine, University of Padua
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Carrieri M, Bartolucci GB, Scapellato ML, Spatari G, Sapienza D, Soleo L, Lovreglio P, Tranfo G, Manno M, Trevisan A. Influence of glutathione S-transferases polymorphisms on biological monitoring of exposure to low doses of benzene. Toxicol Lett 2012; 213:63-8. [DOI: 10.1016/j.toxlet.2011.11.031] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 11/29/2011] [Indexed: 10/14/2022]
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Cottica D, Grignani E, Scapellato ML, Butera R, Bartolucci GB. [Guides to chemical risk assessment in the construction industry]. G Ital Med Lav Ergon 2012; 34:294-298. [PMID: 23213805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The presence of chemical agents in construction is certainly relevant in terms of quality, quantity and toxicity. Their manipulation can result in potential exposure as inhaled and/or through the skin. It is therefore possible and necessary to identify a list of substances to be considered relevant for the risk assessment and the possible environmental monitoring to verify the adequacy of the estimate made. The many variables inherent in construction make it extremely difficult to apply the usual methods of the industrial hygiene because it would not very significant conclusions in terms of space-time representation. SIMLII in one of its guidelines have proposed a "indexes" method that can provide useful information to the figures of prevention for the actions of their competence. The subsequent introduction of the REACH Regulation and exposure scenarios may help to further sharpening the assessment of chemical hazards in construction.
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Affiliation(s)
- D Cottica
- Centro Ricerche Ambientali, Fondazione Salvatore Maugeri, IRCCS, Pavia-Padova, Padova, Italy.
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36
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Scapellato ML, Aprea MC, Apostoli P, Bartolucci GB. [The role of scientific associations in the definition of occupational limit values]. G Ital Med Lav Ergon 2011; 33:443-446. [PMID: 23393895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The definition and compliance with occupational limit values for pollutants in the workplace are the main tool for risk reduction and prevention of possible adverse health effects. There is no doubt that the decisions on the limit values are now closely linked to what produced in the European Community, if not at the international level. However, we believe that Scientific Associations should play a role in proposing and updating the limit values adopted by law in Italy. Become prominent interlocutors of lawmakers and institutional bodies is equally important.
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Affiliation(s)
- M L Scapellato
- Dipartimento di Medicina Ambientale e Sanità Pubblica, Università di Padova, via Giustiniani 2, 35128 Padova, Italy.
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Aprea MC, Scapellato ML, Bartolucci GB, Apostoli P. [Environmental and biological limit values and reference values]. G Ital Med Lav Ergon 2011; 33:430-433. [PMID: 23393892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The application of air quality guidelines and limits for occupational exposure in the workplace are the main tools for risk reduction and prevention of the effects of pollutants on health of the general population and workers respectively. The Biological Reference Values (BRVs), determined in situations of non-occupational exposure, and the Biological Limit Values (BLVs) contribute to the interpretation of biological monitoring data. In the occupational field the comparison with the BRVs should be informative about the existence of exposures greater than the general population and are particularly important for substances without VLBs or whose effects include chronic diseases.
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Affiliation(s)
- M C Aprea
- Laboratorio di Sanità Pubblica Area Vasta Toscana Sud Est, Azienda USL 7 di Siena. Strada del Ruffolo, 53100 Siena, Italy.
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Maestrelli P, Canova C, Scapellato ML, Visentin A, Tessari R, Bartolucci GB, Simonato L, Lotti M. Personal exposure to particulate matter is associated with worse health perception in adult asthma. J Investig Allergol Clin Immunol 2011; 21:120-128. [PMID: 21462802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Epidemiological studies have shown positive associations between particulate matter (PM) air pollution and short-term mortality and morbidity for asthma. The hypothesis that lung inflammation is responsible for these effects has been tested in panel and controlled exposure studies in asthmatic adults, with inconsistent results. OBJECTIVES We investigated whether personal exposure to PM10 and PM2.5 were related to changes in the clinical course of asthma and to lung inflammatory responses in adult asthmatics. METHODS A cohort of 32 asthmatic patients was followed for 2 years. Asthma control test (ACT) and St George's Respiratory Questionnaire (SGRQ) scores, forced expired volume in the first second (FEV1), exhaled nitric oxide (Fe(NO)), and pH of exhaled breath condensate (EBC) were determined on 6 occasions during different seasons. Personal exposure to PM was measured for 24 hours prior to clinical assessments. RESULTS A 10 microg/m3 increase in PM10 personal exposure was associated with an increase in SGRQ scores (regression coefficient beta = 0.22; 95% confidence interval [CI], -0.005 to 4.451; P =.055) and with a decrease in ACT scores (beta = -0.022; 95% CI, -0.045 to 0.001; P = .060), whereas no associations were found between PM10 and FEV1, Fe(NO), or EBC pH. A positive association was detected between Fe(NO) and outdoor O3 (P = .042) and SO2 (P = .042) concentrations in the subgroup of nonsmoking asthmatics. CONCLUSIONS We concluded that increments in personal exposure to PM10 are associated with a decrease in asthma control and health-related quality of life. However, this study does not provide evidence that 24-hour exposures to PM are associated with short-term changes in lung function or inflammatory responses of the lung.
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Affiliation(s)
- P Maestrelli
- Department of Environmental Medicine and Public Health, University of Padova, Padova, Italy.
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Tranfo G, Bartolucci GB, Pigini D, Paci E, Scapellato ML, Doria D, Manno M, Carrieri M. Comparison of hydrolysis and HPLC/MS/MS procedure with ELISA assay for the determination of S-phenylmercapturic acid as a biomarker of benzene exposure in human urine. J Chromatogr B Analyt Technol Biomed Life Sci 2010; 878:2529-33. [DOI: 10.1016/j.jchromb.2009.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Revised: 10/21/2009] [Accepted: 11/03/2009] [Indexed: 11/25/2022]
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Scapellato ML. [Individual exposure to particulate matter and autonomic activity in patients with myocardial infarction]. G Ital Med Lav Ergon 2010; 32:344-347. [PMID: 21438295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Particulate matter (PM) exposures are correlated in several studies with short-term increases of morbidity and mortality for cardiovascular diseases. Some of these effects are believed to be exacerbated by dysregulation of cardiac rhythm. We studied patients with antecedent myocardial infarction showing that a reduction of heart rate variability (HRV) correlates with the intensity of exposures to quasi-ultrafine particles (PM0.25). However, this correlation was not found in patients taking beta-blockers. These data suggest that the effects of PM could be mediated through a rapid imbalance of the autonomic regulation of the heart. Current mechanistic hypotheses are discussed leading to the conclusion that the most studied one, i.e. pulmonary inflammation, may trigger reflexes or, more likely PM interact with bronchial receptors directly, and inflammation may be simply bystander.
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Affiliation(s)
- M L Scapellato
- Dipartimento di Medicina Ambientale e Sanità Pubblica, Università degli Studi di Padova, Italy.
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41
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Canova C, Torresan S, Simonato L, Scapellato ML, Tessari R, Visentin A, Lotti M, Maestrelli P. Carbon monoxide pollution is associated with decreased lung function in asthmatic adults. Eur Respir J 2009; 35:266-72. [PMID: 19679604 DOI: 10.1183/09031936.00043709] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of the present study was to test the effects of exposure to air pollutants on lung function. A panel of 19 adult asthmatics living in Padua (Italy) was followed for five 30-day periods during 2 yrs consecutively (1,492 morning and 1,434 evening measures analysed). Peak expiratory flow (PEF) and forced expiratory volume in 1 s (FEV(1)) were measured using a pocket electronic meter. Daily levels of air pollutants and meteorological variables were collected at outdoor city monitoring sites. Significant inverse associations were observed between morning and evening PEF and carbon monoxide level (p = 0.01-0.03), without clear differences between lags (0-3 days). An increment of 1 mg.m(-3) CO was associated with a PEF variation ranging -2.6- -2.8%. All effect estimates on PEF for CO remained significant and even increased after controlling for particles with a 50% cut-off aerodynamic diameter of 10 microm (PM(10)), nitrogen dioxide and sulphur dioxide in single and multi-pollutant models. A similar trend was observed for FEV(1), but the associations were nonsignificant. A nonsignificant inverse relationship between evening PEF and SO(2) was also detected. PEF and FEV(1) were not related to PM(10) and NO(2) concentrations. The present results indicate that, in this panel of adult asthmatics, the worsening of lung function is associated with exposure to gaseous pollutants and occurs at levels of CO and SO(2) lower than current European standards.
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Affiliation(s)
- C Canova
- Dept of Environmental Medicine and Public Health, University of Padova, Via Loredan 18, 35151 Padova, Italy. E-mail:
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Scapellato ML, Canova C, de Simone A, Carrieri M, Maestrelli P, Simonato L, Bartolucci GB. Personal PM10 exposure in asthmatic adults in Padova, Italy: seasonal variability and factors affecting individual concentrations of particulate matter. Int J Hyg Environ Health 2009; 212:626-36. [PMID: 19574093 DOI: 10.1016/j.ijheh.2009.06.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Revised: 05/18/2009] [Accepted: 06/02/2009] [Indexed: 11/25/2022]
Abstract
Personal exposure to PM(10) measured in different seasons in a sample of asthmatic subjects living in Padova (Northern Italy) was compared with simultaneously measured outdoor PM(10) concentrations. The specific contribution of ambient PM(10) and other factors to individual exposure was evaluated in one of the areas of Europe with the worst air pollution. Thirty-one asthmatic subjects (21 non-smokers and 10 smokers) carried personal PM(10) monitors for six 24-hr sessions, in different seasons of the year. Concomitant daily 24-hr ambient PM(10) concentrations were measured by air quality monitoring networks. A multivariate analysis was performed to identify factors explaining personal exposure to PM(10), using a random effect model. The analysis on the 31 subjects referred to a total of 155 observations. The mean personal PM(10) exposure was higher (range 79.3-126.1microg/m(3)) than the outdoor concentrations (range 37.3-85.4microg/m(3)) in all seasons; and personal exposures varied less than outdoor PM(10) levels from one season to another. Smokers had significantly higher personal PM(10) concentrations than non-smokers (127.99 vs 78.8microg/m(3); T=-5.70; p<0.001). Moderate correlations emerged between outdoor and personal PM(10) concentrations. The correlation improved after excluding subjects exposed to active or passive smoking (median Pearson's R 0.41 vs 0.26). Considering all the subjects, smoking was the main factor affecting personal exposure, contributing to 41% of the variability. Outdoor PM(10) concentrations (25%), temperature (12%) and season (15%) also contributed to personal PM(10) exposure. Outdoor PM(10) (46%), temperature (20%), season (19%) and time spent indoors (6%) were significantly associated with personal exposure in non-smokers. We concluded that it is crucial to perform personal monitoring and to evaluate the complexity of factors that contribute to individual PM exposure. While tobacco smoke was the primary source of PM(10) in all subjects, the contribution of ambient components was particularly relevant for the personal exposure levels of our non-smokers living in a highly-polluted environment.
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Affiliation(s)
- Maria Luisa Scapellato
- Department of Environmental Medicine and Public Health, University of Padova, Padova, Italy.
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Folino AF, Scapellato ML, Canova C, Maestrelli P, Bertorelli G, Simonato L, Iliceto S, Lotti M. Individual exposure to particulate matter and the short-term arrhythmic and autonomic profiles in patients with myocardial infarction. Eur Heart J 2009; 30:1614-20. [PMID: 19411666 DOI: 10.1093/eurheartj/ehp136] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
AIMS Epidemiological studies show that peak exposure to air pollution is associated with increased morbidity and mortality from cardiovascular events. Panel and controlled exposure studies show that particulate matter (PM) may influence the parasympathetic regulation of the heart. The aim of this study was to concurrently measure individual exposure to PM of various sizes, heart rate variability (HRV), and electrical instability in patients with myocardial infarction. METHODS AND RESULTS Personal exposures to PM(10), PM(2.5), and PM(0.25) was measured over 24 h in 39 patients (36 males, 3 females; mean age 60.3 years) with prior myocardial infarction (>6 months). Simultaneously, a 24 h ECG was recorded and then analysed for HRV and ventricular arrhythmias. Breath condensate and blood samples also were collected at the end of monitoring to measure several indexes of inflammation. Negative correlation was found between HRV and exposure to PM(0.25) in a group of patients not taking beta-blockers. More severe ventricular arrhythmias were observed at the highest concentrations of PM(10) and PM(2.5). Indexes of inflammation in either breath condensate or blood did not correlate with PM exposures. CONCLUSION Our study shows that exposure to ultrafine particles is associated with autonomic dysregulation in selected patients with myocardial infarction. More severe arrhythmias occur at the highest exposures to larger particles. Nevertheless, the underlying mechanisms remain hypothetical because inflammation may be evoked by PM or be related to the disease itself.
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Affiliation(s)
- Antonio F Folino
- Department of Cardiology, University of Padua, Via Giustiniani, 2, Padova 35128, Italy.
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Gori G, Carrieri M, Scapellato ML, Parvoli G, Ferrara D, Rella R, Sturaro A, Bartolucci GB. 2-Methylanthraquinone as a Marker of Occupational Exposure to Teak Wood Dust in Boatyards. The Annals of Occupational Hygiene 2008; 53:27-32. [PMID: 18977849 DOI: 10.1093/annhyg/men069] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Giampaolo Gori
- Dipartimento di Medicina Ambientale e Sanità Pubblica, Università di Padova, Via Giustiniani 2, 35128 Padova, Italy
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Aprea C, Sciarra G, Bozzi N, Pagliantini M, Perico A, Bavazzano P, Leandri A, Carrieri M, Scapellato ML, Bettinelli M, Bartolucci GB. Reference values of urinary trans,trans-muconic acid: Italian Multicentric Study. Arch Environ Contam Toxicol 2008; 55:329-340. [PMID: 18214577 DOI: 10.1007/s00244-007-9119-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2007] [Accepted: 12/20/2007] [Indexed: 05/25/2023]
Abstract
This article reports the results of a study, conducted in the framework of the scientific activities of the Italian Society for Reference Values, aimed at defining reference values of urinary trans,trans-muconic acid (t,t-MA) in the general population not occupationally exposed to benzene. t,t-MA concentrations detected in 376 subjects of the resident population in three areas of Italy, two in central (Florence and southern Tuscany) and one in northern Italy (Padua), by three laboratories, compared by repeated interlaboratory controls, showed an interval of 14.4-225.0 microg/L (5th-95th percentile) and a geometric mean of 52.5 microg/L. The concentrations measured were influenced by tobacco smoking in a statistically significant way: Geometric mean concentrations were 44.8 microg/L and 76.1 microg/Ll in nonsmokers (264 subjects) and smokers (112 subjects), respectively. In the nonsmoking population, a significant influence of gender was found when concentrations were corrected for urinary creatinine, geometric mean concentrations being 36.7 microg/g creatinine in males (128 subjects) and 44.7 microg/g creatinine in females (136 subjects). The place of residence of subjects did not seem to influence urinary excretion of the metabolite, although personal inhalation exposure to benzene over a 24-h period showed slightly higher concentrations in Padua and Florence (geometric means of 6.5 microg/m(3) and 6.6 microg/m(3), respectively) than in southern Tuscany (geometric mean of 3.9 microg/m(3)). Concentration of t,t-MA in urine samples collected at the end of personal air sampling showed little relationship to personal inhalation exposure to benzene, confirming the importance of other factors in determining excretion of t,t-MA when concentrations in personal air samples are very low.
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Affiliation(s)
- C Aprea
- Laboratorio di Sanità Pubblica, Azienda USL 7 di Siena, Siena, Italy.
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Maccà I, Scapellato ML, Carrieri M, Pasqua di Bisceglie A, Saia B, Bartolucci GB. Occupational exposure to electromagnetic fields in physiotherapy departments. Radiat Prot Dosimetry 2008; 128:180-90. [PMID: 17562660 DOI: 10.1093/rpd/ncm309] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
To assess occupational exposure to electromagnetic fields, 11 microwave (MW), 4 short-wave diathermy and 15 magneto therapy devices were analysed in eight physiotherapy departments. Measurements taken at consoles and environmental mapping showed values above European Directive 2004/40/EC and ACGIH exposure limits at approximately 50 cm from MW applicators (2.45 GHz) and above the Directive magnetic field limit near the diathermy unit (27.12 MHz). Levels in front of MW therapy applicators decreased rapidly with distance and reduction in power; this may not always occur in work environments where nearby metal structures (chairs, couches, etc.) may reflect or perturb electromagnetic fields. Large differences in stray field intensities were found for various MW applicators. Measurements of power density strength around MW electrodes confirmed radiation fields between 30 degrees and 150 degrees , with a peak at 90 degrees , in front of the cylindrical applicator and maximum values between 30 degrees and 150 degrees over the whole range of 180 degrees for the rectangular parabolic applicator. Our results reveal that although most areas show substantially low levels of occupational exposure to electromagnetic fields in physiotherapy units, certain cases of over-occupational exposure limits do exist.
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Affiliation(s)
- I Maccà
- Department of Environmental Medicine and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
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Abstract
"Would you tell me please, which way I ought to go from here," asked Alice. "That depends a good deal on where you want to go to," said the cat. (Lewis Carroll, Alice's Adventures in Wonderland) A large number of epidemiological studies show positive correlations between increasing levels of particulate matter (PM) in urban air and short-term morbidity and mortality for diverse acute cardiopulmonary diseases. Brought about by PM increments, inflammation is thought to exacerbate preexisting inflammatory diseases. Experimental evidence suggests a hierarchical oxidative stress model, in which a weakened antioxidant defense, as observed in disease or induced by inhaled particles, increases the PM ability to cause lung inflammation, accounting for exacerbations that occur in asthmatics and in patients with chronic obstructive lung disease. The role of PM-induced inflammation leading to acute cardiovascular events such as arrhythmia, heart failure, and myocardial infarction is more speculative. There is neither clear-cut evidence in humans that inhaled PM could get as far as blood circulation nor that proinflammatory mediators are significantly released from inflamed lung tissues, nor that blood coagulability is critically altered. As a whole, data in humans indicate that short-term inflammatory responses to PM are not always detected; they are usually mild and loosely correlated with functional changes. Among these studies, the diversity of PM characteristics, dose metrics, and endpoints hampers a clear discerning of inflammatory mechanism(s). Thus, the question arises as to whether inflammation represents the mechanism of acute cardiopulmonary PM toxicities in susceptible individuals, or rather an event that may coexist with other relevant mechanism(s). This review article discusses the evidence in humans linking short-term PM increments to inflammation and to exacerbations of cardiopulmonary diseases. Although there is a large amount of data available, there still remains a gulf between the number of epidemiological and panel studies and that of controlled exposures. Research on controlled exposure needs expanding, so that the results of time-series and panel studies will be better understood and short-term standards for human exposure may be more confidently allocated.
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Affiliation(s)
- Maria Luisa Scapellato
- Dipartimento di Medicina Ambientale e Sanità Pubblica, Università degli Studi di Padova, Padova, Italy.
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Scapellato ML, Mastrangelo G, Fedeli U, Carrieri M, Maccà I, Scoizzato L, Bartolucci GB. A longitudinal study for investigating the exposure level of anesthetics that impairs neurobehavioral performance. Neurotoxicology 2007; 29:116-23. [PMID: 18022695 DOI: 10.1016/j.neuro.2007.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Revised: 09/27/2007] [Accepted: 10/02/2007] [Indexed: 11/29/2022]
Abstract
There is conflicting evidence on the level of anesthetics that impairs neurobehavioral performance, leading to differences in exposure standards (25 or 50 ppm for N(2)O). Thirty-eight operating room nurses and 23 unexposed nurses were asked to provide information on confounding variables: age, gender, years of schooling, alcohol and coffee consumption, smoking, length of work, symptoms (Euroquest) and results of Block Design test. Afterward, all workers were repeatedly examined (on Monday and Friday of a working week, before and after workshift) for stress and arousal (Mood Scale) and complex reaction times (Color Word Vigilance, CWV), the latter being the outcome. Individual exposure was assessed through urinary end-shift concentrations of nitrous oxide (N(2)O) and isoflurane. According to the highest value of urinary excretion of N(2)O in the week, exposed workers were subdivided in three groups (<13; > or =13 and <27; and > or = 27 microg/l). The values of 13 and 27 microg/l correspond to environmental concentrations of 25 and 50 ppm, respectively. In order to take into account the pre-existing abilities of exposed and reference workers, and investigate the neurobehavioral changes over time, longitudinal data were analyzed by a two-stage regression model and analysis of variance for repeated measures (MANOVA). The former method, controlling for confounding factors and Monday morning CWV (which conveyed the pre-existing ability of the subjects), showed that, with respect to unexposed nurses, reaction times were significantly (p<0.020) higher only in workers with urinary N(2)O> or = 27 microg/l. Therefore, at MANOVA, all subjects were categorized in two classes (N(2)O urinary concentrations<or > or = 27 microg/l), and CWV results were adjusted for the confounding variables and effects of stress and arousal, taken concurrently with CWV. CWV significantly (p<0.039) decreased over a working week (indicating a learning effect) in workers with urinary N(2)O<27 microg/l, while remained steady (indicating impairment of neurobehavioral performance) in those with urinary N(2)O> 27 microg/l.
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Carrieri M, Bonfiglio E, Scapellato ML, Maccà I, Tranfo G, Faranda P, Paci E, Bartolucci GB. Comparison of exposure assessment methods in occupational exposure to benzene in gasoline filling-station attendants. Toxicol Lett 2005; 162:146-52. [PMID: 16289653 DOI: 10.1016/j.toxlet.2005.09.036] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was to assess gasoline filling-station attendants' exposure to benzene and to determine which biological exposure index (BEI), trans,trans-muconic acid (t,t-MA) or S-phenylmercapturic acid (S-PMA), shows better correlation with environmental exposure. Exposure to benzene was measured using passive samplers (Radiello) attached to the collar of the overalls of subjects (n=33) just before the work-shift (approximately 8h); analysis was performed by GC-FID. S-PMA and t,t-MA were determined, respectively, by an immunochemiluminescent assay based on specific monoclonal antibodies and by HPLC-UV at 264 nm. Both methods of biological monitoring were performed on beginning and end-shift urine samples, and expected t,t-MA and S-PMA values were calculated. Smoking habits and life-style were ascertained by means of a questionnaire. Both environmental and biological monitoring data showed that benzene exposure for gasoline filling-station attendants was low when compared with the respective ACGIH limit values (means-benzene: 0.044 mg/m(3); t,t-MA: 171 microg/g creatinine; S-PMA: 2.7 microg/g creatinine). No significant correlation was found between exposure to benzene and t,t-MA or S-PMA excretion data. The use of expected values was also experimented for S-PMA and t,t-MA. This consists of calculating, on the basis of the known half-life of the benzene metabolite, the concentration of that metabolite that a worker should present at the end of the work-shift, the difference between this value and the value actually found is a measure of benzene exposure during work. The use of expected values in biological monitoring did not improve correlations. At these low benzene levels, environmental monitoring seems to be the best method of evaluating individual exposure. However, biological monitoring remains useful, as a mean of assessing group exposure.
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Affiliation(s)
- Mariella Carrieri
- Department of Environmental Medicine and Public Health, University of Padova, Via Giustiniani 2, Padova 35128, Italy.
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Gori G, Bonfiglio E, Carrieri M, Lazzarin M, Cecchinato C, Scapellato ML, Maccà I, Bartolucci GB. [Tannin and gallic acid as marker of exposure to hardwood dust]. G Ital Med Lav Ergon 2005; 27:332-4. [PMID: 16240588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The total tannin concentration was determined, using two different SPF methods, in 35 dust powdered wood species, both hard and softwood. Using direct reading-method (280 nm) the concentration varied from 2485 mg/g for Swedish pine to 35,843 mg/g for European oak (quercus robur, hardwood). The data obtained with the second method (Folin-Chocalteau) were well correlated (y = 0.9885x + 4.3373; r = 0.84; n=35) with the data obtained with the first method. The measured concentrations are usually higher in hardwood than softwood tested. Finally, a simple HPLC-DAD method was tested for gallic acid (GA), recently proposed as a marker for oak dust.
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Affiliation(s)
- G Gori
- Dipartimento di Medicina Ambientale e Sanità Pubblica, Sede di Medicina del Lavoro, Università degli Studi di Padova.
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