1,721,090 research outputs found
Occupational Exposure to Ionizing Radiation Is Associated with Autoimmune Thyroid Disease
No full textIn the August issue of the Journal (1) Volzke et al. claim that occupational exposure to ionizing radiation is associated with autoimmune thyroid disease (AITD). Since this is the first published study on this subject, Authors suggest that additional case-control studies are needed to confirm their findings. We are performing a study similar to that of Volzke et al reaching, however, opposite conclusions. In fact, we have data on 125 subjects (70 males and 55 females) exposed to ionizing radiations and on 125 controls of similar age (± 2 years) and of the same sex, never exposed to radiation. Both patients and controls worked in a large teaching hospital, and the study was performed in their working environment, so that accurate information about the cumulative dosage and time of exposure was obtained. Using the combined presence of a hypoechogenic thyroid echopattern and positive antithyroperoxidase antibodies (anti-TPO) levels for the diagnosis of AITD, we diagnosed the disorder in 3 female subjects in both groups (p=1), and in no male subject. No relationship between time of exposure or dosage and AITD was observed.
In addition, we feel that the conclusion of Volzke et al is not justified by their own data. In fact, AITD was diagnosed in 3.3 % of exposed subjects (4 out of 120) and in 3.4% of the female population of controls (data on the prevalence of AITD in male control population are not given); among exposed males (representing two thirds of the whole exposed population) no subject had AITD; the prevalence of a hypoechogenic thyroid echopattern and positive anti-TPO levels was quite similar in the 2 groups: positive anti-TPO were found in 3.1% of exposed subjects and in 4.6% of non exposed ones, whereas a hypoechogenic pattern was detected in 8.1% and 7.3%, respectively.
Last but not least, overt thyroid disorders were more frequent in non exposed subjects (10%) than in exposed ones (5.6%), barely missing statistical significance (p=0.07): should one infer that lack of exposure to radiation may be a risk factor for thyroid diseases other than AITD?
In conclusion, on the basis of the present evidence, we disagree that workers exposed to ionizing radiation are at high risk for AITD.
Nevertheless, the possibility of a marginal risk cannot be excluded, and further studies may be useful in this respect
Evaluation of immunity to measles in a cohort of Medical Students in Rome, Italy
No full textMeasles is a highly contagious viral disease with serious complications. Currently, in Italy, measles vaccination is not mandatory for health care workers (HCWs) and medical students, and the free offer of the Measles Mumps Rubella (MMR) vaccine is the only national prevention measure to increase the coverage rate among these subjects
Cost-effectiveness of workplace vaccination against measles
No full textMeasles is one of the most contagious infectious diseases. Measles vaccine, which has been introduced in Italy in 1979, is highly effective in preventing the disease (two-dose vaccine effectiveness is 99%). In 2017, Italy was the second country of EU for number of cases of measles. A study conducted in the same year showed that 22.3% of measles infection happened in hospital settings and 6.6% of cases occurred in HCWs. This risk group showed low rates of adhesion to the vaccination campaign. For this reason, we hypothesized that workplace vaccination could lead to better vaccination rates in HCWs. Moreover, we focused the vaccination campaign on a specific target group composed of HCWs not serologically immune and previously not vaccinated. We analyzed the clinical records of measles-specific IgG antibodies of 2,940 HCWs, that underwent occupational health surveillance between 1 January 2017 and 31 December 2017. 15.3% (450) was seronegative for measles, especially in the age group under 35 years. We compared the costs related to strategies with and without serological screening. Our study confirmed that immunization strategy with pre-vaccination screening was cost-effective compared to the vaccination without screening. In our sample, in fact, administration of two dose vaccine only susceptible HCWs determine a saving of 146,262 euro. The vaccination of HCWs remains a topical issue in preventing the transmission of infectious disease in the hospital setting. Due to the cost-effectiveness evaluation, we recommend extending the pre-vaccination screening to identify the real susceptible workers
Vaccine Hesitancy among Healthcare Workers in Europe: A Systematic Review
Full text linkThis study analyzes vaccine hesitancy (VH) among healthcare workers (HCWs) in 15 European countries. We have undertaken a systematic review by synthesizing data from 46 articles (between 2015 and 2022) encompassing 55,612 subjects. Despite the heterogeneity of the methods in the various studies, we found that physicians had consistently higher vaccination rates than nurses across different countries and different vaccines. Physicians’ average vaccination rate was 79% across a selection of vaccines, while that of nurses was 62%. Concerns regarding vaccine safety, information gaps, and the responsibility of healthcare authorities in managing VH are highlighted by qualitative insights. This research contributes to our comprehension of the ways in which VH among HCWs is impacted by healthcare roles, vaccine types, and regional disparities. The insights gleaned from this analysis can serve as a guide for targeted interventions aimed at increasing vaccine acceptance and coverage in Europe, ultimately strengthening public health
Pre-vaccination IgG screening for mumps is the most cost-effectiveness immunization strategy among Health Care Workers
No full textHealth Care Workers (HCWs) have an increased risk of contracting contagious disease, including mumps. In January 2017 the Italian National Vaccine Prevention Plan 2017-2019, recommended the administration of a dose of MMR vaccine (Measles-Mumps-Rubella) to the Health Care Workers (HCWs) that, working in a risky environment, did not carry out the complete vaccination cycle of MMR or that are seronegative for at least one of the three vaccine viruses. In October of the same year, the Advisory Committee on Immunization Practices (ACIP) recommended a third dose of a vaccine containing Mumps Virus for people previously vaccinated with 2 doses, belonging to a group or to a population at increased risk of acquire mumps in the event of an epidemic. We analyzed the clinical records and values of mumps-specific IgG antibodies of 3032 HCWs (mean age 32.80 +/- 10.75 years), that underwent occupational health surveillance between January 1st 2017 and March 31th 2018. The HCWs were also screened for measles, rubella, mumps using serological methods. 13% (405) was seronegative for mumps, especially among HCWs between 18 and 36 years. We calculated the cost-effectiveness of two-doses and three-doses MMR vaccination. The cost of vaccination without screening was significantly more expensive (cost difference: 99 712 euro and 184 996 euro) both in case of two-dose and three-dose MMR vaccination respectively. Our study suggests that, in HCWs, the assessment of the mumps antibody titer before vaccination may be a useful complement to vaccination itself, because it is more accurate and cost-effective than direct immunization of unvaccinated subjects
Are thyroid dysfunctions related to stress or microwave exposure (900 MHz)?
No full textIn the last decade, numerous scientific evidence suggested possible adverse health effects from exposure to electromagnetic fields (EMF'S) and the use of mobile phones. According to some studies EMF induced changes of trans-membrane Ca++ flux may lead to altered metabolism and/or secretion of neurohormones including TSH, ACTH, GH, prolactin and melatonin. The aim of this research was to analyse the effects of mobile phone use on thyroid function and to evaluate the possible role of occupational stress. 2598 employees (1355 men and 1243 women) with different duties (vendors, operators and network technicians) were included in the study. Exposure to EMF'S, generated by mobile phones, was assessed both by submitting a questionnaire directly to the employees and acquiring data regarding conversation times. The workers were divided into three groups on the basis of their personal mobile phone use. Moreover, a group of 160 workers with TSH values below 0.4 UI/l was characterized. No statistically significant difference regarding TSH values below 0.4 UI/l was observed among workers with different duties but there was a greater prevalence of subjects with low SH values among 192 employees with more than 33 hrs./month conversation time; this difference was statistically significant (p<0.05). On the basis of our data, it is not possible to establish whether this result is determined by exposure to EMF'S from mobile phones of by the stress of using these instruments
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