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N Petrosillo

Publications and source records attributed to N Petrosillo.

At least 19 recordsLinked to original sources

Peer-reviewed articles and public health: the mad cow affair in Italian newspapers.

CONTEXT: It has been suggested that early announcements of research works to be published in peer-reviewed journals may diminish newsworthiness of scientific articles, but this issue has not been widely studied. OBJECTIVE: To analyze the impact on the news media, in terms of volume and prominence of coverage, of a scientific article published in peer-reviewed journals about issues with relevance to public health compared with the impact of preliminary release of information on the same issue. DESIGN: Analysis of press coverage of Creutzfeldt-Jakob disease (CJD) and bovine spongiform encephalopathy (mad cow disease) in the 7 newspapers with the widest circulation in Italy, between March 20, 1996, when the British secretary of state for health announced the identification of 10 cases of a new-variant CJD, described April 6, 1996, in The Lancet, and May 10, 1996. Related newspaper articles were identified by hand search. MAIN OUTCOME MEASURES: Numbers of newspaper articles published before and after publication of the Lancet article. RESULTS: We collected 535 articles, of which 62 (11.6%) appeared on the front page. The number of articles published daily peaked on March 26 with 48 items and 1 article on the front page of all the newspapers. A total of 386 (72%) of the 535 articles and 56 (88.7%) of the 62 published on the front page were published in the first 2 weeks of the study period, before the Lancet publication. CONCLUSIONS: Our analysis suggests that, in the case of issues of public health importance, when peer-reviewed research is published after a health risk is disclosed to the public, its impact in the media is small. Coordination between news release by public health authorities and publication by peer-reviewed journals may improve the quality of public information.

Encephalopathy, Bovine Spongiform

Prevalence and incidence of hepatitis B virus, hepatitis C virus and human immunodeficiency virus among personnel and patients of a psychiatric hospital.

In 1989 and 1992, HIV, HBV and HCV serosurveys were carried out among personnel and patients of an Italian Psychiatric Hospital. No HIV cases were found. Mean annual HBV seroconversion rate was 0.99% in patients and 4.4% in personnel; HCV rate was 0.42% among patients. Although the nosocomial risk of bloodborne infection was low, efforts should be made to minimize it.

Adult

Hepatitis B virus, hepatitis C virus and human immunodeficiency virus infection in health care workers: a multiple regression analysis of risk factors.

A seroprevalence survey of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV), was conducted using serum samples obtained from 5813 health care workers (HCWs) in five public hospitals in the Latium region of Italy, during the 1985 vaccination campaign against HBV. The seroprevalences of HBV, HCV and HIV were 23.3% [95% confidence interval (CI) = 22.3-24.4%], 2% (95% CI = 1.6-2.4%) and 0.07% (95% CI = 0.001-0.13%), respectively. In a logistic regression model, sex, increasing age, all job categories vs. physicians, dental treatment in the previous six months, and needlestick injury during the previous year were significantly associated with HBV. Conversely, no occupational and community risk factors, but only history of blood transfusion were significantly associated with HCV. Nevertheless, the documented risk of HCV as well as of HIV transmission through percutaneous and mucocutaneous exposure to blood and body fluids should lead to continued efforts to minimize risks of infection by enhancing the compliance of HCWs with vaccination against HBV and adherence to infection control measures, and by introducing safer devices and techniques.

Adult

Risk of hepatitis C seroconversion after occupational exposures in health care workers. Italian Study Group on Occupational Risk of HIV and Other Bloodborne Infections.

BACKGROUND: To determine the incidence of hepatitis C virus (HCV) seroconversion, health care workers reporting an occupational exposure with blood or other risk-prone body materials from a patient known to be seropositive for HCV antibody were enrolled. METHODS: HCV seroconversion within 6 months of a reported exposure was assessed by second-generation enzyme immunoassay and immunoblot assay. RESULTS: From January 1992 through December 1993, 331 (51%) hollow-bore needlesticks, 105 (16.5%) suture needle or sharp object injuries, 85 (13%) mucous membrane contaminations, and 125 (19.5%) skin contaminations were reported. Four HCV seroconversions were observed after hollow-bore needlesticks (1.2%; 95% CI 0.3% to 3.0%); no seroconversions occurred after other routes of exposure. Blood-filled needlesticks and source patient coinfection with HIV appeared to be associated with a higher risk of seroconversion. CONCLUSIONS: The risk of HCV seroconversion after occupational exposure appears to be low but is not negligible. Aggressive implementation of universal precautions is important for preventing risk-prone exposure, but safer devices are also needed.

Adolescent

The risks of occupational exposure and infection by human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in the dialysis setting. Italian Multicenter Study on Nosocomial and Occupational Risk of Infections in Dialysis.

BACKGROUND: The dialysis setting has been recognized as a high-risk environment for transmission to both patients and health care personnel of blood-borne infections, such as hepatitis B virus, hepatitis C virus, and HIV. METHODS: A seroprevalence survey of HIV, hepatitis B virus, and hepatitis C virus infection among 1002 patients and a subsequent 1-year surveillance study of percutaneous injuries and skin and mucous membrane contaminations were carried out among 527 health care workers in nine Italian dialysis units. The risks of occupational acquisition of HIV, hepatitis B virus, and hepatitis C virus infections among health care workers were calculated according to a deterministic model. RESULTS: HIV antibody, hepatitis B surface antigen, and hepatitis C antibody prevalences among patients were 0.1%, 5.1%, and 39.4%, respectively. A total of 67 percutaneous injuries, 29 mucous membrane contaminations, and 271 skin contaminations were reported by health care workers. The risk of acquiring infection was calculated to be 4000 and 8000 times lower for HIV than for hepatitis B and C, respectively. CONCLUSIONS: The risks of infection with HIV, hepatitis B, and hepatitis C for health care workers at dialysis units differ greatly and depend on the demographic profile and medical history of patients undergoing dialysis. To minimize the risk of exposure to HIV and other blood-borne pathogens, efforts must continue to increase compliance with universal precautions. Needle designs incorporating safety features and improvements in dialysis equipment design are also needed to avoid potential exposure.

Blood-Borne Pathogens

The risk of occupational exposure to blood and body fluids for health care workers in the dialysis setting. Italian Multicenter Study on Nosocomial and Occupational Risk of Infections in Dialysis.

In 1991, to assess the risk of occupational exposure to blood or other body fluids in health-care workers (HCWs) working in the dialysis setting, properly trained interviewers used standardized questionnaires asking the 583 HCWs employed in 19 Italian dialysis units to recall exposures sustained in the previous year. On a total of 208,498 dialyses performed in the previous year, 105 (5 per 10,000 dialyses) needlesticks, and 579 (28 per 10,000 dialyses) skin/mucous membrane contaminations were recalled. Recapping injuries were recalled in 38 cases (1.8 per 10,000 dialyses), but 67 needlestick injuries (4.1 per 10,000 dialyses) occurred during other circumstances (p = 0.006). The highest rate of skin/mucous membrane contaminations were recalled during the dialysis patient care, but more than one third of exposures occurred in other circumstances (break in blood circuit, disposal, contamination with blood-soiled equipment. To minimize the risk of occupational exposure to blood efforts must continue to increase compliance with Universal Precautions; moreover, needle designs incorporating safety features to prevent sticks are needed.

Blood-Borne Pathogens

Occupational hepatitis C virus infection in Italian health care workers. Italian Study Group on Occupational Risk of Bloodborne Infections.

The risk of exposed health care workers in 16 Italian hospitals becoming infected with hepatitis C virus was assessed through two serosurveys at a 1-year interval and at follow-up. Prevalence, which was 2.2%, was significantly associated with previous acute hepatitis, blood transfusions, housekeeping, and older age (> 46 years) but not with occupational risk factors. After 1 year, 2622 (87%) of the 3006 seronegative health care workers were retested, and 3 (0.1%), who did not acknowledge occupational or community risk factors, seroconverted. Additionally, 133 (97 needlesticks) out of 370 reported occupational exposures were to hepatitis C virus; one pricked nurse seroconverted (0.75%). Although the risk is not negligible, hepatitis C virus infection does not seem to be easily occupationally transmitted.

Adult

[The knowledge, attitudes and practice in regard to the risk for occupational HIV infection in a group of gynecologists from 3 Italian regions].

The risk of occupational infection by blood-borne pathogens has been well evaluated. However, a low perception of this risk among health care workers (HCWs) and a low compliance to infection control measures has been documented by several studies. During a meeting of gynecologists of Southern Italy, a survey of knowledge, attitudes and practices (K.A.P.) on HIV and other blood-borne viral infections was conducted among 143 obstetricians-gynecologists. 133 (93%) HCWs answered the questionnaire. 81% of them recalled almost one occupational exposure during their career and 54% almost two in the past year. Our data suggest a low knowledge about HIV and the other blood-borne viral infections and Universal Precautions (UP): only 16% of HCWs knew the rate of vertical transmission of HIV, less than 15% knew the rate of seroconversion after occupational exposure to HBV and HCV, and finally only 33% knew to which body fluids apply UP. Moreover, 93.7% of HCWs believed that HIV antibody screening of all patients is an effective strategy to reduce the risk of occupation HIV infection. More than 90% of gynecologists used to request HIV-antibodies to pregnant women, 21% after the first trimester. Although HCWs interviewed can not be considered representative of Italian gynecologists, our data suggest the need of an intensive training to increase gynecologists' knowledge about HIV, other blood-borne pathogens and the risk of occupational infections also in order to modify attitudes and practices.

Adult

Prevalence of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among dialysis patients. The Italian Multicentric Study on Nosocomial and Occupational Risk of Blood-Borne Infections in Dialysis.

In April 1991, a cross-sectional study of HIV, HBV and HCV markers among dialysis patients was carried out in 19 Italian units in order to evaluate the spread of these bloodborne infections among patients and to evaluate the potential risk for staff who care for them. A total of 2,180 patients were eligible and all consented to be tested. Of the 1,347 patients who had not been given hepatitis B vaccine, 67.9% had at least one marker of HBV infection; of these 9.2% were HBsAg carriers; conversely, the rates were 7.6 and 0.4%, respectively, among the 833 vaccinated patients. Antibodies against HCV were found in 501 patients (23%) by EIA C100-3; of these, 270 were tested by RIBA-100: 246 (91%) were reactive and 11 (4.1%) indeterminate. Five patients resulted anti-HIV positive [0.22%, 95% CI (Poisson distribution): 0.07-0.53] by EIA and Western blot techniques. Length of time on dialysis seems to correlate with higher prevalence of HBV and HCV infection markers, but (not) HIV. Overall, 608 (28%) patients were a potential source of infections for other patients and staff. This emphasizes the need for stricter adherence to infection control, barrier precautions and preventive behaviours with all patients.

Adolescent

Needlestick injury in hospital personnel: a multicenter survey from central Italy. The Latium Hepatitis B Prevention Group.

OBJECTIVES: To assess the rate of needlestick injury in hospital personnel in an Italian region. To identify risk factors potentially amendable to correction. DESIGN: Hospital workers undergoing hepatitis B prevaccination testing in 1985 through 1986 were interviewed regarding needlestick injury in the previous year, job category, area of work, years of employment, and other pertinent information. SETTING: Of the 98 public hospitals of the Latium region, 68 participated in the survey: 32 of 55 with less than 200 beds, 20 of 25 with 200 to 300 beds, 11 of 13 with 400 to 900 beds, and all of the 5 with more than 1,000 beds. PARTICIPANTS: All healthcare workers providing direct patient care or environmental services as well as student nurses were invited by the hospital directors to undergo hepatitis B prevaccination testing and vaccination, if eligible. RESULTS: Of 30,226 hospital workers of the 68 participating hospitals, 20,055 were interviewed (66.3%): 47.7% of the 7,172 doctors, 71% of the 14,157 nurses, 55.9% of the 2,513 technicians, and 71.9% of the 6,384 ancillary workers. Needlestick injury was recalled by 29.3%; the rates were 54.9%, 35.3%, 33.8%, 26.5%, 18.7%, and 14.7% in surgeons, registered and unskilled nurses, physicians, ancillary workers, and technicians, respectively. The recalled injury rate was 39.7% and 34.0% in surgical and intensive care areas; in infectious diseases, it was 16.7%. Rates were lower in hospitals with 200 to 300 beds (25.6%). The needlestick injury rate declined from 32% in those with less than 5 years of employment to 28% in those with more than 20 years (p less than .01). Prevalence of HBV infection was higher in student nurses and young workers recalling a needlestick exposure (14.3% and 15.8%, respectively), versus 10.1% and 12.8% in those not exposed (p less than .01 and less than .05, respectively). CONCLUSIONS: Parenteral exposure to blood-borne infectious agents is a relevant risk among healthcare workers in our region, particularly in defined job categories and hospital areas (surgeons, nurses, surgical, and intensive care areas). Immunization and educational efforts should be made along with better designs of devices to reduce the risk of infection.

Hepatitis B