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2 International Journal of Occupational Medicine and Environmental Health

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Monitoring of liver and kidney profiles in anesthesiologists working in a regional reference teaching hospital in Northern Italy: analysis of health surveillance data using a linear mixed model

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Rahmani A. , Dini G. , Montecucco A. , Priano L. , Leonetti M. , Manca A. , Kusznir Vitturi B. , Durando P.

International Journal of Occupational Medicine and Environmental Health

2024

tom 37

nr 5

557-568

Objectives Anesthesiologists represent an occupational group exposed to specific occupational hazards, including potential exposure to waste anesthetic gas released during medical procedures. In recent decades, halogenated anesthetic gases, such as desflurane and sevoflurane, have largely replaced nitrous oxide, due to better safety profiles and lower adverse health effects. However, possible long-term effects of low concentration exposures are unknown. A longitudinal analysis of health surveillance data was performed to test for possible changes over time in key markers of liver and kidney function. Moreover, we assessed the appropriateness of applying linear mixed models to occupational health data. Material and Methods A retrospective cohort study was conducted using health surveillance data from a cohort of anesthesiologists and a cohort of unexposed physicians working at the Polyclinic Hospital San Martino of Genoa, Italy, during 2016–2022. A 2-level linear mixed model with covariance structure of first order autoregressive model (AR(1)) type at the first level and unstructured type at the second level was applied. Results One hundred seventy subjects were included in the analysis, equally divided between exposed and unexposed. At the first and last periodic examination, liver and kidney markers were not statistically different in the 2 cohorts. The only significant change found related to estimated glomerular filtrate, which was found at the last follow-up to be greater among the exposed (M = 104.18 vs. 90.07, p = 0.007). The linear mixed model showed that anesthetic gas exposure was not associated with any of the outcomes. These results suggest the absence of increase in liver and kidney profile markers in the study population. Conclusions Health surveillance data, aggregated and analyzed with appropriate statistical models, allow inferences to be made about potential health effects of workers due to uncontrolled exposures. To this end, the linear mixed model represents a powerful tool for longitudinal analysis of data derived from monitoring workers.

Clinical and epidemiological characteristics of COVID-19 during the early phase of the SARS-CoV-2 pandemic: a cross-sectional study among medical school physicians and residents employed in a regional reference teaching hospital in Northern Italy

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Dini G. , Montecucco A. , Rahmani A. , Barletta C. , Pellegrini L. , Debarbieri N. , Orsi A. , Caligiuri P. , Varesano S. , Manca A. , Vargiu M. P. , Di Carlo P. , Massa E. , Icardi G. , Durando P.

International Journal of Occupational Medicine and Environmental Health

2021

tom 34

nr 2

189-201

ObjectivesThe aim of the study was to evaluate the clinical presentation and burden of SARS-CoV-2 infections among medical school physicians and residents, mainly young medical doctors. The awareness of COVID‑19 clinical manifestations can improve the early detection of mild cases, possibly reducing further transmission to colleagues and patients.Material and MethodsThe study was carried out in March–May 2020, involving medical school physicians in a teaching hospital in northern Italy, with a working population of 881 medical doctors. Data collection was performed using a structured form investigating clinical and epidemiological information.ResultsOne hundred sixty-two medical doctors contacted the Occupational Health Service reporting acute respiratory symptoms or close contact exposure to a confirmed COVID‑19 case. Among the confirmed COVID‑19 cases, most were male doctors during residency, and 85% presented a mild clinical picture. Fever (70.3%) and cough (51.4%) represented the most prevalent symptoms of COVID‑19. As revealed by the univariate analysis, the prevalence of real-time reverse transcriptase-polymerase chain reaction (RT-PCR) positivity increased with age (OR = 1.08, 95% CI: 1.02–1.14, p = 0.012), working in a COVID‑19 ward (OR = 3.33, 95% CI: 1.09–10.21, p = 0.031), presenting alteration or loss of smell/taste (OR = 10.00, 95%CI: 2.80–35.69, p < 0.001) and myalgia (OR = 3.20, 95% CI: 1.00–10.26, p = 0.046), while being a resident (OR = 0.20, 95% CI: 0.05–0.80, p = 0.030) was associated with reduced odds of being infected, compared to staff physicians. Age and loss of smell/taste were the only factors independently associated with RT-PCR positivity.ConclusionsThe majority of COVID‑19 cases showed a mild clinical syndrome, ranging from absence or paucity of symptoms to common cold or influenza-like symptoms. The findings of the present study increase the accuracy of the clinical diagnosis for the prompt identification and management of suspected COVID‑19 cases, being particularly useful during resurges of the SARS-CoV-2 pandemic.