Angela Del Cimmuto

Microbiological air quality in an urban solid waste selection plant

Background: Exposure to bioaerosols may pose health risks to workers operating in the processing of Urban Solid Waste (USW). The aim of this study is to evaluate microbiological air quality within an USW selection facility. Methods: Nine sampling points in an USW selection plant situated in central-southern Italy were selected. One outdoor sampling point provided the background data. Sampling was performed on a yearly basis (2005 ‐ 2009) upon request by the management of the selection plant. Total Mesophilic Counts (TMC), as well as fungal and Gram-negative concentrations were determined. Results: The highest viable fungal particles concentrations (medians) were found in waste delivery areas (about 20000 CFU/m 3), while the lowest were found in the control rooms (485 ‐ 967 CFU/m 3). TMC (median) was highest (6116 CFU/m 3) at the delivery pit, followed by the machine shop (3147 CFU/m 3), where no waste processing takes place. Medians of Gram-negative bacteria are below the suggested Occupational Exposure Limit of 1000 CFU/m 3, although this limit was exceeded at several single time-points in the waste delivery areas, and also in a personnel resting room. The lowest Gram-negative contamination was found in the control rooms (medians <1 CFU/m 3). Conclusions: Some areas within a USW selection plant act as internal sources of contamination towards those areas where partially processed waste, or no waste at all, is present. Well-designed air flows, or carefullythought positioning of areas that are not directly involved in waste processing are necessary and effective in obtaining satisfactory microbiological air quality, provided that personal protection practices are strictly enforced.

International Physical Activity Questionnaire: validation and assessment in an Italian sample

Background: A standardized method for the assessment of physical activity, the International Physical Activity Questionnaire (IPAQ), was developed in the late 1990s as instrument for cross-national assessment. This study aims to evaluate the reliability and validity of the IPAQ short and long version questionnaire in a Italian sample. Methods: The long and short versions of IPAQ questionnaires were administered twice, with an interval of one day between each administration, to 2 different random samples. Cronbach’s alpha was used as a measure of the internal consistency of the two versions. Results: The long version was administered to 60 subjects and the short version to 58. The Cronbach’s alpha on items about physical activity in the long version was 0.73, and 0.60 for the short version. The referred comments on short and long version were not very different both in number and content though they suggest a better understanding of the short version compared to the long one. Discussion: IPAQ short and long versions show acceptable reliability properties in the Italian adult setting. The utilization of a questionnaire seems be more influenced by time of administration and number of requested information. In terms of internal consistency and validity they appear to have similar performance.

Association between waste management and HBV among solid municipal waste workers: A systematic review and meta-analysis of observational studies

Aim. To conduct a systematic review of this relationship using available published observational studies in the field of solid municipal waste treatment. Methods. The review of the scientific literature was based on Medline and Scopus databases up to December 2012, using the keywords HBV, waste, solid, treatment, workers, disposal, and refuse in different combinations. Results. 160 studies were found and checked. Finally, 5 observational studies were considered suitable, all cross-sectional. The pooled proportion of HBs-Ag considering all the studies was 11% (95% CI: 5–21%), and considering the high quality studies only, this proportion was 14% (95% CI: 6–24%). The pooled proportion of HBs-Ab positivity among waste workers considering all the studies was 14.2% (95% CI: 1.4–37.2%), and considering the high quality studies only, this proportion was 24% (95% CI: 18–30%). The pooled proportion of HBc-Ab positivity among waste workers considering all the studies was 24% (95% CI: 6–49%). The pooled estimation of the risk of HBV positivity (HBsAg) among exposed was OR = 2.39 (95% CI: 0.88–6.52). Conclusion. In conclusion, waste workers need to be vaccinated against HBV infection since they are at risk of acquiring this infection through the exposure to potentially infected waste.

Legionella control in the water system of antiquated hospital buildings by shock and continuous hyperchlorination: 5 years experience

BackgroundTo control the presence of Legionella in an old hospital water system, an integrated strategy of water disinfection-filtration was implemented in the university hospital Umberto I in Rome.MethodsDue to antiquated buildings, hospital water system design and hospital extension (38 buildings), shock hyperchlorination (sodium hypochlorite, 20–50 ppm of free chlorine at distal points for 1–2 h) followed by continuous hyperchlorination (0.5-1.0 mg/L at distal points) were adopted, and microbiological and chemical monitoring of the water supply was carried out in the university hospital (December 2006-December 2011).ResultsOverall, 1308 samples of cold <20°C (44.5%), mixed ≥20°C ≤ 45°C (37.7%) and hot >45°C (17.8%) water were collected, determining residual free chlorine (0.43 ± 0.44 mg/L), pH (7.43 ± 0.29) and trihalomethanes (8.97 ± 18.56 μg/L). Legionella was isolated in 102 (9.8%) out of 1.041 water samples without filters (L. pneumophila sg 1 17.6%, L. pneumophila sg 2–14 28.4%, L. non pneumophila 53.9%), and in none of the 267 samples with filters. Legionella was recovered in 23 buildings out of 38 and 29 samples (28.4%) exceeded 103 cfu/L. When considering the disinfection treatment Legionella was isolated: before shock hyperchlorination (21.1%), 15 days after shock hyperchlorination (7.8%), 30 days after shock hyperchlorination (3.5%), during continuous hyperchlorination (5.5%) and without continuous hyperchlorination (27.3%). Continuous hyperchlorination following the shock treatment achieved >70% reduction of positive samples, whereas no continuous hyperchlorination after shock treatment was more frequently associated to Legionella isolation (OR 6.41; 95% CI 3.10–13.26; p <0.001). Independent risk factors for Legionella isolation were: residual free chlorine <0.5 mg/L (OR 13.0; 95% CI 1.37 – 123.2; p <0.03), water T° ≥20°C ≤ 45°C (OR 12.0; 95% CI 1.28 – 111.48; p <0.03) and no continuous hyperchlorination after shock treatment (OR 10.3; 95% CI 1.06 – 100.05; p <0.05).ConclusionsShock and continuous hyperchlorination achieved significant Legionella reduction, but effective chlorine levels (>0.5 < 1.0 mg/L) deteriorated water quality (organoleptic and chemical). However, shock and continuous hyperchlorination remains a valid-term option in old buildings with no water system rational design, managing problems due to hospital extension and absence of a proper hot water recirculation system.

Ready-to-eat vegetables production with low-level water chlorination: an evaluation of water quality and of its impact on end products

INTRODUCTION We evaluated the microbiological impact of low-level chlorination (1 ppm free chlorine) on the production of ready-to-eat (RTE) vegetables by monitoring the microbiological quality of irrigation and processing water in two production plants over a 4-season period, as well as the microbiological quality of unprocessed vegetables and RTE product. Water samples were also characterized in terms of some chemical and physico-chemical parameters of relevance in chlorination management. MATERIALS AND METHODS Both producers use water with maximum 1 ppm free chlorine for vegetables rinsing, while the two processes differ by the number of washing cycles. RESULTS AND CONCLUSIONS Salmonella spp and Campylobacter spp were detected once in two different irrigation water samples out of nine from one producer. No pathogens were found in the vegetable samples. As expected, the procedure encompassing more washing cycles performed slightly better in terms of total mesophilic count (TMC) when comparing unprocessed and RTE vegetables of the same batch. However, data suggest that low-level chlorination may be insufficient in preventing microbial build-up in the washing equipment and/or batch-to batch cross-contamination.

Impact on knowledge and behaviour of the general population of two different methods of solid waste management: An explorative cross-sectional study.

The objectives of the present study were to evaluate knowledge among general population about the risks factors of waste management, to estimate the feeling of anxiety concerning the waste, and to compare knowledge of two different methods for collecting municipal solid waste (MSW): a street separate collection system and a door-to-door separate collection system. A cross-sectional study was performed, administering an anonymous questionnaire to 180 inhabitants in Aprilia, Latium, Italy. The study sample consisted of 183 citizens: 64 in the intervention group and 119 in the control group. The intervention was represented by a campaign of door-to-door collection. The correct implementation of separate collection of waste was 87.5% in the intervention group and 63% in the control group (p<0.001). For both groups, the favourite type of waste collection was door-to-door (p=0.013); a high difference concerning the quality of information was found (p<0.0001): in the intervention group, 84% declared to be satisfied (67% sufficient and 17.2% good), while in the control group, 21% declared to be satisfied (16.8% sufficient and 4.2% good). The advice mainly reported from the control group respondents was to increase the size of the information pack (80.7%, p=0.024). The information campaign seemed to increase people’s awareness about the problem, improving the management of waste and household waste. The door-to-door collection was appreciated and preferred by both groups. The adoption of a door-to-door scheme seems to be a winning option mostly because it is supported by an information and education system for the citizens.

Association between Work Related Stress and Health Related Quality of Life: The Impact of Socio-Demographic Variables. A Cross Sectional Study in a Region of Central Italy

The aim of this work is investigate relationship between health-related quality of life and work-related stress and the impact of gender, education level, and age on this relationship. A cross-sectional study was conducted among workers of various setting in Rome and Frosinone. Work-related stress was measured with a demand–control questionnaire and health-related functioning by SF (short form)-12 health survey. There were 611 participants. Men reported high mental composite summary (MCS) and physical composite summary (PCS). In multivariate analysis age, gender (p < 0.001) and job demand (0.045) predicted low PCS. Low MCS predicted poor PCS. Job demand and educational level resulted negatively associated with MCS. In an analysis stratified for age, gender, and educational level, gender and age resulted effect modifier for MCS, gender and education level for PCS. In women increase of decision latitude predict (p = 0.001) an increase in MCS; a low job demand predict high MCS in male (p ≤ 0.001). In younger workers, a lower level of job demand predicted high MCS (<0.001). For PCS, gender and education level resulted effect modifier. In women, high decision latitude predicted higher PCS (p = 0.001) and lower level of job demand results in higher PCS (p ≤ 0.001). Higher educational level resulted predictor of low PCS. Management of risk about work-related stress should consider socio-demographic factors.

Detection of Escherichia coli O157 in raw and cooked meat: comparison of conventional direct culture method and Enzyme Linked Fluorescent Assay (ELFA)

Abstract Background : Verocytotoxin Escherichia coli is a frequent and important cause of diarrhea and haemolytic uremic syndrome all over the world. Consumption of ground beef, lettuce, and other kinds of food have been associated with outbreaks. The aim of this study was to detect the presence of E. coli O157 in meat products collected from hospital food catering services in Rome, using a rapid detection method in comparison with a standard culture method to verify the effectiveness of HACCP system. Methods : Three hundred and ten food samples (80 of cooked and 230 of raw meat) were screened for E.coli O157 by ISO culture method and by enzyme-linked-fluorescent-assay (ELFA)-based methods (VIDAS®system, bioMerieux). All isolates obtained were tested for VT1 and VT2 genes by PCR. The statistical analysis considered absolute frequencies and percentages. The K statistic was applied to assess agreement between direct culture method and the VIDAS system. Results : A total of 6 (1,9%) E.coli O157 isolates were recovered from raw meat samples by the culture method; of these only four were identified by PCR as VTEC producers. A total of 9 (2,9%) E.coli O157 isolates were recovered from raw meat samples by the VIDAS® system. No E.coli O157 was detected in cooked products. All comparisons between the direct culture method and the VIDAS system were statistically significant (K= 0,795; p<0.001). Conclusions : The present study showed how ELFA-based methods are highly specific and rapid for the detection of E.coli O157 in food samples compared with the direct culture method. ELFA method is useful to verify the effectiveness of the HACCP system in the risk management of potential contaminating hazards during the preparation of foods for susceptible persons.

Microbiological safety of glasses dispensed at 3D movie theatres

Recent popularity of three-dimensional movies raised some concern about microbiological safety of glasses dispensed into movie theatres. In this study, we analysed the level of microbiological contamination on them before and after use and between theatres adopting manual and automatic sanitation systems. The manual sanitation system was more effective in reducing the total mesophilic count levels compared with the automatic system (P < 0.05), but no differences were found for coagulase-positive staphylococci levels (P = 0.22). No differences were found for mould and yeast between before and after levels (P = 0.21) and between sanitation systems (P = 0.44). We conclude that more evidences are needed to support microbiological risk evaluation.

Reliability and Use of Copenhagen Burnout Inventory in Italian Sample of University Professors

Academics often have to face with burnout syndrome at work. This cross-sectional study evaluates the reliability of the Italian version of the Copenhagen Burnout Inventory (CBI) in a sample of Academics of Sapienza University of Faculty of Medicine and Pharmacy, through an online questionnaire composed of the CBI, SF12 Health Survey, and Positivity Scale. Univariate, bivariate, multivariate analyses, and Cronbach α coefficients of CBI were performed. Ninety-five participants completed the questionnaire (response rate 85%). Cronbach’s α of the three domains were high (0.892, 0.868, and 0.836). Women, younger and part time professors reported higher score in personal (p = 0.025; 0.060) and work burnout. In multivariate analysis decreasing age (β = −0.263; p = 0.001); being a professor in environmental technicians (β = −0.120; p = 0.098); and low mental (β = −0.263; p = 0.020), physical (β = −0.319; p ≤ 0.001) and positivity scores (β = −0.237; p = 0.031) predict significantly higher personal burnout. Low physical (β = −0.346; p < 0.001) and mental (β = − 0.249; p = 0.013) positivity (β = −0.345; p = 0.001) scores; fewer years of work (β = −0.269; p ≤ 0.001); and being a medical or nursing professor (β = 0.169; p = 0.016) predicts high work burnout. Low MCS predicts a high level of student burnout. Results suggest that the Italian version of the CBI is a reliable instrument. Further research should focus on the prevalence of burnout in academics.