George Rachiotis

Factors associated with adolescent cigarette smoking in Greece: Results from a cross sectional study (GYTS Study)

BackgroundData about the predictors of smoking among adolescents in Greece are sparse. We tried to identify factors associated with current cigarette smoking among in-school adolescents in Greece in the context of GYTS study.MethodsA secondary analysis of data from a questionnaire study using the Global Youth Tobacco Survey methodology was conducted to identify factors associated with smoking among adolescents in Greece. Data were collected in 2004–2005. The outcome variable was cigarette smoking within the past 30 days preceding the survey while independent variables included age, gender, parental educational status, parental smoking, perception of harmfulness of smoking, and the amount of pocket money at the adolescents disposal.Results6141 adolescents (51.5% males and 48.5% females) participated in the study. In multivariate analysis, cigarette smoking was associated with male gender (OR: 1.62; 95% CI: 1, 08–3.08), parental smoking (OR: 2.59; 95% CI: 1.45–5.89), and having pocket money ≥ 16 Euros (OR: 2.64; 95% CI: 1.19–5.98).ConclusionMale gender, parental smoking, and having pocket-money ≥ 16 Euros were independently associated with current smoking among Greek students. These findings could be taken into account in order to formulate a comprehensive anti-smoking strategy in Greece.

Pesticide exposure and lymphohaematopoietic cancers: a case-control study in an agricultural region (Larissa, Thessaly, Greece)

BackgroundThe causality of lymphohaematopoietic cancers (LHC) is multifactorial and studies investigating the association between chemical exposure and LHC have produced variable results. The aim of this study was to investigate the relationships between exposure to pesticides and LHC in an agricultural region of Greece.MethodsA structured questionnaire was employed in a hospital-based case control study to gather information on demographics, occupation, exposure to pesticides, agricultural practices, family and medical history and smoking. To control for confounders, backward conditional and multinomial logistic regression analyses were used. To assess the dose-response relationship between exposure and disease, the chi-square test for trend was used.ResultsThree hundred and fifty-four (354) histologically confirmed LHC cases diagnosed from 2004 to 2006 and 455 sex- and age-matched controls were included in the study. Pesticide exposure was associated with total LHC cases (OR 1.46, 95% CI 1.05-2.04), myelodysplastic syndrome (MDS) (OR 1.87, 95% CI 1.00-3.51) and leukaemia (OR 2.14, 95% CI 1.09-4.20). A dose-response pattern was observed for total LHC cases (P = 0.004), MDS (P = 0.024) and leukaemia (P = 0.002). Pesticide exposure was independently associated with total LHC cases (OR 1.41, 95% CI 1.00 - 2.00) and leukaemia (OR 2.05, 95% CI 1.02-4.12) after controlling for age, smoking and family history (cancers, LHC and immunological disorders). Smoking during application of pesticides was strongly associated with total LHC cases (OR 3.29, 95% CI 1.81-5.98), MDS (OR 3.67, 95% CI 1.18-12.11), leukaemia (OR 10.15, 95% CI 2.15-65.69) and lymphoma (OR 2.72, 95% CI 1.02-8.00). This association was even stronger for total LHC cases (OR 18.18, 95% CI 2.38-381.17) when eating simultaneously with pesticide application.ConclusionsLymphohaematopoietic cancers were associated with pesticide exposure after controlling for confounders. Smoking and eating during pesticide application were identified as modifying factors increasing the risk for LHC. The poor pesticide work practices identified during this study underline the need for educational campaigns for farmers.

Medical supplies shortages and burnout among greek health care workers during economic crisis: a pilot study.

Greece has been seriously affected by the economic crisis. In 2011 there were reports of 40% reduction to public hospital budgets. Occasional shortages of medical supplies have been reported in mass media. We attempted to pivotally investigate the frequency of medical supplies shortages in two Greek hospital units of the National Health System and to also assess their possible impact on burnout risk of health care workers. We conducted a cross-sectional study (n=303) of health care workers in two Greek hospitals who were present at the workplace during a casually selected working day (morning shift work). The Maslach Burnout Inventory (MBI) was used as the measure of burnout. An additional questionnaire was used about demographics, and working conditions (duration of employment, cumulative night shifts, type of hospital including medical supplies shortages and their impact on quality of healthcare. The prevalence of emotional exhaustion, depersonalization and low personal accomplishment was 44.5%, 43.2% and 51.5%, respectively. Medical supply shortages were significantly associated with emotional exhaustion and depersonalization. This finding provides preliminary evidence that austerity has affected health care in Greece. Moreover, the medical supply shortages in Greek hospitals may reflect the unfolding humanitarian crisis of the country.

Hepatitis B virus infection and waste collection: Prevalence, risk factors, and infection pathway†

BACKGROUND Waste collectors have a potential risk of infectious diseases. The aim of the study was to assess; the prevalence of hepatitis B (HBV), risk factors for infection and possible ways of virus transmission among municipal solid waste workers (MSWWs) in a municipality of central Greece. METHODS A cross-sectional study was conducted among the employees of a municipality in Central Greece. The prevalence of an HBV infection biological marker (anti-Hbc) and its association with exposure to waste, socio-demographic factors, and history of occupational injuries with sharp objects/needle sticks was examined among 208 employees. RESULTS The prevalence of HBV infection among the municipal waste collectors was 23%. Logistic regression analysis showed that exposure to waste (OR = 4.05;95%CI = 1.23-13.33) and age (OR = 5.22;95% CI = 1.35-20.1) were independently associated with the anti-Hbc positivity. Moreover, waste collectors who reported occupational injuries with needle sticks were at higher risk of HBV infection (RR = 2.64; 95% CI = 1.01-6.96). CONCLUSIONS Occupational exposure to waste is a possible risk factor for HBV infection. Occupational injury with sharp instruments could be a means of hepatitis B virus transmission. Immunization of MSWWs and adoption of more safe ways for waste collection could be considered in order to control the risk of HBV infection.

Occupational health legislation and practices related to seafarers on passenger ships focused on communicable diseases: results from a European cross-sectional study (EU SHIPSAN PROJECT).

BackgroundSeafarers play an important role in the transmission of communicable diseases. The aim of the present study is to draw information and identify possible gaps on occupational health practices related to seafarers sailing on ships within the European Union Member States (EU MS) with focus on communicable diseases.MethodsA structured questionnaire was sent to competent authorities from 21 EU MS. The questionnaire included questions about occupational health policies, medical certification of seafarers, communicable diseases reporting and relevant legislation. Descriptive analysis of the data was conducted by the use of Epi Info software: EU MS were categorized in four priority groups (A, B, C, D) based on: number of passenger ships visits, volume of passengers, and number of ports in each country. Moreover, EU MS were categorized to old and new, based on the date of entry in the EU.ResultsAll 21 countries with relevant competent authorities responded to the questionnaire. The existence of specific national legislation/regulation/guidelines related to vaccination of seafarers was reported by three out of the 21 (14%) responding authorities. Surveillance data of communicable diseases related to seafarers are collected and analyzed by 4 (19%) authorities. Five out of 21 of the responding countries (24%) reported that tuberculin test result is required for the issuance of seafarers medical certificate while a great variety of medical examination is required for the issuance of this certificate among countries.Gaps on occupational health services focused on communicable diseases related to maritime occupation have been reported by 33% of the responding countries.Responding authorities from Group A and B had the highest percentage of reported gaps followed by groups C and D. Old MS reported a higher frequency regarding gaps on occupational health services in comparison to new MS.ConclusionOur results revealed heterogeneity regarding occupational health of maritime employees in EU MS. This work provides some evidence that further work at international and European level could be considered, in order to explore the potential for harmonized initiatives regarding occupational health of seafarers.

Determinants of exposure to Environmental Tobacco Smoke (ETS) among non smoking adolescents (aged 11-17 years old) in Greece: results from the 2004-2005 GYTS Study.

The aim of the study is to investigate the determinants of exposure to ETS among Greek adolescents aged 11–17 years old. The GYTS questionnaire was completed by 5,179 adolescents. About 3 in 4 responders (76.8%) were exposed to ETS at home, and 38.5% were exposed to ETS outside of the home. Gender, age group, parental and close friends smoking status were significant determinants of adolescent’s exposure to ETS. The results of the study could be valuable for the implementation of public health initiatives in Greece aiming to reduce the burden of adolescent’s exposure to passive smoking.

Acute lead intoxication in a female battery worker: Diagnosis and management

Lead is a significant occupational and environmental hazard. Battery industry is one of the settings related to lead intoxication. Published information on the use of oral chelating agents for the treatment of anaemia in the context of acute lead intoxication is limited. The patient was a 33 year immigrant female worker in a battery manufacture for 3 months. She complained for malaise that has been developed over the past two weeks. Pallor of skin and conjunctiva was the only sign found in physical examination. The blood test on admission revealed normochromic anaemia. Endoscopic investigation of the gastrointestinal system was negative for bleeding. The bone marrow biopsy was unrevealing.At baseline no attention has been paid to patients occupational history. Afterwards the patients occupational history has been re-evaluated and she has been screened for lead intoxication. The increased levels of the lead related biomarkers of exposure and effect confirmed the diagnosis. The patient received an oral chelating agent and an improvement in clinical picture, and levels of haematological and lead related biochemical parameters have been recorded. No side effect and no rebound effect were observed. This case report emphasizes the importance of the occupational history in the context of the differential diagnosis. Moreover, this report indicates that lead remains a significant occupational hazard especially in the small scale battery industry

Elevated Bathing-Associated Disease Risks Despite Certified Water Quality: A Cohort Study

Bacteriological water quality criteria have been recommended to ensure bathers’ health. However, this risk-assessment approach is based mainly on routine measurements of fecal pollution indicator bacteria in seawater, and may not be adequate to protect bathers effectively. The aim of this study was to assess the risks of symptoms related to infectious diseases among bathers after exposure to seawater which was of excellent quality according to EU guidelines. This study is a cohort study recruiting bathers and non-bathers. Water samples were collected for estimating bacterial indicators. Univariable and multivariable analysis was performed to compare the risks of developing symptoms/diseases between bathers and non-bathers. A total of 3805 bathers and 572 non-bathers were included in the study. Water analysis results demonstrated excellent quality of bathing water. Significantly increased risks of symptoms related to gastrointestinal infections (OR = 3.60, 95% CI 1.28–10.13), respiratory infections (OR = 1.92, 95% CI 1.00–3.67), eye infections (OR = 2.43, 95% CI 1.27–4.63) and ear infections (OR = 17.21, 95% CI 2.42–122.34) were observed among bathers compared with non-bathers. Increased rates of medical consultation and medication use were also observed among bathers. There was evidence that bathers experienced increased morbidity compared with non-bathers though the bathing waters met bacteriological water quality criteria. These results suggest that risk assessments of recreational seawaters should not only focus on bacteriological water quality criteria.

Pattern of smoking habit among Greek blue and white collar workers.

The aim of our study was to investigate the prevalence of smoking in a Greek working population. A questionnaire regarding smoking habit was collected from 1,005 out of 1,200 blue and white-collar employees (response rate: 84%). The overall smoking prevalence was 48.4% and did not differ by sex, age, education, and occupation. The mean cigarette consumption per day was 25.54, with no difference observed by occupation. The above-mentioned findings, if confirmed by further research, are alarming and inconsistent with the prevalent pattern of smoking habits in the West.

Prevalence and Risk Factors of Overweight and Obesity among Adolescents and Their Parents in Central Greece (FETA Project)

The increasing obesity trend in adolescence is a public health concern. The initial phase of Feeding Exercise Trial in Adolescents (FETA) aimed in investigating the prevalence of overweight and obesity in adolescents and their parents and in identifying associated factors among parents’ and adolescents’ demographics, eating habits, and parental style. The sample consisted of 816 adolescents, aged 12–18 years old, and their parents from 17 middle and high schools in Larissa, central Greece. During school visits, anthropometric measurements were performed along with examination of blood pressure. The students completed the study tool that comprised of demographics and the modified versions of Parental Authority Questionnaire (PAQ), the Parent-Initiated Motivational Climate Questionnaire-2 (PIMCQ-2) and the Family Eating and Activity Habits Questionnaire (FEAHQ). Their parents completed a questionnaire with demographics, anthropometrics and FEAHQ. Normal Body Mass Index was found in 75.2% of the adolescents, 2.6% of the adolescents were underweight, 18% overweight and 4.2% obese. Regarding the parents, 76.3% of the fathers and 39.2% of the mothers were overweight or obese. The logistic regression analysis revealed that, overweight or obesity in adolescence was associated with gender (boy), maternal overweight or obesity, lower maternal educational level, eating without feeling hungry, eating in rooms other than kitchen and having a father that motivates by worrying about failing. A significant proportion of adolescents and their parents are overweight or obese. Future interventions should focus both on the parents and children, taking into account the role of parental authority style, in preventing adolescents’ obesity.