PDF(Pubmed)
Abstract：
In Italy, Legionnaires\' Disease (LD) causes >1000 hospital admissions per year, with a lethality rate of 5 to 10%. Occupational exposures could reasonably explain a substantial share of total cases, but the role of Occupational Physicians (OPs) in management and prevention of LD has been scarcely investigated. The present survey therefore evaluates the knowledge, attitudes and practices (KAP) regarding LD from a convenience sample of Italian OPs, focusing on their participation in preventive interventions. A total of 165 OPs were recruited through a training event (Parma, Northeastern Italy, 2019), and completed a specifically designed structured questionnaire. The association between reported participation in preventive interventions and individual factors was analyzed using a binary logistic regression model, calculating corresponding multivariable Odds Ratio (aOR). Overall, participants exhibited satisfactory knowledge of the clinical and diagnostic aspects of LD, while substantial uncertainties were associated epidemiological factors (i.e., notification rate and lethality). Although the majority of participating OPs reportedly assisted at least one hospital (26.7%) and/or a nursing home (42.4%) and/or a wastewater treatment plant, only 41.8% reportedly contributed to the risk assessment for LD and 18.8% promoted specifically designed preventive measures. Working as OPs in nursing homes (aOR 8.732; 95% Confidence Intervals [95%CI] 2.991 to 25.487) and wastewater treatment plants (aOR 8.710; 95%CI 2.844 to 26.668) was associated with participation in the risk assessment for LD, while the promotion of preventive practice was associated with working as an OP in hospitals (aOR 6.792; 95%CI 2.026 to 22.764) and wastewater treatment plants (aOR 4.464, 95%CI 1.363 to 14.619). In other words, the effective participation of the OP in the implementation of preventive measures appears uncommon and is limited to certain occupational settings. Collectively, these results highlight the importance of tailoring specifically designed information campaigns aimed to raise the involvement of OPs in the prevention of LD in occupational settings other than healthcare.
摘要：
在意大利,军团病（LD）原因每年>1000住院，致死率为5-10%。职业暴露可以合理地解释总病例的很大一部分，但是职业医师（OP）在LD的管理和预防中的作用几乎没有研究。因此，本调查评估了知识，关于LD的态度和做法(KAP)来自意大利OPs的便利样本，重点是他们参与预防性干预。通过一次培训活动共招募了165名OP(帕尔马，意大利东北部,2019),并完成了专门设计的结构化问卷。使用二元逻辑回归模型分析了报告的预防性干预措施的参与与个体因素之间的关联，计算相应的多变量赔率比(AOR)。总的来说,参与者对LD的临床和诊断方面表现出令人满意的知识，而大量的不确定性与流行病学因素相关(即，通知率和杀伤力)。尽管据报道，大多数参与的OPs至少协助了一家医院（26.7%）和/或疗养院（42.4%）和/或废水处理厂，据报道，只有41.8％的人参与了LD的风险评估，而18.8％的人推广了专门设计的预防措施。在疗养院（aOR8.732;95％置信区间[95CI]2.991至25.487）和废水处理厂（aOR8.710;95CI2.844至26.668）担任OPs与参与LD的风险评估有关，而预防性实践的推广与在医院(aOR6.792;95CI2.026至22.764)和污水处理厂(aOR4.464,95CI1.363至14.619)中担任OP相关。换句话说,OP有效参与预防措施的实施似乎并不常见，并且仅限于某些职业环境。总的来说，这些结果凸显了定制专门设计的信息活动的重要性,这些活动旨在提高OPs在医疗保健以外的职业环境中预防LD的参与度.
