Knowledge, attitudes, beliefs and practices of construction workers towards tetanus vaccine in Northern Italy

Abstract

Construction workers (CWs) are both more exposed to tetanus and at higher risk to be inadequately immunized. Our aim was to evaluate tetanus immunization status and knowledge/attitudes towards tetanus vaccination in CWs in Italy. In this field report, the immunization status of 554 unskilled CWs (i.e. labourers). Immunization status was assessed recalling immunization booklets/certificates. Attitudes and knowledge were collected through a standardized questionnaire. In 240/554 CWs, immunization status was inadequate/not documented: in 184 subjects (33.2%), the last vaccination shot was older than 10 years, whereas basal immunization was incomplete in 20 cases, more frequently in foreign-born people (FBP) than in Italian born (IBP) (OR=7.116). In 198 cases (35.7%), an Occupational Physician (OPh) performed last booster, usually with monovalent (T, n=173) vaccine. The main reason for inadequate immunization was having forgotten the periodic booster (148/554; 26.7%), whereas 42 subjects (7.6%) deliberately avoided tetanus vaccine because of personal/religious beliefs, more frequently in FBP than in IBP (OR=3.182). In summary, the prevalence of inadequate immunization status was relatively high (43.4%): the high prevalence of “forgotten boosters” enlightens the key role of OPh in recalling and promoting vaccination policies. Moreover, the inappropriate use of Td vaccine points out the opportunity for educational campaigns in OPh.

Knowledge, attitudes and beliefs towards compulsory vaccination: a systematic review

“…A total of 22 studies assessed knowledge, attitudes and beliefs towards vaccination programs [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] (Table 1), while 9 papers, two of which presented results obtained from the same study, assessed attitudes towards the Human Papilloma Virus (HPV) vaccine in young girls specifically (Table 2). 25,26,38,[44][45][46][47]…”

“…30 Finally, nine studies assessed attitudes towards specific mandatory occupational vaccination protocols for different types of workers. 27,[31][32][33][34][39][40][41][42] The first study was performed in 2009 in Australia, and aimed to assess knowledge, attitudes and beliefs concerning a policy directive which requires all staff in certain patient care areas to prove protection against certain infectious diseases or to be vaccinated against measles, mumps, rubella, diphtheria, tetanus, pertussis, hepatitis B and varicella. A total of 1,200 paper surveys were distributed and 894 collected, and 185 questionnaires were submitted electronically, resulting in a total of 1,079 completed questionnaires.…”

“…32 An Italian study published in 2017 assessed the attitudes towards mandatory tetanus vaccination for agricultural workers: 79.5% of participants were favourable to some degree and 72.7% were aware that tetanus vaccination is mandatory for agricultural workers in Italy. 40…”

Air temperatures and occupational injuries in the construction industries: a report from Northern Italy (2000–2013)

“…Second, due to the physical nature of construction industry, construction workers usually perform their activities outdoors, being poorly protected against meteorological factors such as extreme heat and solar radiation 30,39) . Third, health and safety training in the construction industry are frequently inadequate, and again small companies are less likely to implement appropriate procedures and guidelines 30,32,[37][38][39][40] . Hence, many workers may continue to work beyond a safe heat exposure limit as they are unaware of the risks associated with the heat exposure, or have inappropriate knowledge of the preventive measures, as avoiding the hottest hours of the day for most strenuous physical exertion, or increasing the water intake during the HWs [41][42] .…”

Association between air temperatures and occupational injuries: a case-crossover analysis using workers’ compensation claims data in the construction industries in Northern Italy

“…Second, due to the physical nature of construction industry, CWs usually perform a large share of their activities outdoors, poorly protected against meteorological factors such as extreme heat and solar radiation (30,39). Third, health and safety training in CWs are frequently inadequate, and again small companies are less likely to implement appropriate procedures and guidelines (30,32,(37)(38)(39)(40). Hence, many CWs may continue to work beyond a safe heat exposure limit as they are unaware of the risks associated with the heat exposure, or have inappropriate knowledge of the preventive measures, e.g.…”