Medicine, Health Policy, Infectious Diseases, Epidemiology
38
Scopus Publications
Scopus Publications
Long-Term Electrocardiographic Changes in Healthcare Workers Following Mild to Moderate Cases of Coronavirus (COVID-19): A Longitudinal Observational Study Luca Coppeta, Giuseppina Somma, Stella Andreadi, Andrea Attanasio, Andrea Magrini, Cristiana Ferrari Healthcare Switzerland, 2025 Background: The cardiovascular effects of SARS-CoV-2, including autonomic dysregulation, are becoming increasingly recognized, even following mild infections. However, long-term electrocardiographic (ECG) changes remain poorly characterized. Methods: We conducted a prospective study of 151 unvaccinated healthcare workers with RT-PCR-confirmed mild to moderate SARS-CoV-2 infection. Standard 12-lead ECGs were recorded before infection (T0) and at 6–12 months (T1) and >12 months (T2) after infection. Key parameters included heart rate (HR), PR interval, QRS duration, and corrected QT interval (QTc). Results: Heart rate (HR) increased transiently at T1 (p < 0.05) and normalized by T2. Mild but persistent PR interval shortening was observed at both follow-ups (p < 0.01). There were no significant changes in QRS or QTc intervals. No arrhythmias or conduction blocks occurred. ECG alterations were not associated with sex or age, except for greater PR shortening in males. Conclusions: Mild SARS-CoV-2 infection can result in transient sinus tachycardia and subtle PR shortening, which is likely to be a post-viral autonomic effect. Long-term ECG surveillance appears unnecessary in asymptomatic cases.
Vaccine Attitudes, Knowledge, and Confidence Among Nursing, Pediatric Nursing, and Midwifery Undergraduate Students in Italy Ersilia Buonomo, Daniele Di Giovanni, Gaia Piunno, Stefania Moramarco, Giuliana D’Elpidio, Ercole Vellone, Enkeleda Gjini, Mariachiara Carestia, Cristiana Ferrari, Luca Coppeta Vaccines, 2025 Background: Vaccine hesitancy (VH) represents a growing concern among healthcare professionals and students, potentially undermining public health efforts. Nursing, pediatric nursing, and midwifery students are future vaccinators and educators, making it essential to understand their attitudes, knowledge, and confidence toward vaccination. This study aims to assess vaccine-related perceptions and behaviors among these student populations in an Italian university. Methods: A cross-sectional survey was conducted between November 2022 and February 2024 at the University of Rome “Tor Vergata”. A structured, anonymous questionnaire, including the Vaccination Attitudes Examination (VAX) scale, vaccine knowledge items, and sources of information, was administered to students in nursing (n = 205), pediatric nursing (n = 46), and midwifery (n = 21). Statistical analyses included descriptive statistics, ANOVA, post hoc tests, and Mann–Whitney U tests. Results: Among the 272 participants, 20.6% reported refusing at least one recommended vaccine, and 18.4% delayed vaccination for non-medical reasons. Vaccine knowledge and confidence increased significantly with academic progression (p < 0.001). Midwifery students showed both the highest concern for long-term vaccine effects and the greatest confidence in vaccine safety. Institutional and scientific sources were the most trusted, though traditional and non-institutional media also influenced perceptions, particularly among midwifery students. Conclusions: Despite high COVID-19 vaccine uptake, VH persists among health professional students. Discipline-specific patterns highlight the need for early, targeted educational strategies to enhance vaccine literacy and reduce hesitancy. Tailored training may empower future professionals to become informed and credible advocates for vaccination.
Long-Term Pulmonary Function in Healthcare Workers: A Spirometric Evaluation Three Years Post-COVID-19 Pandemic Lorenzo Ippoliti, Luca Coppeta, Giuseppe Bizzarro, Cristiana Ferrari, Andrea Mazza, Agostino Paolino, Claudia Salvi, Laura Angelini, Cristina Brugaletta, Matteo Pasanisi, Antonio Pietroiusti, Andrea Magrini Biomedicines, 2025 Background: The long-term impact of SARS-CoV-2 infection on pulmonary function remains insufficiently characterised, particularly among individuals who have experienced mild or asymptomatic disease. This study aimed to assess spirometric changes over a three-year period and evaluate potential associations with demographic and clinical variables. Methods: We retrospectively analysed spirometry data from 103 healthcare workers (HCWs) who underwent pulmonary function tests at three time points: before the pandemic (Time 0), one year post-pandemic (Time 1), and two years post-pandemic (Time 2). Linear regression models were employed to evaluate the impact of various factors, including age, BMI, gender, smoking status, history of SARS-CoV-2 infection, vaccination status prior to infection, and the number of infections, on changes in FVC and FEV1. Results: A statistically significant decrease in both FVC and FEV1 were observed at Time 1 and Time 2 compared to baseline (p < 0.05). Smoking habits were significantly associated with a greater decline in both FVC and FEV1. Multiple infections were associated with larger reductions in FVC at Time 1. No significant associations were found with age, gender, BMI, or vaccination status. Even in the absence of severe symptoms of the disease, healthcare workers exhibited a measurable decline in pulmonary function over time. Smoking and reinfection emerged as relevant factors associated with reduced lung capacity. Conclusions: These findings emphasise the need for ongoing respiratory monitoring in occupational settings and the importance of targeted preventive measures.
Nuclear Factor Erythroid 2-Related Factor 2 and SARS-CoV-2 Infection Risk in COVID-19-Vaccinated Hospital Nurses Stefano Rizza, Luca Coppeta, Gianluigi Ferrazza, Alessandro Nucera, Maria Postorino, Andrea Quatrana, Cristiana Ferrari, Rossella Menghini, Susanna Longo, Andrea Magrini, Massimo Federici Vaccines, 2025 Background/Objectives: The COVID-19 pandemic has caused sickness and death among many health care workers. However, the apparent resistance of health care workers to SARS-CoV-2 infection despite their high-risk work environment remains unclear. To investigate if inflammation and circadian disruption contribute to resistance or diminished susceptibility to the SARS-CoV-2 virus, we retrospectively evaluated a cohort of volunteer hospital nurses (VHNs). Methods: A total of 246 apparently healthy VHNs (mean age 37.4 ± 5.9 years) who had received the BNT162b2 mRNA vaccine were asked to report their sleep quality, according to the Pittsburgh Sleep Quality Index, and number of SARS-CoV-2 infections during the observational study period (from the end of December 2020 to April 2025). The expression of inflammation-associated mediators and circadian transcription factors in peripheral blood mononuclear cells, as well as sleep quality, were examined. Results: Our findings revealed no anthropometric, biochemical, or inflammation-associated parameters but demonstrated significantly greater levels of NFE2L2, also known as nuclear factor erythroid-derived 2-like 2 (NFR2), gene expression in peripheral blood mononuclear cells among VHNs who had never been infected with SARS-CoV-2 (n = 97) than in VHNs with only one (n = 119) or with two or more (n = 35) prior SARS-CoV-2 infections (p < 0.01). This result was confirmed through one-to-one propensity score matching (p < 0.01). Moreover, NRF2 gene expression was not associated with the number of COVID-19 vaccinations (p = 0.598). Finally, NRF2 gene expression was higher among participants who reported better sleep quality (p < 0.01). Conclusions: Our findings suggest possible interactions among NRF2 gene expression, protection against SARS-CoV-2 infection, and the modulation of COVID-19 vaccination efficacy.
Evaluation of Anti-HB Levels in a Multi-Ethnic Cohort of Health Profession Students † Lorenzo Ippoliti, Andrea Pizzo, Agostino Paolino, Luca Coppeta, Giuseppe Bizzarro, Cristiana Ferrari, Andrea Mazza, Claudia Salvi, Ersilia Buonomo, Fabian Cenko, Andrea Magrini, Antonio Pietroiusti Vaccines, 2025 Background: Despite the widespread implementation of childhood vaccination programmes, hepatitis B virus (HBV) infection remains an ongoing occupational risk for healthcare students. In multi-ethnic and international university settings, differences in vaccination programmes and immune responses must be considered. This retrospective study aimed to assess the prevalence of protective levels of anti-HBs among medical students at an international university in Rome, exploring associations with demographic and vaccination-related factors. Methods: Data were collected from routine occupational health surveillance conducted in 2023. Anti-HB titres were measured in 507 students, and information on age, sex, country of birth, age at vaccination, and time since the last dose was analysed. Results: Overall, 55.0% of students had antibody levels of at least 10 mIU/mL, indicating serological protection. Higher seroprotection rates were observed among students vaccinated in the first year of life compared to those vaccinated later. A significant decline in antibody titres was also associated with longer intervals since vaccination. Students born outside Europe tended to show lower levels of protection. Conclusions: These results emphasise the importance of screening future healthcare professionals and continuously monitoring antibody titres to help reduce HBV infections.
Occupational Radiation Exposure and Thyroid Nodules in Healthcare Workers: A Review Aikaterini Andreadi, Stella Andreadi, Marco Cerilli, Federica Todaro, Massimiliano Lazzaroni, Pietro Lodeserto, Marco Meloni, Cristiana Ferrari, Alfonso Bellia, Luca Coppeta, Andrea Magrini, Davide Lauro International Journal of Molecular Sciences, 2025 Thyroid nodules are a common clinical finding, with their prevalence influenced by multiple environmental and occupational factors, including exposure to ionizing radiation. Healthcare workers, particularly those operating in radiology, nuclear medicine, interventional cardiology, and radiation oncology, are potentially at increased risk due to chronic low-dose radiation exposure. This review aims to evaluate the current evidence regarding the association between occupational radiation exposure and the development of thyroid nodules among healthcare professionals. The findings suggest a higher prevalence of thyroid nodules in radiation-exposed workers compared to the general population, although data heterogeneity and methodological limitations exist. Factors such as the duration of exposure, radiation protection practices, and frequency of monitoring play critical roles in modulating the individual risk. While some studies report no significant difference in malignancy rates, the increased detection of nodules underlines the need for regular thyroid surveillance in at-risk populations. Further longitudinal and multicentric studies are warranted to clarify the causality and guide preventive strategies. This review highlights the importance of occupational health protocols, including radiation shielding and periodic thyroid evaluation, in safeguarding the long-term endocrine health of healthcare workers.
Persistence of Anti-HB Antibodies in Healthcare Trainees: The Impact of Childhood Versus Adolescent Vaccination Luca Di Giampaolo, Luca Coppeta, Paola Borrelli, Piergiorgio Astolfi, Andrea Resta, Lucia Loffredo, Flavia Di Menno Di Bucchianico, Rocco Mangifesta, Lorenzo Ippoliti, Cristiana Ferrari Vaccines, 2025 Background: Hepatitis B virus (HBV) infection remains a significant occupational health concern for healthcare workers (HCWs), including trainees exposed to biological risks. Although vaccination is the most effective preventive measure, the persistence of immunity over time and the need for booster doses remain subjects of debate. Objective: The present study aims to assess the prevalence of protective anti-HB antibody titers among healthcare trainees at the “SS Annunziata” Hospital in Chieti, comparing those vaccinated in infancy with those vaccinated during adolescence. Methods: A retrospective observational study was conducted on 2028 healthcare trainees from 2021 to 2024. Participants were divided into two groups based on vaccination timing: infancy (PED group) and adolescence (ADO group). Serological tests were performed to measure anti-HB titers, with a protective threshold set at ≥10 IU/L. Statistical analyses were conducted to evaluate differences in immunity persistence between the two groups. The results showed that the overall prevalence of protective anti-HB titers was 50.7%, with significant differences between the PED and ADO groups. Protective immunity was observed in 79.2% of individuals vaccinated during adolescence, compared to 44.6% of those vaccinated in infancy (p < 0.001). No significant differences in antibody persistence were found between males and females. Notably, 92.4% of participants with non-protective titers received a booster dose within two months of testing. Conclusions: The study confirms a significant decline in anti-HB titers over time among individuals vaccinated in infancy, suggesting a potential need for booster doses later in adulthood. The high adherence to vaccination recommendations among healthcare trainees is a promising finding, reinforcing the importance of continuous education and immunization programmes in healthcare settings. Further research, including longitudinal studies and additional HBV biomarkers, is necessary to optimize vaccination strategies and long-term immunity monitoring in HCWs.
Waste Collection and Viral Hepatitis: Assessing the Occupational Risk of HBV and HCV Lorenzo Ippoliti, Federica Crivaro, Luca Coppeta, Giuseppina Somma, Filippo Lecciso, Gianmarco Manili, Viola Giovinazzo, Margherita Iarossi, Cristiana Ferrari, Antonio Pietroiusti, Andrea Magrini Acta Microbiologica Hellenica Switzerland, 2025 Hepatitis B and C (HBV and HCV) infections persist as significant public health concerns. Specific occupational groups, such as waste collectors, continue to face elevated risk due to exposure to contaminated materials. Research studies have underscored heightened infection rates, notably from needle prick injuries. The present study aspires to re-evaluate the prevalence of HBV and HCV among waste collectors and to scrutinize associated risk factors, thereby contributing to the development of effective public health and occupational safety strategies. The study analyzed data from 116 Italian waste collectors who were undergoing regular occupational visits, examining demographics, health conditions, HBV immunization, and annual blood tests for the HBsAg, HBsAb, and HCVAb. The HBsAb was detected in 66 individuals (56.9%), while the HCVAb was found in 4 (3.4%). Logistic regression showed HBV immunization and longer job experience to be significant factors associated with HBsAb presence. Waste collection may increase HBV infection risk due to occupational exposure, unlike HCV, which requires blood-to-blood contact. Preventive strategies, including education, protective equipment, and HBV vaccination, are essential. Ensuring vaccination coverage among waste collectors could reduce infection risk. Further research should assess the occupational risks and the effectiveness of preventive measures.
The Influence of Occupational Factors on Contact Dermatitis in Symptomatic Healthcare Workers: A Patch Test Study † Cristiana Ferrari, Giuseppina Somma, Viola Giovinazzo, Margherita Iarossi, Michele Treglia, Margherita Pallocci, Luca Di Giampaolo, Andrea Magrini, Luca Coppeta Diseases, 2025 Healthcare workers (HCWs) are frequently exposed to a variety of chemical agents, which can result in the development of allergic or irritant contact dermatitis. The present study aimed to assess the prevalence of skin sensitization among HCWs who presented with symptoms of contact dermatitis, considering both occupational and non-occupational risk factors. The study population comprised 127 HCWs who attended routine occupational health surveillance at the Tor Vergata Teaching Hospital in Rome between November 2023 and May 2024. A structured dermatitis questionnaire and patch testing were administered to the participants. Demographic and lifestyle data, including information on occupation, night shift work, smoking habits, and body mass index (BMI), were collected. Patch test positivity was observed in 31.5% of participants, with the most common clinical presentation being erythematous-desquamative allergic contact dermatitis. A significantly higher likelihood of patch test positivity was observed among nurses (57.1%), particularly for nickel sensitization, compared to other occupational groups. A trend towards an association between night shift work and skin sensitization was observed, although this did not reach statistical significance. No significant associations were found for ages over 35 years, sex, or BMI. These findings highlight the elevated risk of contact sensitization among nurses, emphasizing the need for targeted interventions, including exposure reduction strategies and protective measures, to mitigate occupational skin hazards in healthcare settings.
Systematic literature review and meta-analysis on the reproductive effects of micro- pollutants in humans and animals Luca Coppeta, Cristiana Ferrari, Lorenzo Ippoliti, Luisa Campagnolo, Andrea Magrini Frontiers in Toxicology, 2025 Background Micro-pollutants, such as particulate matter, heavy metals, endocrine-disrupting compounds, and persistent organic pollutants, raise significant concerns regarding reproductive health in both humans and animals. Methods This systematic review and meta-analysis, conducted according to PRISMA guidelines, assessed available evidence on micro-pollutant exposure and reproductive outcomes. Out of 2,134 records identified, 52 studies (31 human, 21 animal) met inclusion criteria. Results Exposure to micro-pollutants was consistently associated with adverse reproductive outcomes. Human studies reported increased risks of irregular menstruation, preterm delivery (OR = 1.42), intrauterine growth restriction (OR = 1.36), and reductions in sperm concentration (SMD = −0.48) and testosterone levels. A meta-analysis of 23 studies confirmed these associations, while animal studies provided mechanistic support, including histological damage and epigenetic modifications. Despite substantial heterogeneity, the overall quality of included studies was moderate-to-high. Conclusion Evidence indicates that micro-pollutants are strongly associated with impaired reproductive health. While causality cannot be definitively established due to observational study designs, the consistency of findings across populations, pollutants, and species highlights an urgent need for further research and regulatory measures to mitigate reproductive risks.
Nanomaterials and security in occupational and forensic medicine: insights from nanotoxicology Lang Tran, Michele Treglia, Luca Coppeta, Cristiana Ferrari, Margherita Pallocci, Luisa Campagnolo, Luiz C. De Miranda Junior, Bruno Piccoli, Sharyn Gaskin, Francisco Cortes Fernandes, Fabio Dantas Filho, Pierluigi Passalacqua, Antonio Pietroiusti, Lorenzo Ippoliti, Mario Bragaglia, Francesca Nanni, Andrea Magrini, Luigi Tonino Marsella Frontiers in Toxicology, 2024
Pulmonary function assessment after COVID-19 in vaccinated healthcare workers Lorenzo Ippoliti, Luca Coppeta, Giuseppina Somma, Giuseppe Bizzarro, Francesco Borelli, Teresa Crispino, Cristiana Ferrari, Ilaria Iannuzzi, Andrea Mazza, Agostino Paolino, Andrea Magrini, Antonio Pietroiusti Journal of Occupational Medicine and Toxicology, 2023
