Tetanus immunity in construction workers in Italy.
BACKGROUND
Tetanus is a serious vaccine-preventable disease that remains a significant health risk in certain occupations. Since 2006, Italy has reported the highest number of cases in Europe. Some professions, such as construction workers, are more exposed to tetanus.


OBJECTIVE
To evaluate tetanus immunity status and associated factors in construction workers in Italy.


METHODS
A cross-sectional study of construction workers attending for periodic occupational health surveillance at one site in Italy between September 2011 and January 2013. Serum tetanus antitoxin levels were measured and analysed according to demographic and clinical variables.


RESULTS
All 5275 workers attending for health surveillance between September 2011 and January 2013 agreed to participate. Protective tetanus antitoxin levels (>0.1 IU/ml) were found in 4116 workers (78%). Multivariate logistic regression analysis suggested that the following risk factors were significantly associated with inadequate immunization status: older age (age >58 years, odds ratio [OR] 1.78, 95% confidence intervals [CIs] 1.76-1.84), poor education (no formal education: OR 3.74, 95% CI: 3.69-3.78), unskilled work tasks (OR 2.71, 95% CI: 2.67-2.77) and country of origin (Egypt: OR 1.72, 95% CI: 1.67-1.77; Morocco: OR 1.69, 95% CI: 1.62-1.76).


CONCLUSIONS
In this study, a significant proportion of construction workers in Italy were not adequately immunized against tetanus, as required by Italian law. Occupational health professionals should promote and implement vaccination campaigns, especially among migrant workers, for public health and legal reasons.
Department of Internal Medicine and Systemic Diseases, Section of Occupational Medicine, University of Catania, Catania 95123, Italy.
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V
Rapisarda
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M
Bracci
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Nunnari
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M
Ferrante
C
C
Ledda
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D060389:Construction Industry; D003430:Cross-Sectional Studies; D004522:Educational Status; D006801:Humans; D007114:Immunization; D007558:Italy; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D016272:Occupational Health; D013742:Tetanus / Q000276:immunology*; D013743:Tetanus Antitoxin; D013745:Tetanus Toxoid; D014611:Vaccination; D055815:Young Adult
D013743:Tetanus Antitoxin; D013745:Tetanus Toxoid
Clostridium tetani; Italy; construction workers; immigrant; tetanus; vaccine.