Abstract

Background

Health behaviours among doctors has been suggested to be an important marker of how harmful lifestyle behaviours are perceived. In several countries, decrease in smoking among physicians was spectacular, indicating that the hazard was well known. Historical data have shown that because of their higher socio-economical status physicians take up smoking earlier. When the dangers of smoking become better known, physicians began to give up smoking at a higher rate than the general population. For alcohol consumption, the situation is quite different: prevalence is still very high among physicians and the dangers are not so well perceived. To study the situation in Switzerland, data of a national survey were analysed to determine the prevalence of smoking and alcohol drinking among primary care physicians.

Methods

2'756 randomly selected practitioners were surveyed to assess subjective mental and physical health and their determinants, including smoking and drinking behaviours. Physicians were categorised as never smokers, current smokers and former smokers, as well as non drinkers, drinkers (AUDIT-C < 4 for women and < 5 for men) and at risk drinkers (higher scores).

Results

1'784 physicians (65%) responded (men 84%, mean age 51 years). Twelve percent were current smokers and 22% former smokers. Sixty six percent were drinkers and 30% at risk drinkers. Only 4% were never smokers and non drinkers. Forty eight percent of current smokers were also at risk drinkers and 16% of at risk drinkers were also current smokers. Smoking and at risk drinking were more frequent among men, middle aged physicians and physicians living alone. When compared to a random sample of the Swiss population, primary care physicians were two to three times less likely to be active smokers (12% vs. 30%), but were more likely to be drinkers (96% vs. 78%), and twice more likely to be at risk drinkers (30% vs. 15%).

Conclusion

The prevalence of current smokers among Swiss primary care physicians was much lower than in the general population in Switzerland, reflecting that the hazards of smoking are well known to doctors. However, the opposite was found for alcohol use, underlining the importance of making efforts in this area to increase awareness among physicians of the dangers of alcohol consumption.

No abstract

Work-satisfaction with current income, social prestige and professional relations are important correlates of mental health among primary care physicians, as well as emotional exhaustion. Higher levels of these dimensions of work-related satisfaction seems to mitigate the relationship between emotional exhaustion and physicians' mental health.

AIMS OF THE STUDY: A new emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in Wuhan, China, in December 2019 and then spread rapidly, causing a global pandemic. In Europe, the first case was identified in Italy on 21 February 2020, in the Lombardy region bordering on the southern part of Switzerland (Canton Ticino), where 4 days later the first case was identified . Ticino was the most affected canton in Switzerland during the first wave of pandemic. In order to provide a reliable indicator for the spread of the virus in this region and help decision making at the public health level, a seroprevalence study of SARS-CoV-2 was conducted. METHODS: A cohort study was implemented on a randomly selected sample of 1500 persons. The sample is representative of the general population of the Canton of Ticino, stratified by sex and age from 5 years old.  Antibodies against the SARS-CoV-2 nucleocapsid protein were detected using a rapid qualitative test in 4 data collection periods over the course of 12 months (from May–June 2020 to May–June 2021). RESULTS: The seroprevalence of SARS-CoV-2 was estimated at 9.0% in spring 2020 (weeks 20–26), 8.4% in summer 2020 (weeks 32–38), 14.1% in autumn 2020 (weeks 45–52) and 22.3% in spring 2021 (weeks 18–23). In none of these four phases was evidence of an association between sex or specific age groups and presence of anti-SARS-CoV-2 antibodies detected. For risk factors, the only strong and significant association found was with diabetes in the first three data collection periods but not in the fourth. Among people who participated in all four phases of the study and tested positive anti-SARS-CoV-2 antibodies in the first test, 61.8% were still positive even in the fourth, 12 months later. CONCLUSIONS: The results support the hypothesis that, after one year and despite the severe burden in terms of hospitalisations and deaths experienced by the Canton Ticino, SARS-CoV-2 infection affected only a minority of the population (20%) and also suggest that the anti-nucleocapsid antibodies persist after 12 months in the majority of infected persons.

Issue and description of the problem Ticino is one of the twenty-six Cantons of the Swiss Confederation and is located in the southernmost part of the country. Ticino covers an area of 2812 km2 and almost 350'000 people live in this region. The mission of the Ticino health service is promoting health and prevention of noncommunicable disease among the population, particularly on four main topics: physical activity, alcohol abuse, smoking and overweight. However, the small size of the area and the consequent limited availability of resources pose several challenges. Firstly there is an issue in terms of the representativeness of the data but equally there are difficulties in terms of the effectiveness of the decision-making process. Intervention In order to seek to improve both these aspects, a framework encompassing the whole process from data collection to visualization is under development. It is anticipated that this will improve the capability to provide a reliable representation of the region's health data and issues together with a set of relevant tools to assist decision making. Lessons learned Throughout the data collection, the small sample size issue is being addressed by integrating different data sources and looking for correlations among them. In order to define real community health needs, the focus is on epidemiological analysis and multivariate models to try to identify the most relevant characteristics of the respective target. Finally, in order to help decision-makers to take policy decisions and communicate these effectively, the epidemiological results are being represented using visualization models coming from different scientific fields such as extending health promotion on social media (Facebook). It is planned that such initiatives will aid the collection of new data on population needs, monitor feedback on specific topics and targeting the right segment of population.