[Tetanus vaccination and antibody tritation: compulsory vaccination at work and the role of the occupational medicine in the induction of protective effects in the population in general].

In Italy in the last ten years tetanus incidence has been considerably decreased. It is a result first of the application of national laws that make compulsory the tetanus vaccine for some workers' group and for the population in general, and on the other hand for the working class as a consequence of D.Lgs 626/94. It was carried out by the U.O.O.M.L. of Garbagnate an activity of sanitary surveillance towards the working class with a tetanus biological risk (i.g. builder, metalworker, cleaning staff policemen, health visitors, cooks, etc.). During this activity it was considered the possibility of a tetanus vaccine cycle for those people that couldn't provide any certification about previous tetanus vaccine. The justification for this propose is to reduce the risk of side effects due to iperimmunization in case of close vaccinations and the safety and low cost of the tritation test of antibody anti-tetanus toxin method. Therefore it was decided to determine the personal condition of tetanus immunization for all those people without a valid certification. It resulted that 38% of people subject to sanitary surveillance were not protected and 55 years people resulted to be the group with highest risk. This result was also confirmed by the Ministry of Health that considers older population the highest risk group. It becomes clear that the vaccination for working purposes protects the population in general too. In conclusion we firmly think the procedure we followed completely accomplish the general principle of healthcare for infectious risk on the application of the tit. VIII of D.Lgs. 626/94.