The objective of the present study was the identification of farming practices in the\nproduction of turkeys for human consumption, and their ranking in terms of the occupational\nprobability of exposure to antimicrobial resistant (AMR) bacteria, for farm workers. We gathered\nevidence and data from scientific literature, on risk factors for AMR in farmers, and on the prevalence\nof those hazards across farming phases. We administered semi-structured interviews to public and\nprivate veterinarians in Northern Italy, to obtain detailed information on turkey farming phases,\nand on working practices. Data were then integrated into a semi-quantitative Failure Modes and\nEffect Analysis (FMEA). Those working practices, which are characterized by direct contact with\nnumerous animals, and which are carried out frequently, with rare use of personal protection devices\nresulted as associated with the greatest probability of exposure to AMR. For methicillin resistant\nStaphylococcus aureus (MRSA), these included vaccination and administration of any individual\ntherapy, and removal and milling of litter, given the exposure of farmers to high dust level. Indeed,\nlevels of occupational exposure to MRSA are enhanced by its transmission routes, which include direct\ncontact with animal, as well as airborne transmission. Level of exposure to extended spectrum beta\nlactamase (ESBL) is more strictly associated with direct contact and the oral-fecal route. Consequently,\nexposure to ESBL resulted and associated with the routinely tipping over of poults turned on their\nback, and with the individual administration of therapies.
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