Background: West Nile virus (WNV) is a mosquito-borne RNA virus, with birds as reservoirs and humans as incidental hosts. WNV often causes asymptomatic infections, but severe neuroinvasive disease occurs in fewer than 1% of human cases. Recent climatic changes and occupational exposure have increased its spread, particularly in Southern Italy. This study aimed to assess WNV seroprevalence and occupational risks among outdoor workers to guide targeted public health interventions. Methods: This cross-sectional study was conducted in the Apulia region, southeastern Italy, from November 2023 to April 2024. Participants completed a detailed questionnaire on socio-demographics, occupational exposure, travel history, and health symptoms. Blood samples were analyzed using enzyme-linked immunosorbent assay (ELISA) and neutralization assays to detect WNV-specific antibodies. Results: 250 outdoor workers in southeastern Italy were recruited, including agricultural workers, veterinarians, forestry workers, and livestock breeders. The latter showed the highest WNV prevalence at 6.5%. Protective measures such as repellent use (β = −0.145, OR = 0.95, p = 0.019) and personal protective equipment (PPE) usage (β = −0.12, OR = 0.94, p = 0.04) significantly reduced the likelihood of WNV infection. Conclusions: The study highlights the significant occupational risk posed by WNV to outdoor workers involved in livestock breeding in Southern Italy, likely due to their frequent exposure to mosquito-prone environments. Tailored public health strategies and education programs are needed to protect high-risk outdoor workers from WNV, amidst the backdrop of changing climatic conditions that favor increased transmission.

Tick-borne diseases (TBDs) pose a growing occupational risk due to the expanding geographical range of tick species and their associated pathogens. This study aims to assess TBD seroprevalence among different occupational groups in Europe, identifying high-risk professions and guiding targeted prevention efforts. A systematic review and meta-analysis were conducted following PRISMA guidelines to evaluate TBD seroprevalence in occupational settings across Europe from January 2013 to June 2024. A comprehensive search of PubMed, Web of Science, and Scopus identified 36 relevant studies. Heterogeneity among studies was assessed using Cochran's Q test and the inconsistency index (I²), with sensitivity and outlier analyses applied to evaluate their impact. Publication bias was examined through funnel plot analysis, Egger's test, and Duval & Tweedie's trim-and-fill method. Seroprevalence varied significantly across occupations. The highest rates were found for Coxiella burnetii among livestock and dairy producers (up to 73.7 % in Italy) and Borrelia burgdorferi among forestry workers, particularly in Poland. A meta-analysis of 33 studies revealed seroprevalence rates of 8.2 % in military workers (no publication bias), 26.0 % in forestry workers, 8.0 % in veterinarians, and 18.0 % in farmers, with high overall heterogeneity. TBD risk is influenced by occupational exposure, environmental factors, and regional differences. Given the substantial variation across worker categories, targeted preventive measures, increased awareness, and enhanced surveillance efforts are necessary to mitigate risks in high-exposure professions.