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Introduction: From the beginning of the COVID-19 pandemic, healthcare workers had to face unprecedented emergency needs associated with an extraordinary amount of psychological distress. In this cross-sectional multicenter study, we investigated sleep disturbances, and the level of anxiety and depression among the healthcare and non-healthcare staff of three hospitals in Milan (Italy) during the COVID-19 outbreak. Moreover, we explored potential predisposing factors for affective symptoms and poor sleep. Methods: Between June and July 2020, we administered an online questionnaire to evaluate the presence of sleep disorders (Pittsburgh Sleep Quality Index), insomnia (Sleep Condition Indicator), anxiety (State Trait Anxiety Inventory), and depression (Beck Depression Inventory-II). We used univariate and multivariate analysis to evaluate the association between the personal conditions and sleep and affective disorders. Results: The 964 participants reported high rates of sleep disorders (80.3%)—mainly insomnia (30.5%)—anxiety (69.7%), and depression (32.8%). The multivariate analysis showed a strong association of sleep disorders, especially insomnia, with female gender (p = 0.004), divorced marital status (p = 0.015), self-isolation (p = 0.037), and chronic diseases (p = 0.003). Anxiety was significantly associated with teleworking (p = 0.001), while depressive symptoms were associated with self-isolation (p = 0.028), modified work schedules (p = 0.03), and chronic diseases (p = 0.027). Conclusion: In hospital workers, the high prevalence of sleep and psychiatric symptoms during the COVID-19 outbreak appears to be determined mainly by modifications of personal or work habits. Teleworking was associated with increased anxiety. An accurate planning of hospital activities and a psychological support are needed to prevent and manage sleep and mental disorders. [ABSTRACT FROM AUTHOR]

Stress, circadian patterns, and sleep-related factors may have a role on occupational injuries. We investigated the association between occupational injuries among the workers of an Italian hospital and their secretion of salivary melatonin and cortisol. We used a case-control study design. 27 injured cases and 31 non-injured controls provided 5 salivary samples every 60 min from 9 pm to 1 am. Melatonin and cortisol concentrations were measured, and the Dim Light Melatonin Onset (DLMO) derived using two fixed thresholds (1 and 3 pg/mL). The associations between injury, melatonin, cortisol, and DLMO were assessed through univariate and multivariate analyses. Non-injured controls had higher melatonin (median 2.28 pg/mL) and lower cortisol concentrations (0.71 ng/mL), as well as earlier DLMO times (9:00 pm with the 1 pg/mL melatonin cutoff) than cases (1.01 pg/mL, 1.14 ng/mL and 9:12 pm, respectively), although only few results were statistically significant. Measuring these hormones might be helpful to characterize the risk of injury among hospital workers. [ABSTRACT FROM AUTHOR]

Triptans represent the most specific and effective treatment for migraine attacks. Nevertheless, in clinical practice, they are often underused. Hospital workers, in particular physicians, are expected to be more aware of the correct use of specific drugs, especially for a very common disease such as migraine. Aim of this study was to evaluate whether different hospital workers affected by migraine are able to correctly manage the most suitable therapy for their migraine attacks. During a 1-year period, we submitted hospital employees to a structured interview with a questionnaire to investigate the presence of headache and its characteristics. In particular, in the subpopulation of subjects affected by migraine, we took information regarding their usual treatment for the control of attacks. The type of drug and the category of the working activity were synthesized as two different ordinal variables. Difference in the distribution of the different drug categories was evaluated with Chi squared test. Statistics was performed with SPSS 13.0 for Windows systems. We enrolled 1250 consecutive subjects: 20.3 % of the population (254 patients) was affected by migraine. Triptans use was significantly lower than that of non-steroidal anti-inflammatory drugs. The distribution of the use of the drugs was significantly different ( p < 0.0001) at Chi squared test. Among migraineur physicians, only 10.7 % used triptans. Even in this subgroup, we observed a significant difference ( p < 0.0001) in the distribution of the use of the drugs at Chi squared test. Our findings show a reduced use of triptans among hospital workers. These data reflect the unsatisfactory dissemination of knowledge regarding the correct management of migraine attacks and the advantages of treatment with triptans. An incorrect therapeutic approach to migraine contributes to the risk of the most important complications, such as drugs abuse or illness chronicization. These findings suggest that an insufficient awareness of migraine-related therapeutic options also involves hospital workers, including physicians. [ABSTRACT FROM AUTHOR]

Headache prevalence is very high, especially during working life. Hospital workers are expected to be particularly careful with health problems. Few data are available about the dimension of the headache-related problems among hospital workers, including disease awareness and diagnostic delay. 502 subjects employed in our hospital (doctors, nurses, technicians, administrative employees) were enrolled over a 3-month period and submitted to a questionnaire about the presence of headache, its characteristics and time spent from disease onset to diagnosis. We used the ID-migraine test, a validated tool, to obtain a correct migraine diagnosis based on a three-question test. Age and education were collected as continuous variables while the other variables (sex, presence of headache, presence of migraine, diagnosis put by the general practitioners) were encoded as binary. The difference of the distribution of the analyzed variables in tables was evaluated with χ test. The data were analyzed with SPSS 13.0 for Windows systems. In the analyzed population (mean age 40.15 ± 11.0 years; males 60.7 %), 216 patients complained of headache (43.1 %) and 77 (15.4 %) were diagnosed as migraineous at the in-hospital evaluation. Among the 216 cephalalgic patients, the majority (59.7 %, p < 0.0001 at χ test) did not refer to their general practitioner. Of the 77 patients affected by migraine, 55.8 % referred to their general practitioner, but only 27 (35.1 %) received a definite migraine diagnosis. Fifty subjects (64.9 %) were still undiagnosed and unevaluated at the moment of our survey ( p < 0.0001 at χ test). Headache prevalence was very high in this population of hospital workers. Diagnostic errors and delays were frequent. Unexpectedly, self-awareness of the headache was very low. Headache, particularly migraine, is a relevant cause of loss of working days and low productivity. Our findings suggest the necessity to program initiatives aimed to raise the awareness of headache in order to improve diagnostic and therapeutic possibilities. [ABSTRACT FROM AUTHOR]