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Commuting accidents (CA) play an important role in many systems of workers' compensation insurance and with good reason, as they generally bring about more serious consequences in terms of permanent disablement and death than ordinary occupational accidents; this usually leads to high social costs. Nevertheless, research investigations aimed at studying the possible causes underlying the phenomenon are not available in medical literature. Objective of the present study is to evaluate whether excessive daytime sleepiness (EDS) might influence the occurrence of CA. 463 CA occurred to 411 police officers in northern Italy during the period 1999 - 2002 were collected; 51.9% of the subjects were working on shifts, 48.1% were non-shift workers. The study was carried out by submitting a self-administered questionnaire to gather information on age and physical characteristics, working conditions, sleep-related problems and accidents occurrence; EDS was measured by the Epworth Sleepiness Scale (ESS). A large number of workers (36%) complained of EDS; a strict significant relationship between shift - work condition and the presence of EDS was found, thus suggesting that CA are significantly influenced by EDS. The shift work schedule adopted by Italian Police might be accountable for the disruption of the balance between circadian and homeostatic factors.

Shift-work disrupts the sleep-wake cycle and could bring about sleep disorders and excessive daytime sleepiness. We studied two samples of shift-workers, a group of 178 nurses and one of 174 police officers, all working in the town of Palermo (Italy); their answers to a sleep disorder questionnaire were scored and added in order to create a Sleep Disorder Score (SDS). The SDS cut-off value, discrimining pathological values from physiological ones, was settled a-priori. In both groups SDS did not depend on sex, age, weight, height nor on working seniority, but it increased non linearly (cubic form) with shift-work seniority. In nurses this mathematical description of SDS exceeded the cut-off value after 15 years of shift-work seniority; in police officers it settled asymptotically under the critical value. This could be ascribable both to the different composition in sex of the two samples (nurses: 49% F-51% M vs. police officers: 6% F-94% M) both to the self-selection process that seems to undergo police officers (nurses do not leave shift-work because of salary incentives).