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The present study explores the modifications of cardiovascular autonomic control (CAC) during wake and sleep time and the systemic inflammatory profile associated with exposure to indoor air pollution (IAP) in a cohort of healthy subjects. Twenty healthy volunteers were enrolled. Indoor levels of fine particulate matter (PM 2.5 ), nitrogen dioxide (NO 2 ) and volatile organic compounds (VOCs) were monitored using a portable detector for 7 days. Together, a 7-day monitoring was performed through a wireless patch that continuously recorded electrocardiogram, respiratory activity and actigraphy. Indexes of CAC during wake and sleep time were derived from the biosignals: heart rate and low-frequency to high-frequency ratio (LF/HF), index of sympathovagal balance with higher values corresponding to a predominance of the sympathetic branch. Cyclic variation of heart rate index (CVHRI events/hour) during sleep, a proxy for the evaluation of sleep apnea, was assessed for each night. After the monitoring, blood samples were collected to assess the inflammatory profile. Regression and correlation analyses were performed. A positive association between VOC exposure and the CVHRI (Δ% = +0.2% for 1 μg/m 3 VOCs, p = 0.008) was found. The CVHRI was also positively associated with LF/HF during sleep, thus higher CVHRI values corresponded to a shift of the sympathovagal balance towards a sympathetic predominance (r = 0.52; p = 0.018). NO 2 exposure was positively associated with both the pro-inflammatory biomarker TREM-1 and the anti-inflammatory biomarker IL-10 (Δ% = +1.2% and Δ% = +2.4%, for 1 μg/m 3 NO 2 ; p = 0.005 and p = 0.022, respectively). The study highlights a possible causal relationship between IAP exposure and higher risk of sleep apnea events, associated with impaired CAC during sleep, and a pro-inflammatory state counterbalanced by an increased anti-inflammatory response in healthy subjects. This process may be disrupted in vulnerable populations, leading to a harmful chronic pro-inflammatory profile. Thus, IAP may emerge as a critical and often neglected risk factor for the public health that can be addressed through targeted preventive interventions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Work-related fatalities represent an important global public health threat, accounting for over 300,000 deaths annually. Despite preventive strategies, fatalities persist, necessitating comprehensive investigations. Autoptic investigations, when ordered, offer comprehensive data on fatal accidents, in particular with detailed information about the type of accident, lesions, and type of work, enabling a thorough analysis of various factors contributing to workplace deaths. This study investigates work-related fatalities in Milan and Monza Brianza, Lombardy, analyzing patterns, industries, and factors leading to death among workers., Methods: This retrospective study analyzed all fatal work accident data from the Autopsy Database of the Legal Medicine Institute of Milan from January 2000 to December 2022. We also estimated the risk of fatal accidents per 1.00.000 workers using ISTAT data for the different work sectors., Results: Of the 17,841 violent deaths in Milan and Monza Brianza, 308 resulted from work-related accidents. The majority were male (95.1%). The secondary sector showed the higher estimated risk (27 /106 vs. 19/106 in primary and 2.3/106 in tertiary sector) accounted for 78.5% of fatalities, with specialized workers (35.1%) and construction workers (25%) being the most affected. Falls from above were the leading cause of death (36.7%). A decreasing trend in fatal accidents over the study period was observed, with July having the greatest frequency. The most common causes of death were polytrauma (36.4%) and head injuries (19.2%). Non-Italian workers constitute a noteworthy percentage of fatal cases (24%)., Conclusions: The secondary sector has the most fatal accidents at work despite a decrease in accidents over the observed time period. There is a need for rigorous analysis and interventions, using forensic autopsy case data to help understand causes, and collaboration between institutions is encouraged to develop effective preventive policies.

Background: The General Health Questionnaire-12 (GHQ-12) is a widely used screening tool for mental health assessment however its traditional scoring methods and cutoffs may not adequately capture the mental health complexities of younger populations., Methods: This study explores GHQ-12 responses from a sample of university students. Possible differences in means scores considering gender, age, academic field and degree course were assessed through t-test or one-way ANOVA as appropriate. To deeper understanding different levels of severity and individual item impact on general distress measurement, we applied Item-Response-Theory (IRT) techniques (two-parameters logistic model). We compared students' population with a population of workers who underwent a similar psychological evaluation., Results: A total of 3834 university students participated in the study. Results showed that a significant proportion (79%) of students reported psychological distress. Females and younger students obtained significantly higher average scores compared to others. IRT analysis found item-specific variations in mental distress levels, with more indicative items for short-term fluctuations and potential severe mental health concerns. Latent class analysis identified three distinct subgroups among students (including 20%, 37%, 43% of the participants respectively) with different levels of psychological distress severity. Comparison with a population of adults showed that students reported significantly higher scores with differences in the scale behavior., Conclusion: Our results highlighted the unique mental health challenges faced by students, suggesting a reevaluation of GHQ-12 applicability and cutoff scores for younger populations, emphasizing the need for accurate instruments in mental health evaluation., (© 2024. The Author(s).)

Objective: This observational study investigates workability and its associations with cognitive functioning, sleep quality and technostress among an older working population, also shedding light on potential differences between two occupational categories with different work schedules., Methods: Workers aged over 50, employed in different working sectors (banking/finance, chemical and metal-mechanic industry) were administered a self- report questionnaire including Work Ability Index (WAI), cognitive tests (Stroop Color Task, Corsi Blocks, Digit Span), sleep quality questionnaires (Pittsburgh Sleep Quality Index-PSQI; Insomnia Severity Index-ISI; Ford Insomnia Response to Stress Test-FIRST) and technostress scale. Linear regression models evaluated associations among variables, interaction effects investigated potential moderators., Results: A total of 468 aged workers categorized as white (WCWs; N  = 289, 62%) or blue collars (BCWs; N  = 179, 38%) were enrolled; most BCWs ( N  = 104; 58%) were night shift workers. WCWs reported higher workability, cognitive functioning, sleep quality and lower technostress (except for invasion and privacy subscales) than BCWs. Associations between cognitive functioning and workability were statistically significant only for BCWs [slopes equal to 0.2 (0.33), 0.8 (0.34), -0.02 (0.001) for Memory Span Corsi, Block Span Digit and Interference Speed respectively]; additionally, sleep quality significantly moderated this association ( p  = 0.007). Higher levels of technostress were associated with lower workability, and this relationship was stronger for BCWs., Conclusion: The aging of the workforce has important implications for occupational health and safety. Our findings suggest potential interventions and protective measures to promote older workers' wellbeing; blue-collar workers particularly should benefit from tailored intervention to sustain workability and prevent technostress, considering the role of healthy sleep habits promotion., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer DC declared a shared affiliation with the author CC to the handling editor at the time of review., (Copyright © 2024 Fattori, Comotti, Barnini, Di Tecco, Laurino, Bufano, Ciocan, Serra, Ferrari and Bonzini.)