Search

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.

Study Objectives: Night work can be dangerous because both circadian sleep propensity (process C) and sleep pressure due to the prolonged wakefulness (process S) contribute to the reduction of vigilance levels. As naps are a countermeasure to sleepiness, this study evaluates the role they play in preventing sleep-related accidents in Italian shift-working police drivers., Design/setting/participants: The study concerns highway car accidents that occurred to Italian shift-working police drivers; it was performed in 2 steps: a retrospective analysis of the overall number of accidents that occurred during the years 1993--1997 (n, 1195), followed by a validation analysis of a smaller cohort of accidents prospectively collected during 2003 (n, 84)., Interventions: N/A., Measurements and Results: RETROSPECTIVE ANALYSIS: The influence of process S, process C, driver characteristics, and context conditions on accident risk, estimated by means of Cox hazard regression, revealed that nighttime accident risk was mainly influenced by process S levels. Consequently, an experimental mathematical model linking the hourly observed number of accidents to process S levels was designed. Its generalization to the theoretical case of drivers omitting naps showed an increase of about 38% of accidents. PROSPECTIVE ANALYSIS: In order to validate our results, we compared retrospective and prospective sleep patterns: no statistical difference was found. Again, the hourly number of accidents increased with homeostatic sleep pressure; the theoretical efficacy of napping was quantified in 48% accidents decrease., Conclusions: Our data seem to confirm that napping before working a night shift is an effective countermeasure to alertness and performance deterioration associated with night work. Moreover, this self-initiated behavior could have a prophylactic efficacy in reducing the number of car accidents.

The aim of this study was to evaluate the effects of shiftwork on sleepiness, sleep disorders and sleep related accidents in a population of policemen. Data concerning age and physical characteristics, working conditions, sleep problems and accidents were collected by a questionnaire. Sleepiness was evaluated by the Epworth Sleepiness Scale (ESS) while the presence of sleep disorders was evaluated by a score (SD-score) drawn from indicators of insomnia, breathing disorders, periodic limb movements-restless leg syndrome and hypersomnia. The effects of age, gender, body mass index, working condition and seniority on ESS, SD-score and accidents were analysed by linear and logistic regression. Participants were 1280 policemen: 611 shiftworkers and 669 non-shiftworkers. The ESS scores were not higher in shiftworkers than in non-shiftworkers, but the SD-score was found to be significantly influenced by shiftwork condition and seniority. The occurrence of sleep-related accidents was found to have been significantly increased for shiftworkers and related to the presence of indicators of sleep disorders. The sleepiness could be underestimated or even overcome by the influence of stressing conditions. However our data should alert occupational health physicians for the diagnosis and prevention of possible lurking intrinsic sleep disorders likely to influence health problems and risk of accidents in shiftworkers.