[On the statistical and epidemiological evaluation of psycho-physical stress. Research based on the determination of urinary vanilmandelic acid and on questionnaires].
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Biomedical subjects
Publications and source records attributed to V Balestra.
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Although measurement of chemiluminescence has become a widespread tool in the study of phagocytosis of peripheral neutrophils, several problems linked to spontaneous fluctuation in chemiluminescence and the number of variables involved have occasionally either limited its usefulness for clinical and experimental purposes or compelled operators to take particular care when using the technique. In the present paper, sources of variability are investigated and most of the parameters involved are thoroughly analysed and step-by-step normalised. A stochastic calibration procedure for validation of the method is applied and a monofunctional test protocol for quantitative evaluation of plasma opsonizing activity in whole blood chemiluminescence is suggested. With regard to the goal of proposing a reverse monofunctional test, we discuss the reasons why further studies aimed at standardised evaluation of the cellular components are needed.
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UNLABELLED: Policemen are workers exposed to risk from both shiftwork and delicate tasks. This study aims to investigate sleep habits, prevalence of sleep disturbance, sleepiness and hypnotic drug intake in the whole population of Italian State Policemen working in the Genoa district. Italian literature is completely lacking of such data. The study has been carried out by means self administered and assisted questionnaires. Eighty-five percent of the population accepted and answered the questionnaire. Here we focus on the differences between 540 not-shiftworkers, NS, (413 males, 127 females), and 575 shiftworkers, S, (483 males, 92 females). A higher prevalence of difficulties in falling asleep, sleep-latency longer than 20 min. and early awakenings was found in S. No significative differences in daytime sleepiness and drug intake were found between the two groups. Concerning the self-evaluation of the numbers of hours slept during the night and during the 24 hours a higher quantity of sleep was reported by S. CONCLUSIONS: Data seem to indicate a low quality of sleep in S without any evidence of increased daytime sleepiness or increased hypnotic drugs assumption. Shiftworkers seem to compensate their poor quality of sleep with a greater amount of time spent sleeping in the 24 hour period. Such a condition could be the expression of a prolonged recovery from the shift effects.
Sleep disorders and daytime sleepiness are the most frequent disturbances reported by shift-workers. Sleepiness and fatigue can increase the risk of human errors and accidents especially during night work. In order to evaluate the time distribution and the possible role of sleepiness on road accidents in policemen on shift-work on highway patrols over 24 hours, we analyzed 1218 car accidents that occurred on the Italian highway network in the period 1993-1997. Accidents occurring during day shifts were significantly correlated with traffic density while accidents occurring during night shifts were not. During the 19:00-01:00 h shift the number of accidents showed a progressively increasing trend with two significant peaks around 23:00 and 01:00 h. Accidents occurring during the 01:00-07:00 h shift did not show significant trends. Information about sleep habits before starting night shifts were obtained by means of telephone interviews. While 85% of the subjects usually took a nap (30-90 min) before the 01:00-07:00 h shift only 15% took a short nap (< 30 minutes) before the 19:00-01:00 h shift. The data can be interpreted as a balance between circadian factors, homeostasis and fatigue related influences and spontaneously adopted counteracting strategies to increase the level of vigilance during night work hours. While a long nap seems to reduce the risk of accidents during the 01:00-07:00 h shift, policemen seem to underestimate the risk of sleepiness during the shift 19:00-01:00 h shift.
Sleepiness has been identified as a significant risk factor for vehicle accidents, and specific surveys are needed for Italy. The aim of this study was to assess incidence and characteristics of sleep-related vehicle-crashes on Italian highways. The database of the Italian National Institute of Statistics (1993-1997) was the source for the survey (50859 accidents with 1632 (3.2%) ascribed to sleep by the police). The distribution of accidents was evaluated by means of the analysis of variance considering the year, the day of the week, the age and the time of day and their interactions as main factors. The relative risk of sleep-related accidents was also evaluated with reference to the relative traffic density as estimated by the Italian Highways Society. The counts of sleep-related accidents, and even more the relative risk, revealed the presence of peaks and troughs in zones at a higher level of sleepiness and alertness respectively. Death of the driver occurred in 11.4% of sleep related accidents versus 5.6% in general accidents. The great majority of sleep-related accidents occurred to drivers under 35 (61.4%) mainly during the night with an increasing trend in the yearly number of sleep-related accidents, especially on weekends. Therefore sleepiness appears a remarkable risk factor and, in our opinion, its incidence as sole or contributory cause of accidents on Italian highways is still underestimated.
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