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"Durando, Paolo"
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Co-Morbidity, Mortality, Quality of Life and the Healthcare/Welfare/Social Costs of Disordered Sleep: A Rapid Review
by
Magnavita, Nicola
,
Sannita, Walter
,
Garbarino, Sergio
in
Accidents
,
Comorbidity
,
Cost of Illness
2016
Sleep disorders are frequent (18%–23%) and constitute a major risk factor for psychiatric, cardiovascular, metabolic or hormonal co-morbidity and mortality. Low social status or income, unemployment, life events such as divorce, negative lifestyle habits, and professional requirements (e.g., shift work) are often associated with sleep problems. Sleep disorders affect the quality of life and impair both professional and non-professional activities. Excessive daytime drowsiness resulting from sleep disorders impairs efficiency and safety at work or on the road, and increases the risk of accidents. Poor sleep (either professional or voluntary) has detrimental effects comparable to those of major sleep disorders, but is often neglected. The high incidence and direct/indirect healthcare and welfare costs of sleep disorders and poor sleep currently constitute a major medical problem. Investigation, monitoring and strategies are needed in order to prevent/reduce the effects of these disorders.
Journal Article
Sleep Apnea, Sleep Debt and Daytime Sleepiness Are Independently Associated with Road Accidents. A Cross-Sectional Study on Truck Drivers
by
Magnavita, Nicola
,
Guglielmi, Ottavia
,
Dini, Guglielmo
in
Accidents
,
Accidents, Occupational - statistics & numerical data
,
Accidents, Traffic - statistics & numerical data
2016
Recent research has found evidence of an association between motor vehicle accidents (MVAs) or near miss accidents (NMAs), and excessive daytime sleepiness (EDS) or its main medical cause, Obstructive Sleep Apnea (OSA). However, EDS can also be due to non-medical factors, such as sleep debt (SD), which is common among professional truck drivers. On the opposite side, rest breaks and naps are known to protect against accidents.
To investigate the association of OSA, SD, EDS, rest breaks and naps, with the occurrence of MVAs and NMAs in a large sample of truck drivers.
949 male truck drivers took part in a cross-sectional medical examination and were asked to complete a questionnaire about sleep and waking habits, risk factors for OSA and EDS.
MVAs and NMAs were reported by 34.8% and 9.2% of participants, respectively. MVAs were significantly predicted by OSA (OR = 2.32 CI95% = 1.68-3.20), SD (OR = 1.45 CI95% = 1.29-1.63), EDS (OR = 1.73 CI95% = 1.15-2.61) and prevented by naps (OR = 0.59 CI95% = 0.44-0.79) or rest breaks (OR = 0.63 CI95% = 0.45-0.89). NMAs were significantly predicted by OSA (OR = 2.39 CI95% = 1.47-3.87) and SD (OR = 1.49 CI95% = 1.27-1.76) and prevented by naps (OR = 0.52 CI95% = 0.32-0.85) or rest breaks (OR = 0.49 CI95% = 0.29-0.82).
When OSA, SD or EDS are present, the risk of MVAs or NMAs in truck drivers is severely increased. Taking a rest break or a nap appear to be protective against accidents.
Journal Article
Insomnia is associated with road accidents. Further evidence from a study on truck drivers
by
Magnavita, Nicola
,
Guglielmi, Ottavia
,
Dini, Guglielmo
in
Accidents
,
Accidents, Traffic - psychology
,
Accidents, Traffic - statistics & numerical data
2017
Sleep-related problems are known risk factors for road accidents. However, very few studies have investigated the role played by insomnia and its components, and no data are available for a population of occupational drivers at risk, such as the truck driver category.
To measure the prevalence and impact of insomnia on motor vehicle accidents (MVAs) and near-miss accidents (NMAs) in 949 truck drivers.
Cross-sectional survey.
Insomnia affected 27.5% of the sample. Compared to other drivers, in the 3 years prior to the study, truck drivers with insomnia had reported a significantly higher number of MVAs; they had also reported a greater number of NMAs in the previous 6 months. After correction for the presence of obstructive sleep apnea, excessive daytime sleepiness, short sleep duration, and other concurrent diseases, insomniac truck drivers had an almost two-fold risk of driving accidents (OR: 1.82, CI 95%:1.33-2.49) and a more than three-fold increased risk of near-miss accidents (OR: 3.35, CI95%:2.06-5.45) compared to non-insomniac drivers.
Insomnia emerged as an independent risk factor for MVAs and NMAs. We strongly advise screening commercial drivers for signs and symptoms of insomnia in order to improve health and safety on the road.
Journal Article
Spatial and temporal distribution of the prevalence of unemployment and early retirement in people with multiple sclerosis: A systematic review with meta-analysis
by
Rahmani, Alborz
,
Montecucco, Alfredo
,
Dini, Guglielmo
in
Biology and Life Sciences
,
Cognitive impairment
,
Development and progression
2022
We aimed to summarise the prevalence of unemployment and early retirement among people with MS and analyze data according to a spatio-temporal perspective. We undertook a systematic search of PubMed/MEDLINE, Scopus, SciVerse ScienceDirect, and Web of Science. We included any peer-reviewed original article reporting the prevalence of unemployment and early retirement in the working-age population with MS. We excluded articles off-topic, with other study designs, whose study sample were unlikely to be representative of the MS population and in case of unavailability of the full text or essential information. A random-effects meta-analysis was used to measure overall prevalence estimates of unemployment and early retirement. We used meta-regression and subgroup analysis to evaluate potential moderators of prevalence estimates and the leave-one-out method for sensitivity analyses. Our research identified 153 studies across 29 countries encompassing 188436 subjects with MS. The pooled overall effect size for unemployment and early retirement was 35.6% (95% CI 32.8-38.4; I.sup.2 = 99.31) and 17.2% (95% CI 14.6-20.2; I.sup.2 = 99.13), respectively. The prevalence of unemployment varied according to the year of publication (p < 0.001) and there was a statistically significant decrease in the prevalence of unemployment over time (p = 0.042). Regarding early retirement, only seven (31.8%) estimates obtained from studies that were published before 2010 were below the overall effect size in comparison to 27 (60.0%) estimates extracted from data published between 2010 and 2021 (p = 0.039). There was a significant difference in prevalence according to countries (p < 0.001). Psychiatric illness was an important clinical feature responsible for patients leaving the workforce in regions with a high MS prevalence. Unemployment and early retirement due to MS remain highly prevalent, despite a slight decline in the last decade. The prevalence of unemployment and early retirement varies globally.
Journal Article
Vocational rehabilitation for people with multiple sclerosis: A systematic scoping review of international evidence
by
Grasso, Maria Grazia
,
Nasone, Lorenza
,
Presicce, Giorgia
in
Biology and Life Sciences
,
Care and treatment
,
Employment
2026
People with multiple sclerosis (pwMS) may encounter challenges in their professional lives, due to a combination of environmental and individual factors. According to Escorpizo et al., 2011 framework, Vocational rehabilitation (VR) aims to optimise job participation, providing support in the job access, retention and in the return to work for people with disability. However, the corpus of research on VR for pwMS is poor. This scoping review aims to map the available literature on VR interventions for pwMS, summarising their characteristics, study designs, implementation features, feasibility, and stakeholders' perspectives.
Following the Joanna Briggs Institute (JBI) and the PRISMA-ScR guidelines, seven databases were searched up to October 2025: PubMed, SCOPUS, PsycInfo, CINAHL, Google Scholar, OT Seeker (University of Queensland), and the Physiotherapy Evidence Database (PEDro). Studies were eligible if they were related to VR interventions for pwMS, focused on job access, return, or retention and if they were primary articles. Data were extracted and synthesised following the Population-Concept-Context (PCC) framework.
Out of 2,360 records, 28 articles describing 28 distinct VR interventions were included. Studies were published between 1996 and 2025, mostly from Western countries. Designs ranged from descriptive to randomized trials, with an increasing number of interventional and feasibility studies in recent years. The 61% of the interventions were multi-dimensional delivering a combination of rehabilitation, educational, and reasonable accommodation services. PwMS highlighted the importance of empathetic and individualized approaches, symptom management, and legal counselling as key elements in VR interventions, while logistical, personal and health issues were barriers to participation. Overall, interventions were considered feasible and acceptable.
This is the first comprehensive overview of VR interventions for pwMS, outlining a progressive shift toward multidisciplinary and goal-oriented approaches over time. Despite promising feasibility and stakeholder satisfaction, further rigorous trials are needed to evaluate effectiveness and inform evidence-based implementation of VR programmes in diverse contexts.
Journal Article
Occupational outcomes of people with multiple sclerosis: a scoping review
2022
ObjectivesTo update the knowledge on the occupational outcomes associated with multiple sclerosis (MS), systematically examine the extent, scope and nature of the pre-existing literature and identify research gaps in the existing literature.DesignScoping review.Data sourcesA comprehensive database search of PubMed/MEDLINE, Scopus, SciVerse ScienceDirect and Web of Science was performed. There were no time limits.Eligibility criteriaWe included any peer-reviewed original article reporting the occupational outcomes of people with MS between the ages of 18 and 65 years. We excluded those off-topic and with insufficient information.MethodsThis review was conducted following the Joanna Briggs Institute recommendations and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping review checklist. Screening, reading of full-texts and data extraction was performed in a standardised way by expert reviewers from 14 July 2021 to 31 October 2021. We provided a narrative synthesis and an overview of findings.ResultsThe initial systematic search yielded 104 228 results. After removing duplicates and applying the exclusion criteria, 403 articles were included in the review. In total, the studies evaluated 492 062 subjects with MS. One hundred fifty-four (38.2%) articles were published in the last 5 years, mostly from Europe and North America (50.9% and 33.0%, respectively). Concerning the occupational outcomes, studies mostly addressed unemployment (311, 77.2%), early retirement (120, 29.8%), disability pension (117, 29.0%), sick leave (77, 19.1%), the indirect cost of MS (74, 18.4%) and work characteristics (57, 14.1%). The results were categorised into seven subtopics: ‘Changes in work and occupational status due to MS’, ‘work-related socio-economic consequences of MS’, ‘risk factors for unfavourable occupational outcomes’, ‘reported barriers to employment’, ‘reported job accommodations and vocational rehabilitation strategies’, ‘job satisfaction, stigma, and disclosing the diagnosis in the workplace’ and ‘rating clinical scales’.ConclusionsThere are several issues that deserve further in-depth study by the scientific community in order to improve the occupational outcomes of people with MS.
Journal Article
Leveraging Big Data for Exploring Occupational Diseases-Related Interest at the Level of Scientific Community, Media Coverage and Novel Data Streams: The Example of Silicosis as a Pilot Study
by
Bragazzi, Nicola Luigi
,
Durando, Paolo
,
Dini, Guglielmo
in
Bibliography as Topic
,
Bibliometrics
,
Big Data
2016
Silicosis is an untreatable but preventable occupational disease, caused by exposure to silica. It can progressively evolve to lung impairment, respiratory failure and death, even after exposure has ceased. However, little is known about occupational diseases-related interest at the level of scientific community, media coverage and web behavior. This article aims at filling in this gap of knowledge, taking the silicosis as a case study.
We investigated silicosis-related web-activities using Google Trends (GT) for capturing the Internet behavior worldwide in the years 2004-2015. GT-generated data were, then, compared with the silicosis-related scientific production (i.e., PubMed and Google Scholar), the media coverage (i.e., Google news), the Wikipedia traffic (i.e, Wikitrends) and the usage of new media (i.e., YouTube and Twitter).
A peak in silicosis-related web searches was noticed in 2010-2011: interestingly, both scientific articles production and media coverage markedly increased after these years in a statistically significant way. The public interest and the level of the public engagement were witnessed by an increase in likes, comments, hashtags, and re-tweets. However, it was found that only a small fraction of the posted/uploaded material contained accurate scientific information.
GT could be useful to assess the reaction of the public and the level of public engagement both to novel risk-factors associated to occupational diseases, and possibly related changes in disease natural history, and to the effectiveness of preventive workplace practices and legislative measures adopted to improve occupational health. Further, occupational clinicians should become aware of the topics most frequently searched by patients and proactively address these concerns during the medical examination. Institutional bodies and organisms should be more present and active in digital tools and media to disseminate and communicate scientifically accurate information. This manuscript should be intended as preliminary, exploratory communication, paving the way for further studies.
Journal Article
Parsonage–Turner syndrome following coronavirus disease 2019 immunization with ChAdOx1-S vaccine: a case report and review of the literature
by
Grandis, Marina
,
Schenone, Angelo
,
Icardi, Giancarlo
in
Acute brachial neuritis
,
Adverse reactions
,
Brachial Plexus Neuritis
2021
Background
Parsonage–Turner syndrome is an acute peripheral neuropathy that affects the upper brachial plexus region. Previously published reports demonstrate that the condition can be triggered by surgery, infection, autoimmune diseases, strenuous exercise, trauma, radiation, and vaccination. Parsonage–Turner syndrome has already been reported in three other patients who were vaccinated against coronavirus disease 2019.
Case presentation
We report the case of a 51-year-old Caucasian man without comorbidities who received the first dose of the ChAdOx1-S recombinant vaccine (Vaxzevria, AstraZeneca, Oxford, UK) against coronavirus disease 2019 and was diagnosed with Parsonage–Turner syndrome. A few days after getting vaccinated, the patient reported a progressive increase in pain in the region of vaccine administration. One month later, the shoulder pain was followed by symptoms of hypoesthesia and muscle weakness on abduction and elevation of the left upper limb. Neurological examination revealed an atrophy of the proximal muscles of the left upper limb, accompanied by paresis of the left deltoid, biceps brachii, triceps brachii, and infraspinatus muscles. Electroneuromyography carried out 3 months after the onset of symptoms showed signs consistent with brachial plexus neuritis. The adverse reaction has been properly reported to the Italian Pharmacovigilance System (Italian Medicines Agency—
Agenzia Italiana del Farmaco
.
Conclusion
The increased awareness of such association is essential for early identification and diagnosis and, thus, better clinical outcomes.
Journal Article
Occupational Infections Among Workers in Europe: Protocol for a Scoping Review
by
Rahmani, Alborz
,
Durando, Paolo
,
Mattioli, Stefano
in
Biohazards
,
Epidemiology
,
Europe - epidemiology
2025
Workers may be exposed to different infectious agents, putting them at risk of developing occupational diseases. This can occur in many ways, through deliberate use of specific microorganisms or through potential exposure from close contact with biological material. Infection prevention and control measures against biohazards can reduce the risk of infection among workers. During the last few decades, an increasing proportion of workers in Europe have been exposed to infectious biological agents in their workplace. Knowledge gaps on this topic in Europe have limited our understanding of the overall phenomenon in occupational settings.
This study aims to understand the extent and type of evidence on the epidemiology of occupational or work-related infections caused by bacterial, viral, fungal, and parasitical agents in European countries, the factors affecting their occurrence among workers, and the burden of disease among workers due to occupational risk.
The review will be conducted following the Joanna Briggs Institute methodology for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. This review will consider studies that include data on the epidemiology of occupational infections, risk factors and determinants, and burden of disease among workers employed in specific occupational sectors in European countries in the period 2010-2023. The search will include MEDLINE, Web of Science, and Scopus databases. Independent reviewers (including GD, SC, AR, PD, and SM) will screen the titles, abstracts, and full texts of the selected studies. Data extraction will be performed using a tool developed by the researchers. The data will be mapped and analyzed according to the type of extracted data.
The literature search through different scientific databases started in April 2024 and is expected to be completed by December 2024. The findings will be extracted using an ad hoc data extraction tool, and relevant results will be presented in narrative and tabular form.
This scoping review aims to provide rigorous evidence to fill the knowledge gap in the epidemiology of occupational or work-related infections in European countries, the factors affecting their occurrence, and the burden of disease in different professional settings. Such findings could improve the understanding of this complex occupational phenomenon in the European context, enabling more accurate and up-to-date surveillance of infections incurred in the workplace.
PRR1-10.2196/59606.
Journal Article
Monitoring of liver and kidney profiles in anesthesiologists working in a regional reference teaching hospital in Northern Italy: analysis of health surveillance data using a linear mixed model
by
Rahmani, Alborz
,
Kusznir Vitturi, Bruno
,
Montecucco, Alfredo
in
Adult
,
Anesthesiologists
,
Anesthetics, Inhalation - adverse effects
2024
Anesthesiologists represent an occupational group exposed to specific occupational hazards, including potential exposure to waste anesthetic gas released during medical procedures. In recent decades, halogenated anesthetic gases, such as desflurane and sevoflurane, have largely replaced nitrous oxide, due to better safety profiles and lower adverse health effects. However, possible long-term effects of low concentration exposures are unknown. A longitudinal analysis of health surveillance data was performed to test for possible changes over time in key markers of liver and kidney function. Moreover, we assessed the appropriateness of applying linear mixed models to occupational health data.
A retrospective cohort study was conducted using health surveillance data from a cohort of anesthesiologists and a cohort of unexposed physicians working at the Polyclinic Hospital San Martino of Genoa, Italy, during 2016-2022. A 2-level linear mixed model with covariance structure of first order autoregressive model (AR(1)) type at the first level and unstructured type at the second level was applied.
One hundred seventy subjects were included in the analysis, equally divided between exposed and unexposed. At the first and last periodic examination, liver and kidney markers were not statistically different in the 2 cohorts. The only significant change found related to estimated glomerular filtrate, which was found at the last follow-up to be greater among the exposed (M = 104.18 vs. 90.07, p = 0.007). The linear mixed model showed that anesthetic gas exposure was not associated with any of the outcomes. These results suggest the absence of increase in liver and kidney profile markers in the study population.
Health surveillance data, aggregated and analyzed with appropriate statistical models, allow inferences to be made about potential health effects of workers due to uncontrolled exposures. To this end, the linear mixed model represents a powerful tool for longitudinal analysis of data derived from monitoring workers. Int J Occup Med Environ Health. 2024;37(5):557-68.
Journal Article