Saf Health Work.  2016 Jun;7(2):120-123. 10.1016/

Maintenance of Wakefulness and Occupational Injuries among Workers of an Italian Teaching Hospital

  • 1Epidemiologic Service, Regional Health Directorate, Friuli Venezia Giulia Region, Udine, Italy.
  • 2Unit of Hygiene and Clinical Epidemiology, University Hospital of Udine, Udine, Italy.
  • 3Department of Medical and Biological Sciences, University of Udine, Udine, Italy.
  • 4Neurology Clinic, University Hospital of Udine, Udine, Italy.


To assess in a laboratory setting the ability to stay awake in a sample of workers of an Italian hospital and to investigate the association between that ability and the risk of occupational injury.
Nine workers at the University Hospital of Udine who reported an occupational injury in the study period (cases), and seven noninjured workers (controls) underwent a polysomnography and four 40-minute maintenance of wakefulness tests (MWT). Differences in sleep characteristics and in wakefulness maintenance were assessed using Wilcoxon's rank sums tests and Fisher's exact tests.
Controls had greater sleep latency, lower total sleep time, fewer leg movements, and a higher percentage ratio of cycling alternating pattern, were more likely not to fall asleep during the MWT and were less likely to have two or more sleep onsets. Although not all the differences reached statistical significance, cases had lower sleep onset times in Trials 1-3.
In the literature, the evidence of an association between MWT results and real life risk of accidents is weak. Our results suggest a relationship between the MWT results and the risk of injury among hospital workers.


case-control study; maintenance of wakefulness test; occupational injury; teaching hospital
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