title: A case-crossover study of sleep, fatigue, and other transient exposures at workplace and the risk of non-fatal occupational injuries among the employees of an Italian academic hospital.
abstract: OBJECTIVE
  Transient exposure with acute effect has been shown to affect the risk of occupational injuries in various industrial settings and at the healthcare workplace. The objective of this study has been to identify transient exposures related to occupational injury risk in an Italian teaching hospital.
  
  
  METHODS
  A case-crossover study was conducted among the employees of the University Hospital of Udine who reported an occupational injury, commuting accident, or incident involving biological risk in a 15-month period in the years 2013 and 2014. The matched-pair interval approach was used to assess the role of acute sleep deprivation whereas the usual frequency approach was used for other 13 transient exposures.
  
  
  RESULTS
  Sleep hours were not associated with the risk of injuries whereas a significant risk increase was associated with fatigue, rush, distraction, emergency situations, teaching to or being taught by someone, non-compliant patients, bloody operative/work field, excess noise, complex procedures, and anger.
  
  
  CONCLUSIONS
  We identified transient exposures that increased the risk of occupational injuries in an Italian teaching hospital, providing indications for interventions to increase workers' safety at the healthcare workplace. Int J Occup Med Environ Health 2016;29(6):1001-1009.
authors.affiliation: Regional Health Directorate, Friuli Venezia Giulia Region, Udine, Italy (Epidemiologic Service). francesca.valent@regione.fvg.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Valent
authors.affiliation: University Hospital of Udine, Udine, Italy (Unit of Hygiene and Clinical Epidemiology). marika.mariuz@uniud.it.
authors.forename: Marika
authors.initials: M
authors.lastname: Mariuz
authors.affiliation: University Hospital of Udine, Udine, Italy (Unit of Hygiene and Clinical Epidemiology). liva.giulia@aoud.sanita.fvg.it.
authors.forename: Giulia
authors.initials: G
authors.lastname: Liva
authors.affiliation: University Hospital of Udine, Udine, Italy (Accreditation, Clinical Risk Management and Performance Assessment Unit). bellomo.fabrizio@aoud.sanita.fvg.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bellomo
authors.affiliation: University Hospital of Udine, Udine, Italy (Accreditation, Clinical Risk Management and Performance Assessment Unit). decorti.daniela@aoud.sanita.fvg.it.
authors.forename: Daniela
authors.initials: D
authors.lastname: De Corti
authors.affiliation: University Hospital of Udine, Udine, Italy (Accreditation, Clinical Risk Management and Performance Assessment Unit). degan.stefania@aoud.sanita.fvg.it.
authors.forename: Stefania
authors.initials: S
authors.lastname: Degan
authors.affiliation: University Hospital of Udine, Udine, Italy (Accreditation, Clinical Risk Management and Performance Assessment Unit). alberto.ferrazzano@uniud.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ferrazzano
authors.affiliation: University of Udine, Udine, Italy (Department of Medical and Biological Sciences). brusaferro.silvio@aoud.sanita.fvg.it.
authors.forename: Silvio
authors.initials: S
authors.lastname: Brusaferro
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000328:Adult; D018592:Cross-Over Studies; D005221:Fatigue; D005260:Female; D006761:Hospitals; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D060051:Occupational Injuries / Q000453:epidemiology* / Q000209:etiology; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D012307:Risk Factors; D012892:Sleep Deprivation / Q000150:complications*
keywords: Italy; academic hospital; case-crossover; fatigue; occupational injuries; sleep duration