Evaluating the effectiveness of artificial intelligence-based tools in detecting and understanding sleep health misinformation: Comparative analysis using Google Bard and OpenAI ChatGPT-4.

This study evaluates the performance of two major artificial intelligence-based tools (ChatGPT-4 and Google Bard) in debunking sleep-related myths. More in detail, the present research assessed 20 sleep misconceptions using a 5-point Likert scale for falseness and public health significance, comparing responses of artificial intelligence tools with expert opinions. The results indicated that Google Bard correctly identified 19 out of 20 statements as false (95.0% accuracy), not differing from ChatGPT-4 (85.0% accuracy, Fisher's exact test p = 0.615). Google Bard's ratings of the falseness of the sleep misconceptions averaged 4.25 ± 0.70, showing a moderately negative skewness (-0.42) and kurtosis (-0.83), and suggesting a distribution with fewer extreme values compared with ChatGPT-4. In assessing public health significance, Google Bard's mean score was 2.4 ± 0.80, with skewness and kurtosis of 0.36 and -0.07, respectively, indicating a more normal distribution compared with ChatGPT-4. The inter-rater agreement between Google Bard and sleep experts had an intra-class correlation coefficient of 0.58 for falseness and 0.69 for public health significance, showing moderate alignment (p = 0.065 and p = 0.014, respectively). Text-mining analysis revealed Google Bard's focus on practical advice, while ChatGPT-4 concentrated on theoretical aspects of sleep. The readability analysis suggested Google Bard's responses were more accessible, aligning with 8th-grade level material, versus ChatGPT-4's 12th-grade level complexity. The study demonstrates the potential of artificial intelligence in public health education, especially in sleep health, and underscores the importance of accurate, reliable artificial intelligence-generated information, calling for further collaboration between artificial intelligence developers, sleep health professionals and educators to enhance the effectiveness of sleep health promotion.

Fitness to Drive: It is Time for Evidence-Based Consensus and Italian Guidelines for Medical Driving Assessment.

European Union (EU) and non-EU countries have adopted different medical procedures for the issuance and renewal of a driver's license showing relevant matters of concern. In Europe, EU directives have been only partially supplemented with national laws, and there is a paucity of evidence-based criteria and methods for fitness-to-drive assessment. For instance, there is no agreement on standards for establishing which is the competent authority charged with the medical examination. Furthermore, license conditions, restrictions, or vehicle modifications, which appear as "limited use" codes on the driver's license are not regulated. This may generate confusion and deformity when it comes to the medico-legal evaluation, with potential ethical implications due to lack of transparency and equity and legal disputes between citizens and competent authorities. In this article, Italian experts on fitness-to-drive medical assessment highlight some major issues concerning the medical driving assessment activity in the EU. The Italian experience is shown as a case study, which is representative of other EU member states, for launching a call for evidence-based consensus documents and scientific guidelines on this topic, which may be helpful to international regulators and medico-legal stakeholders.

Does observance of Ramadan affect sleep in athletes and physically active individuals? A systematic review and meta-analysis.

The purpose of this systematic review and meta-analysis is to provide an accurate description of the effect of Ramadan observance on sleep duration, sleep quality, daily nap duration, and daytime sleepiness in athletes and physically active individuals. Five electronic databases (PubMed, Web of Science, Scopus, Wiley, and Taylor and Francis) were used to search for relevant studies conducted with athletes or physically active individuals during Ramadan, published in any language, and available before May 23, 2021. Studies that included assessments of sleep quantity and/or quality, and/or daytime sleepiness, and/or daily naps in athletes and physically active individuals were included. The methodological quality of the studies was assessed using "QualSyst". Of the 18 papers included in this study (298 participants in total), 14 were of strong quality, two were moderate, and the remaining two were rated as weak. Individuals who continued to train during Ramadan experienced a decrease in sleep duration (number of studies, K = 17, number of participants, N = 289, g = -0.766, 95% confidence interval [CI] -1.199 to -0.333, p = 0.001). Additionally, the global score of the Pittsburgh Sleep Quality Index increased from 4.053 (K = 5, N = 65, 95% CI 3.071-5.034) pre-Ramadan, to 5.346 (95% CI 4.362-6.333) during Ramadan, indicating a decrease in sleep quality. The duration of daytime naps increased during compared to pre-Ramadan (K = 2, N = 31, g = 1.020, 95% CI 0.595-1.445, p = 0.000), whereas Epworth Sleepiness Scale scores remained unchanged during versus pre-Ramadan (K = 3, N = 31, g = 0.190, 95% CI -0.139-0.519, p = 0.257). In conclusion, individuals who continued to train during Ramadan experienced a decrease in sleep duration, impairment of sleep quality, and increase in daytime nap duration, with no change in daytime sleepiness levels.

Expression and Biological Functions of miRNAs in Chronic Pain: A Review on Human Studies.

Chronic pain is a major public health problem and an economic burden worldwide. However, its underlying pathological mechanisms remain unclear. MicroRNAs (miRNAs) are a class of small noncoding RNAs that post-transcriptionally regulate gene expression and serve key roles in physiological and pathological processes. This review aims to synthesize the human studies examining miRNA expression in the pathogenesis of chronic primary pain and chronic secondary pain. Additionally, to understand the potential pathophysiological impact of miRNAs in these conditions, an in silico analysis was performed to reveal the target genes and pathways involved in primary and secondary pain and their differential regulation in the different types of chronic pain. The findings, methodological issues and challenges of miRNA research in the pathophysiology of chronic pain are discussed. The available evidence suggests the potential role of miRNA in disease pathogenesis and possibly the pain process, eventually enabling this role to be exploited for pain monitoring and management.

Global, regional, and national burden of Guillain-Barré syndrome and its underlying causes from 1990 to 2019.

BACKGROUND: This article presents the first detailed analysis of the prevalence and disability burden of Guillain-Barré syndrome (GBS) from 1990 to 2019 by cause, age, sex, and Socio-demographic Index (SDI) in 204 countries and territories. METHODS: Data from the Global Burden of Diseases Study (GBD) 2019 were used. GBD 2019 modelled the prevalence of GBS using hospital and claims data. Years lived with disability (YLDs) were estimated as the product of the GBS prevalence and the disability weight. This article also reported proportions in the age-standardised prevalence rate that were due to six underlying causes of GBS. RESULTS: In 2019, there were 150,095 [95% uncertainty intervals (UI) 119,924 to 188,309] total cases of GBS worldwide, which resulted in 44,407 (95% UI 28,016 to 64,777) YLDs. Globally, there was a 6.4% (95% UI 3.6 to 9.5) increase in the age-standardised prevalence of GBS per 100,000 population between 1990 and 2019. High-income Asia Pacific [1.9 (95% UI: 1.5 to 2.4)] and East Asia [0.8 (95% UI: 0.6 to 1.0)] had the highest and lowest age-standardised prevalence rates (per 100,000), respectively, in 2019. Nationally, Japan [6.4 (95% UI: 5.3 to 7.7)] and China [0.8 (95% UI: 0.6 to 1.0)] had the highest and lowest age-standardised prevalence rates (per 100,000). The age-standardised burden of GBS increased with increasing age and was higher in males in all age groups. Furthermore, the age-standardised prevalence of GBS (per 100,000) had a positive association with the level of development, as measured by SDI, although this association was not strong. Upper respiratory infections and unknown causes accounted for the highest proportions of underlying causes. CONCLUSIONS: Globally, the prevalence of GBS continues to increase. Geographical differences and strategies aimed at preventing infectious diseases should be considered in future health policy planning and decision-making processes. This study had several limitations, such as using the same disability weight for all causes and a reliance on hospital- and self-reported data, which should be addressed in future research.

Can intermittent, time-restricted circadian fasting modulate cutaneous severity of dermatological disorders? Insights from a multicenter, observational, prospective study.

The impact of intermittent circadian fasting (ICF) on skin disorders is far to be plenty deciphered. However, the circadian rhythm seems to exert a modulation on dermatoses severity, drug-response, and drug-related side effects. We aimed to evaluate ICF effect in the daily management of dermatological diseases. In this multicenter, prospective observational study we enrolled patients willing to undergo the 2018 ICF (from May 16 to June 14). Dermatoses severity were evaluated at the beginning of ICF (T0) and at the end of ICF (T1) by two independent board-certified dermatologists. Seventy-two patients suffering from different dermatoses volunteered to take part into the study. They displayed a mean age of 40.38 ± 12.46 years (median 41.0 years), 25 subjects were males (34.7% of the entire sample). The median weight change was 0 kg. The overall ICF effect size was -0.58 ([95% CI -0.83 to -0.33], P < .0001, medium effect size). Since in the present investigation no weight loss occurred, we could speculate that the impact of fasting in terms of improvements in the clinical symptoms could be rather due to the perturbation of the human biological clock. Despite our data remain preliminary, a chronobiological approach should be incorporated in the dermatological armamentarium.

Suicide mortality data from the Italian police during the COVID-19 pandemic.

Suicide is a major public health issue worldwide, with about 880,000 dying annually for such a cause. The COVID-19 pandemic has led to severe social disruption both from health and economic standpoints. Law enforcement personnel have been significantly involved in helping to face the many difficulties due to the pandemic. Police officers have been subjected to further stress from managing social restrictions imposed by governments to contain the pandemic. The Italian State Police steadily approximate 100,000 people aged 25-65 years: 14 subjects (mean age 43.64 years) died by suicide in 2015, 7 (mean age 47.5 years) in 2016, 13 (mean age 45.62 years) in 2017, 10 (mean age 48.1 years) in 2018, 18 (mean age 46.78 years) in 2019, and 12 (mean age 52 years) in 2020. Our records excluded significant changes in suicide incidence rate within 2015-2020 (till December 2020). However, the COVID-19 pandemic spread faster in Italy than in other regions, meaning that the Italian State Police possibly faced prolonged, intense stress. Suicide prevention, therefore, remains a priority, especially during this difficult time.

Excessive daytime sleepiness in obstructive sleep apnea: implications for driving licenses.

PURPOSE: Excessive daytime sleepiness (EDS) while driving is a major international public health issue resulting in a more than doubled risk of motor vehicle accidents (MVAs). Obstructive sleep apnea (OSA) is the most frequent medical cause of EDS. Therefore, the European Union Directive 2014/85/EU determined that "untreated moderate to severe OSA coincident with EDS constitutes a medical disorder leading to unfitness to drive." The paper aims are to provide a brief review of sleepiness and its implications for driving safety, as well as to describe the subjective and objective methods to accurately evaluate EDS in order to assess fitness to drive in patients with OSA. METHODS: We examined databases including PubMed, Medline, and EMBASE using the search terms "sleepiness at the wheel, excessive daytime sleepiness, sleepiness measure, sleep-wake cycle, obstructive sleep apnea, driving license, fitness to drive." RESULTS: Significant interindividual variability in EDS exists in patients with comparable severity of OSA. Objective methods of measuring EDS are too expensive and time consuming to be suitable for the certification of driving licenses. The reliability of subjective methods depends upon the clinical setting and subjective tools assess only limited aspects of EDS. Objective measures, such as biochemical biomarkers, must, therefore, support subjective methods. CONCLUSIONS: Extensive data have supported different subjective and objective methods for the appraisal of EDS in patients with OSA depending upon the clinical and experimental setting. Challenges remain to determine an appropriate tool for the evaluation of fitness to drive.

Association of Anxiety and Depression in Obstructive Sleep Apnea Patients: A Systematic Review and Meta-Analysis.

Background: Obstructive sleep apnea (OSA) has been associated with mental disorders, but the strength of this association is unknown. The aim of our study was to investigate the association among OSA, depression, and anxiety in adults and to quantitatively summarize the results. Methods: A literature search in Medline, PubMed, PsycInfo, Scopus, and Web of Science was conducted. Seventy-three articles were selected for study. Results: The pooled prevalence of depressive and anxious symptoms in OSA patients was 35% (95% CI, 28-41%) and 32% (95% CI, 22-42%), respectively. Conclusions: The association between OSA, anxiety, and depression indicates the value of an early diagnosis and personalized treatment of OSA to improve mental disorders conditioning compliance to therapy. These conditions share a probably bidirectional relationship.

Fitness for working in a policeman being treated for OSAS.

A policeman who has been ill with OSAS for 10 years is in optimal CPAP therapy. During this time, the overall assessment of his work activities was excellent and he had no traffic accidents or accidents at work. Concerning his work as a policeman, the Medical Commission of 1st instance considered him unfit to work. Conversely, the Medical Commission of 2nd instance declared him fit to work. In the adult general population, the prevalence of moderate and severe OSAS is more than 20%. It is therefore likely that there are many policemen affected by OSAS and the number of requests for assessments of fitness to work in those with OSAS will increase. It is a priority: (i) to integrate the training course of the medical staff of the Police Forces and the Armed Forces with updates on OSAS; (ii) to delete OSAS from the list of chronic diseases for which night shift work is not indicated.

Sleep quality, obstructive sleep apnea, and psychological distress in truck drivers: a cross-sectional study.

PURPOSE: Sleep disorders are highly prevalent in truck drivers. The aim of this study is to evaluate the prevalence of self-reported obstructive sleep apnea (OSA) and poor sleep quality in truck drivers, and to analyze the relationship between sleep problems and mental health. METHODS: A total of 526 male truck drivers (mean age 45.9; DS 9.4) responded to a questionnaire about risk factors for OSA (STOP-Bang), sleep quality perception (Pittsburg sleep questionnaire inventory, PSQI), excessive daytime sleepiness (Epworth sleepiness scale, ESS), and psychological disorders (general health questionnaire, GHQ-12). RESULTS: It was found that 51.1% of the drivers were at risk of OSA, 17.3% had bad sleep quality, and 8.9% had excessive daytime sleepiness (EDS). The association between psychological distress, OSA (OR = 1.67; CI 95% 0.99-2.83; p = 0.057), bad sleep quality (OR = 2.58; CI 95% 1.52-4.37; p < 0.001), and EDS (OR = 1.65; CI 95% 0.83-3.30; p = 0.151) was assessed. CONCLUSIONS: The high prevalence of sleep problems, especially suspected OSA, and low quality of sleep in truck drivers can worsen the general and psychological wellbeing of the workers. Educational programs focusing on sleep hygiene and behavioral interventions are needed to promote adequate sleep habits and improve individual and public health.

Obstructive sleep apnea (OSA) and driving safety. / Apnee ostruttive nel soono (OSA) e Sicurezza alla Guida.

Intermittent hypoxia and sleep fragmentation cause excessive daytime sleepiness (EDS) and cognitive impairment in obstructive sleep apnoea (OSA); neuroimaging and neurophysiological studies in patients with OSA have delineated a putative regional "fingerprint" of OSA-induced brain injury: a disconnection of the fronto-parietal regions and a disruption of the thalamocortical oscillator, with involvement of the hippocampal formation with impaired attention, awareness, working memory, time reaction, visuoconstructive and executive functions. For these reasons OSA is the main medical cause of EDS and is also associated with an increased risk of motor vehicle accidents (MVAs). About 7% of MVAs for a population of male drivers involved in MVAs are attributable to OSA. Subjects with OSA have nearly twofold increased odds of work accidents. Professional drivers add fatigue to sleep deprivation. A higher risk of MVAs cannot be adequately explained by OSA and sleep deprivation (SD), and EDS is a further, independent risk factor like the other two. There is an association between the amount of hours of sleep per night and MVA or near miss accidents (NMA) rates with an inverse linear correlation. 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 MVAs e NMAs and they should be considered a primary prevention strategy together with screening for OSA, EDS, and SD.

Obstructive sleep apnea (OSA): healthcare and social costs. / La Sindrome dell 'Apnea Ostruttiva nel sonno (OSAS): I costi sanitari e sociali.

Obstructive sleep apnea (OSA) syndrome is an underdiagnosed widespread chronic disease involving both sexes and all ages. Undiagnosed and untreated OSA is associated with workplace productivity losses and significant direct and indirect medical costs. A cost analysis of OSA was carried out in Italy ten years ago. Overall OSA medical costs, largely due to treatment of comorbidity, amounted to € 2,9 billion or 55% of total medical costs. Direct medical costs, due to diagnosis and treatment of OSA, were 6% of overall OSA costs, while medical costs due to the absence of diagnosis and of prevention of comorbidities represented 49% of the overall cost. Non-medical costs made up for the remaining 45%. € 1.5 billion could be saved by promoting screening campaigns aimed at detecting OSA that would otherwise remain undiagnosed and by improving adherence to treatment. Bearing in mind the increasing OSA prevalence and the recent quantification of avoidable OSA-related road accidents, the real cost of OSA is higher than estimated up to now.

Workplace health promotion programs for older workers in Italy.

BACKGROUND: Italy is the European country with the highest number of citizens over the age of sixty. In recent years, the unsustainability of the social security system has forced the Italian government to raise the retirement age and reduce the chances of early exit, thus sharply increasing the age of the workforce. Consequently, a significant proportion of older workers are currently obliged to do jobs that were designed for young people. Systematic health promotion intervention for older workers is therefore essential. OBJECTIVES: The European Pro Health 65+ project aims at selecting and validating best practices for successful/active aging. In this context we set out to review workplace health promotion projects carried out in Italy. METHODS: To ascertain examples of workplace health promotion for older workers (WHPOW), we carried out a review of the scientific and grey literature together with a survey of companies. RESULTS: We detected 102 WHPOW research studies conducted in conjunction with supranational organizations, public institutions, companies, social partners, NGOs and educational institutions. The main objectives of the WHPOW were to improve the work environment, the qualifications of older workers and attitudes towards the elderly, and, in many cases, also to improve work organization. CONCLUSIONS: The best way to promote effective WHPOW interventions is by disseminating awareness of best practices and correct methods of analysis. Our study suggests ways of enhancing WHPOW at both a national and European level.

[The operational role of the occupational health physician in the assessment and management of health risks related to night risks]. / Il ruolo del medico del lavoro nella valutazione e nella gestione dei rischi correlati al lavoro notturno alla luce della disciplina nazionale e comunitaria.

The operational role of the occupational health physician in the assessment and management of health risks related to night work. Night work, in the last 30-40 years, has been extended to almost all areas of employment. The potential effects on workers' health--related to the disruption of circadian rhythms--are now well defined and studied in the Literature. All issues about the protection of safety and health for night workers are governed by the Italian Legislative Decree no. 66/2003 and subsequent amendments. The management of night work hasn't been included into the main Law on Occupational Safety and Health (Italian Legislative Decree no. 81/2008 and subsequent amendments) and a coordination between the two disciplines is desirable. The occupational health physician, as a global consultant for the protection of all health issues into a company, has to evaluate the potential effects of night work on health, both individually and as a group of workers. In this way, the physician may use either traditional tools (history, physical examination, blood tests) or innovative tools (questionnaires, health promotion programs, interventions on shift schedules). In the management of night work is useful to employ schedules that respect both psychophysical integrity and social welfare of workers and the needs of the production. The occupational health physician plays a significant role in information and training of workers, both individually and as a group of workers, and in the organization of health promotion programs (whit a voluntary participation by the workers).

Measuring psychological trauma in the workplace: psychometric properties of the Italian version of the psychological injury risk indicator-a cross-sectional study.

BACKGROUND: The aim of this study was to cross-culturally adapt the Psychological Injury Risk Indicator (PIRI) and to validate its psychometric properties. METHODS: Workers from 24 small companies were invited to self-complete the PIRI before undergoing their routine medical examination at the workplace. All participants (841 out of 845, 99.6%) were also asked to report occupational injuries and episodes of violence that had occurred at the workplace in the previous 12 months and were given the General Health Questionnaire (GHQ12) to complete. RESULTS: Exploratory factor analysis revealed a 4-factor structure, "sleep problems," "recovery failure," "posttraumatic stress symptoms," and "chronic fatigue," which were the same subscales observed in the original version. The internal consistency was excellent (alpha = 0.932). ROC curve analysis revealed that the PIRI was much more efficient than GHQ12 in diagnosing workers who had suffered trauma (workplace violence or injury) in the previous year, as it revealed an area under the curve (AUC) of 0.679 (95% CI: 0.625-0.734) for the PIRI, while for the GHQ12 the AUC was 0.551 (not significant). CONCLUSIONS: This study, performed on a large population of workers, provides evidence of the validity of the Italian version of the PIRI.

Motor vehicle accidents and obstructive sleep apnea syndrome: A methodology to calculate the related burden of injuries.

The association between motor vehicle accidents (MVAs) and obstructive sleep apnea syndrome (OSAS) has always been quantified as risk of MVAs for individual drivers with OSAS. We evaluated the expected injured patients per year attributable to OSAS-dependent MVAs in a general population. By combining OSAS prevalence and OSAS-dependent MVAs odds ratio, we assessed the population attributable fraction (PAF), an epidemiological tool that can be used to quantify the proportion of road traffic injuries (RTIs) attributable to OSAS. For an apnea hypopnea index >5, the weighed median and combined average of OSAS prevalence were 4.4 (95% confidence interval (CI): 3.7-7.5) and 4.7 (95% CI: 4.2-5.2), respectively; values of risk of OSAS-dependent MVAs were 2.83 (95% CI: 2.72-3.08) and 2.52 (95% CI: 2.07-3.08), respectively. The PAF showed weighed median and combined average values of 6.6 (95% CI: 4.3-9.8) and 7.3% (95% CI: 6.0-13.5), respectively. Our results show that about 7% of RTIs for a population of male drivers involved in MVAs are attributable to OSAS. This value can be used to assess the potential impact, on the reduction of incidence of the motor vehicle injuries, of prevention programs aimed at reducing the number of subjects with an undiagnosed and/or untreated OSAS.

Effect of ethylic alcohol on attentive functions involved in driving abilities.

The burden of injuries due to drunk drivers has been estimated only indirectly. Indeed, alcohol is considered one of the most important contributing cause of car crash injuries and its effect on cognitive functions needs to be better elucidated. Aims of the study were i) to examine the effect of alcohol on attentive abilities involved while driving, and ii) to investigate whether Italian law limits for safe driving are sufficiently accurate to prevent risky behaviours and car crash risk while driving. We conducted a cross-over study at IRCCS Fondazione Santa Lucia Rehabilitation Hospital in Rome. Thirty-two healthy subjects were enrolled in this experiment. Participants were submitted to an attentive test battery assessing attention before taking Ethylic Alcohol (EA-) and after taking EA (EA+). In the EA+ condition subjects drank enough wine until the blood alcohol concentration, measured by means of Breath Analyzer, was equal to or higher than 0.5 g/l. Data analysis revealed that after alcohol assumption, tonic and phasic alertness, selective, divided attention and vigilance were significantly impaired when BAC level was at least 0.5 g/l. These data reveal that alcohol has a negative effect on attentive functions which are primarily involved in driving skills and that Italian law limits are adequate to prevent risky driving behaviour.

[24-hour work: the interaction of stress and changes in the sleep-wake cycle in the police force]. / II lavoro H24: I'interazione stress e alterazione del ritmo sonno-veglia nelle forze di polizia.

Disruption in police officers. In recent years there has been a widespread growth in services, available regardless of time or day organization (24/7 service) and a diffuse increase in their use, both in work and private lives, generally ignoring the importance of a regular sleep organization. Police officers - often need to work extended shifts and long hours under highly stressful conditions, which results in reduced levels of safety and operational effectiveness. In numerous studies, perceived stress has been found to correlate with both subjective and objective disturbances in sleep. Consequently, excessive daytime sleepiness is one of the most frequent health and safety hazards that police officers have to deal with. Sleep deprivation affects performance outcomes through a wide range of cognitive domains. Sleepiness and fatigue, caused by sleep loss, extended work and wakefulness, circadian misalignment and sleep disorders are major causes of workplace human errors, incidents, and accidents. Therefore, prevention of sleep loss, high levels of stress and fatigue is a key factor to consider when assessing emergency intervention. In order to combat fatigue and sleepiness, a 30-90 minutes nap before night shift could be a viable option.

[Evaluation methods in the work/stress correlations in law enforcement]. / Metodi di valutazione dello-stress lavoro-correlato nelle Forze dell'Ordine.

UNLABELLED: Stress in police: assessment methods. INTRODUCTION: Police work is unanimously considered stressful. Prevention of stress in police is of the utmost importance, as a distressed officer could be hazardous for third parties. There is scientific evidence that the relationship between occupational stressors and their psychological and physical consequences can be described by Karasek's demand-control-support (DCS) model and the effort / reward imbalance (ERI) model of Siegrist. METHOD: This study summarizes the results of surveys conducted using the DCS and ERI questionnaires.on police officers from the VI Mobile Unit of Genoa who were engaged in public order management at the G8 summit in L'Aquila in 2009. RESULTS: In spite of the high alert due to expected threats to public order during the G8 meeting, police officers were not affected by "distress". When the policemen were compared to other categories of workers, their stress levels were in the lowest range. In most cases, the personality profile of these workers did not differ substantially from that of the general population. There was an association between personality and stress response. The levels of perceived stress were significantly associated with absence from work. The prevalence of mental disorders in police officers was significantly lower than that of the general population. Occupational stress was associated with indicators of depression, anxiety and burnout. CONCLUSIONS: The DCS and ERI models yielded complementary results and proved to be effective in assessing the effects of stress in law enforcement. The extent of perceived stress does not directly depend on external events, but on the way in which these are handled: routine work may be more stressful than a single critical event. Special police forces are particularly resilient to stress, partly due to the characteristics and personality of individual officers, but mainly on account of their training. Occupational stress is associated with a lower level of psychological well-being and an increase in the frequency of absences from work.