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Perzl J, Riedl EM, Thomas J. Measuring Situational Cognitive Performance in the Wild: A Psychometric Evaluation of Three Brief Smartphone-Based Test Procedures. Assessment 2024; 31:1270-1291. [PMID: 38097924 PMCID: PMC11292980 DOI: 10.1177/10731911231213845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
Mobile devices provide new opportunities to draw conclusions about cognitive performance in everyday situations. To gain insights into cognitive performance patterns in healthy adult populations, we adapted three established cognitive tests for smartphone use: the Digit Symbol Substitution Task (DSST), Sustained Attention to Response Task (SART), and Psychomotor Vigilance Task (PVT). To increase their feasibility for ambulatory assessment, we identified the minimum measurement durations that provide reliable and valid state measures of cognitive performance. Over 2 weeks, 46 participants performed each test once per day at random times, along with self-reports (e.g., on concentration, mood, and mental demands). The validity and reliability of change are promising for the 30-second PVT and 90-second DSST and SART. The DSST and SART provide fruitful outcomes for ambulatory field studies linked to mood, stress, and mental demands. We provide digital versions of the adapted DSST and SART online for free.
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Affiliation(s)
- Johanna Perzl
- Catholic University of Eichstätt-Ingolstadt, Germany
- University of Würzburg, Germany
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2
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Weetman S, Roche M, Leckie T, Samuels T, Hodgson L. Feasibility of application-based psychomotor vigilance testing to assess fatigue in doctors working night shifts and correlation with smartwatch assessed shift intensity. Occup Environ Med 2024; 81:252-257. [PMID: 38658047 DOI: 10.1136/oemed-2023-109311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 04/13/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES To assess: (1) the feasibility of novel data collection methods (wearable technology and an application-based psychomotor vigilance test (PVT)), (2) the impact of night shift working on fatigue, both objective and perceived, for doctors working night shifts in acute hospital specialties and (3) the effects of shift intensity and naps obtained on participant fatigue. METHODS We adopted an innovative, multimodal approach to data collection allowing assessment of objective and perceived measures of fatigue, in addition to markers of shift intensity. This comprised 5 min PVT for objective quantification of fatigue (via the validated, smartphone-based NASA PVT+ application), wearable electronic devices (Fitbit Versa2) for assessment of shift intensity (step counts and active minutes) and questionnaires to elicit perceptions of fatigue and shift intensity. RESULTS Data was collected from 25 participants for a total of 145 night shifts. Objective fatigue (assessed by PVT performance) was significantly increased post night shift, with a PVT mean reaction time 257 ms pre shift versus 283 ms post shift (p<0.0001). However, differences in PVT pre and post shift were not affected by night shift intensity, nor breaks or naps taken on shift. Differences in psychomotor performance between doctors working in different specialties were also observed. CONCLUSIONS The data collection methods used were found to be feasible with good participant engagement. Findings support existing evidence that night shift working in healthcare workers is associated with fatigue, with psychomotor impairment observed post shift. Lower shift intensity and napping did not appear to mitigate this effect.
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Affiliation(s)
- Stefan Weetman
- Anaesthetics and Intensive Care, University Hospitals Sussex NHS Foundation Trust, Worthing, UK
| | - Matthew Roche
- Anaesthetics and Intensive Care, University Hospitals Sussex NHS Foundation Trust, Worthing, UK
| | - Todd Leckie
- Anaesthetics and Intensive Care, University Hospitals Sussex NHS Foundation Trust, Worthing, UK
| | - Theophilus Samuels
- Anaesthetics and Intensive Care, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
| | - Luke Hodgson
- Respiratory Medicine and Intensive Care, University Hospitals Sussex NHS Foundation Trust, Worthing, UK
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3
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Marvin G, Schram B, Orr R, Canetti EFD. Occupation-Induced Fatigue and Impacts on Emergency First Responders: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7055. [PMID: 37998287 PMCID: PMC10671419 DOI: 10.3390/ijerph20227055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
Fatigue in emergency first responders (EFRs) is known to affect performance abilities and safety outcomes for both patients and EFRs. The primary aim of this review was to determine the main contributors to occupation-induced fatigue in EFRs and its subsequent impacts. Following the PRIMSA checklist, academic databases (Medline, Embase, CINAHL, and SPORTDiscus) were searched using key terms with results subjected to inclusion and exclusion criteria. Populations of interest were firefighters, paramedics, or emergency call centre personnel. Of the 5633 records identified, 43 studies, which reported on 186 unique measures from a total population of 6373 participants, informed the review. Synthesis revealed fatigue was caused by lack of sleep during the shift and consistent poor sleep quality which negatively impacted cognitive function, alertness, and physical and mental health while increasing safety-compromising behaviours and injuries. Both subjective and objective assessments of fatigue are necessary for effective risk management in EFRs. EFRs that are consistently fatigued are at a greater risk of poor physical and mental health, reduced cognitive function, and increased injuries. No studies reported on fatigue in emergency call centre personnel, highlighting a literature gap. Funding was provided by the Australian Capital Territory Emergency Services Agency. Preregistration was filed in OSF: osf.io/26f3s.
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Affiliation(s)
- Graham Marvin
- Tactical Research Unit, Faculty of Health Sciences & Medicine, Bond University, Robina, QLD 4226, Australia
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4
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Rose C, Ter Avest E, Lyon RM. Fatigue risk assessment of a Helicopter Emergency Medical Service crew working a 24/7 shift pattern: results of a prospective service evaluation. Scand J Trauma Resusc Emerg Med 2023; 31:72. [PMID: 37924156 PMCID: PMC10623805 DOI: 10.1186/s13049-023-01143-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND The work of Helicopter Emergency Medical Services (HEMS) teams crosses the boundaries of several high-risk occupations including medicine, aviation, and transport. Working conditions can be challenging and operational demands requires a 24-h rota, resulting in disruption of the normal circadian rhythm. HEMS crews are therefore prone to both mental and physical fatigue. As fatigue in medical providers is linked to poor cognitive performance, degradation of psychomotor skills and error, this study aimed to explore the existence of predictable patterns of crew-fatigue in a HEMS service. METHODS HEMS medical crew members working a 3-on 3-off forward rotating rota with a 5-week shift cycle were asked to do psychomotor vigilance tests (PVT) as an objective measure of fatigue. PVT testing was undertaken at the start, mid- and at the end of every shift during a full 5-week shift cycle. In addition, they were asked to score subjective tiredness with the Samn-Perelli Fatigue Scale (SPFS), and to keep a Transport Fatigue Assessment shift log, wherein they noted shift characteristics potentially related to fatigue. Primary outcome of interest was defined as the change in PVT and SPFS scores over time. RESULTS Mean baseline resting PVT in milliseconds at the start of the study period was 427 [390-464]. There was an overall trend towards higher PVT-scores with shift progression mean [95% CI] PVT at the start of shifts 447 [433-460]; halfway through the shift 452 [440-463]; end of the shift 459 [444-475], p = 0.10), whereas SPFS scores remained constant. Within a 5 week forward-rotating cycle, an overall trend towards a gradual increase in both average PVT (from 436 [238-454] to 460 [371-527, p = 0.68] ms;) and SPFS (from 2.9 [2.6-3.2] to 3.6 [3.1-4.0], p = 0.38) was observed, although significant interindividual variation was present. Reported SPFS scores ≥ 4 (moderate fatigue) were mainly related to workload (number of jobs) and transport mode (car-based shifts). CONCLUSION An overall trend towards a decline in psychomotor vigilance and an increase in self-reported tiredness was found for HEMS crew over a 5-week shift cycle. Using a bespoke predictive fatigue tool on a day-to-day basis could increase fatigue awareness and provide a framework to which relevant mitigating options can be applied.
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Affiliation(s)
- C Rose
- Kent, Surrey and Sussex Air Ambulance Trust, Redhill Airfield, Redhill, Surrey, RH1 5YP, UK
| | - E Ter Avest
- Kent, Surrey and Sussex Air Ambulance Trust, Redhill Airfield, Redhill, Surrey, RH1 5YP, UK.
- Department of Emergency Medicine, University Hospital Groningen, Groningen, The Netherlands.
| | - R M Lyon
- Kent, Surrey and Sussex Air Ambulance Trust, Redhill Airfield, Redhill, Surrey, RH1 5YP, UK
- School of Health Sciences, University of Surrey, Guildford, UK
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5
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Silva I, Costa D. Consequences of Shift Work and Night Work: A Literature Review. Healthcare (Basel) 2023; 11:healthcare11101410. [PMID: 37239693 DOI: 10.3390/healthcare11101410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/20/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Nonstandard work schedules such as shift work and night work tend to trigger problems for workers in different areas. To illustrate the diversity of areas affected and the relative interest of the scientific community, we conducted a literature review of the effects of shift work and night work on workers. In particular, we intended to identify the main variables addressed in the field of health, the family sphere, and the organizational context. The literature review was carried out using the Web of Science with the following terms: "shift work", "rotating shifts", and "night work". Inclusion criteria incorporated empirical studies and articles written in Portuguese or English published in 2019. We selected 129 of the 619 articles identified. Regarding the impacts of shift work and night work, there existed a high discrepancy of focus between the three defined areas: health, family life, and organizational context. Specifically, health-related variables were the most studied (83.4%), followed by organizational variables (9.2%), and, lastly, family variables (7.4%). Based on these results, it is essential to extend the study of the two underrepresented impacts to other crucial areas, not only for the worker but also for organizations.
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Affiliation(s)
- Isabel Silva
- Interdisciplinary Centre of Social Sciences (CICS.NOVA.UMinho), University of Minho, 4710-057 Braga, Portugal
- School of Psychology (EPsi-UMinho), University of Minho, 4710-057 Braga, Portugal
| | - Daniela Costa
- School of Psychology (EPsi-UMinho), University of Minho, 4710-057 Braga, Portugal
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Allison P, Tiesman HM, Wong IS, Bernzweig D, James L, James SM, Navarro KM, Patterson PD. Working hours, sleep, and fatigue in the public safety sector: A scoping review of the research. Am J Ind Med 2022; 65:878-897. [PMID: 35711032 PMCID: PMC9851314 DOI: 10.1002/ajim.23407] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The public safety sector includes law enforcement officers (LEO), corrections officers (CO), firefighter service (FF), wildland firefighting (WFF), and emergency medical services (EMS), as defined in the National Occupational Research Agenda (NORA) of the National Institute for Occupational Safety and Health (NIOSH). Across these occupations, shiftwork, long-duration shifts, and excessive overtime are common. Our objective was to identify research gaps related to working hours, sleep, and fatigue among these workers. METHODS We used a scoping review study design that included searches of MEDLINE, Embase, CAB Abstracts, Global Health, PsychInfo, CINAHL, Scopus, Academic Search Complete, Agricultural and Environmental Science Collection, ProQuest Central, Cochrane Library, Safety Lit, Homeland Security Digital Library, and Sociological Abstracts using a range of occupational search terms and terms related to working hours, sleep, and fatigue. RESULTS Out of 3415 articles returned from our database search, 202 met all inclusion criteria. Six common outcomes related to working hours, sleep, and fatigue emerged: sleep, fatigue, work performance, injury, psychosocial stress, and chronic disease. Nearly two-thirds (59%, n = 120) of the studies were observational, of which 64% (n = 77) were cross sectional and 9% were (n = 11) longitudinal; 14% (n = 30) of the studies were reviews; and 19% (n = 39) were experimental or quasi-experimental studies. Only 25 of the 202 articles described mitigation strategies or interventions. FFs, LEOs, EMS, and WFFs were the most studied, followed by COs. CONCLUSIONS In general, more longitudinal and experimental studies are needed to enrich the knowledge base on the consequences of long working hours, poor sleep, and fatigue in the public safety sector. Few experimental studies have tested novel approaches to fatigue mitigation in diverse sectors of public safety. This gap in research limits the decisions that may be made by employers to address fatigue as a threat to public-safety worker health and safety.
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Affiliation(s)
- Penelope Allison
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Hope M. Tiesman
- Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Imelda S. Wong
- Division of Science Integration, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - David Bernzweig
- Ohio Association of Professional Fire Fighters, Columbus, Ohio, USA
| | - Lois James
- Sleep and Performance Research Center, Washington State University, Spokane, Washington, USA
| | - Stephen M. James
- Sleep and Performance Research Center, Washington State University, Spokane, Washington, USA
| | - Kathleen M. Navarro
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - P. Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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7
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Patterson PD, Weiss LS, Weaver MD, Salcido DD, Opitz SE, Okerman TS, Smida TT, Martin SE, Guyette FX, Martin-Gill C, Callaway CW. Napping on the night shift and its impact on blood pressure and heart rate variability among emergency medical services workers: study protocol for a randomized crossover trial. Trials 2021; 22:212. [PMID: 33726840 PMCID: PMC7962082 DOI: 10.1186/s13063-021-05161-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/27/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND There is an emerging body of evidence that links exposure to shift work to cardiovascular disease (CVD). The risk of coronary events, such as myocardial infarction, is greater among night shift workers compared to day workers. There is reason to believe that repeated exposure to shift work, especially night shift work, creates alterations in normal circadian patterns of blood pressure (BP) and heart rate variability (HRV) and that these alterations contribute to increased risk of CVD. Recent data suggest that allowing shift workers to nap during night shifts may help to normalize BP and HRV patterns and, over time, reduce the risk of CVD. The risk of CVD related to shift work is elevated for emergency medical services (EMS) shift workers due in part to long-duration shifts, frequent use of night shifts, and a high prevalence of multiple jobs. METHODS We will use a randomized crossover trial study design with three study conditions. The targeted population is comprised of EMS clinician shift workers, and our goal enrollment is 35 total participants with an estimated 10 of the 35 enrolled not completing the study protocol or classified as lost to attrition. All three conditions will involve continuous monitoring over 72 h and will begin with a 36-h at-home period, followed by 24 total hours in the lab (including a 12-h simulated night shift), ending with 12 h at home. The key difference between the three conditions is the intra-shift nap. Condition 1 will involve a simulated 12-h night shift with total sleep deprivation. Condition 2 will involve a simulated 12-h night shift and a 30-min nap opportunity. Condition 3 will involve a simulated 12-h night shift with a 2-h nap opportunity. Our primary outcomes of interest include blunted BP dipping and reduced HRV as measured by the standard deviation of the inter-beat intervals of normal sinus beats. Non-dipping status will be defined as sleep hours BP dip of less than 10%. DISCUSSION Our study will address two indicators of cardiovascular health and determine if shorter or longer duration naps during night shifts have a clinically meaningful impact. TRIAL REGISTRATION ClinicalTrials.gov NCT04469803 . Registered on 9 July 2020.
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Affiliation(s)
- P. Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
- Division of Community Health Services, Emergency Medicine Program, University of Pittsburgh, School of Health and Rehabilitation Sciences, Pittsburgh, PA 15261 USA
| | - Leonard S. Weiss
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Matthew D. Weaver
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115 USA
- Harvard Medical School, Division of Sleep Medicine, Boston, MA 02115 USA
| | - David D. Salcido
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Samantha E. Opitz
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Tiffany S. Okerman
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
- Division of Community Health Services, Emergency Medicine Program, University of Pittsburgh, School of Health and Rehabilitation Sciences, Pittsburgh, PA 15261 USA
| | - Tanner T. Smida
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Sarah E. Martin
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Francis X. Guyette
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Christian Martin-Gill
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
| | - Clifton W. Callaway
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine, 3600 Forbes Ave., Iroquois Building, Suite 400A, Pittsburgh, PA 15261 USA
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8
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Patterson PD, Weaver MD, Guyette FX, Martin‐Gill C. Should public safety shift workers be allowed to nap while on duty? Am J Ind Med 2020; 63:843-850. [PMID: 32761915 PMCID: PMC7540594 DOI: 10.1002/ajim.23164] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/12/2022]
Abstract
Fatigue and sleep deficiency among public safety personnel are threats to wellness, public and personal safety, and workforce retention. Napping strategies may reduce work-related fatigue, improve safety and health, yet in some public safety organizations it is discouraged or prohibited. Our aim with this commentary is to define intra-shift napping, summarize arguments for and against it, and to outline potential applications of this important fatigue mitigation strategy supported by evidence. We focus our discussion on emergency medical services (EMS); a key component of the public safety system, which is comprised of police, fire, and EMS. The personnel who work in EMS stand to benefit from intra-shift napping due to frequent use of extended duration shifts, a high prevalence of personnel working multiple jobs, and evidence showing that greater than half of EMS personnel report severe fatigue, poor sleep quality, inadequate inter-shift recovery, and excessive daytime sleepiness. The benefits of intra-shift napping include decreased sleepiness and fatigue, improved recovery between shifts, decreased anxiety, and reduced feelings of burnout. Intra-shift napping also mitigates alterations in clinician blood pressure associated with disturbed sleep and shift work. The negative consequences of napping include negative public perception, acute performance deficits stemming from sleep inertia, and the potential costs associated with reduced performance. While there are valid arguments against intra-shift napping, we believe that the available scientific evidence favors it as a key component of fatigue mitigation and workplace wellness. We further believe that these arguments extend beyond EMS to all sectors of public safety.
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Affiliation(s)
- P. Daniel Patterson
- Department of Emergency Medicine, School of Medicine University of Pittsburgh Pittsburgh Pennsylvania
- Division of Community Health Services, Emergency Medicine Program, School of Health and Rehabilitation Sciences University of Pittsburgh Pittsburgh Pennsylvania
| | - Matthew D. Weaver
- Division of Sleep and Circadian Disorders Brigham and Women's Hospital Boston Massachusetts
- Division of Sleep Medicine Harvard Medical School Boston Massachusetts
| | - Francis X. Guyette
- Department of Emergency Medicine, School of Medicine University of Pittsburgh Pittsburgh Pennsylvania
| | - Christian Martin‐Gill
- Department of Emergency Medicine, School of Medicine University of Pittsburgh Pittsburgh Pennsylvania
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9
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Patterson PD, Mountz KA, Agostinelli MG, Weaver MD, Yu YC, Herbert BM, Markosyan MA, Hopkins DR, Alameida AC, Maloney Iii JA, Martin SE, Brassil BN, Martin-Gill C, Guyette FX, Callaway CW, Buysse DJ. Ambulatory blood pressure monitoring among emergency medical services night shift workers. Occup Environ Med 2020; 78:29-35. [PMID: 32847989 DOI: 10.1136/oemed-2020-106459] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/16/2020] [Accepted: 07/25/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Higher 24-hour blood pressure (BP) and blunted BP dipping during sleep and night-time hours are associated with adverse health outcomes. Night shift work may affect 24-hour BP and dipping patterns, but empirical data in emergency medical services (EMS) clinician shift workers are sparse. We implemented ambulatory blood pressure monitoring (ABPM) in EMS workers to characterise BP during night shift work versus a non-workday, and sleep versus wake. METHODS Participants worked night shifts. Hourly ABPM and wrist actigraphy (to measure sleep) were collected during two 24-hour periods, one scheduled night shift and one non-workday. Blunted BP dipping was defined as a BP decrease of <10%. RESULTS Of 56 participants, 53 (53.6% female, mean age 26.5 (SD 7.5) years) completed the study. During daytime sleep on a workday, 49.1% of participants had blunted systolic BP (SBP) or diastolic BP (DBP) dipping. During night-time sleep on a non-workday, 25% had blunted SBP dipping and 3.9% blunted DBP dipping. Blunted SBP or DBP dipping occurred among all participants who did not nap during the night shift or who napped <60 min. Blunted SBP dipping occurred in only 14.3% of participants who napped 60-120 min. CONCLUSIONS During night shift work, the BP dipping of EMS shift workers is blunted; however, most who nap for 60 min or longer experience a healthy dip in BP. The potential health consequences of these observations in EMS clinicians warrant further study.
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Affiliation(s)
- P Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kristina A Mountz
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael G Agostinelli
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Matthew D Weaver
- Departments of Medicine and Neurology, Brigham and Women's Hospital Division of Sleep and Circadian Disorders, Boston, Massachusetts, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Yi-Chuan Yu
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brandon M Herbert
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mark A Markosyan
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - David R Hopkins
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alana C Alameida
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - John A Maloney Iii
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sarah E Martin
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Bridget N Brassil
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Christian Martin-Gill
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Francis X Guyette
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Clifton W Callaway
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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