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Ahlström C, Anund A. Development of sleepiness in professional truck drivers: Real-road testing for driver drowsiness and attention warning (DDAW) system evaluation. J Sleep Res 2024:e14259. [PMID: 38837467 DOI: 10.1111/jsr.14259] [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: 02/13/2024] [Revised: 05/16/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024]
Abstract
All new vehicle types within the European Union must now be equipped with a driver drowsiness and attention warning system starting from 2022. The specific requirements for the test procedure necessary for type approval are defined in the Annex of EU Regulation C/2021/2639. The objectives of this study were to: (i) investigate how sleepiness develops in professional truck drivers under real-road driving conditions; and (ii) assess the feasibility of a test procedure for validating driver drowsiness and attention warning systems according to the EU regulation. Twenty-four professional truck drivers participated in the test. They drove for 180 km on a dual-lane motorway, first during daytime after a normal night's sleep and then at nighttime after being awake since early morning. The results showed higher sleepiness levels during nighttime driving compared with daytime, with a faster increase in sleepiness with distance driven, especially during the night. Psychomotor vigilance task results corroborated these findings. From a driver drowsiness and attention warning testing perspective, the study design with sleep-deprived drivers at night was successful in inducing the targeted sleepiness level of a Karolinska Sleepiness Scale score of ≥ 8. Many drivers who reported a Karolinska Sleepiness Scale ≥ 8 during the drives also acknowledged feeling sleepy in the post-drive questionnaire. Reaching high levels of sleepiness on real roads during daytime is more problematic, not the least from legal and ethical perspectives as higher traffic densities during the daytime lead to increased risks.
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Affiliation(s)
- Christer Ahlström
- Swedish National Road and Transport Research Institute, Linköping, Sweden
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Anna Anund
- Swedish National Road and Transport Research Institute, Linköping, Sweden
- Rehabilitation Medicine, Linköping University, Linköping, Sweden
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2
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Hittle BM, Keller EG, Lee RC, Daraiseh NM. Pediatric nurses' fatigue descriptions in occupational injury reports: A descriptive qualitative study1. Work 2024:WOR230273. [PMID: 38820042 DOI: 10.3233/wor-230273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024] Open
Abstract
Background Despite the high risks associated with occupational fatigue in healthcare, few organizations require nurses to screen and report fatigue symptoms. As a result, little is known about if and how nurses would report fatigue while on the job. Objective To determine if hospital-based pediatric nurses reported fatigue as part of an active injury reporting method. Methods This secondary analysis of qualitative data used a descriptive design with content analysis. Data from the parent study were collected at a U.S. pediatric hospital where nurses verbally reported on-shift injuries or near misses and pre- and post-shift health status via a digital voice recorder. Researchers used content analysis to independently code data for nurses' references to fatigue. Codes were then analyzed for patterns and themes. Results Approximately 30% (n = 104) of participants reported fatigue-related content. Emergent themes were Work Stressors, Individual Risk Factors, Fatigue Descriptors, Adverse Outcomes from Fatigue, Fatigue Buffers, Descriptors for Buffered Fatigue, and Favorable Outcomes from Buffered Fatigue. Fatigue descriptions align with prior literature, demonstrating the accuracy of the voice recorder data collection method. In addition, nurses expressed uncertainty about the appropriateness of reporting fatigue symptoms. Conclusion Findings from this study support pediatric nurses will report fatigue, when provided an opportunity. Additional efforts are needed to better understand effective ways to improve fatigue reporting among nurses, including harnessing current technology for real-time reporting and how to change the culture around fatigue reporting.
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Affiliation(s)
- Beverly M Hittle
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | | | - Rebecca C Lee
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Nancy M Daraiseh
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Cai H, Chen MY, Li XH, Zhang L, Su Z, Cheung T, Tang YL, Malgaroli M, Jackson T, Zhang Q, Xiang YT. A network model of depressive and anxiety symptoms: a statistical evaluation. Mol Psychiatry 2024; 29:767-781. [PMID: 38238548 PMCID: PMC11153039 DOI: 10.1038/s41380-023-02369-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Although network analysis studies of psychiatric syndromes have increased in recent years, most have emphasized centrality symptoms and robust edges. Broadening the focus to include bridge symptoms within a systematic review could help to elucidate symptoms having the strongest links in network models of psychiatric syndromes. We conducted this systematic review and statistical evaluation of network analyses on depressive and anxiety symptoms to identify the most central symptoms and bridge symptoms, as well as the most robust edge indices of networks. METHODS A systematic literature search was performed in PubMed, PsycINFO, Web of Science, and EMBASE databases from their inception to May 25, 2022. To determine the most influential symptoms and connections, we analyzed centrality and bridge centrality rankings and aggregated the most robust symptom connections into a summary network. After determining the most central symptoms and bridge symptoms across network models, heterogeneity across studies was examined using linear logistic regression. RESULTS Thirty-three studies with 78,721 participants were included in this systematic review. Seventeen studies with 23 cross-sectional networks based on the Patient Health Questionnaire (PHQ) and Generalized Anxiety Disorder (GAD-7) assessments of clinical and community samples were examined using centrality scores. Twelve cross-sectional networks based on the PHQ and GAD-7 assessments were examined using bridge centrality scores. We found substantial variability between study samples and network features. 'Sad mood', 'Uncontrollable worry', and 'Worrying too much' were the most central symptoms, while 'Sad mood', 'Restlessness', and 'Motor disturbance' were the most frequent bridge centrality symptoms. In addition, the connection between 'Sleep' and 'Fatigue' was the most frequent edge for the depressive and anxiety symptoms network model. CONCLUSION Central symptoms, bridge symptoms and robust edges identified in this systematic review can be viewed as potential intervention targets. We also identified gaps in the literature and future directions for network analysis of comorbid depression and anxiety.
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Affiliation(s)
- Hong Cai
- Unit of medical psychology and behavior medicine, school of public health, Guangxi Medical University, Nanning, Guangxi, China
| | - Meng-Yi Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Xiao-Hong Li
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
- Atlanta VA Medical Center, Atlanta, GA, USA
| | - Matteo Malgaroli
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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Kotnik P, Roelands B, Bogataj Š. Prolonged theoretical classes impact students' perceptions: an observational study. Front Psychol 2024; 15:1278396. [PMID: 38449760 PMCID: PMC10916696 DOI: 10.3389/fpsyg.2024.1278396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/12/2024] [Indexed: 03/08/2024] Open
Abstract
Mental fatigue (MF) arises during prolonged demanding cognitive activity and results in acute feelings of tiredness and a decreased physical and/or cognitive performance capacity. An often-overlooked population that is significantly at risk for the development of MF are university students. The current study investigated the impact of prolonged in-person theoretical classes on the perceptions of MF, boredom, and sleepiness among 27 Slovenian university students (first-year physiotherapy). Their subjective experiences at various time points during a 4-h class interspersed with a 20 min break were assessed with a repeated measures ANOVA and consequent Bonferroni post-hoc tests (significance set at <0.05). Subjective MF and sleepiness significantly increased during the first and the second part of the class (p < 0.05), while they significantly decreased during the break (p < 0.05). Boredom levels only increased significantly during the second part of the class (p < 0.05). Additionally, students who had inadequate sleep the night before the class reported higher levels of MF at the beginning of the class. This study highlighted a significant impact of a theoretical class on subjective feelings of mental fatigue and showed that a break in the middle of the class temporarily alleviated this negative impact. These results emphasize the importance of adequate sleep, effective breaks, and strategies to manage cognitive workload in optimizing students' cognitive well-being and academic performance. Further research is needed to better understand the underlying factors and develop targeted interventions to support students' cognitive functioning and well-being during prolonged academic sessions.
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Affiliation(s)
- Petra Kotnik
- Faculty of Health Sciences, University of Novo Mesto, Novo Mesto, Slovenia
| | - Bart Roelands
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Špela Bogataj
- Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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5
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Sprajcer M, Ferguson SA, Dawson D. How much advance notice do workers need? A review and theoretical framework for determining advance notice periods for unpredictable work. INDUSTRIAL HEALTH 2024; 62:2-19. [PMID: 36948632 PMCID: PMC10865088 DOI: 10.2486/indhealth.2022-0140] [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: 07/27/2022] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
Regulatory guidance materials for fatigue management typically advise that employees be provided with days or weeks of advance notice of schedules/rosters. However, the scientific evidence underpinning this advice is unclear. A systematic search was performed on current peer reviewed literature addressing advance notice periods, which found three relevant studies. A subsequent search of grey literature to determine the quality of evidence for the recommendation for advance notice periods returned 37 relevant documents. This review found that fatigue management guidance materials frequently advocated advance notice for work shifts but did not provide empirical evidence to underpin the advice. Although it is logical to suggest that longer notice periods may result in increased opportunities for pre-work preparations, improved sleep, and reduced worker fatigue, the current guidance appears to be premised on this reasoning rather than empirical evidence. Paradoxically, it is possible that advance notice could be counterproductive, as too much may result in frequent alterations to the schedule, particularly where adjustments to start and end times of the work period are not uncommon (e.g., road transport, rail). To assist organisations in determining the appropriate amount of advance notice to provide, we propose a novel theoretical framework to conceptualise advance notice.
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Affiliation(s)
| | | | - Drew Dawson
- Appleton Institute, Central Queensland University, Australia
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Sprajcer M, Robinson A, Thomas MJW, Dawson D. Advancing fatigue management in healthcare: risk-based approaches that enhance health service delivery. Occup Med (Lond) 2023; 73:459-463. [PMID: 38157486 DOI: 10.1093/occmed/kqad112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Given the need for 24/7 healthcare services, fatigue is an inevitable consequence of work in this industry. A significant body of regulatory advice and hospital services have focused primarily on restricting work hours as the primary method of mitigating fatigue-related risk. Given the inevitability of fatigue, and the limited capacity of labour agreements to control risk, this commentary explores how the principles of fatigue risk management might be applied in a healthcare setting.
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Affiliation(s)
- M Sprajcer
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, South Australia, 5034, Australia
| | - A Robinson
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, K1H 8L1, Canada
| | - M J W Thomas
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, South Australia, 5034, Australia
| | - D Dawson
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, South Australia, 5034, Australia
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7
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Kovac K, Vincent GE, Paterson JL, Hilditch CJ, Ferguson SA. A preliminary framework for managing sleep inertia in occupational settings. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 4:zpad050. [PMID: 38046222 PMCID: PMC10693319 DOI: 10.1093/sleepadvances/zpad050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/26/2023] [Indexed: 12/05/2023]
Abstract
Sleep inertia, the temporary period of impairment experienced upon waking, is a safety hazard that has been implicated in serious work-related incidents resulting in injuries as well as the loss of life and assets. As such, sleep inertia warrants formal management in industries where personnel are required to undertake their role soon after waking (e.g. emergency services, engineers, and health care). At present, there is a lack of practical, evidence-based guidance on how sleep inertia could be formally managed at an organizational level. We propose a preliminary framework for managing sleep inertia based on the translation of research findings into specific work procedure modifications/control mechanisms. Within the framework, work procedure modifications/control mechanisms to manage sleep inertia are organized into three levels: (1) modifications/controls that eliminate the chance of sleep inertia, (2) modifications/controls that reduce sleep inertia severity, and (3) modifications/controls that manage the risk of errors during sleep inertia. Practical considerations, limitations, and areas of further research are highlighted for each modification/control to help determine how readily each control measure could be implemented by industries at present. A guide for organizations to use this preliminary framework of sleep inertia management is put forward, as well as the next research priorities to strengthen the utility and evidence base of the framework. This paper is part of the Sleep and Circadian Rhythms: Management of Fatigue in Occupational Settings Collection.
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Affiliation(s)
- Katya Kovac
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | - Grace E Vincent
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | - Jessica L Paterson
- Flinders University Institute of Mental Health and Wellbeing, College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA, Australia
| | - Cassie J Hilditch
- Fatigue Countermeasures Laboratory, San José State University, San José, CA, USA
| | - Sally A Ferguson
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Wayville, SA, Australia
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Wang Y, Genon S, Dong D, Zhou F, Li C, Yu D, Yuan K, He Q, Qiu J, Feng T, Chen H, Lei X. Covariance patterns between sleep health domains and distributed intrinsic functional connectivity. Nat Commun 2023; 14:7133. [PMID: 37932259 PMCID: PMC10628193 DOI: 10.1038/s41467-023-42945-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 10/25/2023] [Indexed: 11/08/2023] Open
Abstract
Sleep health is both conceptually and operationally a composite concept containing multiple domains of sleep. In line with this, high dependence and interaction across different domains of sleep health encourage a transition in sleep health research from categorical to dimensional approaches that integrate neuroscience and sleep health. Here, we seek to identify the covariance patterns between multiple sleep health domains and distributed intrinsic functional connectivity by applying a multivariate approach (partial least squares). This multivariate analysis reveals a composite sleep health dimension co-varying with connectivity patterns involving the attentional and thalamic networks and which appear relevant at the neuromolecular level. These findings are further replicated and generalized to several unseen independent datasets. Critically, the identified sleep-health related connectome shows diagnostic potential for insomnia disorder. These results together delineate a potential brain connectome biomarker for sleep health with high potential for clinical translation.
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Affiliation(s)
- Yulin Wang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Sarah Genon
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute for Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Debo Dong
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Feng Zhou
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Chenyu Li
- Sleep Center, Department of Brain Disease, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Dahua Yu
- Information Processing Laboratory, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, Shanxi, China
| | - Qinghua He
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Tingyong Feng
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China.
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Hittle BM, Hils J, Fendinger SL, Wong IS. A scoping review of sleep education and training for nurses. Int J Nurs Stud 2023; 142:104468. [PMID: 37080122 PMCID: PMC10180237 DOI: 10.1016/j.ijnurstu.2023.104468] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Shift work and resulting sleep impairment among nurses can increase their risk for poor health outcomes, occupational injuries, and errors due to sleep deficiencies. While sleep education and training for nurses has been recommended as part of a larger fatigue risk management system, little is known about training programs designed specifically for nurses. OBJECTIVE Investigate the literature for current sleep education or training programs specifically for shift working nurses, with intent to assess training content, delivery characteristics, and outcome measures. DESIGN A scoping review conducted October 2020 through September 2021. METHODS The bibliographic databases Cumulative Index of Nursing and Allied Health (CINAHL), Scopus, PubMed, and NIOSHTIC-2 were searched using words such as "nurse," "sleep hygiene," "shift work," and "education". Studies were included if they: 1) were original research; 2) discussed sleep education, training, or sleep hygiene interventions; 3) included a study population of nurses engaging in shift work; 4) focused on sleep as a primary study measure; 5) were written in English language; and 6) were published in 2000 or later. RESULTS Search results included 17,237 articles. After duplicates were removed, 14,620 articles were screened. Nine articles were found to meet established criteria. All studies included sleep hygiene content in the training programs, with five studies adding psychological and/or behavior change motivation training to support change in nurse sleep habits. Three studies added specific training for nurses and for managers. Delivery modes included in-person training of various lengths and frequency, mobile phone application with daily engagement, an online self-guided presentation, and daily reading material coupled with audio training. Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were the outcome measures most frequently used. Although studies demonstrated improved sleep measures, most were pilot studies testing feasibility. CONCLUSION Although there is a paucity of studies focused on sleep education and training for shift working nurses, we found the inclusion of sleep hygiene content was the only common characteristic of all nine studies. The variability in training content, delivery methods, and outcome measures suggests further research is needed on what constitutes effective sleep education and training for nurses.
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Affiliation(s)
- Beverly M Hittle
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers, for Disease Control and Prevention, 1090 Tusculum Ave, Cincinnati, OH 45226, USA; University of Cincinnati, College of Nursing, 3110 Vine St, Cincinnati, OH 45219, USA.
| | - Janie Hils
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers, for Disease Control and Prevention, 1090 Tusculum Ave, Cincinnati, OH 45226, USA; Oak Ridge Institute for Science and Education, P.O. Box 117, Oak Ridge, TN 37830, USA; Division of Environmental Health Science and Practice, National Center for Environmental, Health, Centers for Disease Control and Prevention. Mailstop S106-5, 4770 Buford Highway, Atlanta, GA 30341, USA.
| | - Sherry L Fendinger
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers, for Disease Control and Prevention, 1090 Tusculum Ave, Cincinnati, OH 45226, USA.
| | - Imelda S Wong
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers, for Disease Control and Prevention, 1090 Tusculum Ave, Cincinnati, OH 45226, USA.
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The Anti-Fatigue Effect of Glycoprotein from Hairtail Fish (Trichiurus lepturus) on BALB/c Mice. Foods 2023; 12:foods12061245. [PMID: 36981171 PMCID: PMC10048760 DOI: 10.3390/foods12061245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Abstract
Fatigue is related to a variety of chronic diseases and has become a hot research topic in recent years. Various bioactive components have been extracted from hairtail fish (Trichiurus lepturus); however, none of these studies involved the anti-fatigue activity of hairtail fish glycoprotein (HGP). Thus, antioxidant experiments were conducted in vitro, and the anti-fatigue activity of HGP was further evaluated in BALB/c mice. The effects of HGP on the behavior of BALB/c mice were verified by classical behavioral experiments, and the indicators related to anti-fatigue activity were detected. The results showed that the antioxidant capacity in vitro of HGP increased gradually in the concentration range of 10 to 100 mg/mL. HGP improved the exercise ability of the mice. HGP was also found to significantly (p < 0.05) reduce the serum levels of lactate dehydrogenase (LDH), blood lactic acid (BLA), blood urea nitrogen (BUN), and creatine kinase (CK). The contents of liver glycogen (LG) and muscle glycogen (MG) were also significantly (p < 0.05) increased by HGP. Malondialdehyde (MDA) content in the serum and brains of the mice was significantly (p < 0.05) reduced and catalase (CAT), glutathione peroxidase (GPX), and superoxide dismutase (SOD) were significantly (p < 0.05) increased by HGP, especially in the middle- and high-dose groups. These results enhance our understanding of the anti-fatigue function of HGP and lay an important foundation for the further development and utilization of hairtail fish resources.
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Maisey G, Cattani M, Devine A, Dunican IC. Fatigue Risk Management Systems Diagnostic Tool: Validation of an Organizational Assessment Tool for Shift Work Organizations. Saf Health Work 2022; 13:408-414. [PMID: 36579003 PMCID: PMC9772465 DOI: 10.1016/j.shaw.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/25/2022] [Accepted: 08/07/2022] [Indexed: 12/31/2022] Open
Abstract
Background This study aimed to determine and define the elements of an Fatigue Risk Management System (FRMS) diagnostic tool to assist an organization in systematically assessing its level of implementation of an FRMS. Methods A modified Delphi process was used involving 16 participants with expertise in sleep science, chronobiology, and fatigue risk management within occupational settings. The study was undertaken in two stages 1) review of elements and definitions; 2) review of statements for each element. Each stage involved an iterative process, and a consensus rule of ≥ 60% was applied to arrive at a final list of elements, definitions, and statements. Results Stage 1: a review of elements (n = 12) and definitions resulted in a final list of 14 elements and definitions with a consensus of ≥ 60% achieved after 2 Delphi rounds. Stage 2: a review of statements (n = 131) resulted in a final list of 119 statements with a consensus of ≥ 60% achieved after 2 Delphi rounds. Conclusion The final FRMS diagnostic tool will enable an organization to systematically assess the level of implementation of their current FRMS and identify gaps and opportunities to reduce risk.
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Affiliation(s)
- Gemma Maisey
- Corresponding author. School of Medical and Health Science, Edith Cowan University, Perth, WA, Australia.
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Hagan-Haynes K, Pratt S, Lerman S, Wong I, Baker A, Flower D, Riethmeister V. US research needs related to fatigue, sleep, and working hours among oil and gas extraction workers. Am J Ind Med 2022; 65:840-856. [PMID: 34775611 DOI: 10.1002/ajim.23310] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND During 2003-2013, 1189 US oil and gas extraction (OGE) workers died while working, resulting in an average annual workplace fatality rate seven times that for all US workers. OGE work commonly involves long hours, shiftwork, irregular schedules, and long commutes, but effects of these factors on fatigue, occupational injury, and illness in OGE are largely unknown. METHODS A scoping review of relevant OGE research during 2000-2019 was completed and supplemented by input from a NIOSH-sponsored Forum. RESULTS Seventy-eight papers were identified; 76% reported only offshore research. Five themes for research needs emerged: build knowledge about the impacts of fatigue; explore interactions between on- and off-the-job risk factors; identify and evaluate interventions; assess effectiveness of technology; and increase the diffusion of fatigue risk management information. CONCLUSIONS Further collaboration between researchers and OGE operators and contractors can lead to action-oriented recommendations to mitigate the effects of fatigue, inadequate sleep, and shiftwork.
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Affiliation(s)
- Kyla Hagan-Haynes
- Western States Division, National Institute for Occupational Safety & Health, Denver, Colorado, USA
| | - Stephanie Pratt
- Strategic Innovative Solutions LLC, Morgantown, West Virginia, USA
| | | | - Imelda Wong
- Division of Science Integration, National Institute for Occupational Safety & Health, Cincinnati, Ohio, USA
| | - Angela Baker
- Royal Dutch Shell, Human Factors, The Hague, The Netherlands
| | - David Flower
- British Petroleum, Global Health, London, United Kingdom
| | - Vanessa Riethmeister
- Royal Dutch Shell, High Risk Transport, The Hague, South Hollands, The Netherlands
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Wong I, Swanson N. Approaches to managing work-related fatigue to meet the needs of American workers and employers. Am J Ind Med 2022; 65:827-831. [PMID: 35661203 PMCID: PMC10583120 DOI: 10.1002/ajim.23402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 02/01/2023]
Abstract
On September 13-14, 2019, the National Institute for Occupational Safety and Health (NIOSH) hosted a national forum entitled "Working hours, sleep and fatigue: Meeting the needs of American workers and employers." The purpose of this inaugural meeting was to discuss current evidence about the broad-based risks and effective countermeasures related to working hours, sleep, and fatigue, with further considerations to tailor solutions for specific industries and worker populations. We aimed to identify the knowledge gaps and needs in this area and future directions for research. We also sought to identify similarities across industries with the goal of sharing lessons learned and successful mitigation strategies across sectors. Participants included an international representation of academics, scientists, government representatives, policymakers, industry leaders, occupational health and safety professionals, and labor representatives. A total of eight manuscripts were developed following stakeholder comments and forum discussions. Six focused on sector-specific approaches (i.e., Agriculture, Forestry & Fishing; Healthcare & Social Assistance; Mining; Oil and Gas Extraction; Public Safety; Transportation, Warehousing & Utilities) to identify unique factors for fatigue-risk and effective countermeasures. Two additional manuscripts addressed topic areas that cut across all industries (disproportionate risks, and economic evaluation). Findings from the Forum highlight that the identification of common risk factors across sectors allows for transfer of information, such as evidence for effective mitigation strategies, from sectors where fatigue risk has been more widely studied to those sectors where it has been less so. Further considerations should be made to improve knowledge translation activities by incorporating different languages and modes of dissemination such that information is accessible for all workers. Additionally, while economic evaluation can be an important decision-making tool for organizational- and policy-level activities, multi-disciplinary approaches combining epidemiology and economics are needed to provide a more balanced approach to economic evaluation with considerations for societal impacts. Although fatigue risk management must be tailored to fit industries, organizations, and individuals, knowledge gained in this forum can be leveraged, modified, and adapted to address these variabilities. Our hope is to continue sharing lessons learned to encourage future innovative, multi-disciplinary, cross-industry collaborations that will meet the needs of workers and employers to mitigate the risks and losses related to workplace fatigue.
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Affiliation(s)
- Imelda Wong
- Division of Science Integration, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Naomi Swanson
- Division of Science Integration, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
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14
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Basacik D, Tailor A. A feast-and-famine pattern of sleep: Do railway staff get the sleep they need? APPLIED ERGONOMICS 2022; 102:103711. [PMID: 35276419 DOI: 10.1016/j.apergo.2022.103711] [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: 03/31/2021] [Revised: 01/04/2022] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
The relationship between sleep and health and wellbeing is receiving increasing attention in our society, following decades of research that has demonstrated the impact of insufficient sleep on performance and health. Fatigue has been identified as a factor in 21% of high-risk incidents in the GB rail industry, and insufficient sleep and long periods of being awake are known to be two key contributors to fatigue. This paper presents evidence from a recent survey conducted in the GB rail industry, which enabled the sleep and wakefulness of railway workers to be quantified. There were 7807 responses to the survey, which represents a very large sample. Responses were primarily collected online, though paper copies were made available in some organisations. Respondents reported sleeping less when working nights, more when working days, and the most on days off, which suggests a feast-and-famine pattern of sleep. 41% were getting 6 h of sleep or less when working days, compared to 63% when working nights. Getting 6 h or less of sleep was associated with excessive daytime sleepiness. Although it is accepted that individuals' sleep requirements vary, the patterns that shift workers reported in this survey suggest that many are not achieving the amount of sleep they need. The findings of the survey presented in this paper highlight that there is work to be done to understand and address the causes of insufficient sleep in railway workers.
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15
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Hagan-Haynes K, Ramirez-Cardenas A, Wingate KC, Pratt S, Ridl S, Schmick E, Snawder J, Dalsey E, Hale C. On the road again: A cross-sectional survey examining work schedules, commuting time, and driving-related outcomes among U.S. oil and gas extraction workers. Am J Ind Med 2022; 65:749-761. [PMID: 35735247 PMCID: PMC10078245 DOI: 10.1002/ajim.23405] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/20/2022] [Accepted: 05/31/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Oil and gas extraction (OGE) workers in the United States experience high fatality rates, with motor vehicle crashes the leading cause of death. Land-based OGE workers drive frequently to remote and temporary worksites. Limited information is available on factors that may influence crash risk for this workforce. METHODS A cross-sectional survey of 500 land-based OGE workers examined work schedules and hours, commuting, sleep, employer policies, and their relationship to potentially harmful events while driving. RESULTS Over 60% of participants worked 12 or more hours per day. The mean daily roundtrip commuting time was 1.82 h. Longer daily commutes, nonstandard work schedules, less sleep on workdays, and lack of employer policies were associated with one or more risky driving-related outcomes. CONCLUSIONS Implementation and evaluation of OGE employer policies and programs to limit long work hours, reduce long daily commutes, promote sufficient sleep, and reduce drowsy driving among U.S. OGE workers are needed.
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Affiliation(s)
- Kyla Hagan-Haynes
- Western States Division, National Institute for Occupational Safety and Health, Lakewood, Colorado, USA
| | | | - Kaitlin C Wingate
- Western States Division, National Institute for Occupational Safety and Health, Lakewood, Colorado, USA
| | - Stephanie Pratt
- Western States Division, National Institute for Occupational Safety and Health, Lakewood, Colorado, USA
| | - Sophie Ridl
- Western States Division, National Institute for Occupational Safety and Health, Lakewood, Colorado, USA
| | - Emily Schmick
- Western States Division, National Institute for Occupational Safety and Health, Lakewood, Colorado, USA
| | - John Snawder
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Elizabeth Dalsey
- Western States Division, National Institute for Occupational Safety and Health, Lakewood, Colorado, USA
| | - Christa Hale
- Western States Division, National Institute for Occupational Safety and Health, Lakewood, Colorado, USA
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16
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Corbett MA, Newman DG. Student Drowsiness During Simulated Solo Flight. Aerosp Med Hum Perform 2022; 93:354-361. [PMID: 35354514 DOI: 10.3357/amhp.5275.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION: Pilot fatigue is a significant concern in aviation, where efforts are directed at improving rosters, developing models, and improving countermeasures. Little attention has been given to in-flight detection of fatigue/drowsiness. The aims of this research were to determine whether drowsiness is an issue and explore whether infrared reflectance oculography could prove useful for continuous inflight monitoring.METHODS: Nine university-based pilot trainees wore activity monitors and completed diaries, prior to a simulated navigational exercise of approximately 4 h, during the secondary window of circadian low. During the flight they wore a head-mounted device. Oculographic data were collected and converted into a single number, using the Johns Drowsiness Scale (JDS), with increasing values indicating greater drowsiness (range 0.0 to 10.0).RESULTS: Peak JDS values reached 6.5. Values declined from shortly before top of descent, continuing until landing. Two of the nine participants (22.2%), reached drowsiness levels at or above a cautionary warning level, below which is considered safe for driving a motor vehicle.DISCUSSION: The results of this study revealed the timeline and levels of fatigue that might be experienced by student pilots; showing that drowsiness is a potential issue for student pilots operating in flying conditions similar to those in the simulation. Analysis indicated that pilots are likely to experience levels of drowsiness above a cautionary warning level when modeling predicted effectiveness below 90%, indicating a potential drowsiness issue for pilots. It was concluded that oculography is worthy of further investigation for use as an objective fatigue detection tool in aviation.Corbett MA, Newman DG. Student drowsiness during simulated solo flight. Aerosp Med Hum Perform. 2022; 93(4):354-361.
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17
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Bedtime Procrastination and Fatigue in Chinese College Students: the Mediating Role of Mobile Phone Addiction. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00796-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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18
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Dorrian J, Chapman J, Bowditch L, Balfe N, Naweed A. A survey of train driver schedules, sleep, wellbeing, and driving performance in Australia and New Zealand. Sci Rep 2022; 12:3956. [PMID: 35273197 PMCID: PMC8913649 DOI: 10.1038/s41598-022-07627-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/21/2022] [Indexed: 01/18/2023] Open
Abstract
Train drivers work long hours on 24 h schedules and many factors impact their fatigue risk at work, creating a clear imperative for good rostering practice. Adopting a systems approach, this study investigated the relationship between multiple interrelated factors (train drivers’ schedule, sleep, wellbeing, and fatigue) and the perceived influence of these factors on train driving performance and safety using an online survey distributed in Australia and New Zealand. In addition to demographics and work schedule, passenger and freight train drivers (n = 751) answered questions about: (1) Sleep duration; (2) wellbeing, including physical and mental health, the extent to which shiftwork causes sleep, social, domestic, and work problems, and (3) the extent to which ten fatigue, health and wellbeing factors in the work and home environment negatively impact their driving performance. The key factor that emerged from analyses, with the largest and most consistent negative effects (and controlling for other factors) was schedule irregularity. Approved rosters were ranked as having the most important impact on day-to-day driving performance, followed by physical and mental health, and outside work factors. Results also suggested that schedule irregularity may amplify the negative impacts of the roster, impaired physical and mental health, and outside work factors on driving performance. As shift variability and schedule irregularity are often poorly represented in existing industry guidance, these results provide evidence for increased reflection on current fatigue management guidelines for train drivers and suggest a need for greater focus on schedule irregularity through the lens of a systems approach.
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Affiliation(s)
- Jillian Dorrian
- University of South Australia, UniSA Justice and Society, Adelaide, 5001, Australia.
| | | | - Lorelle Bowditch
- Central Queensland University, Appleton Institute for Behavioural Science, Wayville, SA, 5034, Australia
| | - Nora Balfe
- Trinity College Dublin, Centre for Innovative Human Systems, Dublin, Ireland
| | - Anjum Naweed
- Central Queensland University, Appleton Institute for Behavioural Science, Wayville, SA, 5034, Australia
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19
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Ganesan S, Manousakis JE, Mulhall MD, Sletten TL, Tucker A, Howard ME, Anderson C, Rajaratnam SMW. Sleep, alertness and performance across a first and a second night shift in mining haul truck drivers. Chronobiol Int 2022; 39:769-780. [PMID: 35176952 DOI: 10.1080/07420528.2022.2034838] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This study examined the impact of first and second night shift work on sleep and performance in mining haul truck drivers. Sleep-wake patterns were monitored using wrist actigraphy. The Karolinska Sleepiness Scale (KSS), Psychomotor Vigilance Test (PVT) and a truck simulator were administered at the start and end of the first (N1) or second (N2) night shift (19:00-07:00 h). Participants were categorised into those who demonstrated a decline in performance (increase of one or more PVT lapses [reaction time >500 msec] from the start to the end of shift) or those who did not demonstrate a decline in performance (no increase in lapses) from the start to the end of shift. Total sleep time (TST) was longer in the 24 h prior to N1 (9.05 ± 1.49 h) compared to N2 (5.38 ± 1.32 h). PVT lapses and the slowest 10% of reaction times were similar at the start and end of N1, while greater impairments on these outcomes were observed at the end of N2 compared to the end of N1 (p < .05). In contrast, subjective sleepiness was equally impaired at the end of both night shifts. PVT performance (lapses and slowest 10% of reaction times) and drive violations demonstrated a similar direction of change on N1 and N2. Participants who demonstrated a decline in performance showed reduced TST in the 48 h prior to shifts compared to those who demonstrated no decline in performance across the shift. Likely due to short sleep prior, the end of N2 was associated with pronounced performance impairments on the PVT and drive violations compared to the start of the shift. The findings suggest that drive violations may be more sensitive to sleep loss compared to the other driving measures examined in this study. This study also emphasizes the need for adequate recovery sleep between night shifts.
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Affiliation(s)
- Saranea Ganesan
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Australia
| | - Jessica E Manousakis
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Megan D Mulhall
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Australia
| | - Tracey L Sletten
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Australia
| | - Andrew Tucker
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Australia
| | - Mark E Howard
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Australia.,Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
| | - Clare Anderson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Australia
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Australia
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20
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Sprajcer M, Thomas MJW, Sargent C, Crowther ME, Boivin DB, Wong IS, Smiley A, Dawson D. How effective are Fatigue Risk Management Systems (FRMS)? A review. ACCIDENT; ANALYSIS AND PREVENTION 2022; 165:106398. [PMID: 34756484 PMCID: PMC8806333 DOI: 10.1016/j.aap.2021.106398] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/30/2021] [Accepted: 09/09/2021] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Fatigue Risk Management Systems (FRMS) are a data-driven set of management practices for identifying and managing fatigue-related safety risks. This approach also considers sleep and work time, and is based on ongoing risk assessment and monitoring. This narrative review addresses the effectiveness of FRMS, as well as barriers and enablers in the implementation of FRMS. Furthermore, this review draws on the literature to provide evidence-based policy guidance regarding FRMS implementation. METHODS Seven databases were drawn on to identify relevant peer-reviewed literature. Relevant grey literature was also reviewed based on the authors' experience in the area. In total, 2129 records were screened based on the search strategy, with 231 included in the final review. RESULTS Few studies provide an evidence-base for the effectiveness of FRMS as a whole. However, FRMS components (e.g., bio-mathematical models, self-report measures, performance monitoring) have improved key safety and fatigue metrics. This suggests FRMS as a whole are likely to have positive safety outcomes. Key enablers of successful implementation of FRMS include organisational and worker commitment, workplace culture, and training. CONCLUSIONS While FRMS are likely to be effective, in organisations where safety cultures are insufficiently mature and resources are less available, these systems may be challenging to implement successfully. We propose regulatory bodies consider a hybrid model of FRMS, where organisations could choose to align with tight hours of work (compliance) controls. Alternatively, where organisational flexibility is desired, a risk-based approach to fatigue management could be implemented.
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Affiliation(s)
| | | | | | | | - Diane B Boivin
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Imelda S Wong
- Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health, USA
| | | | - Drew Dawson
- Appleton Institute, CQUniversity, Adelaide, Australia
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21
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Maisey G, Cattani M, Devine A, Lo J, Fu SC, Dunican IC. Digging for data: How sleep is losing out to roster design, sleep disorders, and lifestyle factors. APPLIED ERGONOMICS 2022; 99:103617. [PMID: 34700190 DOI: 10.1016/j.apergo.2021.103617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/10/2021] [Accepted: 10/19/2021] [Indexed: 06/13/2023]
Abstract
Shift workers employed at a remote mining operation may experience sleep loss, impaired alertness, and consequently negative health and safety outcomes. This study determined the sleep behaviors and prevalence of risk for sleep disorders among shift workers; and quantified alertness for a roster cycle. Sleep duration was significantly less following; night shift by 77 ± 7 min and day shift by 30 ± 7 min. The wake after sleep onset was less by 23 ± 3 min for night shifts and 22 ± 3 min for day shifts (p < 0.05 for all). The prevalence of risk for sleep apnea was 31%, insomnia was 8%, and shiftwork disorder was 44%. Average alertness for all working hours was 75%. Shiftwork in remote mining operations is a significant factor that leads to sleep loss and reduced alertness, which is exacerbated by the high prevalence of risk for sleep disorders.
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Affiliation(s)
- Gemma Maisey
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia.
| | - Marcus Cattani
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia
| | - Amanda Devine
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Perth, W.A., Australia
| | - Shih Ching Fu
- School of Science, Edith Cowan University, Perth, W.A., Australia
| | - Ian C Dunican
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia
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22
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Dugan AG, Decker RE, Zhang Y, Lombardi CM, Garza JL, Laguerre RA, Suleiman AO, Namazi S, Cavallari JM. Precarious Work Schedules and Sleep: A Study of Unionized Full-Time Workers. OCCUPATIONAL HEALTH SCIENCE 2022; 6:247-277. [PMID: 35372671 PMCID: PMC8962924 DOI: 10.1007/s41542-022-00114-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 02/22/2022] [Accepted: 03/03/2022] [Indexed: 11/28/2022]
Abstract
Unlike precarious employment which is temporary and insecure, with inadequate pay, benefits, and legal protections, precarious work schedules can affect workers with permanent full-time jobs in sectors where employment has historically been secure, well-compensated, and even unionized. Precarious work schedules - characterized by long shifts, non-daytime hours, intensity and unsocial work hours - are increasingly prevalent. Relations between precarious work schedules and poor health are not well understood, and less is known about how to attenuate this relation. We examined the indirect effects of precarious work schedules on fatigue and depressive symptoms through sleep quantity. Two moderators - schedule flexibility and sleep quality - were examined as buffers of these associations. Workers from the Departments of Correction and Transportation in a northeast state (N = 222) took surveys and reported on demographics, work schedule characteristics, schedule flexibility, sleep quality and quantity, fatigue, and depressive symptoms. Results revealed that precarious work schedules had indirect effects on fatigue and depressive symptoms through sleep quantity. Schedule flexibility moderated the relation between precarious work schedules and sleep quantity, such that workers with greater schedule flexibility had more hours of sleep. Sleep quality moderated the association between sleep quantity and fatigue and depressive symptoms, such that workers reported greater fatigue and depressive symptoms when they had poorer sleep quality. Findings have direct applicability for developing initiatives that enhance Total Worker Health® through individual and organizational changes. Supplementary Information The online version contains supplementary material available at 10.1007/s41542-022-00114-y.
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Affiliation(s)
- Alicia G Dugan
- Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Ragan E Decker
- Society for Human Resource Management, 1800 Duke Street, Alexandria, VA 22314 USA
| | - Yuan Zhang
- Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, 113 Wilder Street, Lowell, MA 01854-5126 USA
| | - Caitlin M Lombardi
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT 06269 USA
| | - Jennifer L Garza
- Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Rick A Laguerre
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06269 USA
| | - Adekemi O Suleiman
- Department of Public Health Sciences, University of Connecticut School of Medicine, 195 Farmington Ave, Farmington, CT 06030 USA
| | - Sara Namazi
- Department of Health Sciences, Springfield College, 468 Alden St, Springfield, MA 01109 USA
| | - Jennifer M Cavallari
- Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030 USA.,Department of Public Health Sciences, University of Connecticut School of Medicine, 195 Farmington Ave, Farmington, CT 06030 USA
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23
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Gurubhagavatula I, Barger LK, Barnes CM, Basner M, Boivin DB, Dawson D, Drake CL, Flynn-Evans EE, Mysliwiec V, Patterson PD, Reid KJ, Samuels C, Shattuck NL, Kazmi U, Carandang G, Heald JL, Van Dongen HP. Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society. J Clin Sleep Med 2021; 17:2283-2306. [PMID: 34666885 PMCID: PMC8636361 DOI: 10.5664/jcsm.9512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022]
Abstract
CITATION Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: (1) a recognition of the factors contributing to fatigue and fatigue-related risks; (2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and (3) an informed approach to selecting workplace-specific strategies for managing work hours. We propose a series of guiding principles to assist stakeholders with designing a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.
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Affiliation(s)
- Indira Gurubhagavatula
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Laura K. Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Christopher M. Barnes
- Department of Management and Organization, Foster School of Business, University of Washington, Seattle, WA, USA
| | - Mathias Basner
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Diane B. Boivin
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Drew Dawson
- Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | | | - Erin E. Flynn-Evans
- Fatigue Countermeasures Laboratory, NASA Ames Research Center, Moffett Field, CA, USA
| | - Vincent Mysliwiec
- STRONG STAR ORU, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, TX, USA
| | - P. Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathryn J. Reid
- Center for Circadian and Sleep Medicine, Department of Neurology, Division of Sleep Medicine, Northwestern University, Chicago, IL, USA
| | - Charles Samuels
- Centre for Sleep and Human Performance, Calgary, Alberta, Canada
| | - Nita Lewis Shattuck
- Operations Research Department, Naval Postgraduate School, Monterey, CA, USA
| | - Uzma Kazmi
- American Academy of Sleep Medicine, Darien, IL, USA
| | | | | | - Hans P.A. Van Dongen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
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24
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Wingelaar-Jagt YQ, Wingelaar TT, Riedel WJ, Ramaekers JG. Fatigue in Aviation: Safety Risks, Preventive Strategies and Pharmacological Interventions. Front Physiol 2021; 12:712628. [PMID: 34552504 PMCID: PMC8451537 DOI: 10.3389/fphys.2021.712628] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/06/2021] [Indexed: 01/22/2023] Open
Abstract
Fatigue poses an important safety risk to civil and military aviation. In addition to decreasing performance in-flight (chronic) fatigue has negative long-term health effects. Possible causes of fatigue include sleep loss, extended time awake, circadian phase irregularities and work load. Despite regulations limiting flight time and enabling optimal rostering, fatigue cannot be prevented completely. Especially in military operations, where limits may be extended due to operational necessities, it is impossible to rely solely on regulations to prevent fatigue. Fatigue management, consisting of preventive strategies and operational countermeasures, such as pre-flight naps and pharmaceuticals that either promote adequate sleep (hypnotics or chronobiotics) or enhance performance (stimulants), may be required to mitigate fatigue in challenging (military) aviation operations. This review describes the pathophysiology, epidemiology and effects of fatigue and its impact on aviation, as well as several aspects of fatigue management and recommendations for future research in this field.
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Affiliation(s)
- Yara Q Wingelaar-Jagt
- Center for Man in Aviation, Royal Netherlands Air Force, Soesterberg, Netherlands.,Department of of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Thijs T Wingelaar
- Diving Medical Center, Royal Netherlands Navy, Den Helder, Netherlands
| | - Wim J Riedel
- Department of of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Johannes G Ramaekers
- Department of of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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25
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Hakola T, Niemelä P, Rönnberg S, Ropponen A. Longer Work Shifts, Faster Forward Rotation-More Sleep and More Alert in Aircraft Inspection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158105. [PMID: 34360399 PMCID: PMC8345940 DOI: 10.3390/ijerph18158105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this intervention study is to compare sleep, alertness, and work ability among aircraft inspectors working under two different shift schedules. The original schedule was forward rotating: MMM – – EEE – NNN – – – (M = morning, E = evening, N = night, – = day off). The new schedule was fast forward rotating: MEN – – with 10-h shifts. The baseline data were collected before the schedule changed, and the follow-up data 12 months (n = 10, Group A) or 5 months (n = 13, Group B) after the change. Three of subjects were women and average age was 46.6 years (range 31–58). The surveys included questions on sleep quantity, sleep quality, severe sleepiness, alertness, perceived stress, current work ability, and satisfaction with the shift schedule. The results indicated that in the new schedule, the sleeping times were longer and sleep loss was less. Moreover, shift specific severe sleepiness decreased, and alertness during shifts improved. Compared to baseline, perceived stress was lower and work ability was better. Satisfaction with the shift system had also improved. To conclude, the quickly forward rotating shift system might be beneficial in terms of increased sleep length and improved alertness and overall well-being especially among older aircraft inspectors.
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Affiliation(s)
- Tarja Hakola
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00032 Työterveyslaitos, Finland;
- Correspondence:
| | - Paula Niemelä
- Finnair Health Services, P.O. Box 15, 01053 Finnair, Finland; (P.N.); (S.R.)
| | - Sari Rönnberg
- Finnair Health Services, P.O. Box 15, 01053 Finnair, Finland; (P.N.); (S.R.)
| | - Annina Ropponen
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00032 Työterveyslaitos, Finland;
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
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Cori JM, Manousakis JE, Koppel S, Ferguson SA, Sargent C, Howard ME, Anderson C. An evaluation and comparison of commercial driver sleepiness detection technology: a rapid review. Physiol Meas 2021; 42. [PMID: 34338222 DOI: 10.1088/1361-6579/abfbb8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/26/2021] [Indexed: 11/11/2022]
Abstract
Objective. Sleepiness-related motor vehicle crashes, caused by lack of sleep or driving during night-time hours, often result in serious injury or fatality. Sleepiness detection technology is rapidly emerging as a sleepiness risk mitigation strategy for drivers. Continuous monitoring technologies assess and alert to driver sleepiness in real-time, while fit for duty technologies provide a single assessment of sleepiness state. The aim of this rapid review was to evaluate and compare sleepiness detection technologies in relation to specifications, cost, target consumer group and validity.Approach. We evaluated a range of sleepiness detection technologies suitable for consumer groups ranging from regular drivers in private vehicles through to work-related drivers within large businesses.Main results. Continuous monitoring technologies typically ranged between $100 and $3000 AUD and had ongoing monthly costs for telematics functionality and manager alerts. Fit for duty technologies had either a one-off purchase cost or a monthly subscription cost. Of concern, the majority of commercial continuous monitoring technologies lacked scientific validation. While some technologies had promising findings in terms of their ability to detect and reduce driver sleepiness, further validation work is required. Field studies that evaluate the sensitivity and specificity of technology alerts under conditions that are regularly experienced by drivers are necessary. Additionally, there is a need for longitudinal naturalistic driving studies to determine whether sleepiness detection technologies actually reduce sleepiness-related crashes or near-crashes.Significance. There is an abundance of sleepiness detection technologies on the market, but a majority lacked validation. There is a need for these technologies and their validation to be regulated by a driver safety body. Otherwise, consumers will base their technology choices on cost and features, rather than the ability to save lives.
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Affiliation(s)
- Jennifer M Cori
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.,Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.,Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Jessica E Manousakis
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Sjaan Koppel
- Monash University Accident Research Centre, Monash University, Melbourne, Australia
| | - Sally A Ferguson
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Wayville, South Australia, 5034, Australia
| | - Charli Sargent
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Wayville, South Australia, 5034, Australia
| | - Mark E Howard
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.,Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.,Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Department of Medicine, University of Melbourne, Australia
| | - Clare Anderson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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Gurubhagavatula I, Barger LK, Barnes CM, Basner M, Boivin DB, Dawson D, Drake CL, Flynn-Evans EE, Mysliwiec V, Patterson PD, Reid KJ, Samuels C, Shattuck NL, Kazmi U, Carandang G, Heald JL, Van Dongen HPA. Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society. Sleep 2021; 44:6312566. [PMID: 34373924 DOI: 10.1093/sleep/zsab161] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/17/2021] [Indexed: 11/12/2022] Open
Abstract
Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: (1) a recognition of the factors contributing to fatigue and fatigue-related risks; (2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and (3) an informed approach to selecting workplace-specific strategies for managing work hours. We propose a series of guiding principles to assist stakeholders with designing a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.
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Affiliation(s)
- Indira Gurubhagavatula
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Laura K Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Christopher M Barnes
- Department of Management and Organization, Foster School of Business, University of Washington, Seattle, WA, USA
| | - Mathias Basner
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Diane B Boivin
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Drew Dawson
- Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | | | - Erin E Flynn-Evans
- Fatigue Countermeasures Laboratory, NASA Ames Research Center, Moffett Field, CA, USA
| | - Vincent Mysliwiec
- STRONG STAR ORU, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, TX, USA
| | - P Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathryn J Reid
- Center for Circadian and Sleep Medicine, Department of Neurology, Division of Sleep Medicine, Northwestern University, Chicago, IL, USA
| | - Charles Samuels
- Centre for Sleep and Human Performance, Calgary, Alberta, Canada
| | - Nita Lewis Shattuck
- Operations Research Department, Naval Postgraduate School, Monterey, CA, USA
| | - Uzma Kazmi
- American Academy of Sleep Medicine, Darien, IL, USA
| | | | | | - Hans P A Van Dongen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
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28
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Sprajcer M, Vincent GE, Jay SM, Vakulin A, Lack L, Ferguson SA. Perception versus Reality: The Relationship between Subjective and Objective Measures of Sleep When On-call under Simulated Laboratory Conditions. Behav Sleep Med 2021; 19:533-546. [PMID: 32835537 DOI: 10.1080/15402002.2020.1807985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND On-call working arrangements have been shown to negatively impact sleep. However, workers may perceive their sleep to be worse than it actually is. The aim of this study was to compare participants' pre- and post-sleep estimates of sleep duration and sleep quality with objectively measured sleep when on-call under laboratory conditions. PARTICIPANTS 72 healthy, adult males. METHODS Analyses were performed on three interrelated studies, all of which consisted of four nights in a sleep laboratory. Following adaptation and baseline nights were two on-call nights (sleep opportunity 23:00 h - 07:00 h). Before and after each sleep opportunity, participants provided subjective estimates of sleep. Sleep was objectively measured using polysomnography. RESULTS Estimated sleep duration (6.74 ± 1.13 h) and sleep onset latency (20.55 ± 14.85 min) were significantly poorer than objectively measured sleep outcomes (sleep duration 7.21 ± 1.25 h; sleep latency 13.20 ± 10.06 min). Of the variance in post-sleep estimated sleep duration, 14% was associated with objectively measured minutes of N3 (R2Δ = 0.55) and REM (R2Δ = 0.75). Additionally, 14% of post-sleep sleep quality estimation variance was associated with minutes of N2 (R2Δ = 0.60) and N3 (R2Δ = 0.79), measured by polysomnography. CONCLUSIONS Some objective measures of sleep were associated with subjective estimates of sleep duration and sleep quality. However, individuals may overestimate sleep onset latency and underestimate sleep duration during on-call periods. It may be beneficial for on-call workers to actively reflect on feelings of fatigue/alertness for workplace fatigue management, rather than relying solely on estimates of sleep.
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Affiliation(s)
- M Sprajcer
- Appleton Institute, Central Queensland University, Adelaide, Australia
| | - G E Vincent
- Appleton Institute, Central Queensland University, Adelaide, Australia
| | - S M Jay
- Appleton Institute, Central Queensland University, Adelaide, Australia
| | - A Vakulin
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia.,Woolcock Institute of Medical Research, Centre for Sleep and Chronobiology, Sydney, New South Wales, Australia
| | - L Lack
- Adelaide Institute for Sleep Health, College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia
| | - S A Ferguson
- Appleton Institute, Central Queensland University, Adelaide, Australia
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29
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Onninen J, Pylkkönen M, Tolvanen A, Sallinen M. Accumulation of sleep loss among shift-working truck drivers. Chronobiol Int 2021; 38:1344-1353. [PMID: 34030528 DOI: 10.1080/07420528.2021.1929280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Sleep loss is known to contribute to road traffic accidents. Professional drivers are vulnerable to curtailment of sleep due to long driving bouts and shift work. To fill in the gap in the literature related to the buildup of sleep loss in irregular shift systems, we recorded the sleep and working hours of 47 shift-working long-haul truck drivers during a two-week period. Sleep (time in bed) was verified by actigraphy and sleep logs. Sleepiness was measured using the Karolinska Sleepiness Scale (KSS). Individual sleep need was based on self-assessments. We examined the accumulated sleep versus self-reported sleep need across the study period, using midnights as points of observation, and the accumulated sleep loss within 72 h prior to shift end (sleep versus need, SVN72). Across the study period, the drivers' sleep was close to their self-reported sleep need, but 45% of the drivers showed accumulated sleep loss of >6 h at least once. SVN72 averaged -1.5 h and was 2.87 h shorter in connection with morning shifts compared to day or evening shifts. Night shifts showed no such difference. During days off, sleep exceeded sleep need by 1.13 h and was not dependent on the type of preceding work shift. SVN72 showed small-to-medium negative associations with on-duty KSS even after accounting for sleep within the 24 h prior to the shift end. Our results show that long-haul truck drivers are exposed to severe levels of accumulated sleep loss while working irregular shifts, but they can catch up on their lost sleep, especially during days off.
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Affiliation(s)
- Jussi Onninen
- Finnish Institute of Occupational Health, Helsinki, Finland.,Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Mia Pylkkönen
- Finnish Institute of Occupational Health, Helsinki, Finland.,Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Asko Tolvanen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Mikael Sallinen
- Finnish Institute of Occupational Health, Helsinki, Finland.,Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
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30
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Iridiastadi H. Fatigue in the Indonesian rail industry: A study examining passenger train drivers. APPLIED ERGONOMICS 2021; 92:103332. [PMID: 33249276 DOI: 10.1016/j.apergo.2020.103332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 11/08/2020] [Accepted: 11/14/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The railway industry in Indonesia has grown substantially in the past five years, with greater network and tracks length that will double in 2030. There has been a growing concern, however, that fatigue among front-line personnel have not been addressed satisfactorily. This study aimed at evaluating the degree of fatigue among passenger train drivers and suggested practical recommendations to the Indonesian Railway Company. METHOD A total of 32 train drivers (driving for about 4 h during the morning or afternoon shifts) agreed to participate in the study. Subjective and objective measures of fatigue (and sleepiness) were obtained prior to, during, and immediately following the end of a duty. Fatigue and driving performance were also determined based on (off-line) analysis of continuous video recordings of the drivers performing the duty. RESULTS Fatigue generally increased as a function of time and, for some, 2 h of driving was sufficient in inducing substantial level of fatigue increase. Unlike the morning shift, the afternoon shift was characterized with increased undue fatigue and unacceptable level of performance decrements. CONCLUSION In general, fatigue was not found among train drivers working the morning shift. For these drivers, however, there were a couple of individuals with excessive levels of fatigue. The effects of fatigue were more apparent for the afternoon shift. This is possibly due to the degraded sleep quality as a result of split rest periods obtained prior to the duty. It is suggested in this study that the company pay a much closer attention to the work-sleep schedules, and to improve sleep quality by redesigning better sleeping arrangements.
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Affiliation(s)
- Hardianto Iridiastadi
- Faculty of Industrial Technology, Institut Teknologi Bandung, JL. Ganesha No. 10, Bandung, 40132, Indonesia.
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31
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Tseng VWS, Valliappan N, Ramachandran V, Choudhury T, Navalpakkam V. Digital biomarker of mental fatigue. NPJ Digit Med 2021; 4:47. [PMID: 33707736 PMCID: PMC7952693 DOI: 10.1038/s41746-021-00415-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 02/08/2021] [Indexed: 01/28/2023] Open
Abstract
Mental fatigue is an important aspect of alertness and wellbeing. Existing fatigue tests are subjective and/or time-consuming. Here, we show that smartphone-based gaze is significantly impaired with mental fatigue, and tracks the onset and progression of fatigue. A simple model predicts mental fatigue reliably using just a few minutes of gaze data. These results suggest that smartphone-based gaze could provide a scalable, digital biomarker of mental fatigue.
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32
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Dawson D, Sprajcer M, Thomas M. How much sleep do you need? A comprehensive review of fatigue related impairment and the capacity to work or drive safely. ACCIDENT; ANALYSIS AND PREVENTION 2021; 151:105955. [PMID: 33383522 DOI: 10.1016/j.aap.2020.105955] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 06/12/2023]
Abstract
In developed countries, deaths attributable to driving or working while intoxicated have steadily declined over recent decades. In part, this has been due to (a) public education programs about the risks and (b) the deterrence value associated with penalties and prosecutions based on an individual being 'deemed impaired' if they exceed a proscribed level of blood alcohol or drug concentration while driving/working. In contrast, the relative proportion of fatigue-related accidents have remained stubbornly high despite significant public and workplace education. As such, it may be useful to introduce the legal principle of 'deemed impaired' with respect to fatigue and/or sleep loss. A comprehensive review of the impairment and accident literature was performed, including 44 relevant publications. Findings from this review suggests that a driver or worker might reasonably be 'deemed impaired' once the amount of sleep falls below five hours in the prior 24. Building on the legal principles first outlined in recent New Jersey legislation (Maggie's Law), this review argues that an individual can reasonably be 'deemed impaired' based on prior sleep wake behaviour. In Maggie's Law, a driver can be indirectly 'deemed impaired' if they have not slept in the prior 24 h. Based on the extant literature, we argue that, relative to drug and alcohol intoxication, this may be overly conservative. While roadside measurement of fatigue and prior sleep-wake behavior is not yet possible, we suggest that public education programs should provide specific guidance on the amount of sleep required and that post-accident forensic examination of prior sleep wake behaviours may help the community to determine unsafe behaviours and liability more objectively than is currently the case.
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Affiliation(s)
- D Dawson
- Appleton Institute, Central Queensland University, Adelaide, South Australia, Australia.
| | - M Sprajcer
- Appleton Institute, Central Queensland University, Adelaide, South Australia, Australia
| | - M Thomas
- Appleton Institute, Central Queensland University, Adelaide, South Australia, Australia
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33
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Åkerstedt T, Klemets T, Karlsson D, Häbel H, Widman L, Sallinen M. Acute and cumulative effects of scheduling on aircrew fatigue in ultra-short-haul operations. J Sleep Res 2021; 30:e13305. [PMID: 33631838 DOI: 10.1111/jsr.13305] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/20/2020] [Accepted: 01/20/2021] [Indexed: 01/20/2023]
Abstract
Aircrew fatigue constitutes a safety hazard in aviation, which authorities attempt to mitigate through flight time limitations. Some gaps in knowledge exist, however. The purpose of the present study was to investigate the associations of schedule characteristics with fatigue and amount of sleep in the acute 24-h window, and as cumulative effects across the 7-day work period. One hundred and six aircrew (14% cabin crew) participated. They rated fatigue on the Karolinska Sleepiness Scale (KSS) three times per flight day for four 7-day work periods, with up to 7 days off between work periods. Mixed model regression was applied to the data. In the multivariable model, more sleep was associated with lower fatigue (p = .000)), corresponding to 0.26 KSS units less per hour of sleep. Very early, early and late duty types, as well as duty time, were associated with higher fatigue. For the 7-day work period, accumulation of very early duties and longer duty time were associated with increased fatigue, and more accumulated sleep was associated with lower fatigue in the adjusted model (0.08 KSS units per hour of sleep) (p = .000). Accumulated duty time was not significant when analysed as a single variable, but became so after adjustment for sleep. The results suggest that sleep, duty time and early starts are important predictors of fatigue in the 24-h window and that the number of very early starts and short sleep have cumulative effects on fatigue across a 7-day work period.
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Affiliation(s)
- Torbjorn Åkerstedt
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Stress Research Institute, University of Stockholm, Stockholm, Sweden
| | | | | | - Henrike Häbel
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Linnea Widman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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34
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Mohd Fauzi MF, Mohd Yusoff H, Mat Saruan NA, Muhamad Robat R, Abdul Manaf MR, Ghazali M. Fatigue and recovery among Malaysian doctors: the role of work-related activities during non-work time. BMJ Open 2020; 10:e036849. [PMID: 32978189 PMCID: PMC7520834 DOI: 10.1136/bmjopen-2020-036849] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES This paper aims to estimate the level of acute fatigue, chronic fatigue and intershift recovery among doctors working at public hospitals in Malaysia and determine their inter-relationship and their association with work-related activities during non-work time. DESIGN Cross-sectional. SETTING Seven core clinical disciplines from seven tertiary public hospitals in Malaysia. PARTICIPANTS Study was conducted among 330 randomly-sampled doctors. Response rate was 80.61% (n=266). RESULTS The mean score of acute fatigue, chronic fatigue and intershift recovery were 68.51 (SD=16.549), 54.60 (SD=21.259) and 37.29 (SD=19.540), respectively. All these scores were out of 100 points each. Acute and chronic fatigue were correlated (r=0.663), and both were negatively correlated with intershift recovery (r=-0.704 and r=-0.670, respectively). Among the work-related activities done during non-work time, work-related ruminations dominated both the more frequent activities and the association with poorer fatigue and recovery outcomes. Rumination on being scolded/violated was found to be positively associated with both acute fatigue (adjusted regression coefficient (Adj.b)=2.190, 95% CI=1.139 to 3.240) and chronic fatigue (Adj.b=5.089, 95% CI=3.876 to 6.303), and negatively associated with recovery (Adj.b=-3.316, 95% CI=-4.516 to -2.117). Doing work task at workplace or attending extra work-related activities such as locum and attending training were found to have negative associations with fatigue and positive associations with recovery. Nevertheless, doing work-related activities at home was positively associated with acute fatigue. In terms of communication, it was found that face-to-face conversation with partner did associate with higher recovery but virtual conversation with partner associated with higher acute fatigue and lower recovery. CONCLUSIONS Work-related ruminations during non-work time were common and associated with poor fatigue and recovery outcomes while overt work activities done at workplace during non-work time were associated with better fatigue and recovery levels. There is a need for future studies with design that allow causal inference to address these relationships.
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Affiliation(s)
- Mohd Fadhli Mohd Fauzi
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
- Occupational and Environmental Health Unit, Selangor State Health Department, Shah Alam, Malaysia
| | - Hanizah Mohd Yusoff
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Nur Adibah Mat Saruan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
- Occupational and Environmental Health Unit, Selangor State Health Department, Shah Alam, Malaysia
| | - Rosnawati Muhamad Robat
- Occupational and Environmental Health Unit, Selangor State Health Department, Shah Alam, Malaysia
| | - Mohd Rizal Abdul Manaf
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Maisarah Ghazali
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
- Occupational and Environmental Health Unit, Selangor State Health Department, Shah Alam, Malaysia
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35
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Dawson D, Ferguson SA, Vincent GE. Safety implications of fatigue and sleep inertia for emergency services personnel. Sleep Med Rev 2020; 55:101386. [PMID: 33027747 DOI: 10.1016/j.smrv.2020.101386] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/12/2020] [Accepted: 07/13/2020] [Indexed: 12/31/2022]
Abstract
Emergency services present a unique operational environment for the management of fatigue and sleep inertia. Communities request and often expect the provision of emergency services on a 24/7/365 basis. This can result in highly variable workloads and/or significant need for on-demand or on-call working time arrangements. In turn, the management of fatigue-related risk requires a different approach than in other more predictable shift working sectors (e.g., mining and manufacturing). The aim of this review is to provide a comprehensive overview of fatigue risk management that is accessible to regulators, policy makers and organisations in the emergency services sector. The review outlines the unique fatigue challenges in the emergency services sector, examines the current scientific and policy consensus around managing fatigue and sleep inertia, and finally discusses strategies that emergency services organisations can use to minimise the risks associated with fatigue and sleep inertia.
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Affiliation(s)
- Drew Dawson
- Central Queensland University, Appleton Institute, Adelaide, South Australia, Australia.
| | - Sally A Ferguson
- Central Queensland University, Appleton Institute, Adelaide, South Australia, Australia
| | - Grace E Vincent
- Central Queensland University, Appleton Institute, Adelaide, South Australia, Australia
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36
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Caldwell JL, Schroeder VM, Kunkle CL, Stephenson HG. Differential effects of modafinil on performance of low-performing and high-performing individuals during total sleep deprivation. Pharmacol Biochem Behav 2020; 196:172968. [DOI: 10.1016/j.pbb.2020.172968] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/08/2020] [Accepted: 06/13/2020] [Indexed: 12/31/2022]
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37
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Jeklin AT, Davies HW, Bredin SSD, Hives BA, Meanwell LE, Perrotta AS, Warburton DER. Fatigue and sleep patterns among Canadian wildland firefighters during a 17-day fire line deployment. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2020; 17:364-371. [PMID: 32469682 DOI: 10.1080/15459624.2020.1759809] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The purpose of this investigation was to enhance our understanding of the effects the current British Columbia Wildfire Service (BCWS) firefighting schedule have on the development of fatigue and sleep deprivation. This was a cohort study that objectively and subjectively measured sleep quantity, sleep quality, and fatigue throughout a 17-day British Columbia wildland firefighting deployment. Wildland firefighters (n = 30) conducted daily testing of sleep and fatigue measures during 14 days of activity on the fire line and three days immediately post deployment during their three-day rest period, for a total of 17 days of data collection. Sleep was assessed using wrist-worn actigraphy (ActiGraph LLC, Pensacola, FL) and subjective sleep questionnaires. Fatigue was assessed using subjective fatigue questionnaires and cognitive performance through the psychomotor vigilance test. Total sleep time was less on fire days (M = 6.6 h ± 49.2 min) compared to non-fire days (M = 6.8 h ± 92.2 min). Participants performed poorer on cognitive performance tests, (p = 0.288), and reported being significantly sleepier, (p = 0.038), toward the end of their 17-day deployment compared to day 1. Participants continued to report high levels of sleepiness, fatigue, and poor quality of sleep on their rest days compared to their fire line days. Working 14 consecutive days was associated with increased levels of objective fatigue and suboptimal sleep in wildland firefighters. Wildland firefighters reported significantly higher levels of fatigue and decreased alertness with increasing days on deployment and these levels did not improve following a three-day rest period.
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Affiliation(s)
- Andrew T Jeklin
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- School of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Hugh W Davies
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shannon S D Bredin
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ben A Hives
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leah E Meanwell
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew S Perrotta
- Department of Kinesiology, Langara College, Vancouver, British Columbia, Canada
| | - Darren E R Warburton
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Experimental Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Riedy S, Dawson D, Fekedulegn D, Andrew M, Vila B, Violanti JM. Fatigue and short-term unplanned absences among police officers. POLICING (BRADFORD, ENGLAND) 2020; 43:483-494. [PMID: 34135688 PMCID: PMC8205509 DOI: 10.1108/pijpsm-10-2019-0165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE – The purpose of this paper is to assess whether shift work, sleep loss and fatigue are related to short-term unplanned absences in policing. DESIGN/METHODOLOGY/APPROACH – N = 367 police officers from the Buffalo Police Department were studied. Day-by-day work and sick leave data were obtained from the payroll. Absenteeism was defined as taking a single sick day on a regularly scheduled workday. Biomathematical models of fatigue (BMMF) predicted officers' sleep-wake behaviors and on-duty fatigue and sleepiness. Prior sleep, fatigue and sleepiness were tested as predictors of absenteeism during the next shift. FINDINGS – A total of 513,666 shifts and 4,868 cases of absenteeism were studied. The odds of absenteeism increased as on-duty fatigue and sleepiness increased and prior sleep decreased. This was particularly evident for swing shift officers and night shift officers who were predicted by BMMF to obtain less sleep and have greater fatigue and sleepiness than day shift officers. The odds of absenteeism were higher for female officers than male officers; this finding was not due to a differential response to sleep loss, fatigue or sleepiness. PRACTICAL IMPLICATIONS – Absenteeism may represent a self-management strategy for fatigue or compensatory behavior to reduced sleep opportunity. Long and irregular work hours that reduce sleep opportunity may be administratively controllable culprits of absenteeism. ORIGINALITY/VALUE – Police fatigue has consequences for police officers, departments and communities. BMMF provide a potential tool for predicting and mitigating police fatigue. BMMF were used to investigate the effects of sleep and fatigue on absenteeism.
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Affiliation(s)
- Samantha Riedy
- Sleep and Performance Research Center, Washington State University, Spokane, Washington, USA
| | - Drew Dawson
- Appleton Institute, Central Queensland University, Wayville, Australia
| | - Desta Fekedulegn
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Michael Andrew
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Bryan Vila
- Department of Criminal Justice and Criminology, Washington State University, Spokane, Washington, USA
| | - John M Violanti
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York, USA
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Stroemel-Scheder C, Kundermann B, Lautenbacher S. The effects of recovery sleep on pain perception: A systematic review. Neurosci Biobehav Rev 2020; 113:408-425. [PMID: 32275917 DOI: 10.1016/j.neubiorev.2020.03.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 03/13/2020] [Accepted: 03/29/2020] [Indexed: 01/04/2023]
Abstract
Experimental studies highlight profound effects of sleep disruptions on pain, showing that sleep deprivation (SD) leads to hyperalgesic pain changes. On the other hand, given that sleep helps normalizing bodily functions, a crucial role of restorative sleep in the overnight restoration of the pain system seems likely. Thus, a systematic review of experimental studies on effects of recovery sleep (RS; subsequently to SD) on pain was performed with the aim to check whether RS resets hyperalgesic pain changes occurring due to SD. Empirical animal and human studies including SD-paradigms, RS and pain assessments were searched in three databases (PubMed, Web of Science, PsycINFO) using a predefined algorithm. 29 studies were included in this review. Most results indicated a reset of enhanced pain sensitivity and vulnerability following RS, especially when total SD was implemented and pressure pain or painful symptoms (human studies) were assessed. Further research should focus on whether and how recovery is altered in chronic pain patients, as this yields implications for pain treatment by enhancing or stabilizing RS.
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Affiliation(s)
| | - Bernd Kundermann
- Vitos Clinic for Psychiatry and Psychotherapy Giessen, Giessen, Germany; Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Marburg, Germany.
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40
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Riedy SM, Fekedulegn D, Andrew M, Vila B, Dawson D, Violanti J. Generalizability of a biomathematical model of fatigue's sleep predictions. Chronobiol Int 2020; 37:564-572. [PMID: 32241186 DOI: 10.1080/07420528.2020.1746798] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction: Biomathematical models of fatigue (BMMF) predict fatigue during a work-rest schedule on the basis of sleep-wake histories. In the absence of actual sleep-wake histories, sleep-wake histories are predicted directly from work-rest schedules. The predicted sleep-wake histories are then used to predict fatigue. It remains to be determined whether workers organize their sleep similarly across operations and thus whether sleep predictions generalize.Methods: Officers (n = 173) enrolled in the Buffalo Cardio-Metabolic Occupational Police Stress study were studied. Officers' sleep-wake behaviors were measured using wrist-actigraphy and predicted using a BMMF (FAID Quantum) parameterized in aviation and rail. Sleepiness (i.e. Karolinska Sleepiness Scale (KSS) ratings) was predicted using actual and predicted sleep-wake data. Data were analyzed using sensitivity analyses.Results: During officers' 16.0 ± 1.9 days of study participation, they worked 8.6 ± 3.1 shifts and primarily worked day shifts and afternoon shifts. Across shifts, 7.0 h ± 1.9 h of actual sleep were obtained in the prior 24 h and associated peak KSS ratings were 5.7 ± 1.3. Across shifts, 7.2 h ± 1.1 h of sleep were predicted in the prior 24 h and associated peak KSS ratings were 5.5 ± 1.2. The minute-by-minute predicted and actual sleep-wake data demonstrated high sensitivity (80.4%). However, sleep was observed at all hours-of-the-day, but sleep was rarely predicted during the daytime hours.Discussion: The sleep-wake behaviors predicted by a BMMF parameterized in aviation and rail demonstrated high sensitivity with police officers' actual sleep-wake behaviors. Additional night shift data are needed to conclude whether BMMF sleep predictions generalize across operations.
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Affiliation(s)
- Samantha M Riedy
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Desta Fekedulegn
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Michael Andrew
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Bryan Vila
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Department of Criminal Justice and Criminology, Washington State University, Spokane, WA, USA
| | - Drew Dawson
- Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | - John Violanti
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
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Riedy SM, Roach GD, Dawson D. Sleep–wake behaviors exhibited by shift workers in normal operations and predicted by a biomathematical model of fatigue. Sleep 2020; 43:5811671. [DOI: 10.1093/sleep/zsaa049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 02/24/2020] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study Objectives
To compare rail workers’ actual sleep–wake behaviors in normal operations to those predicted by a biomathematical model of fatigue (BMMF). To determine whether there are group-level residual sources of error in sleep predictions that could be modeled to improve group-level sleep predictions.
Methods
The sleep–wake behaviors of 354 rail workers were examined during 1,722 breaks that were 8–24 h in duration. Sleep–wake patterns were continuously monitored using wrist-actigraphy and predicted from the work–rest schedule using a BMMF. Rail workers’ actual and predicted sleep–wake behaviors were defined as split-sleep (i.e. ≥2 sleep periods in a break) and consolidated-sleep (i.e. one sleep period in a break) behaviors. Sleepiness was predicted from the actual and predicted sleep–wake data.
Results
Consolidated-sleep behaviors were observed during 1,441 breaks and correctly predicted during 1,359 breaks. Split-sleep behaviors were observed during 280 breaks and correctly predicted during 182 breaks. Predicting the wrong type of sleep–wake behavior resulted in a misestimation of hours of sleep during a break. Relative to sleepiness predictions derived from actual sleep–wake data, predicting the wrong type of sleep–wake behavior resulted in a misestimation of sleepiness predictions during the subsequent shift.
Conclusions
All workers with the same work–rest schedule have the same predicted sleep–wake behaviors; however, these workers do not all exhibit the same sleep–wake behaviors in real-world operations. Future models could account for this group-level residual variance with a new approach to modeling sleep, whereby sub-group(s) may be predicted to exhibit one of a number of sleep–wake behaviors.
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Affiliation(s)
- Samantha M Riedy
- Sleep and Performance Research Center, Washington State University, Spokane, WA
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA
| | - Gregory D Roach
- Appleton Institute, Central Queensland University, Wayville, South Australia, Australia
| | - Drew Dawson
- Appleton Institute, Central Queensland University, Wayville, South Australia, Australia
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42
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Gander P, O'Keeffe K, Santos-Fernandez E, Huntington A, Walker L, Willis J. Development and evaluation of a matrix for assessing fatigue-related risk, derived from a national survey of nurses' work patterns. Int J Nurs Stud 2020; 112:103573. [PMID: 32334846 DOI: 10.1016/j.ijnurstu.2020.103573] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 02/19/2020] [Accepted: 03/07/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Multiple aspects of nurses' rosters interact to affect the quality of patient care they can provide and their own health, safety and wellbeing. OBJECTIVES (1) Develop and test a matrix incorporating multiple aspects of rosters and recovery sleep that are individually associated with three fatigue-related outcomes - fatigue-related clinical errors, excessive sleepiness and sleepy driving; and (2) evaluate whether the matrix also predicts nurses' ratings of the effects of rosters on aspects of life outside work. DESIGN Develop and test the matrix using data from a national survey of nurses' fatigue and work patterns in six hospital-based practice areas with high fatigue risk. METHODS Survey data included demographics, work patterns (previous 14 days), choice about shifts, and the extent to which work patterns cause problems with social life, home life, personal relationships, and other commitments (rated 1 = not at all to 5 = very much). Matrix variables were selected based on univariate associations with the fatigue-related outcomes, limits in the collective employment contract, and previous research. Each variable was categorised as lower (score 0), significant (score 1), or higher risk (score 2). Logistic multiple regression modelling tested the independent predictive power of matrix scores against models including all the (uncategorised) work pattern and recovery sleep variables with significant univariate associations with each outcome variable. Model fit was measured using Akaike and Bayesian Information Criterion statistics. RESULTS Data were included from 2358 nurses who averaged at least 30 h/week in the previous fortnight in one of the target practice areas. Final matrix variables were: total hours worked; number of shift extensions >30 min, night shifts; breaks < 9 h; breaks ≥ 24 h; nights with sleep 11pm to 7am; days waking fully rested; and roster change. After controlling for gender, ethnicity, years of nursing experience, and the extent of shift choice, the matrix score was a significant independent predictor of each of the three fatigue-related outcomes, and for all four aspects of life outside work. For all outcome variables, the model including the matrix score was a better fit to the data than the equivalent model including all the (uncategorised) work pattern variables. CONCLUSIONS A matrix that predicts the likelihood of nurses reporting fatigue-related safety outcomes can be used to compare the impact of rosters both at work and outside work. It can be used for roster design and management, and to guide nurses' choices about the shifts they work.
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Affiliation(s)
- Philippa Gander
- Sleep/Wake Research Centre, Massey University, Private Box 756, Wellington 6140, New Zealand.
| | - Karyn O'Keeffe
- Sleep/Wake Research Centre, Massey University, Private Box 756, Wellington 6140, New Zealand
| | - Edgar Santos-Fernandez
- Sleep/Wake Research Centre, Massey University, Private Box 756, Wellington 6140, New Zealand
| | | | - Leonie Walker
- School of Health Sciences, Massey University, New Zealand
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43
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Gajšek B, Ðukić G, Butlewski M, Opetuk T, Cajner H, Kač SM. The impact of the applied technology on health and productivity in manual "picker-to-part" systems. Work 2020; 65:525-536. [PMID: 32116272 DOI: 10.3233/wor-203107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Manual "picker-to-part" order picking takes place in a labour-intensive and time-consuming working environment where humans are the central actors and co-determine the effectiveness and efficiency of the process. Throughout Europe, work-related musculoskeletal disorders affect millions of workers, especially in the logistics sector, and cost employers billions of euros. OBJECTIVE This paper studies how order pickers relate the use of technology as well as their relationship with the logistics company to their well-being, health and productivity. METHODS To obtain data, a survey consisting of questions regarding work characteristics, health problems and the logistics company's relationship with employees was conducted in Poland, Slovenia and Croatia. RESULTS Workers who carry most items manually experience more health problems than cart and forklift users. The most common complaint is lower back pain - only 6% of order pickers (n = 221) never experienced it. The use of barcode or RFID scanner/terminal/smart phone correlates with more health problems than the use of other technologies. Participation in the selection of transport means or in training on health preservation can reduce the perceived health problems. CONCLUSIONS Workers' perception of the impact of the applied technology on health and productivity can differ from the impact that is calculated or measured. Through their relationship with employees, logistics companies can influence employees' perception of their health problems.
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Affiliation(s)
- Brigita Gajšek
- University of Maribor, Faculty of Logistics, Celje, Slovenia
| | - Goran Ðukić
- University of Zagreb, Faculty of Mechanical Engineering and Naval Architecture, Zagreb, Croatia
| | - Marcin Butlewski
- Poznan University of Technology, Faculty of Mechanical Engineering and Management, Poznan, Poland
| | - Tihomir Opetuk
- University of Zagreb, Faculty of Mechanical Engineering and Naval Architecture, Zagreb, Croatia
| | - Hrvoje Cajner
- University of Zagreb, Faculty of Mechanical Engineering and Naval Architecture, Zagreb, Croatia
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44
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Yaseen YA, Abdulah DM, Piro RS. Emotional intelligence dimensions as predictors of coping reactions to stress in nursing practitioners. Fukushima J Med Sci 2020; 65:99-108. [PMID: 31656254 PMCID: PMC7012585 DOI: 10.5387/fms.2019-11] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/01/2019] [Indexed: 11/12/2022] Open
Abstract
Stress is an inevitable part of nursing life. Nurses need to respond to their stressful environment contents to reduce negative consequences. We examined the role of dimensions of emotional intelligence in predicting coping reactions to stress in 201 college nursing practitioners in this cross-sectional study between November 2017 and January 2018. The nurses appraised their own emotions, but they were not sure that appraised others' emotions, regulated their and others' emotions. They could cope with new ideas and faced obstacles. Most of the nurses were moderately stressed. Those nurses were not able to regulate their own emotions were determined to have a higher level of perceived stress. Active coping, positive reframing and acceptance were the most prevalent coping mechanisms. The investigation showed that others' emotion appraisal was a predictor for self-blame reaction, and emotion utilization was the predictor for positive reframing and self-blame.
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Affiliation(s)
- Yousif Ali Yaseen
- Depaerment of Medicine, College of Medicine University of Duhok, Iraqi Kurdistan
| | - Deldar Morad Abdulah
- Adult Nursing Department, College of Nursing, University of Duhok, Iraqi Kurdistan
| | - Rasoul Sabri Piro
- Adult Nursing Department, College of Nursing, University of Duhok, Iraqi Kurdistan
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45
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Pichard LE, Simonelli G, Schwartz L, Balkin TJ, Hursh S. Precision Medicine for Sleep Loss and Fatigue Management. Sleep Med Clin 2019; 14:399-406. [PMID: 31375208 DOI: 10.1016/j.jsmc.2019.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Sleep loss is a widespread phenomenon and a public health threat. Sleep disorders, medical conditions, lifestyles, and occupational factors all contribute to insufficient sleep. Regardless of the underlying cause, insufficient sleep has well-defined consequences and the severity of said consequences partially influenced by individual characteristics. It is here where precision medicine needs to understand and define sleep insufficiency in hopes for personalizing medical approach to improve patient outcomes. Following a discussion on causes and consequences of sleep loss, this article discusses tools for assessing sleep sufficiency, mitigating strategies to sleep loss, and sleep loss in the context of fatigue management.
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Affiliation(s)
- Luis E Pichard
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA.
| | - Guido Simonelli
- Behavioral Biology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Lindsay Schwartz
- Institutes for Behavior Resources, Inc, 2104 Maryland Avenue, Baltimore, MD 21218, USA
| | - Thomas J Balkin
- Behavioral Biology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Steven Hursh
- Institutes for Behavior Resources, Inc, 2104 Maryland Avenue, Baltimore, MD 21218, USA
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46
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Banks S, Landon LB, Dorrian J, Waggoner LB, Centofanti SA, Roma PG, Van Dongen HP. Effects of fatigue on teams and their role in 24/7 operations. Sleep Med Rev 2019; 48:101216. [DOI: 10.1016/j.smrv.2019.101216] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 07/22/2019] [Accepted: 09/09/2019] [Indexed: 12/17/2022]
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47
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Epstein M, Söderström M, Jirwe M, Tucker P, Dahlgren A. Sleep and fatigue in newly graduated nurses-Experiences and strategies for handling shiftwork. J Clin Nurs 2019; 29:184-194. [PMID: 31609523 DOI: 10.1111/jocn.15076] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/30/2019] [Accepted: 09/29/2019] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore newly graduated nurses' strategies for, and experiences of, sleep problems and fatigue when starting shiftwork. A more comprehensive insight into nurses' strategies, sleep problems, fatigue experiences and contributing factors is needed to understand what support should be provided. BACKGROUND For graduate nurses, the first years of practice are often stressful, with many reporting high levels of burnout symptoms. Usually, starting working as a nurse also means an introduction to shiftwork, which is related to sleep problems. Sleep problems may impair stress management and, at the same time, stress may cause sleep problems. Previously, sleep problems and fatigue have been associated with burnout, poor health and increased accident risk. DESIGN AND METHODS Semi-structured interviews were conducted with nurses (N = 11) from four different Swedish hospitals, and qualitative inductive content analysis was used. The study was approved by the Regional Ethical Review Board in Stockholm. The COREQ checklist was followed. RESULTS Many nurses lacked effective strategies for managing sleep and fatigue in relation to shiftwork. Various strategies were used, of which some might interfere with factors regulating and promoting sleep such as the homeostatic drive. Sleep problems were common during quick returns, often due to difficulties unwinding before sleep, and high workloads exacerbated the problems. The described consequences of fatigue in a clinical work context indicated impaired executive and nonexecutive cognitive function. CONCLUSION The findings indicate that supporting strategies and behaviours for sleep and fatigue in an intervention for newly graduated nurses starting shiftwork may be of importance to improve well-being among nurses and increase patient safety. RELEVANCE TO CLINICAL PRACTICE This study highlights the importance of addressing sleep and fatigue issues in nursing education and work introduction programmes to increase patient safety and improve well-being among nurses.
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Affiliation(s)
- Majken Epstein
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Marie Söderström
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stressmottagningen/Stress clinic, Stockholm, Sweden
| | - Maria Jirwe
- Department for health promoting science, Sophiahemmet University, Stockholm, Sweden.,Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Philip Tucker
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Psychology, Swansea University, Swansea, UK
| | - Anna Dahlgren
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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48
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Dawson D, Thomas MJW. Fatigue management in healthcare: it is a risky business. Anaesthesia 2019; 74:1493-1496. [PMID: 31486063 DOI: 10.1111/anae.14833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2019] [Indexed: 11/30/2022]
Affiliation(s)
- D Dawson
- Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | - M J W Thomas
- Appleton Institute, Central Queensland University, Wayville, SA, Australia
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49
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Ghasemi F, Samavat P, Soleimani F. The links among workload, sleep quality, and fatigue in nurses: a structural equation modeling approach. FATIGUE-BIOMEDICINE HEALTH AND BEHAVIOR 2019. [DOI: 10.1080/21641846.2019.1652422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Fakhradin Ghasemi
- Department of Ergonomics, Occupational Health & Safety Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Parnia Samavat
- Department of Occupational Health and Safety Engineering, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Soleimani
- Department of Occupational Health and Safety Engineering, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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50
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Riethmeister V, Matthews RW, Dawson D, de Boer MR, Brouwer S, Bültmann U. Time-of-day and days-on-shift predict increased fatigue over two-week offshore day-shifts. APPLIED ERGONOMICS 2019; 78:157-163. [PMID: 31046947 DOI: 10.1016/j.apergo.2019.02.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 02/07/2019] [Accepted: 02/27/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the accumulation of fatigue over a two-week offshore period. In particular, the effects of (1) time-of-day and days-on-shift as well as (2) acute and chronic sleep loss on the rate at which fatigue accumulates were investigated. METHODS 42 day-shift offshore workers were examined. Fatigue was measured using pre- and post-shift scores on the Karolinska Sleepiness Scale (KSS). Total sleep time was measured using actigraphy (Motionwatch8, Camntech). Data was analyzed using a linear mixed model analyses. RESULTS Average sleep loss per night was 92 min (95%CI: 89.6-94.0; p < .001). Mean cumulative sleep loss across the study was 21:20hrs (SD = 08:10hrs) over the 14 days. Chronic sleep loss was significantly related to a modest increase in sleepiness (KSS) across the shift (95%CI: 0.01-0.17; p = .020) and in post-shift scores (95%CI:.07-0.19; p < .001). Time-of-day (95%CI: 0.63 to -0.01; p = .042) and days-on-shift (95%CI: 0.03-0.08; p < .001) as well as their interaction (95%CI: 0.08 to -0.00; p = .027) influenced the rate at which fatigue accumulated over a two-week offshore period. CONCLUSIONS Pre- and post-shift fatigue accumulate in different ways over the two-week offshore period. The accumulation of post-shift fatigue scores was positively related to successive days-on-shift and chronic sleep loss. Our results suggest that prolonging offshore periods will likely result in elevated fatigue risk. Accumulating fatigue and sleep loss over two-week offshore periods should be considered in fatigue risk management plans and systems.
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Affiliation(s)
- V Riethmeister
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands.
| | - R W Matthews
- Karolinska Institute, Department of Clinical Neuroscience, Nobels väg 9, 171 77, Stockholm, Sweden; Stress Research Institute, Stockholm University, Frescati Hagväg 16 A, SE-106 91, Stockholm, Sweden; Appleton Institute for Behavioural Science, Central Queensland University Australia, Adelaide Campus, 44 Greenhill Road, Wayville, SA, 5034, Australia.
| | - D Dawson
- Appleton Institute for Behavioural Science, Central Queensland University Australia, Adelaide Campus, 44 Greenhill Road, Wayville, SA, 5034, Australia.
| | - M R de Boer
- Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, Department of Health Sciences, Faculty of Earth and Life Sciences, Amsterdam, the Netherlands.
| | - S Brouwer
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands.
| | - U Bültmann
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands.
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