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Hamilton NA, Russell J, Hamadah K, Youngren W, Toon A, Nguyen TA, Joles K. Screening for Comorbidity of Sleep Disorders in Career Firefighters. J Occup Environ Med 2024; 66:43-50. [PMID: 37853663 DOI: 10.1097/jom.0000000000002993] [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: 10/20/2023]
Abstract
BACKGROUND The purpose of this study was to assess the prevalence and sequelae of insomnia, obstructive sleep apnea (OSA), and comorbid OSA and insomnia (COMISA). METHOD In the morning, after a shift end, Midwest career firefighters ( N = 89) in a midsized city completed an electronic battery of questionnaire to screen for OSA, daytime sleepiness, insomnia, presleep arousal, nightmares, mental and physical health symptoms, and a one-night sleep diary. RESULTS Prevalence of firefighters exceeding screening thresholds: OSA: 54%; insomnia: 30%; COMISA: 17%; four or more nightmares per month: 15%. Firefighters who met criteria for COMISA had shorter total sleep time, less restful and worse sleep quality, higher depression and anxiety symptoms, and presleep arousal symptoms than firefighters without self-reported sleep problems. CONCLUSIONS Many firefighters are at elevated risk of individual behavioral sleep disorders, COMISA, and daytime dysfunction.
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Affiliation(s)
- Nancy A Hamilton
- From the University of Kansas, Lawrence, Kansas (N.A.H., J.R., K.H., W.Y., A.T., T.A.N.); and Lawrence, Douglas County Fire and Medical, Lawrence, Kansas (K.J.)
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Latent profile analysis of post-traumatic stress and post-traumatic growth among firefighters. Eur J Psychotraumatol 2023; 14:2159048. [PMID: 37052101 PMCID: PMC9848271 DOI: 10.1080/20008066.2022.2159048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Due to the job characteristics, firefighters are repeatedly exposed to trauma incidents. However, not all firefighters exhibit the same level of post-traumatic stress disorder (PTSD) or post-traumatic growth (PTG). Despite this, few studies have looked into firefighters' PTSD and PTG.Objective: This study identified subgroups of firefighters based on their PTSD and PTG levels, and investigated the influence of demographic factors and PTSD/PTG-related factors on latent class classification.Method: Latent profile analysis was used to examine the patterns of PTSD and PTG among 483 firefighters in South Korea. Using a cross-sectional design, demographic factors and job factors were examined as group covariates through a three-step approach. PTSD-related factors such as depression and suicide ideation, as well as PTG-related factors such as emotion-based response were analysed as differentiating factors.Results: Four classes were identified and named 'Low PTSD-low PTG (65.2%),' 'Mid PTSD-mid PTG (15.5%),' 'Low PTSD-high PTG (15.3%),' and 'High PTSD-mid PTG (3.9%).' The likelihood of belonging to the group with high trauma-related risks increased with more rotating shift work and years of service. The differentiating factors revealed differences based on the levels of PTSD and PTG in each group.Conclusions: 34.8% of firefighters experienced changes due to traumatic events while on the job, and some required serious attention. Modifiable job characteristics, such as the shift pattern, indirectly affected PTSD and PTG levels. Individual and job factors should be considered together when developing trauma interventions for firefighters.
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Incomplete off-duty work hours and sleep quality among firefighters: a cross-sectional study, Taiwan. Int Arch Occup Environ Health 2023; 96:247-257. [PMID: 36063231 DOI: 10.1007/s00420-022-01918-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/24/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE We examined whether firefighters in Taiwan have a sleep problem and investigated the related factors of poor sleep quality. METHODS In this cross-sectional study, 2123 male shift firefighters in the Greater Taipei area were invited, and 37.7% of them satisfactorily completed the questionnaire online. The Chinese version of Pittsburgh sleep quality index (PSQI) was used to evaluate sleep quality. Multiple logistic and linear regression analyses were used to determine the associations among demographic characteristics, work-related characteristics, and poor sleep quality. RESULTS As revealed by 801 valid questionnaires, 77.2% were poor sleepers (PSQI cutoff score > 6), and 61.2% reported incomplete off-duty in the past month. Moreover, 42.6% of incomplete off-duty workers reported extended overtime of more than 5 h on off-duty days in the past month. Poor sleep quality was associated with the following factors: (1) demographic characteristics: age, working tenure, having children, and chronotype and (2) work-related characteristics: shift schedule and incomplete off-duty. The final model for poor sleep quality as per PSQI included age, chronotype, shift schedule, and incomplete off-duty hours in the past month. Longer hours of incomplete off-duty work were associated with increased risks of overall poor sleep quality and of poor subjective sleep quality, long sleep latency, sleep disturbances, and daytime dysfunction. CONCLUSION Firefighters are advised to have a complete off-duty day to avoid poor sleep quality, long sleep latency, short sleep duration, sleep disturbances, and daytime dysfunction. Our results confirm the need for implementing appropriate shift schedules to ensure adequate rest time for firefighters.
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Association between sleep quality and type of shift work in Korean firefighters. Ann Occup Environ Med 2022; 34:e27. [PMID: 36452253 PMCID: PMC9685296 DOI: 10.35371/aoem.2022.34.e27] [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: 05/05/2022] [Revised: 08/16/2022] [Accepted: 09/16/2022] [Indexed: 11/07/2022] Open
Abstract
Background Shift work that interferes with normal sleep patterns, is known to be a cause of sleep disturbance and has been studied through various occupational groups. However, it is not known which shift type is better for sleep health. Methods This study included 568 firefighters. Sleep quality was evaluated using Pittsburgh Sleep Quality Index. Sleep quality was categorized into 2 groups; good quality (≤ 5 points) and poor quality (≥ 6 points). Demographic variables, depression, anxiety, type of shift, and job were collected by self-reported questionnaires. The χ2 test, t-test, and multiple logistic regression analysis were used to evaluate the effect of shift type on the sleep quality of firefighters. Results Three hundred thirty-seven firefighters (59.3%) have poor sleep quality. Compared to day workers, the odds ratios (ORs) of poor sleep quality were 2.169 (95% confidence interval: 1.137-4.134) in 6-day cycle, 2.161 (1.150-4.062) in 9-day cycle, 1.805 (1.087-2.997) in 21-day cycle, and 1.485 (0.718-3.069) in 3-day cycle. The ORs of poor sleep quality were 1.697(1.021-2.823) in fire suppression and 2.325 (1.213-4.455) in emergency medical service compared to administration. Conclusions All shift work type except for the 3-day cycle was associated with poor sleep quality compared to day work.
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Billings JM. Firefighter sleep: a pilot study of the agreement between actigraphy and self-reported sleep measures. J Clin Sleep Med 2022; 18:109-117. [PMID: 34314350 PMCID: PMC8807900 DOI: 10.5664/jcsm.9566] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
STUDY OBJECTIVES The aim of this study is to determine the extent of agreement between self-reported measurements of total sleep time (TST) and actigraphy in the fire and emergency services occupation. METHODS Twenty-four firefighters participated in an 18-day study. Four measurements were used to assess TST: Pittsburgh Sleep Quality Index, a newly developed habitual Extended Sleep Survey, a newly developed daily Emergency Services Sleep Diary (ESSD), and actigraphy. The Extended Sleep Survey and ESSD were constructed to address the specific job-related characteristics of fire and emergency services that other measurements cannot achieve (eg, multiple sleep episode in a single night). RESULTS The Pittsburgh Sleep Quality Index TST is least accurate compared to actigraphy. The Extended Sleep Survey TST shows improvement over Pittsburgh Sleep Quality Index TST, but was statistically different from actigraphy TST. No difference in mean TST was found between ESSD TST and actigraphy TST. Furthermore, ESSD TST and actigraphy TST correlated strongly together. CONCLUSIONS Without modification, traditional self-reported measures may not be appropriate in the fire and emergency service occupation. This study suggests that the ESSD may serve as a useful alternative to actigraphy to measure TST. CITATION Billings JM. Firefighter sleep: a pilot study of the agreement between actigraphy and self-reported sleep measures. J Clin Sleep Med. 2022;18(1):109-117.
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Affiliation(s)
- Joel M. Billings
- Address correspondence to: Joel M. Billings, PhD, Department of Security and Emergency Services, Embry-Riddle Aeronautical University, 1 Aerospace Boulevard, Daytona Beach, Florida 32114;
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Demiralp N, Özel F. Evaluation of metabolic syndrome and sleep quality in shift workers. Occup Med (Lond) 2021; 71:453-459. [PMID: 34791382 DOI: 10.1093/occmed/kqab140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Shift workers have risks associated with metabolic syndrome and low sleep quality. AIMS This study aimed to examine metabolic syndrome and sleep quality in firefighters and mine workers working shifts and daytime hours. METHODS A comparative descriptive study was conducted in two institutions on firefighters and mine workers (n = 120) who were working shifts (n = 84) and working daytime hours (n = 36). The data were obtained using a questionnaire including socio-demographic information, anthropometric measurements and the Pittsburgh Sleep Quality Index. RESULTS When risk of metabolic syndrome was compared with sleep quality, it was found that according to International Diabetes Federation criteria, 11% of those diagnosed with metabolic syndrome among shift-working firefighters and 5% of those diagnosed with metabolic syndrome among shift-working miners had low sleep quality. It was found that according to the National Cholesterol Education Program-Adult Treatment Panel III criteria, 9% of those diagnosed with metabolic syndrome among shift firefighters and 2% of those diagnosed with metabolic syndrome among shift miners had low sleep quality. CONCLUSIONS Preventive measures should be taken to reduce the risk of metabolic syndrome in shift workers.
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Affiliation(s)
- N Demiralp
- Department of Civil Defense and Fire Fighting Program, Kastamonu University, Bozkurt Vocational High School, Kastamonu, Turkey
| | - F Özel
- Department of Nursing, Kastamonu University, School of Health Science, Kastamonu, Turkey
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Morais KCPD, Silva RMD, Beck CLC, Camponogara S, Dalmolin GDL, Tavares JP. Correlation between quality of life and sleep quality of military firefighters. ABCS HEALTH SCIENCES 2021. [DOI: 10.7322/abcshs.2020105.1559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Introduction: Among the professions that are impacted by the work context, the military firefighter is mentioned, who carries out activities with danger, physical and emotional exhaustion, which can have an impact on quality of life. Objective: To analyze the relation between quality of sleep and quality of life of Brazilian Military Firefighters. Methods: Research with a quantitative, transversal, correlational and analytical approach, carried out with 129 military firefighters working in Rio Grande do Sul, Brazil, that had been performing operational and administrative assistance for more than six months. Questionnaires containing socio-occupational and lifestyle data, the Pittsburgh Sleep Quality Index and the World Health Organization Quality of Life to assess quality of life were used. Descriptive and analytical statistics were used. Results: The analysis of quality of life shows a higher average in the physical domain (77.52), a direct correlation between the physical domain and the other quality of life domains, and inverse correlations between global sleep quality and the domains of quality of life. Regarding sleep quality, a higher percentage of poor classification (71.3%) is observed in military firefighters. Conclusion: There was a predominance of workers with poor sleep quality and good perception of general quality of life. An inverse correlation was identified between sleep quality and the domains of quality of life. When comparing quality of life with sleep quality domains, a significant difference was identified.
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Hsu WC, Wang CH, Chang KM, Chou LW. Shifted Firefighter Health Investigation by Personal Health Insurance Record in Taiwan. Risk Manag Healthc Policy 2021; 14:665-673. [PMID: 33623456 PMCID: PMC7896789 DOI: 10.2147/rmhp.s285729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 01/13/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Taiwan's firefighters use a shift rotation system with 2 days of work and 1 day of rest. Numerous papers have already explored the risks of shift work to the body. However, little data concern the impact of shift work on health as reflected in medical visits. This study used individuals' medical visit record in Taiwan's health insurance system. The locally called "health bank" contains individuals' medical visit record, health insurance payment points and the medicine used. METHODS Consent was obtained from 150 firefighters who were serving under the shift rotation system to obtain their 2015 individual "My Health Bank" medical data. Comparisons were made between national health insurance data norm. RESULTS Firefighters make significantly more visits for Western medicine than the annual average (firefighters 6.27 vs norm 5.24, P = 0.04142), more total number of medical visits (9.57 vs 7.75, P = 0.0102), more annual average payment points for Western medicine (4079 vs 2741, P = 0.003151), and a greater average number of total annual medical visit points (7003 vs 4940, p = 0.0003157). Firefighters had significantly higher incidents of respiratory diseases, urogenital diseases, skin and subcutaneous tissue diseases, musculoskeletal system and connective tissue diseases, injuries, and illness from poisoning than did the norm (P<0.05). CONCLUSION A persuasive health-survey-based method for workers in high occupational hazard industries was proposed in this study, and the result was highly correlated with risk factors of fireworkers. The proposed study method is potential to investigate risk factors of other working.
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Affiliation(s)
- Wei-Ching Hsu
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
- Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung, Taiwan
| | | | - Kang-Ming Chang
- Department of Computer Science and Information Engineering, Asia University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Department of Digital Media Design, Asia University, Taichung, Taiwan
| | - Li-Wei Chou
- Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung, Taiwan
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
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Shi Y, Bender B, McGovern P, Jung EM, DeMoulin D, Jacobs S, Prichard JR, Kim H. Daytime sleepiness among Midwestern firefighters. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 76:433-440. [PMID: 33138730 DOI: 10.1080/19338244.2020.1841718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Excessive daytime sleepiness (EDS) is the most common symptom of sleep-disorders. Although high levels of EDS have been reported among firefighters, there is a limited understanding on EDS in firefighters. A cross-sectional survey was conducted in full-time firefighters (n = 275). The survey included the Epworth Sleepiness Scale to assess EDS, as well as other questions related to job characteristics, health history, and demographics. Firefighters reported inadequate sleep hours, extremely short sleep latencies, and high EDS higher than the general population. A majority of firefighters indicated a willingness to consult with a sleep professional. Risk factors associated with EDS included at least five years of professional experiences and depression diagnosis. Our findings suggest that EDS is widespread among firefighters. With increasing time on the job, frequencies of both obesity and EDS increase, which can have severe and compounding effects on health and safety.
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Affiliation(s)
- Yihe Shi
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Bridget Bender
- Department of Psychology, University of St. Thomas, Saint Paul, Minnesota, USA
| | - Patricia McGovern
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Eun Mi Jung
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Douglas DeMoulin
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Samuel Jacobs
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - J Roxanne Prichard
- Department of Psychology, University of St. Thomas, Saint Paul, Minnesota, USA
| | - Hyun Kim
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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