Effects of Sleep Deprivation on Fire Fighters and EMS ... - NAEMT

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<strong>Effects</strong> <strong>of</strong> <strong>Sleep</strong> <strong>Deprivation</strong> on Fire Fighters and EMS Responders against fatigue-related injuries and accidents. They hoped to establish scientifically based hours-<strong>of</strong>-service regulations. It was an ambitious undertaking, and its disappointing midpoint report underscores the difficulty in assessing, and by extension, regulating and reforming seafarers’ work. Despite the thoughtful plans, little was accomplished due to unpredictability <strong>of</strong> schedules, limited on board space and crews’ unwillingness to participate (2007). 2.5a Cardiff Report Researchers from Cardiff University have been studying seafarer fatigue for more than five years (Smith, Allen & Wadsworth, 2006). In January 2007, the Cardiff University group published findings as a report entitled, Adequate Manning and Seafarers’ Fatigue: the International Perspective. They surveyed almost 2000 seafarers, collected diary reports and performed objective testing on board. In addition to the clear confirmation that fatigue is a problem, the studies also exposed a tendency <strong>of</strong> many seafarers to under-record their working hours. Importantly, researchers also made recommendations for managing fatigue. The report calls for a holistic approach to maritime fatigue, encouraging the development <strong>of</strong> an on board safety culture underpinned by realistic staffing levels and a more robust approach to regulation. In addition to the general conclusions presented in Table 2.2 (page 27), certain observations concerning work force reform were felt relevant to seafarers. Inaction <strong>of</strong>ten appeared to be the consequence <strong>of</strong> misconceptions that reform necessitates excessive resources. Off-the-shelf health and safety plans generally do not work as well as those that are workplace specific, and business friendly approaches usually are more effective than harsh enforcement. However, in high hazard industries, external regulatory pressure may be needed for compliance. John Bainbridge, Assistant Secretary <strong>of</strong> the International Transport Workers’ Federation’s Seafarers’ section, said: “This report confirms what we already know. Seafarers are routinely working excessively long hours, endangering themselves and the marine environment. It’s time to stop putting seafarers at risk and to learn from the examples <strong>of</strong> best practice in other industries.” 2.5b Coast Guard Program for Crews The United States Coast Guard developed a Crew Endurance Management (CEM) maritime program for fatigue (www.uscg.mil/hq/g-m/cems/i) (Comperatore & Rivera, 2003). The use <strong>of</strong> ‘endurance’ in its title reflected the principle that just as a ship’s endurance is determined by how long it can support operations without replenishing supplies, a crew’s endurance is determined by their ability to cope with job-related physiological, psychological and environmental challenges. This program is research-based and oriented toward vessels with a structured routine (to the extent that this is achievable in any maritime operation). Its use requires training a local team <strong>of</strong> fatigue experts, who become the program advocates and fatigue management coaches. It has three sections. Section I introduces the concept <strong>of</strong> crew endurance management. Section II provides specific guidance on how to recognize endurance risk factors and the detrimental 25
<strong>Effects</strong> <strong>of</strong> <strong>Sleep</strong> <strong>Deprivation</strong> on Fire Fighters and EMS Responders effects <strong>of</strong> psychological, physiological, and environmental stress. Section III contains guidelines on how to assess crew endurance and implement improvements. The fatigue team enlists the entire crew’s involvement and coaches them through the change process. Examples <strong>of</strong> suggestions include striving for at least six hours <strong>of</strong> continuous sleep on all days, tuning into one’s own fatigue level and adjusting sleeping when needed and changing ship policies to allow showering and meals at different times to match work schedules. It recommended on-watch napping in the early morning hours, when work is completed and at least one other crew member is awake on watch. In 2002, the Coast Guard and the American Waterway Operators chartered a working group to implement CEM in the barge and towing vessel industry. A demonstration project showed improvement on a number <strong>of</strong> measures over a six-month period (United States Coast Guard, 2005). According to a 2005 report, more than 70 towing vessels were in some stage <strong>of</strong> documented CEM implementation. The CEM website has many additional resources, including links to a newsletter, s<strong>of</strong>tware to facilitate crew endurance risk factor assessment and information about training seminars held regionally to learn how to implement the system. However, this well designed program requires considerable investment <strong>of</strong> resources, which may restrict its use to larger vessels and interested companies (Gander, 2005). 2.5c Canadian Program for Pilots Concerned with apparent fatigue related incidents involving marine pilots, Transport Canada reviewed the literature, collected data via questionnaires and on board observations and developed a Fatigue Management Plan for use in workshops with marine pilots (Transport Canada, 2002). Resources produced include a marine pilots’ Fatigue Management Guide and Trainer’s Handbook. 2.6 Fatigue on the Road Crashes when driving a motor vehicle have a clear relationship to fatigue and other types <strong>of</strong> driver impairment, and commercial motor vehicle (CMV) transport (trucking) is the industry with the greatest number <strong>of</strong> studies relating long work hours to their impact on safety. Driving is a complex task that requires the coordination <strong>of</strong> physical, psychomotor and cognitive skills (Mayhew & Simpson, 1995). However, many driving situations are routine and monotonous, which can exacerbate driver impairment due to long work hours and other fatigue-promoting influences. 26
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Effects of Sleep Deprivation on Fire Fighters and EMS ... - NAEMT

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