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

<strong>Effects</strong> <strong>of</strong> <strong>Sleep</strong> <strong>Deprivation</strong> on Fire Fighters and EMS Responders
The rules and regulations presented in Table 2.3 refer to long-haul drivers. Short-haul drivers
(within 150 mile radius <strong>of</strong> their base) have different rules, as they are less likely to fall asleep
at the wheel. They are more likely to follow a more typical shift structure, and their driving is
interrupted by the physical activity <strong>of</strong> loading and unloading, which improves alertness. In
addition, short-haul driving generally occurs in urban settings requiring high levels <strong>of</strong> alertness,
but also providing more stimuli to drivers. Similarly, regulations differ for drivers <strong>of</strong> passenger
carrying vehicles, who have shorter work hour regulated limits.
As a group, truckers’ lifestyles are unhealthy, even more so than the average American. For
example, tobacco use among truck drivers is nearly double that <strong>of</strong> the U.S. population average
(Roberts & York, 1997). Smoking substantially increases the risk <strong>of</strong> cardiovascular disease and
causes about 30 percent <strong>of</strong> all cancer deaths. Truck drivers who smoke are perhaps at even
greater risk, as they get a double dose <strong>of</strong> toxins breathing in secondhand smoke inside the cab.
Also on average, truckers are fatter than the already overweight average U.S. adult, and almost
three-quarters are either overweight or obese [Roberts & York, 1997). Being overweight or obese is
a well-established risk factor for cardiovascular disease, hypertension, diabetes and certain
malignancies. It exacerbates problems such as arthritis and back pain. And importantly it is a
known association with obstructive sleep apnea, a condition which places individuals at a much
higher risk for day time sleepiness and motor vehicle crashes.
In general, studies document that the majority <strong>of</strong> CMV drivers are chronically sleep deprived. In
four major studies where sleep was verified using either an actigraph watch (wrist-worn monitoring
device) or electroencephalogram (brain wave monitoring), CMV operators averaged from 3.8 to
5.3 hours <strong>of</strong> sleep per day (Dinges, et al., 2005; Balkin et al., 2000; Mitler et al., 1997; Wylie et al.,
1996; Hanowski et al., 2000). When more than 500 truckers were surveyed at a highway stopping
area, half reported that they reduced their sleep duration by getting up early when beginning a
long distance journey, and 10 percent reported that they had not slept in the 24 hours before the
interview.
The increased prevalence <strong>of</strong> sleep deprivation and driving among CMV operators may relate to
several factors, including industry norms and cultural influences among drivers (Philip et al.,
1996; Philip et al., 1999), economic rewards (Arnold et al., 1997) and an unawareness <strong>of</strong> the
effects <strong>of</strong> sleep deprivation, both in general and for them personally when driving.
2.8 Drowsy Driving and Crashes
Crashes caused by fatigue are a problem among all drivers. The general reduction in sleep that
has occurred in recent years, along with greater reliance on motor vehicles, have increased fatigue
related crashes. In the U.S., the National Highway Traffic Safety Administration estimates that drowsy
driving is responsible for 100,000 police-reported crashes and 40,000 injuries each year (NHTSA,
2000). Nine out <strong>of</strong> every 10 North American police <strong>of</strong>ficers report having stopped a driver who
they believed was drunk, but turned out to be drowsy, according to the AAA Foundation for
Traffic Safety survey (2004). Driving fatigued may be even more common than the alarming crash
statistics suggest. When drivers were randomly surveyed, one in five said they had nodded <strong>of</strong>f
or fallen asleep at least once while driving in the past 12 months.
<strong>Sleep</strong>-related crashes have certain characteristics that set them apart. Typically there is no
indication <strong>of</strong> braking or other attempts to avoid the crash, the driver is <strong>of</strong>ten alone, they occur
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