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 Anonymous surveys (Frakes & Kelly, 2004, 2005 & 2007) and small studies have assessed the impact <strong>of</strong> different work schedules for EMS flight nurses. Surveys <strong>of</strong> flight EMS personnel indicated that as anticipated, crew members reported significant sleep debts. Interestingly, the investigators found that 80 percent <strong>of</strong> 24 hour and 50 percent <strong>of</strong> 12 hour non-pilot crew members had outside employment (Frakes & Kelly, 2005 & 2007), and <strong>of</strong> concern, more than half reported having arrived to work within eight hours <strong>of</strong> leaving their other job. Employers differed on whether they allowed sleeping at work. Some did not allow naps, because they felt it might encourage arriving at work fatigued. However, pre-shift sleep did not vary with that variable. In a small study <strong>of</strong> 10 EMS flight nurses, 12 and 18 hour shifts were compared. The investigators could find no decrement in performance with the longer work hours in that short term study, and 18 hour shifts were preferred by the nurses due to lifestyle issues (Thomas et al., 2006). 4.8 Summary <strong>of</strong> Studies <strong>of</strong> Work Hours, Fire Fighters and EMS Responders The reports concerning long work hours and fire fighters and EMS responders presented in this Section are summarized in Table 4.1 (next page). As stated in this Section’s outset, there is a paucity <strong>of</strong> available well done studies, and many <strong>of</strong> investigations have been done in countries other than the U.S. Despite those limitations, certain potential implications are apparent. • Fire fighters have documented increases in their risks for cardiac disease and malignancies, which are also are illnesses that may be promoted by the chronic sleep deprivation associated with long work hours. • Fire fighters and EMS responders are at risk for the decrements in mental and physical performance that have been well documented among others working long hours and during the night. • Fatigue among fire fighters may relate to the disproportionately higher fireground injury rates observed for the early morning hours. • Fatigue when driving may increase the risk <strong>of</strong> crashes when driving following long work hours. Long commutes following work may be a particular hazard. 57
<strong>Effects</strong> <strong>of</strong> <strong>Sleep</strong> <strong>Deprivation</strong> on Fire Fighters and EMS Responders Table 4.1. Summary <strong>of</strong> Study Findings about Work Hours, Fire Fighters and EMS Responders Source anecdotal reports from websites and the near-miss reporting systems EMS Responder Group fire fighters Outcomes only a complaints about long work hours; only 7 <strong>of</strong> more than 1000 near-miss reports were identified as fatiguerelated anecdotal fire fighter, paramedic 2 reported deaths commuting home due to fatigue San Jose and West Metro, Denver switch to 48/96 schedule Murphy et al., 1994 fire fighters fire fighter survey change reported satisfactory for fire fighters and their family and both supported the change; no identified adverse effects; crashes commuting not reported sleep disturbances were among causes <strong>of</strong> stress for NW career fire fighters Brody et al., 2006 Welch fire fighters elevated cortisol (stress hormone) levels among fire fighters Bos et al., 2004 Dormrachev et al., 2004 Dutch fire fighters Russian fire fighters sleep disturbance among fire fighters were comparable to those <strong>of</strong> other night shift workers alertness levels fell over a 12 hour shift Knauth, 1995 U.K. fire fighters alertness levels were lower at night Takeyama et al., 2005 Japanese fire fighters calls in the middle <strong>of</strong> the night were most disruptive to sleep Sobeith et al., 2002 Cincinnati fire fighters reduced postural stability over a 12 hour shift Karter, 2003 Childress, 2004 NFPA and NFIRS U.S. fire fighters wildland fire fighters increased rate <strong>of</strong> injury per 100 fires from midnight to 6 AM to twice that <strong>of</strong> mid-afternoon injury rates decreased immunoglobulin levels working longer than12 hour shift Bailey, 2006 wildland fire fighters fatigue associated crashes when driving from work sites Boudraux et al., 1997 EMS responders switch from 24 to 12 hour shift more productive and less socially disruptive 58
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Effects of Sleep Deprivation on Fire Fighters and EMS ... - NAEMT

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