Fire Fighter Fatigue Management Program: Operation Fight Fatigue
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Shift-Work Sleep Disorder
- Sponsor
- Brigham and Women's Hospital
- Enrollment
- 620
- Locations
- 1
- Primary Endpoint
- Sleep and performance of firefighters measured by a composite of physiological monitoring
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
Firefighters frequently work extended duration shifts and long work weeks which have adverse effects on alertness, health, safety and performance. This protocol uses a survey instrument to examine the effects of extended duration shifts on safety outcomes (e.g., motor vehicle crashes, accidents, injuries), health (e.g., diagnosis and treatment of sleep disorders, improved general health indices, decreased number of sick days), and performance (e.g., decreased response time). This study will expand understanding of the nature, scope, etiology and consequences of firefighter fatigue and increase our ability to develop guidelines that can be generalized across fire departments throughout North America. This study could provide an avenue to make lasting policy improvements that could enhance the safety, health, and performance of firefighters.
Detailed Description
Firefighters work some of the most challenging schedules known under highly stressful and demanding conditions. The need to work frequent extended shifts leads to acute and chronic sleep deficiency as well as disruption of circadian rhythms. Firefighters on-call overnight are also particularly susceptible to sleep inertia, the neurocognitive impairment experienced immediately upon waking. In addition, it is likely that a significant proportion of firefighters suffer from undiagnosed sleep disorders, which further impair sleep and exacerbate fatigue. The proposed fatigue countermeasure aims to increase sleep opportunities, and thereby improve firefighter safety and health. We will be conducting a station-level, randomized clinical trial of policies designed to maximize sleep opportunities during current 24-hour shifts to improve alertness, performance, health and safety in firefighters. We will leverage the comprehensive fatigue management program we developed and the web-based technology we implemented in previous Federal Emergency Management Agency projects, and will continue to offer our web-based education program and sleep disorders screening. By conducting a collaborative study involving sleep medicine clinicians, sleep researchers, a consultant on alarms, together with the representatives from the management, and union leadership of the fire department, we expect we will develop a sleep optimization program with a high probability of success and test the hypotheses that increasing the sleep opportunity of firefighters will improve the alertness, performance, safety and physical and mental health of firefighters. The results of this study will provide policy makers with the scientific evidence they require to develop effective fatigue countermeasure programs for firefighters. We will be conducting a randomized clinical trial, providing the most rigorous evaluation possible in an operational setting. Half the fire stations in a department will be randomly assigned to complete the intervention, termed Operation Fight Fatigue, in the first year of the study. The other half of the fire stations will complete the intervention in the second year. In this way, all firefighters will have the chance to benefit. We expect the fatigue countermeasure intervention to improve the alertness, performance, health and safety of firefighters. We will be evaluating a cost-effective intervention to improve the safety and health of firefighters in departments throughout the United States.
Investigators
Charles Andrew Czeisler, MD, PhD
Charles Andrew Czeisler, MD, PhD
Brigham and Women's Hospital
Eligibility Criteria
Inclusion Criteria
- •Must be a fire department employee at a participating fire department.
Exclusion Criteria
- •May not be 17 years of age or younger.
- •Will not be included if not a firefighter.
Outcomes
Primary Outcomes
Sleep and performance of firefighters measured by a composite of physiological monitoring
Time Frame: Participants will be involved for up to 3 weeks and will have a follow-up physical exam (including blood work) up to 1 year later.
Participants will participate in physiological monitoring to obtain objective data on sleep and performance. These data may also be used to validate the data reported on the survey. These firefighters will complete daily sleep/work diaries, wear an actigraph continuously and wear the Optalert glasses on the commute from each work shift. Subjects will also have 2 physical exams which include blood work.
Composite of firefighter information provided by the participating fire department
Time Frame: Up to 1 year
The following outcomes will be collected: a) work hours data: scheduled work hours, overtime and vacation time; b) health and safety data: driving accidents and vehicle damage (including severity of accidents in terms of financial cost, time away from work, and extent of injury), on-the-job injuries (related and unrelated to motor vehicle crashes), sick time; and c) job performance data: response time and clear time (i.e., time to initial response and completion of a self-initiated or assigned task) and other measures considered pertinent to firefighters' performance by the department.
Sleep and health screening of firefighters using a composite of survey instruments
Time Frame: The baseline survey will be conducted at the start of the study and the follow-up survey will be conducted approximately 12 months later.
All firefighters in intervention and control stations will be asked to complete two surveys in which they document their work hours, sleep hours, sleep quality, caffeine consumption, and baseline health; their mood, sleepiness, and quality of life on a series of validated scales. Descriptions of any motor vehicle crashes, near miss crashes, and on-the-job injuries will also be obtained. Mental health will be assessed with three validated survey instruments. They will also receive the sleep disorders screening survey. Those found at high risk will be contacted to make aware.
Secondary Outcomes
- Documentation of motor vehicle crashes (MVC), and reported injuries(Up to 1 year)
- Employment verification as a firefighter of all participants(Up to 1 year)
- Composite of firefighter health information(Up to 1 year)