Randomized, prospective study of the impact of a sleep health program on firefighter injury and disability

Jason P. Sullivan, Conor S. O'Brien, Laura K Barger, Shantha M. W. Rajaratnam, Charles A. Czeisler, Steven W. Lockley, Harvard Work Hours, Health and Safety Group

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Study Objectives: Firefighters' schedules include extended shifts and long work weeks which cause sleep deficiency and circadian rhythm disruption. Many firefighters also suffer from undiagnosed sleep disorders, exacerbating fatigue. We tested the hypothesis that a workplace-based Sleep Health Program (SHP) incorporating sleep health education and sleep disorders screening would improve firefighter health and safety compared to standard practice. Design: Prospective station-level randomized, field-based intervention. Setting: US fire department. Participants: 1189 firefighters. Interventions: Sleep health education, questionnaire-based sleep disorders screening, and sleep clinic referrals for respondents who screened positive for a sleep disorder. Measurements and Results: Firefighters were randomized by station. Using departmental records, in an intention-to-treat analysis, firefighters assigned to intervention stations which participated in education sessions and had the opportunity to complete sleep disorders screening reported 46% fewer disability days than those assigned to control stations (1.4-5.9 vs. 2.6-8.5 days/firefighter, respectively; p = .003). There were no significant differences in departmental injury or motor vehicle crash rates between the groups. In post hoc analysis accounting for intervention exposure, firefighters who attended education sessions were 24% less likely to file at least one injury report during the study than those who did not attend, regardless of randomization (OR [95% CI] 0.76 [0.60, 0.98]; Χ2 = 4.56; p = .033). There were no significant changes pre-versus post-study in self-reported sleep or sleepiness in those who participated in the intervention. Conclusions: A firefighter workplace-based SHP providing sleep health education and sleep disorders screening opportunity can reduce injuries and work loss due to disability in firefighters.

Original languageEnglish
Article numberzsw001
Number of pages10
JournalSleep
Volume40
Issue number1
DOIs
Publication statusPublished - 1 Jan 2017

Keywords

  • Disability
  • Education
  • Firefighters
  • Injuries
  • Sleep

Cite this

Sullivan, J. P., O'Brien, C. S., Barger, L. K., Rajaratnam, S. M. W., Czeisler, C. A., Lockley, S. W., & Harvard Work Hours, Health and Safety Group (2017). Randomized, prospective study of the impact of a sleep health program on firefighter injury and disability. Sleep, 40(1), [zsw001]. https://doi.org/10.1093/sleep/zsw001
Sullivan, Jason P. ; O'Brien, Conor S. ; Barger, Laura K ; Rajaratnam, Shantha M. W. ; Czeisler, Charles A. ; Lockley, Steven W. ; Harvard Work Hours, Health and Safety Group. / Randomized, prospective study of the impact of a sleep health program on firefighter injury and disability. In: Sleep. 2017 ; Vol. 40, No. 1.
@article{fca5506c3db54c75b677e00ad7935c5d,
title = "Randomized, prospective study of the impact of a sleep health program on firefighter injury and disability",
abstract = "Study Objectives: Firefighters' schedules include extended shifts and long work weeks which cause sleep deficiency and circadian rhythm disruption. Many firefighters also suffer from undiagnosed sleep disorders, exacerbating fatigue. We tested the hypothesis that a workplace-based Sleep Health Program (SHP) incorporating sleep health education and sleep disorders screening would improve firefighter health and safety compared to standard practice. Design: Prospective station-level randomized, field-based intervention. Setting: US fire department. Participants: 1189 firefighters. Interventions: Sleep health education, questionnaire-based sleep disorders screening, and sleep clinic referrals for respondents who screened positive for a sleep disorder. Measurements and Results: Firefighters were randomized by station. Using departmental records, in an intention-to-treat analysis, firefighters assigned to intervention stations which participated in education sessions and had the opportunity to complete sleep disorders screening reported 46{\%} fewer disability days than those assigned to control stations (1.4-5.9 vs. 2.6-8.5 days/firefighter, respectively; p = .003). There were no significant differences in departmental injury or motor vehicle crash rates between the groups. In post hoc analysis accounting for intervention exposure, firefighters who attended education sessions were 24{\%} less likely to file at least one injury report during the study than those who did not attend, regardless of randomization (OR [95{\%} CI] 0.76 [0.60, 0.98]; Χ2 = 4.56; p = .033). There were no significant changes pre-versus post-study in self-reported sleep or sleepiness in those who participated in the intervention. Conclusions: A firefighter workplace-based SHP providing sleep health education and sleep disorders screening opportunity can reduce injuries and work loss due to disability in firefighters.",
keywords = "Disability, Education, Firefighters, Injuries, Sleep",
author = "Sullivan, {Jason P.} and O'Brien, {Conor S.} and Barger, {Laura K} and Rajaratnam, {Shantha M. W.} and Czeisler, {Charles A.} and Lockley, {Steven W.} and {Harvard Work Hours, Health and Safety Group}",
year = "2017",
month = "1",
day = "1",
doi = "10.1093/sleep/zsw001",
language = "English",
volume = "40",
journal = "Sleep",
issn = "0161-8105",
publisher = "Associated Professional Sleep Societies",
number = "1",

}

Sullivan, JP, O'Brien, CS, Barger, LK, Rajaratnam, SMW, Czeisler, CA, Lockley, SW & Harvard Work Hours, Health and Safety Group 2017, 'Randomized, prospective study of the impact of a sleep health program on firefighter injury and disability' Sleep, vol. 40, no. 1, zsw001. https://doi.org/10.1093/sleep/zsw001

Randomized, prospective study of the impact of a sleep health program on firefighter injury and disability. / Sullivan, Jason P.; O'Brien, Conor S.; Barger, Laura K; Rajaratnam, Shantha M. W. ; Czeisler, Charles A.; Lockley, Steven W.; Harvard Work Hours, Health and Safety Group.

In: Sleep, Vol. 40, No. 1, zsw001, 01.01.2017.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Randomized, prospective study of the impact of a sleep health program on firefighter injury and disability

AU - Sullivan, Jason P.

AU - O'Brien, Conor S.

AU - Barger, Laura K

AU - Rajaratnam, Shantha M. W.

AU - Czeisler, Charles A.

AU - Lockley, Steven W.

AU - Harvard Work Hours, Health and Safety Group

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Study Objectives: Firefighters' schedules include extended shifts and long work weeks which cause sleep deficiency and circadian rhythm disruption. Many firefighters also suffer from undiagnosed sleep disorders, exacerbating fatigue. We tested the hypothesis that a workplace-based Sleep Health Program (SHP) incorporating sleep health education and sleep disorders screening would improve firefighter health and safety compared to standard practice. Design: Prospective station-level randomized, field-based intervention. Setting: US fire department. Participants: 1189 firefighters. Interventions: Sleep health education, questionnaire-based sleep disorders screening, and sleep clinic referrals for respondents who screened positive for a sleep disorder. Measurements and Results: Firefighters were randomized by station. Using departmental records, in an intention-to-treat analysis, firefighters assigned to intervention stations which participated in education sessions and had the opportunity to complete sleep disorders screening reported 46% fewer disability days than those assigned to control stations (1.4-5.9 vs. 2.6-8.5 days/firefighter, respectively; p = .003). There were no significant differences in departmental injury or motor vehicle crash rates between the groups. In post hoc analysis accounting for intervention exposure, firefighters who attended education sessions were 24% less likely to file at least one injury report during the study than those who did not attend, regardless of randomization (OR [95% CI] 0.76 [0.60, 0.98]; Χ2 = 4.56; p = .033). There were no significant changes pre-versus post-study in self-reported sleep or sleepiness in those who participated in the intervention. Conclusions: A firefighter workplace-based SHP providing sleep health education and sleep disorders screening opportunity can reduce injuries and work loss due to disability in firefighters.

AB - Study Objectives: Firefighters' schedules include extended shifts and long work weeks which cause sleep deficiency and circadian rhythm disruption. Many firefighters also suffer from undiagnosed sleep disorders, exacerbating fatigue. We tested the hypothesis that a workplace-based Sleep Health Program (SHP) incorporating sleep health education and sleep disorders screening would improve firefighter health and safety compared to standard practice. Design: Prospective station-level randomized, field-based intervention. Setting: US fire department. Participants: 1189 firefighters. Interventions: Sleep health education, questionnaire-based sleep disorders screening, and sleep clinic referrals for respondents who screened positive for a sleep disorder. Measurements and Results: Firefighters were randomized by station. Using departmental records, in an intention-to-treat analysis, firefighters assigned to intervention stations which participated in education sessions and had the opportunity to complete sleep disorders screening reported 46% fewer disability days than those assigned to control stations (1.4-5.9 vs. 2.6-8.5 days/firefighter, respectively; p = .003). There were no significant differences in departmental injury or motor vehicle crash rates between the groups. In post hoc analysis accounting for intervention exposure, firefighters who attended education sessions were 24% less likely to file at least one injury report during the study than those who did not attend, regardless of randomization (OR [95% CI] 0.76 [0.60, 0.98]; Χ2 = 4.56; p = .033). There were no significant changes pre-versus post-study in self-reported sleep or sleepiness in those who participated in the intervention. Conclusions: A firefighter workplace-based SHP providing sleep health education and sleep disorders screening opportunity can reduce injuries and work loss due to disability in firefighters.

KW - Disability

KW - Education

KW - Firefighters

KW - Injuries

KW - Sleep

UR - http://www.scopus.com/inward/record.url?scp=85014166715&partnerID=8YFLogxK

U2 - 10.1093/sleep/zsw001

DO - 10.1093/sleep/zsw001

M3 - Article

VL - 40

JO - Sleep

JF - Sleep

SN - 0161-8105

IS - 1

M1 - zsw001

ER -