Extended Work Shifts and the Risk of Motor Vehicle Crashes Among Interns

Details

• Personal Author:
  Ayas NT ; Barger LK ; Cade BE ; Cronin W ; Czeisler, Charles A. ; Rosner B ; Speize FE
• Description:
  Background: Long work hours and work shifts of an extended duration (24 hours) remain a hallmark of medical education in the United States. Yet their effect on health and safety has not been evaluated with the use of validated measures. Methods: We conducted a prospective nationwide, Web-based survey in which 2737 residents in their first postgraduate year (interns) completed 17,003 monthly reports that provided detailed information about work hours, work shifts of an extended duration, documented motor vehicle crashes, near-miss incidents, and incidents involving involuntary sleeping. Results: The odds ratios for reporting a motor vehicle crash and for reporting a near-miss incident after an extended work shift, as compared with a shift that was not of extended duration, were 2.3 (95 percent confidence interval, 1.6 to 3.3) and 5.9 (95 percent confidence interval, 5.4 to 6.3), respectively. In a prospective analysis, every extended work shift that was scheduled in a month increased the monthly risk of a motor vehicle crash by 9.1 percent (95 percent confidence interval, 3.4 to 14.7 percent) and increased the monthly risk of a crash during the commute from work by 16.2 percent (95 percent confidence interval, 7.8 to 24.7 percent). In months in which interns worked five or more extended shifts, the risk that they would fall asleep while driving or while stopped in traffic was significantly increased (odds ratios, 2.39 [95 percent confidence interval, 2.31 to 2.46] and 3.69 [95 percent confidence interval, 3.60 to 3.77], respectively). Conclusions: Extended-duration work shifts, which are currently sanctioned by the Accreditation Council for Graduate Medical Education, pose safety hazards for interns. These results have implications for medical residency programs, which routinely schedule physicians to work more than 24 consecutive hours. [Description provided by NIOSH]
• Subjects:
  Accidents, Occupational Automobiles Health Personnel Occupational Health Safety Shift Work Schedule Sleep Sleep Initiation And Maintenance Disorders
• Keywords:
  Accident-potential Accident-rates Accident-statistics Health-care-personnel Medical-personnel Motor-vehicles Shift-work Shift-workers Sleep-deprivation Statistical-analysis Surveillance-programs

  More +
• ISSN:
  0028-4793
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; OSHA Region 1
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  125-134
• Volume:
  352
• Issue:
  2
• NIOSHTIC Number:
  nn:20025824
• Citation:
  N Engl J Med 2005 Jan; 352(2):125-134
• Contact Point Address:
  Dr. Czeisler at the Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave., Boston, MA 02115
• Email:
  caczeisler@hms.harvard.edu
• Federal Fiscal Year:
  2005
• Performing Organization:
  Brigham and Women's Hospital
• Peer Reviewed:
  True
• Start Date:
  20010930
• Source Full Name:
  New England Journal of Medicine
• End Date:
  20060929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:49c96721c83a6dc9b1a578ff7f434a83106e89cf759837432ca58cd4d1f94272836247ccfac1c695f6eec64f2d1c193707010286d321f1718630f9c040f5b5e4
• Download URL:
  https://stacks.cdc.gov/view/cdc/197040/cdc_197040_DS1.pdf
• File Type:
  [PDF - 98.00 KB ]