Fire Fighter Fatigue Management Program: Operation Fight Fatigue

NCT01672502 | Completed

• 1 other identifier: EMW-2010-FP-00521
• Study Type: interventional
• Target: 620
• Locations: 1 country
• Sites: 1

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.

Conditions

Shift-Work Sleep Disorder; Insomnia; Restless Leg Syndrome; Obstructive Sleep Apnea; Impaired Driving

Keywords

sleep; firefighter; fire; apnea; insomnia; shift; narcolepsy; restless leg; rls; fatigue; Optalert; actigraph; actigraphy; actiwatch; safety; sleepiness; sleepy; work; hours; FEMA; drowsy

Outcome Measures

Primary Outcomes (3)

• Sleep and health screening of firefighters using a composite of survey instruments

  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.

  The baseline survey will be conducted at the start of the study and the follow-up survey will be conducted approximately 12 months later.

• Composite of firefighter information provided by the participating fire department

  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.

  Up to 1 year

• Sleep and performance of firefighters measured by a composite of physiological monitoring

  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.

  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.

Secondary Outcomes (3)

• 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

Study Arms (2)

Intervention

EXPERIMENTAL

Firefighters in this group will receive at the beginning of the study an introduction to the study, sleep education, sleep disorder screening survey, health survey, increased sleep opportunities at their fire department, followed later by physiological monitoring of a portion of the firefighters, and then finally an 'end of year' survey at the end of the study.

Behavioral: Sleep health education provided via a web-based program; Other: Sleep disorder detection and treatment; Other: Optimization of Sleep in Fire Station

Control

ACTIVE COMPARATOR

Firefighters in this group will only receive an introduction to the study and a health survey, followed later by physiological monitoring of a portion of the firefighters, and then at the end of the study will receive the sleep disorders screening survey, sleep education (Intervention group received screening survey and education much earlier at the beginning of the study), and an 'end of year' survey. None of these firefighters will receive the increased sleep opportunities as the Intervention group will.

Behavioral: Sleep health education provided via a web-based program; Other: Sleep disorder detection and treatment

Interventions

Sleep health education provided via a web-based program BEHAVIORAL

All firefighters in the experimental group and controls will be asked to complete an approximately 30 minute education session. This education session will split into two modules, module 1: an introduction to the program along with basic sleeps hygiene information and module 2: standard training. Topics covered in module 2 will include basic sleep physiology, the causes and consequences of sleep disorders, and fatigue countermeasures. We will emphasize strategies to maximize sleep and reduce fatigue both on and off work.

Also known as: Operation Fight Fatigue, OFF, Comprehensive Fatigue Management Training Program

Control; Intervention

Sleep disorder detection and treatment OTHER

Firefighters in the intervention districts will complete a sleep disorders screening questionnaire. The questionnaire will focus on identifying individuals who show increased likelihood of suffering from obstructive sleep apnea, insomnia, shift work disorder, and restless legs syndrome using validated screening tools. Those assessed to be at high risk for one of these sleep disorders will be referred to a local AASM-accredited Clinical Sleep Disorders Service for evaluation and, if necessary, treatment. Diagnosis and treatment of sleep-related disorders will reduce the risk of fatigue-related accidents and improve the health and safety of affected individuals.

Also known as: Operation Fight Fatigue, OFF, Comprehensive Fatigue Management Training Program

Control; Intervention

Optimization of Sleep in Fire Station OTHER

First, we will review and retrofit the sleeping quarters to provide a better environment for napping and sleep; light, noise, bed type, space, temperature, and location would all be considered and where possible, changes made to improve the sleeping environment. Secondly, we will work with management and union personnel to develop a 'sleep friendly' policy during the daytime, with specified protected times for naps during the day before the overnight work in order to reduce sleepiness during overnight work. Finally, we will upgrade the alerting systems, that is, we will work with management and union personnel to consider changing the policy that requires the sleeping areas of all stations to receive all alarm calls, even if that particular station is not required to attend the alarm.

Also known as: Operation Fight Fatigue, OFF, Comprehensive Fatigue Management Training Program

Intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Must be a fire department employee at a participating fire department.

You may not qualify if:

• May not be 17 years of age or younger.
• Will not be included if not a firefighter.

Sponsors & Collaborators

• Brigham and Women's Hospital: lead
• Federal Emergency Management Agency: collaborator

Study Sites (1)

Division of Sleep Medicine; Brigham and Women's Hospital

Boston, Massachusetts, 02215, United States

Location

MeSH Terms

Conditions

Sleep Disorders, Circadian Rhythm; Sleep Initiation and Maintenance Disorders; Restless Legs Syndrome; Sleep Apnea, Obstructive; Apnea; Narcolepsy; Fatigue; Sleepiness

Interventions

Therapeutics

Condition Hierarchy (Ancestors)

Chronobiology Disorders; Nervous System Diseases; Dyssomnias; Sleep Wake Disorders; Occupational Diseases; Mental Disorders; Sleep Disorders, Intrinsic; Parasomnias; Sleep Apnea Syndromes; Respiration Disorders; Respiratory Tract Diseases; Signs and Symptoms, Respiratory; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Disorders of Excessive Somnolence

Study Officials

• Charles Czeisler, PH.D., M.D.

  Brigham and Women's Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Charles Andrew Czeisler, MD, PhD

Study Record Dates

• First Submitted: August 16, 2012
• First Posted: August 27, 2012
• Study Start: September 1, 2012
• Primary Completion: May 1, 2014
• Study Completion: May 1, 2014
• Last Updated: March 17, 2016

Record last verified: 2016-03

Locations

US (1)