Fire Fighter Fatigue Management Program: Operation Healthy Sleep

NCT01988129 | Completed Results

• 1 other identifier: 2009-P-000697
• Study Type: interventional
• Target: 1,189
• Locations: 1 country
• Sites: 1

Brief Summary

Firefighters work some of the most demanding schedules known under highly stressful and demanding conditions. The need to work frequent extended shifts and long work weeks leads to acute and chronic partial sleep deprivation as well as misalignment of circadian phase. Sleep disorders are common, costly, and treatable, but often remain undiagnosed and untreated and it is likely that a significant proportion of firefighters suffer from undiagnosed sleep disorders which will further impair their sleep and exacerbate fatigue.In the current proposal, we aim to address the health, performance and safety issues related to fatigue in firefighters and test the effectiveness of a Comprehensive Firefighter Fatigue Management Program (CFFMP) that we have termed 'Operation Healthy Sleep.'

Conditions

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

Keywords

sleep; firefighter; fire; apnea; insomnia; shift; narcolepsy; restless leg; rls; fatigue; actigraph; actigraphy; actiwatch; safety; sleepiness; sleepy; work; hours; Federal Emergency Management Agency; drowsy

Outcome Measures

Primary Outcomes (4)

• Firefighters' Health, as Determined by Number of 'Sick' Days Over 12 Months

  We assessed 'sick days' cumulatively over 12 months in two ways from departmental payroll records; the number of 24-hour pay periods coded as 'sick' time per firefighter and the number of 24-hr pay periods coded as injury and disability per firefighter. Fewer sick days is indicative of better health.

  12 months

• Firefighter Safety, as Determined by Motor Vehicle Crashes Over 12 Months

  Fewer motor vehicle crashes is indicative of better health. We assessed motor vehicle crashes cumulatively over 12 months. Accidents were counted as any incident that resulted in the filing and review of a departmental Fleet Accident Report.

  12 months

• Firefighter Safety, as Determined by On-the-job Injuries Over 12 Months

  Fewer on-the-job injuries is indicative of better health. We assessed injuries cumulatively over 12 months. Injuries that triggered the filing of an official city government accident report as the result of following normal departmental procedures were included in this study.

  12 months

• Firefighters' Performance, as Determined by Response Time Over 12 Months

  A lower response time is indicative of better performance. Following detailed review of departmental procedures and records, we determined that 'turn-out time' was already very rapid and not considered an accurate measure of firefighters' performance by the department. Similarly, 'clearance time' (time from the start until the end of the event), which could last for many hours, was also not considered an appropriate measure of firefighter' performance in relation to sleep and alertness given the multiple factors, many of which are not under the control of the firefighters, that could affect clearance times. We therefore did not address this aim.

  12 months

Secondary Outcomes (7)

• Change in the Mean Total Sleep Time

  Baseline to 12 months

• Change in the Mean Alertness and Cognitive Performance of Firefighters - Sleepy During Meetings

  Baseline to 12 months

• Change in the Mean Alertness and Cognitive Performance of Firefighters - Sleeping on the Telephone

  Baseline to 12 months

• Change in the Mean Alertness and Cognitive Performance of Firefighters - Sleeping While Driving

  Baseline to 12 months

• Change in the Mean Alertness and Cognitive Performance of Firefighters - Sleeping While Stopped in Traffic

  Baseline to 12 months

Other Outcomes (1)

• Number of Participants With Sleep Disorders According to Voluntary Sleep Disorders Screening Questionnaire

  Baseline (Study start)

Study Arms (2)

Intervention

EXPERIMENTAL

Workplace-based fatigue risk management program consisting of sleep health education and sleep disorders screening. The 32 fire department stations were paired according to the previous calendar years' workload. One station from each pair was randomly assigned to receive the intervention program. Sleep education sessions were scheduled according to station. On the education day(s) assigned to that stations, all personnel present that day were instructed to attend, and 542/601 did so.

Other: Sleep disorders education and screening

Control

NO INTERVENTION

Current practice. Firefighters in the Control Stations continued their normal role and were not invited to attend the sleep education and sleep disorders screening program. There was no formal contact with the control group. As part of normal operational requirements, a small number of firefighters are reassigned to other stations each day and therefore 18/588 firefighters from control stations happened to be reassigned to an intervention station on the day of the education session and attended the session.

Interventions

Sleep disorders education and screening OTHER

Firefighters were instructed to attend an education presentation as operations allowed which provided information on firefighter mortality, fatigue-related health hazards and discussed the importance of sleep, and also included strategies to improve sleep hygiene and how to use caffeine and naps effectively to promote alertness. Firefighters were then invited to complete a voluntary sleep disorders screening survey. This survey used validated, self-report screening tools for obstructive sleep apnea, moderate to severe insomnia, restless legs syndrome and shift work disorder. All of those who screened positive for a high risk of any sleep disorder were notified by letter as to their risk and provided with contact information for a partnering sleep clinic if they chose to follow-up.

Intervention

Eligibility Criteria

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

You may qualify if:

• This proposal includes research involving human subjects (fire department employees).
• Active firefighters working in the study fire department will be eligible to participate in the study.
• All applicants will be considered without bias, regardless of race, ethnicity, or national origin.

You may not qualify if:

• Non fire department employees

Sponsors & Collaborators

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

Study Sites (1)

BWH Division of Sleep Medicine

Boston, Massachusetts, 02215, United States

Location

MeSH Terms

Conditions

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

Interventions

Mass Screening

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

Intervention Hierarchy (Ancestors)

Diagnostic Techniques and Procedures; Diagnosis; Health Surveys; Surveys and Questionnaires; Data Collection; Epidemiologic Methods; Investigative Techniques; Diagnostic Services; Preventive Health Services; Health Services; Health Care Facilities Workforce and Services; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health; Public Health Practice

Results Point of Contact

• Title: Steven W. Lockley PhD
• Organization: Brigham and Women's Hospital

slockley@hms.harvard.edu

16177324977

Study Officials

• Steven Lockley, Ph.D.

  Brigham and Women's Hospital

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

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 A Czeisler, Ph.D., M.D.,

Study Record Dates

• First Submitted: July 27, 2010
• First Posted: November 20, 2013
• Study Start: March 1, 2009
• Primary Completion: September 1, 2013
• Study Completion: September 1, 2013
• Last Updated: March 16, 2017
• Results First Posted: July 29, 2015

Record last verified: 2017-02

Locations

US (1)