Psychiatric News June 17, 2005
Volume 40 Number 12
© 2005 American Psychiatric Association
p. 22
Sleep Deprivation Recognized As Public-Safety Issue
Lynne Lamberg
Long work shifts and extensive overtime undermine workers' job
performance, health, and safety, sleep experts say.
Testifying before a joint House-Senate Intelligence Committee in September
2002, Cofer Black, who directed the Central Intelligence Agency's
Counterterrorist Center on September 11, 2001, praised his staff for
"working 14- to 18-hour days, seven days a week, month after
month."
Bryan Vila, Ph.D., chief of Crime Control and Prevention Research at the
National Institute of Justice in Washington, D.C., groaned as he read Black's
assertion aloud at a public policy forum sponsored by the National Sleep
Foundation (NSF) in the nation's capital in March.
"It's hard to think of an activity more likely to be impaired by lack
of sleep than intelligence analysis," Vila said. "Yet dedicated
people with the best of intentions often work while sleep deprived."
Vila and representatives of several other federal agencies discussed
fatigue's impact on job performance and health at the forum, one of several
NSF events marking National Sleep Awareness Week. The forum is held each
spring just before the change to Daylight Saving Time, when Americans
collectively sacrifice an hour's sleep.
Many police agencies have too few staff members to meet 24/7 demands, said
Vila, author of Tired Cops: The Importance of Managing Police Fatigue
(Washington, D.C.: Police Executive Research Forum, 2000). They use overtime
to fill gaps, commonly double shifts of 16 hours straight, and sometimes even
24-hour triple shifts.
"Such long work hours increase the probability of accidents and
on-the-job injuries, as well as poor decisions," Vila said, "some
of which may have horrible consequences."
In the wake of 9/11, 200 New York Port Authority officers at least doubled
their salaries with overtime, he said; one worked 360 days in 2002, earning
four times his base salary. Nineteen Boston police officers earned more than
$200,000 in 2004 by working overtime. In Boston, police officers are allowed
to work up to 96 hours a week.
Scientists in the Sleep and Circadian Research Laboratories at Harvard
Medical School will test the effectiveness of comprehensive fatigue-management
strategies in 1,000 Boston-area police officers in a one-year intervention
scheduled to start later this year, Vila said. The researchers will provide
sleep education, schedules designed to foster sleep, and screening and
treatment for sleep disorders. They also will assess the program's impact on
job performance and off-duty life.
The accident at Three Mile Island (TMI) in Pennsylvania in 1979, the
nation's worst civilian nuclear accident, focused attention on human factors
issues in the design and operation of nuclear power plants, said David
Desaulniers, Ph.D. He is a senior human factors analyst in the Nuclear
Regulatory Commission (NRC) Office of Nuclear Reactor Regulation.
The meltdown of TMI's reactor began between 4 a.m. and 6 a.m., at the nadir
of alertness in the human circadian cycle, and involved workers who had just
rotated from day shift to night shift. Some sleep specialists have blamed TMI
on worker fatigue and poor schedules.
The workers' difficulty in diagnosing the condition of the plant and taking
appropriate actions to mitigate problems was consistent with decision-making
difficulties observed with fatigue, Desaulniers said. NRC concluded, however,
he said, that the primary contributors to the accident were problems with
information presentation in the control room and with training. While NRC
addressed these matters through subsequent regulatory actions, he added, it
left power-plant licensees flexibility in scheduling.
Work conditions common today at the nation's 103 nuclear reactors,
Desaulniers said, include 24/7 operations, 12-hour work shifts on schedules
that can include five or more consecutive workdays, particularly when plant
outages occur, and extensive use of overtime associated with heightened
security following the 9/11 terrorist attacks.
NRC is reviewing proposed work-hour controls that limit individuals to 72
hours work in any seven-day period, and groups of workers to 48 hours per
person per week, averaged over 13 weeks, he noted. Following NRC approval, the
proposed rule will be published in the Federal Register for a 120-day
public comment period.
Most transportation workers, such as truckers, bus drivers, and locomotive
engineers, work on shifts longer than eight hours. Most also perform jobs with
significant mental and physical stress, said Stephen Popkin, Ph.D., who
directs the fatigue monitoring and countermeasures research team at the John
A. Volpe National Transportation Systems Center in Cambridge, Mass. The Volpe
Center is a fee-for-service organization within the Department of
Transportation (DOT) that aims to foster technological innovation.
Transportation work often involves varying high and low workloads, night
work, and irregular work and rest patterns, Popkin said. Noise, vibration, and
temperature, along with age, health, and use of medications, alcohol, or drugs
also affect workers' levels of fatigue.
DOT launched its operator fatigue management program in 1999, a partnership
among government, industry, and labor to create tools to address
fatigue-related safety concerns. Its products so far include a compendium of
research on the utility of various fatigue countermeasures and software to
help managers and schedulers assess how work schedules may affect on-duty
alertness.
People with expertise in devising and managing ergonomic work schedules are
in short supply, said Popkin, who is working to develop a curriculum and
credentials for such professionals. 
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