title: Sleep and arousal as risk factors for adverse health and work performance in public health workers involved in the 2004 Florida hurricane season.
abstract: BACKGROUND
  We examined the relation of sleep disturbance and arousal to work performance, mental and physical health, and day-to-day functioning in Florida Department of Health (FDOH) employees 9 months after the 2004 Florida hurricane season.
  
  
  METHODS
  FDOH employees were contacted via e-mail 9 months after the 2004 hurricanes. Participants (N = 2249) completed electronic questionnaires including measures of sleep disturbance, arousal, work performance, physical health, mental health, day-to-day function, hurricane injury, and work demand.
  
  
  RESULTS
  More than 18% of FDOH employees reported ≥ 25% reduced work performance and 11% to 15.3% reported ≥ 7 "bad" mental or physical health days in the past month. Sleep disturbance and elevated arousal were strongly associated with impaired work performance (odds ratios [ORs] 3.33 and 3.34, respectively), "bad" mental health (ORs 3.01 and 3.64), "bad" physical health (ORs 3.21 and 2.01), and limited day-to-day function (ORs 4.71 and 2.32), even after adjusting for sex, race, age, education, and marital status.
  
  
  CONCLUSIONS
  Among public health workers exposed to the 2004 hurricanes, sleep disturbance and arousal were associated with personal and work impairment. Future research should continue to examine the effect of repeated exposure to disasters in first responders.
authors.affiliation: Center for the Study of Traumatic Stress, Dept of Psychiatry,Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4799, USA. jodi.mckibben.ctr@usuhs.mil
authors.forename: Jodi B A
authors.initials: JB
authors.lastname: McKibben
authors.forename: Carol S
authors.initials: CS
authors.lastname: Fullerton
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ursano
authors.forename: Dori B
authors.initials: DB
authors.lastname: Reissman
authors.forename: Kathleen
authors.initials: K
authors.lastname: Kowalski-Trakofler
authors.forename: James M
authors.initials: JM
authors.lastname: Shultz
authors.forename: Leming
authors.initials: L
authors.lastname: Wang
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D000488:Allied Health Personnel / Q000523:psychology*; D016001:Confidence Intervals; D055867:Cyclonic Storms; D004190:Disasters; D004650:Employee Performance Appraisal; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015980:Public Health Practice; D012307:Risk Factors; D020921:Sleep Arousal Disorders / Q000150:complications* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult