title: Sleep quality, posttraumatic stress, depression, and human errors in train drivers: a population-based nationwide study in South Korea.
abstract: OBJECTIVE
  Human error is defined as an unintended error that is attributable to humans rather than machines, and that is important to avoid to prevent accidents. We aimed to investigate the association between sleep quality and human errors among train drivers.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Population-based.
  
  
  METHODS
  A sample of 5,480 subjects who were actively working as train drivers were recruited in South Korea. The participants were 4,634 drivers who completed all questionnaires (response rate 84.6%).
  
  
  METHODS
  None.
  
  
  METHODS
  The Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), the Impact of Event Scale-Revised (IES-R), the State-Trait Anxiety Inventory (STAI), and the Korean Occupational Stress Scale (KOSS).
  
  
  RESULTS
  Of 4,634 train drivers, 349 (7.5%) showed more than one human error per 5 y. Human errors were associated with poor sleep quality, higher PSQI total scores, short sleep duration at night, and longer sleep latency. Among train drivers with poor sleep quality, those who experienced severe posttraumatic stress showed a significantly higher number of human errors than those without. Multiple logistic regression analysis showed that human errors were significantly associated with poor sleep quality and posttraumatic stress, whereas there were no significant associations with depression, trait and state anxiety, and work stress after adjusting for age, sex, education years, marital status, and career duration.
  
  
  CONCLUSIONS
  Poor sleep quality was found to be associated with more human errors in train drivers, especially in those who experienced severe posttraumatic stress.
authors.affiliation: Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea: Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Hong Jin
authors.initials: HJ
authors.lastname: Jeon
authors.affiliation: Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Ji-Hae
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Seoul National University, Seoul, Korea.
authors.forename: Bin-Na
authors.initials: BN
authors.lastname: Kim
authors.affiliation: Seoul National University, Seoul, Korea.
authors.forename: Seung Jin
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
authors.affiliation: Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: David
authors.initials: D
authors.lastname: Mischoulon
authors.affiliation: Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Eun-Ho
authors.initials: EH
authors.lastname: Kang
authors.affiliation: Department of Mental Health Research, Seoul National Hospital, Seoul, Korea.
authors.forename: Sungwon
authors.initials: S
authors.lastname: Roh
authors.affiliation: Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Dongsoo
authors.initials: D
authors.lastname: Lee
mesh_terms: D000059:Accidents / Q000523:psychology* / Q000706:statistics & numerical data*; D001007:Anxiety / Q000150:complications / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011890:Railroads; D056910:Republic of Korea / Q000453:epidemiology; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000150:complications / Q000453:epidemiology*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000453:epidemiology*; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology; D011795:Surveys and Questionnaires; D000078329:Workforce
keywords: depression; human error; sleep quality; train drivers; trauma