title: The association between weekly work hours, crew familiarity, and occupational injury and illness in emergency medical services workers.
abstract: OBJECTIVE
  Emergency Medical Services (EMS) workers are shift workers in a high-risk, uncontrolled occupational environment. EMS-worker fatigue has been associated with self-reported injury, but the influence of extended weekly work hours is unknown.
  
  
  METHODS
  A retrospective cohort study was designed using historical shift schedules and occupational injury and illness reports. Using multilevel models, we examined the association between weekly work hours, crew familiarity, and injury or illness.
  
  
  RESULTS
  In total, 966,082 shifts and 950 reports across 14 EMS agencies were obtained over a 1-3 year period. Weekly work hours were not associated with occupational injury or illness. Schedule characteristics that yield decreased exposure to occupational hazards, such as part-time work and night work, conferred reduced risk of injury or illness.
  
  
  CONCLUSIONS
  Extended weekly work hours were not associated with occupational injury or illness. Future work should focus on transient exposures and agency-level characteristics that may contribute to adverse work events.
authors.affiliation: Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts.|Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Weaver
authors.affiliation: Department of Emergency Medicine, Carolinas HealthCare System Medical Center, Charlotte, North Carolina.
authors.forename: P Daniel
authors.initials: PD
authors.lastname: Patterson
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania.
authors.forename: Anthony
authors.initials: A
authors.lastname: Fabio
authors.affiliation: Carolinas HealthCare System, Dickson Advance Analytics Group, Charlotte, North Carolina.
authors.forename: Charity G
authors.initials: CG
authors.lastname: Moore
authors.affiliation: Department of Medicine, Vanderbilt University, School of Medicine, Nashville, Tennessee.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Freiberg
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Songer
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000458:organization & administration; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data*; D005221:Fatigue; D006801:Humans; D007400:Interprofessional Relations; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D060051:Occupational Injuries / Q000453:epidemiology / Q000209:etiology*; D010561:Personnel Staffing and Scheduling; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014940:Work Schedule Tolerance
keywords: emergency medical services; occupational injury; shift work