title: Randomized, Prospective Study of the Impact of a Sleep Health Program on Firefighter Injury and Disability.
abstract: Firefighters' schedules include extended shifts and long work weeks which cause sleep deficiency and circadian rhythm disruption. Many firefighters also suffer from undiagnosed sleep disorders, exacerbating fatigue. We tested the hypothesis that a workplace-based Sleep Health Program (SHP) incorporating sleep health education and sleep disorders screening would improve firefighter health and safety compared to standard practice.
  
  
  
  Prospective station-level randomized, field-based intervention.
  
  
  
  US fire department.
  
  
  
  1189 firefighters.
  
  
  
  Sleep health education, questionnaire-based sleep disorders screening, and sleep clinic referrals for respondents who screened positive for a sleep disorder.
  
  
  
  Firefighters were randomized by station. Using departmental records, in an intention-to-treat analysis, firefighters assigned to intervention stations which participated in education sessions and had the opportunity to complete sleep disorders screening reported 46% fewer disability days than those assigned to control stations (1.4 ± 5.9 vs. 2.6 ± 8.5 days/firefighter, respectively; p = .003). There were no significant differences in departmental injury or motor vehicle crash rates between the groups. In post hoc analysis accounting for intervention exposure, firefighters who attended education sessions were 24% less likely to file at least one injury report during the study than those who did not attend, regardless of randomization (OR [95% CI] 0.76 [0.60, 0.98]; χ2 = 4.56; p = .033). There were no significant changes pre- versus post-study in self-reported sleep or sleepiness in those who participated in the intervention.
  
  
  
  A firefighter workplace-based SHP providing sleep health education and sleep disorders screening opportunity can reduce injuries and work loss due to disability in firefighters.
authors.affiliation: Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, and the Sleep Health Institute, Brigham and Women's Hospital, Boston, MA.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Sullivan
authors.affiliation: Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, and the Sleep Health Institute, Brigham and Women's Hospital, Boston, MA.
authors.forename: Conor S
authors.initials: CS
authors.lastname: O'Brien
authors.affiliation: Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, and the Sleep Health Institute, Brigham and Women's Hospital, Boston, MA.|Division of Sleep Medicine, Harvard Medical School, Boston, MA.
authors.forename: Laura K
authors.initials: LK
authors.lastname: Barger
authors.affiliation: Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, and the Sleep Health Institute, Brigham and Women's Hospital, Boston, MA.|Division of Sleep Medicine, Harvard Medical School, Boston, MA.|Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.
authors.forename: Shantha M W
authors.initials: SM
authors.lastname: Rajaratnam
authors.affiliation: Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, and the Sleep Health Institute, Brigham and Women's Hospital, Boston, MA.|Division of Sleep Medicine, Harvard Medical School, Boston, MA.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Czeisler
authors.affiliation: Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, and the Sleep Health Institute, Brigham and Women's Hospital, Boston, MA.|Division of Sleep Medicine, Harvard Medical School, Boston, MA.
authors.forename: Steven W
authors.initials: SW
authors.lastname: Lockley
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D061388:Firefighters / Q000706:statistics & numerical data*; D006266:Health Education / Q000379:methods; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D011446:Prospective Studies; D012017:Referral and Consultation; D057566:Self Report; D012892:Sleep Deprivation / Q000517:prevention & control; D056508:Sleep Medicine Specialty / Q000379:methods*; D012894:Sleep Stages / Q000502:physiology; D012893:Sleep Wake Disorders / Q000175:diagnosis; D011795:Surveys and Questionnaires; D014481:United States; D017132:Workplace; D055815:Young Adult
keywords: disability.; education; firefighters; injuries; sleep