Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA.
Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA.
Am J Ind Med. 2022 Nov;65(11):878-897. doi: 10.1002/ajim.23407. Epub 2022 Jun 16.
The public safety sector includes law enforcement officers (LEO), corrections officers (CO), firefighter service (FF), wildland firefighting (WFF), and emergency medical services (EMS), as defined in the National Occupational Research Agenda (NORA) of the National Institute for Occupational Safety and Health (NIOSH). Across these occupations, shiftwork, long-duration shifts, and excessive overtime are common. Our objective was to identify research gaps related to working hours, sleep, and fatigue among these workers.
We used a scoping review study design that included searches of MEDLINE, Embase, CAB Abstracts, Global Health, PsychInfo, CINAHL, Scopus, Academic Search Complete, Agricultural and Environmental Science Collection, ProQuest Central, Cochrane Library, Safety Lit, Homeland Security Digital Library, and Sociological Abstracts using a range of occupational search terms and terms related to working hours, sleep, and fatigue.
Out of 3415 articles returned from our database search, 202 met all inclusion criteria. Six common outcomes related to working hours, sleep, and fatigue emerged: sleep, fatigue, work performance, injury, psychosocial stress, and chronic disease. Nearly two-thirds (59%, n = 120) of the studies were observational, of which 64% (n = 77) were cross sectional and 9% were (n = 11) longitudinal; 14% (n = 30) of the studies were reviews; and 19% (n = 39) were experimental or quasi-experimental studies. Only 25 of the 202 articles described mitigation strategies or interventions. FFs, LEOs, EMS, and WFFs were the most studied, followed by COs.
In general, more longitudinal and experimental studies are needed to enrich the knowledge base on the consequences of long working hours, poor sleep, and fatigue in the public safety sector. Few experimental studies have tested novel approaches to fatigue mitigation in diverse sectors of public safety. This gap in research limits the decisions that may be made by employers to address fatigue as a threat to public-safety worker health and safety.
公共安全部门包括执法人员（LEO）、惩教人员（CO）、消防员服务（FF）、野外消防员（WFF）和紧急医疗服务（EMS），这是国家职业研究议程（NORA）中对国家职业安全与健康研究所（NIOSH）的定义。在这些职业中，轮班工作、长时间轮班和过度加班是很常见的。我们的目标是确定与这些工人的工作时间、睡眠和疲劳相关的研究差距。
我们使用了范围综述研究设计，包括对 MEDLINE、Embase、CAB 摘要、全球健康、心理信息、CINAHL、Scopus、学术搜索完整、农业和环境科学收藏、ProQuest 中心、Cochrane 图书馆、安全文献、国土安全数字图书馆和社会学摘要的搜索，使用了一系列职业搜索词和与工作时间、睡眠和疲劳相关的术语。
从我们的数据库搜索中返回的 3415 篇文章中，有 202 篇符合所有纳入标准。与工作时间、睡眠和疲劳相关的六个常见结果出现：睡眠、疲劳、工作表现、伤害、心理社会压力和慢性疾病。近三分之二（59%，n=120）的研究是观察性的，其中 64%（n=77）是横断面研究，9%（n=11）是纵向研究；14%（n=30）的研究是综述；19%（n=39）是实验或准实验研究。在 202 篇文章中，只有 25 篇描述了缓解策略或干预措施。FFs、LEOs、EMS 和 WFFs 是研究最多的，其次是 COs。
总的来说，需要更多的纵向和实验研究来丰富公共安全部门长时间工作、睡眠不佳和疲劳后果的知识库。很少有实验研究测试了在公共安全不同部门中缓解疲劳的新方法。这种研究差距限制了雇主为解决疲劳作为公共安全工人健康和安全威胁而做出的决策。
