Bonnell Nicola, Jamal Kaiz, Boicu Bianca, Brubacher Jeffrey R
Department of Emergency Medicine, University of British Columbia, Vancouver, CAN.
Cureus. 2024 Nov 18;16(11):e73922. doi: 10.7759/cureus.73922. eCollection 2024 Nov.
Resident physicians often work extended-duration work shifts (EDWSs) exceeding 16 hours. EDWSs are associated with fatigue, workplace errors, mental health problems, and motor vehicle incidents. A 2019 systematic review reported that resident physicians had an increased risk of motor vehicle collisions (MVCs) and of falling asleep at the wheel after EDWSs. This systematic review updates those findings with recent literature. Embase, PubMed, Cochrane Database, and Ovid Medline were searched for original research articles studying resident physician driving safety following EDWS. Two authors independently reviewed articles for inclusion. Both reviewers performed data extraction and quality appraisal for each included article. Six articles met the inclusion criteria. Three articles found associations between EDWS and increased sleepiness in resident physicians. Self-reported sleepiness was increased by 46% following an EDWS compared to a normal-length shift. Objective measures of sleepiness were also increased following an EDWS. Similarly, there was a three-fold increase in adverse driving events following an EDWS compared to pre-EDWS. One study found 3.90 higher odds of an adverse driving incident following an EDWS compared to a day shift. EDWS are associated with an increased risk of adverse driving incidents, including collisions and falling asleep while driving, in resident physicians. Possible solutions including compensation for ride-share and taxi services, scheduled breaks, education on risks of driving while fatigued, and the use of caffeine may lower the risk of adverse driving incidents post-EDWSs. Further research is needed to assess the impact of possible solutions.
住院医师经常进行超过16小时的长时间轮班工作。长时间轮班工作与疲劳、工作场所失误、心理健康问题和机动车事故有关。2019年的一项系统评价报告称，住院医师在长时间轮班工作后发生机动车碰撞事故（MVC）和在驾驶时睡着的风险增加。本系统评价用最新文献更新了这些发现。在Embase、PubMed、Cochrane数据库和Ovid Medline中检索了研究住院医师长时间轮班工作后驾驶安全性的原始研究文章。两位作者独立审查文章以确定是否纳入。两位评审员对每篇纳入文章进行了数据提取和质量评估。六篇文章符合纳入标准。三篇文章发现长时间轮班工作与住院医师嗜睡增加之间存在关联。与正常时长的轮班相比，长时间轮班工作后自我报告的嗜睡增加了46%。长时间轮班工作后，嗜睡的客观指标也有所增加。同样，与长时间轮班工作前相比，长时间轮班工作后不良驾驶事件增加了两倍。一项研究发现，与日班相比，长时间轮班工作后发生不良驾驶事件的几率高出3.90倍。长时间轮班工作与住院医师发生不良驾驶事件的风险增加有关，包括碰撞和驾驶时睡着。可能的解决方案包括为拼车和出租车服务提供补偿、安排休息时间、开展疲劳驾驶风险教育以及使用咖啡因，这些可能会降低长时间轮班工作后发生不良驾驶事件的风险。需要进一步研究来评估可能的解决方案的影响。
