Insufficient sleep and fitness to drive in shift workers: A systematic literature review

Knott, Melissa; Classen, Sherrilene; Krasniuk, Sarah; Tippett, Marisa; Alvarez, Liliana

doi:10.1016/j.aap.2019.07.010

Cited by 9 publications

(6 citation statements)

References 27 publications

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“…In addition to study methods involving driving simulation, two on-the-road studies investigated one night of sleep deprivation on driving performance and convincingly found that lateral control of the vehicle was also severely impaired following sleep deprivation [11,12]. Furthermore, compared to older drivers, adolescents and younger adults (aged [16][17][18][19][20][21][22][23][24][25][26][27][28][29] are particularly susceptible due to driving inexperience and overconfidence in their driving competence [13,14].…”

Section: Introductionmentioning

confidence: 99%

“…However, these times are not always suited to the sleep patterns dictated by the economic interests and activities of modern life. Modern sleep patterns which fall outside the natural cycle, such as shift-work, can cause sleep deprivation severe enough to place the individual at an increased risk of accidental injury, particularly when driving, with several studies highlighting healthcare workers as those frequently affected [20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

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The impact of sleep deprivation and alcohol on driving: a comparative study

Lowrie

Brownlow²

2020

BMC Public Health

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Background: There is concern about the detrimental effects of shift-workers' increasing working hours particularly when driving sleep deprived. The approach to measuring the magnitude of driving impairment caused by sleep deprivation was by comparing it to alcohol. The study compared driving performance after 24-h of wakefulness to performance with a BrAC of just over 22 μg/100mls of breath which is equal to 50 mg of alcohol per 100mls of blood (Scottish drink-drive limit). The effectiveness of coffee as a countermeasure for driver fatigue and the association between subjective impairment and actual performance was also investigated.Methods: A study of 30 participants (11 male and 19 female; mean age 21) was conducted. Subjects were tested under three conditions: fully rested, sleep deprived, and alcohol intoxicated -BrAC mean [SD] 25.95 μg [2.78]. Under each condition, subjects were tested before and after coffee ingestion. This involved driving simulation (Lane Change Task and Reaction Test) and subjective Likert scales (Karolinska Sleepiness Scale and driver impairment scale). Outcome measures included lane tracking adaptive mean deviation, reaction time, and subjective sleepiness and impairment ratings. Results: Compared to alcohol, sleep deprived mean reaction times were slower (2.86 s vs. 2.34 s) and lateral control of the vehicle was reduced (lane tracking adaptive mean deviation: 0.5 vs. 0.3). Coffee did not produce an improvement when sleep deprived, and instead, performance deteriorated. Females were less impaired following sleep deprivation than males. Following prolonged wakefulness, the correlation between subjective impairment and actual performance was significant.Conclusions: It was concluded that sleep deprivation has a greater impact on driving performance than a BrAC of 22 μg/100mls of breath, as measured by driving simulation. Coffee is not an effective countermeasure for sleep deprived driving and drivers' ability to judge this impairment is suggested to be limited.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of sleep deprivation and alcohol on driving: a comparative study

Lowrie

Brownlow²

2020

BMC Public Health

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“…A study predominantly composed of nurses found that 27.1% of survey participants reported nodding off while driving over the past year, but this rate increased to 49.3% among those who work night shift and 51.3% in those who work a rotating schedule 26 . Similar sleepiness and fatigue issues are likely to affect both nurses and general surgery residents, particularly because both are subject to rotating schedules and there is some evidence to suggest that exposure to night-shift work may predict adverse driving outcomes 27 …”

Section: Discussionmentioning

confidence: 99%

A National Survey of Motor Vehicle Crashes Among General Surgery Residents

et al. 2020

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Objectives:Evaluate the frequency of self-reported, post-call hazardous driving events in a national cohort of general surgery residents and determine the associations between duty hour policy violations, psychiatric well-being, and hazardous driving events.Summary of Background Data:MVCs are a leading cause of resident mortality. Extended work shifts and poor psychiatric well-being are risk factors for MVCs, placing general surgery residents at risk.Methods:General surgery residents from US programs were surveyed after the 2017 American Board of Surgery In-Training Examination. Outcomes included self-reported nodding off while driving, near-miss MVCs, and MVCs. Group-adjusted cluster Chi-square and hierarchical regression models with program-level intercepts measured associations between resident- and program-level factors and outcomes.Results:Among 7391 general surgery residents from 260 programs (response rate 99.3%), 34.7% reported nodding off while driving, 26.6% a near-miss MVC, and 5.0% an MVC over the preceding 6 months. More frequent 80-hour rule violations were associated with all hazardous driving events: nodding off while driving {59.8% with ≥5 months with violations vs 27.2% with 0, adjusted odds ratio (AOR) 2.86 [95% confidence interval (CI) 2.21–3.69]}, near-miss MVCs, [53.6% vs 19.2%, AOR 3.28 (95% CI 2.53–4.24)], and MVCs [14.0% vs 3.5%, AOR 2.46 (95% CI 1.65–3.67)]. Similarly, poor psychiatric well-being was associated with all 3 outcomes [eg, 8.0% with poor psychiatric well-being reported MVCs vs 2.6% without, odds ratio 2.55 (95% CI 2.00–3.24)].Conclusions:Hazardous driving events are prevalent among general surgery residents and associated with frequent duty hour violations and poor psychiatric well-being. Greater adherence to duty hour standards and efforts to improve well-being may improve driving safety.

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“…ESV driving is undertaken in high-pressure, time-sensitive situations with significant stress attached. Additionally, ESV drivers commonly work in a shift pattern which increases the likelihood of fatigue and drowsy driving [23]. ESV drivers are often required to engage in emergency or 'lights and sirens' driving in an emergent situation.…”

Section: The Emergency Driving Taskmentioning

confidence: 99%

Medical fitness to drive, emergency service vehicles and crash risk

et al. 2023

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Background Emergency service vehicle (ESV) drivers are an important part of the health, fire and police services. ESV driving is associated with increased crash risk, but little guidance exists in the literature on relevant medical conditions among drivers and their potential for adding to higher crash risks. Aims We undertook a narrative review to examine the role of medical and other conditions in crash risk of ESV drivers. Method A literature search was conducted using the ScienceDirect and Transport Research International Documentation (TRID) databases. There was no time frame for the search, and results were restricted to review and research articles. Results Of 570 papers identified, 13 remained after screening and full-text review. A range of factors have been shown to have an impact on increased crash risk, including the nature of the task, physical features of the equipment, training, experience, environmental conditions and secondary tasks. There was scant information on medical conditions other than alcohol use disorders. Conclusions Given issues of speed, vehicle and environment, it would seem prudent to mandate levels of medical fitness to drive similar to and sometimes exceeding (i.e. colour blindness for traffic signals and alerts, hearing impairment as first responders) those for group 2 drivers with extra stipulations relating to specific service needs such as enhanced visual (such as colour blindness and contrast sensitivity) and auditory function. Further research is needed on the prevalence and emergence of relevant medical conditions among ESV drivers, with due consideration of their application to the driving tasks in each service.

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Insufficient sleep and fitness to drive in shift workers: A systematic literature review

Cited by 9 publications

References 27 publications

The impact of sleep deprivation and alcohol on driving: a comparative study

The impact of sleep deprivation and alcohol on driving: a comparative study

A National Survey of Motor Vehicle Crashes Among General Surgery Residents

Medical fitness to drive, emergency service vehicles and crash risk

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