Sleep Deprivation and Firefighter Work Schedules: Health Risks

Introduction

Intensive investigations into the human body have revealed new information about the importance of specific functions such as sleeping. Although sleep has always been recognized as an important component of human functioning, research into this process demonstrates that sleep provides individuals with notable benefits, including the ability to repair significant internal damage. With this in mind, it is not surprising to find that researchers have begun to focus on the problems that can arise when individuals experience sleep deprivation. This phenomenon can be readily studied in subjects who endure prolonged hours of work. Through research in this area, scholars are now able to compare outcomes for subjects that receive "normal" levels of sleep with those who are essentially sleep deprived.

Given the importance of sleep to the development and maintenance of the human body, there is a direct impetus to better understand the outcomes that result when an individual becomes sleep deprived. Using this as a basis for investigation, this research considers how prolonged hours of work and sleep deprivation impact outcomes for the individual. Specifically, it examines altered sleep-wake schedules for firefighters and first responders. Through a careful review of the existing literature, it will be possible to provide a more thorough understanding of the problems that can arise when individuals do not acquire enough sleep.

Prolonged Hours of Work and Sleep Deprivation

In order to begin this investigation, it is first helpful to consider what has been noted about the scope and impact of prolonged work hours on sleep deprivation. A critical review of the literature demonstrates that there are a myriad of ways in which this issue can be addressed. Research has focused on both the physiological impacts as well as the overall impact of sleep deprivation on work performance.

Examining the physiological impact of sleep deprivation first, Kushida (2005) reports that sleep deprivation can create a cascade of events that makes it difficult for the body to function properly. Kushida reports that sleep deprivation affects almost every aspect of physiological functioning, altering cardiovascular, respiratory, gastrointestinal, renal, integumentary, neurological, immunological, and endocrine function. Researchers have found that sleep induces certain physiological changes needed to improve the functioning of the human body; thus, when sleep deprivation occurs, changes in the overall function of most bodily systems follow.

Åkerstedt and Nilsson (2003) also considered the physiological impact of sleep deprivation on the human body, examining separate areas of human function and development to elucidate the overall impact that inadequate sleep can have. Their findings are as follows:

Clearly, the data presented by Åkerstedt and Nilsson (2003) demonstrates the overall importance of sleep to improving the functioning of the human body.

Turning to the impact of sleep deprivation on workplace performance, Kenyon (2007) examined the results of a nursing survey in which on-call professionals were asked about their experiences. Kenyon reports that while most nurses start their shifts well rested, those required to remain on the job for twelve hours or more often begin to experience symptoms of sleep deprivation. Describing these symptoms, Kenyon notes that sleep deprivation results in "increased anxiety, decreased short term memory, slowed reaction time, decreased work efficiency, reduced motivational drive, decreased vigilance, increased variability in work performance, and increased errors of omission which increase to commission when time pressure is added to the task" (p. 631). The end result, argues Kenyon, is a greater chance of error and greater risk-taking behavior. Similar results have been reported elsewhere in the literature (Residency programs…, 2007).

Åkerstedt, Fredlund, Gillberg, and Jansson (2002) also considered the impact of sleep deprivation on workplace performance, specifically examining fatal occupational accidents and their relationship to both sleeping difficulties and occupational factors. According to these authors, while the link between sleep deprivation and occupational accidents has not been widely investigated, anecdotal evidence suggests a direct relationship. In particular, they report that "disturbed sleep because of night work or long hours has been implicated in several major accidents, such as the nuclear plant accidents at Three-Mile Island and Chernobyl, as well as in transport disasters such as the grounding of the oil tanker Exxon Valdez" (p. 69). Despite this, few studies had attempted to make a quantitative link between occupational accidents and sleep deprivation.

In an effort to address this gap in the literature, Åkerstedt et al. (2002) surveyed a national sample of 47,860 individuals over the course of a 20-year period, during which 166 fatal occupational accidents occurred. Accident data was correlated with a host of variables to determine the impact of sleep deprivation in these incidents, including gender, relative risk, difficulties in sleeping, shift work or non-day work, age, socioeconomic status, hectic work, overtime, and strenuous work. The results demonstrate that self-reported disturbed sleep was a statistically significant predictor of accidental death at work. Other significant variables included gender—men rather than women were more likely to die in workplace accidents—and non-day work, as a majority of accidents occurred during shifts in the evening or at night. These results clearly demonstrate the impact that sleep deprivation can have on outcomes for both the individual and the workplace.

Firefighters and First Responders

Because the central focus of this investigation is firefighters and first responders, it is important to consider what has been noted about the impacts of prolonged hours on these professionals. It is first necessary to review the working conditions experienced by firefighters. Takeyama (2005), in his review of working conditions in firefighting, makes the following observations:

"Firefighters must be on duty 24 hours a day to handle unexpected emergencies. The duty of firefighters is characterized by their heavy social responsibility and the various risks they encounter in fire extinguishing and lifesaving activities. These activities also expose them to critical risk factors and impose a high psycho-physiological workload. Firefighting and lifesaving activities are very strenuous. Previous studies have indicated that firefighting is more stressful due to sudden alarm calls after a long period of relative inactivity as well as to the burden of social responsibility and the risks associated with firefighting" (p. 1).

Takeyama goes on to report that, in most instances, firefighters do not receive enough sleep; however, the overall impact of this working environment has not been widely investigated.

While the data on sleep deprivation and work outcomes clearly demonstrates the negative impact that prolonged work hours can have on sleep and occupational performance, a review of how these issues specifically affect firefighters and first responders is also warranted. Although research on this topic is limited, some reports provide insight into the issue. Sollecito (2007) reports that a study of employees regularly working evening and night shifts in 24/7 operations found that "these workers tend to consume more cigarettes, caffeine, and other stimulants than their daytime counterparts, with more than double the rate of smoking" and account for about 18 percent of the total workforce. Sollecito notes that because firefighters work these types of schedules, these findings are particularly relevant to this group.

Conclusion

Synthesizing all of the data provided in this investigation, it becomes evident that sleep deprivation can have notable impacts on the ability of the individual to perform his or her job. While sleep deprivation can be a temporary state that affects the individual only periodically, professions such as firefighting and first responding present considerable sleep challenges as a day-to-day reality of the work environment. Although there are steps that individuals and organizations can take to reduce the negative impact of sleep deprivation on work performance, the unique demands of firefighting and emergency response make it difficult for meaningful changes in work schedules to occur. Given that these professionals provide such an important and essential service to the community, it seems reasonable to argue that further research in this area is needed to determine how improvements could be made. If first responders are not able to perform their jobs effectively, society will face considerable obstacles in meeting basic public safety needs.