ORCID Profile
0000-0001-8386-4100
Current Organisations
Boston Children's Hospital
,
Brigham and Women's Hospital
,
Harvard Medical School
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Publisher: AMPCo
Date: 04-2014
DOI: 10.5694/MJA13.10412
Abstract: An increasing weight of evidence is demonstrating that sleep deprivation and circadian rhythm disruption in doctors are associated with human error and harm to both patients and doctors. The increasing junior doctor workforce entering the hospital system in Australia provides a rare opportunity for workplace and roster reforms. There are cultural, educational and industrial challenges to reforming working hours. Any changes should be evidence-based and monitored to ensure that training for junior doctors and patient care are not compromised.
Publisher: Health Affairs (Project Hope)
Date: 09-2015
Publisher: American Medical Association (AMA)
Date: 21-12-2011
Abstract: Sleep disorders often remain undiagnosed. Untreated sleep disorders among police officers may adversely affect their health and safety and pose a risk to the public. To quantify associations between sleep disorder risk and self-reported health, safety, and performance outcomes in police officers. Cross-sectional and prospective cohort study of North American police officers participating in either an online or an on-site screening (n=4957) and monthly follow-up surveys (n=3545 officers representing 15,735 person-months) between July 2005 and December 2007. A total of 3693 officers in the United States and Canada participated in the online screening survey, and 1264 officers from a municipal police department and a state police department participated in the on-site survey. Comorbid health conditions (cross-sectional) performance and safety outcomes (prospective). Of the 4957 participants, 40.4% screened positive for at least 1 sleep disorder, most of whom had not been diagnosed previously. Of the total cohort, 1666 (33.6%) screened positive for obstructive sleep apnea, 281 (6.5%) for moderate to severe insomnia, 269 (5.4%) for shift work disorder (14.5% of those who worked the night shift). Of the 4608 participants who completed the sleepiness scale, 1312 (28.5%) reported excessive sleepiness. Of the total cohort, 1294 (26.1%) reported falling asleep while driving at least 1 time a month. Respondents who screened positive for obstructive sleep apnea or any sleep disorder had an increased prevalence of reported physical and mental health conditions, including diabetes, depression, and cardiovascular disease. An analysis of up to 2 years of monthly follow-up surveys showed that those respondents who screened positive for a sleep disorder vs those who did not had a higher rate of reporting that they had made a serious administrative error (17.9% vs 12.7% adjusted odds ratio [OR], 1.43 [95% CI, 1.23-1.67]) of falling asleep while driving (14.4% vs 9.2% adjusted OR, 1.51 [95% CI, 1.20-1.90]) of making an error or safety violation attributed to fatigue (23.7% vs 15.5% adjusted OR, 1.63 [95% CI, 1.43-1.85]) and of exhibiting other adverse work-related outcomes including uncontrolled anger toward suspects (34.1% vs 28.5% adjusted OR, 1.25 [95% CI, 1.09-1.43]), absenteeism (26.0% vs 20.9% adjusted OR, 1.23 [95% CI, 1.08-1.40]), and falling asleep during meetings (14.1% vs 7.0% adjusted OR, 1.95 [95% CI, 1.52-2.52]). Among a group of North American police officers, sleep disorders were common and were significantly associated with increased risk of self-reported adverse health, performance, and safety outcomes.
Publisher: American Academy of Pediatrics (AAP)
Date: 03-2021
Abstract: Extended-duration work rosters (EDWRs) with shifts of 24+ hours impair performance compared with rapid cycling work rosters (RCWRs) that limit shifts to 16 hours in postgraduate year (PGY) 1 resident-physicians. We examined the impact of a RCWR on PGY 2 and PGY 3 resident-physicians. Data from 294 resident-physicians were analyzed from a multicenter clinical trial of 6 US PICUs. Resident-physicians worked 4-week EDWRs with shifts of 24+ hours every third or fourth shift, or an RCWR in which most shifts were ≤16 consecutive hours. Participants completed a daily sleep and work log and the 10-minute Psychomotor Vigilance Task and Karolinska Sleepiness Scale 2 to 5 times per shift approximately once per week as operational demands allowed. Overall, the mean (± SE) number of attentional failures was significantly higher (P =.01) on the EDWR (6.8 ± 1.0) compared with RCWR (2.9 ± 0.7). Reaction time and subjective alertness were also significantly higher, by ∼18% and ∼9%, respectively (both P & .0001). These differences were sustained across the 4-week rotation. Moreover, attentional failures were associated with resident-physician–related serious medical errors (SMEs) (P =.04). Although a higher rate of SMEs was observed under the RCWR, after adjusting for workload, RCWR had a protective effect on the rate of SMEs (rate ratio 0.48 [95% confidence interval: 0.30–0.77]). Performance impairment due to EDWR is improved by limiting shift duration. These data and their correlation with SME rates highlight the impairment of neurobehavioral performance due to extended-duration shifts and have important implications for patient safety.
Publisher: Springer Science and Business Media LLC
Date: 03-2009
DOI: 10.1007/S11910-009-0024-7
Abstract: Almost 15% of the full-time workers in the United States are shift workers. We review the physiologic challenges inherent not only in traditional night or rotating shifts but also in extended-duration shifts and other nonstandard hours. The challenging schedules of those in particularly safety-sensitive professions such as police officers, firefighters, and health care providers are highlighted. Recent findings describing the neurobehavioral, health, and safety outcomes associated with shift work also are reviewed. Comprehensive fatigue management programs that include education, screening for common sleep disorders, and appropriate interventions need to be developed to minimize these negative consequences associated with shift work.
Publisher: Oxford University Press (OUP)
Date: 20-05-2019
DOI: 10.1093/SLEEP/ZSZ110
Abstract: We compared resident physician work hours and sleep in a multicenter clustered-randomized crossover clinical trial that randomized resident physicians to an Extended Duration Work Roster (EDWR) with extended-duration (≥24 hr) shifts or a Rapidly Cycling Work Roster (RCWR), in which scheduled shift lengths were limited to 16 or fewer consecutive hours. Three hundred two resident physicians were enrolled and completed 370 1 month pediatric intensive care unit rotations in six US academic medical centers. Sleep was objectively estimated with wrist-worn actigraphs. Work hours and subjective sleep data were collected via daily electronic diary. Resident physicians worked fewer total hours per week during the RCWR compared with the EDWR (61.9 ± 4.8 versus 68.4 ± 7.4, respectively p 0.0001). During the RCWR, 73% of work hours occurred within shifts of ≤16 consecutive hours. In contrast, during the EDWR, 38% of work hours occurred on shifts of ≤16 consecutive hours. Resident physicians obtained significantly more sleep per week on the RCWR (52.9 ± 6.0 hr) compared with the EDWR (49.1 ± 5.8 hr, p 0.0001). The percentage of 24 hr intervals with less than 4 hr of actigraphically measured sleep was 9% on the RCWR and 25% on the EDWR (p 0.0001). RCWRs were effective in reducing weekly work hours and the occurrence of consecutive hour shifts, and improving sleep duration of resident physicians. Although inclusion of the six operational healthcare sites increases the generalizability of these findings, there was heterogeneity in schedule implementation. Additional research is needed to optimize scheduling practices allowing for sufficient sleep prior to all work shifts. Clinical Trial: Multicenter Clinical Trial of Limiting Resident Work Hours on ICU Patient Safety (ROSTERS), t2/show/NCT02134847
Publisher: Health Affairs (Project Hope)
Date: 06-2015
No related grants have been discovered for Christopher Landrigan.