Fire Fighter Fatigue Management Program: Operation Fight Fatigue

Mass General Brigham

Status: Completed

Conditions: Restless Leg Syndrome; Shift-Work Sleep Disorder; Insomnia; Impaired Driving; Obstructive Sleep Apnea

Treatments: Behavioral: Sleep health education provided via a web-based program; Other: Sleep disorder detection and treatment; Other: Optimization of Sleep in Fire Station

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT01672502

EMW-2010-FP-00521

Details and patient eligibility

About

Firefighters frequently work extended duration shifts and long work weeks which have adverse effects on alertness, health, safety and performance. This protocol uses a survey instrument to examine the effects of extended duration shifts on safety outcomes (e.g., motor vehicle crashes, accidents, injuries), health (e.g., diagnosis and treatment of sleep disorders, improved general health indices, decreased number of sick days), and performance (e.g., decreased response time). This study will expand understanding of the nature, scope, etiology and consequences of firefighter fatigue and increase our ability to develop guidelines that can be generalized across fire departments throughout North America. This study could provide an avenue to make lasting policy improvements that could enhance the safety, health, and performance of firefighters.

Full description

Firefighters work some of the most challenging schedules known under highly stressful and demanding conditions. The need to work frequent extended shifts leads to acute and chronic sleep deficiency as well as disruption of circadian rhythms. Firefighters on-call overnight are also particularly susceptible to sleep inertia, the neurocognitive impairment experienced immediately upon waking. In addition, it is likely that a significant proportion of firefighters suffer from undiagnosed sleep disorders, which further impair sleep and exacerbate fatigue.

The proposed fatigue countermeasure aims to increase sleep opportunities, and thereby improve firefighter safety and health. We will be conducting a station-level, randomized clinical trial of policies designed to maximize sleep opportunities during current 24-hour shifts to improve alertness, performance, health and safety in firefighters.

We will leverage the comprehensive fatigue management program we developed and the web-based technology we implemented in previous Federal Emergency Management Agency projects, and will continue to offer our web-based education program and sleep disorders screening. By conducting a collaborative study involving sleep medicine clinicians, sleep researchers, a consultant on alarms, together with the representatives from the management, and union leadership of the fire department, we expect we will develop a sleep optimization program with a high probability of success and test the hypotheses that increasing the sleep opportunity of firefighters will improve the alertness, performance, safety and physical and mental health of firefighters. The results of this study will provide policy makers with the scientific evidence they require to develop effective fatigue countermeasure programs for firefighters.

We will be conducting a randomized clinical trial, providing the most rigorous evaluation possible in an operational setting. Half the fire stations in a department will be randomly assigned to complete the intervention, termed Operation Fight Fatigue, in the first year of the study. The other half of the fire stations will complete the intervention in the second year. In this way, all firefighters will have the chance to benefit. We expect the fatigue countermeasure intervention to improve the alertness, performance, health and safety of firefighters. We will be evaluating a cost-effective intervention to improve the safety and health of firefighters in departments throughout the United States.

Enrollment: 620 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Must be a fire department employee at a participating fire department.

Exclusion criteria

• May not be 17 years of age or younger.
• Will not be included if not a firefighter.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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620 participants in 2 patient groups

Intervention

Experimental group

Description:

Firefighters in this group will receive at the beginning of the study an introduction to the study, sleep education, sleep disorder screening survey, health survey, increased sleep opportunities at their fire department, followed later by physiological monitoring of a portion of the firefighters, and then finally an 'end of year' survey at the end of the study.

Treatment:

Other: Optimization of Sleep in Fire Station

Other: Sleep disorder detection and treatment

Behavioral: Sleep health education provided via a web-based program

Control

Active Comparator group

Description:

Firefighters in this group will only receive an introduction to the study and a health survey, followed later by physiological monitoring of a portion of the firefighters, and then at the end of the study will receive the sleep disorders screening survey, sleep education (Intervention group received screening survey and education much earlier at the beginning of the study), and an 'end of year' survey. None of these firefighters will receive the increased sleep opportunities as the Intervention group will.

Treatment:

Other: Sleep disorder detection and treatment

Behavioral: Sleep health education provided via a web-based program