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Sleep Health and Safety
for Railroaders
Lessons in Sleep Health Education
Janis L Anderson, Ph.D.
Asst. Prof of Psychology/Dept of Psychiatry
Harvard Medical School, Brigham & Women's Hospital
Division of Sleep Medicine
view as of 5/10/10
SLEEP MEDICINE
SLEEP MEDICINE
we slowed the pools" "held away agreements"
"monthly mileage maximums" "early mark off"
"protect trespass" "standing bid agreement"
"visibility of pulls and returns" "spread times"
"protecting extra boards" "work-rest boards"
"show-up crew" "tie off"
SLEEP MEDICINE
SLEEP MEDICINE
SLEEP MEDICINE
SLEEP MEDICINE
Abolishing Sleep Illiteracy
and Ignorance
Sleep Disorders and Sleep Deprivation--An
Unmet Public Health Problem (Institute of
Medicine, 2006)
• “…a public health campaign is required to
increase awareness among the general
population.”
• “…specific education and training strategies
are needed to increase awareness among
health professionals including improved
curriculum content…”
SLEEP MEDICINE
The Sleep Health and
Education Program
• Help individuals and their sleep partners
recognize sleep problems.
• Provide primary care physicians and other
clinicians with information to recognize/treat
sleep problems.
• Assist medical students and other health care
trainees to understand the importance of good
sleep health in themselves and in their future
patients.
• Respond to the media's need for information that
is credible, accurate and easily accessible.
SLEEP MEDICINE
Sponsors of the Sleep and Health
Education Program
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•
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Cephalon
Sanofi-Aventis
Sepracor
Takeda Pharmaceuticals North America
JL Anderson, Ph.D. Funding:
U.S. Dept of Education, Institute of Education
Sciences: Univ. of New Mexico/Washington U
American Sleep Medicine Foundation
U.S. Dept of Transportation: HMS
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http://www.understandingsleep.org
SLEEP MEDICINE
Sleep Health and Education Program
“Tree of Sleep Knowledge”
• Sleep Apnea
• Insomnia
• CRSD
• Limb movement
• Narcolepsy
• Shift-work
• Learning and memory
• Metabolism
• Disease and psychiatry
• Drowsy driving
• Pediatric disorders
• Newborn sleep
• Children
• Adolescents
• Geriatric
Clinical Sleep
Disorders
Sleep through
the ages
“Get Sleep”
Consequences of
insufficient sleep
Editor: Dr. C. Landrigan
“Healthy Sleep”
Beta-Dec 2008
Final-Jan 2009
Editor: Dr. S. Shea
Beta - Oct 2007
Final - Jan 2008
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SLEEP MEDICINE
online training video for firefighters produced by Harvard Work
Hours Health and Safety Group
SLEEP MEDICINE
Firefighter interview regarding experiences
involving sleep, fatigue and safety.
SLEEP MEDICINE
The Operation Stay Alert! Fatigue management training program
endorsed by union leaders; individuals are encouraged to take
online confidential screening for sleep disorders. Information about
treatment and referrals to local clinics and providers are also easily
available.
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http://healthysleep.med.harvard.edu/need-sleep/successstories/lou-killer-shift
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Sleep Health and Safety for Railroaders
• online information, videos, interactives
SLEEP MEDICINE
Interactive
http://healthysleep.med.harvard.edu/need-sleep/whats-init-for-you/how-awake-are-you
SLEEP MEDICINE
DCohen et al 2010 Science Translational Medicine Vol 2(14)
SLEEP MEDICINE
Errors per 1000 patient days
Serious Medical Errors
300
p<0.001
250
200
p<0.001
Traditional
Intervention
150
100
50
0
Serious Medical Errors,
Interns
Serious Medical Errors,
Unit Wide
Effect of Reducing Interns’ Work Hours
on Serious Medical Errors in Intensive Care Units
Landrigan, CP, et.al. NEJM 2004;351:1838-48
SLEEP MEDICINE
Odds Ratio for Having Motor Vehicle Accident
or Near Miss Event
During Commute Home from Work
7
* 95% CI
6.30
5.40
6
5
Motor Vehicle
Accident
Near Miss
4
3
*
3.30
1.60
2
1
0
Non-Extended Shifts
After Extended Shifts
Data From Table 1:
Barger, L, et al: Extended
Work Shifts
and the Risk of
Motor Vehicle Crashes
among Interns.
NEJM, 352(2).125-134, 2005
American Academy of Sleep Medicine
Risk Factors for Drowsy Driving
Taking any sedating medications
Drinking even small amounts of alcohol
Having a sleep disorder (sleep apnea)
Driving long distances without breaks
Driving alone or on a boring road
450
400
350
300
250
200
150
100
50
0
Number of
Crashes
Number of Crashes
•
•
•
•
•
Pack et al 1995
0:00
3:00
6:00
9:00
12:00
15:00
18:00
21:00
Time of Day
Time of Day
Driving home post-call
© American Academy of Sleep Medicine
American Academy of Sleep Medicine
Drive Smart; Drive Safe
• AVOID driving if drowsy.
• If you are really sleepy, get a ride home, take a
taxi, or use public transportation.
• Take a 20 minute nap and/or drink a cup of coffee
before going home post-call.
• Stop driving if you notice the warning signs of
sleepiness.
• Pull off the road at a safe place, take a short nap.
© American Academy of Sleep Medicine
Sleep Health and Safety for
Railroaders
PARTNERSHIP
• Harvard Sleep Health and Education Program
• WGBH Educational Foundation
• Volpe National Transportation Systems
Center
• FRA Office of Safety
• FRA Office of R & D Human Factors Program
• You
SLEEP MEDICINE
Sleep Health and Safety for Railroaders
AIMS
• multi-media web-based education
program to provide Class I, II, and III railroad
employees with educational resources and
accessible information regarding sleep
science, sleep health, fatigue and fatigue
management
• scientifically valid way to assess personal
risk for prevalent sleep disorders as
potentially related to work schedules
SLEEP MEDICINE
our team
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Interim Editor-in-Chief: Stuart F Quan MD
Module Editor: Janis L Anderson PhD
Executive Producer: Arthur Smith
Associate Producer: Sara Chaudhary
SLEEP MEDICINE
our process
• research and background
– educational goals for this industry
• specific content most important to the
multiple audiences within Railroader
community
– key messages
– specific contexts
– frequently asked questions
– success stories
SLEEP MEDICINE
your input
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•
•
•
Frequently Asked Questions
user needs
how this site would help your programs
alpha testers and beta testers: receive prereleases of the site, give anonymous
feedback
SLEEP MEDICINE