Perceived physical work capacity, stress, sleep disturbance and occupational accidents among firefighters working during a strike

Fire-fighting and rescue work are arranged in such a way that various kinds of accidents and catastrophes can be handled. In an understaffed situation, such as a strike, this goal may not be met. The objective of this study was to investigate factors associated with perceived physical work capacity, stress, sleep disturbance, and occupational accidents among firefighters who remained at work during an extended strike. A cross-sectional questionnaire study was carried out among 543 firefighters (83% of the target group) in 71 fire brigades in Finland. After the strike had lasted for 9 to 11 weeks, most of the firefighters perceived their physical work capacity to be rather good or very good. Stress increased along with a decreasing number of personnel in a crew (OR= 2.3, CI= 1.0-5.3, for less than 75% of a normal crew vs. normal crew) and with decreasing number of personnel in a shift (OR= 2.4, CI= 1.1-5.4, for less than 25% of normal shift vs. normal shift). Sleep disturbance was reported to occur as soon as the total working time exceeded 50 h/week. Working more than 70 h/week increased the risk of occupational accidents almost 4-fold compared with working no more than 50 h/week. These results suggest that exceptional situations, such as a strike, are a challenge to human capacity. With time, increased stress and sleep disturbance may lead to serious consequences.     

Individual differences in working hours, work perceptions and accident rates in veterinary surgeries

This study addresses an under-researched outcome of occupational stress, namely the frequency of accidents at work and car accidents. A large, random sample of 778 vets and their auxiliary personnel was assessed in relation to socio-demographic variables, work perception and accident involvement. The study, involving veterinary practices in Germany, revealed that work-related injuries/accidents experienced during the previous 12-month period were significantly related to individual differences in job-related stress and job satisfaction. The average yearly number of car accidents was predicted by age, working climate and job satisfaction. Furthermore, driving accidents going to or from work during the previous year were calculated against distance travelled. Vets working in excess of 48 h/week displayed significantly more driving accidents when visiting clients. Results indicate heterogeneous correlations both between and within the two categories of car and work accidents, suggesting that these are different phenomena, each with its own associated personal and work factors. Results also suggest that work perceptions may act as intermediary influences on accident rates.     

Individual differences in working hours,work perceptions and accident rates in veterinary surgeries

This study addresses an under-researched outcome of occupational stress, namely the frequency of accidents at work and car accidents. A large, random sample of 778 vets and their auxiliary personnel was assessed in relation to socio-demographic variables, work perception and accident involvement. The study, involving veterinary practices in Germany, revealed that work-related injuries/accidents experienced during the previous 12-month period were significantly related to individual differences in job-related stress and job satisfaction. The average yearly number of car accidents was predicted by age, working climate and job satisfaction. Furthermore, driving accidents going to or from work during the previous year were calculated against distance travelled. Vets working in excess of 48 h/week displayed significantly more driving accidents when visiting clients. Results indicate heterogeneous correlations both between and within the two categories of car and work accidents, suggesting that these are different phenomena, each with its own associated personal and work factors. Results also suggest that work perceptions may act as intermediary influences on accident rates.     

Dealing with shift work: Physical fitness, temperature, and napping

This paper reviews the effects of generally controllable factors such as physical conditioning, ambient temperature, and amount of prior sleep in adjustment to night work periods and shift work. One can expect a 5-10% decline in capacity for work in nocturnal work periods as compared to daytime work periods. This decreased capacity would dissipate if workers maintained a consistent sleep-wake routine for 8-16 days after moving to a new shift. Proven means for accelerating this adaptation are currently not available. The ability to perform work also declines as the length of the work period increases but depending upon individual tasks. Physical conditioning improves mood and general well-being, but no strong evidence currently indicates that conditioning increases tolerance or adjustment to shift work.

Increased ambient temperature increases the stress of work, although studies do not address heat as a factor in adjustment to shift work. While lower nocturnal temperature would be assumed to reduce heat stress during night shifts, supporting data does not exist. Studies have not addressed the negative consequences of cold stress or of rotating from night to day shifts with added heat stress.

The proper use of short sleep periods either as preparation for or as a response to a shift change can ameliorate some effects of shift rotation. Data indicate that performance on 'graveyard' shifts can be maintained close to baseline levels following true prophylactic naps while performance may decline by up to 30% when such naps are not taken. While there is evidence that naps or even rest periods without sleep are beneficial in improving mood in normal young adults, these data do not apply to 'replacement' naps. Studies of interjected naps imply that such naps do reduce sleep debt but do not imply that such naps are more beneficial than longer sleep periods. Naps appear to be most advantageous when the accumulated sleep debt is least.     

A preliminary investigation of post-traumatic stress symptoms among firefighters

Emergency service personnel are at high risk of developing post-traumatic stress disorder (PTSD). However, there is little in-depth information on the psychological responses of firefighters to the daily incidents that they attend. This preliminary study aimed to investigate the PTSD symptoms of firefighters in relation to traumatic events experienced by them, and the availability of social support. Thirty-one UK fire service workers completed an adapted version of the Post-traumatic Diagnostic Scale (PDS; Foa, 1995) to investigate the existence of post-traumatic stress disorder (PTSD). They were also individually interviewed to explore the symptoms they had experienced, what events these were related to, types of social support and coping strategies. Two participants reached the DSM-IV criteria for PTSD. Rumination and sleep disturbance were the most commonly reported PTSD symptoms. Participants reported high levels of social support from within the service and outside. The results suggest that fire service personnel are at risk of developing some symptoms of PTSD; however most had not experienced severe enough symptoms for PTSD to be diagnosed. The study suggests that high levels of social support may play a role in buffering firefighters from the development of PTSD.     

A preliminary investigation of post-traumatic stress symptoms among firefighters

Emergency service personnel are at high risk of developing post-traumatic stress disorder (PTSD). However, there is little in-depth information on the psychological responses of firefighters to the daily incidents that they attend. This preliminary study aimed to investigate the PTSD symptoms of firefighters in relation to traumatic events experienced by them, and the availability of social support. Thirty-one UK fire service workers completed an adapted version of the Post-traumatic Diagnostic Scale (PDS; Foa, 1995) to investigate the existence of post-traumatic stress disorder (PTSD). They were also individually interviewed to explore the symptoms they had experienced, what events these were related to, types of social support and coping strategies. Two participants reached the DSM-IV criteria for PTSD. Rumination and sleep disturbance were the most commonly reported PTSD symptoms. Participants reported high levels of social support from within the service and outside. The results suggest that fire service personnel are at risk of developing some symptoms of PTSD; however most had not experienced severe enough symptoms for PTSD to be diagnosed. The study suggests that high levels of social support may play a role in buffering firefighters from the development of PTSD.     

Health, well-being and burnout of ICU nurses on 12- and 8-h shifts

It is generally agreed that some features of shift systems can influence the extent of well-being and health problems experienced by the workers involved. Extended working days (9-12 h) have been found to aggravate some problems associated with shiftwork, especially when the work is mentally and emotionally demanding. The aim of the study was to compare measures of health, sleep, psychological and social well-being, job satisfaction and burnout of ICU nurses on 12- and 8-h shifts. The groups of subjects were matced for age, length of shiftwork experience, marital status and number of hours worked. the 12-h shift nurses, when compared to their 8-h shift colleagues, experienced more chronic fatigue, cognitive anxiety, sleep disturbance and emotional exhaustion. Job satisfaction seems to be independent of the shift duration. The nurses on 12-h shifts reported less social and domestic disruption than those on 8-h shifts. The 12-h shift nurses showed worse indices of health, well-being and burnout tan the 8-h shift nurses. It is suggested that this may be associated with their longer daily exposure to the stress of work. The increased number of rest days of 12-h shift nurses seems tobe insufficient to dissipate the adverse health and well-being effects that built up over their longer shifts.     

The many meanings of sleep

Reductions in sleep are concomitant with night shift work. Data are presented showing that these robust differences in sleep are even present in experienced permanent night shift workers who most prefer to work nights. A model is presented which relates these reductions to chronic sleep deprivation. This, in turn, may be associated with performance decrements, and lead to accidents and illness. Better work schedule selection, worker training programs, and preventive medical action are unproven but promising approaches to overturning this model.     

Perceptions of work stress in Australian firefighters

This study surveyed 747 firefighters on their perceptions of work stress. The current emphasis in the fire brigades is on the management of traumatic or critical incident stress, but other work stressors may also be important. The firefighters rated their jobs as more stressful than other occupations, and psychological work stress as highest among a set of potential sources and types of stress. Although many factors were mentioned, the most frequently indicated stressors were associated with exposure to traumatic incidents such as major accidents or the suffering of others. Those who had previous experience with stress were more likely to rate current and future risk of stress as higher. Knowledge of existing organizational approaches to stress management was limited. The firefighters rated individual and informal sessions for dealing with stress as potentially more useful than the formal debriefing sessions now common in many emergency organizatins. Those who had previous experience with stress, however, were more likely to favour a formal organizational approach.     

The impact of shiftwork on personnel at a nuclear power plant: An exploratory survey study

Shiftwork may constitute an additional risk factor in high-hazard industries where system failure could exact heavy human, environmental and economic costs. This exploratory survey study examined the impact of shiftwork upon nuclear power plant workers' perceived health, sleep, and social problem, as well as levels of alertness. Overall, the night shik proved to be the most problematic in ternis of decreases in alertness, sleep duration and quality, and disruptions to health, social and family life. The permanent shift preferences of the shiftworkers were also explored to establish the practicability of introducing a theoretically safer permanent mght shdt at such a facility. Importantly, the small proportion of the sample who showed a preference for a pemianent night shift was insufficient to provide operational cover. Although these shtftworkers reported experiencing less disruption on the night shift than those who would choose to work a permanent day shift, their preference appeared to be based upon a greater esprit de corps on this shift rather than on any predisposing individual characteristics. These results have practical implications for work scheduling in high-hazard industries.

The present study investigates the dimensional structure of the psychosocial work environment as assessed by Karasek's job characteristics scales and a set of factorial scales derived from the Dictionary of Occupational Titles (DOT) observers' ratings of occupational characteristics for census occupations. Scale scores on the Karasek and DOT were linked to information on occupation from the Epidemiologc Catchment Area (ECA) study sample. Scale intercorreladons and factor analysis were performed on those ECA subjects who reported ever having a full-time job (n=11,789). DOT'sS Substantive Complexity scale was positively correlated with Karasek's Skill Discretion and Decision Authority scales, and DOT's Physical Demands and Hazards scale was positively correlated with Karasek's Physical Demands scale. In addition, the DOT system compared to the Karasek system seems to assess psychosocial work domains less characteristic of traditional industrial jobs (interpersonal stress, expressive work). The content validity of the Karasek scales might be increased with the assessment of these domains. Giving support to Karasek's Demand/Control Model, the factor structure of the psychosocial work enviromnent in the probability sample of five US metropolitan populations yielded two major dimensions: Control, and Physical Demands.     

Perceptions of work stress in Australian firefighters

Abstract

This study surveyed 747 firefighters on their perceptions of work stress. The current emphasis in the fire brigades is on the management of traumatic or critical incident stress, but other work stressors may also be important. The firefighters rated their jobs as more stressful than other occupations, and psychological work stress as highest among a set of potential sources and types of stress. Although many factors were mentioned, the most frequently indicated stressors were associated with exposure to traumatic incidents such as major accidents or the suffering of others. Those who had previous experience with stress were more likely to rate current and future risk of stress as higher. Knowledge of existing organizational approaches to stress management was limited. The firefighters rated individual and informal sessions for dealing with stress as potentially more useful than the formal debriefing sessions now common in many emergency organizatins. Those who had previous experience with stress, however, were more likely to favour a formal organizational approach.     

Perception and control of occupational injury risks in fishery--a pilot study

The frequency of occupational accidents in fishery is high in most fishery nations. Implementation of safety measures has, however, been limited. The purpose of the present cross-sectional study was to explore Swedish fishermen's attitudes towards occupational risks and accident control. Information was acquired through a questionnaire distributed to a convenience sample of 92 fishermen. Indices were built, containing variables relevant to perceived risk levels in connection with work, perceived manageability of risks, activity in safety work, technical knowledge and individual attitudes towards risks. The results did not support earlier findings of low risk awareness and risk acceptance among fishermen. Perceived manageability of risks but not perceived risk level, accident experience or risk acceptance, were significantly associated with activity in safety work. The results suggest that safety work might benefit from efforts to develop fishermen's understanding of how the development of hazardous situations can be prevented or managed. The results do not support strategies for accident control in fishery based solely on increasing risk awareness.     

Mesothelioma Among Brake Mechanics: An Expanded Analysis of a Case-Control Study

The U.S. Environmental Protection Agency has begun discussions to consider its assessment of asbestos toxicity related to mineral form and fiber size. Brake workers are typically exposed to short chrysotile fibers. To explore the mesothelioma risk among brake workers, considering other occupational exposures to asbestos, data from a study that was published previously were obtained and the analysis was extended. The National Cancer Institute provided data from a case-control study of mesothelioma. Because many participants with a history of brake work also had employment in other asbestos-related occupations, mesothelioma cases and controls were compared for a history of brake work, controlling for employment in eight occupations with potential asbestos exposure. A stratified analysis was also performed excluding those with any of the eight occupations. Possible interactions between brake work and other occupational exposures related to risk of mesothelioma were also examined. The odds ratio (OR) for employment in brake installation or repair was 0.71 (95% CI: 0.30-1.60) when controlled for insulation or shipbuilding. When a history of employment in any of the eight occupations with potential asbestos exposure was controlled, the OR was 0.82 (95% CI: 0.36-1.80). ORs did not increase with increasing duration of brake work. Exclusion of those with any of the eight exposures resulted in an OR of 0.62 (95% CI: 0.01-4.71) for occupational brake work. There was no evidence of an interaction between brake work and other occupational exposures. These latter analyses were based on small numbers of exposed cases. The results are consistent with the existing literature indicating that brake work does not increase the risk of mesothelioma and adds to the evidence that fiber type and size are important determinants of mesothelioma risk.     

Perception and control of occupational injury risks in fishery--a pilot study

The frequency of occupational accidents in fishery is high in most fishery nations. Implementation of safety measures has, however, been limited. The purpose of the present cross-sectional study was to explore Swedish fishermen's attitudes towards occupational risks and accident control. Information was acquired through a questionnaire distributed to a convenience sample of 92 fishermen. Indices were built, containing variables relevant to perceived risk levels in connection with work, perceived manageability of risks, activity in safety work, technical knowledge and individual attitudes towards risks. The results did not support earlier findings of low risk awareness and risk acceptance among fishermen. Perceived manageability of risks but not perceived risk level, accident experience or risk acceptance, were significantly associated with activity in safety work. The results suggest that safety work might benefit from efforts to develop fishermen's understanding of how the development of hazardous situations can be prevented or managed. The results do not support strategies for accident control in fishery based solely on increasing risk awareness.     

Ready for the storm

The coming decade is likely to be more turbulent than any we have faced. In fact, the basic structures and roles of health care may begin to shift and dissolve in ways that we cannot begin to predict. In turbulent times, long-term plans are vulnerable to fundamental shifts in the environment. Planning recedes in importance compared to preparing--nurturing the institutional and individual capacity for change. Rigid planning is about power and control. Preparing is about unleashing the strengths of each person on the crew. Self-development is largely a matter of recognizing what your strengths are, learning to live in those strengths, while nurturing the abilities that do not come naturally. Leadership is largely a matter of creating an environment that helps your crew work from their strengths and supports them in their weaker areas.     

Relations between environmental problems,psychology and health among shift-workers in the Norwegian process industry

Abstract

A group of 89 male shift-workers, mean age 38 years, was examined for health complaints, subjective experience of their work environment, psychological defence strategies, and immunological factors. They worked in a process industry, controlling a complex chemical process partly by instruments and partly by direct checking of mechanical devices such as valves. Shifts were eight hours long and changed every second week.

The main problem areas identified were problems with the management, colleagues and superiors, feelings of being under-valued, time pressure, fear of making mistakes, and lack of influence and communication. The main health complaints were sleep disturbance and gastro-intestinal problems. Shift workers also complained about allergies, breathing difficulties, tension, anxiety and depression. There were no pathological levels of plasma immunoglobulins (Ig) or Ig complements. However, levels did correlate with experience of work-related problems and with measures of defence mechanisms. Up to 25% of the variance in die immunological indicators was explained by a combination of defence mechanism scores and those of perceived health and work problems. This suggests that immunoglobulins may be an indicator of work-related health risks (‘stress’), even if the level of explained variance is too low to use immunoglobulins alone as a ‘marker’. The same variables, and immunoglobulins, also related significantly to perceived health. This may be a particularly important indicator, and when combined with immunology and psychological variables, also as a risk factor for organic disease.     

Effort-reward imbalance,overcommitment and sleep in a working population

The relationship between workplace characteristics and nocturnal sleep in a working population was investigated. Data from 709 employees (mean age=39 years; 87% men) from two German companies were analysed at the entry of the longitudinal cohort study (overall accrual 73%). We investigated the association between the effort-reward imbalance model at work (Siegrist, ) and self-reported sleep quality and sleep disturbances, as assessed by the Jenkins Sleep Quality Index. Effort and overcommitment were found to be higher, and reward was lower in participants with lower (N=328) vs. higher sleep quality (N=381), as well as in participants with (N=217) vs. without (N=492) disturbed sleep (all ps<.001). In regression analyses, lower sleep quality (R ²=.33) and sleep disturbances (R ² _Nagelkerke=.33) were predicted by older age, female gender (only significant for sleep disturbances), shift-work, lower physical and mental health functioning, and higher overcommitment. Individuals were 1.7 times more likely to report disturbed sleep per standard deviation increase in overcommitment. Gender-stratified analyses revealed that higher overcommitment was associated with unfavourable sleep in men, while in women poor sleep was related to lower reward. The findings suggest that overcommitment at work interferes with restful sleep in men, while in women disturbed sleep may be associated with the amount of overcommitment and perceived job reward and sleep quality associated with the perceived reward.     

Psychosocial factors and safety behaviour as predictors of accidental work injuries in farming

Farming is one of the most hazardous occupations in terms of the incidence and seriousness of accidental injuries. Research with other occupational groups has drawn attention to the role of psychosocial factors and stress. Such research needs to be extended to agriculture. Since stress may be a problem faced by farmers, there is a particular need to investigate the associations between farm accidents and work stressors and stress reactions. Using multivariate logistic regression analyses, this study aimed to uncover the best psychosocial predictors of injury, while controlling for exposure-related confounders. From a randomly selected sample of 794 farms, 10% of all farms in Ringkoebing County, Denmark, 393 farmers completed completed weekly accident registration over 12 months. The study sample consisted of 310 farmers who also completed questionnaires on psychosocial factors. Results indicated that farm stressors (including perceived economic problems), stress symptoms, and safety behaviour were predictors of occupational farm accidents. Higher levels of stressors and stress symptoms and poor safety behaviour were all associated with an elevated risk of injury. In the case of stress symptoms, the relation with accidents occurred via an interaction with safety behaviour. The combination of high levels of stress symptoms and poor safety behaviour was associated with a particularly high accident risk.     

Participatory analysis of accidents and incidents as a tool for increasing safety behaviour in fishermen. A pilot intervention study

Although occupational accidents are common in fishery, safety work is often not given priority by the fishermen. The aims of this study were to test a group-based intervention for increased activity in safety work through group discussion of accident/incident experience; to study occurred incidents/accidents and how such events were managed; and to study intervention effects on activity in safety work, risk acceptance and perceived manageability of risks. A sample of men from five crews (11 men) of Swedish fishermen participated. The study had a one group pre-test-post-test design for questionnaire data. The emphasis was on qualitative information collected during the intervention and interviews. The results indicated that accident causes could be appraised as being unmanageable even when technical solutions were possible. Psychological factors may cause incidents not to be documented or discussed. Incident experience seldom leads to preventive measures. Interaction between structural, social and psychological factors seemed to explain this. Questionnaires, observations and interview data suggested that some increase in safety work took place during the intervention. After the discussions the participants perceived risks to be less manageable. The study indicated that, although sensitive to dropout, participative safety interventions in fishery are feasible and may be effective. A longer or more intensive intervention may be necessary in order to progress from problem orientation to action orientation.     

Psychophysical conditions and hormonal secretion in nurses on a rapidly rotating shift schedule and exposed to bright light during night work

The psychophysical conditions of 15 young female nurses, working in a rapidly-rotating shift system (2-2-2-2), modified according to some psychophysiological criteria, and exposed to short period (4 × 20 min) of bright light (2350 Lux) during their night duty, were studied in order to evaluate their adaptation to night work and to test a possible positive effect on it of bright light. Subjective evaluations of work load and psychophysical conditions, performance measures, hormonal excretion (cortisol, 6-sulphatoxymelatonin and catecholamines), oral temperature and activity-sleep logs were taken during the shiftwork cycle, comprising one morning, one afternoon and two consecutive nights under normal and bright light. The results showed that this rapidly-rotating shift system had little effect upon the normal circadian rhythms of the body. Moreover, the lengthening of the night shift to 10 h can be considered to be acceptable, provided that work load is reduced and there are sufficient rest pauses available. On the other hand, the reduction to 7 h of the length of the day shifts and delayed start of the morning shift to 07:00 h appeared to be convenient both in relation to the work load and sleep duration. Some positive effects of bright light upon psychophysical conditions and performance efficiency were noted, while hormonal excretion and body temperature did not show any effect of bright light; in particular, melatonin excretion was not suppressed appreciably by the bright light used.