Last data update: May 28, 2024. (Total: 46864 publications since 2009)
Records 1-14 (of 14 Records) |
Query Trace: Caruso CC [original query] |
---|
Research priorities to reduce risks from work hours and fatigue in the healthcare and social assistance sector
Caruso CC , Arbour MW , Berger AM , Hittle BM , Tucker S , Patrician PA , Trinkoff AM , Rogers AE , Barger LK , Edmonson JC , Landrigan CP , Redeker NS , Chasens ER . Am J Ind Med 2022 65 (11) 867-877 BACKGROUND: The services of Healthcare and Social Assistance (HCSA) workers are needed by society around the clock. As a result, these workers are exposed to shift work and long work hours. The combination of demanding work schedules and other hazards in the HCSA work environment increases the health and safety risks to these workers, as well as to their patients/clients and the public. METHODS: This paper has three aims: (1) provide an overview of the burden of shift work, long hours, and related sleep and fatigue problems in this sector; (2) suggest research priorities that would improve these; and (3) discuss potential positive impacts of addressing these research priorities for the health and safety of workers and the public. The authors used a modified Delphi approach to anonymously rank-order priorities for improving HCSA worker health and safety and public safety. Input was also obtained from attendees at the 2019 National Institute for Occupational Safety and Health (NIOSH) Work Hours, Sleep, and Fatigue Forum. RESULTS: The highest rated research priorities were developing better designs for work schedules, and improving the HCSA culture and leadership approaches to shift work and long work hours. Additional priorities are identified. CONCLUSION: Research in these priority areas has the potential to benefit HCSA workers as well as their patients/clients, employers, and society. |
Pilot test of 'NIOSH training for law enforcement on shift work and long work hours'
James L , Caruso CC , James S . J Occup Environ Med 2022 64 (7) 599-606 OBJECTIVE: Pilot test the effectiveness of an online training program for managing shift work and long work hours. METHOD: Fifty-seven officers from across the United States participated for 12 weeks in a pre-test, training intervention, post-test design assessing the following measures: sleep using actigraphy, diaries, and surveys; knowledge and feedback about the training using surveys. RESULTS: After the training, actigraphy data showed significant reductions in sleep latency and awakenings during sleep. Survey data showed reductions in sleepiness, difficulty staying awake during the day, and difficulty getting things done. Frequency of nightmares also decreased. Participants knowledge about sleep improved and satisfaction with the training was high. CONCLUSION: Participants were satisfied with the training and showed objective improvements in their sleep and subjective improvements in feelings when awake. This research will help inform interventions to improve police officer health and wellness. |
Nurse health: The influence of chronotype and shift timing
Hittle BM , Caruso CC , Jones HJ , Bhattacharya A , Lambert J , Gillespie GL . West J Nurs Res 2020 42 (12) 1031-1041 Extreme chronotype and circadian disrupting work hours may increase nurse disease risks. This national, cross-sectional study of nurses (N = 527) had three hypotheses. When chronotype and shift times are incongruent, nurses will experience increased likelihood of (1) obesity, (2) cardiovascular disease/risk factors, and (3) obesity or cardiovascular disease/risk factors when theoretically linked variables exist. Chronotype mismatched nurses' (n = 206) average sleep (6.1 hours, SD = 1.2) fell below 7-9 hours/24-hours sleep recommendations. Proportion of male nurses was significantly higher chronotype mismatched (12.3%) than matched (6.3%). Analyses found no direct relationship between chronotype match/mismatch with outcome variables. Exploratory interaction analysis demonstrated nurses with mismatched chronotype and above average sleep quality had an estimated 3.51 times the adjusted odds (95% CI 1.52,8.17; p = .003) of being obese. Although mechanism is unclear, this suggests sleep quality may be intricately associated with obesity. Further research is needed to inform nurses on health risks from disrupted sleep, chronotypes, and shift work. |
Policy brief: Nurse fatigue, sleep, and health, and ensuring patient and public safety
Caruso CC , Baldwin CM , Berger A , Chasens ER , Edmonson JC , Gobel BH , Landis CA , Patrician PA , Redeker NS , Scott LD , Todero C , Trinkoff A , Tucker S . Nurs Outlook 2019 67 (5) 615-619 Society needs critical nursing services around the clock and, as a result, nurses often work shift work and long work hours (SWLWH). These hours can prevent nurses from getting the seven or more hours of quality sleep each day that experts recommend (Watson, et al., 2015). Nurses on SWLWH are at risk for cardiovascular disease, gastrointestinal and psychological disorders, cancer, type 2 diabetes, injuries, musculoskeletal disorders, all-cause mortality, adverse reproductive outcomes, and difficulty managing chronic diseases (Caruso, et al., 2017; Caruso & Waters, 2008; Gan, et al. 2015; Gu, et al., 2015; DHHS, 2018; IARC Monographs Vol 124 Group, 2019; NIOSH, et al., 2015; Ramin, et al., 2014; Torquati, et al., 2017). Furthermore, tired nurses are at risk for making patient care errors and drowsy driving crashes (Bae & Fabry, 2014; Ftouni, et al., 2013; Geiger-Brown, et al., 2012; Geiger-Brown & Trinkoff, 2010; Lee, et al., 2016; Trinkoff, et al., 2011). The presence of SWLWH is also related to retention issues, including nurses expressing intention-to-leave or quitting the job (Hayes, et al., 2012; Moloney, et al., 2018). These conditions also have contributed to nursing shortages in certain specialties and practice locations (Marć, et al., 2018 ). Shortages are a grave concern, as the population is aging and the need for nurses is projected to strongly increase (Auerbach, Buerhaus, & Staiger, 2017). Thus, interventions to reduce nursing fatigue are sorely needed. The American Academy of Nursing (the Academy) supports efforts to reduce fatigue in nurses through education, workplace policies and management systems, and fatigue countermeasures. The Academy recommends that healthcare services and standard-setting organizations establish policies to address this pervasive workplace hazard, thereby promoting nurses’ health and safety along with patient and public safety. |
Workplace interventions to promote sleep health and an alert, healthy workforce
Redeker NS , Caruso CC , Hashmi SD , Mullington JM , Grandner M , Morgenthaler TI . J Clin Sleep Med 2019 15 (4) 649-657 STUDY OBJECTIVES: The purpose of this review is to synthesize the published literature that addresses employer-initiated interventions to improve the sleep of workers and in turn improve health, productivity, absenteeism, and other outcomes that have been associated with sleep disorders or sleep deficiency. METHODS: We conducted a systematic search and a selective narrative review of publications in PubMed from 1966 to December 2017. We extracted study characteristics, including the workers' professions, workplace settings and shift work, and workplace interventions focused on worker sleep. Because of the high degree of heterogeneity in design and outcomes, we conducted a narrative review. RESULTS: We identified 219 publications. After restriction to publications with studies of workplace interventions that evaluated the outcomes of sleep duration or quality, we focused on 47 articles. An additional 13 articles were accepted in the pearling process. Most studies employed non-randomized or controlled pretest and posttest designs and self-reported measures of sleep. The most common workplace interventions were educational programs stressing sleep hygiene or fatigue management. Other interventions included timed napping before or after work, urging increased daytime activity levels, modifying workplace environmental characteristics such as lighting, and screening, and referral for sleep disorders treatment. Overall, most reports indicated that employer efforts to encourage improved sleep hygiene and healthier habits result in improvements in sleep duration, sleep quality, and self-reported sleepiness complaints. CONCLUSIONS: These studies suggest employer-sponsored efforts can improve sleep and sleep-related outcomes. The existing evidence, although weak, suggests efforts by employers to encourage better sleep habits and general fitness result in self-reported improvements in sleep-related outcomes, and may be associated with reduced absenteeism and better overall quality of life. Candidate workplace strategies to promote sleep health are provided. |
Position statement: Reducing fatigue associated with sleep deficiency and work hours in nurses
Caruso CC , Baldwin CM , Berger A , Chasens ER , Landis C , Redeker NS , Scott LD , Trinkoff A . Nurs Outlook 2017 65 (6) 766-768 The American Academy of Nursing promotes management practices in health care organizations and | strategies in the nurse’s personal life to support sleep | health in nurses and, as a result, an alert nursing | workforce fit to perform their jobs and more able to live | healthy lives. Society requires critical nursing services | around the clock. Consequently, shift work and long | work hours are common in health care organizations | and negatively affect a significant percent of nurses. | Working at night and irregular hours compromise | human physiology dictated by the need for sleep and | circadian rhythms. The challenge that nurses on shift | work face is the need to work at night (when our | physiology promotes sleep) and sleep during the day | (when our physiology promotes activity). When shift | work combines with long work hours (e.g., shifts of | 12 hr or more) and leads to sleep deficiency or disruption to circadian rhythms, the health and safety costs | of this conflict with human physiology are potentially | significant. Sleep deficiency is a broad term that includes inadequate sleep duration, poor sleep quality, | untreated sleep disorders, and mistimed sleep that is | not synchronized with circadian rhythms. Sleep deficiency can affect nurses’ work readiness and health, | safety, and well-being. Evidence is building that long | shifts, shift rotations, double shifts, evening, and night | shifts are associated with multiple short- and longterm health and safety risks to the nurse (National | Institute for Occupational Safety and Health [NIOSH]; | NIOSH, Caruso, Geiger-Brown, Takahashi, Trinkoff, & | Nakata, 2015). Tired nurses are also at risk for making | fatigue-related patient care errors that can endanger | their patients (Bae & Fabry, 2014). These risks also | extend to the nurse’s family, their employer/health | care organization, and the broader society when tired | nurses make errors at work and home or crash their vehicle due to drowsy driving. This complex hazard | requires a variety of personal, workplace, and public | health strategies to reduce these risks. Unfortunately, | persons working in health care organizations may not | fully understand the health and safety risks that are | associated with fatigue and may be unaware of | evidence-based strategies to reduce these risks. Yet | evidence shows that it is possible to limit or modify the | adverse impact of shift work and long work hours on | nurses by improving their sleep and reducing fatigue. |
Health consequences of electric lighting practices in the modern world: A report on the National Toxicology Program's workshop on shift work at night, artificial light at night, and circadian disruption
Lunn RM , Blask DE , Coogan AN , Figueiro MG , Gorman MR , Hall JE , Hansen J , Nelson RJ , Panda S , Smolensky MH , Stevens RG , Turek FW , Vermeulen R , Carreon T , Caruso CC , Lawson CC , Thayer KA , Twery MJ , Ewens AD , Garner SC , Schwingl PJ , Boyd WA . Sci Total Environ 2017 607-608 1073-1084 The invention of electric light has facilitated a society in which people work, sleep, eat, and play at all hours of the 24-hour day. Although electric light clearly has benefited humankind, exposures to electric light, especially light at night (LAN), may disrupt sleep and biological processes controlled by endogenous circadian clocks, potentially resulting in adverse health outcomes. Many of the studies evaluating adverse health effects have been conducted among night- and rotating-shift workers, because this scenario gives rise to significant exposure to LAN. Because of the complexity of this topic, the National Toxicology Program convened an expert panel at a public workshop entitled "Shift Work at Night, Artificial Light at Night, and Circadian Disruption" to obtain input on conducting literature-based health hazard assessments and to identify data gaps and research needs. The Panel suggested describing light both as a direct effector of endogenous circadian clocks and rhythms and as an enabler of additional activities or behaviors that may lead to circadian disruption, such as night-shift work and atypical and inconsistent sleep-wake patterns that can lead to social jet lag. Future studies should more comprehensively characterize and measure the relevant light-related exposures and link these exposures to both time-independent biomarkers of circadian disruption and biomarkers of adverse health outcomes. This information should lead to improvements in human epidemiological and animal or in vitro models, more rigorous health hazard assessments, and intervention strategies to minimize the occurrence of adverse health outcomes due to these exposures. |
Reducing risks to women linked to shift work, long work hours, and related workplace sleep and fatigue issues
Caruso CC . J Womens Health (Larchmt) 2015 24 (10) 789-94 In the United States, an estimated 12% to 28% of working women are on shift work schedules, and 12% work more than 48 hours per week. Shift work and long work hours are associated with many health and safety risks, including obesity, injuries, and negative reproductive outcomes. Over time, the worker is at risk for developing a wide range of chronic diseases. These work schedules can also strain personal relationships, owing to fatigue and poor mood from sleep deprivation and reduced quality time to spend with family and friends. Worker errors from fatigue can lead to reduced quality of goods and services, negatively impacting the employer. In addition, mistakes by fatigued workers can have far-reaching negative effects on the community, ranging from medical care errors to motor vehicle crashes and industrial disasters that endanger others. To reduce the many risks that are linked to these demanding work hours, the National Institute for Occupational Safety and Health (NIOSH) conducts research, develops guidance and authoritative recommendations, and translates and disseminates scientific information to protect workers, their families, employers, and the community. The key message to reduce these risks is making sleep a priority in the employer's systems for organizing work and in the worker's personal life. The NIOSH website has freely available online training programs with suggestions for workers and their managers to help them better cope with this workplace hazard. |
Negative impacts of shiftwork and long work hours
Caruso CC . Rehabil Nurs 2013 39 (1) 16-25 PURPOSE: Healthcare organizations often have to provide patient care around the clock. Shift work (any shift outside of 7 a.m. to 6 p.m) and long work hours increase the risk for short sleep duration and sleep disturbances. Thirty-two percent of healthcare workers report they do not get enough sleep. The purpose of the article is to give an overview of the wide range of risks to nurses, patients, and employers that are linked to shift work, long work hours, and poor sleep from other sources. FINDINGS: Shift work and long work hours increase the risk for reduced performance on the job, obesity, injuries, and a wide range of chronic diseases. In addition, fatigue-related errors could harm patients. Fatigued nurses also endanger others during their commute to and from work. CONCLUSION AND CLINICAL RELEVANCE: The key strategy to reduce these risks is making sleep a priority in the employer's systems for organizing work and in the nurse's personal life. |
Better sleep: antidote to on-the-job fatigue
Caruso CC . Am Nurse Today 2012 7 (5) 38-39 Getting enough good-quality sleep each day is important not just for nurses’ personal health and safety but for patient safety, too. Like the basic need to eat and drink, the need to sleep is critical for maintaining life and health-and for working safely. Sleeping 7 to 8 hours per night is linked to a wide range of better health and safety outcomes. Long work hours and shift work, in contrast, are tied to sleep disturbances and health and safety risks for nurses, including declines in mental function and physical ability, reduction in immunologic function, and higher rates of depression, injury, heart disease, GI disorders, mood disturbances, and cancer. Multiple studies have found that performance in a person who has been awake for 17 hours or more resembles that of someone with alcohol intoxication. | Negative effects of fatigue extend to employers, who lose an estimated $2,000 to $10,000 per employee annually from reduced productivity, increased errors, absenteeism, lack of full functioning at work, increased healthcare and worker compensation costs, and worker turnover due to disability, death, or resigning to take jobs with less demanding schedules. Risks extend to the community, as when a tired nurse makes a patient-care error or has a motor vehicle accident while commuting. | Obviously, sleep deprivation can have serious and even fatal consequences. Nurses, managers, and employers all share in the responsibility to reduce risks connected with fatigue. A 2010 study found the percentage of American healthcare workers who reported 6 or fewer hours of sleep per day (too little, according to sleep experts) increased from 28% in the mid-1980s to 32% in the mid-2000s. So it’s likely that a growing number of nurses aren’t getting enough sleep. |
Strategies for nurses to prevent sleep-related injuries and errors
Caruso CC , Hitchcock EM . Rehabil Nurs 2010 35 (5) 192-197 Rehabilitation nurses work shift schedules or long hours to provide essential patient services around the clock. These demanding hours can lead to sleep difficulties, declines in performance, and increased worker errors. This article gives an overview of selected declines in cognitive performance that are associated with inadequate sleep and several factors that increase risk for fatigue-related errors. Selected strategies for nurses and managers to reduce these risks are discussed, such as better sleep practices, improved work schedule design, naps, caffeine, exposure to light, and rest breaks. Both nurses and managers share responsibility for implementing strategies to reduce risks from inadequate sleep. |
Nurses, smoking, and immunity: a review
Nakata A , Swanson NG , Caruso CC . Rehabil Nurs 2010 35 (5) 198-205 Nurses regularly are exposed to a variety of occupational hazards. In addition to documented occupational hazards, exposure to smoking remains a major concern. This article reviews the prevalence of smoking among nurses working in the United States and discusses their reasons for smoking. Researchers conducted a state-of-the-art review on the effects of cigarette smoking and exposure to secondhand smoke (Si-IS) on the immune system. Smoking prevalence among nurses working in the United States ranged from 7%-12%, and high work stress, poor work environment, shift work, and peer influence were suspected major risk factors influencing smoking behavior. A review of the effects of smoking on immunity revealed that both active smoking and exposure to SHS negatively affects immune function. When rehabilitation nurses stop smoking, their health improves and nonsmokers are exposed to less SHS. Rehabilitation nurses are encouraged to share knowledge of the immunological benefits of smoking cessation with patients to facilitate nurse-led rehabilitation programs. |
Occupational health and safety for nurses benefits patients, too
Caruso CC . Rehabil Nurs 2010 35 (5) 176, 222 This issue of Rehabilitation Nursing is devoted to worker safety and health. We greatly appreciate our authors' efforts to share their expertise for this special issue. Their articles discuss risks posed by violence, smoking, fatigue and sleep loss, and patient lifting. |
Work schedules and health behavior outcomes at a large manufacturer
Bushnell PT , Colombi A , Caruso CC , Tak S . Ind Health 2010 48 (4) 395-405 There is evidence that work schedules may influence rates of unhealthy behaviors, suggesting that addressing work schedule challenges may improve health. Health Risk Assessment (HRA) survey responses were collected during 2000-2008 in a multinational chemical and coatings manufacturer. Responses of 26,442 were sufficiently complete for analysis. Rates of smoking, lack of exercise, moderate to high alcohol use, obesity (BMI >= 30), and short sleep duration were compared by work schedule type (day, night, or rotating shift) and daily work hours (8, 10, or 12 h). Prevalence rate ratios (RRs) were calculated, adjusting for age group, sex, marital/living status, job tenure, and occupational group. The reference group was 8-h day shift employees. Overall prevalence rates were: sleep duration of 6 h or less per night 47%, smoking 17.3%, no exercise 22.0%, BMI >= 30 28.3%, and moderate to heavy alcohol consumption 22.2%. Statistically significant RRs include the following: Short sleep duration: 10 h rotating shift (RR=1.6), 12 h day and 12 h rotating shifts (RR=1.3); Smoking: 12 It day and rotating shifts (RR=1.6), 10 and 12 h night and 8 h rotating shift (RR=1.4); No exercise: 8, 10, and 12 h rotating shifts (RR=1.2 to 1.3), 12 h day schedules (RR=1.3). Obesity (BMI >= 30): 8 and 10 h night shifts (RR=1.3 and 1.4, respectively). |
- Page last reviewed:Feb 1, 2024
- Page last updated:May 28, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure