What can we learn from others?i

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

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view as of 5/10/10

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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"

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Abolishing Sleep Illiteracy Abolishing Sleep Illiteracy and Ignoranceand Ignorance

Sleep Disorders and Sleep Deprivation--An Sleep Disorders and Sleep Deprivation--An Unmet Public Health Problem (Institute of Unmet Public Health Problem (Institute of Medicine, 2006)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…”

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The Sleep Health and The Sleep Health and Education ProgramEducation 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.

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Sponsors of the Sleep and Health Sponsors of the Sleep and Health Education ProgramEducation Program

• 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

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““Healthy Sleep”Healthy Sleep”Editor: Dr. S. Shea

Beta - Oct 2007Final - Jan 2008

Clinical Sleep Clinical Sleep DisordersDisorders

Sleep through Sleep through the agesthe ages

““Get SleepGet Sleep””Consequences ofConsequences ofinsufficient sleepinsufficient sleep

Editor: Dr. C. LandriganEditor: Dr. C. LandriganBeta-Dec 2008Beta-Dec 2008Final-Jan 2009Final-Jan 2009

• Sleep ApneaSleep Apnea• InsomniaInsomnia• CRSDCRSD• Limb movementLimb movement• NarcolepsyNarcolepsy

• Pediatric disordersPediatric disorders• Newborn sleepNewborn sleep• ChildrenChildren• AdolescentsAdolescents• GeriatricGeriatric• Shift-workShift-work

• Learning and memoryLearning and memory• MetabolismMetabolism• Disease and psychiatryDisease and psychiatry• Drowsy drivingDrowsy driving

Sleep Health and Education ProgramSleep Health and Education Program““Tree of Sleep Knowledge”Tree of Sleep Knowledge”

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online training video for firefighters produced by Harvard Work Hours Health and Safety Group

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Firefighter interview regarding experiences involving sleep, fatigue and safety.

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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/success-stories/lou-killer-shift

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Sleep Health and Safety for Railroaders

• online information, videos, interactives

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Interactivehttp://

healthysleep.med.harvard.edu/need-sleep/whats-in-it-for-you/how-awake-are-you

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DCohen et al 2010 Science Translational Medicine Vol 2(14)

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Serious Medical Errors

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Serious Medical Errors,Interns

Serious Medical Errors,Unit Wide

Traditional

Intervention

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Effect of Reducing Interns’ Work Hourson Serious Medical Errors in Intensive Care UnitsLandrigan, CP, et.al. NEJM 2004;351:1838-48

Odds Ratio for Having Motor Vehicle Accidentor Near Miss Event

During Commute Home from Work

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Non-Extended Shifts After Extended Shifts

Motor VehicleAccident

Near Miss

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

*3.301.60

6.305.40

* 95% CI

© American Academy of Sleep Medicine

American Academy of Sleep Medicine

Risk Factors for Drowsy Driving

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Driving home post-callPack et al 1995

• 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

© 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.

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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

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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

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our team

• Interim Editor-in-Chief: Stuart F Quan MD

• Module Editor: Janis L Anderson PhD

• Executive Producer: Arthur Smith

• Associate Producer: Sara Chaudhary

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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

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your input

• Frequently Asked Questions• user needs• how this site would help your programs• alpha testers and beta testers: receive pre-

releases of the site, give anonymous feedback