Off-duty Days Research Articles

Sleep Deprivation and Fatigue among Nurses Working Consecutive Night Shifts: A Prospective Observational Study.

This study aimed to identify changes in sleep patterns and fatigue levels during consecutive night shifts among shift nurses and to determine the association between sleep parameters and increased fatigue levels during work. This prospective observational study employing ecological momentary assessments was conducted using data collected from 98 shift nurses working in Korean hospitals between June 2019 and February 2021. The sleep patterns were recorded using actigraphy. The participants reported their fatigue levels at the beginning and end of each night shift in real time via a mobile link. Linear mixed models were used for the analysis. Nurses spent significantly less time in bed and had shorter sleep durations during consecutive night shifts than on off-duty days, whereas their wake times after sleep onset were much longer on off-duty days than on on-duty days. Fatigue levels were higher on the second and third night-shift days than on the first night-shift days. A shorter time spent in bed and asleep was associated with a greater increase in fatigue levels at the end of the shift than at the beginning. Nurses experience significant sleep deprivation during consecutive night shifts compared with off-duty days, and this sleep shortage is associated with a considerable increase in fatigue levels at the end of shifts. Nurse managers and administrators must ensure sufficient intershift recovery time during consecutive night shifts to increase the time spent in bed and sleeping.

Incomplete off-duty work hours and sleep quality among firefighters: a cross-sectional study, Taiwan.

We examined whether firefighters in Taiwan have a sleep problem and investigated the related factors of poor sleep quality. In this cross-sectional study, 2123 male shift firefighters in the Greater Taipei area were invited, and 37.7% of them satisfactorily completed the questionnaire online. The Chinese version of Pittsburgh sleep quality index (PSQI) was used to evaluate sleep quality. Multiple logistic and linear regression analyses were used to determine the associations among demographic characteristics, work-related characteristics, and poor sleep quality. As revealed by 801 valid questionnaires, 77.2% were poor sleepers (PSQI cutoff score > 6), and 61.2% reported incomplete off-duty in the past month. Moreover, 42.6% of incomplete off-duty workers reported extended overtime of more than 5h on off-duty days in the past month. Poor sleep quality was associated with the following factors: (1) demographic characteristics: age, working tenure, having children, and chronotype and (2) work-related characteristics: shift schedule and incomplete off-duty. The final model for poor sleep quality as per PSQI included age, chronotype, shift schedule, and incomplete off-duty hours in the past month. Longer hours of incomplete off-duty work were associated with increased risks of overall poor sleep quality and of poor subjective sleep quality, long sleep latency, sleep disturbances, and daytime dysfunction. Firefighters are advised to have a complete off-duty day to avoid poor sleep quality, long sleep latency, short sleep duration, sleep disturbances, and daytime dysfunction. Our results confirm the need for implementing appropriate shift schedules to ensure adequate rest time for firefighters.

Jacob S. Matubis, MD (1950-2022) “Bye, Jake!”

Jacob S. Matubis, MD (1950-2022) “Bye, Jake!”

A Type-2 Fuzzy Controller to Enable the EFR Service from a Battery Energy Storage System

The increased use of distributed energy resources, especially electrical energy storage systems (EESS), has led to greater flexibility and complexity in power grids, which has led to new challenges in the operation of these systems, with particular emphasis on frequency regulation. To this end, the transmission system operator in Great Britain has designed a control scheme known as Enhanced Frequency Response (EFR) that is especially attractive for its implementation in EESS. This paper proposes a Type-2 fuzzy control system that enables the provision of EFR service from a battery energy storage system in order to improve the state-of-charge (SoC) management while providing EFR service from operating scenarios during working and off-duty days. The performance of the proposed controller is compared with a conventional FLC and PID controllers with similar features. The results showed that in all scenarios, but especially under large frequency deviations, the proposed controller presents a better SoC management in comparison without neglecting the EFR service provision.

Firefighters Are More Physically Active On-Duty Compared to Off-Duty.

Physical inactivity, coupled with increasing obesity levels, in firefighters plays a key role in aggregated cardiovascular events. The purpose of this study was to investigate device-measured physical activity (PA) for firefighters while on- and off-duty to have a clearer understanding of their overall PA level. Methods: Twenty-nine career firefighters participated in this non-experimental, within-subjects study by wearing an accelerometer to assess PA intensities and step-count. Obesity was classified using body mass index (BMI). Dependent t-tests were used to examine mean differences in PA intensities when on- and off-duty. Pearson product-moment correlations were used to assess the association between PA intensities when on and off-duty. Results: According to the World Health Organization BMI categorizations, 20 firefighters were overweight, 9 were obese, and, thus, none were normal weight. Only light PA (LPA) was statistically significant (p = 0.026) for on- and off-duty days with a small-to-medium effect size (d = 0.47), meaning that on average, firefighters performed more minutes of LPA when on-duty compared to off. There was a significant difference between on- (9060.2 ± 2636.4) and off-duty (7495.3 ± 2835.8) daily step counts (p = 0.011). Conclusion: As the results demonstrate, there is a dire need for increased PA levels in firefighters while on- and off-duty.

Morning and evening salivary melatonin, sleepiness and chronotype: A comparative study of nurses on fixed day and rotating night shifts

To compare morning and evening salivary melatonin levels, sleep quality and chronotype between nurses working fixed day shifts and those working rotating night shifts. Rotating night shift work is an inevitable part of nursing and is a major reason for disrupted sleep. Cross-sectional comparative design. We used cluster sampling to recruit 520 female nurses working fixed day and rotating night shifts in the United Arab Emirates. Morning and evening melatonin were measured from corresponding saliva samples. The Pittsburgh Sleep Quality Index used to evaluate sleep quality and self-assessment of preferred circadian times was used to assess participants' chronotypes. Data were collected between October 2017-December 2018. Rotating night shift nurses had significantly lower evening melatonin compared with the fixed day shift group. No significant difference was found in sleep quality between the groups, although more participants in the rotating night shift group (N=110, 42.31%) expressed better sleep quality than those in the fixed day group (N=90, 36.00). Participants in the rotating night shift group expressed better subjective sleep, longer sleep duration, less disturbed sleep and better daily function (p>.05) than the fixed day group. Rotating night shift participants were more likely to have evening or intermediate chronotypes and more likely to report alignment of shift work to their chronotype compared with fixed day shift participants (p=.001). Longer shift duration, marital status and city location were associated with reduced evening melatonin among nurses on rotating night shifts. Rotating night shift nurses showed evidence of better sleep than those from the fixed day shift. Proper shift assignment, chronotype and alignment with shift work appeared to produce better sleep quality. Organizational policy must consider a novel model for work schedules that allow adequate off-duty days for sleep recovery among nurses.

Comparison Of Physical Activity And Cardiorespiratory Fitness In Midwest Firefighters

Firefighters are at an increased risk for cardiovascular events (e.g., heart attack) due to increased incidence of physical inactivity and obesity. PURPOSE: To compare objectively measured physical activity and cardiorespiratory fitness between two independent fire departments. METHODS: Two independent fire departments from the Midwest participated in the study. Waist circumference (WC) and body mass index (BMI) were used to classify obesity status. Firefighters were classified as obese if they had a WC ≥102 cm and BMI ≥ 30 kg/m2. Firefighters wore an accelerometer to track physical activity and associated intensities for the duration of their department’s tour, which consisted of on- and off-duty days. Additionally, firefighters completed a stage-graded treadmill exercise test in their bunker gear (pants, boots, and jacket) to determine maximal oxygen uptake (VO2max). RESULTS: Fire department one (FD1) had 29 firefighters complete the study (age: 34.45 ± 7.15 years; BMI: 28.97 ± 2.52 kg/m2; WC: 96.48 ± 7.45 cm) and fire department two (FD2) had 11 complete the study (age: 36.18 ± 4.29 years; BMI: 27.79 ± 4.00 kg/m2, WC: 94.95 ± 6.41 cm). Six firefighters were classified as obese (five from FD1 and one from FD2). There were no significant differences between the two departments for sedentary (t (38) = -0.485, p > 0.63), light physical activity (t(38)= 0.167, p = 0.87), and moderate-to-vigorous physical activity (MVPA) (t(38)=0.046, p = 0.96). Where the average daily MVPA was 31.3 ± 15.96 and 31.6 ± 18.28 minutes/day for FD1 and FD2, respectively. Similarily, there was no significant difference in cardiorespirtory fitness between FD1 and FD2 with VO2max of 40.82 ± 6.95 and 39.51 ± 4.77 mL·kg-1·min-1, respectively (t(38)=-0.576, p = 0.58). Overall, both departments met the American College of Sports Medicine’s recommendation of at least 30 minutes of MVPA per day. However, they did not meet the National Fire Protection Association’s (NFPA) cardiorespiratory fitness recommendation of VO2max = 42 mL·kg-1·min-1. CONCLUSION: This data demonstrates the need for increased focus on improving physical activity levels to improve overall health and wellness in firefighters. As part of the NFPA’s Wellness Fitness Initiative, fire departments should strive to have at least one hour per day of dedicated time for physical activity.

How does financial burden influence the crash rate among taxi drivers? A self-reported questionnaire study in China

Objective: Taxis play an important role in the transportation system of China, but they have a relatively high accident rate. The current study discusses the driver’s financial burden in the Chinese context and explores its correlation with working conditions, risky driving behavior, and other characteristics of taxi drivers who are involved in accidents.Method: A total of 2,391 taxi drivers from 29 companies in four Chinese cities were interviewed and then asked to complete a questionnaire concerning their socio-demographic characteristics, working conditions, risky driving behavior, and accident frequency during the previous two years. Given the increase in the management fee (measured in CNY) charged by taxi companies, the drivers were divided into three groups: the “less than 150” group, the” 150 to 180” group and the “over 180” group, where were named Group 1, Group 2 and Group 3, respectively. Finally, the zero-inflated Poisson model was used to investigate the factors that contributed to the accident rate for each group.Result: The significant factors that lead to accidents differed significantly for drivers with different levels of financial burden. First, most of the factors were weakly correlated with the crash rate among Group 1 drivers. Second, many factors related to working conditions and risky driving behavior were significant for drivers in Groups 2 and 3, while working hours and off-duty days were significant only for drivers in Group 3. Third, working hours were negatively correlated with accident rates for drivers in Group 3, and the drivers who suffered from the heaviest financial burden were most affected by fatigue and sleep problems.Conclusion: Financial burden is the root cause behind the propensity of taxi drivers to be involved in accidents. Taxi companies should find ways to reduce drivers’ expenses, and new technologies, such as taxi-calling or location and navigation based on mobile applications, should be introduced into the traditional taxi industry.

Is it wrong for doctors to be human? Can resident doctors learn to function with less sleep?

<p class="abstract"><strong>Background:</strong> Medical residency programs are traditionally supposed to be having long working hours, which can be associated with a poor quality of sleep and resultant daytime sleepiness. This poses threat to both physician and patient. This study has an alarming importance in recent scenario, where India is witnessing growing incidents of assaults against resident doctors. We evaluated the subjective sleep quality, day time sleepiness, satisfaction with life, stress, anxiety and depression and their association with subjective sleep quality amongst the residents on their off-duty days and also compared these findings amongst various departments of our institution.</p><p class="abstract"><strong>Methods:</strong> This cross-sectional study was conducted among 77 first year resident doctors of Government Medical College, Amritsar during the period from May 2018 to March 2019. The tools used for assessment were Pittsburgh sleep quality index, Epworth sleepiness scale, the satisfaction with life scale (SWLS) and depression, anxiety and stress scale-21 questionnaire. </p><p class="abstract"><strong>Results:</strong> Our results indicated that 71.43% residents were poor sleepers. 53.24% residents had day time sleepiness of which 46.75% had excessive day time sleepiness. 40.26% residents had mild to moderate stress, 44.16% had mild to moderate anxiety, 31.16% residents suffered from depression of which 18.18% residents suffered moderate to severe depression. 90.91% residents were satisfied with their life on applying SWLS. Poor sleep quality was perceived greatly by the resident doctors in our public hospital.</p><p class="abstract"><strong>Conclusions:</strong> Understanding the potential impacts of fatigue on resident physicians performance /safety and using this knowledge to optimize shift-duty schedule may reduce the risks to both doctors and patients.</p>

Self-reports of workloads and aberrant driving behaviors as predictors of crash rate among taxi drivers: A cross-sectional study in China

Objective: Taxis provide an important mode of public transport in China, but there has been very little in-depth research on the crash involvement propensity of taxi drivers. Thus, this study was conducted to develop a quantitative model for predicting the crash rate of taxi drivers.Methods: A total of 2,391 taxi drivers from 29 companies in 4 Chinese cities completed a structured and anonymous face-to-face questionnaire reporting their demographic information, workload conditions, aberrant driving behaviors, and crash history within the 2 years prior to the survey. Using the self-reported variables, a negative binomial model was implemented to predict taxi drivers’ property damage only (PDO) and personal injury (PI) crash rates and identify the factors contributing to this risk.Results: Descriptive analysis of the survey data revealed that the workload of taxi drivers in China is relatively heavy. Seven significant predictors of PDO and PI crash rates were identified, including crossing red lights, dangerous overtaking, honking at a slow driver, failure to use an indicator lamp, driving while fatigued, stopping in forbidden areas to pick up or drop off a passenger, and driving with one hand. Taxi drivers’ average off-duty days per week, aggressive driving behaviors, and preventing another driver from merging had significant effects only on PDO crash rate, and sleep problems were found to be significantly correlated with PI crash rate.Conclusions: To improve the safety of taxi drivers, considerable measures should be strictly implemented, ranging from periodic driver training and safety education to workload reduction, with the cooperation of government agencies and taxi companies. The findings of this study contribute to the design of potentially useful policy initiatives as well as targeted safety promotion programs.

The Relationship Between Firefighters’ Physical Activity Levels and Cardiorespiratory Fitness

Improved physical activity (PA) and cardiorespiratory fitness (CRF) levels are necessary for firefighters to adequately perform strenuous occupational demands. These demands have been associated with increased cardiovascular events leading to disability and death. Sudden cardiac death accounted for 44% of all annual on-duty deaths in U.S. firefighters from 1995-2004. Thus, the National Fire Protection Association (NFPA) has made it a priority to emphasize PA levels in order to maintain and increase CRF. PURPOSE: The purpose of the study was to investigate the relationship between sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) to CRF in career firefighters. METHODS: Firefighters wore an accelerometer for eight consecutive on- and off-duty days. The accelerometer was worn on the right hip and tracked SB, LPA, and MVPA. Freedson’s (1998) cut point determined PA intensity, while Choi’s (2011) algorithm was used to remove non-wear time. Additionally, each participant completed a stage-graded exercise test with submaximal square-wave verification bout to determine maximal oxygen uptake (VO2max). VO2max was also estimated using self-reported physical activity rating and a non-exercise regression equation. Pearson’s correlations were performed between the PA components and VO2max as well as between estimated and actual VO2max (ml/kg/min). RESULTS: Preliminary results (n=9) for total wear time for the accelerometer was 920 (min) with 58.7% SB, 37.7 % LPA, and 3.6% MVPA. There were no significant correlations between VO2max and SB (r = -0.18, P = 0.637) or LPA (r = 0.33, P = 0.388). Further, there was no significant correlation between estimated (45.2 ± 7.5) and actual VO2max (39.2 ± 7.1) (r = 0.52, P = 0.149). There was a statistically significant correlation between VO2max and MVPA (r = 0.74, P = 0.022). CONCLUSION: The initial results suggest that firefighters are meeting ACSM’s PA guidelines but are not are not meeting the NFPA’s minimal CRF recommendation of 42 ml/kg/min. Therefore, further research is necessary in order to make recommendations regarding PA and CRF for active firefighters. Twenty-one additional firefighters are expected to complete the study for a total sample of 30.

Estimating long-haul airline pilots’ at-home baseline sleep duration

ObjectiveCharacterize the baseline sleep of long-haul airline pilots. MethodsSleep of 332 pilots (median age = 51 years, range = 23-64 years) from 4 airlines was measured by actigraphy while at home and off-duty and by retrospective estimate of the total amount of nighttime sleep usually obtained at home. ResultsMean actigraphic sleep per 24 hours during baseline periods was 6.8 hours (SD = 1.0 hour), 52 minutes shorter than mean self-reported usual nighttime sleep (7.6 hours, SD = 1.1 hours). ConclusionsPilots’ self-reported sleep duration was comparable to weekend sleep of men in general population samples, but their actigraphic baseline sleep was longer than objectively monitored sleep of other samples. Long-haul pilots routinely experience sleep restriction and circadian disruption across trips, both of which are implicated in increased health risks. We recommend that they be educated about the long-term importance for health of obtaining adequate sleep on off-duty days.

Assessment of stress and autonomic nervous activity in Japanese female ambulance paramedics working 24-hour shifts.

We studied the physical and mental conditions of 8 healthy young female ambulance paramedics working 24-hour shifts during their menstrual cycle, including assessment of cardiac autonomic nervous system activity by heart rate variability power spectral analysis. The autonomic activity during the awake period of on- and off-duty days in the follicular, late luteal, and menstruation phases was measured. Questionnaires regarding fatigue and menstrual distress were administered and correlated with the autonomic profile. While degrees of fatigue significantly increased after work, the changes in autonomic activity during the awake period on on-duty days were not significantly different from those on off-duty days (LF/HF, p=0.123; HF/(HF+LF), p=0.153). As for the sleeping period, there were no significant differences. Although the Menstrual Distress Questionnaire (MDQ) revealed the presence of mild menstrual discomfort in the late luteal and menstruation phases, no significant difference was observed in the autonomic profile of the three menstrual cycle phases. No significant correlation was observed between the degree of menstrual distress and autonomic profile, though there was a significant correlation in the late luteal phase between degree of menstrual distress and fatigue after work (p<0.01). These results showed that, while subjects experienced menstrual discomfort and fatigue after work, their autonomic profile did not alter in the menstrual cycle. It is suggested that healthy young female ambulance paramedics may tolerate 24-hour shifts, though attention should be paid to subjective menstrual symptoms and fatigue.

The relationship between quality of sleep and night shift rotation interval.

BackgroundShift work is closely related with workers' health. In particular, sleep is thought to be affected by shift work. In addition, shift work has been reported to be associated with the type or direction of shift rotation, number of consecutive night shifts, and number of off-duty days. We aimed to analyze the association between the night shift rotation interval and the quality of sleep reported by Korean female shift workers.MethodsIn total, 2,818 female shift workers from the manufacturing industry who received an employee physical examination at a single university hospital from January to August in 2014 were included. Subjects were classified into three groups (A, B, and C) by their night shift rotation interval. The quality of sleep was measured using the Korean version of the Pittsburgh Sleep Quality Index (PSQI). Descriptive analysis, univariate logistic regression, and multivariate logistic regression were performed.ResultsWith group A as the reference, the odds ratio (OR) for having a seriously low quality of sleep was 1.456 (95% CI 1.171–1.811) and 2.348 (95% CI 1.852–2.977) for groups B and C, respectively. Thus, group C with the shortest night shift rotation interval was most likely to have a low quality of sleep. After adjustment for age, obesity, smoking status, alcohol consumption, exercise, being allowed to sleep during night shifts, work experience, and shift work experience, groups B and C had ORs of 1.419 (95% CI 1.134–1.777) and 2.238 (95% CI 1.737–2.882), respectively, compared to group A.ConclusionOur data suggest that a shorter night shift rotation interval does not provide enough recovery time to adjust the circadian rhythm, resulting in a low quality of sleep. Because shift work is influenced by many different factors, future studies should aim to determine the most optimal shift work model and collect accurate, prospective data.

Physical Activity in Police Beyond Self-Report

Police officers have a higher risk for cardiovascular disease. Reductions in occupational physical activity may contribute to the risk, yet there have been few efforts to characterize the physical demands of police work beyond self-report. To compare measured physical activity between work and off-duty hours and assess the effects of stress on physical activity. Officers (n = 119) from six departments wore a pattern recognition monitor for 96 hours to measure total energy expenditure (kilocalorie per hour) (1k/cal = 4184 joules), activity intensity, and step count per hour. Participants were more active on their off-duty days than at work; the effects of stress on physical activity seemed moderated by sex. Police work is primarily a sedentary occupation, and officers tend to be more active on their off-duty days than during their work hours.

Factors associated with New Graduate Nurses' Reality Shock

Purpose: The purpose of this study was to identify factors that affect reality shock in new nurses. Methods: Participants were 216 newly graduated nurses with less than 1 year experience in 5 university and 10 general hospitals in Busan, Ulsan and Gyeongnam, A self-report questionnaire was completed by the nurses between November 18 and December 25, 2013. Data were analyzed using t-test, ANOVA and hierarchial multiple regression analysis with the SPSS/WIN 21.0 Program. Results: Average scores for work environment and environmental reality shock were 2.63±0.33 and 2.66±0.43 points respectively. Regression analysis showed that with the nurses' demographic and work characteristics controlled, work environment explained 4.2% of the reality shock. Factors significantly affecting reality shock included nurses' changing residence because of job (β=.21, p=.001), whether they were able to work on the unit of their choice (β=-.13, p=.031) and whether they had a choice in days off (β=-.14, p=.038). Conclusion: When these factors are considered, reduction in nurses' reality shock requires improvement in work environment, placing new nurses in a department of their choice and allowing them a choice in off-duty days. These measures would also help achieve organizational goals and develop the new nurses as professional nurses.

Neuromuscular Exercise and Counseling Decrease Absenteeism Due to Low Back Pain in Young Conscripts

Controlled intervention with group randomization. To investigate the effectiveness of a 6-month neuromuscular exercise and counseling program for reducing the incidence of low back pain (LBP) and disability in young conscripts, with a healthy back at the beginning of their compulsory military service. Basic military training is physically demanding on the back and requires adequate physical fitness. LBP causes significant morbidity and absence from military service. Participants were conscripts of 4 successive age cohorts (n = 1409). In the prestudy year, before adoption of the intervention, 2 successive cohorts of conscripts of 4 companies (n = 719) were followed prospectively for 6 months to study the baseline incidence of different categories of LBP. In the intervention year, conscripts (n = 690) of 2 new cohorts of the same companies (intervention group: antitank, engineer; control group: signal, mortar) were followed for 6 months. The intervention program aimed to improve conscripts' control of their lumbar neutral zone and specifically to avoid full lumbar flexion in all daily tasks. Total number and incidence of off-duty days due to LBP were significantly decreased in the intervention companies compared with controls (adjusted hazard ratio = 0.42, 95% confidence interval = 0.18-0.94, P = 0.035). The number of LBP cases, number of health clinic visits due to LBP, and number of the most severe cases showed a similar decreasing trend but without statistical significance. These findings provide evidence that exercise and education to improve control of the lumbar neutral zone have a prophylactic effect on LPB-related off-duty service days in the military environment when implemented as part of military service among young healthy men.

Development of Web-based Network Diligence and Indolence Management System

Abstract In recent diligence and indolence management systems, server and client are not separated and data are not convert into data base. Therefore these recent systems have several weaknesses such as data modification and management. In this paper, we propose a new Web-based Network Diligence and Indolence Management system (WNDIM) to solve the weakness and improve the system performance of recent system. The main features and contributions of the proposed system are as follows. First, server and clinet are separated, and all data are converted into data base, Second, with the construction of APM server the data modification and management are efficiently operated. Third, a political decision of the system is defined. Fourth, the system can efficiently support user-oriented services such as the collection of diligence and indolence data and the sum of off-duty days. From the implementation and performance evaluation of the proposed WNDIM, we can see the system can efficiently support the diligence and indolence management, currently we are using the proposed WNDIM system in the real filed.Key Words : 근태관리 시스템, Server-Client System, 데이터 베이스, MSSQL

National survey of the association of depressive symptoms with the number of off duty and on-call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study.

BackgroundPhysicians' mental health may be adversely affected by the number of days of work and time spent on-call, and improved by sleep and days-off. The aim of this study was to determine the associations of depressive symptoms with taking days of off duty, hours of sleep, and the number of days of on-call and overnight work among physicians working in Japanese hospitals.MethodsA cross-sectional study as a national survey was conducted by mail. The study population was 10,000 randomly selected physicians working in hospitals who were also members of the Japan Medical Association (response rate 40.5%). Self-reported anonymous questionnaire was sent to assess the number of days off-duty, overnight work, and on-calls, and the average number of sleep hours on days not working overnight in the previous one month. Depressive state was determined by the Japanese version of the Quick Inventory of Depressive Symptomatology. Logistic regression analysis was used to explore the associations between depressive symptoms and the studied variables.ResultsAmong the respondents, 8.3% of men and 10.5% of women were determined to be depressed. For both men and women, depressive state was associated with having no off-duty days and averaging less than 5 hours of sleep on days not doing overnight work. Depressive state was positively associated with being on-call more than 5 days per month for men, and more than 8 days per month for women, and was negatively associated with being off-duty more than 8 days per month for men.ConclusionSome physicians need some support to maintain their mental health. Physicians who do not take enough days-off, who reduced sleep hours, and who have certain number of days on-calls may develop depressive symptoms.

Day To Day Differences In Periodic Cortisol Measurements Seen In Professional Firefighters

Figure 1: Mean Periodic Cortisol Concentration.INTRODUCTION: Professional firefighters (PF) are routinely exposed to life-threatening environments. As a result, PF are at risk for the development of both psychological and physical stress related disorders. PURPOSE: This study sought to assess day to day changes in the diurnal cycle of eight PF (age: 45±7 yrs & 21.8±7.27 yrs experience) Cortisol. METHODS: Saliva samples were collected from eight PF at 09:00, 12:00, 18:00, and 22:00 hours during nine on-duty days and two off-duty days. Cortisol concentration was measured in saliva samples using ELISA. RESULTS: Despite a downward trend in Fig. 1, ANOVA did not reveal a significant trend (P>.05) for time and a main effect for days. The interaction between the on-duty and off-duty assessments also failed to reach significance. Lastly, the interaction between test day and time period was not significant (p>.05). CONCLUSION: Cortisol levels did not differ from day to day at any time point for PF. However, the non-significant trend of Cortisol levels throughout the day reflects a normal diurnal pattern. The data suggests that future research is needed to probe for Cortisol level differences between on-duty and off-duty days as well as Cortisol levels in response to emergency dispatch.