Extended Work Shifts and the Risk of Motor Vehicle Crashes among Interns
Open accessAbstract
BACKGROUND: Long work hours and work shifts of an extended duration (> or =24 hours) remain a hallmark of medical education in the United States. Yet their effect on health and safety has not been evaluated with the use of validated measures. METHODS: We conducted a prospective nationwide, Web-based survey in which 2737 residents in their first postgraduate year (interns) completed 17,003 monthly reports that provided detailed information about work hours, work shifts of an extended duration, documented motor vehicle crashes, near-miss incidents, and incidents involving involuntary sleeping. RESULTS: The odds ratios for reporting a motor vehicle crash and for reporting a near-miss incident after an extended work shift, as compared with a shift that was not of extended duration, were 2.3 (95 percent confidence interval, 1.6 to 3.3) and 5.9 (95 percent confidence interval, 5.4 to 6.3), respectively. In a prospective analysis, every extended work shift that was scheduled in a month increased the monthly risk of a motor vehicle crash by 9.1 percent (95 percent confidence interval, 3.4 to 14.7 percent) and increased the monthly risk of a crash during the commute from work by 16.2 percent (95 percent confidence interval, 7.8 to 24.7 percent). In months in which interns worked five or more extended shifts, the risk that they would fall asleep while driving or while stopped in traffic was significantly increased (odds ratios, 2.39 [95 percent confidence interval, 2.31 to 2.46] and 3.69 [95 percent confidence interval, 3.60 to 3.77], respectively). CONCLUSIONS: Extended-duration work shifts, which are currently sanctioned by the Accreditation Council for Graduate Medical Education, pose safety hazards for interns. These results have implications for medical residency programs, which routinely schedule physicians to work more than 24 consecutive hours.
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Sleep loss and night work are linked to lower alertness and cognitive performance and are a safety concern for round-the-clock operations, including medicine.
“Sleep loss and night work are associated with reduced alertness and cognitive performance1 and represent a safety challenge for all 24/7 operations, including medicine.2–6”
From Sleep and Alertness in a Duty-Hour Flexibility Trial in Internal Medicine (2019) · cites this paper as [3]
The Abstract reports that extended shifts pose safety hazards for medical interns and discusses fatigue-related crashes among truck drivers. This supports the safety concern in medicine and another round-the-clock occupation, but the paper does not establish it for all 24/7 operations. The sentence cites a different source for reduced alertness and cognitive performance. (LLM, conf=0.84)
Experimental — accuracy not yet measuredShifts of 24 or more hours were associated with increased odds of motor vehicle crashes.
“Subsequent evaluations found that shifts of 24 or more hours were associated with increased odds of fatigue-related medical errors and preventable adverse events (PAEs),3 percutaneous injuries4 and motor vehicle crashes.5”
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Cites
Fundamentals of Biostatistics.
(1969) · Annals of Internal Medicine · doi:10.7326/0003-4819-70-4-873 · Cited by 4,573 · see citing works
Impact of sleep debt on metabolic and endocrine function
Spiegel, K., Leproult, R., & Van Cauter, E. (1999) · The Lancet · doi:10.1016/s0140-6736(99)01376-8 · Cited by 3,668 · see citing works
Van Dongen, H. P. A., Maislin, G., Mullington, J. M., & Dinges, D. F. (2003) · Sleep · doi:10.1093/sleep/26.2.117 · Cited by 3,173 · see citing works
Effect of Reducing Interns' Work Hours on Serious Medical Errors in Intensive Care Units
Landrigan, C. P., Rothschild, J. M., Cronin, J. W., Kaushal, R., Burdick, E., Katz, J. T., Lilly, C. M., Stone, P. H., Lockley, S. W., Bates, D. W., et al. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa041406 · Cited by 1,760 · see citing works
Self-citationBelenky, G., Wesensten, N. J., Thorne, D. R., Thomas, M. L., Sing, H. C., Redmond, D. P., Russo, M. B., & Balkin, T. J. (2003) · Journal of Sleep Research · doi:10.1046/j.1365-2869.2003.00337.x · Cited by 1,436 · see citing works
Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures
Lockley, S. W., Cronin, J. W., Evans, E. E., Cade, B. E., Lee, C. J., Landrigan, C. P., Rothschild, J. M., Katz, J. T., Lilly, C. M., Stone, P. H., et al. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa041404 · Cited by 913 · see citing works
Self-citationShould We Use a Case-Crossover Design?
Maclure, M., & Mittleman, M. A. (2000) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.21.1.193 · Cited by 751 · see citing works
Learning, Satisfaction, and Mistreatment During Medical Internship
Daugherty, S. R., Baldwin, D. C., & Rowley, B. D. (1998) · JAMA · doi:10.1001/jama.279.15.1194 · Cited by 313 · see citing works
Friedman, R. C., Bigger, J. T., & Kornfeld, D. S. (1971) · New England Journal of Medicine · doi:10.1056/nejm197107222850405 · Cited by 312 · see citing works
Rotating Shift Work Schedules That Disrupt Sleep Are Improved by Applying Circadian Principles
Czeisler, C. A., Moore‐Ede, M. C., & Coleman, R. M. (1982) · Science · doi:10.1126/science.7089576 · Cited by 265 · see citing works
Self-citationWyatt, J. K., Cajochen, C., Cecco, A. R.-D., Czeisler, C. A., & Dijk, D. (2004) · SLEEP · doi:10.1093/sleep/27.3.374 · Cited by 182 · see citing works
Self-citationA National Survey of Residents’ Self-Reported Work Hours: Thinking Beyond Specialty
Baldwin, D. C., Daugherty, S. R., Tsai, R., & Scotti, M. J. (2003) · Academic Medicine · doi:10.1097/00001888-200311000-00018 · Cited by 165 · see citing works
Work Hours Reform: Perceptions and Desires of Contemporary Surgical Residents
Whang, E. E., Perez, A., Ito, H., Mello, M. M., Ashley, S. W., & Zinner, M. J. (2003) · Journal of the American College of Surgeons · doi:10.1016/s1072-7515(03)00602-1 · Cited by 97 · see citing works
A Survey of Residents and Faculty Regarding Work Hour Limitations in Surgical Training Programs
Niederee, M. J. (2003) · Archives of Surgery · doi:10.1001/archsurg.138.6.663 · Cited by 83 · see citing works
Effect of Reducing Interns??? Weekly Work Hours on Sleep and Attentional Failures
Lockley, S. W., CRONIN, J. W., Evans, E. E., Cade, B. E., Lee, C. J., Landrigan, C. P., Rothschild, J. M., Katz, J. T., Lilly, C. M., Stone, P. H., et al. (2005) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000157053.65669.09 · Cited by 81 · see citing works
Self-citationUS Graduate Medical Education, 2001-2002
Brotherton, S. E., Simon, F. A., & Etzel, S. I. (2002) · JAMA · doi:10.1001/jama.288.9.1073 · Cited by 55 · see citing works
Dement, W. C. (1997) · New England Journal of Medicine · doi:10.1056/nejm199709113371111 · Cited by 48 · see citing works
Historical Perspective of Medical Residency Training: 50 Years of Changes
Cassell, E. J. (1999) · JAMA · doi:10.1001/jama.281.13.1231-jms0407-6-1 · Cited by 9 · see citing works
Historical Perspective of Medical Residency Training: 50 Years of Changes
Cassell, E. J. (1999) · JAMA · doi:10.1001/jama.281.13.1231 · Cited by 1 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [4]4. Safety study: fatigue, alcohol, other drugs, and medical factors in fatal-to-the- driver heavy truck crashes. Vol. 1. 1990.
- [7]7. Department of Transportation. Hours of service of drivers; driver rest and sleep for safe operations; proposed rule. Fed Regist 2000;65(85):25541-611.
- [19]19. Spiegel K, Leproult R, Van Cauter E. Im- pact of sleep debt on metabolic and endo- crine function. Lancet 1999;354:1435-9.
Cited by
Sorted by citations
Sleep Health: Can We Define It? Does It Matter?
Buysse, D. J. (2014) · SLEEP · doi:10.5665/sleep.3298 · Cited by 2,607 · see citing works
Physician wellness: a missing quality indicator
Wallace, J. E., Lemaire, J. B., & Ghali, W. A. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61424-0 · Cited by 1,608 · see citing works
Rates of medication errors among depressed and burnt out residents: prospective cohort study
Fahrenkopf, A. M., Sectish, T. C., Barger, L. K., Sharek, P. J., Lewin, D., Chiang, V. W., Edwards, S., Wiedermann, B. L., & Landrigan, C. P. (2008) · BMJ · doi:10.1136/bmj.39469.763218.be · Cited by 1,175 · see citing works
Self-citationHealth consequences of shift work and insufficient sleep
Kecklund, G., & Axelsson, J. (2016) · BMJ · doi:10.1136/bmj.i5210 · Cited by 1,195 · see citing works
Panel, C. C., Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., et al. (2015) · Sleep · doi:10.5665/sleep.4886 · Cited by 906 · see citing works
Vigilance, alertness, or sustained attention: physiological basis and measurement
Oken, B. S., Salinsky, M. C., & Elsas, S. M. (2006) · Clinical Neurophysiology · doi:10.1016/j.clinph.2006.01.017 · Cited by 887 · see citing works
The link between fatigue and safety
Williamson, A. M., Lombardi, D. A., Folkard, S., Stutts, J. C., Courtney, T. K., & CONNOR, J. L. (2010) · Accident Analysis & Prevention · doi:10.1016/j.aap.2009.11.011 · Cited by 824 · see citing works
The Effects of Coffee and Napping on Nighttime Highway Driving
Philip, P., Taillard, J., Moore, N. D., Delord, S., Valtat, C., Sagaspe, P., & Bioulac, B. H. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-144-11-200606060-00004 · Cited by 650 · see citing works
Sleep loss and fatigue in shift work and shift work disorder
Åkerstedt, T., & Wright, K. P. (2009) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2009.03.001 · Cited by 639 · see citing works
Impacts of shift work on sleep and circadian rhythms
Boivin, D. B., & Boudreau, P. (2014) · Pathologie Biologie · doi:10.1016/j.patbio.2014.08.001 · Cited by 594 · see citing works
Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., Kushida, C., et al. (2015) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.4950 · Cited by 568 · see citing works
Impact of Extended-Duration Shifts on Medical Errors, Adverse Events, and Attentional Failures
Barger, L. K., Ayas, N. T., Cade, B. E., Cronin, J. W., Rosner, B., Speizer, F. E., & Czeisler, C. A. (2006) · PLoS Medicine · doi:10.1371/journal.pmed.0030487 · Cited by 533 · see citing works
Self-citationResident Duty Hours: Enhancing Sleep, Supervision, and Safety
Ulmer, C. C., Wolman, D. M., & Johns, M. M. E. (2009) · Cited by 481 · see citing works
Shift work and the assessment and management of shift work disorder (SWD)
Wright, K. P., Bogan, R. K., & Wyatt, J. K. (2013) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2012.02.002 · Cited by 437 · see citing works
The Impact of Shift Work on Sleep, Alertness and Performance in Healthcare Workers
Ganesan, S., Magee, M., Stone, J. E., Mulhall, M. D., Collins, A., Howard, M. E., Lockley, S. W., Rajaratnam, S. M. W., & Sletten, T. L. (2019) · Scientific Reports · doi:10.1038/s41598-019-40914-x · Cited by 429 · see citing works
Sleep and Circadian Rhythms in Humans
Czeisler, C. A., & Gooley, J. J. (2007) · Cold Spring Harbor Symposia on Quantitative Biology · doi:10.1101/sqb.2007.72.064 · Cited by 425 · see citing works
Self-citationNeurobehavioral Performance of Residents After Heavy Night Call vs After Alcohol Ingestion
Arnedt, J. T., Owens, J., Crouch, M., Stahl, J., & Carskadon, M. A. (2005) · JAMA · doi:10.1001/jama.294.9.1025 · Cited by 419 · see citing works
Extended Work Duration and the Risk of Self-reported Percutaneous Injuries in Interns
Ayas, N. T., Barger, L. K., Cade, B. E., Hashimoto, D. M., Rosner, B., Cronin, J. W., Speizer, F. E., & Czeisler, C. A. (2006) · JAMA · doi:10.1001/jama.296.9.1055 · Cited by 411 · see citing works
Self-citationShift work, sleep, and sleepiness – differences between shift schedules and systems
Sallinen, M., & Kecklund, G. (2010) · Scandinavian Journal of Work, Environment & Health · doi:10.5271/sjweh.2900 · Cited by 412 · see citing works
Sleep disorders, health, and safety in police officers
Rajaratnam, S. M. W., Barger, L. K., Lockley, S. W., Shea, S. A., Wang, W., Landrigan, C. P., O’Brien, C. S., Qadri, S., Sullivan, J. P., Cade, B. E., et al. (2011) · JAMA · doi:10.1001/jama.2011.1851 · Cited by 405 · see citing works
Self-citationWorkhours in relation to work stress, recovery and health
Härmä, M. (2006) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.1055 · Cited by 387 · see citing works
Effects of Health Care Provider Work Hours and Sleep Deprivation on Safety and Performance
Lockley, S. W., Barger, L. K., Ayas, N., Rothschild, J. M., Czeisler, C. A., & Landrigan, C. P. (2007) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/s1553-7250(07)33109-7 · Cited by 390 · see citing works
Self-citationShift and night work and long working hours – a systematic review of safety implications
Wagstaff, A. S., & Sigstad Lie, J.-A. (2011) · Scandinavian Journal of Work, Environment & Health · doi:10.5271/sjweh.3146 · Cited by 367 · see citing works
Leape, L. L., Shore, M. F., Dienstag, J. L., Mayer, R. J., Edgman‐Levitan, S., Meyer, G. S., & Healy, G. B. (2012) · Academic Medicine · doi:10.1097/acm.0b013e318258338d · Cited by 359 · see citing works
Valentin, A., Ferdinande, P., & ESICM Working Group on Quality Improvement (2011) · Intensive Care Medicine · doi:10.1007/s00134-011-2300-7 · Cited by 333 · see citing works
Patient Safety in the Cardiac Operating Room: Human Factors and Teamwork
Wahr, J. A., Prager, R. L., Abernathy, J. H., Martinez, E. A., Salas, E., Seifert, P. C., Groom, R. C., Spiess, B. D., Searles, B. E., Sundt, T. M., et al. (2013) · Circulation · doi:10.1161/cir.0b013e3182a38efa · Cited by 331 · see citing works
Effects of Work Hour Reduction on Residents’ Lives: A Systematic Review
Fletcher, K. E., Underwood, W., Davis, S. Q., Mangrulkar, R. S., McMahon, L. F., & Saint, S. (2005) · JAMA · doi:10.1001/jama.294.9.1088 · Cited by 328 · see citing works
Patient safety research: an overview of the global evidence
Jha, A. K., Prasopa-Plaizier, N., Larizgoitia, I., & Bates, D. W. (2010) · BMJ Quality & Safety · doi:10.1136/qshc.2008.029165 · Cited by 317 · see citing works
Shift Work and Shift Work Sleep Disorder
Wickwire, E. M., Geiger-Brown, J. M., Scharf, S. M., & Drake, C. L. (2016) · CHEST Journal · doi:10.1016/j.chest.2016.12.007 · Cited by 322 · see citing works
Transport and industrial safety, how are they affected by sleepiness and sleep restriction?
Philip, P., & Åkerstedt, T. (2006) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2006.04.002 · Cited by 292 · see citing works
Oxytocin: new perspectives on an old drug
Clark, S. L., Simpson, K. R., Knox, G., & Garite, T. J. (2008) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2008.06.010 · Cited by 285 · see citing works
Barger, L. K., Flynn-Evans, E. E., Kubey, A., Walsh, L., Ronda, J. M., Wang, W., Wright, K. P., & Czeisler, C. A. (2014) · The Lancet Neurology · doi:10.1016/s1474-4422(14)70122-x · Cited by 277 · see citing works
Self-citationOptimizing sleep to maximize performance: implications and recommendations for elite athletes
Simpson, N. S., Gibbs, E. L., & Matheson, G. O. (2016) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.12703 · Cited by 274 · see citing works
Modeling the impact of the components of long work hours on injuries and "accidents".
Folkard, S., & Lombardi, D. A. (2006) · American Journal of Industrial Medicine · doi:10.1002/ajim.20307 · Cited by 274 · see citing works
Sleep, Anesthesiology, and the Neurobiology of Arousal State Control
Lydic, R., & Baghdoyan, H. A. (2005) · Anesthesiology · doi:10.1097/00000542-200512000-00024 · Cited by 251 · see citing works
Risks of Complications by Attending Physicians After Performing Nighttime Procedures
Rothschild, J. M. (2009) · JAMA · doi:10.1001/jama.2009.1423 · Cited by 248 · see citing works
How Near-Misses Influence Decision Making Under Risk: A Missed Opportunity for Learning
Dillon, R. L., & Tinsley, C. H. (2008) · Management Science · doi:10.1287/mnsc.1080.0869 · Cited by 247 · see citing works
Depner, C. M., Cheng, P., Devine, J. K., Khosla, S., de Zambotti, M., Robillard, R., Vakulin, A., & Drummond, S. P. A. (2019) · SLEEP · doi:10.1093/sleep/zsz254 · Cited by 245 · see citing works
Foster, F., & Wulff, K. (2005) · Nature reviews. Neuroscience · doi:10.1038/nrn1670 · Cited by 243 · see citing works
The Relationship between Nurse Work Schedules, Sleep Duration, and Drowsy Driving
Scott, L. D., Hwang, W.-T., Rogers, A. E., Nysse, T., Dean, G. E., & Dinges, D. F. (2007) · Sleep · doi:10.1093/sleep/30.12.1801 · Cited by 242 · see citing works
Yaghmour, N. A., Brigham, T. P., Richter, T., Miller, R. S., Philibert, I., Baldwin, D. C., & Nasca, T. J. (2017) · Academic Medicine · doi:10.1097/acm.0000000000001736 · Cited by 243 · see citing works
Mental Health Consequences of Shift Work: An Updated Review
Brown, J., Martin, D., Nagaria, Z., Verceles, A. C., Jobe, S. L., & Wickwire, E. M. (2020) · Current Psychiatry Reports · doi:10.1007/s11920-020-1131-z · Cited by 235 · see citing works
Residents Report on Adverse Events and Their Causes
Jagsi, R., Kitch, B. T., Weinstein, D. F., Campbell, E. G., Hutter, M. M., & Weissman, J. S. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.22.2607 · Cited by 234 · see citing works
Mansukhani, M. P., Kolla, B. P., Surani, S., Varon, J., & Ramar, K. (2012) · Postgraduate Medicine · doi:10.3810/pgm.2012.07.2583 · Cited by 227 · see citing works
Modelling fatigue and the use of fatigue models in work settings
Dawson, D., Ian Noy, Y., Härmä, M., Åkerstedt, T., & Belenky, G. (2011) · Accident Analysis & Prevention · doi:10.1016/j.aap.2009.12.030 · Cited by 217 · see citing works
High risk of near-crash driving events following night-shift work
Lee, M. L., Howard, M. E., Horrey, W. J., Liang, Y., Anderson, C., Shreeve, M. S., O’Brien, C. S., & Czeisler, C. A. (2015) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1510383112 · Cited by 214 · see citing works
Self-citationSmith‐Coggins, R., Howard, S. K., Mac, D. T., Wang, C., Kwan, S. W., Rosekind, M. R., Sowb, Y. A., Balise, R. R., Levis, J. T., & Gaba, D. M. (2006) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2006.02.005 · Cited by 215 · see citing works
Circadian and wakefulness-sleep modulation of cognition in humans
Wright, K. P., Lowry, C. A., & LeBourgeois, M. K. (2012) · Frontiers in Molecular Neuroscience · doi:10.3389/fnmol.2012.00050 · Cited by 209 · see citing works
Possible broad impacts of long work hours.
Caruso, C. (2006) · Industrial Health · doi:10.2486/indhealth.44.531 · Cited by 212 · see citing works
The Productivity of Working Hours
Pencavel, J. H. (2015) · Social Science Research Network · doi:10.1111/ecoj.12166 · Cited by 207 · see citing works
The Impact of Cognitive Stressors in the Emergency Department on Physician Implicit Racial Bias
Johnson, T. J., Hickey, R., Switzer, G., Miller, E., Winger, D., Nguyen, M., Saladino, R., & Hausmann, L. (2016) · Academic Emergency Medicine · doi:10.1111/acem.12901 · Cited by 195 · see citing works
Landrigan, C. P., Fahrenkopf, A. M., Lewin, D. S., Sharek, P. J., Barger, L. K., Eisner, M., Edwards, S., Chiang, V. W., Wiedermann, B. L., & Sectish, T. C. (2008) · PEDIATRICS · doi:10.1542/peds.2007-2306 · Cited by 190 · see citing works
Self-citationAge-Related Reduction in the Maximal Capacity for Sleep—Implications for Insomnia
Klerman, E. B., & Dijk, D. (2008) · Current Biology · doi:10.1016/j.cub.2008.06.047 · Cited by 189 · see citing works
Countermeasures that work: A highway safety countermeasure guide for state highway safety offices
(2007) · PsycEXTRA Dataset · doi:10.1037/e424112008-001 · Cited by 187 · see citing works
Barger, L. K., Lockley, S. W., Rajaratnam, S. M. W., & Landrigan, C. P. (2009) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-009-0024-7 · Cited by 184 · see citing works
Self-citationImpact of long work hours on police officers and the communities they serve
Vila, B. (2006) · American Journal of Industrial Medicine · doi:10.1002/ajim.20333 · Cited by 179 · see citing works
Artazcoz, L., Cortès, I., Escribá-Agüir, V., Cascant, L., & Villegas, R. (2009) · Journal of Epidemiology and Community Health · doi:10.1136/jech.2008.082123 · Cited by 175 · see citing works
(2006) · doi:10.1002/ajim.20373 · Cited by 249 · see citing works
Morning Circadian Misalignment during Short Sleep Duration Impacts Insulin Sensitivity
Eckel, R. H., Depner, C. M., Perreault, L., Markwald, R. R., Smith, M. R., McHill, A. W., HIGGINS, J. A., Melanson, E. L., & Wright, K. P. (2015) · Current Biology · doi:10.1016/j.cub.2015.10.011 · Cited by 173 · see citing works
Weaver, M. D., Vetter, C., Rajaratnam, S. M. W., O’Brien, C. S., Qadri, S., Benca, R. M., Rogers, A. E., Leary, E. B., Walsh, J. K., Czeisler, C. A., et al. (2018) · Journal of Sleep Research · doi:10.1111/jsr.12722 · Cited by 169 · see citing works
Self-citationSleep and errors in a group of Australian hospital nurses at work and during the commute
Dorrian, J., Tolley, C., Lamond, N., van den Heuvel, C. J., Pincombe, J. I., Rogers, A. E., & Dawson, D. E. (2008) · Applied Ergonomics · doi:10.1016/j.apergo.2008.01.012 · Cited by 166 · see citing works
Barger, L. K., Rajaratnam, S. M. W., Wang, W., O’Brien, C. S., Sullivan, J. P., Qadri, S., Lockley, S. W., Czeisler, C. A., & for the Harvard Work Hours, H. A. S. G. (2015) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.4534 · Cited by 158 · see citing works
Self-citationEffects of the 2011 Duty Hour Reforms on Interns and Their Patients
Sen, S., Kranzler, H. R., Didwania, A. K., Schwartz, A. C., Amarnath, S. R., Kolars, J. C., Dalack, G. W., Nichols, B., & Guille, C. (2013) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.351 · Cited by 157 · see citing works
Long working hours, occupational health and the changing nature of work organization
Johnson, J. V., & Lipscomb, J. (2006) · American Journal of Industrial Medicine · doi:10.1002/ajim.20383 · Cited by 214 · see citing works
West, C. P., Tan, A. D., & Shanafelt, T. D. (2012) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2012.07.021 · Cited by 158 · see citing works
Interns' Compliance With Accreditation Council for Graduate Medical Education Work-Hour Limits
Landrigan, C. P., Barger, L. K., Cade, B. E., Ayas, N., & Czeisler, C. A. (2006) · JAMA · doi:10.1001/jama.296.9.1063 · Cited by 152 · see citing works
Self-citationSanthi, N., Horowitz, T. S., Duffy, J. F., & Czeisler, C. A. (2007) · PLoS ONE · doi:10.1371/journal.pone.0001233 · Cited by 152 · see citing works
Self-citationSleepy Driver Near-Misses May Predict Accident Risks
Powell, N. B., Schechtman, K. B., Riley, R. W., Guilleminault, C., Chiang, R. P., & Weaver, E. M. (2007) · SLEEP · doi:10.1093/sleep/30.3.331 · Cited by 151 · see citing works
Reed, D. A., Fletcher, K. E., & Arora, V. M. (2010) · Annals of Internal Medicine · doi:10.7326/0003-4819-153-12-201012210-00010 · Cited by 149 · see citing works
Sleep and Cardiovascular Disease: An Overview
Malhotra, A., & Loscalzo, J. (2008) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2008.10.004 · Cited by 147 · see citing works
McCormick, F. M., Kadzielski, J. J., Landrigan, C. P., Evans, B. T., Herndon, J. H., & Rubash, H. E. (2012) · Archives of Surgery · doi:10.1001/archsurg.2012.84 · Cited by 149 · see citing works
Circadian misalignment affects sleep and medication use before and during spaceflight
Flynn-Evans, E. E., Barger, L. K., Kubey, A. A., Sullivan, J. P., & Czeisler, C. A. (2016) · npj Microgravity · doi:10.1038/npjmgrav.2015.19 · Cited by 148 · see citing works
Self-citationHuman Performance and Patient Safety
Rall, M., Gaba, D. M., Howard, S. K., & Dieckmann, P. (2010) · Elsevier eBooks · doi:10.1016/b978-0-443-06959-8.00006-6 · Cited by 148 · see citing works
Driving Fatigue in Professional Drivers: A Survey of Truck and Taxi Drivers
Meng, F., Li, S., Cao, L., Li, M. K., Peng, Q., Wang, C., & Zhang, W. (2014) · Traffic Injury Prevention · doi:10.1080/15389588.2014.973945 · Cited by 145 · see citing works
The Effects of On-Duty Napping on Intern Sleep Time and Fatigue
Arora, V. M., Dunphy, C., Chang, V. Y., Ahmad, F., Humphrey, H. J., & Meltzer, D. O. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-144-11-200606060-00005 · Cited by 144 · see citing works
Automated acquisition of explainable knowledge from unannotated histopathology images
Yamamoto, Y., Tsuzuki, T., Akatsuka, J., Ueki, M., Morikawa, H., Numata, Y., Takahara, T., Tsuyuki, T., Tsutsumi, K., Nakazawa, R., et al. (2019) · Nature Communications · doi:10.1038/s41467-019-13647-8 · Cited by 145 · see citing works
Damadi, A., Davis, A. T., Saxe, A., & Apelgren, K. N. (2007) · Journal of surgical education · doi:10.1016/j.jsurg.2007.07.008 · Cited by 141 · see citing works
Czeisler, C. A., Walsh, J. K., Wesnes, K. A., Roth, T. G., & Arora, S. (2009) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(11)60666-6 · Cited by 141 · see citing works
Self-citationHealth promoting practices and personal lifestyle behaviors of Brazilian health professionals
Hidalgo, K., Mielke, G. I., Parra, D. C., Lobelo, F., Simões, E. J., Gomes, G. A., Florindo, A. A., Bracco, M. M., de Moura, L., Brownson, R. C., et al. (2016) · BMC Public Health · doi:10.1186/s12889-016-3778-2 · Cited by 142 · see citing works
Clinical aspects of human circadian rhythms
Klerman, E. B. (2005) · Journal of Biological Rhythms · doi:10.1177/0748730405278353 · Cited by 139 · see citing works
Ftouni, S., Sletten, T. L., Howard, M. E., Anderson, C., Lenné, M. G., Lockley, S. W., & Rajaratnam, S. M. W. (2012) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2012.01038.x · Cited by 137 · see citing works
Work patterns and fatigue-related risk among junior doctors
Gander, P., Purnell, H., Garden, A., & Woodward, A. (2007) · Occupational and Environmental Medicine · doi:10.1136/oem.2006.030916 · Cited by 147 · see citing works
Robb, G., Sultana, S., Ameratunga, S. N., & Jackson, R. (2008) · Injury Prevention · doi:10.1136/ip.2007.016766 · Cited by 135 · see citing works
Melatonin, Sleep, and Shift Work Adaptation
Burch, J. B., Yost, M. G., Johnson, W., & Allen, E. (2005) · Journal of Occupational and Environmental Medicine · doi:10.1097/01.jom.0000177336.21147.9f · Cited by 135 · see citing works
Effects of circadian misalignment on cognition in chronic shift workers
Chellappa, S. L., Morris, C. J., & Scheer, F. A. J. L. (2019) · Scientific Reports · doi:10.1038/s41598-018-36762-w · Cited by 139 · see citing works
Schwartz, J. R. L., & Roth, T. G. (2006) · Drugs · doi:10.2165/00003495-200666180-00007 · Cited by 133 · see citing works
Boudreau, P., Dumont, G. A., & Boivin, D. B. (2013) · PLoS ONE · doi:10.1371/journal.pone.0070813 · Cited by 128 · see citing works
Cost Implications of Reduced Work Hours and Workloads for Resident Physicians
Nuckols, T. K., Bhattacharya, J., Wolman, D. M., Ulmer, C. C., & Escarce, J. J. (2009) · New England Journal of Medicine · doi:10.1056/nejmsa0810251 · Cited by 131 · see citing works
Work–family conflict, cardiometabolic risk, and sleep duration in nursing employees.
Berkman, L. F., Liu, S. Y., Hammer, L. B., Moen, P., Klein, L. C., Kelly, E. L., Fay, M. E., Davis, K. D., Durham, M., Karuntzos, G. T., et al. (2015) · Journal of Occupational Health Psychology · doi:10.1037/a0039143 · Cited by 132 · see citing works
Sleepiness, near-misses and driving accidents among a representative population of French drivers
Sagaspe, P., Taillard, J., Bayon, V., Lagarde, E., Moore, N. D., Boussuge, J., Chaumet, G., Bioulac, B. H., & Philip, P. (2010) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2009.00818.x · Cited by 131 · see citing works
Killgore, W. D. S., Rupp, T. L., Grugle, N. L., Reichardt, R. M., Lipizzi, E. L., & Balkin, T. J. (2008) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2008.00654.x · Cited by 131 · see citing works
The 10-Year Risk of Verifed Motor Vehicle Crashes in Relation to Physiologic Sleepiness
Drake, C. L., Roehrs, T., Breslau, N., Johnson, E. O., Jefferson, C., Scofield, H., & Roth, T. G. (2010) · SLEEP · doi:10.1093/sleep/33.6.745 · Cited by 123 · see citing works
Arora, V. M. (2008) · JAMA · doi:10.1001/jama.300.10.1146 · Cited by 123 · see citing works
Development and preliminary psychometric properties of a well-being index for medical students
Dyrbye, L. N., Szydlo, D. W., Downing, S. M., Sloan, J. A., & Shanafelt, T. D. (2010) · BMC Medical Education · doi:10.1186/1472-6920-10-8 · Cited by 128 · see citing works
Sleep Deprivation, Physician Performance, and Patient Safety
Olson, E. J., Drage, L. A., & Auger, R. R. (2009) · CHEST Journal · doi:10.1378/chest.08-1952 · Cited by 116 · see citing works
Fisman, D. N., Harris, A. D., Rubin, M. A., Sorock, G. S., & Mittleman, M. A. (2007) · Infection Control and Hospital Epidemiology · doi:10.1086/510569 · Cited by 118 · see citing works
Altered sleep/wake patterns and mental performance
Åkerstedt, T. (2006) · Physiology & Behavior · doi:10.1016/j.physbeh.2006.09.007 · Cited by 119 · see citing works
Asleep at the Wheel—The Road to Addressing Drowsy Driving
Higgins, J. S., Michael, J., Austin, R. A., Åkerstedt, T., Dongen, H. P. A. V., Watson, N. F., Czeisler, C. A., Pack, A. I., & Rosekind, M. R. (2017) · SLEEP · doi:10.1093/sleep/zsx001 · Cited by 116 · see citing works
Self-citationAssociation between work productivity and sleep health: A cross-sectional study in Japan
Ishibashi, Y., & Shimura, A. (2020) · Sleep Health · doi:10.1016/j.sleh.2020.02.016 · Cited by 113 · see citing works
Association between long working hours and sleep problems in white‐collar workers
Nakashima, M., Morikawa, Y., Sakurai, M., Nakamura, K., Miura, K., Ishizaki, M., Kido, T., Naruse, Y., Suwazono, Y., & Nakagawa, H. (2010) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2010.00852.x · Cited by 117 · see citing works
- Authors
- Barger, L. K., Cade, B. E., Ayas, N. T., Cronin, J. W., Rosner, B., Speizer, F. E., & Czeisler, C. A.
- Affiliations
- Brigham and Women's Hospital (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2005-01-13
- Volume
- 352
- Issue
- 2
- Pages
- 125-134
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2112447342
- Cited by
- 928
- References
- 19
- Citations by year
- 2026: 17 · 2025: 26 · 2024: 20 · 2023: 32 · 2022: 36 · 2021: 39 · 2020: 41 · 2019: 42 · 2018: 31 · 2017: 39 · 2016: 45 · 2015: 36 · 2014: 56 · 2013: 42 · 2012: 45
- FWCI
- 88.98
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Aeronautics and Space Administration (NCC958)
- Brigham and Women's Hospital (T32 HL079010)
- National Space Biomedical Research Institute (NCC 9‐58)
- British Columbia Lung Association
- Agency for Healthcare Research and Quality (F32 HS14130, R01 HS 12032, RO1 HS12032)
- Canadian Institutes of Health Research
- National Heart, Lung, and Blood Institute (T32 HL079010)
- National Institute for Occupational Safety and Health (1 R01 OH07567)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Keywords
- traffic accidents, medical interns, medical residents, near misses, working hours, graduate medical education, occupational safety, sleepiness while driving
- MeSH terms
- Accidents, Traffic, Automobile Driving, Fatigue, Humans, Internship and Residency, Personnel Staffing and Scheduling, Prospective Studies, Surveys and Questionnaires, Risk, Sleep, Sleep Deprivation, United States, Work Schedule Tolerance, Odds Ratio, Workload
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