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J Occup Environ Med. 2014 May;56(5):510-5. doi: 10.1097/JOM.0000000000000132.

Association of sleep habits with accidents and near misses in United States transportation operators.

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From the Department of Environmental & Occupational Medicine & Epidemiology (Drs Johnson, Baur, and Kales), Harvard School of Public Health, Boston; The Cambridge Health Alliance (Drs Johnson and Kales), Harvard Medical School, Cambridge; Division of Sleep Medicine (Drs Patel and Malhotra), Brigham and Women's Hospital, Harvard Medical School, Boston, Mass; Interdisciplinary Center for Hormone and Metabolic Disorders (Dr Baur), Endokrinologikum ULM, Ulm, Germany; Army Capabilities Integration Center (Dr Edens), Fort Eustis, Va; and National Center for Intermodal Transportation (Dr Sherry), University of Denver, Colo.



To explore sleep risk factors and their association with adverse events in transportation operators.


Self-reported sleep-related behaviors were analyzed in transportation operators (drivers, pilots, and rail operators) aged 26 to 78 years who completed the National Sleep Foundation's 2012 "Planes, Trains, Automobiles, and Sleep" survey. Regression analyses were used to assess the associations of various sleep-related variables with the combined outcome of self-reported accidents and near misses.


Age- and body mass-adjusted predictors of accidents/near misses included an accident while commuting (odds ratio [OR] = 4.6; confidence interval [CI], 2.1 to 9.8), driving drowsy (OR = 4.1; CI, 2.5 to 6.7), and Sheehan Disability Scale score greater than 15 (OR = 3.5; CI, 2.2 to 5.5). Sleeping more than 7 hours nightly was protective for accident/near misses (OR = 0.6; CI, 0.4 to 0.9).


Recognized risk factors for poor sleep or excessive daytime sleepiness were significantly associated with self-reported near misses and/or accidents in transportation operators.

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