Research Laboratories and Divisions

Harvard Work Hours Health and Safety Group

Division of Sleep Medicine, Brigham and Women's Hospital
Director: Charles A. Czeisler, PhD, MD, FRCP

HWHHS group photo

Overview

Founded in 2001, the Harvard Work Hours Health and Safety Group, is a multi-disciplinary collaborative whose mission is to investigate sleep and work practices among physicians, police officers, and other occupational groups, and implement strategies to improve the safety of patients, workers, and the general public.

The Harvard Work Hours Health and Safety Group collaboration has led to numerous endeavors, such as the Intern Sleep and Safety Study, funded by AHRQ, a national survey study of interns, as well as ongoing investigations funded by the National Institute of Justice and the Centers for Disease Control into the causes and consequences of sleep deprivation among police officers. The current program builds on the considerable research into patient safety and sleep deprivation that has been conducted by investigators at Brigham and Women’s Hospital, and represents a synergistic merging of these fields to rigorously measure the effects of sleep deprivation and circadian factors on the incidence of serious medical errors and other on-the-job hazards.

References

1.    Ayas, N. T., Barger, L. K., Cade, B. E., Hashimoto, D. M., Rosner, B., Cronin, J. W., Speizer, F. E. and Czeisler, C. A. Extended work duration and the risk of self-reported percutaneous injuries in interns. JAMA, 2006, 296: 1055-1062.
2.    Barger, L. K., Cade, B. E., Ayas, N. T., Cronin, J. W., Rosner, B., Speizer, F. E. and Czeisler, C. A. Extended work shifts and the risk of motor vehicle crashes among interns. N Engl J Med, 2005, 352: 125-134.
3.    Cajochen, C., Khalsa, S. B. S., Wyatt, J. K., Czeisler, C. A. and Dijk, D. J. EEG and ocular correlates of circadian melatonin phase and human performance decrements during sleep loss. Am. J. Physiol., 1999, 277: R640-R649.
4.    Cavallo, A., Jaskiewicz, J., Ris, M. D. Impact of night-float rotation on sleep, mood, and alertness: the resident's perception. Chronobiol. Int., 2002, 19:893-902.
5.    Cavallo, A., Ris, M. D. and Succop, P. The night float paradigm to decrease sleep deprivation: good solution or a new problem? Ergonomics, 2003, 46: 653-663.
6.    Christmas, A. B., Reynolds, J., Hodges, S., Franklin, G. A., Miller, F. B., Richardson, J. D., Rodriguez, J. L. Physician extenders impact trauma systems. J Trauma, 2005, 58: 917-920.
7.    Czeisler, C. A. and Klerman, E. B. Circadian and sleep-dependent regulation of hormone release in humans. Recent Prog. Horm. Res., 1999, 54: 97-132.
8.    Dawson, D. and Reid, K. Fatigue, Alcohol and performance impairment. Nature, 1997, 388: 235.
9.    Dijk, D. J. and Czeisler, C. A. Paradoxical timing of the circadian rhythm of sleep propensity serves to consolidate sleep and wakefulness in humans. Neurosci. Lett., 1994, 166: 63-68.
10.    European Working Time Directive. http://www.incomesdata.co.uk/information/worktimedirective.htm
11.    Friedman, R. C., Bigger, J. T. and Kornfield, D. S. The intern and sleep loss. N. Engl. J. Med., 1971, 285: 201-203.
12.    Grantcharov, T. P., Bardram, L., Funch-Jensen, P. and Rosenberg, J. Laparoscopic performance after one night on call in a surgical department: prospective study. B. M. J., 2001, 323: 1222-1223.
13.    Horrocks, N. and Pounder, R. Working the night shift: Preparation, survival and recovery.  A guide for Jr. Doctors.  2006. London, Royal College of Physicians of London.
14.    Howard, S. K., Gaba, D. M., Rosekind, M. R. and Zarcone, V. P. The risks and implications of excessive daytime sleepiness in resident physicians. Acad. Med., 2002, 77: 1019-1025.
15.    Jewett ME (1997) Models of circadian and homeostatic regulation of human performance and alertness, Ph.D. dissertation, 1-276, Harvard University, Cambridge, MA.
16.    Jewett, M. E., Wyatt, J. K., Ritz-De Cecco, A., Khalsa, S. B., Dijk, D. J. and Czeisler, C. A. Time course of sleep inertia dissipation in human performance and alertness. J. Sleep Res., 1999, 8: 1-8.
17.    Johnson, M. P., Duffy, J. F., Dijk, D. J., Ronda, J. M., Dyal, C. M. and Czeisler, C. A. Short-term memory, alertness and performance:  A reappraisal of their relationship to body temperature. J. Sleep Res., 1992, 1: 24-29.
18.    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. and Czeisler, C. A. Effect of reducing interns' work hours on serious medical errors in intensive care units. N Engl J Med, 2004, 351: 1838-1848.
19.    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., Aeschbach, D. and Czeisler, C. A. Effect of reducing interns' weekly work hours on sleep and attentional failures. N Engl J Med, 2004, 351: 1829-1837.
20.    Mullington, J. M., Chan, J. L., van Dongen, H. P. A., Szuba, M. P., Samaras, J., Price, N. J., Meier-Ewert, H. K., Dinges, D. F. and Mantzoros, C. S. Sleep loss reduces diurnal rhythm amplitude of leptin in healthy men. J. Neuroendocrinol., 2003, 15: 851-854.
21.    Nuckols, T. K. and Escarce, J. J. Residency work-hours reform. A cost analysis including preventable adverse events. J Gen. Intern. Med, 2005, 20: 873-878.
22.    Oswanski, M.F., Sharma, O.P., Raj, S.S. Comparative review of use of physician assistants in a level 1 trauma center. Am. Surg. 2004, 70: 272-9.
23.    Petersen, L. A., Brennan, T. A., O'Neil, A. C., Cook, E. F., and Lee, T. H. Does Housestaff Discontinuity of Care Increase the Risk for Preventable Adverse Events?  Annals of Internal Medicine 1994, 121:866-72.
24.    Petersen, L. A., Orav, E. J., Teich, J. M., and O'Neil, A. C. Using a Computerized Sign-Out Program to Improve Continuity of Inpatient Care and Prevent Adverse Events. Joint Commission Journal on Quality Improvement 1998, 24:77-87
25.    Richardson, G. S., Wyatt, J. K., Sullivan, J. P., Orav, E., Ward, A., Wolf, M. A. and Czeisler, C. A. Objective assessment of sleep and alertness in medical house-staff and the impact of protected time for sleep. Sleep, 1996, 19: 718-726.
26.    Stickgold, R., James, L. and Hobson, J. A. Visual discrimination learning requires sleep after training. Nat. Neurosci., 2000, 3: 1237-1238.
27.    Van Dongen, H. P. A., Maislin, G., Mullington, J. M. and Dinges, D. F. The cumulative cost of additional wakefulness:  Dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep, 2003, 26: 117-126.
28.    Van Eaton, E. G., Horvath, K. D., Lober, W. B., Rossini, A. J. and Pellegrini, C. A. A randomized, controlled trial evaluating the impact of a computerized rounding and sign-out system on continuity of care and resident work hours. J Am Coll Surg, 2005, 200: 538-545.



Faculty

Charles A. Czeisler, PhD, MD, FRCP

Affiliated Faculty


Administrative Contact Name

Christopher Landrigan, MD MPH
clandrigan@rics.bwh.harvard.edu
617-732-4013

Brigham and Women’s Hospital
221 Longwood Ave BLI 438
Boston, MA 02115

http://www.workhoursandsafety.org/

Site Map | Contact Us | © 2006 by the President and Fellows of Harvard College