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Residents' Work Hours Not the Only Cause of Fatigue

Night work and shifting schedule contribute to excessive sleepiness and clinical errors

WEDNESDAY, March 28 (HealthDay News) -- Among young physicians, long hours are not the only work-related pattern that accounts for excessive sleepiness and fatigue-related clinical errors. Night work and schedule instability may take an even greater toll, according to the results of a study published online March 26 in Occupational and Environmental Medicine.

Philippa Gander, M.D., of Massey University in Wellington, New Zealand, and colleagues conducted an anonymous survey of 1,366 junior doctors who worked more than 40 hours per week.

The researchers found that 30 percent of subjects were excessively sleepy according to the Epworth Sleepiness Score, 24 percent reported falling asleep while driving home, 66 percent reported nearly falling asleep at the wheel during the previous 12 months, and 42 percent reported a fatigue-related clinical error during the previous six months. After controlling for demographic factors, the investigators also found that night work and schedule instability were more significantly associated with fatigue than were the number of hours worked.

"Interestingly, regular access to adequate supervision moderated the perceived impact of work patterns, and may therefore represent a useful fatigue countermeasure," the authors conclude. "The findings support the view that a more comprehensive risk management approach is needed to reduce doctors' sleepiness and improve patient safety."

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