Effects of Chronic Stress on the 24-hour Shift Worker

The goal of this project, Effects of chronic stress on the 24- hour shift worker was to bring awareness of the long-term consequences of extended shift work in emergency medical services (EMS) personnel. Extended shift work, lack of sleep and repeated exposure to high stress environments cause chronic excess cortisol stimulation and may result in a variety of hypothalamus-pituitary-adrenal axis disease processes resulting in long-term health consequences in EMS personnel. Metabolic syndrome, obesity, hypothyroidism, low testosterone, cardiovascular disease, hypertension, depression and fatigue are among the most prevalent. The current culture in EMS does not reflect one of safety and sleep deprivation is an expected consequence of the job. There is no current standard or guidelines to protect extended shift workers according to the Occupational Safety and Health Administration. The objectives of this project include surveying a group of current EMS providers for symptoms alluding to the presence or potential of disease in personnel working 24-hour shifts and bring awareness to consequences of long term allostatic load; to provide education about the issue to EMS personnel and to provide tools to help them manage the demands of the job without the sacrifice to their overall health; and finally, dissemination to a larger audience. The implementation of this project included several steps. First, after Institutional Review Board approval was obtained, demographic information was gathered from a group of EMS providers currently working full time in Idaho via an anonymous questionnaire. A questionnaire was developed and administered prior the educational modules to assess current knowledge of the subject and then administered again after the presentation, assessing knowledge gained. A presentation of the educational material was developed and given to the group of EMS providers. The education module was designed to bring awareness and provide solutions for continued health despite the stress as an EMS provider. A plan for dissemination of this information includes post study findings presentations to the participating agencies and a subsequent EMS conference in September of 2016. Self reported rates of depression, anxiety, hypothyroidism, low testosterone, and obesity among the surveyed participants were significantly higher than the national average. Further research that would include medical examinations and lab measurements may reveal a more accurate assessment of alterations in the HPA axis and future implications of this information. Continued education about the implications of chronic stress and lack of sleep during extended shift work should be a part of employee health and EMS education.