Running on Empty- Safe Driving on a Shift Work Schedule
While people worry about the dangers of sky diving, bungee jumping, and other death-defying activities, in fact one of the most dangerous things you can do is turn that little metal key in your car every day. In the U.S., someone dies in a car accident once every 13 seconds. Since shift workers experience many of the symptoms that are the most frequent causes of car crashes- fatigue and drowsiness, nodding off from lack of sleep, drug use, and use of sleep aids- driving safety is especially important from shift workers. The perils of a commute after a long day (or especially after working nights) can be deadly.
According to the National Highway Traffic Safety Administration (NHTSA), there are about 43,000 people killed in fatal car accidents each year in the United States. In addition to fatal accidents, about 2.9 million people are injured each year. In the U.S., one person dies in a car accident every 13 seconds, approximately 115 deaths a day. And while motor vehicle accidents account for only 5% of all deaths per year, versus cancer – 23% and heart disease – 20%, they are the leading cause of death among people ages 4 to 34 (35% of all deaths in this age group in 2005).<!–[if !vml]–>1
While the number of fatal car accidents has remained relatively constant over the ten years from 1996 to 2006, the number of occupants killed in car accidents has actually decreased by 21% during this period. Unfortunately, the number of occupant deaths from motorcycles, large trucks and light trucks has increased by 78%, 30% and 28%, respectively. The accident involvement rates per 100 million miles of driving for cars, large trucks and light trucks have all decreased in the ten year period. The involvement rate for motorcycles has increased by 78% during this period.
SmartMotorist.com reports that over 95% of motor vehicle accidents involve some degree of driver behavior (e.g., fatigue, distraction, aggressive driving, drunk driving) combined with one of three other factors, including equipment failure, roadway design and poor roadway maintenance.
This article is going to focus on driver behavior. This topic is especially important to shift workers because:2
• Shift workers sleep an average of 6.5 hours on workdays—nightshift-only workers sleep even less
• 41% of shift workers report having nodded off while driving to or from work; 24.3% report this happening several times per month
• 60% of shift workers report feeling drowsy at work several times per month; 11.6% report feeling this way several times per shift
• 26.5% of shift workers report making mistakes of inattention several times per month
• Nearly 12% of shift workers have Obstructive Sleep Apnea, a breathing disorder that causes disrupted sleep compared to 2-4% of the regular population
• A number of shift workers have to drive as part of their normal work responsibilities
Also, the Circadian Technologies, Inc. 2007 Shiftwork Practices Report stated that 69% of 24/7 facilities cited moderate or severe fatigue problems, up from 61% in 2005. To cope, many shift workers resort to prescription and nonprescription drugs. They use sleeping pills, alcohol or barbiturates to sleep, and caffeine or stronger stimulants to stay awake. These drugs can become habit-forming, and can adversely affect sleep, work, and emotional well-being. Timing the use of stimulants and sleep aids can be difficult, especially when working rotating shifts. This can add to the risk of causing a motor vehicle accident.
A study, conducted by the Virginia Tech Transportation Institute and NHSTA) and released in April 2006, found that almost 80 % of crashes and 65 % of near-crashes involved some form of driver inattention within three seconds of the event. The new study found that the most common distraction is the use of cell phones, followed by drowsiness.3
A survey of dangerous driver behavior released in January 2007 by Nationwide Mutual Insurance Co found that 73 % of drivers talk on cell phones while driving; cell phone use was highest among younger drivers. The survey found that 19 % of motorists say they text message while driving. At least one study has found that driving and talking on a cell phone at the same time quadruples the risk of crashing.
The April 2006 study found, however, that cell phone use is far less likely to be the cause of a crash or near-miss than other distractions. Reaching for a moving object, such as a falling cup, increased the risk of a crash or near-crash by 9 times, while talking or listening on a hand-held cell phone only increased the risk by 1.3 times. The study tracked the behavior of 241 drivers of 100 vehicles for more than one year.
Other research studies have also indicated that a substantial percentage of accidents are caused by driver distraction. According to a study conducted by the Virginia Department of Motor Vehicles (DMV) and Virginia Commonwealth University (VCU), rubbernecking (slowing down to look at another accident) caused the most accidents: 16 % of all distraction-related crashes. Other distractions resulting in crashes include:
• Driver fatigue – 12%
• Looking at scenery – 10%
• Other passengers or children – 9%
• Adjusting the radio, cassette or CD player – 7%
• Reading (e.g., newspaper, books, maps) – 2 %
Speed is also a significant contributor to collisions. Higher speed increases the risk of serious injury or death in a crash. Increasing speed increases the severity of the crash because the impact is so much greater. In 2003, 31% or 13,380 motor vehicle fatalities were a direct result of excessive speed.
Road rage or aggressive driving is a significant factor as well. NHTSA says about 66 % of all traffic fatalities annually are caused by aggressive driving behaviors, such as passing on the right, running red lights, aggressive tailgating, rude gestures, verbal abuse and physical assault.
Alcohol is a factor in roughly 39 %of fatal motor vehicle accidents. Men are 4 times more likely than women to get involved in alcohol related driving accidents. According to NHTSA, 17,602 people died in alcohol-related crashes in 2006, the highest level since 1996 and up 0.1 % from 17,590 in 2005. Alcohol was involved in 41 % of all crash fatalities in 2006. The Federal Bureau of Investigation estimates that 1.5 million drivers were arrested for driving under the influence of alcohol or narcotics in 2006.
Drowsy driving is a significant contributor to motor vehicle accident rates. A report by the National Sleep Foundation published in November 2007 documents that 100,000 police-reported crashes, 71,000 injuries, and 1,550 deaths occur due to drowsy driving each year in the United States. Most likely these statistics significantly underestimate the problem due to the lack of accurate and consistent data collection by police officers. This report found all states now address fatigue and/or sleep in some manner within their crash report forms but these codes are inconsistent. It also found that police officers are not being adequately trained on how fatigue affects driving performance. Also, there is a lack of enforcement for the worst offenders.
In the National Sleep Foundation’s 2005 Sleep in America poll, 60% of adult drivers – about 168 million people – said they had driven a vehicle while drowsy in the past year. More than one-third (37% or 103 million people) have actually fallen asleep at the wheel! Of those who have nodded off, 13% say they have done so at least once a month. Four %– approximately eleven million drivers – admit they have had an accident or near accident because they dozed off or were too tired to drive.
People with sleep apnea are at double the risk of being in a car accident when driving, a new study by Vancouver Coastal Health Research Institute and University of British Columbia Respirologists finds. The study reports that patients with sleep apnea are 3 to 5 times more likely to be in a serious car crash involving personal injury. Even patients with fairly mild sleep apnea had an increased risk of serious crashes.
Men are 70% more likely to be involved in a fatal collision than women; as many as 73% of the people who die are men. Part of the reason for this may be that men drive more than women, up to 65% more. Also, some researchers cite hormones related to aggressiveness as the reason, while others attribute it to increased alcohol use by men while driving.
The shift work population is getting older, so age should be considered when assessing the workforce for risk of driving accidents. A recent review of motor vehicle deaths in Canada showed that among seniors, the rate of death from a motor vehicle accident from 2000 through 2004 was 13.2 per 100,000 population. This was higher than the national rate of 9.0 per 100,000 for the total population and second only to the rate for 15 to 24 year olds. As pedestrians, seniors were vulnerable too. From 2000 through 2004, 1,746 pedestrians died in accidents involving motor vehicles; over one-third of them (636) were 65 or older. The average annual death rate among seniors from this cause was over 3 per 100,000 population, significantly higher than the rate for any other age group.4
Many people continue to be good, safe drivers as they get older. But there are changes that can affect driving skills as we age. Older bodies are stiffer and muscles are weaker. It can be harder to turn to look backwards, turn the steering wheel or safely hit the brakes. Eyesight and hearing change, too. Peripheral vision may become narrower. Vision problems from eye diseases such as cataracts, macular degeneration or glaucoma can also affect driving ability. Reflexes get slower; attention spans may shorten.
Some older people have conditions like Alzheimer’s disease that change their thinking and behavior; they may forget familiar routes or even how to drive safely. And, while health problems can affect driving at any age, some occur more often at older ages. For example, arthritis, Parkinson’s disease, and diabetes may make it harder to drive. The effects of a stroke can cause driving problems. Devices such as an automatic defibrillator or pacemaker might cause an irregular heartbeat or dizziness, which can make driving dangerous.
Decreasing the Risks of Motor Vehicle Accidents When Working Shifts
There are some things that workers and employers can do to decrease the risks:
Employees:
• Get enough sleep
• Get screened for sleep apnea if you are concerned you may have it
• Minimize the use of prescription and nonprescription drugs, stimulants and sleep aids
• Minimize alcohol intake
• Always use a seatbelt
• Minimize the use of cell phones and two way radios while driving
• Obey all traffic laws
• If drowsy, pull over and take a rest
• Make sure you are trained to use any specialized motor vehicles you are driving
• Make sure the equipment is in good condition
Employers:
• Design and enforce a comprehensive driver safety policy
• Enforce mandatory seat belt use
• Do not require workers to drive irregular hours or far beyond their normal working hours
• Do not require workers to conduct business on a cell phone while driving
• Develop work schedules that allow employees to obey speed limits and to follow applicable hours-of-service regulations
• Check driving records of prospective employees and perform periodic rechecks after hiring
• Maintain complete and accurate records of workers’ driving performance
• Teach workers strategies for recognizing and managing driver fatigue and driving distractions
• Provide training to workers operating specialized motor vehicles or equipment
• Make sure equipment is in good working order and passes inspection
• Emphasize the need to follow safe driving practices on and off the job to workers
Other Relevant Information
1. Suggested Reading: Traffic- Why We Drive the Way We Do by Tom Vanderbilt (July, 2008) http://tomvanderbilt.com/traffic/the-book/
This is an entertaining book that looks at the physical, technical and emotional aspects of traffic: why it occurs, how we deal with it and what we can do about it. Tom Vanderbilt writes about design, technology, science and culture for Wired, Slate, The New York Times and other publications. He lives in Brooklyn, NY.
2. The National Sleep Foundations’ Drowsy Driving Week will be November 10-16, 2008.
————————
1 Motor Vehicle Traffic Crashes Leading Cause of Death in the United States, 2005
In 2005, motor vehicle traffic Crashes were the leading cause of death for ages 4 through 34 http://www.nhtsa.dot.gov/portal/nhtsa_static_file_downloader.jsp?file=/staticfiles/DOT/NHTSA/NCSA/Content/RNotes/2008/810936.pdf
2 Circadian Information LLC, Health in Extended Hours Operations
3 The 100-Car Naturalistic Driving Study
4 Motor vehicle accident deaths, 1979 to 2004,” published in “Health Reports” by the Health Information and Research Division (HIRD) of Statistics Canada
©2008workingnights
This material is provided for personal, non-commercial, educational and informational purposes only and does not constitute a recommendation or endorsement
Tags: death, drugs, fatigue, napping, sleep, Working Nights
