Paramedics and the effects of shift work on sleep: a literature review.

INTRODUCTION This paper investigates the literature regarding the impact of shift work on prehospital emergency providers. While the issue of shift work has been thoroughly investigated in other health disciplines, this is not the case for the paramedic discipline, particularly in the Australian context. OBJECTIVE To identify the literature available on prehospital providers regarding the effects of shift work on sleep. METHOD Electronic databases used were the Cochrane Database of Systematic Reviews, Ovid MEDLINE, Proquest, AMED and CINAHL. The following MeSH terms and keywords with truncation were used in the search strategy: 'shift work'; 'sleep disorder'; 'sleep deprivation'; 'circadian rhythm'; 'fatigue'; 'occupational stress'. RESULTS The electronic databases cited 226 articles, of which nine met the inclusion criteria with another three articles sourced from references in the retrieved papers. There is a lack of literature describing the effect of shift work on sleep in the prehospital arena, with only one paper exploring paramedics in the Australian setting. These findings suggest that further work is required to examine shift hours and workforce health and safety in the prehospital setting. CONCLUSIONS Shift work can affect health and well-being on a variety of levels, both physiologically and psychologically, affecting aspects of work and personal life. Further research is warranted to prevent the issues of patient safety, work-related fatigue and the cumulative effects of shift work.