Working environment and fatigue among fishers in the north Atlantic: a field study.

BACKGROUND: This study investigates how Faroese deep-sea fishers' exposure to work-related stressors affects their sleep, sleepiness, and levels of fatigue. Being constantly exposed to the unpredictable and harsh North Atlantic Ocean, having long work hours and split sleep for up to 40 days consecutively, they will arguably suffer from fatigue. MATERIALS AND METHODS: One hundred and fifty seven fishers participated in this study, and data was gathered throughout 202 days at sea. Subjective data was collected at the start and end of trips via questionnaires, sleep and sleepiness diaries and supplemented by objective sleep data through actigraphs. Ship movements were logged with a gyroscope connected to a laptop. A noise metre measured each work station and resting area, and noise exposure profiles were calculated based on each participant's activity and location. Linear mixed-effect models investigated the effects of work exposure variables on sleep efficiency, and cumulative link mixed models measured effects on the Karolinska Sleepiness Scale and physical fatigue scale. RESULTS: Time of day followed by ship movement were the exposure variables with the highest impact on the outcome variables of sleep efficiency, sleepiness and physical fatigue. The number of days at sea revealed correlations to outcome variables either by itself or interacting with the sleep periods per day. Crew size, shift system or noise did not impact outcome variables when in the model with other variables. Larger catches improved sleep efficiency but did not affect sleepiness and physical fatigue ratings. CONCLUSIONS: The findings indicate a chronically fatigued fisher population, and recommends urgent attention being paid to improving the structure of vessels and installing stabilators for greater stability at sea; work schedules being evaluated for protection of health; and work environments being designed that fulfill human physiological requirements in order to ensure the wellbeing and safety of those at sea.

Impact of work exposure on cognitive performance in Faroese deep-sea fishers: a field study.

BACKGROUND: This study examines the impact of work-related exposure on the cognitive performance of Faroese deep-sea fishers. Faroese fishing crews work long hours in demanding and noisy environments amidst highly uncertain and challenging weather conditions. These factors, together with compromised patterns of rest and sleep, are known to increase fatigue. Our aim was to study if changes could be measured in fishers' cognitive performance at the end of the trip when compared with the baseline measure at the beginning. MATERIALS AND METHODS: Data was collected over 15 months (May 2017 to July 2018) from 157 fishers on 18 fishing trips which involved 202 investigative days on board. Questionnaires and six computerised cognitive tests: Simple Reaction Time, Numeric Working Memory, Corsi Blocks, Rapid Visual Information Processing, Digit Vigilance, and Card Sorting Test were used for data collection at the beginning and end of the trip. Differences between the outcomes on the two test points were analysed with one-way ANOVA comparing the performances at the beginning and end of the voyage, and two-way ANOVA to examine the interactive effect of chronotype and test occasions on the outcomes. Mixed models were used to test for the effects of predictor variables. RESULTS: Significant declines in cognitive performance were observed from the beginning to the end of the trip, with decreases in visuospatial memory and reaction times, and increases in cognitive lapses. Furthermore, slowing in response times was observed in the second half of the Digit Vigilance test when comparing the halves. CONCLUSIONS: Declines in performance were observed from the start to the end of the trip. Furthermore, fishers performed significantly worse in the second half of some parted tests, and evening types seem less influenced by irregular work hours. These findings call for improving the safety of the vessels and their crew.

Sleep, Sleepiness, and Fatigue on Board Faroese Fishing Vessels.

Purpose: Faroese fishers have four times more accidents than workers on land. The aim was to understand fishers' fatigue better and how their work and sleep patterns influenced their sleepiness levels and cognitive performance. Materials and Methods: A total of 157 Faroese fishers wore wrist-worn actigraphs at sea and one week on land and filled in sleep and sleepiness diaries during the trip. Furthermore, a 3-minute simple reaction time (SRT) test was completed at the beginning and end of the trip. The ship's movement and noise were also logged. The actiwatch results were analysed with mixed methods repeated measures. The sleepiness registrations and performance on the SRT-test were analysed with paired t-test. The ship movements (Pitch and roll) were divided into approximately three same-sized groups (lowest 1/3, medium 1/3, and highest 1/3) and compared against the Karolinska Sleepiness Scores (KSS ranging from 1-9) ≥7 and physical tiredness (ranging from 1-9) scores ≥7. Chi-square tests were used to determine the significance of these differences. Mean sleepiness scores at sea, and the proportion of sleepiness scores ≥7 were calculated, as well as sleepiness scores as a function of the time of day. Results: While at sea, fishers had more split sleep, slept less, and had lower sleep efficiency than onshore. Sleepiness was higher at the end of the trip, and cognitive decline was found. The number of major lapses was higher at the end of the trip, but with no significant difference between the median reaction times. Conclusion: The crew on-board the freezer longliner, who worked 8-8 shifts, slept the most, had the longest continuous sleep periods, the highest sleep efficiency, the lowest sleepiness levels, and the highest noise exposure during their time off.

Physiological and autonomic stress responses after prolonged sleep restriction and subsequent recovery sleep in healthy young men.

PURPOSE: Sleep restriction is increasingly common and associated with the development of health problems. We investigated how the neuroendocrine stress systems respond to prolonged sleep restriction and subsequent recovery sleep in healthy young men. METHODS: After two baseline (BL) nights of 8 h time in bed (TIB), TIB was restricted to 4 h per night for five nights (sleep restriction, SR, n = 15), followed by three recovery nights (REC) of 8 h TIB, representing a busy workweek and a recovery weekend. The control group (n = 8) had 8 h TIB throughout the experiment. A variety of autonomic cardiovascular parameters, together with salivary neuropeptide Y (NPY) and cortisol levels, were assessed. RESULTS: In the control group, none of the parameters changed. In the experimental group, heart rate increased from 60 ± 1.8 beats per minute (bpm) at BL, to 63 ± 1.1 bpm after SR and further to 65 ± 1.8 bpm after REC. In addition, whole day low-frequency to-high frequency (LF/HF) power ratio of heart rate variability increased from 4.6 ± 0.4 at BL to 6.0 ± 0.6 after SR. Other parameters, including salivary NPY and cortisol levels, remained unaffected. CONCLUSIONS: Increased heart rate and LF/HF power ratio are early signs of an increased sympathetic activity after prolonged sleep restriction. To reliably interpret the clinical significance of these early signs of physiological stress, a follow-up study would be needed to evaluate if the stress responses escalate and lead to more unfavourable reactions, such as elevated blood pressure and a subsequent elevated risk for cardiovascular health problems.

Seafarer fatigue: a review of risk factors, consequences for seafarers' health and safety and options for mitigation.

BACKGROUND: The consequences of fatigue for the health and safety of seafarers has caused concern in the industry and among academics, and indicates the importance of further research into risk factors and preventive interventions at sea. This review gives an overview of the key issues relating to seafarer fatigue. MATERIALS AND METHODS: A literature study was conducted aiming to collect publications that address risk factors for fatigue, short-term and long-term consequences for health and safety, and options for fatigue mitigation at sea. Due to the limited number of publications that deals with seafarers, experiences from other populations sharing the same exposures (e.g. shift work) were also included when appropriate. RESULTS: Work at sea involves multiple risk factors for fatigue, which in addition to acute effects (e.g., impaired cognition, accidents) contributes through autonomic, immunologic and metabolic pathways to the development of chronic diseases that are particularly prevalent in seafarers. CONCLUSIONS: Taking into account the frequency of seafarer fatigue and the severity of its consequences, one should look into the efficacy of the current legislative framework and the industry's compliance, the manning of the international merchant fleet, and optimised working, living and sleeping conditions at sea. Considering circumstances at sea, e.g. working in shifts and crossing time zones, that cannot be altered, further assessment of the potentials of preventive interventions including fatigue prediction tools and individual fatigue mitigation management systems is recommended.

Partial sleep restriction activates immune response-related gene expression pathways: experimental and epidemiological studies in humans.

Epidemiological studies have shown that short or insufficient sleep is associated with increased risk for metabolic diseases and mortality. To elucidate mechanisms behind this connection, we aimed to identify genes and pathways affected by experimentally induced, partial sleep restriction and to verify their connection to insufficient sleep at population level. The experimental design simulated sleep restriction during a working week: sleep of healthy men (N = 9) was restricted to 4 h/night for five nights. The control subjects (N = 4) spent 8 h/night in bed. Leukocyte RNA expression was analyzed at baseline, after sleep restriction, and after recovery using whole genome microarrays complemented with pathway and transcription factor analysis. Expression levels of the ten most up-regulated and ten most down-regulated transcripts were correlated with subjective assessment of insufficient sleep in a population cohort (N = 472). Experimental sleep restriction altered the expression of 117 genes. Eight of the 25 most up-regulated transcripts were related to immune function. Accordingly, fifteen of the 25 most up-regulated Gene Ontology pathways were also related to immune function, including those for B cell activation, interleukin 8 production, and NF-κB signaling (P<0.005). Of the ten most up-regulated genes, expression of STX16 correlated negatively with self-reported insufficient sleep in a population sample, while three other genes showed tendency for positive correlation. Of the ten most down-regulated genes, TBX21 and LGR6 correlated negatively and TGFBR3 positively with insufficient sleep. Partial sleep restriction affects the regulation of signaling pathways related to the immune system. Some of these changes appear to be long-lasting and may at least partly explain how prolonged sleep restriction can contribute to inflammation-associated pathological states, such as cardiometabolic diseases.

Sleep, sleepiness, and neurobehavioral performance while on watch in a simulated 4 hours on/8 hours off maritime watch system.

Seafarer sleepiness jeopardizes safety at sea and has been documented as a direct or contributing factor in many maritime accidents. This study investigates sleep, sleepiness, and neurobehavioral performance in a simulated 4 h on/8 h off watch system as well as the effects of a single free watch disturbance, simulating a condition of overtime work, resulting in 16 h of work in a row and a missed sleep opportunity. Thirty bridge officers (age 30 ± 6 yrs; 29 men) participated in bridge simulator trials on an identical 1-wk voyage in the North Sea and English Channel. The three watch teams started respectively with the 00-04, the 04-08, and the 08-12 watches. Participants rated their sleepiness every hour (Karolinska Sleepiness Scale [KSS]) and carried out a 5-min psychomotor vigilance test (PVT) test at the start and end of every watch. Polysomnography (PSG) was recorded during 6 watches in the first and the second half of the week. KSS was higher during the first (mean ± SD: 4.0 ± 0.2) compared with the second (3.3 ± 0.2) watch of the day (p < 0.001). In addition, it increased with hours on watch (p < 0.001), peaking at the end of watch (4.1 ± 0.2). The free watch disturbance increased KSS profoundly (p < 0.001): from 4.2 ± 0.2 to 6.5 ± 0.3. PVT reaction times were slower during the first (290 ± 6 ms) compared with the second (280 ± 6 ms) watch of the day (p < 0.001) as well as at the end of the watch (289 ± 6 ms) compared with the start (281 ± 6 ms; p = 0.001). The free watch disturbance increased reaction times (p < 0.001) from 283 ± 5 to 306 ± 7 ms. Similar effects were observed for PVT lapses. One third of all participants slept during at least one of the PSG watches. Sleep on watch was most abundant in the team working 00-04 and it increased following the free watch disturbance. This study reveals that-within a 4 h on/8 h off shift system-subjective and objective sleepiness peak during the night and early morning watches, coinciding with a time frame in which relatively many maritime accidents occur. In addition, we showed that overtime work strongly increases sleepiness. Finally, a striking amount of participants fell asleep while on duty.

Prolonged sleep restriction affects glucose metabolism in healthy young men.

This study identifies the effects of sleep restriction and subsequent recovery sleep on glucose homeostasis, serum leptin levels, and feelings of subjective satiety. Twenty-three healthy young men were allocated to a control group (CON) or an experimental (EXP) group. After two nights of 8 h in bed (baseline, BL), EXP spent 4 h in bed for five days (sleep restriction, SR), followed by two nights of 8 h (recovery, REC). CON spent 8 h in bed throughout the study. Blood samples were taken after the BL, SR, and REC period. In EXP, insulin and insulin-to-glucose ratio increased after SR. IGF-1 levels increased after REC. Leptin levels were elevated after both SR and REC; subjective satiety remained unaffected. No changes were observed in CON. The observed increase of serum IGF-1 and insulin-to-glucose ratio indicates that sleep restriction may result in an increased risk to develop type 2 diabetes.

Sleep restriction increases the risk of developing cardiovascular diseases by augmenting proinflammatory responses through IL-17 and CRP.

BACKGROUND: Sleep restriction, leading to deprivation of sleep, is common in modern 24-h societies and is associated with the development of health problems including cardiovascular diseases. Our objective was to investigate the immunological effects of prolonged sleep restriction and subsequent recovery sleep, by simulating a working week and following recovery weekend in a laboratory environment. METHODS AND FINDINGS: After 2 baseline nights of 8 hours time in bed (TIB), 13 healthy young men had only 4 hours TIB per night for 5 nights, followed by 2 recovery nights with 8 hours TIB. 6 control subjects had 8 hours TIB per night throughout the experiment. Heart rate, blood pressure, salivary cortisol and serum C-reactive protein (CRP) were measured after the baseline (BL), sleep restriction (SR) and recovery (REC) period. Peripheral blood mononuclear cells (PBMC) were collected at these time points, counted and stimulated with PHA. Cell proliferation was analyzed by thymidine incorporation and cytokine production by ELISA and RT-PCR. CRP was increased after SR (145% of BL; p<0.05), and continued to increase after REC (231% of BL; p<0.05). Heart rate was increased after REC (108% of BL; p<0.05). The amount of circulating NK-cells decreased (65% of BL; p<0.005) and the amount of B-cells increased (121% of BL; p<0.005) after SR, but these cell numbers recovered almost completely during REC. Proliferation of stimulated PBMC increased after SR (233% of BL; p<0.05), accompanied by increased production of IL-1beta (137% of BL; p<0.05), IL-6 (163% of BL; p<0.05) and IL-17 (138% of BL; p<0.05) at mRNA level. After REC, IL-17 was still increased at the protein level (119% of BL; p<0.05). CONCLUSIONS: 5 nights of sleep restriction increased lymphocyte activation and the production of proinflammatory cytokines including IL-1beta IL-6 and IL-17; they remained elevated after 2 nights of recovery sleep, accompanied by increased heart rate and serum CRP, 2 important risk factors for cardiovascular diseases. Therefore, long-term sleep restriction may lead to persistent changes in the immune system and the increased production of IL-17 together with CRP may increase the risk of developing cardiovascular diseases.

The multi-source interference task: the effect of randomization.

Recently a novel interference task was developed, that was aimed at obtaining robust patterns of interference in individual subjects, both behaviorally and neurophysiologically (Bush, Shin, Holmes, Rosen & Vogt, 2003). This multi-source interference task (MSIT) combined elements of spatial and flanker interference, and huge interference effects were obtained in a blocked design. This task could thus in principle be used to assess frontal abnormalities, such as ADHD. In the present study, we further examined the nature of the MSIT. We examined the effect of randomization, and the relative contribution of each type of interference. Using a group of healthy subjects, we found a much smaller interference effect than Bush et al. (2003). In addition, we found that most of the interference could be ascribed to flanker interference, and much less to spatial interference. It seems to be the case that there is a trade-off between obtaining robust and reliable effects, and isolating a specific psychological process.