Fatigue and on-duty injury among police officers: The BCOPS study

IntroductionPolicing involves inherent physical and psychological dangers as well as occupational stressors that could lead to chronic fatigue. Although accounts of adverse events associated with police fatigue are not scarce, literature on the association between chronic fatigue and on-duty injury are limited. Methods: Participants were officers from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study. A 10-item questionnaire was administered to assess how tired or energetic the officers generally felt irrespective of sleep hours or workload. The questionnaire consisted of five positively worded and five negatively phrased items that measured feelings of vigor/energy and tiredness, respectively. Total as well as separate scores for positive and negative items were computed by summing scores of individual items. Payroll records documenting each officer's work history were used to assess occurrence of injury. Poisson regression was used to estimate prevalence ratios (PR) of injury. Results: Nearly 40% of officers reported feeling drained. Overall prevalence of on-duty injury during the past year was 23.9%. Injury prevalence showed a significant increasing trend across tertiles of total fatigue score: 19.6, 21.7, and 30.8% for lowest, middle and highest tertiles, respectively (trend p-value = 0.037). After controlling for potential confounders, a 5-unit increase in total fatigue score was associated with a 12% increase in prevalence of injury which was marginally significant (p = 0.075). A 5-unit increase in fatigue score of the positively worded items was associated with a 33% increase in prevalence of injury (PR = 1.33, 95% CI: 1.04–1.70, p = 0.022). Conclusion: Officers who do not feel active, full of vigor, alert, or lively had a significantly higher prevalence of non-fatal work place injury compared to their counter parts. Practical applications: With additional prospective evidence, workplace interventions designed to enhance level of energy may reduce feelings of tiredness and hence may prevent workplace injury.     

Fatigued driver’s driving behavior and cognitive task performance: Effects of road environments and road environment changes

This study aims to explore the effects of different road environments and their changes on driving behaviors and cognitive task performance of fatigued drivers. Twenty-four participants volunteered in a 2 (road environment) × 3 (fatigue level) within-subjects factorial design simulated driving experiment. Participants were asked to perform basic numerical calculation and distance estimation of traffic signs when driving normally, and provide answers to a questionnaire on fatigue rating. Results show that fatigued drivers faced greater attention demand, were less alert, and tended to overestimate the distance to roadside traffic signs. Fatigue caused by driving in complex road environment had the greatest negative impact on driving behavior and visual distance estimation, and the fatigue transfer effect worsened significantly but differently on both driving behavior and performance of fatigued drivers when switching from a complex to a monotonous road environment and vice versa. Notably, this study shows that fatigued drivers performed relatively better in arithmetic tasks than non-fatigued ones. In addition, when switching from a monotonous to a complex road environment, drivers’ performance in visual distance estimation and arithmetic tasks improved though their driving behavior deteriorated, revealing that the fatigue effect upon drivers might be explained to some extent by their alertness and arousal levels.     

Healthcare utilization and costs among older adult female drivers and former drivers

PurposeThis study compared the healthcare utilization and costs for specific types of medical services among older adult women who currently drive and those who no longer drive.MethodsThis study included 347 women aged 65 or older who were either former (had stopped driving) or current drivers, randomly sampled from a large U.S. health plan to participate in a telephone survey, and who had automated health records with healthcare utilization and cost data. Bivariate analyses and generalized linear modeling were used to examine associations between driving status and healthcare utilization and costs.ResultsAdjusting for age, income, and marital status, former drivers were more likely than current drivers to use mental health care services (RR = 3.37; 95% CI: 1.03, 10.98). Former drivers also tended to use more inpatient (RR = 1.85; 95% CI: 0.88, 3.87) and emergency services (RR = 1.89; 95% CI: 0.96, 3.70), but results did not reach statistical significance. Total annual healthcare costs in 2005 were almost twice as high for former drivers compared with current drivers ($13,046 vs. $7,054; mean difference = $5,992; 95% CI: -$360, $12,344), although this relationship was not statistically significant (CR = 1.61; 95% CI: 0.88, 2.96).Impact on IndustryFormer drivers were more than three times as likely as current drivers to use mental health services, and tended to use more emergency and inpatient services. Further research on factors that potentially mediate the relationship between driving status and health service use is warranted.     

Using a cluster randomized controlled trial to determine the effects of intervention of battery and hardwired smoke alarms in New South Wales,Australia: Home fire safety checks pilot program

IntroductionIn 2014, Fire & Rescue New South Wales piloted the delivery of its home fire safety checks program (HFSC) aimed at engaging and educating targeted top “at risk” groups to prevent and prepare for fire. This pilot study aimed to assess the effectiveness of smoke alarms using a cluster randomized controlled trial.MethodsSurvey questionnaires were distributed to the households that had participated in the HFSC program (intervention group). A separate survey questionnaire was distributed to the control group that was identified with similar characteristics to the intervention group in the same suburb. To adjust for potential clustering effects, generalized estimation equations with a log link were used.ResultsMultivariable analyses revealed that battery and hardwired smoking alarm usage increased by 9% and 3% respectively among the intervention group compared to the control group. Females were more likely to install battery smoke alarms than males. Respondents who possessed a certificate or diploma (AOR = 1.31, 95% CI 1.00–1.70, P = 0.047) and those who were educated up to years 8–12 (AOR = 1.32, 95% CI 1.06–1.64, P = 0.012) were significantly more likely to install battery smoke alarms than those who completed bachelor degrees. Conversely, holders of a certificate or diploma and people who were educated up to years 8–12 were 31% (AOR = 0.69, 95% CI 0.52–0.93, P = 0.014) and 24% (AOR = 0.76, 95% CI 0.60–0.95, P = 0.015) significantly less likely to install a hardwired smoke alarm compared to those who completed bachelor degrees.ConclusionsThis pilot study provided evidence of the benefit of the HFSC in New South Wales. Practical Applications: Fire safety intervention programs, like HFSC, need to be targeted to male adults with lower level of schooling even when they are aware of their risks.     

Dropout during a driving simulator study: A survival analysis

IntroductionSimulator sickness is the occurrence of motion-sickness like symptoms that can occur during use of simulators and virtual reality technologies. This study investigated individual factors that contributed to simulator sickness and dropout while using a desktop driving simulator.MethodEighty-eight older adult drivers (mean age 72.82 ± 5.42 years) attempted a practice drive and two test drives. Participants also completed a battery of cognitive and visual assessments, provided information on their health and driving habits, and reported their experience of simulator sickness symptoms throughout the study.ResultsFifty-two participants dropped out before completing the driving tasks. A time-dependent Cox Proportional Hazards model showed that female gender (HR = 2.02), prior motion sickness history (HR = 2.22), and Mini-SSQ score (HR = 1.55) were associated with dropout. There were no differences between dropouts and completers on any of the cognitive abilities tests.ConclusionsOlder adults are a high-risk group for simulator sickness. Within this group, female gender and prior motion sickness history are related to simulator dropout. Higher reported experience of symptoms of simulator sickness increased rates of dropout.Practical applicationsThe results highlight the importance of screening and monitoring of participants in driving simulation studies. Older adults, females, and those with a prior history of motion sickness may be especially at risk.     

Assessing the impact of risk-taking behavior on road crash involvement among University students residing in two Mediterranean countries

Surveillance systems are indispensable for injury prevention; yet, detailed electronic records are rarely available. The “Student’s Health Card” is a self-reporting electronic tool addressing health issues of University students, while aiming to actively involve them in preventive practices and health promotion. Utilizing data from the injury prevention related section, this study sought to investigate the impact of risk-taking behavior on road crash involvement among University students residing in two Mediterranean countries. A total of 978 University students, 451 Greek and 527 Italian, provided information on prior road crash involvement, as well as on eight behavioral variables, comprising a risky behavior score. Multiple logistic regression analysis was performed. The already known tendency for clustering of risky behaviors was evident. One degree increment in the risky behavior score was found to increase the risk of road crash involvement by 35%. Driving after drinking (OR = 2.55, CI = 1.53–4.26), riding with a drunk driver (OR = 2.19, CI = 1.08–4.45) and tobacco smoking (OR = 1.95, CI = 1.18–3.22) significantly multiplied the risk. Despite their better compliance with safety measures, Italian students, compared with Greek, reported worse alcohol-related driving habits and engaged more frequently in mobile phone use while driving. Clustering of risky behaviors was found to be an important predictor of road crash involvement. Screening and awareness of risk-taking propensity of University students could guide early intervention. The “Student’s Health Card” could provide, at minimal cost, reliable risk-taking and road crash involvement information, which is needed for both personal risk assessment and surveillance purposes.     

Occupational stressors identified by small-scale,independent commercial crab pot fishermen

IntroductionWe interviewed fishermen to identify jobs and/or tasks of concern in order to guide and inform current ergonomic interventions.MethodsWe administered surveys to two groups of southeastern US commercial crab fishermen: a cohort contacted by telephone and fishermen recruited at 11 local fish houses. Fishermen were asked to rate physical stress of selected work tasks and conditions on a scale from 0 (no problem) to 10 (major problem). Fishermen were also asked open-ended questions about other work-issues of concern.ResultsFishermen who completed the survey (n = 91) were predominantly male (90%), white (96%), and over 40 years of age (71%). The five most physically strenuous tasks and conditions as rated by fishermen were pulling pots by hand (mean 6.4), rough weather (6.1) or rough water (6.2), unloading without mechanical assistance (5.8), and long work days (5.3). Task stress ratings with the most variability measured by the inter-quartile range (IQR) included: pulling pots by hand (IQR = 5), unloading without mechanical assistance (IQR = 5), gear maintenance (IQR = 4.5), and moving boxes and baskets on board (IQR = 4.5). Other situations that fishermen identified as a problem included: economic, off-shore work, declining industry, mental stress, environment, regulation, conflict with other commercial or recreational fishermen, issues with crew, sun (glare or burn), and breaking up frozen bait.ConclusionsIn general, stressful tasks identified from previous research were rated similarly by the fishermen surveyed. Development and testing of ergonomic interventions is ongoing.     

Effects of applied voltage on hydrogen production rate of a single reactor BML with Clostridium sp.

This study aimed to explore the influences of single-chamber systems with different applied voltage on bio-hydrogen (H₂) production. The reactor used was the bio-electrochemically assisted microbial reactor (BEAMR) membrane-less (BEAMR-membrane-less, BML). The microbial dark fermentative H₂ production method was adopted. After the hot screening process and the DNA sequencing, the domesticated dominant microflora was Clostridium sp. This study discussed the influences of the cases with (continuous and intermittent) and without applied voltage separately. The results showed that, the H₂ production rate of the case with intermittent applied voltage (117 mL/h g VSS) of 0.24 V was increased of 1.7 folds higher than the without applied voltage (69 mL/h g VSS) and 1.3 folds higher than the case with continuous applied voltage (88.2 mL/h g VSS) of 0.24 V. The produced H₂ concentration with intermittent applied voltage was 18.9% (18.6–19.1%) higher than the without applied voltage, while there was no significant difference with continuous applied voltage.     

Fate of trace tetracycline with resistant bacteria and resistance genes in an improved AAO wastewater treatment plant

The fate of trace tetracycline, tetracycline resistant bacteria (TRB) and tetracycline resistant genes (TRGs) in an improved anaerobic-anoxic-oxic (AAO) wastewater treatment plant (WWTP) was investigated in this study. Quantitative real-time polymerase chain reaction (qPCR) and conventional heterotrophic plate count method were used to measure eight tet genes (tetA, tetB, tetC, tetE, tetM, tetO, tetS and tetX) and TRB, respectively. The TRB percent of total heterotrophic bacteria (THB) is about 1.31–24.1% in WWTP influent. Tet gene abundance in the WWTP varied greatly among the gene types. The concentrations of TRGs in effluent samples ranged from 7.11 × 10⁻⁹ to 1.53 × 10⁻⁴ copies/copy 16S rRNA gene. TRB and THB, tetM and tetO, tetE and tetX, but not the others, showed a significant correlation with each other (p < 0.01). The relationships between ribosomal protection protein genes, enzymatic modification gene and corresponding concentrations of antibiotics were found to be considerably significant (R² = 0.898, p < 0.01 for ribosomal protection protein genes and R² = 0.872, p < 0.05 for enzymatic modification gene).     

Participation in driver education/training courses during graduated driver licensing,and the effect of a time-discount on subsequent traffic offenses: Findings from the New Zealand Drivers Study

IntroductionThe New Zealand GDL includes a time-discount at the restricted license stage, for attendance at an approved driver education course. This is despite international evidence showing that earlier licensure associated with a time-discount can increase risk for newly licensed drivers.ObjectiveTo examine participation in driver education courses and especially those that qualify for a time-discount; compare the profiles of course participants with non-participants; examine reasons for participation; and examine the association between a time-discount and traffic offenses once fully licensed.MethodThis study was based on the New Zealand Drivers Study (NZDS), a prospective cohort study of newly licensed drivers. Data on driver education courses were obtained at the full license interview (n = 1763), driver license and traffic offense data from the NZ Driver Licence Registry, and other data at the NZDS interviews.Results94% had heard of and 49% (n = 868) participated in a defensive driving course (DDC). No other course had more than 1% participation. Compared with the others, the DDC group were young, non-Māori, and from an area of relatively low deprivation. Through GDL, the DDC group were relatively more compliant with the conditions, and less likely to crash or receive a traffic offense notice. The groups did not differ on personality, alcohol and drug use. The reason most (85%) attended a DDC was to get their full license sooner; 86% (n = 748) received a time-discount. The time-discount group were 40% more likely to receive a traffic offense notice on their full license; this reduced to 10% after controlling for other factors.Conclusion and practical implicationsThe results of this study, when viewed in conjunction with other NZ crash evidence, indicate that a time-discount should not be given for completing a DDC or Street Talk course.     

Removal of toluene vapour from air stream using a biofilter packed with polyurethane foam

Biodegradation of toluene vapour was investigated for 168 days in a polyurethane packed biofilter inoculated with a mixed microbial population. Biofilter consisted of five square cross-section modular units each of size 0.16 m × 0.16 m × 0.20 m and filled with the polyurethane foam cubes up to a height of 0.15 m. Inlet concentration of toluene was varied from 0.04 to 2.5 g m^?3 and the volumetric flow rate of toluene loaded air from 0.06 to 0.90 m³ h^?1.Depending upon initial loading rates, removal efficiency ranging from 68.2 to 99.9% and elimination capacity ranging from 10.85 to 90.48 g h^?1 m^?3 were observed during steady state operations. More than 90% removal efficiency was observed up to an inlet loading rate of 76.3 g h^?1 m^?3. High carbon recovery (>90%) indicated effective biodegradation in the bed. Low variation of pH (7.2–8.8) and pressure drop (45.8–76.3 Pa) was observed. The stability of the biomass was evident from the fast response of the biofilter to shutdown and restartup.     

Characterization of fall patients: Does age matter?

IntroductionEvaluating age-specific fall characteristics is important for prevention programs. The aim was to characterize fallers who presented to our trauma center. We hypothesized that fall characteristics and outcomes would vary with age.MethodsData were retrospectively collected from the trauma registry and electronic medical records during January 1st, 2014-December 31st, 2015. Data were analyzed by Chi-square test with Yates’ continuity correction and one-way ANOVA with Bonferroni’s multiple comparisons test.ResultsThere were 1541 fallers, 814 (52.8%) were male. Ages ranged from 11 months to 100 years. The admission rate was high at 86%, with an average hospital stay of 5.7 days. Patients in the 0-18 and 19-45 age groups spent significantly less time in the hospital (p < 0.0001). Elderly patients had the highest average injury severity score (p < 0.0001). However, the youngest patients required surgery more often (p = 0.0004). The overall mortality rate was 3.6% and 52.8% were male. The mortality rate increased with age, from 0% for the 0-18 age group to 6.9% for patients ≥ 65 years of age. Remarkably, fallers in the 19-45 and 46-64 age groups predominantly died from ground level falls even though the average fall height in these groups was the highest (p < 0.0001). More fallers in the 19-45 and 46-64 age groups tested positive for alcohol/drug use (p < 0.0001). Middle-aged and elderly patients were more likely to be discharged to a skilled nursing or rehabilitation facility compared to younger patients who were discharged home.Conclusions and practical applicationsFall characteristics and outcomes varied with age. Data on age-specific characteristics, outcomes, and risk factors of falls will help in developing targeted interventions and may lead to better approaches to treat patients.     

Slow eyelid closure as a measure of driver drowsiness and its relationship to performance

Objective: Slow eyelid closure is recognized as an indicator of sleepiness in sleep-deprived individuals, although automated ocular devices are not well validated. This study aimed to determine whether changes in eyelid closure are evident following acute sleep deprivation as assessed by an automated device and how ocular parameters relate to performance after sleep deprivation.

Methods: Twelve healthy professional drivers (45.58 ± 10.93 years) completed 2 randomized sessions: After a normal night of sleep and after 24 h of total sleep deprivation. Slow eye closure (PERCLOS) was measured while drivers performed a simulated driving task.

Results: Following sleep deprivation, drivers displayed significantly more eyelid closure (P < .05), greater variation in lane position (P < .01) and more attentional lapses (P < .05) compared to after normal sleep. PERCLOS was moderately associated with variability in both vigilance performance (r = 0.68, P < .05) and variation in lane position on the driving task (r = 0.61, P < .05).

Conclusions: Automated ocular measurement appears to be an effective means of detecting impairment due to sleep loss in the laboratory.     

Magnetophoretic separation of Chlorella sp.: Role of cationic polymer binder

Cationic polyelectrolyte promoted effective attachment of iron oxide nanoparticles (IONPs) onto microalgal cells through electrostatic attraction. Poly(diallyldimethylammonium chloride) (PDDA) and chitosan (ChiL), both are cationic polymer, are feasible to act as binding agent to promote rapid magnetophoretic separation of Chlorella sp. through low gradient magnetic separation (LGMS) with field gradient ▿B less than 80 T/m in real time. Cell separation efficiency up to 98% for the case of PDDA and 99% for the case of ChiL can be achieved in 6 min when 3 × 10⁷ cells/mL Chlorella sp. are exposed to 300 mg/L surface functionalized-IONPs (SF-IONPs). Different polyelectrolytes do not give significant effect on cell separation efficiency as long as the particle attachment occurred. However, the PDDA is more preferable as the binder for all type of microalgae medium than the chitosan (ChiL) since it is not pH dependent. SF-IONPs coated with PDDA guarantee the cell separation performance for all pH range of cell medium, with 98.21 ± 0.40% at pH 8.84. On the other hand, the ChiL performance will be affected by the cell medium pH, with only 22.93 ± 31.03% biomass recovery at pH 9.25.     

Effects of high ammonia loads on nitrogen mass balance and treatment performance of a biotrickling filter

A biotrickling filter packed with coal slag as packing medium was continuously used for more than 9 months under high ammonia loading rates of up to 140 g/m³/h. Nitrogen mass balance and microbial community analysis were conducted to evaluate the inhibitory effects of high ammonia concentration and metabolic by-products on the rates of nitrification. Ammonia removal efficiency reached above 99% at an empty bed retention time of as low as 8 s when inlet concentrations were below 350 ppm. The maximum and critical elimination capacities of the biotrickling filter were 118 g/m³/h and 108.1 g/m³/h, respectively. Kinetics analysis results showed that less than 2.5 s was required for the biotrickling filter with pH control to treat ammonia at concentrations of up to 500 ppm in compliance with the Taiwan EPA standard (outlet NH₃ < 1 ppm). Results of mass balance and microbial community analysis indicated that complete removal was mainly contributed by the activities of autotrophic ammonia oxidizing bacteria and not by physical absorption or adsorption at low loading rates. However, at high inlet loadings, ammonium became the dominant by-product due to inhibitory effects of high ammonia concentration on the bacterial community.     

Body Mass Index (BMI) as a first-line screening criterion for detection of excessive daytime sleepiness among professional drivers

OBJECTIVES: Obstructive sleep apnea (OSA) is the main predisposing factor of excessive daytime sleepiness (EDS), and, therefore, increases the risk of road crashes. However, it is difficult to rely on medical intake for OSA or fatigue since drivers' symptoms reports are not reliable. On the other hand, direct measurement of EDS among large numbers of drivers carries serious practical drawbacks. Obstructive sleep apnea, in turn, is strongly related to obesity, and elevated body mass index (BMI) is considered one of the major risk factors for OSA. Thus, it could be postulated that BMI may carry predictive value for EDS proneness. METHODS: The present study examined the interrelation between BMI, degree of OSA, as measured with Respiratory Distress Index (RDI), and the degree of EDS, as measured with the mean sleep onset latency in the Multiple Sleep Latency Test (MSLT) among obese (BMI = 32) professional drivers. The drivers went through polysomnography followed by the five sessions of MSLT in the next day. RESULTS: In accordance with prior studies, we have found strong correlation between BMI and the degree of OSA on the one hand, and between the degree of OSA and EDS on the other hand. OSA was detected among 77.7% of the drivers, 47.1% were sleepy, 19% had severe sleepiness [mean sleep latency [MSL < or = 5 min.], 28.1% had moderate sleepiness [MSL < or = 10 min.]. None of the drivers complained about any sleep problem, including snoring, and all reported that they do not experience excessive daytime sleepiness. Thus, there was no correlation between their subjective report and objective findings. CONCLUSIONS: Obese drivers with BMI above 32 are highly prone to be sleepy during the day. Their subjective reports of OSA or fatigue symptoms are not reliable. Therefore it is highly recommended to screen them easily by weight and height measure for further sleep study and decision about their driving abilities.     

Characterization of heavy metals in fly ash from municipal solid waste incinerators in Shanghai

This study aims to develop a methodology for analysis of characteristics of heavy metals in MSWI fly ash. It performed analysis of composition of heavy metals, leaching toxicity, leaching behavior as a function of pH, specification distribution and corresponding mineral components of residue derived from each step of the sequential extraction. It is found that content of heavy metals follows the sequence of Zn > Pb > Cu > Cr > As > Ni > Cd approximately Hg in both plants, and that total heavy metals account for less than 1% by mass of fly ash. Major hazardous heavy metals in fly ash are As, Cd, Hg, Pb and Zn, whose leaching ratios exceed the limit value described in hazardous waste identification standard. Measured leaching results of Cu, Pb and Zn are essentially consistent with the simulated results at pH between 0 and 13. Content of calcium-silicates, alumino-silicates and glass phases in residue derived from sequential extraction procedure increases steadily from the first step to the fifth step of the sequential extraction procedure. Cu, As, Cr, Hg, Cd, and Ni, relatively stable under strong basic conditions, can be leached out under strong acidic conditions, while Zn and Pb tend to be leached out under both strong acidic and basic conditions.     

Adult opinions about the age at which children can be left home alone, bathe alone, or bike alone: Second Injury Control and Risk Survey (ICARIS-2)

ProblemThis study describes adult opinions about child supervision during various activities.MethodsData come from a survey of U.S. adults. Respondents were asked the minimum age a child could safely: stay home alone; bathe alone; or ride a bike alone. Respondents with children were asked if their child had ever been allowed to: play outside alone; play in a room at home for more than 10 minutes alone; bathe with another child; or bathe alone.ResultsThe mean age that adults believed a child could be home alone was 13.0 years (95% CI = 12.9-13.1), bathe alone was 7.5 years (95% CI = 7.4-7.6), or bike alone was 10.1 years (95% CI = 10.0-10.3). There were significant differences by income, education, and race.DiscussionAssessing adult's understanding of the appropriate age for independent action helps set a context for providing guidance on parental supervision. Guidelines for parents should acknowledge social norms and child development stages.Impact on IndustryKnowledge of social norms can help guide injury prevention messages for parents.     

Shift schedules on North Sea oil/gas installations: A systematic review of their impact on performance,safety and health

Continuous production processes on North Sea installations necessitate extended work schedules; 2-week offshore tours (alternating with shore breaks), 12 h shifts and rapid day/night shift changes are inherent features of offshore work. These intensive rosters, worked in a demanding physical and psychosocial environment, are potential sources of fatigue and impaired performance among offshore personnel. This article focuses on offshore working time arrangements, and presents a systematic review of studies which examine offshore day/night shift patterns in relation to operational safety and individual health risks. Of the 53 studies retrieved, 24 met the review criteria.Field study findings are generally consistent in showing that sleep, alertness and performance are relatively stable across day-shift tours; initial night shifts are adversely affected by circadian disruption, but full physiological and psychological adaptation occurs within 5–6 days; re-adaptation to day shifts is slower, and varies widely across individuals; the offshore environment is conducive to night-shift adaptation, but interventions to facilitate re-adaptation have proved only modestly effective. Analyses of survey data and accident/sickness records identify offshore night work as a risk factor for impaired sleep, health problems, and injuries, but little is known about the long-term health effects of different offshore shift rotations.In conclusion, research methodology and findings, and working time issues of current concern to the offshore oil/gas industry, are discussed. Aspects of offshore work schedules that have been not been widely studied (e.g. overtime, irregular work patterns) are also highlighted, and research areas that would merit further attention are noted.