SWIFT: Shiftwork in Firefighters

A natural experiment to assess the impact of work schedules on sleep, health, and safety in firefighters

Swift Logo: Shiftwork in Firefighters

Over 1.1 million firefighters in the United States play a vital role in their communities working to suppress fires and provide emergency and rescue services. The increased urbanization in the United States over the last 70 years, in conjunction with the growing number of houseless residents and the opiate epidemic, has resulted in four-times the number of calls to fire departments in the last 20 years. Yet, fire departments have remained relatively the same size. Consequently, firefighters experience low-quality sleep that is associated with a 4-fold increased risk of accidents and may also increase their risk for cardiovascular disease and poorer mental health. Furthermore, firefighters also struggle to balance family and social obligations that are often at odds with the need to sleep during days off. As a means to improve firefighter moral and provide additional consecutive days off-shift, a number of stations across the country have switched from a 24/48 (hour on/hour off) to either a 48/96 or a 24/72/48/72 (also referred to as a 1/3/2/3 with day on/days off/days on/days off) schedule.

This study project will provide comprehensive data, from firefighters and their families in order to systematically examine the impact of the 24/48 vs. the 1/3/2/3 schedules through:
    •    Continuous ambulatory assessment of sleep and activity and measures of cardiovascular disease risk when on-shift at the
          fire station and when off-shift at home
    •    Biological assessment of stress load and cardiovascular health
    •    Objective measures of mental/physical health, life satisfaction, and emotional distress
    •    Daily assessments of alertness at the fire station and at home
    •    Measurements of nonwork recovery experiences, namely psychological detachment and relaxation
    •    Measurements of psychosocial and family dynamics via partner participation
    •    Self-reported workplace injuries and close calls

As a secondary component, this study will examine the effectiveness of dissemination deliverables among our study participants in order to increase the reach of study findings when disseminating on a national level.  

Firefighters across the country have been adopting new work schedules that provide them additional consecutive time off-shift, but often at the cost of additional consecutive days on-shift. The additional time on shift could lead to an increased accumulation of sleep loss. In the short-term, a reduction in total sleep time can increase rates of injury and accidents, and over the long-term chronic insufficient sleep can lead to disease, as well as work-family conflict. The physical, emotional, and cognitive stressors that firefighters face may worsen sleep and affect their ability to manage a healthy work-life balance.

Thus, this study aims to empower firefighters and other emergency service personal to use an evidence-based approach when considering a work design that most benefits the mental and physical health of firefighters, a high-risk occupation and a sector of public servants who carry a high burden of comorbidity.

To achieve this aim, this study includes participatory and research partnership with labor unions, with the primary research aims driven by their questions. In parallel the study has strong support from city bureau leadership (i.e., Portland’s Fire Chief, Safety & EMS Division Chief).

In the last six years the number of fire departments that have switched to a schedule that includes a two-day shift to accommodate three or more consecutive days off-shift has increased from 65 in 2015 to >300 in 2021. However, the efficacy of these schedules with regards to recovery and firefighters’ cardiovascular health have not been established.

More specifically, there are currently no reports or objective measures available regarding the 1/3/2/3 schedule, and thus, it remains unknown how changing to a 1/3/2/3 schedule influences health, well-being or safety compared to a more traditional 24/48 schedule. In March 2022 Portland Fire & Rescue adopted the 1/3/2/3 schedule from the 24/48 giving the study team the unique opportunity to take advantage of a naturally occurring schedule change to holistically examine the effects of a 24/48 vs. 1/3/2/3 schedule on the aforementioned outcomes. The study will also more broadly assess firefighters working a 24/48 or a 1/3/2/3 schedule across the state of Oregon to validate findings obtained with Portland Fire & Rescue.

This work was supported by the Oregon Healthy Workforce Center, a National Institute for Occupational Safety and Health (NIOSH) Total Worker Health Center of Excellence [grant number U19OH010154]. This work was also partly supported by the Oregon Institute of Occupational Health Sciences at Oregon Health & Science University via funds from the Division of Consumer and Business Services of the State of Oregon (ORS 656.630).

Nicole Bowles, PhD

Nicole P. Bowles PhD, MS
Assistant Professor
Oregon Institute of Occupational Health Sciences

Andrew McHill, PhD, Assistant Professor, School of Nursing, Oregon Health & Science University

Andrew W. McHill, PhD
Assistant Professor
School of Nursing
Oregon Health & Science University

David A. Hurtado, ScD, Assistant Professor, Oregon Institute of Occupational Health Sciences, OHSU

David A. Hurtado, ScD,
Assistant Professor
Oregon Institute of Occupational Health Sciences

Steven A. Shea, PhD, Professor, Director Oregon Institute of Occupational Health Sciences, OHSU

Steven A. Shea, PhD
Professor and Director
Oregon Institute of Occupational Health Sciences

Todd Bodner, PhD, Professor Department of Psychology, Portland State University

Todd Bodner, PhD
Department of Psychology
Portland State University

Aanu Ayeni, BS

Aanu Ayeni, BS
Research Associate
Oregon Institute of Occupational Health Sciences

Latroy Robinson

Latroy Robinson
Senior Research Assistant
Oregon Institute of Occupational Health Sciences

Ayeisha Haswarey

Ayeisha Haswarey
Student worker