The Occupational Safety and Health Administration (OSHA), the main federal agency charged with the enforcement of workplace safety and health, is looking at limiting the number of hours medical residents can work to 80 hours a week.
The decision to consider such limits came after OSHA received a petition filed by Public Citizen; the Committee of Interns and Residents/SEIU Healthcare; the American Medical Student Association; Dr. Charles Czeisler, Baldino professor of sleep medicine and director of the division of sleep medicine at Harvard Medical School; Dr. Christopher Landrigan, assistant professor of pediatrics and medicine at Harvard Medical School; and Dr. Bertrand Bell, professor of medicine at Albert Einstein College of Medicine.
Petition signatories noted their concerns about medical residents working extremely long hours,” anc cited evidence linking sleep deprivation with an increased risk of needle sticks, puncture wounds, lacerations, medical errors, and motor vehicle accidents.
In agreeing to consider the petition, assistant secretary of Labor for Occupational Safety and Health David Michaels, who heads OSHA, noted that “the relationship of long hours, worker fatigue and safety is a concern beyond medical residents, since there is extensive evidence linking fatigue with operator error. In its investigation of the root causes of the BP Texas City oil refinery explosion in 2005, in which 15 workers were killed and approximately 170 injured, the U.S. Chemical Safety Board identified worker fatigue and long work hours as a likely contributing factor to the explosion.”
In addition to seeking a limit of 80 hours of work in each and every week for hospital residents, the petition also seeks:
A limit of 16 consecutive hours worked in one shift for all resident physicians and subspecialty resident physicians;
At least one 24-hour period of time off work per week and one 48-hour period of time off work per month, for a total of five days off work per month, without averaging;
In-hospital on-call frequency no more than once every three nights, no averaging;
A minimum of at least 10 hours off work after a day shift, and a minimum of 12 hours off after a night shift;
A maximum of four consecutive night shifts with a minimum of 48 hours off after a sequence of three or four night shifts.
You can view Dr. Michaels’ full response to the petition here.
Also, here’s one surgeon’s entertaining take on the issue, in the Psychology Today blog. You can guess his point of view by his title: “Training surgeons not sissies.”