1. What can we learn from others? i Sleep Health and Safety for Railroaders Lessons in Sleep Health Education Janis L Anderson, Ph.D. Asst. Prof of Psychology/Dept of Psychiatry Harvard Medical School, Brigham & Women's Hospital Division of Sleep Medicine

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4. we slowed the pools" "held away agreements" "monthly mileage maximums" "early mark off" "protect trespass" "standing bid agreement" "visibility of pulls and returns" "spread times" "protecting extra boards" "work-rest boards" "show-up crew" "tie off"

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8. Abolishing Sleep Illiteracy and Ignorance Sleep Disorders and Sleep Deprivation--An Unmet Public Health Problem (Institute of Medicine, 2006) “…a public health campaign is required to increase awareness among the general population.” “…specific education and training strategies are needed to increase awareness among health professionals including improved curriculum content…”

9. SLEEP MEDICINE The Sleep Health and Education Program Help individuals and their sleep partners recognize sleep problems. Provide primary care physicians and other clinicians with information to recognize/treat sleep problems. Assist medical students and other health care trainees to understand the importance of good sleep health in themselves and in their future patients. Respond to the media's need for information that is credible, accurate and easily accessible.

10. SLEEP MEDICINE Sponsors of the Sleep and Health Education Program Cephalon Sanofi-Aventis Sepracor Takeda Pharmaceuticals North America JL Anderson, Ph.D. Funding: U.S. Dept of Education, Institute of Education Sciences: Univ. of New Mexico/Washington U American Sleep Medicine Foundation U.S. Dept of Transportation: HMS

11. SLEEP MEDICINE http://www.understandingsleep.org

12. SLEEP MEDICINE “Healthy Sleep” Editor: Dr. S. Shea Beta - Oct 2007 Final - Jan 2008 Clinical Sleep Disorders Sleep through the ages “ Get Sleep ” Consequences of insufficient sleep Editor: Dr. C. Landrigan Beta-Dec 2008 Final-Jan 2009 Sleep Apnea Sleep Apnea Insomnia Insomnia CRSD CRSD Limb movement Limb movement Narcolepsy Narcolepsy Pediatric disorders Pediatric disorders Newborn sleep Newborn sleep Children Children Adolescents Adolescents Geriatric Geriatric Shift-work Shift-work Learning and memory Learning and memory Metabolism Metabolism Disease and psychiatry Disease and psychiatry Drowsy driving Drowsy driving Sleep Health and Education Program “Tree of Sleep Knowledge”

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14. online training video for firefighters produced by Harvard Work Hours Health and Safety Group

15. SLEEP MEDICINE Firefighter interview regarding experiences involving sleep, fatigue and safety.

16. SLEEP MEDICINE The Operation Stay Alert! Fatigue management training program endorsed by union leaders; individuals are encouraged to take online confidential screening for sleep disorders. Information about treatment and referrals to local clinics and providers are also easily available.

17. SLEEP MEDICINE http://healthysleep.med.harvard.edu/need-sleep/success- stories/lou-killer-shift

18. SLEEP MEDICINE Sleep Health and Safety for Railroaders online information, videos, interactives

19. SLEEP MEDICINE Interactive http://healthysleep.med.harvard.edu/need-sleep/whats-in- it-for-you/how-awake-are-youhealthysleep.med.harvard.edu/need-sleep/whats-in- it-for-you/how-awake-are-you

20. SLEEP MEDICINE DCohen et al 2010 Science Translational Medicine Vol 2(14)

21. SLEEP MEDICINE Serious Medical Errors p<0.001 Errors per 1000 patient days Effect of Reducing Interns’ Work Hours on Serious Medical Errors in Intensive Care Units Landrigan, CP, et.al. NEJM 2004;351:1838-48

22. Odds Ratio for Having Motor Vehicle Accident or Near Miss Event During Commute Home from Work Data From Table 1: Barger, L, et al: Extended Work Shifts and the Risk of Motor Vehicle Crashes among Interns. NEJM, 352(2).125-134, 2005 * 3.30 1.60 6.30 5.40 * 95% CI

23. © American Academy of Sleep Medicine American Academy of Sleep Medicine Risk Factors for Drowsy Driving Time of Day Number of Crashes Driving home post-call Pack et al 1995 Taking any sedating medications Drinking even small amounts of alcohol Having a sleep disorder (sleep apnea) Driving long distances without breaks Driving alone or on a boring road

24. © American Academy of Sleep Medicine American Academy of Sleep Medicine Drive Smart; Drive Safe AVOID driving if drowsy. If you are really sleepy, get a ride home, take a taxi, or use public transportation. Take a 20 minute nap and/or drink a cup of coffee before going home post-call. Stop driving if you notice the warning signs of sleepiness. Pull off the road at a safe place, take a short nap.

25. SLEEP MEDICINE Sleep Health and Safety for Railroaders P ARTNERSHIP Harvard Sleep Health and Education Program WGBH Educational Foundation Volpe National Transportation Systems Center FRA Office of Safety FRA Office of R & D Human Factors Program You

26. SLEEP MEDICINE Sleep Health and Safety for Railroaders A IMS multi-media web-based education program to provide Class I, II, and III railroad employees with educational resources and accessible information regarding sleep science, sleep health, fatigue and fatigue management scientifically valid way to assess personal risk for prevalent sleep disorders as potentially related to work schedules

27. SLEEP MEDICINE our team Interim Editor-in-Chief: Stuart F Quan MD Module Editor: Janis L Anderson PhD Executive Producer: Arthur Smith Associate Producer: Sara Chaudhary

28. SLEEP MEDICINE our process research and background –educational goals for this industry specific content most important to the multiple audiences within Railroader community –key messages –specific contexts –frequently asked questions –success stories

29. SLEEP MEDICINE your input Frequently Asked Questions user needs how this site would help your programs alpha testers and beta testers: receive pre- releases of the site, give anonymous feedback