0383 Depression Symptoms as a Pre-Shift Work Risk Factor for the Development of Shift Work Disorder in Emergency Personnel Following 12-Months of Work

Abstract Introduction Emergency service personnel, such as paramedics, predominantly perform rotational shift work to provide the public with around-the-clock care in times of crisis. Consequently, a high prevalence of emergency service personnel experience shift work disorder (SWD), a circadian rhythm sleep disorder associated with the shift work schedule that comprises symptoms of insomnia and/or excessive sleepiness. Despite the high rates of SWD in paramedics, the risk factors that predispose new personnel to SWD are not well understood. The present study examined whether mental health symptoms in new paramedics prior to shift and emergency work were associated with SWD later in their career. Methods Mental health symptoms and sleep disorder risk were examined in recruit paramedics (n=105) at baseline, prior to any shift and emergency work, and then again after 12-months of shift work as a paramedic. Prior to baseline, participants had no previous employment in any emergency service or defence force and had not worked shift work in the last 3 months. At both timepoints, participants completed validated measures to assess depression (Patient Health Questionnaire-9) and anxiety symptoms (Generalised Anxiety Disorder-7) and screen for risk of SWD (SWD Screening Questionnaire). Multivariate logistic regression models examined whether depression and anxiety symptoms at baseline were associated with SWD risk at the 12-month follow-up, after adjustment for confounders using the backward elimination method. Results Eighteen percent of paramedics were high risk of SWD after 12-months of shift and emergency work. Increased depression symptoms before beginning shift and emergency work were associated with higher odds of SWD at the 12-month timepoint (Adjusted Odds Ratio 1.25, 95% Confidence Interval 1.01-1.56, p = 0.04). Anxiety symptoms at baseline were not associated with SWD at the 12-month follow-up (Adjusted Odds Ratio 1.07, 95% Confidence Interval 0.88-1.28, p = 0.44). Conclusion Our findings establish depression symptoms before shift and emergency work as an early risk factor for the later development of SWD in new paramedics. These results suggest the need to investigate the effectiveness of interventions that target depression early in paramedics’ careers to reduce the future risk of SWD in this demanding occupation. Support (if any) APP1138322, ASA Rob Pierce Grant in Aid