OSHA to Examine Physician Work Hours

In response to a petition filed last week by Public Citizen and others, OSHA said it will examine the need for regulations that would limit the work hours of resident physicians, according Labor Department Assistant Secretary, David Michaels.

"We are very concerned about medical residents working extremely long hours, and we know of evidence linking sleep deprivation with an increased risk of needle sticks, puncture wounds, lacerations, medical errors and motor vehicle accidents," Michaels said.

He also said 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 Chemical Safety Board "identified worker fatigue and long work hours as a likely contributing factor to the explosion."

"It is clear that long work hours can lead to tragic mistakes, endangering workers, patients, and the public," he said. "Hospitals and medical training programs are not exempt from ensuring that their employees' health and safety are protected."

In its petition, Public Citizen cited recommendations made by the Institute of Medicine in its 2009 Report on Resident Duty Hours. They included:

• A limit of 80 hours of work each week, without averaging.
• 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.
• And in-hospital on-call frequency no more than once every three nights, no averaging.

These recommendations are "necessary for protecting the safety of resident physicians and subspecialty resident physicians," according to the petition submitted by Public Citizen, the Committee of Interns and Residents/SEIU Healthcare, and the American Medical Students Association.

"Their implementation would also have the secondary benefit of resulting in a safer, better standard of care for patients nationwide," the petition added.