HMS Seeks Work Limits

The Occupational Safety and Health Administration will consider a petition filed in part by Harvard Medical School Professors Charles A. Czeisler ’74 and Christopher P. Landrigan seeking to lower the nationwide limit on the number of hours that medical residents can work per week.

In a petition submitted on Sept. 2, Czeisler and Landrigan—along with Albert Einstein College of Medicine Professor Bertrand M. Bell, consumer advocacy group Public Citizen, the Committee of Interns and Residents, and the American Medical Student Association—expressed concerns about the consequences of current extreme work conditions.

“Studies have shown that residents [who were working more than 20 hour shifts] made 36 percent more errors,” Czeisler said. “24-hour shifts have been shown to be associated with mistakes that injured a patient.”

Addressing OSHA Assistant Secretary David Michaels, the petition recommended limiting resident physicians’ shift to a maximum of 16 consecutive hours and scheduling at least one 24-hour period of time off of work per week.

The petitioners noted that under current regulations, an average work week for a medical resident could average 66.6 hours with extended shifts often lasting 29.9 hours.

Although regulations currently exist, 83.6 percent of all interns reported work hours in violation of the standards set by the Accreditation Council for Graduate Medical Education, the organization overseeing resident physician training.

Czeisler said that he has been concerned about this issue since legislation in New York limited work hours for medical residents in the 1980s. Harvard led a commission to establish guidelines for Massachusetts medical schools to limit the number of resident work hours, but this self-regulating system did not produce substantial change, Czeisler said.

Michaels wrote in a statement on Sept. 2 that the petitioners’ concerns will be thoroughly examined.

“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,” he said.

“Hospitals and medical training programs are not exempt from ensuring that their employees’ health and safety are protected.”

—Staff writer Barbara B. DePena can be reached at barbara.b.depena@college.harvard.edu

—Staff writer Monica M. Dodge can be reached at mdodge@college.harvard.