Veille documentaire MTPH

Médecine du travail du personnel hospitalier

Caffeine for the prevention of injuries and errors in shift workers

Éditeur     The Cochrane Collaboration
Auteur     Katharine Ker
Auteur     Philip James Edwards
Auteur     Lambert M Felix
Auteur     Karen Blackhall
Auteur     Ian Roberts
Éditeur     Katharine Ker
Titre du livre     Cochrane Database of Systematic Reviews
Lieu     Chichester, UK
Éditeur     John Wiley & Sons, Ltd
Date     2010-05-12

Sleepiness leads to a deterioration in performance and is associated with an increased risk of error and injury. Shift work is an major cause of sleepiness as it requires workers to be awake at times which are different to those dictated by their ‘body clock’. This in turn can compromise the safety of themselves and of others – sleepiness is a risk factor for events such as traffic crashes, occupational injuries and medical errors.
The identification of interventions which can reduce the risk of error and injury is necessary to help ensure that those who are required to work through the night, can do so safely. Caffeine has been proposed as one such intervention, although how effective it is in shift workers is unknown.
For this systematic review, the authors searched for randomised controlled trials which investigated the effects of caffeine on injury, error and cognitive performance in shift workers. They found 13 trials – none of the trials looked at the effect on injury, two trials measured error, while the remaining trials used neuropsychological tests to assess cognitive performance.
The results of the trials suggest that compared to no intervention, caffeine can reduce the number of errors and improve cognitive performance in shift workers. No difference in effect was found by the trials comparing caffeine with other interventions (such as nap, bright light and modafinil). However, due to some methodological weaknesses of the trials, some caution is required when interpreting the results.
The authors of the systematic review conclude that caffeine may be an effective intervention for improving performance in shift workers however, there are no trials from which they could assess its effect on injuries. Based on the current evidence, the review authors judge that there is no reason for healthy shift workers who already use caffeine within recommended levels to improve their alertness, to stop doing so. They go on to suggest that it would be useful for further trials to be undertaken to assess the effects of caffeine against other potential countermeasures.

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