Ranjana Mehta had just finished presenting her work on occupational fatigue at a conference when a first responder approached her with a somewhat startling request: Could the neuroergonomics researcher look into performance-enhancing drugs as options for overtaxed, worn-out emergency medical services personnel?
The question lingered with Mehta, a professor of industrial and systems engineering at the University of Wisconsin-Madison whose research includes human performance under fatigue and stress.
Ranjana Mehta
“We don’t have effective support systems to help our first responders,” says Mehta. “They are just figuring it out on their own, how to manage their fatigue. As a fatigue researcher, it becomes my responsibility to do something that really works for them.”
In the years since that interaction, Mehta has begun to explore noninvasive neurostimulation—the use of targeted electrical pulses to certain regions of the brain—as a potential solution.
In work published in the journal Frontiers in Neuroergonomics, Mehta and collaborators at Pennsylvania State University interviewed fire and emergency medical services professionals about the prospect of using neurostimulation to counter fatigue, then analyzed the responses and detailed the ethical considerations of such technology.
Their research could help guide the design of future neurostimulation systems and policies for how they’re implemented.
Neurostimulation is used to treat a wide range of medical conditions, from intractable depression to heart failure. Clinical trials of transcranial direct current stimulation, in which a wearable device delivers low electric current through the scalp, have shown promise for treating fatigue in patients with multiple sclerosis and chronic fatigue. In prior research, Mehta found that weak doses for 10 minutes can counter fatigue-related performance declines for up to an hour.
The idea of using such a device to combat fatigue in a workplace setting is less developed; the founders of the company LIFTiD, which makes a headset to improve focus, appeared on the TV show Shark Tank in 2020 but failed to persuade the judges to buy into their venture.
Given the frequency of long shifts and high levels of stress involved with first responders’ work, fatigue in the profession isn’t a surprise. A study from the University of Pittsburgh published in 2011 found more than half of surveyed EMS personnel were fatigued, which resulted in 3.6 times greater odds of behavior that compromised safety. And taxing work conditions aren’t helpful for recruitment in a profession that’s facing a workforce shortage: A 2018 study by the National Center for Health Workforce Analysis projected the field would need to add 40,000 full-time workers by 2030 to keep pace with demand.
“Fatigue is not just an issue for response readiness or safety; it is also linked to their mental health,” says Mehta, whose lab is working with the emergency medicine department at UW Health to study fatigue management strategies. “Fatigue can exacerbate mental health conditions for these individuals. So, everyone agreed that something needed to be done. Everyone agreed that what they have currently isn’t really working for them.”
In their interviews with active and retired fire and emergency medical services personnel, Mehta and her collaborators found that more than half were interested in neurostimulation as a countermeasure to fatigue. The first responders’ biggest concerns were autonomy over using a device, privacy regarding their usage data, and the long-term safety of neurostimulation.
They also raised questions about the wearability of any device, which is why Mehta is working with a team of students in the Department of Biomedical Engineering’s undergraduate design program to create a system that fits inside a hard hat.
Mehta hopes to use the device for a pilot study in the lab before partnering with an EMS agency for field testing.
“We want to collect more of such data that is presented in this paper,” she says, “where we can create recommendations for how such technologies should be responsibly designed, trained on, rolled out, and sustained.”
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