Fatigue is 'more than just sleepiness' and the responsibility of both employer and employee, says OHS expert
Employers should treat work-related fatigue as any other workplace hazard, says Imelda Wong, Coordinator of the Center for Work and Fatigue Research at the National Institute for Occupational Safety and Health (NIOSH).
She also says that work-related fatigue is an issue though some industries may see higher instances of fatigue due to the nature of the work, it is a problem which affects workers in all industries – something which must be understood to effectively understand and treat the problem at its roots:
“Fatigue is pervasive and non-discriminating, potentially affecting any worker at any job in any organization,” says Wong.
Fatigue vs. Sleep
In the occupational realm, “fatigue” is commonly related to working hours or work schedules, says Wong, but it can also be attributed to other work factors such as physical or mental demands, monotonous work or exposure to hot or cold environments.
“There is no standard definition for fatigue, but I think we need to recognize that fatigue is more than just sleepiness and its effects are more than just falling asleep,” says Wong. “Fatigue is on a continuum, not a cut point. We are all fatigued to some extent, but what we really need to manage is the risk for a fatigue-related safety critical event.”
Citing a 2012 paper from the American College of Occupational and Environmental Medicine Presidential Task Force on Fatigue Risk Management, Wong says that the researchers differentiate between sleep and fatigue:
Sleepiness is the tendency to fall asleep while fatigue is the body’s response to sleep loss or to prolonged physical or mental exertion. Understanding this difference will help determining effective fatigue mitigation strategies, says Wong.
Another difference is that fatigue may be reduced by sedentary activity or rest without sleeping while subjective sleepiness and the propensity for sleep are often exacerbated by sedentary activity or rest.
Financial and physical costs
According to the National Security Council (NSC), work-related fatigue can cost employers around $151 billion annually in reduced productivity. But, says, Wong:
“This is just a fraction of the true cost, as chronic sleep deprivation and nonstandard work schedules have been linked with increased risk of depression, obesity, cardiovascular disease, cancer and other illnesses with ultimate effects on work productivity, worker health and safety.”
Employers need to “understand the driving factors behind work-related fatigue in [their] organization,” says Wong. “Talk to your workers to get a better understanding of what they feel are the contributing factors and their suggestions for improving their work situation.”
Through doing this, employers can work with their safety professionals to develop a comprehensive safety management plan which includes fatigue risk management.
Because the effects of work-related fatigue can be dire.
“Fatigue can slow reaction times, reduce attention or concentration, limit short-term memory, and impair judgment, increasing the risk for fatigue-related incidents, such as work injuries,” says Wong.
On a more frequent scale, this is a concern for drivers for example.
Drowsy driving increases the risk for motor vehicle crashes by 250 per cent.
“Work-related fatigue can also have a devastating public safety impact, particularly in occupations with high-risk consequences. For example, the nuclear meltdown at Three Mile Island and the grounding of the Exxon Valdez oil tanker are two major disasters in which human fatigue was cited as a contributing factor,” says Wong.
So how can employers help mitigate the risk of fatigue at work?
“Often times when employers think about mitigating fatigue risk, they revert to prescriptive hours of work, that is – focusing on work hours,” says Wong. “Most usually it has to do with limiting work hours, such as they have done in the European Working Time Directive.”
However, she says that fatigue is more than just hours of work – and its effects as mentioned before are more than just sleepiness.
“I think we need to recognize that work-related fatigue is multi-faceted and can stem from various work and non-work factors,” says Wong.
While we’re aware of work factors such as shift timing and duration, there are individual factors too such as age or chronotype (i.e. the tendency to be an early bird or night owl). Then there are life or lifestyle factors such as depending care and commuting.
“As such,” says Wong, “work-related fatigue is a shared responsibility between workers and employers.”
“Employers need to provide workers with opportunities for adequate rest and recovery – and this could be several different types of strategies which include shift scheduling practices that consider things like time of shifts, shift duration, the number of successive shifts and breaks within and between shifts and successive series of shifts,” she says.
It is important to keep in mind that more rest and recovery time is needed for work that is physically or mentally demanding, or result in severe circadian misalignment as with shift work and early morning starts.
Wong says that Fatigue Risk Management Systems (FRMS) are a holistic and effective approach to managing fatigue risk – and have been widely adopted in the aviation and railway industries.
Though there are different models of FRMS, there are broadly six main components:
• Policies and procedures – which outline the backbone of the organizational structure and basic procedures
• Roles and responsibilities of management and employees
• Risk Assessment and Management of sleep, hours of work, recognition of fatigue and reporting
• Training and educational programs which promote knowledge and management of fatigue
• Control and Action that include fatigue management tools
• And lastly, an audit and review component to keep re-evaluating FRMS to ensure effectiveness.
“Workers also need to take responsibility to ensure that they take time away from work to obtain adequate rest. This includes good sleep behaviors, such as limiting electronics use before bedtime and in bed, and a sustaining a healthy lifestyle.”
For information, visit: https://www.cdc.gov/niosh/topics/fatigue/center.html