Waking up to Fatigue

Dr Karen McDonnell, Head of Royal Society for the Prevention of Accidents (RoSPA) Scotland and Occupational Health and Safety Policy Adviser RoSPA, discusses the impact of fatigue on organisations.

Fatigue contributes significantly to accidents at work, at home, on the road, and in other settings. It damages health and reduces the quality of life for those affected both directly and indirectly.

Extreme fatigue while at work can result from the interplay of many factors, including shift patterns, physical workload, monotonous and unstimulating work, poor sleep hygiene and other lifestyle factors, medical conditions and/or associated therapies, and personal life challenges. Many workers currently experience both temporary and dangerous fatigue as a result of: working long and/or poorly scheduled hours doing several jobs; carrying out tedious, difficult and physically demanding tasks; having challenging caring responsibilities, poor quality and inadequate sleep or travel-to-work difficulties; or experiencing harmful stress associated with domestic and workplace factors.

While excessive physical and mental fatigue can have many causes that are often interconnected, and workers need to address it as best they can, employers have legal duties to assess and control tiredness in the workplace, taking reasonably practicable steps to reduce it and to mitigate its effects.

Fatigue can contribute to accidents and unplanned events by adversely affecting motivation, vigilance/monitoring, reaction times, sustained attention, visual tracking, logical reasoning and calculation, encoding and decoding of information, memory, communication, multi-tasking, and complex decision-making. Cumulative fatigue is a significant risk factor not only in front-line safety-critical work but also in many other tasks, which, if performed poorly, can result in latent safety problems.

While some workers may be seen as more susceptible to excessive fatigue than others, the potential for exhaustion and tiredness to adversely affect individuals needs to be accepted as a widespread problem, potentially affecting every work organisation. Those who suffer from extreme and prolonged mental and physical exhaustion are more likely to develop persistent insomnia, sleepiness, mood disturbance, relationship difficulties, substance abuse, absenteeism, and disciplinary problems as well as long-term health detriments such as stomach upsets and cardiovascular disease.

To ensure that excessive physical and mental exhaustion is never ignored, stigmatised, and is reduced and managed appropriately, organisations must put in place appropriate systems, personnel, and procedures to achieve these objectives. These include removing or controlling the risk of fatigue by organising and planning the number of hours employees work and how these hours are scheduled, and not simply by observing the requirements of the Working Time Regulations 1998 (as amended) [1].

There is also a need to adequately control fatigue risks associated with work patterns, which, while legally compliant, may still be fatiguing and hence increase the risk of fatigue-related error, incidents, accidents, and possibly ill-health.

As with occupational stress, assessment of fatigue in the workforce requires the adoption of appropriate techniques. The purpose must be to identify problems and trends and to pinpoint specific tasks, shifts, work patterns, or demographic factors where fatigue is an issue, and devise effective primary and secondary interventions.

ScORSA recommends in general: ensuring that workers have the opportunity to have enough time between shifts to commute, wash, eat, socialise and carry out domestic duties, as well as sleep; restricting consecutive night shifts to a maximum of two to three or two 12-hour shifts; and allowing at least two days off after the last night shift in a string of such shifts.

Shifts should always be rotated forwards (early shifts changing to afternoons and afternoons changing to nights). Long shifts should be avoided as should too much over-time.

Quality breaks and scope for “power napping” should always be provided (although the latter needs to be treated with caution to make sure it does not introduce additional risks). Scope for workers to self-select shift patterns that suit them best should always be considered.

There are a number of further general steps which all organisations should take to address the problem of fatigue and exhaustion in the workplace:

• Fully consulting the workforce and their representatives about the organisation’s overall approach and its programmes of work to address the problem of excessive fatigue
• Developing and communicating a clear policy that destigmatises fatigue, ensuring it is not wrongly described as indolence or laziness 
• Delivering workplace awareness-raising about fatigue and its avoidance, including steps to improve and maintain good health and good sleep hygiene
• In particular, training line and middle managers in order to raise their awareness and help them to develop necessary interpersonal skills to engage with individuals about fatigue and the issues involved 
• Taking account of fatigue in all risk assessment processes, particularly for safety critical work
• Reviewing fatigue as a possible causal factor in all accidents and incidents
• Considering any difficulties in travel to and from work which may contribute to fatigue
• Avoiding workers driving when dangerously tired, both when driving for work and driving to and from work
• Engaging outside experts to help
• Ensuring appropriate occupational health support.

Remember #DrivingTiredKills

Sources:

[1] legislation.gov.uk. 1998. Working Time Regulations 1998. [Online] [Accessed]