Worker Fatigue: New Regulations and Implications For Employers.

Friday 3rd April 2009

In today's 24/7 work environment, getting the most from your employees
is paramount to being successful in an ever expanding, competitive global
community. But there is a very fine line between pushing your employees
to high production standards, and pushing them to the point of burnout.

Gone are the days when fatigue was only a concern for traditional round-
the-clock industries like mining or transportation. While the immediate
impact of worker fatigue in your workplace may not be as catastrophic as,
say, the Chernobyl nuclear incident in which fatigue was a contributing
factor - it can absolutely still have a major impact on your employees,
your company and your bottom line.

Although fatigue can present itself as a symptom of other health concerns
such as stress or depression, it can also be a stand alone condition that
adversely affects the health and productivity of employees. Effective
fatigue management strategies should be considered essential in order
to minimise associated risks and maximise safety, performance and
health, thus reducing the cost burden. Beyond simply looking to get the
most value from your employees and fulfilling your OH&S requirements -
you should consider a fatigue management plan for the benefit of your
employees and the community at large. Corporate social responsibility
and corporate social integration are evolving concepts. They are concepts
that forward thinking companies are latching on to and forging the way,
educating their employees as well as nurturing a work environment that
truly enables work-life balance. The result: happier, healthier and more
productive employees. A win-win situation for you, the community and
your company's most valuable asset - its people.

This whitepaper describes some of the evidence indicating fatigue as an
injury risk and detriment to job performance, as well as discuss recent
fatigue guidelines in Australia and essential elements of fatigue
management strategies.

Worksafe states it very clearly "Fatigue affects a person's health,
increases the chance of workplace injuries occurring, and reduces
performance and productivity in the workplace" (2008)1.

Firstly, it is important to understand that fatigue is more than feeling tired.
You can't tell your employees to "just deal with it". Fatigue has measurable
cognitive and physiological effects reducing one's ability to perform tasks.
Secondly, one needs to appreciate that there are a multitude of factors that
contribute to the onset of fatigue, and that these effects are individualised.
That is, something that causes one person to be fatigued may not affect
another person in the same way, and vice-versa. And to complicate it more,
the same set of circumstances may affect either one person to a different
extent on another day depending on other outside factors. This makes the
management of fatigue difficult.

A key for the effective management strategy in the workplace is education.
Your employees need to be aware of fatigue and be able to recognise when
it's occurring, or identify specific activities that can instigate it.

A number factors that can contribute to fatigue include:

Mental and physical demands of the work
Work scheduling and planning
Working time
Exposure to harsh environment (noise, vibration, heat, cold...)
Of course in addition to the factors listed above, there are also personal
factors that can contribute to fatigue including sleep quality, sleep loss,
social activities, family demands and travel.

Feeling tired or drowsy following prolonged mental or physical exertion is
normal. Fatigue, however is an acute, and/or ongoing state of tiredness that
leads to mental and physical exhaustion preventing someone from
functioning at their normal level. The direct impact on work performance
includes inability to focus or concentrate, taking longer to perform tasks,
slowed reaction times, increased irritability and reduced alertness.
The implications of these symptoms on safety diligence in the workplace are
obvious. The ability to recognise a dangerous situation, react to or solve a
problem is all sub-optimal.

Research in the field has tended to focus a lot on the impact of night shifts,
shift rotations and prolonged sleep deprivation2-5. This may not be
applicable to all industries directly in terms of work time, however with
the demands of modern life, even if your workplace runs a more traditional
day-time office, you can be certain that members of your staff are likely
travelling further, working longer and have higher demands on their time
away from work than they have in the past. A study in the US estimated
that nearly 40% of US workers showed signs of fatigue at work suggesting
that this is not only a problem for industries involving shift work 6.

With that said, the available research is still valuable as it can give us an
idea of the measurable impact of fatigue. Beyond stating that it can reduce
your reaction times or hand-eye coordination, we can indicate to what
extent. Research has shown that being awake for 17 hours has a
physiological effect on your focus akin to a blood-alcohol level of 0.05;
being awake 20 hours is equivalent to having a blood-alcohol level of 0.11.
Would you like one of your staff members performing a safety-critical task
within an hour of consuming 4-5 beers?

Micro-sleeps are another major safety concern of fatigue. Micro-sleeps
are a phenomena that has gained recent recognition through road safety
promotional media, and is when a fatigued or sleep deprived person
experiences a short-term episode of brain activity normally associated
with a state of sleep3. This means that the person literally, lapses into
a few moments of sleep. The eyes may or may not close, and it may only
last for a few seconds - but during this time the person is not likely to
react to external stimulus. Micro-sleeps are most common during times
when a person is awake at a time they would normally be sleeping, ie.
during the normal sleep time of their body's circadian rhythm. However
they can occur at other times if a person is sufficiently fatigued or sleep
deprived. Micro-sleeps are a genuine safety threat in any industrial setting
where night shifts or long shift rotations exist.

There are numerous studies in Australia, the UK and the US that have
looked at the error rate of nurses and other medical professionals in
patient care during overnight shifts and long-call situations 2,3,5.
The increase in error rate in relation to job time and/or sleep deprivation
is undeniable - showing that the measurable impairments in cognitive
and physiological function do actually have a carry over effect on job
performance. In addition to poor job performance, the increased rates
of motor vehicle accidents while commuting to and from these particular
working rotations are also higher2,5. Job performance is compromised,
risk of error, accident or injury while at work is increased, and the risk
of personal injury outside of work is increased. Not to mention the risk
to members of the wider community with drowsy, accident prone drivers
on the roads.

A study by Spurgeon (2003)7 also suggested that in addition to night work
or long shifts, long work hours overall have negative impacts on safety and
health. She concluded working more than a 48 hour week significantly
increased the risk of mental health problems. If she is alluding to stress or
depression then you can bet it's costing you or your company money.
According to a Medibank Private report (2008), stress is costing the
Australian economy in excess of $14.8 billion annually, and leads to 3.2
lost work days per employee, per year8, directly affecting your bottom
line. Spurgeon went on to conclude that an average work week of 60 hours
or more significantly increases the risk of cardiovascular disease -
Australia's biggest killer9. With a third of Australian workers averaging a
60 hour week, this is a real concern 10

Clearly fatigue presents a significant health and safety issue that, if ignored
may be impacting on the productivity of your workforce, contributing to
health costs and may be jeopardising your safety record. A review of your
current policies in light of new regulations and guidelines may provide you
with a significant return in cost savings and improve your bottom line in this
current difficult economy.

On the 29 September, 2008 new Heavy Vehicle Driver Fatigue laws
commenced in Australia. If you are in the transport industry and have not
updated your fatigue policy since September, you should review current
updates to the law that apply to you by contacting your state or territory
road transport agency 12.

This was an important law reform. The transport industry is another in
which fatigue has been well studied. A 2002 report from the Australian
Transport Safety Bureau suggested that fatigue played a significant role
in around 17% of all fatal vehicle crashes, and almost 30% for articulated
truck crashes 11.

The new laws allow transport companies or solo drivers to choose
between adhering to a standardised set or work to rest ratios, or to
apply for more flexible options under either a "Basic" or "Advanced
Fatigue Management" program. The latter two options allow for more
flexibility, but still require a regulation policy that fits within certain
ranges to be approved.

In addition to the new transportation laws, Worksafe in Victoria and
New South Wales also published fatigue management guidelines
during 20081. These are designed to act as a guide for employers to
enhance their work safety policies and incorporate strategies that help
to prevent worker fatigue.

So what kind of principles may be applicable to you and your business?
We have established that fatigue can rise from a combination of factors;
therefore the most effective management strategy must also implement
a combination of control measures to be successful. Your foundation
should be on awareness and education. Your workers need to understand
the effects and possible impact of fatigue, and be able to learn to recognise
the early signs in themselves and others - with an emphasis on "others"
because often people are a poor judge of their own levels of fatigue 3.

The education needs to begin with managers and team leaders. An old
school mentality of managers telling workers to "grab a coffee" or "just
get over it" must be avoided. They need to understand that the complaint
of fatigue may be genuine, and that it may be adversely affecting work
performance and safety. Providing workers with the opportunity for
frequent rest breaks, sensible shift scheduling or weekly hour reductions
make more sense than paying your workers to sleep on the job - as does the
prevention of future mental and physical health problems that are
associated with long-term fatigue. With a rapidly aging workforce it makes
good business sense to provide an accommodating work environment that
is poised to retain your skilled workers as long as possible.

If your workplace incorporates shift rotations or night work, research has
shown that a forward shift rotation has less impact on sleep disruption than
a backward rotation1,4. That is, a shift rotation of day-to-evening-to-night
as opposed to day-to-night-to-evening. In addition the speed of rotations
has also been shown to impact fatigue and generally a slow rotation
(changing shifts every week) being less problematic than a faster rotation
days)4. It should be noted that slower rotations can be less popular with
workers highlighting the importance of educating them so that they are
aware of the reasons behind your management.

Be open-minded to the needs of individuals. A 2006 study into napping
showed that a 40-minute nap break (averaging in 26 minutes of actual sleep)
improved the performance of nurses working at night for up to three hour
post-nap during a 12 hour shift3. This supported results from a 1994 study
that showed a 40 minutes in-flight nap for pilots reduced the number of
micro-sleeps experienced during the final 90 minutes of long-haul flights3.
A paid 40 minute break during the night that improves productivity for up
to three hours after, or reduces the error rate and injury risk towards the
end of a shift may be a very worthy investment. So think outside the box
and try and include your workers in your policy development.

Other scheduling principles to consider include1:

Avoiding short shift changeovers (e.g. finishing at 11pm and then starting
at 7am)
Avoiding shifts longer than 12 hours (including overtime)
Consider providing alternative transport/close accommodation at the
end of a long/overtime shift
Allocate shift workers consecutive days off following a shift rotation
(research shows it takes the body two consecutive nights of 6-8 hours sleep
to recover from significant sleep debt)4
Industries vary in many ways, as do the demographics of their workforce.
A blanket approach to fatigue management is not the answer. You need to
consider your specific work environment, and where possible include your
workers in the development of your policy.

Fatigue is one of those issues that can be difficult for an employer to
effectively manage because of the need for a one-to-one approach.
The education needs to branch beyond the walls of your workplace
and include other lifestyle issues, such as sleep patterns. After investigating
some of the possible hidden costs fatigue may be having in your workplace
as outlined in this white paper, a thorough approach incorporating several
strategies may have a very positive impact.

Some corporate health companies, such as Health by Design provide
comprehensive health, safety and lifestyle programs that include a
very individualised approach. The benefit of this is that program
material is to your workers in a manner that is applicable to them as
individuals. Personal coaching in combination with tailored health
promotional material can maximise the engagement of your workforce,
and improve the amount of information learned and subsequently
integrated into the daily behaviours of your workers. In terms of fatigue
management, educating your individual employees on personally
relevant lifestyle components such as sleep patterns, relaxation techniques
and individual pre-bed routines may help improve sleep quality.
In addition, helping them personally with time management and lifestyle
balance can all have a profound impact on reducing fatigue induced by
our modern lives.

The research seems evident that not doing anything about fatigue will
undoubtedly be hitting your bottom line. It may also be sending your
employees on the road to burnout, which can certainly affect your retention.
Identifying if fatigue is a concern for your staff is your first step.
Once established you can reduce the impact by integrating fatigue
prevention strategies outlined here in order to begin reducing this
hidden cost burden.

And as a conclusion, it would seem that any reduction in hours or
tightening of the ropes imposed by the recent fatigue guidelines in
the transportation industry and by Worksafe are likely to be beneficial,
in the end providing a return on investment by improved safety and
productivity of your employees.

For more information on fatigue management within your workplace,
please contact Health by Design on 1300 304 068
or info@healthbydesign.com.au

Sources: (Websites accessed November 2008)

Worksafe Victoria (2008): "Fatigue: Prevention in the Workplace";
Worksafe Victoria, Edition Number 1, June 2008.
Dawson, D and Zee, P: "Work Hours and Reducing Fatigue-Related
Risk: G ood Research vs. Good Policy"; JAMA. 2005;294(9):1 104-1106
Caldwell, J.A; Caldwell, J.L and Schmitd, R.M: "Alertness management
strategies for operational contexts"; Sleep Medicine Reviews. 2008;12: 257-273
Ross, J: "Fatigue: Do You Understand the Risks to Safety?"; Journal of
PeriAnesthesia Nursing. 2008;23(1 ):57-59
Dorrian J. Tolley C. Lamond N. van den Heuvel C. Pincombe J. Rogers
AE. Drew D: "Sleep and errors in a group of Australian hospital nurses
at work and during the commute"; Applied Ergonomics. 2008;39(5):605-13
Ricci, J.A; Chee, E; Lorandeau, A.L; Berger, J: "Fatigue in the U.S. Workforce:
Prevalence and Implications for Lost Productive Work Time"; Journal of
Occupational and Environmental Medicine. 2007;49(1 ):1 -10
Spurgeon, A: "Working time: it's impact on safety and health";
International Labour Office Report. Geneva: International Labour
Organization, 2003\
Medibank Private: "The Cost of Workplace Stress in Australia"; August, 2008
The Australian Heart Foundation website: http://www.heartfoundation.org.au/
The Australian Bureau of Statistics website: http://www.abs.gov.au/
Australian Government - Department of Infrastructure, Transport,
Regional Development and Local Government website:
www.infrastructure.gov.au/roads
National Transport Commission website: http://www.ntc.gov.au/
Published by Seeking Media. http://www.seekingmedia.com.au/