Managing Fatigue Concrete, Cement and Aggregate’s Association Annual Safety Seminar

October, 2019

Dr Kirsty McCulloch

Are We Getting Enough?

Sleep Length v’s Caffeine C

affeine (m

g/h

ead/d

ay)

1910 1930 1950 1970 1990

Slee

p (

hrs

) 10

9

8

7

500

400

300

200

100 6

Are We Getting Enough?

Sleep Length v’s Caffeine C

affeine (m

g/h

ead/d

ay)

1910 1930 1950 1970 1990

Slee

p (

hrs

) 10

9

8

7

500

400

300

200

100 6

Cycle 1 Cycle 2 Cycle 3 Cycle 4 Cycle 5

Awake

REM Sleep

Stage 1

Stage 2

Stage 3 (Slow-Wave)

‘Normal’ Sleep Quality

10pm 11pm 12am 1am 2am 3am 4am 5am 6am

Why Manage Fatigue?

Vehicle Accidents

• 20-30% of serious Australian road accidents • 300 fatalities per year (ABS, 2013)

• Highest risk groups: • young drivers

• shift workers (including heavy vehicle drivers)

• drivers with sleep disorders

Three Mile Island (1979) Bhopal (1984) Chernobyl (1986)

Challenger Space Shuttle (1988)

British Airways BAC1 (1990) Esso Longford (1998)

Michigan Train Derailment (2001)

BP Texas City (2005) Buncefield Oil Depot (2005)

We are poor judges of impairment

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Alertness

Performance

# Nights on Shift

Good

Poor

Comparing Fatigue & Alcohol

• 40 subjects

• 2 experimental conditions

• Sleep deprivation (28hrs)

• Alcohol (1 standard drink every 30mins from 0830)

• Performance measured half hourly via computer-based tests

Sleep & Performance in Athletes

• Studies with athletes have shown that consistently getting more than 7-10 hours sleep per night results in:

• Improved reaction times

• Reduced injury rates, improved overall health

• Longer playing careers

• Better accuracy and faster sprint times

• Better judgement and fewer mental errors

Impact on Health

•Early onset dementia

•Alzheimer’s disease

• Obesity

• Cardiovascular health

• Stroke

• Cancer

• Stress, anxiety, depression

• Social isolation

• Poor immune system

• Gastrointestinal upsets

• Aches/pains

Short Term Physical

Short Term Psychological

Long Term Psychological

Long Term Physical

Three Pillars of Health

NUTRITION SLEEP Exercise

Fatigue Risk Management Models

• Restricted Hours

• Industrially Negotiated

• Largely Ineffective at FRM

Traditional FRM

• Multiple Controls

• “Red Flag” System

• Identify Risk Manage Risk

Best-Practice FRMS

Managing Fatigue: It’s About Sleep!

Sleep Opportunity (Work Hours)

Sleep and Wakefulness

Symptoms and Behaviours

Errors & Near-misses

INCIDENTS Dawson & McCulloch (2005), Sleep Medicine Reviews, 9 (5), 365-380

Work Hour Considerations

Symptoms & Behaviours

Physical Yawning

Heavy Limbs Appearance

Headache/Nausea Sore Eyes

Poor Coordination Slow Reaction Speed

Extreme Drowsiness Heavy Eyelids Micro-sleeps Falling Asleep

Mental Poor Concentration

Disorganisation Easily Distracted

Poor Communication Situational Awareness Poor Info Processing

Poor Memory

Poor Decision Making Risk Taking Behaviour

Errors

Emotional Quiet and Withdrawn

Lack of Motivation Increased Stress Levels

Mood Change Decreased Tolerance

Irritability

Uncontrolled Temper Aggression

Self management

Supervisory monitoring Double check critical tasks Consider relief of duties

Cease work immediately Relieved of duties, and transported to sleeping accommodation

Risk Identification Risk Mitigation

• Have rostered hours been exceeded? ID

• Has the individual obtained at least 6hrs sleep in the last 24hrs? ID

• Is the individual experiencing fatigue-related symptoms or behaviours? ID

• What safety critical tasks is this individual performing?

• What could potentially go wrong if they’re tired? Mitigation

• Should this individual continue with planned work?

• What can be done to reduce the likelihood of error? Mitigation

• Work hour parameters • Biomathematical modelling • Planned v’s actual work hours

• Min 6 hours sleep / 24 hours • Max 18 consecutive hours awake • Reporting protocols

• Reporting protocols • Investigation criteria • Review & improvement

• Define symptoms • Avoid “inform supervisor if tired” • Reporting protocols

Managing Fatigue: It’s About Sleep!

Ind

ivid

ual

res

po

nsi

bili

ty

Org

anis

atio

nal

res

po

nsi

bili

ty

Remember – it’s a joint responsibility

Fatigue

Work-Related

Hours of Work

Work Tasks & Environment

Non-Work Related

Situation & Lifestyle

Physiological / Medical Reasons

Summary

• Sleep is a basic biological need that is essential to our

health, performance, safety and quality of life

• Sleep deprivation has serious negative consequences

• Signs and symptoms of sleep difficulties should never

be dismissed, but discussed with a doctor for further

referral

Questions?

Dr Kirsty McCulloch

Director & Principal Consultant

e: kmc.consulting@outlook.com

m: 0401 059 030