Managing Fatigue

Training Program for Employees

Managing Fatigue

For the Employee

What is FatigueSigns of fatigueWhat causes fatigueFatigue mitigation strategiesUtility Policy

What is Fatigue

“A reduction in physical and/or mental capability as the result of physical, mental or emotional exertion which may impair nearly all physical abilities including: strength; speed; reaction time; coordination; decision making; or balance.”

Source: International Maritime Organization, Maritime Safety Committee Circular

Signs of Fatigue

Signs of FatigueConstant yawningBlurred visionHeavy or sore eyesPoor concentrationSlowed reaction timePoor judgmentSpeech slurredHeadachesDecreased ability to exert force

Leg pain and crampsLoss of appetiteGiddinessDecreased ability to pay attentionIrregular heart beatsHeaviness in arms and legsDecreased eye-hand coordination

What Causes Fatigue

Lack of Sleep Quality of SleepBiological Clock (circadian rhythm) factorsShift work Extended HoursHealth (diet and/or illness) Ingested chemicals (alcohol, drugs, caffeine)

Lack of Sleep (an off duty issue)

Individuals’ needs are unique Recommended 7 – 8 hours of sleep per 24 hour

period 5 stages of Sleep

Stage 1 – Light Sleep - less than 10% Stages 2-4 – Deep Sleep - approximately 65% Stage 5 - REM Sleep – Rapid Eye Movement Sleep

– approximately 25% Each cycle takes about 90 minutes = 5-1/2 cycles

per 8 hour night Need all five stages for the body’s recovery from

daily fatigue

Quality of Sleep (an off duty issue)

Sleep should be Uninterrupted Try for long periods of sleep

Short naps will not restore the body to normal operation.

One seven hour period of sleep is much more restorative than seven one hour naps

Try for sufficient sleep before any periods you anticipate a sleep deficiency

Biological Clock

Most animals (including Humans) follow a daily routine (song birds in the morning, nocturnal animals, etc.)

Called Circadian Rhythm

Time related information controlled within the hypothalamus region of the brain

Melatonin hormone. Increase in Melatonin – Decrease in alertness

Biological Clock

Human Circadian Rhythm is actually on a 25 hour clock. Did you ever notice it’s easier to stay up late than it is to

get up early? Jet Lag is a symptom of the body trying to reset the

biological clock to a new time zone. It is easier to “reset” when flying east to west (You get to

sleep-in in the morning) than when flying west to east (You have to get up earlier than your internal clock expects).

The internal clock can only adjust by an hour or two each day. This is helped by environmental cues (such as

darkness)

Biological Clock

Humans exhibit two “Troughs” or low points in alertness One between midnight and 6 am One between 2 and 4 pm

Fatigue related motor vehicle accidents are: Twice as high at 2 pm as they are at 10 am Six times as high at 2 am as they are at 10 am

Biological Clock

What do the following have in common?

•Three Mile Island

•Chernobyl

•Bhopal

•Exxon Valdez

The Midnight Shift

1979 - Three Mile Island – 4 am local time - Pressure relief valve opens dumping reactor coolant – control room operators failed to recognize the event. Core meltdown

1984 – Bhopal, India – shortly after midnight Methyl Isocyantate Gas (MIC) leak kills 3,800

1986 - Chernobyl Reactor disaster – 12:23 am – 1:28 am local time - critical control room operator error in failing to reset a controller. Core meltdown and release

1989 – Exxon Valdez – 12:04 am ship hits Bligh Reef and spills 10.8 Million gallons of oil

Extended Hours

Normal work day and week = 8 hours per day and 5 days per week

Anything greater is Extended hours OSHA recommendations:

Limit use of extended hours Take additional breaks Tasks that require heavy physical labor should be

performed at the beginning of the shift Monitor for the signs and symptoms of fatigue

Extended Hours

A study by sleep researchers in Australia found that: A person kept awake for 17 hours will exhibit behaviors

and performance of someone with a Blood Alcohol Concentration (BAC) of 0.05

A person kept awake for 24 hours will exhibit behaviors and performance of someone with a BAC of 0.10

Health Issues (an off-duty issue)

Fatigue can be associated with: Medical Conditions (such as heart problems) and Illness (common cold or fever)

Diet can affect feelings of fatigue Refined sugars can cause a short term energy boost but

are often followed by a rapid drop in blood sugar levels causing weakness and instability

Eating a large meal before bedtime can disrupt sleep Psychological Issues of stress or family worries can disrupt

sleep There are Sleep Disorders such as insomnia or sleep apnea

(waking up suddenly due to interrupted breathing)

Ingesting Chemicals (an off duty issue)

Medications can cause drowsiness Caffeine - short duration alertness but

side affects hypertension, headaches, mood swings and anxiety

Alcohol is a depressant however, the important REM sleep is disrupted

preventing body recovery.

Fatigue Mitigation Strategies

Develop a pre-sleep routine (warm shower, reading a book) Sleep in a dark, quiet, cool environment Avoid alcohol prior to sleep Avoid caffeine at least six hours prior to sleep Eat regular, well balanced meals Drink a sufficient amount of water Exercise regularlyGet enough proper sleep

Utility Policy

Insert utility policies

References

“Driver fatigue - an accident waiting to happen”, by academy staff of the Australian Academy of Science, June 2006

“Guidance on Fatigue Mitigation and Management”, MSC (Marine Safety Committee) Circular 1014, International Maritime Organization, June 12, 2001

“Extended/Unusual Work Shifts”, Occupational Safety and Health Administration (OSHA), September, 2, 2004

“Sleepless in Seattle: injured worker’s case shows hazards of fatigue”, Shoop, Julie Gannon, Publication: “Trial”, Dec. 1, 1993

“Personal & Financial Health” Scott, Diane E., RN MSN, Vermont Nurse Connection, Feb. 1, 2008

“Circadian Rhythms and Shift Work” American College of Emergency Physicians, September 2003