Lesson 3 – Risk-Based Fatigue Management

Fatigue

The level of fatigue for both individuals and work groups is determined by a wide variety of interacting variables.  The following diagram sets out an overview of the major causes of fatigue. Whilst the above model is not claimed to be a complete representation of all the cause of fatigue, it points towards a need to broaden our efforts to manage this issue.   It suggests that effectively managing fatigue requires a comprehensive and integrated strategy.  The main aims of such an approach are to ensure that;

• Recruitment processes identify candidates with a potential for fatigue (e.g. those with sleeping disorders).
• There is a regular review and improvement of organisational issues practices to manage work related cause of fatigue (including exposures, shift and roster design etc.) to minimise the potential for fatigue.
• Employees develop the attitudes and skills necessary to manage their fatigue.
• Employees are willing to monitor and intervene when a work mate appears fatigues.

 

The main aims of such an approach are to ensure that;

• Supervisors have the knowledge, skills and willingness to:

–Actively monitor and manage fatigue;

–Foster a culture that supports employee self-management; and,

–To take wearily and appropriate action where doubt exists about an individual’s capacity to carry   out his or her assigned tasks safely.

• There is an ongoing and effective strategy to promote employees’ capacity to manage fatigue.
• Effective strategies are in place to assist and manage employees’ who’s fitness for work is compromised by fatigue or other causes.

 

Key Misconceptions in the Management of Fatigue

The management  of fatigue has been a contentious issue in the workplace in recent years.  This has given  rise to three key misconceptions that have limited the effectiveness  of the workplace’s  efforts to address this issue.  These are:

• Fatigue can be effectively addressed by focusing on rosters and hours of work (or the other so called “work related” causes of fatigue).
• Efforts to control  fatigue  should  have  as  their  primary  focus  the  establishment  of workplace “systems” rather than focusing on the key role of the individual in managing fatigue.
• That there will soon be a technological “silver bullet” that will solve all fatigue problems.

 

Whilst  workplace  issues are important  in the management  of fatigue, this review is based on the following assumptions:

• The primary cause of fatigue is inadequate or poor-quality sleep.
• The effective management of fatigue depends on the management  of the organisation’s culture and on the promotion of self-management than on technological solutions.

 

The Impact of Fatigue

Fatigue can have considerable impact on organisations and individuals.

 

These include:

• Organisational costs

 

The direct costs to organisations include:

• Increased rates of incidents and accidents
• Loss of productivity
• Higher maintenance costs
• Higher levels of absenteeism and turnover.

 

Health effects on employees

Fatigue may have adverse effects on the health of individuals.   Evidence from studies of shift workers indicates a higher incidence of:

• Increased accident rates both at work and in employee’s private time.
• Increased levels of medical disorders (gastrointestinal, cardiovascular etc.).
• Higher levels of stress and complaints associated with stress (e.g., anxiety, depression).
• Higher rates of personal and marital problems.

Those already suffering from digestive disorders, diabetes, heart  diseases, psychological problems, alcohol and drug addictions and chronic sleep disturbances face additional burdens.

 

Effects on family and social life

• The fatigue and disruption that results from shift work or excessive hours of work often makes a normal family life and social commitments difficult  for employees,  families and communities. This  dislocation,  results  in  pressures  on  relationships,  domestic  workloads  and  community activities.  This has implications for safety and health, productivity, morale, absenteeism and turnover rates.

 

ASPECTS TO BE CONSIDERED WHEN DEALING WITH FATIGUE

Introduction. What is Fatigue?

Fatigue can be defined as increasing difficulty in performing physical or mental activities. Signs of fatigue include tiredness even after sleep, psychological disturbances, loss of energy and inability to concentrate. Fatigue can lead to incidents because workers are not alert and are less able to respond to changing circumstances. As well as these immediate problems, fatigue can lead to long term health problems.

 

Factors  to be considered when addressing fatigue at mines

Causes of fatigue

• Fatigue is a loss of alertness & performance caused by: Too little sleep
• Poor quality sleep
• Working at times you should be asleep
• Mentally or physically demanding work

 

The Extent of Fatigue

• The above guidelines  appear to associate most of the cause of fatigue with shift work, hours of work and other organisational issues.  Whilst these factors are important and need to be addressed,  these formulations leave out many of the most important factors that contribute to fatigue.  In particular they ignore individual factors such as;

–The presence of sleeping disorders

–Age

–Alcohol and drug use (including caffeine, smoking and sleeping medications)

–Inherent capacity to cope with shift work

–Personal management and skills (preparing for night shift etc.)

–Knowledge and skills to manage the demands of shift work.

–External demands (second jobs, family commitments,  study etc.).

• Acute fatigue is caused by immediate  episodes  of sleep  deprivation,  e.g. because  of long periods of wakefulness  from excessively long shifts or nightshifts without adequate day time rest.  Ongoing sleep disruption can lead to sleep debt and chronic sleep deprivation, placing individuals in a state of increased risk to themselves and to others.
• If sleep deprivation continues,  work performance  can deteriorate  even  further.   Causes of fatigue can result  from features of the work and workplace  and from features of a worker’s life  outside  work.     Levels  of  work-related  fatigue   are  similar  for  different   individuals performing  the  same  tasks.    Work-related   fatigue  can  and  should   be  measured   and managed at an organisational level.  Non-work related causes very considerably between individuals.  Non-work  related fatigue is best managed at an individual level.

 

Work-related Causes

Work-related causes result from:

• Shift schedule  design,  e.g.  too  many  consecutive   night  shifts,  work  time arrangements.
• Aspects of the tasks being undertaken,  e.g. greater  workload  within standard shifts, work stress.
• Features of the working environment, e.g. noise or temperature extremes, poor ergonomic design of workstations and equipment.

 

Non Work-related Causes

Causes of non-work-related fatigue include:

• Sleep disruption due to ill family members.
• Strenuous activities outside of work, such as second jobs.
• Sleep disorders.
• Inappropriate use of alcohol, prescription and illegal drugs.
• Stress associated with financial difficulties or domestic responsibilities.
• Living conditions.
• Lack of exercise.
• Undiagnosed I poor management of medical condition

 

Why is fatigue a Problem?

• Fatigue causes an increased risk of incidents because of tiredness and lack of alertness. When workers  are  fatigued,  they  are  more  likely  to  exercise  poor judgment  and have a slow reaction to signals.   This can increase all risks on site because fatigued workers are less able to respond effectively to changing circumstances,  leading  to increased  likelihood  of  incidents  due  to human  error. Fatigue can also result in long term health problems, such as:

–Digestive problems.

–Heart disease.

–Stress.

–Mental illness.

 

 

Total Worker Fatigue:

• The  fatigue experienced  by  a person  is  an accumulation  of  several  factors  as described above.  Simply put: FT = FSS + FEW+ FPF

 

Where:

• FT    = FSS  = FEW  = FPF         =

 

Total Fatigue

• Fatigue caused by the shift system I rostering
• Fatigue caused by ergonomic, environmental and work factors
• Fatigue caused  by personal factors such as insufficient I poor sleep, health, nutrition and personal lifestyle

 

FSS (Fatigue caused by the shift system I rostering)

• Fatigue augmented by the shift system I rostering can be significantly reduced through the optimal design of the shift system and rostering. In order to assess the risks caused by your shift system, examine each of the risk factors in detail.
  • FEW (Fatigue caused by ergonomic, environmental and work factors) Similarly, fatigue compounded by a  person’s working environment can be  mitigated through ergonomic  interventions, e.g.   cab   designs, and taking the person’s abilities and  limitations into  account.
  • FPF (Fatigue caused by personal  factors  such  as insufficient  I poor sleep, health, nutrition and personal lifestyle)
  • The introduction to the following and I or the education of employees with regards to the following can reduce the risks introduced through a person’s personal circumstances:

–Sleep management.

–Education and training.

–Lifestyle interventions.

–Health screening and counselling.

–Nutrition.

 

Assessing Fitness for Work

• Mine Managers and Supervisors are responsible for assessing the fatigue levels and Fitness for Work of individuals under their control, at the start of and throughout the work period.

 

Minimizing the impact of Fatigue

• Mine Managers and Supervisors will ensure that all practical steps are taken to minimise fatigue and its effects. This will include;

–assessing education on the effects of fatigue, especially its effects on alertness and performance;

–obtaining  the  skills  to  assess  fatigue and  using  their  authority  to  direct  fatigued individuals to leave the work place;

–modifying the physical environment to reduce the impact of fatigue (e.g., using bright lighting to stimulate alertness).

 

Safety Representative

• Responsible for safety related and other inputs and feedback with regards to the Fatigue Management Programme.

 

Occupational Medical Practitioner I OHP

• Responsible for occupational health related and other inputs and feedback with regards to the Fatigue Management Programme.

 

Occupational Hygiene Practitioner

• Responsible for occupational hygiene related and other inputs and feedback with regards to the Fatigue Management Programme.

 

Engineering Representative

• Responsible for engineering related and other inputs and feedback with regards to the Fatigue Management Programme.

 

Union Representative

• Responsible for assisting the Fatigue Management Committee and Barberton Mines (Ply) Ltd management by being actively involved in the development of the Fatigue Management Programme and implementation thereof by interacting with their members and branch management with regards to the strategies.

 

Employees and Individuals (contractors, visitors)

• Each individual is responsible to ensure their own safety and health at work and to avoid adversely affecting the health and safety of any other person. In order to fulfil this responsibility, each individual has the following obligations.

 

Reporting for work in a fit condition.

• Individuals are expected to arrive at work sufficiently rested to be able to safely perform their duties for the duration of the work period. This will include;

–ensuring that they obtain adequate sleep to prevent fatigue (this is especially important for shift workers who should actively plan to obtain adequate rest);

–ensuring that their activities outside working hours do not compromise their capacity to work safely and effectively; and

–exercising particular care to prevent fatigue at critical times such as returning to site, shift change and commuting.

• If the employee reports for work and believes they are not sufficiently rested to commence duties they must report it to their supervisor.

 

Notification of any actual or potential impairment of Fitness for Work

• Individuals must notify their immediate Manager I Supervisor of any concerns about or potential impairment of their Fitness for Work due to fatigue or any other issue. This includes;

–notifying the company of  any  commitments (other jobs,  hobbies, study, excessive commuting time etc.) which may cause them to be fatigued (the Manager will assess the potential impact of this on their ability to comply with the requirements of this procedure); and

–informing their supervisor if at any time during the shift they become too fatigued to work safely.

 

 

Appropriate use of medication

• Individuals must ensure that any prescription or non-prescription medication that could cause fatigue is taken safely. This requires individuals to;

–Discuss with the prescribing medical practitioner the nature of their duties and any possible impact of the medication on their safety or work performance.

–Notify their immediate manager or the site medical staff of any medication that could affect their safety or work performance.

–Take medication strictly in accordance with their doctor’s instructions or the manufacturer’s recommendations.

–Report any side effects to their doctor and to advise their immediate manager or the site medical staff of their concerns.

 

 

Notification of breaches of the Policy

• All individuals must notify their immediate Manager or Supervisor of any situation in which this policy may have been breached. This includes any  situation in  which  the  other individuals may be fatigued and unfit for work or any other apparent breach of the policy.
• All such information will be dealt with in confidence in accordance with the procedure below on confidentiality.

 

Assistance for Employees with Fatigue Problems

• The site will ensure that all individuals have access to a confidential and professional assistance to address and resolve work and personal issues that might cause fatigue. This will require the site to establish appropriate medical and psychological providers with specific expertise in this area. In addition, these providers will also advise and support Managers and Supervisors in dealing with employees with fatigue and other Fitness for Work problems.

 

Management of Employees who are Fatigued at work

• Individuals who are fatigued at the commencement of the working period
• Where a manager or supervisor believes that an individual may be fatigued at the start of shift, they will assess the situation and decide;
• if the individual is to be allowed to,

–remain at work doing their normal duties, or,

–be removed from their duties but perform other useful work, or,

–be stood down and sent home for the rest of the shift.

• if the fatigue is a result of,

–the individual’s deliberate decisions or behaviour, or

–factors outside the individual’s control (e.g., difficulty sleeping during the day). The supervisor will also record the incident through the appropriate process,

–take appropriate action which may include referral for assistance or appropriate disciplinary counselling.

• Where the supervisor is aware of repeated occurrences of such behaviour, he or she should refer the individual to the appropriate manager for assessment and action.
• Managing individuals who become unfit for work during the course of a work period
• Where an individual becomes fatigued during a working period, the supervisor will; ensure that the individual is immediately isolated from the workplace and prevented from driving a vehicle or operating any machinery until an assessment has been made.
• The supervisor will consider the specific circumstances of the situation and consider action such as:

–continue at work with increased supervision or assistance from a co-worker,

–a rest break of appropriate duration at a location away from the workplace,

–allocation to other, non-safety sensitive duties,

–removal from the workplace and transport back to his or her accommodation.

• The supervisor will also;

–attempt to determine if the Fatigue is a result of,

i.the individual’s deliberate decisions or behaviour, or,

ii.factors outside the individual’s control (e.g., difficulty sleeping during the day.

–record the incident through the appropriate process,

–take appropriate action which may include referral for assistance or appropriate disciplinary counselling.

• Where the supervisor is aware of repeated occurrence, he or she should refer the individual to the appropriate manager for assessment and action.

 

Counselling and Discipline Procedures

• All counselling and disciplinary action taken in support of this procedure shall be carried out in accordance with the company’s HR Policies and Procedures.

 

Protection of Job Security

• Employee’s promotional opportunities and job security will not be jeopardized because of voluntary notification that they are fatigued.  However, if the employee is identified as being fatigued on a regular basis then the matter will be managed through the company’s usual Policies and Procedures.

 

THE EFFECTIVENESS OF THE FATIGUE MANAGEMENT PLAN

With any safety programme, the direct measurement of effectiveness is extremely difficult for a number of reasons including;

• Direct measurement tends to focus on the high probability (but typically low impact) events. These often tell us little about the likelihood of a catastrophic event.
• Changes in any targeted outcomes result from a large number of known and unknown factors and these may conceal the true effects of the programme.
• In addition, an exclusive focus on outcome measures often results in efforts to “manage the figures” rather than the risks.

 

As  a  result  of  the  above,  the measurement  of  programme  effective  should  strike  an  appropriate  balance between “leading indicators” and outcome measures.  The following are examples of the former;

• The number of individuals diagnosed and treated with sleeping disorders.
• The number of individuals who self-report fatigue when at work.

 

Obviously we should be interested in outcomes and these will involve the usual measures such as;

• Incident I accident rates
• Equipment damage
• Feedback from employees, etc.