Back to Basics is a weekly feature that highlights important but possibly overlooked information that any EHS professional should know. This week, we examine how to manage worker fatigue.
Workers face many hazards on the job, but one of the most overlooked may be fatigue. Worker fatigue increases the risk for illnesses and injuries and it affects workers across many industries, including healthcare, transportation, the military, construction, service and hospitality, and first responders.
Fatigue can be caused by too little, poor quality, or interrupted sleep over a period time, according to the Occupational Safety and Health Administration (OSHA). Long work hours and extended or irregular shifts may lead to fatigue, which in turn leads to physical and mental stress. Extended work shifts can also result in prolonged exposure to potential health hazards such as noise and chemicals.
Accident and injury rates are 18% greater during evening shifts and 30% greater during night shifts when compared to day shifts, according to OSHA. Working 12 hours per day is associated with a 37% increased risk of injury.
Indeed, OSHA notes, decreased alertness from worker fatigue has been cited in the following:
- Industrial disasters including the Texas City BP oil refinery explosion of 2005, the Colgan air crash of 2009, the explosion of the space shuttle Challenger, and the nuclear accidents at Chernobyl and Three Mile Island.
- An increase in sleep problems and injury risk among full-time employees in relation to the number of hours worked per week.
- Errors in patient care, increased needlesticks and exposure to blood and other body fluids, and increased occupational injuries among healthcare workers.
- Directly or indirectly linking to increased costs from lost productivity, increased injury and illness costs, increased time off the job due to illness, and increased workers’ compensation costs.
- An estimated annual cost of $136.4 billion from fatigue-related, health-related lost productive work time to employers.
The impact of fatigue
Fatigue can cause weariness, sleepiness, irritability, reduced alertness, impaired decision-making, and a lack of motivation, concentration, and memory, according to OSHA. Fatigue is also linked to health issues such as:
- Heart disease
- Stomach and digestive problems
- Musculoskeletal disorders
- Reproductive problems
- Depression
- Some cancers (breast and prostate)
- Sleep disorders
- Poor eating habits and obesity
- Worsening of existing chronic diseases such diabetes and epilepsy
Managing fatigue
According to the National Safety Council (NSC), a typical employer with 1,000 employees can expect to experience more than $1 million lost each year to fatigue: $272,000 due to absenteeism and $776,000 due to presenteeism, which is when employees come to work while sick or unwell, leading to decreased productivity and potential spread of illness.
Employers can take the following steps to reduce the risk of fatigue in the workplace and assist employees in getting the proper amount of sleep, according to the NSC.
Employees with rotating shift schedules or frequent night shift schedules face higher risks of fatigue. To avoid this, employers should:
- Avoid assigning permanent night shift schedules if possible
- Assign regular, predictable schedules
- Avoid long shift lengths (no longer than 12 hours, 8-10 hours is preferable)
- Provide adequate time to recover between shifts
- Give employees input into their schedules
- Rotate shifts forward when regularly rotating shifts
- Provide frequent breaks within shifts
Other options include allowing napping where feasible, according to the NSC. Encouraging employees to rest when it’s safe could prevent an injury or mistake.
Providing education about the importance of sleep is also important. This can help employees avoid the risks of fatigue. In addition to scheduling changes, employers can:
- Promote in-person and online programs focused on sleep
- Offer sleep disorder screening programs
- Make sleep part of corporate wellness programs
The NSC advises that employers adopt a sleep health culture and support workers in taking advantage of these programs. Employers should:
- Discourage employees from sacrificing sleep for work-related activities
- Provide accommodations if early or late hours are required
- Provide transportation or nap facilities to help employees stay alert while driving to or from work
- Adopt policies that encourage work-related activities such as email during off hours
Sleep Matters Initiative
For more help with sleep health education and sleep disorder screening programs, contact the Sleep Matters Initiative (SMI), which is led by clinicians and researchers at Brigham and Women’s Hospital and Harvard Medical School. The SMI aims to improve health, safety, performance, and well-being of people by putting research on sleep and circadian rhythms into practice.
The SMI provides research programs, advocates for sleep and circadian-friendly policies, and by developing evidence-based interventions and educational offerings for businesses and schools. Among its offerings are sleep health and wellness programs, fatigue risk management program evaluation, an electronic sleep diary, travel policies and recommendations, schedule design, and a fatigue risk management certification program.