The Symptoms of Fatigue

A news release from the RAND Corporation in November 2016 stated that a lack of sleep leads to the UK losing around 200,000 working days a year and was costing the economy up to £40 billion per annum. In addition to the effect on the economy, fatigue can also cause serious work-related accidents and even loss of life.

Road Accidents

Driving is the most dangerous work-related activity undertaken by most people. Research suggests that almost one in five accidents on major UK roads are related to fatigue, and about 40 per cent of those involve commercial vehicles.

Many professional drivers, especially HGV drivers, report increased levels of sleepiness and are involved in a disproportionately high number of fatigue-related accidents.

A 2017 study discovered that amongst 2170 trainee anaesthetists in the UK, 84% said they had felt too tired to drive home following a night shift, and 57% had experienced an accident or near-miss when driving home from a night shift.

People are killed or seriously injured every week in crashes involving someone driving, riding or otherwise using the road for work-related purposes. Department for Transport figures for 2015 show fatigue was a contributory factor in 68 deaths on Great Britain’s roads. In addition to these fatalities, 435 people were seriously injured, and 2,279 people suffered minor injuries in accidents caused by fatigued drivers. These figures are worse than those for accidents involving drivers who were impaired by illicit or medicinal drugs.

The statistics for fatigue-related driving are so poor because sleep-related accidents are more likely to result in a fatality or serious injury as they tend to be high-speed impacts, simply because a driver who is asleep at the wheel cannot brake or swerve to avoid or reduce an impact.

Fatigue and Shift Work

There is a direct link between shift work and fatigue. The incidence of accidents and injuries is higher on night shifts, following a series of shifts, after long shifts and when there are insufficient breaks.

There are over 3.5 million shift workers in the UK. They work in many industries including the emergency services, healthcare, manufacturing (including the oil, gas & chemical industries), the utility services, transport and retail.

Fatigue, accidents, injuries and ill health in these industries are often caused by long working hours and poorly planned shift-working arrangements that do not adequately balance the demands of work with the time needed for rest and recovery.

Interruption of sleep can lead to “sleep debt” which in turn leads to fatigue. Night workers are particularly at risk of sleep debt because their daytime sleep is often lighter, shorter, and more easily disturbed. The worker is also often reluctant to sleep during daylight.

The Symptoms

Fatigue is defined as the state of feeling very tired, weary or sleepy. The symptoms can include:

  • slower reaction times
  • difficulty in processing information
  • more frequent lapses of attention or memory
  • decreased awareness
  • underestimation of risk
  • reduced coordination
  • occasionally falling asleep
  • momentarily or for several minutes
  • increased irritability

Fatigue in a workplace setting can lead to errors, accidents, injury, ill-health and reduced productivity due to presenteeism. This is when an employee is at work, but working at a sub-optimal level.

The Causes

Fatigue is the result of insufficient sleep, prolonged mental or physical work, or poor working conditions, including prolonged exposure to harsh environmental conditions, like working outside in the rain or snow.

A heavy workload or having to perform boring or repetitive tasks, and extended periods of stress or anxiety can also produce feelings of fatigue, as can some medical conditions.

The Law

Employers have a legal duty to manage fatigue because it is considered to be a hazard. Although the Working Time Regulations dictate certain aspects of how working hours should be organised, compliance alone is not sufficient to adequately manage the risks. Scheduling of work hours should occur irrespective of an individual’s willingness to work extra hours or their preference for specific shift patterns. The employer must be aware of the hours a person works and must take action to prevent any risk to the worker or others.

If an employee is required to drive on the road as part of their job the employer is also expected to assess the risks involved and put in place all “reasonably practicable” measures to manage those risks. These measures should ensure that their drivers are not at risk of falling asleep at the wheel.

How To Combat Fatigue

Employers can help combat fatigue through a fatigue risk management system. This may include developing a robust system of recording working hours, overtime, shift-swapping and on-call working. The key features should be:

  • Balanced workload and staffing – spreading workloads between staff and thereby reducing the likelihood of fatigue.
  • Shift scheduling – ideally employees should work during the day rather than at night, consecutive day shifts should be restricted to five or six days and night shifts to four days, safety-sensitive work may have to be allocated to other employees or another time to take advantage of alertness, frequent breaks should be provided and workers should have at least two consecutive days off.
  • Workplace design – ensuring the workplace has bright lighting, cool temperatures, and minimising humidity, noise and vibration.
  • Monitoring of fatigue – reporting of fatigue-related incidents, investigation and auditing.
  • Fatigue related training and education- including promoting the importance of sleep and good sleep habits, and how to recognise fatigue.

Fatigue can occur in all industries, but those that are at the highest risk are where people work long hours or many days in a row.

The key to reducing fatigue in the workplace is having a management system in place. The HSE has produced detailed guidance for employers on complying with the law and also provides a Fatigue Risk Index which is a useful tool that can help employers schedule work hours.

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