Fatigue Risk Management in the Workplace

March 8, 2012
Worker fatigue is a risk factor that can be managed like any other hazard in the workplace. The American College of Occupational and Environmental Medicine’s (ACOEM) Presidential Task Force on Fatigue Risk Management recently released a guidance document to provide background, key concepts and references needed to promote and support a fatigue risk management system (FRMS).

Worker fatigue adversely can impact personal health and safety as well as the efficiency and safety of operations. The most effective method to minimizing worker fatigue is through a comprehensive FRMS. An FRMS requires the active participation of all parts of the organization, including management, support functions and workers, according to ACOEM’s task force.

Fatigue and decreased alertness resulting from insufficient or poor-quality sleep can have several safety-related consequences, including slowed reaction time, reduced vigilance, reduced decision-making ability, poor judgment, distraction during complex tasks and loss of awareness in critical situations. Workers believe they adapt to chronic sleep loss or that recovery requires only a single extended sleep episode, but studies have shown that this is not the case.

Key Components of an FRMS

According to the task force, key components of an FRMS include:

· A fatigue management policy;
· Fatigue risk management, including collecting information on fatigue as a hazard, analyzing its risk, and instigating controls to mitigate that risk;
· Fatigue reporting system for employees;
· Fatigue incident investigation;
· Fatigue management training and education for employees, management (and families);
· Sleep disorder management; and
· A process for the internal and external auditing of the FRMS that delivers corrective actions through a continuous improvement process.

An FRMS requires a senior manager to be ultimately accountable for managing fatigue risk. However, all key stakeholders need to be actively engaged, according to the task force.

“A positive organizational culture where employees and management trust one another and where information about fatigue is openly reported is important to the successful implementation of an FRMS,” wrote the members of the task force. “As with the management of all risks, however, there is not a ‘one-size-fits-all’ solution and the FRMS must be developed in response to the needs of the industry, the regulatory environment and the organization in which it applies.”

Most Overlooked Cause of Fatigue

We’re all doing more with less. According to the task force, one of the most important (but frequently overlooked) root causes of employee fatigue is an imbalance between workload and staffing levels. Extensive academic research and employer attention has been paid to the relative merits and risks of shift scheduling alternatives such as 12-hour shifts versus 8-hour shifts, fixed shifts versus rotating shifts, clockwise rotating versus counterclockwise rotating shifts and fast-rotating versus slow-rotating schedules. These measures do not recognize the underlying impact of staffing levels in the outcome metrics that are used.

According to the task force, the imbalance between workload and staffing levels can worsen problems with shift work and scheduled and unscheduled employee absences can worsen problems with shift work.

Changes in workload (increased demand, merging of facilities, etc) can worsen problems with shift work. For example, staffing levels, not shift schedules, play the largest role in determining the following:

· Average amount of overtime per employee;
· Average time off between shifts;
· Average time off between consecutive blocks of shifts;
· Average length of shifts;
· Average work hours per week;
· Average number of consecutive days worked;
· Discrepancy between the published shift schedule and the actual shift schedule worked.

This is because, in most 24/7 operations, the number of positions to fill on each shift is fixed. If the staffing level is lower than optimal, then the employees in that operation have to work additional hours or extra shifts to keep the positions filled. These hours often are added by holding employees over for additional hours at the end of their shifts; bringing in employees early for additional hours at the beginning of their shifts; bringing employees into work on their days off for additional shifts; having employees work double or even triple shifts; and short notice call-in to cover vacant positions.

“As a result, the amount of overtime worked by employees is increased, and the additional hours and days worked make the published shift schedule a work of fiction,” claim the members of the task force.

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