Health & Safety

DEMM Engineering & Manufacturing - - EDITORIAL -

1. AD­E­QUATE SLEEP IS ES­SEN­TIAL FOR MAIN­TAIN­ING AND RESTOR­ING FULL HU­MAN FUNC­TION­ING

Most hu­mans need an av­er­age of around 7.5–9 hours of good qual­ity sleep a night for con­sis­tent phys­i­cal and men­tal re­cov­ery from daily ac­tiv­i­ties. Get­ting ad­e­quate sleep is the only way to re­cover from fa­tigue, es­pe­cially for the brain. Just as mus­cle fa­tigue can only be re­versed through rest, men­tal fa­tigue can only be re­versed through sleep.

Sleepi­ness, like hunger and thirst, is a sig­nal from the body of a ba­sic need. In ex­treme sleepi­ness, a per­son may be­gin to ‘nod off’ with­out be­ing aware of do­ing so, or even fall asleep.

Work-re­lated sleep loss is a sig­nif­i­cant pub­lic health is­sue. In a re­cent sur­vey, 37 per­cent of New Zealan­ders aged 30 to 60 years said that they ‘never’ or ‘rarely’ got enough sleep at night, and 46 per­cent said they ‘never’ or ‘rarely’ woke up feel­ing re­freshed.

In the short term, peo­ple who do not sleep well tend to eat more, and are more likely to pick up in­fec­tions. Long-term health ef­fects re­lated to sleep prob­lems in­clude di­ges­tive sys­tem up­set, car­dio­vas­cu­lar dis­ease, and other com­plaints.

Im­pli­ca­tions for em­ploy­ers

When em­ploy­ees’ sleep is af­fected by shift work ( par­tic­u­larly night work) they will not func­tion as ef­fec­tively as em­ploy­ees who work nor­mal day shifts.

Aim to man­age shift work and over­time so that em­ploy­ees have reg­u­lar op­por­tu­ni­ties for ad­e­quate re­cov­ery through high qual­ity sleep.

2. STIMULANTS PRO­VIDE ONLY LIM­ITED, SHORT­TERM RE­LIEF

The use of stimulants such as nico­tine, caf­feine, and some other drugs can help main­tain alert­ness in the short term. How­ever, this gain comes at a cost – the ‘crash’ when the ef­fects of the stimulants wear off. Poor qual­ity sleep may re­sult from carry- over ef­fects of the stimulants.

Sleep­ing tablets can re­duce fa­tigue ef­fec­tively if used ap­pro­pri­ately and for lim­ited pe­ri­ods. How­ever, they just mask the prob­lem if the causes of sleep prob­lems re­main un­changed. Only good qual­ity, nat­u­ral sleep will pro­vide full re­cov­ery.

Im­pli­ca­tions for em­ploy­ers

Pro­vid­ing cof­fee is not a solution to work­place fa­tigue. You need to man­age shift work in ways that re­duce em­ploy­ees’ need for stimulants.

3. FA­TIGUE LEADS TO PHYS­I­CAL AND MEN­TAL IM­PAIR­MENT

Lab­o­ra­tory stud­ies in­di­cate that fa­tigue im­pair­ment can be equal to or greater than al­co­hol im­pair­ment.

In the work­place, fa­tigue may cause work­ers to:

• Feel sleepy.

• Find it hard to pay at­ten­tion.

• Have slower re­ac­tion times and poorer co­or­di­na­tion.

• Have slower, mud­dled think­ing.

Im­pli­ca­tions for em­ploy­ers

Eval­u­ate the risks posed by tasks per­formed when lev­els of fa­tigue can be ex­pected to be high, and have sys­tems in place to de­tect fa­tigue im­pair­ment. De­sign work to pre­vent fa­tigue ac­cu­mu­lat­ing, and sup­port re­cov­ery by pro­vid­ing ad­e­quate op­por­tu­ni­ties for high qual­ity sleep.

4. SHIFT WORK ( PAR­TIC­U­LARLY NIGHT WORK) CAN BE A SIG­NIF­I­CANT CAUSE OF FA­TIGUE

While shift work in it­self in­evitably pro­duces fa­tigue, it is not the only di­rect cause. Shift work acts as a cause of fa­tigue along with other work and non-work fac­tors.

Other causes of shift worker fa­tigue may in­clude:

• Phys­i­cal and men­tal task de­mands – high work­load, lack of breaks, work du­ra­tion, type of work, work sched­ul­ing, un­pre­dictabil­ity of hours of work.

• En­vi­ron­men­tal fac­tors such as noise, ar­ti­fi­cial light, heat, hu­mid­ity, and vi­bra­tion .

• Bi­o­log­i­cal fac­tors – lack of sleep, less func­tional times in the body’s daily cy­cle, poor health.

• Ac­tiv­i­ties away from work – fam­ily re­spon­si­bil­i­ties, so­cial com­mit­ments, com­mut­ing.

Shift work­ers have more ac­ci­dents com­mut­ing to and from work than non- shift work­ers, which are likely to be caused by fa­tigue.

Im­pli­ca­tions for em­ploy­ers

You need to be es­pe­cially alert to the pos­si­bil­ity of fa­tigue-in­duced im­pair­ment in shift work­ers by:

• Iden­ti­fy­ing the times when work­ers are more likely to be af­fected by fa­tigue.

• Tim­ing the start­ing and end­ing points of shift ros­ters to min­imise fa­tigue.

• Ap­ply­ing and fol­low­ing the types of strate­gies de­scribed in part 2.

5. ALERT­NESS AND CA­PA­BIL­ITY VARY WITH THE TIME OF DAY

Peo­ple’s abil­ity to be alert or to fo­cus at­ten­tion is not con­stant through­out the course of a day. There are two low points dur­ing the 24-hour cy­cle, which oc­cur for most peo­ple some­where be­tween 3.00 and 5.00am, and again be­tween 3.00 and 5.00pm.

These low points are re­flected in the times when most fa­tigue-re­lated driv­ing ac­ci­dents hap­pen.

Im­pli­ca­tions for em­ploy­ers

This in­for­ma­tion has pos­si­ble im­pli­ca­tions for:

• Task sched­ul­ing.

• Per­for­mance ex­pec­ta­tions.

• The num­ber, length, and use of breaks.

Shift work­ers may be less able to as­sess their safety and mod­ify their be­hav­iour dur­ing the low­func­tion­al­ity times of day or night. You and your em­ploy­ees need to agree to take a con­ser­va­tive ap­proach to safety at those times.

The par­tic­u­lar mea­sures you take to pre­vent fa­tigue-re­lated er­rors will de­pend on the risk – how likely such er­rors are, and how se­ri­ous their con­se­quences would be.

6. PEO­PLE ARE PRO­GRAMMED TO BE AWAKE DUR­ING THE DAY AND ASLEEP AT NIGHT

Hu­mans have an in­built ‘body clock’ that con­trols daily rhythms of alert­ness and sleepi­ness.

When peo­ple do shift work they must try to over­ride the body clock to re­main ac­tive at night when the body wants to sleep, and to sleep when the body wants to be ac­tive. As a re­sult, they may be work­ing when they are at their least func­tional and most er­ror­prone, and not get­ting enough sleep be­tween shifts to re­cover fully.

The body clock sel­dom adapts fully to shift work. An ex­cep­tion is when work­ers are never ex­posed to day­light at all. Work­ers on oil plat­forms in the North Sea, for ex­am­ple, al­most com­pletely re­verse their body rhythms af­ter 2 weeks of work­ing in this way.

Im­pli­ca­tions for em­ploy­ers

Try to min­imise dis­rup­tion to nat­u­ral rhythms when plan­ning shift work. Pro­vide a ros­ter that al­lows em­ploy­ees to reg­u­larly re­set their body clocks to the nat­u­ral rhythms.

7. THE ABIL­ITY TO FALL ASLEEP EAS­ILY VARIES WITH THE TIME OF DAY

Gen­er­ally speak­ing, most peo­ple fall asleep nat­u­rally some­where be­tween 10.00 and 11.00pm, (al­though peo­ple do vary, with some pre­fer­ring to go to bed ear­lier, and oth­ers pre­fer­ring to stay up later). There is a pe­riod of wake­ful­ness be­fore this, from around 6.00pm to 10.00pm, when it is dif­fi­cult for most peo­ple to fall asleep.

It is also dif­fi­cult to fall asleep when the in­ter­nal drive to be awake reaches its daily peak. This hap­pens about six hours af­ter the ear­ly­morn­ing peak in sleepi­ness; that is, late morn­ing for most peo­ple. It may be slightly later af­ter a se­ries of night shifts.

Im­pli­ca­tions for em­ploy­ers

Where prac­ti­ca­ble, avoid or min­imise con­sec­u­tive shifts that mean em­ploy­ees will need to sleep at those times when fall­ing asleep is most dif­fi­cult.

8. HOW MUCH TIME PEO­PLE NEED TO RE­COVER FROM FA­TIGUE DE­PENDS ON THE TIME OF DAY

This fact, to­gether with the fol­low­ing one (sleep loss is cu­mu­la­tive), means that while it is rea­son­able to ex­pect em­ploy­ees to get ad­e­quate sleep dur­ing a nor­mal overnight break of 12 hours, it is not rea­son­able to ex­pect that they will get ad­e­quate sleep in a 12-hour break that be­gins in the morn­ing.

Im­pli­ca­tions for em­ploy­ers

If pos­si­ble, al­low em­ploy­ees longer pe­ri­ods off if they must sleep dur­ing the day.

9. SLEEP LOSS IS CU­MU­LA­TIVE

As a pat­tern of shift work con­tin­ues, the ef­fects of sleep loss and poor- qual­ity sleep ac­cu­mu­late, lead­ing to in­creas­ing sleepi­ness and per­for­mance im­pair­ment.

Two full nights of un­bro­ken sleep within the nor­mal self-se­lected sleep time of 10.00pm to 8.00am, with a nor­mal day in be­tween, are a min­i­mum re­quire­ment for ad­e­quate re­cov­ery af­ter pe­ri­ods of overnight work.

Im­pli­ca­tions for em­ploy­ers

Pro­vide breaks with at least two full nights off (and where nor­mal day- ori­ented func­tion­ing is pos­si­ble) as part of the nor­mal shift ros­ter.

De­pend­ing on when the time-off pe­riod be­gins, this may mean pro­vid­ing a pe­riod longer than 48 hours. For ex­am­ple, a 48-hour break be­gin­ning at mid­night gives only one full night of un­in­ter­rupted sleep. Shift work­ers who cross time zones (such as in­ter­na­tional pilots) will have ad­di­tional prob­lems that need spe­cial mea­sures.

10. VAR­I­OUS STRATE­GIES CAN MIN­IMISE FA­TIGUE AND PRO­MOTE BET­TER SLEEP

Good ed­u­ca­tion about fa­tigue leads to com­mon un­der­stand­ing and ap­pro­pri­ate work­place-spe­cific so­lu­tions. Shift work­ers can be given strate­gies to im­prove their qual­ity of life and sleep, such as im­prov­ing their sleep fa­cil­i­ties, and avoid­ing caf­feine or al­co­hol within the hours be­fore sleep.

Make sure you cover the fol­low­ing top­ics in your in­for­ma­tion and train­ing ses­sions:

• Ad­just­ing the sleep­ing area to pro­mote good sleep.

• Good nu­tri­tion while work­ing shifts.

• Use and avoid­ance of stimulants.

• Recog­nis­ing fa­tigue.

• Get­ting to and from work safely.

• Fit­ness and ex­er­cise.

• Ef­fec­tive nap­ping.

• Main­tain­ing home and fam­ily life.

• Child­care ar­range­ments.

• Equal fa­cil­i­ties for shift work­ers. Im­pli­ca­tions for em­ploy­ers Pro­vide train­ing in fa­tigue man­age­ment strate­gies be­fore an em­ployee be­gins shift work. Ed­u­ca­tion and train­ing are an im­por­tant part of any shift work man­age­ment sys­tem, but they are never a com­plete solution.

11. PRE­VENT­ING WORK­PLACE FA­TIGUE RE­QUIRES CO­OP­ER­A­TION AND COM­PRO­MISE

Shift-work­ing ar­range­ments are a com­pro­mise be­tween the busi­ness’s need for work to con­tinue at a time when peo­ple are nor­mally asleep, and em­ploy­ees’ need to re­cover ad­e­quately through qual­ity sleep.

Find­ing com­pro­mises that are ac­cept­able to the great­est num­ber of peo­ple will re­quire em­ployee in­volve­ment and par­tic­i­pa­tion. Some ros­ters are bet­ter than oth­ers, but ev­ery­one in­volved needs to ac­cept that there is no ‘per­fect’ night- shift ros­ter.

Bear in mind that:

• There is a sense that the most suc­cess­ful ros­ter is the one that staff pre­fer.

• Peo­ple adapt their lives to any ar­range­ments over time, and chang­ing ar­range­ments can be seen as a threat to their adap­ta­tions.

• If a ros­ter never changes, it can­not be im­proved. Im­pli­ca­tions for em­ploy­ers The suc­cess of any shift-work­ing ar­range­ments will largely de­pend on the qual­ity of the con­sul­ta­tion process. Peo­ple tak­ing on shift work need re­li­able, ba­sic in­for­ma­tion to make in­formed choices. Chang­ing shift-work­ing ar­range­ments is a ma­jor un­der­tak­ing. Em­ploy­ees will need time to ad­just.

12. VAR­I­OUS STRATE­GIES ARE AVAIL­ABLE FOR MAN­AG­ING SHIFT WORK TO MIN­IMISE FA­TIGUE

Strate­gies avail­able for as­sess­ing and man­ag­ing shift work in­clude stan­dard au­dit frame­works, ros­ter de­sign prin­ci­ples, risk assess­ment tools, and fa­tigue mod­el­ling meth­ods.

There are var­i­ous tools to use in de­vel­op­ing these sys­tems:

• Faid fa­tigue safety sys­tem – see www.faid­safe.com

• Aus­tralia New Zealand Stan­dard 4360:1999 – risk man­age­ment.

Im­pli­ca­tions for em­ploy­ers

No sin­gle method of shift work man­age­ment will fit all cir­cum­stances. Which­ever method you use, you will need to tai­lor it to the needs of the or­gan­i­sa­tion.

WORKSAFE.GOVT.NZ

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