1 Fatigue and Accidents

2 Objective(s) Explain How Sleep Cycles, Hours and Circadian Rhythm Disturbances Can Develop Into Short- Term, Cumulative and Chronic Effects on Performance and contribute to accidents. Explain How Sleep Cycles, Hours and Circadian Rhythm Disturbances Can Develop Into Short- Term, Cumulative and Chronic Effects on Performance and contribute to accidents.

3 Why Should We Care ? 31% of All Drivers Have Fallen Asleep at the Wheel Sometime During Their Lifetime 31% of All Drivers Have Fallen Asleep at the Wheel Sometime During Their Lifetime 56% of Shift Workers Have Fallen Asleep on the Job 56% of Shift Workers Have Fallen Asleep on the Job 55% of Adults Stated They Experienced Daytime Drowsiness. 55% of Adults Stated They Experienced Daytime Drowsiness.

4 The Human Toll 100,000 Fatigue Related Collisions Per Year 100,000 Fatigue Related Collisions Per Year 1,544 Fatigue Related Deaths Per Year 1,544 Fatigue Related Deaths Per Year Imagine: Imagine: A Boeing 727 Crashing Every Six Weeks A Boeing 727 Crashing Every Six Weeks Or the Titanic Sinking Once a Year Or the Titanic Sinking Once a Year Or an Oklahoma City Bombing Every Month and a Half. Or an Oklahoma City Bombing Every Month and a Half.

5 Who Pays the Costs?

6 Where Are We Now? In the Past 20 Years: 158 Hours Added Annually to Our Schedule In the Past 20 Years: 158 Hours Added Annually to Our Schedule Since 1969: 241 Hours Added Yearly to Working Mothers’ Schedule Since 1969: 241 Hours Added Yearly to Working Mothers’ Schedule

7 What is Fatigue? Fatigue Is a Complex State Characterized by a Lack of Alertness and Reduced Mental and Physical Performance, Often Accompanied by Drowsiness Fatigue Is a Complex State Characterized by a Lack of Alertness and Reduced Mental and Physical Performance, Often Accompanied by Drowsiness Misconception: Fatigue Is Not Just Falling Asleep. Misconception: Fatigue Is Not Just Falling Asleep.

8 Fatigue Signs and Symptoms Forgetfulness Forgetfulness Poor Communication Poor Communication Impaired Decision - Making Skills Impaired Decision - Making Skills Lack of Alertness Lack of Alertness Slow Reaction Time Slow Reaction Time Microsleep. Microsleep.

9 Fatigue Signs and Symptoms (cont’d) Withdrawn Behavior Withdrawn Behavior Depressed Depressed Moody Moody Quick to Anger Quick to Anger No Sense of Humor No Sense of Humor Lack of Interest Lack of Interest Always Tired. Always Tired.

10 Factors That Affect Fatigue Time of Day/Circadian Effects Time of Day/Circadian Effects Sleep Disorders Sleep Disorders Environmental Conditions Environmental Conditions Nutrition Nutrition Physical Fitness Physical Fitness Drugs Drugs Health Health Age. Age.

11 Mental Fatigue Tired and Drowsy Due to Loss of Sleep Tired and Drowsy Due to Loss of Sleep Loss of Concentration And/Or Alertness Loss of Concentration And/Or Alertness Diminished Levels of Creativity and Logic. Diminished Levels of Creativity and Logic.

12 Physical Fatigue A Decrease in Physical Performance A Decrease in Physical Performance A Feeling of Muscle Discomfort or Soreness A Feeling of Muscle Discomfort or Soreness Lack of Energy. Lack of Energy.

13 SLEEP A Highly Complex Physiological Process During Which the Brain and Body Alternate Between Periods of Extreme Activity and Quiet, but Are Never Shut off. A Highly Complex Physiological Process During Which the Brain and Body Alternate Between Periods of Extreme Activity and Quiet, but Are Never Shut off.

14 What Do We Know? Sleep Is a Vital Need Sleep Is a Vital Need One-third of Our Life SHOULD BE Spent Asleep One-third of Our Life SHOULD BE Spent Asleep The Average Person Needs at Least 8 Hours of Uninterrupted Sleep The Average Person Needs at Least 8 Hours of Uninterrupted Sleep Some People Mistakenly Feel They Don’t Need a Full Night’s Sleep. Some People Mistakenly Feel They Don’t Need a Full Night’s Sleep.

15 Accumulating a Sleep Debt Sleep Loss Is Cumulative and Builds a Debt Most People Get 1 to 1.5 Hours Less Sleep Per Night Than They Need People whose sleep was restricted to 4 to 5 hours per night for one week needed two full nights sleep to recover vigilance, performance, and normal mood How Do You Get Out of Sleep Debt? SLEEP!.

16 The Two States of Sleep State I Non-REM Sleep Non-REM Sleep Physical and Mental Activities Slow Physical and Mental Activities Slow Physical Restoration Occurs Physical Restoration Occurs State II REM: Rapid Eye Movement Extreme Mental Activity Mental Restoration Major Muscles Are Paralyzed

17 States and Stages of Sleep

18 Effects of Alcohol on Sleep Breaks Down Into Sugar and Will Disrupt Sleep Eliminates All REM Sleep in First Half of Sleep Period Can Lead to Balancing Act.

19 Sleep Disorders Chronic Insomnia Chronic Insomnia Narcolepsy Narcolepsy Sleep Apnea Sleep Apnea Restless Leg Syndrome Restless Leg Syndrome Periodic Limb Movement Disorder. Periodic Limb Movement Disorder.

20 Driving Drowsy Affects Performance Like Driving Drunk 19 Hours Without Sleep Is Similar to a BAC of.05% 24 Hours Without Sleep Is Similar to a BAC of.10%.

21 Who is Most at Risk? Sleep Loss Sleep Loss Working/Operating/Driving Patterns Working/Operating/Driving Patterns Midnight Till 0600am Midnight Till 0600am Mid-afternoon Mid-afternoon Many Miles Many Miles Many Hours Many Hours Monotony. Monotony.

22 Who is Most at Risk? (cont’d) Use of Sedating Medications Use of Sedating Medications Untreated Use of Sedating Medications Untreated Use of Sedating Medications Unrecognized Sleep Disorders Unrecognized Sleep Disorders Consumption of Alcohol. Consumption of Alcohol.

23 Internal Body Clock (Circadian Rhythms) All Animals Have It All Animals Have It It Runs on About a 24 Hour Cycle It Runs on About a 24 Hour Cycle All Human Functions Are Controlled by It. All Human Functions Are Controlled by It.

24 Daily Sleepiness and Performance Rhythms Two Times of Peak Sleepiness Each Day Two Times of Peak Sleepiness Each Day About 3 to 5 A.M. About 3 to 5 A.M. About 3 to 5 P.M. About 3 to 5 P.M.

25 Biological and Social Effects on Shift Workers 60 to 80% Have Chronic Sleep Problems 60 to 80% Have Chronic Sleep Problems 4 to 5 Times More Likely to Have Stomach Disorders 4 to 5 Times More Likely to Have Stomach Disorders 80% Affected by Chronic Fatigue 80% Affected by Chronic Fatigue 5 to 15 Times More Likely to Suffer From Mood Swings and Depression 5 to 15 Times More Likely to Suffer From Mood Swings and Depression Divorce and Spousal Abuse Rates Higher Divorce and Spousal Abuse Rates Higher Drug and Alcohol Abuse Rates Higher. Drug and Alcohol Abuse Rates Higher.

26 Incidents Related to Circadian Disruption Chernobyl1:23am Chernobyl1:23am Bhopal12:40am Bhopal12:40am Three Mile Island4:00am Three Mile Island4:00am Exxon Valdez12:04am. Exxon Valdez12:04am.

27 Incidents Related to Circadian Disruption (cont’d) Most Mistakes by Rail Employees3-5am Most Mistakes by Rail Employees3-5am Most Mistakes by Omission3-5am Most Mistakes by Omission3-5am Surgeons Surgeons Nurses Nurses Postal Workers Postal Workers Telephone Operators. Telephone Operators.

28 What to Expect if You Don’t Sleep Behavioral Problems Behavioral Problems Performance Performance Mood Swings Mood Swings Eventually You WILL Sleep. Eventually You WILL Sleep.

29 What are the costs of fatigue?

30 Where Do You Go to Find the Costs? Examine Crash Data, Incident Logs Examine Crash Data, Incident Logs Review Workers’ Compensation Claims, Sick Leave, and OSHA 300 Log For Data Review Workers’ Compensation Claims, Sick Leave, and OSHA 300 Log For Data Review Overtime, or On-call Status. Review Overtime, or On-call Status.

31 The Costs? (cont’d) Consider Fatigue As a Possible Contributing or Causal Factor in All Investigations Consider Fatigue As a Possible Contributing or Causal Factor in All Investigations Traffic, Industrial/Workplace, Internal, External Incidents: Review With Fatigue in Mind. Traffic, Industrial/Workplace, Internal, External Incidents: Review With Fatigue in Mind.

32 What is your Company Policy? Overtime, On-call Overtime, On-call Outside Employment for Employees Outside Employment for Employees Prescription/Non-prescription Medication Policy Prescription/Non-prescription Medication Policy Napping Napping Technology. Technology.

33 What is the Company Policy? (cont’d) Screening Employees for Sleep Disorders Screening Employees for Sleep Disorders Employee Fatigue Awareness Training Employee Fatigue Awareness Training Corporate Culture: Corporate Culture: Supervisor/Dispatcher/Employee Authority/Latitude to Confront Fatigue Issues Supervisor/Dispatcher/Employee Authority/Latitude to Confront Fatigue Issues Priority of Safety Concerns. Priority of Safety Concerns.

34 Supervision of Employees Are You Empowered to Approach Management With Fatigue Issues in the Workplace?. Are You Empowered to Approach Management With Fatigue Issues in the Workplace?.

35 Keys to Change Knowledge of Fatigue Awareness of Fatigue’s Effect on Safe Operations Understanding of Your Workplace Safety Culture.