1. Managing Fatigue Training Program for Employees

2. Managing Fatigue For the Employee  What is Fatigue  Signs of fatigue  What causes fatigue  Fatigue mitigation strategies  Utility Policy

3. What is Fatigue  “A reduction in physical and/or mental capability as the result of physical, mental or emotional exertion which may impair nearly all physical abilities including: strength; speed; reaction time; coordination; decision making; or balance.”  Source: International Maritime Organization, Maritime Safety Committee Circular

4. Signs of Fatigue

5.  Constant yawning  Blurred vision  Heavy or sore eyes  Poor concentration  Slowed reaction time  Poor judgment  Speech slurred  Headaches  Decreased ability to exert force  Leg pain and cramps  Loss of appetite  Giddiness  Decreased ability to pay attention  Irregular heart beats  Heaviness in arms and legs  Decreased eye-hand coordination

6. What Causes Fatigue  Lack of Sleep  Quality of Sleep  Biological Clock (circadian rhythm) factors  Shift work  Extended Hours  Health (diet and/or illness)  Ingested chemicals (alcohol, drugs, caffeine)

7. Lack of Sleep (an off duty issue)  Individuals’ needs are unique  Recommended 7 – 8 hours of sleep per 24 hour period  5 stages of Sleep  Stage 1 – Light Sleep - less than 10%  Stages 2-4 – Deep Sleep - approximately 65%  Stage 5 - REM Sleep – Rapid Eye Movement Sleep – approximately 25%  Each cycle takes about 90 minutes = 5-1/2 cycles per 8 hour night  Need all five stages for the body’s recovery from daily fatigue

8. Quality of Sleep (an off duty issue)  Sleep should be Uninterrupted  Try for long periods of sleep  Short naps will not restore the body to normal operation.  One seven hour period of sleep is much more restorative than seven one hour naps  Try for sufficient sleep before any periods you anticipate a sleep deficiency

9. Biological Clock  Most animals (including Humans) follow a daily routine (song birds in the morning, nocturnal animals, etc.)  Called Circadian Rhythm  Time related information controlled within the hypothalamus region of the brain  Melatonin hormone.  Increase in Melatonin – Decrease in alertness

10. Biological Clock  Human Circadian Rhythm is actually on a 25 hour clock.  Did you ever notice it’s easier to stay up late than it is to get up early?  Jet Lag is a symptom of the body trying to reset the biological clock to a new time zone.  It is easier to “reset” when flying east to west (You get to sleep-in in the morning) than when flying west to east (You have to get up earlier than your internal clock expects).  The internal clock can only adjust by an hour or two each day.  This is helped by environmental cues (such as darkness)

11. Biological Clock Humans exhibit two “Troughs” or low points in alertness  One between midnight and 6 am  One between 2 and 4 pm  Fatigue related motor vehicle accidents are:  Twice as high at 2 pm as they are at 10 am  Six times as high at 2 am as they are at 10 am

12. Biological Clock  What do the following have in common? Three Mile Island Chernobyl Bhopal Exxon Valdez

13. The Midnight Shift  1979 - Three Mile Island – 4 am local time - Pressure relief valve opens dumping reactor coolant – control room operators failed to recognize the event. Core meltdown  1984 – Bhopal, India – shortly after midnight Methyl Isocyantate Gas (MIC) leak kills 3,800  1986 - Chernobyl Reactor disaster – 12:23 am – 1:28 am local time - critical control room operator error in failing to reset a controller. Core meltdown and release  1989 – Exxon Valdez – 12:04 am ship hits Bligh Reef and spills 10.8 Million gallons of oil

14. Extended Hours  Normal work day and week = 8 hours per day and 5 days per week  Anything greater is Extended hours  OSHA recommendations:  Limit use of extended hours  Take additional breaks  Tasks that require heavy physical labor should be performed at the beginning of the shift  Monitor for the signs and symptoms of fatigue

15. Extended Hours  A study by sleep researchers in Australia found that:  A person kept awake for 17 hours will exhibit behaviors and performance of someone with a Blood Alcohol Concentration (BAC) of 0.05  A person kept awake for 24 hours will exhibit behaviors and performance of someone with a BAC of 0.10

16. Health Issues (an off-duty issue)  Fatigue can be associated with:  Medical Conditions (such as heart problems) and  Illness (common cold or fever)  Diet can affect feelings of fatigue  Refined sugars can cause a short term energy boost but are often followed by a rapid drop in blood sugar levels causing weakness and instability  Eating a large meal before bedtime can disrupt sleep  Psychological Issues of stress or family worries can disrupt sleep  There are Sleep Disorders such as insomnia or sleep apnea (waking up suddenly due to interrupted breathing)

17. Ingesting Chemicals (an off duty issue)  Medications can cause drowsiness  Caffeine - short duration alertness but  side affects  hypertension, headaches, mood swings and anxiety  Alcohol is a depressant  however, the important REM sleep is disrupted preventing body recovery.

18. Fatigue Mitigation Strategies  Develop a pre-sleep routine (warm shower, reading a book)  Sleep in a dark, quiet, cool environment  Avoid alcohol prior to sleep  Avoid caffeine at least six hours prior to sleep  Eat regular, well balanced meals  Drink a sufficient amount of water  Exercise regularly  Get enough proper sleep

19. Utility Policy  Insert utility policies

20. References  “Driver fatigue - an accident waiting to happen”, by academy staff of the Australian Academy of Science, June 2006  “Guidance on Fatigue Mitigation and Management”, MSC (Marine Safety Committee) Circular 1014, International Maritime Organization, June 12, 2001  “Extended/Unusual Work Shifts”, Occupational Safety and Health Administration (OSHA), September, 2, 2004  “Sleepless in Seattle: injured worker’s case shows hazards of fatigue”, Shoop, Julie Gannon, Publication: “Trial”, Dec. 1, 1993  “Personal & Financial Health” Scott, Diane E., RN MSN, Vermont Nurse Connection, Feb. 1, 2008  “Circadian Rhythms and Shift Work” American College of Emergency Physicians, September 2003