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       Hazards special online report, September 2016
Tired out: Don’t take fatigue risks lying down
Work-related fatigue can be very bad for your safety and your health. But Hazards editor Rory O’Neill says union safety reps can play a crucial role in stopping employers wringing ever more work out of fewer workers.

 

When Cambridgeshire fire brigade decided in 2016 firefighters should move to a system of 96-hour shifts, their union FBU was unimpressed. The system, ‘day crew plus’, would mean the hours a firefighter works in one week doubled, spending four days and nights working on a fire station.

Local FBU officer Riccardo La Torre said fire chief Chris Strickland was “playing Russian roulette with the lives of firefighters and the public they serve. He is fully aware that these proposals are unlawful and he’ll also be aware of studies that show the detrimental impact on the health of individuals working excessive shift work. It is completely immoral.”

In 2015, in a case brought to an employment tribunal by the South Yorkshire branch of the FBU, the Health and Safety Executive (HSE) ruled a similar shift system was “unlawful” and contravened the Working Time Regulations. HSE communicated this information to all chief fire officers.

But wringing more work out of fewer workers has become the norm. And the TUC says it is up to unions like FBU to wake up employers to the frightening range of risks related to fatigue.

Worn out workers

Fatigue isn’t the inevitable consequence of going to work. A US presidential taskforce on fatigue risk management reported in 2012 that “fatigue is an unsafe condition in the workplace,” adding that “like other risk factors, fatigue can be managed” through ‘Fatigue Risks Management Systems.’

Too often though fatigue is the forgotten occupational health and safety issue – with potentially deadly consequences, from injuries, to ill-health to major disasters.

As well as an increased risk of injury at work, fatigue caused by too demanding work hours and patterns can increase the risk of health conditions including heart, digestive and mental health problems, UK union confederation the TUC has warned.

Fatigue - a guide for health and safety representatives, a July 2016 publication from the union body, says “prolonged exertion, sleep loss or disruption of the internal clock” can cause a lack of motivation and energy. It adds: “Even though fatigue and drowsiness are not the same, drowsiness, or the desire to sleep, is a common effect that people with fatigue experience. Apathy may also accompany fatigue.”

These effects can be deadly in sectors like road, sea and air transport, with for example 20 per cent of road accidents thought to result from fatigue. A study published in the Proceedings of the National Academy of Sciences in 2016 warned workers are more at risk of a fatal accident on their drive home from a night shift.

“However any organisation can have an issue with fatigue and it can be a problem with any sector where there are long hours, high demands, monotonous work, shift work or where low pay forces workers to take on additional part-time work. It can lead to accidents, poor production and considerable health problems,” the TUC guide notes. It adds “employers will tend to blame the worker if they have an accident when suffering from fatigue.

“In fact most fatigue is caused by the demands placed on people by the employer and can be prevented by ensuring that workers are not fatigued or having systems in place to stop them working when fatigued.”

Advising safety reps to check for problems in their workplaces, the guide notes: “Employers have a responsibility to prevent workers from getting fatigued through work and, where there is a safety critical job, they also need procedures to be in place to monitor the risk of a fatigued worker placing themselves and others at risk, even if the fatigue is a result of factors outside their work.”

Certain groups of workers may be at elevated risk from work-related fatigue, because of factors specific to their jobs, their shifts, their contracts or because of the combination of pressures at work and outside of work. Safety rep surveys or other investigations should make sure they take account of differences, or the impact on these groups of workers could be overlooked.

Fatigue causes

The TUC says the main cause of fatigue is a lack of sleep, either ‘acute’ from the night before, or ‘cumulative’ as a result of lack of sufficient regular sleep over a longer period. Studies have shown that working long days or long weeks means workers carry over their fatigue from day to day.

Learning from down under
A 2013 guide to fatigue prevention from the Australian federal regulator SafeWork Australia broke the major causes into four groups:
  Work schedules – shiftwork, night work, hours of work, breaks
  Job demands -  for example, extended periods of time, performing repetitive or monotonous work and performing work requiring continued physical effort. Workers can be mentally and physically fatigued at the same time. Work which is reactive and performed under high pressure, for example emergency services, may also increase the risk of fatigue.
  Sleep – length of sleep time, quality of sleep and time since sleep.
  Environmental conditions - Working in harsh and uncomfortable conditions can contribute to fatigue, for example, exposure to heat, cold, vibration or noisy workplaces can make workers tire quicker and impair performance.

Fatigue can also be caused by poor quality sleep or changes in sleep patterns, which again can be related to work factors.

TUC’s guide says while there can be medical reasons for fatigue, or it could be a result of personal issues such as a new-born child, it is often work-related. “Long working hours, or poorly-designed shift work can lead to fatigue and of course stress can also be a significant cause of sleep loss.”

A 2016 study published in the Journal of Occupational and Environmental Medicine found women who put in long hours for the bulk of their careers are at greater risk of life-threatening illnesses, including heart disease and cancer.

The TUC guide says work-related factors include:
Duration of shifts, split shifts, time off between shifts and changes to shift patterns.
Ability to sleep on rest days, the quality of sleep, and sleeping disorders.
Scheduling and quality of rest breaks during a shift.
Cold starts and inadequate recovery times.
Commuting time to and from work.
Workload and physical and mental factors, including repetitive, monotonous, demanding or strenuous work.
The impact of second or multiple jobs.
Stress at work.

TUC adds that a working environment that is too warm, dark or quiet can add to problems, as can “digital life”, including the pressure to respond to emails when not at work.

A total disaster

A number a major workplace disasters have been linked to fatigue and shiftwork. BP’s Texas City refinery blast in 2005 killed 15 and injured 180. The official investigation by the US Chemical Safety Board found worker fatigue and downsizing were causative factors, noting immediately prior to the explosion operators had been working 12-hour shifts for 29 or more consecutive days.

Fatigue was also linked directly to the Buncefield oil storage explosions and fires the (below) same year, in what was Britain’s most costly industrial disaster. A July 2007 report from the joint regulator-industry Buncefield taskforce recommended operators should: “Ensure that shift work is adequately managed to control risks from fatigue by the end of June 2008.”

Other major incidents, including Union Carbide’s Bhopal disaster, Exxon Valdez, Chernobyl, the Challenger space shuttle explosion and Three Mile Island were all found by investigations to have worker fatigue as a major contributory factor.

Fatigue effects

The TUC says a person who is either acutely or chronically fatigued is likely to:

Find it hard to concentrate, make clear decisions or take in and act on information.
Have more frequent lapses of attention or memory.
React more slowly (for example, to hazards).
Make more errors.
Occasionally fall asleep at work – momentarily or for several minutes.
Have little motivation or interest in their work.
Be irritable.

“This means that people with fatigue are not only likely to be performing badly, they can also pose a danger to themselves and others. Over time, they also risk damaging their health,” the TUC guide notes. “The long term effects of fatigue can be similar to stress and often people who are suffering from fatigue think they are stressed. Of course work can cause both stress and fatigue and they often go together.”

Being fatigued can compromise the body’s immune response, leaving workers more vulnerable to infections or other work hazards, like chemical exposures (Hazards 49). Some occupational exposures, like organic solvents, vibration or noise, can cause fatigue symptoms, potentially compounding the impact of fatigue caused by physically demanding work, long hours of lack of rest.

Symptoms can include:

Insomnia
depression and anxiety
headaches
confusion
dizziness
blurred vision
unexplained weight loss or gain, and
digestive problems.

And fatigue is one of the defining features of ‘Karoshi’, death from overwork as a result of heart attack or stroke, a compensated occupational disease in Japan.

Role of unions

“If you think that fatigue is an issue in your workplace then try surveying your members to find out what the causes are and raise it with your employer,” TUC’s guide advises. “You can also raise awareness of the dangers of fatigue and work with employers to try to develop an environment where workers can report when they are fatigued without fear of repercussions.”

The TUC says unions can support fatigued members by ensuring they are referred to an occupational health provider for help if they are ill as a result. But it adds “in most cases the best support you can give is to ensure that the causes of the fatigue are removed.”

The guide emphasises the positive role unions play in preventing workplace fatigue. “In many industries, including rail, road transport, aviation, oil and gas extraction, manufacturing, power generation and shipping trade unions have sought to work with employers to ensure that the demands of work and shift patterns do not risk the health of workers or the public.”

It adds unions should “support members who are threatened with disciplinary action because the employer claims they have made a mistake or underperformed as a result of fatigue. 

“Employers have a responsibility to prevent workers from getting fatigued through work and, where there is a safety critical job, they also need procedures to be in place to monitor the risk of a fatigued worker placing themselves and others at risk, even if the fatigue is a result of factors outside their work.”

It concludes: “If a mistake happens because a worker is fatigued, it is because these procedures have failed and they should not scapegoat the worker.”

The law on fatigue

“Fatigue needs to be managed, like any other hazard, through risk assessment and risk management,” the TUC notes. “Simply complying with the Working Time Regulations alone is insufficient to manage the risks of fatigue. Nor can an employer claim that a person willingly worked additional hours or shifts.

“The employer must ensure that they are aware of the hours a person works and take action to prevent any risk to the worker or to others.” It adds there is a legal requirement to consult with the workforce, either directly or through safety representatives where there is a recognised union.

The HSE has produced detailed guidance for employers on complying with the law and managing fatigue risks, backed up by a ‘fatigue risk index’. HSE advises employers to check:

Working hours are not too long.
Employees get enough rest between shifts.
Employees don’t work too many night shifts in a row.
Managers negotiate with staff about overtime or double shift working.
Managers recognise individuals’ preferences – some people prefer nights.
Critical jobs are avoided at the end of shifts or at ‘low points’ in the day or night.
Shifts rotate ‘forwards’ - mornings, then afternoons, then nights.
Employees take quality rest breaks in their work.
Fatigue related problems are reported and acted on.
The physical environment doesn’t cause drowsiness.
Planning staffing levels minimises excessive overtime or double shifts.
Incidents or accidents where fatigue may be responsible are investigated.

Fatigue - a guide for health and safety representatives, TUC, July 2016.

 

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TIRED OUT

Work-related fatigue can be very bad for your safety and your health. But Hazards editor Rory O’Neill says union safety reps can play a crucial role in stopping employers wringing ever more work out of fewer workers.

Contents
Introduction
Worn out workers
Fatigue causes
A total disaster
Fatigue effects
Role of unions
The law on fatigue

Hazards website
  Hours
  Deadly business
  Stress

TUC resources
  Fatigue - a guide for health and safety representatives, TUC, July 2016


Graphics: Ned Jolliffe