Welcome to… Fatigue Risk Management For Employees In The Heavy Civil Construction Industry In...

Welcome to…Welcome to…

Fatigue Risk Management For Employees In The

Heavy Civil Construction Industry In Alberta

Fatigue Risk Management For Employees In The

Heavy Civil Construction Industry In Alberta

Table of Contents

Upon completion of this manual, you will be able to:

• Recognize the effects, signs and symptoms of fatigue• Describe the workings of your body clock, also called

circadian rhythms• Understand the stages of sleep and develop good sleep

habits• Use the Five-Level Fatigue Hazard Control Model• Develop appropriate corrective measures to reduce fatigue• Plan travel and recovery suggestions• Make food choices that provide the required energy• Discover the health benefits of regular physical activity• Learn ways to maintain a good relationship with family

and friends• Monitor fatigue issues and how to address them

OBJECTIVESOBJECTIVES

As defined by Alberta Workplace Health & Safety, "Fatigue is a state of being tired.

It can be caused by long hours of work, long hours of physical or mental activity,

inadequate rest, excessive stress and combinations of these factors."

What is FatigueWhat is Fatigue

What Variables Impact Fatigue?What Variables Impact Fatigue?

• Time of day

• Temperature

• Working alone

• Repetitive or “boring” functions

• Personal protective equipment

• Sleep debt

• Length and frequency of breaks

• Availability of food and water

• Lifestyle choices

• Corporate culture

• Type of work

• Job Stress

• Home Stress• Duration of the extended

hours/consecutive days

• Decreased alertness• Slowed reaction

time• High error rate• Failure to respond• Poor

communication• Nodding off

What Are The Consequences of Fatigue?What Are The Consequences of Fatigue?

• Below standard performance• Reduced motivation• Impaired judgment• Poor decision making• Reduced short-term memory• Increased tendency for risk-

taking

Fatigue Information for DriversFatigue Information for DriversAny factor that gets in the way with a driver’s ability to safely operate

a motor vehicle is impairment. Whether the impairment is physical (caused fatigue), psychological (personal problems/aggressiveness), or chemically induced through alcohol or drugs, the results are the same: response time slows, physical coordination weakens, and attention span is greatly reduced. If you drive while impaired, you will be less aware of your surroundings, less cautious, and your judgment will be delayed. Operating a motor vehicle while impaired can have deadly consequences.

It is important to note that some causes of fatigue are uniquely individual to drivers. Acute fatigue is caused by immediate episodes of sleep loss (because of long periods of wakefulness (forcing yourself to stay awake), from extremely long shifts or nightshifts without enough daytime rest). Ongoing sleep disruption can lead to sleep debt and chronic sleep deprivation, placing individuals in a state of increased risk to themselves and to others. Acute fatigue can result in:

Unpleasant muscular weariness

Tiredness in everyday activities

Reduced coordination and alertness

"Do you realize you might have driven a vehicle while being impaired?" If you continue to rob yourself of sleep – performance will deteriorate to the state of

impairment."I’m speaking of sleeping impairment not alcohol or drug impairment."

On the roads, more vehicle collisions occur in the early morning hours than at other times, a time when the fewest vehicles are on the road but when people experience the greatest degree of sleepiness. An analysis of incidents involving commercial trucks found that drivers in fatigue-related incidents had slept an average of five and a half hours during their last sleep period, compared with eight hours for drivers in non-fatigue-related incidents. Also, evidence shows that the one hour lost in the switch to daylight savings time increases collision rates by seven percent. In the week following the change to daylight savings, fatal incidents (on and off the job) increase by six and a half percent.

An Australian study measured the effects of fatigue and rated them against those of alcohol impairment. Findings suggest that after only 20 hours of staying awake, a person may be as impaired as someone with a blood alcohol concentration of 0.10 percent. The results of this study support the suggestion that even moderate levels of continually staying awake reduce performance to an extent greater than is currently acceptable for alcohol intoxication. The results are important for anyone working extended hours over multiple days or weeks without adequate periods of rest. As sleep debt is cumulative, meaning it continues to add up, similar performance impairments should be expected in drivers fatigued by that.

Like rocks in a backpack, accumulated sleep debt is a burden that weights down the individual driver. Each additional hour being awake adds another rock of sleep debt to the driver’s backpack. The further away you get from not having the right number of hours of sleep you need, the harder your brain will force you to eventually sleep.

Warning SignsWarning Signs

Physical warning signs:

• Trouble keeping eyes open/head up

• Frequent yawning, nodding off

• Failure to dim high-beams at night

• Missing a gear or braking too late

• Difficulty maintaining a constant speed

Warning SignsWarning Signs

Mental Warning Signs:

• Disconnected or wandering thoughts

• Hallucinations• Difficulty in

remembering the last few kilometers

• Drifting in and out of sleep

• Missing an exit or road sign

• Failure to check mirrors

What Makes Fatigue Worse?What Makes Fatigue Worse?

Activities …

Health …

Fatigue accidents are typically …

Circadian RhythmsCircadian Rhythms

• Sleep/Wake (Alertness Cycle)

• Body Temperature

• Digestion

• Immune Response System

• Hormonal Secretion

• Cell Division

8am

noon 4pm

8pm

midnight 4am

8am

10 pm

2-5 am

98.5 F / 36.9 C

96.5 F / 35.8 C

AlertnessLevel

Sleep/Wake Cycle and Body TemperatureSleep/Wake Cycle and Body Temperature

1. Start the morning with a good breakfast. Have a snack 2 or 3 hours later that morning to stabilize blood sugar level.

2. Keep lunches to a reasonable size. A large meal increases the urge to sleep.

3. Make sure your breakfast and lunch contain protein, carbohydrates and good fats. Avoid high fat lunches. Limit food that has high amounts of saturated or hydrogenated fats.

Improving Productivity During Circadian Trough (Low Point)Improving Productivity During Circadian Trough (Low Point)

4. Avoid foods high in sugar since sugar can lead to blood sugar spikes that result in a powerful insulin response.

5. Hydration. Have a glass or two of cold water.6. Make it a habit that during the 2:00 p.m. to 4:00

p.m. time tasks requiring precise concentration are routinely done at other times.

7. Go for a brisk walk, get fresh air, get natural light at this time, or have a brief stretching routine.

8. Learn to take 15 to 20 minute power naps. A power nap can return two hours of high productivity.

1. Improving afternoon alertness a.b.

2. Successful sleep strategiesa.b.

3. Implementing fatigue countermeasures (preventing fatigue - Fatigue Proofing) a.b.

4. Tips on nutritiona.b.

5. Getting more physically activea.b.

6. Maintaining a good relationship with family and friendsa.b.

Fatigue Management Plan Fatigue Management Plan

Hours of Sleep

SleepStages

midnight

1 2 3

Awake

1

2

3

4 5 6 7 8

4

REM

Understanding Sleep Adult Sleep PatternUnderstanding Sleep Adult Sleep Pattern

1. Adequate sleep every night

2. Continuous sleep

3. Consistent schedule

4. Wind down

5. Bedtime routine

6. Make up for lost sleep ASAP

7. Dark and quiet bedroom

8. Cool bedroom

9. Aerobic exercise for deep sleep

10.Reduce caffeine intake 4 hrs. before bed

11.Avoid alcohol near bedtime

Good Sleep HabitsGood Sleep Habits

Insomnia

Sleep Apnea

Restless Legs Syndrome

Sleep DisordersSleep Disorders

Delayed/Advanced Sleep Syndrome

1. Don’t force sleep, get up after 30 minutes. Do

something relaxing like reading.

2. Have a light carbohydrate snack, glass of milk,

or herbal tea with a little honey.

3. Try herbs like Valerian Root or Chamomile.

4. Try Melatonin or Tryptophan.

5. See a sleep specialist.

Suggestions For InsomniaSuggestions For Insomnia

Six Strategies For The Alert DriverSix Strategies For The Alert Driver

#1: Pay Attention To Your Body Clock

#2: Know How Much Sleep Your Body Needs

#3: Practice Healthy Sleep Habits

#4: Plan Your Trips

#5: Recognize The Signs Of Sleepiness

#6: Develop A Driver’s Checklist

REACTIVE

Fatigue-related incidents Level 5Incident analysis

Address levels 1-4

Fatigue-related errors Level 4Analysis of fatigue-related errors

Fatigue-proofing strategies

PROACTIVE

Fatigue-related symptoms Level 3Individual/collegial symptom

checklistPhysiological monitoring

Acceptable levels of prior sleep and wake

Level 2Individual fatigue likelihood score

Prior sleep/awake assessment

Adequate sleep opportunity Level 1 Hours of work guidelines

Error Path

Hazard assessment Control mechanismFive-Level Fatigue Hazard Control Model

LEVEL 1 CONTROLS: Providing Working Time Arrangements And Sleep

Opportunity

Critical question:

Do the working time arrangements provide sufficient sleep opportunity for recovery and

not have people awake for too long?

LEVEL 2 CONTROLS: Assessing Actual Sleep

Critical question:

Am I safe to work – have I had enough sleep recently, and have I not been awake

for too long to be safe for myself or my co-workers?

Fatigue Assessment Score

Step 1: Sleep in prior 24 hours

Sleep <2 hours 3 hours 4 hours >5 hoursPoints 12 8 4 0

Step 2: Sleep in prior 48 hours

Sleep <8 hours 9 hours 10 hours 11 hours >12 hoursPoints 8 6 4 2 0

Step 3: Prior wake

Count the total hours you will have been awake at the end of your shift (excluding any anticipated sleep during the shift).

For every hour more than your sleep in the prior 48 hours, add one point.

Total points

Individual Fatigue LikelihoodStep 4: Add all points together to determine your score.

Score Control Level

1 - 4 Self-monitoring

5 - 8 Supervisor Monitoring

9 + Supervisor provides control measures.

Fatigue Assessment Score

Step 1: Sleep in prior 24 hours Person got 4 hrs sleep

Sleep <2 hours 3 hours 4 hours >5 hoursPoints 12 8 4 0

4

Step 2: Sleep in prior 48 hours Got 4 hrs & 7 hrs = 11hrs sleep

Sleep <8 hours 9 hours 10 hours 11 hours >12 hoursPoints 8 6 4 2 0

2

Step 3: Prior wake Wake time 14 hrs minus Sleep time 11hrs =3

Count the total hours you will have been awake at the end of your shift (excluding any anticipated sleep during the shift).

For every hour more than your sleep in the prior 48 hours, add one point.

3

Total points 9

Sample Worksheet

Individual Fatigue LikelihoodStep 4: Add all points together to determine your score.

Score Control Level

1 - 4 Self-monitoring

5 - 8 Supervisor Monitoring

9 + Supervisor provides control measures.

LEVEL 3 CONTROLS: Assessing Symptoms Of Fatigue

Critical question:

Am I safe to work – am I feeling okay or am I exhibiting symptoms of fatigue? Is my co-

worker displaying symptoms of fatigue?

Samn-Perelli fatigue checklist

1. Fully alert, wide awake

2. Very lively, responsive, but not at peak

3. Okay, somewhat fresh

4. A little tired, less than fresh

5. Moderately tired, let down

6. Extremely tired, very difficult to concentrate

7. Completely exhausted, unable to function effectively

Fatigue checklistSamn-Perelli

fatigue checklist Risk level Controls

1-3 LowNo specific controls necessary. Except in the presence of higher level indicators of fatigue (i.e. symptoms, errors or incidents).

4-5 ModerateInitiate moderate fatigue risk mitigation actions Level 2 and 3 assessment Individual controls.

6 High

Initiate high fatigue risk mitigation actions Document with job site supervisor Level 2 and 3 assessment Individual controls Team-based controls Support napping and safe-home policies.

7 Very HighIntolerable risk. No individual scheduled beyond this threshold. Any proposed exceptions to be reviewed by supervisor for approval.

Name: Date: Circle: Pre/Post Shift

Fatigue-related Symptoms

Physical Mental Emotional

Yawning Difficulty concentrating More quiet or withdrawn than normal

Heavy eyelids Lapses in attention Lacking in energy

Eye-rubbing Difficulty remembering what you are doing

Lacking in motivation to do the task well

Head drooping Failure to communicate important information

Irritable or grumpy behaviour

Micro-sleeps Failure to anticipate events or actions Other

Other Accidentally doing the wrong thing (error)

Accidently not doing the right thing (omission)

Other

Symptom Checklist

Fatigue Proofing: Individual Controls

Caffeine Increase social interaction Energy Drinks (use with caution) Double check familiar tasks

Ensure crewmembers have access to adequate hydration and food intake

Perform complete tasks earlier in the shift, if possible

Recognize individual and crew fatigue Utilize the buddy system

Take short and frequent breaks Ask for a second opinion - Supervisor/Co-worker

Rotate and perform various functions of short duration during extended hours

Downgrade responsibilities - don't drive if fatigue is severe

Quiet rest time Increase supervision - contact with Control Work Desk

Power napping (if conditions are available)

Assess and control hazards and risks

Sleep Consider any options to limit travel time to and from work

Increase physical activity

Fatigue Proofing: Team Controls Inform and educate all workers about

the Fatigue Management Program Solicit short-term help to minimize

extended hours Communicate fatigue status during

safety meeting Examine the option of not acting as

primary operator Minimize extended hours of work

when possible Defer non-urgent work

Recognize individual and crew fatigue, and encourage workers to look out for each other (increase cross-checking)

Identify health problems which may affect an employee's ability to work extended hours, i.e., diabetes, sleep apnea

Give as much advanced notice of extended hours and a minimum of 24 hours notice if shift changes

Shift swaps-on-call swap

Define whether the work is urgent or not

Fatigue leave - stand down - Fit for work (send home to get rest, i.e., ahead of a storm)

Increase supervision Change or modify duties after on call Seek a second opinion - Supervisor /

Co-worker Schedule rest days

Safe-home policy

WholeGrains

Vegetables

Healthy Protein

Your Plate Should Look Like This

Your Plate Should Look Like This

Fruits

Breakfast7 am

Snack10 am

Lunchnoon

Snack3 pm

Supper6 pm

Snack9 pm

Grazing Pattern Grazing Pattern

Bread, Cereal, Rice & Pasta

Walk the dogTake longer routes Take the stairs

instead of the elevator

Park your car farther away Work in your garden

Walk to the storeor the mailbox

10,000 Steps

Strength TrainingPush-Ups / Curl-Ups / Weight Lifting

FlexibilityStretching, Yoga,

Pilates, and Tai Chi

2-3 Times a Week

Aerobic Exercise (20+minutes) Brisk Walk

Cross Country SkiBicycling Swimming

Recreation (30+minutes) Soccer Hiking

Basketball TennisMartial Arts Dancing

2-3 Times a Week

Every Day

Fitness PyramidFitness Pyramid

• Talk about your needs.• Get a convenient and agreed upon time for telephone calls. • When you’re having supper alone at a restaurant far from home take a few

minutes to write your children some postcards. It shows you’re thinking of them. • Find ways to spend time with each of the members of your family when you have

your days off.• If you are in a location for a considerable number of days, far from home, some

workers have their partner or family come and visit them on the weekend.• Do not take out frustrations or troubles on those closest to you.• If your family life is unhappy or turned upside down, avoid the use of drugs to

help you cope. • When discussing problems, the desired solutions are best when they come from

the whole family.• As important as it is to have regular time together with the whole family, it is

equally important that you actively schedule time to be alone with your partner.• Keep your family life alive. • Protect your family life, and it will protect you.

Family and FriendsFamily and Friends

Welcome to… Fatigue Risk Management For Employees In The Heavy Civil Construction Industry In...

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