Managing Worker Fatigue Regulatory Document Helen McRobbie CSSE - - PowerPoint PPT Presentation

Managing Worker Fatigue Regulatory Document

e-doc 5992081

CSSE October 31, 2019

Helen McRobbie

2

Outline

• Background information
• Frameworks
• Hours of work limits and recovery periods
• Fatigue management elements
• Next steps

Background Information

4

CNSC’s Mandate

• Regulate use of nuclear energy and

materials to protect the health, safety and security of persons and the environment

• Implement Canada’s international

commitments on the peaceful use of nuclear energy

• Disseminate objective scientific,

technical and regulatory information

5

CNSC’s Scope

6

REGDOC – Fitness for Duty: Managing Worker Fatigue

7

Inputs to REGDOC

• Research

– CNSC and licensees’ research reports – Peer-reviewed scientific literature

• Benchmarking

– International nuclear regulators – Non-nuclear sectors

• Public consultation

7

8

Symptoms of Fatigue

Transport Canada, TP 14573

• “Cognitive slowing” (Bratzke et al., 2007)

9

Context for Regulatory Document

• Workers are a key contributor to nuclear safety

– Must be able to effectively perform their duties

• Fatigue can affect fitness for duty

– Fatigue degrades performance (concentration, memory, etc.) – Identified as causal factor in several high-profile events

• Risks related to fatigue must be

effectively managed

• Certain aspects of work increase the likelihood of

fatigue (night shifts, rotating shifts, extended shifts)

Workers are fit for duty

Risks related to fatigue are managed Risks related to

• ther FFD

factors are managed

10

Basic Facts About Fatigue

• Sleep fulfils a physiological need, like food and water
• Sleep deprivation is a loss of sleep that can occur

‒ Acutely (extended wakefulness) or ‒ Cumulatively (some sleep loss each night over consecutive nights)

• Night work poses a greater risk for fatigue due to

circadian rhythms

• If the body does not get enough sleep, it will take it

involuntarily

‒ Involuntary drive for sleep can overcome motivation to remain awake

Multiple risk factors Greatest fatigue levels

Frameworks

12

Fatigue is managed

Sufficient Workplace Environment

Assessment and Continual Improvement

Sufficient Staffing Levels Sufficient Sleep Opportunity Sufficient Sleep Obtained Sufficient Alertness Behaviour

Goals

• Sufficient

staffing levels for volume of work and 24/7 coverage

• Shift

scheduling

• Hours of

work limits and recovery periods

• Management
• f workers

with higher risk of fatigue

• Self-

reporting

• Workplace

design

• Break

policies

• Supervisory

& peer monitoring

• Practices

when risk

• f fatigue is

high

Control Measures

Fatigue-related problems are identified

Defense 1 Defense 2 Defense 3 Defense 4 Defense 5

Captured in management system

Based on Lerman, S., Eskin, E., Flower, D., George, E., Gerson, B., Hartenbaum, N., Hursh S. & Moore-Ede, M. (2012). Fatigue risk management in the workplace. Journal of Occupational and Environmental Medicine, 54(2), 231-258.

Framework for managing fatigue

13

Framework Supporting Limits on Hours of Work & Recovery Periods

Fatigue is managed

Sufficient Workplace Environment Sufficient Staffing Levels Sufficient Sleep Opportunity Sufficient Sleep Obtained Sufficient Alertness Behaviour Provide sufficient time for sleep daily Restrict consecutive shifts to limit build- up of sleep debt Provide time off to allow for recovery from sleep debt Limit average weekly hours as safeguard against cumulative fatigue

Acute Cumulative

Conceptual Framework Supporting Hours of Work Limits and Recovery Periods in REGDOC-2.2.1

• 1. After ~17 hrs awake,

performance declines rapidly

• 1. People sleep less on

work days than on days off

• 1. Free days allow for

recovery from sleep debt and fatigue-related performance decrements

• 1. Longer term limits

provide a safeguard against cumulative fatigue while allowing short-term scheduling flexibility Supporting Facts Sufficient sleep

• pportunity

Provide sufficient time for daily sleep Restrict consecutive shifts to limit build- up of sleep debt Provide time off to allow for recovery from sleep debt

Limit average weekly hours to allow for recovery from residual sleep debt

3 At least 11 hour free from work is required to give people 8 hr sleep

• pportunity / day
• 2. When people get 8

hrs in bed / day, performance remains stable

• 3. Performance

decrements accumulate across consecutive days of restricted sleep

• 2. Sleep debt builds up

when people get less sleep than they require

• 2. Insufficient

recovery time can result in performance decrements when a new shift sequence begins

• 2. Increasing weekly

hours are related to shorter sleep durations and increased rates of errors, car accidents and injuries

15

Population – graded approach

Workers –

perform work referred to in a licence

(NOTE: Applies to workers directly employed by a licensees and to contractors and subcontractors)

Analysis based on work activities Excluded Broad Safety-sensitive positions Potential through work activities to pose risk to nuclear safety or security Do not have potential through work activities to pose risk to nuclear safety or security Role in the operation, where impaired performance could result in a significant incident

Limits on Hours of Work & Recovery Periods

Fatigue Management Provisions Performance- based criteria addressing HoW Prescriptive HoW limits

Broad Population Safety- sensitive positions

    

17

17 Low

NOTE: Except for first point showing 8-hour day worker, all shifts are 12 hours

High

Relative fatigue levels of various shift sequences

12-hour shifts Outside limits Within limits of REGDOC

18

Sleep Debt

• People need sleep every

day

• People sleep less on work

days than on free days

• Although sleep needs are

individual, most sleep >7 hours/day

Work Days Free Days Average

19

Cumulative Fatigue: Sleep Obtained by Smelter Workers (2 days, 2 nights, 4 off)

(Baulk et al., 2009)

20

Sleep Debt & Restrictions on Consecutive Shifts

4 hr TIB 6 hr TIB 8 hr TIB Total sleep deprivation

24 hours of sleep deprivation NOTE: Sleep obtained during the night

• If 12-hr shift workers get ~6 hours TIB on average (Paech et al., 2010;

Geiger-Brown et al., 2012), then expect performance declines over consecutive days (Van Dongen et al., 2003)

21

Daily Limits

Requirements Guidance 16 hours work/24 hours 12 hr work shift/24 hrs (normal) 8 consecutive hours free between shifts 11 consecutive hrs free /24 hrs (regular)

• Anything less should be rare

28 hrs work/48 hrs

22

Daily Limits

Konowal et al., 1999

2008 Sleep in America Poll

23

Weekly Limits

• Longer work weeks (50-60+ hours) are associated with

increased risk of

– Errors (Rogers et al., 2004; Cappuccio et al., 2009) – Vehicle accidents (Stutts et al., 2003) – Injuries (Dembe et al., 2005; Dong, 2005; Vegso et al., 2007)

• Working at weekly limit of 60 hours is not sustainable

long-term

– US NRC - security personnel “questioned their readiness and ability to perform … because of the adverse effects of cumulative fatigue” following September 11, 2001.

– “individuals had been working up to 60 hours per week for extended periods” (Federal Register, Vol 73, No. 62, p. 17135)

– Fatigue experts cautioned European Aviation Safety Agency against allowing 3 consecutive 60-hour weeks (Moebus, 2008)

Programmatic Fatigue Management Elements

Fatigue Management Provisions Performance- based criteria addressing HoW Prescriptive HoW limits

Broad Population Safety- sensitive positions

   

25

Fatigue management elements

– provide sufficient time for sleep daily – restrict consecutive shifts to limit the build-up of sleep debt – provide sufficient time off to allow for recovery from sleep debt – limit average weekly hours as a safeguard against cumulative fatigue

• Establish limits on hours
• f work and minimum

recovery periods

26

Fatigue management elements

• Identify and manage worker fatigue

– temporary or ongoing circumstance(s) or condition(s) that increase risk of fatigue at work – expectations related to rest periods that include an opportunity to sleep, if permitted – self-reporting – actions for supervisors

• Train and educate

Sufficient Sleep Obtained

People are not good at evaluating how fatigue degrades their performance

27

Fatigue management elements

• Identify and manage worker fatigue

– Additional supervisory oversight and independent verification when the risk of fatigue is highest (e.g., during the night shift, near the end of a shift, working beyond 12 hours) – Scheduling safety-critical tasks outside of peak times for fatigue (especially between 2 and 6 a.m.) when possible

Sufficient Alertness Behaviour

28

Fatigue management elements

• Problem identification and resolution

– Record the work schedule of workers directly involved for at least one week prior to the incident

– Asking “were you tired” is not enough

– Assess data periodically to determine the effectiveness of limits – Record fatigue-related factors of the workers directly involved

– work schedule – sleep obtained prior to the incident compared to sleep normally obtained – consecutive hours awake at the time of the incident

29

Fatigue management elements

• Assessment and continual improvement

– Periodic assessments

– verify that staffing levels are sufficient for enabling adherence to limits on hours of work and recovery periods Sufficient Staffing Levels

30

Next steps

• Oversight strategy

– Review of documentation – Inspections

• REGDOC review cycle

31

Consensus Conference Panel, Watson, N., Badr, M., Belenky, G., Bliwise, D., Buxton, O., Buysse, D. et al. (2015). Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion, Sleep, 38(8),1161-83.

32

Thank you!

QUESTIONS?

33

Sample of literature reviewed

Type of Study Examples Meta- analyses

Folkard et al., 2006; Philibert, 2005; Pilcher et al., 1996; Pilcher et al., 2000; Lim et al., 2010; Driskell, 2005; Hutchins et al., 2013; Wickens et al., 2015

Systematic review

Saksvik et al., 2011; Parkes, 2012; Tucker, 2003; Wagstaff et al., 2011; Robb et al., 2008

Narrative review

Beswick et al., 2003; Durmer et al., 2005; Ficca et al., 2010; Goel, 2013; Harrison et al., 2000; Knauth, 2007; Folkard, 2008

Laboratory

Banks et al., 2010; Belenky et al., 2003; Bratzke et al., 2007; Cohen et al., 2010; Dijk et al., 1992; Doran et al., 2001; Drake et al., 2001; Ferguson et al., 2012; Johnson et al., 1992

34

Sample of literature reviewed (cont’d)

Type of Study Examples

Workplaces Dorrian et al., 2011; Baulk et al., 2009; Ferguson et al., 2010; Gohar et al., 2009; Heslegrave et al., 2000 (H-Q); Paech et al., 2010; Baker et al., 1995; Tucker et al., 1999 Population surveys Basner et al, 2007; Dembe et al., 2014; Escriba et al., 1992; Hale, 2005; Lombardi et al., 2010; Joint Consensus Statements & ACOEM Task Force American Academy of Sleep Medicine and Sleep Research Society, 2015 (recommended amount of sleep); National Sleep Foundation Drowsy Driving Working Group; American College of Occupational and Environmental Medicine (ACOEM) Guidance Statement

• Fatigue Risk Management, 2012

35

Meta-analyses

• Lim - A meta-analysis of the impact of short-term sleep deprivation on cognitive

variables

• Philibert - Sleep loss and performance in residents and nonphysicians: A meta-

analytic examination

• Wickens - The impact of sleep disruption on complex cognitive tasks: A meta-

analysis

Systematic and narrative reviews

• Harrison - The impact of sleep deprivation on decision making: A review
• Goel - Neurocognitive consequences of sleep deprivation

Laboratory

• Belenky - Patterns of performance degradation and restoration during sleep

restriction and subsequent recovery: a sleep dose-response study

• Banks - Neurobehvioral dynamics following chronic sleep restriction: Dose-

response effects of one night for recovery

• Van Dongen - The cumulative cost of additional wakefulness: Dose-response

effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation

• Cohen et al., Uncovering residual effects of chronic sleep loss on human

performance

Sample of literature reviewed (cont’d)

36

Workplace studies

• Heslegrave - A prospective study examining the changes to worker health and

safety after shifting from 9 to 12.5-hour shifts

• Gohar - Working memory capacity is decreased in sleep-deprived internal medicine

residents

Population surveys

• Basner - American time use survey: Sleep time and its relationship to waking

activities

• Dembe - The impact of overtime and long work hours on occupational injuries and

illnesses: new evidence from the United States

• Lombardi -, Daily sleep, weekly working hours, and risk of work-related injury: US

national health interview survey (2004-2008)

Joint Consensus Statements and Task Forces

• Recommended amount of sleep for a healthy adult: A joint consensus statement of

the American Academy of Sleep Medicine and Sleep Research Society

• Fatigue Risk Management in the Workplace, American College of Occupational and

Environmental Medicine Task Force

• Sleep-deprived motor vehicle operators are unfit to drive: a multidisciplinary expert

consensus statement on drowsy driving

Sample of literature reviewed (cont’d)