Optimising alertness and workplace performance though fatigue risk - PowerPoint PPT Presentation

Optimising alertness and workplace performance though fatigue risk management Jennifer Alcock Human Performance Specialist Office of the National Rail Safety Regulator 21 October 2014

Agenda • Why sleep is fundamental to workplace safety and productivity • How to optimise sleep and alertness • Tools to help identify and manage fatigue-related-risk • How health & safety representatives (HSRs) can contribute to fatigue risk management Image credit: StockFreeImages.com

“If sleep does not serve an absolutely vital function, then it is the biggest mistake the evolutionary process has ever made.” Allan Rechtschaffen University of Chicago Sleep Laboratory 1978

Fatigue, safety and productivity Sleep loss and MECHANISM fatigue

Fatigue is an important workplace hazard Distraction Fatigue interacts with Alcohol Expectation Drugs and amplifies other factors that influence Fatigue human performance Workload Time Systems Environ Health pressure and ment procedures Stress Experience pre- occupation

Performance is not uniform across time Performance by time of day Source: Folkard and Tucker 2003

Biology of sleep Circadian rhythm (body clock) MODEL OF SLEEP (circadian) cyclical alerting process

Sleep biology Sleep drive S MODEL OF SLEEP S leep process = drive to sleep with time awake C (circadian) cyclical alerting process Page 9

Sleep biology Sleep drive S SLEEP FIRST 9 1 NIGHT SHIFT MODEL OF SLEEP S leep process = drive to sleep with time awake C (circadian) cyclical alerting process Page 10

Cumulative sleep loss Circadian rhythm X Sleep loss over days N = 17 Z 1 2 3 4 > 4.16 3.08 Days of sleep loss 2.58 2.33 1.65

Cumulative sleep loss effects Performance deterioration Self rated sleepiness Source: Van Dongen et al 2003 (figures from Hursh 2010)

Sleep biology S Sleep inertia (grogginess on waking) I sleep inertia MODEL OF SLEEP S leep process = drive to sleep with time awake C (circadian) cyclical alerting process I Sleep Inertia = transient grogginess

Implications for safety: Risk of incidents for different types of shift Relative risk Relative risk Relative risk Relative risk After Morning noon Night Consecutive night shifts Consecutive morning/day shifts Type of shift Source: Folkard and Akerstedt 2004

Implications for cost (US rail) Human factors accident – average cost $1,800,000 x 4 $1,600,000 $1,400,000 $1,200,000 $1,000,000 $800,000 $600,000 $400,000 $200,000 $0 Low fatigue High fatigue Source: US Department of Transportation Federal Railroad Administration 2011 15

Implications for individual cost Shiftwork associated with increased risk of: • Injury • Heart disease • Stroke • Depression • Ulcers • Cancer • Gastro intestinal problems • Infertility

Other sources of fatigue Work environment Task dimensions Social family factors Sleep environment Blocks image credit: www.freeimages.co.uk' Health and mental state

Fatigue effects: Attention • Decreased attention span • Lapses on attention rich tasks (eg monitoring, driving) • Easily distracted by interesting things, more engaging tasks • Tunnelling – changes in field of attention, blind spots • Micro-sleeps • Sleep incapacitation

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Cognition (thinking) • Slower to interpret and integrate information • Short term recall, working memory • Reduced ability to learn • Decision making: • Difficulty weighing up options • Persist with ineffective responses

Emotional control • Feeling low and irritable • Inability to suppress responses • Terse communications

Motivation and insight • Compensatory effort to maintain performance • Initiates ok but then deteriorates • Neglect tasks judged non essential • Less interested in outcomes • Less likely to pick up someone else’s errors • End goal seduction

The fatigue risk management cycle Establish the context Identify Monitor Review risks Evaluate Analyse and treat risks risks 23

Fatigue risk management cycle Establish the context 1. What activities/tasks are Monitor Identify carried out? HSRs can help Review risks identify important contextual that is 2. Where? Under what relevant to their conditions? (normal, degraded, emergency, designated work nightwork) group. Evaluate Analyse 3. What are your objectives? and treat (business, client, worker) risks risks 24

Fatigue risk management cycle HSRs are in the best position to Establish identify what 1. What are the can go wrong if the sources of fatigue? people are context fatigued. 2. What errors & shortcuts might happen if Monitor Identify people are tired? Review risks 3. What happens if these errors/ shortcuts happen? Evaluate Analyse and treat risks risks 25

Fatigue risk management cycle Establish 1. What controls are in the place? context Engineered controls Controls on work hours Rules and procedures Supervision, training competency Check Identify HSRs can provide 2. How effective are current controls risks essential input controls? Are rosters minimising fatigue? into evaluating the Is our staffing right? effectiveness of Do we have effective procedural controls for safety critical tasks? controls, How effective are engineered particularly if controls? there are routine Evaluate Analyse 3. What is current level of short cuts and treat risk? risks because of risks production pressures

Fatigue risk management cycle Establish the 1. Are risks tolerable? context What else could be done? - Changed rosters - Improved work design Double checking Check Identify - Better engineered controls - More workers /redistribution controls risks Controlled napping 2. How do benefits compare with costs? Evaluate Analyse and treat risks risks Errors ? ? Fatigue- Task related incident Violations 28

Fatigue risk management cycle Establish 1. Monitor the Compliance with controls (planned vs actual hours) context (management of roster changes) 2. Evaluate How are people performing? Monitor Identify Errors? People may be Are people feeling drowsy Review risks more likely to give Are people getting enough sleep feedback to HSRs 3. Investigate than managers. Incidents accidents Often there is Collect work history reluctance to 4. Analyse data and report report fatigue. HSR’s can Evaluate Analyse encourage “just and treat Why didn’t these work? risks culture” risks investigations. Errors Controls Fatigue- Task related incident Violations

Tools and models: Have you optimised your layers of defence? Developed by ONRSR based on Reason 1997, Dawson McCulloch 2003 and Moore Ede et al 2009 Are incident investigations looking for gaps in the system

Layer 1: Adequate skilled staff Staffing • Workforce planning/ forecasting (leave, training, attrition) • Workload monitoring • Fatigue modelling • Proactive recruitment • Retention strategies • Succession planning 31

Layer 2: Scheduling of work to optimise sleep Work Scheduling • Rostering processes  Limit exposure to nights/early mornings  Re-set breaks for full recovery  Roster stability/predictability  Timing of breaks during work  Limit to weekend, evening work (high family value time) • Controlled swaps • Commuting risk considered • Overtime distributed

Layer 3: Fitness to do the task Fitness for the task • Fatigue reporting • Task risk grading • Controlled naps • Screening for sleep disorders BMI>40 • Sleep management skills • Sleep studies/coaching • Cool dark quiet sleep environment • PPE (mask, ear plugs) • Strategic caffeine use 33

Layer 4: Job and task design to optimise alertness and performance Job/task design • Timing of higher risk tasks away from circadian lows • Task rotation & breaks • Workload optimisation • Supervision & teamwork • Communication protocols • Continuous improvement based on  End user feedback  Formal error identification techniques 34

Layer 5: Work environment to optimise alertness and performance Work environment • Noise • Temperature • Vibration • Lighting/Glare • Equipment and seating ergonomics • Access to food & rest facilities away from tasks • Positive culture (promotes fatigue reporting) 35

Layer 6: Work environment to optimise alertness and performance Error detection and recovery • Alarms • Software dialogue boxes eg “are you sure you want to ….?” • Culture rewards error identification/reporting • Cross checks • Double checks • Checklists • Communication protocols • Teamwork 36

Layer 7: Engineered or technological systems Engineered controls • Automated systems • Automatic cut out • Limit switches • RCD switches • Bunding for leaks • Relief valves 37

Tool: fatigue models • Distribution of fatigue across business units • Staffing imbalance • Analyse roster options but not determine safe or unsafe • Look for fatigue hotspots • Not valid for individuals • Don’t replace rostering principles Manoeuvre Source: Cabon, Lancelle and Mollard 2009