Being tired at work is something most Americans can relate to. Those warm afternoons on slow days at work almost invite us to get a little drowsy. While snapping a picture of a co-worker snoring at their desk may seem like a harmless source of office humor, the potential consequences of fatigue and sleep deprivation are no laughing matter. Imagine if that same sleepy employee had instead been providing medical care to your sick child, working in a lab with hazardous chemicals, or operating a forklift in a busy warehouse.  Potentially dangerous in all environments, the seriousness of fatigue is amplified in occupational settings.

Mental and physical fatigue in workers is influenced by many factors such as home life, sleep, and overall health. Fatigue can then be exacerbated by working shifts that are out of sync with an individual’s circadian rhythm, the rigor and requirements of their position, and the length of their shift. OSHA’s webpage on Long Work Hours, Extended or Irregular Shifts, and Worker Fatigue says fatigue is how the body indicates rest is needed, and is associated with  “weariness, sleepiness, irritability, reduced alertness, impaired decision making, and lack of motivation, concentration and memory.” Cognitive function is crucial for many jobs, especially for those who work with machinery, chemicals and around other humans. One of the best ways to combat fatigue is sleep.

The Dangers of Fatigue 

In a 2015 consensus statement, the American Academy of Sleep Medicine and Sleep Research Society concluded long term sleep deprivation is linked to “weight gain and obesity, diabetes, hypertension, heart disease and stroke, depression, and increased risk of death.” They also said less than 7 hours of sleep a night is associated with “impaired performance, increased errors, and greater risk of accidents”. Some research even shows that being up for more than 18 hours straight has the same effect on things like driving or operating machinery as having a blood alcohol concentration of 0.05%! Health, safety and performance suffer with a lack of sleep.

Research related to worker fatigue and sleep deprivation often focuses on those who do shift work, work shifts longer than 8 hours, work more than 40 hours a week, or work rotating shifts. Shift work is work performed outside of the traditional 9:00 AM to 5:00 PM range. This includes evening and night shifts when people normally rest and sleep. Less sleep leads to greater risk of error and accidents. Safety sensitive industries such as healthcare, law enforcement, manufacturing, emergency response, aviation, energy, and transportation frequently fall into these alternate shift categories.

In 2012, the International Labor Organization published a document called Working Time, Health and Safety: a Research Synthesis Paper . This paper summarizes research related to safety, health, and the types of shifts people work. It states, “the risk of injury tends to be higher at night than during the day (by about 25-30 percent)” and “is higher for 12-hour shifts than 8-hour shifts (by about 25-30 percent).” This same report explains that for those working 40 hours a week or more “both sleep problems and risk increase in roughly linear fashion with the number of hours worked per week.” Further, those working more than 60 hours a week have a 23% higher risk of suffering from occupational illness and injury as compared to those working less than 60 hours a week.

Effects on Employee Productivity 

Fatigue can cost employers in other ways besides workplace injuries. Estimates from research titled  The cost of poor sleep: workplace productivity loss and associated costs indicate that productivity losses due to fatigue can cost employers almost $2000 a year per employee. Additionally, increases in workers compensation premiums, property damage, and blows to a company’s reputation resulting from big accidents and employee injuries can be very costly. Another sobering thought is the potential danger people face on the roads when driving home after a strenuous workday. The National Highway Traffic Safety Administration reported 795 deaths in 2017 were attributable to drowsy driving.

Despite the known dangers of fatigue and sleep deprivation, the Occupational Safety and Health Administration (OSHA) has no specific regulations addressing them. That being said, the General Duty Clause of the OSH Act of 1970 declares that each employer “shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.” This clause is applicable in every situation where there is no specific regulation. It means employers have a responsibility to address situations they know can be hazardous, including occupational conditions which could lead to excessive fatigue.

 Combating Fatigue in the Workplace

Fatigue is a complex issue and employers can’t control how much sleep their workers get each night, but there are a few things companies can do to encourage workers to be more alert at work. The first step a company should take is develop a solid safety culture. Employees need to know their employer cares about them. When this happens, workers feel more comfortable speaking up about issues they see. They may provide feedback on interventions and propose solutions of their own. What works for one company may not work for others, so establishing lines of communication with employees is very important.

Some companies choose to develop in depth fatigue risk management systems (FRMS) which strive to strategically prevent injuries, accidents, and illnesses associated with worker fatigue. An excellent guidance statement on FRMS was published by the American College of Occupational and Environmental Medicine, it is called Fatigue Risk Management in the Workplace. Not every company will develop full programs, but elements of fatigue risk management systems can be helpful to any company. A company looking to make changes should do their research to be sure they have an accurate understanding of what is actually needed. Implemented solutions should then be routinely reviewed for success.

Below is a list of ideas for combating fatigue and its effects:

1. Training sessions: Employers can provide information on the importance of sleep and good sleep hygiene to their employees. This instruction can take place during morning stand-ups, new hire orientation, or other training opportunities. Employees should be taught to identify fatigue related behavior in themselves and others and what to do about it.

2. Time limitations: Employers can limit the amount of time an employee is allowed to work in safety sensitive positions. For example, truckers have a period of 14 consecutive hours in which to get 11 hours of driving in. Then, by law, they must take 10 hours off before driving again.

3. Breaks: Employers can make sure their employees are taking full advantage of work breaks and even provide extended work breaks if appropriate. Employees shouldn’t feel so stressed to get work done that they skip breaks and meals.

4. Napping stations: Providing peaceful areas for short naps during breaks may prove beneficial for some people.

5. Managing schedules: Employers can limit shift lengths to 12 hours and be mindful of how much overtime they ask employees to work. Where possible, schedules can be arranged to reduce shift work, especially for safety sensitive positions.

6. Wellness programs: Programs can be implemented to encourage employees to exercise, get enough sleep and eat healthily. Wearable technology is available (Fitbits and apps for the Apple Watch, to name a few) that track how much sleep a person gets a night. Employees can be rewarded for reaching a set sleep goal.

7. Work environments: Occupational environments can be altered to encourage alertness. Consider bright lighting, sufficient ventilation and appropriate air conditioning to start.

8. Uber, Lyft and calling a cab: When projects are due and it’s common knowledge employees will be working long hours, consider paying for ride services during that time. That way employees aren’t driving home drowsy.

9. Last but not least, include all employees: The need to be alert and present at work is important for all employees’ safety, not just those working safety sensitive positions, night shifts, or overtime. Be sure to include office and day shift employees in conversations about fatigue and sleep.

NMS Health is an occupational health screening company that can help you administer testing for your employees or candidates anywhere in the country. If you’d like to learn more about how we help our clients save time on pre-employment medical testing while providing a national test solution, check out an overview of our services.

Article written by Alexandra Cox