Abstract
The occupational and environmental health nurse can be instrumental in developing a fatigue risk management system.
Sleep, or the lack of it, affects workers’ abilities to be healthy and safe at work. The hours worked annually by U.S. workers have risen steadily over the past several decades while the time slept has decreased (Elliot & Kuehl, 2007). According to the National Sleep Foundation (n.d.), adults, age 26 to 64 years, need between 7 and 9 hours of sleep each day, and older adults, 65 years and older, should have between 7 and 8 hours of sleep daily. Approximately 38% of the U.S. workforce is fatigued and can cost employers more than US$60 million in lost productivity, workplace injuries, and health care expenses (Lerman et al., 2012).
Chronic sleep deprivation and long work hours have been linked to health complaints, obesity, obstructive sleep apnea, and perhaps a higher risk of cardiovascular disease (Elliot & Kuehl, 2007).
Fatigue is defined as “a feeling of weariness, tiredness, or lack of energy” (Lerman et al., 2012, p. 242). Fatigue can contribute to slowed reaction time, poor judgment, impaired decision-making ability, and distraction during complex tasks (Lerman et al., 2012). Risk factors for fatigue include “sleep deprivation, circadian variability, time awake, health factors (sleep disorders, medications), environmental issues (light, noise), and workload” (Lerman et al., 2012, p. 231). Populations at risk for fatigue include shift workers, employees who work more than one job, individuals who must travel for work (e.g., commercial drivers, international travelers), employees who work long hours, or those who have health issues that interfere with adequate sleep.
A fatigue risk management system (FRMS) can be implemented to address fatigue at work. Occupational and environmental health nurses can be instrumental in developing FRMS. The FRMS may include a fatigue management policy, fatigue risk management (who is at risk and strategies to mitigate the risk), fatigue reporting system, fatigue incident investigation, educational programs for employees and management, sleep disorder management, and program evaluation (Lerman et al., 2012).
Occupational and environmental health nurses can minimize the effects of fatigue by developing primary and secondary prevention strategies. Primary prevention strategies include the following:
Developing a policy to address fatigue management at the worksite;
Reviewing work schedules to determine rotations and frequency of shift changes;
Educating management, supervisors, employees, and families about circadian rhythms; and
Conducting education sessions to minimize fatigue risk factors and improve sleep hygiene (Rogers, Randolph, & Mastroianni, 2009).
Secondary prevention strategies include the following:
Surveying workers to assess employees’ perceptions of fatigue and whether they are experiencing signs of fatigue,
Analyzing absenteeism and injury rates to identify potential problems,
Monitoring employees who may be at risk for fatigue or have health conditions that may be affected by fatigue, and
Counseling employees regarding strategies to promote effective sleep (Rogers et al., 2009).
Increased awareness of fatigue and its management can improve the health and safety of all employees.