OCCUPATIONAL HEALTH AND SAFETY – FATIGUE MANAGEMENT

Fatigue Management Techniques: Reducing the impact of stress in the workplace

            Stress in the workplace often happens. It is a common problem among workers in various parts of this world. According to  (1997) stress is defined as the pressure, tension, or excess strain and its profound effects on the mental and physical health support that fact that we live in a high stress world. Aside from stress, fatigue also occurs in a number of workers in the work place. According to   (1996) fatigue involves a diminished ability for work and possibly decrements in attention, perception, decision making and skill performance. In addition,  (1997) defined fatigue as an individual’s multi-dimensional physiological-cognitive state associated with stimulus repetition which results in prolonged residence beyond a zone of performance comfort. Stress and fatigue in the workplace could be due to a number of factors. The work environment could contribute to the physical or mental pressure that the employee feels. Furthermore, poor lifestyle choices could also be partly responsible for the fatigue and stress that a worker feels.

            This paper examines the fatigue in the work place. A discussion on the issues of sleep and stress cause by poor lifestyle choices will be given in this paper. Moreover, fatigue management techniques and the impact on a person with fatigue both at work and home will also be discussed.

I. Stress

            According to the  (2003) stress in the workplace is the outcome of the interaction between the individual and the work place. For the worker it is the knowledge that he or she is not able to cope up with the demands in his or her job together with the negative emotional response. What are the causes of stress to an individual particularly the worker?

            Stress can either come within the work place or outside the work place. Stress in the workplace includes pressure to finish the task, different shifts, physical factors in the work environment such as noise, heat or cold, unrealistic deadlines. Stress outside the work environment involves family problems, second job, poor physical and mental health, and poor lifestyle choices.   (2007) have reported that about 40% of workers have reported that their job is stressful, 25% stated that their job is the no. 1 stressor, ¾ of employees believe that the workers nowadays have more stressful jobs than the prior generations, and 29% of workers felt extremely stressed at the workplace. In addition,  (2001) have identified that 80% of workers feel stress on the job and 25% felt like shouting and screaming due to job stress.

II. Signs and Symptoms of Stress

             (1998) identified two forms of symptoms of stress in the workplace and these are the personal and the organisation symptoms.

Personal Symptoms- personal symptoms are divided into four categories and these are physiological, behavioural, cognitive, and emotional.

            Physiological- symptoms include increase in the blood pressure, pains in the chest, palpitations of the heart, hyperventilation, headaches, gastro-intestinal disorders, sleep disorders, and fatigue. (1998) cited that 96% of social workers stated that their job is stressful and 58% have felt the manifestation of physiological symptoms of stress.  

            Behavioural- symptoms include poor patterns of sleep, decreased in the reaction times, and erratic behaviour.

            Cognitive- symptoms include difficulty in concentrating on the job and memory, and the inability to make decisions. 40% of women working in different shifts had perceived that they experience cognitive behavioural effects of fatigue ( 2002).

            Emotional- symptoms include depressed mood states, anxiety, irritability, and loss of self-confidence.

Organisation symptoms- transforming the factors that contribute stress in the workplace may produce more productive results that focusing on the personal factors. Just like the personal symptoms it is also divided into categories and these are behavioural and emotional.

            Behavioural- symptoms include the high level of absenteeism or sick leave, high turnover of staff, poor industrial relations, poor productivity and quality, increased in the rates of illness and accidents in the workplace, increased in the claims of stress by the workers, as well as, retirement rates. According to  (2006) 55% percent of Americans have reported that they are stressed at work and 25% of Americans miss 16 days of work due to stress.

            Emotional- symptoms include having low moral and loss of contribution of the employees in the planning and the process of improvement in the workplace.  

            Due to stress caused by fatigue and poor lifestyle choices the performance of an individual in the workplace could be greatly affected in a negative way. Stress occurs whether the person is employed in a white collar job or blue collar job, according to the study of  (1999) there is little difference between the individuals working in a white collar job and blue collar job in terms of the signs and symptoms of stress such as depression, satisfaction in life, and physiological complaints.

III. Categories of work-related stress

            (1990) have grouped four categories of work-related stress and these are:

• Work load- wherein the tasks could either be too much or too little and too difficult or too easy.


• Work conditions- wherein there is poor organisational structure in the company, too much politics in the work place, the design of the job is not good, poor organisational culture, and the management has low control over the work of the employees.


• Work patterns- the patterns of job in the workplace could also contribute to the stress of the employee, patterns include shifts in the time of work, and repetition of tasks.


• Work roles- the role of the worker in the job also adds to the stress especially if the roles are ambiguous, the demand of the job could emerge conflicts within or outside the workplace, and disagreement on the commitment with personal acquaintances and the job.

Exposure of individuals to the stressors in the environment particularly the workplace does not inevitably cause serious health problems in people ( 2001). Even though stress may co-exist with feelings of emotional distress, and may notably affect the well-being of an individual, it does not necessarily lead to a serious psychological and physiological disorder. Minimal stress is also important in the work because without stress workers may find that their task in the workplace will be boring and their performance suffers because they will feel unmotivated. On the other hand, if there is too much stress in the work place the individual’s performance in his or her job will suffer greatly and can even interfere in his or her actions. Due to stress  (1997) stated that the American industry loses 0 billion annually because of the lost hours in absences of the employees, and the decrease in the productivity and efficiency of the workers.   (2001) reported that approximately 150,000 workers in the United Kingdom have taken leave due to stress-related illness wherein the British Industry have lost an estimated £370 million a year.

IV. Fatigue

            Fatigue is the state of the muscle, and viscera or central nervous system of an organism, wherein it has prior physical activity and mental processing, but in the absence of enough rest, the outcomes would be insufficient capacity of the cells in the body to sustain the original level of activity by utilisation of the normal resources in the body ( 2001). There are two types of fatigue the central and the peripheral:

Central Fatigue-  (2004) defined central fatigue as fatigue in the central nervous system which occurs in the large portion of the intercerebral control circuits that is due to the repression in the level of voluntary exciting that are subdued in numerous motor units to the level of voluntary neuromuscular junctions and the firing frequency. In addition, according to  (2001) the central part to fatigue is described as the decrease in the neural drive or nerve-based motor command in the working muscles wherein the outcome in the decline in the output of the force.

Peripheral Fatigue- according to  (2004) peripheral fatigue a disorder in the neuromuscular junction transmission and metabolic disease that is due to fatigability of the muscles wherein it is characterised by the failure to maintain the force during contraction of the muscles.  

V. Physiological bases of Fatigue

            Fatigue has a number of physiological bases, according to the         the following bases are the physical exertion, sleep disruption, circadian disruption, domestic and social factors.

Physical Exertion- according to (1988) it is a common source of fatigue wherein the level of fatigue depends on the frequency and length of application of the forces in the muscles, as well as the nature of work. In addition,  stated that physical exertion could be measured in many ways like electromyography, measuring the oxygen consumption, and counting heartbeats. The level of fitness of the worker plays an important role in the degree of fatigue that he or she experienced in the workplace. If a worker is not physically fit to perform in jobs that need a great amount of physical effort like manual labour, he or she will experience a tremendous amount of fatigue due to physical exertion. Furthermore, if a worker is not disciplined enough to take care of his or her health then fatigue could be easily felt by the worker.

Sleep Disruption- in order to sustain the alertness of an individual in the work place, he or she needs a specific amount of sleep, however individuals have different needs in sleep and the factors that contribute to these differences are not yet well understood ( 1991). Moreover, if an individual have reduced his or her time of sleep by one hour it could cause increase in the level of sleepiness and can even lead to severe outcomes if it continues ( 1981).  (1994) stated that the quality of sleep and its continuity is a significant factor that could affect the consecutive alertness and performance of a worker. Sleep is very important to all individuals because lack of sleep will lead to stress and fatigue in the workplace. If an individual chooses to sleep late or not sleep at all, the result will be devastating because he or she will either be absent on the work or go to work but have a bad performance. According to (1991) there are three aspects in the work schedule of an individual that could disrupt sleep and these are:

·         Longer hours in the workplace

·         The hours of job is irregular

·         And working in schedules that require people to work even though they should be asleep.

Circadian Disruption- the circadian biological clock is the part of the body that efficiently programmes people to sleep during night time and be awake during the day according to ( 1995). Moreover, it is the one that relates the daily cycle that lives in the functions of the physiology and behaviour of the body and synchronises with the cues of time in the environment.  (1994) stated that the time and quality of sleep of an individual relies on his or her circadian clock. And an individual that is not able to adapt his or her circadian clock to shifting work schedules could degrade the efficiency and productivity of his or her performance which can lead to stress and fatigue in the workplace. Poor lifestyle choices could also contribute to the incomplete adaptation of the circadian clock, an example if the employee’s schedule was changed from dayshift to night shift and does not gain enough sleep during day time to adjust his or her circadian clock, then most likely he or she will eventually get stress.

Domestic and Social Factors- when a worker changes schedule due to shifts in the work place, they face challenges in incorporating their patterns of work with his or her activities in life. In the case of workers in the night shift, most of them are unable to socialise with their relatives and friends, do the work in the house, or even performs social activities such as shopping and watching a movie because he or she must rest and gain enough sleep to perform his or her job at night. The inability to do the activities could eventually cause stress and fatigue to the worker because once in a while he or she needs these activities to keep himself or herself from the stress in the work place and if the worker is unable to do that most probably he or she will succumb to the pressures of work and stress.

VI. Causes of Stress

            According to  (2005) workers such as the transportation equipment operators experience fatigue and stress due to the following reasons:

Extended Work and Commuting Periods- most jobs especially in manual labours require longer working hours, therefore longer work hours could result to fatigue. The extension of working hours and inadequate period of sleep could result to stress and fatigue in the workplace.

Work Schedules- the changing work schedules of workers also contributes to the fatigue and stress of the worker. The following are the different work schedules that contributes to fatigue and stress in the work place.

            Split-Shifts- this type of work schedule could increase the possibility of the worker to be fatigue because the schedules are not conducive to gaining sufficient sleep.  When the work schedule requires employees to gain their sleep during periods that must be awake the quantity and quality of sleep greatly suffers.

            Changing or Rotating Work Schedules- some jobs require frequent changes in the schedule, the different schedules could lead to transformation in the time of day wherein the workers could gain sleep that may result in inadequate levels of rest.

            Unpredictable work Schedules- the unpredictable work schedules could force the workers to change their sleeping patterns which lead to low-quality of sleep. Moreover, the unpredictable schedules could also make workers wake sooner than necessary so that they could come to work on time.

Lack of Rest or Nap periods during work- a number of jobs do not require workers to take naps during work, however a number of research have pointed out that planned napping by the employees could restore the alertness of the workers in the job. (2005) found that performance improved after longer naps.

Sleep Disruption- disruptions in the sleep could make returning to sleep harder; studies have shown that disruption in sleep could have an adverse effect on the alertness of a worker during daytime. A study on the performance of anaesthetists, have shown that performance in the job is worse if their sleep has been disturbed (, 2003).

Inadequate Exercise Opportunities- most of the workers especially from the white collar jobs do not have enough time to exercise therefore these people have the greatest probability to be stress or fatigue, studies have shown that individuals who exercise regularly have fewer episodes of being sleepy especially in the workplace. In a randomized investigation of 197 men and 160 women,   (1993) showed that subjects who participated in a walking/jogging aerobic program at an intensity of 60 to 73 percent of maximal heart rate (30-minute duration, 3 to 5 times per week) significantly lowered their stress scores and improved perceived self-esteem, mental outlook, and mood compared to the control subjects.

Poor Diet- the food that people eat could be a factor in the quality of sleep an individual obtains some foods that could disrupt sleep are spicy foods which can cause heartburn during sleep that is why it must be avoided prior to bedtime, drinking alcohol could induce an individual to fragmented sleep, and drinking drinks with caffeine could delay the sleep of an individual.

            Aside from the ones mentioned by the Transportation Research Board,         discussed in her paper that individual factors and lifestyle of an individual or worker may contribute to stress and fatigue to. The different personality variables could also be involved in stress at work are the type A behaviour patterns, hardiness, locus of control, negative affectivity, and self esteem. These factors, according to  (1987) moderate the relationship among stressor-stress-strain, it can influence the evaluation of the environment, it can even create stressful environments, have the power to affect the range of responses to the stress and coping mechanisms.

VII. Management of Fatigue and Stress in the Workplace

            Fatigue and Stress could greatly affect the performance of the employees in the workplace, therefore the management as well as the labour unions must find ways to help ease and manage stress and fatigue in the working environment. Working hours is usually one of the main reasons why most employees experience stress and fatigue in the workplace. In order to counter it government agencies create measures. An example discussed by the (2006) is in Western Australia wherein the        released a code of practice on the working hours which provides guidance in the application of risk management to fatigue in all industries. The Code is based on management assumptions that are added through prescriptive guidelines for a wide range of risk factors. The launch of the Code has been supplemented by education campaign in order to let the management of various industries understand and be aware of their responsibilities to their workers. (

2005)

In New South Wales   2005 was introduced to reduce fatigue among the long haul truck drivers wherein it requires the risk of harm from fatigue to the health of the driver to be assessed, controlled, and eliminated (  2005).

In Queensland      in 2005 wherein it provides guidance on decreasing the damaging effects of fatigue and stress by utilising risk management principles

            In        program was launched in 2003 wherein it enhances and improves the health of the driver and decrease the negative effects of fatigue in workers in the road transport.

            In the Northern Territory, the        introduced in 2001 a Code of Practice on Road Transport Fatigue Management, which gives the operators the basic set of important principles that they must apply in the management of fatigue in the workplace (  2001)

VIII. Strategies to manage Stress in the Workplace

            The management of stress and fatigue in the workplace must be done in order to avoid problems to be huge. Managing stress is important in order to cope up with the load of work in the workplace. According to  (2004) strategies in coping up with stress are grouped in the following categories and these are:

Direct Action Coping Strategies- wherein the person tries to counter the stressor it involves devising a plan to get out of the stressful situation or confronting the person or the situation that causes stress.

Action Inhibition Coping Strategies- it is a response to stress wherein the individual does nothing from doing anything that could worsen the scenario it includes waiting for information, not responding impulsively, and waiting for other people to help cope up with the situation.

Information Seeking Coping Strategies- it is appropriate to use in situations that are ambiguous. Depending on the facts obtained the response of the person could either be low or high.

Intrapsychic Scoping Strategy- it includes thinking about the stressful situations in order to decrease the emotional impact, this strategy could enable the person to realise that he or she is placing too much relevance on the stressor or the result that he or she devalues the potential impact. The interventions in the stress management are classified into primary, secondary, and tertiary approaches (  2000).

Primary Approach- in the primary approach it can be on the national level and the organisational level. Strategies that can be utilised in the national level are having legislation, monitoring systems of the government, and the active transfer of information regarding risk management in stress and fatigue in the workplace. In the organisational level, stress prevention are being implemented and discussed in the development of the organisation.

Secondary Approaches- it emphasis on decreasing the impact of stress response before it worsens; approaches include training the workers to be flexible with the stressors in the workplace.

Tertiary Approaches- these approaches emphasis the improvement of the determined stress condition. Kendall et al discussed that in the workplace in Australia tertiary stress approaches include case, injury, and disability management. Tertiary approaches could also include post-traumatic assistance and psychotherapy ( 2000).

Aside from the approaches for stress management  (2002) discussed some countermeasure that workers could do in order to combat stress and fatigue in the workplace and it includes the following:

Obtaining adequate sleep- researchers have agreed in an umber of studies that adults require an average of 7.5 to 8 hours of sleep every night to be alert and perform a good job in the workplace.

Napping- when utilised in an appropriate manner napping can be a good strategy for supplementing inadequate sleep at night and could even improve the alertness of the worker in the job.

Anchor sleep- anchor sleeping could be utilised as a coping mechanism for situations wherein a worker cannot obtain a full and continuous eight hours of sleep during night time. Anchor sleep has the benefit of stabilising the circardian biological clock of an individual.  

Caffeine- it is one of the most widely used countermeasures for fatigue usually drinking coffee, it has the advantage of breaking the routine in the job that causes fatigue and stress.

Good sleeping environment- a good sleeping environment is important in assuring the individual will get adequate sleep. The environment should be quiet and dark and the temperature must be approximately 65°F.

Case Studies

            (2006) discussed some of the case studies in fatigue in the workplace and these are:

Fatigue Analysis of Shiftwork Scheduling

In a global forestry company in Canada, the management want to determine if their shiftwork schedules have the probability of inducing mental fatigue. After analysis of the data the human resource department have identified that the shiftwork schedules contribute to excessive fatigues. The company developed implemented new policies such as prohibiting driving after 17 hours of work.

            In air Canada’s Pilot Union the group asked for analysis of fatigue for the layover schedule on Vancouver to Hong Kong Flights, after utilising the actigraph technology and FAST modelling the result revealed that an 18 hour layover have the least amount of fatigue.

Development of a Napping Strategy

            The Richmond Hospital in Canada allows their nurses to take naps during night shifts. The human resourced department of the hospital is determining the best time to take a nap to decrease fatigue during night shifts. Napping for 20 minutes is not enough therefore recommendation were made to enhance napping and sleeping at work.

References:

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