Part 2: Managing workplace fatigue

A framework for managing shift work to minimise fatigue

The framework presented here is not the only way to meet your obligations as an employer under the Health and Safety in Employment (HSE) Act. It is just one approach, based on the idea that the best focus is on opportunities for recovery, rather than on the number of hours worked.

Strong leadership will be required, with one person with adequate authority overseeing the project as a whole. Good faith will also be required, with the understanding that shift work inevitably requires a balancing of interests.

The search for the 'perfect roster' is a wild goose chase. A shift work management system is never final-reviewing and evaluating it at an agreed level of formality must be part of shift work policy.

The framework below will apply more easily to larger employers. It is most important that it is applied in safety-critical work. A simpler set of strategies for small employers is provided at the end of Part 2.

Figure 2-A framework for managing shift work to minimise fatigue

See larger version of the image and read the text of image

1. Develop a shift work and fatigue policy

Obtain senior management commitment

Managing shift work successfully needs high level commitment-and support with time and resources proportional to the importance of shift work in your business.

As an employer you need to:

• approve a responsible shift work policy
• support all activities needed to manage shift work
• insist on being up to date with any developments on shift work policy.

Review operational and legal needs

Identify what your operation needs in terms of work that must be done by shift workers

Check what you and your employees have to do under the Health and Safety in Employment Act to manage fatigue. As an employer your obligations include the following.

• Take all practicable steps to ensure the safety of employees at work. In relation to roster design, this could include:
  • reducing night work to the minimum possible
  • ensuring no worker spends more than 2-4 days on any one night shift
  • providing a minimum of 2 full nights' recovery after 2-4 night shifts
  • rotating shifts forward (usually, although some rosters can work with backward rotation)
  • avoiding rosters that require starting work before 6.00am
  • implementing responsible alternatives where the measures above cannot be implemented.
• Systematically identify hazards and assess their significance in relation to shift work. This could include:
  • identifying risks in tasks to be performed
  • assessing the risk of performing tasks when workers are fatigued.
• Eliminate, isolate or minimize these hazards, in that order of priority.
• When employees face significant hazards, monitor their hours of work and their health.
• Provide information, training, and supervision for shift workers and health and safety representatives. Include families in training sessions if possible (though this is not an HSE Act requirement).
• Ensure that accident investigations consider whether fatigue was a contributing factor.

Define employer and employee responsibilities

Review internal company policies and traditional operating methods alongside your legal and operational needs, to define who will have responsibility for doing what.

State these responsibilities as specifically and concretely as possible, as in the following examples.

Employees have a responsibility to:

• cooperate with the employer in matters of health and safety
• alert the employer if following normal procedures no longer seems advisable
• report hazards
• report when they feel they are not safe because of fatigue
• attend training, and be 'fatigue aware'
• use recovery and rest times appropriately, as much as they can.

Line managers have a responsibility to:

• contain working hours within specified fatigue limits
• monitor employee health, if required under the HSE Act
• keep training up to date and inform employees of hazards, including new hazards as they arise.

Senior managers have a responsibility to:

• take part in policy development
• provide facilities for night workers (training, access to HR, appropriate food) equivalent to those provided for day workers
• ensure regular reporting against standards
• evaluate from time to time how the shift management programme is going
• review counter-fatigue measures against specific standards
• provide adequate resources.

Develop and draft a policy document

A shift-work management policy should be constructed on two levels:

• the corporate level-establishing commitment from senior management
• the operational level-describing how the system will operate.

This policy (which could use the headings from this framework) can set a standard against which to evaluate the actual management of the shift work.

Remember that plans work best when they are SMART-that is: Specific, Measurable, Achievable, Realistic, and Time-framed. For example:

In 3 months all employees in the 'Product A' Division will be asked:

• what they know about the hazards of shift work
• what countermeasures they use to minimise the effects of fatigue
• what their last month's roster arrangements were
• what their opinions of their current roster arrangements are
• how they assess the hazards on their jobs.

Review and redraft

The policy will need to be reviewed and revised from time to time. Input from the people involved may identify areas that have been left out or need revising, and more formal evaluations may indicate where changes are needed.

Implement

Once the policy is agreed on, move on to the next step.

2. Review the hours of work

Hours worked are one of the key factors affecting worker fatigue. Aspects of hours worked include:

• the number of hours
• the time of day
• the day of the week
• overtime or extended hours
• what breaks are provided within the work period.

The patterns of work to be done by each employee or group of employees need to be planned in advance and assessed.

Outline business requirements

Identify your business requirements in terms of the outputs and inputs needed at different times of the day.

Some examples of outputs might be:

• wiring a home building extension
• driving from point A to point B and delivering so many packages
• ensuring the target amount of product is produced to the required standard.

Some examples of inputs are:

• adequate supplies
• trucks in roadworthy condition
• raw materials on hand.

Patterns of work hours for employees in a small business may have a less regular pattern than those of larger businesses.

Review skills, leave, and training time needed

The outline of business requirements will indicate the roles required to do the work, the abilities and skills of workers in each role, and the training required for each role.

Shift workers need the same facilities as non-shift workers, such as access to first aid, training, human resources facilities, and refreshment. These needs should be planned for.

Calculate the real need for workers

Using the information gathered under the previous headings, you can work out the number of workers needed at different times of the day, and so plan and assess a roster.

Making clear the extent to which the hours of work may vary will allow for appropriate planning by everyone. Unpredictability is a key element in employee dissatisfaction with shift work-for example, being called back to work unexpectedly while on leave, or at short notice.

Fatigue assessment of planned hours

Table 1 outlines some of the factors that you will need to consider when developing a roster.

Table 1. Suggestions for roster arrangements

Factor	Conventional recommendation
1. Night work	Reduce to the minimum possible.
2. Length of work	Extended working hours (shifts longer than 8 hours) may need to be examined. Are the nature of the work and the workload suitable for extended hours? Is the system designed to prevent fatigue accumulating? Are arrangements to cover for absentees adequate? Will overtime and/or double shifts be avoided or minimised? Are toxic exposures limited? Is adequate recovery after work possible before the start of the next shift? Is there a high acceptance of the working time?
3. Rate of rotation	Rotate shifts quickly-no more than 2-4 days on any one shift.
4. Direction of rotation	Rotate shifts forwards (ie, morning, afternoon, night). Some shift arrangements operate well when they rotate backwards, but such arrangements seem to need more commitment from employees.
5. Shift start and end times	Avoid rosters that require starting work before 6.00am. If possible, give longer breaks between shifts when breaks start in the early morning.
6. Lengths of periods off	Allow at least 2 full nights recovery time with normal daily activity after working nights-this is the minimum needed for recovery. Provide for some complete weekends off.

These recommendations reflect the requirements of human physiology. They are not all hard and fast rules, and it may be possible to devise successful shift-working arrangements that do not stick to them, if there are other ways of preventing fatigue accumulating.

Once you have designed a roster, you can assess how fatigue is likely to accumulate. There are various software programmes available for this purpose. However, fatigue modelling software may not take into account the effects of workload, environment, breaks within shifts, out-of-work activities, or the possible consequences of errors.

Fatigue assessment of the actual hours worked

The actual hours people work can differ from what is planned because of factors such as delays, call-backs, altered deadlines or delivery schedules, breakdowns, and shift-swapping.

Monitor the actual hours worked. If they differ significantly from the planned hours of work (and particularly if the actual hours worked cause a high level of fatigue) then you will need to revise the work schedule.

3. Manage risk

Establish fatigue risk context

What are the risks (product liability, personal and public safety consequences of errors) if things go wrong? The answer to these questions will determine how important it is to make sure that shift work is managed properly.

Form a risk assessment workgroup

A risk assessment workgroup could be formed to carry out the activities described in this section of the management system. The group would need to represent all employees affected by shift work.

Identify fatigue hazards

Assess each job or task to see if there are hazards that could worsen the consequences of a fatigue-related error. For example:

• moving machinery poses an extra hazard if a worker 'nods off'
• carrying out a maintenance operation early in the morning could result in incorrect reassembly.

Identifying hazards and assessing their significance are requirements of section 7 of the HSE Act.

Analyse and evaluate risks

Once you have identified the hazards, assess the risk associated with each one. You can do this using a framework such as that in the Australia/New Zealand Standard for Risk Management (ANZS 4360).

Table 2. Risk assessment scoring

Likelihood	Consequences
	Insignificant	Minor	Moderate	Major	Catastrophic
A. Almost certain	High	High	Extreme	Extreme	Extreme
B. Likely	Medium	High	High	Extreme	Extreme
C. Moderate	Low	Medium	High	Extreme	Extreme
D. Unlikely	Low	Low	Medium	Medium	Extreme
E. Rare	Low	Low	Medium	Medium	Medium

It is clear that this process is valid only when there is good information about both the likelihood and the consequences of an event. If good information is not available then estimates of risk should not be presented as anything other than 'guesstimates'.

Treat risks in priority order

Risk control measures are described at this step and their effectiveness can be assessed from time to time. As an employer you are required to:

• assess each hazard identified and decide whether it is significant or not
• take all practicable steps to eliminate, isolate, or minimise significant hazards, in that order of priority
• where significant hazards can only be minimised, monitor workers' exposure to each significant hazard and, with their informed consent, monitor their personal health in relation to it.

Report

Results from this section of the system feed into shift work policy.

4. Train and educate

The HSE Act requires that employees be informed about the hazards that exist in the workplace and about the measures the company is using to control them.

Information, training, and supervision of employees should aim to create a set of values, beliefs, and expectations shared by management, employees, and other affected people.

Provide new staff with information about shift work at induction. Those doing night work should be trained during their normal work hours-they should not have to come back during the day for training. Families and partners can be included in the training programmes. Educating their families about the importance of sleep will help night shift workers.

Determine relevant groups

You will need to decide how to group employees and management (and perhaps other stakeholders) for training and education. Groups could be based, for example, on the similarities of their work/sleep patterns.

Assess the groups

To design appropriate training, you will need to assess the current knowledge, values, beliefs, and expectations of each group in relation to shift work.

Questions to assess an employee's knowledge of shift work and its hazards could include some of the following:

• What are some of the hazards of shift work and night work related to fatigue, safety issues, and long term health problems?
• What are some hazards faced by night workers that are not faced by day workers in the same organisation?
• What are some of the warning signs and effects of fatigue?
• What does being 'fatigue aware' mean?
• What are some ways to promote high quality sleep?
• What are good eating and drinking practices for shift workers?
• How can exercise affect sleep quality and workplace alertness?
• How can commuting be affected by working shifts?
• How can working shifts affect family relationships?
• What are some helpful strategies to promote shift workers' family life?

Develop training programmes

Design a training programme for each group of trainees that covers all the topics listed in Table 3.

Table 3. General training topics

Topic	Topic has consequences for work arrangements and facilities	Topic has consequences for out of work activities and sleeping facilities
Fatigue related hazards and measures to combat them.
Napping
Fatigue awareness
Getting to and from work
Stimulant use and avoidance
Promoting good sleep
Fitness
Childcare arrangements	*2
Home and social life	*3
Nutrition
Exercise	*4
Self-management, lifestyle choices, responsibilities

Notes

1. Will be relevant in workplaces that promote napping.
2. Providing childcare facilities may be an option for some workplaces.
3. Certain elements in work life overlap home arrangements for night workers; eg, ability of family to contact night workers in a home emergency.
4. Exercise is an important factor in shift work. Providing exercise facilities in workplaces can help people manage sleepiness.

Implement training programmes

Training programmes can now be conducted. However, to make the desired behaviours possible, the organisation will need to implement the policies, processes, and workplace changes needed.

Evaluate and update training programmes

You will need to evaluate the training programmes continually to find out whether:

• it is possible to apply the strategies proposed in the training
• the strategies are being applied
• there are any gaps in training and opportunities
• employees retain the information.

Various methods are available for evaluation, including focus groups, semi-structured interviews with employees and supervisors, direct observation, and questionnaires.

Maintain a training register

A training register can help you manage, track, schedule and document training activities, requirements, and staff who have completed training activities

5. Monitor and evaluate

This section describes four further steps that will be important in your shift work management programme.

Identify shift workers who are not coping well

Some people do not cope well with shift work, especially when concerns outside the workplace weigh more heavily than usual (for example, a sick relative, a difficult relationship, or a bereavement). Managers and supervisors should be aware of the warning signs that an individual is not coping or is fatigued.

Factors that can affect individuals' responses to shift work are:

• training and experience
• general health and fitness
• age
• sex
• eating habits
• general coping skills
• rigidity of sleeping habits
• adaptability to different daily rhythms
• whether they are a morning person or an evening person
• whether they are introverted or extroverted.

The Health and Safety in Employment Act requires employers to take all reasonably practicable steps to identify when a fatigued employee is impaired to the point where they are a danger to themselves, their colleagues, or the public.

Monitor hazard exposure and health

As mentioned earlier, monitoring employees' exposure to significant hazards and, with their consent, their personal health in relation to such hazards, is a requirement of the HSE Act.

Examples of exposure to a significant fatigue-related hazard include:

• operating dangerous machinery in the early morning
• having responsibility for seriously ill patients
• being a security officer.

Fatigue estimation software can help you to predict when people might experience hazardous levels of fatigue, and to adjust rosters accordingly.

It may help to consider the issues below, which can affect individual responses to shift work.

• Is the shift worker single, or living with a partner?
• Is the partner also a shift worker?
• How many children are affected by the shift work, and what ages are they?
• What housing does the shift worker have?
• What job alternatives are there in the locality?
• Is there a local shift-working community, and if so, how big is it?
• What local shift-working traditions exist?
• What leisure activities are available to the shift worker?
• What social support does the shift worker have?
• How much time does the shift worker have to spend travelling?

Find out about 'near hits'

To get valid feedback about how well a shift-work management system is working, you need to know about fatigue-related 'near hits'. These include such things as when:

• a driver 'nods off' and clips a safety barrier
• a maintenance engineer realises later that she omitted a step in a reassembly procedure.

An anonymous, no-blame reporting system will make employees more willing to provide information about these sorts of incidents. Analysing the information may alert both you and your employees to safety issues and increase fatigue awareness.

Design a questionnaire for shift workers

Supervisors need to be alert for signs of fatigue. A questionnaire to monitor the individual effects of shift work can be circulated to all employees at regular intervals, or be available for individuals to complete at any time.

The questionnaire could include questions such as the following.

1. Are you generally coping with shift work better or worse than you have done in the past?
• If worse, why do you think this is?
2. Do you recover from periods of shift work more slowly now than you did in the past?
   • If yes, why do you think this is?
3. Has your health been affected by working shifts?
• If yes, how has your health been affected?
4. Have you been involved in a 'near hit' where you felt that your safety, or the safety of your colleagues or the public, was at risk because of some aspect of shift work?
   • Please describe the incident (without giving names) and say why you think it happened.

Continually evaluate and improve the system

At agreed intervals, as specified in policy documents, carry out an evaluation of the system involving all the key stakeholders.

Strategies for small employers

Small businesses may lack the time, skilled personnel, or resources to develop complex, systematic approaches to the fatigue aspect of safety management. However, a responsible employer with good staff support would find the strategies below reasonable, and easily accommodated into daily work activities and normal contract with staff.

To manage shift work well:

• involve your employees
• agree on responsibilities in relation to preventing fatigue
• work safe numbers of hours and allow enough recovery time
• ensure that high-risk tasks are done at safe times, or under special precautions
• train and educate staff to develop a culture of fatigue awareness
• support staff as far as possible (and ask staff about the best way to do this)
• look out for staff who are not coping (in both the short and the long term)
• take steps to detect impairment from fatigue
• monitor staff health, where they face significant hazards
• be alert for the contribution of fatigue in accident investigations
• assume that your arrangements will never be perfected, so evaluate them from time to time.

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