ACOEM Releases Guidance on Managing Workplace Fatigue

A workplace in which hazards are well-controlled, with an active culture of health and a supportive work environment, can enhance worker health and well-being, both on and off the job.

Implementing a comprehensive fatigue risk management system could improve workplace safety and efficiency, according to a new guidance paper released by the American College of Occupational and Environmental Medicine.

Safety and productivity in the workplace are directly related to worker health, reports the paper, titled, “Fatigue Risk Management in the Workplace.” A workplace may have chemical, physical, biological, and/or psychosocial hazards that have the potential to impact physical and psychological well-being.

How these hazards are managed in the workplace is key. A workplace in which these hazards are well-controlled, with an active culture of health and a supportive work environment, can enhance worker health and well-being, both on and off the job. Insufficient or poor-quality sleep contributes to fatigue and can have several safety-related consequences, including slowed reaction time, reduced vigilance, reduced decision making ability, poor judgment, distraction during complex tasks, and loss of awareness in critical situations.

Specific factors in the organization of work have been shown to promote either alertness or fatigue. Because of the potential impact of fatigue on health, safety, and productivity, any organization in which individuals work extended hours or hours during which people typically sleep can benefit from addressing fatigue in the workplace. This is particularly important for safety-sensitive operations such as the transportation, health care, and energy industries.

Occupational and environmental medicine (OEM) physicians, whether directly employed by or serving as a consultant to an organization, have an important role to play in fatigue risk management. Where no program is currently in place, OEM physicians can and should advise management of the opportunities to enhance health, safety, and productivity through the development of a fatigue risk management system (FRMS).

An FRMS requires the active participation of all parts of the organization, including management, support functions, and workers. By promoting and participating in the development and implementation of an FRMS, OEM physicians can provide an important service to the organizations they support, those organizations’ employees, and the communities in which they operate.

"Fatigue is a managed condition in the workplace. Once organizations are able to identify, screen, diagnose, treat, and monitor effective management and treatment using the resources provided in the FRMS, employees will remain safer, more productive, and alert," said Benjamin Gerson, M.D., co-author and member of the ACOEM Task Force on Fatigue Risk Management and medical director of University Services, a multi-specialty medical services company.

The key defenses to assist in the design of an FRMS are balance between workload and staffing, shift scheduling, employee fatigue training and sleep disorder management, workplace environment design, and fatigue monitoring and alertness for duty. The first three of these impact sleep management and the last two affect alertness management. Each level of defense against errors and fatigue provides an opportunity to identify the presence or absence of appropriate control mechanisms in the FRMS.

"A comprehensive FRMS must take each of these defenses into consideration in order to effectively implement and monitor a successful program," Gerson said. "The demands of our 24-hour society can be mitigated once the proper steps have been taken to manage and limit fatigue."

Click here to read the entire paper.

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