1

Fatigue and AccidentsFatigue and Accidents

2

Objective(s)Objective(s)

Explain How Sleep Cycles, Hours Explain How Sleep Cycles, Hours and Circadian Rhythm and Circadian Rhythm Disturbances Can Develop Into Disturbances Can Develop Into Short- Term, Cumulative and Short- Term, Cumulative and Chronic Effects on Performance Chronic Effects on Performance and contribute to accidents.and contribute to accidents.

3

Why Should We Care ?Why Should We Care ?

31%31% of All Drivers Have Fallen of All Drivers Have Fallen Asleep at the Wheel Sometime Asleep at the Wheel Sometime During Their LifetimeDuring Their Lifetime

56%56% of Shift Workers Have Fallen of Shift Workers Have Fallen Asleep on the JobAsleep on the Job

55%55% of Adults Stated They of Adults Stated They Experienced Daytime Drowsiness.Experienced Daytime Drowsiness.

4

The Human TollThe Human Toll

100,000 Fatigue Related Collisions 100,000 Fatigue Related Collisions Per YearPer Year

1,544 Fatigue Related Deaths Per 1,544 Fatigue Related Deaths Per YearYear

Imagine:Imagine: A Boeing 727 Crashing Every Six A Boeing 727 Crashing Every Six

WeeksWeeks Or the Titanic Sinking Once a YearOr the Titanic Sinking Once a Year Or an Oklahoma City Bombing Every Or an Oklahoma City Bombing Every

Month and a Half. Month and a Half.

5

Who Pays the Costs?Who Pays the Costs?

6

Where Are We Now?Where Are We Now?

In the Past 20 Years: 158 In the Past 20 Years: 158 Hours Added Annually to Hours Added Annually to Our ScheduleOur Schedule

Since 1969: 241 Hours Since 1969: 241 Hours Added Yearly to Working Added Yearly to Working Mothers’ ScheduleMothers’ Schedule

7

What is Fatigue?What is Fatigue?

Fatigue Is a Complex State Fatigue Is a Complex State Characterized by a Lack of Characterized by a Lack of Alertness and Reduced Mental Alertness and Reduced Mental and Physical Performance, Often and Physical Performance, Often Accompanied by DrowsinessAccompanied by Drowsiness

Misconception: Misconception: Fatigue Is Fatigue Is NotNot Just Falling Asleep. Just Falling Asleep.

8

Fatigue Signs and SymptomsFatigue Signs and Symptoms

ForgetfulnessForgetfulness Poor Poor

CommunicationCommunication Impaired Decision - Impaired Decision -

Making SkillsMaking Skills Lack of AlertnessLack of Alertness Slow Reaction TimeSlow Reaction Time Microsleep.Microsleep.

9

Fatigue Signs and Symptoms Fatigue Signs and Symptoms (cont’d)(cont’d)

Withdrawn BehaviorWithdrawn Behavior DepressedDepressed MoodyMoody Quick to AngerQuick to Anger No Sense of HumorNo Sense of Humor Lack of InterestLack of Interest Always Tired.Always Tired.

10

Factors That Affect Fatigue Factors That Affect Fatigue

Time of Day/Circadian EffectsTime of Day/Circadian Effects Sleep DisordersSleep Disorders Environmental ConditionsEnvironmental Conditions NutritionNutrition Physical FitnessPhysical Fitness DrugsDrugs HealthHealth Age.Age.

11

Mental FatigueMental Fatigue

Tired and Drowsy Tired and Drowsy Due to Loss of Due to Loss of Sleep Sleep

Loss of Loss of Concentration Concentration And/Or AlertnessAnd/Or Alertness

Diminished Levels Diminished Levels of Creativity and of Creativity and Logic. Logic.

12

Physical FatiguePhysical Fatigue

A Decrease in A Decrease in Physical Physical PerformancePerformance

A Feeling of A Feeling of Muscle Muscle Discomfort or Discomfort or SorenessSoreness

Lack of Energy.Lack of Energy.

13

SLEEPSLEEP

A Highly Complex Physiological A Highly Complex Physiological Process During Which the Brain and Process During Which the Brain and

Body Alternate Between Periods Body Alternate Between Periods of of Extreme Activity and Quiet, but Extreme Activity and Quiet, but Are Are Never Shut off.Never Shut off.

14

What Do We Know?What Do We Know?

Sleep Is a Vital NeedSleep Is a Vital Need One-third of Our Life One-third of Our Life SHOULD BESHOULD BE

Spent AsleepSpent Asleep The Average Person Needs at The Average Person Needs at

Least 8 Hours of Uninterrupted Least 8 Hours of Uninterrupted SleepSleep

Some People Mistakenly Feel Some People Mistakenly Feel They Don’t Need a Full Night’s They Don’t Need a Full Night’s Sleep. Sleep.

15

Accumulating a Sleep DebtAccumulating a Sleep Debt

Sleep Loss Is Cumulative and Builds a Sleep Loss Is Cumulative and Builds a DebtDebt

Most People Get 1 to 1.5 Hours Less Most People Get 1 to 1.5 Hours Less Sleep Per Night Than They NeedSleep Per Night Than They Need

People whose sleep was restricted to People whose sleep was restricted to 4 to 5 hours per night for one week 4 to 5 hours per night for one week needed two full nights sleep to needed two full nights sleep to recover vigilance, performance, and recover vigilance, performance, and normal moodnormal mood

How Do You Get Out of Sleep Debt? How Do You Get Out of Sleep Debt? SLEEP!.SLEEP!.

16

The Two States of SleepThe Two States of Sleep

State IState I Non-REM SleepNon-REM Sleep

Physical and Physical and Mental Activities Mental Activities SlowSlow

Physical Physical Restoration Restoration OccursOccurs

State IIState II REM: Rapid Eye REM: Rapid Eye

MovementMovement Extreme Mental Extreme Mental

ActivityActivity Mental Mental

RestorationRestoration Major Muscles Major Muscles

Are ParalyzedAre Paralyzed

17

States andStages of Sleep

18

Effects of Alcohol on SleepEffects of Alcohol on Sleep

Breaks Down Into Sugar and Will Breaks Down Into Sugar and Will Disrupt SleepDisrupt Sleep

Eliminates All REM Sleep in First Half Eliminates All REM Sleep in First Half of Sleep Periodof Sleep Period

Can Lead to Balancing Act.Can Lead to Balancing Act.

19

Sleep DisordersSleep Disorders

Chronic InsomniaChronic Insomnia NarcolepsyNarcolepsy Sleep Apnea Sleep Apnea Restless Leg SyndromeRestless Leg Syndrome Periodic Limb Movement Disorder.Periodic Limb Movement Disorder.

20

Driving Drowsy Affects Driving Drowsy Affects Performance Like Driving Performance Like Driving

DrunkDrunk 19 Hours Without 19 Hours Without

Sleep Is Similar to Sleep Is Similar to a BAC of .05%a BAC of .05%

24 Hours Without 24 Hours Without Sleep Is Similar to Sleep Is Similar to a BAC of .10%.a BAC of .10%.

0.00%

0.01%

0.02%

0.03%

0.04%

0.05%

0.06%

0.07%

0.08%

0.09%

0.10%

0 HOURS 19 Hours 24 HOURS

21

Who is Most at Risk?Who is Most at Risk?

Sleep LossSleep Loss Working/Operating/Working/Operating/

Driving PatternsDriving Patterns Midnight Till 0600amMidnight Till 0600am Mid-afternoonMid-afternoon Many MilesMany Miles Many HoursMany Hours Monotony.Monotony.

22

Who is Most at Risk? (cont’d) Who is Most at Risk? (cont’d)

Use of Sedating Use of Sedating MedicationsMedications

Untreated Use of Untreated Use of Sedating MedicationsSedating Medications

Unrecognized Sleep Unrecognized Sleep DisordersDisorders

Consumption of Consumption of Alcohol.Alcohol.

23

Internal Body ClockInternal Body Clock(Circadian Rhythms)(Circadian Rhythms)

All Animals Have ItAll Animals Have It It Runs on About a It Runs on About a

24 Hour Cycle24 Hour Cycle All Human All Human

Functions Are Functions Are Controlled by It.Controlled by It.

24

Daily Sleepiness and Daily Sleepiness and Performance RhythmsPerformance Rhythms

Two Times of Two Times of Peak Sleepiness Peak Sleepiness Each DayEach Day About 3 to 5 A.M. About 3 to 5 A.M. About 3 to 5 P.M.About 3 to 5 P.M.

0

200

400

600

800

1000

1200

MidnightNumber ofCollisions

25

Biological and Social EffectsBiological and Social Effects on on Shift WorkersShift Workers

60 to 80% Have Chronic Sleep Problems60 to 80% Have Chronic Sleep Problems 4 to 5 Times More Likely to Have 4 to 5 Times More Likely to Have

Stomach DisordersStomach Disorders 80% Affected by Chronic Fatigue80% Affected by Chronic Fatigue 5 to 15 Times More Likely to Suffer From 5 to 15 Times More Likely to Suffer From

Mood Swings and DepressionMood Swings and Depression Divorce and Spousal Abuse Rates HigherDivorce and Spousal Abuse Rates Higher Drug and Alcohol Abuse Rates Higher.Drug and Alcohol Abuse Rates Higher.

26

Incidents Related to Circadian Incidents Related to Circadian DisruptionDisruption

ChernobylChernobyl 1:23am1:23am BhopalBhopal 12:40am12:40am Three Mile IslandThree Mile Island 4:00am4:00am Exxon ValdezExxon Valdez 12:04am.12:04am.

27

Incidents Related to Circadian Incidents Related to Circadian Disruption (cont’d)Disruption (cont’d)

Most Mistakes by Rail EmployeesMost Mistakes by Rail Employees 3-3-5am5am

Most Mistakes by OmissionMost Mistakes by Omission 3-3-5am5am SurgeonsSurgeons Nurses Nurses Postal WorkersPostal Workers Telephone Operators.Telephone Operators.

28

What to Expect if You Don’t What to Expect if You Don’t SleepSleep

Behavioral Problems Behavioral Problems PerformancePerformance Mood SwingsMood Swings Eventually You Eventually You WILLWILL Sleep. Sleep.

29

What are the costs of fatigue?What are the costs of fatigue?

30

Where Do You Go to Find Where Do You Go to Find the Costs?the Costs?

Examine Crash Data, Incident Examine Crash Data, Incident Logs Logs

Review Workers’ Compensation Review Workers’ Compensation Claims, Sick Leave, and OSHA Claims, Sick Leave, and OSHA 300 Log For Data300 Log For Data

Review Overtime, or On-call Review Overtime, or On-call Status.Status.

31

The Costs? (cont’d)The Costs? (cont’d) Consider Fatigue As a Possible Consider Fatigue As a Possible

Contributing or Causal Factor in Contributing or Causal Factor in All InvestigationsAll Investigations

Traffic, Industrial/Workplace, Traffic, Industrial/Workplace, Internal, External Incidents: Internal, External Incidents: Review With Fatigue in Mind. Review With Fatigue in Mind.

32

What is your Company Policy?What is your Company Policy? Overtime, On-callOvertime, On-call Outside Employment for Outside Employment for

EmployeesEmployees Prescription/Non-prescription Prescription/Non-prescription

Medication PolicyMedication Policy NappingNapping Technology.Technology.

33

What is the Company Policy? What is the Company Policy? (cont’d)(cont’d)

Screening Employees for Sleep Screening Employees for Sleep DisordersDisorders

Employee Fatigue Awareness Employee Fatigue Awareness TrainingTraining

Corporate Culture:Corporate Culture: Supervisor/Dispatcher/Employee Supervisor/Dispatcher/Employee

Authority/Latitude to Confront Fatigue Authority/Latitude to Confront Fatigue IssuesIssues

Priority of Safety Concerns. Priority of Safety Concerns.

34

Supervision of EmployeesSupervision of Employees

Are You Empowered to Approach Are You Empowered to Approach Management With Fatigue Issues in Management With Fatigue Issues in the Workplace?.the Workplace?.

35

Keys to ChangeKeys to Change

Knowledge of Fatigue Knowledge of Fatigue

Awareness of Fatigue’s Effect on Awareness of Fatigue’s Effect on Safe OperationsSafe Operations

Understanding of Your Workplace Understanding of Your Workplace Safety Culture.Safety Culture.