Fatigue Flashcards
give examples of acute and chronic fatigue
- acute: 1 very long work day, travelers jetlag, events you have no control over
- chronic: rotating hours of work, permanent night work, consistent irregular work hours, compressed work weeks, extended overtime
List types of work that are susceptible to fatigue
- 24/7 operations: truckers, manufacturers, service industry
- Professional service industry: doctors, nurses, airlines, police…
How can we measure fatigue
- Qualitative or quantitative work
- perceptions; interviews
- questionnaires; Epworth sleepiness scale
- fatigue risk index
- EEG
- flicker fusion tests
- psychomotor tests
- mental tests
List physical and emotional symptoms of fatigue
- Physical: Drowsiness, yawning, sore eyes, blurred vision, language impairment, slowed reflexes, microsleeps, automatic behavior
- Emotional: bored, restless, depressed, giddy, grouchy, impatient
Describe cognitive symptoms of fatigue
- poor concentration
- inability to remember recent things
- Failure to respond to changes in surroundings
- less alertness
- poor logic/judgement
- reduced decision making, innovation
- decreased motivation
How does fatigue impact the organization
- increased absenteeism, increased turnover, decreased productivity, increased accidents, decreased social interactions, increased abusive behavior, decreased decision making, decreased engagement, increased liability
How does fatigue affect society
- increased motor vehicle accidents, stress related incidents, impact family relationships, community engagement, increased health related impacts
What individual factors cause fatigue
- Sleep debt, long hours of activity, time of day/circadian rhythms
Why do we need sleep
- Restoration, growth, immune function, hormone release, unconscious thought processes, memory
Describe the stages of non-REM sleep
- 1: 10-15 min, transition btwn awake and light sleep
- 2: “clinical sleep”: BP/HR drop
3/4: restorative sleep, body and mind repair
differentiate cumulative and acute sleep debt
- cumulative: More than 8 hours accumulation
- acute: less than 8 hours in the last 24 hrs
What qualifies as long hours of work
- more than 41 hours/week
- more than 8 hours a day
How long hours of work affect our health
- increased risk of smoking
- increased risk of higher BMI (men)
- unhealthy weight gain
- increased alcohol consumption
- increased mental health disorders
How long hours of work affect our performance
- difficulty concentrating, weakness/dizziness, increased errors
differentiate over arousal errors and under arousal errors
- over: Errors of commission/over correction
- under: errors of omission
What is the purpose of circadian rhythms
- endogenous clock for: body temp, metabolism, HR, BP, respiration, hormonal secretion, urine flow…
- mismatch in circadian rhythm and behavior can lead to decreased performance, poor health, reduced sleep
Describe the purpose of melatonin and what inhibits its release
- regulates sleep wake cycle, anticancer hormone; prevents angiogenesis
- light inhibits its release, particularly blue light
Define shift work
- covers a broad spectrum of systems dividing 24 hrs into time spans
define double day shift
- 2 8 hour shifts
define continuous/discontinuous 3 shift systems
- continuous: normally 4 groups of workers operating the system and rotation occurs weekly
- discontinuous: 3 groups of workers operate for 24 hrs over 5 days and nights
Define split shift
- splitting the daily hours of work into two or more shifts
define permanent shifts
- workers stay on one shift indefinitely
define irregular shifts
- shift duration and length are not defined in advance
forward shift rotation
- morning to evening to night
backwards shift rotation
- morning to night to evening
compressed hours
- any shift longer than 8 hours that results in working less than 5 days/week
Why has there been an increase in shift work
- technological advances
- increased cost of equipment
- 24 hr services
- less energy during peak times
- globalization
Why do people choose to work shift work
- they like the nature of the job
- family
- better pay
- personal preference
draw the model of shift work; consider initial effects; secondary effects; and negative outcomes
see lecture.
What issues do young vs old individuals face when adapting to shift work
- young: social issues
- old: physiological issues
What individual factors make someone more or less susceptible to the negative effects of shift work
- Attitude (biggest)
- Women are more susceptible to social alienation
- Neurotic extroverts are more suitable
- Morning people are less tolerant
- fitness levels may reduce fatigue and increase working memory
How does task performance relate to circadian rhythm
- Flucuations in alertness follow fluctuations in temperature
- perception and decision making is most vulnerable in night work
**? What organization factors are affected by shift/night work
- Limited access to management as they often don’t work shifts
- resources
- training and support
- pay incentives
- lack of tools to track actual schedule
Health effects of shift work
- prone to GI disorders, weight problems, CAD/CVD, increased risk of cancer
Mental health effects of shift work
- evening shifts are associated with increased psychological stress
- higher stress with high demand-low control shift work
How does sleep change with shift work
- shift workers get less sleep
- sleep loss is greatest by last day of shifts
- less REM sleep
How does shift work affect social factors
- disrupted social activities
- night workers more prone to alcohol/drug abuse
- increased divorce rate
- isolated from friends/family
- Split shift/irregular shifts are associated with the lowest work-life balance satisfaction levels while rotating shifts reported opposite
How is safety and performance affected on the night shift
- increased accidents
- decreased performance
- increased absenteeism on morning shift after night
- increased absenteeism in second week of nights
What are three ways in which night workers become an agent of risk
- performance decreases leading to greater error
- sleep loss leads to night shift paralysis; brain shuts down for microseconds
- circadian dysfunction creates reckless attitude
What types of legislation are in place to deal with the hours worked
- federal/provincial legislation cover the hours worked; provide overtime pay (poor incentive, worsens the problem)
- no legislation covers shift work practices
how can we plan safe shift work
- ensure workload/task demand exceeds employees ability to sustain work pace
What types of organizational support should be available for shift workers
- written policies/procedures
- frequent assessments
- management on all shifts
- resources on all shifts
- Support for families/spouses
- supports for breaks
What should be considered when doing a work shift assessment
- review safety records
- carry out field interviews/questionnaires
- consider individual characteristics of workers: age, sex, drug/alcohol use, marital/family status, eating behaviours
- work schedule/preferences
- non-work activities/preferences
- noisy sleep environments
What environment issues should be considered in a work shift assessment
- community and organization shift work history
- health/safety/legal issues
- demand for product/services
- maintenance and support required
- staffing requirements
….
What is the best type of shift work/worst type
- best: unknown
- worst: Weekly backwards rotating shifts
- Fixed shifts are better physiologically, but worse socially, rotating = opposite
What should be considered with shift start times
- avoid 5/6 am starts (shorter sleep, increased fatigue)
- no more than 4 early starts in a row
- shorten length of early shift to prevent fatigue later on
- do not combined early and late shifts on consecutive days
- rest perios of 24 h after each set of night shifts
- EOWEO
What types of support programs should be available for shift workers
- training: teach about hazards, nutrition, sleep, fitness…
- Provide daycare, food services, training/development
Discuss 5 napping strategies
- planning: nap prior to sleep loss
- nap environment: laying down, quiet dark space
- Timing: nap when the body is most receptive to it
- Duration: 10-40 min
- Sleep inertia: plan 15-20 wake up periods at night and 10-15 in day
