Posted by National Sleep Awareness Week might have been last week, but many of us are feeling the importance of shuteye this week, as we struggle to drag ourselves out of bed at what feels like an inappropriate hour. While Daylight Saving Time may get the blame for sleepiness this week, though, there are important year-round factors that cause fatigue. In honor of National Sleep Awareness Week, the National Institute for Occupational Safety and Health’s NIOSH Science Blog published two posts about the impact of work demands on sleep. Claire Caruso and Roger Rosa start off by highlighting the challenges of long hours and shift work:
The timing of a shift can strain a worker’s ability to get enough sleep. Working at night or during irregular hours goes against the human body’s biology, which is hard-wired to sleep during the night and be awake and active during the day. Still, society needs certain workers around the clock to provide vital services in public safety, healthcare, utilities, food services, manufacturing, transportation, and others. The resulting shift work–any shift outside the normal daylight hours of 7 a.m. to 6 p.m.–is linked to poorer sleep, circadian rhythm disturbances, and strains on family and social life. It is not possible to eliminate shift work altogether, so the challenge is to develop strategies to make critical services available while keeping workers healthy and everyone around them safe. In addition to shift work, some data suggest that a growing number of employees are being asked to work long hours on a regular basis. Every extra hour on the job is one less spent attending to the person’s off-the-job responsibilities. When the day is too full to fit everything in, it is often sleep that gets the short shrift.
They list some of the risks to workers from long work hours and shift work, including a decline in mental function and physical ability; decline in immune-system functioning; higher rates of depression; an increased risk of heart disease; and an increased risk of illness or injury. These risks to workers also matter for employers, who can see reduced productivity, more errors, and increased healthcare and workers’ compensation costs. And, of course, fatigued workers can make medical errors and contribute to car crashes and industrial disasters whose impacts extend far into their communities.
In an American Journal of Public Health article offering recommendations for shift duration and sequence during emergency response activations, Paula Burgess focuses on the times of day at which industrial and engineering disasters have occurred, suggesting “a possible association between human error and circadian rhythm as it relates to shift work.” She gives several examples:
The incident at the Three Mile Island nuclear facility in Pennsylvania on March 28, 1979, occurred because night shift workers failed to recognize the loss of core coolant water resulting from a stuck valve between 4:00 AM and 6:00 AM. Similarly, on June 9, 1985, the Davis-Besse reactor in Oak Harbor, Ohio, went into automatic shutdown followed by a total loss on the main feed water at 1:35 AM. The incident reached more critical proportions when an operator in those early morning night shift hours pushed the wrong 2 buttons in the control room, defeating the safety function of the auxiliary feedwater system. When the Racho Seco nuclear reactor near Sacramento, Calif, automatically tripped after DC power to the integrated control system was lost at 4:14 AM on December 26, 1985, human errors of omission and commission caused time delays in regaining control of the plant. Even the nuclear plant catastrophe at Chernobyl is officially acknowledged to have begun at 1:23 AM as the result of human error.
The Presidential Commission on the space shuttle Challenger accident cited the contribution of human error and poor judgment related to sleep loss and shift work during the early morning hours. This same commission also cited early morning shift work error in a previous near-catastrophic launch of the shuttle Columbia on January 6, 1986.
The incidents involving the Bhopal Union Carbide tragedy and the Exxon Valdez, as well as the Estonia ferry incident, all occurred in the early morning hours. Investigations have concluded that all of these were at least in part attributable to fatigue and human error.
Burgess recommends that when 24-hour emergency coverage is necessary, 8-hour shifts are preferable to 12-hour shifts, and if the size of the personnel pool allows it, shifts for each worker should rotate as follows: three day shifts, followed by three evening shifts, three night shifts, and three recuperative days off.
Caruso and Rosa also have suggestions that apply to all employers and workers, not just those engaged in emergency response:
What can employers do to address this issue?
- Regular Rest: Establish at least 10 consecutive hours per day of protected time off-duty in order for workers to obtain 7-8 hours of sleep.
- Rest Breaks: Frequent brief rest breaks (e.g., every 1-2 hours) during demanding work are more effective against fatigue than a few longer breaks. Allow longer breaks for meals.
- Shift Lengths: Five 8-hour shifts or four 10-hour shifts per week are usually tolerable. Depending on the workload, twelve-hour days may be tolerable with more frequent interspersed rest days. Shorter shifts (e.g., 8 hours), during the evening and night, are better tolerated than longer shifts.
- Workload: Examine work demands with respect to shift length. Twelve-hour shifts are more tolerable for “lighter” tasks (e.g., desk work).
- Rest Days: Plan one or two full days of rest to follow five consecutive 8-hour shifts or four 10-hour shifts. Consider two rest days after three consecutive 12-hour shifts.
- Training: Provide training to make sure that workers are aware of the ups and downs of shiftwork and that they know what resources are available to them to help with any difficulties they are having with the work schedule.
- Incident Analysis: Examine near misses and incidents to determine the role, if any, of fatigue as a root cause or contributing cause to the incident.
What can workers do to address this issue?
- Make sure you give yourself enough time to sleep after working your shift.
- Avoid heavy foods and alcohol before sleeping and reduce intake of caffeine and other stimulants several hours beforehand since these can make it difficult to get quality sleep.
- Exercise routinely, as keeping physically fit can help you manage stress, stay healthy, and improve your sleep.
- Choose to sleep someplace dark, comfortable, quiet, and cool so you can fall asleep quickly and stay asleep.
- Seek assistance from an appropriate healthcare provider if you are having difficulties sleeping.
Also, if you find yourself staying up later than you should clicking on one YouTube video after another, remind yourself that sleep is important for safety — then turn off the computer and get some sleep.
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