FATIGUE

Fatigue Information for employers

Although there is no scientific definition for fatigue, it is normally described as feeling tired and not being able to carry out work as effectively as usual. A worker who is fatigued may have lower levels of concentration, short term memory problems, slower reaction times and less interest in their work than normal.

What causes fatigue at work? Fatigue can be caused by:

• Excessive time at work and/or shift patterns that are not well thought out • Working too hard or for too long • Not sleeping enough or having poor quality sleep • Disrupted sleep patterns, such as working nights/early mornings • Poorly designed shift work • Inadequate breaks

It’s made worse by lifestyle factors such as poor diet, irregular meals, alcohol, and being under or overweight.

Employers should be aware that, in many cases, workers may not be good at assessing how fatigued they are; even when they are good at managing fatigue, fatigue itself can increase stress and the risk of ill health.

What is the impact of fatigue at work? Fatigue causes physical and psychological problems. These can lead to poor performance and reduced productivity, as well as operator errors, accidents, injuries and ill health.

It’s important that employers control long working hours, especially if workers are involved in major hazard work. Changes to working hours need to be risk assessed. Fatigue can cause:

• Slower reaction times • Falling asleep at work • Inability to concentrate or process information • Problems with short-term memory • Lack of attention to detail • Poor decision making • Underestimation of risk • Poor coordination

Fatigue is also thought to be responsible for some major disasters, (eg Herald of Free Enterprise) as well as being a factor in around 20% of accidents on main roads.

As with any other hazard at work, it’s important to manage fatigue to reduce risk.

Shift work Shift work, involving hours outside normal daylight hours, can put workers at risk of fatigue. There is a higher incidence of accidents and injuries on night shifts, ‘low points’ (eg after lunch), or when shifts are long with inadequate breaks. In one study, 62% of shift workers had sleeping problems, compared with 20% of day workers. Shift workers are also more likely to have digestive disorders and a higher risk of cardiovascular disease.

Over 3.5 million people in the UK are shift workers, including in the construction industry. There is no specific legislation for shift work but employers are responsible for the health and safety of workers and this includes reducing the risk of fatigue by planning shift work schedules effectively. This, in turn, reduces risks associated with fatigue and can prevent ill health, injuries and/or accidents. You can find out more about shift work at: support.fitforwork.org/app/answers/detail/a_id/607.

Fatigue and the law It is the employer’s duty to manage any risks from fatigue, even if a worker is prepared to work long hours and/or shifts. It is not enough to comply with the Working Time Regulations.

It’s important to:

• Risk assess any changes to working hours with reference to the Health and Safety Executive (HSE) guidance. You can use the Fatigue Risk Index on the HSE website at: www.hse.gov.uk/research/rrpdf/rr446g.pdf

• Consult workers about their working hours and shift patterns • Have a policy to address and set limits on workers’ hours, overtime and swapping of shifts

to reduce fatigue • Monitor and enforce your policy, for example by recording hours that are worked,

overtime, and shift-swapping • Remember that night workers are particularly at risk of fatigue

For more information about fatigue, visit: www.hse.gov.uk/humanfactors/topics/fatigue.htm. There is also an HSE briefing note at: www.hse.gov.uk/humanfactors/topics/10fatigue.pdf which includes a list of ways to manage fatigue.

Managing fatigue risks The HSE advises that the approach is to focus on a system of controlling excessive or fatiguing working hours. It is the employer’s legal duty to manage risks from fatigue (even when a worker is happy to work additional hours or prefers to work inappropriate shift patterns, eg for social reasons).

It’s important to have well thought out shift patterns and monitor any changes to these, or any overtime worked by individuals involved in major hazard work. Fatigue needs to be managed, just as with any other hazard.

You can find out more about good practice on shift roster design at: www.hse.gov.uk/humanfactors/topics/specific2.pdf.

There is also an HSE shift work and fatigue toolbox at: www.hse.gov.uk/toolbox/organisation/shiftwork.htm.

How can employers reduce fatigue? There are a number of ways that you can help workers to reduce fatigue. These include:

• Ensuring that there is time for workers to sleep between shifts and restricting night shifts to four in a row (or two in a row if they are 12 hour shifts)

• Allowing at least two days off after night working • Rotating shifts forwards, (ie mornings followed by afternoons followed by nights) • Limiting overtime to comply with the EU Working Hours Directive • Making sure that workers take regular breaks

You can find more information about the Working Time Regulations at: www.hse.gov.uk/contact/faqs/workingtimedirective.htm and ideas for reducing fatigue at: www.hse.gov.uk/humanfactors/topics/10fatigue.pdf. There are also some suggested guidelines for shift design on page 9 of the Unite Guide to Shift Work and Night Work at: www.unitetheunion.org/uploaded/documents/ShiftandNightWork%2011-4950.pdf.

Enforcement and advice • Health and Safety at Work etc Act 1974 Section 3 responsibilities towards contractors

and other non-employee staff on site are particularly relevant (see: www.legislation.gov.uk/uksi/1999/3242/pdfs/uksi_19993242_en.pdfwww.legislation.gov.uk/ukpga/1974/37/section/3) .

• The Management of Health and Safety at Work Regulations 1999 – regulations 3 and 5 are key areas for enforcement (see: www.legislation.gov.uk/uksi/1999/3242/made)

• Further guidance can be found at: www.hse.gov.uk/humanfactors/topics/specific2.pdf .

Chronic fatigue syndrome Chronic fatigue syndrome (CFS) is when someone is so affected by extreme tiredness that it impacts on their day to day life and isn’t improved by having more sleep. Sometimes known as myalgic encephalomyelitis (ME), extreme fatigue can cause long term illness and disability. CFS may be categorised as follows:

• Mild: workers may require time off (as sickness days) to rest • Moderate: mobility may be affected and there may be sleep problems • Severe: workers may have significant disabilities, with difficulty carrying out everyday

tasks and concentrating

What are the symptoms? As well as chronic physical and mental fatigue, people with CFS may have difficulty with short term memory, concentration, and communication. Other common symptoms include:

• Pain in the joints and muscles • Headaches, which may be severe • Problems with sleeping (sleeping too much or too little)

• Hypersensitivity to light, noise, alcohol and/or foods • Depression, anxiety and other problems affecting mental health

In some cases, symptoms may also include dizziness, problems with balance, and difficult controlling body temperature, (eg excessive sweating).

Is there any treatment for CFS? Although as yet there is no cure, treatments can include medication, exercise programmes, cognitive behavioural therapy (CBT) and/or complementary therapies such as acupuncture or homeopathy.

Chronic fatigue and the law The Equality Act 2010 states that employers have to make ‘reasonable adjustments’ according to workers’ needs. Examples of adjustments that may need to be made include:

• Adjusting working hours • Flexible working (allowing workers to take short rests; working from home; part-time work;

job sharing) • Changing roles so that less energy is required • Allowing time off for attending appointments/treatment • Frequent/longer breaks • Providing a place for a worker to rest if necessary

Expert help is available from Constructing Better Health. You can contact us for impartial and confidential advice on: 0845 873 7726 or at: www.cbhscheme.com. CBH accredited occupational health service providers are listed on the CBH website.

More information about the issues covered here is available at: HSE website at: www.hse.gov.uk/humanfactors/topics/fatigue.htm

HSE website at: www.hse.gov.uk/humanfactors/topics/10fatigue.pdf

Working rule agreement for the construction industry (revised 1st May 2013) at: www.ucatt.org.uk/files/publications/2013cijcagreement.pdf

HSE advice about good practice on shift roster design at: www.hse.gov.uk/humanfactors/topics/specific2.pdf

HSE Shift work and fatigue toolbox at: www.hse.gov.uk/toolbox/organisation/shiftwork.htm

Unite guide to shift work and night work at: www.unitetheunion.org/uploaded/documents/ShiftandNightWork%2011-4950.pdf

Rough Nights: the growing dangers of working at night (Young foundation) at: youngfoundation.org/wp-content/uploads/2012/10/Rough_Nights.pdf

Enabling a Better Working World (Health & Safety Laboratory) at: www.hsl.gov.uk/resources/health-safety-insights/fatigue-the-insidious-risk-to-health-and-safety

Fit for Work advice line on: 0800 032 6235 (English) or 0800 032 6233 (Welsh)

Fit for Work website at: support.fitforwork.org/app/answers/detail/a_id/741/type/Employer

NHS Choices: www.nhs.uk/Livewell/tiredness-and-fatigue/Pages/why-am-I-tired.aspx

NHS Choices: www.nhs.uk/Conditions/Chronic-fatigue-syndrome/Pages/Introduction.aspx

The ME Association: www.meassociation.org.uk/about/what-is-mecfs/

Fatigue and driving

http://www.rospa.com/road-safety/advice/drivers/fatigue/road-accidents/