Employer’s duty to manage it.
Fatigue in the workforce is a topic that has been discussed a lot in the Health & Safety press over the last week or so. Whether it is caused by a medical condition, working hours, shift patterns or personal circumstances, fatigue is a health and safety risk that can often be overlooked, but must be controlled by employers.
So, this week I thought that I would also look at this topic covering causes of fatigue, medical issues, which not necessarily caused by work, but need to be considered by employers. The legislation that applies to fatigue at work and some case studies. I will, of course, also be giving you advice as to how you manage it so that it doesn’t become a problem.
So what exactly is Fatigue?
Fatigue is defined as: ‘Extreme tiredness resulting from mental or physical exertion or illness’. It comes from the Latin fatigare ‘tire out’
Fatigue is common amongst the population, but particularly among those working abnormal hours, and can arise from excessive working time or poorly designed shift patterns. It is also related to workload, in that workers are more easily fatigued if their work is machine-paced, complex or monotonous.
A significant cause of fatigue is the amount and quality of sleep an individual receives, and night workers are particularly at risk because their day sleep is often lighter, shorter and more easily disturbed due to daytime noise and a natural reluctance to sleep during daylight.
Fatigue has also been cited as a major contributory factor in numerous well-documented accidents and incidents including:
Human error played a part, in these cases with operators being required to perform crucial safety-related tasks having worked excessively long hours, fatigued as a result.
Those operating within high hazard industries such as COMAH sites or nuclear installations will be well-versed in the need to risk assess and manage human factors, including the likelihood of fatigue, as these are often an inherent part of the operator’s statutory safety case or licence conditions.
Likewise, those within the aviation and rail sectors have also been subject to their own sets of regulations and guidance on the management of fatigue for some time, given the intense focus required for often repetitive, monotonous – but safety critical – tasks that pilots/ drivers/ engineers and other workers are required to perform over long shift durations.
Now most of you reading this, do not run or work in these high hazard industries but it is an issue that should nevertheless be considered and addressed by all employers, in keeping with their duties under the Health and Safety at Work etc. Act 1974 and other legislation – see Legislation list.
In terms of shift work and working hours however, it is possible to opt out of the 48-hour week under the Working Time Regulations 1998 (WTR), and individuals (particularly those on hours-based pay) may apply for additional overtime in order to boost their earnings. This applies not just to those within the industries mentioned above, but across many other sectors including NHS staff, retail workers, security staff and emergency services workers, to name a few.
HSE has therefore clarified, in its own guidance on shift work, HSG256 Managing Shift Work, that adherence with WTR will not, in itself, be sufficient to ensure adequate protection of workers from fatigue, and more must be done by employers to demonstrate that the risk is controlled.
HSG256 relates to those employers who manage employees on shift work, as fatigue will most often be associated with such workers – according to HSE, there are more than 3.5 million shift workers in the UK, and those workers are thought to be the second highest at risk of road accidents when driving home from shifts.
The length of shifts; number of consecutive working days; frequency of changes in the pattern of shifts; and frequency of rest periods all need to be considered by those responsible for organising working patterns, to ensure that employees get sufficient rest and adequate sleep.
By effectively assessing the risk, designing effective and safe shift patterns and educating staff on the effects and controls of fatigue, these risks can be managed and avoided.
What about staff with medical conditions?
Fatigue, as defined, can affect other employees too. It is most commonly described as extreme tiredness resulting from mental or physical exertion or illness – and it can be caused by factors outside of the workplace, as well as within it. It will therefore be relevant to consider employees who may be suffering from fatigue as part of a medical condition, illness, or treatment.
Employees diagnosed with medical conditions such as MS (Multiple Sclerosis), ME (Myalgic Encephalomyelitis)/ Chronic Fatigue Syndrome, fibromyalgia, or sleep disorders for example, all include fatigue as a recognised symptom that are likely to impact upon the individual’s day to day physical and mental health, and may impact upon their performance.
Similarly, employees who are required to take certain medication, or who may be undergoing cancer treatment, for example, may experience extreme fatigue as a side effect, and many mental health conditions such as depression and anxiety can manifest with bouts of sustained stress and sleep deprivation, which in turn result in fatigue.
However, fatigue as a result of a recognised medical condition or medical treatment can be more difficult to manage, as unlike tiredness, it is unlikely to be alleviated by sleep alone; and unlike shift work, it is not simply a case of shift and resource planning to help the individual manage the symptoms.
If made aware of such conditions, employers may need to consider what reasonable adjustments can be made in the workplace, not only to ensure that the employee is treated fairly, but also to ensure that the employee is protected from any further risk to their health or safety and that, whilst in the workplace, the fatigue is managed as well as possible. Such reasonable adjustments might include flexible working patterns; reduced hours or workload; working from home; or frequent rest breaks. It may also be that symptoms are exacerbated by the workplace environment such as poor lighting or temperature control, lack of natural sunlight, or noise levels.
If the affected employee is required to operate any heavy machinery or drive as part of their role, details of the side effects of any medication will need to be obtained and a risk assessment carried out to determine whether the fatigue could have a detrimental impact on the safe performance of their tasks.
The impact of fatigue on a person’s ability to perform can vary from individual to individual, but commonly it can result in slowed reaction times; an inability to concentrate or maintain focus; impairment of memory, confusion and forgetfulness; heightened emotional state; lack of energy and motivation; irritability; impairment of physical strength; and the inability to communicate and express oneself clearly. Fatigue can not only lead to human error in the workplace, it can also have a severe impact on an individual’s personal health and wellbeing. HSG256 acknowledges that chronic fatigue has been associated with a number of long-term health conditions
What can employers do?
Fatigue can be managed through policy, using tools to design shift patterns (e.g. the HSE’s Fatigue Risk Index), and promoting awareness and education of fatigue. Take into account early starts, shift length, rest periods, shift rotation, social considerations and environmental factors.
Offer a health assessment to those who work at night, which is a legal duty under Working Time Regulations. Provide awareness and education around fatigue and sleep deprivation as part of wider employee wellbeing initiatives.
Some good practice guidance on shift roster design
- Restrict number of night shifts (to 4 maximum if possible).
- Allow at least 2 days off following night shift.
- Avoid keeping workers on permanent night shifts.
- Move early shift starts before 6am forward (e.g. 7am not 6am start).
- Limit the number of successive early starts ie before 7am (to 4 maximum if possible)
- Shifts involving an early start should be shorter in length to counter the impact of fatigue later in the shift.
- If 12-hour shifts worked then no overtime worked in addition.
- Avoid long working hours (more than 50 hours per week).
- If 8/10 hour shifts then no more than 4/2 hours additional overtime to be worked.
- Restrict ‘back to backs’ with 8 hour shifts and avoid entirely with 12 hour shifts.
- Allow minimum of 12 hours between shifts and avoid ‘quick return’ of 8 hours if possible. (Rest period between shifts should permit sufficient time for commuting, meals and sleep.)
- Plan some weekends off, advisably at least every 3 weeks.
- Rotate shifts quickly (e.g. every 2-3 days). Avoid rotating shifts every 1-2 weeks.
- Use forward rotation (morning/afternoon/night) for preference.
- Arrange start/finish times of the shift to be convenient for public transport, social and domestic activities.
- Consider travelling time of workforce.
- Allow some individual choice where possible to accommodate larks/owls and family commitments.
- Keep the timing of shifts regular and predicable but also allow employees to have some flexibility to choose their own work schedule.
Fatigue is an issue that is already on the radar of specialist regulators such as The Office of Rail and Road and The Office for Nuclear Regulation, who will carry out human factors assessments and inspections to ensure that shift work and working hours are being managed appropriately. However, HSE’s Enforcement Register shows that this is under current scrutiny by HSE as well, with recent Improvement Notices being served in this area – albeit to date these have focused on those within the high hazard industries.
Given the statistics around road safety – with one in five road deaths thought to be due to sleepiness – and the increasing focus on driving for work, there is a clear need for employers to address the risk of fatigue not just for those who drive as part of their job, but for any employees who are at risk of driving to/from work whilst fatigued – and indeed, as discussed above, for any individuals who may suffer from fatigue whilst at work. Employers must proactively address the issue, and keep an eye out for signs of fatigue within the workforce in order to ensure they do “all that is reasonably practicable” to manage the risk.
HSG256 para 33: “Sleepiness is thought to be the cause of up to one in five accidents on major roads in the UK, contributing significantly to the approximate 3000 road deaths recorded annually. After young men, shift workers are considered to be the category of drivers most at risk from accidents and, compared to day workers, night workers are more likely to be involved in accidents while driving home from work”
Legislation and guidance
The main areas of health and safety law relevant to fatigue are:
Help available from The Wilkins Safety Group Ltd
Here at the Wilkins Safety Group we can help clients with:
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Our next Seminar will be on Wednesday 25th September 2019 Could you please arrive by 12:30pm prompt.
Our speaker for this one is Alistair Moore of Giacomini will talk about Underfloor Heating
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