Approximately 40 million workers in the United States (nearly 30 percent of the workforce) are employed in nonstandard work schedules such as shiftwork and extended work hours. These types of schedules are common and often required in industries such as transport, healthcare, mining, oil and gas, utilities, public safety, and information technology. Fatigue can reduce attention and concentration, impair communication skills, and limit decision-making ability, increasing the risk for safety-critical incidents such as injuries and motor vehicle crashes. For example, studies have shown that the risk of fatigue and safety-critical incidents not only increases over the course of a night shift, but it also increases dramatically over successive night shifts. Therefore, organizations that use shiftwork schedules need to manage the risk associated with fatigue to keep their workers safe and productive.

Limiting hours worked has been the traditional way of managing fatigue in some industries. This often means creating rules based on the number of consecutive shifts, break minima, shift length, or the maximum number of hours worked in a week or month. However, fatigue can stem from a number of sources such as extended time on task, heavy physical or mental workloads, monotony, exposure to hot or noisy environments, night work, and impaired sleep. For these reasons, managing fatigue in the workplace requires a holistic approach that recognizes its many sources and creates a framework to mitigate the risks. Fatigue Risk Management Systems A fatigue risk management system (FRMS) is a set of management practices for identifying and controlling fatigue-related risks. The use of this approach has been widely adopted internationally in the last two decades. More recently, in the U.S., FRMSs have been effectively incorporated by the Federal Aviation Administration and the Federal Railroad Administration.

To effectively manage work-related fatigue, we need to recognize not only the likelihood of fatigue, but also its related consequences. A unique aspect of an FRMS is that it recognizes that fatigue should be considered on a continuum, not a cut-point, and the risk for a safety-critical event relates the level of fatigue with the level of effort needed for the occupational task. Acknowledging that fatigue is impossible to eliminate entirely is a critical first step in identifying and controlling fatigue-related risk. This approach has been successfully adopted across a number of international jurisdictions and within key U.S. transport industries. Fatigue-proofing the workplace by reducing the likelihood or consequence of a fatigue-related error has clearly been shown as a method to reduce the risk associated with a fatigue-related error.

This risk-based approach to fatigue management generally allows a greater degree of operational flexibility. It is usually more accepted by workers because it doesn’t mean a complete stoppage of work and resulting loss in pay, as would happen with work hour limitations. This is not to say that work can or should continue indefinitely without breaks within the context of an FRMS, but rather that decisions about working time arrangements should be made based on an assessment of risk, not on arbitrary limitations to work hours.

Key components of an FRMS Components that should be included in an organization’s FRMS are policies and procedures that identify roles and responsibilities in the organization; risk assessment tools to quantify and assess fatigue risk; control plans and actions to provide ideas and decision trees for a graduated approach to manage fatigue; non-punitive reporting systems to create a trusted and strong safety culture; education and training to help workers and managers identify fatigue risk and strategies for minimizing those risks; and methods for regular monitoring and evaluating of the system for effectiveness (that is, a continual improvement process).

Policies and Procedures While some industries are bound by work hour regulations—one example is commercial truck transport, which is regulated by the Federal Motor Carrier Safety Administration—most organizations have formal and informal practices to manage workplace fatigue. Formal approaches include traditional work hour limitations. Informal approaches may include a “buddy system” where workers look out for each other to keep each other safe. An example of the buddy system is having another person double-check an employee’s work. Additional considerations may need to be made for compliance with any local legislations.

Roles and responsibilities regarding the management of fatigue should be identified, as managing fatigue is a shared responsibility among workers, managers, and organizational leaders. While workers are responsible for ensuring they arrive well rested and fit for work, the most effective practice is to manage fatigue at the organizational or leadership level through work schedules or job design.

Fatigue-Related Risk Assessment Organizational risk assessment generally involves the identification, measurement, and control of factors that influence the likelihood and consequence of an adverse health and safety outcome. Using the ISO 31000 standard for risk assessment, fatigue-related risk is determined based on the likelihood and consequence of a fatigue-related error (see Figure 1). In this context, fatigue likelihood is generally based on a combination of analysis of work schedule structure, prior sleep/wake behavior, and self-assessment. Consequence severity depends on the tasks undertaken by workers when they are fatigued. For example, tasks where consequences would result in major or catastrophic outcomes would be at the more severe end of the rating scale.

Non-Punitive Reporting Non-punitive reporting (sometimes referred to as a “just culture framework”) is fundamental to developing a strong and trusted safety culture and the successful operation of any fatigue management system. Non-punitive reporting allows managers and workers to report if they, or their co-workers, are too fatigued to work safely. This may include anonymous reporting; a sufficiently mature safety culture—one that is supported by the executive level—will ensure workers will not be punished for reporting fatigue. This allows the organization to discuss and recognize fatigue as similar to other workplace hazards without stigma or fear of backlash from management or workers. If punitive measures are taken or authority gradients are too steep, the result can be a culture of silence and mistrust that enables unsafe work practices.

Education and Training Education and training programs help organizations to meet their legal responsibility to inform employees about risk factors within the workplace. These programs not only provide information about fatigue risks and mitigation strategies, but also include opportunities where information is developed, learned, and used to encourage healthful behavioral change for workers and managers. Such training can be provided as short lessons or safety discussions that can be easily and gradually incorporated into regular work activities to allow for long-term, meaningful changes. Lessons would generally include practical training on the day-to-day functionality of the FRMS (for example, what to do if they are fatigued at work and how to manage any fatigue detection technology they have in place).

Monitoring and Evaluation Monitoring and evaluation of the FRMS is integral to continual assessment of its effectiveness as needs or situations change. Data gathered from various sources such as work scheduling, safety incident reports, overtime costs, absenteeism, and sick leave can be used to indicate if the FRMS is still effective over time. For example, data can be used to assess any positive or negative effects of work schedule changes on work injuries. It can also be used to determine the impacts of organizational or governmental policies on overtime costs, sick leave, or absenteeism. Ideally, these data sources should be monitored regularly to determine if any changes to the FRMS are needed to remain relevant. However, system evaluation is only as good as the data on which it is based. Considerations for good data sources include ease of collection and assessment, operational practicality, and data quality. These considerations apply not only to system components such as incident investigations or work schedules, but also to any technologies that may be used, such as fatigue detection sensors and modelling software. It is critical that operational needs and technological effectiveness are also considered when fatigue-detection technology is selected.

Viewing Fatigue As a Hazard Fatigue risk management is not just about providing people with hints for how to get a good night’s sleep. If fatigue is viewed as a hazard, in the same way as drugs, alcohol, or hazardous materials, it can—like those hazards—be embedded and mitigated within occupational safety and health management systems.

Many organizations are now combining work hour rules with an FRMS for a hybrid or transitional approach, which presents the opportunity for increased flexibility to accommodate different working conditions while increasing safety. The hybrid or transitional approach typically includes both risk-based and prescriptive components. This novel approach may include reducing the standard hours of work limits (where work can be undertaken without risk assessment or the implementation of controls). This reduced prescriptive envelope of permitted work time would then be supplemented with a risk-based approach. Work could be undertaken outside of this envelope, but only if the operator can demonstrate that it can be undertaken safely—that is, they can demonstrate that the fatigue-related risk has been assessed and controlled appropriately.

Incorporating elements of an FRMS doesn’t have to be complicated or costly, and it doesn’t necessarily mean overhauling your safety management system. Many organizations already have elements of an FRMS in place that can simply be updated, formalized, and enhanced. Similarly, FRMS components such as fatigue training during toolbox talks and risk assessment procedures can be added to your existing safety management system (but make sure you have clear policies and procedures for any new additions). These “quick wins” can be the first steps toward improving worker safety and well-being—or to developing a comprehensive FRMS.