A substantial body of literature indicates that shift workers have a significantly higher risk of workplace accidents and injuries, compared to workers in regular daytime schedules. This can be attributed to work during nights which require workers to stay awake during normal sleeping hours and sleep during natural waking hours, leading to circadian desynchronization, sleep disruption and cognitive impairment. A fatigue-risk trajectory model developed by Dawson and McCulloch has been used to describe the series of events which may precede fatigue-related incidents. This includes insufficient sleep opportunities, impaired sleep, fatigue-behavioral symptoms, and fatigue-related errors. The purpose of this paper is to provide examples of control measures along each level of the fatigue-risk trajectory, which include: (i) work scheduling strategies to include breaks for adequate sleep opportunities; (ii) training and educational programs to help workers make best use of recovery times for quality sleep; (iii) fatigue-detection devices to alert workers and safety managers of fatigue-related behaviors and errors. A brief introduction to Fatigue-Risk Management systems is also included as a long-term sustainable strategy to maintain shift worker health and safety. The key statements in this paper represent a consensus among the Working Time Society regarding a multi-level approach to managing occupational sleep-related fatigue.
SUMMARYThe apparent connection between sleep debt, performance decrements and workplace accidents has generated a need for feasible vigilance tests that focus on the quantification of daytime sleepiness in occupational settings. The objective of this study was to evaluate the sensitivity of the Maintenance of Wakefulness Test (MWT) to acute sleep deprivation of various doses. Eight healthy female volunteers, mean age 28.9 years (range 23-36), participated in this laboratory study. After an adaptation night, the subjects were assigned to four counterbalanced, randomly ordered night sleep conditions. These four conditions allowed for a time in bed (TIB) of 0, 2, 4 or 8 h, producing a total sleep time of 0, 113, 218 and 427 min, respectively. The ability to sustain wakefulness was measured after the TIB period at 11.00 and 17.00 hours by the MWT. Analysis of variance with repeated measures was used to study the dependence of MWT sleep latencies on the immediately prior TIB period. Both the latency of stage 1 sleep onset and the appearance of slow eye movements reduced significantly with increased sleep loss. The quantitative relationship between the previous total sleep time and the subsequent MWT sleep latencies followed an exponentially decaying function showing a high sensitivity to acute, severe night sleep loss but low sensitivity to less severe sleep restrictions. It is concluded that the MWT seems to be a sensitive method for the estimation of acute sleep deprivation. The test results appear, however, non-linearly related to the earlier sleep debt.
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