Minimising Fatigue, Maximising Performance

MINIMISING FATIGUE,
MAXIMISING PERFORMANCE
MINIMISING FATIGUE,
A VIDEOTEL PRODUCTION
IN ASSOCIATION WITH THE STEAMSHIP MUTUAL
UNDERWRITING ASSOCIATION (BERMUDA) LTD
AUTHOR
Sheila Brownlee
84 NEWMAN STREET, LONDON W1T 3EU

TELEPHONE +44(0)20 7299 1800
FACSIMILE +44(0)20 7299 1818
E-MAIL mail@videotelmail.com
WEB www.videotel.co.uk
MINIMISING FATIGUE,
A VIDEOTEL PRODUCTION
IN ASSOCIATION WITH THE STEAMSHIP MUTUAL
UNDERWRITING ASSOCIATION (BERMUDA) LTD
THE PRODUCERS WOULD LIKE TO ACKNOWLEDGE THE ASSISTANCE OF

THE MASTER, OFFICERS AND CREW OF THE MAERSK ROSYTH
Anglo Eastern Ship Management
Chemical Distribution Institute, (CDI)
European Maritime Safety Agency, (EMSA)
International Maritime Health Association, (IMHA)
International Maritime Organization, (IMO)
International Shipping Federation, (ISF)
Maritime and Coastguard Agency, (MCA)
The Maersk Company Ltd
Ugland Marine Services AS
Seafarers International Research Centre, Cardiff University
United States Coast Guard
PRODUCER
Peter Wilde
WRITER/DIRECTOR
George Bekes
PRINT AUTHOR
Sheila Brownlee
WARNING
Any unauthorised copying, hiring, lending, exhibition diffusion, sale, public performance or other exploitation of this video is strictly prohibited
and may result in prosecution.
© COPYRIGHT Videotel 2005
This video is intended to reflect the best available techniques and practices at the time of production, it is intended purely as comment.
No responsibility is accepted by Videotel, or by any firm, corporation or organisation who or which has been in any way concerned, with the
production or authorised translation, supply or sale of this video for accuracy of any information given hereon or for any omission herefrom.
MINIMISING FATIGUE, MAXIMISING PERFORMANCE VIDEOTEL PRODUCTIONS
CONTENTS
INTRODUCTION 4
THE PROGRAMME 4
CARRYING OUT THE TRAINING 5
• Discussion 5
• Session 1 6
• Session 2 6
• Session 3 6
WHAT IS FATIGUE? 7
THE EFFECTS OF FATIGUE (INCLUDING CASE STUDIES) 8
THE CAUSES OF FATIGUE 12
THE NATURE OF SLEEP 15
A 5-STEP FATIGUE MANAGEMENT SYSTEM 18
ASSESSING THE RISKS AND BRINGING ABOUT CHANGE 25
RISK ELEMENTS SPECIFIC TO DIFFERENT DEPARTMENTS 25
GENERAL RISK ELEMENTS 28
• Scheduling and manning 28
• Watchkeeping 29
• Strategic napping 29
• Using light management to help adjust between day and night work 30
• Noise management 32
• Vibration management 32
• Use of rest and leisure periods 33
• Food and drink 34
• Working in extreme temperatures 35
• Exercise 36
• Stress and personal problems 39
SUMMARY GUIDELINES 42
ASSESSMENT QUESTIONS 43
FURTHER READING AND RESOURCES 47
APPENDIX 49
• IMO model formats 49
• Regulations relating to fatigue 52
• Case studies 54
3
INTRODUCTION
It is only recently that fatigue has been recognised as a potential cause of or
contributor to human error. In the past, there was a belief that willpower, training
and professionalism could prevent fatigue. But there is now reliable research
proving that fatigued people perform less well and are more likely to cause
accidents and casualties.
Fatigue is a problem wherever accidents can happen. Every seafarer, whatever their job, may
become fatigued while at work and at risk of harming themselves or others, or of causing
damage to the vessel. But fatigue can be minimised, and people’s performance maximised, if a
ship-wide, practical FATIGUE MANAGEMENT SYSTEM is implemented.
The benefits of successfully managing fatigue include crewmembers feeling more alert and
making fewer mistakes, and their managers feeling more confident in the efficient running of the
ship, and in crewmembers’ safety and morale. As well as reducing the chances of accidents and
casualties, everyone will feel more on top of their work. They will feel less stressed and enjoy
their rest periods more.
THE PROGRAMME
The purpose of MINIMISING FATIGUE, MAXIMISING PERFORMANCE is to explain

the causes and effects of fatigue, and to show how to put a management strategy
in place that will improve the effectiveness of everyone on board as well as
helping to safeguard life, property and the environment, and to further the
management of hours of work and rest.
The programme is aimed primarily at senior management and Safety Officers, who will be able to
cascade the training down through the whole crew.
The package consists of a video, this workbook, and an interactive CD-ROM, which contains
material both from the video and the workbook.
Areas covered in the programme are:
• The negative effects of fatigue.

• The causes of fatigue specific to the marine industry.
• How to recognise fatigue in yourself and others.
• The nature of sleep and our body clocks.
• How to implement a successful Fatigue Management System.
• The importance of relaxation during rest periods.
4
INTRODUCTION
• The importance of sufficient good quality sleep.
• Using light management techniques to adjust between day and night work.
• Addressing stress, personal problems, psychosocial and cultural factors.
• The importance of a balanced diet and regular exercise.
It also includes assessment questions, suggestions for further reading and appendices with a
case study, further information and guidance about existing regulations.
CARRYING OUT THE TRAINING

Minimising fatigue and maximising performance can only be a good thing for both crew and
management. However, as with any new changes, safety and training officers may come across
resistance towards the programme and measures that are implemented, not only because it may
be perceived as ‘yet more training’ and changes, but also because the marine industry culture
tends to be a macho one, in which nobody wants to admit to being tired or fatigued.
It is therefore vital to gain acceptance of the concept of fatigue and to enable people to relate to it
personally. Although the new system will mean adapting to different procedures, the Safety
Officer should emphasise that ultimately everyone will benefit so that people participate more
willingly in the training and in the changes that will be implemented.
There is no set method for using this programme. However, the training can be divided into three
sessions (see page 6). Before you begin, you may want to prepare by watching the video on your
own so that you can see how it relates to the workbook and how it is applicable to fatigue and
performance issues on your ship.
DISCUSSION
Training is most effective, and messages best remembered, when the trainees enter into
discussion on the topic. Encourage the group to focus on fatigue as it impacts on their
performance on their ship.
You may get a better response from the group if you divide them into pairs or small groups to
think about the questions you want them to discuss. In some circumstances it can help if you
ask each small group to appoint a spokesperson.
What follows is a suggestion for how you might want to break the training up, but this will
obviously depend on how long you plan to make each session. More, shorter sessions might
be more suitable for your schedule.
5
INTRODUCTION
SESSION 1
1 Open with a general discussion, using section one of this booklet, WHAT IS
FATIGUE? As a basis. Move on to THE EFFECTS OF FATIGUE, THE CAUSES OF
FATIGUE, and THE NATURE OF SLEEP.
2 Show the whole video.
3 Ask participants for their reactions to the video.
4 Sum up the main points from the session.
SESSION 2
1 Ask trainees for brief summary of what they learned in Session 1.

2 Show the first part of the video, up to 16.39 minutes (at the end of the risk
assessment and theory sections, where the programme dips to black).
3 Check understanding and discuss.
4 Go through A 5-STEP FATIGUE MANAGEMENT SYSTEM in the booklet.
5 Sum up the main points from the session.
SESSION 3
1 Ask trainees for brief summary of what they learned in Session 2.

2 Show the second part of the video.
3 Check understanding and discuss.
4 Go through ASSESSING THE RISKS AND BRINGING ABOUT CHANGE.
5 Show the whole video again.
6 Carry out the 20 question assessment exercise at the end of the workbook.
Sum up the main points of the whole training programme and ask for any further questions.
6
WHAT IS FATIGUE?
Not everyone agrees on exactly what fatigue is, but it is generally accepted as
being a state of tiredness, weariness or sleepiness which is due to long periods of
work, worry, and/or lack of sleep.
The International Maritime Organization (IMO) defines it as:
“A reduction in physical and/or mental capability as the result of physical,

mental or emotional exertion which may impair nearly all physical abilities
including: strength; speed; reaction time; coordination; decision making;
or balance.”
DISCUSSION
• How would you define fatigue?
• When was the last time you were really fatigued, either at home or at work?
• What did it feel like?
7
THE EFFECTS OF FATIGUE

“Lack of sleep needs to stop being regarded as a badge of honour and seen for
the serious hazard that it actually is.”
Feyer A M (2001) Fatigue: time to recognise and deal with an old problem.
Editorials British Medical Journal: 322:808-809
There is a tendency in the maritime industry to deny the fact that people suffer from fatigue, but
the reality is that everyone, whatever field of work they are in, feels fatigued from time to time.
When seafarers are fatigued, it can have a whole range of negative outcomes, whether it is poor
performance in carrying out their tasks, minor or major accidents, damage to health or a
worsening of interpersonal relationships on board.
Long before people reach the stage where they actually fall asleep, fatigue will start to affect
their performance. It can cause:
• Poor work performance. Fatigued people are less able to carry out their tasks
efficiently.
• Lack of strength. Physical performance is hampered.
• Lack of attention and concentration. People tend to be less vigilant than usual.
• Inability to make good decisions. This might be misjudging distance, speed, time
and so on, disregarding the information required to make complex decisions, or
failing to anticipate danger.
• Poor short-term memory, including forgetting to carry out a task or part of a task.
• Slow reactions to abnormal or emergency situations.
• Reduced competence in interpersonal dealings. Short temper, forgetting their
manners, and losing their sense of humour are all common effects of fatigue.
• Mood and/or attitude change. People might become depressed and unmotivated,
or temporarily elated and energetic. They can become careless, too willing to take
risks, and ignore warning signs.
8
EFFECTS OF SLEEP DEPRIVATION ON PERFORMANCE

Research from Transport Canada* suggests that how long a person can work and how much
fatigue is accumulated depends on factors such as time of day, the type of work involved, the
person’s age, and how much sleep they have or have not had.
Sleep loss can be either acute or chronic:
• Acute sleep loss results from very short periods (1 or 2 days maximum) when the
person has either not had any sleep at all or has only napped for less than two
hours per 24 hours. The effects of acute sleep loss on performance do not last
long and are usually reversed by one good night’s sleep (9 to 10 hours).
• Chronic sleep loss happens when the person’s sleep period has been shortened
for several days or even weeks to below what they normally need. The effects of
chronic sleep loss on performance and health may take longer to wear off.
• Studies of partial sleep deprivation show that although a person’s mood may
suffer quickly, they can keep up an adequate level of performance for a few days
with a little more than half of the usual amount of night sleep (5 hours).
Sleepiness increases and performance declines when similar schedules are
maintained for more than 4 days or when sleep is reduced below 5 hours.
• Total sleep loss leads to a deterioration in memory and decision-making. In fact,
creative thought and problem solving become increasingly difficult as the lack of
sleep accumulates. By the 18th hour, an individual (for example, a Master
continuously conducting the navigation of the vessel in fog) will have great
difficulty remembering things he has done or said a few moments ago and his
reaction time will have almost doubled in duration. By the 24th hour his ability to
think creatively and make decisions will be dangerously low.
Studies have shown that fatigued individuals do not recognise how fatigued they are, and that the
effects of sleep loss on performance and perception are similar to the effects of alcohol. When
fatigued, individuals can still do simple tasks and follow procedures but if they are faced with an
unusual situation or having to respond quickly to a problem they are very susceptible to making
errors and are more likely to give an incorrect command or misjudge distances and duration.
Vigilance tasks such as monitoring radar and traffic will be more error prone when working for
over 18 hours without sleep.
* Fatigue Management Guide for Canadian Marine Pilots – A Trainer's Handbook (TP 13960E) 9

ACCIDENTS
Almost every job at sea has a safety component, so any decline in performance
can put other crewmembers or the vessel at risk.
Research by the Marine Accident Investigation Branch (MAIB) show that watchkeeper fatigue is a
major factor in many accidents and particularly in groundings in the short sea trade. Fatigue has
been indicated as a cause of (or contributor to) the following*:
Grounding off the Summer Islands

On 29th June 2003, the Cypriot-registered general cargo vessel “Jambo” ran aground off the
Summer Islands, at the entrance to Loch Broom on the west coast of Scotland. The German-
owned, single-hold vessel built in 1990 was carrying 3300 tonnes of zinc concentrate from
Dublin to Odda in Norway and subsequently sank.
“Jambo” went aground because the Chief Officer who was alone on the bridge and asleep
missed the waypoint. Although the hours he had worked in the days before the accident
generally conformed to the regulations, there were periods when he had less than 6
consecutive hours’ sleep in a 24-hour period. On top of this, his 6-on 6-off watch pattern had
been broken by port visits and this led to increased levels of fatigue that accumulated over
time.
The Chief Officer’s fatigue not only made him sleep but also affected his judgment and this
may have contributed to his failure to make sure that a lookout remained on the bridge.
Cargo vessel grounding in the Firth of Clyde

In September 2004 the Antigua and Barbuda registered general cargo vessel “Jackie Moon”
ran aground off Dunoon breakwater in the Firth of Clyde. The vessel was re-floated the same
day and damage was limited to indentations to the hull and distortion to the internal frames.
At 0400 the Chief Officer adjusted the course set on the autopilot, fell asleep in a chair and the
ship ran aground 30 minutes later. He had been alone on the bridge – a separate lookout was
not used as the ABs were expected to be needed for cargo operation the next morning.
There were a number of contributory factors including the fact that the Chief Officer had
become increasingly fatigued during his 4 months on board, had been unable to have
sufficient rest as required by regulation ILO 180 and had not slept well immediately before the
accident. He also had around 17 units of alcohol in his bloodstream when he took over the
watch at 0100.
10 *Three more accident case studies are included in the Appendix.


Exxon Valdez oil disaster
Just after midnight on 24th March 1989 the “Exxon Valdez” ran aground on Bligh Reef in Prince
William Sound. More than 11 million gallons of crude oil – a fifth of its total cargo – spilled
into the sea. It was one of the worst disasters of its kind of the twentieth century.
The crew had been working for 22 hours without a break and the probable cause was the
failure of the third mate to manoeuvre the vessel properly, due to fatigue and excessive
workload.
Pilot scheduling problem

The “Raven Arrow” ran aground in the Johnstone Strait, British Columbia on 24th September
1997. The Pilot had been awake for almost 20 hours and altered course too soon.
Other fatigue-related accidents

Other fatigue-related accidents include the Three Mile Island and Chernobyl nuclear power
plant meltdowns, and the toxic chemicals leak at Bhopal.
MICROSLEEPS
A microsleep happens when a person is so tired or fatigued that they fall asleep just for a few
seconds. Often they are unaware that they have been asleep at all. Microsleeps are obviously
especially risky when operating machinery.
The Waterfall train disaster

At 7.15 am on 31st January 2003, the driver of an Australian intercity train service leaving from
Waterfall, New South Wales had a heart attack and the train derailed and collided with a rock
wall. The driver and six passengers were killed, and many passengers were injured.
Although the primary cause was the driver’s heart attack, the accident could have been
prevented if the guard had not been in a microsleep and failed to apply the emergency brake.
DISCUSSION
• Describe an accident you know of that was probably caused by fatigue.
• Can you give an example of how fatigue affects you or someone you know, either in your
personal life or on the ship?
• Have you noticed any other symptoms of fatigue in yourself or others?
11
THE CAUSES OF FATIGUE

The main causes of human fatigue are lack of continuous good quality sleep, illness, stress and
overwork. But for seafarers there are other risk elements which are related to the nature of the
work rotation, the way the ship is managed, the ship’s design and the environment.
Work at sea involves spending several months at a time on a vessel where work and leisure take
place in the same physical space. Seafarers have to live and work with fellow crewmembers of
different nationalities and cultures – on average one new crewmember every eight days. On top of
all this, the seafarer has long working hours, changes between day and night work, the
movement of the vessel to contend with, and extremes of weather conditions and temperatures.
Most crucially, operational aspects such as manning levels, the length of watches
and port rotation all vary from vessel to vessel, and, depending on how these are
arranged can lead to excessive stress and workload.
Everyone has their own personality and preference about how they spend their leisure time, how
they respond to stress, and so on. Some people just feel more tired or fatigued than others do.
But there are certain factors that can be considered common causes of fatigue:
• Long shifts.
• Not enough good quality sleep.
• Rest breaks which are too short or not well spent.
• Disturbances to the body clock due to changeover
in shift.
• Difficulty adjusting to a new time zone.
• Stress, fear, boredom, homesickness.
• Personal problems, including difficult interpersonal
relationships.
• Too much work, or being put into positions beyond
the person’s skill level or training.
• Poor diet.
• Lack of exercise.
• Illness.
• Inappropriate use of alcohol, caffeine and/or sleeping
medication (prescription and non-prescription).
12

On top of these, management suffers from:
• Pressure over staffing, rules and regulations, resources and upkeep

of vessel.
• Too much administration.
• A heavy training load.
• An inflexible company culture.
• Short periods between port calls.
• The need to adapt to different weather conditions and traffic density
en route.
There are also fatigue issues relating to the ship and the physical environment:
• Cramped work spaces and cabins.

• Uncomfortable beds.
• Old ships which are less comfortable and not as well designed as modern ones.
• Unreliable equipment.
• Cabins in the vicinity of noisy working areas.
• Ship motion, forcing people to expend extra energy to keep their balance, and in
some cases leading to motion sickness.
• Noise.
• Vibration.
• Excessive heat, cold and/or humidity within the ship (accommodation and work
areas), and also due to weather conditions.
Obviously not all these factors are controllable, but many can be eliminated or at least alleviated
through a proper FATIGUE MANAGEMENT SYSTEM, which will be discussed in future chapters.
13
DISCUSSION
• What would you say are the risk elements for fatigue on board your ship?
Crew
Management
Ship and environment
14
THE NATURE OF SLEEP

HOW MUCH SLEEP WE NEED
Most recent research indicates that 7-8 hours’ sleep in every 24-hour period is
necessary to feel fresh, alert and with sufficient energy to function well. On the
other hand, some scientists believe that there is a range of normal sleep times in
healthy adults and there is a debate over what is the minimum continuous period
of sleep needed to ward off fatigue.
Research from Transport Canada* suggests that it is not possible to store sleep. While you are
awake, a sleep need develops, however well rested you were at the beginning of the wake cycle.
The sleep need continues to build up until you go to sleep. If you do not get enough sleep you
develop a ‘sleep debt’ and your performance will suffer correspondingly.
THE QUALITY OF SLEEP
Not all sleep is of the same quality. We need deep sleep to feel rested, and it is
not enough simply to be tired to go into deep sleep. We must go through several
stages of sleep (including Rapid Eye Movement, or REM sleep, which is when we
dream) all of which are important in their own way for different aspects of our
development and our ability to function properly during waking hours.
* Fatigue Management Guide for Canadian Marine Pilots – A Trainer's Handbook (TP 13960E) 15
THE NATURE OF SLEEP

WHAT THE REGULATIONS ARE
Seafarers’ rights to rest are covered by ILO Convention 180 Concerning Seafarers’ Hours of Work
and the Manning of Ships, Article 5:
1 The limits on hours of work or rest shall be as follows:
A Maximum hours of work shall not exceed:

• 14 hours in any 24-hour period; and
• 72 hours in any seven-day period;
or
B Minimum hours of rest shall not be less than:
• Ten hours in any 24-hour period; and
• 77 hours in any seven-day period.
2 Hours of rest may be divided into no more than two periods, one of which
shall be at least six hours in length, and the interval between consecutive
periods of rest shall not exceed 14 hours.
The Maritime Working Time Directive (99/63/EU) implements ILO 180 for EU Member States.
THE BODY CLOCK, CIRCADIAN RHYTHM AND THE ‘RED ZONE’

Animals, plants and human beings all have internal body clocks, which are regulated by what are
known as circadian rhythms. These are related to light and darkness and play an important role
in our sleeping and eating patterns. Physical processes such as brain wave patterns, hormone
production and cell regeneration all tie in with the cycle of the circadian rhythm.
Our body clocks send us sleep signals at certain times during a 24-hour period, whether or not
we are working. Human beings naturally feel sleepy in night-time hours, which is when our
energy levels are restored, rather than during day-time when energy is expended.
Shifting rotations and crossing time zones play havoc with seafarers’ circadian rhythms. Our body
clocks only adjust by approximately an hour every day, so it can take up to a week to adjust to a
new schedule.
16
THE NATURE OF SLEEP

Not everyone’s cycle is the same, but we tend to feel most energetic around 10
am and again in the early evening at about 6 pm. Similarly, there are two dips in
alertness every day and these are known as the Red Zone. Typically, these occur
in the early-mid afternoon (roughly 2-4 pm) and in the early morning (roughly 3-5
am). The period from 3 am to dawn is the time most likely for human error-
related accidents to occur.
THE RED ZONE

ENERGY
DAYLIGHT DAYLIGHT
1400 1600 1800 2000 2200 2400 0200 0400 0600 0800 1000 1200 1400
TIME OF DAY
A number of factors play a role in how seriously the crewmember is affected by their individual
Red Zone – particularly how much sleep they have had and what they have eaten and drunk.
It has been proven that Red Zones can be successfully managed by using light management
techniques, and we will come back to this during the chapter on the FATIGUE MANAGEMENT
SYSTEM.
DISCUSSION
• How much sleep do you feel you need, as an individual, to perform at your peak?
• At what times of day do you feel most alert, and at your sleepiest?
• How do you manage the fatigue that comes with a change in work schedule?
17
A 5-STEP FATIGUE MANAGEMENT SYSTEM

It is not possible to eliminate fatigue entirely from seafarers’ lives, but it can be minimised, and
performance maximised, by adopting a thorough, scientifically-based Fatigue Management
System and by managing the hours of work and rest. A key element of this system is re-
organising manning and work schedules where possible but, unlike previous methods of fatigue
management, it also takes into consideration a broad range of environmental, organisational,
cultural, physiological and psychological factors.
This system takes a thorough, holistic approach to fatigue, and is an ongoing

process. It has to operate ship-wide, as many of the measures rely on the
company’s commitment to it. Only certain elements, such as personal choices
about alcohol consumption and how to spend rest periods, can be undertaken by
individuals.
According to the US House of Representatives, accidents have been cut by more than 50% when
similar systems were implemented in the Australian and US trucking industries.
STEP ONE
The first step is to gain the support of heads of departments to embark on the
programme. A head or facilitator should then be selected – the Safety Officer for
example. The facilitator then appoints a dedicated team to assess fatigue risk on
the vessel. As well as the Safety Officer, this might be the Master, a navigation
officer, a deck officer, an engineer, an able seaman and someone from the galley.
18

The Safety Officer, or other designated member of the team, carries out the crew training on how
to minimise fatigue and maximise performance, so that individuals can make the kind of
improvements that are in their power to achieve, such as taking more exercise.
This team will also be responsible for making sure that the system is kept on track through all its
phases of implementation, assessment and refinement.
Once a team has been selected, the first meeting is held to discuss how to proceed. This involves:
• The facilitator setting out the context for the system: why it is necessary, the
benefits it will bring, reassurance that it will not add significantly to the workload
long term.
• Separating out the tasks and assigning them to relevant individuals.
• Agreeing on timescales for each of the key stages of the project.
NOTE: All members of the team should help to build a no-blame culture on board ship, in which
crewmembers are encouraged to tell their supervisor, without fear of recrimination or stigma, if
they feel too fatigued to carry out their tasks effectively.
STEP TWO
The team now spends an agreed period assessing the risk elements for all job
roles on the vessel, making sure that all risk assessments for job roles include
factors relevant to fatigue. You could use the following form as a checklist for
gathering information.
19

FATIGUE MANAGEMENT RISK ELEMENT FORM
Q1 Department (engine, cargo control, bridge, galley)
Q2 Job role
Q3 Working pattern and maximum hours worked in any 24 hour period
Q4 Minimum rest hours in any 24 hour period
Q5 Describe the working environment

a Spaciousness and comfort.
b Air quality.
c Temperature.
d Brightness of light.
e Noise.
f Vibration.
Q6 Describe the rest/recreation environment

b Air quality and humidity level.
c Brightness/darkness level.
20

FATIGUE MANAGEMENT RISK ELEMENT FORM
d Temperature and ventilation.
e Noise.
f Vibration.
g Recreation facilities and opportunities for exercise.
Q7 Describe the sleeping environment

b Air quality and humidity level.
c Brightness/darkness level.
d Temperature and ventilation.
e Noise.
f Vibration.
Q8 Describe the diet

a Balanced diet.
(mix of fats, protein, and carbohydrates including fruit and vegetables)
b Availability of main meal at appropriate time of day.
Q9 Likelihood of unplanned events and any other risk elements
21

STEP THREE
The team gives all the information they have collected to the facilitator, who collates it under
different categories such as:
• Procedural changes.
• Design improvements.
• Optimising work schedules in line with seafarers’ body clocks.
• Training for crew members.
The facilitator presents the findings to the committee and a team meeting is held in which each
category is discussed in turn and a plan is agreed on that includes suitable measures to minimise
fatigue and so maximise performance.
These will be divided into:
• Those requiring the approval of the Master.

• Ones that the Heads of Department should initiate.
STEP FOUR
Once the new measures have been approved, they are implemented.
STEP FIVE
After an agreed period, the results from the new measures are evaluated and measures are
refined. The process then begins again.
22

THE FATIGUE MANAGEMENT SYSTEM – A CYCLICAL PROCESS
The system is a rolling one. Team members regularly review the situation and
report back on findings, so improvements can be made.
Appoint Fatigue
Management System
team members
Team identifies
risk elements
New measure(s) Plan agreed to

assessed and implement new
refined measures
New measure(s) Measures

agreed and implemented
implemented
Measures
assessed and
refined
23

EXAMPLE
Here is an example of how the system might work in practice:
a A team member is appointed to assess the quality of sleep in the watchkeepers’

cabins.
b Watchkeepers report that their sleep is being disturbed at 6 am by noisy cleaning
just outside the quarters.
c The team member relays this information to the team and a decision is made to
re-schedule cleaning to begin at 8 am.
d On evaluation a week later, it is found that people are sleeping better from 6 to 8
am but the cabins are still too hot.
e Air conditioning is adjusted.
f A week later, the responsible team member measures the temperature again and
finds it is now at acceptable levels.
g The team member continues making regular evaluations of the sleeping
environment and reporting back to the team with his findings, so that
improvements can be made.
DISCUSSION
• How would you go about setting up a Fatigue Management System team?
• How would you prioritise the tasks (rescheduling, improving quality of sleep, etc)?
• What are the main risk elements for your job role?
24
ASSESSING THE RISKS AND BRINGING ABOUT CHANGE

RISK ELEMENTS SPECIFIC TO DIFFERENT DEPARTMENTS
Having collated all the risk element information, it is then a question of sorting through the
issues that relate specifically to each department and issues that are general to the ship.
Your findings about risk elements for each job role and department may be very
different, but our research for the Minimising Fatigue, Maximising Performance
video provides a representative example:
ENGINE DEPARTMENT
The engine department’s duty cycle here is the most susceptible to unplanned changes. Although
the Chief Engineer Officer will step in when the need arises, the Second Engineer Officer is the
most hands-on member of the team, so his normal work schedule and rest periods are the most
likely to be interrupted by sailing schedules as well as by maintenance work or unexpected
breakdowns.
Everyone in the engine department, engineers and ratings, work in a noisy

environment with extremes of hot and cold, and this can significantly decrease
their energy levels and increase fatigue.
25

CARGO CONTROL
Risk elements, which impact on the hours that cargo officers and deckhands have to work, are:
• Berth availability. • Pumping capacity.

• Shore breakdowns. • Weather.
• Tide. • Extreme heat or cold.
Schedules often prove to be just academic.
BRIDGE
There are many risk elements of fatigue on the bridge, especially on the night watch. Officers
who are not fully rested before their watch may suffer from:
• An inability to concentrate.
• A diminished decision-making ability.
• Misjudgment of distance and speed.
• Overlooking information required for making complex decisions.
MAIB has many incidences of collision and grounding on record where one or more of these
symptoms were found to be the cause of an accident.
26

MASTER
Besides having the overall responsibility for the ship’s safety and operations, the Master is ‘on
call’ any time day or night. Besides his normal daytime hours, he is required to be on the bridge
during sailing in confined waters and in port, at arrival and departure. He has to deal with visiting
officials, port control, surveyors and superintendents whenever they appear. This can increase his
stress levels and build up a sleep debt, leading to increased fatigue and impaired decision-
making ability.
MAIB (Safety Digest 02/1997) reports that in many marine accidents the Master has been involved
and in nearly every case he was unaware that this performance had deteriorated. Most Masters
take great pride in their ability to be alert after many hours awake but even the best and most
robust among them will be facing a degradation in their performance.
The best way to reduce a Master’s stress levels is to have a culture of open communication on
ship, and a good complement of officers and crew in whom he has absolute confidence.
GALLEY
Heavy seas and extreme temperature levels can be very energy sapping. This tends to affect the
cooks’ performance, though as they have a fairly regular schedule consisting of three periods of
work per day fatigue is not usually a significant problem for them.
Cooks with other duties outside the galley could be given additional rest periods, although it is
most likely that they would have the benefit of uninterrupted good quality sleep during the night
because their schedules permit this.
The cook should be sensitive to food issues that relate to different cultures or religions such as
Muslims fasting in Ramadan and the importance of daily portions of rice to Asian people. This will
improve morale and so alleviate stress.
27

GENERAL RISK ELEMENTS
SCHEDULING AND MANNING
Although many factors play a part in causing fatigue, managing the hours of work and rest by
scheduling is probably the most pertinent one to the marine industry, particularly in the short sea
trade. On some ships it is difficult to predict the workload as trading patterns change, and
realistically even the best planned schedules are frequently interrupted by rough weather,
emergency drills, technical problems and many other incidents.
Where possible:
• It is recommended that scheduling of work patterns should be revised to support

7-8 hours of continuous sleep in 24 hours.
• Watchkeeping should be scheduled to meet current regulations.
• Drills should be scheduled so that disturbance to rest/sleep periods is minimised.
• The crew should be regularly updated on relief schedules.
For crew who need to change between night and day work, it is advisable to phase the changes
over a number of days, for example by shifting work patterns by four hours per day.
For those travelling long hours (and especially if they have crossed time zones) to join the ship
and who are expected to go on watch as soon as they arrive on board, it is recommended that
they have enough time to get over their fatigue and to familiarise themselves with the ship.
28

WATCHKEEPING
Research from all groundings in UK waters that were reported to MAIB over a 10 year period and
which involved a merchant vessel of over 500gt showed that groundings were much more likely to
occur at night. The most common times were 0400-0500, 1700-1900 and at about 2300, indicating
that fatigue was likely to be a factor.
MAIB recommends increasing minimum safe manning levels so that each seagoing vessel of over
500gt has at least a Master and two bridge watchkeeping officers. On minimally manned vessels,
the workload should be shared fairly between the officers even if this means the Master turning
to on deck.
A designated lookout should always be posted as a 2nd watchkeeper at night in accordance with
Standards of Training, Certification and Watchkeeping (STCW), so that he can both keep an
efficient lookout and help keep the watchkeeping officer alert.
Operational modifications may be considered in order to avoid 6-on 6-off watch periods for any
significant period. On sixes it is difficult to get a full six hour break as watches are handed over
and stand-bys called.
This may be achieved by increasing the manning and being a little more flexible.
The International Shipping Federation Watchkeeper software assists with scheduling so that
nobody breaches regulations. The programme can also verify the schedules to check if they are in
line with ILO and STCW codes, as required by Port State Control since July 2003.
‘STRATEGIC NAPPING’
However well hours are scheduled, there are bound to be times when a crewmember has not had
enough good quality sleep and is too fatigued to perform adequately.
‘Strategic napping’ is a short-term relief technique which can help maintain performance levels,
and Heads of Department should be open to the idea of people taking these short, controlled
naps.
Twenty minutes is the ideal – longer than 30 minutes and you run the risk of feeling disoriented
when you wake, and of not being able to get to sleep later, when you go to bed.
(See the Appendix for IMO and ILO recommended formats for shipboard working 29
arrangements and for records of hours of work or hours of rest.)

USING LIGHT MANAGEMENT TO HELP ADJUST BETWEEN DAY
AND NIGHT WORK
Changes in work schedule severely disrupt the body clock and it can take several days to adjust
to a new rhythm of sleep and work. Performance in this time can take a dive, because people
suffer from sleepiness and disorientation when they are supposed to be working.
The disruption to the body clock can be minimised by using light management techniques:
• A night-time worker’s Red Zone can be shifted by exposing their eyes to artificial
light between sunset and 2 a.m. Research has shown that fitting bright lighting,
such as a daylight bulb, rapidly boosts alertness and helps adjust the body clock
to daytime. Thirty minutes per hour is enough to achieve this. But note: the
person should on no account look directly into the artificial daylight source.
• The light levels in the cabins should be high enough to trigger the production of
seratonin after crewmembers wake up. Seratonin is a hormone that promotes
alertness and efficient brain activity and is produced when high light levels reach
the eyes. The suggested type of lighting is 1000 lumen or above.
• Spending the period before going to bed in a place with subdued lighting helps
create the illusion that it is night time when the night worker prepares to go to
sleep in the morning.
• Sunlight and bright light should be avoided during sleeping time, so make sure
cabins are sufficiently dark by fitting black-out curtains (made of heavy, dark
fabric), blinds or ‘hurricane shutters’ to block out light that comes through
portholes and doors. If there is heavy light seepage, another solution is to use eye
masks as sold in airports.
30

SHIFTING THE RED ZONE
ENERGY
DAYLIGHT
1–2 days
1400 1600 1800 2000 2200 2400 0200 0400 0600 0800 1000 1200 1400
TIME OF DAY

ENERGY
DAYLIGHT
3–4 days
1400 1600 1800 2000 2200 2400 0200 0400 0600 0800 1000 1200 1400 1600 1800
TIME OF DAY

ENERGY
DAYLIGHT
5–6 days
1400 1600 1800 2000 2200 2400 0200 0400 0600 0800 1000 1200 1400 1600 1800 2000 2200
TIME OF DAY
31

NOISE MANAGEMENT
A quiet cabin is essential for a good night’s sleep.

Noise management includes:
• Watchkeepers’ cabins in particular should be located in the quietest part of the

ship.
• Sound insulation helps combat the problem of noise from cargo operations,
engine room and adjacent cabins.
• Consider rescheduling routine activities in the accommodation area, such as
vacuuming the alleyways.
VIBRATION MANAGEMENT
High levels of vibration can lead to fatigue, especially where accommodation

areas are affected.
Ideally:
• Because vibration dampers assist in combating vibration (and noise) they should
be suitably fitted to machinery, for example in air conditioning fan rooms and on
engine room and deck machinery.
• If possible, watchkeepers’ cabins in particular should be located in areas of the
ship least susceptible to vibration.
• It is best if cabins are not adjacent to bow thruster rooms or directly adjacent to or
above the engine room.
32

USE OF REST AND LEISURE PERIODS
It is important to unwind and relax before going to bed, and a good night’s sleep
can be facilitated by avoiding anything that might stimulate the brain shortly
before retiring.
For example, drinking coffee or playing computer games in brightly lit environments may keep
you awake, or at least disturb your sleep. Doing strenuous exercise shortly before going to bed
also makes it more difficult to sleep.
Good ways of unwinding after work are:
• Developing a regular pre-bed routine such as having a warm shower or reading a

calming book or magazine.
• Mixing with other crewmembers in day rooms.
• Watching movies or satellite TV, if available.
• Emailing friends and family, if there is internet access.
Drinking alcohol, which is prohibited on ship, may make it easier for you to fall asleep initially,
but the effect it has on the liver means that the quality of sleep is not so good, and you are more
likely to wake up periodically. Even if you have not drunk enough to cause a hangover, which will
obviously affect your performance at work, you are more likely to suffer from fatigue for some
hours after you get up.
MEDICATION TO SLEEP OR STAY AWAKE

Try to avoid or reduce the use of prescription and over-the-counter sleeping drugs. These can be
addictive and in many cases the effects have not worn off by the time you start work, slowing your
reactions and decision-making, and generally dulling your alertness.
Drinking too much coffee or using over-the-counter stimulants to stay awake during work also
leads to problems. Over-use can make a person anxious, unable to unwind at the end of the
working day, and paradoxically more fatigued in the long run.
33

FOOD AND DRINK
Remember, sleep + a balanced diet = energy!

It is not possible to have complete control over what you eat and drink on board ship but there are
certain dietary guidelines you can follow to sleep well and stay alert during work hours.
Try to base your food choices around a balance of fats (especially the ones that come originally
from plants and seeds, such as avocados, olive oil, sunflower or peanut oil, and from certain fish
like mackerel), proteins (meat/poultry, cheese, eggs, fish, nuts, and pulses such as lentils), and
carbohydrates (rice, pasta, potatoes, fruit and vegetables). The World Health Organization
recommends eating five portions of fruit and vegetables a day.
• If possible, make breakfast your largest meal, and eat a much lighter meal a few
hours before going to bed.
• Drink plenty of water (but not sodas – the main ingredient is sugar, and some also
contain caffeine, so they have no nutritional value and only contribute to weight
gain), especially when you are working in a hot environment. The recommended
minimum is 2 litres of water a day. Not drinking enough can lead to a range of
health problems including kidney stones.
• Avoid too many fried foods, too much salt, and foods with a high sugar content.
• Reduce tea and coffee to a maximum of one or two cups a day, and these should
not be consumed for at least four hours before going to sleep. Cola and chocolate
also contain caffeine.
• Don’t go to bed hungry. Have a snack such as a piece of fruit or a handful of nuts.
Training for cooks will help to provide healthy balanced meals at the right times of day for
crewmembers according to whether they work during the day or night. If the galley is left open 24
hours a day this will encourage people to eat more healthily and avoid snacking on chocolate,
chips and sodas before going to sleep, which can lead to weight gain and diabetes.
34

WORKING IN EXTREME TEMPERATURES
HEAT
Extremes of both heat and cold can sap energy and cause fatigue. In hot environments, it is vital
to drink plenty of fluids. This is especially the case in hot, dry climates, where you are less aware
of your body losing moisture. The best fluid is plain water or water with a little salt in it. Salt
tablets are also available on board ship.
COLD
In extreme cases cold can lead to frostbite, but simply being very cold can lead to fatigue as the
body works harder than usual to keep warm.
In cold temperatures, protective clothing should always be worn on deck:
• Next to the skin, a layer of modern synthetic fabric.

• Then a layer for warmth.
• A looser layer for more warmth, and
• An outer layer to protect you from the wind – also loose, to trap the heat.
You may need two layers of gloves, and these should be worn at all times.
Bare hands can freeze when in contact with exposed metals.
We can lose up to 40% of our body heat through our heads and necks,
so it is important to wear proper headgear.
Warm boots should be ankle high and have non-slip soles.
35

EXERCISE
Although exercising shortly before going to bed is a bad idea (because it has a stimulating effect),
regular exercise at other times of day does help to reduce fatigue and improve performance by
reducing stress levels and causing the body to produce endorphins – chemicals which give you a
sense of well-being.
Thirty minutes of continuous activity at least three times a week will not only help to reduce
fatigue, it also leads to:
• More energy and stamina.

• A lower risk of heart disease.
• Improved posture (which is good for the back).
• Weight loss and better body shape.
Ships should provide exercise facilities. Ideally this would be a brightly-lit, air-conditioned gym
with up-to-date equipment. But there are other ways to exercise on board if there is no gym.
Note: If you do exercise on other parts of the ship, be careful to wear trainers or other cushioned
shoes, because the deck and floors are not sprung and you may damage your ankles or calves by
running on hard surfaces.
There are many books and DVDs on the market which contain routines for work-outs and advice
about how to build up your fitness. But to get you started, here are some suggestions.
WARM UP, WORK OUT, COOL DOWN
• Start slowly with ten minutes or so of gentle movement to warm up your muscles,
then stretch arms, legs and back.
• The central part of the work-out consists of 20 minutes of vigorous exercise such
as running which should raise your heart rate. If you are overweight and/or unfit,
you should build up your exercise level gradually.
• After working out, it is important to bring the heart rate down slowly. Wind down
for five minutes with some walking and more stretches as this is safer than
stopping abruptly.
• Work out with colleagues.
36

Working out with other people can motivate you to keep going with regular exercise if you team
up with one or more fellow crewmembers. It is also more fun and sociable. If there are
opportunities for games like table tennis, these are exciting and competitive as well as helping to
keep you fit.
SET GOALS
A fast way to improve is to set goals for yourself or each other. Keep note of when you exercise
and for how long, and how you are building up the number and duration of exercises as you go
along.
RUNNING
Running is an obvious way to get fit and can be done on the spot, where space is limited. If you
are out of shape, it is best to start gently, with a few minutes at a time, and build up.
MUSCLE BUILDING
Strengthen your arms and legs by twisting a towel and leaving a loop for your wrist or ankle to go
into. Your partner holds the towel while you do the exercises, such as leg raises or arm curls, so
that you work against gravity and the resistance your partner puts on the towel.
WEIGHTS
If there are no weights on board you can improvise with cans of food or bottles of water, for
example.
CABIN EXERCISES
Sit-ups, press-ups, running on the spot and stretching routines can even be done in your cabin.
37

STRETCHING
If your job involves a lot of sitting or working in one position, it is a good idea to
take a few minutes every hour to do some stretching exercises. This will make
you less stiff and tense and help to keep you alert.
Neck stretches. Turn your head as far as you can to the left then to the right. Repeat several
times. Looking forwards, bend your head several times from side to side, moving your right ear
nearer to your right shoulder and then the same on the other side.
Arms. Stretch your arms out in front of you, link your fingers so that the backs of your fingers are
facing you and raise your linked arms over your head. Bend your upper body slightly to the right,
then slightly to the left. Repeat several times.
Standing twist. Stand up and put your hands on your hips, with your feet apart. Swing gently
round to your right, and then to your left.
Shoulders. While sitting, roll your shoulders forwards several times, then backwards several
times.
Lower back. While sitting, pull your shoulders back and roll your buttocks gently forward so that
there is a hollow in your lower back. Reverse the movement, so that the arch is the other way.
Repeat several times.
Squats. Stand up with your hands on your hips, and with a straight back lower yourself by
bending your knees until you are sitting on your heels. Straighten up again and repeat several
times.
Walk around! Whenever possible, take the opportunity to stretch your legs. This will prevent
stiffening up and boost circulation.
Important note: If while you are exercising you feel dizzy or faint, or get pains in
your chest, stop immediately and seek medical advice!
GENERAL EXERCISE TIPS
• Remember to drink plenty of water before, during and after your work-out.
• Do not exercise after a heavy meal.
• Use the stairs rather than the lift whenever possible.
• Work out at your own pace.
• Start with a warm-up and end with a cool-down.
38

STRESS AND PERSONAL PROBLEMS
It is not possible to eliminate stress from your life entirely, and work at sea is subject to
particular pressures, caused for example by:
• Long periods spent away from home.

• Extremes of weather conditions and temperatures.
• Days of uneventful travel followed by frantic activity in port.
• The necessity of getting on with a frequently changing crew of different
nationalities and cultures.
• Increased accountability and economic pressures.
• More and more administration and dealings with officials.
GOOD AND BAD STRESS

Even if it were possible to eliminate stress, this would not be desirable. We need a certain
amount of stress in our lives to remain stimulated and alert. It enables us to work faster, more
efficiently and pay more attention to what we are doing than if we were completely relaxed. This
is ‘good’ stress.
When the level of stress tips over a certain point, however, it becomes unpleasant and intolerable.
It not only affects our ability to concentrate and make good decisions, it is also damaging to our
health. Research shows that it contributes to heart disease and high blood pressure.
People respond to ‘bad’ stress in different ways, but there are two classic reactions:
• Fight – aggressive responses such as snapping at colleagues.

• Flight – removing oneself from a situation, denying it exists, or panicking.
Obviously both types of response affect performance negatively, and indeed can be dangerous in
an emergency. There are better ways of managing stress.
DEALING WITH STRESS

Feeling panicky, anxious, oppressed or depressed are ‘bad’ kinds of stress and bound to sap
energy and affect performance. The Master or Head of Department should take time to talk
regularly to all crewmembers to check if they have any personal or interpersonal difficulties that
require solutions.
39

To deal with stress effectively, the Master or Head of Department may need to probe what is at
the root of the problem, before he can make progress.
These are some issues that are worth exploring:
• Lack of communication. Do people feel able to talk openly about their problems?
Are they listened to? How can a more open and tolerant culture be instilled on
board?
• Problems at home. What help is available?
• Inability to carry out tasks. Is more skills training or support necessary? How
organised is the person? Do they manage their time effectively?
• Interpersonal problems on board. If there are unresolved resentments, how can
these be addressed? Do people feel that they (or others) are being over or under
used?
Homesickness and isolation can be lessened by offering internet access with email facilities, so
that people can regularly contact their loved ones.
Sometimes interpersonal difficulties can be caused by a mix of crew of different nationalities and
cultures.
A related problem is when crew members who are the only person of their nationality, or the only
woman aboard, feel isolated and may be treated by their fellow crew members in an
unacceptable way, perhaps through rough teasing or a dismissive attitude. The Master or Head
of Department should keep a special eye on vulnerable crew members like these, and find an
opportunity to talk to them one-to-one to ask how they are getting on.
A policy of common courtesy and mutual respect will help to improve cooperation and
performance on board.
40

DISCUSSION
• What are the risk elements for your job role?
• Regulations stipulate a minimum of 6 hours’ continuous sleep. What do you feel about this?
• How well insulated are your cabins against noise, vibration and light?
• What is your routine before going to bed?
• How could exercise facilities be improved?
• How could the menus be improved?
• What extra stresses do you face in your job, and how do you usually respond?
41
SUMMARY
Fatigue Management Systems, including training, will not only reduce fatigue and
improve performance but also improve the general sense of well-being and
morale on board.
Here is a summary of guidelines that will help you maintain your performance:
• Try to take your whole sleep allowance for each 24-hour period.
• Take strategic naps if necessary, as part of your overall rest period.
• Take breaks when they are assigned, even if you do not feel like it.
• Use light management to help you adjust between day and night work.
• Develop a calming pre-bed routine.
• Avoid taking sleeping medication.
• Reduce caffeine (tea, coffee, cola, chocolate) intake.
• Eat a balanced diet including lots of fats, protein, and carbohydrates including
fresh fruit and vegetables.
• Drink plenty of water.
• Take regular exercise.
• Contribute to a happy working environment.
42
ASSESSMENT QUESTIONS
MORE THAN ONE MULTIPLE CHOICE ANSWER MAY BE CORRECT!
Q1 Which of the following are symptoms of fatigue?
a Loss of short-term memory.
b Poor concentration.
c Slow reactions.
d Inability to make good decisions.
e Mood change.
f Irritability with other people.
Q2 Is a ‘microsleep’
a A useful short-term technique for combating fatigue, or
b A few seconds’ sleep which is potentially dangerous?
Q3 How can ship motion lead to fatigue?

a Through sickness.
b Through poor ship design.
c Through the extra energy used up to keep one’s balance.
Q4 In any 24 hour period, regulations stipulate that the minimum amount of

sleep should be:
a 6 hours.
b 8 hours.
c 12 hours in three blocks of 4.
Q5 The ‘Red Zone’ is:

a The internal mechanism that makes us feel sleepy in the dark.
b The time when we feel most alert.
c The dip in alertness we experience through our body clock.
43
Q6 When we change time zone, our body clocks adjust by:

a One hour every day.
b One hour every week.
c Two hours every day.
Q7 Fatigue Management Systems in Australia and the US have cut trucking

accidents by:
a Less than 50%.
b More than 50%.
c Around 80%.
Q8 The Minimising Fatigue, Maximising Performance System takes the

following amount of time:
a No fixed time – it is a continuous process.
b Two months – one to assess and one to implement.
Q9 What are the fatigue risk elements for cargo officers and deckhands?
a Berth availability.
b Shore breakdowns.
c Pumping capacity.
d Weather.
e Tide.
f Extreme heat and cold.
44
Q10 Masters are particularly susceptible to fatigue because:
a They are not allotted sufficient rest hours in the schedule.
b They tend not to delegate to officers.
c They suffer from stress because of their overall responsibility for the ship’s safety.
d They have to deal with so many officials.
Q11 The legal requirement for minimum rest hours in any 24-hour period is:
a They are not allotted sufficient rest hours in the schedule.
b They tend not to delegate to officers.
c They suffer from stress because of their overall responsibility for the ship’s safety.
Q12 Which of the following food groups should you base your diet around in
order to avoid fatigue?
a Proteins.
b Carbohydrates.
c Fats.
Q13 The best way of dealing with noise from routine activities such as
vacuuming in the accommodation area is:
a Asking the people undertaking the vacuuming to work very quietly.
b Providing ear plugs for people trying to sleep.
c Rescheduling the activities.
Q14 Crewmembers joining the vessel after a long journey should not be
expected to go on watch as soon as they arrive on board.
True or false?
45
Q15 The ideal duration for a ‘strategic nap’ is:

a 10 minutes.
b 20 minutes.
c 60 minutes.
Q16 Stress, even at low levels, always affects performance negatively.

True or false?
Q17 The most effective method of adjusting people’s body clocks is by:
a Light management techniques.
b Noise management techniques.
Q18 Taking vigorous exercise shortly before going to bed:

a Aids a good night’s sleep.
b Jeopardises a good night’s sleep.
Q19 The most substantial meal of the working day should be eaten:
a As breakfast.
b In the middle of the day.
c Four hours before going to sleep.
Q20 Three or more cups of tea or coffee a day are good for optimum
performance.
True or false?
46
FURTHER READING AND RESOURCES

International Labour Organization: Convention Concerning Seafarers’ Hours of Work and the
Manning of Ships – No.180.
European Union Maritime Working Directives 1999/63/EC – concerning the Agreement on the
organisation of working time of seafarers, and 1999/95/EC – concerning the enforcement of
provisions in respect of seafarers' hours of work on board ships calling at Community ports.
Code of Safe Working Practices for Merchant Seamen (COSWP) – Risk Assessment Chapter 1.
Consolidated Edition and Amendment 5, April 2004 is 406 pages and can be found at
www.mcga.gov/uk/c4mca/coswop-2.pdf.
Statutory Instrument 2002;No. 2125 Merchant Shipping (Hours of Work) Regulations.
United States Coastguard: Crew Endurance Management Practices – a Guide for Maritime
Operations January 2003.
Transport Canada’s “Fatigue Management Guide for Canadian Marine Pilots – A Trainer's
Handbook” (TP 13960E) can be found at: www.tc.gc.ca/tdc/publication/tp13960e/13960e.htm
IMO, MSC/Circ.1014 Guidance on Fatigue Mitigation and Management.
IMO, MSC 68/INF.15 Human Errors on the Bridge - A study of Finnish Shipping.
IMO, MSC 69/INF.10.Seafarer fatigue: Wake up to the dangers.
IMO, MSC 69/INF.15 Fatigue - Groundings and collisions.
IMO, MSC 69/INF.16. Report on the investigation into near misses.
IMO, MSC 71/INF.8. Report on the investigation into near misses.
IMO, MSC/Circ.565. Fatigue as a Contributory Factor in Maritime Accidents.
IMO, MSC/Circ.621. Guidelines for the investigation of accidents where fatigue may have been a
contributory factor.
Marine Accident Investigation Branch Safety Digest, Lessons from Marine Accident Reports
1/2005.
Civil Aviation Authority CAP737 Crew Resource Management (CRM) Training, Appendix 3.
Australian Maritime Safety Authority. A survey of the health, stress and fatigue of Australian
Seafarers (FASTOH report), and Great Barrier Reef pilotage fatigue risk assessment. These can
be found at www.amsa.gov.au/Publications/index.asp.
Ship Captain’s Medical Guide. This book covers everything from first aid to major operations, and
is available on every ship. It is published by The Stationery Office in the UK and can be ordered
from The Publications Centre, PO Box 29, Norwich NR3 1GN. Tel: 0870 600 5522. Website:
www.tso.co.uk
47
WEBSITES
International Maritime Organization: www.imo.org
International Shipping Federation: www.marisec.org/isf
Marine Accident Investigation Branch: www.maib.dft.gov.uk
The Maritime & Coastguard Agency: www.mcga.gov.uk
United States Coast Guard: www.uscg.mil
Transportation Safety Board of Canada: www.tsb.gc.ca
Transport Canada: www.tc.gc.ca
Australian Maritime Safety Authority: www.amsa.gov.au
International Maritime Health Association: www.imha.net
48
MODEL FORMAT FOR RECORD OF HOURS OF WORK OR HOURS OF REST OF SEAFARERS
APPENDIX
Name of ship: IMO number (if any): Flag of ship:
Seafarer (full name): Position/rank:
Month/year: Watchkeeper: yes no
RECORD OF HOURS OF WORK/REST

Please mark periods of work or rest, as applicable, with an X, or using a continuous line or arrow.
MINIMISING FATIGUE, MAXIMISING PERFORMANCE
COMPLETE THE TABLE ON THE REVERSE SIDE
The following national laws, regulations and/or collective agreements governing limitations on working hours or minimum rest periods apply to this ship:
I agree that this record is an accurate reflection of the hours of work or rest of the seafarer concerned.
Name of Master or person authorised by Master to sign this record:
Signature of Master or authorised person Signature of seafarer:
A copy of this record is to be given to the seafarer. This form is subject to examination and endorsement under proceedures established by:
(name of competent authority)
The terms used in this model table are to appear in the working language or languages of the ship and in English.
49
VIDEOTEL PRODUCTIONS
50
MODEL FORMAT FOR TABLE OF SHIPBOARD WORKING ARRANGEMENTS
APPENDIX
Name of ship: Flag of ship: IMO number (if any): Latest update of table: ( ) of ( ) pages.
The maximum hours of work or minimum hours of rest are applicable in accordance with: (national law or regulation) issued in conformity with
ILO’s Seafarers’ Hours of Work and the Manning of Ships Convention 1996 (No. 180) and with any applicable collective agreement registered or authorised in accordance with
that Convention and with the International Convention on Standards of Training, Certification and Watchkeeping for Seafarers, 1978, as amended, (STCW Convention).
Maximum hours of work or minimum hours of rest:
Other requirements:
Position/rank Scheduled working hours at sea Scheduled working hours in port Comments Total daily work/rest hours
Watchkeeping Non-watchkeeping Watchkeeping Non-watchkeeping At sea In port

(from–to) duties (from–to) (from–to) duties (from–to)
Signature of Master:
The terms used in this model table are to appear in the working language or languages of the ship and in English. For those positions/ranks that are also listed in the ship’s safe
manning document, the terminology used should be the same as in that document. For watchkeeping personnel, the comments section may be used to indicate the anticipated
number of hours to be devoted to unscheduled work and any such hours should be included in the appropriate total daily work hours column.
Please mark periods of work or rest, as applicable, with an X, or using a continuous line or arrow
NOT TO BE COMPLETED
BY THE SEAFARER
APPENDIX
Hours 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Hours Comments

of rest
in 24-hour Hours of work Hours of work
period or rest in any or rest in any
Date
24-hour period 7-day period
Hours 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23
For completion and use in accordance with the procedures established by the component authority in compliance with the relevant requirements of the Seafarers’ Hours of Work and
the Manning of Ships Convention, 1996 (Convention No. 180). Additional calculations or verifications may be necessary to ensure compliance with the relevant requirements of the
Seafarers’ Hours of Work and the Manning of Ships Convention, 1996 (Convention No. 180) and the International Convention on Standards of Training, Certification and Watchkeeping,
1978, as amended (STCW Convention).
51
APPENDIX
REGULATIONS RELATING TO FATIGUE
Each individual Flag Administration is responsible for the development, acceptance,
implementation and enforcement of national and international legislation (conventions, codes,
guidelines, etc.) that deal with the various fatigue aspects: work hours, rest periods, crew
competency and watchkeeping practices.
The following international organisations have issued various conventions and other instruments
that address fatigue:
INTERNATIONAL LABOUR ORGANIZATION (ILO)

Convention Concerning Seafarers’ Hours of Work and the Manning of Ships – ILO Convention
No.180. This convention introduces provisions to establish limits on seafarers’ maximum working
hours or minimum rest periods so as to maintain safe ship operations and minimize fatigue.
Article 5, paragraph 1. The limits on hours of work or rest shall be as follows:
a maximum hours of work shall not exceed: (i) 14 hours in any 24-hour period; and (ii) 72
hours in any seven-day period; or
b minimum hours of rest shall not be less than: (i) ten hours in any 24-hour period; and (ii) 77
hours in any seven-day period.
Article 5, paragraph 2. Hours of rest may be divided into no more than two periods, one of which
shall be at least six hours in length, and the interval between consecutive periods of rest shall
not exceed 14 hours.
Article 5, paragraph 6. Nothing in paragraphs 1 and 2 shall prevent the Member from having
national laws or regulations or a procedure for the competent authority to authorise or register
collective agreements permitting exceptions to the limits set out. Such exceptions shall, as far as
possible, follow the standards set out but may take account of more frequent or longer leave
periods or the granting of compensatory leave for watchkeeping seafarers or seafarers working
on board ships on short voyages.
Article 7, paragraph 1. Nothing in this Convention shall be deemed to impair the right of the
Master of a ship to require a seafarer to perform any hours of work necessary for the immediate
safety of the ship, persons on board or cargo, or for the purpose of giving assistance to other
ships or persons in distress at sea.
Article 7, paragraph 3. As soon as practicable after the normal situation has been restored, the
Master shall ensure that any seafarers who have performed work in a scheduled rest period are
provided with an adequate period of rest.
Other ILO Conventions related to fatigue include the following convention numbers: 92, 133, 140,
141 and 147. Each introduces minimum habitability requirements (e.g. noise control and air
conditioning) on board ships.
52
APPENDIX
THE EUROPEAN UNION
The Maritime Working Time Directive (99/63/EU) implements ILO 180 for EU State Members.
INTERNATIONAL MARITIME ORGANIZATION (IMO)

International Convention on Standards of Training Certification and Watchkeeping for Seafarers,
1978, as amended in 1995 (STCW Convention) 7; Seafarer’s Training, Certification and
Watchkeeping Code (STCW Code) Parts A 8 and B 9; International Safety Management Code (ISM
Code) 10; and various guidelines/recommendations.
In addition to the international standards, company and flag administration policies, which may be
more stringent in some cases, should be followed on board all ships.
UNITED KINGDOM MERCHANT SHIPPING (HOURS OF WORK)

REGULATIONS, STATUTORY INSTRUMENT (2002, NO. 2125)
Minimum hours of rest
5. - (1) Subject to regulation 6, the minimum hours of rest shall be not less than -
(a) ten hours in any 24-hour period; and
(b) 77 hours in any seven-day period.
(2) Subject to regulation 6, hours of rest may be divided into no more than two periods, one of
which shall be at least six hours in length, and the interval between such consecutive periods
shall not exceed 14 hours.
53
CASE STUDIES
The Nautical Institute has a confidential marine accident reporting scheme called
MARS. MARS stories of near-misses, including ones where work-hour related
fatigue is a major contributing factor, are published monthly in the Institute
magazine ‘Seaways’. See www.nautinst.org.
Many other organisations publish case studies of fatigue-related accidents at sea, including the
following:
1. Transportation Safety Board of Canada: Case study on the striking by the Bulk
Carrier “NIRJA” of the Tanker “HAMILTON ENERGY”, Hamilton, Ontario on 11th
December 1993.
The following is an extract from report number M93C0003.
SYNOPSIS
On 11th December 1993, the bulk carrier "NIRJA", carrying a partial load of steel, was attempting
to berth at a slip in Hamilton Harbour, Ontario. While turning off the entrance to the slip in strong
stern winds and with three tugs assisting, the "NIRJA" did not successfully negotiate the turn and
struck the tanker "HAMILTON ENERGY" which was moored alongside the oil barge "PROVMAR
TERMINAL I" at the entrance to the slip. There was no injury or pollution, but the wharf and the
vessels involved sustained some damage.
The Board determined that the "NIRJA", while manoeuvring in strong wind conditions under the
conduct of a Pilot, did not successfully negotiate the turn into the slip and struck the "HAMILTON
ENERGY" because the vessel was not stopped in the available distance. The fact that the tugs
were not secured to the vessel, that the anchor was not deployed and that the performance of the
Pilot was probably less than optimal contributed to the accident.
54
CASE STUDIES
PARTICULARS OF THE VESSELS
NIRJA HAMILTON ENERGY
ex-ERMIS
Official Number 18702-90 307998
Port of Registry Panama Halifax, Nova Scotia
Flag Panamanian Canadian
Type Bulk carrier Tanker
Gross Tons 15,875 982
Length 190 m 59.2 m
Draught (max. F: 6.07 m F: 10 m (estimated)

at time of occurrence) A: 7.26 m A: 14 m
Built 1972, Tamise, Belgium 1965, Grangemouth, Scotland
Propulsion ACEC/MAN, Polar Atlas,

type K8Z70/120E, 8,238 kW, 840 kW diesel motor
driving a fixed-pitch,
right-handed propeller
Owners JS & S Shipping Ltd., Provmar Fuels Inc.,

Hong Kong Toronto, Ontario
DESCRIPTION OF THE VESSELS

The "NIRJA" is a conventional bulk carrier with bridge, accommodation and engine-room aft of
the six cargo holds. The vessel is fitted with a bulbous bow. On the fore-and-aft centre line, there
are three steel masts and six slewing derricks.
The "HAMILTON ENERGY" is a small, single-hull tanker used for ship refuelling in the Great
Lakes area. At the time of the occurrence, the vessel was double-banked starboard side to the
"PROVMAR TERMINAL I" on the north face of Pier 24.
55
CASE STUDIES
DESCRIPTION OF THE VOYAGE
Upon arrival at Hamilton on 7th December 1993, the "NIRJA" anchored inside the harbour
breakwater awaiting a berth.
On 11th December at 1100 a Pilot boarded the "NIRJA" at anchor. Due to strong stern winds, the
Pilot, in consultation with the Master, called for three tugs to assist in berthing the vessel.
At 1220, the port anchor of the "NIRJA" was weighed and the vessel backed out of the anchorage.
When her allocated berth became available, the "NIRJA" proceeded toward Pier 23, the
southernmost slip of the harbour. The Pilot, who had the conduct of the vessel, the Master, the
officer of the watch (OOW) at the engine telegraph, and a quartermaster at the helm were on the
bridge.
Between 1230 and 1240, the three tugs made contact with the "NIRJA" which was off Section 27
(see Appendix A), and were positioned on the port side of the bulk carrier abreast of hatches Nos.
1, 3 and 6, respectively. The vessel was proceeding on the starboard side of the centre channel
heading on to a chimney landmark beyond the channel.
At 1235, the OOW noted the vessel's approximate position as being off the knuckle of Pier 21. At
1249, when the vessel was off Section 26 and moving ahead at between three and four knots (kn)
in a south-easterly direction, the main engine was stopped. The three tugs began assisting under
the direction of the Pilot. None was made fast to the "NIRJA".
At 1254, slow astern was ordered, followed about half a minute later by half astern. The tug
abreast of hatch No. 6 was ordered to push closer to the bow in way of hatch No. 1 along with the
other two tugs. When the bow reached the knuckle of Pier 23, the vessel barely began turning to
starboard. At 1255, the engine telegraph was placed on full astern followed about half a minute
later by emergency full astern.
Subsequently, orders were given to let go the starboard anchor, but the anchor was not dropped.
At 1258, the bow of the "NIRJA" came in contact with the "HAMILTON ENERGY" aft of the engine-
room bulkhead.
PILOT'S SCHEDULED ASSIGNMENTS

The Pilot commenced his tour of duty on 9th December 1993 after eight days off. He had no
assignment on that day. The following day, 10th December, he boarded a vessel at Port Weller,
Ontario, at approximately 1530 and piloted her to Cape Vincent, Lake Ontario, arriving there
around midnight. He then boarded an upbound freighter at about 0230 on 11th December and
piloted her to Port Weller, arriving there at approximately 1030. He then went to the pilot office
and was asked to take on another assignment in Hamilton. The ship's agent drove him to
Hamilton where he boarded the "NIRJA" at about 1100. The Pilot maintained that, on each of the
two trans-lake assignments, he had had about five hours' sleep and was consequently rested. He
also indicated that he had had to get up at Mid-Lake Ontario calling-in point (CIP) to make a
56
CASE STUDIES
report to the Vessel Traffic Centre (VTC). The accident occurred at 1300 on 11th December, some
22 hours from the time of his first assignment.
Following the "NIRJA" assignment, the Pilot returned to the pilot station where he was asked to
take on another (fourth) assignment which he declined.
NON-DEPLOYMENT OF ANCHOR
Even if the boatswain was not necessarily in the immediate area at the time orders were given to
let go the starboard anchor, the Chief Officer, after ensuring that it was safe to drop the anchor,
could have returned to the windlass and executed the order, albeit with a delay of a few seconds.
As both the Pilot and the Master were on the bridge at the time the vessel's port anchor had
previously been weighed, both should have been aware of the state of readiness of the anchor for
immediate deployment. As immediate deployment of an anchor is a pre-requisite for handling
emergency situations in confined spaces, both the Master and the Pilot should have ensured that
the anchor was ready and the station appropriately manned, especially since berthing was to take
place in stern wind conditions and without the tugs secured to the vessel.
The time at which orders should have been given to let go the starboard anchor would vary
depending on the assessment and realisation of the developing situation. If the engine did not
respond appropriately and in a timely manner, the orders to let go the anchor should have been
given when this was realised. The Pilot's normal practice was to initiate the turn to starboard
when the vessel was a ship's length away from the knuckle of Pier 23. However, on this occasion,
the first astern movement had reportedly been given earlier owing to the strong stern winds, but
the vessel barely started swinging to starboard when the bow was in line with the knuckle of Pier
23. Hence, the need for deployment of the anchor should have been realised well before the
vessel reached the knuckle. In such a case, the anchor could have been deployed. However, if the
engine responded promptly and appropriately, the order to drop the anchor should have been
given when it was realised that the headway could not be stopped in time, which would be later in
the manoeuvre.
The evidence from the ship's personnel and the Pilot is consistent with their respective positions.
Thus, in the absence of an entry in the bridge movement book of the time that "let go starboard
anchor" was ordered, the precise timing of the order in relation to the complete manoeuvre
cannot be established nor is it possible to ascertain the precise impact that the deployment of the
anchor would have had on the outcome of the occurrence.
As the Pilot had the conduct of the vessel and the Master was monitoring the vessel's progress,
both had to have witnessed the situation developing. In any event, the anchor was not deployed in
a timely manner, and the "NIRJA" struck the "HAMILTON ENERGY" because she did not
successfully negotiate the turn to starboard nor was she stopped in the available distance.
57
CASE STUDIES
SPEED OF APPROACH
There was conflicting evidence regarding the speed of the vessel during approach. On the one
hand, the Pilot maintained that the Master wanted him to go faster. Since he considered this
request to be reasonable, he explained that he would go from dead slow ahead to slow ahead for
some two minutes (1240 to 1242) and then revert to dead slow ahead. On the other hand, the
Master indicated to the Pilot that he considered the vessel's speed to be considerable for the
conditions. In this case, any increase in speed would obviously have exacerbated the situation.
However, it is known that the vessel proceeded on dead slow ahead for the major portion of the
seven minutes (1242 to 1249) before the main engine was stopped prior to the astern movement.
It should be noted that the manoeuvring characteristics of the vessel show that a consistent dead
slow ahead movement can give a speed of 4 to 5 kn. As the Master's preference was at variance
with the Pilot's approach, the Master was well aware of the limitations/difficulties of the
manoeuvre. Consequently, it is unlikely that the Master would have requested the Pilot to proceed
faster.
Of the nine minutes before the striking, the main engine was stopped for the first five minutes,
between 1249 and 1254. During the following four minutes, between 1254 and 1258, astern
movements were ordered, the last three minutes of which (between 1255 and 1258) were full
astern, followed by emergency full astern. The Pilot provided contradictory evidence with respect
to the vessel's position when full astern was ordered. While he indicated that it was given when
the vessel was some two ship's lengths from the knuckle of Pier 23, the position he indicated on
the chart placed the vessel one ship's length away; the latter is consistent with his normal
approach practice. He also indicated that he had asked for full astern at least three times
whereas the ship recorded that slow astern and half astern had been ordered before full astern.
The "NIRJA" nonetheless struck the tanker. This would suggest that either the vessel's engine did
not respond in a timely manner or that the vessel's headway was such that, despite timely and
appropriate engine response, the vessel could not be stopped within the available distance.
EFFECT OF PILOT'S REST ON PERFORMANCE
At the time of the striking, the Pilot was on his third assignment in a 24-hour
period; the previous two had been trans-lake assignments.
The Pilot departed Port Weller at approximately 1530 the day before the occurrence on his first
assignment, and his opportunity to sleep on that passage would have occurred during a period of
maximum wakefulness. Any sleep obtained during this time probably would not have been
restorative.
58
CASE STUDIES
Notwithstanding the requirement for a 12-hour rest period following a trans-lake assignment, the
Pilot boarded another vessel between 0200 and 0300, and his earliest opportunity to go to sleep
would have been some time between 0400 and 0500, which is near the end of the period when he
would likely obtain restful sleep.
On each of these two trans-lake passages, the Pilot reportedly had five hours of sleep, but he had
to wake up at Mid-Lake Ontario CIP to make a report to the VTC.
In view of the above, it is unlikely that the Pilot had achieved five consecutive hours of restorative
sleep and, consequently, he was likely to be accruing a sleep debt.
Manoeuvres such as those carried out by the "NIRJA" are demanding and require high levels of
concentration, good judgment, close monitoring and immediate response to a developing
situation. The Pilot was familiar with the "NIRJA" and her manoeuvring characteristics, had
extensive experience which included docking vessels in stronger wind conditions than on this
occasion, and three tugs were assisting in manoeuvring the vessel, but he was unable to turn the
"NIRJA" successfully or to avert the striking. This would suggest that the Pilot, who had the
conduct of the vessel, misjudged the developing situation and did not take effective action in
ample time. Judgmental errors of this type are typical of the performance of a fatigued person.
As the Pilot had been on duty continuously for the last 22 hours, it is most likely that more than
24 hours had passed since his last significant sleep episode. Further, after 18 hours of
wakefulness, a 30 per cent decrement in the performance of cognitive tasks can be expected.
Although the Pilot had obtained some sleep during his trans-lake assignments, it is probable that
he was operating with a sleep debt which could compromise his ability to perform precise
monitoring, control and decision-making tasks. Since the Pilot's condition was not assessed on
site immediately following the accident, the extent to which his performance may have been
degraded by sleep debt cannot be established. However, degradation of the Pilot's performance,
as manifested in impaired judgment, probably contributed to the occurrence.
As people are poor judges of their own fatigue and alertness levels, it is unlikely that the Pilot's
self-assessment in accepting a second and a third assignment was objective, more so as
continuing to work involved personal financial benefit.
The negative effects of shift work and irregular work schedules can be mitigated by a
combination of sleep schedules and control of one's environment and diet. In this instance, the
Pilot had control over sleep but limited control of his environment and diet. The fact that the Pilot
did not avail himself of a 12-hour rest period after each trans-lake assignment, but instead opted
to carry out two trans-lake assignments followed by the berthing of the "NIRJA" within a period
of 22 hours without restorative sleep, suggests that he did not fully appreciate the negative
effects of shift work and irregular work schedules on his performance.
59
CASE STUDIES
FINDINGS
• The vessel attempted to berth in strong stern wind conditions.
• The vessel did not successfully negotiate the turn to starboard and her approach
speed was such that she was not stopped in the available distance.
• The anchor was not deployed in sufficient time to ensure its desired effect; i.e., to
successfully negotiate the turn or avert the striking.
• The tugs were not effectively deployed for optimal performance and could not be
used to retard the forward motion of the vessel at a critical point in the
manoeuvre.
• At a critical stage in the vessel's manoeuvre, the Pilot was limited to the use of
the main engine to retard/control the vessel's forward motion.
• It is possible that the vessel's engine did not respond to the full astern
movement(s) in a timely manner or that the orders were given too late to stop the
vessel before the striking.
• The cumulative effect of the strong stern winds and of the tugs pushing at the
forward end of the vessel would account for the resultant motion at the time of
the striking.
• Following two trans-lake assignments, the "NIRJA" was the Pilot's third
continuous assignment allocated by the dispatcher.
• The Pilot was required to rest for 12 hours following a trans-lake assignment, but
he did not.
• The Pilot had been on duty for some 22 hours without restorative sleep and this
probably adversely affected his performance.
• The demands to clear large numbers of vessels from the Seaway system before
its closure was, in part, responsible for the Pilot being given additional
assignments.
• Research indicates that persons suffering from sleep debt may not be capable of
objectively assessing the negative effect of their irregular work schedules on their
performance.
• There is neither a directive nor an educational programme in place to provide
guidance to Pilots regarding work-related stress, fatigue and performance
maximisation associated with work schedules/environment.
• Although the Master raised some concerns regarding the manoeuvre, he relied on
the Pilot's local knowledge and experience.
60
CASE STUDIES
2. Marine Accident Investigation Branch Safety Digest: Lessons from Marine
Accident Reports 1/2005 Case 9
ZZZZZZ - BUMP - WHERE AM I?

NARRATIVE
In the early hours of a summer morning, a foreign general cargo vessel ran aground on the west
coast of Scotland. The single-hold vessel was built in 1990 and was carrying 3300 tonnes of zinc
concentrate. She subsequently sank, prompting fears of serious environmental damage in an
area of outstanding natural beauty.
The vessel carried 7 crew, with the Master and Chief Officer holding the 6 to 12 and the 12 to 6
watches respectively. In addition to watchkeeping, the Chief Officer was responsible for
overseeing cargo operations in port.
The able seaman assigned to the watch was absent from the bridge for at least an hour before
the vessel grounded. No watch alarm was fitted on the bridge.
The Chief Officer fell asleep while alone on the bridge, missing an intended change of course. He
was awoken, standing at the engine controls, by the impact of the vessel grounding. The sea was
calm, there was no swell and the visibility was good. It was daylight, although the sun was yet to
rise. The vessel was stationary aground.
The circumstances of this accident are, unfortunately, not uncommon. In fact, watchkeeper
incapacitation or absence leads to about 6 groundings a year in UK waters alone, and over 58% of
all the collisions and groundings investigated by the MAIB over the last 5 years, can be attributed
to single-handed bridge watchkeeping.
THE LESSONS
• Six-on six-off watches are tiring in any event, and this problem was made worse
by the regular port visits, during which time the Chief Officer was still required to
work, regardless of how this disrupted his watch pattern. He fell asleep as a
result of very high levels of fatigue caused by the cumulative effect of this
irregular working pattern. It is also likely that his decision to allow the AB to leave
the bridge was as a result of poor perception of the risks, also caused by fatigue.
If you are tired, not only are you more likely to fall asleep, but your judgment will
also be affected, often without you realising it. Working within the hours of work
regulations does not necessarily protect you from fatigue. If you are in any doubt
as to your fitness for duty, tell the Master. The company will not thank you for
saving a few hours if its vessel is lost as a result!
61
CASE STUDIES
• The only real protection from fatigue is adequate manning for the work being
done. The manning level on this vessel was within that stated on the vessel’s Safe
Manning Certificate. However, this is a minimum requirement, and does not take
account of the vessel’s trading pattern.
Had the able seaman been on the bridge, or had the bridge been equipped with a
working and switched on watchkeeper alarm, it is likely that the mate would not
have been asleep long enough for the vessel to have run aground. He would,
however, have been just as tired, and likely to make serious errors of judgment as
a result.
Had there been another mate on board, all the navigating officers would have
been able to gain sufficient rest. Fatigue would not then have been an issue.
3. Great Barrier Reef grounding: “New Reach” Report no. 147 from the
Australian Safety Transport Bureau:
The Panama flag general cargo ship New Reach sailed from Cairns, Queensland, at 0654 on 16th
May 1999 bound for Penang, Malaysia, with a full cargo of sugar. A licensed Pilot was embarked
to take charge of the navigation through the inner route of the Great Barrier Reef.
At about 1020 on 16th May, New Reach passed Low Isles, the southern limit of the compulsory
pilotage area.
The pilotage proceeded routinely until about 0311 on 17th May, when, after making a routine
mandatory report to the Reef Reporting Centre, the Pilot realised that the light on Heath Reef
was in the wrong position relative to the ship’s heading. He altered course to port to bring New
Reach to the west of Heath Reef. At about 0320, the ship grounded in shallow waters about 220 m
south of the reef edge on a heading of 327°, about one hour before low water.
Nobody was hurt as a result of the grounding and no oil or other pollutant escaped from the ship.
At about 0920 on 17th May, New Reach was refloated under its own power and, after reporting to
the Reef Centre, went to anchor south of Night Island, 17 nautical miles to the north. The
Australian authorities issued detention orders. At 1314 the vessel was given permission to move
to Lloyd Bay, close to the Lockhart River Settlement and its airstrip.
On 18th May, divers, surveyors and other officials boarded the vessel. A new Pilot also joined New
Reach to relieve the Pilot on board.
After an underwater inspection by the divers and an examination of the fore peak tank by the
class society surveyor, the ship was cleared to resume its voyage. The vessel cleared Booby
Island at 0530 on 19th May.
62
CASE STUDIES
CONCLUSIONS
These conclusions identify the different factors contributing to the incident and should not be
read as apportioning blame or liability to any particular individual or organisation.
Based on the evidence available, the following factors are considered to have contributed to the
incident:
• When the Pilot realised that the ship was out of position, he did not establish the
ship’s true position to allow him to take appropriate action based on full and
correct information.
• The Pilot’s navigation of the ship in proximity to Heath Reef was based on
insufficient information, faulty analysis and inexperience.
• The Pilot made an error of judgment and his overall performance was affected by
fatigue.
• The Pilot did not have any effective strategy to manage or counteract inevitable
fatigue levels.
• Neither the Master nor Pilot briefed the watchkeeping officers on the passage
through the inner route. Communications regarding navigation between the Pilot
and the officers on watch were minimal.
• The 2nd mate did not fulfil his duties and obligations to maintain the ship on
course by bringing the Pilot’s attention to the plotted position of 0249 or the
plotted position of 0307.
• Approaching Heath Reef, the 2nd mate established that the ship was to the east of
the intended course line but did not alert the Pilot to the ship’s position.
• With the Pilot on the bridge for the passage from Fife Reef, the 2nd mate was
unconcerned at the relative position of Heath Reef light.
• There was a marked lack of bridge resource management, which led to New
Reach grounding through over-reliance on a single person.
• The fishing vessel Shanendale was well clear of New Reach and did not in any way
restrict the cargo ship’s sea room.
63
ASSESSMENT ANSWERS
Q1 Correct answers: All
Q2 Correct answers: b
Q3 Correct answers: a and c
Q4 Correct answers: a
Q5 Correct answers: c
Q9 Correct answers: All
Q10 Correct answers: b, c and d
Q12 Correct answers: All of the above
Q13 Correct answers: c
Q14 Correct answers: True
Q16 Correct answers: False
Q20 Correct answers: False

64
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Minimising Fatigue, Maximising Performance

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MINIMISING FATIGUE,

84 NEWMAN STREET, LONDON W1T 3EU

THE PRODUCERS WOULD LIKE TO ACKNOWLEDGE THE ASSISTANCE OF

The purpose of MINIMISING FATIGUE, MAXIMISING PERFORMANCE is to explain

• The negative effects of fatigue.

CARRYING OUT THE TRAINING

1 Ask trainees for brief summary of what they learned in Session 1.

1 Ask trainees for brief summary of what they learned in Session 2.

“A reduction in physical and/or mental capability as the result of physical,

THE EFFECTS OF FATIGUE

EFFECTS OF SLEEP DEPRIVATION ON PERFORMANCE

Sleep loss can be either acute or chronic:

EFFECTS OF SLEEP DEPRIVATION ON PERFORMANCE

Grounding off the Summer Islands

Cargo vessel grounding in the Firth of Clyde

10 *Three more accident case studies are included in the Appendix.

EFFECTS OF SLEEP DEPRIVATION ON PERFORMANCE

Pilot scheduling problem

Other fatigue-related accidents

The Waterfall train disaster

THE CAUSES OF FATIGUE

THE CAUSES OF FATIGUE

• Pressure over staffing, rules and regulations, resources and upkeep

• Cramped work spaces and cabins.

THE CAUSES OF FATIGUE

Ship and environment

THE NATURE OF SLEEP

THE QUALITY OF SLEEP

THE NATURE OF SLEEP

1 The limits on hours of work or rest shall be as follows:

A Maximum hours of work shall not exceed:

THE BODY CLOCK, CIRCADIAN RHYTHM AND THE ‘RED ZONE’

THE NATURE OF SLEEP

THE RED ZONE

A 5-STEP FATIGUE MANAGEMENT SYSTEM

This system takes a thorough, holistic approach to fatigue, and is an ongoing

A 5-STEP FATIGUE MANAGEMENT SYSTEM

A 5-STEP FATIGUE MANAGEMENT SYSTEM

Q3 Working pattern and maximum hours worked in any 24 hour period

Q4 Minimum rest hours in any 24 hour period

Q5 Describe the working environment

Q6 Describe the rest/recreation environment

b Air quality and humidity level.

A 5-STEP FATIGUE MANAGEMENT SYSTEM

g Recreation facilities and opportunities for exercise.

Q7 Describe the sleeping environment

b Air quality and humidity level.

d Temperature and ventilation.

Q8 Describe the diet

b Availability of main meal at appropriate time of day.

Q9 Likelihood of unplanned events and any other risk elements

A 5-STEP FATIGUE MANAGEMENT SYSTEM

• Those requiring the approval of the Master.

A 5-STEP FATIGUE MANAGEMENT SYSTEM

New measure(s) Plan agreed to

New measure(s) Measures

A 5-STEP FATIGUE MANAGEMENT SYSTEM

a A team member is appointed to assess the quality of sleep in the watchkeepers’

ASSESSING THE RISKS AND BRINGING ABOUT CHANGE

RISK ELEMENTS SPECIFIC TO DIFFERENT DEPARTMENTS

Everyone in the engine department, engineers and ratings, work in a noisy

ASSESSING THE RISKS AND BRINGING ABOUT CHANGE

• Berth availability. • Pumping capacity.