BASIC

FATIGUE MANAGEMENT
TRAINING
Prepared for Botaş - BTC, Feb.-2004
Symptoms of Fatigue

 Forgetfulness  Fixated
 Poor decision making  Apathetic
 Slowed reaction time  Lethargic
 Decrease in Alertness  Bad mood
 Communication skills at its  Nodding off
worst!

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Fatigue Must Be Handled As An Issue

Because;
 fatigue is a contributing factor in 30-40% of all heavy trucking accidents
 the most commonly cited probable cause of fatal to the driver trucking
accidents.
 fatigue is implicated in more fatal to the driver trucking accidents than
alcohol or drugs alone
 “Fatigue is the number one truck safety issue”

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Fatigue Must be Handled as an Issue !

 Driver fatigue takes the blame for as many as 240,000 motor

vehicle accidents in the U.S. annually.
U.S. National Highway Traffic Safety Administration

 Sleep related accidents cost American government and

business an estimated $46 billion each year.
National Commission on Sleep Disorders and Research

 Forty-million Americans suffer debilitating sleep disorders;

the majority of them are undiagnosed.
National Sleep Foundation
FATIGUE-RELATED ACCIDENTS

International Data N=6052

1200
1100
1000
900
Number

800
700
600
500
400
300
200
100
Midnight 6am Noon 6pm Midnight
 Sleep Architecture: NREM/REM Cycle
Wake

REM

Stage 1

Stage 2

Stage 3

Stage 4

2400 0100 0200 0300 0400 0500 0600 0700

Time
Why is Sleep Important?

 Loss of sleep leads to an increasing state of sleepiness

 The more you are sleepy;
 It gets harder to do any kind of physical or mental work
 You work more slowly
 You make more mistakes
 Your mood gets worse

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What happens to your reaction-time?
Sleep Apnoea
 Symptoms
 breathing pauses during sleep
 loud snoring
 excessive sleepiness

 Who is at risk?
 Males
 middle aged
 overweight (large neck)

 Can cause increased risk of -

 heart disease, high blood pressure, stroke
 motor vehicle accidents
 long distance truck drivers with sleep-disordered breathing have double the accident
rate per mile driven
Some Factors Affecting the State of Being
Sleepy
 Age
 Amount and structure of sleep changes as the aging continues, sleep
becomes lighter, more disrupted, total sleep at night decreases

 Alcohol:
 Prevents the mind activites from being rapid and variable, causes sleepiness
symptoms, and leads to a more disrupted sleep
 Its interaction with sleep loss may increase sleepiness within the day

 Effects of Drugs
 The usage of drugs may have several effects due to the compound of the
drug and due to the human’s specific answers to that particular drug
 Can make it harder to fall asleep, can change the structure of sleep, can alter
total sleep time

 Effects of environmental factors

 Noise, temperature, light, etc. may affect the quality of sleep
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Circadian Rhythms

 Circa - about dies - a day

 A circadian clock in the brain co-ordinates daily cycles
Sleep / wake Performance
Temperature Hormones
Digestion Immune system…

 The clock programmes us to sleep at night and be awake

during the day
 Without any time cues from the environment, the biological
day is about 25 hours
Measuring Rhythms

temperature
rhythm

cycle length
(period)
amplitude

6 am 6 pm
2 Sensitive Lags..

 Two sensitive Lags

Morning 3 - 5
 lowest body temperature
 maximum sleepiness
 lowest physical and mental performance

Afternoon 3 - 5
 secondary peak in sleepiness
 performance drop in some tasks

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If you are a Shift Worker

 Working when your clock says you should be asleep

 Body clock - out of step
 JOB: ‘Be active at night!’
 FAMILY: ‘Be together with us during the daytime!’
 DAYLIGHT: ‘Be active at daytime!’
 WEEKENDS: ‘It’s just weekend, time to be active!’

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Why is Sleep Such a Problem?

 The clock sends out an “internal wakeup call” about 6 hours

after the daily temperature low point
 Morning sleep after night shift is cut short

 Sometimes, the clock won’t let you fall asleep

 a few hours before your usual bed time
 around the time of the wakeup signal

 Environmental disturbances, competing time demands

Shift Work and Health

 Shift workers compared to day workers:

 have more general health complaints
 are more likely to have more sleep problems
 are more likely to have gastro-intestinal problems
 probably have more cardiovascular problems
 have more mental health problems in some industries

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Awareness on Shift working

 Accident Statistics  Performance

 Peak’s  Peak’s
 02.00 – 06.00hrs & 15.00 –  0700 - 1000hrs &
17.00hrs daily  1700 - 2000hrs ???
 1st , 2 - 4 hours of shift
 4-12hrs peak drops
 > 12hr shift it Doubles
 > 14 hr shift it Trebles

 12hr shifts 15% more accidents

than 8 hr.
Common Misconceptions

“If people need 8 hours of sleep, then the minimum rest

period is 8 hours’’

 The quality versus the quantity of sleep

 (8 hours) disrupted sleep, may create the effects of a sleepiness similar to the effects
of having not enough sleep
 The sleep after a sleepiness period is not longer but deeper

 An 8 hours rest period does not allow enough time for 8 hours of sleep

“I know how tired I am”

“I’ve lost sleep before and I did just fine”
“Sleepiness does not effect me because I am in a good mood”

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Common Misconceptions

“The solution is easy”

“There is a quick fix, a magic bullet, that will work for
everyone, every kind of vehicle operation”

Why Not?
• Sleep and daily rhythm physiology are complex
• People are not the same
• Different rosters and types of operations present different
demands

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At Home : Naps and Sleep

 A nap can acutely improve alertness

 If immediately before work, naps should not be over 40 minutes
 If you sleep too long and go into deep sleep, it may take longer for you to
become fully awake
 Some sleep is better than none
 Develop and practise a regular pre-sleep routine
 Keep sleep time sacred, minimize other responsibilities
 If hungry, eat a light snack; do not eat or drink heavily before bedtime
 Avoid alcohol, caffeine, and cigarettes before going to bed
 If you don’t fall asleep in 30 minutes, get out of bed

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At Home: Good Sleep Habits

 Sleep environment
 Dark room (if necessary use heavy curtains)
 Silent room (turn off phone)
 Comfortable temperature
 Comfortable bed (sleep surface)

 Lifestyle
 Have a regular sleep pattern for each shift
 Eat a balanced diet, have enough liquids, care about what you eat

Reporting Fit for Work Rests With You

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8 Drowsy Driver Danger Signs...

According to the American Medical Association:

1) Eyes closing or going out of focus

2) Trouble keeping your head up
3) Yawning non-stop
4) Wandering, disconnected thoughts
5) Not remembering driving the last few minutes
6) Drifting between lanes, tailgating or missing traffic signs
7) Jerking the car back into the lane
8) Drifting off the road

If you have any of these symptoms, pull !!!

Driving: If You Feel Symptoms of Fatigue ‘Take
a Break’
 Until you arrive at the place for the break, get cool and fresh
air, listen to the news!
 If you need to take a nap
 Park immediately and safely
 Let your manager/family know what you are doing and where
 Don’t sleep in the driver’s seat
 Don’t sleep longer than 40 minutes
 Walk around the vehicle and do a safety check before you drive away
 Stop and ‘Kick the Tyres’ to check
 Get out of the car and do some stretching or back exercises
 When you get back in, readjust the seat position

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The Importance of Breaks

 Breaks during driving

 breaks can reduce the build up of physiological sleepiness on long night
drives

 Days off
 two nights of unrestricted sleep is usually enough for complete recovery from
sleep loss

 Annual Leave
 important to relax and refresh yourself on a regular basis
At Work: Strategic Use of Caffeine

 Use caffeine to acutely increase alertness

 Don’t use it when already alert (at the start of duty or after a
nap)
 Avoid caffeine near bedtime
 Drink enough other liquids, and think about what you eat. If
necessary, bring your own food and drinks
Effects of Trucking Operations

 Trucking operations are a non-stop business

 Trucking operations activities;
 may not let an undisrupted sleep at night
 a regular sleep , wake lifestyle can not be continued

 Long Duty Periods;

 prolongs wakefulness period
 creates fatigue
 creates a mood of boredom and complacency
 causes excessive sleepiness

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Fatigue Check List !

 Fatigue checklist
 Have you slept well in the last 2 days?
 How long since you last slept?
 Time of day (3:00 - 5:00 am or 3:00 - 5:00 pm)

 Look for things that increase environmental stimulation

 Conversation
 Music
 Cool, fresh air
If You Remember Nothing Else...

 Fatigue symptoms have logical causes related with our

physiology..
 Sleepiness can have severe consequences - take it
seriously...
 Improve the current situation - do it yourself, now
 People are different - tailor this information to your own
needs...
 There is no one simple answer - these are
recommendations, find out what works for you..
Fatigue Management – Integrated Approach

Lobbying, Industry-Wide
Government Policies, Laws, Approach
Regulations
Incident and Accident
Investigation
Corporate Politics and Medical Examination and
Procedures Controls

Healthy Roster
Designing

Personal Coping
Strategies, Change of Training of Managers,
Approach Driver Supervisors,
Drivers
Thank you for your contribution and interest...

Nuri Ersan