Featured Health & Safety

I’LL SLEEP WHEN I’M DEAD: THE IMPORTANCE OF SLEEP IN FATIGUE MANAGEMENT

Sleep is an essential biological function, required for maintaining both physical and psychological health. However, in today’s society, sleep is often limited or disrupted, with disastrous consequences. The impact of fatigue on the road is well documented and communicated in the media, but what about the impact sleep deprivation is having in the workplace, both short and long-term?

Kaitlyn Bruschi, Dietitian from Corporate Bodies International, investigates how sleep deprivation could be impacting your workplace.

In the early hours of the morning of March 24, 1984, the Exxon Valdez tanker was on its way to California, carrying over 200 million litres of crude oil. Just after midnight, without warning, the Exxon Valdez ran aground on Bligh Reef off the coast of Alaska, releasing millions of litres of crude oil into the ecosystem, and marking one of the worst environmental disasters in human history. From the formal investigations that followed, fatigue was found to be at the root cause of the spill. This marked a turning point in the importance placed on sleep and fatigue prevention in the workplace.

By 1997, a considerable body of research was building, correlating impaired sleep quality with reduced performance, alertness and an increased risk for workplace accidents. However, the risks associated with fatigue were yet to be quantified. A research team from the University of Adelaide took up this challenge, comparing psychomotor performance under the influence of alcohol with impairment in performance resulting from sleep deprivation. Researchers found that with 17 hours of continued wakefulness, participants had the equivalent psychomotor performance as someone with a blood alcohol concentration (BAC) of 0.05 percent. Extend this beyond 20 hours continued wakefulness and participants experienced equivalent to a 0.08 percent BAC. In the mining industry, a world of shift-work, rosters and extended hours, 17 hours is alarmingly easy to exceed.

Similar to the influence alcohol can have, individuals with sleep-deprivation often continued to operate in denial regarding the impact fatigue was having on their performance. Participants insisted that they were not impaired, despite demonstrated lapses in performance. These impairments translate directly to an individual’s injury risk, with sleep-deprived workers displaying increased risk-taking behaviours, poorer worksite communication, and reduced adherence to standard procedures and controls that minimise risk. Sleep problems have been suggested to increase an individual’s risk of a workplace injury by up to 62 percent.

In addition to increasing individual risk, fatigue can also negatively affect business bottom dollar. Through presenteeism, absenteeism, reduced productivity, and increasing health claims, businesses suffer the direct costs of a sleep-deprived workforce. From an Australian study conducted in 2016, 17 percent of participants reported missing at least one day of work in the month prior to the study due to fatigue, while 17 percent also reported falling asleep on the job. A similar study found individuals suffering from sleep deprivation to be 6.1% less productive than their co-workers. It is clear that fatigue can have significant societal and economic implications.

The importance of sleep

Sleep is far more than a dormant, passive state of relaxation, but is a complex coordination of physiological functions that allow our mind and body to heal and grow. Without adequate sleep, our health rapidly declines. Our immune system deteriorates, resulting in a greater susceptibility to pathogens in the environment. Hormonal changes start to alter our appetite, leading to an increased dietary intake of approximately 20 percent.  At the same time, our motivation to engage in regular physical activity declines. Weight gain and an increased risk for a range of chronic diseases quickly ensue. Several studies have shown that achieving less than seven hours of sleep on average each night is associated with an increased risk for cardiovascular disease, type two diabetes, and even some cancers. Changes in hormonal systems that regulate our emotional response can also occur during sleep deprivation, leading to an increased susceptibility for anxiety and depression. To aggravate this issue, as an individual’s health declines their ability to achieve adequate rest and recovery is limited, creating a self-feeding cycle of sleep deprivation with deteriorating health.  It goes to follow, that a healthy lifestyle plays a vital role in fatigue management and prevention.

Unfortunately, sleep problems are common. According to a sleep survey conducted in 2015 on over 1000 individuals across Australia, 66 percent reported their sleep to be disturbed, with this figure climbing to 77 percent among shift workers. Sleep disorders such as sleep apnoea, insomnia and restless leg syndrome are widespread throughout the population, though often undiagnosed and untreated.  Not only are these exacerbating fatigue risk among the population, they also contribute to an increased prevalence of fatigue-related health issues.

Investigating the cause

Despite the long-term impacts, sleep often slips down the priority list. Particularly in the mining industry where around the clock operation requirements, demanding rosters, long commutes, and poor sleep environments all contribute to an accumulating sleep debt. Add to this a workplace culture that discourages employees from speaking up about sleep, and fatigue becomes an inevitable risk within the industry.  However, fatigue is a multifaceted condition, triggered by a variety of individual, environmental and organisational factors.

Society and technology also have a part to play in the emergence of sleep disorders in Australia. Blue lights on electronic devices, designed to enhance the user experience, suppress the body’s natural production of the hormone melatonin, which has an integral role in sleep initiation and maintenance. Evidence also now exists, which links artificial lighting and suppressed melatonin production with increased risk for many cancers, including breast and colon cancer. This is an emerging area of research, which has significant implication for shift workers.

Overstimulation does not stop with the lighting. Research shows that every time an individual checks their email, Facebook or message bank, and finds a new piece of information, the brain releases a dose of dopamine, initiating the pleasure response and reinforcing the urge to check again. This instant gratification ‘programs’ individuals to always be available and overrides the fatigue signals from the brain. The impact of this ‘around the clock’ connection is profound.

How far we have come

Since the Exxon Valdez disaster, sleep and fatigue have climbed significantly in importance in the workplace health sphere. Significant resources have been invested in fatigue research, particularly in the Australian mining industry, where legislation and regulations have been embraced by industry leaders to result in significant improvements in the rates of fatigue-related incidents. However, scope remains for further improvements. This can only be achieved by taking a coordinated, holistic approach to fatigue management: providing education on sleep hygiene, addressing environmental concerns around camp design (e.g. isolating sleeping dongas from recreational), optimising roster design, building a safety-focused culture, and delivering interventions targeting the lifestyle risk factors associated with fatigue (obesity, diet, exercise, and mental health).

 

Written by Kaitlyn Bruschi – Dietitian, Corporate Bodies International