Managing Fatigue

1. Managing Fatigue Training Program for Supervisors and Gas Controllers

2. Managing Fatigue For the Employee • What is Fatigue • Signs of fatigue • What causes fatigue • Fatigue mitigation strategies Additionally, for the Supervisor • Fatigue regulations • Case Law Examples • Utility procedures

3. What is Fatigue • “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.” • Source: International Maritime Organization, Maritime Safety Committee Circular

4. Signs of Fatigue

5. Signs of Fatigue • Constant yawning • Blurred vision • Heavy or sore eyes • Poor concentration • Slowed reaction time • Poor judgment • Speech slurred • Headaches • Decreased ability to exert force • Leg pain and cramps • Loss of appetite • Giddiness • Decreased ability to pay attention • Irregular heart beats • Heaviness in arms and legs • Decreased eye-hand coordination

6. What Causes Fatigue • Lack of Sleep • Quality of Sleep • Biological Clock (circadian rhythm) factors • Shift work • Extended Hours • Health (diet and/or illness) • Ingested chemicals (alcohol, drugs, caffeine)

7. Lack of Sleep (an off duty issue) • Individuals’ needs are unique • Recommended 7 – 8 hours of sleep per 24 hour period • 5 stages of Sleep • Stage 1 – Light Sleep - less than 10% of a night's sleep. If woken up, will claim was not asleep. • Stages 2-4 – Deep Sleep - approximately 65% of a night’s sleep metabolic rates vary between the stages • Stage 5 - REM Sleep – Rapid Eye Movement Sleep – approximately 25% of a night's sleep – most vivid dreams • Each cycle takes about 90 minutes = 5-1/2 cycles per 8 hour night • Need all five stages for the body’s recovery from daily fatigue

8. Quality of Sleep(an off duty issue) • Sleep should be Uninterrupted • Try for long periods of sleep • Short naps can improve alertness for a short time (10 minute nap – alertness improved for about an hour), but will not restore the body to normal operation. • One seven hour period of sleep is much more restorative than seven one hour naps • Try for sufficient sleep before any periods you anticipate a sleep deficiency

9. Biological Clock • Most animals (including Humans) follow a daily routine (song birds in the morning, nocturnal animals, etc.) • Called Circadian Rhythm • Scientists have found that the time related information is controlled within the hypothalamus region of the brain and believe that it stimulates the production of a hormone called Melatonin. The increase in melatonin levels corresponds with the reduction in body temperature and alertness.

10. Biological Clock • Human Circadian Rhythm is actually on a 25 hour clock. • Did you ever notice it’s easier to stay up late than it is to get up early? • Jet Lag is a symptom of the body trying to reset the biological clock to a new time zone. • It is easier to “reset” when flying east to west (You get to sleep-in in the morning) than when flying west to east (You have to get up earlier than your internal clock expects). • The internal clock can only adjust by an hour or two each day. • This is helped by environmental cues (such as darkness)

11. Biological Clock Humans exhibit two “Troughs” or low points in alertness • One between midnight and 6 am • One between 2 and 4 pm • Fatigue related motor vehicle accidents are: • Twice as high at 2 pm as they are at 10 am • Six times as high at 2 am as they are at 10 am

12. Biological Clock • What do the following have in common? • Three Mile Island • Chernobyl • Bhopal • Exxon Valdez

13. The Midnight Shift • 1979 - Three Mile Island – 4 am local time - Pressure relief valve opens dumping reactor coolant – control room operators failed to recognize the event. Core meltdown • 1984 – Bhopal, India – shortly after midnight Methyl Isocyantate Gas (MIC) leak kills 3,800 • 1986 - Chernobyl Reactor disaster – 12:23 am– 1:28 am local time - critical control room operator error in failing to reset a controller. Core meltdown and release • 1989 – Exxon Valdez – 12:04 am ship hits Bligh Reef and spills 10.8 Million gallons of oil

14. Shift Work • Shift Work Considerations: • Fixed shifts are better than rotating shifts. • Fixed shifts allow the body to adjust to the new circadian rhythm • Rotating Shifts require constant adjustments • If Rotating Shifts are required: • Set up longer periods between rotation. Two to three month rotations allow the body to adjust vs. weekly rotations • Rotate the shifts clockwise vs. counterclockwise (easier to stay up later than to get up earlier) • Consider 02:00 – 10:00, 10:00 – 18:00, 18:00 – 02:00 shifts to allow each shift some sleep time during normal sleep periods.

15. Shift Work • Shift Workers experience sleep deficits as their bodies fight the normal circadian rhythm and attempt to adjust to new schedules

16. Extended Hours • Normal work day and week = 8 hours per day and 5 days per week • Any schedule that requires more continuous hours or more consecutive days should be considered extended or unusual • Often used to maximize scarce personnel resources or during response and recovery phase of emergencies. • OSHA recommendations: • Managers should limit use of extended hours • Additional break periods or meals should be provided • Tasks that require heavy physical labor should be performed at the beginning of the shift • Managers and Supervisors should diligently monitor for the signs and symptoms of fatigue and plan for adequate replacement personnel

17. Extended Hours • A study by sleep researchers in Australia found that: • A person kept awake for 17 hours will exhibit behaviors and performance of someone with a Blood Alcohol Concentration (BAC) of 0.05 • A person kept awake for 24 hours will exhibit behaviors and performance of someone with a BAC of 0.10

18. Health Issues (an off-duty issue) • Fatigue can be associated with: • Medical Conditions (such as heart problems) and • Illness (common cold or fever) • Diet can affect feelings of fatigue • Refined sugars can cause a short term energy boost but are often followed by a rapid drop in blood sugar levels causing weakness and instability • Eating a large meal before bedtime can disrupt sleep • Psychological Issues of stress or family worries can disrupt sleep • There are Sleep Disorders such as insomnia or sleep apnea (waking up suddenly due to interrupted breathing)

19. Ingesting Chemicals (an off duty issue) • Some medications can aggravate fatigue issues by causing drowsiness • Caffeine can give short duration alertness but has side affects such as hypertension, headaches, mood swings and anxiety • Alcohol is a depressant and should logically help someone sleep. However, the important REM sleep is disrupted preventing body recovery.

20. Fatigue Mitigation Strategies • Develop a pre-sleep routine (warm shower, reading a book) • Sleep in a dark, quiet, cool environment • Avoid alcohol prior to sleep • Avoid caffeine at least six hours prior to sleep • Eat regular, well balanced meals • Drink a sufficient amount of water • Exercise regularly • Get enough proper sleep

21. Fatigue Mitigation Strategies • For Shift Workers who need to sleep during the day: • Make sleep a priority during off-duty hours • Install room darkening shades in the bedroom • Decrease room temperature • Consider ear plugs to block outside noise • Put a Do Not Disturb sign outside the door • Unplug the telephone • Do not exercise prior to sleeping. It raises body temperature and heart rate

22. Fatigue Mitigation Strategies • For Shift Workers who need to stay alert during their shift: • Exercise when feeling fatigue • Schedule short breaks • Avoid unhealthy foods during the shift • Never rely on medications to enhance alertness • Exercise caution when driving home

23. Fatigue Issues for Supervisors

24. Fatigue Regulations • U.S. Labor Dept. Wage & Hour Laws • Social policy to create more jobs and provide disincentive for overtime • Time & a Half • Does not limit the number of hours that an employee can be required to work nor the number of days in a week. • [Insert state requirements] • OSHA Regulations • None

25. DOT Regulations • CDL Driver rest periods are mandated • Gas Control Room Management regulation 49CFR192.615(d): • “Each operator must implement the following methods to reduce the risk associated with controller fatigue…. • Establish shift lengths and schedule rotations that provide controllers off duty time sufficient to achieve eight hours of continuous sleep; • Educate Controllers and Supervisors in fatigue mitigation strategies and how off-duty activities contribute to fatigue • Train Controllers and Supervisors to recognize the effects of fatigue • Establish a maximum limit on Controller hours-of-service, which may provide an emergency deviation from the maximum limit if necessary for the safe operation of a pipeline facility”. Fatigue Regulations

26. Case Law Examples • Pilgrim v. Fortune Drilling Company • Employee worked 12 on / 24 hour off shift with a three hour commute each way • Supervisor knew he was exhausted but let him drive home. • Employee hit another vehicle • victim sued the employer claiming company should have supervised the employee • Suit thrown out on appeal

27. Case Law Examples BUT • Robertson v. Lemasters • Employee worked 27 hours, no break • again accident on the way home • victim sued employer and won • There was an unreasonable risk of injury - The employer should have supervised the employee and found alternate transportation home.

28. Case Law Examples AND • Truitt v. J. H. Kelly Construction Co. • “Sleepless in Seattle” case • Employee worked 36 hours straight • On his way home he fell asleep, veered off the road flipped the car and slammed into a telephone pole. • Survived but permanent Brain Damage • Case was settled. • Employer should have driven him home or put him up in a motel.

29. Workers Compensation • Designed to limit Liability lawsuits • Worker does not have to show negligence on the part of the employer to collect Worker's Comp. must show only that injury arose out of employment • In turn, Worker gives up the right to sue the employer for damages - Called the Worker's Compensation Bar

30. Case Law Examples • Krushwitz v. McDonalds • 18 year old employee worked a 3:30 – 8 pm shift and then volunteered to work from midnight until 8:21 am, was exhausted and told Supervisor he was too tired to work an upcoming afternoon shift. • Supervisor knew he was exhausted but let him drive home • He fell asleep at the wheel, hit another vehicle head on and was killed. His family sued the employer • Employer used the defense that the Workers Compensation Bar applied, that the accident was work related and that Workers Compensation was the only recourse. The circuit court agreed. But this was ultimately overturned by the State Supreme Court. • Interpretation - Workers Comp does not apply during the employee's commuting period. But the employer can still be held liable under a wrongful death charge for the actions of their employees after work.

31. Utility Policy • Insert discussion of utility procedures.

32. References • “Driver fatigue - an accident waiting to happen”, by academy staff of the Australian Academy of Science, June 2006 • “Guidance on Fatigue Mitigation and Management”, MSC (Marine Safety Committee) Circular 1014, International Maritime Organization, June 12, 2001 • “Extended/Unusual Work Shifts”, Occupational Safety and Health Administration (OSHA), September, 2, 2004 • “Sleepless in Seattle: injured worker’s case shows hazards of fatigue”, Shoop, Julie Gannon, Publication: “Trial”, Dec. 1, 1993 • “Personal & Financial Health” Scott, Diane E., RN MSN, Vermont Nurse Connection, Feb. 1, 2008 • “Circadian Rhythms and Shift Work” American College of Emergency Physicians, September 2003