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Project presented to Nigerian Institute of
Safety Professionals for membership
upgrade.
Project topic:
Fatigue management awareness
Written by:
MOLOKWU ONYECHI
Date:July 23, 2011
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Introduction
Queen English dictionary & thesaurus of the English language published for
Parragon by Geddes & Grosset, defined fatigue as tiredness from physical and
mental efforts, the tendency of a material to break under repeated stress, and
stress as accent, highlight, point up, press, pressurize, effort, force etc.
A more elaborate description says stress is a psychological condition occurring
when individuals feel unable to cope with the demands being made on them.
They also believe that this failure will have important consequences. This
condition is sometimes called distress, to distinguish it from the positive or
pleasant aspects of stressful situations. Stress is usually associated with feeling a
lack of control and involvement in the decisions which affect life and work. The
jobs with the highest strain are those in which there is heavy pressure to perform,
where hours and procedures are rigid, there is a threat of redundancy, there is
little opportunity to learn new skills, and there is little involvement in decision
making. Such jobs tend to be the least prestigious. Workers low in the hierarchy
tends to experience the most stress. It is unclear how stress affects health, but
one possibility is that it disturbs important systems in the body, such as the
hormonal, nervous, or immune system.
This clearly shows that stress is completely different from fatigue which is
sometimes misinterpreted by family, friends or colleagues, who mistakenly
assume that the person with stress is depressed or just not trying hard enough.
Fatigue does not relate to relapses, or to any permanent increase in disability,
although previously experienced symptoms may recur during fatigue but subside
after rest. However, people can experience fatigue that interrupts their daily life
or that prevents them from working whilst having no other symptoms. Although
for some people drug therapy can help with fatigue, treatment is primarily based
on helping someone find ways of managing their life to prevent or lessen the
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impact of fatigue. An occupational therapist is often central to the development
of management strategies. Occupational therapists (OT) look at all the physical,
psychological, environmental and social issues that are relevant to the individual.
By suggesting adaptations, equipment and different ways of tackling tasks, an OTworks with the individual to enable them to achieve maximum independence.
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Fatigue Management Awareness
What is fatigue?
Fatigue is something every person has experienced. It is a natural part of the daily
life cycle. But fatigue is also a major factor in many serious accidents.Extensive
training, the proper safety equipment and a perfect track record of experience
cannot compensate for fatigue. Fatigue is a feeling of weariness, tiredness, or lack
of energy that does not go away when you rest.
Fatigue management can be vital in allowing you to live as full a life as possible
despite suffering with a tiredness syndrome. Of course, not all fatigue is caused by
chronic fatigue syndrome, or even anything related to it. A lot of extreme
tiredness is caused by something even more serious such as heart disease or
cancer, and a lot of it is simply caused by overwork and poor body maintenance.
Every case needs different treatment, but the symptoms can be remarkably
similar, so knowing exactly what to do can be quite a problem. The best course of
action is to attack it on two fronts as illness (ie Cancer, HIV etc) and daily lifecycle
(tiredness).
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Employees, in most dynamic and multi-national companies, are accustomed to
long hours, frequent changes of schedule and long hours of travel from one
assignment to the next all factors that add real excitement to our work, but that
also can lead to profound fatigue.
The effects of fatigue on our alertness, our judgment, and our ability to recognize
and respond to potential problems, can contribute to costly and sometimes tragic
events.
To properly address these issues, it is vital to raise our awareness of fatigue, its
causes, the risks it poses and proven methods for managing those risks.
For the purposes of our discussion, fatigue is defined as the lack of energy
resulting from prolonged, extensive mental or physical activity, or from
insufficient sleep. Shift work, long work hours and international travel across time
zones can all promote fatigue.
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What are the signs of fatigue?
Falling asleep while you are driving, monitoring equipment or performing othervigilance tasks is obviously a serious problem. But long before fatigue causes you
to fall asleep, it can adversely affect your judgment and your physical
coordination in ways that can lead to serious incidents or crashes.
The onset of fatigue can be recognized in ourselves and others as:
1. Physical or mental weariness.2. Something, such as tiring effort or activity that causes weariness: the
fatigue of a long hike.
3. Physiology. The decreased capacity or complete inability of an organism, anorgan, or a part to function normally because of excessive stimulation or
prolonged exertion. etc
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SymptomsFatigue can cause a vast range of other physical, mental and emotional symptoms
including:
Chronic tiredness or sleepiness
Headache Dizziness
Sore or aching muscles
Muscle weakness
Slowed reflexes and responses
Impaired decision-making and judgment
Moodiness, such as irritability
Impaired hand-to-eye coordination Appetite loss
Reduced immune system function
Blurry vision
Short-term memory problems
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Poor concentration
Hallucinations
Reduced ability to pay attention to the situation at hand
Low motivation.
Certain signs of fatigue are largely universal and can be split into two groups;
cognitive (psychological) and physical. This means that people may feel fatigued
in body or mind that is physical or psychological fatigue. With physical fatigue,
your muscles cannot do things as easily as they used to. You might notice this
when you climb stairs or carry bags of groceries. With psychological fatigue, it
may be difficult to concentrate for as long as you used to. In severe cases, youmight not feel like getting out of bed in the morning and doing your regular daily
activities.
Cognitive (psychological):Negative mood
Reduced communication
Slips and lapses
Poor memory
Reduced attention
Impaired problem solving
Increased risk taking
Physical:FidgetingRubbing eyes
Repeated yawning
Staring blankly
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Blinking
Difficulty keeping eyes open
Head nodding
What are the causes of fatigue?These signs allow us to recognize that we need to sleep, and are our bodys way
of telling us to do so. To prevent or manage the effects of fatigue, we need to
understand how and why it can become a problem. So what's making you so tired
all the time? Most of the time, fatigue can be traced to one or more of your habits
or routines. Fatigue can be a normal and important response to physical exertion,
poor eating habits, emotional stress, boredom, or lack of sleep. In some cases,
however, fatigue is a symptom of an underlying medical problem that requires
medical treatment.
Our bodies, including our brains, operate on a biological clock set to daily cycles,
known as circadian rhythms. We normally feel more alert during the daylight
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hours and less alert at night, a fact of life even for people who have worked nights
for a very long time.
This nighttime sleepiness can lead to poor performance and reduced alertness,
increasing the likelihood and frequency of accidents and mistakes in judgment. All
of us experience two periods of maximum sleepiness each day, between 2 a.m.and 6 a.m., and again between 2 p.m. and 4 p.m. It is in or around these two
periods of low alertness that some of the most notorious tragedies of our time
have occurred.
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A range of causesThe wide ranges of causes that can trigger fatigue include:
Medical causes unrelenting exhaustion may be a sign of an underlying illness,
such as a thyroid disorder, heart disease or diabetes.
Lifestyle-related causes feelings of fatigue often have an obvious cause, such
as sleep deprivation, overwork or unhealthy habits.
Emotional concerns and stress fatigue is a common symptom of mental health
problems, such as depression and grief, and may be accompanied by other signs
and symptoms, including irritability and lack of motivation. Fatigue can also be
caused by a number of factors working in combination.
Medical causes:
Many diseases and disorders can trigger fatigue, including:
The flu
Glandular fever
Anemia
Sleep disorders, such as sleep apnea or restless leg syndrome CFS (formerly known as chronic fatigue syndrome)
Hypothyroidism
Hepatitis
Tuberculosis
Chronic pain
Addisons disease
Parkinsons disease Heart problems
HIV
Cancer
Certain medications.
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Lifestyle related causes
Common lifestyle choices that can cause fatigue include:
Lack of sleep typically adults need about eight hours of sleep each night. Some
people try to get by on fewer hours of sleep.
Too much sleep adults sleeping more than 11 hours per day can lead to
excessive daytime sleepiness.
Alcohol and drugs alcohol is a depressant drug that slows the nervous system
and disturbs normal sleep patterns. Other drugs, such as cigarettes and caffeine,
stimulate the nervous system and can cause insomnia.
Sleep disturbances disturbed sleep may occur for a number of reasons, for
example, noisy neighbors, young children who wake in the night, a snoring
partner, or an uncomfortable sleeping environment such as a stuffy bedroom.
Lack of regular exercise and sedentary behavior physical activity is known to
improve fitness, health and wellbeing, reduce stress, and boost energy levels. It
also helps you sleep.
Poor diet low kilo-joule diets, low carbohydrate diets or high energy foods that
are nutritionally poor dont provide the body with enough fuel or nutrients to
function at its best. Quick fix foods, such as chocolate bars or caffeinated drinks,
only offer a temporary energy boost that quickly wears off and worsens fatigue.
Individual factors personal illness or injury, illnesses or injuries in the family,
too many commitments (for example, working two jobs) or financial problems can
cause fatigue.
There are lifestyle changes you can make which will benefit every type of fatigue
case no matter what the underlying cause, and these should be implemented as
quickly as possible. In many cases, they alone will be enough to return the patient
to health. In other cases, they will help to stabilize the condition while a thorough
diagnosis is carried out. The first important point to understand is that the
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balance between rest and exercise can be upset either way, and that feelings of
fatigue can result from a lack of either.
Workplace related causes Common workplace issues
that can cause fatigue include: Shift work the human body is designed to sleep during the night. This pattern
is set by a small part of the brain known as the circadian clock. A shift worker
confuses their circadian clock by working when their body is programmed to be
asleep.
Poor workplace practices can add to a persons level of fatigue. These may
include long work hours, hard physical labor, irregular working hours (such as
rotating shifts), stressful work environment (such as excessive noise or
temperature extremes), boredom, working alone with little or no interaction with
others, or fixed concentration on a repetitive task.
Workplace stress can be caused by a wide range of factors including job
dissatisfaction, heavy workload, conflicts with bosses or colleagues, bullying,
constant change, or threats to job security.
Burnout can be described as striving too hard in one area of life while
neglecting everything else. Workaholics, for example, put all their energies into
their career, which puts their family life, social life and personal interests out of
balance.
Unemployment financial pressures, feelings of failure or guilt, and the
emotional exhaustion of prolonged job hunting can lead to stress, anxiety,depression and fatigue.
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Psychological causes:
Studies suggest that psychological factors are present in at least 50 per cent of
fatigue cases.
These may include: Depression this illness is characterized by severe and prolonged feelings of
sadness, dejection and hopelessness. People who are depressed commonly
experience chronic tiredness.
Anxiety and stress a person who is chronically anxious or stressed keeps their
body in overdrive. The constant flooding of adrenaline exhausts the body, and
fatigue sets in.
Grief losing a loved one causes a wide range of emotions including shock,
guilt, depression, despair and loneliness.
Diagnosis can be difficult
Since fatigue can present a vast range of symptoms and be caused by many
different factors working in combination, diagnosis can be difficult. Your doctor
may diagnose fatigue using a number of tests including:
Medical history recent events such as childbirth, medication, surgery or
bereavement may contribute to fatigue.
Physical examination to check for signs of illness or disease. The doctor may
also ask detailed questions about diet, lifestyle and life events.
Tests such as blood tests, urine tests, x-rays and other investigations. The idea
is to rule out any physical causes, for example anemia, infection or hormonal
problems.
A shift worker confuses their circadian clock by working when
their body is programmed to be asleep.
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For example, the Chernobyl and Three Mile Island nuclear plant disasters bothoccurred in the early morning hours, and both were caused at least in part by
fatigue.
Even at times of day when fatigue would not normally be a problem, disrupted
schedules or unusually long periods of sustained work can create a dangerous
level of fatigue. For example, in Cali, Colombia, American Airlines flight 965
crashed killing 164 people. Investigators determined that fatigue was a major
cause as a fatigued flight crew was unable to respond effectively when a serious
problem arose.
In Port-Harcourt and our country Nigeria, there are too many examples of serious
accidents, injuries and deaths in which fatigue played a critical role.
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In 1988, the Piper Alpha disaster in the North Sea resulted in the loss of 167 lives,
with fatigue as a major contributing factor. Numerous tragedies on a smaller scale
have occurred and all of them might have been prevented with a greater
awareness of the risks of fatigue and how to manage them safely.
Why is alertness critical to safety?
Alertness is the critical factor in human performance. Defined as a state of
readiness to respond, alertness is what gives us the ability to recognize hazards
and take appropriate actions to manage them. Without alertness, all the training
and experience in the world will not protect you.
Factors which determine your level of alertness include the time of day, the
length of time since you last had a period of consolidated sleep, and the duration
and quality of that sleep. A periodic break in your work schedule is also critical to
alertness; too many consecutive days on duty can begin to affect alertness, even
if you have been getting a normal amount of sleep each day. The hazard of fatigue
in combination with the vigilance task of driving is our most deadly combination.
Studies suggest that as many as 50 percent of fatal crashes on highways are
caused by drivers falling asleep or briefly nodding off behind the wheel.
How do we manage fatigue?
The following sections describe the six principles of fatigue management.
1. Take frequent rests
Listen to your body. Don't be tempted to overdo it if you are having a goodspell - you might pay the price in a day or two!
It can be helpful to divide the day into three parts: be active in two of themand rest well in the third
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If you have a big event coming up, prepare for it by getting as much rest aspossible beforehand - and remember that rest means doing nothing at all
Many people find it difficult to sit and do nothing and allow their mind to rest
properly. Relaxation techniques can give focus to periods of non activity and help
to achieve a deeper level of rest than simply sitting down. Relaxation can also
help to reduce stress and anxiety, which can increase fatigue.
Tips for relaxation
1. Choose a quiet place free from distraction.2. Body temperature drops during relaxation, so ensure the room is warm
enough or cover yourself with a light blanket.
3. You may want to loosen clothing and/or remove glasses or jewellery.4. Find a comfortable position, either sitting or lying. If sitting, have your head
supported.
5. Close your eyes to avoid distraction.6. Practice your chosen technique - some people use tapes, soothing music or
meditation. Like anything new, it may take a few sessions to achieve the
desired result.
7. Maximize benefits of relaxation by doing at least 20 minutes every day.2. Prioritize activities
Prioritize tasks into those that are essential and those that can wait Save your energy for what you can do rather than struggling with tasks you
find difficult - delegate these to other people!
Conserve your energy whenever possible. If you have to go upstairs to usethe bathroom, save up other chores that need doing upstairs, to avoid
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having to make separate journeys. Also, keep duplicate cleaning materials
upstairs and downstairs
Explore the possibility of working from home or cutting down your hours topart-time work
3. Plan ahead / time management
Make a daily or weekly timetable of activities that need to be done and try to put
activities in order of priority so that those that must be done are done before you
run out of energy. Break large complicated tasks into smaller stages that can be
spread throughout the day, e.g. peel potatoes in the morning to cook in the
evening. Set yourself realistic targets. An important word in time management is
NO.
Myths about time
Those who are the most active get the most done If I do it myself it will be done faster and better than if anyone else does it The harder one works, the more work is done Time can be 'saved'
4. Lead a healthy lifestyle/exercise
Try to keep generally fit. Exercises are essential, but remember to balance the
exercise with rests. Eat a well balanced diet. Excess weight, alcohol and smoking
can all have a negative effect on fatigue.
Remember the saying 'Use it or lose it'. Keep mobile, even if it only sitting inthe garden - fresh air does wonders for depression. If possible, stand up
and have a walk round every so often, to prevent stiffness in your legs
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Take regular exercise if you are able. Swimming is a good option. Even ifyou are not a strong swimmer, spending time in warm water can be
beneficial and relaxing
Exercising with a friend can be fun and can help to keep you motivated
5. Adopt a good posture
Try to maintain an upright and symmetrical posture during all tasks. If necessary,
rest on a perching stool while carrying out tasks. Avoid excessive twisting and
bending and remember to rest in order to reduce strain on your joints and soft
tissue..
6. Organize tools, materials and work area
It is suggested that people divide their working space into different areas to make
use of energy more efficiently
Vertically
Area A: From shoulder to extended arm height
Objects that are lightweight and used less often
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Area B: Between hip and shoulder
Tools and objects in continual use
Area C: From the hip to the floor
Heavy and less used items
Horizontally:
Area D: From your body to your finger tips with elbows bent
Items in current use
Area E: From the end of area D to your finger tips with your armextended
Items used less often
Through our experience in the field, and through scientific research, we have
learned a number of practical countermeasures for fatigue. For example, taking a
pre-work nap, avoiding vigilance tasks during known times of low alertness,
varying your job routine, taking breaks, adjusting the work environment andmanaging your nutritional intake can all reduce the risk of fatigue-related
accidents.
Avenues for sharing this information include websites, presentations and
Remember, the fundamental concept of being accountableis the right and
responsibility of every person to stop the job for any quality, health, safety or
environmental hazard. Foremost among these is stopping any job where the
hazard of fatigue has placed you, the operations or the environment at risk.
Your alertness, both physically and mentally, is required to ensure that you and
your team continue to be excellent in execution. There are documentations from
companies like Schlumberger, British Gas etc.
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Some companies recognize the importance of understanding fatigue, recognizing
its causes and symptoms, and taking effective steps to prevent its consequences.
When fatigue is not relieved by enough sleep, good nutrition, or a low-stressenvironment, it should be evaluated by your doctor.
Where to get help
Your doctor
Things to remember
Fatigue can be caused by a number of factors working in combination, such asmedical conditions, unhealthy lifestyle choices, workplace problems and stress.
Fatigue is a known risk factor in motor vehicle and workplace accidents.
Always see your doctor for diagnosis if you are suffering from chronic tiredness.
Summary
Fatigue can affect every aspect of our business and private lives so managing it
successfully is a shared responsibility between employer and its employees.Thats why some company management, employees and contractors, are
proactive in managing fatigue. Not only is their own safety is at risk, but also that
of their co-workers and others with whom they share the workplace and the
roads.
Fatigue is a fact of life, and even plays an important role in letting us know when
its time for a rest.
During our daily activities we should remember to apply the soundFatigue
Managementstrategies available to us to ensure we remain safe, rested and alert.
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References
http://www.answers.com/topic/fatigue
The University of Western Australia fatigue management planhttp://www.safety.uwa.edu.au/health/fatigue_management
http://www.mstrust.org.uk/information
"Fatigue."American Cancer SocietyJune 2001. [cited June 28, 2001]. .Melissa
Knopper, M.S.
Eating Well Through Cancer. Clegg, Holly B., and Gerald Miletello, Baton Rouge:
Holly B. Clegg Inc., 2001.
"Effects of Physical Activity on the Fatigue and Psychologic Status of Cancer
Patients During Chemotherapy." Cancer85, no. 10 (May 15, 1999): 22737.
Mark A. Demitrack, Susan E. Abbey (1999). Chronic Fatigue Syndrome: An
Integrative Approach to Evaluation and Treatment.
http://www.answers.com/topic/fatiguehttp://www.answers.com/topic/fatiguehttp://www.safety.uwa.edu.au/health/fatigue_managementhttp://www.safety.uwa.edu.au/health/fatigue_managementhttp://www.mstrust.org.uk/informationhttp://www.mstrust.org.uk/informationhttp://www.mstrust.org.uk/informationhttp://www.safety.uwa.edu.au/health/fatigue_managementhttp://www.answers.com/topic/fatigueTop Related