Fatigue Management Continued from page 25 drowsiness. Fatigue is objectively observed as changes in many aspects of performance, including increased reaction time, lapses in attention (e.g., reaction times greater than 500 milliseconds) and reduced speed of cognitive tasks, situational aware- ness, and motivation. A person’s perceived fatigue levels are often lower than observed decrements in performance.” The most effec- tive way to counteract fatigue is to ensure opportunities for restorative sleep. Of course, this isn’t always as easily accomplished as it sounds, so developing a management system is key to proactively identifying and mitigating fatigue-related issues. Just as a safety management system provides a framework for gathering, understanding and sharing information with respect to an organi- zation’s risk profile, management of fatigue should take on a systematic approach. Clearly, individuals are most able to manage lifestyle choices like diet, exercise and healthy sleep habits. However, organizations are responsible not only for workload scheduling and the work environ- ment, but also for educating employ- ees on the science behind fatigue, providing the tools to manage fatigue, and fostering an environment where fatigue risk can be reported and ad- dressed without fear of repercussions. To understand how fatigue can adversely affect performance, it is helpful to think a bit about how our bodies function within the sleep cycle. Our bodies function in a pat- tern affected by light and dark called circadian rhythms. Disruptions to circadian rhythms, which generally tell us we should be awake when it is Aviation Business Journal | 3rd Quarter 2016 light and asleep when it is dark, can be powerful contributors to fatigue. Night shifts, overtime and changes in time zone can all introduce cir- cadian disruptions. On a smaller scale, our circadian rhythms can be thrown off by interruptions to our sleep cycle (the stages of sleep types our brains move through during our nightly sleep). Though there isn’t much we can do about alarm clocks, interruptions from crew scheduling or a late night call out, simply being aware of the increased risk for fatigue posed by these events can help us realistically assess our limitations. What symptoms might we expect from a coworker or employee who is fatigued? It is important to know that fatigue itself is a symptom, but it can cause additional indicators that might help to identify fatigue. Restlessness, frequent blinking or yawning, and anxiety may all be signs that a person is fatigued. Changes in mood or diet can also appear as a result of fatigue, and a person may become quieter than normal, more irritable, or show signs similar to depression. Ironically, when sleep-deprived workers oper- ate a vehicle (like a tug, bag loader, or refueler), instead of slowing down to maintain control and accuracy, they often speed up, unintention- ally making more mistakes. Being aware of, and actively looking for, these indicators of fatigue is some- thing each of us can do to reduce fatigue-related errors. Organizations like the National Sleep Foundation (www.sleepfoundation.org) have terrific resources for improving organizational training about iden- tifying fatigue and combating its unwanted effects on the job. As fatigue management programs have matured into systems-based ap- proaches, the metrics for managing organizational fatigue have changed. The International Air Transport Association (IATA) provides a number of tools in its Fatigue Risk Management Program literature (http://www.iata.org/whatwedo/ ops-infra/Pages/fatigue-risk.aspx), including a few suggested fatigue safety performance indicators. Some that can be easily incorporated, even in small organizations, are self- reported assessments of sleep and fatigue, schedule tracking, industry fatigue models and objective tests that use electronic equipment (rang- ing from laboratory grade monitors to personal fitness devices). One of the simplest ways to identify fa- tigue is simply to ask employees. The Karolinska Sleepiness Scale is a widely-accepted tool for assigning val- ues to how tired a person feels. We’ll explore more on how to incorporate this sort of information in just a bit. 1 = extremely alert 2 3 = alert 4 5 = neither sleepy nor alert 6 7 = sleepy, but no difficulty remaining awake 8 9 = extremely sleepy, fighting sleep Figure 1. Karolinska Sleepiness Scale Continued on page 28 27
