Employees need to be proactively managing worker sleep and fatigue – especially with employees who are working nights and other shifts – as it significantly affects health, wellbeing and safety, a conference has heard.
Professor Clare Anderson, professor of sleep and circadian science at the University of Birmingham, outlined the physiological causes of fatigue for shift workers at the recent RCN/SOM Joint Occupational Health Nursing Conference in November.
“We can all reflect on sleep; it is a great shared talking point among people. If you think about the last 24 hours and how much sleep have you got – was it five hours, six, seven?” she said.
“We can think about it at an individual level, but if we step that up to a global level, in the past 24 hours there were around 65 billion hours that were spent asleep on our plant within the human population. That shows you how incredibly important sleep is.”
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In her presentation, Professor Anderson outlined our understanding of the consequences of fatigue for shift workers, focusing on health, safety and performance.
She also discussed the complexities of fatigue and some of the counter-strategies employers and individuals can use to help manage the effects of fatigue.
Workloads, long hours, high demands, demanding shift schedules, restricted leave options, training needs, home responsibilities, managerial and supervisor responsibilities can all play a part in fatigue, she emphasised.
Circadian “misalignment” can have severe health and safety and health and wellbeing consequences, Professor Anderson warned.
“If you have insufficient sleep over three to four days then try to do a night shift, your ability to cope with that night shift is much more compromised than someone who is sleeping seven to eight hours a night,” she pointed out.
“Circadian misalignment does have adverse effects on performance,” she added.
Increase in errors and accidents
Professor Anderson highlighted studies from the US that have looked at fatigue among medical residents. These found that 24-hour shifts are associated with a 36% increase in medical errors, a sixfold increase in diagnostic errors, and you are twice as likely to have a needlestick injury.
When we have this vital function and are constantly fighting it, we do pay the price over the longer term in relation to health.” – Professor Clare Anderson
There is also the risk of driver fatigue and accidents on way home as well, as more widely, heightened cardiovascular risk, mental ill health, an increased risk of cancer, especially breast, colorectal, and prostate cancer. Fatigue and poor sleep can also be associated with weight gain, type 2 diabetes, behavioural changes and obesity.
“When we have this vital function and are constantly fighting it, we do pay the price over the longer term in relation to health. So it is really important where possible that we try to prioritise sleep to make sure that we minimise the risk,” she said.
“We want to control exposure to shifts and we want to control exposure to light, to inform people around how to best manage their sleep and light exposures,” she added.
The complexities of this issue did mean it was “no wonder” organisations often look at it and think “where do I start?”.
“An understanding of fatigue and being able to talk about fatigue in an open culture, an accepting culture, and how we support people and manage workloads,” Professor Anderson also highlighted.
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