Fatigue can be a potentially hazardous state. In Australia, between 20-30% of fatal motor vehicle crashes have been attributed to fatigue impairment.1 Over 2011-12, there was a larger number of fatal road crashes attributed to fatigue than there was to drink driving.2
Sleeping disturbances or disorders may be a major contributor to these accidents. In one survey study it was found that high levels of sleepiness in individuals was over 8 times more likely before a crash when compared to people who had not been involved in a crash.3 Additionally, risk of a motor vehicle crash in drivers with sleep apnoea may be 2 to 3 times higher than drivers without sleep apnoea.4 These impairments are not limited to just a small sector of the population; indeed, around parts of Australia:
- 8.9% of the population may have a sleeping disorder (such as sleep apnoea);5
- 30% of the working population report fatigue;6 and
- One-fifth (18.4%) of the population are chronically sleep restricted and 11.7% are chronically sleepy.7
Considering these prior points and that fatigue is four times more likely than drugs or alcohol to be a contributor to workplace impairment,8 the broad health and safety implications of fatigue can be seen.
However, the negative impact of fatigue extends beyond road safety. Aviation, rail, maritime, utilities and power, construction, mining, hospitals and health, and virtually all other occupational settings are also affected. One large-scale study looked at the association between sleeping difficulties and fatal occupational accidents based on a national sample of 47,860 working individuals surveyed over a 20 year period.9 This study found that sleeping difficulties within the past two weeks were associated with a nearly doubling of fatal occupational accident risk.
More recently, a systematic review and meta-analysis of studies relating to sleeping problems and work-related injuries was undertaken.10 A total of 27 observational studies across a range of industries made inclusion for analysis, equating to over 268,000 combined participants and 54 relative risk estimates. This study found that workers with a sleeping problem were 1.62 times more likely of being injured compared to workers not reporting sleeping problems. This study found that around 13% of workplace injuries were due to sleeping problems; thereby confirming the link between work injuries and sleeping problems.
These findings highlight the importance for employers/PCBUs to address occupational fatigue in discharge of their work health and safety due diligence requirements. Fatigue risk must be identified, analysed and prioritised, treated, and reviewed. This process must be cognisant of the fact that fatigue is more to do with sleep and time of day, than it is about working schedules or hours.
Given that the hazards relating to fatigue, and thus knowledge on how to mitigate fatigue risk is extensive and addressed through codes of practice and industry guidelines around Australia, and even recognised by the parliament of Australia as a core issue of safety,8 pleading ignorant of fatigue risk will be of little use as a defence should an unfortunate (yet most probably reasonably avoidable) safety incident occur.
References
- Australian Transport Council. (2011). National Road Safety Strategy 2011-2020.
- Roads & Maritime Services. (2012). Annual Report, 2011-12. Transport for NSW. Retrieved 31 July, 2013, from: http://www.rta.nsw.gov.au/publicationsstatisticsforms/downloads/1112-rms-annual-report-overview.pdf
- Connor, J., Norton, R., Ameratunga, S., Robinson, E., Civil, I., Dunn, R., et al. (2002). Driver sleepiness and risk of serious injury to car occupants: Population based case control study. British Medical Journal, 324(7346), 1125.
- Access Economics. (2011). Reawakening Australia: The economic cost of sleep disorders in Australia, 2010, report to Sleep Health Foundation, October.
- Ellen, R. L., Marshall, S. C., Palayew, M., Molnar, F. J., Wilson, K. G., & Man-Son-Hing, M. (2006). Systematic review of motor vehicle crash risk in persons with sleep apnea. Journal of Clinical Sleep Medicine, 2(2), 193–200.
- Skinner, N., Pisaniello, S., & Dorrian, J. (2010). FLAWS in our lives: Fatigue, Life and Work Strain. Adelaide: Centre for Work + Life, University of South Australia.
- Bartlett, D.J., Marshall, N.S., Williams, A., & Grunstein, R.R. (2008). Sleep health New South Wales: chronic sleep restriction and daytime sleepiness. Intern Med J., 38(1), 24-31.
- House of Representatives Standing Committee on Communications, Transport and the Arts. (2000). Beyond the Midnight Oil: Managing Fatigue in Transport. Parliament of Australia, Canberra.
- Akerstedt, T., Fredlund, P., Gillberg, M., & Jansson, B. (2002). A prospective study of fatal occupational accidents—Relationship to sleeping difficulties and occupational factors. Journal of Sleep Research, 11, 69–71.
- Uehli, K., Mehta, A.J., Miedinger, D., Hug, K., Schindler, C., Holsboer-Trachsler, E., Leuppi, J.D., & Künzli, N. (2013). Sleep problems and work injuries: A systematic review and meta-analysis. Sleep Med Rev., pii: S1087-0792(13)00008-7. doi: 10.1016/j.smrv.2013.01.004.
