Work-related Fatigue Reaches Beyond the Workplace

Fatigue has been defined as “the body’s response to sleep loss or to prolonged physical or mental exertion.”¹ As such, with increasing periods of insufficient sleep or physical/mental exertion, the more fatigued we become. This fatigue can only be reduced with sufficient rest.

However, for workers employed in nonstandard schedules, such as with shift work, early mornings and extended hours, opportunities for sufficient rest and recovery are limited^2-4. Shortened or disrupted sleep is associated with fatigue and alters regions in the brain with short- and long-term effects on cognition. This can affect decision making, attention and concentration which can have significant negative impacts on performance and safety. Some studies have demonstrated similarities in cognitive and physiological impairment resulting from sleep deprivation with alcohol impairment. Not getting 8 hours of sleep has the same sedative effect as drinking 10-11 beers; and being awake for 17 consecutive hours resulted in the same performance impairment that occurs with a blood alcohol content of 0.05% ^5-7. Sleep deprivation can affect short-term memory and performance speed; and increasing years of shiftwork can impair memory performance and accelerate brain aging⁸. Unfortunately, leaving nonstandard work schedules does not necessarily guarantee a quick return to normal cognitive functioning. Studies have reported that it can take up to up to 5 years to gradually regain regular cognition⁹.

A recent survey reported that 43% of American workers admit that they do not get enough sleep such that it affects their ability to make critical decisions at work¹⁰. While 1 in 3 regular dayshift workers report not getting enough sleep, the prevalence of insufficient sleep is higher among those working night shifts: over 60% of night shift workers report not getting the recommended 7-9 hours of sleep per day¹¹. Insufficient sleep, and the consequences of fatigue, not only jeopardizes their safety, but also the safety of their coworkers. Fatigue at work can also have a devastating public impact, particularly in occupations with high risk consequences. This is best illustrated in high profile disasters such as the nuclear meltdown at Three Mile Island and the grounding of the Exxon Valdez oil tanker^12,13.

But fatigue at work doesn’t just stay at the workplace.

The effects can be magnified as a public health and safety concern, for example, when tired workers drive on public roads. The National Highway Traffic Safety Administration estimates that in 2017, drowsy driving was a factor in 91,000 police-reported motor vehicle crashes which resulted in approximately 50,000 injuries and 800 fatalities¹⁴. However, it is broadly agreed that this is an underestimation of the impact of drowsy driving, as not all crashes are reported to the police and fatigue can be a difficult causal factor to identify.

The Spillover-Crossover model of work-life interaction describes how work experiences can be carried over from an individual to their home life and family members¹⁵. Fatigue can affect mood and psychological well-being with negative consequences for the family^16,17. Studies have reported that fatigue can extend from workers to their partners, by limiting personal resources and time to attend to household responsibilities and social recovery¹⁸. In addition, impaired cognition and decision-making abilities can jeopardize the development and safety of dependents. Shift work has been found to increase the probability of separation or divorce, especially for parents working nights^19,20, and negative developmental and school outcomes for children¹⁷.

Ideally, non-work time allows for recovery from work. However, insufficient recovery due to household and other responsibilities can worsen fatigue²¹, resulting in workers returning to their jobs in a perpetual, or even accumulating, state of fatigue.

So what can be done to stop this cycle? Because fatigue can stem from a variety of work and nonwork-related sources, a multi-level, holistic approach to mitigation strategies at the community, workplace, home and individual levels is required. A shared responsibility among workers, employers and the community is needed to ensure occupational and public health and safety.

Does your work make you feel fatigued? Do you feel that you can fully recover from your work? How has fatigue from work affected your family or you during nonwork hours? What have you done to reduce the effects? Please let us know in the comment section below.

Imelda Wong, PhD, is the Coordinator of the Center for Work and Fatigue Research at the National Institute for Occupational Safety and Health and a Director for the International Working Time Society.

Anna Arlinghaus, PhD, is a Senior Consultant with Ximes GmbH, Vienna and an Executive Board member for the International Working Time Society.

See also What Workers and Employers Can Do to Manage Workplace Fatigue during COVID-19.

References

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