The Who, What, How and When of Implementing Fatigue Monitoring and Detection Technologies

Posted on by Kyla Retzer, MPH, Imelda Wong, PhD, and Emanuele Cauda, PhD


Worker fatigue can result from a variety of sources, such as insufficient sleep, long work hours, physical exertion and stress. Fatigue can slow down reaction times, reduce attention or concentration, limit short-term memory, and impair judgment, affecting the health and safety of workers and their co-workers1,2. Worker fatigue has contributed to catastrophic industrial events with loss of life. Predicting or detecting fatigue can allow for the prevention of fatigue-related safety critical events. Employers who have prioritized this issue are turning to fatigue monitoring and detection technologies (FMDT) so that steps can be taken to ensure their workers’ health and safety.

The first blog in our series on FMDT discussed factors for employers to consider in the selection of an FMDT. This blog offers considerations for the effective implementation of an FMDT in the workplace, such as: who to include in the implementation of an FMDT, what implementation means, the steps for how the FMDT can be implemented, and when implementation begins.

Who: Create an implementation team composed of all the operating divisions who will use the FMDT. Representation on the team from all levels in the organization will provide unique and critical perspectives and promote the success of the FMDT during its roll out. The ideal implementation team will include the workers affected, occupational safety and health (OSH) professionals, labor representatives, support staff, front-line supervisors, and executive leadership. The creation of an inclusive team with equally valued contributions by all members is likely to increase worker trust, a critical component to the success of your new device. Research shows employee acceptance of technology is more likely when workers are involved in its selection and implementation3.

What: Implementation is the process of launching an FMDT with its associated policies and procedures effectively into the workplace. Common elements of implementation include defining the program’s objectives, developing a policy, pilot testing (i.e. trial run) the device, communicating the new program and policy to workers, training workers and supervisors on the system and its purpose, and finally, deploying the devices.

How: Proposed steps for FMDT implementation include:

1) Refine program objectives: While program objectives are first developed prior to the selection of an FMDT, they may need to be refined with the implementation team. Example objectives could be “To decrease fatigue-related driving events” or “To decrease the number of workers who are not fit for duty”. Additionally, develop performance measures that will define success based on the program objectives. An example performance measure for a driver monitoring device might be to track “The number and severity of fatigue-related events identified by the device”. A performance measure for a fitness-for-duty test might be to track “The number of workers identified as fatigued at the beginning of each shift”.

2) Develop a policy: Create a transparent policy (available to workers and supervisors) that contains information about how the FMDT works, what measures of fatigue are collected by the device, and how the data will be used. Keep in mind that greater acceptance of wearable technologies occurs when data are collected during on-duty hours only3. Clearly outline the roles and responsibilities for all staff affected by the FMDT. Explain if data will be shared, and if so, how and when it will be shared, with whom, and in what circumstances. Describe how long data will be stored. Explain how privacy issues will be handled. Lastly, when writing your policy, consider the sustainability of the program over time and what it will take in terms of personnel and financial resources to ensure the program can be properly managed.

3) Pilot test (i.e. trial run): Implement the FMDT as a pilot test within a small group of workers before rolling out to the whole company. An ideal group of workers to consider for a pilot test may be those whose working environment put them at high risk for fatigue. Some examples include those with long work hours, unpredictable shifts or long commutes. Another good choice may be workers who are often alone and for whom fatigue may go unnoticed by peers or supervisors.

Consider testing the technologies in a wide variety of physical environments, such as hot and cold temperatures, to ensure the device is durable for your worksites. Ask for workers’ feedback on the technology throughout the pilot. Important questions may include “Is it comfortable and safe to wear?”, “Is it easy to use?”, “Did it interfere with your work?”, and “Was it easily damaged?”. Consider gathering feedback anonymously to encourage open and honest answers. Also gather supervisors’ feedback on the data received from the FMDT, such as “Was the data useful for making decisions?” and “Was the data easy to understand and access?”. Also, use the pilot period to assess the vendor’s responsiveness to your needs and the effort required to keep the FMDT functioning. Once the pilot test is complete, revisit your selection of the technology to ensure it addresses the pre-defined objectives of the device.

4) Communicate policy to workers: Before rolling out the technology, employers should communicate to all affected workers the purpose of the technology and the associated policy. Any fears that workers have about the data collected and how the data will be used can be lessened by explaining: why fatigue is a concern in your place of employment, actual data confirming fatigue as an issue, the causes and countermeasures for fatigue, what the FMDT will measure, who will receive the data collected by the FMDT, and what will be done with the information. Reassure workers that the FMDT is not used to penalize workers, rather it is a tool to improve worker safety. Open and ongoing dialogue with workers about the program will increase trust.

5) Train supervisors, occupational health and safety professionals (OHS) and workers on how the technology works. Supervisors may also require additional training to access and interpret the data to assist with coaching or other types of fatigue mitigation strategies. Coaching of workers by supervisors on safer driver behaviors is an important component to behavior change as found with the use of in-vehicle monitoring systems4.

6) Rollout and begin using the FMDT: Depending on the technology, this could involve the installation of devices in vehicles or distributing devices to workers. Set aside ample time to ensure the technology is working correctly in each workers’ environment and to answer additional questions about the device. Designate staff to provide ongoing technical support where needed.

7) Evaluate the use of FMDT periodically: Determine how well it is achieving objectives. Evaluation will need to occur frequently at the beginning so that course corrections can be made quickly. Include feedback from workers and supervisors in the evaluation. Consider collaborating with an outside entity to perform a rigorous evaluation at baseline and periodically after its rollout.

When: The implementation of an FMDT is BEST when it is one element of a more holistic fatigue risk management plan to reduce fatigue and fatigue-related events. Examples of other elements of such a plan may include limits on working hours, overtime, and driving, fatigue awareness and training, and collection of fatigue-related information during incident investigations4.

Let NIOSH know how the implementation of your FMDT is going!

Imelda Wong, PhD, is the Coordinator for the NIOSH Center for Work and Fatigue Research

Kyla Retzer, MPH, is the Coordinator for the NIOSH Center for Motor Vehicle Safety

Emanuele Cauda, PhD, is the co-Director for the NIOSH Center for Direct Reading and Sensor Technologies


See the other blogs in this series: 

Choosing the “Right” Fatigue Monitoring and Detection Technology

Setting Objectives for Fatigue Detection Technologies


  1. Lerman SE, Eskin E, Flower DJ, et al. Fatigue risk management in the workplace. Journal of Occupational & Environmental Medicine. 2012;54(2):231-258.
  2. Williamson, A., et al., The link between fatigue and safety. Accid Anal Prev, 2011. 43(2): p. 498-515.
  3. Jacobs JV, Hettinger LJ, Huang YH, Jeffries S, Lesch MF, Simmons LA, Verma SK, Willetts JL. Employee acceptance of wearable technology in the workplace. Appl Ergon. 2019 Jul;78:148-156. doi: 10.1016/j.apergo.2019.03.003. Epub 2019 Mar 13. PMID: 31046946.
  4. Bell, Jennifer & Taylor, Matthew & Chen, Guang-Xiang & Kirk, Rachel & Leatherman, Erin. (2016). Evaluation of an In-Vehicle Monitoring System (IVMS) to Reduce Risky Driving Behaviors in Commercial Drivers: Comparison of In-Cab Warning Lights and Supervisory Coaching with Videos of Driving Behavior. Journal of Safety Research. 60. 125-36. 10.1016/j.jsr.2016.12.008.
Posted on by Kyla Retzer, MPH, Imelda Wong, PhD, and Emanuele Cauda, PhD

6 comments on “The Who, What, How and When of Implementing Fatigue Monitoring and Detection Technologies”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    This is truly a fantastic breakthrough and such a great way to improve the lives of all, workers and non workers alike, because some of the catastrophic incidents that occur because of fatigue effect unsuspecting standbys as well.
    I personally believe that lack of attention is the number one cause of “incidents” and I further believe that fatigue is the number one cause of lack of attention.
    Maybe this will enable NIOSH to lead the fight into helping the three shift economy to work smarter, not harder.
    My only worry is that people will see this as a way of weeding out the “weak”, so it really needs to be communicated well when it is implemented.

    Thank you so much for your comment. We agree that effective communication by employers about these technologies is critical. These devices may identify workers with fatigue due to underlying causes (e.g. sleep disorders, stress) and employers should be aware of and guide workers to resources that can help resolve any underlying issues as much as possible. Technologies should not be used in a punitive manner.

    Good to see this post. You might want to include in the policy, the company’s intention to assist those who have a lot of fatigue events captured by the systems. We can expect that around 10% to 20% of the workforce will have numerous events and as such, should be assisted with a ‘care program’. I am assisting with one of these programs at the moment and the employees being assisted are not only becoming ‘fit for work’ again, they are undoing some of the physical harm that poor sleep can cause. In some cases, when you fix the sleep, you help the person lose weight, return their blood sugar levels to safer levels, and reduce their cardiometabolic risk incredibly. Wins all round.

    Thank you so much for this important additional policy consideration! A ‘care program’ for those with high levels of fatigue sounds to be very beneficial and we look forward to hearing more examples about such an approach and the pay-off from this level of investment in workers’ health.

    Thanks for sharing such an interesting article. This is surely going to help a lot of people. Got to see valuable content after such a long time

    Thank you for your comment, these technologies have a lot of potential to improve safety for workers.

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Page last reviewed: May 30, 2023
Page last updated: May 30, 2023