Shift work fatigue - Five areas of focus

Rotational shift work effects can be hard on the human body and mind

Shift work fatigue

Rotating shift work often requires individuals to be awake, alert and productive for extended periods and at times which are more typically associated with rest and sleep.

This increases the risk of shift work fatigue…a physiological state which negatively impacts a person’s physical and mental functions.

Shift work fatigue can have serious consequences for both shift workers and their employers, making it a key part of best practice shift pattern design, shift work management and shift worker support.

In an economy where 24 7 shift patterns are commonplace, managing rotational shift work effects is an essential component in maintaining safe and efficient operations.

This article is the first in a series exploring key aspects of shift work fatigue. It briefly touches on some of the background and outlines the ‘five areas of focus’ when you consider fatigue management for shift workers.

What is shift work fatigue?

Shift work fatigue is more than just tiredness. It can manifest itself in many ways.

The closest to an official definition of shift work fatigue was made by the UK’s Health and Safety Executive in 2006’s Managing shift work: Health and Safety Guidance:

“The decline in mental and/or physical performance that results from prolonged exertion, lack of quality sleep or disruption of the internal body clock. The degree to which a worker is prone to fatigue is also related to workload.”

Shift work fatigue is therefore a complex issue that is very much linked to a combination of an individual’s demographics and physiology…as well as the hours of work and nature of the work they are undertaking.

The consensus amongst experts is that, even though it may not be directly observable or objectively measurable, shift work fatigue does produce measurable outcomes in terms of lost productivity, increased risk of accidents and is an attributable factor in some health conditions.

Some of the common physical effects of shift work fatigue include headaches and dizziness as well as musculoskeletal pain and injuries.

From a psychological perspective shift work fatigue is often associated with more intense negative emotions including increased frustration, irritability, sadness and anger.

These effects can impact an individual’s:

– Speed of reaction and information processing

– Concentration, memory retention and recall

– Lower alertness, awareness and underestimation of risk

– Reduced attention span, co-ordination and reaction time

The impact of shift work fatigue on human function is why it’s frequently linked to errors, accidents, performance issues and ill health.

Shift Patterns

Finding shift patterns that balance the needs of your organisation and shift workers can be a slow and painful process.

optashift’s Shift Pattern Design service combines data science, expert insight and collaboration to create shift patterns that are fully optimised for your performance and people.

Fatigue and shift work

It’s important to note that rotational shift work does not automatically lead to fatigue.

Traditionally, the focus has been on daily hours, weekly total hours, overtime and extended workdays. These act as a crude proxy for sleep opportunity, sleep loss and therefore increased fatigue risk.

However, there is a much broader set of interlocking factors which impact how rotational shift work effects shift workers and therefore the risk of shift work fatigue.

The significant diversity in terms of how much influence these factors have over any given scenario or individual make it impossible to create standardised approaches to fatigue management for shift workers.

Employers and employees need to be aware of shift work and fatigue risk factors and apply them to their own organisations and lives.

Ultimately every fatigue risk management system (FRMS) needs to be tailored and capable of responding to the dynamic variables which impact rotational shift work effects and shift work fatigue.

The key influences on shift work fatigue you need to consider include:

The shift pattern

Does the shift pattern feature permanent nights, fast/slow rotations and does it create changing, irregular or unpredictable working hours?

Does your approach to rotational shift work require regular early starts and late finishes?

How often are shift workers required to work nights and is there adequate compensatory rest after a run of shifts?

Demand and capacity

Are your shift patterns aligned to demand or is there a reliance on overtime which increases the number of hours worked?

How frequently do you use ‘call-in’ shifts, are these interrupting rest and recuperation time and are you balancing any additional hours required across the workforce?

Shift work management

Have you built adequate breaks and rest periods into shift patterns, rotas and rosters?

Are your workforce management (WFM) systems configured to prevent employee scheduling actions which increase shift work fatigue risk?

Tasks

What type of tasks are your shift workers required to do and how mentally and physically intensive are they?

What is the duration of these tasks and how frequently are they being carried out?

When are these tasks being done within the shift, or within a run of shifts?

The individual

What is the demographic profile of the shift worker and does this make them more susceptible to rotational shift work effects?

Are they in good health generally and how do they manage sleep hygiene, nutrition and exercise?

What are their personal circumstances, and could their lifestyle have any impact on their fatigue levels?

Are they aware of the signs of shift work fatigue and do you empower them to act accordingly?

Environment

Where is the work being carried out and under what conditions (light, noise etc.)?

Are your shift workers exposed to dramatic weather and temperature changes within shift or between shifts?

Organisation

What strategies, policies and processes do you have in place to assess, manage and monitor shift work fatigue risk?

Is your organisation’s leadership focused on rotational shift work best practice and minimising shift work fatigue risk?

Is there an engrained ‘hardworking’ culture which normalises long hours working and non-reporting of issues?

Ultimately all these factors interact with each other in different ways and at different times. Typically the impact of each is cumulative and therefore hard to predict and track.

It makes it key to have a robust approach to fatigue management for shift workers.

Shift work fatigue should be a consideration in any fatigue risk management system (FRMS), particularly in high-risk situations and industries like manufacturing, emergency services, engineering, processing and energy.

Shift work fatigue regulations

Whilst there isn’t any specific shift work fatigue management legislation yet, The Health and Safety at Work etc. Act 1974 means employers have a legal duty to protect employees from its impact…just like any other hazard that poses a risk to health and wellbeing.

This act is re-enforced by the Management of Health and Safety at Work Regulations 1999. This compels employers to assess the risks to employees from work activities and make a commitment to introduce measures that are reasonably practicable to remove or control these risks.

Shift work fatigue falls within the scope of this health and safety legislation given that some of the rotating shift work conditions that can lead to negative consequences are within the control of the employer.

In addition these specific pieces of legislation, there is also the Working Time Regulations 1998.

Whilst these are not specific shift work fatigue regulations, they do lay down the minimum legal requirements on how to organise working time.

On top of this sits industry-specific regulations, where there are additional compliance requirements designed to reduce the risk of shift work fatigue.

Sectors like rail, aviation and road logistics all have their own regulations particularly for roles where shift work fatigue poses a significant risk to employees and the wider public.

So essentially whilst there aren’t any specific regulations around fatigue management for shift workers, the law requires you to:

– Eliminate the risk of shift work fatigue if possible

– If shift work fatigue risk can’t be eliminated, it must be managed

– Assess the risks associated with working hours and how they might impact shift work fatigue

– Take action to reduce any shift work fatigue risk identified

– Establish systems to manage the associated risks and to prevent shift workers operating when fatigued

– Check and review your shift work arrangements regularly (this is important given the dynamic nature of the influences on shift work fatigue)

The legal duty is on employers to manage risks from shift work fatigue, irrespective of any individual’s willingness to work (e.g. to take on extra hours for career progression or financial gain, or because they prefer certain shift patterns for personal lifestyle reasons).

We are seeing a growing body of evidence around rotational shift work effects and their impact on shift work fatigue and wider employee health and wellbeing.

It is therefore likely that more specific shift work regulations may well find their way onto the statute books in future.

However given the impact shift patterns and shift work conditions have on health and safety, sickness absence, productivity and employer brand, it’s prudent that you embed best practice…regardless of the legislative landscape.

Shift work fatigue and Environmental Social Governance (ESG)

Above and beyond legal duties, shift worker health and wellbeing should be a focus of your organisation’s Environmental Social Governance (ESG) strategy.

Employers with shift workers who may be exposed to the risk and impact of shift work fatigue need to consider what systems, policies and reporting frameworks are in place that support wider ESG commitments.

Measuring the impact of initiatives and reporting against targets is essential to transparency and evidencing your organisations’ commitment to maintaining safe and healthy shift working conditions.

organisations that profess to look after the interests of their workers but fail to demonstrate a tangible focus on tackling shift work fatigue risk may leave themselves open to accusations of ‘wellbeing washing’.

Any gap between your employer brand messaging and the reality of working conditions exposes your business to potential significant reputational damage and even future litigation.

Shift Work Assessment

Optimising shift patterns and shift work delivers huge benefits…but complexity and competing priorities sees many organisations leave things as they are.

Our Shift Work Assessment is a streamlined process which quickly analyses all relevant operational and HR factors to give you a tailored plan for immediate improvement.

What is the HSE fatigue risk index?

The HSE fatigue risk index is a free fatigue risk calculator that was available on the Health & Safety Executive website.

It calculates a risk score and a fatigue score based on the working hours inputted.

For many years it was widely used by organisations as part of their shift pattern design process and fatigue risk management systems (FRMS).

However, the HSE fatigue risk index was removed from the Health & Safety Executive website in June 2021 and is no longer supported or endorsed by the regulator.

The HSE fatigue risk index was removed because the HSE felt that it was being used without adequate understanding of it’s limitations and how the outputs relate to real world environments.

Some of the principles have been absorbed and built upon in other fatigue risk calculators (including within our own optashift | Analyse shift work data and optashift |Plan shift pattern design tools), However, these should not be seen as ‘quick fix’ to fatigue management for shift workers, as every organisation, shift worker, task and environment is different.

Much like the HSE fatigue risk index, any fatigue risk management systems (FRMS) needs to be consistent with good practice and used in conjunction with other data insights, subject matter expertise and stakeholder engagement.

Shift work fatigue impact case study

Because it’s based on a wide range of variables, it’s difficult to objectively predict and measure rotational shift work effects and the impact of shift work fatigue on any given individual.

However the outcomes of shift work fatigue are clear and are frequently cited in accident investigations. In the UK alone there have been several high-profile incidents where shift work fatigue has been a key factor.

One of the most widely recognised is the fire at the Buncefield oil storage facility in December 2005.

It’s regarded as Britain’s largest peacetime explosion and was the subject of many detailed investigations, including by the Health & Safety Executive (HSE). The HSE looked in detail at human factors and whether shift work fatigue was a contributory factor.

Whilst there were many and varied issues which led to the disaster, investigators found that an important element was the planning and management of shift work and the increased risk of shift work fatigue.

In our experience the issues uncovered by the investigation are unfortunately all too common in rotational shift work environments:

– Recruitment and retention issues had created significant gaps in cover. This meant that an eight-week shift pattern, that was designed for 10 supervisors, was being worked by just eight people.

– The shift pattern saw employees working seven, 12-hour shifts continuously in weeks 4 and 5 of the rotation. This required them to work five 12-hour night shifts and meant there were inadequate rest days between runs of shifts.

– To meet demand and overcome the capacity shortfall, employees were working sustained overtime and averaged an additional 48 hours per person over a five-month period.

– Shift workers were not having regular in-shift rest periods and many meal breaks were being missed to keep on top of the workload.

– There was very little governance around workforce management processes, with shift workers able to arrange their own holiday and relief cover without appropriate oversight or checks.

Above all else there was no formal policy, procedure or processes relating to fatigue management for shift workers.

This meant any issues remained unaddressed, creating an environment that exacerbated the cumulative effects and impact of shift work fatigue.

Shift work fatigue and the ‘five areas of focus’

Employers have a clear responsibility to manage the risk of shift work fatigue, but every approach needs to be different and tailored to the precise variables of your organisation and workforce.

There is however commonality in certain areas, which allows you to ensure your Fatigue Risk Management System (FRMS) is based on shift work best practice.

The ‘five areas of focus’ provides a framework to ensure you understand any areas of potential risk. You can then use this to inform how you minimise and manage risk in line with responsibilities outlined in the shift work fatigue regulations section of this article.

Area 1 - Shift work fatigue risk assessment

Understanding where and how shift work fatigue risk may be present in your organisation is key.

Undertake a detailed risk analysis to audit and review the key areas that influence shift work fatigue. This should include:

– Using data-led insights to review shift patterns and staffing levels

– Appraising workload and how that workload is balanced across shift rotations and within shifts

– Analysing tasks from a human factors perspective

– Identifying potential hazards and exposure risk

– Exploring factors in the physical environment that might contribute to shift work fatigue risk

Shift work fatigue risk assessments should be based on recognised good practice that can be adapted and made relevant to your organisation, operating environment and workforce.

Alongside detailed shift work data analytics, it should also incorporate a focused and sensitive stakeholder engagement programme to ensure qualitative factors are captured and reviewed.

Area 2 - Shift work fatigue policy

Governance is key to minimising shift work fatigue risk over the long term.

It underpins regulatory, legislative and best practice compliance as well as fatigue monitoring and ESG reporting.

Develop a strategy clearly defining your organisation’s commitment, objectives, roles and responsibilities for managing shift work fatigue in a systematic way (i.e. one that is prescribed, consistent and documented).

Cascade this strategy into an operational policy that sets out key limits and rules to guard against fatigue.

Here are some examples of what your fatigue management policy could include:

– Working hours

– Rest periods

– Overtime use, limits and balanced application

– Shift-swaps

– Break lengths, distribution and enforcement

Your shift work fatigue policy should cover face-to-face elements such as quality and regularity of handover communications and fitness for duty checks.

It should also look to embed fatigue as a key consideration in future incident or near miss investigations.

Area 3 - Shift work fatigue solutions

Having conducted a shift work fatigue assessment and using this to shape your fatigue policy…the next area of focus is developing tailored shift work fatigue solutions.

Work with your stakeholders to co-design and implement a series of control measures spanning all the aspects of shift planning and workforce management that influence shift work fatigue.

You could include:

– Optimised shift patterns with options for certain scenarios (e.g. process upsets, abnormal working and emergency situations)

– Shift patterns for individual shift worker risk profiles (e.g. exposed roles, demographics, chronotypes)

– Enhanced processes for the management of overtime and ‘on-call’ shifts to reduce exposure to long working hours, disruption to rest periods or concentration of additional hours in certain teams or individuals

– Considered design of your task and break management systems and processes

– Workforce management (WFM) solutions to accurately record and monitor hours and lock in compliance with the thresholds set within your shift work fatigue policy

In addition to the management of tasks, breaks, hours and abstractions, your solutions should also consider the wider shift work environment.

This can span everything from lighting and temperature controls to appropriate break areas and catering facilities.

Area 4 - Shift work fatigue monitoring

Shift work fatigue risk is related to a whole range of dynamic factors which makes continuous monitoring essential.

It’s vital to proactively monitor compliance risk and report on performance and progress against your shift work fatigue strategy.

When it comes to shift work fatigue monitoring you should consider:

– Harnessing shift work data to support visibility, decision making, risk mitigation and continuous shift work optimisation

– Establishing shift work fatigue Key Performance Indicators and analytics to continuously track risk and provide early warnings and timely interventions

– The capabilities of your workforce management (WFM) systems or software and if they can be configured in line with the operating rules and thresholds set out in your shift work fatigue policy

Shift work fatigue monitoring should provide a feedback loop that informs your continuous improvement of shift work policy development, shift pattern design and shift work management processes.

Area 5 - Shift work fatigue guidance

As shift work fatigue is a human issue it’s important to embed awareness and knowledge of the topic across your organisation.

This can take many forms…but often the most effective starting point is to create a communications and engagement programme that is sustained and spans all your key stakeholders.

This can include bespoke fatigue management training and workplace fatigue resources tailored to the operating environment, as well as specific roles and responsibilities.

There are also many ways to provide shift workers with tools to help them self-manage rotational shift work effects and their own shift work fatigue risk.

This can include educative resources around shift work fatigue and wider relevant topics including sleep hygiene, nutrition and exercise.

The focus on shift work fatigue guidance needs to be sustained to ensure processes are embedded and the wider culture effectively shaped.

It’s important to think about guidance for new starters at induction, particularly if they have not experienced rotational shift work before.

Environmental nudges and interventions can also help keep shift work fatigue risk front of mind and encourage co-worker support or self-reporting for those potentially feeling effects linked to shift work fatigue.

The role of leadership in shift work fatigue

We’ll often see workplace cultures where high levels of overtime and long hours working are engrained.

In many cases this has become normalised with leadership teams, managers and shift workers themselves all seeing it as ‘part of the job’.

In some organisations shift work fatigue is not raised as an issue as management rely on overtime and long hours to meet demand… whilst shift workers benefit from enhanced remuneration.

The five areas of focus outlined above provide practical frameworks to help you address shift work fatigue…but to overcome potential cultural barriers, these need to be underpinned by a commitment from leadership.

Leaders play a crucial role in setting the context and agenda.

Addressing shift work fatigue needs to be prioritised and embedded through clear targets, strategies, responsibilities and rewards.

Progressive organisations are increasingly embedding shift work fatigue in their Environmental Social and Governance (ESG) strategies, alongside wider impact reporting around shift worker health and wellbeing.

It shouldn’t take an accident or near miss to push this topic up the agenda.

Shift work fatigue has a direct impact on productivity, sickness absence, recruitment and retention and reputation

Taking a proactive and preventative approach therefore makes commercial sense too.

Leaders have the power to shape culture from the top…making fatigue management for shift workers a priority is within their gift and can play a huge part in tacking shift work fatigue.

Key takeaways on shift work fatigue

Understand the risks

Use data to baseline your key shift work metrics (fatigue, physical and mental health, sleep, nutrition, exercise, social aspects etc).

You can then measure the cumulative effects of a wide variety of variables that impact shift work fatigue (e.g. impact of shift patterns and rotations, hours worked, rest time, work undertaken in shift). It allows you to effectively zero in on what needs to be addressed and prioritise.

Develop a proactive plan

You’re not going to tackle everything around shift work fatigue immediately.

Create the strategy and framework for a continuous programme that effectively builds, is shaped by data insights and remains responsive to change (across the operating environment, workforce, legislative landscape etc).

Engage employees

Building awareness, understanding and participation is fundamental to successful fatigue management for shift workers.

Think carefully about co-creating the programme with colleagues and how to engender a positive, trusting, collaborative and supportive environment.

Affect real change

There’s a huge range of strategic, operational, practical and technical solutions available that will actively help you address rotational shift work effects on physical and mental health.

You should try and avoid passive, generic and non-evaluated platforms and programmes where possible.

Measure the impact

Capture, track and analyse shift work data to evaluate the impact of your initiatives and interventions.

This will inform continuous improvement of your shift work fatigue management programme and provide robust evidence to support employee engagement, ESG reporting and employer brand.

Shift Work Health

The effects of shift work on physical and mental health are clear…so responsible employers need to provide shift workers with tailored support across sleep, nutrition, exercise and social issues.

optashift will help you deliver a programme that blends strategic, operational, practical and technical solutions that are designed in collaboration with your workforce.

Shift work fatigue experts

If you are interested in discussing your approach to shift work fatigue in more detail, get in touch.

optashift has a cross-discipline team of shift work fatigue experts that includes Chartered Human Factors specialists.

They are leading authorities on fatigue management for shift workers and former senior inspectors for the Health and Safety Executive (HSE).

Our advice and solutions are shaped by decades of regulatory experience across fatigue risk assessment, fatigue policy development and fatigue management strategies within manufacturing, utilities, nuclear, transport, offshore and many other industries.