Water Well Journal Q&A

Published On: May 13, 2024By Categories: Features, Safety

The research behavioral scientist in NIOSH’s Spokane Mining Research Division discusses effectively managing work-related fatigue risk.

By Mike Price

Tim Bauerle, Ph.D.

Fatigue continues to be one of the top safety concerns in the water well industry with its hard labor and long hours, which have only increased since the pandemic.

It’s a serious threat that has long been examined by researchers at the National Institute for Occupational Safety and Health (NIOSH). They estimate that close to one in eight of all workplace injuries may relate to fatigue. More than one in five of all fatal vehicle crashes involves a drowsy driver.

Tim Bauerle, Ph.D., is a research behavioral scientist in NIOSH’s Spokane Mining Research Division and has become an expert on fatigue in the mining workforce with 12 publications and more than 20 invited talks on the subject.

With the water well industry like the mining industry, Water Well Journal reached out to learn more about effectively managing work-related fatigue risk from Bauerle. He recently served as the principal investigator of several mineworker fatigue projects to develop resources to better support the industry (see images).

“What makes me the most proud is when I get to hear that my research is helping to make a real difference,” says Bauerle who most enjoys getting a boots-on-the-ground perspective in the field.

“Not having an engineering or technician background, I always appreciate the opportunities to be welcomed into that world, to be educated by the operators and laborers who are experts in their own work domain and get a small glimpse of the everyday role they play and the significance of their experiences.

“I usually learn something every time that I could never have read in a textbook, and I receive crucial feedback on my research from the workers whose opinions matter the most.”

June is National Safety Month and WWJ appreciates Bauerle taking the time to answer our questions.

Water Well Journal: How should fatigue management be viewed by water well contractors and their employers?
Tim Bauerle, Ph.D.: There are many ways to think about managing work-related fatigue, but here I’ll focus on three big topics to consider: shared responsibility, work schedules, and worker health.

Shared responsibility is a foundational component of fatigue management and refers to how both workers and their companies [owner and contractor] have joint accountability in reducing fatigue-related risk in the workplace, given that factors for fatigue can occur both inside and outside of the work environment. In conversations about fatigue, the tendency among some health and safety professionals is to concentrate
on what the worker can do and really drill in on getting enough sleep and showing up ready to work.

However, the employer role in prevention is also critical: enabling the time and opportunity for workers to get enough quality sleep, providing workers with accommodations for adequate rest and recovery, developing effective training on sleep and fatigue topics, and actively identifying and controlling fatigue risks in the workplace.

While workers unquestionably have vital roles and responsibilities in the management of fatigue, it is also important for contracting and owner companies to support workers in reducing risk by enacting solid policies and procedures and providing resources.

A work schedule that works: As mentioned, providing adequate opportunity for rest, recovery, and quality sleep is a key component of managing fatigue-related risk. In general, workers need sufficient time off between consecutive work shifts to obtain a minimum of seven hours of sleep, commute to and from work, and tend to other non-work responsibilities (family, household, etc.).

Although some shift work guidelines recommend around 10 to 12 hours between shifts, there are no universally agreed upon standards that will apply to every worker or every jobsite. Therefore, it’s important to involve relevant parties—workers, owners, contracting companies, safety professionals, unions, managers, sleep and fatigue scientists—to determine a work schedule that can accomplish operational demands safely, and put strong contingency policies and practices in place for what actions both the worker and the employer need to take if hours worked extend beyond hours scheduled. It should also be noted that the amount of time off needed may be greater for some conditions than others, such as extreme temperatures or physically and mentally demanding work.

Keeping both health and safety in mind: While it is common to treat fatigue as predominantly a risk factor in vehicle collisions and injuries, it is important to note that adequate sleep—or lack thereof—contributes to worker health as well as safety.

For example, poor sleep fundamentally impacts work-related fatigue risk and risk of injuries on the job and has also been associated with increased rates of disease (cardiovascular, metabolic, neurocognitive, cancer), mortality, and poorer mental health.

Moreover, many of the same workplace contributors to poor mental health—job demands such as overexertion, workload, pace, repetitive/monotonous tasks, dim/hot/loud work environments—can also increase worker fatigue. Although it is categorically important to put adequate controls in place to mitigate fatigue-related safety incidents, maintaining an increased awareness of the mental and physical health aspects of sleep and fatigue is also critical for worker’s longevity.

WWJ: Is there data that shows worksite accidents due to fatigue are on the rise?
Bauerle: The precise role of fatigue in many safety incidents is difficult to determine with much certainty. The data needed to establish whether a particular injury or safety incident was predominantly fatigue-related is often not recorded in a meaningful way in many large scale data sources.

For example, some studies have found general trends in injury rates based on the number of work hours (e.g., less than eight hours of work) or shift type (e.g., night). While this research helps in identifying longer working hours and night shifts as risk factors, it is possible that fatigue may not be the sole source or even a contributing factor in many of these injuries.

That said, some researchers have suggested that fatigue may be one of several contributors to the annual increases in motor vehicle fatality rates in the United States since 2020. Another consideration is that some industries are reporting experiences in post-pandemic labor shortages which can indirectly affect fatigue by restricting the available pool of employees that companies are able to schedule, thereby potentially increasing overtime, call-outs, and other unplanned schedule changes.

WWJ: What are the most common signs of fatigue? What are the action steps to take if a worker is showing signs of fatigue?
Bauerle: First, while there is no single commonly used definition, several descriptions characterize fatigue as a decrease in the functional capacity for activity or effort that is often associated with tiredness and reduced performance. Therefore, checklists for fatigue symptoms will often point to recognizable signs of lower-than-normal performance (e.g., poor communication, slow reaction time, trouble remembering things) and exhaustion or sleepiness (e.g., yawning, trouble keeping eyes open, nodding head).

Before workers show signs of fatigue, companies may consider having open-ended conversations with workers, managers, and others on how fatigue risk can be identified across different jobs and worker groups (e.g., checklists, monitoring equipment), and what should happen if elevated fatigue risk is identified. Effective strategies rely on non-punitive reporting systems, fatigue-related toolbox talks or safety shares, and treating fatigue similar to other occupational safety risks.

Based on the information on hand, solutions can range from further monitoring to rotating into a lower risk task to taking time off work to rest and recover. Part of this process relies on a resilient work culture built on trust, which can be difficult to maintain across different jobsites and companies that may diverge in how they view fatigue management. For that reason, fostering open and honest dialogue between workers and their supervisors can help with consistency. [See image of signs of fatigue.]

Fatigue can increase feelings of stress and lower the ability to effectively regulate emotions, and in turn, stress can negatively affect sleep quality through worry and rumination, creating a negative feedback loop.

WWJ: How might a company monitor fatigue management with its work crews?
Bauerle: There are many different ways to monitor fatigue. Generally, more effective fatigue risk management systems tend to measure and manage fatigue underneath three broad categories: predictive, proactive, and reactive.

Predictive: Determining fatigue-related risk in advance of a workday. Examples include work schedule analysis, biomathematical modeling, and sleep disorder screening.

Proactive: Preemptively assessing fatigue-related risk during day-to-day operations. Examples include surveys and checklists, psychomotor tests (e.g., reaction time), vehicle monitoring, in-cab video monitoring, and physiological measures (e.g., heart rate, brain wave activity).

Reactive: Investigating fatigue post-incident as a contributing factor in safety incidents. Examples include Root Cause Analysis or other retroactive incident investigation strategies.

WWJ: How does the summer heat affect fatigue management?
Bauerle: Heat stress and fatigue have several shared symptoms, such as increased tiredness and decreased vigilance. Additionally, heat is one of several work-related environmental demands that can increase fatigue.

Standard controls for physically intensive work that are relevant to fatigue—such as more work breaks and access to cold water—may need to be ramped up depending on the heat, humidity, and exposure to direct sunlight.

WWJ: How does fatigue lead to stress?
Bauerle: The difficult thing about fatigue and stress is that there is at least some evidence for a bidirectional relationship.

In other words, fatigue can increase feelings of stress and lower the ability to effectively regulate emotions, and in turn, stress can negatively affect sleep quality through worry and rumination, creating a negative feedback loop. Compounded over time, long working hours, high job demands, and elevated levels of work stress may lead to a condition referred to as burnout, which is characterized by physical exhaustion, mental disengagement from work, and reduced effectiveness.

WWJ: What do you recommend if stress is affecting someone’s sleep?
Bauerle: The answer to this is highly dependent on the source and intensity of stress as well as other contextual factors.

First, talking to a primary care provider or a sleep health specialist can help determine whether an underlying medical condition (e.g., diabetes) may be making the problem worse. Along these lines, seeking help from a trusted mental health counselor can assist in providing targeted, effective coping and stress management strategies. Given the potential overlap that can exist between stress and insomnia symptoms, determining whether Cognitive Behavioral Therapy for Insomnia (CBT-I) is a good fit may be worthwhile.

A recent meta-analysis in 2022 that looked at nearly 6000 people across 43 studies found that CBT-I and other similar non-pharmacological sleep treatments were also effective in reducing anxiety symptoms.

Apart from medical-based solutions, focusing extra attention on establishing good sleep practices, such as developing a consistent sleep schedule and bedtime routine, may be beneficial especially during times of distress.

Additionally, there is some limited evidence that sleep outcomes may be improved through conventional stress reduction strategies such as lavender aromatherapy, a warm shower or bath, relaxation exercises, meditation, and avoiding excessive smartphone usage before bed.

WWJ: What are some physical issues that can impact someone with severe fatigue?
Bauerle: After 18 to 24 hours without sleep, cognitive psychomotor performance can start to mimic that of someone with a blood-alcohol concentration (BAC) of 0.05 to 0.10 percent, respectively. As the duration of sleep deprivation increases, the biological drive for sleep becomes stronger and involuntary sleep in the form of “microsleep” events may be observed. These events can occur quickly and the person experiencing them may not be aware of it or recall the episode later on.

According to a 2016 report of fatigue video monitoring technology in mining haul truck cabs, over the course of 107.75 million miles travelled, operators were asleep for 570 hours. This equates to an average of one second of sleep every 52.5 miles.

WWJ: Lastly, you’ve developed 10 sleep tips for miners [see image of list] that are applicable to water well contractors. How can contractors follow these tips while working away from home?
Bauerle: This is an excellent question that is difficult to fully address.

First, because of the absence of familiar external cues that normally prompt us when to go to bed, it is especially important for people in these situations to prioritize restful sleep and make specific, proactive, tailored plans for when to go to bed and when to wake up. Research on mine workers in “Fly-In-Fly-Out” (FIFO) work arrangements indicate that sleep is shorter and of poorer quality away from home.

Therefore, extra effort should be made to improve the non-home sleeping environment, such as comfortable bedding in a room that is dark (e.g., blackout shades, sleep mask), quiet (e.g., ear plugs, white noise machines), and cool (e.g., 60° to 68°F, well ventilated). Workers should also plan for ways to rest and recover away from electronic screens, as excessive use can reduce time set aside for sleep and the backlight can have an awakening effect.

While this is relevant in the home environment as well, FIFO workers may be especially reliant on smartphones and other similar technologies for entertainment and keeping in touch with family and friends back home. Dimming lights or practicing relaxing bedtime routines may be considered.

Lastly, other research on FIFO mine workers suggests that different shift patterns can influence the mental health of those working away from home, particularly when it comes to work-life conflict (especially for parents) and loneliness. Given the overlap between mental health and fatigue mentioned earlier, these types of workers may benefit from effective mental health resources and workplace initiatives such as traditional Employee Assistance Programs, peer-based programs, or utilizing extended social networks.

Mike Price is the senior editor of Water Well Journal. In addition to his WWJ responsibilities, Price contributes to the Association’s scientific publications. He can be reached at mprice@ngwa.org, or at (800) 551-7379, ext. 1541.

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