Managing shiftwork. Health and safety guidance. HSE Books

Transcription

1 Health ad Safety Maagig shiftwork Health ad safety guidace This is a free-to-dowload, web-friedly versio of HSG256 (published 2006). This versio has bee adapted for olie use from HSE s curret prited versio. You ca buy the book at ad most good bookshops. ISBN Price 9.95 This book is for employers, safety represetatives, trade uio officials, employees, regulators ad other stakeholders. It explais employers legal duties to assess risks associated with shift work. It aims to improve uderstadig of shift work ad its impact o health ad safety by: providig advice o risk assessmet, desig of shift-work schedules ad the shift-work eviromet; suggestig measures employers, safety represetatives ad employees ca use to reduce the egative impact of shift work; ad reducig tiredess, poor performace ad accidets by eablig employers to cotrol, maage ad moitor the risks of shift work. HSE Books Page 1 of 45

2 Health ad Safety Crow copyright 2006 First published 2006 ISBN All rights reserved. No part of this publicatio may be reproduced, stored i a retrieval system, or trasmitted i ay form or by ay meas (electroic, mechaical, photocopyig, recordig or otherwise) without the prior writte permissio of the copyright ower. Applicatios for reproductio should be made i writig to: The Office of Public Sector Iformatio, Iformatio Policy Team, Kew, Richmod, Surrey TW9 4DU or [email protected] This guidace is issued by the Health ad Safety. Followig the guidace is ot compulsory ad you are free to take other actio. But if you do follow the guidace you will ormally be doig eough to comply with the law. Health ad safety ispectors seek to secure compliace with the law ad may refer to this guidace as illustratig good practice. Page 2 of 45

3 Health ad Safety Cotets Itroductio 4 Backgroud 5 Duty uder law 5 What do we mea by shift work? 6 Shift workers i the UK 6 Assessig ad maagig the risks associated with shift work 7 Cosider the risks of shift work ad the beefits of effective maagemet 8 What are the udesirable effects of shift work? 8 Cosider the costs ad beefits of effective maagemet of shift-workig arragemets 12 Establish systems to maage the risks of shift work 13 Seek maagemet commitmet to cotrol the risks of shift work 13 Idetify idividuals resposible for shift-workig arragemets 13 Ivolve safety represetatives ad workers 13 Assess the risks associated with shift work i your workplace 14 Cosider the risks that workers may be exposed to 14 Establish who might be harmed by shift work 14 Cosult workers ad their safety represetatives 15 Take actio to reduce the risks 16 Assess how severe the risks are ad idetify where improvemets eed to be made 16 Improve the shift-work schedule 16 Improve the workplace eviromet 23 Apply good practice guidelies 28 Check ad review your shift-work arragemets regularly 31 Implemet a system for early reportig of problems associated with shift work 31 Moitor alteratios to shift-work schedules ad/or work coditios 31 Periodically review the effectiveess of your shift-workig arragemets 32 Appedix 1 Legal requiremets 33 Appedix 2 Strategies ad practical advice shift workers ca use to improve their health ad well-beig 35 Appedix 3 Assessmet tools ad techiques 38 Appedix 4 Further sources of iformatio ad help 39 Appedix 5 Refereces ad further readig 40 Maagig shift work Page 3 of 45

4 Health ad Safety Itroductio 1 This guidace aims to improve safety ad reduce ill health by: makig employers aware of their duty uder law to assess ay risks associated with shift work; improvig uderstadig of shift work ad its impact o health ad safety; providig advice o risk assessmet, desig of shift-work schedules ad the shift-work eviromet; suggestig measures employers, safety represetatives ad employees ca use to reduce the egative impact of shift work; reducig fatigue, poor performace, errors ad accidets by eablig employers to cotrol, maage ad moitor the risks of shift work. 2 The guidace is aimed at employers, safety represetatives, trade uio officials, employees, regulators ad other stakeholders. Maagig shift work Page 4 of 45

5 Health ad Safety Backgroud Duty uder law 3 The Workig Time Regulatios 1998 (as ameded) (WTR) lay dow the miimum legal requiremets o how to orgaise workig time. 1,2 Some workers i certai sectors, such as the aviatio idustry ad mobile workers i road ad sea trasport are curretly exempt from WTR ad are subject to specific legislatio that relates to workig time. The basic rights ad protectios that WTR provide are outlied i Appedix 1. 4 I additio to WTR, workers doig safety-critical work o the railways are also subject to the Railway ad Other Guided Trasport Systems (Safety) Regulatios ,4 These Regulatios iclude a duty to make arragemets to prevet serious cosequeces arisig from tired/fatigued employees ad so edager safety. 5 It is ot however sufficiet to rely o the above requiremets to esure that you meet your obligatios for health ad safety i regard to shift-workig arragemets (see Appedix 1). Whe you orgaise ad pla shift work, you must also comply with employers geeral duties uder the Health ad Safety at Work etc Act 1974 (the HSW Act) 5 ad the Maagemet of Health ad Safety at Work Regulatios 1999 (MHSWR). 6 Uder the HSW Act all employers, icludig the self employed, have a duty, so far as it is reasoably practicable, to protect the health, safety ad welfare at work of all their employees. They also have a duty, so far as is reasoably practicable, to esure that others are ot exposed to health ad safety risks through their udertakig. 6 Uder MHSWR, employers are required to make a assessmet of the risks to employees from work activities ad make a commitmet to itroduce measures that are reasoably practicable to remove or cotrol these risks. This icludes the umber of hours worked ad how these hours are scheduled. 7 Employees also have a duty to take reasoable care of their ow health ad safety ad that of other people, who may be affected by their activities at work. This duty implies that employees should take positive steps to uderstad the risk factors i their work, such as the causes of fatigue, comply with safety rules ad procedures ad make sure that othig they do or fail to do at work puts ayoe at risk. 8 Uder the Safety Represetatives ad Safety Committees Regulatios ad the Health ad Safety (Cosultatio with Employees) Regulatios 1996, 8,9 employers must cosult with employees o health ad safety matters. Cosultatio ivolves employers ot oly givig iformatio to employees but also listeig to ad takig accout of what employees say before they make ay health ad safety decisios. If a decisio ivolvig work equipmet, processes or orgaisatio could affect the health ad safety of employees, such as ay proposed chages to shiftworkig arragemets, the employer must allow time to give the employees (or their represetatives) iformatio about the proposals. The employer must also give the employees (or their represetatives) the chace to express their views. The the employer must take accout of these views before reachig a decisio. Maagig shift work Page 5 of 45

6 Health ad Safety What do we mea by shift work? 9 There is o specific defiitio of shift work i law, but it usually meas: a work activity scheduled outside stadard daytime hours, where there may be a hadover of duty from oe idividual or work group to aother; a patter of work where oe employee replaces aother o the same job withi a 24-hour period. 10,11 10 Stadard daytime hours are cosidered as: a work schedule ivolvig a activity durig the day, commoly for a period of eight hours betwee 7.00 am ad 7.00 pm. There are usually two periods of work, oe i the morig, the other i the afteroo, separated by a luch-time break. 11 I this guidace, all systems of work other tha stadard daytime hours are cosidered as shift work. Examples of shift work might be: work durig the afteroo, ight or weeked, typically with periods of the work schedule outside stadard daytime hours; exteded work periods of 12 hours or more, ofte associated with compressig the workig week; rotatig hours of work; split shifts, where work periods are divided ito two distict parts with several hours break i betwee; overtime; stadby/o-call duties. Shift workers i the UK 12 The umber of shift workers i the UK has gradually icreased over the last 25 years reachig a peak i 2000, whe aroud 15% of the workig populatio (approximately 3.8 millio people), worked shifts for most of the time. Sice the, umbers have stabilised, with aroud 14% of the workig populatio (3.6 millio people) ow doig shift work most of the time I the past, shift work was traditioally associated with idustries where 24-hour operatio was either ecessary (eg essetial public services like hospitals, the police, the fire brigade ad the utilities) or practical (eg the trasportatio, chemical, miig ad other process ad maufacturig idustries). The recet upward tred i the percetage of people employed i shift work reflects a adoptio of shift work beyod the traditioal sectors. 11 For example supermarkets, petrol statios ad call cetres ow commoly employ shift workers. 14 This tred has developed because of chages i society, supported by workers who are prepared to do shift work. There may be several reasos for this, such as the recet shift towards a 24-hour society, lack of employmet optios or a preferece for compesatory factors such as flexible workig, better pay or time off i lieu. Maagig shift work Page 6 of 45

7 Health ad Safety Assessig ad maagig the risks associated with shift work 15 The mai priciple of the HSW Act is that those who create risk from work activity are resposible for the protectio of workers ad the public from ay cosequeces. As shift work may affect the health ad safety of your employees ad the public, it is importat for you to cotrol risks effectively ad prevet harm to people. 16 The HSE publicatio, Successful health ad safety maagemet 13 describes a systematic approach to assessig ad maagig health ad safety risks. A approach based o this, that you might wish to use to maage shift-workig arragemets, is summarised i Figure This approach will allow you to assess ad better orgaise your shift-work schedules. You may also wish to cosult ay specific guidace or stadards of good practice that have bee developed for your particular idustry. Uder certai circumstaces, however, additioal exteral expertise may be required, for example whe: your orgaisatio has difficulty makig decisios; the plaig ad orgaisatio of the shift-work schedule is too complex; there are safety critical issues to cosider. Sources of further iformatio ad help ca be foud i Appedix 4. Cosider the risks of shift work ad the beefits of effective maagemet. Establish systems to maage the risks of shift work. Assess the risks associated with shift work i your workplace. Take actio to reduce these risks. Check ad review your shift-work arragemets regularly. What are the udesirable effects of shift work? Cosider the costs ad beefits of effective maagemet of shift-workig arragemets. Seek maagemet commitmet to cotrol the risks of shift work. Idetify idividuals resposible for shift-workig arragemets. Ivolve safety represetatives ad workers. Cosider the risks that workers may be exposed to. Establish who might be harmed by shift work. Cosult workers ad their safety represetatives. Assess how severe the risks are ad idetify where improvemets eed to be made. Improve the shift-work schedule. Improve the workplace eviromet. Apply good practice guidelies. Implemet a system for early reportig of problems associated with shift work. Moitor alteratios to shift-work schedules ad/or work coditios. Periodically review the effectiveess of your shiftworkig arragemets. Figure 1 A systematic approach to assessig ad maagig the risks associated with shift work Maagig shift work Page 7 of 45

8 Health ad Safety Cosider the risks of shift work ad the beefits of effective maagemet What are the udesirable effects of shift work? 18 Research has show that there ca be udesirable cosequeces for those workig shifts outside stadard daytime hours, particularly those coverig the ight or with early morig starts. 14,15 For example, shift work may result i: disruptio of the iteral body clock; fatigue; sleepig difficulties; disturbed appetite ad digestio; reliace o sedatives ad/or stimulats; social ad domestic problems, which i tur ca affect performace, icrease the likelihood of errors ad accidets at work ad might have a egative effect o health. Disruptio of the iteral body clock (circadia rhythms) 19 By ature, humas are active ad perform best durig the day ad eed to sleep at ight whe performace is geerally poorer. We follow this iate patter because of a iteral body clock, located i the brai which sets the daily cycle of biological activities, such as chemical ad hormoe release that ifluece body activity. For example, heart rate, blood pressure ad body temperature are icreased durig the day. At ight they are reduced ad we slow dow ad feel sleepy. This daily cycle is kow as the circadia rhythm ad explais why we eat ad sleep at similar times each day. 16 Exteral factors or cues such as daylight, meal times, clocks ad workig hours help to regulate this iteral body clock, ad play a importat role i keepig our bodies i step with the world aroud us. 20 Our iteral body clock ca chage gradually, but for most people it is resistat to the abrupt chages i the sleep/wake cycle that are required by shift-work schedules or flyig across time zoes. This ca cause our atural daily rhythms to become out of tue with those of the world aroud us. This is the reaso why we ca feel out of sorts ad less able to fuctio to the best of our ability whe we do ot get eough sleep. 21 The adjustmet of our iteral body clock to a abrupt chage i the sleep/ wake cycle may take days or weeks. It will start to adjust body fuctios after a few days of shift work, but at differet rates, so behaviours that rely o a regular cycle such as digestio, alertess ad sleep are disturbed. The adjustmet may be more successful i specialised work eviromets, such as submaries ad oil rigs, where the effects of exteral cues are miimised. However, our iteral body clock will ever fully adjust, eve for workers o permaet ight shifts. Those regular ight workers who chage back to daytime routies durig rest days will cotiue to suffer the cosequeces of a disrupted iteral clock, as it attempts to reset to daylight rhythms durig days off. Maagig shift work Page 8 of 45

9 Health ad Safety Sleep disturbace/loss 22 A cosesus view by scietists who study huma performace ad safety is that sleep is a powerful ad vital biological eed. Isufficiet ad disturbed sleep, chroic sleep loss ad beig awake for prologed periods, icreases the risk of errors ad accidets. 17,18 23 Day sleep is usually lighter ad shorter i duratio ad therefore less restorative tha ight sleep. 14 It is more ofte disturbed because of warmer temperatures ad daytime activity such as the phoe rigig, oisy childre or domestic resposibilities. While we ca rearrage some exteral cues, for example meal times, it is difficult to cotrol all ifluetial sleep/wake cues, particularly daylight. For example exposure to bright light at daw after a ight shift may make you less iclied to sleep. 24 People s adaptability meas that we ca, if we eed to, resist our iteral body clock ad fuctio for periods with either reduced sleep or eve o sleep at all. The cost of resistig this eed to sleep is kow as a sleep debt. The desire to recover this debt ca be very hard to resist, particularly whe exteral cues or our body s iteral body clock are drivig us to sleep. 25 Research reveals that whe we are sleep deprived ad/or fatigued, performace is affected ad errors are more likely. 19,20 This particularly applies to tasks that require: vigilace ad moitorig; decisio makig; awareess; fast reactio time; trackig ability; memory. Fatigue 26 Fatigue is the declie i metal ad/or physical performace that results from prologed exertio, lack of quality sleep or disruptio of the iteral body clock. 21 The degree to which a worker is proe to fatigue is also related to workload. For example, work that requires costat attetio, is machie paced, complex or mootoous will icrease the risk of fatigue A poor balace betwee the demads of work ad the time provided for rest ad recovery, resultig for example, from poorly desiged shift-work schedules ad log workig hours is likely to result i chroic fatigue. 28 Levels of fatigue are also affected by persoal factors such as home life or idividual characteristics. You will eed to be aware of these factors whe you carry out your risk assessmet, but you are ot expected to cotrol them. 29 The cosequeces of fatigue iclude reduced alertess, poor ad slow perceptio ad sleepiess. 19 Chroic fatigue has also bee associated with a umber of log-term health problems. 21 Errors, productivity ad accidets 30 For shift workig to be fiacially viable, you eed to maitai a satisfactory level of productivity ad safety. Fatigued shift workers may perform less well tha those workig stadard daytime hours, especially durig periods of low alertess. The cosequeces of this could rage from relatively mior evets to serious accidets. Take both eds of this spectrum ito accout whe you are assessig the costeffectiveess of shift workig as the social ad fiacial costs of frequet mior evets may equate over time to those associated with a rarely occurrig serious accidet. Maagig shift work Page 9 of 45

10 Health ad Safety 31 The risk of errors, accidets ad ijuries has bee foud: to be higher o the ight shift; to rise with icreasig shift legth over eight hours; to icrease over successive shifts, especially if they are ight shifts; to icrease whe there are ot eough breaks. 18,22 32 Poorly desiged work schedules causig fatigue-iduced impairmet of performace will icrease the risks. For example, a log ight shift without breaks after a successio of previous ight shifts will icrease the likelihood of errors, accidets ad ijuries. 33 It is importat ot to uderestimate the potetial risk for serious fatiguerelated errors ad accidets. Sleepiess is thought to be the cause of up to oe i five accidets o major roads i the UK, 23 cotributig sigificatly to the approximate 3000 road deaths recorded aually. 24 After youg me, shift workers are cosidered to be the category of drivers most at risk from accidets ad, compared to day workers, ight workers are more likely to be ivolved i accidets while drivig home from work Fatigue, ight work ad/or shift-workig arragemets have bee cited as major cotributory factors i umerous well-documeted accidets ad icidets icludig Three Mile Islad i 1979, Bhopal i 1984, Challeger Space Shuttle i 1986, Cherobyl i 1986, Clapham Juctio i 1988 ad Exxo Valdez i ,27 Health effects 35 As well as chroic fatigue, there is some evidece associatig log-term exposure to shift work ad the followig ill health effects: gastroitestial problems such as idigestio, abdomial pai, costipatio, chroic gastritis ad peptic ulcers; cardiovascular problems such as hypertesio, coroary heart disease; icreased susceptibility to mior illesses such as colds, flu ad gastroeteritis. 36 Reproductive problems i female shift workers have also bee reported. 32 While the associatio for reproductive effects is less strog, it would be wise to cosider shift work, especially ight shifts, as a potetial risk to reproductio. Research ito a possible lik betwee shift work ad breast cacer has bee icoclusive Shift work may also exacerbate existig health problems such as diabetes, asthma, epilepsy ad psychiatric illess. Moreover, the effectiveess ad potetial toxicity of some drugs may vary depedig o the time they are take as the doserespose patters of may drugs follow a circadia patter. 28,31 38 Shift workers, particularly those who work at ight, may be at risk of ill health because shift work ca disrupt our body clock (by iterferig with the productio of hormoes by the body), disturb sleep ad cause fatigue. I recogitio of the particular risks to ight workers, the WTR iclude a right for these workers to receive free health assessmets. 1,34 39 Idividual ad social factors may also cotribute to the risk of ill health effects Cosequetly, ot everyoe will experiece or have the same patter or degree of health problems. A idividual s attitude, behaviour, lifestyle, age, sex ad family history plus the coditios they work i, will all play a part. Maagig shift work Page 10 of 45

11 Health ad Safety Figure 2 The causes ad cosequeces of fatigue (after Folkard et al, 2003) 38 Maagig shift work Page 11 of 45

12 Health ad Safety Disruptio of family ad social life 40 A happy social ad domestic life is a importat foudatio for health ad wellbeig. The amout ad quality of time spet with family ad frieds ca, however, be affected by uusual patters of work. 14, 30 A worker who experieces a disrupted social or domestic life may feel isolated, moody or depressed, which ca affect their health ad performace at work. 41 A work schedule that clashes with domestic resposibility ca lead to a compromise betwee routies suited to work ad those suited to less coflict at home. Shift workers, especially those who are primary carers, may sped more time with their family or fulfillig their domestic duties at the cost of sleep. 39 This will result i fatigue ad its cosequet implicatios for health ad safety. Idividual susceptibility to the effects of shift work o health ad well-beig 42 Idividuals vary i their tolerace to shift work, because: some fid it easier to fall asleep, sleep for loger ad adapt more easily to chages i sleep patters; they may feel more alert at particular times of the day, eg some people could be described as ight owls, others as larks ; the ability to adapt to shift work decreases with age; they have differig degrees of health ad fitess; they use differet behaviours or copig strategies; they orgaise their domestic duties ad social activities i lie with their 35-37, 40 shifts. 43 While we caot chage our ibuilt characteristics or halt the ageig process, it is possible to adopt copig strategies, alter behaviour ad make lifestyle chages that improve sleep quality, icrease alertess ad reduce health risks. 41 See Appedix 2 for strategies ad practical advice shift workers ca use to improve their health ad well-beig. 42 Cosider the costs ad beefits of effective maagemet of shiftworkig arragemets 44 Implemetig a shift-work system or chagig curret shift-workig arragemets ca be a costly ad time-cosumig process. Workers may be resistat to chages i their workig arragemets. While some workers may beefit from the proposed chages, other workers may cosider themselves disadvataged. For this reaso, it is importat to cosult workers ad their safety represetatives ad gai their agreemet before makig ay chages to workig arragemets. 45 It is importat to recogise that a plaed ad systematic approach to assessig ad maagig the risks of shift work ca improve the health ad safety of workers. Reducig the problems associated with shift work may also fiacially beefit your busiess ad society i geeral by: lowerig sickess ad abseteeism; decreasig lost-time icidets; reducig the risk of fatigue-related accidets; reducig the likelihood of compesatio claims; icreasig work efficiecy; improvig product quality; reducig staff turover. Maagig shift work Page 12 of 45

13 Health ad Safety Establish systems to maage the risks of shift work Seek maagemet commitmet to cotrol the risks of shift work 46 Effective maagemet of the risks associated with shift work requires commitmet from seior maagemet. It is vitally importat to make sure seior maagemet (ie those who make the busiess decisios, allocate fuds ad create a drive for chage) are icluded i the developmet of, ad/or modificatio of, shiftworkig arragemets. 47 Developig clear policies ad procedures for maagig shift-workig arragemets esures that people throughout the orgaisatio, o matter how large or small, are aware that prevetig or limitig the risks of shift workig eeds to be cosidered at all levels of plaig. Idetify idividuals resposible for shift-workig arragemets 48 Depedig o the size of the orgaisatio, it may be appropriate to appoit oe or more idividuals to take resposibility for maagig the risks associated with shift work. Broadeig their kowledge about shift work ad their familiarisatio with appropriate health ad safety policy ad legislatio will help develop a positive eviromet for dealig with shift-workig arragemets. See Appedix 4 for sources of further iformatio ad help. Ivolve safety represetatives ad workers 49 By law, employers must cosult with employees o health ad safety matters. So it is critical to cosult ad ivolve the shift workers themselves i discussios about how the maagemet of shift work might affect health ad safety. Ivolvig a broad spectrum of the workforce i the decisio-makig process promotes a culture of opeess. This will make workers more likely to accept chages ad adopt a ew shift-work schedule or differet ways of workig. 50 Oe way to ivolve workers ad other stakeholders with a iterest i shift-work arragemets is to establish a workig group. This is a way of esurig that differet views ad opiios are discussed. For example, you might wish to iclude: workers; safety represetatives; a trade uio represetative; a supervisor or middle maager; a occupatioal health advisor; a health ad safety officer (if applicable); a seior maager. 51 Alteratively, you may use other ways of cosultig your employees or already have appropriate cosultatio procedures i place i your orgaisatio. Maagig shift work Page 13 of 45

14 Health ad Safety Assess the risks associated with shift work i your workplace Cosider the risks that workers may be exposed to 52 Employers should carry out a suitable ad sufficiet assessmet of the risks associated with shift work as part of your orgaisatio s health ad safety maagemet system. You should record ad review the risk assessmet periodically ad wheever chages to shift-workig arragemets are cosidered or made. 53 A risk assessmet requires a employer to cosider risk factors at work ad those who might be harmed by them. The risk assessmet should take full accout of the hazards associated with fatigue, ad the likelihood of fatigue occurrig because of shift workig. To do this you eed to gather ad evaluate iformatio about curret shift-work arragemets i your orgaisatio. You ca the use the risk assessmet to decide what you eed to do to reduce the risks. Establish who might be harmed by shift work 54 The risk factors summarised i the followig sectios are geeral ad apply to most shift-work schedules. There may, however, be other risk factors that oly apply to your idustry sector. So, it is importat to thik about ay additioal risk factors of shift-work desig i your orgaisatio. 55 For example, while all workers are potetially at risk from shift work, you should cosider certai groups who are more vulerable tha others. These iclude: youg workers; older workers; ew ad expectat mothers; workers with pre-existig health coditios, which may be made worse by shift work, such as those with gastro-itestial problems, coroary heart disease ad sleepig problems; workers takig time-depedet medicatio such as isuli; temporary ad other workers, such as sub-cotractors ad maiteace workers, who may ot be familiar with or be able to adhere to curret shift work schedules, or who have bee o a differet schedule with a previous employer; workers, who followig a stadard day s work, have remaied o call through the subsequet ight or weeked You should also cosider members of the public i your risk assessmet, as there may be a risk they could be harmed as a result of accidets ad catastrophes i which poor shift-work arragemets are a cotributig factor. 57 To assess the risks, you will eed to gather data about the shift-work arragemets i your orgaisatio ad use it to idetify areas where you ca make improvemets, if ecessary. Resposibility for decidig how to gather data should be made durig your preparatio ad ideally agreed by those i your orgaisatio who have a iterest i shift-work arragemets. You will also eed to assess how severe ay risk factors are, record your fidigs ad recogise that where there are several risk factors, the likelihood of fatigue-related problems will be icreased. Maagig shift work Page 14 of 45

15 Health ad Safety 58 Idetifyig issues associated with shift work ca be difficult because there are may cotributory factors that may affect your employees. So, it is advisable, to use a variety of iformatio-gatherig techiques to try to idetify ay commo treds or patters. For example, examiig ill health, accidet, absece, productivity ad overtime records, direct observatio of shift workers ad usig assessmet tools ad techiques (see Appedix 3) may be valuable. Commo patters, such as a icreased accidet rate or reduced productio quality/quatity at certai times of day or over certai periods, may be symptoms of fatigue ad poor shift-work desig, but also cosider other factors such as work load ad work activity. Cosult workers ad their safety represetatives 59 It is very importat to cosult the shift workers ad their safety represetatives i the risk assessmet process, as they have a clear iterest i the matter ad a direct kowledge of the advatages ad disadvatages of existig work patters. Keep records of ay iterviews or discussios for future referece. 60 Employig a umber of differet aids ad techiques ca stimulate discussio ad help plaig. For example, you could: ecourage workers to share their experieces of shift work; discuss which shifts are hardest ad why; use assessmet tools ad techiques to highlight potetial problems ad compare differet shift schedules (see Appedix 3); provide examples of differet shift-work schedules; ivite spotaeous cotributio of ideas. 61 You will eed to hadle ay detailed risk assessmet sesitively. Employees have a duty to help you to gather iformatio ad help with the assessmet of risks associated with work. But, they also have rights to privacy ad caot be forced to co-operate i aswerig questioaires or takig part i surveys. Eve if your itetios are good, employees may ot see it that way. The best policy is to explai what you are doig ad your reasos for doig it. This is why ivolvig workers ad their safety represetatives from a early stage is vital for a successful outcome. Maagig shift work Page 15 of 45

16 Health ad Safety Take actio to reduce the risks Assess how severe the risks are ad idetify where improvemets eed to be made 62 Tables 1-10 outlie how differet elemets of your shift-work schedule ad/ or workplace eviromet might cotribute to fatigue ad other shift work-related problems. They also offer advice o how to cotrol risks. Tables summarise the curret advice o cotrollig risks from shift work i the form of good practice guidelies. 63 Havig idetified the shift-work risk factors i your orgaisatio, you the eed to cosider ad prioritise where to make improvemets. If you idetify a umber of issues, cosider if it would be best to desig a ew schedule. 64 You may fid it useful to use assessmet tools such as HSE s Fatigue ad Risk Idex Tool, to idetify whether ay particular aspect of a existig or proposed workig time patter is likely to icrease the risk of fatigue. See Appedix 3 for further details about the Fatigue ad Risk Idex Tool ad other tools ad techiques for assessig the risks associated with shift work. 65 To balace the health ad safety eeds of the workers ad the demads of the orgaisatio, apply the good practice guidelies whe desigig or modifyig shiftworkig arragemets, where appropriate ad where reasoably practicable. Improve the shift-work schedule 66 There are may differet shift-work schedules ad each schedule has differet features. This sheer diversity of work ad workplaces mea that there is o sigle optimal shift system that suits everyoe. Tables 1-7 summarise curret kowledge ad opiio o the various factors that cotribute to the desig of shift-work schedules ad provide practical advice for reducig the risks of shift work. 67 Where relevat, iformatio relatig to the legal requiremets of WTR is also icluded i the tables. However, complyig with WTR may ot i itself be eough to prevet fatigue ad it is ot eough to rely solely o these requiremets to make sure you meet your obligatios regardig health ad safety i shift work. 68 Cosideratio of the factors that cotribute to the desig of shift-work schedules ad addressig their associated risks will help you to reduce the risks that your employees are exposed to by shift work. Maagig shift work Page 16 of 45

17 Health ad Safety Table 1 Workload Workload Commets Advice Metal ad physical demads Workers with a appropriate workload will be more efficiet, effective ad less fatigued tha those who are overburdeed or have too little to do. Cocetratio ad productivity ted to declie towards the ed of the shifts, followig luch ad durig the ight ad early hours of the morig. Whe plaig work, pla a appropriate workload, accordig to the legth ad the timig of the shift. If practical, schedule demadig work for periods whe workers are most alert ad least likely to be fatigued. Where possible, demadig, dagerous ad/or safety-critical work should be avoided durig the ight ad early hours of the morig ad towards the ed of log shifts. Whe work is particularly demadig, cosider shorteig the legth of the shift. Table 2 Work activity Work activity Commets Advice Work Activity Variatio i work activity across a shift ca help to relieve fatigue, especially where the worker has a rage of tasks to complete, each with differig metal ad physical demads. Rotatig routie sedetary metal tasks with physical tasks ca promote alertess or coversely help to relieve physical fatigue. Where possible, schedule a variety of tasks ito the shift pla ad if practicable, allow workers some choice regardig their order of completio. Maagig shift work Page 17 of 45

18 Health ad Safety Table 3 Shift patter Shift patter Commets Advice Permaet shifts Regular shifts allow a worker to adjust to a shift schedule to a certai degree, although ay adjustmet of the iteral body clock will be lost durig rest days if they revert to a ormal diural cycle. Permaet ight workers ad early morig workers ru the risk of chroic sleep debt, fatigue, ill health ad disruptio of family ad social life. Regular shifts allow workers to pla domestic ad social activities. They are appealig to some workers but others may prefer the flexibility of rotatig shifts. Ca create strog healthy bods withi shift teams, but may also ecourage less healthy attitudes or behaviours to develop, which could lead to a team makig bad or irratioal decisios. There may be poor commuicatio due to limited cotact betwee differet shift teams. Permaet ight shifts should be avoided where possible, although some workers ad supervisors may fid them desirable. Esure staff, especially those who work permaet ight shifts or early morig shifts are aware of the risks, through provisio of traiig ad iformatio. If reasoably practicable, offer workers the choice betwee permaet ad rotatig shifts. Esure there is eough supervisio of shifts to facilitate commuicatio betwee workers ad promote appropriate behaviour ad ratioal decisio makig. Improve commuicatio at shift hadover to esure that ew shift teams are fully aware of issues that have arise durig the previous shift. Rotatig shifts Rotatig shift schedules reduce the umber of ights a idividual has to work, as ight work is shared betwee all workers. However, the costatly chagig shift patter meas that workers may have difficulty adaptig to the schedule. The directio ad speed of rotatio ca ifluece how a idividual adapts to rotatig shifts. Forward versus backward rotatio There is limited evidece that the iteral body clock adapts more quickly to forward-rotatig schedules, eg those where the worker progresses from morig to afteroo to ight shifts i a clockwise directio. Chages from a early shift to a later shift may result i reduced rest time compared to a backwardrotatig schedule. Adoptig forward-rotatig schedules rather tha backwardrotatig, may help reduce sleep loss ad fatigue. Esure there is adequate rest time betwee shifts. Uder the WTR, the miimum time allowed betwee shifts is 11 hours. Maagig shift work Page 18 of 45

19 Health ad Safety Table 3 Shift patter (cotiued) Shift rotatio Commets Advice Fast rotatio versus slow rotatio Fast rotatio of shifts miimises disruptio of the iteral body clock ad there is little to o adaptatio to ight shifts/early morig starts. Cosequetly directio of rotatio may be less relevat for rapidly rotatig shift schedules tha for slowly rotatig where there is some adjustmet of the iteral body clock. Rotatig shifts every 2-3 days is recommeded, as the iteral body clock does ot adapt ad sleep loss ca be quickly recovered, reducig the risk of fatigue ad ill health. Weekly/fortightly rotatig shifts are the most disruptive schedule as the iteral body clock starts to adapt ad the has to reset itself as the shift chages. Weekly/fortightly rotatig shift schedules are ot recommeded. Avoid these where possible. Slow rotatio of shifts maximises adaptatio of the iteral body clock, although there is a risk of sleep loss ad fatigue. Ay adjustmet of the iteral body clock to ights/early starts will be lost durig rest days. If fast rotatio is ot possible, the slowly rotatig shifts over at least a 3-week period is the ext best optio. Table 4 Shift timig Shift timig Commets Advice Night shifts Night shifts disrupt the iteral body clock ad ight workers are likely to suffer from sleep loss, poor quality sleep ad fatigue, which may cause ill health. Fatigue may also icrease the risk of errors ad accidets, especially durig the ight, whe people are less alert. Physically ad/or metally demadig or mootoous work will icrease the risk of fatigue. Night work icreases the risk of ill health ad disrupts family ad social life. Workig at ight may limit access to traiig, developmet ad workplace facilities such as staff restaurats, first aid ad occupatioal health services. Oly a limited umber of workers ca successfully adapt to ight work. Try to fid alteratives to ight work for those workers who caot adapt. Where possible, permaet ight shifts should be avoided. Cosider the type of work beig doe ad the workload. Where possible, avoid demadig, mootoous, dagerous ad/or safety-critical work durig the ight ad early hours of the morig. Provide traiig ad iformatio about the risks of shift work for workers ad their families. Make staff aware of sources of iformatio ad support, such as child care ad cousellig services. Uder the WTR, ight workers have a right to receive free health assessmets. Where reasoably practicable, provide similar facilities ad opportuities for ight workers as those available for your daytime workers. Maagig shift work Page 19 of 45

20 Health ad Safety Table 4 Shift timig (cotiued) Shift timig Commets Advice Early morig starts Afteroo starts Although less disruptive tha ight work, early morig starts ca also reduce sleep ad icrease the risk of fatigue ad ill health. Commutig times ad availability of public trasport may cotribute to the fatigue related to early starts. Ability to sleep may be low i the early eveig whe the mid is alert ad family ad social commitmets are competig. Loss of sleep may result i fatigue. Risk of fatigue, ill health ad accidets is lower tha that from ight as there is less disruptio to the iteral body clock. Performace does ot appear to suffer uduly i compariso with day shifts. Where early morig starts are ot essetial for busiess eeds, avoid shift starts before am. Cosider if providig trasport to ad from the workplace would be beeficial. Provide traiig ad iformatio about the risks of shift work for workers ad their families. Make staff aware of sources of iformatio ad support, such as child care ad cousellig services. Afteroo shifts are suitable for most workers ad where practicable, you should adopt them i preferece to ight or early morig shifts. Daytime shifts Table 5 Shift duratio Workers who start work i the afteroo ofte sleep more tha workers o other shift types. Afteroo starts ca however reduce family ad social cotact. Preferred shift because it does ot disrupt the iteral body clock. Provide traiig ad iformatio about the risks of shift work for workers ad their families. Make staff aware of sources of iformatio ad support such as child care ad cousellig services. Where practicable, adopt day shifts rather tha ight or early morig shifts. Shift duratio Commets Advice 8-hour shifts 12-hour shifts 8-hour shifts are cosidered to be the optimum legth for sustaied ad cosistet work. They allow more time for rest ad completio of daily activities, but are geerally less popular as there are fewer work-free days per week tha with12-hour shifts. 12-hour shifts are popular as they make the workig week shorter ad may offer some advatages over 8-hour shifts i terms of sleep, health ad well-beig. The perceived social beefits ca lead to workforces tedig to choose such shift legths ad patters. However, workers have a limited metal ad physical resource, which is depedet o their curret state of fatigue ad the type ad duratio of the job they are doig. Fatigue, especially towards the ed of a log shift or durig the ight may reduce productivity ad icrease the risk of accidets. There are few differeces i the effects of 8-hour ad 12-hour shifts o workers ad there are o clear advatages to either system. However, the ature of the work eeds to be cosidered. 8-hour shifts are preferable whe work is mootoous, demads cocetratio or vigilace, is isolated, is safety critical ad/or there is exposure to work-related physical or chemical hazards. Avoid shifts that are loger tha 8 hours, where work is demadig, safety critical or mootoous ad/or there is exposure to work-related physical or chemical hazards. Ecourage ad promote the beefit of frequet ad regular breaks to reduce the risk of fatigue. Allow adequate recovery time betwee shifts ad bear i mid that commutig times ad availability of public trasport may cotribute to the fatigue related to log shifts. Limit 12-hour ight shifts to 2-3 cosecutive ights. Maagig shift work Page 20 of 45

21 Health ad Safety Table 5 Shift duratio (cotiued) Shift duratio Commets Advice 12-hour shifts Shifts loger tha 12 hours Variable shift legths Loger shifts may icrease the risk of fatigue ad ill health i vulerable groups such as older workers ad ew ad expectat mothers. Ay advatages of 12-hour shifts i terms of health ad well-beig are likely to be lost if workers take o overtime or secod jobs durig their free time. As fewer shift teams are required for a 12-hour tha for a 8-hour shift schedule it may be more difficult to arrage cover for illess, holidays, traiig ad overtime. Alertess ad performace ca sigificatly deteriorate over log shifts, which may icrease the risk of errors ad accidets. Variable shift legths ca give some of the free time beefits of loger workdays ad may be less fatiguig. They are provig a icreasigly popular compromise to the 8-hour vs 12-hour debate. Cosider the eeds of vulerable workers: arrage for these workers to do shorter shifts if ecessary. Shifts should ot be plaed to be loger tha 12 hours. Avoid overru ad discourage overtime. Moitor ad cotrol shift swappig. Make adequate arragemets to cover absetees. Discourage workers from takig secod jobs. If this is a particular problem you could set this as a coditio of employmet i cotracts of work. Make adequate arragemets to cover absetees. Some compaies iclude a extra shift i their rosters (usually days) to allow flexibility ad time for traiig, developmet etc. Moitor ad cotrol shift swappig. Avoid shifts that are loger tha 12 hours i legth. Avoid overru ad discourage overtime. Moitor ad cotrol shift swappig. Make adequate arragemets to cover absetees. Discourage workers from takig secod jobs. Cosider if shifts of variable duratio ad/or flexible start ad ed times could offer a suitable compromise for your orgaisatio. Bear i mid that schedule desig will be more complex ad require more plaig ad orgaisatio. Split shifts Split shifts, where a idividual s daily work is divided ito two or more shifts, are upopular as they legthe the workig day. The risk of fatigue is icreased if there is too short a break betwee shifts to warrat a retur home. If reasoably practicable, avoid split shifts, as they do ot allow eough recovery time betwee shifts. If split shifts are ecessary, esure that suitable o-site caterig ad rest facilities are available. Early starts coupled with late fiishes ca result i fatigue, ill health ad disruptio of family ad social life. Esure workers are aware of the risks of shift work, through provisio of traiig ad iformatio. Maagig shift work Page 21 of 45

22 Health ad Safety Table 6 Rest breaks withi shifts Rest breaks withi shifts Commets Advice The risk of fatigue-related problems is higher towards the ed of a shift ad also durig the ight. Frequet short breaks ca reduce fatigue, improve productivity ad may reduce the risk of errors ad accidets, especially whe the work is demadig or mootoous. Depedig o the ature of the work, allowig workers some choice about how log ad how ofte their breaks are may reduce fatigue ad icrease productivity. For example, a worker may beefit from more frequet breaks towards the ed of a shift as fatigue sets i. Whe work is machie-paced rather tha self-paced, itroductio of frequet pre-plaed rest breaks may icrease productivity ad reduce fatigue. A short period of sleep of aroud 20 miutes has bee advocated by some as a way of copig with fatigue, especially o log shifts ad o ight shifts. However, if workers sleep for loger periods tha this they may wake up feelig urefreshed ad less alert. This may decrease productivity ad icrease the risk of errors ad accidets. Whe they wake up, workers may experiece a short period (up to 15 miutes) of impaired alertess. A break take away from the work statio ad/or work eviromet is cosidered to be more beeficial tha those take at the workstatio. Ecourage ad promote the beefit of frequet ad regular breaks to reduce the risk of fatigue. Uder the WTR, workers are etitled to a 20-miute rest break if the workig day is loger tha six hours. But cosider the legth of the shift ad the workload whe plaig the amout ad legth of breaks. A short break of 5-15 miutes every 1-2 hours may help maitai performace ad reduce accidets, particularly whe the work is demadig or mootoous. If practicable, workers should be allowed some discretio over whe they take a break from work. Ideally, workers should be allowed to rest before they experiece fatigue. However, workers may ot always act as the best judge of whe a break is eeded ad should be strogly discouraged from savig up their rest time i order to leave earlier. Where the pace is out of the worker s cotrol (eg machie/ system paced), schedule frequet rest breaks i the shift pla. Nappig should be well supervised ad oly be used as a strategy i orgaisatios where there is a high risk of ivolutary sleepig, such as drivig ad ight-time vigilace tasks. Do ot adopt it i work eviromets where importat decisios, especially safety-critical decisios, could be clouded by sleepiess. If appig is adopted, appropriate facilities should be provided with scheduled breaks of aroud 40 miutes to allow workers sufficiet time to have a short ap, refresh themselves ad regai alertess before resumig work. Make facilities available ad ecourage workers to take their loger breaks away from their workstatio. Maagig shift work Page 22 of 45

23 Health ad Safety Table 7 Rest breaks betwee shifts Rest breaks betwee shifts Commets Advice Rest periods betwee cosecutive shifts Rest days The risk of fatigue-related problems icludig ill health, errors ad accidets icreases whe the break betwee the ed of oe shift ad the start of the ext shift is too short. Too may cosecutive work days ca lead to a accumulatio of fatigue ad icrease the risk of fatigue-related problems icludig ill health, errors ad accidets. Sleep loss ad fatigue ca also build up if there are too may successive ight shifts ad/or early morig starts. The optimal umber of successive workdays is uclear, as it depeds o a umber of factors icludig the shift patter, the workload ad the workplace eviromet. If there are a large umber of rest days betwee successive shift schedules, lack of commuicatio betwee workers ad loss of familiarity with the work may icrease the risk of errors ad/or accidets. Rest days are best whe they allow the worker to recover from a work schedule, take part i social ad domestic activities ad if required, eable them to adjust to a ew work schedule. Havig free weekeds is traditioally importat to workers for social ad domestic activities. Workers eed sufficiet time betwee shifts to commute, eat meals, sleep ad participate i domestic ad social activities. Uder WTR, the miimum time allowed betwee shifts is 11 hours. I geeral, a limit of 5-7 cosecutive workig days should be set for stadard (ie 7-8 hour) shifts. Where shifts are loger tha this, for ight shifts ad for shifts with early morig starts it may be better to set a limit of 2-3 cosecutive shifts, followed by 2-3 rest days to allow workers to recover. Cosider if regular refresher traiig i complex procedures ad time allowed for refamiliarisatio/ updatig would help whe there are exteded rest periods (icludig holidays) betwee successive shifts. Uder WTR, workers are etitled to a 24-hour day off per week, although days off may be averaged over a fortight. Whe switchig from day to ight shifts or vice versa, make provisio to allow workers a miimum of 2 ights of full sleep to eable them to adjust to the ew schedule. Where possible, regular weeked breaks should be built ito the shift schedule. Improve the workplace eviromet 69 Poor workig coditios add to the risks of shift work ad it is importat to idetify where improvemets ca be made. I may cases, chages to the workplace eviromet may be reasoably straightforward ad easily itroduced. However, it is importat whe you cosider ay alteratios to cosult ad ivolve your employees ad their safety represetatives i the process. 70 Tables 8-10 outlie how factors i the workplace eviromet may icrease the risks associated with shift work ad offer advice o how to make improvemets to reduce these risks. Maagig shift work Page 23 of 45

24 Health ad Safety Table 8 Physical eviromet Physical eviromet Commets Advice Facilities Lightig Temperature Shift workig ca isolate workers ad prevet access to daytime workplace facilities such as staff restaurats, first aid, occupatioal health services, iformatio ad traiig. Workplace lightig levels should be good eough to eable people to work, use workplace facilities ad move from place to place i safety ad to complete their tasks without the risk of eyestrai. Bright lights (> 6000 lux) have bee show to trigger chages i the iteral body clock, which i tur may aid adaptatio to ight work by icreasig alertess ad reducig sleepiess The Workplace (Health, Safety ad Welfare) Regulatios 1992 (as ameded) 43 lay dow requiremets for temperature i idoor workplaces. The associated Approved Code of Practice (ACOP) states that the temperature i work rooms should provide reasoable comfort without the eed for special clothig. The miimum temperature should be at least 16 o C, or 13 o C if the work ivolves severe physical effort. A maximum temperature for work rooms is ot specified. I additio to air temperature, the degree of vetilatio, humidity ad locatio of radiat heat sources will all affect the degree of comfort felt by workers. Where reasoably practicable, provide similar facilities ad opportuities for shift workers as those available for your daytime workers. Where this is ot possible, it is importat to make provisio for workers to make a drik ad heat up food ad to allow workers to take their loger/meal breaks away from their workstatio. First-aid facilities, ad if possible, a traied first-aider should be made available for all shifts. You should take ito accout the extet of atural lightig, the reflective properties of the surroudig area ad the work materials, the ature of tasks beig udertake ad the age of the workforce whe you cosider workplace lightig. A combiatio of direct ad idirect lightig (eg uplightig) will help reduce glare ad areas of shadow. The practical applicatio of bright light exposure to shift-work schedules is a complicated area. As yet it is relatively utried, ad may require cosiderable resource. Seek specialist advice whe cosiderig this as a meas of icreasig alertess. Moitor workplace temperature o a regular basis to determie if adjustmets to the heatig supply eed to be made for particular shifts. For example, durig the ight, heatig may eed to be icreased to compesate for the drop i body temperature, however, a warm, stuffy atmosphere ca cause drowsiess. Allow workers cotrol of local heatig arragemets. Where maitaiig a comfortable temperature is impractical, take all reasoable steps to achieve a temperature which is as comfortable as possible. These may iclude providig localised heatig/ coolig devices, appropriate clothig ad provisio of rest facilities. Maagig shift work Page 24 of 45

25 Health ad Safety Table 9 Maagemet issues Maagemet issues Commets Advice Supervisio Overtime Shift swappig Stadby ad o-call duties Uder the HSW Act, employers must provide supervisio as far as is reasoably practicable to esure the health ad safety at work of their employees. Good supervisio of workers is vital for idetifyig potetial hazards ad esurig compliace with health ad safety rules. Employers should esure that people resposible for shift-workig arragemets, especially those i self-maaged teams, have the competece ad opportuity eeded to fulfil this role. Supervisors ca also play a key role i recogisig problems associated with shift-workig arragemets ad idetifyig employees at risk of shift work-related problems. Overtime, especially whe followig log shifts, is likely to icrease the risk of fatigue-related problems icludig ill health, errors ad accidets. Uder-staffig, lack of flexibility for illess/absece cover, plat shutdow, pay icetives or persoal coveiece ca lead workers to work exteded hours ad igore recommeded shift-work practice. Ucotrolled shift swappig may icrease the risk of fatigue-related problems icludig ill health, errors ad accidets, especially if workers do double shifts or do ot have eough time to rest betwee shifts. Workers who carry out stadby ad o-call duties have ot etirely fiished work ad its related stresses, ad whether actually called out or ot, may experiece disrupted ad/or poor quality sleep ad a accumulatio of fatigue. Workers may be at risk of fatigue-related problems icludig ill health, errors ad accidets if they are called ito work, or have to remai at work followig a shift. Cosider if icreased supervisio would be beeficial durig key periods of low alertess, eg durig the ight ad early hours of the morig, followig luch ad towards the ed of log shifts. Esure supervisors are aware of the risks of shift work, through provisio of traiig ad iformatio. Esure that they are sufficietly traied to recogise the symptoms of fatigue, which may idicate that a worker is failig to cope with their curret shift-work schedule or that there are geeral problems with the shiftworkig arragemets. Where possible, avoid overtime by establishig systems to provide relief staff to cover absetees, vacacies, icreased workloads ad emergecies. If overtime is uavoidable, review a worker s precedig work ad rest periods before agreeig to it. You should also moitor ad record the hours that idividuals have worked to idetify where actio should be take to avoid excessive workig hours. This is especially importat whe a idividual has opted out of WTR, i workplaces where shift swappig is permitted ad durig exceptioal circumstaces such as emergecy workers attedig a icidet. Shift swappig should be moitored ad recorded by supervisors. It is importat to review a worker s scheduled work ad rest periods before agreeig to a swap to avoid excessive hours beig worked. Uder WTR, periods whe workers carryig out stadby ad o-call duties are required to be at the workplace, whether workig or ot, is cosidered workig time. Make provisio i the work schedule to allow adequate rest for those workers carryig out stadby/ocall duties. Esure workers are aware of the risks associated with fatigue through provisio of traiig ad iformatio. Maagig shift work Page 25 of 45

26 Health ad Safety Table 9 Maagemet issues (cotiued) Maagemet issues Commets Advice Traiig ad iformatio Commuicatio Traiig ad iformatio relatig to shift work for shift workers ad their families will icrease uderstadig of the cosequeces of shift work ad help workers to recogise fatiguerelated problems ad develop copig strategies. This may reduce fatigue-related ill health, improve productivity ad reduce the risks of errors ad accidets. However, traiig should ot be relied o as the primary meas of cotrollig risks from shift work. Ideally, traiig should complemet other cotrols that have bee put i place, such as improvemets to the shift-work schedule ad the workplace eviromet. Access to daytime traiig sessios may be limited, especially for those o permaet ight shifts. Commuicatio betwee workers ca help to promote alertess, reduce the risk of errors ad accidets ad help prevet feeligs of isolatio. Tailored traiig ad/or iformatio regardig the risks associated with shift work should be available for workers, their families, their supervisors, safety represetatives ad maagemet. Make workers aware of the potetial impact fatigue may have o safety, health ad well-beig. Ecourage workers to report shift work-related problems they may have ad cosider ay suggestios workers make i relatio to improvig the shiftworkig arragemets. Ecourage workers to take resposibility for their welfare outside work ad promote the use of appropriate copig strategies to help workers ad their families to adapt to shift work (see Appedix 2). If possible, arrage/adapt traiig sessios to the shift patter rather tha restrictig it to daytime hours. Alteratively, esure that workers are give compesatory time off if they have to atted traiig durig rest periods by establishig a system to provide relief staff whe required. To help this, some compaies iclude extra shifts i their rosters (usually o days) to allow flexibility ad time for traiig ad developmet. Ecourage iteractio ad if possible arrage for employees to work together or i teams. If a employee must work aloe, ecourage them to make cotact with other workers at regular itervals. If they are located remotely the cotact ca be provided by telephoe or similar commuicatios devices. I case of emergecy, provide a alarm or other commuicatio device. Esure iformatio o workplace issues is made available to all staff. Maagig shift work Page 26 of 45

27 Health ad Safety Table 9 Maagemet issues (cotiued) Maagemet issues Commets Advice Commuicatio Hadover of accurate, reliable iformatio across shift chages is essetial to esure cotiuity of safe ad effective workig. Poor commuicatio at shift hadover may icrease the risk of errors ad accidets, particularly: durig plat maiteace; whe safety systems have bee over-ridde; durig abormal operatios; followig legthy abseces from work; ad whe hadovers are betwee experieced ad iexperieced staff. Adoptig loger shifts ca improve commuicatio betwee successive shifts, as there are fewer hadovers, however, this may be couterbalaced by a icreased risk of fatigue-related problems ad by the effects of exteded rest periods o familiarity ad skills. Agree o, ad make sure timig ad procedures for trasmittig iformatio to the ext shift team are clear, available to all staff ad followed at all times. Avoid extedig shifts by good plaig of the hadover, eg by buildig i a small overlap betwee start ad fiish times o cosecutive shifts. Ideally, shift hadovers should be coducted face-to-face ad be two-way, with all participats takig resposibility for esurig accurate commuicatio, usig both verbal ad writte meas, be based o a pre-determied aalysis of the iformatio eeds of icomig staff ad be give as much time as ecessary to esure clear ad accurate commuicatio. Table 10 Welfare Welfare Commets Advice Occupatioal health A umber of ill-health effects, icludig gastro-itestial problems, cardiovascular disease, reproductive problems ad icreased susceptibility to mior illesses have bee associated with shift work. A fit ad healthy workforce will be more resistat to stress ad illess ad may fid it easier to adapt to shift work. Ecourage workers to iform their doctor about their workig arragemets, as this may help early diagosis of ay shift workrelated ill health. Cosider if alterative work is available for workers who have difficulties adaptig to shift work or develop shift work-related health problems. This is particularly importat for groups such as ageig workers ad ew ad expectat mothers who might be more vulerable to the risks of shift workig. Promote healthy livig strategies like icreasig exercise ad improvig diet, such as those icluded i Appedix 2. Maagig shift work Page 27 of 45

28 Health ad Safety Table 10 Welfare (cotiued) Welfare Commets Advice Occupatioal health Loe workig/violece Uder WTR, employers are required to esure that workers are fit for ight work ad must offer a free health assessmet to ayoe who is about to start workig ights ad to all ight workers o a regular basis. Shift workers, especially those who work aloe or usociable hours may be vulerable to violece. Employers should seek specialist advice from a suitably qualified health care professioal, whe devisig ad assessig the results of health assessmets. If a worker suffers from health problems that are caused or made worse by ight work, you should, where possible, trasfer him or her to day work. Employers should take steps to make sure that the workplace ad its surroudigs are well lit, safe ad secure. Cosider if shift start ad ed times ca be adjusted to fit i with the availability of public trasport. If ot, cosider providig trasport to ad from the workplace. Promote car sharig ad esure car parks ad etraces are well lit ad secure. Ecourage commuicatio betwee workers ad esure all, especially those who work aloe, have access to telephoes ad alarm systems. Cosider if you eed to istal security cameras ad/or provide security staff. Apply good practice guidelies 71 The best advice curretly available regardig shiftwork schedule desig ad the workplace eviromet is summarised i Tables Where reasoably practicable, you should follow these guidelies whe desigig or alterig your shift-workig arragemets. You may fid the assessmet tools ad techiques listed i Appedix 3 useful whe you cosider ay chages to your ow particular shift-workig arragemets. 72 These guidelies are geeral though, ad cover a wide rage of factors that may or may ot be relevat to your particular sector. Guidelies ad sectorspecific stadards of good practice have also bee developed by some idustrial sectors ad may give you more ideas. 73 Give the wide variety of possible shift-workig arragemets, it is ecessary to use commo sese whe applyig the good practice guidelies. For example durig exceptioal circumstaces, there may be times whe curtailig overtime ad forcig a chage of shift might be more risky tha allowig workers to complete a task. Likewise, emergecy workers may ot always be able to take a scheduled break while attedig a serious icidet. I such cases, it is importat to moitor ad record the hours people have worked, to idetify where to take actio to avoid excessive hours beig worked ad that there are suitable arragemets to make sure workers are give compesatory time off followig the icidet. 74 You will also eed to balace the good practice guidelies with the operatioal cocers of your ow busiess. You will eed to cosider: your available resources, eg perso hours available; how you use these resources, eg umber of work groups, hadovers betwee shifts; whether curret resources are sufficiet to support chages to the shift-workig arragemets, eg do they meet the busiess demads? 75 Applyig, where reasoably practicable, the good practice guidelies will help you reduce the risks that your employees are exposed to by shift workig. Maagig shift work Page 28 of 45

29 Health ad Safety Table 11 Good practice guidelies for shift-work schedule desig Pla a workload that is appropriate to the legth ad timig of the shift. If reasoably practicable, schedule a variety of tasks to be completed durig the shift ad allow workers some choice about the order they eed to be doe i. Avoid schedulig demadig, dagerous, mootoous ad/or safety-critical work durig the ight, early morig, towards the ed of log shifts ad durig other periods of low alertess. Avoid placig workers o permaet ight shifts. If possible, offer workers a choice betwee permaet ad rotatig shift schedules. Where possible, adopt a forward-rotatig schedule for rotatig shifts rather tha a backward-rotatig schedule. Either rotate shifts very quickly, eg every 2-3 days or slowly, eg every 3-4 weeks ad avoid weekly/fortightly rotatig shift schedules. If ot strictly ecessary for busiess eeds, try to avoid early morig starts before 7.00 am. Where possible, arrage shift start/ed times to be coveiet for public trasport or cosider providig trasport for workers o particular shifts. Limit shifts to a maximum of 12 hours (icludig overtime) ad cosider the eeds of vulerable workers. Limit ight shift or shifts where work is demadig, mootoous, dagerous ad/or safety critical to 8 hours. Cosider if shifts of a variable legth or flexible start/ed times could offer a suitable compromise. Avoid split shifts uless absoloutely ecessary to meet busiess eeds. Ecourage ad promote the beefit of regular breaks away from the workstatio. Where possible, allow workers some discretio over whe they take a break, but discourage workers from savig up break time i order to leave earlier. I geeral, limit cosecutive workig days to a maximum of 5-7 days ad make sure there is adequate rest time betwee successive shifts. Where shifts are log (> 8 hours), for ight shifts ad for shifts with early morig starts, it may be better to set a limit of 2-3 cosecutive shifts. Whe switchig from day to ight shifts or vice versa, allow workers a miimum of 2 ights full sleep. Build regular free weekeds ito the shift schedule. Maagig shift work Page 29 of 45

30 Health ad Safety Table 12 Good practice guidelies for improvig the shift-work eviromet Provide similar facilities ad opportuities for shift workers as those available for your daytime workers. Esure that workplace lightig is adequate ad adjustable by workers. Esure that the workplace temperature is adjustable ad allows workers to carry out their tasks i reasoable comfort. Cosider icreasig supervisio durig key periods of low alertess, eg durig the ight, early morig, towards the ed of log shifts ad other periods of low alertess. Make sure supervisors ad team members with resposibility for shift-workig arragemets are aware of the risks associated with shift work ad ca recogise shift work-related problems. Cotrol overtime ad shift swappig by moitorig ad recordig hours worked ad rest periods. Discourage workers from takig secod jobs. Make provisio i the work schedule to allow adequate rest for those workers carryig out stadby/o-call duties or overtime. Provide traiig ad iformatio for workers, their families ad maagemet o the risks associated with shift work ad o copig strategies. This may help workers to cope better with shift work. Make provisio to release staff for foreseeable traiig, developmet ad commuicatio eeds. Ecourage iteractio betwee workers ad provide a meas of commuicatio for loe workers. Agree o, ad esure timig ad procedures for trasmittig iformatio to the ext shift team are followed at all times. Ecourage workers to iform their doctor about their workig arragemets. Promote healthy livig strategies such as icreasig exercise ad improvig diet. Esure that free health assessmets are provided for ight workers. Esure that the workplace ad its surroudigs are well lit, safe ad secure ad that workers are free from the threat of violece. Maagig shift work Page 30 of 45

31 Health ad Safety Check ad review your shift-work arragemets regulary Implemet a system for early reportig of problems associated with shift work 76 Assessig ad maagig the risks associated with shift work will improve the health ad safety of workers by reducig the risks they are exposed to.this process will also help idetify may of the problems associated with shift work. However, it is ot always possible to prevet shift work-related problems ad so it is very importat to have systems i place for reportig ad ivestigatig ay problems that may occur. 77 As some workers may be reluctat to report problems, it is vital that maagemet ad safety represetatives emphasise ad promote the beefits of early reportig. Key groups such as supervisors or shift maagers ca play a major role i this, if they are ecouraged to report early. The reportig process should be simple ad straightforward ad make sure ay problems are dealt with i a timely maer. 78 Where there are cases of ill health that may be associated with your shiftworkig arragemets, you may fid it beeficial to seek advice from a occupatioal health professioal who ca determie if the complait is related to work, provide advice o the ature of the complait, its treatmet ad the potetial for ay log-term effects. Moitor alteratios to shift-work schedules ad/or work coditios 79 Alterig the desig of your shift schedules ad makig chages to the shiftwork eviromet may help solve some problems, but create others. It may take a umber of chages ad some time to get thigs right, so it is importat to moitor ad review ay chages o a regular basis. 80 Whe makig chages it is vitally importat to cosult your workers ad explai what you are doig ad your reasos for doig it. Ivolvig them i the process makes the acceptace of chages to shift-workig arragemets more likely. 81 To fid out if chages to the shift-workig arragemets have reduced risks, you will eed to moitor ad udertake a risk assessmet both before ad after ay chages take place. This will help you set clear ad measurable targets for improvemet ad idetify if these have bee met. Table 13 gives some geeral examples of idicators you could use to determie if chages have helped, however, you should also cosider if there are other measures more suited to your particular sector. 82 To get a full picture, collect a mixture of objective ad subjective iformatio. For example, you could moitor worker s opiios o old ad ew shift-workig arragemets by usig focus groups, questioaires, iterviews ad assessmet tools. 83 You could also use recorded iformatio such as ill health, accidet, absece, productivity ad overtime ad shift-swappig records, as these are valuable sources of iformatio. You may also fid it helpful to make observatios durig each shift. Maagig shift work Page 31 of 45

32 Health ad Safety 84 The more you do to assess the effectiveess of chages to the shift-workig arragemets, the more likely you are to get thigs right. However, you should oly do what is reasoably practicable for the size of your orgaisatio. Periodically review the effectiveess of your shift-workig arragemets 85 It is importat that you moitor ad periodically review your shift-workig arragemets to check they are still effective ad do ot impact o health ad safety. You should also use these processes to eable a cycle of cotiuous improvemet, which will help both your workers ad your orgaisatio. Table 13 Issues ad measures of success Idicator Fatigue Sleepiess at work Accidets, ear misses ad safety-critical evets Abseteeism Staff turover Employee welfare Performace ad productivity Compay profits Examples of possible performace criteria (measures of success) Use assessmet tools such as HSE s Fatigue ad Risk Idex Tool to idetify if chages i the shift-work schedule have reduced fatigue. Use assessmet tools such as the Epworth sleepiess scale to determie sleepiess. Do records show a reductio i accidets, ear misses ad safety-critical evets? Do records show a decrease i abseteeism? Do records show a decrease i staff turover? Use focus groups, iterviews, questioaires ad observatio to determie if workers view the shiftworkig arragemets positively. Do records show a icrease i performace ad/or productivity? Have profits icreased sice chages were made? Maagig shift work Page 32 of 45

33 Health ad Safety Appedix 1 Legal Requiremets 1 Employers have legal resposibilities to esure the health ad safety at work of their employees, ad this icludes removig or cotrollig the risks of fatigue by orgaisig ad plaig shift-workig arragemets. They also have a broader resposibility for the health ad safety of others who might be affected by their work activities, which is aother reaso why it is importat to cotrol fatigue. 2 The Health ad Safety at Work etc Act 1974 ad the Maagemet of Health ad Safety at Work Regulatios 1999 place geeral duties o employers ad others i regard to maagig the risks of shift work. There are also other regulatios, which impose specific requiremets o employers with regard to the umber of hours worked ad how these hours are scheduled. These iclude the Workig Time Regulatios 1998 (as ameded) ad other idustry-specific legislatio such as the Railway ad Other Guided Trasport Systems (Safety) Regulatios It is also a requiremet uder the Safety Represetatives ad Safety Committees Regulatios ad the Health ad Safety (Cosultatio with Employees) Regulatios 1996 that employers cosult with employees o health ad safety matters ad take accout of their views before reachig ay decisio. Workig Time Regulatios Summary 4 The basic rights ad protectios that the Workig Time Regulatios 1998 (as ameded) provide for workers are: a limit of a average of 48 hours a week which a worker ca be required to work (though workers ca choose to work more if they wat to); for ight workers, a limit of a average of 8 hours work i each 24-hour period; a right for ight workers to receive free health assessmets; a right to 11 hours cosecutive rest a day; a right to a day off each week; a right to a rest break if the workig day is loger tha six hours; a right to four weeks paid leave per year. 5 A worker is someoe who has a cotract of employmet, or someoe who is paid a regular salary or wage ad works for a orgaisatio, busiess or idividual. A youg worker is someoe who is above the miimum school leavig age but uder If you are self-employed, ruig your ow busiess ad are free to work for differet cliets ad customers, the Workig Time Regulatios do ot apply. 7 Certai workers are ot subject to these Regulatios, because they are/will be govered by sector-specific provisios. These are: sea trasport, as covered by the Seafarers Directive (1999/63/EC); mobile workers i ilad waterways ad lake trasport; workers o board sea-goig fishig vessels; air trasport, as covered by the Aviatio Directive (2000/79/EC). Maagig shift work Page 33 of 45

34 Health ad Safety 8 Mobile workers i road trasport are oly subject to certai provisios of these Regulatios. They are covered by the Road Trasport Directive (2002/15/EC). 9 The armed forces, the police ad emergecy services are outside the scope of the Regulatios i certai circumstaces. However, youg workers i the armed forces, the police ad emergecy services, the aviatio sector ad the road trasport sector are covered by the youg workers provisios i the Regulatios. 10 Workers ca agree to work loger tha the 48-hour limit. A agreemet must be i writig ad siged by the worker. This is geerally referred to as a opt-out. It ca be for a specified period or a idefiite period. Employers caot force a worker to sig a opt-out. Workers caot be fairly dismissed or subjected to detrimet for refusig to sig a opt-out. 11 Youg workers may ot ordiarily work more tha 8 hours a day or 40 hours a week. These hours worked caot be averaged out ad there is o opt-out available. They should ot ordiarily work at ight, although there are certai exceptios. 12 To be sure workers are fit for ight work, employers must offer a free health assessmet to ayoe who is about to start workig ights ad to all ight workers o a regular basis. A ight worker caot opt-out of the ight work limit. Where a ight worker s work ivolves special hazards or heavy physical or metal strai, there is a absolute limit of eight hours o the worker s workig time each day this is ot a average. 13 The limits ad health assessmets (if a ight worker) are eforced by HSE, local authority evirometal health departmets, the Civil Aviatio Authority ad the Vehicle ad Operator Services Agecy. The etitlemets to rest ad leave are eforced through employmet tribuals. 14 This is geeral guidace oly ad should ot be regarded as a complete or authoritative statemet of the law. The latest iformatio ca be foud at: gov.uk/employmet/ employmet-legislatio/workig-time-regs/idex.html. Maagig shift work Page 34 of 45

35 Health ad Safety Appedix 2 Strategies ad practical advice shift workers ca use to improve their health ad well-beig Drivig to ad from work 1 Drivig to ad from work ca be risky, particularly after a log shift, a ight shift or before a early start. The followig strategies may make drivig safer: cosider usig public trasport or taxis rather tha drivig; exercise briefly before your jourey; share drivig if possible; drive carefully ad defesively; try ot to hurry; stop if you feel sleepy ad take a short ap if it is safe to do so; make occasioal use of caffeie or eergy driks. Idetify a suitable sleep schedule 2 Most adults eed 7-8 hours sleep a day, although this decreases with age. If you caot do this, try to rest, as this is still beeficial. Recordig sleep patters ad problems usig a diary may help to explai fatigue ad tiredess. It ca also be used to help fid the most suitable strategies ad coditios for a better quality of sleep: if you work regular shifts, try goig to bed at differet times, eg soo after you arrive back from work or stay up ad sleep before the ext shift; have a short sleep before your first ight shift; if comig off ight shifts, have a short sleep ad go to bed earlier that ight; oce you have idetified a suitable sleep schedule, try to keep to it. Make the eviromet favourable for sleepig 3 Sleep loss ad fatigue are some of the most sigificat problems for shift workers. It is importat to try ad maitai your ormal level of sleep ad rest. Daytime sleep is usually lighter, shorter ad of poorer quality tha ight time sleep. It is more frequetly disturbed because of warmer temperatures ad daytime oise. To help make the eviromet favourable for sleepig: sleep i your bedroom ad avoid usig it for other activities such as watchig televisio, eatig ad workig; use heavy curtais, blackout blids or eye shades to darke the bedroom; discoect the phoe or use a aswer machie ad tur the riger dow; ask your family ot to disturb you ad to keep the oise dow whe you are sleepig; discuss your work patter with close eighbours ad ask them to try ad avoid oisy activities durig your sleep time; if it is too oisy to sleep cosider usig earplugs, white oise or backgroud music to mask exteral oises; adjust the bedroom temperature to a comfortable level, cool coditios improve sleep. Maagig shift work Page 35 of 45

36 Health ad Safety Techiques to promote sleep 4 To promote sleepig, try to follow a similar routie to the oe you follow before a ormal ight s sleep. The followig tips may help you relax after a shift ad promote sleep: go for a short walk, relax with a book, liste to music ad/or take a hot bath before goig to bed; avoid vigorous exercise before sleep as it is stimulatig ad raises the body temperature; avoid caffeie, eergy driks ad other stimulats a few hours before bedtime as they ca stop you goig to sleep; do t go to bed feelig hugry: have a light meal or sack before sleepig but avoid fatty, spicy ad/or heavy meals, as these are more difficult to digest ad ca disturb sleep; avoid alcohol as it lowers the quality of sleep. Diet 5 It is very importat to cosider the timig ad quality of your meals. Digestive problems are commo i shift workers, due to disruptio of the iteral body clock ad poor diet. Pla your meals to help you stay alert at work ad to relax/sleep whe you eed to rest: regular light meals/sacks are less likely to affect alertess or cause drowsiess tha a sigle heavy meal; choose foods that are easy to digest such as pasta, rice, bread, salad, fruit, vegetables ad milk products; avoid fatty, spicy ad/or heavy meals as these are more difficult to digest. They ca make you feel drowsy whe you eed to be alert. They may also disturb sleep whe you eed to rest; avoid sugary foods, such as chocolate - they provide a short-term eergy boost followed by a dip i eergy levels; fruit ad vegetables are good sacks as their sugar is coverted ito eergy relatively slowly ad they also provide vitamis, mierals ad fibre; drik plety of fluid, as dehydratio ca reduce both metal ad physical performace, but avoid drikig too much fluid before sleepig, as this may overload the bladder. Stimulats ad sedatives 6 Shift workers ofte tur to stimulats such as coffee or cigarettes to keep them awake ad sedatives such as alcohol or sleepig pills to help them sleep. Avoid such aids, as they oly have short-term effects o alertess as tolerace to their effects develops. Persistet use may also icrease the risk of depedece: caffeie is a mild stimulat preset i coffee, tea ad cola as well as i tablet form ad i special eergy driks. It ca improve reactio time ad feeligs of alertess for short periods. Oly use caffeie occasioally ad do t rely o it to keep you awake. If you do decide to take caffeie or other stimulats, you should cosider what might happe whe its effects wear off, eg whe you are operatig machiery or drivig. avoid the use of alcohol to help you fall asleep. Although alcohol ca promote the oset of sleep it is also associated with earlier awakeigs, disrupted sleep ad poorer sleep quality. Regularly drikig too much icreases the risk of log-term damage to your physical ad metal health, your work, social ad persoal relatioships. Maagig shift work Page 36 of 45

37 Health ad Safety regular use of sleepig pills ad other sedatives to help sleep are ot recommeded, because they ca lead to depedecy ad addictio. ew drugs have recetly bee developed that ca alter our state of alertess. Although their use may be widespread abroad, the ways they work ad their logterm effects are ot yet fully uderstood. Cosequetly their use is ot advised, uless uder medical supervisio. Physical fitess ad a healthier lifestyle 7 A uhealthy lifestyle combied with shift work may icrease the likelihood of sleep disorders ad sleep loss or exacerbate existig sleep problems. A good diet, regular meals ad exercise ca improve sleep quality, health ad well-beig: you ca improve your fitess by spedig 30 miutes a day o a physical activity icludig housework ad walkig. Cosider joiig a gym or takig part i a regular exercise class; eat healthy meals o a regular basis; cut dow or give up smokig; reduce your alcohol itake; seek advice from your doctor, if you require regular medicatio such as isuli for diabetes or suffer from a chroic coditio such as epilepsy. Family ad frieds 8 Workig shifts that differ from the routies of frieds ad family ca leave you feelig isolated. It is importat to make the effort ot to lose cotact with them: talk to frieds ad family about shift work. If they uderstad the problems you are facig it will be easier for them to be supportive ad cosiderate; make your family ad frieds aware of your shift schedule, so they ca iclude you whe plaig social activities; make the most of your time off ad pla meal times, weekeds ad eveigs together; pla your domestic duties aroud your shift schedule ad try to esure that you do ot complete them at the cost of rest/sleep. You may eed to chage the times/days whe some jobs are doe; ivite others who work similar shifts to joi you i social activities whe others are at work ad there are fewer crowds. Ways to improve your alertess at work 9 O some shifts, such as ights ad very early morigs, you may fid it difficult to remai alert ad this ca affect your performace. It may also icrease the risk of mistakes, ijury ad accidets. You may fid it helpful to: take moderate exercise before startig work which may icrease your alertess durig the shift; keep the light bright; take regular short breaks durig the shift if possible; get up ad walk aroud durig breaks; pla to do more stimulatig work at the times you feel most drowsy; keep i cotact with co-workers, as this may help both you ad them stay alert. Maagig shift work Page 37 of 45

38 Health ad Safety Appedix 3 Assessmet tools ad techiques 1 A umber of tools ad techiques are available, which may help you to assess the risks associated with shift work. Tools that assess the risks of particular shift schedules geerally use mathematical modellig to assess the ifluece of factors such as time ad duratio of shift, umber ad legth of rest breaks ad rest days ad cumulative fatigue (ie the build up of fatigue from sleep disruptio). 2 HSE s Fatigue ad Risk Idex Tool cotais two idices. The Fatigue Idex icorporates factors kow to be related to the build up of fatigue, icludig shift timig, shift duratio, breaks, rest periods, cumulative fatigue (ie the build up of fatigue from sleep disruptio) ad the workload ad its output relates to the probability of high levels of sleepiess. The Risk Idex is based o occupatioal ijury data ad is expressed i terms of the relative risk of a icidet occurrig. 3 There are also a umber of questioaires/surveys available. These rage from the very simple, such as the Epworth Sleepiess Scale, which provides a measure of a idividual s geeral level of daytime sleepiess, to more complicated surveys, icludig the Stadard Shiftwork Idex ad the Swedish Occupatioal Fatigue Ivetory that have bee developed for assessig large groups of idividuals. 4 Other techiques that might also be valuable i the assessmet ad maagemet of the risks associated with shift work iclude the use of sleep diaries, health assessmets ad employee educatio programmes. Summary evaluatio of tools used to estimate shift work-associated fatigue Stoe B M 2004 Tools ad techiques for estimatig risks associated with shift work Rail Safety ad Stadards Board Huma Factors Research Catalogue CD-ROM 2004 HSE s Fatigue ad Risk Idex Tool The developmet of a fatigue/risk idex for shiftworkers RR446/2006 Available from A electroic versio of the Fatigue ad Risk Idex Tool is available at gov.uk/research/rrpdf/rr446cal.xls The Epworth Sleepiess Scale Johs M W A ew method for measurig daytime sleepiess: The Epworth sleepiess scale Sleep (6) The Stadard Shiftwork Idex Barto J, Spelte E, Totterdell P et al The Stadard Shiftwork Idex: A battery of questioaires for assessig shift-related problems Work ad Stress (1), 4-30 Swedish Occupatioal Fatigue Ivetory Ahsberg E, Gamberale F ad Kjelberg A Perceived Quality of Fatigue durig Differet Occupatioal Tasks. Developmet of a Questioaire Iteratioal Joural of Idustrial Ergoomics (2) Maagig shift work Page 38 of 45

39 Health ad Safety Appedix 4 Further sources of iformatio ad help Govermet bodies Health ad Safety Rose Court 2 Southwark Bridge Lodo SE1 9HS Tel: Fax: [email protected] web: Departmet of Trade ad Idustry Respose Cetre 1 Victoria Street Lodo SW1H 0ET Tel: [email protected] Website: Departmet of Health Richmod House 79 Whitehall Lodo SW1A 2NL Tel: [email protected] Website: Professioal societies whose membership icludes experts i huma performace, fatigue, shift work ad huma reliability The Ergoomics Society Elms Court Elms Grove Loughborough Leicestershire LE11 1RG Tel: Fax: [email protected] Website: The British Psychological Society St Adrews House 48 Pricess Road East Leicester LE1 7DR Tel: Fax: [email protected] Website: The Society of Occupatioal Medicie 6 St Adrews Place Regets Park Lodo NW1 4LB Tel: Fax: [email protected] Website: The British Occupatioal Health Society 5/6 Melboure Busiess Court Milleium Way Derby DE24 8LZ Tel: Fax: [email protected] Website: Other orgaisatios with a iterest i huma performace, fatigue, shift work ad huma reliability The Royal Society for the Prevetio of Accidets RoSPA House, Edgbasto Park, 353 Bristol Road, Edgbasto, Birmigham B5 7ST Tel: Fax: [email protected] Website: The Workig Time Society AUDI AG I/SG-1 D Igolstadt Germay Tel: Fax: [email protected] Website: Europea Foudatio for the Improvemet of Livig ad Workig Coditios Wyattville Road, Loughlistow Dubli 18, Irelad Tel: Fax: [email protected] Website: Advisory, Cociliatio ad Arbitratio Service (ACAS) Brado House 180 Borough High Street Lodo, SE1 1LW Tel: Website: Trades Uio Cogress Cogress House Great Russell Street Lodo, WC1B 3LS Tel: Fax: [email protected] Website: Maagig shift work Page 39 of 45

40 Health ad Safety Appedix 5 Refereces ad further readig Refereces 1 The Workig Time Regulatios 1998 (as ameded) SI1998/1833 The Statioery Office1998 ISBN Departmet of Trade ad Idustry Your Guide to the Workig Time Regulatios: Workers ad Employers Available olie at 3 Office of Rail Regulatio 2006 The Railways ad other Guided Trasport Systems (Safety) Regulatios Office of Rail Regulatio Guidace o Maagig fatigue i safety-critical work is i preparatio. it will be available olie at 5 Health ad Safety at Work etc Act 1974 (c.37) The Statioery Office 1974 ISBN Maagemet of health ad safety at work. Maagemet of Health ad Safety at Work Regulatios Approved Code of Practice ad guidace L21 (Secod editio) HSE Books 2000 ISBN Safety represetatives ad safety committees L87 (Third editio) HSE Books 1996 ISBN A guide to the Health ad Safety (Cosultatio with Employees) Regulatios Guidace o Regulatios L95 HSE Books 1996 ISBN Cosultig employees o health ad safety: A guide to the law Leaflet INDG232 HSE Books 1996 (sigle copy free or priced packs of 15 ISBN ) 10 Advisory, Cociliatio ad Arbitratio Service Chagig patters of work ACAS Publicatios 2002 ACAS Advisory Booklet No B09 11 M c Ormod T Chages i workig treds over the last decade Labour Market Treds (1) Office for Natioal Statistics Labour Force Survey The Statioery Office Successful health ad safety maagemet HSG65 (Secod editio) HSE Books 1997 ISBN Mok T H ad Folkard S Makig shiftwork tolerable Taylor ad Fracis Smith C S, Folkard S ad Fuller J A Shiftwork ad Workig Hours i Hadbook of Occupatioal Health Psychology Washigto DC: America Psychological Associatio 16 Miors D S ad Waterhouse J M Circadia rhythms i geeral Occupatioal Medicie (2) Pesylvaia USA: Haley ad Belfus Maagig shift work Page 40 of 45

41 Health ad Safety 17 Åkerstedt T, Czeisler C, Diges D F et al Accidets ad Sleepiess: A cosesus statemet from the Iteratioal Coferece o Work hours, Sleepiess ad Accidets Joural of Sleep Folkard S ad Tucker P Shift work, safety ad productivity Occupatioal Medicie (2) Krueger G P Sustaied work, fatigue, sleep loss ad performace: A review of the issues Work ad Stress (2) Harriso Y ad Hore J M The impact of sleep deprivatio o decisio makig: A review Joural of Experimetal Psychology: Applied (3) Kroemer K E H ad Gradjea E Fittig the task to the huma: A textbook of Occupatioal Ergoomics (Fifth editio) Taylor ad Fracis Folkard S, Lombardi D A ad Tucker P Shiftwork: Safety, sleepiess ad sleep Idustrial Health , Hore J A ad Reyer L A Vehicle accidets related to sleep: A review Occupatioal ad Evirometal Medicie (5) Departmet for Trasport/Office for Natioal Statistics Road Casualties Great Britai: 2004 The Statioery Office 2004 ISBN Available olie at dft_trasstats_ pdf 25 Royal Society for the Prevetio of Accidets Driver Fatigue Ad Road Accidets. A Literature Review Ad Positio Paper 2001 Available olie at ifo/fatigue.pdf 26 Mittler M M, Carskado M A, Czeisler C A et al Catastrophes, Sleep ad Public Policy: Cosesus Report Sleep (1) Diges D F A overview of sleepiess ad accidets Joural of Sleep Research (S2) Costa G The impact of shift ad ight work o health Applied Ergoomics Europea Foudatio for the Improvemet of Livig ad Workig Coditios Shiftwork ad Health Office for official publicatios of the Europea Commuities, Bulleti of Europea studies o time No 1/ Harrigto J M Health effects of shiftwork ad exteded hours of work Occupatioal ad Evirometal Medicie Kutsso A Health disorders of shift workers Occupatioal Medicie (2) Nurmie T Shift work ad reproductive health Scadiavia Joural of Work, Eviromet ad Health (S3), Shift work ad breast cacer: a critical review of the epidemiological evidece HSE 2003 Available olie at Maagig shift work Page 41 of 45

42 Health ad Safety 34 Society of Occupatioal Medicie Guidace o the Provisio of Health Assessmets Uder the Workig Time Regulatios 1998 Society ad Faculty of Occupatioal Medicie Härmä M Ageig, physical fitess ad shiftwork tolerace Applied Ergoomics (1) Nachreier F Idividual ad social determiats of shiftwork tolerace Scadiavia Joural of Work, Eviromet ad Health (S3) Costa G Factors ifluecig health of workers ad tolerace to shift work Theoretical Issues i Ergoomics Sciece (3-4) Folkard S, Sutto L ad Yates A Impact of shiftwork o fatigue Rail Safety ad Stadards Board Huma Factors Research Catalogue CD-ROM Loudou R J ad Bohle P L Work/o-work coflict ad health i shiftwork: Relatioships with family status ad social support The Iteratioal Joural of Occupatioal ad Evirometal Health (3), S71-S77 40 Costa G Shift work ad occupatioal medicie: A overview Occupatioal Medicie (2) Kauth P ad Horberger S Prevetative ad compesatory measures for shift workers Occupatioal Medicie (2) Natioal Istitute for Occupatioal Safety ad Health Plai Laguage about Shiftwork 1997 Available olie at 43 Workplace health, safety ad welfare. Workplace (Health, Safety ad Welfare) Regulatios Approved Code of Practice L24 HSE Books 1992 ISBN Further readig Other sources of iformatio used i the productio of this guidace Ahasa R, Lewko J, Campbell, D et al Adaptatio to ight shifts ad sychroisatio processes of ight workers Joural of Physiological Athropology (4) Åkerstedt T Shift work ad disturbed sleep/wakefuless Occupatioal Medicie (2) Åkerstedt T, Klecklud G, Gillberg M et al Sleepiess ad days of recovery Trasportatio Research 2000 F Boefod A, Tassi P, Roge J et al A critical review of techiques aimig at ehacig ad sustaiig worker s alertess durig the ight shift Idustrial Health Burgess H J, Sharkey K M ad Eastma C I Bright light, dark ad melatoi ca promote circadia adaptatio i ight shift workers Sleep Medicie Reviews 6 (5) Driskell J E The efficacy of aps as a fatigue coutermeasure: A meta aalytic itegratio Huma Factors (2) Maagig shift work Page 42 of 45

43 Health ad Safety Europea Foudatio for the Improvemet of Livig ad Workig Coditios Cotiuous shift systems 1998 Office for official publicatios of the Europea Commuities, Bulleti of Europea studies o time No. 11/1998 Folkard S Is there a best compromise shift system? Ergoomics (12) Folkard S ad Akerstedt T Treds i the risk of accidets ad ijuries ad their implicatios for models of fatigue ad performace Aviatio, Space ad Evirometal Medicie (3 Suppl) A Effective shift hadover: A literature review OTO HSE 1996 Available olie at Shiftwork, Health ad Safety: A overview of the scietific literature CRR 31/1992 HSE 1992 Available olie at idex.htm Iteratioal Labour Orgaizatio Workig time: Its impact o health ad safety Occupatioal Safety ad Health Research Istitute 2003 Available olie at www. ilo.org/public/eglish/protectio/codtrav/publ/wtwo-as-03.htm Jais I Victims of Groupthik: A Psychological Study of Foreig-Policy Decisios ad Fiascoes Houghto Miffli 1972 ISBN Johs M W A ew method for measurig daytime sleepiess: the Epworth sleepiess scale Sleep (6) Joste E J C, Ng-A-Tham J E ad Thierry H The effects of exteded workdays o fatigue, health, performace ad satisfactio i ursig Joural of Advaced Nursig 44 (6) Kogi K Likig better shiftwork arragemets with safety ad health maagemet systems Revista de Saúde Pública (Suppl) Kauth P Desigig better shift systems Applied Ergoomics (1) Mohre D C, Jase, N W, Kat I J et al Prevalece of commo ifectios amog employees i differet work schedules Joural of Occupatioal ad Evirometal Medicie (11) Plus Erratum i: Joural of Occupatioal ad Evirometal Medicie 45 (1) 105 Mok T What ca the chroobiologist do to help the shift worker? Joural of Biological Rhythms (2) Mok T H, Folkard S ad Wedderbur A I Maitaiig safety ad high performace o shiftwork Applied Ergoomics (1) Natioal Istitute for Occupatioal Health ad Safety Overtime ad exteded work shifts: Recet fidigs o illess, ijuries ad health behaviours NIOSH Publicatios Dissemiatio DHHS (NIOSH) 2004 Publicatio Number Available olie at Reid K ad Dawso D Comparig performace o a simulated 12 hour shift rotatio i youg ad older subjects Occupatioal ad Evirometal Medicie Roehrs T ad Roth T Sleep, sleepiess, sleep disorders ad alcohol use ad abuse Sleep Medicie Reviews (4), Maagig shift work Page 43 of 45

44 Health ad Safety Smith L, Folkard S, Tucker P et al Work shift duratio: a review comparig 8 hour ad 12 hour shift systems Occupatioal ad Evirometal Medicie Stutts J C, Wilkis J W, Osberg J S et al Driver risk factors for sleep-related crashes Accidet Aalysis ad Prevetio Takeyama H, Kubo T ad Itai T The ighttime ap strategies for improvig ight shift work i workplace Idustrial Health , Tucker P The impact of rest breaks upo accidet risk, fatigue ad performace: a review Work ad Stress (2) Tucker P, Folkard S ad MacDoald I Rest breaks ad accidet risk The Lacet Tucker P, Smith L, MacDoald I et al The impact of early ad late shift chageovers o sleep, health ad well-beig i 8- ad 12-hour shift systems Joural of Occupatioal Health Psychology (3) Tucker P, Smith L, MacDoald I et al, Distributio of rest days i 12 hour systems: impacts o health, well beig ad o shift alertess Occupatioal ad Evirometal Medicie Tucker P, Smith L, MacDoald I et al Effects of directio of rotatio i cotiuous ad discotiuous 8 hour shift systems Occupatioal ad Evirometal Medicie Wilso J L The impact of shift patters o healthcare professioals Joural of Nursig Maagemet Wortley V ad Grierso-Hill L Developig a successful self-rosterig shift system Nursig Stadard (42) Maagig shift work Page 44 of 45

45 Health ad Safety Further iformatio HSE priced ad free publicatios ca be viewed olie or ordered from or cotact HSE Books, PO Box 1999, Sudbury, Suffolk CO10 2WA Tel: Fax: HSE priced publicatios are also available from bookshops. For iformatio about health ad safety rig HSE s Ifolie Tel: Fax: Textphoe: [email protected] or write to HSE Iformatio Services, Caerphilly Busiess Park, Caerphilly CF83 3GG. The Statioery Office publicatios are available from The Statioery Office, PO Box 29, Norwich NR3 1GN Tel: Fax: [email protected] Website: (They are also available from bookshops.) Statutory Istrumets ca be viewed free of charge at Published by HSE 09/09