La ocupación en la economía social y el tercer sector

The following measures are examples of proactive measures as an ingredient of a Fa- tigue Management System.

Working hours & Shift System assessment

An important proactive measure often found in F(R)MS’s is that of assessing working hours and estimating the related fatigue risk. The main idea is that one inputs a work schedule into a (computer) program which calculates the expected risk of fatigue. The analyses performed are based on factors like, the length of the working hours, the tim- ing of shifts (circadian elements) and recuperation periods (cumulative fatigue), fre- quency of breaks, the content of work, early morning shifts, etc. Using these factors it is possible to analyse work patterns with respect to safety and fatigue both prospec- tively and retrospectively.

The FAID software tools for instance are used regularly in retrospective analysis of actual hours of work.

Example:

Fatigue Audit Inter Dyne (FAID) is designed for use by individuals, dispatchers or adminis- trators involved in scheduling workers and constructing rosters. With an increasing corpo- rate recognition of the risks involved with roster related fatigue, and the public awareness of the impact of these risks, there is a need to proactively address the problem of fatigue- inducing work practices.

FAID can be used as part of a fatigue risk management system to improve worker alertness and workplace safety. It is suited to many uses including the aviation industry, railways, truck transport and other areas where shift work and extended hours are potential problems.

The philosophy is: if the work is regular analysis can be prospective, where it is irregu- lar it is most appropriate to asses retrospectively. Figure 33 shows some example FAID output.

The software program using the FAID model is commercially available to company risk managers to see if enough sleeping opportunities are provided. Based on the out- come, it is possible to identify if fatigue and/or staffing levels are safe or not. Then, the core question is: “do we have the right balance?” The FAID and FAID-safe family of products expanded upon just hours of work analysis, also including elements related to the general fatigue management system like the development of management compe- tencies related to fatigue, the development of emergency plans, and the organisation of workshops on fatigue.

Other authors and institutions have developed similar roster analysis modelling sys- tems, for instance; the Sleep, Activity, Fatigue, and Task Effectiveness (SAFTE) model, developed for the US Department of Defence (DOD) (Hursh, et al, 2004) and HSE Fatigue Index, developed for the UK Heath and Safety Executive (Spencer, Robertson, & Folkard, 2006). The system developed for the UK Health and Safety Executive (HSE) additionally attempts to move from the prediction of fatigue to the prediction of risk directly (Spencer, Robertson, & Folkard, 2006). Fatigue models tend to base their predictions on experimental sleep research while the risk-index is based on real world risk research (e.g. observed relative incident risk in shifts). However the risk-index is a new development and explicitly not intended to replace fatigue model- ling but is according to HSE to be used in conjunction (for more information on the risk- index and the tool, see: http://www.hse.gov.uk/research/rrhtm/rr446.htm.)

In Germany mathematical fatigue models are developed to predict fatigue within the ALERT program. A system used primarily in road transport. The main determinants of fatigue are the time of the day (i.e. the circadian rhythm), time since last sleep and the time on a task. Fatigue resulting from performing a task superimposes on circadian and sleep-related fatigue. Breaks between tasks are supposed to "set back" fatigue to the value which is caused by the combined influence of the time of the day and sleep re- lated factors. Also within Germany a computer program (the DLR-program "ALERT") has been constructed on the basis of these mathematical models.

These programs can be used to predict phases of critically increased fatigue during a traffic operation. The program’s enable drivers and schedulers to plan operations and rosters carefully to keep alertness at an acceptable level.

According to one of the interviewed experts, the shipping industry as such needs a supporting tool to make a better planning and to discover causes of fatigue. In Den- mark there are already initiatives (Andreas Northseth, Denmark) to develop such com- puter-based tools as well. This diagnosis and planning tool gives insight in distribution of tasks/workload/rest periods on board. Inspiration for this initiative was a more flexible way of manning ships. This tool could also be used for safe-manning.

Roster analysis and modelling as provided by FAID, SAFTE, ALERT or the Fa- tigue/Risk Index can be used both retrospectively (e.g. are our rosters ‘safe’ with re- spect to fatigue) and prospectively (e.g. can we schedule this trip for this driver at this time). Additionally these systems can provide insight into the fatigue risks of nomi- nally legal work plans. The model might for instance communicate to planners that a ‘roster is legal but ill-advised as it runs a real risk of excessive fatigue, especially at these days/times of the schedule’. In this manner fatigue modelling can play an impor- tant part in any fatigue management program.

Although all aforementioned fatigue models are based strongly on the very influential three process model developed in sleep science, they may differ in their scientific de- tails leading to subtly different predictions. For mathematical fatigue models to be ac-

curate, the impacts of the different determinants have to be quantified. To this end, fatigue data have to be obtained from drivers of different transport modes (e.g. truck, aeroplane, rail transport) at different times of the day, considering the time since last sleep and time on duty.

Related to shift systems and rostering some experts underline the need for better en- forcement of the existing rules and regulations in the shipping industry. Nowadays seafarers sometimes falsify documents regarding work and rest hours. Research shows that e.g. the working time directives quite frequently broken by companies (Cardiff report, Smith, 2006). From the documents it seems that everyone complies with the rules and regulations, but this picture does not match reality. This has been a discus- sion in Denmark in the end of 2007: how should we effectively enforce rules and regu- lations? If everybody complies then there wouldn’t be a problem. The arrangement on working hours form a part of the ISM safety management systems on ships and within companies, but as long as the rules are not followed, this will not give solutions. Quote: “In shipping one can question if it is hours of work or hours of rest that matters. On shore most is about hours of work, but in shipping industry hours of rest may be far more important.” Actually we think it is the hours of rest that matter, also on shore. Some experts say: still, the best way to prevent fatigue in the shipping industry if the shipping industry worked in the same way as aviation, in which there are always two people available. The best way to prevent negative consequences of someone to fall asleep is to have a second person available, but they have to be comparable in ranking. Fit for duty

Whose responsibility is it to check if someone is fit for duty? Logically it is the master. Seasickness is also an issue, but it is hardly ever talked about (if someone has been vomiting all night, he lost sleep). It affects performance.

Fitness for Duty can be checked by means of tests applied before the start of duty which give information about the physiological and psychological status of the driver and his or per preparedness to drive.

− The prior sleep wake model (Dawson & McCulloch, 2005.)

In Europe the Risk Management Approach of the human factors already existed for a longer time. Fatigue is integrated in the concept of Bridge Resource Man- agement (like crew resource management training in aviation). This provides the opportunity to manage fatigue in irregular working conditions.

The main issue is that there is no regulation of working hours, since this has ap- peared to be ineffective. Working hours are managed by the ‘prior sleep wake model’. By using this model a probability of fatigue risks can be given.

According to this model, 3 questions will be asked prior before starting duty: 1. Did you have <5 hours of sleep in the last 24 hours prior to start? -> risk! 2. Did you have less than 12 hours sleep in the last 48 hours ? -> risk!

3. Have you been awake longer than the hours you slept in the last 24 hours? -> risk !

If there is a risk, the next step is to organize risk reduction activities based on risk as- sessment.

A scoring system and a risk- based profile will lead to a decision matrix. There are 3 levels of risk: green, yellow, red.

− YELLOW (a manageable increase of risk): fatigue countermeasures will be taken. Risk reduction has to equal risk activities, like e.g. increased level of supervision, task rotation (selection of tasks, staying in the office, etc).

− GREEN: ok.

Actually, it is a semi quantitative risk model.

The duration of development of the program is 2 to 3 weeks: countermeasures have to be developed, participation with the work floor and consultation.

Very important in this approach is the sense of ownership of employees. They have to be actively engaged and involved (e.g. in the development of countermeasures). Fit for duty tests (Gundel)

Before starting a potentially risky operation fit for duty tests may be presented to the driver on a Palm Computer. The test results indicate if the driver is in a proper state to drive, i.e. not fatigued to a critical extent. The data obtained are telemetrically trans- ferred to a computer comparing the present performance with stored data on the driver's performance in a clearly awake state. Impairments can be reported immedi- ately to both the driver and the scheduler.

Requirements and kinds of fit for duty tests

Fit for duty tests should be sensitive to the effects of fatigue or other performance de- grading influences. Possible fit for duty tests are reaction time tests or the unstable tracking task. Most importantly, tests should be easy to perform and valid. Unfortu- nately, several problems arise similar to those mentioned with driver assistance sys- tems.

Problems of fit for duty tests

First, it is necessary to find a behavioural parameter, which properly reflects fatigue or decreased fitness in a proper way. Second, one has to determine the critical threshold of the dependent variable above which the driver is advised not to drive. Due to large individual differences, this appears to be very difficult

Additionally, an important discussion around this type of technology is on benchmark- ing data. This can be based on either (a) population data or (b) individual historical data. Depending on which is used sensitivity and specificity of the task is very differ- ent and legal defensibility of the use of population data could be a problem.

Other proactive measures

− Good sleep environment/ appropriate areas for sleep/rest.

In shipping the quality of sleep is also an issue (acoustic, temperature, vibrations). If there is too much noise in the port to sleep, there are several possibilities. A sleeping environment can be provided in onshore facilities. Also industrial ear- plugs can help. . There is a device available that can be used on the wrist for sleep quality duration a simple and effective help is acoustic isolation.

− Special diets: how you handle diet is important. Timing of eating can be a fatigue minimization strategy, e.g. you get tired after a full meal (see example of tool in article Flower in Annex B).

− In road transport Driver Assistance Systems serve the function to prevent fatigue- related accidents by means of technical devices that give a warning signal in case fatigue arises (e.g. cameras recording eye-movements).

Example:

Swedish FMS- program in road transport by using technical devices as one of the elements (Lützhöft , 2007)

1. How does fatigue show?/how can you recognize it?/ how is the driving impaired? /

what is going on? (fatigue is one form of impairment)

2. Can I have a system to defect it? (VTI systems technical systems)

3. When I have defected it what can I do?

Examples of options are:

- disable the car

- Put all warning systems on a higher level?

- Next station and can I take a nap there?

- temperature/smell/music/vibration

4. Preventive, detecting first signs, early stages of fatigue, This is much more difficult.

Especially it is difficult to build a system, detecting fatigue. For humans it is easy to see if someone is getting fatigued. It is more difficult to do it for example by camera, physiological measurement, ECG brainwaves, etc.

Such systems are almost impossible to implement in real life. Camera systems are promis- ing. The car manufacturers are developing such systems. E.g. LEXUS had drowsiness de- tection. There are comparable experiments in simulators for shipping.

With physiological measurement not-normal driving is detected, e.g. the use of gear, the way the car moves on the road, speed, lateral position, steering wheel angle variation. This works now for 90%, it should work over 99% before the car manufacturers will use it without fear due to negative image and costs.

3.4.5 Reactive fatigue measures as potential ingredients of an FMS.