Mark Holmes, Circadian Australia - Fitness for Work: Ensuring Alertness on Duty in the Control Room

Copyright Circadian Technologies, Inc. 2010 9/747 Fairfield Road, Yeerongpilly QLD 4178 Phone: +617 3392 9529 Fax: +617 3319 6602

www.circadianaustralia.com.au www.fa1guetrainingonline.com

Presented by Mark Holmes Chairman

Circadian® Australia e: [email protected]

M: +61 (0) 409 265 278

ENSURING ALERTNESS ON DUTY IN THE CONTROL ROOM

Copyright Circadian Technologies, Inc. 2010


ACTIGRAPHY

9/747 Fairfield Road, Yeerongpilly QLD 4178 Phone: +617 3392 9529 Fax: +617 3319 6602

The Value of Ac1graphy Delivering Objec1ve Sleep Data

In “Con1nuous Improvement”

Fa1gue Risk Management Systems




The Global Standard in Avia1on, Refining & Petrochemicals, Gas Pipeline,

Nuclear Power & Mining Industries

FATIGUE RISK MANAGEMENT SYSTEMS FRMS




CIRCADIAN® Founded by Dr. Martin Moore-Ede




CIRCADIAN® GLOBAL OFFICES

San%ago Brisbane Johannesburg (2015)

Jakarta

Osaka

London

Boston Toronto

St Petersburg Amsterdam Schmalkalden

Global Clients – Global Service Delivery



FINANCIAL DISCLOSURE


Mark Holmes is chairman, and a shareholder of Circadian Holdings Australia Pty Ltd “CIRCADIAN® AUSTRALIA” A 100% OWNED AND OPERASTED Australian company and an affiliate of Circadian Inc., the licensee of CIRCADIAN® branded products & services to the interna1onal group of CIRCADIAN® companies servicing more than 50% of the Fortune 500 corpora1ons and many interna1onal companies. Consul%ng Services: Fa1gue Risk Management System (FRMS) Design & Implementa1on, Fa1gue Risk Assessments, Shiiwork Opportunity Assessments, Shii Schedule Op1miza1on Program, Staffing Level Analysis, and Fa%gue Risk Assessments (FRA’s). Seminars & Training Programs: Managing a Shiiwork Lifestyle, Supervisor Fa1gue Training, Train the Trainer Programs, Workshops & Seminars on shiiwork and FRMS Publica%ons & Media: Working Nights publica1ons and newslelers, video, CD-‐ROM, DVD, management reports, books and white papers available on www.circadianaustralia.com.au SoCware Tools: Circadian Alertness Simulator (CAS), Fa1gue Accident/Incident Causa1on Tes1ng System (FACTS), Schedule Risk Analyser Online Tools: Fa1gue Training Online , FACTS Online, Schedule Risk Analyser. Health Screening & Assessment: Sleep Apnea Screening and Training, Diagnosis and Treatment (u1lising FDA approved ARES OSA diagnosis kit) Products: Readiband Ac%graphy Watch (from Fa1gue Science, Vancouver.)


90% of Incidents & Accidents are caused by Human Error

70% of Human Error Incidents &

Accidents are caused by

Fa1gue


Accident Inves1ga1ons Reveal:



Fa1gue can be described as: “a state of impaired physical and/or mental performance and lowered alertness arising as a result of inadequate restora1ve sleep. Other mediators of fa1gue are 1me of day and length of 1me awake”


What is Fa1gue?




Consequences of Fa1gue in Control Rooms

Employee Turnover and Absenteeism Adverse Health Consequences Adverse Family & Social Impacts Increased Error Rates Process Risk Reduced Produc1vity REPUTATION – License to Operate And more.....$$$$$$$ cost



Then… …and Now

Humans were not designed for peak performance at night


Human Design Specs

! Alertness levels naturally fluctuate during the day and night ! Basic func1ons – diges1on, body temperature – follow predictable 24-‐

hour palerns ! Adjustment to night work creates health challenges for shiiworkers ! Performance decreases during overnight and post-‐lunch dip hours ! Fa1gue supercedes training & experience ! Fa1gue is a major cause of human error


!   SCN controls hundreds of biological rhythms, including alertness, diges1on, hormone produc1on, blood pressure, mood, etc.

!   Light has the greatest effect in controlling the biological clock !   The rhythms of the SCN are a basic physiological func1on – It is

difficult to fool or “tough it out” !   Understanding physiology is cri1cal to successful shiiwork

management www.circadianaustralia.com.au www.fatiguetrainingonline.com

Cerebral Cortex Hypothalamus

SCN

Eye Brain Stem

Spinal Cord Optic Nerve

Physiology: Well Established Scien1fic Research on Biological Clock (SCN)

Pituitary


Core Body Temperature

36.9

35.8

11 pm 7 am 11 pm 7 am

Sleep Night ShiC


Circadian Temperature Rhythms

Dusk Dawn Dusk Dawn

Maximum Fa%gue/Improved Alertness



-‐-‐-‐-‐-‐ Reac1on 1mes -‐-‐-‐-‐-‐ Simple math -‐-‐-‐-‐-‐ Driving simula1on -‐-‐-‐-‐-‐ Flight simula1on

-‐-‐-‐-‐-‐ Hand-‐eye coordina1on

Performance Variability in a 24-‐Hr Period


Time of the Day noon 3pm 6pm 9pm midnight 3am 6am 9am noon

10 5 0

-‐05

-‐10

-‐15

-‐20



Time of the Day Rela1ve Risk Circadian Temperature Rhythms (Body Temperature)

Source: Mitler, et al 1997

Fatal Accidents by Time of Day


Far greater risk of fatal accidents in

night hours



!   State of impaired mental/physical performance !   Impaired or reduced alertness !   Reduced vigilance/alen1veness !   Loss of cogni1ve and logical reasoning skills !   Impaired judgment !   Reduced motor coordina1on !   Slower reac1on 1me !   Inability to process communica1ons

What is Fa1gue?




1. Circadian (Body Clock) Factors !   Working when you would normally be asleep !   Sleeping when you would normally be awake !   Frequently having to change your sleep/wake cycles

!   Misalignment of daily alertness cycles with work requirements

What Causes Fa1gue?




2. Sleep Factors !   Geung less than normal hours of sleep !   Geung poor quality of sleep !   Having poor or inconsistent bed1me rou1nes !   Having a poor or inadequate sleep environment


What Causes Fa1gue? (contd…)




3. Work and Environmental Factors !   Having early shii start 1mes !   Having to work fast rota1ng schedules and/or long, irregular hours (i.e. over1me)

!   Having inadequate rest/recovery 1me between shiis and/or work blocks

!   Having boring/monotonous work environment

!   Having boring/monotonous job





4. Health Factors !   Medical sleep disorder problems !   Underlying health issues (e.g. hypertension,

diabetes, epilepsy, etc.)

!   Improper 1ming and content of food (i.e. building cardiac risk factors, diges1ve disorders, etc.)

!   Use/abuse of coping substances (e.g. caffeine, sleeping pills, alcohol, etc.)

!   General lifestyle issues



Consequences of Fa1gue The Dangers of Microsleeps

Unit 9, 747 Fairfield Road· Yeerongpilly QLD 4105· Phone: (07) 3392 9529 Unit 9, 747 Fairfield Road· Yeerongpilly QLD 4105· Phone: (07) 3392 9529


The following video shows part of a sleep depriva1on experiment. Seanan, in Canada, works as a paramedic whilst also studying medicine at night and training hard as a karate black belt. As a fit and healthy 24 year old, he has volunteered to have only 3 hours sleep a night in 3 days. That’s only 9 hours sleep in 3 days. Let’s see how he performs in a driving test.


The Dangers of Microsleeps




Workers Compensa1on Costs Effec1veness of Fa1gue Management Programs



Alertness Repor1ng for Duty

Individual Shiiwork Tolerance

Sleeping Facili1es

Shiiwork Lifestyle

Adapta1on

Over1me

Shii Schedule

Cumula1ve Sleep Dura1on & Quality

Time of Day

Elapsed Hours Awake

Vigilance & Safe Driving Performance

Plant Opera1ons Environment

Alertness on Duty

Alertness Support Systems

Alertness Monitors

Alertness Recovery Procedures

Policies and Procedures

Personal Prac1ces


Determinants of Alertness & Performance in the Total Shiiworker Environment



STAKEHOLDER EDUCATION

& COOPERATIVE DESIGN

Defenses in Depth

Fa%gue

Hazards

Fa%gue

Accidents

& Losses


Reason’s Defenses in Depth Concept (Slices of Swiss Cheese)

Based on James Reason’s concept




•  American Petroleum Ins%tute published ANSI standard RP-‐755 requiring all US refineries & petrochemical plants to implement a comprehensive CIRCADIAN® FRMS (Fa%gue Risk Management System)

n  US law HR 5900 requiring all airlines to implement a comprehensive CIRCADIAN® FRMS (Fa%gue Risk Management System)

n  Interna%onal Civil Avia%on Organiza%on (ICAO) issued FRMS guidelines for all airlines

n  New US pipeline safety agency (PHMSA) regula%ons requires fa%gue risk management

n  Many mul%na%onal corpora%ons implemen%ng FRMS across their global opera%ons

Emergence of FRMS as a Global Standard since 2009



Fa1gue Risk Management System


FRMS -‐ should be based on sound science and recognise opera1onal issues, and shall include consulta1on with key stakeholders in the development and implementa1on of the local applica1on of the FRMS. The FRMS should include a process to review and enhance the FRMS, as needed, with a goal of con1nuous improvement.


Fatigue-related Errors

Peer monitoring Fitness for duty audit, Alertness monitoring

Goa

ls

Act

ions

M

etri

cs

Sufficient Staffing Levels

Defence 1 Sufficient

Sleep Opportunity

Shift / Duty scheduling, Overtime policies,

Fatigue risk models

Sufficient Sleep

Obtained

Employee training

Sleep disorder

treatment & compliance

Sufficient Workplace Environmen

t

Sufficient Alertness Behavior

Schedule Driven Fatigue

Risk

Sleep Deprivation

Lifestyle stress

Workplace Environmen

t Fatigue

Excessive overtime Staffing

Imbalance

Workload- Staffing Balance

Proportional 24/7 staffing

Workplace design,

Light color filtering,

Rest policies

SLEEP ALERTNESS Defence 2 Defence 3 Defence 4 Defence 5

Fatigue Risk Root Cause Analysis


Fa1gue Risk Management System Steps in Con1nuous Improvement Process

Inci

dent

s &

Acc

iden

ts

FACTS



ACTIGRAPHY


The Value of Ac1graphy Delivering Objec1ve Sleep Data

In “Con1nuous Improvement”

Fa1gue Risk Management Systems


WHAT IS ACTIGRAPHY?



Ac%graphy is a non-‐invasive technique used to assess cycles of ac1vity and sleep over a period of 1me (several days to several weeks).


WHY USE ACTIGRAPHY?




SELF JUDGEMENTS ARE INACCURATE




ACTIGRAPHY



Tracks 3D movements of the wrist 16 1mes per second and then uses a sophis1cated algorithm to analyse the quality and quan1ty of sleep, and like a blood alcohol test, how those levels affect performance and reac1on 1mes.


How is Sleep affec1ng Your Control Room Workforce?

•  The only way you can find out how sleep is affec1ng your workforce is with accurate SCIENTIFICALLY VALIDATED informa1on.



!   Lightweight !  Waterproof

!   Indestruc1ble

•  Based on a model developed by the US Military to convert fa1gue levels into performance data

•  FDA and Health Canada approved & is easy to wear

•  Recommended by the American Academy of Sleep Medicine


ACTIGRAPHY



SCREEN Schedule all workers for ac1graphy screening Screen all new employees prior to start Integrate ac1graphy screening as part of procedural devia1on & incident inves1ga1on


ACTIGRAPHY



IDENTIFY Analyse management data to gain insight on overall fa1gue levels Iden1fy high-‐risk individuals and groups Define ac1on plan for high-‐risk individuals


ACTIGRAPHY



IMPLEMENT Limit high-‐risk individuals to low-‐risk schedules Define processes for diagnosis and treatment of sleep issues Provide Fa1gue Awareness, Educa1on and Training and promote the importance of good sleep hygiene


ACTIGRAPHY



MONITOR Re-‐screen high risk workers to monitor the success of controls Monitor the impact of health, lifestyle and shii changes on sleep palerns Illustrate material improvement to management, insurance providers and shareholders


ACTIGRAPHY WEB DASHBOARD AGGREGATED SLEEP METRICS




ACTIGRIPHY Web Dashboard AVERAGE SLEEP SCORES BY USER




CONTROL ROOM OPERATOR GOOD SLEEPER



SLEEP QUANTITY & QUALITY

Night sleep

Day Sleep

Day Sleep

Night Sleep





PERFORMANCE & RISK LEVELS






Night ShiC Night ShiC

Night ShiC

28/11/13 to 7/12/13


CONTROL ROOM OPERATOR GOOD SLEEPER – SLEEP QUALITY




CONTROL ROOM OPERATOR POOR SLEEPER



SLEEP QUANTITY & QUALITY

Poor Night Sleep

Poor Day Sleep

Poor Day Sleep

Poor Night Sleep

Poor Night Sleep











Night ShiC

Night ShiC

27/11/13 TO 19/12/13


CONTROL ROOM OPERATOR POOR SLEEPER – SLEEP QUALITY





BAC SCALE (Blood Alcohol Concentra1on)



Performance Comparison Good Sleeper V Poor Sleeper

Mental Effec%veness & BAC Equivalence at 4am on Night ShiC

Good Sleeper Poor Sleeper 1st Night Shift 1st Night Shift

70% Mental Effectiveness 64% Mental Effectiveness 0.08 BAC Equivalence Attention lapse 6.5 x more likely*

2nd Night Shift 2nd Night Shift 69.4% Mental Effectiveness 60.3% Mental Effectiveness

0.08 BAC Equivalence

Attention lapse 8 x more likely*

* more likely than a person with 100% mental effectiveness



THANK YOU
