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Presented by:
Circadian Technologies
Stoneham, MA
www.circadian.com
2 Main Street, Suite 310 · Stoneham, MA 02180 · Phone: 781-439-6300 · Fax: 781-439-6399 Copyright Circadian Technologies, Inc. 2014
Circadian Technologies, Inc.
International research and consulting firm for 24-hour
operations
Based in Stoneham, Massachusetts (North of Boston)
Outgrowth of Harvard Medical School and the
discovery of human biological clocks
Utilizes objective, scientific approach to scheduling and
shiftwork issues
Assist companies improve operating efficiency and
overall health, safety & employee work/life balance
through development of Fatigue Risk Management
Programs (FRMP)
WE HUMANS DO NOT…
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Copyright Circadian Technologies, Inc. 2014
Design Specs of the Human Body
Cerebral
Hypothalamus Cortex
SCN
Brain Stem
Pituitary
Eye
Optic Nerve Spinal Cord
06 12 18 24 06 12 18 24 06
Time of Day
20
Full
Alertness
15
Moderate
Alertness Alertness
Level 10
(MSLT) Reduced
Alertness
5
Drowsy
0
12 15 18 21 24 03 06 09 12
Time of Day
Source: Circadian Technologies, Inc. (1993)
10
-5
Hand-eye coordination
Reaction times
-10
Simple math
Driving simulation
-15 Flight simulation
-20
noon 3pm 6pm 9pm midnight 3am 6am 9am noon
Time of Day
09 12 15 18 21 24 03 06 09
20
Full
Alertness
15
Moderate
Alertness Alertness
Level 10
(MSLT) Reduced
Alertness
5
Drowsy
0
0 5 10 15 20 25
Successive Hours of Sleep Deprivation
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Copyright Circadian Technologies, Inc. 2014
APPLYING FATIGUE MANAGEMENT
STANDARDS TO IMPROVE
OCCUPATIONAL HEALTH AND
SAFETY
Work/Rest
Training &
Human Standards
FRMS
FRMS
Education
Fatigue Employee
Workplace Risk Behavior
Environment
FRMS
Sleep Disorders
Compliance Monitoring and
Policies Human Error Analysis
and
Procedures
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Copyright Circadian Technologies, Inc. 2014
JAMES REASON’S
Multiple Causation Theory
Safe traffic
Lining up risks Safe
Safe road conditions
vehicle
Driver conditions
awareness
High-volume
Low tire traffic
Accident
Raining tread
Hands-free phone
conversation
Successive layers of defences, barriers, & safeguards
18 Source: Reason 1990
Copyright Circadian Technologies, Inc. 2014
INTEGRATED FRMS MODEL
SLEEP ALERTNESS
Defense 1 Defense 2 Defense 3 Defense 4 Defense 5
Sufficient Sufficient Sufficient Sufficient Sufficient
Goals
& Accidents
Shift / Duty Employee Job Peer
Incidents
Workload-
Staffing scheduling, training stimulation monitoring
Actions
Staffing
Levels
Provide an adequate staffing level to:
Maintain overtime at or below 10% of an
Workload-
Staffing average 40-42 hour work week
Actions
Balance
Consistently work within recognized Hours of
Proportional
24/7 staffing Service Guidelines
Excessive
– Consecutive & total workdays
– Time off between consecutive shifts and worksets
Metrics
overtime
Staffing
Imbalance Account for and provide coverage for
anticipated levels of training, vacations,
sickness and other absences
Sleep
Opportunity
Design Biocompatible
Shift / Duty
scheduling, Shift Schedules focused
Actions
Overtime
policies, Operational Employee On Three Main Criteria
Fatigue risk Requirements Preferences
models
Schedule
Metrics
Driven
Fatigue Risk
Physiological
Requirements
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Copyright Circadian Technologies, Inc. 2014
FRMS Defenses in Depth
#2. Core Schedule Design:
Biocompatible
Consecutive Workdays
7 with 8-hour shifts
4-5with12-hour shifts
Slow Rotation
(easier on body)
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Copyright Circadian Technologies, Inc. 2014
FRMS Defenses in Depth
#2. Schedule Design: Outer Limits
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Copyright Circadian Technologies, Inc. 2014
FRMS DEFENSES IN DEPTH
#3: SHIFTWORK LIFESTYLE TRAINING
Sleep
Obtained
Basic sleep, circadian, and fatigue physiology
Employee
training Strategies for achieving good quality, restorative
Actions
Sleep
disorder sleep including sleeping quarters design
treatment &
compliance Recognizing symptoms of sleep disorders
Sleep Managing an alert and healthy lifestyle
Metrics
Deprivation
Lifestyle
stress Understanding risks of fatigue impairment
Recognizing the signs of fatigue impairment and
ways to mitigate them
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Copyright Circadian Technologies, Inc. 2014
FRMS DEFENSES IN DEPTH
#3: SHIFTWORK LIFESTYLE TRAINING
Typical
Daytime
Schedule
Time of Day
Typical
Nighttime
Schedule of
“Daytime”
Person
Time of Day
Caffeine…The Pro’s:
• Can increase alertness
• Can improve reaction time
• Can improve performance
• Can improve overall energy
• Works quickly (in about 30 minutes)
• The effects last for 3-5 hours in most
people
The Cons:
• Can cause gastrointestinal problems
• Stays in the body for several hours
• Caffeine is addictive; a dependence can develop
• May worsen some sleep disorders
• High levels promote stress, anxiety and irritation
• Coffee is a mild diuretic (increases urine
production)
• Cutting back can cause withdrawal symptoms
None
1-3 cups
Constipation/ 4 cups or more
Diarrhea
Indigestion
Heartburn
Disturbed
Appetite
0 10 20 30 40 50
Percentage of Shiftworkers
Copyright Circadian Technologies, Inc. 2014
FRMS DEFENSES IN DEPTH
#3: SHIFTWORK LIFESTYLE TRAINING
Energy Drinks
• Becoming ever more popular
• U.S. sales were $10 billion+ in 2012
• Especially among younger shiftworkers (prefer over coffee)
• 4 calories
• caffeine based
• sugar free
• contains B vitamins and amino acids
• fruit flavored
• called a "dietary supplement"
• touted as a "pick me up" to increase alertness and energy
• company claims it "significantly" outperforms placebos in
attention and alertness tests
• company tests haven't been published or peer reviewed to
screen biases
• independent tests show that it contains about 207 mg of
caffeine, compared to an 8 ounce serving of Starbucks
coffee, which has 180 mg
• no research to suggest that B vitamins or amino acids
provide any boost
Workplace impacted by
Environment job design and
work
Job
environment workplace
stimulation
Actions
Workplace environment
design,
Light color
filtering,
Workplace Defense 3
Metrics
Environment
Fatigue
Defense 2 Defense 3
Alertness
Behavior are necessary.
Peer
monitoring
Actions
Fitness for
duty audit,
Fatigue Policies and Procedures
monitoring
Technologies
Fatigue-
Metrics
related
Errors
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Copyright Circadian Technologies, Inc. 2014
FRMS DEFENSES IN DEPTH
#5 FATIGUE MONITORING AND RISK MITIGATION.
Technology
Camera based, non-contact, non-
intrusive sensor observing the driver
Measures eyelid closure
Measures head orientation
Event Types Detected
Fatigue events characterised by
extended eye closure
duration>1.5sec / speed>4mph
Distraction events characterised by
glances away from the road
duration>4.5sec / speed>10mph
& Accidents
Incidents
The number of hours awake
The number of hours of sleep in the past 24-72 hours by the
individuals involved
Shift duration and any overtime worked
Operational condition: normal operation, extended shift, call out,
outage
& Accidents
Incidents
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Copyright Circadian Technologies, Inc. 2014
EXCESS COSTS OF FATIGUE IN
SHIFTWORK OPERATIONS
Total excess cost of increased absenteeism, turnover,
Extended hours operations cost U.S. businesses
health care, incidents & accidents and productivity loss
Over $200 billion annually ($8,577 per employee)
averages $10,100 per shiftworker per year
Absenteeism
25%
Productivity $59.3
38% $93.9 Billion
TOTAL COST/YEAR
Billion US ECONOMY
$46.0
= $242.5 BILLION
Billion
$33.3
Billion $10 Turnover
Billion 19%
Source: "Safety Analysis of Surface Mining Accidents," MSHA, 1998 and “Haulage Truck Dump
Site Safety," MSHA & NIOSH, 2001
Copyright Circadian Technologies, Inc. 2014
CONCLUSION:
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Copyright Circadian Technologies, Inc. 2014
bdavis@circadian.com