Don’t hit the snooze button! It’s time for organisations to wake up to fatigue management

Fatigue can be incredibly harmful for workers and can create serious financial, reputational and legal risks for organisations. Changing work cultures and the introduction of new technologies is creating an enhanced risk of fatigue and burnout creeping into many of our workplaces.

Fatigue causes almost 10,000 serious workplace injuries each year and costs the Australian economy over $36 billion a year due to lost productivity, healthcare costs and loss of healthy life.¹ While short term risks of fatigue to people’s safety are generally well understood, fatigue also affects people’s mental health in the long term which deserves more attention from organisations and their leaders.

With enhanced regulation and scrutiny on psychosocial hazards across Australia,² now is the time for organisations to be proactive in implementing tailored systems and frameworks that allow them to be agile in adapting to changes in culture and work dynamics to ensure they are addressing the serious, and sometimes fatal, harm caused by fatigue. 

Understanding the harm from fatigue

Fatigue is a feeling and experience of either mental or physical exhaustion (or both).³ It can be caused by things outside of work, such as poor-quality sleep.⁴ But it can also be caused specifically by work-related activities like:

• Working excessively long shifts; 
• Not having enough time to recover between shifts and blocks of shifts; 
• Undertaking very strenuous jobs & tasks; and 
• Having a long commute time.⁵

In an immediate sense, fatigue is a serious risk to health and safety as it has profound effects on people’s cognitive abilities.⁶ This includes:

• being less productive; 
• making more mistakes;
• not recognising risks and appreciating complex situations; 
• impaired memory and decision-making; 
• reduced ability to concentrate and avoid distraction; 
• poor emotion regulation; and
• communicating less effectively.⁷

In fact, researchers have found that being awake for 17 hours can be equivalent to having a blood alcohol concentration of 0.05% (the level used for drink driving violations in Australia).⁸ Over the long term, fatigue from working night shifts has been linked to increased risk of cancer.⁹

We have known the risks of fatigue in workplaces for a long time. It has been recognised that certain industries are particularly susceptible to workers experiencing fatigue, including transport (road, rail and aviation), manufacturing, mining and healthcare industries.¹⁰ Looking closely at healthcare workers, even prior to the Covid-19 pandemic the healthcare industry was under the spotlight for poor fatigue management with experts suggesting that unsustainable working hours contributed to healthcare workers experiencing burnout and mental illness.¹¹

A study by Monash Health into the impact of fatigue in the healthcare industry identified problematic work design issues to be systemic in these workplaces, including:

• roster patterns; 
• long shifts and periods of awake time;
• insufficient breaks;
• insufficient recovery time between shifts; 
• demanding work, and 
• harsh environmental conditions.¹²

Beyond these factors, additional stressors in healthcare settings can combine to exacerbate fatigue risk such as low autonomy or control over work and exposure to trauma, violence & aggression by patients.¹³

A recent SafeWork NSW inspection of 41 New South Wales hospitals, found 12 to be in breach of work health and safety laws.¹⁴ Key fatigue risk related breaches included significant understaffing and lengthy recruitment processes causing nurses and doctors to routinely work overtime.¹⁵ SafeWork inspectors did, however, also identify positive initiatives in these workplaces aimed at managing worker fatigue, including specific rostering arrangements to ensure that nurses are not working consecutive days with high-risk patients who are more likely to be emotionally exhausting.¹⁶ 

Working long hours and overtime causing fatigue

While improvements in technology has made it easier for many workers to stay connected, especially for those working from home, it can also lead to a culture of workers routinely working outside of their set hours of work.

Factors influencing why people undertake routine overtime include organisation-led factors such as staff shortages, high work demands & KPIs, but personal factors also contribute such as competition with peers for career progression.¹⁷

Of interest is that there are clear age differences in who works overtime, with over half of people under the age of 40 reporting they often felt it necessary to work outside of scheduled hours, compared with only one third of workers between 40 and 59.¹⁸

Working around the clock and being hesitant to take sick leave are symptoms of poor fatigue management. In the United States, 38% of workers report feeling fatigued.¹⁹ What should concern organisations is that fatigued workers are much more likely to have lost productive time at work and experience negative impacts on their personal life which can affect their working life.²⁰

Working long hours could increase a person’s risk of experiencing new mental ill-health symptoms in the long term.²¹ Researchers have found there may relationship between long work hours and risks of someone developing new depression symptoms, but these effects are influenced by the psychosocial safety climate of their workplace and that person’s individual work engagement.²² How this may play out in a workplace is that workers who are highly engaged can be motivated to work longer hours, which could subsequently lead to them experiencing psychological harm if there are no systems in place to prevent them from working such long hours.²³ Organisations therefore need to be assessing these risks and putting in controls for all workers across all workplaces.

Work health & safety prosecutions from fatigue-related incidents 

The two cases outlined below demonstrate failures in managing the risk of fatigue can lead to fatal outcomes. The failures range from not properly understanding the risk, inadequate monitoring of workers, and ineffective development and/or implementation of a system to eliminate/reduce workers becoming fatigued. 

DPP v Royal Automobile Club of Australia²⁴

In 2021, under the Victorian Occupational Health and Safety Act,²⁵ the Royal Automobile Club of Australia (RACV) was convicted for breaching their safety duties by requiring drivers to work long hours.²⁶ This prosecution resulted from a fatal collision where a driver, Mr John Halls, fell asleep at the wheel during a shift which caused the RACV Roadside Assist vehicle he was driving to veer off the road and collide with a tree.²⁷  

The Court heard that RACV did not train their employees or contractors in relation to the risks of fatigue. It also heard that in the 12 months before Mr Hall’s death, he and another driver would routinely work alternative 96 hour straight rosters comprising of four days and nights on followed by four days and nights off.²⁸ Mr Hall and his colleague would also cover for each other when the other was sick or took leave. 

On the day of the incident, Mr Hall had already worked 89 hours of a 96 hour shift and was observed to be visibly tired by a colleague.²⁹ 

The Court found that fatigue was the cause of Mr Hall’s fatal collision. RACV was convicted and fined $475,000.

Subsequent conviction of YJ Auto Repairs Pty Ltd

On 27 September 2023, YJ Auto Repairs Pty Ltd, which was sub-contracted by the RACV to operate the roadside assistance service and was the employer of Mr Halls, was sentenced after pleading guilty to failing to provide and maintain safe systems of work and failing to provide information, instruction or training.

The court heard that YJ Auto Repairs did not provide training on how to protect against fatigue or have a safe system of work related to fatigue. As well, it was reasonably practicable to have procedures and work schedules in place to minimise the risk of drivers becoming fatigue – such as setting maximum shifts lengths and/or breaks between shifts.

WorkSafe Executive Director of Health and Safety Narelle Beer said “It is unacceptable for workers to be pushed beyond their physical and mental limits day after day”.

5 key take aways for employers 

Remember there is nothing to gain, and only the potential to cause harm, from workers being affected by fatigue. 

Holistic and thorough approaches by organisations is required to successfully manage fatigue. Any management system should involve education & training, clear and practical policies & procedures, effective intervention, and shared responsibility from leaders.³⁶ Organisations should also look to have systems in place that are able to capture fatigue-related errors so that they can be mitigated in the future and practices can be improved.³⁰

Organisations and their leaders should be undertaking the following steps as a matter of priority:

1. Know your workplace & industry risks: 

• Identify how worker fatigue can materialise in your workplace;
• Develop and implement strategies to prevent workers from becoming fatigued; and
• Have frameworks and systems to monitor and recognise the signs of fatigue and ways to effectively adjust workloads to ensure workers’ wellbeing. 

No system is perfect. Organisations need to regularly review, consider and look for ways to do things better. That’s how organisations can get the best results from any Safety Management System.

2. Be proactive in your preventative approach for managing worker fatigue: 

• Positively promote “switching off”, especially if work is being remotely;
• Eliminate incentives (including financial and personal motivations) to work while fatigued;
• Encourage taking sick leave when your workers are ill or injured, rather than persevering and working remotely; and
• Lead by example – show what appropriate work habits look like and recognise others who do the same. 

3. Communicate the importance of wellbeing and fatigue management:

• Communicate clear expectations and work arrangements; and
• Maintain regular contact with workers if they are isolated, working from home or working remotely. This includes regular check-ins, structured performance & goal-setting conversation and reminders about the importance of logging off & work life balance. 

4. Education and training is key 

• Educate and train your workforce so that they are able to: 
  • Identify the signs and symptoms of fatigue; and
  • Understand fatigue management strategies to minimise the risk of accidents and injuries.  

5. Invest in technology and engage fatigue experts

• Look at what innovative technologies are out there. For example, wearable technologies could be easily implemented and used to monitor and identify certain fatigue symptoms; and
• Ask for expert advice. Fatigue experts can assist organisations to develop and implement bespoke solutions to prevent and manage fatigue in their workplaces. These tailored solutions can provide huge benefits to organisations.

Clyde & Co’s Health, Safety and Environment Practice is specialised in Safety Management and regularly works with organisations to ensure that their Safety Management Systems are up to scratch, and identify opportunities for continuous improvement. 

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¹Monash University (Media Release 9 January 2014)

²Work Health and Safety Regulations 2011 (Cth) ss 55A-55D; Work Health and Safety (National Uniform Legislation) Regulations 2011 (NT) ss 55A-55D; Work Health and Safety Regulation 2017 (NSW) ss 55A-55D; Work Health and Safety Regulation 2011 (QLD) ss 55A-55D; Work Health and Safety Regulations 2022 (Tas) ss 55A-55D; Work Health and Safety (Psychosocial Risks) Amendment Regulations 2023 (SA) ss 55A-55D; and Work Health and Safety (General) Regulations 2022 (WA) ss 55A-55D; 

³Safe Work Australia (Website) 

⁴Safe Work Australia, Fatigue Management a Worker’s Guide (November 2013)

⁵Ibid

⁶Dawson, D., & Reid, K. (1997). Fatigue, alcohol and performance impairment. Nature, 388(6639), 235-235

⁷Monash Health, The Impact of Fatigue in the healthcare setting (Scoping Review, 2019) 5

⁸Dawson, D., & Reid, K. (1997). Fatigue, alcohol and performance impairment. Nature, 388(6639), 235-235

¹⁰IARC. (2020). IARC Monographs on the Identification of Carcinogenic Hazards to Humans. Night Shift Work, Lyon, France, June 4-11 2020. Kim, S., Cranor, B. D., & Ryu, Y. S. (2009). Fatigue: Working under the influence. Proceedings of the XXIst Annual International Occupational Ergonomics and Safety Conference, Dallas, Texas, USA, June 11–12 2009, 317-322; and Tomioka, K., Morita, N., Saeki, K., Okamoto, N., & Kurumatani, N. (2011). Working hours, occupational stress and depression among physicians. Occupational Medicine, 61(3), 163-170.

¹¹Rachael Lucas, ‘Doctor burnout crisis looms for overburdened healthcare system, psychologist warns’ (Web Page, 25 September 2021)

¹²Monash Health, The Impact of Fatigue in the healthcare setting (Scoping Review, 2019) 4

¹³Tomioka, K., Morita, N., Saeki, K., Okamoto, N., & Kurumatani, N. (2011). Working hours, occupational stress and depression among physicians. Occupational Medicine, 61(3), 163-170

¹⁴NSW Government, ‘SafeWork Wrap’ (Web Page, April 2023)

¹⁵Ibid

¹⁶Ibid

¹⁷Eliza Littleton and Lily Raynes, Call Me Maybe (Not): Working Overtime and A Right to Disconnect in Australia (The Centre for Future Work at the Australia Institute, November 2022) 13

¹⁸Ibid

¹⁹Ricci, J. A., Chee, E., Lorandeau, A. L., & Berger, J. (2007). Fatigue in the US workforce: prevalence and implications for lost productive work time. Journal of Occupational and Environmental Medicine, 1-10

²⁰Ibid

²¹Zadow, A et al, ‘Predicting new major depression symptoms from long working hours, psychological safety climate and work engagement: a population-based cohort study’ (2021) 11(6) BMJ Open

²²Ibid

²³Ibid 

²⁴[2021] VCC 2150

²⁵2004 (Vic)

²⁶DPP v Royal Automobile Club of Victoria [2021] VCC 2150 at [13]

²⁷Ibid at [1]

²⁸Ibid at [8]

²⁹Ibid at [2]

³⁰Ibid