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Fatigue Management - Mental Health Week 2019

Professor Drew Dawson is nationally and internationally recognised for his contributions to the scientific community and to industry in the areas of sleep and fatigue research, organisational psychology and human behaviour, industrial relations negotiations, and the human implications of hours of work.

As Director of the internationally recognised Appleton Institute, he oversees basic and applied research into the effects of shift work and sleep loss on the health and well-being of employees

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Fatigue Management, Professor Drew Dawson – Mental Health Week 2019

Teegan Modderman: Good afternoon everyone and welcome to our live broadcast around fatigue with Professor Drew Dawson my name's Teegan Modderman and I'm the Director of Psychological Health with Workplace Health and Safety Queensland.

Now this live broadcast is brought to you as part of Safe Work Month which is celebrated nationally throughout October in Queensland. We deliver a wide range of activities including our Injury prevention and management conference, our Safe Work Month awards and our breakfast forums. It's also Mental Health Week which promotes the importance of mental health and well-being and reduces the stigma associated with mental well-being, mental illness I should say, so this year the theme is 'Take time', and I'd like to thank you for taking the time to listen to our live broadcast to understand more about fatigue.

Fatigue is a really unique hazard, it's something that every single one of us can experience at some point in time in our lives. It's not something that we can always plan for as well so as such we need to have robust strategies in place both individually as well as organizationally to control for the risk of fatigue related incidents, but also to enhance the well-being both of physical and psychological well-being of our workforce.

Now we're very lucky today to have Drew Dawson as our speaker, he is nationally and internationally recognized for his fatigue-related contributions. He is currently the director of the Appleton Institute and will be talking to us today about the latest research on shift work and how it affects the body and exploring strategies on how to minimise fatigue related risks.

So the format for today's live broadcast will be firstly Drew will present and then the two of us will have some informal discussion around some of the questions that you may ask during the session so I encourage you as listeners to ask any questions throughout and we'll try and livestream those to Drew or we'll wait that towards the end of the session and we'll ask some more questions but I'll now pass over to Drew to talk to you about fatigue. welcome Drew,

Drew Dawson: Thank you very much Teegan, this is a bit of a new experience for me it's kind of weird talking out into nothingness but I'm going to try and start off and keep your attention and I'm going to make a couple of what I believe are quite controversial statements in the area of fatigue management and the first is that you can't eliminate fatigue.

I'm going to say that again, you can't eliminate fatigue - and the reason for this is really simple.

If you're working at 4 o'clock in the morning it doesn't matter how much sleep you've had you're still going to be fatigued, not because you've been up particularly long but because your body clock is at the wrong point, you're in your window of circadian load so one of the things that we think is really important for organisations to understand is to change the narrative and the way that they talk about fatigue. Rather than saying if we comply with our rules of rostering then fatigue won't be a problem, we actually think a far more useful way for organisations to think about this is to think about how can I work safely when I'm fatigued - and we think that's important for a couple of reasons, one it acknowledges that fatigue is an inevitable consequence of shift work, it's an inevitable consequence that sometimes you'll be up with a sick kid or you might be running late or you may have had a bad night's sleep you can't get rid of fatigue in the workplace and what we think is that if you change the narrative around that you'll lead to some very interesting conversations within your workplace, the second thing I'd like to talk about, and again is I don't really care whether you're fatigued, you'll see lots of workplace policies and stuff that say to people if you're fatigued you need to notify your employer and you need to not work.

Part of the problem in those rules is that everybody knows that they're stupid. When we're thinking about fatigue the important thing for us to think about is the risk not the actual fatigue. As I said we can't eliminate fatigue but what we can do is start to think about fatigue in an honest and realistic way and think about some of the things that we can do to eliminate the risk associated with fatigue rather than eliminating fatigue per se, and the last thing I'd like to say is we're going to talk about some of the reasons why organizations find it really difficult to talk about fatigue.

I think there's a couple of really important reasons for this, the first is everyone gets nervous, fatigue management is secret code for overtime reduction strategy or it's going to cost us ten percent in the next EBA in additional hours or overtime penalty payments, most people are frightened about having a conversation about fatigue because they don't know how to manage it - I'm going to say to you we have all the tools that we need now to manage fatigue very very effectively and what I'm going to do is go through some of the regulatory frameworks and the tools that are available now, it'll make it very easy for you and your organization's to think about how to manage fatigue.

So let's start off with this, I've been working around the world for the last five or ten years looking at how organizations and how regulatory environments are starting to think about fatigue and there's a couple of interesting things that have happened - there's been a big push towards what we call fatigue risk management systems but also pushback because some organizations found the complexity and the information technology systems required to manage a pure FRMS system very difficult and many regulators didn't have enough people in place in order to enforce those regulations, what we've seen happen around the world is increasing shift in particularly in the english-speaking world an increasing shift to what we call hybrid models and the hybrid models are very simple in the sense that they say if the risk is really low just get on with it so if you're working for example Monday to Friday 9:00 to 5:00 weekends off, the likelihood of work-related fatigue is really low, and other than having something in place to identify when somebody may not be fit for work due to non work related causes you don't need to think about it a lot but as the likelihood of fatigue goes up and therefore the risk of fatigue goes up the more the controls that we need to put in place so if you look at the diagram here you'll see that we have an emerging principle where we have what's effectively the green zone and within the rule sets sitting around your hours of work and those kind of things if it sits within that Monday to Friday 9:00 to 5:00 kind of working practices then you don't really need to think about it too much.

On the other hand, as the risk increases and you can see as you move outside of the green circle into the yellow circle there's a slight increase in risk and therefore you will require moderate levels of controls in order to do that as you go further out and hit the orange zone then you'll find that that needs major controls if people are to continue to work, and then finally there will be a red zone where you really don't want people operating there unless the risks of ceasing to work out way the risks of continuing to work - and they could be situations of emergency services or health care workers, situations sometimes mean a tired doctor is better than no doctor at all.

The other thing that's important to understand here is that in these hybrid environments there tends to be some rules of rostering or general principles that are used to define when you're within the Green Zone when you're in the yellow and orange zones and when you're in the red zone and the general principle is if you're in the Green Zone you can probably work with your rules of rostering and you probably shouldn't be going into the red zone but from our risk-based perspective if you're operating in the yellow and the orange zones it's critical that you have a clear process for assessing the risk that is how far from the green zone you are and then putting in place controls that are appropriate to mitigate the risk.

Now we've done some work over the last couple of years with a lot of regulatory agencies and as you'll see on the graph here or the diagram here there are five key dimensions around rosters that people work and there's a pretty good body of research to support the relative risks associated with a working time arrangement based on these five dimensions that's how many hours you work per week how long the shifts you work are, how short the breaks are between shifts whether you work night work or not and how often you get a weekend break and by that we mean a reset break or a weekend break which is two night's sleep and a day off in between and as you can see from the diagram here if you're working less than 45 hours a week if you're shift durations are less than 10 hours if you're getting at least 14 hours off between shifts you work no night work and by that we typically mean somewhere between 8 p.m. and 8 a.m. and if you're getting at least one weekend break a week fatigue is probably not likely to be a major problem as a result of your working time arrangement, on the other hand if it exceeds 72 hours per week if your shifts are longer than 14 hours if your break durations are less than 10 hours, if durations are less than 10 hours if you're working night work and if you're getting a reset break less than once a week up to once every two weeks then we know once you exceed those limits it's probably difficult for any organization to manage the risks unless it's in an emergency services environment so these broad principles gives organizations a way of determining am i in the green zone and I don't need to do a lot, or am I in the fatigue risk management zone where I need to be able to assess and manage the risk or is what I'm proposing beyond the pale and there are some environments where that's possible but we would suggest there would be a reversal of the burden of proof and people need to demonstrate that they can do it but what these measures indicate is the likelihood of fatigue these will tell you how likely it is that somebody will be fatigued.

If you've worked from a risk management perspective you know that you'll be required to categorize that on a scale of one to five from one which is very unlikely to five which is almost certain but likelihood doesn't tell you the risk and as many of you will know the Australian standard for risk management which has now been adopted by the international standards organization or ISO 31000 sets up a very simple risk matrix which requires you to assess the likelihood of fatigue ,the consequence of a fatigue related error and then use those two pieces of information in order to determine the level of risk and having determined the level of risk as you saw from that previous diagram we then require people to identify the risk and then put in place the mitigations that are necessary in order to continue work so you'll see again if it's green you probably don't need additional controls if it's a moderate risk you need minor additional controls if it's a high risk you need significant additional controls and if it's in an extreme risk situation is probably only going to occur in emergency or exceptional circumstances situations with the emergency zone what about the workers on offshore week where they normally do 14 hours on 14 hours off I don't think they do 14 hours on 14 hours off that's a 28 hour day so that would move around if they are doing that and I guess it's possible my understanding was that they did 14 tens on most of the offshore rigs but if they're doing 14 hours on then you can see it is right at the upper limit the breaks are a little bit bigger but the interesting thing then is if they are moving 28 hours per cycle then they'll be moving around the clock continuously so as the people who probably work those shifts know they're going to be very fatigued at certain times in the cycle okay so now I'm going to talk about how we determine the likelihood and how we determine the consequence of particular behaviours in the workplace.

I'm going to use a model that's well accepted in Australian around the world this is based on some work done by a graduate student of mine Kirsty McCulloch and myself about 12 years ago this is what's referred to as the defences in-depth model and it's a very simple model which says that if there is a fatigue related accident there's probably a series of causally linked events that lead up to that incident somebody may not have had an adequate opportunity to sleep somebody may have had an adequate opportunity to sleep but didn't use it to get sufficient sleep as a result they didn't have enough sleep they exhibited signs and symptoms of fatigue that led to an error and then as a consequence that led to an incident.

In most organizations we focus on regulating this working time arrangement and that's the only defence that we have in place but if you think about it if we have techniques to identify when people haven't had sufficient sleep when they are exhibiting the signs and symptoms of fatigue or when they're making errors we have a whole range of other areas where we can start to intervene to identify when people are at risk because the likelihood of fatigue is higher now if we take those principles, it's sometimes referred to other five levels of control from fatigue and on those levels of control we've taken all of the things that are done around managing fatigue and tried to put them into a simple model level one which is the farthest from the incident is the sleep opportunity or the working time arrangement what do you have in place to ensure that people are provided an adequate sleep opportunity at level two you want to know how much sleep and weight did somebody actually get because the sleep opportunity only tells you what happens on average to most people on the other hand what happens to you today can be very different to what happens on average what can we do to identify how much sleep and weight you've had in the last 24 or 48 hours and haven't we used that to get a better estimate of the likelihood of fatigue similarly observed fatigue behaviours, fatigue related errors and fatigue incidents can be part of that.

What I'd like to do is to take you through now some very simple principles but before you do that I'm going to show you a quick slide that shows you a free fatigue calculator that you can use that will enable you to do all of the things that I show you in the next few minutes so if we go to the level one sleep opportunity those five dimensions I talked about before enable you to look at the Working Time arrangement over a seven-day period and then determine the total number of hours the longer shift the shortest break how many hours occurred at night and how long or how many days between of the reset breaks and you can score it up and based on the outcome from that you'll get a score somewhere between zero and forty if you take that score you can determine the likelihood most rosters that people work will give you a score somewhere between five and thirty and as the color coding shows it will give you a likelihood score somewhere between five and thirty out of that overall maximum of 40 what we've done is then calibrated that against the ISO 31000 five levels and those ISO 31000 levels have been calibrated in the following graph so if you get a score of zero to five you can assess the likelihood as a level one using ISO 31000 with the degree of certainty similarly as the score goes up so does the likelihood and then as you determine the likelihood and the consequence of a fatigue-related error then you can determine what the risk is and then having done that you can look at the risk mitigations that should be put in place and for most organizations there will be a process whereby you take those risk assessments and then put in place the appropriate controls to manage that and on the next slide you will see some work that's been done by a number of organizations where the risk is and the types of controls that can be put in place so you'll see in very simple terms in a low risk environment you're good to go in a moderate risk environment they are what we call self-managed controls look after yourself in a high-risk environment it's look after each other that's what we call team-based processes and in the red zone or the extreme just look out that is if we go through these an increasing level of risk mitigation now these risk mitigation actions will actually be decided in advance by an organization often at the workgroup level but that just shows you what to do with the sleep opportunity the second thing that we can look at is how much sleep and how much weight you've been able to get again using the app you'll get a number of questions that you can answer and they will enable you to put in the amount of sleep you've had in the prior 24 and 48 hours when you woke up when you started working when you're finishing work and then that will give you a series of scores based on the start and the end of the shift and then into the next 24 hours so you can see the implications of starting early extending a shift and use that for planning purposes now you don't need to go into the details today but the app will give you a score and if you look at the next score over the next slide you'll see that those scores have been put on a range of 0 to 14 which is what will you typically see in most workplaces for most people at the bottom a sign of a score of zero means that you're probably able to work safely at most tasks most of the time and by the time you get up to a score of 12 to 14 then you're pretty tired again on the right hand side you will see that we have calibrated those against a well-recognized standard for fatigue which is the Karolinska sleepiness scale for those of you who are familiar with that you'll see that a score of 0 equates to a Karolinska sleepiness score at 6 4 goes to 7 6 goes to 8 and 12 goes to 9 so they give you an indication of the level of fatigue by plugging in your own personal sleep and wake scores you're able to do that and then again we have taken the liberty of calibrating those against the ISO 31000 scale and there you can see with a score of 0 you would have a likelihood of 1 and by the time your score goes up to 12 plus you have a score of 5 then depending on the task that you were doing you would go to your risk matrix and again having gone to your risk matrix you would be in a position to be able to determine what would be the appropriate mitigations to put in place the third level that you can operate this at is in terms of the behaviour indicators of what we would suggest you use is the Karolinska sleepiness scale a lot of times we see organizations who invented their own scale and there's nothing wrong with that until you have to go to court and then you're going to be asked why did you select that scale and you say well it seemed like a good thing to make it up at the time that's not really a good legal defense in our opinion so what we would suggest to you is use the Karolinska sleep in a scale for a couple of reasons A it's in the public domain, B it's very well validated it's been used in probably over a thousand studies it's well calibrated we've done lots of experiments where we look at people's KSS scores and how they perform in the workplace it's legally and scientifically defensible and probably more importantly it's free so again you can see on the left-hand side of the slide it's a 1 to 9 point scale that goes through extremely alert through at a very sleepy great effort to keep awake and fighting sleep in that situation you can again calibrate it against the ISO 31000 scores and you'll see here a likelihood score of 1 equates to a Karolinska sleeping a scale of 1 and then a 5 is at 8 plus you look at again in terms of your risk matrix you put in place the controls that have been determined for your organization and then having done that you're in a position to determine the likelihood of fatigue from either the wedding time arrangement the prior sleep wake or the behavioural symptoms of that - and for those of you who missed it I'll put the last slide up which shows you where you could download that app for free from and then we'll close it now and I'm going to join Teegen for some questions.

Teegan: Thank you very much, Thank you Drew, you can certainly see your passion and your insight and expertise into the topic of fatigue there - what drives you to be interested in this I know you've been following you for 20 years now and I know that it's definitely an interest of yours, what drives you to be interested in the area of fatigue.

Drew: Well it's actually quite a personal story - yeah when I was first in research and we're doing lots of stuff around sleep and shift work and melatonin and those kind of things my wife was doing her internship year as a doctor and she used to ring me up and say can you please come and pick me up because I'm too tired to drive home I just want to finish up a couple of patients and then I'll be ready and I said you may want to rephrase that because it doesn't sound great but it struck me as I'm not okay to drive but I'm required to look after patients and then when we started to look at fatigue we realize lots of people died as a consequence of fatigue related errors yeah. It's a great way to take really good science and make a difference in the world.

Teegan: And it's interesting what you say there in terms of most people can maybe identify that they're not safe but yet they still want to work on or they still want to just do a couple of things to close out their job is there some reason for that why we can we can maybe identify that we are fatigued enough to not be safe but we still want to work on?

Drew: Well again I think as people have often said the road to hell is paved with good intentions people don't want to let the team down they don't they want to get the job done they don't want to be seen as a leaner as distinct to a lifter so there are all sorts of reasons why people would want to do it the difficulty is while people are very good at determining whether they're fatigued or not they're very bad at identifying whether they're safe or not the tools that we are showing you enable you to use a systematic process for determining how safe you are or what the level of risk is and whether you should or shouldn't be doing it or if you need to continue which is sometimes the case because as we know a tired doctor it's better than no doctor at all what controls do I need in order to work safely whilst fatigue.

Teegan: I think you raised a really good point around having valid and reliable tools and you've certainly identified some free tools there that available I've noticed there's a lot of technology that's coming onto the market how does an organization ensure that that technology if they are integrating that into their safety management system that they're doing their due-diligence?

Drew: I guess you can say around the technology they're using well I think you need to look at the technology and say has it been trialled has it been tested has it been tested in the field what are the validation and calibration data for it but I think it's important to understand that often people will look at those technologies and say oh but it's not perfect it doesn't work when the moon is in Aquarius or something like that that's not actually the right question to ask the right question to ask is is it better than what we're already doing and sometimes perfect can be the enemy of better so what we say to organisations if it increases the certainty that your people are fit for work or not fit for work then it's probably a good thing to put in place and if it makes sense from a financial perspective sometimes having our not so good tool for everybody is better than having a really really cool good tool for just one or two people yeah.

Teegan: And I do notice that in industry there's definitely a drive to have the perfect roster and a lot of effort and time spent in - you know consulting with staff and designing the perfect roster. Is there such a thing as a perfect roster?

Drew: Well no and as you know from the rail industry for many years ago when we did the research on this half the time that somebody's fatigued in the workplace it's due to non-work related causes yeah so the biggest thing most organizations can do in this day and age is to think about what we call a shared responsibility model the new workplace health and safety legislation puts a statutory obligation on employees to identify workplace hazard even if they themselves are the hazard so the biggest area we've seen in the last couple of years of development is around that shared responsibility and giving people a just culture framework and the tools so they can put up their hand and correctly identify when there's a high level of risk and mitigate it yeah and it's not going to be an epidemic we certainly see that in what you're saying to me is up seeing hazardous self so seeing fatigue is a hazard herself and then managing it in that way well it's a really important issue and this notion of self as hazard and it's not just fatigue, it can be drugs and alcohol, it can be bullying and harassment but we have a whole emerging set of what we call 21st century houses where the individual as an employee or a manager are themselves the hazard, one of the challenges is our systems for managing hazards are really good at boots belts buckles sores and that stuff they're not so good for psychological hazards and fatigue is one of the best examples of them yeah absolutely.

Moderator: Do we have any questions from the audience? we do we do have a few questions so while we're talking about risks Joel would like to know how do you take into consideration the risks inherent in the work people are performing?

Drew: In assessing risk it's actually really easy we sit down in a room with a bunch of people who do a particular job and say tell us the dumb things that happen when you're fatigued and we get people to tell the stories about what they do, now nine times out of ten that works occasionally like if we're working with pilots or doctors we have to ask them dumb stuff other people do because they tend not to report it but if you legitimize the narrative if you say it's okay to talk about fatigue, tell us the dumb stuff that happens - you'll really struggle to shut people up at that point. Once you know what goes wrong when people are fatigued you can work on fixing it.

Moderator: Just another question here, Peter asking about the variation in the sleepiness scale between different nationalities, is there a variation in that scale with regard to that.

Drew: Not that I'm aware of Peter that scale has been used right around the world in developing countries developed countries men women all sorts of different people and it seems with the proviso that sometimes you have to translate it from English or its original mistress in Swedish and sometimes there have been some difficulties around exact translation, but once it's translated well it seems to be a very robust and powerful tool to use. The other important thing about this tool is rather than having to put your hand up for your supervisor, your boss and go I'm tired - you can say I haven't had sufficient sleep to work safely today or my Karolinska sleep in a scale score is 8 and that takes a lot of the emotion out of reporting fatigue that we observe in many workplaces.

Moderator: That probably leads into Matthews question he said the self-assessment protocol is quite subjective, especially given casual team members risk losing hours if admitting to fatigue so are there quantitative testing to make this more qualitative.

Drew: Yeah it's a good point and again I'll go back to the thing I said perfect becomes the enemy of better, we don't have a roadside test or an objective blood-alcohol equivalent where we can measure you and say your fatigue level is X - maybe in 10 or 20 or 30 years that technology may emerge but actually it's more a cultural question, people are really good at telling you how fatigued they are in fact the best way to find out how fatigued somebody is is to ask them. The challenge is however getting them to do that in a way where they understand the risk and you're right sometimes people go I want that extra $20 or I need that overtime part of the cultural reengineering process is to get people to focus on lifetime earnings versus weekly earnings so they can be key issues so you don't own a lot of money when your dead.
Moderator: Adam had another interesting question with automation becoming a very real thing do you do you think the future could see jobs that cause high levels of fatigue being replaced by machines and would this be a good thing?

Drew: I was asked to give a big talk on this in Texas a couple of months ago and what will be the implications of it it's a really complex and sophisticated question, because as we go to increasing levels of automation the car isn't absolutely automated - you still have to be managing the car and responsible for it but we're going to put people into a car that manages itself most of the time except in an emergency and then we're going to say don't do anything you just got to try and stay awake and monitor it, and I suspect that's going to be really challenging for people because the temptation to use their iPad or their phone or read a book and all of those kind of things is going to be very powerful and you can be required to reassume control of a car within 2 to 4 seconds and if you're busy reading or if you're sitting at night in an automated car the chances of falling asleep up much higher because you're not doing anything you're not even driving - so I think there's going to be some really big challenges but I think where you can fully automate people out of the system, and I think modern aviation is a really good example of that in a space shuttle to a certain extent, that those situations where you can engineer people out of it - the difficulty is people aren't going to get into a plane that doesn't have a pilot I suspect for a long time so how we manage those situations is going to be a real challenge from a cultural and an engineering perspective.

Moderator: And there was another question as well from Rowan who said there's a big gap between what shifts are rostered and the actual hours that staff works, so how do we move to a more real time and what amount of notification systems ,especially when there's in many industries and lack of that regulatory requirements and the transparency.

Drew: Yeah it's a really good question most people who are managing fatigue will have a requirement to report both proposed or scheduled an actual working time arrangements the tool that I demonstrated today is quite good because it can be used by a worker and a supervisor to measure what hours they actually worked not what they were scheduled to work and it will give you an indication of the likelihood of fatigue as a result of that, at a more sophisticated levels there are bio mathematical software packages which enable you to put in your proposed or scheduled hours of, then your actual hours and see the discrepancy between them I think the key point I'd make is it's a really important issue what you actually work is what we're interested in but in a lot of environments we can't necessarily have that highly accurately in real time we can look at it retrospectively and say how often did we get it right but the kind of tools that we're showing you today do enable you to have a go at assessing the risk from what's actually going on not what was planned.

Moderator: Joel has also said thanks Drew, we're working with doctors here - but what are your tips on the implementation of a frms.

Drew: My suggestion to you is a few years ago we developed the fatigue risk management guidelines for Queensland Health they are readily available on the web and are still pretty good and they've just been picked up by the Canadian government for health care in Canada so I would recommend you look at those and I'm sure if you want to drop me an email if you can't find them but if you go and look for fatigue risk management resource pack on the web you will find a downloadable site where you can get all that information.

Teegan: In implementing those systems sometimes there is barriers do you have any tips for from a change management perspective how do you get buy-in from those who are working with such high workloads and variable hours shift work and the like.

Drew: Yeah that's a really good question too part of the challenge in organizations is the threat of fatigue management for the supervisor or for the operational people is I'm not going to be able to get the job done and I need to get the job done and my performance appraisal requires that and with a bit of luck if nothing goes wrong we won't have a fatigue related accident so in those situations people understandably gamble a low likelihood high consequence event against a relatively low consequence but high frequency event all the time, our experience has been most organizations find the idea of somebody dying in a car accident or a fatality like that very hard to wrap their heads around. One of the techniques we've been using and again this goes back to what we did with Queensland Health what we call politely complacency disruption events, what we will do is get people to envisage the actual scenario that they're going to have to deal with so we will have senior managers have to explain to an actress playing the wife of a deceased employee or we will put people into a coroner's court simulation and have them cross-examined by QC those kind of real-world experiences tend to focus people's attention on how difficult managing the consequences of a badly of a bad outcome from a fatigue related accident get people to actually focus on it and generally they then start to take it quite seriously but at the moment it doesn't impact on them directly or they don't think it will be the new workplace health and safety laws are going to change that fundamentally.

Moderator: We have another question here from Peter just in relation to applying the tools to the team environment specifically that used an example about if you've got a team of two driving is it about sharing and driving those tasks is it as simple as that or is it they're all complexities around sharing some of these tools in a team.

Drew: Well again you've just showed how to use the tools in a very simple way of deciding who to drive at a particular time and if somebody is a bit under the weather let them have a drive and maybe have a bit of rest or work out which bits of the drive you should or shouldn't do, we've given up trying to predict all the clever way people will use the tools the tools enable you to assess likelihood and therefore to calculate risk and work out what controls you need our experience has been when you let people use these tools they're really good at using them because it empowers them and gives them agency in how to manage and quantify fatigue and to talk about it at the organizational level if you say the fatigue risk today is high, then people go oh we've got to do something about that well if you go I'm tired - that doesn't seem to carry the same weight in an operational environment.

Teegan: In terms of before you just mention the WHS laws just I guess a question for those who are in senior management roles or management roles, what are some of the things that they can do to exercise their due diligence or to be able to demonstrate that?

Drew: Well I think you have to demonstrate that you've undertaken a risk assessment you've identified whether a fatigue is a potential hazard for your employees and to the extent that it is a hazard you need to have a system for ensuring a safe system of work and managing it so it's not what it's not doing anything different to you do for any other hazard the challenge I think for senior managers is that they have traditionally seen fatigue as an industrial issue that's managed through the enterprise bargaining agreement and that's where it's done - but actually it's a safety issue so if there's any senior managers out there the single most important thing you can do is to ensure that it goes on the safety agenda and comes out of the industrial relations agenda, doesn't mean that there aren't industrial implications and working time arrangement and we will talk about the fact that rosters have to be family friendly financially friendly and fatigue friendly but fatigue friendly risk assessment and mitigation belongs in the safety department, and not in in the ir/hr space.

Moderator: Just going back to the to the tool the the question from Aaron is can journey lengths be adjusted for with the tool particularly for industries such as mining or energy where travel to work is rarely publicly offered and there are often many hours of travel involved.

Drew: Yeah just add the travel hours to the working hour so if you've got a 12-hour shift with an hour-and-a-half commute at either end then it becomes a 15-hour shift so it shows people thinking about how to use a tool that's fantastic well done Erin.

Teegan: Did you have anything else Drew, that you wanted to talk about any key things that you're seeing or trends you're seeing an industry that you wanted to alert people to or emerging issues.

Drew: I think probably the biggest issue of the next five years is going to be how organisations respond to the changes in the workplace health and safety legislation particularly around shared responsibility and there's been a lot of conversation that we've been having with the road transport industry they have changed enormously in the last few years and what we've seen interestingly emerge from a lot of organizations is what they call an absolute authority to stop if a driver puts their hand up and says I'm not good to go then it's incontestable, so there is no discussion argument you pull over you do what you need to do - if it happens too often then there will be what we politely refer to as a root cause analysis, then we will look at the understanding why that is but on the moment at the moment or on the day it's an uncontestable right because if you told somebody to keep working and there was an accident think about the legal implication that for you as a manager or for you as an organization so I think that shared responsibility empowering employees to be part of that decision-making process it's going to be the next frontier in fatigue management it's going to be a lot less about rosters.

Teegan: I think working in the regulator we often see that as well in terms of trends I think seeing the hazard as self or self as hazard as you call it with the individual we often see systems that don't tend to do the risk assessment of the particular individual and put in control so that they can't drive home or there's alternative accommodation or alternative transport mode sorts of things, we also see that when they are doing their investigations that they perhaps not drilling down past their hours of work and looking at maybe the other factors like sleep that may have contributed to a fatigue related accident or an accident that may have had fatigue present at the time - is that something that you've been seeing as well in your conversations with industry?

Drew: Well I think we're starting to move to more systemic approaches for identifying the link between fatigue error accident and injury but I think the other thing that's probably worth thinking about is we do a lot of work with organizations where people do work overtime and they've worked big hours for many years safely and the key point about this is to say to organizations and organizations may indeed say this back to the employees if you want to work the big hours that's fine that's your choice but you've got to demonstrate to us that you can do it safely and the onus is
increasingly on the organization and the employee to demonstrate where you are working to be ours that's fine but you've got to demonstrate that you can do it safely and our experience has been there's lots of people working big hours who do it very safely most of the time so it's not getting rid of long working hours per se but going back to what we said at the start of the day ensuring that you can work safely if and when you are fatigued.

Moderator: We have just another question coming in this one's from John he's interested in knowing what you think might be I guess the worst mistakes that Australia is making in fatigue which we'll have to look back on in the future and you know potentially be really you know embarrassed by that we were getting it so wrong.

Drew: I think if you look back and it's an interesting question I think the obsession with the roster as the only control that we have in place and I see lots of fatigue management plans for organization which is basically three or four paragraphs carved out of their EBA I think once you realize it's not just about the roster they'd will probably see things move forward and once you stop arguing about the roster it actually becomes really easy to manage fatigue well. The roster just gets in the way all the time.

Moderator: You've mentioned some obviously some the the app you've spoken about you mentioned the resource that it was developed a few years ago for the Queensland Health are there other resources that you can point our audience to that they might find useful?

Drew: Yeah I think if you google fatigue risk management you will find an incredible amount of resources some of them are more suited to large well resourced big organisations but for example the tool we showed you today that was developed specifically in response to small organisations who couldn't afford the great big software packages of those tools and they wanted something to structure a conversation between an employee and a supervisor on the spot, so I think we're starting to see a lot of those tools are out there we've seen the fit bits and equivalents emerge in the last few years which enable people to know exactly how much sleep they have or haven't had and to use that to demonstrate that and there are increasingly products and wearable computing on the market that will use that information to estimate likely levels of fatigue and that kind of stuff so I think there's a lot of stuff happening in that space and generally we have said to people if you want to work the big hours prove to us you can do it safely and here are the kind of tools and technologies whether it be fatigue detection devices in cabs of trucks or people wearing the fit bits or ready bands or those kind of things or using other techniques where you say to people you need to demonstrate to us that you can do it safely people are pretty good at doing that.

Moderator: Ashley's just asked is there a way to assess the fatigue score of split shifts, the app doesn't seem to recognize the shift ending on the following day.

Drew: That's a really good question and no it doesn't but we have that if you there is a workaround for that which would be to summarize the shift to say it's if it was seven hours four-hour break seven hours call it a 14-hour shift you won't go too far wrong with doing that but it's a good point it doesn't do splits yes but there are relatively few people working with split shifts but I'm going to think about how we might incorporate that into it.

Moderator: Another one about the fatigue calculator app just suggesting that it's not available in this country in the region that's what the store is saying.

Drew: Because they didn't use the web address on the bottom they just googled fatigue calculator and it's gone to something else if you use the it will go to the site and if you have any problem send me an email and we'll put you on to the developers excellent well.

Teegan: I think we might wrap it up there thank you very much true very insightful as always and I guess some key takeaways from me is make sure that we look at fatigue is a hazard and incorporate it into our safety risk management systems and make sure as individuals that we use as many apps as possible and communicate in a layman's way I guess to our managers how do we that we're not fit for duty when we're not fit for duty and it and be comfortable with them.

Drew: Yeah it's okay.

Teegan: Excellent well thank you all very much for joining us and taking the time to learn a little bit about fatigue management today we do have our Mental Health Forum tomorrow so hopefully we'll see some of you there tomorrow if you did want some more resources around mental health and fatigue management in particular I encourage you to go to our website we are in the process of developing a new handbook for preventing and managing fatigue related risk and we hope to have that out to you very soon but in the meantime enjoy and take care and be safe thank you thank you.

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