This week was interesting for sure. I got to put into practice research done on Sleep Work Disorder (SWD). In a mock exercise I used information I gathered from very interesting publications on the disorder and applied it to a imaginary MQ-1 Predator crew suffering from fatigue due to shift work. The following is my analysis.
Shift Work Schedule
-Brandon Espinoza
Abstract
While no definite work schedule has been established, partially due to the varying nature of numerous industries and workers individual internal factors, studies have shown there are certain measures that can be made to decrease the negative effects of fatigue, stress, and general well-being in shift workers. This analysis looks at a MQ-1B Medium Altitude, Long Endurance (MALE) UAS squadron and uses a research based schedule to aid in reducing the growing number of fatigue related complaints by crews.
Scheduling Factors
While considerations for development were being made certain factors were implemented and key research done by Dr. Michael J. Thorpy concerning viable solutions to mitigate shift work disorder (SWD) were incorporated into the schedule. Dr. Thorpy states, “Additional studies evaluating the effects of >4 consecutive night shifts…confirm the risk for decreased cognitive performance and increased sever ES. The observed marked increase in the risk for incidents during working hours suggests that working more than 4 consecutive 12-hour night shifts should be avoided (Thorpy, 2010).” It is by this suggestion that the three day on – one day off schedule was derived. This should place the crew well under the suggested work/rest hours as their shifts are under 12 hours. In a study conducted by the Naval Postgraduate School it was found during a re-visitation of work-related fatigue that, “…the number of consecutive days off was increased from two to three in order to provide greater opportunity for recovery sleep. However, study results differed markedly from this expectation. Mean fatigue scores were unchanged compared to one year before with the exception of the CIS-CON (checklist individual strength concentration subscale) scale, a measure of mental fatigue, for which scores were significantly higher compared to the prior year.” Thus in the MQ-1B schedule there has been an attempt to implement more frequent rest periods rather than longer ones which studies have shown offer no aid in fatigue reduction.
SWD Aids
Other factors should be considered beyond scheduling changes as the severity of SWD is manifesting itself in the MQ-1B crew and causing performance issues. According to Dr. Thorpy, “Several nonpharmacologic interventions are available for the treatment of SWD, such as the improvement of sleep hygiene, exercise, and timed exposure to light.” Additionally he identifies, “Two pharmacologic agents – modafinil and its R-enantiomer armodafinil – have been evaluated specifically in patients with excessive sleepiness (ES) associated with SWD and are approved as wakefulness-promoting agents for this indication by the US Food and Drug Administration (FDA) (Thorpy, 2010).” While the agents are not recommended to this squadron at this time, the use of the agents should be noted as a viable option should chronic fatigue related complaints continue after revised schedule implementation. As for the nonpharmacologic interventions, it is suggested to the MQ-1B crew that they make use of exercise and light-therapies both during breaks and off-duty days. These aids will be especially useful for crews operating at night, and special emphasis should be placed on their use to these crews.
Recommendations
Recommended measures are summarized and are as follows:
- Move to a three day on, one day off schedule
- Take advantage of nonpharmacologic interventions – especially for night shift crews
- If needed, pharmacologic options should be evaluated and implemented by a case by case individual basis
- Emphasis to crews the importance of quality sleep of quantity – exercise and sleep hygiene will aid in this
- Educate crew members on fatigue and stress, create an organizational climate supporting safe work and rest schedules
References:
Tvaryanas, A. Platte, W. Swigart, C. Colebank, J. Miller, N. (2014). A Resurvey of Shift
Work-Related Fatigue in MQ-1 Predator Unmanned Aircraft System Crewmembers (2008). Naval Postgraduate School Monterey, California. Retrieved from: file:///C:/Users/Doctor/Downloads/ADA477976.pdf
Thorpy, M. (2014). Managing the patient with shift-work disorder (2010). Supplement to
The Journal of Family Practice. January 2010 / Vol 59, No 1. Retrieved from: http://media.mycme.com/documents/29/culpepper_2010_swd_suppl_70
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