Seafarer Sleepiness and Fatigue Why are they a problem? What have we - - PowerPoint PPT Presentation

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Seafarer Sleepiness and Fatigue

Why are they a problem? What have we learned? What should we do?

Emeritus Professor Mike Barnett

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The Partners:

The Stress Research Institute

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Healthy individuals Rapid onset Short duration Single cause Short-term effect on daily activities

Distinguishing Sleepiness from Fatigue

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Short-term Sleepiness

 May cause health disorders (physical and mental)  Insidious onset  Persists over time  Multi-factor causes  Significantly affects behaviour and wellbeing

Longer-term Fatigue vs

Chronic health effects of fatigue

• Sleeping disorders
• Insomnia
• Sleep apnoea/hypopnoea
• Delayed/advanced sleep phase syndrome
• Cardiovascular disorders
• Myocardial infarction
• Stroke
• Hypertension
• Metabolic disorders
• Metabolic syndrome
• Hyperlipemia
• Diabetes
• Obesity
• Gastrointestinal disorders
• Peptic ulcer
• Irritable bowel syndrome
• Common infections
• Mental disorders
• Depression
• Cancer
• Multiple sclerosis

Source: “Risk factors for Fatigue in seafarers” (In press: Maritime Psychology, Springer) Jepsen, J.R., Zhao,Z., Pekcan, C.H. Barnett, M.L. van Leeuwen, W..

Competing factors on board that contribute to the adverse health effects

• f fatigue
• Nutrition
• Quality
• Quantity
• Soft drinks
• Sweets
• Energy expenditure
• Sedentary work
• Exercise
• Smoking

Project ”MARTHA”: Research Design

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Two European Ship Management Companies:

Company “A”

• 43 Small tankers
• NW Europe
• Intensive trade
• Ports every 3 days
• European officers
• Filipino crew

Company “B”

• 34 Large container

ships

• Far East – Europe
• Asia – S. America
• European officers
• Filipino crew

Data collected from each vessel: 110 volunteer crew members from two shipping companies

• Background questionnaire for each volunteer
• Weekly diaries (including KSS and MFI*) for each

volunteer

• Actiwatch data for two weeks at beginning and

end of tour for selected volunteers.

• Voyage reports of vessel to cover period of study
• Official hours of work/rest for each individual

volunteer

*KSS = Karolinska Sleepiness Scale MFI = Multidimensional Fatigue Inventory

• 1. extremely alert
• 2. very alert
• 3. alert
• 4. quite alert
• 5. neither alert nor sleepy
• 6. some signs of sleepiness
• 7. sleepy, no effort to stay awake
• 8. sleepy, some effort to stay awake
• 9. very sleepy, great effort to keep awake,

fighting sleep.

KSS – The Karolinska Sleepiness Scale

Body Mass Index - BMI

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Weekly working hours

11 Comp mpan any y B Comp mpan any y A

Workload whilst in port

12 B A

Circadian type

13 Comp mpan any y B Comp mpan any y A

Click to edit Master title style What have we learned?

Some results from the analysis of Weekly Diaries and Actigraphy*

*With acknowledgements to Dr Anne P Hillstrom and Gemma Hanson of University of Southampton, Centre for Vision and Cognition

Fatigue: is it higher or lower at the end of a voyage?

A closer look at the 3 ranks (Third officer, Captain, AB) for which there is the highest number(i.e.: n>10)

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Captain Third Officer AB

Is Stress higher or lower at the end of a voyage?

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Sleepiness and Fatigue:

High levels of sleepiness at all times and increasing fatigue

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Several other weekly diary items potentially increase with time at sea (including reduced motivation)

Social Cohesion on board

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Actigraphy and Amount of Sleep

Example of Actiwatch data: A Bosun on Day work

Actigraph example of a Master – disturbed sleep?

Actigraphy: Example of a Master – disturbed sleep?

Amount of Sleep over the Voyage

Average Amount of Sleep by Trade

Average Amount of Sleep by Rank

• Error bars represents 1 sem
• Significant when

anchored at start

• f contract

The effect of voyage time on wake bouts

A Summary of the MARTHA Findings

Sleepiness and Fatigue Levels

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Months at Sea

Recovery periods

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What should we do? Manage the Fatigue Risk. FRMS?

Two Ways to Mitigate the Fatigue Risk:

“Hours of rest” – STCW and MLC Prescriptive

Negotiated Contract Compliance culture: minimum standards Reactive Control Inspection and audit

FRMS within the IMO revised guidelines on fatigue Non-mandatory Goal-based approach

Scientific basis: data driven “Best practice”: aspiring to excellence Custom-built to own company using maturity models

Click to edit Master title style Three Core Elements of Fatigue Risk Management

1 Fatigue Awareness training and cultural change programmes; 2 Fatigue reporting system within a just culture; 3 ”Data-driven” predictive analysis for fatigue risk assessment, workload management and monitoring adequate sleep*

• *Tools may include subjective reporting,

actigraphy, and fatigue prediction models