Determining Fitness for Duty

All workers have an obligation to report to work ‘fit and able to work’ and all employers have an obligation to ensure that all employees are safe at work. Since sleepiness and fatigue both affect one’s fitness for duty, the question arises of how one would determine if someone is, in fact, impaired by sleepiness and fatigue and, therefore, not fit for duty.

Initially, one would look for physical signs of sleepiness and fatigue. In addition to the customary characteristics of eyes closing and head bobbing, one would also look for a slow response rate, disorientation, complacency or slurred speech.

Israeli researchers have made another interesting observation. Individuals were asked simply to stand with their eyes closed. Those who were more sleepy started to sway backward and forward. While not yet scientifically verified, this is a simple test similar to that used by police officers at roadside checks when they suspect drug or alcohol use.

Whatever leads one to suspect impairment due to sleepiness and fatigue, one could then seek information to indicate whether there is any possibility or reason for the sleepiness and fatigue. This can be assessed by determining the amount of sleep one has received in the last 24 – 48 hours and the number of hours one has worked within that same 24 – 48 hours. Currently available assessments which have been scientifically verified use this information to then determine the potential level of impairment risk.

Given that these assessments make an estimation of risk one could not conclude that someone is, in fact, impaired and unfit for duty. If a high level of alertness is a bonifide workplace qualification – that is, fatigue and sleepiness would interfere with safe operation of a vehicle or equipment or in safely and accurately carrying out one’s job duties – then an employer would be justified in moving to a more direct assessment of an individual. This could involve using programs which test an individual’s impairment as it relates to cognitive function.

One such program, called QuickTest is a 5 -7 minute assessment done on an iPad. Though this program was initially developed to assess head injury in sports, it is now being used in the workplace to assess attention, motor speed and memory deficits associated with cognitive impairment.

Using a program such as QuickTest has several benefits. One is that it is very quick and easy to use in the workplace. Secondly, it gives an observable and objective measure that can be viewed by both the employee and the employer.

And finally, it can be used to determine cognitive impairment regardless of the source. Though identifying the source may be important to prevent future occurrences of impairment, what is more critical for the employer is determining whether an employee is fit for duty at the moment and a cognitive test such as QuickTest will allow you to do that.

Other types of tests involve retinal eye scans. These scans use eye movements and response to visual stimuli to determine the extent to which one might be impaired. Specifically, one is assessed on the speed and accuracy with which one responds. Obviously, the slower the response and the more errors, the greater the level of impairment.

While a valuable assessment, using retinal scans has some disadvantages. Since a bigger, more expensive and less portable piece of equipment is required, a worker would need to be removed from the worksite and brought to wherever the machine is. This movement may, in fact, cause the employee in question to become more alert and the outcome may not reflect the actual level of impairment.

Determining fitness for duty is one thing, but it is also important to have policies and protocols to determine what is to be done upon finding a level of impairment that would compromise a worker’s ability to carry out their duties safely. In the case of sleepiness and fatigue, a simple immediate action might be to provide a short rest break or an opportunity for a nap. This should be followed up with a review of the source of the impairment and a determination of what actions or changes are required by the employee or the employer to reduce the potential of impairment in the future.

One strategy to help employees deal with sleepiness and fatigue at work is to offer the 1.5 hour presentation called ‘PowerUP.’ In this presentation, they will learn specific strategies they can use while at work to ensure that they maintain alertness. A version of this presentation called ‘Drive Alert’ is available for those who drive as a function of their work.

To arrange for any of these presentations at your workplace, call 1-866-975-1165.

To hear brief daily comments and strategies to Sleep Better – Feel Better – Work Better go to Carolyn’s podcast at carolynschur.podbean.com or find it on your usual podcast provider.

© Carolyn Schur, December 2018. May be reprinted with attribution. www.carolynschur.com