Cognitive Ergonomics Laboratory, University of Liège, Belgium.
Cognitive Ergonomics Laboratory, University of Liège, Belgium.
Appl Ergon. 2020 Jan;82:102914. doi: 10.1016/j.apergo.2019.102914. Epub 2019 Aug 5.
There is a growing body of studies indicating that extended shift duration has an adverse effect on fatigue, consequently leading to reduced work performance and higher risk of accident. Following modern fatigue risk management systems (FRMS), acceptable performance could be maintained by the mobilization of appropriate mitigation strategies. However, the effective deployment of such strategies assume that workers are able to assess their own level of fatigue-related impairments. In this study, we sought to determine whether emergency physicians' subjective feelings of sleepiness could provide accurate knowledge of actual fatigue-related impairments while working extended shifts. We conducted a prospective observational study with a within-subjects repeated measures component. We collected sleep logs, sleepiness ratings and reaction times on a Psychomotor Vigilance Task (PVT) at different time points during shifts. Our results show that the PVT is sensitive to sleep loss and fatigue, with a 10% increase in mean reaction time across the shift. Subjective sleepiness, however, showed no significant association with time since awakening and was not a significant predictor of PVT performance. Our results are consistent with experimental studies showing that individuals tend to underestimate fatigue-related impairments when sleep deprived or functioning under adverse circadian phase. The discrepancy between subjective sleepiness and actual fatigue-related impairments may give workers the illusion of being in control and hinder the deployment of mitigation strategies. Further research is needed to determine the relative weight of circadian phase shifting and cumulative sleep deprivation in the decline of self-knowledge in extended shifts.
越来越多的研究表明，延长轮班时间对疲劳有不利影响，从而导致工作表现下降和事故风险增加。遵循现代疲劳风险管理系统 (FRMS)，通过调动适当的缓解策略，可以维持可接受的工作表现。然而，这些策略的有效实施假设工人能够评估自己的疲劳相关损伤程度。在这项研究中，我们试图确定急诊医师在延长轮班时的主观困倦感是否能准确了解与疲劳相关的实际损伤程度。我们进行了一项前瞻性观察研究，具有受试者内重复测量的组成部分。我们在轮班的不同时间点收集睡眠日志、困倦评分和精神运动警觉任务 (PVT) 的反应时间。我们的研究结果表明，PVT 对睡眠不足和疲劳很敏感，整个轮班的平均反应时间增加了 10%。然而，主观困倦感与觉醒后时间没有显著关联，也不是 PVT 表现的显著预测因素。我们的研究结果与实验研究一致，表明当睡眠不足或在不利的昼夜节律相位下工作时，个体往往会低估与疲劳相关的损伤。主观困倦感与实际疲劳相关损伤之间的差异可能会给工人一种控制感，并阻碍缓解策略的实施。需要进一步的研究来确定昼夜节律相位变化和累积睡眠剥夺在延长轮班时自我认知下降中的相对权重。
