Better Job Safety

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2011-07-19T17:34:00.000-07:00

We have updated our web site to include all current blog entries. Please go to www.bowles-langley.com to read current blogs and track the latest news about BLT.

Suggestion 13

2011-04-25T16:51:00.000-07:00

According to the article below, the Air Traffic Controllers Association has drawn up a list of 12 suggestions to fight fatigue in the control tower. I am not sure where they are in the process but we would like to add one more suggestion to the list. Suggestion 13 is to provide the Alertometer App with the new monitoring function to each controller. (The monitoring feature will be available Sept 2011.)

Aviation workers suffering from fatigue has been a problem identified by the Federal Aviation Administration several years ago, yet no solutions have been implemented and five air traffic control employees have recently fallen asleep during overnight shifts. Two of the five were fired.

"It's tough to see controllers facing firing when the problem of (midnight) shift sleep deprivation has been acknowledged by the FAA," said retired controller Rick Perl. "Sacrificial lambs is how it feels to me."

A sixth recent incident involved the suspension of an air traffic controller for watching a portable DVD player during the shift. Former and current employees told the Associated Press that it is a common practice for overnight workers to watch movies or read magazines to help them stay awake. They added that staring at a radar scope for the eight hour shift in a dimly lit room is a recipe for fatigue.

Since 1993, when fatigue was first cited as a contributing factor to an accident, 14 aviation accidents and 263 fatalities have occurred due to or in part by fatigue according to the National Transportation Safety Board.

Several solutions have been suggested and put aside, including allowing air traffic controllers to sleep during shifts when not directing aircraft, to take naps during scheduled breaks, and imposing shift limits on schedules.

The National Air Traffic Controllers Association created a group to address controller fatigue, and the group offered 12 recommendations to FAA Administrator Randy Babbitt after a year and a half of research.

Sleeping during scheduled breaks or during flights when the plane was at a cruising altitude and neither ascending nor descending were two of the group’s suggestions. They cited sleep experts’ advice that scheduled naps during night shifts, especially between 1 a.m. and 5 a.m., would help keep workers alert.

Babbitt was "abundantly enthusiastic about us moving forward," said Peter Gimbrere, who is spearheading the controllers association's fatigue effort.

However, administrator and Transportation Secretary Ray LaHood rejected both recommendations.

"We don't pay people to sleep at work at the FAA," Babbitt told AP last week. "I don't know anybody that pays anybody to sleep unless you're buying people to have sleep studies."

Patrick Forrey, a former president of the controllers' union, said that the decision to ignore the recommendation was "unfortunate and political."

"People think, 'Why are we paying people to take a nap?'" Forrey said in an interview. "It doesn't necessarily play well with the public, especially in an economy like today."

Current controllers’ association president Paul Rinaldi said Friday that he is pushing for the FAA to embrace all 12 suggestions.

"The recommendations are based on advice from NASA and the military and in line with international air traffic control best practices," he said in a statement.

He added that small recent changes by the FAA such as adding a second overnight traffic controller and giving workers an extra hour between shifts have “barely scratched the surface” in finding a permanent and workable fatigue solution.

Safety consultant and former NTSB member John Goglia said the FAA’s committee “is going nowhere.” He said that airlines don’t want new rules because they don’t want to deal with schedule complications and unions don’t want new rules because “they’re working tons of overtime to make up for the pay cuts that they took.”

"Everybody who works nights in aviation knows if you're not busy you're going to fall asleep because you're chronically fatigued," Goglia added.

The FAA is currently reviewing all 12 recommendations according to spokeswoman Laura Brown.

Alertometer

2011-03-31T08:31:00.000-07:00

BLT has introduced Alertometer a new App for the iPhone. An Android version is in the plans. We will be introducing exciting new features for this App over the next months to make it a useful tool for managers.

The advantage of the iPhone (or Android platform phone) is obvious. First, the device is portable so an operator can have it with him/her at all times. In addition, it is a personal device that can be used for personal feedback. And iPhones are connection devices which open up an entire world of features and possibilities. As we develop this App many of these features will be incorporated.

Colgan Crash

2011-02-08T12:19:00.000-08:00

The following is from the Seattle PI:
Source: Seattle PI

The Rundown on Commuting and Fatigue on the Flight Deck
Before the crash of Colgan Air Flight 3407, there wasn't a lot of attention paid to the oftentimes grueling commuting schedule of pilots in the United States. At the office of the International Civil Aviation Organization, however, they've been talking about this for years. Next month, in fact, ICAO is expected to adopt a fatigue risk management system that could result in airlines and regulators taking a more sophisticated approach rather than just smacking an arbitrary number into the rule book that says, "This is how much you can fly."

So it made for some pretty interesting reading tonight when a correspondent sent to me, hot off the press, the just-released interim report examining commuting and pilot fatigue. The U.S. Congress launched the National Research Council's Transportation Research Board on the subject with the full support of anyone who read even a single story about the Colgan Air fiasco.

The picture that emerged at the NTSB probable cause hearing into the crash was heartbreaking. It was downright tragic just how compromised both pilots were when they took command of the Bombardier Dash-8. The captain, Marvin Renslow, commuted to Newark from his home in Florida the night before the flight. He was apparently up working on a computer at 3:00 o'clock in morning. First officer Rebecca Shaw - sick with a head cold - arrived in Newark after jump-seating her way across the country from her home in Seattle. The NTSB didn't list fatigue or commuting as contributing factors in the final report, but in a distinction without a difference, concluded that the pilots' performance was likely impaired because of fatigue, but that it could not be determined "conclusively".

Until this disheartening accident no one apparently thought to ask just how many of the nation's pilots commute to work, how many hours that commute might be or how those travel hours should be factored into their flight schedules.

Which brings us to the NRC's assignment. Between now and the end of summer, they have ambitious plans to get the answers to those questions and many more. Eight pilot unions and nine airline associations have been asked to contribute, from business aviation to cargo operators, from the Flight Safety Foundation to the Regional Airline Association.

The committee is gathering ASARs data and NTSB accident reports and most illuminating I think, will be the zip code analysis, which will give the first comprehensive view of where pilots live compared to where they report to work.

Frankly, I can't wait to get my hands on that report and everyone else who travels by air and that especially includes the pilots, should feel the same way. We've been living in the age of 24/7 for far too long not to know more about it affects performance on the flight deck.

Reminder In Case You Forgot

2010-06-07T15:24:00.001-07:00

The National Transportation Safety Board has conducted studies, which concluded driver fatigue could be significantly implicated in up to 20% of all large truck accident fatalities and 7% of all accidents involving both fatalities and injuries. In fact, one-third of drivers questioned in a survey admitted they had fallen asleep at the wheel in the last 12 months. Research shows driver fatigue is most notable between 2 am and 6 am, followed by mid-afternoon. Drivers are under constant pressure to meet delivery deadlines and profit margins can be quite slim, thus forcing drivers to continue driving when fatigued.

FAA Still Not Getting It

2010-04-27T10:07:00.000-07:00

Pilot Fatigue/Sleep Monitoring Program Largely Ignored by FAA/NTSB

Article Source: http://www.articlesbase.com/ - Pilot Fatigue/Sleep Monitoring Program Largely Ignored by FAA/NTSB

With more than 250 air crashes in the last 15 years linked to pilot fatigue or sleep deprivation issues, it seems our own Federal Aviation Agency (FAA) as well as the National Transportation Safety Board (NTSB) have been asleep in their administrative duties. A March 11, 2010 article from WBZTV discloses that data "collected from NASA, the FAA, and the NTSB showed that "over the past five years there have been 689 incidents where pilot fatigue caused a safety concern or a crash." Documents tell of pilots nodding off on approaches and even landing on the wrong runways or taxiways. Pilots are sometimes allowed to work 16 hours in a day, though only eight can be in the cockpit. One retired commercial airline pilot admitted, "I can remember more than one time waking up while we were in route. I had been asleep, looking at the clock, looking at the watch, I had been asleep for 20 minutes, 30 minutes."

Despite the uptick in reports of fatigue and sleep linked accidents, all we continue to hear from the FAA and the NTSB are empty promises of coming changes. In June of 2009 Randy Babbitt (current FAA Administrator) pledged to change pilot regulations, most of which have been in effect since the 1940s. He told reporter Nancy Cordes in her article for CBS News, "We're gonna have a tough decision to make and I don't mind making it." The only recent change to policy has been his approval for pilots to use antidepressant medications on the job. The most common side effects of antidepressants are drowsiness, dizziness and sleep problems, including insomnia. Mr. Babbitt feels that "culture change" and tolerance for those afflicted with depression are more important than the safety of the millions flying the skies. The FAA's mission statement is "to provide the safest, most efficient aerospace system in the world." The FAA's vision statement is "to improve the safety and efficiency of flight. We are responsive to our customers and are accountable to the taxpayer and the flying public." The recent antidepressant policy change as well as the continued delay in amending pilot work hour regulations seriously conflict with the FAA's stated mission and vision objectives.

While our own FAA and NTSB are asleep at the "stick", allowing the airlines to continue to overwork their pilots, most of the international safety boards are joining them in the bunkhouse. The CBC in Canada reported in a March 2010 article that "Twenty-eight people have died in a dozen plane crashes across Canada over the past decade in which fatigue was cited as a possible factor." The Canadian Transportation Safety Board reports note "pilot-fatigue-related issues in six deadly crashes and in an additional six accidents – including the Air France crash in Toronto – where all on board survived." Canadian regulations allow pilots to be on duty for 14 hours, or 17 in "unforeseen circumstances." Barry Wiszniowski, a pilot and expert with the Air Canada Pilots Association, says this about regulations in Canada, "Ours haven't been modified since 1995 and prior to that in the ‘40s."Martin Eley, head of civil aviation at Transport Canada, after initially dismissing pilot fatigue complaints from unions, says, "we've certainly moved on…in June, we are tabling the terms of reference for a working group to actually start looking at the current science and looking at where we need to update our regulations." He noted that "it will likely take a couple of years before the rules change." A 2001 study recommended six changes to work regulations. Four of the six were ignored by Transport Canada. The changes were to address duty schedules relative to circadian rhythm effects on sleep.

Drew Dawson, an expert on fatigue in the workplace, makes the frightening statement:

"There's nothing like a smoking hole in the ground to address attention."

Pilot Kent Wien, in Gadling.com, accused the NTSB of "glossing over fatigue" as the cause of the Colgan Air crash in Buffalo, New York last year. They placed total blame on the pilot's inabilty to properly handle a stall. The crash killed 50 people and the NTSB overlooked the fact that both the pilot and the co-pilot had little sleep in the 24 hours prior to their flight. They placed total blame on inadequate flight simulator training. Robert Sumwalt, one of the NTSB investigators in the case, refused to allow fatigue as a contributing factor saying, "just because the crew was fatigued, that doesn't mean it was a factor in their performance." Sleep deprivation studies have proven that performance levels and response speeds for sleep deprived individuals are equivalent or worse than blood alcohol levels of 0.05%. A British Medical Journal study concluded that fatigue does affect performance, finding that, "getting less than 6 hours a night can affect coordination, reaction time, and judgment" and poses "a very serious risk" to drivers." The NTSB , like the FAA, chooses to ignore the fatigue and sleep deprivation issues jeopardizing the air safety they are charged to protect.

While air transport safety boards and accident investigators overlook fatigue and sleep deprivation as a cause of human error disasters, Air New Zealand has been monitoring and analyzing fatigue, sleep, and fatigue countermeasures since 1998. "Air New Zealand was one of the first airlines in the world to introduce a policy for controlled rest on the flight deck (cockpit napping)." The policy was supported by the Civil Aviation Authority of New Zealand. It allows for a fatigued crew member to take a 45 minute nap after a briefing of the crew members as to time of waking. "No course changes, altitude changes or fuel transfers are permitted during this period." The napping is only permitted for 2, 3, and 4=person crews. The fatigue management program has full support of airline management and union groups. Fatigue report forms from pilots detailing excess fatigue, possible causes and remedies are passed to Flight Operations management for possible action or comment and are then analyzed by a Flight Crew Fatigue Study Group (FCFSG) monthly. The group looks for patterns and problems with particular duties and routes.

Pilots participating in studies wear a "Sleepwatch" on the wrist. The sleepwatch measures wrist activity. It provides information on "timing and quality of sleep." Three questionnaires are utilized in-flight. Fatigue Visual Analogue Scales rate how pilots feel. A Profile of Mood States asks pilots to score certain words based on their moods. The Stanford Sleepiness Scale scores word pictures of the individual's fatigue feelings. The questionnaires are short and only require a few minutes of their time. The pilots then take a quick test called the Psychomotor Vigilance Task in which they have to extinguish a randomly flashing light in a small box by pushing a button using his or her thumb. The notebook sized black box measures and records performance and alertness rankings. More importantly it measures "lapses" which took more than 500 milliseconds to accomplish. The FCFSG has taken the data from these studies and has modified "flight and duty time limitations that are considered safe and acceptable on the basis of reliable data." The group hopes to go pro-active in the future to advise tours of duty before they are introduced instead of modifying them after studies and reports have been completed. The FCFSG has decided to forgo the marketing of their system and they have opened it to the public domain "for the betterment of flight safety in the International Aviation Community."

On March 22, 2010 the United States Senate unanimously passed the FAA Air Transportation Modernization and Safety Improvement Act (S.1451) by a margin of 93-0. Chairman Rockefeller made airline safety a "top priority in the bill." It requires the FAA to "revise the flight and duty time regulations for commercial air carrier pilots and issue the final rule within one year to address pilot fatigue. The existing FAA guidelines on flight time and duty limitations were established in the 1940s without significant modification." Chairman Rockefeller in a press release of December 2009 said, "Addressing pilot fatigue is an issue for which it has taken far too long to achieve meaningful reform. The travelling public deserves a better effort to make certain any plane on which they fly has an alert and well rested flight crew."

Fatigue, sleep deprivation, and their effects on our safety in the air have been sufficiently documented. It is time for the FAA, the NTSB, and their partnered agencies across the globe to wake up and to follow the lead of New Zealand Air. Millions of lives are at stake. They should not need any more "smoking holes in the ground" to wake up from the sleep paralysis that's been plaguing them for years.
Retrieved from "http://www.articlesbase.com/politics-articles/pilot-fatiguesleep-monitoring-program-largely-ignored-by-faantsb-2209186.html"

NTSB Chair Hersman Remarks on Fatigue

2010-03-08T12:55:00.000-08:00

FOR IMMEDIATE RELEASE: March 5, 2010 Washington, DC – National Transportation Safety Board Chairman Deborah A.P. Hersman today encouraged the sleep research and healthcare community to continue their efforts to educate transportation policy makers of the dangers of fatigue in all modes of transportation.

Speaking before the annual conference of the National Sleep Foundation in Washington, D.C., Chairman Hersman remarked that fatigue has been a concern for the Board since the creation of the agency in 1967 and it has been an issue on the Board’s Most Wanted List of Transportation Safety Improvements since the list was established in 1990.

“The work of the National Sleep Foundation and other organizations and individuals is critical to improving transportation safety policy,” said Chairman Hersman. “The NTSB is interested and willing to partner with you in developing a greater awareness of fatigue.”

Hersman highlighted a number of accident investigations across all transportation modes that included fatigue as the probable cause or a contributing factor to accidents. As a result, the Board has made safety recommendations that range from deploying fatigue detection systems to reduce the occurrence of accidents to installing electronic on-board recorders that collect and maintain hours of service data on vehicle operators.

“We can’t always prove fatigue as a cause of an accident, but the frequency with which we now routinely document the presence of fatigue-related factors in transportation operations is alarming,” Hersman stated.

Hersman remarked that while there are still no definitive tools to conclusively identify the degree to which a person is fatigued, the major challenge is to ensure that all those in transportation report to work rested and fit for duty — for their own safety and for the safety of those they are transporting.

Kleen Energy Explosion

2010-03-08T12:51:00.000-08:00

The following is a quote from the AP article:

NEW HAVEN, Conn. — A federal agency investigating a power plant explosion in Connecticut that killed six workers last month says some workers were putting in long hours and it’s looking into whether fatigue played a role.

Authorities say the Feb. 7 explosion at the Kleen Energy Systems plant in Middletown happened as workers were using natural gas to clean out gas lines.

The son of the one of workers who was killed has told The Associated Press his father was working long hours for months and an attorney for an injured worker said they were working seven days per week.

Some workers, including some of those involving in cleaning the gas lines, worked 12-hour shifts, said Donald Holmstrom, lead investigator for the Chemical Safety Board. He emphasized the board has not determined whether fatigue was a factor in the blast.

"There were some workers working long hours," Holmstrom told The Associated Press on Thursday. "We’re documenting their schedules. We’re examining that issue. It’s just not clear that there is any causal connection yet."

Holmstrom could not say how many workers were putting in long hours or for how long. He said investigators still need to talk to key workers.

Kleen Energy declined to comment. Telephone messages were left Friday with other companies involved in the project, including O&G Industries and Keystone Construction.

Erik Dobratz, whose father Ray Dobratz was killed in the blast, said last month his father had told him he was working 12 hours a day, seven days a week, for six months.

"A lot of the guys on the job were doing this for six months, and they were exhausted," Dobratz said at the time. "They were all exhausted. To me that just seems a little ridiculous. Eighty-five hours a week — accidents happen, if you ask me."

Robert Reardon, an attorney for a worker injured in the blast, also has said workers were spending seven days a week on the project and were pressured to get the job done.

The Chemical Safety Board cited worker fatigue as a contributing factor in its report on a 2005 explosion at BP’s Texas City refinery in Texas that killed 15 people and injured 170. Its report cited one key operator who put in 12-hour shifts for 29 consecutive days and said other workers were likely experiencing the effects of fatigue.

That report cited studies finding that people experiencing fatigue are typically more rigid in thinking and have greater difficulty responding to changing or abnormal circumstances and take longer to reason correctly. It raised specific concerns with 12-hour shifts, saying they negatively affect worker performance and can lead to higher accident rates.

The Connecticut blast, heard and felt for miles, occurred about an hour after some workers at the site complained of a heavy gas smell.

The board said last week that the purging process is "inherently unsafe," and should be curbed to prevent similar accidents. The 400,000 cubic feet of natural gas blown through the pipes was released into the air in tight quarters, creating an explosive mixture large enough to fill a professional basketball arena, Holmstrom said.

Exactly what sparked the blast has not been determined, though Holmstrom said there were "several" potential ignition sources nearby.

The U.S. Chemical Safety Board investigates serious chemical accidents. State and local authorities are conducting a separate investigation into whether there was any criminal negligence.

Colgan Pilot Fatigue & NTSB

2010-02-08T13:53:00.000-08:00

I am quoting here from Ken Wien:

As a pilot, I feel the National Transportation Safety Board (NTSB) has failed me. They're tasked to investigate accidents and report on them so the aviation community can hopefully avoid similar mistakes. They also submit recommendations to the FAA for changes they feel will make air travel safer.

But I have to question the impartiality of the NTSB after seeing the outcome of the Colgan 3407 investigation.

Yesterday the NTSB came out with a report on the Colgan 3407 accident in Buffalo, New York last year that puts the blame squarely on the captain.

CAPTAIN'S INAPPROPRIATE ACTIONS LED TO CRASH OF FLIGHT 3407 IN CLARENCE CENTER, NEW YORK, NTSB SAYS.

Clearly, the captain reacted to a reduction in airspeed in a way that is contrary to everything we're taught as pilots. But what caused this?

The NTSB sought to find out just why this reasonably experienced captain would respond in such a manner. Training records were examined, toxicology reports were submitted and everything that was said by the crew during the flight was analyzed.

Glossed over in the report was the fact that both the captain and first officer had very little sleep over the previous 24 hours. The NTSB says the captain had 'reduced sleep opportunities' and attempted to rest in the company crew lounge. Apparently the attempts at sleeping there weren't effective since the captain logged on to a company computer at 3:10 in the morning.

The first officer likely had a full day near her home in Seattle before commuting on an 'all-nighter' to her base in Newark. She also tried to get a nap in at the crew lounge in the morning as well.

But one of the investigators in the Colgan accident, Robert Sumwalt refuses to allow for the possibility that fatigue was even a contributing factor in the accident, saying "...just because the crew was fatigued, that doesn't mean it was a factor in their performance."

Incredible.

Numerous studies have concluded that significant sleep deprivation is equivalent to operating while under the influence of alcohol. The British Medical Journal concluded that "after 17–19 hours without sleep, performance on some tests was equivalent or worse than that at a BAC of 0.05%. Response speeds were up to 50% slower for some tests and accuracy measures were significantly poorer than at this level of alcohol. After longer periods without sleep, (up to 28 hours) performance reached levels equivalent to the maximum alcohol dose given to subjects (BAC of 0.10%)."

It's illegal to drive a car in the U.S. with a blood alcohol content at or above 0.08 to 0.10%.

The role of fatigue was mentioned during an NTSB hearing on the Colgan accident. Board chairman Deborah Hersman argued that several issues, including the crew's sleep deficits and the time of day the accident took place, were factors and said that fatigue was present and should be counted as a contributing factor to the crew's performance.

But the view of board member and former USAirways pilot Robert Sumwalt prevailed. He concluded that fatigue wasn't a factor in the accident. It didn't stop them from detailing the role it played in Colgan 3407 (PDF LINK)

So if nicotine is found to cause some cancer, but its role in a person's life expectancy cannot be determined, should we rule it out as a possible factor in a lung cancer death?

The British Medical Journal study concluded that fatigue does affect performance, finding that, "getting less than 6 hours a night can affect coordination, reaction time and judgment" and poses "a very serious risk" to drivers.

It was precisely this reaction time and judgment that are to blame in the Colgan accident. I'm sure if you had asked Captain Renslow about the proper response in a stall, he would have been able to recite the steps verbatim. But that night, he was operating in a fog caused by a lack of quality sleep for the past 36 hours.

And the copilot, Rebecca Shaw, after commuting across the country all night before starting her day, misinterpreted the stall for possible icing conditions that she thought was affecting the tail and so she retracted the flaps during the recovery, exacerbating an already difficult recovery.

Most pilots expected sleep deprivation to play the leading role in the Colgan 3407 accident. The industry has averaged nearly an accident a year for the past twenty years with fatigue listed as a contributing factor. Could this have been the first case where a lack of sleep was actually considered the cause of a crash?

If a lack of sleep can affect affect coordination, reaction time and judgment, how conclusive does fatigue have to be, to be considered a cause in an accident that lists improper reactions and judgement as the main factors?

This time the NTSB isn't even attaching fatigue as a 'contributing factor' in the Colgan accident, even though they went on to say in the report:

All pilots, including those who commute to their home base of operations, have a personal responsibility to wisely manage their off-duty time and effectively use available rest periods so that they can arrive for work fit for duty; the accident pilots did not do so by using an inappropriate facility during their last rest period before the accident flight.

There is no doubt in my mind that, if a BAC of, say, .08% were discovered in the pilots' blood that the NTSB would list this as the cause of the accident and close the case.

I've always been a proponent of the NTSB. They look at human factor trends and educate us on ways to avoid them. As a fresh 20 year-old pilot, I even defended the local NTSB office in a KOMO4 TV news report when their numbers were reduced.

The NTSB has done as much as the FAA to ensure safe flying for the masses. I don't understand why they've been reluctant to properly address the role of fatigue in a number of accident reports.

Perhaps it's because airlines are terrified at the thought of reducing the 16-hour duty day further, which could lead to the recall of a few pilots at each company. Airlines point to a policy that allows a pilot to call in 'fatigued' if they don't feel rested. But we don't allow pilots to self diagnose when they're too drunk to fly-we simply have limits on how much time must pass before they can fly.

So the fatigue policy, while helpful, isn't the only way to ensure pilots are well rested on their next flight. Furthermore, Colgan unilaterally put new restrictions on the use of fatigue calls by its pilots.

But the FAA was confident enough that fatigue was a causal factor in the Colgan Dash 8 accident to start acting before the final NTSB report has been issued. They are working on new limits that will reduce the duty day for pilots, which includes both flight time and the time sitting around in airports between flights.

To appease the industry, the FAA may have to agree to a slight increase in flight time limits-the number of hours a pilot is allowed to be in the air in a day-currently 8 hours for a two-pilot crew-to secure improvements to the current 16 hour duty day for pilots.

I applaud the FAA's decision to take on this cause after their previous 1995 attempt failed. At least the FAA seems to recognize that, for most pilots, it's not the number of hours flown in a day, but it's the amount of time on duty, and during what time of day a pilot is on duty that affects our safety.

Because there's no way we'll solve the fatigue issue if we continue to deny it leads to accidents.

Fatigue Risks in Constuction

2010-02-01T13:37:00.000-08:00

Fatigue is major accident risk factor in construction

29 January 2010

FATIGUE is the number one accident risk factor for construction workers and requires better recognition by occupational health and safety managers, research at the University of Sydney has found. Margaret Chan’s PhD research focused on four high profile oil and gas Sino joint-venture construction projects in Mainland China, where she interviewed workers, managers and safety supervisors to establish perceived causes of workplace accidents. All three groups considered fatigue to be the most significant risk factor in workplace accidents at these sites.

Chan’s research is the first to identify fatigue as the leading risk factor in a construction environment. Other factors identified were mental stress, failure to follow safety procedures, lack of knowledge, failure to use proper equipment, and fire and explosion.

“My research shows previously identified factors like failure to use equipment or failure by individual workers to follow safety procedures are heavily influenced by fatigue. If you eliminate fatigue, you also eliminate other so-called ‘causes’ of accidents. Previous research shows fatigue can cause performance impairment equivalent to – or greater than 0.10 per cent – of blood alcohol concentration, a level deemed unacceptable for driving a crane or operating dangerous construction equipment or machinery.”

Although her work was based in China, Chan, from the Department of Civil Engineering at the University’s Faculty of Engineering and Information Technologies, believes the findings are equally applicable in Australia.

“It’s well known Australia has more stringent OH&S regulations than China but these do not address fatigue, particularly in construction,” she says. “Australian construction companies – based locally or overseas – need to place greater emphasis on the importance of recovery, a significant moderator of fatigue. Managers should ensure workers take regular breaks from work, and schedule shift rosters to allow the body to adapt to the circadian rhythm. They should also provide facilities allowing workers to recover from the fatigue and stress that comes with working in a high-risk environment.

“Workers at construction projects are predominantly multi-cultured migrants who worked an average of more than 60 hours a week. Based on my findings, I believe that it is imperative managing contractors of these projects provide recreation facilities to help workers recover from fatigue and mental stress, reducing the risk of accidents at construction sites.”

“At the management level, safety officers should factor fatigue and stress into their regular OH&S audits and consider them when investigating accidents. Furthermore, workers at risk should be screened for fatigue at regular intervals,” she concluded.

Railroads

2009-10-26T20:38:00.000-07:00

The railroads are starting to worry about some of the new regulations coming down from the Federal Railroad Association (FRA). The regulators are looking to automatic anti-collision systems. These systems are extremely expensive.

Forget the fancy computers, just upgrade operator performance with alertness testing.

I have a call in to the FRA.

Research Report

2009-10-01T11:15:00.000-07:00

Our research report on testing is available as a download on the BLT web site. (Click the "Research Report" above and then select "Research Report" from the list of "BLT Publications"). This report provides background on the development of our software and explains how it was tested. Briefly, we conducted sleep deprivation trials for validity testing and implementation trials to see how testing is accepted in the workplace.

Half Way to Goa

2009-05-26T10:21:00.000-07:00

From the Times of India (24 May 09):

"An Air India Jaipur-Mumbai flight flew well past its destination with both its pilots fatigued and fast asleep in the cockpit. When the pilots were finally woken up by anxious Mumbai air traffic controllers, the plane was about half way to Goa.

"This nap in the sky took place about a fortnight ago on the domestic leg of a Dubai-Jaipur-Mumbai flight — IC 612 — which had about 100 passengers on board. "The plane took off from Dubai at 1.35am IST and then from Jaipur at 7am. After operating an overnight flight, fatigue levels peak, and so the pilots dozed off after taking off from Jaipur," said a source.

"The flight schedules of pilots prior to this flight is not known.

"The aircraft was supposed to take the A 474 South route — a designated route to Mumbai — and since it was on autopilot, it headed in that direction. "It was only after the aircraft reached Mumbai airspace that air traffic controllers realized it was not responding to any instructions and was carrying on on its own course," said the source.

"Said an air traffic controller: "The aircraft should have begun its descent about 100 miles from Mumbai, but here it was still at cruising altitude. We checked for hijack and when there was no response we made a SELCAL (selective calling)."

"Every aircraft has its own exclusive code. When the ATC uses this high frequency communication system — which it does very rarely and only when other communication draws a blank — a buzzer sounds in the cockpit. Jolted by the sound of the SELCAL buzzer, the pilots woke up and brought the plane back to Mumbai safely.

"Kanu Gohain, directorate general of civil aviation, was not available for comment. Contacted for its version on Wednesday evening, Jitendra Bhargava, director, public relations of Air India, said, "The director, operations, is getting information on the matter."

"General manager, Mumbai aerodrome, M G Junghare, denied that the pilots were asleep behind the control column. "The aircraft had a radio communications failure and so could not be contacted. It had gone only 10 or 15 miles off Mumbai and after we ascertained that it was not hijacked we made the SELCAL," he said.

by Manju Vayalar, TNN

Tragedy in Buffalo

2009-05-14T10:44:00.000-07:00

From the voice recordings of cockpit conversations we can begin to understand the circumstances surrounding the tragic end of Continental Flight 3407 in Buffalo, NY on Feb 12, 2009. The pilots apparently neglected to monitor their falling airspeed. Ice was evident on the windshield. Then there was a stall warning. Captain Renslow may have misinterpred the situation and pulled back on the stick instead of pushing it forward which would have allowed the plane to regain speed. The resulting stall was fatal to the crew and fifty people. The slow and incorrect response to the stall warning makes little sense to experienced pilots trying to understand this event.

The investigation is still pending, but I am going to suggest that the error made here was a consequence of a chain of errors leading up to the flight. Both the pilot and the co-pilot were probably very tired. The co-pilot had been skiing the day before and had taken the red-eye flight from Seattle. At the start of her shift on the evening of Feb 12 she had possibly been awake for 36 hours. The pilot had been using the Continental computer system before dawn so he may have been tired as well. An incorrect response to a sudden alarm is typical of a fatigued individual. The distracting cockpit banter during landing is also typical of two tired people trying to stay awake and alert.

I reluctantly fault the pilots in this case. But the poor judgement may be more on Continental management for not monitoring the shifts and circadian rhythms of their crews. There are plenty of simple steps that could have been taken to insure the pilots were well rested including, of course, testing them when they came on shift. BLT has the technology to do that. The crash occurred 59 minutes after takeoff.

In Iraq

2009-05-05T17:29:00.000-07:00

Some years ago we were called upon to submit a plan for the use of our technology by the Army Tank Corps. Tanks travel fast and in the hands of a fatigued/impaired driver can be deadly. We need to dust that concept off again.

"WASHINGTON - The 130,000 American troops serving in Iraq are more likely to die in accidents, from natural causes, or in other "nonhostile" incidents than at the hands of insurgents, according to Defense Department statistics for the past eight months ending in April.

"The statistics highlight the dramatic reduction of violence in Iraq over the past year, but also underscore a challenge that has bedeviled US troops in Iraq and Afghanistan since hostilities began: A steady stream of soldiers and Marines are losing their lives in circumstances that are often preventable.

"Between September 2008 and April 2009, 72 troops died in Iraq from accidents, illness, or suicide, compared with 67 who died in action, according to the Pentagon - the first extended period in the six-year conflict where insurgents did not pose the greatest threat.

"The biggest cause of nonhostile deaths remains accidents. Since the start of the war in March 2003 more than 500 troops have died from vehicle or aircraft crashes and other accidents such as falls, according to the data.

Quotes are excerpted from Bryan Bender at bender@globe.com.
© Copyright 2009 Globe Newspaper Company.

Fatigue Management Conference in Boston

2009-03-31T09:05:00.000-07:00

I am at the International Conference on Fatigue Management in Transportation Operations. Anneke Heitmann has just presented the results of our three year study of sleep deprivation and alertness testing. Audience interest and participation was very good. Our booth in the exhibits room has attracted numerous interested parties from a great many different industries.

We have three laptops set up continuously cycling through the BLT alertness test.

Its amazing how the issue of fatigue runs through such a variety of industries. We have the FAA, trucking companies, airlines, military and hospital administrators coming by our table and taking sample tests. It is my hope that alertness testing will be recognized as a useful tool, not a cure-all, but something that can make a difference.

Drunk Pilots - Again?

2008-10-29T12:47:00.000-07:00

At Heathrow Airport last Sunday a United Airlines pilot was arrested in the cockpit just prior to takeoff on suspicion of being drunk. He was. He would have taken the controls of the Boeing 777 had it not been for a last minute call from an observant ground crew. It could have been an extremely dangerous 5,300 mile flight to San Francisco.

The situation just described is highly unusual. Pilot fatigue is a far more serious problem. But in the case of fatigue the the pilot would be just as impaired. BLT has long maintained that commercial pilots should be tested for alertness prior to piloting an aircraft. Our short 2 minute BLT Alertness Test is sensitive to fatigue and to other causes of impairment like drugs and alcohol. And while we do not generally anticipate alcohol impairment, obviously, it does happen. The question is how often. In this case detection was almost by chance.

Aircraft mechanics spend hundreds of hours checking an aircraft for flight readiness. Checklist are filled out, inspections are made. As all of us can attest, if a critical component is not right, the aircraft does not fly. Yet the most critical component, the pilot, is not checked at all.

A consistent program of testing will deter this kind of behavior and offer better safety to thousands of passengers who rely on others. Our test will stop drunk pilots before they board.

Inattention at Metrolink

2008-10-06T12:34:00.000-07:00

The Metrolink accident in Chatsworth, California last month cost 25 lives. The question is why. What can be done now.

Immediate after the fact accident reports can often focus a single error. In this case the text-messaging engineer seems to have been at fault. But experience shows that safety failures come from system failures not as a consequences of one person's actions. System redundancies and other measures will have to be examined to get a true picture of what happened.

Nevertheless, as safety expert Barry Sweedler points out that, it does demonstrate the importance of alertness and situational awareness. We need a systems approach but we also need to be aware of how much responsibility can rest on the shoulders of one man.

Sweedler said that 90 percent of the roughly 3,000 rail accidents reported each year are caused by human error: drug use, fatigue, inattentiveness, miscommunication.

A Failed Policy Made Worse

2008-08-29T13:51:00.000-07:00

The Department of Transportation (DOT) mandates that transportation companies test their workers for drug use on a regular basis. This is done by testing urine samples. Over the years a range of evasive tactics have been developed by employees who don't want to be tested and by companies that don't want to spend the money on testing. It has become a serious problem for the program which has been in urgent need of reform for a long time.

Testing has certainly reduced drug use by some transportation workers. But has it had any effect on industry safety? Probably not much, urine testing is largely ineffective for reducing worker impairment related accidents. Moreover it has prevented companies from trying some new solutions because they feel "regulated to death" already.

Nevertheless, the government continues to try to make the urine testing system work and to insist that it is safety related. A new GAO report “Improvements to Drug Testing Programs” (GAO-08-600) finally acknowledges the evasive tactics being used and adds a series of "improvements". The report writers neglect to mention the most obvious improvement which would be to toss the entire drug testing program. Seriously, urine testing needs to be reevaluated in the light of current available alternatives, including, of course, the BLT Alertness Test. But, rather than recommending alternative approaches, the report asks that the screws be tightened a bit more.

In response DOT has amended its regulations (codified at 49 CFR Part 40) for conducting workplace drug and alcohol testing for the federally regulated transportation industry. The new regulations, which took effect on August 25, require all transportation workers who were previously tested (i.e., who have tested positive for a prohibited drug in the past) or who are returning to work have their urine specimens observed by specimen collectors

I do not think this “direct observation” provision and the other requirements of the new regulation will stop drug testing subversion and evasions. Transportation cost will increase and government intrusion will grow. The unfortunate inspectors will become even more unpopular.

Just to be clear, I don’t like the idea of anyone taking illegal drugs especially while driving a truck or anything else. If we are only concerned with drug use on the highway, then urine testing might be the way to go - if we can find a way to make everyone do it. But driver impairment is often the result of driver fatigue, prescription drug effects or emotional stress. We can test for these other factors with computerized impairment tests that are non-invasive and easy to administer.

It is my hope that the DOT will broaden its view and recognize that impairment testing is a practical and direct way to improve transportation safety.

To the Oregonian

2008-03-06T13:57:00.000-08:00

This article which I submitted to the Oregonian was not published. However it outlines some of the current issues facing legislators on the issue of worker testing. Clearly my article is promoting BLT technology, it's an Op/Ed piece after all. The proposed new law was shelved.

An Oregonian editorial, “Don’t Make a Bad Marijuana Law Worse” (Feb 4), supports a bill that permits employers to test workers, including those taking legally prescribed marijuana, for drug use. Letters from readers have both criticized and supported this position. Some of the letters make reference to impairment testing which happens to be my special area of expertise. My company, Bowles-Langley Technology, Inc., (BLT), has been developing this technology for the past 10 years and has a practical system for testing workers for impairment before or during work.

The BLT Alertness Test, which takes two (2) minutes to complete, measures reaction time, orientation, decision making and general cognitive performance with a simple computer graphic-based test. Each person is asked to take the test 10 times to establish a baseline. In subsequent testing current performance is measured against this baseline. If an individual measures significantly below his or her baseline, and cannot improve this score in a retest, the individual should be considered to be severely impaired. Employers can develop appropriate policy for management of these individuals based on the nature of the job.

The perfunctory termination of an employee for trace elements of drug metabolites in urine or blood, without regard to his or her actual condition and ability to work, is an arbitrary and unnecessarily crude method to protect the workplace. Practiced as public policy, it actually makes our workplaces less safe because urine testing is used where impairment testing would be superior. Urine testing tests for specific illegal drugs and the results are typically not available for days. The use of legal drugs combined with fatigue or flu, for example, are factors much more likely to cause an employee to be dangerously impaired. But these obvious impairment factors are not considered by urine testing.

If the citizens of Oregon wish to prevent the use of illegal drugs by testing workers’ urine for evidence of past drug use, it is up to them and their representatives. But they should not be misled into thinking that this practice is driven by safety priorities because impairment testing addresses worker safety more efficiently. With the increasing cost of accidents, it is time that worker impairment be addressed directly and not be used as an excuse for promoting popular anti-drug laws that are irrelevant to the issue.

Sleep Trial

2008-01-20T17:34:00.000-08:00

The sleep deprivation trial is complete. Aside from a couple of server problems it went exceedingly well. The trial was conducted at Anneke Heitmann's excellent lab at her Awake! Institute. During this trial subjects were kept awake for two nights (they were allowed a two hour nap on the second day.) Subjects were wired for EEG data and tested every two hours with a battery of tests, a driving simulator and the standard BLT Alertness Test.

We are now looking at the data to see how well the BLT test correlates with the other measures. In general there is some correlation between all the tests.

I would like to see an clear corelation between the BLT test and the subject's circadian patterns and a clear correlation with subject driving simulator performance in particular. But healthy human subjects are complex interactive data generators and we must deal with the real world data, obviously. There is a huge amount of material to look at from this trial and the results will be published as quickly as we can make sense of it.

Research is supported by the NIH.

Union County Accident

2007-07-10T05:21:00.000-07:00

It is not my intent to have this blog focus exclusively on individual accidents. However this one in Union County, Florida was one many people followed to try to understand the cause. Here is an extract of a newspaper article from the Gainsville Sun that explains:

"Under rules that take effect in October [2007], a truck driver cannot drive more than 12 hours in Florida following 10 consecutive hours off duty. The report stated Wilkerson [the truck driver] had the opportunity for about 90 minutes to obtain rest.

"This placed Mr. Wilkerson in an extreme state of fatigue. Like the consumption of alcohol, an extreme state of fatigue places a driver in a temporary impairment state," the report stated. "While in this temporary state of impairment, Mr. Wilkerson's perception and reaction skills are impaired, his judgment is impaired, his attitude is impaired, his attentiveness and coordination are also impaired. Fatigue also affects the brain's thought processing by not allowing the brain to interpret and understand a hazardous traffic situation."

BY:
Lise Fisher (352-374-5092 or fisherl@gvillesun.com)

Fatigue and other Factors

2007-07-03T11:44:00.000-07:00

Driver fatigue is estimated to be the cause of 100,000 highway crashes and 1,500 deaths each year. We would suggest the number attributed to fatigue could be much higher if driver fatigue were to be counted as a contributing condition. Nevertheless the numbers are daunting.

FATALITIES AND INJURIES

Overall: The U.S. Department of Transportation's Fatal Analysis Reporting System at the National Highway Traffic Safety Administration (NHTSA) projects that 43,300 people died in motor vehicle crashes in 2006, down 0.3 percent from 43,443 in 2005. While deaths among passenger vehicle occupants and nonoccupants fell in 2006, motorcycle riders suffered a 5.4 percent increase. This was the ninth consecutive annual increase in motorcycle rider deaths.

By Vehicle Miles Traveled: The fatality rate — measured as deaths per 100 million vehicle miles traveled — as projected by NHTSA was 1.44 in 2006, down from 1.47 in 2005.

By Crash Type: In 2006 there were 5,930,182 police-reported motor vehicle traffic crashes, down 3.7 percent from 6,159,189 in 2005. Of total crashes, 1,710,000 caused injuries and 4,181,000 caused property damage only. NHTSA estimates 10 million or more crashes go unreported every year.

Work-Related: In 2005 crashes involving vehicles on public roadways were the leading cause of work-related fatalities, according to the U.S. Bureau of Labor Statistics, accounting for almost a quarter of all fatal work injuries.

By Age Group: In 2005 older people (65 and older) made up 15 percent of all traffic fatalities, 14 percent of vehicle occupant fatalities and 20 percent of pedestrian fatalities, in large part because they are frailer and more likely to die from their injuries than younger people. (See Older Drivers paper.) In 2004 there were 28 million older licensed drivers, up from 17 percent in 1994. The total number of drivers rose only 13 percent from 1994 to 2004.

In 2005 drivers between the ages of 15 and 20 accounted for 12.6 percent of all drivers in fatal crashes and for 16 percent of all drivers in police-reported crashes. In 2004 (latest available data) drivers in this age group accounted for 6.3 percent of all licensed drivers. To reduce high accident rates among young drivers, states are increasingly adopting graduated driver license programs, which allow young drivers to improve their skills and driving habits.

By Driver Behavior

Speeding: In 2005, 13,113 lives were lost due to speed-related accidents. Speeding was a contributing factor in 30 percent of all fatal crashes. In 2005, 38 percent of 15- to 20-year old male drivers who were involved in fatal crashes were speeding at the time of the crash. NHTSA says that speed-related crashes cost Americans $40.4 billion each year. A crash is considered speed related when the driver is charged with a speed-related offense or a law enforcement officer indicates that exceeding the posted speed limit, driving too fast for conditions or racing was a contributing factor.

Drunk Driving: There is an alcohol-related traffic fatality every 29 minutes. In 2006, 17,941 people died in alcohol-related crashes, up 2.4 percent from 17,525 in 2005 and was projected to be the highest level since 1992. Alcohol was involved in 41 percent of all crash fatalities in 2006. (See Drunk Driving paper.) Alcohol-related crashes are defined as those where someone involved, either a driver or a nonoccupant such as a pedestrian or bicyclist, had a traceable amount of alcohol in his or her blood.

Drunk Driving and Speeding: In 2005, 40 percent of intoxicated drivers (with a blood-alcohol content at or above 0.08, the definition of drunkenness) involved in fatal crashes were speeding, compared with 14 percent of sober drivers involved in fatal crashes.

Red Light Running: The Insurance Institute for Highway Safety (IIHS) says that more than 900 people a year die and nearly 2,000 are injured as a result of vehicles running red lights. About half of those deaths are pedestrians and occupants of other vehicles who are hit by red light runners.

Fatigue: NHTSA statistics show that at least 100,000 crashes and 1,500 deaths each year are the result of drivers falling asleep at the wheel. A 2002 poll, conducted by the National Sleep Foundation, found that 100 million drivers, close to half of American adult drivers, drive while drowsy and nearly two out of ten admitted to having fallen asleep at the wheel. New Jersey passed a law in 2003 that equates falling asleep at the wheel with reckless driving, and, if a driver falls asleep and kills someone in a crash, he or she can be charged with vehicular homicide and serve up to ten years in jail and pay fines. Although at least four states have considered similar legislation, New Jersey is the only state with such a law on the books.

Near Miss with Tired Pilots

2007-07-03T11:36:00.000-07:00

Airline pilots flying while fatigued poses risk to safety
27 June 2007

A BBC News investigation has revealed growing concerns among airline pilots that fatigue is leading to potentially dangerous incidents in the air. The BBC has heard from 32 pilots who say they have flown while unfit due to fatigue.

The BBC can reveal that an incident – with the first officer sleeping and captain "resting" – required a "quick reaction to avert disaster" as an airliner began turning into the path of another plane.

In another serious incident, investigated by the AAIB (Air Accident Investigation Branch), a fatigued pilot nearly stalled an aircraft in mid–air shortly after take off.

The BBC can also reveal the results of a survey for the pilots union BALPA (British Airline Pilot's Association) which suggests a majority of air crews who responded are affected by fatigue – and that pilots believe passengers should be concerned.

BALPA found that 81% of pilots who responded said that their performance had been affected by fatigue. Pilots the BBC has spoken to blame the growing intensity of the aviation industry – and some say their managers are ignoring their concerns.

One pilot, 'Andy', told the BBC: "I have fallen asleep unintentionally in the air – where you close your eyes for a second and realise that ten minutes have passed."

BALPA commissioned the survey, of over 500 of members, following inquiries by the BBC.

Aviation consultant Dr Ian Perry has treated dozens of fatigued pilots: "You might miss a radio call when you're thinking about 'is my altitude right?' That's chronic fatigue. I think in the last five years it has doubled. So if I see one or two people a fortnight, I'm now seeing four or five people a fortnight, something like that."

Dr Perry added: "... We've been skating on fairly thin ice for some years and have got away with it. For us to have a true fatigue accident I say it could happen at any time now. And then people will turn around and say 'well, why didn't you do something about it?'"

There are limits to how many hours pilots can fly and there's no evidence these are being breached. Most airlines told the BBC that their average hours had barely changed in recent years. But two thirds of pilots surveyed by BALPA said they were flying more than five years ago.

Some short haul crews now do six flights – six landings and take-offs a day – without leaving the cockpit. These require the most concentration and are regarded as the critical periods in the flight.

A pilot working in the low cost sector has told the BBC of an incident when an aircraft, with dozens of passengers onboard, began to turn putting it on a collision course with another passenger plane. Air Traffic Control (ATC) radioed an urgent warning but there was no response.

The aircraft bound for Europe had been on autopilot, while the captain rested. This had been agreed between the two men, and left the first officer in charge. However, on realising there was no response to the ATC warning the captain told the BBC: "So I looked across, and saw he was asleep."

However, in the official report to his airline the captain didn't mention that his co–pilot had been asleep. "I didn't want to get him into trouble. There's no two ways about it. I knew that he would probably be pulled in and be treated fairly harshly ... effectively its gross negligence."

However, many pilots and experts told the BBC that admitting their fatigue to managers is a taboo. Pilot 'Andy' said: "I was genuinely fatigued and whenever I reported that I was completely exhausted the operator says 'are you refusing to do the duty?'. He should not have been asking me, let alone bullying me into doing it."

The pilot added that this "routinely goes on."

This view was reflected in the BALPA poll which found that a third of pilots believed they'd risk disciplinary action if they reported their fatigue. More than one in ten (12%) would carry on flying, without reporting it. Forty percent said they would report fatigue.

The chairman of BALPA, Mervyn Granshaw, claims that fatigue is "the single biggest issue facing aviation today. At the moment we are not seeing it appear as accidents or incidents but we're getting closer to that point."

Another fatigue-related incident published in an AAIB bulletin took place at Birmingham Airport in 2004 (but not reported until April 2006) involving a passenger jet, with 85 passengers on board.

Shortly after leaving the ground the crew raised the plane's wing flaps instead of the landing gear. That created the danger the aircraft could stall – and potentially fall from the sky.

The captain had to lose altitude to increase speed – he recovered at less than 700 feet above the ground. An official investigation by the Air Accident Investigation Board concluded that fatigue was a key factor.

Captain David Chapman, head of flight operations at the UK's air regulator, the CAA (Civil Aviation Authority) maintains the system is working: "We have the finest flight time limitations system in the world. I have no problems at all in saying that I don't believe we have a major fatigue issue."

In a written statement responding to concerns about pilot fatigue, John Hanlon, Secretary General of the ELFAA (European Low Fares Airline Association) said:

"Aircrew flying duties are strictly regulated by the CAA and the IAA in the UK and Ireland which ensures that no pilot can fly more than 900 hours per annum (average 17 hours per week). These safety limits are met by all airlines and are subject to regular audit.

"Europe's low fare airlines have an exemplary safety record and this has been delivered by making safety the number one priority at all times. ELFAA member airlines operate a Just Culture system, whereby all pilots are free to report any issues, which they feel impinge on safety, without having to divulge their identity."

Roger Wiltshire of BATA (The British Air Transport Association) said: "We don’t feel there is a fatigue issue in the industry. Pilots are flying well within the regulated flying hour limits, and in the UK we have some of the most regulated pilot flying hours and duty hours in the world. And although short haul pilots are flying more hours than they were that's because the schedules are more efficient."

FAA on Prescriptive Regulation

2007-06-12T09:46:00.000-07:00

In testimony on 6 June 2007, before the Committee on Transportation and Infrastructure, Subcommittee on Aviation, FAA Deputy Associate Administrator for Aviation Safety Peggy Gilligan responded to concerns voiced the day before by Mark Rosenker, chairman of the National Transportation Safety Board, about the FAA's response to the Board's urgent safety recommendations.

Her excellent comments on the fatigue issue are quoted here:

Flight and Duty time rules have been in existence since the 1950s, and the 121 domestic and 135 scheduled rules were updated in 1985. The rules on pilot flight time and rest have evolved along with advances in commercial air travel. The FAA is confident that, overall, the airline industry complies with the FAA's current rules. In the intervening time, much research has been done on fatigue, which has resulted in a better understanding of complex fatigue-related issues. The research tells us that this issue does not easily lend itself to a set of prescriptive rules. While the existing prescriptive rules have served us well, they do not allow for the flexibility needed to address the various flight regimes that exist.

Understanding the limits of a strictly prescriptive regulatory regime, we worked to alleviate fatigue through other means. Fatigue countermeasures were first developed by NASA, and include providing in-flight rest, as well as training crew members on the use of proper diet, exercising, and even caffeine to manage fatigue. Fatigue countermeasures are covered during Crew Resource Management (CRM) initial training and during CRM recurrent training.

It is also critical to understand the role that personal responsibility plays in fatigue and why prescriptive rules can only provide a framework for safety. Crew members, mechanics, air traffic controllers, everyone involved in the safety of flight must make a personal commitment to report for work well rested and ready to perform their duties. No regulatory scheme can instill that sense of personal commitment and professionalism.

One thing we know, aviation operations will always challenge us in the area of flight time and rest. Aircraft design allows for longer and longer flight times. Recently, FAA issued approval to Delta Airlines for flights in excess of 16 hours from New York JFK to Mumbai, India. This approval was our first implementation of a fatigue risk management approach. Delta proposed – and we analyzed and approved – a detailed plan to assure the crew is rested before the flight begins, is provided appropriate rest throughout the flight, and have sufficient rest before conducting the return flight.

The procedure specifically addresses the impact to circadian rhythm, including the recognized affect of circadian law which occurs at specific times in the daily cycle. This is an example of where we need to move in the future -- away from prescriptive rules and into fatigue risk management.

Air traffic

2007-04-17T15:41:00.000-07:00

I am going to Washington DC next week to speak to FAA officials and to NTSB officials.
This article will be part of my package.

WASHINGTON (CNN) -- Fatigued air traffic controllers contributed to four aviation mishaps in recent years, and may have been a factor in last year's Comair crash that killed 49 people, according to federal accident investigators.

The investigators are calling on the Federal Aviation Administration to revise work schedules and take other actions to prevent controllers from becoming tired on the job.

"Controllers are absolutely more tired now than they have ever been, and it's because they are forced to work overtime. This is an understaffed system, and the FAA is lying when they say it's not," said Doug Church, spokesman for the National Air Traffic Controllers Association.

In a letter to the FAA, Mark Rosenker, chairman of the National Transportation Safety Board, said it's still unclear what role fatigue played in the crash of Comair Flight 5191, but four other incidents "provide clear and compelling evidence" that controllers are sometimes operating while fatigued because of their work schedules and poor use of rest periods.

"That fatigue has contributed to controller errors," Rosenker wrote.
Union: 'This is a wonderful gift'

The air traffic controller's union jumped on the report as validation of its long-held claims that the system is severely understaffed and that controllers are being forced to work overtime against their wishes.

"This is a wonderful gift from the NTSB, to finally tell the FAA that their controllers need more rest," Church said.

FAA spokeswoman Laura Brown said the FAA has between 14,500 and 14,600 controllers, about 1,000 fewer than it had in late 2003. But, Brown pointed out, the peak number was based on a contract with controllers that anticipated growing air traffic, not the drop that followed the September 11 terrorist attacks.

Brown said the FAA will look at scheduling practices in light of the NTSB recommendation, but "many of the schedules we have in place are at the request of employees." She noted that the NTSB said it is also incumbent upon controllers to "use personal strategies" to maximize sleep and minimize fatigue.

The FAA determines rest requirements, but it negotiates with unions on how employees are rotated through shifts, Brown said.

"The (NTSB) recommendations don't say anything about understaffing," Brown noted. "There is mandatory overtime at a very small number of facilities."

In many cases, the FAA is able use controllers who request overtime -- or are on a volunteer list -- before seeking others to work overtime, she said.
Controller working on just 2 hours of sleep when plane crashed

In the August 27 Comair crash in Lexington, Kentucky, the lone air-traffic controller was working on just two hours of sleep, according to the NTSB.

The controller cleared the CRJ-100 to take off from the correct runway, which was 7,003 feet long, but the airplane mistakenly turned onto a shorter runway that was just half that length. The plane crashed into a fence and trees at the airport perimeter, killing 49 of the 50 people onboard.

While the NTSB is focusing on the crew's actions, and aviation experts say the controller was not required to observe the plane's departure, the NTSB is evaluating to what extent, if any, the controller's fatigue may have influenced events.

The controller in the tower had worked a 6:30 a.m.-to-2:30 p.m. shift the day before the accident, then returned nine hours later and worked from 11:30 p.m. until the 6:07 a.m. accident, the NTSB says. He told investigators his only sleep between shifts was a two-hour nap.

"Such limited sleep can degrade alertness, vigilance and judgment," Rosenker wrote.
A history of incidents

The four aviation mishaps that allegedly involved tired controllers all involved what are termed runway incursions -- instances in which aircraft or other vehicles improperly intruded onto operating runways.

The four incidents are:

# Chicago, Illinois, March 23, 2006: The NTSB letter says a controller cleared an Airbus A320 passenger plane to cross a runway and then, less than 15 seconds later, cleared a Boeing 737 to take off on the same runway. The pilot of the Boeing saw the Airbus and stopped before reaching the taxiway intersection. The controller told investigators he had slept only four hours during a nine-hour break between shifts.

# Los Angeles, California, August 19, 2004: A controller cleared a Boeing 737 passenger plane to taxi onto and take off from a runway at the same time that another plane, a Boeing 747, had been cleared to land on the same runway. The pilot of the landing plane saw the 737 and pulled up 12 seconds before a collision would have occurred, passing about 200 feet above the runway. The controller had slept five or six hours before returning to work, the NTSB letter says.

# Denver, Colorado, September 25, 2001: A controller approved a request from a Boeing 757 cargo plane crew to depart from a runway, even though the runway had been closed for construction. The aircraft passed within 32 feet of lights that had been erected in the construction zone. Investigators determined that the controller had slept less than two hours during a nine-hour period between work days.

# Seattle, Washington, July 8, 2001: A controller cleared a Boeing MD-80 passenger airplane to cross a runway at the same time a Boeing 767 passenger airplane was about to land on the runway. The pilots in the landing airplane hit their brakes to avoid a collision, stopping only 810 feet short of the MD-80. The controller was working his third shift in two days, with eight-hour rest periods between shifts.

The NTSB recommended the FAA and controllers' union revise work schedule policies and practices and modify shift rotations to minimize sleep disruptions. The FAA should also develop fatigue awareness programs, which should be taught at regular intervals, the NTSB said.

It commended the FAA for a new "resource management program" to help controllers detect controller and pilot mistakes.

Change the Rules

2007-03-19T21:31:00.000-07:00

Quoted from the Columbian, Clark County, Washington:

Columbian editorial staff

Money can compete with safety when it comes to railroads, which is why it is encouraging that the government’s top railroad official is lobbying to change rules concerning workers’ schedules.

The change could lead to reduction in the number of train accidents caused by crew fatigue. The National Transportation Safety Board told Congress in February that fatigue has been a probable cause of 16 major train accidents in the past 23 years.

This policy change could impact a lot of people in Clark County. Vancouver, long a major switching and maintenance yard, has 450 train-yard and engine employees. More than 50 trains a day move through the terminal here.

Statistically, train workers already can expect to be involved in a fatal railroad accident if they spend a working lifetime on the tracks. There are simply too many people sitting, walking along or crossing tracks when they shouldn’t be.

What train engineers should not have to cope with is being so tired on the job that their physical state contributes to a wreck. Antiquated rules concerning the number of hours a person works versus the number of hours of rest between shifts are a problem.

Joseph Boardman, head of the Federal Railroad Administration, is asking Congress to repeal a 100-year-old law that regulates workers’ schedules, saying the laws are not up to date with scientific knowledge of the impact a lack of sleep has on workers. Boardman wants to require more rest between shifts, or shorter work days.

Right now, the Associated Press reports, train crews and signal workers can work 12 hours straight with 10 hours of rest. But if a train employee works even one minute less than 12 hours, law mandates just eight hours of rest. By the time one gets home, settles in and falls asleep, it isn’t hard to imagine workers getting inadequate sleep before they are due back at work. Unpredictable schedules are also a problem. If a worker doesn’t know when he might be called up next, how can he physically prepare and still have a decent family or social life?

While workers might crave more predictability and more rest, they also know any change is likely to hurt their pocketbooks if the industry has to hire more workers. Ensuring that current workers won’t face dramatic drops in income is key. Boardman and the National Transportation Safety Board need to continue working with unions representing train employees to find the best solution.

Pointing Fingers at Fatigue

2007-02-19T15:09:00.000-08:00

The tragic finger pointing going on here cannot obscure the fact that fatigue more than any other factor caused this accident. Management has an obligation to speak up when crew error is involved and unions need to take responsibility for the action and mistakes of their members. At the same time, the unions are correct about
the hidden issue of fatigue cause by excessive hours.

Here is the summary report:

Safety of Workers and the Public at Risk

WASHINGTON, Feb. 13 /PRNewswire-USNewswire/ -- A Teamsters Rail
Conference official told the House Subcommittee on Railroads, Pipelines and
Hazardous Materials today that worker fatigue is a significant safety
threat to rail workers and the public.
"There is no question in our minds that safety degradation because of
fatigue is a ticking time bomb in the rail industry," said Tom Pontolillo,
Director of Regulatory Affairs of the Brotherhood of Locomotive Engineers
and Trainmen (BLET), which is part of the Teamsters Rail Conference. "The
National Transportation Safety Board (NTSB) has on numerous occasions
pointed to crew fatigue as a potential contributing factor in an accident."
Last year the NTSB adopted a report determining that the 2004 Macdona,
Texas, collision and toxic chlorine release, which killed three people, was
caused by a fatigued locomotive crew's failure to respond to wayside
signals. The crew was criticized by the NTSB for failing to effectively use
off-duty time, thereby not obtaining sufficient restorative rest prior to
reporting for duty and Union Pacific was criticized for train crew
scheduling practices that created inverted crew members' work and rest
patterns.

The Drive Home (2)

2007-01-29T15:27:00.000-08:00

The drive home is often the most dangerous part of work.

This article reminds us of how serious this problam is:

A Dakota County grand jury returned an indictment charging a Farmington woman with misdemeanor careless driving that resulted in the death of teenager Jacquelynn Devney on July 27, 2006.

The jury heard the case on Jan. 18 that involved the defendant Laura Ann Brockhaus, 40, of Farmington, who allegedly fell asleep at the wheel when her car jumped a curb off Pilot Knob Road and hit Devney who was working a summer job weeding the roadside area. The coroner determined that Devney, 18, died instantly after being hit.

The jury declined to indict Brockhaus on a more serious charge of felony criminal vehicular homicide that is punishable up to 10 years in prison and charged her with the careless driving misdemeanor that is punishable with up to 90 days in jail.

Investigations found that Brockhaus worked as a registered nurse at the Veterans Administration Medical Center in Minneapolis. In the three days prior to the car accident she had worked overnight shifts from 7:30 p.m. to 8 a.m. and Brockhaus told police she had only slept three to three and a half hours during the morning of July 26, and about five to six hours during the morning and early afternoon on July 25.

Skipper is Asleep

2007-01-22T20:37:00.000-08:00

A fishing boat grounded on a beach in Tory Channel last April because the skipper fell asleep, an investigation has found.

The Venture, a 13m Nelson-based fishing vessel, grounded at the base of a cliff just north of Tipi Bay in the Marlborough Sounds while on the way from Picton to Oamaru on April 19.

As the boat was in no immediate danger and the crew were uninjured the skipper decided to wait until daylight before seeking help. But the crew of a passing ferry noticed the boat aground and reported it.

The Venture was undamaged and was successfully refloated on the next high tide with help from a tug.

A Transport Accident Investigation Commission (TAIC) report said the skipper of the Venture was probably suffering from fatigue at the time of the grounding.

The report said his fatigue was probably due to a change in his normal routine, combined with stress from navigating unfamiliar waters.

"Had the skipper been more aware of the signs and symptoms of fatigue he would have been better prepared to deal with it," the report said.

It would have been "more prudent" for the skipper to have remained in Picton until the next day to make sure he and the crew were well rested.

If the vessel had had a watchkeeping alarm system it would not have stopped the skipper falling asleep, but may have woken him in time to avoid the grounding, the report said

TAIC recommendations included making sure all vessels owned by the company had a copy of the Fish SAFE organisation's "Safety Guidelines for Small Commercial Fishing Vessels" on board.

Thank you New Zealand Herald

Killer Trucks

2006-10-18T21:22:00.000-07:00

Here is an article by V. Srinivas Ram in the Times of India, 10.18.06 as a reminder that it's not just a problem in the US.

HYDERABAD: Killer trucks are on the loose in the city. There have already been 34 deaths due to trucks in the first five months this year.

The accident on Monday, where eight persons were injured when a truck ran amok at Toli Chowki, is just the latest in the list. This accident happened on a route ‚ NH-9 leading to Mumbai‚ where trucks are permitted. But there are hundreds who are getting away with rash driving on restricted routes in the city. Heavy vehicles are banned from arterial roads, Sardar Patel Road, Mahatma Gandhi Road, Raj Bhavan road, Charminar road, Bank Street ‚ in the city. The situation is even worse in Cyberabad. In areas such as Habsiguda, L B Nagar, it is a free for all.

Moreover, there has been a spurt in accidents involving heavy vehicles on main routes like Mettuguda-Tarnaka, Dilsukhnagar-Malakpet and Retibowli.

In 2004, 85 people were killed by trucks in the city, while the figure was 67 in 2005. According to a UN report, truck driver fatigue due to long hours and sleeplessness was a major cause of accidents. The report suggests states develop trip sheets to overcome this problem, pointing out that 1 pm to 4 pm was the time most of the accidents involving trucks were taking place. Incidentally, the accident at Toli Chowki happened at about 2.30 pm.
...

Places such as Medak and Nalgonda surrounding the city are also highly-accident prone.

Individual Awareness

2006-10-13T08:07:00.000-07:00

This article from Newswire is an excellent reminder.

***

Accident Prevention Begins With Individual Awareness

The safe operation of any vehicle is determined by the attentiveness, alertness and ability of an individual to focus on the task at hand. Increasing your own driver awareness can go a long way to help prevent costly accidents

Whether you drive an SUV, a delivery van, an RV or a long haul truck, it’s vital to always bring along one item… your safety awareness! The safe operation of any vehicle is determined by the attentiveness, alertness and ability of an individual to focus on the task at hand. Increasing your own driver awareness can go a long way to help prevent the costly accidents, fatalities and material losses that affect us all.

Drowsy or Distracted, Both Are Deadly

Impaired mental faculty due to limited sleep, mixed with high demands on alertness and attentiveness, makes for a dangerous combination, one that has been attributed to some $12 billion in yearly costs and thousands of deaths (U.S. Department of Transportation). Driver distraction, or more precisely, driver lapses in attention caused by cell phones, MP3 players, GPS devices and other in-vehicle entertainment, has been named one of the leading safety hazards in the transportation industry. There is no shortage of overwhelming data supporting the need for more safety solutions to mitigate the horrific accidents and fatalities occurring as the result of drowsy or distracted driving. While new technologies are bringing better safety products to market, life saving changes can be made by increasing your individual knowledge about the causes of preventable accidents. Education is a powerful tool, understanding the dangers of unfocused driving may help you think twice. Before you end up on the wrong side of a senseless driving disaster, consider there were 43,443 deaths from motor vehicle accidents in 2005! My guess is numerous were preventable…

The Problem is Everyone’s

Over the last 50 years much has been discussed about the perils of sleep-deprived truck drivers, tired individual drivers and drivers not paying attention. Further complicated by the ever increasing number of trucks on the road, additional concerns arise as a result of the dramatic shortage of qualified drivers, moving an ever growing supply of consumer and consumable products. Moreover, the problem is not limited to truck drivers as is clearly detailed in a report from the NHTSA (National Survey of Distracted and Drowsy Driving Attitudes and Behavior, April, 2003). The survey findings show that most drivers at least occasionally engage in behaviors that draw some percentage of their attention away from their driving task. These behaviors include talking with other passengers (81%), changing radio stations or CDs (66%), and eating or drinking while driving (49%). making outgoing & taking incoming cell phone calls (25%) and dealing with children riding in the rear seat (24%). While it is estimated that more than a billion driving trips are made weekly by drivers engaging in each of these behaviors, fewer than one in four drivers perceive these particular activities as distracting or as making driving much more dangerous! Don’t take the risk of ignorance; always give your full attention to driving whenever you navigate a motor vehicle.

Dangerous Vehicles, Large & Small

It is a well known and documented fact (Commercial Motor Vehicle Facts, Federal Motor Carrier Safety Administration, April 2005) that commercial motor vehicle (CMV) driver alertness/drowsiness is a major safety hazard in modern day society. There are approximately 7.9 million large trucks on our roads today, some driven by drivers working excessive hours, complicated by a shortage of qualified truck drivers. Large trucks alone make up over 400,000 accidents a year with an average cost of over $62,000.00 per incident. In 2002 alone the Total Cost of Fatigue-Related Crashes (in 1999 Dollars) exceeded $2.3 billion! What is a lesser known and reported danger is the ever increasing number of overworked, overtired and highly distracted individuals driving noncommercial trucks, SUV’s and cars numbering over 220 million vehicles. While these automobiles are smaller in size and weight, they are no less dangerous in the hands of a sleep deprived or inattentive driver.

Extending Success

2006-10-10T15:01:00.000-07:00

We just got an amazing email from the NIH. Our research plan for 2007-8 has been approved. We can now make a good test a great test and we will be able to prove it. Thank you NIH.

We like to think this funding has come to us because of our continued success in the field but, realistically, it comes from a recognition of the importance of much work in alertness testing everywhere. Human impairment continues to plague industrial society worldwide through accidents and critical errors. We will never eliminate these errors, our goal is simply to help reduce them, particularly in critical professions. If our research can make a small difference that is enough.

Properly testing and validating any psychological test with human subjects is a significant undertaking. Done properly it would strain the resources of any small company. But this funding allows us to continue building on the years of good scientific progress we have made through incremental steps in university labs and through clinical trials at private corporate labs. We will be conducting advanced clinical trials with hundreds of subjects at some of the best labs in the world at Stanford University, at Harvard Uiversity and on to implementation trials involving many more subjects in real world conditions.

As many of our users know the BLT basic alertness test is a very simple test. It was designed to be just challenging enough to be sensitive to significant human impairment - but not to be so difficult that the average person would find it unpleasant or tricky. We have a number of other tests but the basic alertness test is what we are testing now.

In the next two years we will further refine our "test bed" measurement techniques and our test testing validation methodology including human stress testing and sleep deprivation experiments. We will be able to use the same test bed and other proven techniques to measure the sensitivity and reliability of other test designs.

This means we can test new tests against a known benchmark. Test and game designers who would like to work with us on the next generation of human alertness tests should contact us. Keep in mind the following constraints: 1. Keep it less than 1.5 minutes, 2. Non-linguistic, 3. Easy to learn, 4. Not annoying (the test should not trick the subject). We like the Macromedia Flash application, but, provided the test is web capable, we are interested in ideas for the next generation.

Lack of Sleep Causes Accident

2006-07-13T14:00:00.000-07:00

The National Transportation Safety Board (NTSB) has just released its findings on an accident that occurred 3 years ago near San Antonio, Texas. It is rare for the NTSB to list fatigue as the primary cause of an accident. Usually something like equipment failure or operator error is indicated as the primary cause with fatigue often being a contributing cause. So this is new.

But at 5:30 a.m., Monday, June 28, 2004, a westbound Union Pacific Railroad (UP) freight train was under the control of a conductor and engineer both of whom were probably asleep. They did not respond to wayside signals to stop. Just outside of the rail siding in Macona, Texas the UP freight train smashed into an eastbound BNSF Railway Company train. The collision derailed 4 locomotives and 36 rail cars including one carrying liquid Chlorine. Steel cargo in one car ruptured the Chlorine tank. The escaping gas killed two local resident and the UP train conductor.

Given the schedule the conductor and engineer were working under, it is no wonder they were tired. But it did not help that they apparently made ineffective use of what off time they did have - drinking and card playing. The evidence suggests that both men were asleep or incapacitated by fatigue.

This fatigue would almost certainly have been detected with a simple screening test. More importantly, if they had known that a screening test for fatigue was likely, they would have acted differently and better used their off duty time. I think.

I call upon the railroads look at a program of impairment testing when crews are assigned difficult schedules and duty times.

Against Drug Testing?

2006-07-02T14:39:00.000-07:00

As most readers know, I am not against urine testing per se. If it is seen as a campaign to stop the use of drugs, and it seems to work, well that’s fine with me. But urine testing has little to do with making sure workers are ready for work and it should not be a substitute for alertness testing.

Urine testing raises other issues as well. Here is an excellent article about a case in Canada.

“A construction company discriminated against an employee when it fired him after his pre-employment drug test showed traces of marijuana, an Alberta judge has ruled.

“Justice Sheilah Martin said the man should have been treated like someone with a drug addiction, and that is considered a disability in a growing body of human rights case law across Canada. It is believed to be the first time that Alberta's Court of Queen's Bench has addressed the issue of pre-employment drug testing under human rights legislation, the Canadian Press said.

The ruling is "important for all workers," said Leanne Chahley, an Edmonton labour lawyer who regularly represents unions. It means that a worker does not have to be disabled to challenge a policy as discriminatory, she said. It also means that companies cannot use drug tests to weed out potential employees who test positive. "It's not your employer's [business] if it doesn't affect your work. "No one wants to encourage impairment at work, but a drug test is an invasion of your privacy," Chahley said. "It shouldn't matter to your employer what you might do on off-duty time. That's your business. It's not your employer's [business] if it doesn't affect your work."

The case began in 2002 when John Chiasson was hired by Kellogg Brown & Root for a job as a receiving inspector at Syncrude's oil sands plant north of Fort McMurray, Alta. As a non-unionized employee, he was required to pass a pre-employment drug test. After taking the test, Chiasson was immediately put to work. Nine days later, the company learned his urine was positive for the active ingredient in marijuana. He admitted he had smoked pot five days before the test and was immediately fired, as called for by the company's zero-tolerance policy. Chiasson complained to the Alberta Human Rights Commission, which ruled he was not discriminated against. But Martin overturned that decision in a ruling handed down last month.

Though Chiasson never used drugs at work, the policy treated him as if he had, the judge wrote. The requirement that he be tested for drugs, with an automatic penalty for a positive result, is discriminatory, she added. Alberta human rights legislation prohibits discrimination under 13 grounds, including race, religious beliefs and physical and mental disabilities.
Andrew Robertson, the Calgary lawyer representing Kellogg Brown & Root, said he could not comment on the decision. Company officials could not be reached.

Roadside Screening

2006-06-07T09:46:00.000-07:00

Driving under the influence of drugs is, of course, just as dangerous as driving under the influence of alcohol. And a new survey out of Scotland suggests that "drug driving" is surprisingly common. A survey of 1,072 young people (25-35) found that 20% had taken illegal drugs before driving. This study, conducted by More Than, a major insurance company, has encouraged a movement to introduce additional roadside testing by the police. The push to do this is very strong in Britain where 18% of drivers killed in road accidents have traces of illicit drugs in their blood.

These proposed roadside test would check the driver’s saliva for drug traces and require a FIT test administered by a police officer. ( FIT tests typically ask the subject to perform a series of movements.)

While roadside screening is becoming more practical with the advent of better testing equipment this version seems unnecessarily invasive. If it must be done, computer based performance test (like ours) may be far more acceptable to the population and, therefore, much more likely to be used.

Research was conducted via myvillage.co.uk with 1,072 people between 13 April and 8 May 2006. (69 per cent of myvillage.co.uk users are aged between 25 – 35 years).

Provigil Is the Answer?

2006-04-19T11:47:00.000-07:00

As many of my readers already know, there is a new and wildly popular drug called Provigil by Cephalon (generic name modfinal and is also marketed as “Alertec” by a rival company) to combat fatigue. Revenues from Provigil were $1.2 billion in 2005 and are growing. It is currently promoted to treat specific medical conditions such as narcolepsy but it is also being used as a “lifestyle drug” of choice for fighting drowsiness and fatigue.

So far the drug appears to be non-addictive and it does not cause hand shaking and heart racing like caffeine. Still the FDA is being cautious until more is know. Off-label prescriptions seem to be fueling the run up in demand. It has been used for over ten years so there should be a lot of reports on its down side. But a search of the internet shows only a few reported problems. For example: Anxiety, depression, diarrhea, difficulty sleeping, dizziness, dry mouth, headache, infection, loss of appetite, loss of muscle strength, lung problems, nausea, nervousness, prickling or tingling feeling, runny nose, sore throat. That’s not too bad for a drug that gives you a lift and keeps you working. It obviously does not bother a lot of people.

Is this the magic elixir, the solution to the alertness problem? Pilots report staying awake for three days with this product. It worries me because of the potential for psychological addiction and the long term effects of not getting enough sleep. Will it lead to more stressed out workers when the effects wear off? What happens to human performance after extended use? Does it affect judgement?

We will be conducting sleep deprivation trials this summer to calibrate the BLT alertness test. Maybe our next trial should include Provigil.

Just after I wrote the above, I found this interesting reference to a 2005 study.
Note the very substantial number of subjects and the severity of the sleep deprivation (85 hrs!).

Journal of Sleep Research
Volume 14 Page 255 - September 2005
doi:10.1111/j.1365-2869.2005.00468.x
Volume 14 Issue 3

Performance and alertness effects of caffeine, dextroamphetamine, and modafinil during sleep deprivation
NANCY J. WESENSTEN, WILLIAM D. S. KILLGORE and THOMAS J. BALKIN
Summary
Stimulants may provide short-term performance and alertness enhancement during sleep loss. Caffeine 600 mg, d-amphetamine 20 mg, and modafinil 400 mg were compared during 85 h of total sleep deprivation to determine the extent to which the three agents restored performance on simple psychomotor tasks, objective alertness and tasks of executive functions. Forty-eight healthy young adults remained awake for 85 h. Performance and alertness tests were administered bi-hourly from 8:00 hours day 2 to 19:00 hours day 5. At 23:50 hours on day 4 (after 64 h awake), subjects ingested placebo, caffeine 600 mg, dextroamphetamine 20 mg, or modafinil 400 mg (n = 12 per group). Performance and alertness testing continued, and probe tasks of executive function were administered intermittently until the recovery sleep period (20:00 hours day 5 to 8:00 hours day 5). Bi-hourly postrecovery sleep testing occurred from 10:00 hours to 16:00 hours day 6. All three agents improved psychomotor vigilance speed and objectively measured alertness relative to placebo. Drugs did not affect recovery sleep, and postrecovery sleep performance for all drug groups was at presleep deprivation levels. Effects on executive function tasks were mixed, with improvement on some tasks with caffeine and modafinil, and apparent decrements with dextroamphetamine on others. At the doses tested, caffeine, dextroamphetamine, and modafinil are equally effective for approximately 2–4 h in restoring simple psychomotor performance and objective alertness. The duration of these benefits vary in accordance with the different elimination rates of the drugs. Whether caffeine, dextroamphetamine, and modafinil differentially restore executive functions during sleep deprivation remains unclear.

Red Bull is Not the Answer

2006-03-27T09:39:00.000-08:00

Combining alcohol and Red Bull® reduces the 'perception' of impairment

Alcohol's harmful effects on motor coordination, however, remain intact

Study results show that drinking alcohol and Red Bull® together significantly reduces the perception of headache, weakness, dry mouth and impairment of motor coordination.
Red Bull® does not, however, significantly reduce alcohol-related deficits on objective measures of motor coordination and visual reaction time.
People who combine alcohol with energy drinks may be at even greater risk for problems such as automobile accidents because they believe they are unimpaired.
The combined use of alcohol and "energy drinks" such as Red Bull® have become increasingly popular among youth and young adults in recent years. Users often report reduced sleepiness and increased sensations of pleasure. In the April issue of Alcoholism: Clinical & Experimental Research, Brazilian researchers conduct the first controlled scientific study on the effects of combining alcohol with Red Bull®. Results show a considerable disconnect between subjects' perceptions and objective measures of their abilities: although combined use reduces the sensation of tiredness and sleepiness, actual capabilities are significantly impaired.

"In Brazil, as in other countries, young people believe that Red Bull and other energy drinks avoid the sleepiness caused by alcoholic beverages and increase their capacity to dance all night," explained Maria Lucia O. Souza-Formigoni, associate professor in the department of psychobiology at the Federal University of São Paulo in Brazil and corresponding author for the study. "In fact, many night clubs offer this mix among their cocktails."

In a previous study on the use of energy drinks among Brazilians, Souza-Formigoni said that users reported greater happiness (38%), euphoria (30%), uninhibited behavior (27%), and increased physical vigor (24%). It is unclear, however, if this indicates the ability of energy drinks to reduce the depressant effects, increase the excitatory effects of alcohol, or both.

"This study appears to show us that the use of energy drinks might predispose people to abuse alcohol when its depressant effects – or at least the perception of such effects – are masked by them," said Roseli Boerngen de Lacerda, associate professor in the department of pharmacology at the Universidade Federal do Parana, Brazil.

For the current study, participants (n=26 males) were randomly assigned to one of two groups that received either 0.6 g/kg of alcohol (n=12), or 1.0 g/kg of alcohol (n=14). All participants completed three experimental sessions in random order, seven days apart: ingesting alcohol alone, energy drink alone, or alcohol and energy drink combined. At each session, researchers recorded the participants' subjective sensations of intoxication, as well as objective measures of their motor coordination, breath alcohol concentration, and visual reaction time.

Compared to the ingestion of alcohol alone, the combined ingestion of alcohol and Red Bull® significantly reduced the subjects' perception of headache, weakness, dry mouth and impairment of motor coordination. Red Bull® did not, however, significantly reduce deficits caused by alcohol on objective measures of motor coordination and visual reaction time.

"There are two key points," said Souza-Formigoni. "Although combined ingestion decreases the sensation of tiredness and sleepiness, objective measures of motor coordination showed that it cannot reduce the harmful effects of alcohol on motor coordination. In other words, the person is drunk but does not feel as drunk as he really is. The second important point is that many users reported using energy drinks to reduce a not-so-pleasant taste of alcoholic beverages, which could dangerously increase the amount (as well as the speed of ingestion) of alcoholic beverages."

"The implications of these findings," added Boerngen, "are that this association of alcohol and energy drinks is harmful rather than beneficial, as believed by consumers. Especially because those individuals who combine alcohol and energy drinks, believing they are less impaired than reality would indicate, are actually at an increased risk for problems such as automobile accidents."

"Alcohol affects not only the motor coordination but also the capacity of decision, because it affects one important area of the brain - the prefrontal cortex," explained Souza-Formigoni. "Drunk drivers are dangerous not only because their reactions are delayed and motor coordination affected, but mainly because their capacity to evaluate the risks to which they will be exposed is also affected. People need to understand that the 'sensation' of well-being does not necessarily mean that they are unaffected by alcohol. Despite how good they may feel, they shouldn't drink and drive. Never."

Both Boerngen and Souza-Formigoni spoke of the need for further studies to test higher doses of both alcohol and energy drinks, which Souza-Formigoni is doing with the use of animal models. "We are also testing separately the different substances of energy drinks – caffeine, taurine, etc. – in combination with alcohol to determine which of them are responsible for [for what effects during] interaction."

###
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Effects of Energy Drink Ingestion on Alcohol Intoxication," were: Sionaldo Eduardo Ferreira, Marco Túlio de Mello, and Maria Lucia Oliveira de Souza-Formigoni of the Department of Psychobiology at the Federal University of São Paulo, Brazil. The study was funded by the Associação Fundo de Incentivo à Psicofarmacologia, the Conselho Nacional de Desenvolvimento Científico e Tecnológico, and the Fundação de Amparo à Pesquisa do Estado de São Paulo.

Contact: Maria Lucia O. Souza-Formigoni, Ph.D.
mlformig@psicobio.epm.br
55-115-539-0155
Federal University of Sao Paulo
Roseli Boerngen de Lacerda, Ph.D.
boerngen@bol.com.br
55-419-139-4761
Universidade Federal do Parana

Staten Island Incident

2006-01-10T12:01:00.000-08:00

We all recall the Staten Island ferry accident three years ago. In this incident a comuter ferry, after crossing New York Harbor, inexplicably ran into the dock, killing 11 people. The cause of this accident was difficult to figure, although it did seem to be a sudden lapse on the part of the pilot rather than any kind of equipment failure. Rumors circulated about the pilot’s health.

Well, now the details are out. Captain Richard Smith was sentenced yesterday to 18 months in prison and has apologized to the families of the victims. Capt. Smith, suffering from extreme fatigue and from the effects of pain killers, simply blacked out while docking the ferry. The ship hit the concrete maintenance pier at full speed. There were 1,500 passengers on board at the time of the collision.

Two points: 1. It could have been much worse. 2. It could have been prevented.

My drive and another drive

2005-11-29T17:24:00.000-08:00

My daughter's flight came in to Oakland, California at 6:30 PM on Monday. I picked her up and we drove the 350 miles south on Highway 101 to Carpinteria. We stopped for a 30 minute dinner and got in at 11:30 PM, 6 hours of driving, no big deal. After dropping her off at school, I thought about driving home to Alameda (350 miles) but, as I began to think about how tired I was, I decided to motel it for the night.

The following morning, as I was leaving the Best Western in Carpinteria, the headline on the Santa Barbara News-Press caught my attention, "Fatigue cited in deadly crash." The subhead read: "Accident kills man. pregnant woman."

A Greyhound bus on highway 101 - the same highway I was driving that day - had gone off the road, turned over and killed three of the 44 passengers. Many others were badly injured. Why had this happened?

The bus driver, a 63 year old man named Samuel Henry Bishop, had started his shift at 8 PM on Saturday (11/26/05) in Fresno. He drove a bus loaded with people to Los Angeles. The article says that it should have taken him 5 1/2 hours - according to the Greyhound schedule. So, in theory, he was done with that drive at 1:30 AM on Sunday. I say "in theory" because it was in holiday traffic. He then got behind the wheel of a second bus at 3:15 AM in Los Angeles for the drive to San Luis Obispo. The bus was seen to drift off the road at 7:10 AM near Santa Maria, hit a tree and flip over. The driver had been working for 11 hours at that point. (He may have been driving for 12 or 13 hours if he had to commute to work.)

I know Greyhound has a good safety record. And I know many drivers can work for 11 hours. But, I suspect that this driver was exhausted and simply fell asleep at the wheel. No drugs or alcohol were involved. Holiday traffic is a whole level of difficulty harder to deal with and that may have added to his stress.

Imagine how much harder it is to drive a bus load of people than it is for me to drive my car. And I was tired from half the driving he did. But the schedule speaks for itself and we need to see his shift schedule.

I thought about it as I was driving home. Could BLT technology have prevented this accident? Yes. Had the driver taken an alertness test at the end of his first drive, it is likely he would have been unable to perform near his baseline. Furthermore, if he knew he would have to take such a test, it is probable he would not have even tried it. The deterrent effect of this technology may be its most valuble contribution to workplace safety.

Nuclear Fatigue and the NRC

2005-11-04T07:01:00.000-08:00

Think of the nuclear power industry and you think of controlled risk, of operators in huge control rooms monitoring dials and computer screens, all day every day, until something happens. And nothing much happens - a perfect formula for the conditions that promote fatigue and inattention.

The Nuclear Regulatory Commission “NRC” is deeply concerned with these issues though. They have done some of the best studies available on fitness for work testing. They are acutely aware that maintaining operator vigilance is very important.

In the following article, extracted from their web archives, particularly note the attention paid to the under representation of fatigue as a causal factor in reported incidents. This is a common problem in industry.

Extract from the NRC report: ASSESSMENT OF THE NRC’S “POLICY ON FACTORS CAUSING FATIGUE OF OPERATING PERSONNEL AT NUCLEAR REACTORS” (See NRC - Reading Room)

"Incidence of Fatigue-Related Events

Only a limited number of events at nuclear power plants have been directly attributed to fatigue. This may be in part be the result of the levels of defense-in-depth at nuclear power plants which redesigned to reduce the potential for personnel errors to have consequential effects on plant safety. However, the staff is not able to state with certainty the actual number of events that result from fatigue, and any estimates should be interpreted with caution. In fact, plant incident reports typically do not contain much of the critical information needed to determine the contribution of human error. As noted in an EPRI report concerning control room operator alertness, “it is often necessary to rely on anecdotal evidence when presenting the case for the critical importance of operator alertness in the safe and efficient operation of a nuclear power plant” (EPRI, 1990).

One reason that the staff believes that the number of events attributed to fatigue may be underrepresented is that the research literature and operational data suggest that the conditions of shift work in nuclear power operations are such that one would reasonably expect personnel to be at risk of fatigue-induced impairment.

This research includes the following examples:

• Studies show that personnel who work more than 12 hours a day are at increased risk of personnel error (Folkard, 1997; Dawson and Reid, 1997; Rosa, 1991). The NEI data concerning the use of deviations from the policy statement indicate that thousands of 24 person-hours are worked by personnel when they are at increased risk of impairment (see Section 6).

• Several studies show that nuclear power plant personnel exhibit circadian variations in alertness, and there are variations in the incidence of nuclear power plant personnel errors and events that coincide with these circadian variations in alertness (Bobko, 1998; Cox and Cox, 1996; Maloney, 1992).

• Studies show that personnel who are fatigued have impaired ability to maintain their attention (Harrison and Horne, 2000; Williamson, 2000; Bobko et al., 1998; Dawson and Reid, 1997; Dinges, 1995; Dinges, 1992; Rosa, 1991). The staff reviewed the Human Factors Information System (HFIS) data for 1997 through 1999 and found more than 5,000 instances of less-than-adequate independent verification, self-checking, and awareness or attention.

These data were compared with HFIS data on findings related to the use of overtime. This analysis revealed that nuclear plants with repeated findings concerning use of overtime have a 50-percent higher incidence of HFIS causal factors related to fatigue. Another reason that the staff believes that the number of events attributed to fatigue is underrepresented is that event investigation methodologies may not adequately address fatigue as a root cause, as indicated by the following factors:

• Depth of assessment – Most incidents at nuclear power plants are not subjected to an in-depth analysis that would identify fatigue as the underlying cause. Licensee event reporting requirements (10 CFR Parts 50.72 and 50.73) have not included causes of human performance problems at a level that would necessarily identify fatigue.

• Root cause assessment tools – There are no accepted criteria or structured approaches for evaluating the role of fatigue in accidents (Rosekind et al., 1997). As a result, when events are subjected to root cause assessment, fatigue may still not be identified. McCallum and Raby (1995) assessed investigation procedures employed by the NRC, the Federal Aviation Administration (FAA), and several international transport authorities. They found that the existing procedures do not adequately address the factors underlying fatigue as a causal element in cases in which the initial screening suggests fatigue as a factor.

• Lack of objective proof – When conducting a root cause analysis of events that involve personnel error, it is difficult to conclude that fatigue is a cause because there is little objective proof, absent the person sleeping, that the individual was impaired by fatigue. Even when nuclear plant personnel have been found with their eyes closed, they have asserted that they were not asleep, and investigators have concluded that the individual was “inattentive” (e.g., Peach Bottom, 1989).

• Ease of substantiating event causal factors – Fatigue degrades an individual’s abilities but does not necessarily cause the event. For example, the alert individual recognizes an error in a procedure, whereas the fatigued individual does not and implements an incorrect procedure. As a result, an investigator would focus on objective contributing factors (e.g., the procedure error) or describe the behavior (e.g., cognitive error) without citing a contributor, such as fatigue, that is difficult to substantiate.

• Accuracy of post-event observations – When individuals are debriefed following an incident, they may appear alert because of the stimulation of responding to, or potential consequences of, the event. Impairment from fatigue would not be readily apparent in such circumstances.

• Accuracy of self-assessment – Although self-assessment of fatigue can often indicate the level of fatigue, research suggests that other factors may influence such self-assessments (Wylie et al., 1996; Dinges, 1995 ). In addition, studies have shown that individuals may believe that they are relatively more alert than indicated by physiological indices (Wylie et al.,1996; Dinges, 1995; Rosekind and Schwartz, 1988).

• Veracity of self-assessment – For various reasons, individuals may be reluctant to
acknowledge that they were fatigued at the time of an event involving personnel error, including the implication that they were not fit for duty (Horne and Reyner, 1995).

One outcome of these challenges to identifying fatigue as a causal factor is that the investigation identifies the observable effects or consequences of fatigue, rather than fatigue itself. Other agencies and investigative bodies have come to similar conclusions concerning the attribution of fatigue to events. A letter from Jim Hall, Chairman of the NTSB, to DOT Secretary Rodney E. Slater, dated June 1, 1999, included the following statement.

Fatigue has remained a significant factor in transportation accidents since the Safety
Board’s 1989 recommendations were issued. Although generally accepted as a factor in transportation accidents, the exact number of accidents due to fatigue is difficult to determine and likely to be underestimated. The difficulty in determining the incidence of fatigue-related accidents is due, at least in part, to the difficulty in identifying fatigue as a causal or contributing factor in accidents. There is no comparable chemical test for identifying the presence of fatigue as there is for identifying the presence of drugs or alcohol; hence, it is often difficult to conclude unequivocally that fatigue was a causal or contributing factor in an accident. . . .

Although the data are not available to statistically determine the incidence of fatigue, the transportation industry has recognized that fatigue is a major factor in transportation accidents. Similarly, the DOT has concluded that fatigue statistics that are founded solely on accident reports underestimate the true extent of the problem (DOT, 65 FR 25545). In addition, the staff has learned that the Air Force Safety Center is revising the documentation to be used by accident investigation teams since they now believe that fatigue is underreported as a factor (Palmer et al., 1996). Also, a U.S. Coast Guard study suggests that direct measurement of fatigue may underestimate its true extent (Maritime Safety Committee, 1997). After the Coast
Guard revised its procedures for investigating events, they found that the contribution of fatigue was 20 times greater than previous estimates.

Summary
• Few events at U.S. nuclear power plants have been attributed to fatigue.
• The number of events attributed to fatigue should be interpreted with caution and cannot be reported with certainty.
• Many factors challenge the ability of event investigators to identify fatigue as a causal factor."

The full text can be downloaded from the NRC site.
The "Reading Room" link below is well worth a visit. Try searching on a relevant topic and you will be amazed at the amount of material that is available.

NRC - Reading Room

Inattention

2005-11-02T20:28:00.000-08:00

I am just going to quote this in full. Thank you DDC.

Inattention and Fatigue Primary Causes of Workplace Accidents
Jessica Walter, DDC Command Affairs

During a recent Defense Distribution Center (DDC) Safety and Occupational Health Council meeting, DDC Safety Manager Dave Mack revealed the root cause of most workplace accidents: inattention and fatigue.

According to an internal Accident Review and Analysis, one in every five accidents is due primarily to inattention on the part of the worker. “Inattention is a normal occurrence, and although we cannot eliminate it totally, we can substantially reduce inattention in the workplace by simply reminding people to work safely,” explained Mack. “People get so absorbed in what they’re doing that they don’t realize that they’re no longer paying attention to what is going on around them,” he added. Most DDC workplace injuries occur over the summer months, so Mack and his team are working to promote safety awareness by supplying DDC depots with posters and other marketing materials to remind them to stay alert. Individual behaviors, namely inattentiveness and fatigue, accounted for nearly half of the root causes of workplace accidents according to the Accident Review and Analysis. Accidents with ambiguous root causes and equipment problems accounted for the rest.

We Don't Want to Know (!)

2005-10-10T21:12:00.000-07:00

We have had many meetings with top safety managers at some of the world's leading operating companies. These men, and women, are immensely interested in impairment testing. They are well aware of how fatigue and impairment can undermine safety and, incidentally, the bottom line.

But, occasionally, we get an astonishing reaction. "We do not want to know if an employee is impaired". These are managers in companies with an elaborate system of drug testing and well financed safety programs. And keep in mind that our tests are set to detect severe impairment - the equivalent of three or four drinks. Letting someone drive a truck or operate a crane in that condition is unthinkable. But they do not want to know.

Worker and management teamwork and trust has been undermined in such places. That issue has to be addressed first. But part of this reaction comes from the need to see a way to integrate impairment testing with other testing systems and with safety in general. A company that has never tried impairment testing does not have a policy on managing the process. Handling an employee who does not pass an impairment test seems to be a major issue. So better "not to know." But, of course, these companies do have a policy on this. It is the same policy that dictates how to handle workers who come in intoxicated.

We, at BLT, do not want to write policy for a Fortune 500 company. But we can now offer a draft for their consideration. It simply outlines a series of logical steps for dealing with an employee who cannot pass an impairment test. Ask for it if you are interested.

AlertnessCentral.com is Alive!

2005-09-30T15:51:00.000-07:00

We have just introduced AlertnessCentral - our new alertness testing site. (You need a password to access the system.)

Before we introduced our alertness system on the web, we wanted to be sure quality would not be compromised. We were concerned about data privacy and with security. We also wanted to be sure that test accuracy remained consistent. But the web has grown and improved. Developments of the past three years have provided solutions to many of the problems we anticipated. Still we have been very cautious about this offering.

But after completing the sleep-deprivation trials last year in Boston, Ted and I decided it was time to take the web step. Our web team was brought in and the project was launched. The results are tremendous. This will allow us to offer web-based testing worldwide. Our customers will not have to rent or purchase hardware from us. They can simply sign on with us and be given access to the site AlertnessCentral.com.

Here is how it works. We discuss your company's needs with you and suggest a configuration for your business. We then provide authorization for any number of workers you wish to sign up. We provide a password and you are ready. Suddenly any PC in your organization is an alertness testing station, available all day, every day. Your administrator can configure the system and its reports as he wishes. And we stand by - available to do custom applications as you wish.

Overtime Risks

2005-08-24T13:31:00.000-07:00

The following is straight from Circadian Technologies' news email.

More Evidence on the Risks of Overtime
Research from the University of Massachusetts shows a strong link between working overtime and sustaining a work-related injury. This was found to be true for all occupations, not just those that were physically demanding or in dangerous industries. Of the 110,000 job records that were studied, 5,139 injuries were recorded – more than half of the injuries occurred to people who worked overtime. Working longer hours (12 hours a day or more) was associated with a 37 percent increase in risk, while working 60 hours a week of more was associated with a 23% increase in injuries. (Chantal Britt, Bloomberg, “Overtime, Long Hours Increase Illness, Injury Risk, Study Shows” August 22, 2005)

Circadian Commentary:
This study adds to the wealth of scientific knowledge that has already shown that working long hours has negative health effects. Care must be taken when interpreting the report as it pertains to 12-hour shifts. Previous research has shown that there are no extra safety risks for 12-hour shifts compared to 8-hour shifts, in the absence of excess overtime. However, if more than 4 consecutive 12-hour shifts are worked, there will be the potential for increased health and accident risks. CIRCADIAN recommends a maximum overtime rate of around 12% - this provides flexibility for the organization, the chance to earn some extra cash for the employees, but won’t increase health and accident rates. Employers should also look at the distribution of overtime – a facility may have an average overtime rate of 10%, but just a small minority of employees may be working it all. (Alex Kerin, akerin@circadian.com)

Participate and Be Rewarded

2005-07-27T08:27:00.000-07:00

I have worked closely with Circadian Technologies. Inc. over the past years. This includes losing some sleep in their Sleep Lab. I have to admit though, Dr. Ted langley did the hard part and stayed up all night with subjects being tested. Circadian represent one of the best resources in the country for information about dealing with workplace fatigue. Their tests of our original BLT Alertness Tester are definitive.

Now Circadian is doing a survey of fitness for work testing and is offering a clever reward for participants.

Here is the offer and I urge any of my readers involved in this field to check it out:

"This month’s survey concerns Fitness-for-Duty testing in the workplace. You can complete the survey at Circadian Technologies

"Fitness-for-Duty testing is usually associated with alcohol and drug screening. In 1996, 81% of employers screened workers and pre-employment prospects for illegal substances, according to the American Management Association. However, this practice dropped to 62% of employers in 2004. Many companies are opting out of drug testing because of the cost of the tests, fear of errors, legal implications, and fear of loss of highly valued employees. However, there is general agreement that testing for impairment is particularly necessary in safety-critical jobs. Current urine-based drug testing procedures rarely test for impairment while at work, so a failed (or passed) test may not indicate impairment while at work.

"Please complete our survey at Circadian.com/fitness to receive your free copy of the $199 overtime study, and tell us what you think about impairment testing in the workplace.

"I’ll be happy to answer any questions you might have. Call me directly anytime at 781.676.6900. (Ask for Alex Kerin.)

Crossing Guard Fired

2005-07-22T13:59:00.000-07:00

The following story from the Houston Chronicle, which was picked up on NPR, is another reminder of how pervasive urine testing is becoming. Readers of this blog already know that I am not in favor of the use of drugs, but it is worth repeating that I am not. Nor am I against using urine testing at schools, within the limits of current rules, and where specific kids need to be monitored for drug use. What we do need to look at though is the inappropriate use of testing for people who do not fit a risk category for drug use.

And, of course, using drug testing when alertness testing is what is needed, is dangerous.

Here is the story:

July 21, 2005, 10:06AM
Fired crossing guard gets show of support

Parents want HISD to rehire 79-year-old who was terminated for refusing drug test

By JASON SPENCER
Copyright 2005 Houston Chronicle

School crossing guard Francis Light said he didn't know what to think one morning last month when a woman approached him at his post outside Oak Forest Elementary School and asked for a urine sample.

"I've been doing this school job for about 16 years, and I never heard of anyone taking a drug test, at least the crossing guards," said Light, 79. "Most of us are old people anyways."

So he refused.

"About two hours later, when I got back home, they called and told me I was terminated," Light said. "They told me I had 10 days to turn in my equipment — you know, a stop sign, raincoat, stuff like that."

He shouldn't have been surprised, said Terry Abbott, a Houston Independent School District spokesman.

"Every employee understands if you refuse the drug or alcohol test, you are automatically terminated," Abbott said. "We cannot allow people who are responsible for children's safety to refuse to take a drug or alcohol test."

Light signed a form acknowledging as much in September.

"They give us rules and regulations, and every year they get thicker and thicker," said Light, an Air Force veteran of World War II. "I don't know if I ever read them."

Light said he drank his last beer 51 years ago and has never used illegal drugs. He would have submitted to the drug test, he said, except he couldn't find any Oak Forest administrators to tell him it was required.

"My nurse, my secretary, my principal — nobody was there," Light said. "I didn't have anybody there to talk to, and I didn't know who this lady was."

Now, some Oak Forest parents are lobbying the school district to give Light a second chance.

"This is just one of those situations where a better look at what's going on would serve everyone well," said parent Jim Capfer. "I trust my kid's life with this man."

About 30 parents have come out in support of Light so far, Capfer said.

But HISD can't make an exception for Light, Abbott said, even if Light has a perfect work record.

"It would completely destroy our ability to keep children safe if we allowed people to refuse the drug or alcohol test," he said.

Light said he understands what's at stake. He was on duty April 14 when fifth-grader Anthony Dwight was struck and killed by a vehicle while riding his bike just beyond Light's crosswalk.

"It's still bothering me a lot," Light said. He remembers Anthony as the boy who often offered to sing him the songs he'd learned that day in school. "I think I lost 5 pounds that week."

While he'll miss the $250 checks he received every other week from HISD, Light said it's the relationships with the students he'll miss the most.

"I made a lot of friends over at that school," he said. "They're all good people and all good kids."

jason.spencer@chron.com

Evasion of Urine Tests

2005-05-18T12:43:00.000-07:00

I am following the news with fascination as the House Energy and Commerce Committee, under subcommittee Chairman, Ed Whitfield, R-KY, begins to discover the seedy side of drug testing.

The committee has found evidence from numerous witnesses that urine tests are widely evaded. Numerous web sites advertise a variety of devices that can be used to produce clean urine. The "Whizzinator", in particular, has caught the public's eye - and I will leave it to you to get the details. Several of the individuals who run these sites have been subpoenaed to testify but have taken the 5th.

Chairman Whitfield is preparing to introduce legislation to shut these sites down and generally stop the sale of things to help workers evade drug tests.

I have serious doubts that such legislation can possibly even reduce the use evasive techniques given the ingenuity of the American mind. The public would be better served if the committee would examine the whole structure of mandatory drug testing. As the requirement for drug urine testing has spread, a vast new industry has been built around it which now needs further government intervention to protect it. Not only does urine testing not work very well, it may actually make the workplace less safe.

Workplace drug testing is promoted as a means of making the workplace safer, but misses the issue almost completely. The real issue is that companies think they are reducing impairment by urine testing when they should be screening for actual impairment from fatigue, prescription drugs, etc. Fatigue is more common than drug impairment but is largely ignored. Meanwhile accidents from impairment, completely unrelated to drug use, continue to occur.

Another point about fatigue

2005-04-11T13:43:00.000-07:00

A couple of quotes from my reading:

"According to the National Highway Traffic Safety Administration, over 100,000 automobile accidents a year are caused by driver fatigue: a number that includes over 1,550 dead and 71,000 injured. Accidents caused by tired drivers may actually be much higher: determining whether fatigue played a role in a crash is difficult.

"According to the UK Institute of Advanced Motorists, sleepy drivers kill more people than those who have drunk, with driver fatigue being estimated to play a significant part in up to 25% of accidents on motorways and fast roads.

"About 11% of all motorway accidents caused by fatigue occur between 4am and 6am with drivers 13 times more likely to have a sleep -related accident as someone driving between 10am to noon, or from 8pm -10pm. In an RAC Foundation poll last year more than 60% of drivers questioned said they had driven while sleepy, of which 8% had at some point nodded off at the wheel. Also 30% said they felt more stressed, angry and more likely to confront other drivers when they were tired.

Leading me to wonder about a relative measure for alcohol impairment and fatigue impairment. This summer we will be starting on an extensive sleep impairment trial. Is it possible to relate our results for levels of fatigue to a given level of alcohol impairment. I doubt there is a direct correlation between these two but, intuitively, there is a relationship. Perhaps because both are temporary conditions and both are common, and dangerous when driving.

The Long Drive Home

2005-03-04T13:05:00.000-08:00

The case has taken a long time but it is finally reaching its conclusion. The judge's ruling could initiate significant reforms. Not the best way to change a system, but one way.

While we stress the importance of pre work testing, it may be that post work testing is even more important. In some jobs with extended hours the greatest risk is in driving home.

Here is Rachel Gotbaum's excellent NPR report and a summary of the sleep study by Dr. Laura Barger and Dr. Charles Czeisler in support of her findings:

"Seven years ago, Heather Brewster's car was rear-ended by Sookim Hong, a medical resident who'd just finished a 36-hour hospital shift. Brewster suffered massive brain injuries and was in a coma for weeks. The accident left Brewster permanently disabled: she now walks slowly, doesn't remember much of what she used to and has been declared incompetent by the courts.

Brewster's family is suing Hong and the hospital that employed her at the time. Some medical residents say the courts may be the only way to force a change in hospitals' long-held practice of working residents for long stretches at a time.

The lawsuit comes as new studies find that when doctors-in-training work long on-call shifts, they are more likely to cause motor vehicle accidents when they leave work.

The Science Behind Safety Concerns

Currently, medical residents' hours are set by the Accreditation Council of Graduate Medical Education. Two years ago, the organization reduced residents' on-call shifts to 30 hours maximum.

Dr. Laura Barger, Dr. Charles Czeisler and their colleagues from the division of sleep medicine at Brigham and Women's Hospital in Boston recently surveyed 2,700 first-year interns. They found that when interns worked long on-call shifts, they were more than twice as likely to get into car accidents after leaving the hospital.

The study was conducted in the 2002-2003 academic year, before the ACGME reduced residents' on-call shifts. Below are some highlights from the study.

Summary of Findings from the Harvard Work Hours, Health and Safety Group:

-- Average number of consecutive hours worked by interns in 2002-2003 on extended-duration shifts: 32 consecutive hours*

-- Average number of hours worked per week in 2002-2003: 70.7 hours**

-- When interns drove home from an extended (longer than 24-hour) work shift, their odds of a motor vehicle crash were 2.3 times greater than when the same interns commuted from work after a shift that, on average, was less than 12 hours long. Interns' odds of a near-miss crash (in which bodily harm or property damage were narrowly avoided) were increased nearly six fold after an extended-duration work shift.

-- In a prospective analysis during the 2002-2003 academic year, every extended work shift that was scheduled in a month increased the monthly risk of a motor vehicle crash during the commute from work by 16.2 percent. (The new ACGME regulations allow eight 30-hour shifts to be worked per month.)

-- In months in which interns worked five or more extended shifts, their odds of falling asleep while driving were 2.39 times greater; their odds of falling asleep while stopped in traffic were 3.69 times greater than in months when they did not work extended shifts.

-- Interns were awake 96 percent of their work time in U.S. hospitals during the 2002-2003 academic year. They reported that their patient workload did not allow them to make much use of the "on-call" rooms that hospitals provide for them to sleep.

* Note: In July 2003, ACGME regulations set the shift-duration limit at 30 consecutive hours, and permitted every other shift to be extended. On this new ACGME-sanctioned schedule, a 30-hour shift can alternate with an 10-hour shift in consecutive sequence, such that a typical seven-day work week under the new ACGME guidelines would be: Monday and Tuesday: 30-hour shift; Wednesday: 10-hour shift; Thursday-Friday: 30-hour shift; Saturday: 10-hour shift; Sunday: day off.

** In July 2003, ACGME regulations set the weekly work-hour limit at 80 hours, averaged over four weeks.

Research summary provided by Dr. Charles A. Czeisler, director of the Sleep Medicine Division at Harvard Medical School."

O Rings and Friendly Fire

2005-02-15T14:26:00.000-08:00

Does sleep deprivation cause accidents? Of course not. But it is often a contributing cause. Too often.

Could testing help reduce these kinds of accidents? In some cases - yes, it certainly could.

A culture of awareness and responsible testing could have helped in the Challenger accident. On the battle field, I am not so sure. But certainly, if a comander had information that his forward troops were reaching their limits he might adjust deployment or even delay an event to insure his troops were at their optimal performance level.

I am going to quote directly from Chapter 6 of a US Army War College publication dealing with the issue of sleep deprivation:

THE ROLE OF SLEEP IN SUSTAINING INDIVIDUAL AND ORGANIZATIONAL EFFECTIVENESS
Nancy J. Wesensten, Thomas J. Balkin, and Gregory Belenky

Challenger Disaster

The U.S. Space Shuttle Challenger exploded on January 28, 1986, 73 seconds into its tenth flight, killing all seven crew members, including a civilian schoolteacher, Christa McAuliffe. From an engineering standpoint, the disaster was caused by the failure of an "O" ring in one of the solid rocket boosters to properly seat on ignition. The "O" ring lost flexibility because of the cold temperatures on the day of the launch. The failure to accurately evaluate the reliability of the "O" rings under prevailing weather conditions has been attributed to insufficient sleep on the part of NASA managers involved in the launch decision. Of the 3 high-level NASA managers involved, two had had less than three hours of sleep for 3 consecutive nights prior to the launch. 2

Gulf War Friendly Fire Incident

This case history from the Gulf War illustrates sleep deprivation and time-of-day or circadian effects on organizational performance during military operations. During a night of total sleep deprivation, at approximately 0100 hours on February 26, 1991, a Second Armored Cavalry Regiment Bradley platoon screen line observed hot spots approaching on their thermal sights. They were uncertain as to whether these were friend or foe, and continued to observe. It was not until the lead vehicle actually entered their screen line that the Bradley crews concluded that the hot spots were a column of Iraqi armored personnel carriers. A brief firefight ensued, during which all the Iraqi vehicles were destroyed. However, during the firefight, the two Bradleys at the screen line right flank turned left and faced down their own line, but thought they were still facing the enemy. Perceiving that two Bradleys on the left flank were enemy vehicles, they proceeded to enfilade their own line with fire, destroying the two Bradleys on the left flank.

One of the authors of this chapter led the mental health team attached to the Second Armored Cavalry Regiment and thus was able to reconstruct the friendly fire incident shortly after the event with all crew members present.3 By their own self-report, the Bradley crews had obtained only 3-4 hours of sleep per night over the previous 5 days, and the firefight ensued during the early morning hours. Thus the crews were sleep-deprived and operating at a time of day when complex mental operations are at their worst. Despite this, the crew was still able to put the cross-hairs on the target and fire rounds accurately down-range––as evidenced by the destruction of the Bradleys on the left flank. Their disorientation from the front was the cause of this unfortunate friendly fire incident, because the crew was operating under the axiom that "if it’s in front of us, it dies."

ORGANIZATIONAL AND MILITARY EFFECTIVENESS

The case histories above illustrate that even as computer systems, weaponry, and organizations in general become more sophisticated, the individual and his or her performance remain critical to the success of organizational operations, both military and civilian. In its most basic form, effectiveness in any operational environment depends upon the person making the correct decision within a limited time

Shapes Used for a Test

2005-02-06T21:13:00.000-08:00

Our entry of 2/5/05 spoke about the use of visual challenges for alertness testing. In response to requests for examples of shapes used in the BLT Alertness Test, here are a few. Obviously, these are very simple images, but they are sufficiently challenging when presented in groups of similar images (each row represents a similar set) to present a good proxy for brain function.

Originally uploaded by hmb.

Examples of shapes used in the BLT Alertness Test.

New Tests

2005-02-05T15:46:00.000-08:00

The basic BLT Alertness test uses a set of shapes on the white squares of a small checkerboard. The challenge is to determine if all the shapes are the same or not. Since some of the shapes look similar and are randomly rotated, it can be difficult to tell if they are actually all the same or not. The shapes we use were developed based on certain visual concepts discovered over years of brain testing and cognitive science. One principle draws on the well known tendency of the brain to organize a random world into spacial, geometric and linear organizational patterns.

If a visual field contains many strong visual patterns the brain tends to organize the field into those patterns. A minor deviation or missing segment can be ignored. Up to a point. Hence our patterns tend to be stong visual shapes and the variations tend to add or subtract a subordinate element of the shape. The challenge of overcoming the brain's instinctive visual organizing shortcuts requires an alert mind. This particular feature of the test tends to compress the time required to determine alertness which was one of our goals with this design. Keep in mind that our intent was to design a test that is difficult but not annoying. We could make the test much more difficult, but we do not need to do that to determine general alertness.

We can also make tests that are job specific. For a truck driver we would have a driving simulation, for the crane operator - a crane simulation, But this would mean, essentially, a separate standard of alertness for each profession because each test would need to be recallibrated for a different set of conditions. (Not to mention the problem of deciding what test should be given to each group and sub group.) This was not our intent either, we want a universal test and a universal standard measure of alertness.

Within the limits of our resources, we are, nevertheless, designing new tests. At the moment, the emphasis is on memory tests for Alzheimer's Disease and general memory impairment. Here we are breaking the mold of standardized tests again by using photographs as the memory component item. Of course, we are not reinventing the wheel, our tests fall neatly within the pattern of traditional, standardized tests for memory. But we find using protographs within these standards creates a much more enjoyable test experience. Photographs create their own set of problems too. A photograph can be charged with emotional energy and beauty or, more typically, it can be dull and un interesting. Obviously, the first kind tend to be easy to remember while the latter kind, the dull ones, are forgettable. Introducing variables like this drives cognitive scientists up the wall.

In one of our newest memory tests all the photographs have an "equivalent memory value". Yet the pictures are still visually interesting. To see if we can get away with this watch for our new memory testing site that will be on line in May.

A Pill for Alertness?

2005-02-02T20:57:00.000-08:00

I talk a lot about alertness and its importance to safer work. And we emphasize getting enough sleep and eating properly. But what if it turns out that a simple pill will keep you alert? What if a pill can improve your memory? Well it seems, such medications are not that far away. In a fascinating article in the Dana Foundation newsletter these incredible new (and old) medications are reviewed with considerable optimism about their potential.

There are three "cognitive enhancers" under study, modafinil (Provigil), methylphenidate (Ritalin) and donepezil. These drugs currently have accpted medical uses. Ritlin is commonly prescribed for attention deficit disorder (ADD) in children and donepezil is prescribed for Alzheimer's Disease. But when used by healthy individuals these compounds can have the effect of enhancing brain function.

Modafinil has been shown to enhance processing speed and improve multitasking ability. Pilots taking the drug showed a remarkable improvement in their ability to learn and performed better in emergency drills and landing sequence exercises.

Ritalin "Vitimin R" is used by college students to improve exam performance. Students are willing to risk addiction to the drug for the extra edge it gives them.

The Pentagon is particularly interested in alertness and learning enhancement. Mistakes under stress in combat add to the damage from war. If a means can be developed to reduce these errors, even slightly, war will still be terrible but possibly more rational.

What is the downside? The brain has evolved over millions of years to cope with the stress of life. Changing the brain's chemistry may have long term effects we do not fully understand.

But the science is fascinating. I remain open to anything that can improve job performance, learning and human happiness.

Oprah on the Brain

2005-01-27T13:41:00.000-08:00

The recent issue of Oprah Magazine (Jan 2005) has an interesting series on learning and health. Its surprising what you will find in Oprah which is, I guess, one of the reasons for her success - she is always open to new ideas and approaches to life.

Learning is one of the best ways to challenge the mind and to exercise the brain. And brain health is what keeps us alert. Being alert on the job means being able to address unusual situations when they arise. The number of accidents caused by incorrect responses to unusual situations is huge. So, if you are at the news stand, check out page 143 in the January issue and take up watercolor painting, snowshoeing, or eagle watching, or...you get the point.

Fatigue and Performance

2005-01-19T23:09:00.000-08:00

If a human testing technology is able to measure fatigue, is it also measuring overall performance? I would say yes it is, because fatigue affects many if not all aspects of performance. In other words, if someone is tired his/her performance is going to degrade across the board. And there is plenty of science to back this up. One classic study "The Human as a Limiting Element in Military Systems" tested a group of individuals over a grueling 72 hour no sleep trial.

The study used a variety of computer generated tests including pattern recognition, vigilance, logical reasoning, math performance and recall. What is remarkable is how consistent each of these tests was in measuring fatigue. Performance declined steadily with every type of test, although some tests look a little more stable than others.

The test battery was developed at Walter Reed Army Institute of Research by David R. Thorne, PhD. in 1982 and is still in use.

Fatigue Issues in the US Army

2005-01-10T17:05:00.000-08:00

Fatigue in the military is a major cause of errors. The following article from Soldiers Online Magazine (http://www.army.mil/soldiers/) provides an insiders view. I am surprised with the the study results that soldiers can maintain accuracy even when sleep-deprived. I need to see the results. However, obviously, other target related abilities are impaired. This will require more investigation and I would be interested in readers' views on this.

Story by SSgt. Alan Moore
    With troop strength down and contingency missions up, the Army's need for around-the-clock operations is greater than ever. With the sophistication and lethality of today's weapons, scientists at the Washington, D.C.-based Walter Reed Army Institute of Research warn that danger lurks in drowsy eyes. Consider this true story from research files: During Operation Desert Storm a platoon of Bradley fighting vehicles was rumbling across Iraqi sands. Epitomizing the fighting doctrine: "if it's in front of us, it dies," the platoon had just decimated a column of Iraqi personnel carriers.

   The Bradley platoon, in a staggered line crossing the horizon, advanced to the enemy graveyard. While navigating through the smoldering wreckage, two Bradleys on the right of the line accidentally veered slightly off course. The vehicles' crews spotted two Bradleys on the opposite end of the line and, thinking they were still looking forward, opened fire on their comrades. In short order, both targeted vehicles were reduced to chunks of metal not much larger than an office desk.

   "The crews were very lucky," said Dr. (Col.) Gregory Belenky, the Army's leading expert on sleep management. "They miraculously escaped without a scratch." The incident was a classic example of what can happen when soldiers suffer sleep deprivation. For more than a decade, Belenky has been studying the issue at the Walter Reed Army Institute of Research, where he is director of the Neuropsychiatry Division. Belenky said determining how much sleep a soldier needs to function effectively might not only reduce friendly-fire incidents, but could be the difference between victory and defeat. "The real question is 'effectively' for what?" he said. "This is not an Army where soldiers load flintlock muskets, stand in rows, firing toward the enemy. If that were the case we could get by on very little sleep."

   When soldiers go to the field, the burden of sleep deprivation seems to be as heavy as their rucksacks. For example, soldiers of XVIII Airborne Corps are on a short string for deployment. Within 18 hours after notification, they're in theater and conducting continuous operations. At that rate it could be 36 to 48 hours before some soldiers sleep. A lack of sleep takes an immediate toll on troop alertness, said Dr. (Maj.) Daniel Loube, assistant director of the Sleep Disorder Center at Walter Reed Army Medical Center. "If you take normal young adults and sleep-deprive them about an hour and a half, just one night, their ability to stay awake drops by 20 percent," he said. "If you consistently sleep-deprive these people an hour and a half each night, their sleepiness increases 35 percent." Capt. Thomas E. Hiebert, who commands a long-range surveillance detachment at Fort Bragg, N.C., said that after three or four days of continuous operations, the pace really starts to get to soldiers. "Even after 36 hours of no sleep, soldiers get edgy, decisions are probably not as well thought out as they should be."

   The good news, said Belenky, is that sleep deprivation doesn't impair physical strength, endurance or coordination. "Soldiers can shoot just as tight a cluster with the M-16 after 90 hours awake as they can when well-rested," he said. The bad news is that decision-making, logic and the highest mental functions are the most degraded by sleep deprivation. It boils down to what Belenky calls the temporal envelope, or the amount of time in which a correct decision must be made to avert catastrophe.

   "The speed with which you acquire and process targets is critical, especially in armored operations," he said. "If you see the enemy first, you can kill them. If they see you first, you're history." Belenky's research indicated that as soldiers get progressively sleepier, they maintain accuracy, but they take longer to engage targets. "Once you exceed that temporal envelope, the other guy sees you and -- boom -- it's over."

   When soldiers are sleep-deprived, they lose their place in the battle and get confused about where they are and what they're doing. They lose their grasp of the tactical situation, and that's how "fratricide" can happen, Belenky said. There are no warning signs. "For a period of time, you don't see all that much change in performance with people who are sleep-deprived," he said. "Everything seems to be going okay, then suddenly there's a disaster."

   According to the U.S. Army Safety Center at Fort Rucker, Ala., one of the best ways to head off sleep deprivation is by developing and keeping to a unit sleep plan. The 82nd Airborne Division's CSM Steven England said a sleep plan must start from and be enforced from the top down. "If leaders don't plan well, if they don't have a rest plan, it jeopardizes lives and mission accomplishment," England said. "I know in the 82nd we stress the importance of a well-thought-out sleep plan all the way down to the squad and team level."

   Sometimes leaders and key decision makers don't enforce the sleep plan enough on themselves, said Capt. Joe Clark of the 1st Bn., 17th Cavalry at Fort Bragg. "They make sure the trigger-pullers are getting enough sleep, but they push themselves to the max," he said.

   During training rotations, Clark said he saw some key leaders make decisions that they might not have made were they well-rested. "They were on their last legs; they had been awake for more than 36 hours," he said. "That's the time when the people around them need to say, 'Look, sir, you need to get some sleep for your own good and the good of the unit.'" Some commanders think that by shortchanging themselves sleep they can get more work done. For a day or two they can, but after about three days of limited sleep they're actually getting less done even when they have more time to work, said Belenky. And by tweaking the delicate balance of slumber versus labor, they are courting disaster, he warned.

   It is possible to get by on minimal sleep. Students in Ranger School at Fort Benning, Ga., average 3.2 to 3.6 hours of sleep per night during the grueling 58-day course. "In terms of survival, three hours' sleep is fine if none of your decisions are critical," said Belenky. "To be able to think and plan, most people need eight hours to be at 100 percent." Belenky and Loube cautioned against suggesting that commanders and officers need more sleep than their soldiers. "I don't think it has to do with officer versus enlisted," said Loube. "It depends more on how technical your job is, and how much decision-making skills are a part of your job."

   The infantryman has command and control problems too, said Belenky. "They are every bit as complex as the corps commander's, just smaller in scope," he said. "In fact, if you really look at the temporal envelope, an infantryman has a lot less time in which to be making these decisions." Sometimes intense and repetitive training helps soldiers conquer critical moments, even though they may be sleep-deprived. "That's called automatic behavior," said Loube. "The more a task is repeated, the less decision-making is involved and the better the task will be performed with limited sleep. There's no doubt about that. It has been well established in studies over the last 10 years. That goes for doctors, truck drivers or soldiers."

   In addition to training and implementing a strict sleep plan, some soldiers said the answer is to work when the mission demands it and sleep as often as possible. Give soldiers 10 minutes of wait time, and they'll turn it into a nap. Catnaps are great, said Belenky. "Anything more than five minutes of sleep, and you begin to accumulate benefit. If you get 30 minutes of sleep, you're better off than not getting any," he said. "In fact, sixteen 30-minute naps are almost as good as eight solid hours."

   Fortunately, soldiers have turned catnapping into an art form. They can sleep through just about anything, anywhere -- standing in a foxhole, on a bumpy ride in the back of a Humvee, or in the belly of an ear-thumping CH-47 Chinook. The challenge is for leaders to develop and implement sleep plans that will recharge soldiers and still enable them to accomplish the mission.

Medical Errors

2005-01-04T13:36:00.000-08:00

It is now well established that many errors are made by doctors, nurses and interns. Some of these errors can be horrendous.

Let me say immediately that doctors, nurses and interns are incredibly dedicated and careful. But the hours they work can be enough to put anyone into a state of exhaustion. Interns, for example, work over 80 hours per week on average.

This year, with the help of a NIOSH grant, we plan to conduct an extensive study of the alertness of doctors and interns at a leading East Cost hospital in the Boston area. This will be done with the full cooperation of staff and the medical group we will be testing. They recognize the problem and want to find a way to help without sacrificing efficient operations. Our hope is that through testing we will be able to identify when some individuals are too tired to work and make shift changes to better the alertness of all.

Test Pilots?

2005-01-03T18:35:00.000-08:00

If you look at the instrument panel of a modern aircraft you will note that the old analog instruments have been replaced with what is essentially a flat screen. The display is one big computer screen. In other words, almost anything can be shown.
For example, we could use part of the display for a short alertness test.

I would feel safer when flying if I knew that the pilot took a short alertness test prior to takeoff.

Drug testing

2004-12-31T11:43:00.000-08:00

A JJ Keller article reminded me of how sensitive drug testing is.

We do not condone any kind of drug use by workers engaged in dangerous activities. But it is important to focus on what matters: Can the worker perform safely and efficiently when called upon to do so?

While drug use information may well be important for addressing drug addiction it is often irrelevant to safety.

Here is the article:

"When it comes to DOT drug and alcohol testing, a driver may think that something consumed over the weekend won't show up during the work week.

"If your driver is betting on this, he/she may be in for a shock. The driver may suddenly find that his/her career as a commercial driver is put on hold (until the DOT Return-to-Duty Process is completed) all because of an off-duty indiscretion. Drug and alcohol detection periods vary from individual to individual – the kind of drug and pattern of use factor in, as do the rates of metabolism and excretion. The detection periods listed below should be taken as approximations. There may be times when an individual falls outside of these norms.

Controlled substance
Detection Period

Amphetamine
1-2 days

Methamphetamine
1-2 days

Benzoylecgonine
2-3 days

Cannabinoids (marijuana)

Casual use
Up to 7 days

Chronic use
Up to 30 days

Cocaine
Benzoylecgonine
2-3 days

Codeine
Usually up to 2 days

Hydromorphone (Dilaudid)
Usually up to 2 days

Morphine (for Heroin)
Usually up to 2 days

Phencyclidine (PCP)

Casual use
Up to 8 days

Chronic use
Up to 30 days

It should also be noted that alcohol can be detected between 12-24 hours after consumption.

A drivers needs to be reminded that the behaviors that he/she participates in may have consequences long after the party's over.

Announcement

2004-12-30T23:05:00.000-08:00

This is dedicated to the concept of testing individuals to determine their condition before they begin potentially dangerous work.

This location will provide a forum for discussion of issues related to job safety. And I will provide news as I hear about it relating to job safety and testing.

I encourage contributions from interested individuals whith experience in this field.

My particular approach is to advocate the use of fitness for work testing. This involves the use of short tests before work. Such tests are designed to test individuals before they begin work, particularly in a dangerous work environment. Such tests can be made sensitivite to fatigue which is a major killer on our highways and in other environments requiring good alertness.