Sleep, Lighting Measurements Quantify

Fatigue Risk
Stephen Whitfield, Oil and Gas Facilities Staff Writer | 13 January 2015

Topics

Safety/health

fatigue

A lack of sleep and excessive lighting in the workplace can have negative long-term health effects
for industrial shift workers. In a webinar held by the SPE Health, Safety, Security, Environment, and
Social Responsibility Advisory Committee, Daniel Mollicone and Martin Moore-Ede discussed the
challenges facing late-night shift workers and the studies being done to mitigate the risks associated
with fatigue.
Mollicone, president and chief executive officer (CEO) of Pulsar Informatics, a company that
specializes in developing technology for assessing behavioral alertness, discussed the quantification

of fatigue risk. The use of terms such as tired and fatigue are indications of a loss of function or a
deficit associated with alertness and performance on the job, he said. It is important for
organizations to create tools that put objective numbers to those concepts so that they can devise an
effective fatigue risk management strategy.
When you ask people, they say, Well, I feel OK now. What theyre really saying is they feel equally
bad to the day before. So thats not a very useful absolute measure of deficit. We need these
objective quantifications, numbers that are comparable across individuals and across scenarios so
that we can start to build a science and practical applications within industry, he said.
Mollicone focused on the psychomotor vigilance test (PVT), a widely used method of measuring
behavioral alertness in an individual. The test is straightforward. Individuals look at a small red box in
the middle of a black screen. At random intervals, numbers begin appearing within the red box. Test
takers press a button to stop the numbers, after which their response time is shown in milliseconds.
The PVT measures lapses in attention, which is defined as a response time of a half second
or longer.
In a recent study conducted by the University of Pennsylvanias School of Medicine, people who got
fewer than 8 hours of sleep per night showed a noticeable increase in lapses over a 3-week period,
and the less sleep an individual had, the faster his or her impairment developed. After 1 week
of testing, individuals who slept 6 hours per night functioned at the same level as a person who
had been awake for 24 consecutive hours.
One of the things that was very interesting about the study was that it allowed the cross comparison
of not getting any sleep at all, where youre staying up all night, versus having restricted sleep of 8
hours or less each day, which is a very common occurrence. Getting 6 or 7 hours of sleep is
considered a luxury, and what were saying is that it contributes to deficits that accumulate,
Mollicone said.
He said that people who do not get enough sleep nightly accumulate impairment, or a sleep debt,
based on the amount of sleep they do not get. The PVT helps to quantify the deficit.
As the test is based on responses to basic visual stimuli, there are no elements of aptitude or
learning involved, which makes it easier to conduct tests and compare results under different
conditions or across different time periods.

Fig. 1Performance on psychomotor vigilance test (PVT) vs. time of day.

Source: Pulsar Informatics.
Humans are fundamentally day creatures. At night, the body regulates downward into a period of
sleepiness that culminates in ones circadian peak, or the time at which a person is at his or her
sleepiest. This peak typically happens about the middle of the night, and night workers usually see
their most significant deficits and performance problems during this time, Mollicone said. The body
regulates upward to a circadian low point during the afternoon hours (Fig. 1).
In the figure, the yellow curve represents the circadian rhythm and the blue rectangle represents a
period of sleep. The red line is a subjective measure of fatigue from test subjects, or how tired a
person said he felt at a given time of day. The blue line is an objective measure of PVT responses;
lapses decrease during the day and start to inch up in the evening. Under continual conditions of
sleep deprivation, the strength of this circadian low increases and ultimately affects performance
during typical waking hours.
Mollicone said that day workers under any sleep restriction are at their least alert when they wake up
and at their most alert during the circadian high, which went against his prior conception of the
bodys waking pattern.
The way I thought the world worked was, you went to sleep, you woke up in the morning, you
charged your battery, and youre at your best first thing in the morning after you have a period to
wake up and not be drowsy anymore, and as you grind through the day, you sort of wear yourself
out, Mollicone said. Thats true when youre getting sufficient, adequate, and restful sleep on a daily
basis, but under conditions of chronic sleep restriction, this circadian factor flips it upside down.
The use the PVT to measure behavior and performance under sleep deprivation is one element of a
fatigue risk management strategy. Another element is the measurement of sleep duration,
effectiveness, and how an individual responds to it. Mollicone said that information can be obtained
through actigraphy devices that sense gross motor activity to estimate when a person is at rest,
falling asleep, actually asleep, and waking up based on a set of algorithms.

This data can be used to determine sleep efficiency, which is a ratio of minutes asleep to minutes at
rest. For example, if a person is in bed for 100 minutes but only sleeps for 80 minutes, the sleep
efficiency is 80%. Night workers typically have lower sleep efficiencies than day workers and run a
greater risk of disrupted sleep or insomnia, he said.
When you see sleep efficiencies dropping, that means not only are you not allocating enough time
to sleep, but youre not biologically making the best use of that time to get adequate rest, Mollicone
said. So, the goal is to schedule times when youre going to get the most rest, schedule sufficient
time for rest, and then biologically take advantage of that time to receive the benefits of the rest.
When you do all of those things, youre really on the right track to mitigating the risks associated
with fatigue.
Moore-Ede, the chairman and CEO of Circadian, a research and consulting firm, talked about the
reasons why exposure to light at night has a negative effect on the human body and what is being
done to help mitigate it.
Since 2000, studies have shown that exposure to light at night can disrupt a persons circadian
rhythm even without significant sleep loss, and it increases the risk of health issues such as cancer
and diabetes.
This is due primarily to the presence of blue light in the midst of regular white light. Blue light,
perceived by melanopsin receptors in the eye, is the major synchronizing cue in the bodys biological
clock. The receptors are highly sensitive to certain wavelengths of blue light. Moore-Ede said that a
radiance of 4 W/cm2 of blue light equals 100 W/cm2 of white light.
Blue light is an essential tool to preserving the bodys circadian cycle when observed during waking
hours. However, at night, too much blue light can lead to a phase shift of the biological clock, which
suppresses melatonin (a hormone that protects against cancer risk) in the pineal gland and elevates
cortisol (which increases the risk of diabetes).
Another factor in the increased risk is an overall shift in industrial workplaces from fluorescent
lighting to light-emitting diodes (LEDs), which are more energy-efficient but produce more blue light.
The problem is were about to dose a large number of people with lots more blue light, Moore-Ede
said. This is a point in time where were realizing that the momentum in energy policy and all the
rebates that are being offered to industry to do it are pushing people into what could be a very
unfortunate health and safety direction.
Moore-Ede argued for LED lighting technology that reduces the risks of excessive blue light
exposure and the establishment of lighting exposure standards for shift workers.