Fatigue in transport: a review of exposure, risks, checks and controls

Human fatigue continues to threaten safe transport. There are claims that employers of operators should do more to mitigate the risks, and several regulators are promoting fatigue-risk management in the context of safety management systems (SMS). The current paper reviews fatigue-related risk and exposure factors and control measures for operators of land-and sea-based transport forms. Our review identifies 13 types of measures for the monitoring or control of fatigue risks: optimal staffing; optimal schedule design; optimisation of breaks/naps; monitoring of actual hours worked; optimisation of work content; monitoring and feedback of actual sleep; health screening and treatment; promotion of recovery from work; fitness-for-duty testing; monitoring of fatigue symptoms while operating; control of fatigue while operating; performance monitoring and assistance; and fatigue-proofing. We also identify two systemic measures needed to anchor risk mitigation in SMS: organisational learning and training/other. By structuring monitoring and control measures along Dawson and McCulloch's [Managing fatigue: It's about sleep. Sleep Medicine Reviews, 9(5), 365-380] fatigue-risk trajectory, a framework is obtained that acts as a guide for fatigue-risk management by transport employers. To inform transport managers further, evaluations are needed of the effectiveness of individual control measures as well as whole fatigue-risk management interventions.