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Police Fatigue: an accident waiting to happen.

After working almost 35 hours straight on a case that involved high-stress surveillance, the controlled delivery of nearly 2 tons of marijuana, and the arrest of 5 suspects, a detective on a narcotics task force was driving over 350 miles back home. The judge in the case advised the prosecuting attorney that if the detective was not in court that day by 2 p.m., the case would be dismissed without prejudice. As the detective approached the midway point on his route home, his vehicle, according to witnesses, swerved left, traveled through the median strip, crossed the oncoming traffic lanes, flipped several times, and ultimately came to rest on the opposite side of the interstate. The detective was severely injured and out of work for over a year.

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Accounts of tragedies associated with law enforcement fatigue are not new. In fact, such stories become more commonplace each year. Convincing federal, state, and local law enforcement organizations of the seriousness of fatigue as an occupational health, commercial, public safety, and legal issue ultimately will require law enforcement managers to have a paradigm shift to address this concern. Agencies must acknowledge this problem to improve working conditions for their personnel and to protect them from the scientifically documented consequences that fatigue can cause. For example, researchers assessed neurobehavioral functions after 17 hours of wakefulness and reported performance impairment on a range of tasks. (1) Impairments after 20 hours of wakefulness equaled that of an individual with a blood-alcohol concentration of 0.10, twice the presumptive level of intoxication in most states. (2) Further, the ability to maintain speed and road position on a driving simulator is significantly reduced when the awake period is prolonged by 3 hours. (3) The magnitudes of the decrements were similar to those found at and above the legal limits of alcohol consumption (0.05). (4) All of these studies indicated that moderate levels of sleepiness can substantially impair the ability to drive safely even before an individual actually falls asleep.

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Exhaustion due to shift work, voluntary and mandatory overtime assignments, seemingly endless hours waiting to testify in court, physical and emotional demands of dealing with the public, and management expectations of doing more with less, combined with family responsibilities, puts the modern law enforcement professional at serious emotional and physical risk. Law enforcement fatigue and sleep deprivation also are becoming serious political and legal liabilities for police managers. What department can sustain multimillion dollar lawsuits or afford to lose a veteran officer for years?

The cumulative work hours for many professionals, such as pilots, locomotive engineers, ship captains, public transportation and commercial truck drivers, firefighters, and emergency room doctors, are standardized and regulated through federal or state regulatory commissions (e.g., U.S. Department of Transportation or Federal Aviation Administration). Unfortunately, no such regulations exist for the majority of federal, state, and local law enforcement employees. "Police work is the one profession in which we would want all practitioners to have adequate and healthful sleep to perform their duties at peak levels. Not only is fatigue associated with individual misery, but it also can lead to counterproductive behavior. It is well-known that impulsiveness, aggression, irritability, and angry outbursts are associated with sleep deprivation. It is totally reprehensible that the cops we expect to protect us, come to our aid, and respond to our needs when victimized should be allowed to have the worst fatigue and sleep conditions of any profession in our society." (5)

Throughout the last century, the standard work week was 9 a.m. to 5 p.m., Monday through Friday, designed to not intrude on workers' premium social time, such as evenings and weekends. As such, the 8-hour workday evolved from the widely held belief that the 24-hour day should be split evenly between work, recreation/relaxation, and sleep. While many people take the 8-hour day for granted as a part of normal life, such working conditions are a relatively recent industrial development. Traditionally, law enforcement personnel work long hours for four main reasons. First, they seek monetary gain--the more they work, the more money they make. Traditionally, wages for law enforcement personnel have been low; therefore, the dependence on overtime, night-shift premiums, and moonlighting (working other jobs) has been necessary. Second, they encounter organizational or occupational expectations (we have to do more with less). "Many companies (law enforcement agencies) foster workaholism and actively seek out and reward workaholics." (6) Third, employees want personal satisfaction. The majority of law enforcement professionals could make substantially more money doing something else, but the job is fun, stimulating, exciting, challenging, unpredictable, and dangerous. It attracts risk-aggressive individuals who have chosen not to passively sit behind a desk. Finally, they belong to an exclusive fraternity. Law enforcement gives a person a sense of self-identity, belonging, and self-worth.

Not surprisingly, as long hours, shift work, and irregular hours of work increase, the hours, quality, and quantity of sleep decrease, causing a sleep debt. Conversely, fatigue levels rise, leading to detrimental effects on both health and on-the-job performance.

Fatigue

What is fatigue? How does it relate to sleep? Although there is no universally accepted definition of fatigue, several exist. Fatigue is a "tiredness concerning the inability of disinclination to continue an activity, generally because the activity has been going on too long" (7) or "a feeling of weariness, tiredness, or lack of energy." (8)

People often use drowsiness and fatigue interchangeably, but they are not the same. Drowsiness is a feeling of the need to sleep or the state in which the body is ready to fall asleep. Fatigue is a lack of energy and motivation. Apathy, a feeling of indifference or not caring about what happens, and drowsiness can be symptoms of fatigue. It should be noted that fatigue can be a normal, healthy, and important response to physical exertion, emotional stress, boredom, or lack of sleep. However, it also can signify a more serious psychological or physical disorder. Because fatigue is such a common complaint, sometimes a potentially serious cause may be overlooked.

In the last 25 years, the job of enforcing the law has become increasingly complex from a cognitive perspective. Further, policing the community is creating tasks that require much higher levels of attentiveness than in the past. Long work hours are widely accepted as a major contributing factor to fatigue. (9) As hours of work increase, sleep is reduced with a concomitant elevation in fatigue and reduced levels of alertness. (10)

Sleep

Humans typically have four to six sleep cycles that each last 70 to 90 minutes. At the end of each cycle, they are nearly awake. In light sleep, body movement decreases and spontaneous awakening may occur. People spend most of the night in intermediate sleep, which helps refresh the body. Deep sleep, the most restorative stage, lasts 30 to 40 minutes in the first few cycles and less in later ones. In this stage, people are the most difficult to arouse. Dreaming occurs in REM (rapid eye movement) and heart rate increases. This stage lasts about 10 minutes in the first cycle and 20 to 30 minutes in later ones. During a full night's sleep, these sleep cycles are repeated four to six times, moving from one stage of sleep to another. (11)

Several functions occur during sleep. These include--

* consolidation and optimization of memories;

* conservation of energy;

* promotion of physiological processes that rejuvenate the body and mind (some studies suggest that sleep restores neurons and increases the production of brain proteins and certain hormones);

* the process of unlearning that prevents the brain from becoming overloaded with knowledge; and

* avoidance of danger (prehistoric people adapted the pattern of sleeping in caves at night because it protected humans from species physiologically suited to function well in the dark, such as saber-toothed tigers).

Lack of sleep is considered one of the primary causes of fatigue. Humans need to sleep--it is not a matter of choice but essential and inevitable. The longer a person remains awake, the greater the need to sleep and the more difficult to resist falling asleep. Sleep will inevitably overpower the strongest intentions and efforts to stay awake. (12)

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Little is known about the physiological role of sleep and ways in which it restores the brain to its full function, but the effects of fatigue on the brain can be measured. Studies have shown that after 24 hours of sustained wakefulness, the brain's metabolic activity can decrease by up to 65 percent in total and by up to 11 percent in specific areas of the brain, particularly those that play a role in judgment, attention, and visual functions. One study highlights nine dimensions of workplace performance susceptible to the effects of fatigue, including the inability to--

1) comprehend complex situations, such as processing substantial amounts of data within a short time frame, without distractions (the lack of focused attention associated with sleep deprivation is likely to reduce efficiency of such processing);

2) manage events and improve strategies;

3) perform risk assessment and accurately predict consequences;

4) think latterly and be innovative;

5) take personal interest in the outcome;

6) control mood and behavior;

7) monitor personal performance;

8) recollect timing of events; and

9) communicate effectively. (13) People know when they feel tired--their eyes become a little glassy, they tend to have less eye movement, and yawning is more pronounced. As they try to fight through periods of fatigue, the human body, in an effort to rest, goes into microsleeps where a person literally falls asleep anywhere from 2 to 10 seconds at a time. It is difficult to predict when a person, once fatigued, might slip into a microsleep. Additionally, research has found that as little as 2 hours of sleep loss on one occasion can result in degraded reaction time, cognitive functioning, memory, mood, and alertness.

Accident Risk

Research suggests that fatigue-related errors are common well before the point at which an individual no longer can stay awake. Inattention may get much of the blame, but fatigue often is the culprit. Thus, fatigue studies likely are a conservative estimate of the overall incidence of reported fatigue-related accidents. "Human fatigue is now recognized around the world as being the main cause of accidents in the transportation industry." (14)

In addition to studying the direct link between accidents and fatigue, experts also have thoroughly researched the cognitive impairment thought to mediate the relationship. Major findings show that mood, attitude, and cognitive performance (judgment and competence) deteriorate with sleep deprivation. (15) Moreover, research shows that fatigue is four times more likely to cause workplace impairment than alcohol and other drugs. (16) Ironically, alcohol and drug abuse normally are addressed immediately by management. However, the lack of sleep, probably the most common condition adversely affecting personnel performance, often is ignored.

Fatigue in and of itself is not the key problem. Rather, the risks associated with fatigue impairment include poor judgment, accidents, and injuries. As such, fatigue is a context-dependent safety hazard, an important distinction because it can carry a significant risk in some situations and little or none in others. In some cases, fatigue-induced impairment and accidents may be inconsequential, creating only minor delays in completing a task, or may be detected by checks and balances (e.g., search warrants and fact patterns for probable cause court hearings are reviewed, checked, and proofread for accuracy before submission to judicial systems). In other situations, however, the risks of equipment damage, personal injury, and public safety can be far greater.

Reduced Social Time

The primary effect for law enforcement professionals working long hours is reduced social interactions and isolation from traditional community and social support systems, resulting in the "us against them" point of view. Furthermore, studies have shown that long work hours negatively impact an individual's family relations. (17)

Health Consequences

Fatigue is a symptom common to many diseases directly related to irregularity of daily life. Higher consumption of alcohol, caffeine, and tobacco; reduced physical exercise; stress; depression; social isolation; unbalanced diet and nutrition; and irregularity of daily meals all are hallmarks of law enforcement personnel around the world and can lead to an unhealthy increase in weight gain. (18) In fact, literature has indirectly linked long and irregular work hours with negative health issues to include disruptions of the body's biological rhythms, which may--

* change eating and sleeping habits; (19)

* raise blood pressure; (20)

* affect psychological well-being; (21)

* cause negative effects for pregnant women and fertility rates; (22) and

* result in gastrointestinal disorders, (23) stress-related disability claims, decreased productivity, and increased absenteeism. (24)

Recommendations

Law enforcement agencies should make a concerted effort to provide a strong and coherent research base for the development of sound policies. Equating fatigue-related impairment to blood-alcohol equivalent gives policy makers, employees, and community leaders a clear index of the extent of impairment associated with fatigue. Agencies should develop preventative strategies to implement within the diverse range of political, economic, and social environments in which the law enforcement community functions and ensure cooperation with federal, state, and local court systems.

Departments should establish strict policies and implement effective enforcement regarding employee moonlighting. Administrators should review the policies, procedures, and practices that affect shift scheduling, overtime, rotation, the number of work hours allowed, and the way the organization deals with overly tired employees. Administrators should review recruit, supervisor in-service, and roll-call training, as well as executive retreats, to determine if personnel receive adequate information about the importance of good sleep habits, the hazards associated with fatigue and shift work, and strategies for managing them. Are personnel taught to view fatigue as a safety issue? Agencies should consider either implementing and enforcing regulations regarding a strict time-based work/rest policy, placing responsibility on the organization, or an education-based policy that focuses responsibility on the individual.

Finally, agencies should consider several different work/rest rules. The most common policy is the 16/8 formula. For every 16 hours of work, departments must provide 8 hours of rest time. Work/rest policies are most appropriate for agencies that have sufficient manpower to work in shifts. If resources are limited, managers may have to choose between using volunteers/reserves, implementing mutual aid agreements, or declaring an emergency and breaking the work/rest policy; therefore, any policy must include flexibility. Also, officers should not consider vacations just as missed days of work. They should turn off their cell phones and advise courts of scheduled leave. They always should take the time off that their departments provide and use it, remembering that no one is irreplaceable.

Conclusion

Modern law enforcement practices have developed well-entrenched unwritten rules that treat sleep in utmost disregard and disdain. Agencies often encourage and reward workaholics. A recent news report covering a large party proudly declared: "Four hours into his second 12-hour shift, [the officer] has been busy answering questions, giving directions, listening to drunken declarations of love, and drunken jokes amid the endless roar of the crowd."

When a person is deprived of sleep, actual changes occur in the brain that cannot be overcome with willpower, caffeine, or nicotine. The decline in vigilance, judgment, and safety in relation to the increase in hours on the job cannot be trivialized. Community perceptions of fatigue-related risk have changed and now are viewed as absolutely unacceptable, as well as preventable. As a consequence, law enforcement professionals face a greater reactive pressure both politically and legally to rethink and implement proactive strategies to reduce fatigue-related incidents.

Fatigue is a serious, challenging problem that requires informed, forward-thinking managers to take action sooner, rather than later. Police leaders and sleep research experts need to work in concert to assess each individual agency to minimize the threat that fatigue poses to the community and the individual law enforcement professional. Fatigue is not just an industrial issue to negotiate between employers, unions, and employees but an occupational health, commercial, and public safety concern. Local, state, and federal law enforcement organizations that fail to sensibly manage fatigue today certainly will face a broad range of damaging and enduring legal, ethical, physiological, and personal consequences in the future.

Endnotes

(1) N. Lamond and D. Dawson, "Quantifying the Performance Impairment Associated with Fatigue," Journal of Sleep Research 8 (1999): 255-262.

(2) Ibid.

(3) J. Arendt, G. Wilde, P. Munt, and A. McLean, "How Do Prolonged Wakefulness and Alcohol Compare in the Decrements They Produce on a Simulated Driving Task?" Accident Analysis and Prevention 33, no. 3 (2001): 337-344.

(4) Similar levels of decrement in driving performance have been reported; see N. Powell, K. Schnecchtman, R. Riley, K. Li, R. Troell, and C. Guillcminault, "The Road to Danger: The Comparative Risks of Driving When Sleepy," Laryngoscope 111, no. 5 (2001): 887-893.

(5) William C. Dement, M.D., Ph.D., in Brian Vila, Tired Cops: The Importance of Managing Police Fatigue (Washington, DC: Police Executive Research Forum. 2000): xiv.

(6) Lawson Savery, "Long Hours at Work: Are They Dangerous and Do People Consent to Them?" (Curtin University, Australia).

(7) European Transport Safety Council.

(8) U.S. National Library of Medicine and the National Institutes of Health.

(9) The author bases this conclusion on his extensive research on this topic.

(10) J.C. Carey and J.I. Fishburne, "A Method to Limit Working Hours and Reduce Sleep Deprivation in an Obstetrics and Gynecology Residency Program," Obstetrics and Gynecology 74, no. 4 (1989): 668-672.

(11) Information in this paragraph is derived from "Sleep: Your Body's Means of Rejuvenation"; retrieved on November 28, 2006, from http://health.yahoo.com/topic/sleep/overview/article/mayoclinic/F422495-751C-4684-A0A50B88AB19B576.

(12) Royal Society for the Prevention of Accidents, "Driver Fatigue and Road Accidents: A Literature Review and Position Paper," February 2001; retrieved on December 5, 2006, from http://www.rospa.com/roadsafety/info/fatigue.pdf.

(13) Y. Harrison and J.A. Home, "The Impact of Sleep Deprivation on Decision Making: A Review," Journal of Experimental Psychology Applied 6 (April 2000): 236-249.

(14) http://www.aph.gov.au/house/committee/cita/manfatigue/mfcontents.htm

(15) A. Nocera and D.S. Khursandi, "Doctors' Working Hours: Can the Medical Profession Afford to Let the Courts Decide What Is Reasonable?" Medical Journal of Australia 168 (1998): 616-618.

(16) T. Akerstedt, "Consensus Statement: Fatigue and Accidents in Transportation Operations," Journal of Sleep Research 9 (2000): 395.

(17) D.L. Bosworth and P.J. Dawkins, "Private and Social Costs and Benefits of Shift and Nightwork," in Night and Shiftwork Biological and Social Aspects: Advances in the Biosciences 30, eds. A. Reinberg, N. Vieux, and P. Andlauer (Paris, France: Pergamon Press, 1980), 207-213.

(18) M. Shields, "Long Working Hours and Health," Health Rep 11, no. 2 (1999): 33-48.

(19) G. Costa, "The Impact of Shift and Night Work on Health," Applied Ergonomics 27, (1996): 9-16.

(20) T. Uehata, "Long Work Hours and Occupational Stress-Related Cardiovascular Attacks Among Middle-Aged Workers in Japan," J. Hum Ergol 20, no. 2 (1991): 147-153.

(21) S. Babbar and D. Aspelin, "The Overtime Rebellion: Symptom of a Bigger Problem? (Implications of Forced Overtime)," The Academy of Management Executive 12, (1998): 68-77.

(22) C.W. Henderson, "Study Links Long Hours, Job Stress to Miscarriages," Women's Health Weekly, June 9-16, 1997, 9-10.

(23) G. Costa, "Shift Work and Health," Med Lav 90, no. 6 (1997): 739-751.

(24) C. Mulcany, "Workplace Stress Reaches Epidemic Proportion," National Underwriter 95, no. 4 (1991): 20-21.
The woods are lovely, dark and deep.
But I have promises to keep,
And miles to go before I sleep,
And miles to go before I sleep.
--Robert Frost


By DENNIS LINDSEY, M.Ed.

RELATED ARTICLE: Results of Lack of Sleep
 1. Irritability with coworkers, family, or friends
 2. Inability to remain alert to respond to the demands of work
 3. Memory impairment
 4. Lack of concentration
 5. Lower frustration tolerance
 6. Accidents on the job or in the home
 7. Stress-related illness caused, in part, by a compromised immune
 system
 8. Inattention
 9. Obesity
10. Hypertension
11. Changes in metabolic functions
12. Alteration of hormonal functions in ways that mimic aging
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Author:Lindsey, Dennis
Publication:The FBI Law Enforcement Bulletin
Date:Aug 1, 2007
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