Occupational fatigue, underlying sleep and circadian mechanisms, and approaches to fatigue risk management

In most occupational settings, a primary reason for fatigue is incompatible timing of duty schedules relative to circadian (i.e., 24-hour) rhythm and the need for sleep. This review describes the sleep-related neurobiology of fatigue; factors in the operational environment that contribute to fatigue; and the effects of fatigue on cognitive performance that lead to errors, incidents, and accidents. A range of fatigue countermeasures are reviewed, broadly categorized as preventive countermeasures and operational countermeasures. Fatigue-related optimization of duty schedules and fatigue risk management systems are discussed as comprehensive ways to reduce fatigue and increase safety while maintaining productivity and operational integrity. Occupational fatigue is of significant concern at the individual, organizational, and societal levels, and strategies have been developed to help successfully manage and mitigate fatigue at each level.