Fatigue & Performance

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A Corporate Nutrition article by London Nutritionist Sylvia Hensher

Prevalence of fatigue among the workforce

Fatigue is an everyday experience common among the general working population, with UK prevalence estimates as high as 22% 1 and US prevalence rates ranging as high as 45% 2. Broadly defined as “a feeling of weariness, tiredness or lack of energy,” 3.  Fatigue is best viewed on a continuum with behavioural, emotional and cognitive components 4.

Causes of hazardous fatigue

Fatigue is caused by prolonged periods of physical and/or mental exertion without enough time to rest and recover. By the end of the day, some fatigue is normal but hazardous levels of fatigue can be due to one or more of the following:

  • Feeling stressed for extended periods
  • Excessive workloads
  • Long shifts
  • Working long hours in total over the week or longer periods
  • Working nights
  • Inadequate sleep, particularly over extended periods
    • Iron deficiency anaemia
    • Chronic pain
    • Infections, such as flu
    • Depression
    • Anxiety
    • Cancer
    • Thyroid dysfunction
    • Diabetes
    • Chronic fatigue syndrome (CFS)
    • Lifestyle factors: obesity, insufficient physical activity 5, environmental stressors (eg, personal relationships)
      • Psychosocial work characteristics: job demand, decision latitude, social support, and job strain6

The effects of fatigue on work performance

Employees with fatigue experience more concomitant physical health problems, bodily pain, poorer general health, vitality, and social functioning than workers without fatigue 7. Fatigue has been associated with accidents, injuries 8, and ill-health 9, 10, all of which indirectly impair work performance. Fatigue can also restrict an individual’s ability to compensate physically or mentally for functional impairment from other concurrent health conditions 11.

However, fatigue also directly negatively impacts on work performance 12, 13 since employees with fatigue are significantly more likely to miss work and experience long-term work absence than those without fatigue 14. Research suggests that the majority of lost productivity time is nevertheless due to reduced performance while at work, not work absence 15. This is referred to as “presenteeism,” where employees are physically at work but performing at less than full capacity because they feel stressed, sick, injured, or distracted 16. For example, fatigue has been shown to reduce work performance by interfering with concentration and increasing the time needed to accomplish tasks 17.  Perhaps not surprisingly, research has found that workers in high-control (i.e. high decision latitude) jobs experience higher prevalence of fatigue than workers in low control jobs, possibly because the increased job stress that can come with a high-control job is linked to a higher prevalence of fatigue 18.

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References

1.        Bultmann U  Kant I Kasl SV Beurskens AJ van den Brandt PA (2002) Fatigue and psychological distress in the working population: psychometrics, prevalence and correlates. J Psychosom Res 52 445-452

2.       Ricci JA  Chee E Lorandeau AL Berger J (2007) Fatigue in the U.S. workforce: prevalence and implications for lost productive work time. J Occup Environ Med 49 1 1-10

3.       Medline Plus. Medical Encyclopedia (2011) Fatigue.US National Library of Medicine and the National Institutes of Health. Last accessed online 27.7.2011 at http://www.nlm.nih.gov/medlineplus/fatigue.html

4.      Beurskens AJ Bültmann U Kant I Vercoulen JH Bleijenberg G Swaen GM Beurskens AJHM et al (2000) Fatigue among working people: validity of a questionnaire measure. Occup Environ Med 57 353-357

5.       Chen MK (1986) The epidemiology of self-perceived fatigue among adults. Prev Med 15 174-8

6.      Andrea H Kant IJ Beurskens AJ Metsemakers JF Van Schayck CP (2003)  Associations between fatigue attributions and fatigue, health, and psychosocial work characteristics: a study among employees visiting a physician with fatigue.   Occup Environ Med 60 Suppl 1 i99-104

7.       Ricci JA  Chee E Lorandeau AL Berger J (2007) Fatigue in the U.S. workforce: prevalence and implications for lost productive work time. J Occup Environ Med 49 1 1-10

8.      Bonnet MH & Arand DL (1995) We are chronically sleep deprived. Sleep 18 908-911

9. Charlton SG & Baas P (2001) Fatigue, work-rest cycles, and psychomotor performance of New Zealand truck drivers. NZ J Psychol  30 32-39

10.    Leone SS Huibers MJ Kant I Van Schayck CP Bleijenberg G André Knottnerus  (2006) Long-term predictors of outcome in fatigued employees in sick leave: a 4-year follow-up study. Psychol Med 36 1293-1300

11.     Ricci JA  Chee E Lorandeau AL Berger J (2007) Fatigue in the U.S. workforce: prevalence and implications for lost productive work time. J Occup Environ Med 49 1 1-10

12.    Beurskens AJ Bültmann U Kant I Vercoulen JH Bleijenberg G Swaen GM Beurskens AJHM et al (2000) Fatigue among working people: validity of a questionnaire measure. Occup Environ Med 57 353-357

13. Charlton SG & Baas P (2001) Fatigue, work-rest cycles, and psychomotor performance of New Zealand truck drivers. NZ J Psychol  30 32-39

14.    Janssen N Kant IJ Swaen GM Janssen PP Schröer CA (2003) Fatigue as a predictor of sickness absence: results from the Maastricht cohort study on fatigue at work. Occup Environ Med 60 Suppl 1 i71-6

15.    Ricci JA  Chee E Lorandeau AL Berger J (2007) Fatigue in the U.S. workforce: prevalence and implications for lost productive work time. J Occup Environ Med 49 1 1-10

16.    Harvard business Review (2004) Presenteeism: At Work—But Out of It last accessed 2.5.2011 at http://www.ihpm.org/pdf/HBR%20Presenteeism.pdf

17.    Ricci JA  Chee E Lorandeau AL Berger J (2007) Fatigue in the U.S. workforce: prevalence and implications for lost productive work time. J Occup Environ Med 49 1 1-10

18.    Ricci JA  Chee E Lorandeau AL Berger J (2007) Fatigue in the U.S. workforce: prevalence and implications for lost productive work time. J Occup Environ Med 49 1 1-10

19.    Mohren DC  Swaen GM  Kant IJ Borm PJ Galama JM (2001) Associations between infections and fatigue in a Dutch working population: results of the Maastricht Cohort Study on Fatigue at Work. Eur J Epidemiol 17 1081-1087

20.   Janssen N Kant IJ Swaen GM Janssen PP Schröer CA (2003) Fatigue as a predictor of sickness absence: results from the Maastricht cohort study on fatigue at work. Occup Environ Med 60 Suppl 1 71-6

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