Health and Wellness

Safety Summit 2019: How Must EHS Address Fatigue, Stress, and Well-Being?

At BLR’s Safety Summit 2019, taking place April 8-10 in Austin, Texas, Sionnain McNally, OSH Services Manager for the Manufacturing Safety Alliance of British Columbia, presented a session on the need for safety professionals to broaden their perspective on workplace safety to encompass mental health, stress, fatigue, and other factors affecting employee well-being.


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McNally stressed both the prevalence and the safety impact of fatigue, stress, and mental health. With one in five Americans suffering from a mental health issue, no organization is immune from these challenges. Workplace stress leads to $300 billion in lost productivity every year in the United States alone, and 1 million workers are absent each day due to fatigue, stress, and mental health issues.


A 2014 study by WorkSafeBC on the relative impairment caused by fatigue compared to alcohol found that being awake for 17 hours was equivalent to a blood alcohol concentration (BAC) of 0.05. After 21 hours, the impairment is equivalent to a BAC of 0.08. And after 24-25 hours awake, the impairment is equivalent to a BAC of 0.1. An employee performing safety-sensitive work in a sleep-deprived state—or even driving home at the end of a long shift—presents a significant hazard to him- or herself and others.

Causes of fatigue in the workplace include:

  • Workload and schedule. The type of work (e.g., physical labor vs. sedentary work) and the work schedule (e.g., shift timing and length, consecutive days on and off) both contribute to the likelihood of fatigue hazards.
  • Environmental exposures. Factors such as lighting, temperature, comfort, and noise levels can all function either to exacerbate or to mitigate fatigue hazards.
  • Health considerations. Personal health factors such as sleep apnea, insomnia, and depression can interfere with both the quantity and quality of sleep and increase the risk of fatigue-related incidents.

To reduce fatigue risks, McNally recommended the following steps:

  • Take life activities outside of work into account when assessing fatigue risk.
  • Treat fatigue as a form of impairment and manage the hazards accordingly.
  • Balance workloads, staffing, and shift schedules to minimize fatigue hazards.
  • Train employees on fatigue hazards and mitigation strategies, and encourage frequent breaks to maintain alertness.


A 1999 study by the National Institute for Occupational Safety and Health (NIOSH) found that 26% of respondents were experiencing burnout at work, and 40% indicated high or extreme stress. Nearly 20 years later, a 2017 Harris Poll found that 61% of respondents were experiencing burnout, with 31% indicating high or extreme stress.

These figures translate into significant negative health impacts, from fatigue and anxiety to weight gain, lack of mental focus, anger, and depression. Internal factors that contribute to stress include:

  • Job security worries;
  • Changing job requirements and skills;
  • Poor management;
  • Feeling underskilled to perform a job;
  • Toxic office cultures; and
  • Being expected to possess certain job skills without receiving training.

Prolonged exposure to stressors on the job and critical incidents at work can also create significant stress. To mitigate the impact of stress at work, McNally recommended the following elements:

  • Foster open communication. In the absence of information following a critical event or incident, rumors will circulate—and rumors often disseminate misinformation that is worse than the facts. Open, proactive communication can head off this tendency.
  • Plan for traumatic events. McNally emphasized that in the wake of a critical event, processing and discussing the incident within 24 to 48 hours is crucial for stress reduction. In order to allow this, explore the available support mechanisms at your organization before they are needed. What form of counseling is available, and how quickly can it be mobilized? What role do your benefit providers play in connecting employees with appropriate services to process trauma? These are questions to explore and answer proactively.
  • Lead by example and promote stress relief. If employees witness company leaders and managers dealing with stressful situations in a healthy manner and striking an appropriate work-life balance, they are more likely to follow suit themselves.
  • Support the supervisor-employee bond. McNally emphasized the critical role of a strong relationship between supervisors and their direct reports in identifying and mitigating workplace stress. If supervisors have genuine caring relationships with their direct reports, they will be in a better position to identify out-of-character behavior that may be a red flag indicating high stress, and employees will be more likely to seek out support when they need it.

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Mental Health

Despite the prevalence of mental health issues, a stigma persists, and 50% to 60% of adults with mental health issues do not receive appropriate treatment. These untreated issues negatively impact worker productivity and lead to increased absenteeism, presenteeism, workers’ compensation claims, and short-term disability.

Mental health may seem to be outside of a safety professional’s wheelhouse, noted McNally, but untreated mental health issues produce ripple effects with the potential for profound safety impacts. For example, absenteeism puts increased pressure on the rest of the workforce by reducing workflow. In an effort to compensate for lost productivity, employees may be more likely to take shortcuts that lead to injuries.

McNally outlined a “life cycle” of mental health issues:

  • Healthy at work
  • At work, but struggling
  • At work, but off sick
  • Not at work for less than 1 year
  • Not at work for more than 1 year
  • Never worked

Each successive step in this cycle imposes increased costs on the individual, the employer, and society as a whole, but employers can play a critical role in keeping individuals at work and preventing a destructive downward spiral.

To achieve this, McNally emphasized the importance of removing the stigma surrounding mental health issues and seeking to put support systems in place to assist employees who may be struggling. Employees must be a part of this process, he stressed. They need to know when and how to ask for help and how to recognize the signs of an issue.

On the employer side, mental health must be embedded into the organization through a caring, supportive culture. Employers should be aware of the lifestyle factors that may affect their employees’ mental health, have resources in place to support mental health challenges, and periodically seek feedback from employees on the effectiveness of their offerings through a continuous improvement process.

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