Alertness, Medication, and Job Safety

On June 12, 2013, Scripta founder Dr. Paul S. Bradley welcomed a group of physicians and executives to a meeting of its Physicians Advisory Board.

Now in its third year, the Physicians Advisory Board gives Scripta’s corporate clients an opportunity to discuss medical issues of utmost relevance to the client’s business and to make local doctors aware of unique industry conditions that may impact treatment of the client’s employees.

A Unique Opportunity to Impact Care 

The idea has been to create an opportunity for feedback, by way of ensuring the very best care for the employee. As Dr. Bradley puts it, “To my knowledge, this is a unique arrangement. Normally, insurance is the only thing that links us together.

“Physicians and HR executives never meet. But we probably ought to, and today these caregivers are here of their own free will and incredible graciousness to meet with executives from a great company that goes out of its way to take care of its employees.”

The Physiological Effects of Sleep Deprivation 

For the past two years, one Scripta client has been developing a Safety Management System, which includes a Fatigue Management Program. Chris Hallman (formerly of Baines Simmons Americas) was on hand to talk about wakefulness in the workplace and to ask participating doctors to give special attention to the ways in which their recommended treatments might impact alertness.

It is well known that fatigue impacts accuracy, timing, attention span, focus, and our ability to integrate information, and it stands to reason that the dangers of prolonged wakefulness for those working in high-criticality jobs in manufacturing and transportation safety are significant.

Mr. Hallman pointed out a less well-known fact: “The more tired we get, the worse we are at judging how tired we actually are.”

Research indicates that sleep deprivation affects physiology in several unexpected ways, impacting our circadian rhythms and disrupting the systems that regulate both circulation and body temperature.

Most dangerous is the threat of micro-sleep. Mr. Hallman again shared research to go along with anecdotal evidence. We have all experienced that moment, many of us while driving, when we jerk suddenly awake from an instant’s sleep. Alarmingly, these mini-naps—measured in just fractions of seconds—can occur long before we feel any of the more familiar symptoms of fatigue.

Physician Advisory Board Recommendations

The results of prolonged wakefulness can be catastrophic.

Fatigue was one of the contributing factors in the near meltdown at Three Mile Island, the wreck of Exxon Valdez, and preceding the disastrous final flight of the space shuttle Challenger.

“Sleep disorders are mainly undiagnosed,” said Dr. James A. Daly, Director of Southeast Sleep Disorders Center in Savannah, Georgia. “A full twenty percent of the U.S. population may have undiagnosed sleep apnea and/or insomnia.”

The meeting concluded with the recommendation that a sleep test be administered to any employee with a BMI of 35 or greater or a collar size greater than 18. Doctors were also asked to give special consideration to the potential impact of treatment recommendations on patient alertness.


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