Fatigue-proofing: a new approach to reducing fatigue-related risk using the principles of error management.

In this review we introduce the idea of a novel group of strategies for further reducing fatigue-related risk in the workplace. In contrast to the risk-reduction achieved by reducing the likelihood an individual will be working while fatigued (e.g., by restricting hours of work), fatigue-proofing strategies are adaptive and protective risk-reduction behaviours that improve the resilience of a system of work. That is, they increase the likelihood that a fatigue-related error will be detected and not translate into accident or injury, thus reducing vulnerability to fatigue-related error. The first part of the review outlines the theoretical underpinnings of this approach and gives a series of ethnographically derived examples of informal fatigue-proofing strategies used in a variety of industries. A preliminary conceptual and methodological framework for the systematic identification, development and evaluation of fatigue-proofing strategies is then presented for integration into the wider organisational safety system. The review clearly identifies fatigue-proofing as a potentially valuable strategy to significantly lower fatigue-related risk independent of changes to working hours. This is of particular relevance to organisations where fatigue is difficult to manage using reductions in working hours due to operational circumstances, or the paradoxical consequences for overall safety associated with reduced working hours.