Preliminary risk management system for work-related fatigue among shift workers in the industrial context of Thailand: A review article
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Abstract
Shift workers play a significant role in Thailand’s industrial development. However, shift work has been associated with various adverse health effects, particularly work-related fatigue. The literature indicates that work-related fatigue can be attributed to two main group of factors (1) individual factors, especially poor sleep quality, and (2) work-related factors, including shift schedules, workload intensity, and suboptimal working conditions. Work-related fatigue poses substantial risks in several areas. From a health standpoint, it contributes to circadian rhythm disturbances, increases vulnerability to non-communicable diseases, and is associated with mental health problems. In terms of occupational safety, fatigue increases the probability of workplace accidents. Additionally, it impairs work performance and reduces productivity. To address these concerns, Fatigue Risk Management System (FRMS) is proposed as a structured, evidence-based workplace intervention. Core components of an FRMS include workload management, shift design, employee educational programs, sleep disorder management, improvements to the work environment, and assessment of workers’ fitness for duty. Although the FRMS is not currently mandated under Thai occupational safety regulations, its implementation in the workplace is recommended. It offers a proactive approach to mitigating fatigue among shift workers, strengthens occupational health and safety standards, and enhances overall worker well-being in alignment with sustainable development goals.
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References
Thailand Board of Investment. Manufacturing and economic statistics [Internet]. Bangkok: Thailand Board of Investment; 2025 [cited 2025 Jun 2]. Available from: https://www.boi.go.th/index.php?page=thailand_rankings&language=de
Thailand National Economic and Social Development Council. Gross Domestic Product Q1 2025 [Internet]. Bangkok: Thailand National Economic and Social Development Council; 2025 [cited 2025 Jun 3]. Available from: https://www.nesdc.go.th/nesdb_en/article_attach/article_file_20250522135601.pdf
National Statistical Office. Results of survey on employment status of the population, first quarter 2025 [Internet]. Bangkok: National Statistical Office; 2025 [cited 2025 Jun 10]. Available from: https://www.nso.go.th/nsoweb/storage/survey_detail/2025/20250513150357_11330.pdf. (in Thai)
U.S. Bureau of Labor Statistics. The effects of shift work on the lives of employees. Monthly Labor Review [Internet]. 1981 [cited 2025 Jun 11]. Available from: https://www.bls.gov/opub/mlr/1981/10/art5full.pdf
Ogeil RP, Savic M, Ferguson N, Lubman DI. Shift-Work-Play: understanding the positive and negative experiences of male and female shift workers to inform opportunities for intervention to improve health and wellbeing. Aust J Adv Nurs. 2021;38(2):23–33.
Vitaterna MH, Takahashi JS, Turek FW. Overview of circadian rhythms. Alcohol Res Health. 2001;25(2):85–93.
Reddy S, Reddy V, Sharma S. Physiology, Circadian Rhythm [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2024 Jun 29]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519507/
Richards J, Gumz ML. Mechanism of the circadian clock in physiology. Am J Physiol Regul Integr Comp Physiol. 2013;304(12):R1053–64.
Lerman SE, Eskin E, Flower DJ, George EC, Gerson B, Hartenbaum N, et al. Fatigue risk management in the workplace. J Occup Environ Med. 2012;54(2):231–58.
Health and Safety Executive. Managing shiftwork: Health and safety guidance. London: Health and Safety Executive; 2006.
International Labour Office. Shift work [Information Sheet No. WT-8]. Conditions of Work and Employment Programme, Social Protection Sector. Geneva: International Labour Office; 2004.
Rivera AS, Akanbi M, O’Dwyer LC, McHugh M. Shift work and long work hours and their association with chronic health conditions: a systematic review of systematic reviews with meta-analyses. PLoS One. 2020;15(4):e0231037.
James SM, Honn KA, Gaddameedhi S, Van Dongen HPA. Shift work: disrupted circadian rhythms and sleep—implications for health and well-being. Curr Sleep Med Rep. 2017;3(2):104–12.
Harrington JM. Health effects of shift work and extended hours of work. Occup Environ Med. 2001;58(1):68–72.
Kervezee L, Kosmadopoulos A, Boivin DB. Metabolic and cardiovascular consequences of shift work: the role of circadian disruption and sleep disturbances. Eur J Neurosci. 2020;51(1):396–412.
International Agency for Research on Cancer. Night shift work [Internet]. IARC Monographs on the Identification of Carcinogenic Hazards to Humans, vol. 124. Lyon: International Agency for Research on Cancer; 2020 [cited 2025 Jun 10]. Available from: https://publications.iarc.fr/593
McHugh M, French DD, Kwasny MM, Maechling CR, Holl JL. The impact of shift work and long work hours on employers’ health care costs. J Occup Environ Med. 2020;62(12):1006–10.
Rosenberg R, Doghramji P. Is shift work making your patient sick? Emerging theories and therapies for treating shift work disorder. Postgrad Med. 2011;123(5):106–15.
Canadian Centre for Occupational Health and Safety. Shift work [Internet]. Hamilton (ON): CCOHS; 2023 [cited 2025 Jun 11]. Available from: https://www.ccohs.ca/oshanswers/ergonomics/shiftwrk.html
Safe Work Australia. Guide for managing the risk of fatigue at work [Internet]. Canberra: Safe Work Australia; 2013 [cited 2024 Jun 12]. Available from: https://www.safeworkaustralia.gov.au/system/files/documents/1702/managing-the-risk-of-fatigue.pdf
Shen J, Botly LCP, Chung SA, Gibbs AL, Sabanadzovic S, Shapiro CM. Fatigue and shift work. J Sleep Res. 2006;15(1):1–5.
Government of Queensland. Preventing and managing fatigue-related risk in the workplace [Internet]. Brisbane: Government of Queensland; 2020 [cited 2024 Jun 14]. Available from: https://www.worksafe.qld.gov.au/__data/assets/pdf_file/0018/26109/preventing-and-managing-fatigue-related-risk-in-the-workplace.pdf
Queensland Health. Fatigue risk management systems: implementation guideline QH-GDL-401-3.3:2021 [Internet]. Brisbane: Queensland Health; 2021 [cited 2024 Jun 14]. Available from: https://www.health.qld.gov.au/__data/assets/pdf_file/0033/1137975/qh-gdl-401-3.3.PDF
Taillard J, Gronfier C, Bioulac S, Philip P, Sagaspe P. Sleep in normal aging, homeostatic and circadian regulation and vulnerability to sleep deprivation. Brain Sci. 2021;11(8):1003.
Leung P, Li SH, Graham BM. The relationship between repetitive negative thinking, sleep disturbance, and subjective fatigue in women with generalized anxiety disorder. Br J Clin Psychol. 2022;61(4):666–79.
Gavelin HM, Neely AS, Dunås T, Eskilsson T, Järvholm LS, Boraxbekk CJ. Mental fatigue in stress-related exhaustion disorder: structural brain correlates, clinical characteristics and relations with cognitive functioning. Neuroimage Clin. 2020;27:102337.
McCulloch K, Baker A, Ferguson S, Fletcher A, Dawson D. Developing and implementing a fatigue risk management system. Ottawa: Transport Canada; 2007.
Jansen NWH, van Amelsvoort LGPM, Kristensen TS, van den Brandt PA, Kant IJ. Work schedules and fatigue: a prospective cohort study. Occup Environ Med. 2003;60 Suppl 1:i47-i53.
Jaiyong R, Prasittichok K, Hanpresertpong J. Accessibility to health service for prevention and control of migrant workers granted permission for working in Metropolitan Bangkok. Journal of Medical and Public Health Region 4 [Internet]. 2023 [cited 2024 Apr 16];13(3):110–22. Available from: https://he01.tci-thaijo.org/index.php/JMPH4/article/view/263641
Caldwell JA, Caldwell JL, Thompson LA, Lieberman HR. Fatigue and its management in the workplace. Neurosci Biobehav Rev. 2019;96:272–89.
The Port Health and Safety Leadership Group. Building a fatigue risk management system: good practice guidelines for the ports industry [Internet]. [place unknown]: The Port Health and Safety Leadership Group; 2022 [cited 2025 Jan 17]. Available from: https://www.maritimenz.govt.nz/media/w0aby0rz/building-fatigue-risk-management-system-guidelines.pdf
Dawson D, McCulloch K. Managing fatigue: it’s about sleep. Sleep Med Rev. 2005;9(5):365–80.
Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. American Academy of Sleep Medicine; Sleep Research Society. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015;38(6):843–4.
Moore-Ede MC. Evolution of fatigue risk management systems [Internet]. 2nd ed. Massachusetts: Circadian Information LP; 2010 [cited 2024 Jun 29]. Available from: https://circadian.com/white-paper-evolution-of-fatigue-risk-management-systems
IPIECA, IOGP. Managing fatigue in the workplace: appendix 10.4 – Samn-Perelli fatigue checklist [Internet]. London: IPIECA–IOGP; 2019 [cited 2025 Jan 17]. Available from: https://www.ipieca.org/resources/managing-fatigue-in-the-workplace
Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540–5.
Methipisit T, Mungthin M, Saengwanitch S, Ruangkana P, Chinvarun Y, Ruangkanchanasetr P, et al. The development of sleep questionnaires Thai version (ESS, SA-SDQ, and PSQI): linguistic validation, reliability analysis and cut-off level to determine sleep related problems in Thai population. J Med Assoc Thail. 2016;99(8):893–903.
Ministry of Labour. Ministerial Regulation prescribing standards for the management, administration, and operations regarding safety, occupational health, and working environment related to heat, light, and sound, B.E. 2559 (2016). Bangkok: Government Gazette; 2016.
Sadeghniiat-Haghighi K, Yazdi Z. Fatigue management in the workplace. Ind Psychiatry J. 2015;24(1):12–7.
Federal Aviation Administration. Safety Management System (SMS) explained – components [Internet]. Washington (DC): Federal Aviation Administration; 2021 [cited 2024 Apr 20]. Available from: https://www.faa.gov/about/initiatives/sms/reference_library/policy_and_requirements
Civil Aviation Authority of Thailand. Manual of standards – Air traffic services (MOS ATS) [Internet]. Bangkok: Civil Aviation Authority of Thailand; 2020 [cited 2024 Jun 20]. Available from: https://www.caat.or.th/wp-content/uploads/2020/02/MOS-ATS-%E0%B8%9C%E0%B8%AD.%E0%B8%81%E0%B8%9E%E0%B8%97.-%E0%B8%A5%E0%B8%87%E0%B8%99%E0%B8%B2%E0%B8%A1.pdf
Sprajcer M, Thomas MJW, Sargent C, Crowther ME, Boivin DB, Wong IS, et al. How effective are fatigue risk management systems (FRMS)? A review. Accid Anal Prev. 2022;165:106398.
United Nations in Thailand. Sustainable Development Goals [Internet]. Bangkok: United Nations in Thailand; 2025 [cited 2025 Jun 2]. Available from: https://www.thailand.un.org/th/sdgs
Ministry of Labour. Labour Protection Act B.E. 2541 (1998). Bangkok: Government Gazette; 1998.
National Institute for Occupational Safety and Health. Overtime and extended work shifts: recent findings on illnesses, injuries, and health behaviors [Internet]. Cincinnati (OH): NIOSH; 2004 [cited 2025 Aug 12]; Available from: https://www.cdc.gov/niosh/docs/2004-143/
