Developing a Canadian fatigue risk management standard for first responders: Defining the scope

Abstract

Fatigue is a pervasive problem in first responder occupations, potentially leading to acute effects (e.g. work performance, increased accident risk) and long-term outcomes (e.g., precursor to musculoskeletal disorders, cardiovascular disease, mental health disorders). Reducing and managing fatigue is essential to protect both the first responder and the public they serve. In Canada, a national occupational standard on fatigue risk management is being developed for first responders, an umbrella term of police, firefighters, and paramedics/EMS personnel. We conducted a scoping review of peer-reviewed literature, to examine how fatigue has been conceptualized within each of the three occupations, and to identify differences or similarities based on types of risk factors and outcomes, that should be accounted for in a standard for first responders. We found that the distribution of papers based on the type of fatigue, risk factors, and outcomes differed between occupations. There were stronger similarities in the distribution of outcome types between police and firefighting; physical outcomes were the main focus in all three occupations. Of the papers that describe the link between risk factor, fatigue, and outcome, we found that burnout, cognitive fatigue, and physical fatigue were associated with adverse health and performance outcomes. We recommend that a fatigue risk management standard for first responders should consider managing fatigue of any type and include both workplace and personal/social/cultural risk factors to prevent both short- and longer-term outcomes.