Fatigue can be a significant problem for commercial motor vehicle (CMV) drivers. The lifestyle of a long-haul CMV driver may include long and irregular work hours, inconsistent sleep schedules, poor eating and exercise habits, and mental and physical stress, all contributors to fatigue. Shiftwork is associated with lacking, restricted, and poor-quality sleep and variations in circadian rhythms, all shown to negatively affect driving performance through impaired in judgment and coordination, longer reaction times, and cognitive impairment. Overweight and obesity may be as high as 90% in CMV drivers, and are associated with prevalent comorbidities, including obstructive sleep apnea, hypertension, and cardiovascular and metabolic disorders. As cognitive and motor processing declines with fatigue, driver performance decreases, and the risk of errors, near crashes, and crashes increases. Tools and assessments to determine and quantify the nature, severity, and impact of fatigue and sleep disorders across a variety of environments and populations have been developed and should be critically examined before being employed with CMV drivers. Strategies to mitigate fatigue in CMV operations include addressing the numerous personal, health, and work factors contributing to fatigue and sleepiness. Further research is needed across these areas to better understand implications for roadway safety.

This research used an ABA multiple baseline design across hospitals to evaluate a behavioral intervention designed to reduce absenteeism among 64 certified nursing assistants (CNA) in a rural health care organization. Pre-baseline assessments suggested that when CNAs were absent from work, other employees had to work unscheduled shifts. Because of this metacontingency, employees reported that they skipped work themselves to make up for the extra shifts they had to cover. This cycle created more unscheduled shifts and potentially caused the high absenteeism prevalent at the organization. An intervention with normative and metacontingency feedback significantly decreased the total number of days CNAs were absent per week across the three hospitals from a baseline mean of 0.24 (SD = 0.19) days per week (7.74% of their scheduled hours) to a mean of 0.13 (SD = 0.17) days per week (3.81% of their scheduled hours) during the intervention. In a return to baseline the total number of days CNAs were absent per week across the three hospitals increased to a mean of 0.24 (SD = 0.20) days per week (7.47% of their scheduled hours).

The purpose of this research was to evaluate a reward program designed to reduce absenteeism among staff (N = 38) at a grocery store. The intervention included public feedback and a credit reward system whereby participants got store dollars for attendance and authorized rescheduling of work assignments. Results showed that absenteeism decreased from a group mean of 8 shifts missed per week during baseline to 4.25 shifts missed per week during the intervention before increasing to 6.75 shifts missed per week during the reversal phase. The mean total rescheduling occurrences were reduced from a baseline average of 19.83 per week to 9.25 per week during the intervention and returned to 22.25 per week during the reversal. Employees were also less likely to leave early during the intervention period.

Fatigue has been shown to be a contributing factor in many large truck crashes. Long duty periods, irregular work schedules, and poor sleeping environments make fatigue a noteworthy concern in trucking operations. One way to limit fatigued driving is through prescriptive hours-of-service (HOS) regulations. This duty status information is typically recorded in written logs; however, more trucking companies are moving toward electronic HOS recorders. These devices were first marketed as productivity tools; however, more recently they have been touted for their safety benefits in reducing fatigued truck drivers (because falsifying electronic logs is difficult). The purpose of the current study was to assess the benefits of electronic logging devices (ELDs) on safety and HOS violations in trucks as they operated during normal revenue service. Data on crashes, HOS violations, mileage, and onboard safety systems were obtained from participating motor carriers. Although the final data sets included data from 11 carriers representing medium and large carriers (including a total of 82,943 crashes, 970 HOS violations, and 224,034 truck-years that drove a total of 15.6 billion miles), the data set in the study was skewed toward larger, for-hire carriers and may not represent the overall U.S. trucking population. After controlling for calendar year, carriers in the data set, onboard safety system status, and long-haul/regional indicator, ELD-equipped trucks had a significantly lower total crash rate (11.7% reduction), preventable crash rate (5.1% reduction), driving-related HOS violation rate (53% reduction), and non-driving-related HOS violation rate (49% reduction) than trucks not equipped with ELDs. The results show a clear safety benefit, in terms of crash and HOS violation reductions, for trucks equipped with ELDs.