The Southeast and Gulf Coast states breathed a sigh of relief as the 2009 hurricane season came to an end with only one tropical storm making landfall. Regrettably though, Southern California was battered with numerous wildfires that caused three line-of-duty deaths. As we prepare for the 2010 hurricane and wildfire seasons, we as managers and leaders should start questioning how many hours our employees can or should work before fatigue sets in, and determine how to limit or prevent that from happening.

Emergency-response personnel carry out their duties within an ever-changing and often time-unforgiving environment composed of a set of distinct elements. First, there is the emergency itself — whether it is a wildland fire in the Northwest or Southwest, a tornado in the Midwest, or a hurricane in the Southeast or Gulf Coast — which imposes certain exigencies upon the responders. Second, social structures exist that are governed by the rules and associations — both internal and external — of the responding entities. An emergency response, therefore, takes place within a context of prescribed behaviors, expectations and value judgments that are sometimes in conflict with each other. Third, there is technology that must be understood in order to accomplish group goals. Should this fail to occur, the entire emergency environment may be impacted. Clearly, a breakdown in any of these elements could result in worker injury and might heighten responder stress, fatigue and general well-being.

Olin L. Greene, former U.S. Fire Administrator, recognized that stress is one of the most vexing occupational hazards facing the modern fire service. Additionally, he opined that it is important to recognize exactly how stress can adversely affect our health, job performance, career decision-making, morale and family life. But could Greene have foreseen the coming of numerous hurricanes and other natural disasters, the acts of terrorism and the weapons of mass destruction — and the additional stress these would apply to the fire service community — when he was fire administrator?

Fatigue is a growing issue in the workplace. It is estimated that fatigue results in $8.5 billion dollars in accident damage, $79.9 billion in lost productivity and $28.3 billion in associated health-care costs. Some will argue that workplace fatigue holds true for any profession to some degree; however, fatigue becomes a critical factor for emergency responders who must make split-second decisions that can affect the lives of civilians, as well as their colleagues.

Fatigue goes by many names — among them exhaustion, lethargy, weakness, weariness, lack of spirit, listlessness and burnout — and takes many forms. It can be both physical and mental. Physical fatigue, i.e., muscle weakness or "lack of strength," is a direct term for the inability to exert force with one's muscles to the degree that would be expected given the individual's general physical fitness. Mental fatigue, on the other hand, can manifest itself either as somnolence (decreased wakefulness) or as a general decrease of attention, not necessarily including sleepiness. It also may be described as a decreased level of consciousness. In any case, this can be dangerous when performing tasks that require constant concentration, such as: firefighting, conducting search and rescues, driving an apparatus or treating emergency medical patients.

Fatigue primarily is caused by lack of sleep. However, fatigue is more than just feeling tired or drowsy - it is normal to become tired through physical or mental effort. Rather, fatigue significantly affects a person's ability to function. The most common effects associated with fatigue are:

• Desire to sleep;
• Lack of concentration;
• Impaired recollection of timing and events;
• Irritability;
• Poor judgment;
• Reduced capacity for effective interpersonal communication;
• Reduced hand-eye coordination;
• Reduced visual perception;
• Reduced vigilance;
• Slower reaction times.

Additionally, fatigue can affect one's health. Gastrointestinal disorders and upper-respiratory infections are the most common health problems related to fatigue. While the most common factor that causes upper-respiratory illnesses or infections associated with fatigue is an increase in stress, which weakens one's immune system, the body rhythm for digestion is designed for food to be eaten during the day regardless of whether an individual is working or resting. This can cause problems when heavy or fatty foods are eaten at some point in the night. The most common complaints include bowel-habit changes, digestive complaints and increased risk of peptic (stomach) ulcers. We all are guilty of having something heavy or fatty in the middle of the night, especially after responding to a fire or emergency medical call, because we just cannot fall asleep. Our mindset is that we can sleep better on a full stomach. We have mom to thank for that belief.

Furthermore, the effects of fatigue increase with age. It has been confirmed that people over 50 years of age tend to have lighter, fragmented sleep. This can prevent them from receiving the recuperative effects from a full night's sleep, and can make them more likely to become fatigued.

Moreover, studies indicate that women's reproductive health can be affected by fatigue. Fatigue and irregular sleep patterns have been associated with numerous negative effects for pregnant women and fertility rates. These include irregular menstrual cycles, increased risk of miscarriages, low birth weight and higher occurrences of premature births. As managers and leaders of our departments, should we allow pregnant female responders to continue working on shift, or should we place them on light duty to prevent miscarriages or a premature birth? I know that many females do not want to work light duty and have their doctors write notes stating that they can work until they deliver, but is this truly the right thing to do?

So how many hours should emergency responders work? A study by the International Labor Organization for the United Nations found that Americans work longer hours than anyone else in the industrialized world. Most European workers have four weeks of vacation and many have more than that, while U.S. workers usually have only two weeks of vacation.

Additionally, the United States is the only industrialized nation where the trend for the past 20 years or so has been to work more hours with less personnel resources. In every other country, the trend is toward more time off. Somehow, the United States misses the mark in its belief that being "results oriented," along with a "do more with less" ideology, has greater value than the physical and mental attributes of a human being. Perhaps this is why firefighters are dying at a faster rate of heart-related complications and at a younger age — some less than 40 years of age. A National Sleep Foundation study found that 40% of American adults stated that, "they are so sleepy during the day that it interferes with their activities."