The Effect of Fatigue on Injury Risk in the Film Industry

The Effect of Fatigue on Injury Risk in the Film Industry

From grips to performers, costumers to carpenters, and everyone in between, the film industry is a demanding one, involving long hours, hard work, and erratic schedules. Fatigue is often the norm, not the exception.

But when we talk about work‐related injuries, we tend to focus only on the physical nature of the job, turning to tried and true ergonomic principles designed to eliminate musculoskeletal hazards such as awkward postures or heavy material handling or excessive workloads.

What is often overlooked is the cognitive side of ergonomics, and how sleep‐related fatigue also contribute to injuries.

If you haven’t heard it yet, the science is clear. All adults need a minimum of 7‐9 hours of sleep to fully recharge the body and brain. Anything less than is detrimental to safe work performance.

Let me explain.


Our Energy Hog


When you’re tired, whether from lack of sleep or from running around on your feet all day, the body goes into conservation mode. It does that by shutting down the biggest energy hog we have… our executive control center, known as the prefrontal cortex. That’s the brain’s engine, responsible for regulating our thoughts, emotional responses, and actions.

In the short term, cognitive impairments typically appear first in the form of

  • flawed logic (I’m ok to drive home after an 18‐hour day),
  • working memory problems (did I check the weight limit on that sling?),
  • lack of communication (it’s not complicated, they’ll figure it out),
  • reduced tolerance (I’ll do it, get out of my way),
  • reduced situational awareness (not noticing the boom you walked into, or the spill on the floor),
  • poor judgment (sure they’re tired, but one more “take” and we’ll wrap it up),
  • poor hand‐eye coordination (chuck that roll of duct tape, would you?), and
  • less effective problem solving (let’s just get it done already!).1

Simply put, a tired brain has us under‐estimate risk and be more accepting of risk.

Fatigue also has a direct effect on our physical capabilities. It reduces our muscle’s ability to generate force and decreases joint proprioception and motor performance. In layman’s terms, that means

  • we feel functionally weaker (encouraging us to take more shortcuts that put us in harm’s way),
  • we have impaired equilibrium and coordination (meaning poor body mechanics and material handling techniques), and
  • we lose our sense of balance (more slips, trips and falls).2

Sleep Debt and Injuries

All of this translates into more injuries that are preventable, and we have the research that backs this. For example, in a study of 11,000 Americans over a 13‐year period, jobs with overtime schedules had a 61% higher injury risk rate compared to jobs without overtime.The same study also found that working at least 12 hours per day was associated with a 37% increase in relative risk and working at least 60 hours per week was associated with a 23% increase. In 2010, researchers examined four years of data and were able to demonstrate the impact of sleep and working hours with the relative risk for having a work‐related injury.4


Are your people at risk?

Science reveals there are four key fatigue factors that influence our risk for injury.

  1. Long work hours
  2. Irregular schedules
  3. Short sleep duration
  4. Poor sleep quality

What to do?

Airframe Exoskeleton

Productions still need to focus on reducing physical fatigue to reduce injury risk. That includes

  • Incorporating material handling aids, like exoskeletons
  • Suspending tools with jigs, vices, winches, tool balancers
  • Job rotation to distribute heavy or repetitive work
  • Longer or more frequent breaks for demanding work or challenging environments

Risk associated with sleep‐related fatigue can be addressed by

  • Incorporating schedules that accommodate for adequate recuperative sleep (consider commute times and their impact)
  • On duty rest breaks in quiet areas
  • Ensuring good housekeeping to reduce hazards that may go unnoticed when tired
  • Improving lighting in darkened areas
  • Increases in cross‐checking and double‐checking
  • Incorporation of checklists to reduce errors and incidents
  • Ensuring fatigued workers have safe transport home

Ultimately, preventing injuries requires multiple, overlapping ergonomic controls that address both physical and cognitive factors.

Abd‐Elfattah, H., Abdelazeim, F., & Elshennawy, S. (2015). Physical and cognitive consequences of fatigue: A review. Journal Of Advanced Research(3), 351‐358. doi:10.1016/j.jare.2015.01.011
Dembe AE, Erickson JB, Delbos RG, et al. (2005).The impact of overtime and long work hours on occupational injuries and illnesses: new evidence from the United States. Occup Environ Med 62:588–597.
van der Linden, D. (2011). The urge to stop: The cognitive and biological nature of acute mental fatigue. American Psychological Association.
Lombardi DA, Folkard S, Willetts JL, Smith GS. Daily sleep, weekly working hours, and risk of work‐related injury: US National Health Interview Survey (2004‐2008). Chronobiol Int. 2010;27:1013‐1030.

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Working From Home: Laptop Ergonomics

Working From Home: Laptop Ergonomics

Ahh… living the dream, working from the comfort of your home with your handy laptop! You can work, stream, chat, and do everything without leaving the couch. Unfortunately, with the good, comes the bad.

Notebooks and laptops were designed to give the user the ability to input information when away from the office. Initially, their purpose was to be used for small entry tasks requiring short duration of input time. Striving to make them as portable as possible, designers have continually introduced smaller and lighter models.

This smaller size, along with the inability to independently position the screen and keyboard results in the individual compromising their typing and mousing posture or their head and neck position. Laptop keyboards are also more compact than regular computer keyboards. This presents wrist problems especially for men as even a regular sized keyboard often inhibits them due to their larger hand size and broader builds.

Short‐term, infrequent use of laptops is not problematic (so go ahead, curl up on the couch with your dog and balance the laptop on a pillow) but if a laptop is being used in one location for extended periods of time, then it is not the right tool for the job.

If a laptop needs to be used in one location regularly for any length of time, consideration should be given to attaching a separate monitor, keyboard and mouse. This will help you achieving better posture and prevent those nagging aches and pains from showing up!

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Exoskeletons – All They Are Purported to Be?

Exoskeletons – All They Are Purported to Be?

I recently returned from the NEC ErgoExpo in Las Vegas (Vegas in August… whose idea was that??) and was happy to hear the latest science on the application of exoskeletons for use in industry.

Exoskeletons, often referred to as “lift-assists”, are based on actuation technology, designed to transfer away force/torque from the user to the device instead.  There are passive models (best for light tasks and limited dynamic movements) and active models which are more suited for dynamic tasks and have their own pneumatic or electrical power source, but are more rigid, heavier and bulky.1 This also translates into the passive technologies being less complex and cheaper to implement. However, active models are more versatile and consequently, more costly.

There are also “soft” exoskeletons compared to “hard” versions. The soft are designed to provide better comfort to the worker (an important feature for user acceptance) by being lightweight and reducing movement hindrances.

But can they prevent (insert anatomy here) injuries?

Such technology is often touted as the answer to musculoskeletal disorders (MSDs) and reduction of physical fatigue by their manufacturers. But under scrutiny and scientific rigor, are these devices the solution we’re looking for? The short answer is… it depends.

With the influx of new designs and brands every day, it’s important that you do your homework. That means not relying on the manufacturer’s words and their financially backed studies that may not have been peer-reviewed or evidenced-based.

When I wasn’t loitering at outdoor restaurant misting devices (to cool off) or rehydrating with a mimosa at the trade show (to cool off), I sat in on a session led by Mathew Marino, a specialist in evaluating wearable technologies, and who presented his own findings regarding the use of exoskeletons and their pros and cons.

In a study he conducted in the utility sector, specifically targeting workers responsible for the installation and maintenance of smart meters underground, passive back-assist exoskeletons were used while they performed digging and sustained kneeling/bending/reaching activities. What they found was that the exoskeletons work best in reducing metabolic demands associated with static loading an of the muscles, but they didn’t provide the same advantage in terms of reducing metabolic demands during repetitive motions.

In a different study completed by Mathew Marino2, a comparison of passive back-assist and passive shoulder-assist exoskeletons revealed that, depending on the device being used and the task being performed (in this case, stocking and tire installation tasks), heart rate and step rate could be negatively or positively affected. The back assist that he tested actually demonstrated an increase in mean heart rate (6.8%) compared to the shoulder assist (decrease by 3.4%). Both devices had similar reductions in step rates at 17.4 % and 20.5% accordingly. Whether or not these types of reductions correlate to a reduction in MSDs remains to be seen. As pointed out by Marino during his presentation, there are no longitudinal studies, at least none that are currently published, that clearly indicate any such benefit.

Worker Trials

Perhaps more importantly is the feedback from the workers themselves. As with any wearable technology that is introduced, fit and comfort will influence whether or not the employees will want to wear such devices. In the tire installation study, there were concerns regarding how they also impacted the quality of their body movements and potentially, task completion.

So, if you’re looking to add these types of devices to your arsenal, here are a few things to remember:

  1. What tasks are you looking for help with? Dynamic tasks require more versatility (active devices). Static or restricted postures will benefit more from passive devices.
  2. Determine your targets and how you will measure overall performance impact. Are you looking to reduce injuries? Reduce fatigue? Reduce time spent on task? Improve worker comfort? Be sure that you have completed a thorough risk assessment to determine exactly what your needs are before you start investing in technology that may or may not match.
  3. Comfort and fit are imperative. Each device should be fitted to an individual worker, where it remains theirs to own and maintain, similar to a mechanic having his own tools. While these devices are meant to fit many people, they are not always easy to adjust and you are relying on the workers to have the necessary knowledge and training to optimally readjust the equipment with each use. There is also a concern about hygiene when transferring devices between users. Unfortunately, if one is used per worker, it may make them cost-prohibitive.
  4. Try before you buy. In fact, try several and implement a system usability scale to measure the end-users perceptions of the devices that you are evaluating before purchase. A google search will bring up plenty of scales that you can modify to suit your needs.

At the end of the day, it’s about eliminating hazards and reducing risk. Undoubtedly, these devices will evolve and become better over time (even Ironman had to work out the kinks) and hopefully, the longitudinal studies will follow, but for now, they are limited in their applications. In the interim, don’t forget that there may be other ways to engineer or redesign the job that reduce risk to acceptable levels. Exoskeleton technology is just one more tool to consider adding to your toolbox. It’s not the only tool.Looking for ergonomics training? Check out our Ergonomics Systems Specialist (ESS) Workshop, a 5-day certification course that provides you with the knowledge on how to establish your own internal ergonomics program while earning you continuing education credits. Learn how to secure management commitment, perform risk assessments, utilize cost/benefit tools, measure performance, and ensure program sustainability.1

1Toxiri, Stefano & B. Näf, Matthias & Lazzaroni, Maria & Fernández, Jorge & Sposito, Matteo & Poliero, Tommaso & Monica, Luigi & Anastasi, Sara & G. Caldwell, Darwin & Ortiz, Jesus. (2019). Back-Support Exoskeletons for Occupational Use: An Overview of Technological Advances and Trends. 1-13. 10.1080/24725838.2019.1626303.

2Matthew Marino (2019) Impacts of Using Passive Back Assist and Shoulder Assist Exoskeletons in a Wholesale and Retail Trade Sector Environment, IISE Transactions on Occupational Ergonomics and Human Factors.


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