KUMPULAN MAKALAH ERGONOMI

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1 KUMPULAN MAKALAH ERGONOMI EDITOR : Dr. I G. N. Susila, M.Kes KONGRES NASIONAL XI DAN SEMINAR ILMIAH XIII IKATAN AHLI ILMU FAAL INDONESIA DAN INTERNATIONAL SEMINAR ON ERGONOMICS AND SPORTS PHYSIOLOGY DENPASAR, OKTOBER 2002

2 ERGONOMI KUMPULAN MAKALAH YANG DIPRESENTASIKAN DALAM KONGRES NASIONAL XI DAN SEMINAR ILMIAH XIII IKATAN AHLI ILMU FAAL INDONESIA DAN INTERNATIONAL SEMINAR ON ERGONOMICS AND SPORTS PHYSIOLOGY DI DENPASAR, OKTOBER 2002 Udayana University International Union of Physiological Sciences Organizing Committee IAIFI EDITOR : Dr. I G. N. Susila, M.Kes UDAYANA UNIVERSITY PRESS DENPASAR - BALI ISBN NO

3 512 IS THERE AN ALTERNATIVE TO THE 10-MINUTE PVT FOR FIELD STUDIES? Nicole Lamond, Gregory D. Roach, Sylvia Loh, Drew Dawson Centre for Sleep Research, University of South Australia PO Box 232, Woodville SA 5011, AUSTRALIA ABSTRACT Aims. The 10-minute PVT is a widely accepted measure of neurobehavioural performance in laboratory studies assessing the impact of fatigue. In field studies though, it may be impractical for participants to perform a test of this length. While longer tests are more sensitive to the effects of fatigue, we have previously found significant fatigue-related impairment using a 90-second tracking task. The aim of the current study was to compare performance on a 10-minute PVT, a 5-minute PVT, and a 90-second PVT during 28 hours of sustained wakefulness. Method. Eight participants (3 female, 5 male) slept in the laboratory overnight. From 0800hr the following morning, they remained awake for 28 hours. During every second hour, participants completed the four performance tests, presented in random order. Results. Fatigue-related impairment was observed for all three performance parameters during the 10-minute PVT. During the 5-minute PVT, percentage of lapses and PVT slowing significantly increased with increasing fatigue. Similarly, while the change was not statistically significant, fastest RTs increased. In contrast, none of the performance parameters significantly varied during the 90-second PVT. Conclusions. It is clear from the findings that a 90-second PVT is not a viable test for assessing fatigue. In contrast, the findings indicate that in general, the 5-minute PVT is sensitive to the effects of fatigue. More research is needed to further confirm the validity of the 5-minute PVT before it can be introduced as a valid fatigue assessment tool in operational environments. Keywords. psychomotor vigilance task, performance, fatigue.

4 513 BACKGROUND The prevalence of shiftwork has substantially increased in most industrialised economies in the last three decades (Smith et al., 1998), largely due to increased customer demands, changes in community expectations, and the expansion of global competition. Consequently, more employees are now required to work outside the hours of the standard 9-to-5, Mondayto-Friday work week, and are thus exposed to higher levels of work-related fatigue. For shiftworkers, the symptoms of fatigue typically manifest as reduced alertness and performance, increased sleepiness, and greater risk of injury and accident (Dinges, 1995, Hakkanen and Summala, 2000, Hanecke et al., 1998, Lauber and Kayten, 1988, Mitler et al., 1988, Rosa, 1995). Indeed, the level of neurobehavioural impairment associated with fatigue may be similar to that associated with moderate levels of alcohol intoxication (Dawson and Reid, 1997, Lamond and Dawson, 1998, Williamson and Feyer, 2000). It is clear then that fatigue poses a hazard that must be managed similar to other workplace hazards (e.g. exposure to chemicals, dust, noise). A key component of any hazard management system is the ability to quantify the hazard. In the case of fatigue, this is not a simple matter as there is no universal measure of fatigue. The 10-minute psychomotor vigilance task (PVT), a measure of simple reaction time (RT), has become a widely accepted tool for assessing the impact of fatigue on neurobehavioural performance in laboratory settings (Dinges et al., 1997, Doran et al., 2001, Jewett et al., 1999, Lamond et al., 2002). In field settings though, it may be impractical for participants to perform a test of this length. While longer tests tend to be more sensitive to the effects of fatigue (Dinges and Barone Kribbs, 1991, Johnson, 1982, Kleitman, 1923, Lee and Kleitman, 1923), our group has previously found significant fatigue-related impairment using a 90- second tracking task, indicating that shorter tasks may be sufficiently sensitive to the effects of fatigue. The aim of the current study was to compare performance on a 90-second PVT, a 5-minute PVT, and a 10-minute PVT during 28 hours of sustained wakefulness. Specifically, we wished to identify a performance measure that is sensitive to the effects of fatigue, but not overly disruptive in terms of task length. If the level of agreement between the shorter tests and the 10-minute PVT is sufficiently high, this will confirm that they may be used as alternative performance measures in field studies.

5 514 METHOD Subjects Eight healthy individuals (3 female, 5 male), aged 18 to 26 years, with a body mass index of , participated in the current study. Volunteers were required to complete a general health questionnaire and sleep/wake diary prior to the study. Subjects were non-smokers who did not regularly consume large caffeine (< 350 mg/day) or alcohol (< 6 drinks/week) doses, and participated in a moderate amount of exercise (< 10 hrs/week). Those recruited had no current health problems and were not taking any medication. Subjects reported no history of sleep problems, did not habitually nap, and had not undertaken shift work or transmeridian travel in the past month. Procedure Subjects reported to the laboratory at 1800hr. Prior to retiring at 2300hr, subjects were individually trained on each of the performance tasks, to minimise improvements in performance resulting from learning. Following a night of sleep, subjects were woken at 0800hr and allowed to breakfast and shower prior to the first testing session, which commenced at 0900hr. Performance was then assessed at two-hourly intervals (during each odd hour) for the remainder of the experimental period. The final testing session ended at 1200hr the following day. A schematic representation of the structure of the testing sessions is displayed in Figure 1. At the beginning of each testing hour (e.g. 0900hr), subjects completed one of the performance tasks. The second task was completed 15 minutes after the hour (e.g. 0915hr), the third test was completed 30 minutes after the hour (e.g. 0930hr), and the final test was completed 45 minutes after the hour (e.g. 0945hr). During each testing hour, the four tasks were presented in a random order. In between their testing sessions, subjects were confined to the living quarters where they could read, write, watch television or converse with other subjects. They were not permitted to exercise, shower, or sleep. Food and drinks containing caffeine were prohibited the night before and during the experimental period. Careful monitoring by the researchers ensured wakefulness during the night.

6 WAKE TIME DAY ONE TRAINING SLEEP PERIOD DAY TWO DAY THREE the four tests were presented in random order performance testing hour hourly break between tesing sessions The structure of each 2-hourly testing session Figure 1. A schematic representation of the experimental protocol. Neurobehavioural Performance Performance was evaluated at hourly intervals using a hand-held Psychomotor Vigilance Task (PVT), which was programmed to run for a period of either 10 minutes, 5 minutes, or 90- seconds, and a 90-second Occupational Safety Performance Assessment Test (OSPAT data not reported here). Subjects responded to a visual stimulus presented at variable intervals ( msec) by pressing the appropriate response button with the thumb of their dominant hand. If the correct response was made, the LED display showed the response time (RT) in milliseconds. During test sessions, subjects were seated in front of a blank wall in an isolated room, free of distraction. They received no overt feedback during the study, in order to avoid knowledge of results affecting performance. Statistical Analysis For this report, three PVT performance metrics were evaluated: (1) the percentage of lapses (reaction times (RT) > 500 milliseconds), (2) increases in the duration of responses in the lapse domain (mean 1/RT from slowest 10% of RTs per trial), and (3) shifts in optimum reaction times (the fastest 10% of RTs per trial). For each PVT duration (90-second, 5-minute and 10-minute), evaluation of systematic changes in each performance parameter with

7 516 increasing hours of wakefulness ( time-of-day ) were assessed separately using repeatedmeasures analysis of variance (ANOVA). Differences between the PVT durations were separately analysed and compared using repeated measures ANOVA with two within-subject factors ( time-of-day and task duration ). Significance levels were corrected for sphericity by Greenhouse-Geisser epsilon. Values are reported as mean (+ standard deviation). RESULTS Number of correct responses The number of correct responses (ie. RTs > 100ms) during each trial was calculated for each of the PVT durations. During the 10-minute PVT, subjects correctly responded to (+5.0) stimuli, on average. The 5-minute PVT was associated with an average of (+3.3) correct responses. On average, subjects correctly responded to (+1.4) stimuli during the 90-second PVT. The number of correct responses in each trial did not significantly vary as a function of increasing wakefulness for either the 10-minute, 5-minute or 90-second PVT. Percentage of lapses, PVT slowing and Optimum Responses All three of the performance parameters showed statistically significant variation as a function of increasing wakefulness during the 10-minute PVT. In general, the time-of-day effect on the three PVT parameters was associated with poorest performance between 0700 and 1100hr. During the 5-minute PVT, two of the three performance parameters significantly varied with increasing wakefulness. A notable trend was also observed for the fastest RTs, however this did not reach statistical significance (p=0.0508). Again, poorest performance generally occurred between 0700 and 1100hr. In contrast to the 10- and 5-minute PVT, none of the 90-second PVT performance parameters significantly varied as a function of increasing wakefulness. Comparison of the 5-minute and 10-minute PVT Repeated measures ANOVA with two within-subject factors were conducted to compare performance during the 10-minute and 5-minute PVT. Analysis of the percentage of lapses

8 517 indicated a significant main effect for both task duration (F 1,7 =6.0, p=0.0442) and time-ofday (F 13,91 =8.0, p=0.0001). Similarly, fastest RTs systematically varied as a function of both task duration (F 1,7 =12.9, p=0.0089) and time-of-day (F 13,91 =5.6, p=0.0052). No interaction was observed for either of these variables. For PVT slowing (ie. the slowest 10%), a significant interaction effect (F 13,91 =2.8, p=0.0493) was observed, in addition to a main effect for both task duration (F 1,7 =12.5, p=0.0095) and time-of-day (F 13,91 =21.5, p=0.0001). Comparison of 90-second and 10-minute PVT Analysis of the 10-minute and 90-second PVT parameters indicated a significant main effect for both task duration and time-of-day for the percentage of lapses [(F 1,7 =10.0, p=0.0160);(f 13,91 =6.8, p=0.0120)], PVT slowing [(F 1,7 =15.9, p=0.0053);(f 13,91 =9.5, p=0.0001)], and fastest RTs [(F 1,7 =24.7, p=0.0016);(f 13,91 =4.1, p=0.0153)]. A significant interaction effect was also observed for percentage of lapses (F 13,91 =4.7, p=0.0178) and PVT slowing (F 13,91 =3.4, p=0.0144). Table 1. Summary of ANOVA results for each PVT performance parameter. 10-minute PVT 5-minute PVT 90-second PVT F 7, 91 P F 7, 91 P F 7, 91 P Correct responses % Lapses Slowest RTs Fastest RTs

9 518 Fastest 10% RT Slowest 10% 1/RT Percentage of Lapses Time of Day Figure 2. Percentage of lapses (top panel), PVT slowing (middle panel) and fastest RTs (bottom panel) during 28-hours of wakefulness.

10 519 DISCUSSION The 10-minute psychomotor vigilance task (PVT) has become a widely accepted tool for assessing the impact of experimentally induced fatigue on neurobehavioural performance. An increasing number of researchers now use this particular task in laboratory settings as studies have clearly shown that the 10-minute PVT is sensitive to the effects of both partial and acute sleep loss and to time of day effects (Dinges et al., 1987, Dinges et al., 1997, Doran et al., 2001, Jewett et al., 1999, Lamond et al., 2002). Certainly, this was the case in the current study, which assessed performance during 28 hours of wakefulness. Specifically, as wakefulness was extended into the night, significant performance decrements were observed for all of the PVT parameters evaluated. The popularity of the PVT is also due, in large part, to its simplicity, portability and size (the PVT device measures 21x11x6cm and weighed 658gm). In addition, the PVT is reported to have a learning curve of only 1-3 trials (Dinges et al., 1997), thus reducing the need for extensive, time-consuming training sessions. A further advantage of the PVT is that it assesses not only simple reaction time, but also the well-documented phenomenon of attentional lapses, or brief periods of unresponsiveness, which are considered inevitable in the performance of sleep deprived subjects (Williams et al., 1959). Despite the advantages of the 10-minute PVT, a test of this length may not always be practical in time-constrained field environments. In such instances, a shorter test with similar properties (in terms of sensitivity to the effects of sleep loss) would be more functional. While longer tests tend to be more sensitive to the effects of fatigue (Dinges and Barone Kribbs, 1991, Johnson, 1982, Kleitman, 1923, Lee and Kleitman, 1923), previous studies have also found significant fatigue-related impairment using tasks of short duration (Casagrande et al., 1997, Dawson and Reid, 1997, Glenville et al., 1978, Heslegrave and Angus, 1985). As such, the current study compared performance during a 90-second and 5-minute PVT with performance during the standard 10-minute PVT. Specifically, we wished to identify an easyto-use performance task that is sensitive to the effects of fatigue, but not overly disruptive in terms of task length. It is clear from the findings that a 90-second PVT is not a viable test for assessing fatigue. While previous research shows that the parameters assessed in the current study are sensitive to the effects of sleep deprivation during a PVT that is 10-minutes duration (Dinges et al., 1997), this was not the case when the task was shortened to 90-seconds. In contrast to the 10-

11 520 minute PVT, none of the performance parameters significantly varied as wakefulness was extended into the night. Moreover, increasing wakefulness had a differential impact on performance during the 90-second task, compared to the 10-minute PVT. The fact that the fastest reaction times during the 90-second test were not affected by fatigue is not particularly surprising. Previous research using four different reaction-time tasks found that while there was a progressive increase in the range of reaction times as hours of wakefulness increased, the average of the shortest ten reaction times showed minimal change, even after 78 hours of wakefulness (Williams et al., 1959). Furthermore, research indicates that shortening the duration of a task decreases the task s ability to detect lapses (Dinges and Barone Kribbs, 1991, Williams et al., 1962). In the current study, shortening the PVT to 90-seconds significantly reduced the ability of the task to detect lapses, such that the task was no longer able to detect fatigue-related performance impairment. It is apparent from the findings that the 5-minute PVT may be a somewhat more promising task for assessing performance in field studies. As with the 10-minute PVT, lapsing and PVT slowing became increasingly evident during the 5-minute PVT as wakefulness was extended into the night. Similarly, while a statistically significant effect was not found for the fastest responses, there was a definite trend that indicated increasing impairment. Indeed, visual inspection of Figure 2 indicates similar effects for the 10-minute and 5-minute PVT. It should be noted that, as discussed above, it was expected that this parameter would be the least affected of the parameters assessed here. More importantly, the fact that the effect was not significant may in be in large part due to the relatively small sample size. Indeed, the authors recognise that this study is limited by the small sample size, and additional trials are currently underway to collect more data. While it is evident that the 5-minute PVT is sensitive to the effects of 28-hours of extended wakefulness, the magnitude of change observed for this task was not as great as that observed during the 10-minute PVT. Thus, where time-constraints are not an issue, using the 10- minute PVT to assess performance would be preferable as impairment would be more obvious and thus easier to detect and assess. Further, as an increasing number of researchers currently use this task in both laboratory and field studies, it is now a well-validated task. In contrast, the current study is the first to assess the 5-minute PVT. Thus, while it is apparent from the findings reported here that the 5-minute PVT is sensitive to the effects of fatigue, more research is needed to further confirm the validity of the 5-minute PVT before it can be introduced as a valid fatigue assessment tool in operational environments.

12 521 REFERENCES Casagrande, M., Violani, C., Curcio, G. and Bertini, M. (1997) Ergonomics, 40(6), Dawson, D. and Reid, K. (1997) Nature, 388, 235. Dinges, D., Pack, F., Williams, K., Gillen, K., Powell, J., Ott, G., Aptowicz, C. and Pack, A.I. (1997) Sleep, 20(4), Dinges, D. F. (1995) Journal of Sleep Research, 4, Dinges, D. F. and Barone Kribbs, N. (1991) In Sleep, sleepiness and performance. (Ed, Monk, T. H.) John Wiley And Sons Tld,, pp Dinges, D. F., Orne, M. T., Whitehouse, W. G. and Orne, E. C. (1987) Sleep, 10, Doran, S. M., Van Dongen, H. P. and Dinges, D. F. (2001) Archives Italiennes de Biologie, 139, Glenville, M., Broughton, R., Wing, A. M. and Wilkinson, R. T. (1978) Sleep, 1, Hakkanen, J. and Summala, H. (2000) Sleep, 23, Hanecke, K., Tiedemann, S., Nachreiner, F. and Grzech-Sukalo, H. (1998) Scandinavian Journal of Work, Environment and Health, 24, Heslegrave, R. J. and Angus, R. G. (1985) Behaviour Research Methods, Instruments and Computers,, 17, Jewett, M. E., Dijk, D., Kronauer, R. E. and Dinges, D. F. (1999) Sleep, 22, Johnson, L. C. (1982) In Biological rhythms, Sleep and Performance(Ed, Webb, W. B.) Wiley, NY. Kleitman, N. (1923) American Journal of Physiology, 66, Lamond, N. and Dawson, D. (1998) Journal of Sleep Research, 8, Lamond, N., Dorrian, J., Roacg, G. D., Burgess, H. J., Holmes, A. L., McCulloch, K., Fletcher, A. and Dawson, D. (2002) Human Ergology, In press. Lauber, J. K. and Kayten, P. J. (1988) Sleep, 11, Lee, M. A. M. and Kleitman, N. (1923) American Journal of Physiology, 67, Mitler, M., Carskadon, A. M., Czeisler, C. A., Dement, W. C., Dinges, D. F. and Graeber, R. C. (1988) Sleep, 11, Rosa, R. (1995) Journal of Sleep Research, 4 (Suppl), Smith, L., Macdonald, I., Folkard, S. and Tucker, P. (1998) Applied Ergonomics, 29, Williams, H. L., Granda, A. M., Jones, R. C., Lubin, A. and Armington, J. C. (1962) Electroencephalography and Clinical Neurophysiology, 14, Williams, H. L., Luben, A. and Goodnow, J. J. (1959) Psychological Monographs: General and Applied, 73, Williamson, A. M. and Feyer, A. (2000) Occupational and Envionmental Medicine, 57,

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