Management Practices (Time Period 1)

Attachment

G

Form Approved

OMB No. XXXX-XXXX

Exp. Date XX/XX/XXXX

Management Practices (Time Period 1)

Your Role in Organization (e.g., safety director):________________________________

A. EDUCATION YES NO

1. Are drivers provided training about fatigue?  

If Yes to Item 1, what topics are covered in this training?_________________________

__________________________________________________________________________________________________________________________________________________________________________________________________________________

2. Are drivers provided training about the safety-related risks of fatigue?  

If Yes to Item 2, what topics are covered in this training?_________________________

__________________________________________________________________________________________________________________________________________________________________________________________________________________

3. Are schedulers provided training on these issues?  

4. Are management personnel provided training on these issues?  

5. Are dispatchers provided training on these issues?  

6. Was the effectiveness of training activities evaluated in any way (e.g.,

pre-post-training quizzes)?  

Public reporting burden of this collection of information is estimated to average 45 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX)

B. ALERTNESS STRATEGIES YES NO

7. Are drivers provided training on alertness strategies?  

If Yes to Item 7, please indicate which alertness strategies?

Getting 7-9 hours of sleep  

Napping  

Healthy food  

Exercise  

Staying hydrated  

Caffeine as a short-term countermeasure  

Effect of over-the-counter and prescription drugs  

Limit/eliminate nicotine use  

8. Are there written policies regarding the use of alertness strategies?  

If Yes to Item 8, do the written policies differ in any way in how they are enforced? If Yes, please indicate how they differ?_________________________________________________

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________

9. Are there written policies regarding on-duty rest opportunities?  

10. Not including the sleeper berth, are there facilities to support opportunities to rest in the workplace (e.g., break room that can be made quiet and dark to take a nap after a duty period, prior to your drive home)?  

11. Was the effectiveness of the alertness strategies evaluated in any way?  

If Yes to Item 11, how were they evaluated?________________________________________

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________

12. Do drivers get refresher training on alertness management in addition to any initial training they might receive?  

If Yes to Item 12, how often are these activities performed (e.g., weekly, monthly, quarterly, etc.)?

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________

C. SCHEDULING YES NO

13. Are there written organizational policies for drivers regarding basic work/rest

schedules, in addition to federal hours-of-service regulations, (such as

minimum duration of off-periods, maximum work time, maximum number

of consecutive work periods, and recovery time between work cycles)?  

14. Is there an explicit written procedure that is used for exceptions to these

policies?  

15. Have any changes been made to the number of staff for the purpose

of reducing fatigue?  

If Yes to item 15, indicate what changes have been made to staff and what year those changes were made.________________________________________________________

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________

15. Have any changes been made to the delivery schedule for the

purpose of reducing driver fatigue in the last 3 months?  

If Yes to Item 16, indicate what changes have been made to the delivery schedule and what year those changes were made._______________________________________________

______________________________________________________________________________________________________________________________________________________

15. Have any changes been made to delivery routing for the purpose of reducing driver fatigue.  

If Yes to Item 17, indicate what changes have been made to the delivery routing and what year those changes were made.___________________________________________________

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________

15. Have any changes been made to work shift scheduling for the purpose of reducing driver fatigue?  

If Yes to Item 18, indicate what changes have been made to the work shift schedule and what year those changes were made._______________________________________________

______________________________________________________________________________________________________________________________________________________

D. HEALTHY SLEEP YES NO

19. Is information offered to drivers and other personnel about sleep disorders,

how to recognize sleep disorders, and/or how to get help if they suspect they

have a sleep disorder?  

If Yes to item 19, what information is given?_____________________________________

________________________________________________________________________

20. Is there a written policy that addresses diagnosis, treatment, and continued

duty status of personnel with possible sleep disorders?  

E. ORGANIZATIONAL YES NO

21. Do managers provide:

Education to obtain adequate sleep?  

Alertness strategies to reduce fatigue?  

Scheduling practices that reduce fatigue?  

Encouragement to obtain adequate sleep?  

22. Is there someone at your company who is responsible for coordinating fatigue management activities?  

23. Is there a napping room at the terminal (reserved location for napping/sleep)?  

24. Is there a gym at the terminal (location for drivers to exercise)?  

25. Is top management involved in fatigue management activities and policy

development?  

26. Is there a system that encourages drivers to submit reports of fatigue hazards?  

If Yes to Item 26:,

How does this system work (also indicate if this process is confidential)?_____________________________________________________

________________________________________________________________

How are reports submitted?__________________________________________

________________________________________________________________

What information is requested in the reports?____________________________

________________________________________________________________

Who are reports submitted to?________________________________________

________________________________________________________________

What is the procedure for responding to reports?__________________________

________________________________________________________________

Who receives the responses to the reports?_____________________________

________________________________________________________________

27. If yes to Item 26, have any reports of fatigue hazards been reported?  

28. If yes to Item 27, did any report result in a change to reduce the identified hazard?  

If Yes to Item 28, could you briefly describe one example of such a change (e.g., either one you consider the most significant, or just the first one that comes to mind)?____________

______________________________________________________________________

______________________________________________________________________

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