Fatigue is a common complaint in the working population. Approximately 20% of the working population report symptoms that fall under the concept of fatigue.¹ Other surveys have reported prevalence rates of fatigue varying from 7% to 45%, depending on the instruments used and the applied cut off points.²

At first sight, the presence of fatigue in a working population does not give much reason for concern from an occupational health perspective. After work has been done, some fatigue may be expected and this fatigue is compensated for by social and financial rewards. Occupational health interest in fatigue arises from the adverse consequences that are attributed to fatigue in the more serious acute or chronic forms, and when there is insufficient opportunity to for workers to recover. Bad performance, impaired quality of services and products, and dropout of personnel may be adverse consequences. For employees, feelings of professional incompetence, accidents, and fatigue’s disruptive effects on private social life are serious outcomes. An increased risk of depression, as well as infectious and cardiovascular diseases have been suggested. Effects may be so serious that workers can experience disability leading to long term or even indefinite absenteeism from work. Stress related disorders are labelled under quite a number of interrelated terms and definitions such as adjustment disorders, neurasthenia, nervous breakdown, surmenage, and burnout. Prolonged fatigue is one of the core symptoms, and stress related disorders are responsible for approximately 30% of permanent disability benefits in the Netherlands. In other countries, such as the UK, mental ill health is a growing concern as it is causing increased absenteeism and long term sickness.³

The …