Table 2.

Data extraction from documents that included FRMS/FMP evaluation.

Document	Location	Population	Study details	Was a quantitative risk assessment component included?	Peer reviewed?	Outcomes
Barger et al., 2017	Australia	Firefighters (n > 500)	Randomised trial of 34 fire stations. Half allocated to Fatigue Risk Management Program (FRMP). FRMP included • Sleep health education • Sleep disorder screening • Black out shades • Napping policy Baseline and follow up surveys (one year later)	Not specified	No (conference abstract)	• 81% of participants reported black out shades improved their sleep • 79% used napping policy • FRMP group reported significantly improved sleep p < 0.001 • 49% of FRMP group reported increased sleep duration, compared with 23% in control group • FRMP group reported being less sleepy in follow up survey p < 0.001 • Participants in FRMP group reported that the program was “important and helpful”
Dara, 2019	New Zealand	Surgical intensive care unit nurses (n = 36)	Customised performance-based FRMS implemented. Pre-FRMS, FRMS, and post-FRMS assessment of fatigue and situational awareness. • Self-reported fatigue and sleepiness • Actigraphy • Vigilance testing • Situational awareness estimation	Not specified	No (conference abstract)	• Overall decrease in fatigue and sleepiness scores in post-FRMS phase compared with pre-FRMS • Overall increase in situational awareness in post-FRMS phase compared with pre-FRMS
Fourie et al., 2010	Primarily Australia and New Zealand	Transport industry workers (regulatory bodies, transport managers, researchers, other). Organisations: n = 12 Individuals: n = 59	Interviews conducted to obtain perspectives on FRMS implementation, including advantages and disadvantages.	Yes	No (industry conference paper)	• Improved safety (reported by n = 6 organisations) • Improved staff morale (n = 4) • Reduced absenteeism (n = 2) • Competitive advantage (n = 2) • Advanced compliance (n = 2) • Change in regulatory approach (n = 3) • Perceived potential for abuse (n = 2)
Smiley et al., 2010	Canada	Drivers aged 24 – 64 years (n = 77)	Self-report (mood, fatigue, sleep), performance (psychomotor vigilance task (PVT)) and actigraphy data collected pre- and post-Fatigue Management Plan (FMP) implementation. 8 – 10 day data collection each time. FRMS included: • Education on fatigue and sleep disorders • In home screening and CPAP treatment for sleep disordered breathing • Examination of corporate culture • Assessment of scheduling practices Organisational evaluation also performed (Alertness Management Strategies Evaluation (AMSE) questionnaire). Focus groups regarding scheduling practices.	No	No (industry report)	• Improved sleep duration and quality post-FMP compared with pre-FMP • Reduction in critical events (microsleeps, near misses) • Improved PVT performance on rest days for participants treated for sleep apnea • Significant increases in reported and perceived fatigue management activities post-implementation. • No scheduling improvements reported • Fewer road infractions and accidents • Reduced absent days per kilometer travelled
Lamp et al., 2019	United States	Pilots (n = 40)	80 long-haul flights between the United States and Taiwan, and the United States and Australia. Comparison of safety outcomes on flights managed using Safety Standard Operation (SSO) and Alternative Method of Compliance (AMOC). AMOC flight exceeded standard flight time limitations and employed FRMS strategies. Safety performance indicators (SPIs) assessed as outcome measures: • In-flight sleep • Cognitive performance • Self-reported fatigue • Self-reported sleepiness	Yes	Yes (published in Accident Analysis and Prevention journal)	• AMOC flight found to be as safe as SSO flight (non-inferior) on SPIs.