Factors influencing fatigue of construction workers in hypoxic environments: A survey study

The number of construction projects at high altitude has continued to increase in recent years. Studies have shown that high-altitude environments pose significant challenges to construction workers and that hypoxia can cause cognitive and physical impairments. However, it remains unclear whether and how high-altitude exposure affects construction workers ' fatigue, which limits the effectiveness of occupational safety and health management in high-altitude projects. To address this concern, this cross-sectional study analyzed data from 646 workers at construction sites located at altitudes around 4000 m, aiming to identify factors contributing to fatigue. Using Bayesian network modeling, the study explored the interdependencies between shift conditions, sleep quality, work overload, and duration of high-altitude exposure on pre-service and work fatigue. The analysis revealed that sleep quality and shift patterns are primary predictors of pre-service fatigue, with work overload also playing a significant role. Pre-service fatigue emerged as a critical mediator for work fatigue, especially when combined with high workload. Notably, the duration of high-altitude exposure influenced both pre-service fatigue and work fatigue. These insights emphasize the need for comprehensive fatigue management strategies that consider individual and job-related factors to enhance safety outcomes. The study advocates for targeted fatigue monitoring and management practices, including pre-service training and real-time fatigue monitoring, to ensure the health and safety of workers in high-altitude construction environments.