"So you have an under-reporting problem?" System barriers to incident reporting.

The reporting of safety occurrences and safety-relevant issues and conditions is an essential activity in a learning organisation. Unless people speak up, be it concerns about unreliable equipment, unworkable procedures, or any human performance issue, trouble will fester in the system. In my experience in safety investigation, safety culture and human factors across industries, one of the clearest signs of trouble in a safety-related organisation is a reluctance among staff to report safety issues.

Non-reporting can be hard to detect, especially when managers are disconnected from the work. There may be a built-in motivation not to be curious about a lack of reports: under-reporting gives the illusion that an organisation has few incidents or safety problems, and this may give a reassurance of safety (while a preoccupation with failure, or 'chronic unease', might be true for those who have worked in high reliability organisations). Where it is discovered that relevant events or issues are not being reported, too often this is seen as a sign of a person, or team, gone bad - ignorant, lazy or irresponsible. This might be the case, but only if ten or so other issues have been discounted. I have tried to distill these below, along with some relevant Safety Culture Discussion Cards.


"So you have an under-reporting problem?" Questions for the curious.

1. Is the purpose of reporting understood, and is it consistent with the purpose of the work and  organisation?  

Yes / No / Don't Know

This is the first and most fundamental thing. As Donella Meadows noted in her book Thinking in Systems, "The least obvious part of the system, its function or purpose, is often the most crucial determinant of the system's behaviour". The purpose of reporting may be completely unknown, vague, ambiguous, or (most likely) seemingly inconsistent with the work or with the purpose of at least part of organisation (e.g. a department or division), and its related goals. The purpose of reporting may relate primarily to monitoring and compliance with rules, regulations, standards or procedures. The purpose may relate to checking against organisational goals and numerical targets (e.g. relating to equipment failures, 'errors', safety outcomes, etc). In both cases, there is probably little perceived value to the reporter (and may be little value to the organisation) and incompatible purposes, and hence a disincentive to report. From a more useful viewpoint, the purpose of reporting may be viewed in terms of learning and improving how the work works. Things like demands, goal conflicts, performance variability and capability, flow and conditions become the things of interest. In other words, the purpose of reporting should be compatible with the purpose of the work itself. See Card 1c, Card 1g and Card 4c.

2. Are people trated fairly (and not blamed or published) when reporting?  

Yes / No / Don't Know

An unjust culture is probably the most powerful reason not to report. If people are blamed or punished for their good-will performance, others will not want to report. The effect has a long shelf-life; these particular stories live on in the organisation, serving as disincentives long after the incident. Punishment may take several froms: inquisitorial investigation interview, 'explain yourself' meeting with the boss, formal warning, public admonishment and shaming, non-renewal of contract, loss of job, prosecution...even vigilante revenge attack. A culture of fear may be cultivated by designed organisational processes. The independent Rail Safety and Standards Board (RSSB) estimated that up to 600 RIDDOR incidents were not reported between 2005 and 2010 due to pressure from Network Rail. One key reason was that contractors were under pressure to meet accident targets - a clear disincentive to report, built into the system. The fears of staff were reasonable and took various forms similar to those listed above. In the case of possible punishment by external organisations, a question mark arises over internal support by the organisation. In these cases, if the organisation is not supportive (legally and emotionally), there is motivation not to report. See Card 3h, Card 3d and Card 3g and Card 3f.

3. Are there no incentives to under-report?  

Yes / No / Don't Know

Messages from organisations that accidents, incidents, hazards, etc., 'must be reported' are cancelled out immediately by institutional perverse incentives not to report. They are often linked to targets of various kinds (either clearly related to safety or not), league tables which count safety occurrences, bonuses, prizes, etc. Many incentives combine reward and punishment and so are devastatingly effective in preventing reporting. The US OSHA notes in a recent whistleblower memo regarding safety incentive and disincentive policies and practices that, "some employers establish programs that unintentionally or intentionally provide employees an incentive to not report injuries". Perverse incentives were identified by RSSB in Network Rail's (at least as it operated then) Safety 365 Challenge, in which "staff and departments were rewarded for having an accident-free year with gifts of certificates and branded fleeces and mugs. But failure to get a certificate could lead to staff and departments being downgraded..." (as reported here). Anson Jack, the RSSB's director of risk, noted that the initiatives together with the culture at Network Rail led to unintended consequences of under-reporting. See Card 1f and Card 4h.

4. Do people know how to report, have good access to a usable reporting method?  

Yes / No / Don't Know

It is easy to assume that people have the relevant information and instruction on how to report, but especially with a complicated reporting system or form, it's worth asking whether people really understand how to report. Complicated forms and unusable systems are off-putting, as is asking for help from colleagues or a supervisors (especially in a stressed environment). Even when people know how to report, if the reporting system is hard to access or requires excessive or seemingly irrelevant input, then you have accessibility and usability barriers in the system. See Card 3j.

5. Are people given sufficient time to make the report?  

Yes / No / Don't Know

Reporting incidents and safety issues needs time to think and time to write. Ideally, the report allows the person to tell the story of what happened, not just tick some boxes, and allows then to reflect on  the system influences. The time provided for the activity will send a message to the person about how important it is. If people have to report in their breaks from operational duty or after hours, then under-reporting has to be expected. See Card 2h.

6. Do people have appropriate privacy and confidentiality when reporting?  

Yes / No / Don't Know

Reporting safety related issues and events can be sensitive in many ways. The issue may be serious, with possible further consequences or may cause some embarrassment, awkwardness or ill-feeling. If people have to go to their manager's office or to a public PC in the café, expect them to be put off. Beyond privacy, confidentiality is crucial. Incident reporting programmes that have switched to confidential reporting programmes have seen significant increases in reports, and not just because of a reduction in fear of retribution. As Dekker & Laursen (2007) reported, with non-confidential, punitive reporting systems, people may actually be very willing to report - at a very superficial level, focusing on the first story ('human error') not the second story (systemic vulnerabilities). Even with confidential systems, the first question that comes to mind for some is not about what, how or why, but rather who. Even confidential reporting systems often require identifying details (such as a name, or else date, time, shift, location, etc), which might be used to try to identify the reporter. Confidentiality shouldn't be an issue in a culture which is fair, open and values learning, but it seems to remain key to encouraging reporting. See Card 3l and Card 3f. 

7. Are the issues or occurrences investigated by independent, competent, respected individuals?  

Yes / No / Don't Know

If the investigator is not independent (and is instead subject to interference), if he or she lacks training and competency in investigation, or is simply not respected, then under-reporting will occur. The location of the investigation function within the organisation will be relevant; independence must be in reality, not just on an organisation chart and in a safety management manual. Ideally, investigators would be carefully selected and would have chosen the role, rather than being forced to do it. Once they are in the role, training in human factors and organisational factors is useful, but even more useful is a systems thinking and humanistic approach, with values including empathy, respect and genuineness. See Card 3n and Card 2a.

8. Are reporters actively involved and informed at every stage of the investigation?  

Yes / No / Don't Know

The best investigations, in my experience, involve reportees (and others involved) properly in the investigation. The reporter, despite sharing the same memory and cognitive biases as all of us (including investigators), is essential to tell their story, make sense of the issues, and think about   possible fixes. How those involved understand the event (including different and seemingly incompatible versions of accounts, which will naturally arise from different perspectives) gives valuable information. Whether those involved are seen as co-investigators or subjects will affect the result and the likelihood of reporting. During and after the investigation, a lack of feedback is probably the most common system problem; often the result of flaws in the safety management system or an under-resourced investigation team. More generally, people need to see the results of investigations in order to trust them. Not providing access to reports may confirm fears about reporting. On the other end of the scale, overwhelming people with batches of reports and forcing them to read lengthy and sometimes irrelevant reports will not help. See Card 3k, Card 3m and Card 8a.

9. Does anything improve as a result of investigations, and are the changes communicated properly?  

Yes / No / Don't Know 

The vast majority of organisational troubles and opportunities for improvement are due to the design of the system (94% if you accept Demming's estimate, p. 315), not the individual performance of the workers. If occurrence reports lead to no systemic changes, it seems nearly pointless to report. Often, individuals have reported the same issue before, to no effect. This teaches them that reporting is pointless, going back to Question 1. Even if system changes are made following reports, not communicating to the wider population, via communication channels that they use, means that people may not know they changes have happened, or that they resulted from reporting. See Card 3i, Card 3c, Card 6d and Card 6h.

10. Is there a local culture of reporting, where reporting is the norm and encouraged by colleagues and supervisors?  

Yes / No / Don't Know

People naturally want to fit in. If colleagues and supervisors discourage reporting, as is sometimes the case, then individuals will be uncomfortable, and will have to balance feelings of responsibility against a need to get along with colleagues. The answer to this last question will nearly always be dependent on the answers to the previous questions, though. See Card 3a and Card 3o.

If your organisation has a problem with under-reporting, the chances are there are a few No's and Don't Know's in the answers to the above. In nearly all cases, under-reporting is a system problem. If you're not sure, and want to find out, ask those who could report about the what gets in the way of reporting (for other people, of course). The Safety Culture Discussion Cards might help.

Using the Safety Culture Discussion Cards: Tips for SWOT analysis from a user

David Thompson, a Human Factors Specialist from NATS, UK, has provided some feedback on the use of the Safety Culture Discussion Cards for a SWOT analysis. David organised a session involving six groups, each with a facilitator, and each tackling one element of safety culture. The facilitators distributed cards around the table and the groups discussed each of the topics on the cards (in terms of Safety within NATS) to identify the Strengths, Weaknesses, Opportunities and Threats. Facilitators then recorded the highlights on a flip chart. At the end of the 30 minute session – each facilitator was asked to give the away day audience a brief summary of their topic.



David summarises as follows:

We used the Eurocontrol Safety Culture cards to facilitate a SWOT group discussion within the Directorate of Safety, NATS. The cards proved a very useful basis upon which to stimulate discussion into the varied themes covered. The cards themselves can be employed in a number of simple ways, with helpful examples provided. The whole purpose of which is to get people talking about safety! I see no reason why these cards cannot be used to explore different safety themes within any safety critical organisation. Whilst the cards provide a great platform to discuss safety, for the cards to have residual value, it is important to consider how any safety concerns raised could be managed beyond the horizon of the immediate discussion.

The exercise was organised so that each group had the cards for one element of safety culture:


One useful insight related to the fact that there are different numbers of cards in each element. For instance, the element 'Just culture, Reporting and Learning' has many more cards that 'Responsibility'. One facilitator commented:

The various categories work well, although some topics are in my view more interesting to discuss than others. There are more cards in some areas than others, I don’t think this is a problem; it’s just how the material falls across the categories. But one must be mindful of this, as certain categories may result in longer discussions than others.

A facilitator suggested that it may be better sometimes to give each group a more random set of cards, and perform a SWOT analysis with these, so that the outputs could be compared between groups:

Because we were doing a SWOT analysis into the different category areas, each table’s outputs were different. In all honesty, perhaps the best strategy would have been to randomly assign the cards across the different groups, which would have provided a more homogenised output. When we went round the room one table at a time, this would have allowed a peer comparison as to if we touched on the same topics. Although having said that, there were several common themes identified particularly in the area of ‘Threats’.

The SWOT approach allows a balance between positive and negative safety issues and so helps avoid falling into the trap of seeing safety culture only in a negative light.

Using the Safety Culture Discussion Cards to help understand textual data

‘What we call our data are really our own constructions of other people’s constructions of what they and their compatriots are up to’ (Geertz, 1973)

Probably the most common approach to trying to understand safety culture is via safety climate questionnaires, usually comprising a set of items with a Likert-scale to indicate the level of agreement with each item. Unfortunately, such questionnaires alone do little, if anything, to help understand the meanings that people ascribe to their values, beliefs and behaviour, and so do not explain why we do things, why we do things in the way that we do them, or the conflicts between what we say and what we do. To gain a deeper understanding, a qualitative, interpretive approach is more fruitful, not necessarily to supplant questionnaires, but at least to supplement them. Prior to interactive methods such as focus groups and interviews, one source of data from the questionnaire itself can be a useful starting point to an interpretive approach - the free-text comments written by the respondents.


I recently used the Safety Culture Discussion Cards to help analyse several hundred typed/written unstructured comments from a safety culture questionnaire - a fairly large amount of textual data. Many of the comments were several paragraphs long and referred to a variety of issues, and were mostly very interesting, well thought out and well-written. Making sense of rich textual data is never easy. But a common approach to understanding is via 'content analysis' (Krippendorff, 2004), or textual analysis. This often involves reading the text and applying a set of codes or categories to try to understand the data.

In this case, I decided to try to use the Safety Culture Discussion Cards to help code the data. The aim was to get a detailed understanding of the issues that questionnaire respondents were motivated to comment on - the specific issues, the way the writers related issues to each other, and the number of times that each issue was mentioned. An assumption was that issues mentioned more often by respondents reflect concerns that are important to them.

The cards cover most relevant aspects of safety culture but are (deliberately) not mutually exclusive, so this had to be kept in mind during the analysis. Prior to and during the coding, it was necessary to remove or combine cards as appropriate in order to achieve some satisfactory level of mutual exclusivity.



I started the analysis by reading all of the comments very carefully, and coding pieces of text within each comment using the eight elements of safety culture covered by the cards (Management Commitment; Resourcing; Just Culture, Reporting & Learning; Risk Awareness & Management; Teamwork; Communication; Responsibility; Involvement). Because a person's comment could cover all sorts of issues, it is not possible to apply just one element code to each comment. Even a particular sentence within a comment could cover two or more issues, such as 'Management Commitment' and 'Resourcing'. So at this stage, a sentence or paragraph could be coded using one or more elements.

The next stage was to re-read the comments and now apply more specific codes to the various pieces of text. The specific codes relate to the codes on the safety culture discussion cards, from 1a to 8e, noting also where the text was positive/favourable or negative/unfavourable in nature, or sometimes both. Since some of the cards overlap, where a piece of text could be coded using more than one card (and the cards could not reasonably be mutually exclusive) the codes were combined.

The final stage involved rechecking the use of the codes for each comment to ensure consistency and calculating the usage of each code. (An even more rigorous application of this method would involve having independent coders repeat the exercise with all or some of the text, as I and Amy Chung did when analysing comments relating to HF/Ergonomics practitioners' views on barriers to research application; see Chung and Shorrock, 2010.) This allowed the relative frequency of each issue to be determined, and gave an impression of the perceived pertinence of the various issues.

The frequency of each element as well as the top 20 issues were calculated. The quantitative data, combined with discussion of the actual content of the comments, added substantially to the data received from the Likert-scale standard questionnaire items.

A final interesting output from this exercise is the ability to the the cards to visualise the narratives in the comments by mapping the relationships between issues and the possible meanings emerging. This will be the subject of a different blog entry. The exercise also revealed a few issues that are not covered by the existing cards, as well as the issues that are covered by the cards but that were not mentioned at all by the commenters. This is useful feedback for the further development of the cards.

References

Geertz, C. (1973). The interpretation of cultures: Selected essays. Basic Books.
Krippendorff, K. (2004). Content analysis: An introduction to its methodology. Thousand Oaks, CA: Sage.
Chung, A.Z.Q. and Shorrock, S.T. (2011). The research-practice relationship in ergonomics and human factors - surveying and bridging the gap. Ergonomics, 54(5), 413-429.

Five questions about boredom, fatigue and vigilance

Below are five questions posed by a safety colleague, and the brief responses.

1. How different are boredom and fatigue?
Both affect our ability to pay attention - to notice something that may need attention - but they are different in terms of their causes and can occur completely independently. A person can be bored during a period of low activity, but not fatigued. Prolonged boredom, tends to result in fatigue, but so can high workload, lack of sleep or disruption to sleep patterns, or stress. Other than sleep or rest, there is little that you can do to manage fatigue effectively while on position, while more can be done to tackle boredom and stay in the loop. So preventing and managing fatigue is a key priority to ensure that people remain able to deal with unusual events.

2. Is low workload more dangerous then high workload?
Attention is stretched by both 'overload' and 'underload'. Both require hard work and can be stressful, particularly if there are safety consequences when something is missed. Which is more dangerous will depend on the situation and the person (for instance personality, experience and levels of stress and fatigue), but skilled professionals tend to cope better with higher workload up to the point of overload, when performance degrades more dramatically.

3. How to remain aware and vigilant for unusual situations?
Ask colleagues - people develop different visual and mental strategies that may not be obvious from the outside. But applied research using eye movement tracking gives some tips in terms of scanning. So-called "active scanning" can help to counteract degraded vigilance under low workload situations. With active scanning, people scan displays proactively in sequences or cycles depending on the traffic situation, linking specific information from different information sources. The scanning is more strategic, and helps to anticipate developing situations.

4. When are we most and least vigilant?
In a non-shiftwork environment we could highlight some times of day when we are least alert, especially during the very early morning hours, but shiftwork is a fact of life for many workers working a 24-hour operation. What we can say is that we are most vigilant when well rested, engaged and interested in the activity, not distracted (e.g. TV, radio, visitors) or preoccupied with other thoughts, well hydrated, and well supported by colleagues and supervisors.

5. Is the theoretical human performance knowledge adding value?
Yes, but not nearly as much as it should. So much is known about human performance that it seems that policy and practice are decades behind. But so much that is published is irrelevant to complex systems and activities, does not offer solutions, and technology and practices change fast and do not wait for research to catch up. Much theoretical knowledge in human factors comes from sterile experimental environments, normally focusing on one issue (e.g. vigilance) while 'controlling' (or ignoring) some of the most relevant real-life issues that interact to shape performance in the real world (e.g. motivation, risk, teamwork, supervision, background shift-fatigue). The hard part for practitioners is evaluating what aspects of the research are relevant, piecing them together and drawing out practical implications. With this in mind, the most directly useful human performance knowledge is gained by spending time with end users, listening to and observing them at work, and working with end users and other stakeholders to find solutions to human performance issues.

Should the Institute of Ergonomics and Human Factors be more of a campaigning organisation? Yes.

Published in 'The Ergonomist', Newsletter of the Institute of Ergonomics and Human Factors, October 2012, p. 4

In September's The Ergonomist, the President of the Institute of Ergonomics and Human Factors asked whether the IEHF should become more of a campaigning organisation. Assuming that we want to be a relevant organisation, then the answer must be 'yes'. While we have many interesting research findings and effective applications, we rarely seem to communicate our impact in the world.

It is a sad state of affairs that the 'impact' of publicly-funded research is judged primarily by the citation of journal articles by one's fellow researchers and oneself. It is equally sad that we have so few press releases, white papers, blogs or videos of our impactful theories, findings or applications. We seem to put most effort into forms of communication that are least visible to policy makers, decision makers and the public. Perhaps this is why we are still too anonymous to the wider world.

We cannot be content with only writing to each other via Old Media or speaking to each other in closed conferences if we want to make a visible difference. The research article or technical report should not be the end of the line for any of us. If we think that our discipline is important, then we need to to be confident and decisive in our messages and campaigns, and clever in how we convey them.

It is great to see that our engagement with social media is growing (e.g. LinkedIn, twitter) and that we have had recent public exhibitions. But we need more involvement. We need to be prolific not in how much we write, but in the effectiveness of our communication with decision makers, those affected by our work, and the world at large.

We need to put more effort into the usability of our communication with the world. Think Wordpress, Blogger, twitter, pinterest, Google+, flickr, picaso, Amazon, LinkedIn, Experience Project, e-petitions...as well as letters, magazines, and face-to-face, of course. None of us has 'time' for this, except the time that we prioritise for it. As Jon mentioned, raising awareness isn't just a job for the IEHF. It is for all of us to ensure that our research and practice remains relevant to the world and has broad impact. 

Steve Shorrock

Using the Safety Culture Discussion Cards: Tips from a user

I have received some great practical tips (and considerations for the future) from an ATC Safety colleague who had used the Safety Culture Discussion Cards with several different groups. Thanks to Alfonso Barba Martínez (Head of Regional Safety at AENA, the Spanish Air Navigation Service Provider) for the tips below!

Basically, I find it essential to make an introduction to the aims of the cards and the different ways to use them. What I find could be an improvement is to introduce simple cues for those having to administer them as `facilitators´, because what we have been doing until now is introducing the product to those who can make a better use of it (Instructors, Supervisors, mid-management). This made me think that it might be useful to explain a bit further what the outcome of the cards can result in. So basically I would cue those administering the cards on:

a) Make sure who your audience is, and prepare specific cards for them on each element.
b) The cards are an excellent tool to insert into any meeting as an added practical activity, breaking frequently tedious expositions and offering some `brain refreshment´.
c) Don´t use the cards with more 10-12 people? Otherwise the discussion might drift away very easily.
d) Is anyone supposed to take notes? As facilitator I advised them I would be taking notes, and the different comments and views expressed allowed me to identify weak points in which future safety strategies may be focused on at local level: shifts, fatigue management, airport signaling.
e) Also, I would favour using Option 2 Safety moments at the beginning, as it is a lot easier to engage people in a straight forward discussion on just one item, two maximum.
f) In the `How to use this Cards´ section, Options 1 Comparing views, Option 3 Focus on... and Option 2 SWOT analysis don´t necessarily need to use all cards, but it sounds like you must. It all depends on time available and going through all of them should not be the objective.
g) Be careful with the card selection when mixing groups with different activity areas, i.e. Human Resource, Maintenance, ATS, Financial and again, have relevant questions prepared beforehand.

I hope this can be useful to you. As I say, it is mainly focused on the tasks by those presenting the cards to others who must deal with different audiences, and could perhaps feature as a card of its own at the beginning.

In the near future, I'll be blogging on each of the options for using the cards, and it would be great to hear of any other options for how the cards have been or could be used. In the meantime, you can read more about the cards (and download them all as a PDF via the link at the end of the page) here, and see the individual cards as images here.

Reading on the job: fatigue, boredom and distraction while underloaded

I have received a few queries asking for a view (or "the science") on reading during operational duty, particularly as a possible countermeasure against fatigue during nightshifts. This is in an air traffic control context, meaning reading while a controller on duty at workstation, but it would apply to many other safety-related contexts where people need to monitor.

This is a sticky issue. But it is the kind of issue where a human factors specialist is expected to give advice or at least some succinct guidance or points for consideration. This kind of query is rarely straightforward. The 'science', inasmuch as it is relevant, cannot be simply generalised from laboratories or other contexts, and there is rarely any possibility for controlled experiments to study the problem directly. So, is reading a suitable countermeasure against fatigue? Below are some of my thoughts on this issue.

The task of the air traffic controller, as with many other safety-critical roles, is increasingly visual with high demand for monitoring. Automated tools such as data link and conflict alerts are becoming more common. They usually do not have any associated audible alert or alarm and may not be expected or anticipated. As people naturally become more reliant on such automated aids for normal performance, the need for alertness is even greater.

But there can be fairly long periods of low activity. Reading during operational duty is fairly common during these periods. The motivation to read is one that we can all identify with. We have little tolerance for monitoring when understimulated, and naturally want to fill in the gaps with other activities. Stimulation is often at its lowest during a nightshift (particularly ~0200-0500), when we also experience heightened fatigue. In this scenario, reading may seem like a good idea to maintain alertness. 

But what are we really trying to combat via reading during periods of low activity? Most likely, we use reading to combat boredom rather than fatigue. Boredom is an unpleasant or even distressing state that we naturally wish to avoid. Reading can be stimulating (and effective to counteract boredom) but it can also be visually fatiguing (especially during night shifts). 

Reading, fatigue, boredom and distraction (Photo credit: Ani-Bee http://flic.kr/p/LaxT3 CC BY-NC-ND 2.0)

There is then the issue of distraction. Reading may mean reading from paper (book, newspaper, etc), an e-reader, a smart-phone or a tablet. Reading itself is a primary distraction from operational information, but smartphones and tablets introduce secondary distractions from other applications, such as emails, instant messages, tweets, status updates, notifications, etc - many of which are designed (or can be set) to capture attention (e.g. via pop-up notifications or alerts). 

Reading feels like the most natural way to repel boredom and so maintain stimulation, but at the same time it can increase fatigue and distraction and decrease vigilance and alertness - a situational irony. 

Then there are the legal implications. In the case of a serious incident or accident, reading non-operational material when visual detection may be safety critical could be raised in court, because reading takes attention away from the primary task (e.g. radar monitoring). An argument could be made (ignoring the whole context of the work) that if the person were not reading, then a problem (e.g. conflict) would more likely have been detected. 

It is important to separate the problems of fatigue and boredom because the countermeasures are different. Fatigue requires rest and sleep. Boredom requires stimulation. But often they come as a package, in which case fatigue will usually trump boredom, as fatigue is so much more difficult to counteract without prior planning. A better way to manage fatigue during nights might involve more frequent breaks and scheduled napping, as well as a well-designed shift system (see a EUROCONTROL literature review and Hindsight  Issue 13 on fatigue).

Combating boredom on an operational level also requires frequent breaks - there is positive evidence that light exercise such as a brisk 10 minute walk helps increase arousal. Breaks are only a partial solution, though, because the problem is one of job and task design.While these are not easy to change, while working on position, other tactics might include more active visual scanning (as opposed to reactive scanning), and increasing workload (e.g. combining sectors, offering higher service levels), or rotating activities, tasks or roles (e.g. sectors, positions or non-operational work). A 1996 EUROCONTROL-sponsored research project examined monotony in ATC, and came up with a few recommendations (page 184), but these do not shed much more light on the matter. Note that some other 'common-sense' tactics, such as playing music, can also be counterproductive because of distraction. In the longer term, more strategies are available via personnel selection (some people have a greater tolerance for boredom) and task, job and technology design (for instance, auditory alerts to complement visual information during specified hours), but these options are of little relevance to current operations. 

So reading itself is probably not an effective countermeasure for fatigue while on duty, but we have to recognise that the desire to read indicates another problem that needs to be addressed: boredom. Until we are able to design the boredom out of jobs, it would be useful, then, to share the practical strategies used by different people in different organisations and industries to maintain alertness and vigilance, and fend off boredom, in real world safety-critical environments.