Accumulated (chronic) fatigue is defined as fatigue from which normal rest does not produce recovery. Accumulated fatigue is often caused by extended periods of stress with inadequate recovery periods, which results in decreased productivity, compromised immune function, and reduced alertness. Fatigued workers perform poorly, behave carelessly, tolerate greater errors and become inattentive. Chronic fatigue often results in increased stress, which may present itself through certain behaviorial and physiological indicators, such as those described below:

•Decreased motivation and low morale

• Increased irratability and depression

•Confused, poor problem solving
Poor abstract thinking
poor attention/decisions
poor concentration/memory

•Altered state
A marked increased or decreased awareness of surroundings

•Physical reactions (any of these symptoms may indicate need for medical evaluation. When in doubt, contact a medical professional)
Chills
Thirst
Nausea
Fainting
Twitches
Vomiting
Dizziness
Weakness
Chest pain
Headaches
Elevated blood pressure
Rapid heart rate
Muscle tremors
Profuse sweating
Difficulty breathing

•Extreme emotional responses
Fear
Panic
Intense anger
Emotional outbursts
Feeling overwhelmed
Loss of emotional control
Inappropriate emotional response

•Social/behavorial changes
Withdrawn
Antisocial acts
Erratic movements
Change in speech patterns
Change in usual communications
Alcohol or substance abuse

•Recommendations for chronic fatigue/stress are:
Take longer periods of rest/recovery
Ensure that workers are adequately rested before they begin workshifts
Slow the work pace to a moderate level on physically demanding tasks
Provide periodic rest breaks to allow physical and mental recovery
Alternate between heavy and light tasks
Change assignments to prevent boredom
Provide breaks, naps, or time off after tasks have been completed
Eat well-balanced meals regularly, with energy supplements during periods of high exertion.
Maintain hydration
Ensure workers maintain good personal hygiene
maintain high standards of physical fitness and work capacity
Seek medical attention when in doubt of symptoms
In extreme cases, personnel may need to be relieved of their duties

These tips are specific to Firefighters, but can be applied to all walks of life. Be brave, be honest and be safe.