Fatigue does show up in worse decisions and more errors
The clearest link is between fatigue and error-prone performance. A scoping review of 38 studies of hospital nurses found that 82% identified fatigue as a contributing factor in medication errors and near misses, and it associated fatigue with reduced cognitive performance, weaker attention and vigilance, and poorer patient safety [2]. In intensive care nurses, higher alarm fatigue — the weariness produced by constant device alarms — went together with a greater tendency to make medical errors, and each one-unit rise in alarm fatigue corresponded to a 0.263-unit rise in that tendency [1].
A conceptual paper on aviation adds a different kind of fatigue to the picture. It proposes that cumulative or poorly sequenced organizational change can deplete cognitive and emotional resources and contribute to vigilance loss, reduced procedural adherence, and decision errors, even when ordinary physiological fatigue controls are in place [3]. That is a proposed model with testable propositions rather than a measured outcome, so it should be read as a hypothesis about a mechanism, not a demonstrated cause.
Little control over work is linked to feeling more fatigued
The second half of the chain concerns control. In a survey of 300 people teleworking during the first COVID-19 lockdown, work fatigue was higher among those facing high job demands, and the study treated job control as one of the acknowledged psychosocial predictors of work fatigue [4]. The same study found that fatigue was lower among teleworkers with better privacy fit — a workable, undisturbed home workspace — and that noise and crowding at home predicted poorer privacy fit [4].
That matters for the question because privacy fit and control over conditions are close cousins: a worker who cannot arrange a quiet space has little say over the environment in which they work. The study measured fatigue, not decision errors, so it supports the first link in the chain — low control to more fatigue — without testing the second.
Why the two links probably connect
Put the pieces together and a plausible pathway emerges. Fatigue degrades attention, vigilance, and cognitive performance [2], and demanding, low-resource working conditions raise fatigue [4]. If a worker has little control over hours or conditions, they have fewer ways to protect themselves from the demands that produce fatigue — for example, by adjusting shift patterns, reducing overtime, or securing an undisturbed workspace. The scoping review specifically flags night work and overtime as work characteristics that make nurses susceptible to fatigue, and calls for safe working-hours policy to be re-evaluated [2].
The aviation model offers a compatible account at the organizational level: when the resources available to workers are inadequate relative to the demands placed on them, cognitive overload can follow and safety-critical performance can suffer [3]. This is a framework built from stress and coping theory and the Job Demands–Resources model, so it explains why the connection is reasonable rather than proving it happens.
What the studies did not actually test
The honest answer is that the specific question — do low-control workers carry a larger burden of fatigue-related decision errors — has not been directly measured in these studies. The intensive care nurse study measured alarm fatigue and error tendency but did not examine control over hours or conditions [1]. The nurse medication-error review focused on fatigue and errors without isolating low control [2]. The teleworking study measured fatigue and job control but not decision errors [4]. The aviation paper is conceptual and does not examine workers' control over their hours or conditions [3].
One further study looked at how lighting color temperature affected risky decision-making in fatigued people, but it addressed neither job control nor working conditions, so it does not close the gap [5]. The practical reading is that the burden is likely real and worth taking seriously, especially where overtime and night work are routine [2], but the size of the extra burden borne by low-control workers remains an open question that would need studies measuring control, fatigue, and decision errors together.
Sources used in this answer
The effects of alarm fatigue on the tendency to make medical errors in nurses working in intensive care units
Among 382 intensive care nurses, higher alarm fatigue was significantly correlated with a greater tendency to make medical errors, with each one-unit increase in alarm fatigue associated with a 0.263-unit increase in error tendency.
Fatigue in nurses and medication administration errors: A scoping review
A scoping review of 38 studies found that 82% identified fatigue as a contributing factor in nurses' medication errors and near misses, linking fatigue to reduced cognitive performance, attention, and vigilance, with night work and overtime as contributing factors.
The Human Toll of Change: Reframing Fatigue as a Latent Risk in Aviation Human Factors
This conceptual paper proposes that cumulative or poorly sequenced organizational change can produce 'change fatigue' that depletes cognitive and emotional resources and contributes to vigilance loss, reduced procedural adherence, and decision errors.
Work fatigue during COVID-19 lockdown teleworking: the role of psychosocial, environmental, and social working conditions
In a survey of 300 teleworkers during COVID-19 lockdown, work fatigue was higher with high job demands and lower with better privacy fit, and noise and crowding at home predicted poorer privacy fit.
The Effects of Correlated Color Temperature on Risky Decision-Making in Fatigued Individuals: An Event-Related Potential Study
The study examined how correlated color temperature affects risky decision-making in fatigued individuals using event-related potentials, without addressing job control or working conditions.