Coping With Shift Work

According to Statistics Canada, in 2000/2001 three out of ten employed Canadians worked shift work. In the United States, it is estimated that over 15 million Americans work evening, night or rotating shifts (Bureau of Labor Statistics, 2001).  Shift work is defined as "work that is scheduled outside of the normal daylight hours of 9am to 5pm".  Common occupations that require shift work include health care, customs and immigration, transportation, police and firefighting services.  Interest in the effects of shift work has increased because many experts have blamed shift work for the “human error” resulting in nuclear power plant incidents, air crashes, and other catastrophic accidents.

Negative Effects of Shift work

Circadian Rhythms

The majority of human physical functions follow a daily rhythm of a 24-hour cycle.  These cycles are called circadian rhythms and are more commonly known as our “biological clock”.  Important aspects of bodily functions and human behavior, such as waking, digestion, secretion of adrenalin, body temperature, blood pressure and pulse, are regulated by this 24-hour cycle.  These processes are coordinated to allow high activity during the day and low activity at night, and are “reset” every 24 hours.  Environmental cues, such as light and darkness, as well as meal times, social activities and clock time keep the various rhythms on track and “reset” them accordingly.  When working during the night and sleeping during the day, this is opposite to the body’s natural biological clock, which can result in difficulty sleeping as well as a slower recovery rate from physical and mental exertions.  Some rhythms take two to three days to adapt to shift work while others change only after long periods of time.  Normally on days off, people revert to their “normal” day schedule therefore a total reversal of circadian rhythms may never occur, and frequent disruptions can lead to chronic fatigue and other health problems.

Changes in Sleep Patterns

The quality and quantity of sleep is compromised when working shift work.  Sleeping during the day is often not as deep or as refreshing as sleeping at night, plus shift workers often find it more difficult to fall asleep when they return home in the morning.  This difficulty occurs because the circadian rhythms are in conflict.  After a night shift, you go home and want to sleep but your body may think it is time to wake up.  This usually results in the complaint of constantly being tired. 

Gastrointestinal Disorders

Night and shift workers complain of an increase in gastrointestinal and digestive problems such as indigestion, heartburn, stomachache and loss of appetite.  The timing of meals is often irregular when working shift work, and loss of appetite when working nights often leads to increased consumption of junk food and caffeinated beverages to help cope with the feeling of fatigue. 

Cardiovascular Disorders

Shift work can be associated with cardiovascular disease, as it does influence the natural circadian rhythm of heart rate, blood pressure and hormone secretion.  In a study that examined the association between shift  work and the risk of heart disease among Japanese male workers, it was determined that men who worked rotating shifts were twice as likely to die of heart disease such as a heart attack compared to those who worked day shifts.  It was also found that rotating shift workers who already had risk factors for heart disease, such has high blood pressure, were 3.5 times more likely to die of heart disease than day workers with the same risk factors. It is therefore very important that shift workers follow a proper exercise regime and dietary habits to reduce the risk factors for heart disease.

Effects on Family and Social Life

Individuals who work shift work report a greater interference to their family life, particularly spending time with spouses and children.  Individuals who are unable to maintain a regular daily routine have difficulty planning family responsibilities, participating in clubs, sports and other organized events.  This lack of social involvement can lead to feelings of stress, loneliness and isolation.

Strategies for Coping with Shift Work

For the Employer

· Schedule rotation of shifts forward from day to afternoon to night as this allows the circadian rhythms to adjust better.

· Provide an environment with good lighting and ventilation, and allow workers to work in close proximity to one another to reduce the feeling of isolation.

· Provide full cafeteria services throughout the night shift so that workers can maintain a balanced diet.

· Consider providing shift workers with recreational activities through company sponsored sports teams and organized groups as these opportunities are often minimal for shift workers.

Educate employees on the health and safety effects of shift work and what can be done to alleviate these effects such as through stress recognition and reduction.

For the Shift Worker 

· Maintain regular eating patterns through balanced, varied meals.  Attempt to maintain at least one daily meal with the family to help keep communication channels open.

· Time meals appropriately.  Afternoon workers should aim to have their main meal in the middle of the day instead of at the middle of the work shift.  Night workers should eat lightly through the shift and have breakfast when they return home from work before going to sleep.

· Drink plenty of water throughout the shift.  Avoid greasy foods, salt and excessive amounts of caffeine particularly at night.

· Avoid use of antacids, tranquilizers and sleeping pills.  Attempt to use relaxation techniques to aid sleep.

· Sleep on a set schedule in order to make sleeping during the day easier.

· Make sure you have a dark, quiet, comfortable place to sleep during the day without any disruptions from family members and telephone calls.

· Utilize relaxation techniques, such as reading or deep breathing,  prior to bed to help get better sleep

· Use physical fitness and relaxation techniques for stress reduction.

· Socialize with other shift workers and their families to help minimize the disruption that shift work has on social life.

References

Canadian Centre for Occupational Health and Safety (CCOHS). 

Available at:  http://www.ccohs.ca/healthyworkplaces/topics/shiftwork.html

Occupational Health Clinics for Ontario Workers Inc.  "Shiftwork: Health Effects & Solutions."  Available at: http://www.ohcow.on.ca/resources/handbooks/shiftwork/shiftwork.pdf

Shift work and health.  Health reports, Vol. 13, no 4.  Abstract available at: http://www.statcan.ca/Daily/English/020725/d020725b.htm

National Institute for Occupational Safety and Health (NIOSH).  Work Schedules: Shift Work and Long Work Hours.  Available at:  http://www.cdc.gov/niosh/topics/workschedules/

Fujino, Y., Iso, H., Tamakoshi, A., Inaba, Y., Koizumi, A., Kubo, T., Yoshimura, T. (2006)  A Prospective Cohort Study of Shift Work and Risk of Ischemic Heart Disease in Japanese Male Workers.  American Journal of Epidemiology, 164(2):128-135

Sandalwood Enterprises is a consulting firm that specializes in Ergonomics, Process Optimization, and Information Management. The Ergo Tip of the Month is offered to our customers and friends for the benefit of the Ergonomics community. To request information on our services, click here.