Shift workers


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from Health Action October 2012

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Shift workers

  1. 1. rt*ii-iiiiiii#,i?,1ii:,i.i,:iii#t##lr+:{f-qtrf *?.T.f iiflg Occupational ffazards Shift of Workers K Mahalakshmi Sangeetha ork efficiency and output are very much to adjustto the new cuesbut they adjustslowly and at dependent the healthand physicalfitness on different rates.(Totterdell et al., 1998). of an individual.Provisionof nutritionally Shift work may aggravatecertain medical disorders adequate diets tbr uorkers is appreciatecl onlv as not relatedto circadianrhythm disruption,psychosocia an importantlbrnard step in socialprilctlcebut al:tr tres and/orsleepdeprivation. The Tablebelow lists for increasingindustnaieftlciencr. conditron:that mar be eracerbated ag_eravated or by T o d a y ,m a n y p e o p l ev i e n s h i f t * o r k a s d r i r r n s rrregular schedules and/ornisht nork and are thus societys response challenges to ofthe needtor constanr potential conrraindications shifi u ork. for growth and prosperity.The past few decadeshave Table witnesseda tremendous growth in the populationof shift Potential Contraindications for Shift work workers, especially in the developed and highly Condition Examples/Considerations industrialized countries. Gastrointestinal Peptic ulcer disease,gastritis, Hazards night shift work of disorders irritable bowel syndrome Researches show that shift work, in particularnight Diabetes Potential disruption of dietary and work, can have negativeeffect on health, safetyand mellitus pharmacological controldue to well-being of workers which includes both short and , irregular timing of meals and I long-term. medicationdosing i Circadiun Rhl,thmis defined as the oscillationsin Epilepsy Increasedfrequency of seizure the biochemical, physiological, psychological and episodesdue to sleepdeprivation behavioural functionsof an organismwith a periodicity Cardiovascular Additional risk factors for of 24 hrs. There is sufticient evidenceto prove that disease cardiovasculardiseaserotational shift work affects human health andperformanceb1 disturbing circadianrhythms causing Psychiatric Increasedsusceptibility forn u m e r o u sa l t e r a t i o n si n h u m a n b e h a v i o u r sa n d disorders depressionphysiology.(Deetcon Arendt , Igg4) untl Sleepdisorders Circadianrhythm disruption of A modernhumanbodlcontains ancient genetic codes. sleep/wakecycle and poorThese codes were programmedas our ancestors daytime environmentalconditionssynchronized their activitiesto dayli-eht. darkness and for sleepingseasons the year.The level of light enterin-s eve of thetriggershormone shift and therebythe body then sets Reproductive Potential additional risk factor for preterm birth, low birth-weightits biologicalclock. This clock actslike a choreographer dysfunction and spontaneous abortionof an intricate dance. But shifi work disrupts thiscomplex dance as the switch to night work triggers Continuouswork in the night may lead to chronicchanges bodily rhythms.The changed in rhythms start partial sleep deprivation.In addition to performanceflealth Action . October2012 t4
  2. 2. decrements. chronicsleepdeprivation may leadto many gastrointestinaldisorders in shift workers probablyother clinicai complications. The association between involve dietaryandlifestylefactorsaswell ascircadianshift u ork andsleepdisruptionresultsin adversemedical disruption.In additionto eatingat unusualtimes, shiftand p:1chological consequences. workers may alter their diet due to lack of eating Chronobiologicalobservations have raised concern facilities availableduring the night shift. Circadianthat shiftworkersmay be at increasedrisk of developing rhythm disruption also contributesto gastrointestinalaffectivemood disorderssuchasirritability, fatigue,poor dysfunction. (Steenland Fine,1996: Tepas utrcl 19901sleep, apathy, poor appetite, and psychosomatic While some studieshave not found an increasedcomplaints.In addition, changesin mood have been incidence pepticulcerdisease of (PUD) in shift workers,shown to be associatedwith irregularity of sleep the majorityof studies, addressing outcome,have. thispatterns, with sleepdeprivation{Boivinet al.,1997: and Relevant factors applicableto shift workers include:Healy and Waterhouse, I )199 sleeplossand disruption,psychosocial stress,skipping According to Johnni (2000), the level of cortisol, a meals,and delayedgastricemptying. (Levensteirt ethormonethat stimulatesthe heartrate,digestivesystem, al.,1999).breathing and other functions during the day did not Mamelleet al.(1984)studied relationship the betweenadjust to help night shift workers stay alert. occupationalfatigue factors andrisk of prematurebirth. Severallab studiesconfirm that sleep disturbances McDonald and co-workers found an associationalter the regulationof severalhormoneswhich include between rotating shiftwork and an increasedrisk ofcortisol,,prolactinandgrowth hormonein night workers spontaneous aborlion.The few studies which havebeenand also studieshave shown that working nights and publishedstudyingtime to pregnancy raisethepossibilitybeingon call arenot only related increasedto adrenaline that shift work and long hours of work may reducerelease but alsoto reducedlevelsof testosterone(-/o/znfecundity, particularly of the female partner. ,Axelsson,2003 ) The findings suggest that night time exposure light to Peoplewho work in rotationshiftshave signiflcantlv may elevatebreastcancer risk by suppressing productionl o w e r l e v e l s o f s e r o t o n i n : a l t o r n t o r t e a n d of melatonin. brain hormonethat is made during aneurotransmitter the centralnervoussvstembeliered darkrre::and that normallr peaksat in ( play an importantrole in the re_eulation impulses 2(t0I t ofresponding emotionalandbehavioural to changes.This Short-term effects of shitl work include disturbedresults in cumulative featurescharacterizing "non- sleep,fatigue,stress, irritability,psychosomaticillness,entrained syndrome" which includes fatigue, mood family problems and accidents.Long-term e.ffects ofchanges,erratic behaviour, irritability, decreased shift work are increased risk of gastrointestinal,attention,loss of memory and concentration. poor cardiovascular, psychoneuroticdiseasesand womendecision-making,fading of judgment and decreased shift workers experienceadverse effects on theirproductivity. hormonaland reproductive functionsand lamily roles. Although the reason not clearly understood, is working The term shift (SMS) work maladaptation syndromenights also appearto riase personsrisk of ischemic has been used to describethe typical constellationofheart disease.This may be linked to an elevation of signs and symptoms seen in shiftwork-intoleranttriglyceridesin night shift workers.(Grossman,1998). workers. In SMS, the symptomsare pronouncedand It is documentedthat dietary intake is lower during insteadworsenwith continuedexposureto shiftwork.night shiftsthan during morning andaftemoonshift. The The longer the worker stays on shiftwork, the worseredistribution of food intake from diurnal eating to the symptoms become,andeventually, worker may thenocturnaleating is relatedto serum total cholesterol, be fired, quit his job, or be involved in an accident. ALDL cholesterol and HDL cholesterol which might worker with SMS is likely to get into a vicious cycleincreasethe risk of CVD. (, 1994) due to the lack ofrecognition and understanding ofthe Gastrointestinaldysfunction is common in shift problem by himself/herselfand/orby othersnot familiarworkers.Gastrointestinal complaintsincluding diarrhea, with the condition.Inability to adjustfamily/sociallifeconstipation, excessflatulence,abdominalpain, hearl to the work scheduleand poor scheduledesign mayburn etc are 2 to 3 times more frequent amount shift significantly contribute to the degree of intolerance.norkers. (Leanne 1999). The etiology of (Coleman,l9B9)H e a l t hA c t i o na O c t o b e r 0 1 2 2 l5
  3. 3. Diet and Exercise measuresCounter Caffeine should not be ingestedcloser than around 5Sleep Strategies hours before bedtime. Shiftworkers are advisedto limit The specificshift work schedule designis a significant the doseto around300 milligrams of caffeineper dayandvariable affecting the degree of sleep difficulties to avoid caffeineduring the lasthalfofthe eveningshiftexperiencedbyindividual shiftworkers Knauth, (I99n or night shift, sincethe workers bedtimewill comesoonhas provided detailed practical recommendationsfor after gettinghome.Fruit juice is a good alternativedrinkachieving chronobiologicallysound shift schedule for the secondhalf of the the constraints of the shift schedule principles Good dietary habits and exercise are recommendedindividuatworkerscan applychronobiological After doing the for all workers for preventive health reasonsTheseto determine besttime for sleeping the recommendations, course, apply to shiftworkers as ofnight shift, going to bed assoonaspossibleafter arriving well as regular day workers. Based on the researchhome will usually maximize sleeplength Workersoften discussedabove, concerningCVD and shiftwork it isbenefit from taking a nap for about 2 hours, in the even more important for shiftworkers to follow evening before beginning a run of night shifts Other havebeen preventivehealthrecommendations reducingthe risk for recommendations rotatingwork schedules for of .oronuty heart disease. Additional dietary addressed Monk andFolkard(1992)Applying "Sleep by precautions for shiftworkers include avoiding heavy Hygiene," techniques (regular procedures and gr"u.y or otherwisedifficult to digest mealsbefore bed behavioralrules which enhance ability to fall asleep the ti-" t. during the night shift.(Levenstein al, 1999) et and stay asleep)initially developedto help patientswith Physical fitness training has been demonstrated in primary insomnia. is also recommended for shiftworkersto reducegeneralfatigue and sleepiness shiftworkers. work. increasesleep duration somewhat,and R e c o m m e n d a t i o n s o r a g o o d s l e e p h y g i e n e at f musculoskeletal symptoms As regards programme have recently been summarized by decrease exercise for shiftworkers moderate physical exercise boghramil and Fredman (1999) Environmental preferredover intensivetraining Exerciseshould be considerationsto decreasesleep disruptions, include: is a few hours before the main sleep period For sound-proofing the bedroom from day-time noise; done or day shifts, the best exercise time is after eliminating sunlight with appropriate room darken morning After night shifts, the exerciseshouldbe done shades, curtains,or shutters; having air-conditioning the shifi. and before an evening nap. (Harma, 1996) available for warm daytime temperaturesEye shades and/or ear plugs may be useful. The phone should not FamilySuPPorUEducation ring into the bedroom during the scheduledsleeptime In orderfor individual coping strategies be effective to The shift workers daytime sleepshould be asprotected families must be involved.In addition,the shiftworker from intemrption as the normal night time sleephours must rememberthe toll that the shiftwork schedules are for the rest of societY. may take on the rest of the family The provision of educationalmaterialsfor both the worker and family is essential successful for copingwith shiftwork schedules Several publicationswhich review strategies for increasingworker and family toleranceof shiftwork schedules availableto assistemployeesand their are families in coping with shiftwotk(lttmber I 994) Creating a healthywork environmentis beneficial for both employersand employees is very importantto It educate employeesabout measures cope with the to varied work schedule or else may show long-term imbalancesand complications on healthl (Assistant Professor Department of Foods and Nutrition RVS authol College ofArts and Science,Sulur Coimbatore The acknovletlges various sourceswhich are available on request l( HealthActlon o October2012