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Shift work and health-how to proceed? Scand
... Сменная работа является достаточно распространенным способом организации трудовой деятельности. В Европе в настоящее время лишь четверть нанимаемых работников трудится только в дневную смену, остальные работают нерегулярно, по гибкому графику и посменно [1]. По сообщению Международного агентства по исследованию рака, сменный характер труда распространен среди 15-20% общего работающего населения [2]. ...
... Поскольку работа и сон тесно взаимосвязаны, многочасовые смены, вахты, ночные дежурства и гибкий график работы приводят к нарушению привычных биоритмов (сна, бодрствования, работоспособности), изменению метаболического и гормонального обменов, сокращению времени на отдых, необходимого для восстановления защитных сил организма от неблагоприятного воздействия условий труда, способствуют более быстрому развитию утомления [1,[3][4][5][6][7]. ...
... Создание безопасных условий труда является важной социальной задачей, основой поддержания здоровья общества на высоком уровне. Знание путей и механизмов, объясняющих влияние посменной работы на состояние здоровья, действительно, необходимо для новых идей в оценке риска, анализе и интерпретации эпидемиологических данных, выбора наиболее подходящего метода профилактики [1]. ...
The article provides an overview of domestic and foreign works on the impact of the replaceable labor on the efficiency, general state of health, the health and the dream of workers. Many hours shifts and overtime work were found to disturb likely familiar rhythms (sleep, wakefulness, performance), change the metabolic and hormonal metabolisms, reducing the recovery period between duties, contribute to more rapid development of fatigue. The consequence of circadian dyschrony may be the development of diseases of the cardiovascular system and cancer incidence. Studies have shown that sleep disorders are associated with metabolic changes, and particularly, obesity. In persons working in shifts, there are more often registered as individual features of the metabolic syndrome and the whole syndrome. It is noted that persons forming this group are at higher risk of developing diseases of the gastrointestinal tract. Thus, the problem of shift work is presented to be very important. Knowledge of ways and mechanisms that explain the impact of shift work on health is necessary to evaluate the professional risk. In the system of health measures the attention should be given to the rationalization of work and rest regimens, prevention of fatigue, struggle with sleep disorders and obesity.
... Sleep disruptions can cause a state of asynchronisms between the homeostasis of the circadian rhythm and the sleep-wake cycle, known as circadian misalignment [8][9][10]. Therefore, in the long term, sleep disturbance habits, and respective circadian misalignment, increase the risk of developing a range of negative health outcomes and chronic diseases [1,11,12]. Apart from harming health and wellbeing, evidence implies that sleep can also be decisive for the maintenance of intellectual capability and occupational productivity [13,14]. Further studies indicated that poor quality of sleep is mainly related to working factors [15]. ...
... Further studies indicated that poor quality of sleep is mainly related to working factors [15]. Shift and night work, for instance, are queries which challenge the biological and social cycles, representing an occupational health concern for the international scientific community [12,16,17]. Sleep deprivation is then pointed out as a source of driving accidents [18] and work injuries [19][20][21][22]. ...
Sleep research has grown over the past decades and investigators are deeply involved in studying sleep and its impact on human health and body regulation. Despite the understanding that insufficient sleep is strongly linked to the development of several disorders, unsatisfactory sleep exposes health and safety to innumerous risks. The present study aims to review and analyze the main results of clinical trials, registered at ClinicalTrials.gov and ICTRT databases, and developed construct strategies to improve sleep quality on firefighters and enhance professionals’ sleep and health conditions. The protocol was registered in PROSPERO under number CRD42022334719. Trials registered between first registry and 2022 were included. We retrieved 11 registered clinical trials; seven met eligibility criteria and were included in the review. A relation between sleep disorders, shift work, and occupational health problems was found, and retrieved trials showed that sleep education programs can improve sleep quality and sleep hygiene. Science has already recognized sleep’s importance for metabolic functioning and survivorship. Nevertheless, it continues to play a major role in discovering methods to diminish the problems faced. Strategies contemplating sleep education, or intervention, should be presented to fire services to tackle this problem and promote healthier and safer environments.
... The physiological consequences of light exposure during the biological night are well established in animal studies (2) but less so for humans, due partly to a lack of quantitative exposure data collected in observational settings (4). This speaks to a common limitation in epidemiological studies of shift work, in that characteristics relevant to health risks are often not sufficiently captured and described in the process of exposure assessment (5,6). For example, the International Agency for Hall et al Research on Cancer recently classified shift work that involves circadian disruption as "probably carcinogenic to humans" (Group 2A), based on limited evidence in humans working night shifts and sufficient evidence in animal studies assessing the carcinogenicity of light exposure during the biological night (2). ...
... Within-worker variance and betweenworker variance was small relative to between-group variance for all exposure metrics and groupings. (11,21) Hospital unit -NICU (27,34) Lab technologist (2,4) Hospital unit -Ward (12,20) Lab assistant (3,6) Hospital other -Lab (5,10) Care aide (11,17) Hospital other -Circ (6,11) Security guard (5,9) Unit clerk (4, 7) ...
Objectives Shift workers' increased risk of various adverse health outcomes has been linked to light-at-night (LAN) exposure, but few studies have measured LAN exposure in workplaces. To inform future research methods, this study aimed to (i) measure shift workers' exposures to LAN across industries, occupations, and work environments and (ii) assess components of variance across different exposure groupings and metrics. Methods Between October 2015 and March 2016, 152 personal full-shift measurements were collected from 102 night shift workers in emergency health services (paramedics, dispatchers) and healthcare industries (nurses, care aides, security guards, unit clerks, and laboratory, pharmacy, and respiratory therapy staff) in the province of British Columbia, Canada. Descriptive and variance component analyses were conducted for the 23:00-05:00 period to characterize exposures using multiple metrics of potential biological relevance (median lux, 90 (th)percentile lux, sum of minutes ≥30 lux, and sum of minutes ≥100 lux). Results Average exposure levels were highest in the healthcare industry. By occupation, laboratory workers and care aides displayed the highest and emergency dispatch officers displayed the lowest levels for all LAN exposure metrics. Between-group variance was large relative to within-group variance for all exposure groupings and metrics, and increased as grouping specificity increased (moving from industry to occupation). Conclusions Results from this study suggest that high-level grouping schemes may provide a simple yet effective way of characterizing individual LAN exposures in epidemiological studies of shift work. Ongoing measurement of LAN exposures and assessment of exposure variability is needed in future studies of shift workers as a means to increase sampling efficiency, reduce measurement error, and maximize researchers' ability to detect relationships where they exist.
... Shift work schedules may cause at least 2 forms of such a conflict, i.e., strain-based conflict and time-based conflict. Shift work, including night work, has been reported to disturb biological rhythms and social routines, which results in sleep problems and impaired health [4,5]. These, in turn, may lead to strain-based conflict that appears when exposure to stress in one domain leads to strain that affects ability to perform in the other domain [3]. ...
... Shift work effects on workers' well-being depend largely on shift system parameters [5,24]. There are relatively few studies considering effects of shift schedule parameters on work-family relationship. ...
Objectives:
Existing research has documented that shiftwork consequences may depend on the shift system parameters. Fast rotating systems (1-3 shifts of the same kind in a row) and day work have been found to be less disruptive biologically and socially than slower rotating systems and afternoon and night work. The aim of this study was to compare day workers and shift workers of different systems in terms of rotation speed and shifts worked with regard to work-family and family-work positive and negative spillover, marital communication style, job satisfaction and health.
Material and methods:
Employees (N = 168) of the maintenance workshops of transportation service working different shift systems (day shift, weekly rotating 2 and 3‑shift system, and fast rotating 3-shift system) participated in the study. They completed the Work- Family Spillover Questionnaire, Marital Communication Questionnaire, Minnesota Job Satisfaction Questionnaire and the Physical Health Questionnaire (a part of the Standard Shiftwork Index).
Results:
The workers of quicker rotating 3-shift systems reported significantly higher scores of family-to-work facilitation (F(3, 165) = 4.175, p = 0.007) and a higher level of constructive style of marital communication (Engagement F(3, 165) = 2.761, p = 0.044) than the workers of slower rotating 2-shift systems. There were no differences between the groups of workers with regard to health and job satisfaction.
Conclusions:
A higher level of work-family facilitation and a more constructive style of marital communication were found among the workers of faster rotating 3-shift system when compared to the workers of a slower rotating 2-shift system (afternoon, night). This may indicate that the fast rotating shift system in contrary to the slower rotating one is more friendly for the work and family domains and for the relationship between them. Int J Occup Med Environ Health 2017;30(1):121-131.
... [1] In particular, health care workers work in shifts and have irregular working hours. [1,2] It is known that shift work is one of the most serious risk factors contributing to occupational health problems, [2,3] for example being related to an increased risk of suffering cardiovascular diseases, [4][5][6] breast cancer, [7] mental problems, [8] and occupational injuries. [9] Furthermore, shift work disturbs sleep and alertness, [10,11] and shift workers can experience difficulties in participating in family life as well as undertaking social, cultural, and other free-time activities. ...
... In order to evaluate the potential effect of categorization, we tested the models with the original seven categories, but there was no marked effect on the association between self-reported leisure-time physical activity and sleep time HRV parameters (data not shown). Furthermore, we tested the effect of ward (i.e., acute or long-term care), the type of shift work (two-shift work or three-shift work), the work experience, experience in the shift work, the quality of sleep (1)(2)(3)(4)(5), the length of sleep, BMI (kg/m 2 ), and lifestyle (i.e., smoking, doses of alcohol) as covariates in the models. Since there was no statistically significant influence of the ward, the type of shift work, the work experience, experience in the shift work, quality or length of sleep, BMI or lifestyle factors, they were excluded from the final analyses. ...
Shift work is one of the most serious occupational risk factors for health problems such as cardiovascular diseases. Furthermore, shift work disturbs sleep and alertness and impairs recovery from work, especially if the time between work shifts is insufficient.
The aim of this study was to evaluate if a reduced number of short intervals (i.e., less than 11 hours) between work-shifts would result in better recovery indicated by sleep time heart rate variability reflecting the psychophysiological recovery.
Participants were 39 female shift-working nurses with the mean age of 45 years. The study design was a prospective within-subject study with a one year follow-up. The 24-hour heart rate variability recordings supplemented with questionnaires were performed twice. First, while working in the old shift schedule with frequent short intervals between work shifts, and again after one year of a working schedule with a reduced number of short intervals between work shifts. Statistical analyses were conducted using liner mixed models.
The comparison between the initial shift system and the schedule with the reduced number of short intervals between work shifts caused an increase in heart rate variability parameters reflecting mainly parasympathetic activation of the autonomic nervous system (i.e., RMSSD, HF power and HF power in normalized units) (p˂0.001).
In conclusion, our results suggest that reducing the number of short intervals between work shifts is an effective way to enhance the physiological recovery during the sleep. This study demonstrated that the recovery of autonomic nervous system from shift work can be promoted by implementation of ergonomic recommendations.
... To reduce various biases in epidemiological studies on working time and health, it is crucial to develop more accurate and reproducible exposure variables (30,(34)(35)(36)(37). Such assessments would also increase opportunities to identify unhealthy components of working time patterns associated with long working hours and shift work. ...
... The cut-off levels (eg, long working hours being ≥48 hours a week) are mostly arbitrary and need to be re-defined when outcome data are available. There is some evidence on a few of the cut-offs suggesting, for example that >4 consecutive night shifts (weekly rotating shifts) are related to an increased health risk (21,(34)(35)(36). The suggested cut-off points of 40 and 48 hours for "long" and "very long" weekly working hours, 12 hours for "long" work shifts and the definition of 11 hours for "short" time between shifts are based on the existing European legislation and cut-offs used by many recent studies (51,(60)(61)(62). ...
Objectives Epidemiological studies suggest that long working hours and shift work may increase the risk of chronic diseases, but the “toxic” elements remain unclear due to crude assessment of working time patterns based on self-reports. In this methodological paper, we present and evaluate objective register-based algorithms for assessment of working time patterns and validate a method to retrieve standard payroll data on working hours from the employer electronic records.
Methods Detailed working hour records from employers’ registers were obtained for 12 391 nurses and physicians, a total 14.5 million separate work shifts from 2008–2013. We examined the quality and validity of the obtained register data and designed 29 algorithms characterizing four potentially health-relevant working time patterns: (i) length of the working hours; (ii) time of the day; (iii) shift intensity; and (iv) social aspects of the working hours.
Results The collection of the company-based register data was feasible and the retrieved data matched with the originally published shift plans. The transferred working time records included <0.01% missing data. Two percent were duplicates that could be easily removed. The 29 variables of working time patterns, generated for each year, were stable across the follow-up (year-to-year correlation coefficients from r=0.7–0.9 for 23 variables), their distributions were as expected, and correlations of the variables within the four main dimensions of working hours were plausible.
Conclusion The developed method and algorithms allow a detailed characterization of four main dimensions of working time patterns potentially relevant for health. We recommend this method for future large-scale epidemiological studies.
... The idea that work schedules impact on sleep is not new [18,19]. However, today when only about one fourth of the work force have a regular daytime work schedule [20] the possible effects of work scheduling on sleep is pervasive. A third area of interest for sleep is the physical work environment. ...
... Despite the prevalence of sleep complaints among workers and the implication of the work environment bearing on sleep, there is no current consensus on the relationship between the work environment and sleep. While some reviews have focused on specific work environment factors, populations, or sleep outcomes [11,18,20,21], there is a need for a comprehensive review that provides the "big picture" of our current knowledge. Moreover, while a good deal of research has focused on the effects of sleep deficits on work, examining the opposite direction of impact, i.e., the effects of work on sleep, is warranted given the large changes in working conditions that have occurred over the past 25 y. ...
... Shift work, specially working in night shift is the most recurrent cause of disturbance in circadian rhythm, which significantly causes alteration in biological function, including sleep that leads to influence physical and psychological health [2][3] . Literature showed that shift works are associated with different mental problems, such as depression, anxiety, fatigue and insomnia [4][5][6] . Shift work also affects physical health; currently Van Drongelen et al 7 have identified eight studies that showed the relationship of night shift worker (NSW) with increase body weight. ...
OBJECTIVE: To find out the frequency of anxiety and its associated demographic factors among nursing workforce.
... Insomnia is a debilitating condition with numerous negative consequences on patients and the healthcare system. Shift workers, including eight and 12 hours shifts, are more prone to insomnia, lack of sleep, and circadian disorders that can affect physical and mental health compared to daytime workers [13]. A study in the US showed that 10% of shift workers complain of sleep disturbance [14]. ...
Background Sleep is essential for physical and mental health, and insomnia is the most common sleep disorder. Insomnia is associated with multiple health issues that may affect physicians' health and their decision-making, and subsequently affect patients in the emergency department (ED). This study aimed to assess insomnia and its associated factors among ED physicians in the western region of Saudi Arabia. Methods A cross-sectional study was conducted using a validated online questionnaire to collect data from the target population. The questionnaire included demographic characteristics, the nature of the job, shift characteristics, and the Insomnia Severity Index tool. Data were analyzed using the statistical package for the social sciences (SPSS, version 29.0), and the Chi-square test was used for bivariate analysis. Results The study involved 106 ED physicians, primarily from Saudi Arabia, who worked in government hospitals and were mostly aged from 20 to 29 years old. Of the participants, 35.8% had moderate to severe clinical insomnia, with younger physicians experiencing more severe insomnia than their older colleagues. This highlights the potential role of age in the development of insomnia. No significant associations were found between insomnia severity and other demographic or work-related factors. Conclusion This study found a high prevalence of insomnia among ED physicians in Saudi Arabia, emphasizing the need for further research and interventions to address this issue. Improving the sleep quality of ED physicians is crucial for their health and well-being, as well as for the safety and quality of care provided to their patients.
... We identified four clusters: "Morning" (60% in 2014 and 56% in 2019), "Varying shift types" (22% both in 2014 and 2019), "Employee turnover" (13% in 2014 and 3% in 2019) and "Unstable employment" (5% in 2014 and 19% in 2019). The largest cluster group, "Morning", i.e., the combination of morning shifts and day offs was most common, whereas the combination between various work shifts and days offs (cluster group "Varying shift types") was also rather frequent being in line with earlier indications that around 20-25% of employees in health care work shifts including night work [3,[30][31][32]. The transition rates between work shifts and absences from 2014 to 2019 indicated that most employees stayed in the same cluster groups, and most often in the "Varying shift types" and "Morning" cluster groups. ...
Background
In health care, the shift work is arranged as irregular work shifts to provide operational hours for 24/7 care. We aimed to investigate working hour trends and turnover in health care via identification of time-related sequences of work shifts and absences among health care employees. The transitions between the work shifts (i.e., morning, day, evening, and night shifts), and absences (days off and other leaves) over time were analyzed and the predictors of change in irregular shift work were quantified.
Methods
A longitudinal cohort study was conducted using employer-owned payroll-based register data of objective and day-to-day working hours and absences of one hospital district in Finland from 2014 to 2019 (n = 4931 employees). The working hour data included start and end of work shifts, any kind of absence from work (days off, sickness absence, parental leave), and employee’s age, and sex. Daily work shifts and absences in 2014 and 2019 were used in sequence analysis. Generalized linear model was used to estimate how each identified sequence cluster was associated with sex and age.
Results
We identified four sequence clusters: “Morning” (60% in 2014 and 56% in 2019), “Varying shift types” (22% both in 2014 and 2019), “Employee turnover” (13% in 2014 and 3% in 2019), and “Unstable employment (5% in 2014 and 19% in 2019). The analysis of transitions from one cluster to another between 2014 and 2019 indicated that most employees stayed in the same clusters, and most often in the “Varying shift types” (60%) and “Morning” (72%) clusters. The majority of those who moved, moved to the cluster “Morning” in 2019 from “Employee turnover” (43%), “Unstable employment” (46%) or “Varying shift types” (21%). Women were more often than men in the clusters “Employee turnover” and “Unstable employment”, whereas older employees were more often in “Morning” and less often in the other cluster groups.
Conclusion
Four clusters with different combinations of work shifts and absences were identified. The transition rates between work shifts and absences with five years in between indicated that most employees stayed in the same clusters. The likelihood of a working hour pattern characterized by “Morning” seems to increase with age.
... For example, experimentally-induced sleep restriction has been found to result in impairments in many cognitive domains [6,7]. Thus, it is not surprising that night work is indeed associated with occupational accidents [8]. A higher risk of injury was observed after evening and night work in the past week compared with only day work in a large cohort study of hospital and administrative workers [9]. ...
Background:
Night shift work often implies shorter sleep duration and this can lead to sleepiness, which has been associated with an increased risk of accidents and injuries. The aim is to study how the number of consecutive night shifts affects self-reported sleepiness.
Participants and methods:
The study was a quasi-experimental, within-subject crossover study with 73 police officers. Three work schedules of two, four, and seven consecutive night shifts followed by the same number of recovery days, i.e., days worked or days off, was performed by all participants. Sleepiness was self-reported using the Karolinska sleepiness scale (KSS) every fourth hour on the last night shift and the last recovery day in each sequence.
Results:
We observed differences in the level of sleepiness between recovery days and night shift days but no differences in the pattern of sleepiness levels on night shift days in the different work schedules. The highest levels of KSS were observed before bedtime (at 07:00 after a night shift and 23:00 on a recovery day).
Conclusion:
The number of consecutive night shifts did not affect the self-reported levels of self-reported sleepiness among Danish police officers.
... However, the authors did not analyze the characteristics associated with shift work because this information was not available (22). To fully explore the mechanisms by which shift work might influence mental health, it is necessary to consider specific characteristics of the working environment (e.g., fixed/permanent shifts, number of night shifts worked, start times, and the speed and direction of shift rotation) (23). The data could enable us to develop appropriate interventions. ...
Background
Although shift work is the foundation of the provision of 24-h continuous care in hospitals, it can negatively impact mental health in hospital workers such as nurses. Despite the connection between mental health and overall health, little is known about the effect of shift work-related factors on mental health in this population.
Objectives
We investigated the effect of scheduling practices, physical and psychological characteristics related to shift work, and personal habits during shift work on depression and anxiety among nurses.
Methods
In this multi-center cross-sectional study, 11,061 nurses from 20 hospitals in the Shandong Province of China completed an online survey between December 2020 and February 2022. Multivariate ordered logistic regression analysis was performed to examine shift-related factors associated with depression and anxiety in the study population.
Results
The completion rate of all nurses' questionnaires was 83.00% (n = 9,181). Among the 9,181 respondents, 66.20% (n = 6,078) were shift nurses. Depression and anxiety were found in 58.82 and 62.08% of shift nurses, respectively, and these rates were influenced by fatigue during shift work, psychological stress before/during/after night shifts, feeling of being refreshed after resting before/after night shifts, using sleep medication before/after night shifts, physical discomfort during night shifts, busyness during night shifts, food intake during shift work, working > 40 h/week during shift work, and sleep quality before/after night shifts.
Conclusions
Depression and anxiety in shift nurses may be addressed by reducing their workload, sources of stress during night shifts, and facilitating rest and relaxation.
... 4,5 The economic burden and health-care considerations for the treatment of insomnia, sleep deprivation, and circadian disturbances that can affect physical and mental health are higher for shift workers who work irregular hours than for daytime workers. 6 Approximately 10% of American workers have sleep problems and drowsiness due to shift work, 7 and approximately 55% of their Korean counterparts were found to experience insomnia. 8 Rest time between shifts is an important factor that influences the health of shift workers. ...
Objectives:
A rest time of less than 11 h taken by a shift worker between shifts is defined as quick return (QR). QR is shown to decrease sleep time by virtue of decreasing rest time, diminishing sleepiness and exhaustion, and increasing the number of sick days taken by employees. Therefore, in this multicenter retrospective study, the association between QR and the incidence of insomnia was established using the night-shift questionnaire from the Korean Workers Health Examination-Common Data Model.
Methods:
Three hospitals collected the night-shift profiles and baseline demographic data of 33 669 workers between January 2015 and December 2017. The most recent date of examination was used for participants who had been examined multiple times at the same institution. We used multiple logistic regression to calculate the odds ratios (ORs) and 95% confidence intervals (CIs). The pooled ORs were estimated using combined results from the three institutions.
Results:
The proportion of men was higher than that of women in the QR group at each institution. The pooled ORs were computed using combined data from the three institutions. Workers who reported a QR had the highest risk of sleeplessness (OR, 1.21; 95% CI, 1.12-1.31) compared to those workers who reported a slow return, after adjusting for possible confounders.
Conclusions:
A substantial correlation was established between QR and insomnia using the CDM approach and data from multiple centers. This study may serve as a foundation for developing guidelines to enhance the health of shift workers and prevent occupational accidents.
... In many occupations today, round-the-clock performance is demanded. According to census data, a sizable portion of the workforce is working on nonstandard work schedules, which may include shift work [3]. Such work patterns have been linked to a variety of health issues, including cardiovascular disease, digestive issues, exhaustion, cancer, depression, anxiety, and sleep issues. ...
Sleepiness and sleeplessness are symptoms of shift work disorder (SWD), a sleep disorder caused by a person's work schedule. Understanding the mechanisms underlying shift work-related health concerns may be necessary when scheduling shifts, establishing employment routines, providing clinical care, and selecting employees. In today's workplace, stress has become the most influential element impacting individual efficacy and satisfaction. In this environment, occupational stress is becoming increasingly prevalent in the nursing profession. Nurses in today's healthcare system encounter several obstacles. These difficulties develop as a result of issues at the organizational, state, and national levels. It is critical for nurses to first recognize and comprehend every potential difficulty they may confront to deal with them effectively. Not only should they be recognized and understood, but methods to minimize them should also be sought.
... Směnný provoz souvisí s četnými problémy, např. zdravotními -kardiovaskulární onemocnění, gastrointestinální potíže, deprese, úzkost, únava, ale také problémy se spánkem, tolerancí práce na směny (1,4,5,6), dále problémy společenské, v rodinném či partnerském soužití (5,7,8). Ke špatné kvalitě spánku může přispět i práce na noční směny (3). ...
... An exploratory study Afonso et al. (2017) concluded that long working hours are associated with reduced and disturbed sleep and increased symptoms of anxiety and depression. Härmä and Kecklund (2010) proposed that shift work may disturb mental and physical health, but the involved psychological and behavioral pathways need to be further identified and studied. This study focuses on the association between shift work and affective disorders and proposes to review the existing empirical literature. ...
Atypical working time patterns are known to be associated with adverse physical health consequences.
The impact of chronic exposure to shift work on psychological wellbeing and mental
health is also reported, but not fully appreciated. We conducted a systematic review of the literature
on the association between shift work and affective disorders using the electronic databases
Medline, PsycINFO, Embase, Web of Science and Google Scholar. Data extracted included detailed
characteristics of shift work, the affective disorders under study, and the population targeted. Some
25 extracted articles satisfied all inclusion and exclusion criteria. Findings of these articles reveal
shift work is associated with increases in depressive symptoms (12 studies), anxiety (2 studies), and
depression and anxiety (7 studies). Only three studies found no association between shift work and
depression. The findings of this review suggest that shift work increases the symptoms of depression
and anxiety.
... For example, irregular working hours, overtime, and rotating shifts alter circadian rhythms, which can lead to sleep disruptions [32] and increased PTSD vulnerability [44]. Nevertheless, shift work is unlikely to disappear, which underscores the need for realistic sustainable solutions for individual PSP well-being [45]. ...
Canadian public safety personnel (e.g., correctional workers, firefighters) experience potential stressors as a function of their occupation. Occupational stressors can include organizational (e.g., job context) and operational (e.g., job content) elements. Operational stressors (e.g., exposures to potentially psychologically traumatic events) may be inevitable, but opportunities may exist to mitigate other occupational stressors for public safety personnel. Research exploring the diverse forms of stress among public safety personnel remains sparse. In our current qualitative study we provide insights into how public safety personnel interpret occupational stressors. We use a semi-grounded thematic approach to analyze what public safety personnel reported when asked to further comment on occupational stress or their work experiences in two open-ended comment fields of an online survey. We provide a more comprehensive understanding of how public safety personnel experience occupational stress and the stressors that are unique to their occupations. Beyond known operational stressors, our respondents (n = 1238; n = 828) reported substantial difficulties with organizational (interpersonal work relationship dynamics; workload distribution, resources, and administrative obligations) and operational (vigilance, work location, interacting with the public) stressors. Some operational stressors are inevitable, but other occupational stressors can be mitigated to better support our public safety personnel.
... Although studies have shown that the shift work could lead to a range of psychosomatic disorders in nurses, few studies have explored such a relationship in the healthcare context of Gulf Cooperation Council countries. Shift work has been previously shown to disturb workers' health through psychosocial, behavioral, or psychological mechanisms [8] . ...
Background:
Insomnia, stress, and anxiety affect the mental wellbeing and
distorts the work-life balance of health workers influencing
their performance at work. This study aimed to assess the relationship
of shift work with insomnia, anxiety, and stress among
nurses in a tertiary care hospital in Bahrain.
Methods:
We used a cross-sectional study design. Our study population
was 345 nurses in a major tertiary care hospital in Bahrain. The
sample was selected based on the population probability to
size method. Nurses completed a questionnaire that contained
items, including sociodemographic data, Bergen’s Insomnia
Scale, Perceived Stress Scale, and Shift Work Disorder scale.
Results:
The prevalence of insomnia was highest (85.7%) in the youngest
nurses (20 to 30 years), Bahrainis (92.2%), nurses working
in Surgical (85.5%) and Pediatrics (80.0%) departments,
with 1 to 5 years of shift work experience (81.0%), and 1 to 3
night shifts a month (92.0%). Nurses with very high levels of
stress were between the ages of 20-30 years, Bahrainis, had a
B.Sc. degree, were in the Pediatrics Department, worked for 4
to 6-night shifts per month, and did not consume caffeinated
drinks (p = <0.05). The prevalence of Shift Work Disorder was
11.3% in our study.
Conclusion:
The prevalence of insomnia, stress, and anxiety was high in the
nurses in our study, and it was significantly related to performing
shift work. However, shift work disorder in those who had
insomnia was low in our study although it was still higher in
nurses who suffered from insomnia. Balanced working hours
and support in the evaluation and treatment potential mental
health challenges associated with working in shifts may improve
mental wellbeing of nurses working in tertiary care hospitals
in Bahrain.
... Most common are sleep disturbances such as prolonged sleep onset, reduced sleep duration, and excessive sleepiness. 1,2 Sleepiness is not equivalent to fatigue. Sleepiness refers to a state of increased sleep propensity 3 and is distinguished from fatigue, which is frequently differentiated into muscular and mental fatigue. ...
Objective:
We compared subjectively reported sleepiness and fatigue as well as causes and management strategies for combating sleepiness among pilots working in 2 different helicopter emergency medical services operating with different shift systems.
Methods:
Pilots from the Norwegian Air Ambulance (NAA) and Christophorus Flugrettungsverein (CFV) in Austria participated. NAA performs flight missions 24/7, whereas at the time of the study the participating CFV bases did not fly after sunset. The pilots are on duty for 1 week in both services. NAA and CFV used an identical research protocol, including questionnaires about sleep, sleepiness (Epworth Sleepiness Scale and Karolinska Sleepiness Scale), coping strategies, and work-related causes of fatigue.
Results:
CFV pilots kept busy, whereas NAA pilots slept and did physical exercise as strategies to prevent sleepiness. The majority in both groups used napping and coffee consumption as strategies. CFV pilots reported more frequently than NAA pilots that administrative duties and environmental factors were reasons preventing napping.
Conclusion:
Some differences existed between the 2 pilot groups regarding strategies for managing sleepiness and causes that prevented pilots from napping. Pilots in both groups were healthy, physically active, and had normal Epworth Sleepiness Scale and Karolinska Sleepiness Scale scores.
... På lengre sikt har man sett at skiftarbeidere har økt risiko for å utvikle overvekt, hjerte-og karlidelser, diabetes og enkelte kreftsykdommer (14). Av rapporterte helseproblemer blant skiftarbeidere er det likevel søvnforstyrrelser og følelsen av å ikke vaere uthvilt som er mest utbredt. ...
... Rotating shift and night work is associated with a number of adverse health effects, syndromes, and disorders such as fatigue, anxiety, depression, sleep disorder, digestive and metabolic disorders, and cardiovascular diseases as well as cancer [110][111][112]. Several mechanisms have been suggested as elevating BC risks in rotating shift and night workers including the suppression of melatonin and vitamin D synthesis, disruption of circadian rhythm, suppressed immune system, and sleep deprivation [80][81][82][83]. ...
The paper is motivated by severe concerns regarding currently applied care of the pregnancy-associated breast cancer (PABC) characterised by particularly poor outcomes of the disease. Psychological and ethical aspects play a crucial role in PABC: the highest priority not to damage the foetus significantly complicates any treatment generally, and it is quite usual that patients disclaim undergoing any breast cancer treatment during pregnancy. Although, due to global demographic trends, PABC is far from appearing rarely now, severe societal and economic consequences of the disease are still neglected by currently applied reactive medical approach. These actualities require creating new strategies which should be better adapted to the needs of the society at large by advancing the PABC care based on predictive diagnostic approaches specifically in premenopausal women, innovative screening programmes focused on young female populations, targeted prevention in high-risk groups, and optimised treatment concepts. The article summarises the facts and provides recommendations to advance the field-related research and medical services specifically dedicated to the PABC care.
... Keywords: rls, WeD, sleep, shift work disorder, shift work, night work inTrODUcTiOn Shift work is associated with impaired health, whereof sleep problems are among the most commonly reported complaints (1,2). Work schedules that involve night work are in particular associated with sleep problems, i.e., sleep onset and maintenance difficulties, reduced sleep duration, and excessive sleepiness during work (3). ...
Insomnia and excessive sleepiness are among the most commonly reported sleep problems related to shift work. Sleep-related movement disorders have, however, received far less attention in relation to such work schedules. The objective of this study was to investigate the association between different shift work schedules and the prevalence of Restless legs syndrome/Willis–Ekbom disease (RLS/WED) in a large sample of Norwegian nurses. Our hypothesis was that shift working nurses would report higher prevalence of RLS/WED compared to day workers. A total of 1,788 nurses with different work schedules (day work, two-shift rotation, night work, three shift rotation) participated in a cohort study, started in 2008/2009. Four questions about RLS/WED based on the diagnostic criteria were included in wave 4 (2012). RLS/WED prevalence rates across different shift schedules were explored by the Pearson chi-square test. Logistic regression analysis was used to assess the association between RLS/WED and work schedules and shift work disorder (SWD) with adjustment for sex, age, marital status, smoking, and caffeine use. In total, 90.0% of the nurses were females, mean age 36.5 years (SD = 8.6, range 25–67). The overall prevalence of RLS/WED was 26.8%. We found no significant differences between the prevalence of RLS/WED across the different shift schedules, ranging from 23.3% (day work) to 29.4% (night work). There was a significant difference (p < 0.001) in the prevalence of RLS/WED between nurses having SWD (33.5%) compared to nurses not having SWD (23.8%). SWD remained significantly associated with RLS/WED in the adjusted logistic regression analysis (1.56, CI: 1.24–1.97). This study did not support the hypothesis. RLS/WED was associated with SWD, which might indicate that nurses vulnerable to shift work also are sensitive to other complaints related to a misalignment of the biological clock.
... When shift work was defined as 'not day work', the Standardized Mortality Ratio (SMR) was 115% (95% confidence interval [CI]: 104-126), whereas when shift work was defined more precisely as 'night shift', the SMR increased to 148% (95% CI: 112-191; Knutsson 2004). Although calls have been made to improve the quality of exposure assessment in epidemiological studies of shift work ( Knutsson 2004;Härmä and Kecklund 2010;Stevens et al. 2011;Saksvik et al. 2011), coarse categorizations are still commonly used to assign exposures in studies of shift work and health. In an effort to further understand and characterize the impact of exposure assessment precision in epidemiological studies of shift work, the current study examined associations between work schedule and depression. ...
Introduction:
Coarse exposure assessment and assignment is a common issue facing epidemiological studies of shift work. Such measures ignore a number of exposure characteristics that may impact on health, increasing the likelihood of biased effect estimates and masked exposure-response relationships. To demonstrate the impacts of exposure assessment precision in shift work research, this study investigated relationships between work schedule and depression in a large survey of Canadian nurses.
Methods:
The Canadian 2005 National Survey of the Work and Health of Nurses provided the analytic sample (n = 11450). Relationships between work schedule and depression were assessed using logistic regression models with high, moderate, and low-precision exposure groupings. The high-precision grouping described shift timing and rotation frequency, the moderate-precision grouping described shift timing, and the low-precision grouping described the presence/absence of shift work. Final model estimates were adjusted for the potential confounding effects of demographic and work variables, and bootstrap weights were used to generate sampling variances that accounted for the survey sample design.
Results:
The high-precision exposure grouping model showed the strongest relationships between work schedule and depression, with increased odds ratios [ORs] for rapidly rotating (OR = 1.51, 95% confidence interval [CI] = 0.91-2.51) and undefined rotating (OR = 1.67, 95% CI = 0.92-3.02) shift workers, and a decreased OR for depression in slow rotating (OR = 0.79, 95% CI = 0.57-1.08) shift workers. For the low- and moderate-precision exposure grouping models, weak relationships were observed for all work schedule categories (OR range 0.95 to 0.99).
Conclusions:
Findings from this study support the need to consider and collect the data required for precise and conceptually driven exposure assessment and assignment in future studies of shift work and health. Further research into the effects of shift rotation frequency on depression is also recommended.
... However, a complex effect in the conditions of long time (12-hour shifts) can lead to negative results that are not so known. At the same time, work features can contribute to a change in a functional state of an organism, tension of adaptation mechanisms, formation and development of diseases that have complex multifactorial etiology such as hypertension, disorders of nonspecific resistance, metabolism, musculoskeletal system and formation of diseases caused by a specialty[19][20][21][22][23]. The purpose of the research is to evaluate joint effect of factors of low intensity of the production environment and labor process on work ability and error of action of operators of high-tech energy complexes. ...
Increase in complexity and speed of production processes puts forward strong requirements for accuracy of operators' actions, quick decision-making in performance of management functions. Statistical analysis of data on the oil refining industry showed that a refinery with a capacity of 10 million tons of oil per year loses in average $ 4 million only from accidents caused by operator's errors. Around 40 % of accidents and incidents occur due to operator's errors. Reasons for such errors are related to personal qualities, lack of education, training, as well as to factors of low intensity of production environment. A complex of factors of low intensity can lead to hidden up to a certain time “compensated” homeostatic disturbances or modify harmful effect with demonstration of inadequate reactions. The article presents results of study of operators of central control room of two technological departments of high-tech and hazard production (oil and gas) complex to assess combined influence of factors of low intensity of production environment and labor process on work ability and error of actions during labor process. Studies have showed that a long intense functional load on body's systems with influence of factors of low intensity of production environment and labor process lead to development of fatigue and increased tension that operators suffer during day and night shifts. Significant tension of sensory and intellectual systems of the organism with fatigue determines high physiological cost of labor of high-tech production operators. That indicates a need to develop preventive innovative methods to correct a physiological state of operators to improve their performance and take errors off labor, which reduce risk of physical illness.
... No rigorous study of prevalence of sleep disorders was conducted in bipolar spectrum disorder and depression-related disorders but altered patterns of clock genes were reported in these disorders [16,17]. Conversely, high rates of sleep problems and mental disorders have been reported in shift workers, including insomnia, fatigue, anxiety and depression [18][19][20][21][22][23][24]. It is noteworthy that altered patterns of clock genes were also reported in shift workers [25][26][27]. ...
In mammals, the circadian clocks network (central and peripheral oscillators) controls circadian rhythms and orchestrates the expression of a range of downstream genes, allowing the organism to anticipate and adapt to environmental changes. Beyond their role in circadian rhythms, several studies have highlighted that circadian clock genes may have a more widespread physiological effect on cognition, mood, and reward-related behaviors. Furthermore, single nucleotide polymorphisms in core circadian clock genes have been associated with psychiatric disorders (such as autism spectrum disorder, schizophrenia, anxiety disorders, major depressive disorder, bipolar disorder, and attention deficit hyperactivity disorder). However, the underlying mechanisms of these associations remain to be ascertained and the cause–effect relationships are not clearly established. The objective of this article is to clarify the role of clock genes and altered sleep–wake rhythms in the development of psychiatric disorders (sleep problems are often observed at early onset of psychiatric disorders). First, the molecular mechanisms of circadian rhythms are described. Then, the relationships between disrupted circadian rhythms, including sleep–wake rhythms, and psychiatric disorders are discussed. Further research may open interesting perspectives with promising avenues for early detection and therapeutic intervention in psychiatric disorders.
... Rotating shift and night work: disruption of circadian rhythm and breast cancer risks Shift work (daily working hours other than the standard daylight period of time from 7-8 a.m. to 5-6 p.m.) is associated with risks for numerous health problems such as sleep disorder, fatigue, anxiety, depression, digestive and metabolic disorders, cardiovascular disease and cancer [40][41][42]. About 20 % of the European citizens who are involved in the night work conducted either in permanent or rotating regimes are considered to have the most disruptive effects on the circadian rhythm [43,44]. ...
Rapidly increasing incidence of breast cancer is a new social challenge resulting from a spectrum of internal and external risk factors which appear to be well accepted as an attribute of the 21st century, being, however, new for female sub-populations compared to the past. These include altered socio-economical conditions such as occupational exposure, rotating shift work, specific environmental factors (increased pollution and environmental toxicity, altered dietary inhabitancies, quality and composition of meal) as well as consequently shifted and/or adapted physiologic factors such as lower age at menarche, late age of first full-term pregnancy, if any shorter periods of breastfeeding, later menopause, etc. Consolidated expert statements suggest that over 50 % of all breast cancer cases may be potentially prevented by risk reduction strategy such as regulation of modifiable risk factors. Currently available risk assessment models may estimate potential breast cancer predisposition, in general; however, they are not able to predict the disease manifestation individually. Further, current deficits in risk assessment and effective breast cancer prevention have been recently investigated and summarised as following: gaps in risk estimation, preventive therapy and lifestyle prevention, understanding the biology of breast cancer risk, and implementing known preventive measures. This paper overviews the most relevant risk factors, provides recommendations for improved risk assessment and proposes an extended questionnaire for effective preventive measures.
... In the short term, sleep loss can result in performance impairment, reduced efficiency and increased likelihood of incidents and accidents (Rajaratnam and Arendt, 2001;Akerstedt, 1990;Åkerstedt, 2003). In the longer term, research suggests that chronic sleep loss and disruption to daily rhythms may be associated with burnout and other health issues (Akerstedt, 1990;Costa, 2010;H€ arm€ a and Kecklund, 2010;Knutsson, 2003). In recognition of this, managing workplace fatigue is a critical part of operational safety-management. ...
Residential support workers (RSW) engage in overnight “sleepover” shifts as well as more traditional “standup” night shifts. While research has investigated the consequences of night and on-call work for sleep in other industries, the sleep of RSW has not been evaluated.
In a single-provider case study, six employees completed the Pittsburgh Sleep Quality Index (PSQI), the Depression Anxiety Stress Scale (DASS), a 2-week sleep diary, and a 30 min interview, and four also completed the Shirom-Melamed Burnout Measure (SMBM).
Participants reported sleep of poor quality, low-mild DASS scores, and evidence of SMBM scores that were elevated relative to norms. Sleep was significantly lower (p < 0.01) following “standup” shifts (mean = 4.1, SD = 1.8 h) and during “sleepover” shifts (mean = 5.6, SD = 2.0 h) compared to non-shift nights (mean = 7.3, SD = 2.3 h). Interviews suggested that sleep fluctuates with level of patient care, colleague assistance, stress, and the quality of the sleeping environment (including bed comfort, light, noise and perceived safety).
Findings suggest that this group have sleep that is insufficient and of poor quality and that they may be at risk of burnout. Consideration of ways to optimise sleeping conditions at work (e.g. through noise or stress reduction) would be beneficial. Research in this area has the potential to facilitate improvements in health and safety in this growing industry.
... In fact, 69% of current day workers in the present study are former night workers. Those data reveal the importance of considering individual monitoring of exposure to night work, as argued by Härmä & Kecklund (2010). Puttonen et al. (2012), for instance, observed that metabolic syndrome was more prevalent among former male shift workers (but not among women) compared with day workers. ...
Data on the association between shift work and hypertension are controversial. Sleep restriction is hypothesized to be involved in this relationship. Since on-shift nap can partly compensate for sleep deprivation among night workers, this investigation is aimed at (i) comparing the prevalence of hypertension among workers considering both current and former night work, (ii) testing the association between on-shift naps and hypertension among night workers, and (iii) analyzing the influence of sleep complaints in the association between on-shift nap and hypertension. Nap was defined as a sleep episode with duration shorter than the average nighttime sleep. A cross-sectional study was performed at the 18 largest public hospitals in Rio de Janeiro, Brazil, in 2010-2011 (N = 2588 female registered nurses). Nurses were informally allowed to nap for up to three consecutive hours during working nights. Workers completed a multidimensional questionnaire including self-reported information on physician diagnosis of hypertension, napping, and sleep complaints (insomnia, diurnal sleepiness, and non-satisfactory sleep). Epidemiological and statistical treatment of data included binomial logistic regression and interaction tests. Higher chances of hypertension were observed for both current and former night workers compared with workers with no previous experience in night work, i.e. exclusive day workers (OR = 1.68; CI95% 1.22-2.33 and OR = 1.40; CI95% 1.01-1.96, respectively) after adjustment for age, race/ethnicity, physical activity, smoking, alcohol consumption, insomnia, weekly work hours, and BMI. Compared with exclusive day workers, both non-nappers and nappers were at a higher likelihood of reporting hypertension (OR = 1.93 CI95% 1.35-2.79 and OR = 1.41 CI95% 1.08-2.20, respectively). An interaction was observed between napping behavior and insomnia (p = 0.037). In the whole sample of night workers, the lower OR for nappers was confirmed when they were directly compared with non-nappers (OR = 0.76 CI95% 0.59-0.98). Analysis of night workers stratified by insomnia showed a significant reduction in OR for nappers (compared to non-nappers) only among insomniacs (OR = 0.58). Napping during night work may be a protective factor for hypertension, particularly among insomniacs. Factors related to melatonin secretion, blood pressure control, and blood pressure dipping patterns are likely to be involved in the relationship between on-shift napping and blood pressure.
... In today's Western societies, only a quarter of the labor force works regular 9-5 office hours, while the remainder is engaged in shift work or has irregular work hours (1). More often than day workers, shift workers report mental health symptoms, such as fatigue, nervousness, anxiety, and depressed mood; they also use sleeping pills and tranquillizers more often (2,3). ...
Epidemiological studies investigating mental-health-related sickness absence (SA) among shift workers are lacking. This 10-year observational study investigated the risk of mental health SA among shift compared with day workers.
The data of 5826 male production workers were used for analyses: 4288 (74%) shift and 1538 (26%) day workers. The risk of mental health SA was analyzed with Cox regression analysis. Hazard ratios (HR) and 95% confidence intervals (95% CI) were adjusted for age and occupational grade.
During 10-year follow-up, 351 shift workers and 126 day workers had incident mental health SA. The risk of mental health SA did not differ (HR 1.03, 95% CI 0.84-1.26) between shift and day workers. Among shift workers, the risk of SA due to mood disorders (HR 1.87, 95% CI 0.73-4.76) was non-significantly higher than among day workers. A total of 96 shift workers and 21 day workers had recurrent mental health SA. The risk of recurrent mental health SA did not differ (HR 1.04, 95% CI 0.62-1.74) between shift and day workers.
The risk of incident and recurrent mental health SA did not differ between shift and day workers.
... More than half of the developing world's workers (i.e., nearly 1.5 billion people) are in vulnerable employment''. Night and shiftwork, long and irregular working hours are usually associated with other environmental and organizational health risk factors (Caruso, 2014; Caruso et al, 2006; Harma & Kecklund, 2010). ...
Objective
The current study aimed to investigate the differences in sleep reactivity and sleep effort differs among late night shift workers (LSWs) and non-late night shift workers (non-LSWs), and non-shift workers (non-SWs).
Methods
In total, 6,023 participants (1,613 non-SWs, 3,339 LSWs, and 1,071 non-LSWs) were recruited. Non-SWs was defined as those who works at fixed schedules during standard daylight. LSWs was defined as who work late night hours (10 PM–6 AM), while non-LSWs was SWs who did not work during late night. All completed the Ford Insomnia Response to Stress Test (FIRST), the Glasgow Sleep Effort Scale (GSES), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Insomnia Severity Index (ISI), and the short-term Center for Epidemiologic Studies-Depression scale (CES-D) through online survey.
Results
LSWs and non-LSWs reported higher FIRST, GSES scores than non-SWs. In addition, LSWs reported higher FIRST, GSES scores than non-LSWs. FIRST scores were correlated with CES-D, PSQI, ISI, and ESS for LSWs, non-LSWs, and non-SWs alike. GSES scores were also correlated with CES-D, PSQI, ISI, and ESS for LSWs, non-LSWs, and non-SWs alike.
Conclusion
SWs showed higher sleep reactivity and sleep effort than non-SWs. LSWs had higher sleep reactivity and sleep effort than non-LSWs, and these variables are associated with insomnia, daytime sleepiness, and depressive symptoms. Our findings suggests that late night schedule, may increase sleep reactivity and sleep effort, which are associated with sleep and mood disturbances.
Rationale:
The world of work is changing rapidly, and precarious employment is becoming more prevalent in Britain and elsewhere, particularly since the 2008 financial crisis. This is despite the evidence linking employment precarity to adverse health outcomes, and the policy discourses advocating for high-quality jobs.
Objective:
I seek to establish empirically the extent and nature of the potential link between employment precarity and health outcomes, which is done chiefly at the workplace level. The research can be vital from the perspective of informing policy, given that the workplace represents the level where key policy levers operate.
Methods:
I use nationally representative data from the British Workplace Employment Relations Survey. Four workplace health outcomes (WHOs; viz., injuries, illnesses, job satisfaction, and job anxiety) have been used to examine if organizations with precarious employment arrangements are likely to experience adverse health outcomes. I use alternative econometric approaches to compare organizations that reported to have three types of precarious employment arrangements, viz., shift working, annualised hours, and zero-hours contracts (ZHCs), vis-à-vis their counterparts without such arrangements.
Results:
The results obtained reveal that workplaces with precarious employment arrangements are significantly unhealthier, and those with the most insecure form of precarious employment perform particularly worst in this respect.
Conclusions:
Precarious employment may become ever more prevalent as organizations contend with economic fallouts from shocks such as Brexit or Covid-19. This may lead to sub-standard health outcomes. The positive influence of trade unions on working conditions has largely been decimated and the workforce in Britain is ageing. These combinations may pose significant challenges to public health including mental health crises. Public policy ought to help minimise adverse health outcomes linked to employment precarity.
Epidemiological studies have shown association of sleep disorders with adverse metabolic effects, including obesity, insulin resistance and type 2 diabetes mellitus in adults, with an increased risk of cardiometabolic disease and mortality. Categories of sleep disorders that contributed to the above diseases included changes in sleep duration, chronic sleep deprivation and excessive sleep, changes in sleep architecture, sleep fragmentation, circadian rhythm disorders (e.g., shift work), and obstructive sleep apnea syndrome. Sleep and circadian rhythms modulate or control daily physiological patterns, that play an important role for normal metabolic health. Various metabolic processes, including glucose tolerance, change during the day and night and at different stages of sleep. During sleep, the utilization of glucose by the brain and activity of the sympathetic nervous system decrease, and vagus nerve tone increases. Global rates of obesity and diabetes are on the rise worldwide, and the prevalence of sleep deprivation and sleep disorders are also on the rise. The results of epidemiological and pathophysiological studies conducted in different countries among the population of different socioeconomic groups confirm that sleep disorders predispose to a higher risk of cardiometabolic disorders, including type 2 diabetes. There is a bidirectional relationship between metabolic dysfunction and sleep disorders. Current research data suggest that sleep is a potentially modifiable risk factor for cardiometabolic disease and obesity. More clinical investigations are required to improve our understanding of the mechanisms underlying metabolic dysfunction associated with sleep disorders and to explore the potential benefit of normalizing sleep in people with metabolic disorders. Recommendations for the optimization and hygiene of sleep, treatment of sleep disorders, along with sufficient physical activity and proper nutrition, should be included in preventive and therapeutic strategies to maintain metabolic health.
Poor sleep, which is reportedly prevalent among healthcare professionals, could lead to various detrimental consequences. This study aimed to investigate the sleep quality of individuals working in emergency departments of public hospitals in China and explore the potential factors influencing sleep disturbance. A self-administered questionnaire was completed by 7688 emergency workers from 147 public hospitals in Shandong, China. Log-binomial regression analysis was performed to explore the relationship of sleep disturbance with possible influencing factors, including individual and work characteristics, occupational stress, shift work, and musculoskeletal pain. The participants' mean Pittsburgh Sleep Quality Index score was 9.6 ± 4.8, with 5341 (69.5%, 68.2-70.7%) of them experiencing sleep disturbance. The sleep quality was poorer in doctors (10.2 ± 5.1, 71.0%, 69.0-73.0%) than in nurses (9.2 ± 4.5, 68.6%, 67.0-70.1%), and poorer in those working in secondary (9.9 ± 4.5, 70.2%, 68.0-72.3%) and tertiary (12.2 ± 4.9, 77.5%, 75.3-79.7%) hospitals than in primary hospitals (8.0 ± 4.1, 64.6%, 62.6-66.6%). High prevalence of sleep disturbance was significantly associated with shift work, occupational stress, musculoskeletal pain, fewer breaks in a work shift, and less exercise during leisure time, after adjusting for confounding variables. Sleep disturbance occurred in emergency workers in the following order: two-shift rotation > three-shift rotation > permanent night shift > permanent day shift. Emergency workers in public hospitals in China had poor sleep quality and commonly experienced musculoskeletal pain. Urgent and comprehensive measures are needed to combat these issues.
Background
Perception of higher stress may lead to insomnia which can adversely affect the mental and physical well-being of health professionals and patient care. The aim of the study was to compare the correlation of perceived stress and insomnia among health professionals and other employees in a Government Medical College of Eastern India.
Materials and Methods
This online survey was conducted using two Google forms in a span of 18 months. In the first section of the document, the relevance was explained, and informed consent was taken. In the second part of the form, participants were asked to fill up demographic details and relevant history. In the third part of the form, participants had to fill up the following four scales: Perceived Stress Scale (PSS) of Sheldon Cohen, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Job Satisfaction Scale (JSS).
Results
Participants were divided into two groups: Group A: Health Professionals and Group B: Other Employees. JSS scores were significantly higher among Group A (38.29 ± 6.34) as compared to Group B (35.47 ± 6.98) with a P = 0.0008**. Participants having higher JSS scores also had higher PSS scores (Group A with an r = 0.12; Group B with an r = 0.007). ISI scores were significantly higher in Group A (10.53 ± 3.43) as compared to Group B (6.21 ± 2.77) with a P < 0.001**. Participants having higher PSS scores also had higher scores for ISI (Group A with an r = 0.167 and Group B with an r = 0.333). PSQI scores were significantly higher among Group A (11.52 ± 2.05) as compared to Group B (6.37 ± 2.69) with a P < 0.0001**. PSS scores also positively correlated to PSQI scores (Group A, r = 0.963 and Group B r = 0.959). Participants having higher PSS scores also had higher scores for PSQI (Group A with an r = 0.963 and Group B with an r = 0.959).
Conclusions
Perceived stress scores positively correlated to both severities of insomnia and poor quality of sleep among study participants. This suggests that higher perceived stress levels may be a significant contributor to insomnia and poor sleep quality among health professions as they are constantly exposed to higher professional stress in the present health-care system.
Each organism at an individual level builds its system of temporary relationships with the different amplitude of oscillations - an individual biorhythmological portrait. Using Holter monitoring in the AnnaFlash2000 software in the ISCIM6 statistical processing, the ultradian rhythms of the driller crew in extreme northern latitudes studied. It revealed that the individual rhythmic processes of acrophase and cardiac rhythm bathyphase, which testify to the leading role of hypoxia, hypercapnia in adaptive mechanisms, influence the joint professional activity of small labour groups. It established that working in different biological rhythms, the driller’s team has a low degree of compatibility. The synchronization of biological rhythms in the team is achieving by the general properties of temperament as phlegmatic. More successful in adaptation - phlegmatic sanguine.
The paper provides a biorhythmological assessment of the health of a driver’s team in conditions of joint activity in terms of heart rate variability. Measurements were taken during the working day using Holter monitoring in AnnaFlash2000 software and statistical processing ISCIM6. The cardiogram of the heart was recorded during the working day from 8.00 to 18.00 hours. It was revealed that the rhythmic processes of acrophase and heart rate bathyphase, which testify to the leading role of hypoxia, hypercapnia and desynchronosis of ultradian rhythms, influence the joint professional activity of drillers. The examined drivers found a violation of the synchronization of biological rhythms and desynchronosis at various levels of regulation of heart rhythm regulation. Both drivers, working in different biological rhythms, have a low degree of compatibility and belong to the group of production risk, which negatively affects occupational safety.
Objectives
In a 24/7 society, the negative metabolic effects of rotating night shift work have been increasingly explored. This study aimed to examine the association between rotating night shift work and non-alcoholic fatty liver disease (NAFLD) in steelworkers.
Methods
A total of 6881 subjects was included in this study. Different exposure metrics of night shift work including current shift status, duration of night shifts (years), cumulative number of night shifts (nights), cumulative length of night shifts (hours), average frequency of night shifts (nights/month) and average length of night shifts (hours/night) were used to examine the relationship between night shift work and NAFLD.
Results
Current night shift workers had elevated odds of NAFLD (OR, 1.23, 95% CI 1.02 to 1.48) compared with those who never worked night shifts after adjustment for potential confounders. Duration of night shifts, cumulative number of night shifts and cumulative length of night shifts were positively associated with NAFLD. Both the average frequency of night shifts (>7 nights/month vs ≤7 nights/month: OR, 1.24, 95% CI 1.06 to 1.45) and average length of night shifts (>8 hours/night vs ≤8 hours/night: OR, 1.27, 95% CI 1.08 to 1.51) were independently associated with overall NAFLD after mutually adjusting for the duration of night shifts and other potential confounders among night shift workers. No significant association was found in female workers between different exposure metrics of night shift work and NAFLD.
Conclusions
Rotating night shift work is associated with elevated odds of NAFLD in male steelworkers.
Study Objective
Caffeine is the most widely consumed stimulant in the world and sociodemographic factors including occupation are associated with intake. Shift work, required in various occupations, is associated with poor sleep, inadequate diet, and adverse health effects. Using a large nationally-representative database, demographics, sleep, and caffeine intake of US adults working various shifts were assessed.
Methods
The 24-hour dietary recall data from NHANES 2005-2010 (N=8,500) were used to estimate caffeine intake from foods and beverages. Work shifts were self-reported as: regular day-shift; evening-shift; night-shift; rotating-shift; or other-shift. Regression analyses assessed associations of shift work with caffeine intake after adjustment for sociodemographic factors.
Results
Approximately 74% of employed adults were day-shift workers and 26% were non-day shift workers. Night-shift workers slept for 6.25±0.09 hours per day, somewhat less than day-shift workers who only slept 6.83±0.02 hours (P<0.0001). Mean 24-hour weekday caffeine intake of evening-, night-, and rotating-shift workers (217±23, 184±19, and 206±15 mg, respectively) was similar (P>0.3) to day-shift workers (203±5 mg). Regardless of work schedule, individuals consumed the most caffeine during morning hours. Evening and night-shift workers reported consuming 36-46% less caffeine during their work hours and 72-169% more during non-work hours than day-shift workers. (P<0.01).
Conclusions
Total daily caffeine intake of shift workers is similar to non-shift workers; most caffeine is consumed in the morning regardless of shift. Since shift workers consume less caffeine during regular work hours and more during non-work hours than day workers, they may be using caffeine to, in part, optimize off-duty alertness.
This article examines the individual- and country-level factors that contribute to the risk of working unsocial hours in 30 European countries. Using the EU labor force survey data, the authors test for the influence of labor market dualization, product- and labor market regulation, and collective bargaining on the individual risk of working unsocial hours. The risks of working unsocial hours are strongly dualized in all countries, but the size of the risk gap between low-skilled outsiders and high-skilled insiders varies. In countries where collective bargaining plays a greater role in regulating work hours the gap between low- and high-skilled workers is smaller.
Previous studies have revealed the negative consequences of shift work in some individuals, with others better tolerating shift work. The present study investigated clinical implications of shift work-related sleep complaints as a manifestation of shift-work intolerance. Responses were obtained from 923 shift workers and 850 non-shift workers at Seoul National University Bundang Hospital in Seongnam, Korea. The self-reported questionnaires were administered to assess demographic and clinical factors of the participants. Shift work-related sleep complaints were defined as complaints of insomnia or excessive sleepiness related to shift work schedule. Shift workers with sleep complaints suffered from more severe fatigue, depression, anxiety and impaired quality of life compared with both non-shift workers and shift workers without sleep complaints (all p < 0.05). However, we found no substantial difference in clinical symptoms between non-shift workers and shift workers without sleep complaints. The associated factors of shift work-related sleep complaints were frequent night shifts (OR = 1.09, 95% CI = 1.02–1.15), evening chronotype (OR = 0.97, 95% CI = 0.95–0.99) and resilience (OR = 0.98, 95% CI = 0.97–0.99). Shift workers with sleep complaints can suffer from more severe adverse effects of shift work compared to non-shift workers and shift workers without sleep problems. This study suggests that shift-work-related sleep complaints might be a manifestation of shift work intolerance. Therefore, physicians need to recognize and modify the associated factors with sleep complaints alleviating shift work-related health burden.
Public debate on societal rhythms, in particular working hours, has been dominated by a (fear) scenario about a shift towards a 24/7 society. Factors such as the services- and information-driven economy, deregulation of opening hours, changes in the rhythms of consumer culture have been expected to disrupt “normal” working time. The term ‘24/7 society’ is part of the popular discussion and occasionally encountered in academic writing as well. 24/7-society is expected to create both new opportunities and new risks. In this chapter, we produce up-to-date literature review to examine how the post-industrial, services-dominated economy changes work and leisure time practices. This chapter also employs different data sources (e.g. European working conditions surveys from three decades as well as Time Use Surveys from selected countries) to assess empirically changes in timing of work and time use.
Shiftwork became common during the last few decades with the growing demands of human life. Despite the social inactivity and irregularity in habits, working in continuous irregular shifts causes serious health issues including sleep disorders, psychiatric disorders, cancer, and metabolic disorders. These health problems arise due to the disruption in circadian clock system, which is associated with alterations in genetic expressions. Alteration in clock controlling genes further affects genes linked with disorders including major depression disorder, bipolar disorder, phase delay and phase advance sleep syndromes, breast cancer, and colon cancer. A diverse research work is needed focusing on broad spectrum changes caused by jet lag in brain and neuronal system. This review is an attempt to motivate the researchers to conduct advanced studies in this area to identify the risk factors and mechanisms. Its goal is extended to make the shift workers aware about the risks associated with shiftwork.
This study aimed to evaluate the effects of an intervention on objective working-hour characteristics. The intervention involved making modifications to the collective agreement that would limit employees' entitlement to time off as compensation. The intervention group consisted of 493 and the control group of 2303 health and social care shift workers, respectively. We analysed the objective pay roll-based working-hour data for 2012-2013, which we obtained from employers' records, using the repeated measures mixed model. The changes in objective working-hour characteristics were small, but systematic. The intervention had some positive effects: the amount of short recovery periods (< 28 hours) after the last night shift decreased from 5% to 3%, and the amount of working weeks of over 48 hours decreased from 19% to 17%. The realization of employees' shift preferences increased from 18% to 20%. However, in contrast, consecutive work shifts and the number of scheduled absences increased and days off decreased, suggesting less time for recovery and thus a negative trend in shift ergonomics. When planning shifts, nursing management should avoid regulations that promote specific unhealthy shift characteristics, that is, consecutive work shifts and less days off.
The purpose was to investigate which detailed characteristics of shift schedules that are seen as problems to those exposed. A representative national sample of non-day workers (N = 2031) in Sweden was asked whether they had each of a number of particular work schedule characteristics and, if yes, to what extent this constituted a “big problem in life”. It was also inquired whether the individual's work schedules had negative consequences for fatigue, sleep and social life. The characteristic with the highest percentage reporting a big problem was “short notice (<1 month) of a new work schedule” (30.5%), <11 h off between shifts (27.8%), and split duty (>1.5 h break at mid-shift, 27.2%). Overtime (>10 h/week), night work, morning work, day/night shifts showed lower prevalences of being a “big problem”. Women indicated more problems in general. Short notice was mainly related to negative social effects, while <11 h off between shifts was related to disturbed sleep, fatigue and social difficulties. It was concluded that schedules involving unpredictable working hours (short notice), short daily rest between shifts, and split duty shifts constitute big problems. The results challenge current views of what aspects of shift work need improvement, and negative social consequences seem more important than those related to health.
Pour mieux comprendre les effets du travail en horaires postés, nous avons étudié les variations des perceptions de l’environnement de travail selon le poste travaillé et la phase du poste. Le questionnaire construit, en référence au Job Content Questionnaire, mesure les perceptions de demandes, contrôle et soutien social et deux dimensions supplémentaires : les ressources techniques et humaines et les interférences travail-hors travail. Il a été renseigné à trois reprises (une heure après le début, en milieu et une heure avant la fin du poste) pour chaque poste occupé (matin, après-midi, nuit) par 38 personnels de soins (86 observations). Les résultats montrent des demandes psychologiques globalement plus élevées en début et milieu de poste et des demandes physiques plus élevées en fin de poste. Lors du poste de nuit, les personnels perçoivent davantage d’autonomie et moins de soutien des collègues. Des interactions entre le poste et la phase du poste indiquent une augmentation des ressources sur le poste du matin, une diminution l’après-midi et des valeurs stables la nuit. Pris ensemble, ces résultats indiquent que, si le poste de nuit paraît le moins exposé à la tension professionnelle, celui du matin donne lieu à des perceptions de stress positif en milieu de poste et de faible tension en fin de poste tandis que la tension professionnelle augmente tout au long du poste de l’après-midi. Ils soulignent l’importance d’une évaluation de la charge de travail selon le poste et le moment du poste chez des personnels de soins et de considérer différentes ressources en accord avec le modèle « job demands-resources » (Demerouti et al., 2001). Bien qu’ils ne puissent être généralisés à d’autres situations de travail et doivent être discutés à la lumière de l’activité de travail, la méthodologie développée apporte des données complémentaires à celles obtenues avec une approche plus globale.
Sleep Deprivation, Stimulant Medications, and Cognition provides a review, synthesis and analysis of the scientific literature concerning stimulant medications and neurobehavioral performance, with an emphasis on critically evaluating the practical utility of these agents for maintaining cognitive performance and alertness in sleep-deprived (but otherwise healthy) individuals. The book explores the nature of sleep loss-induced cognitive deficits, neurophysiologic basis of these deficits, relative efficacy and limitations of various interventions (including non-pharmacological), and implications for applying these interventions in operational environments (commercial and military). Readers of this volume will gain a working knowledge of: • Mechanisms contributing to sleep loss-induced cognitive deficits • Differential effects of stimulant compounds on various aspects of cognition • Considerations (such as abuse liability) when applying stimulant interventions in operational settings • Current state and future directions for including stimulants in comprehensive fatigue-management strategies. This text is key reading for researchers and trainees in sleep and psychopharmacology.
Sleep Deprivation, Stimulant Medications, and Cognition provides a review, synthesis and analysis of the scientific literature concerning stimulant medications and neurobehavioral performance, with an emphasis on critically evaluating the practical utility of these agents for maintaining cognitive performance and alertness in sleep-deprived (but otherwise healthy) individuals. The book explores the nature of sleep loss-induced cognitive deficits, neurophysiologic basis of these deficits, relative efficacy and limitations of various interventions (including non-pharmacological), and implications for applying these interventions in operational environments (commercial and military). Readers of this volume will gain a working knowledge of: • Mechanisms contributing to sleep loss-induced cognitive deficits • Differential effects of stimulant compounds on various aspects of cognition • Considerations (such as abuse liability) when applying stimulant interventions in operational settings • Current state and future directions for including stimulants in comprehensive fatigue-management strategies. This text is key reading for researchers and trainees in sleep and psychopharmacology.
Background:
Beyond workload and specific environmental factors, flight attendants can be exposed to irregular working hours, conflicting with their circadian rhythms and having a negative impact in sleep, fatigue, health, social and family life, and performance which is critical to both safety and security in flight operations.
Objective:
This study focuses on the irregular schedules of cabin crew as a trigger of fatigue symptoms in a wet lease Portuguese airline. The aim was to analyze: what are the requirements of the cabin crew work; whether the schedules being observed and effective resting timeouts are triggering factors of fatigue; and the existence of fatigue symptoms in the cabin crew.
Methods:
A questionnaire has been adapted and applied to a sample of 73 cabin crew-members (representing 61.9% of the population), 39 females and 34 males, with an average age of 27.68 ± 4.27 years.
Results:
Our data indicate the presence of fatigue and corresponding health symptoms among the airline cabin crew, despite of the sample favorable characteristics. Senior workers and women are more affected.CONCLUSIONS: Countermeasures are required. Recommendations can be made regarding the fatigue risk management, including work organization, education and awareness training programmes and specific countermeasures.
The organization of times and places of work are key elements of working conditions, and define employees’ possibilities for
balancing work and other life spheres. This study analyses several aspects of temporal and spatial flexibility, and their
associations with employees’ work-life balance. This study separates four dimensions of temporal flexibility and one indicator
of spatial flexibility. The dimensions of temporal flexibility are the number of hours worked, when the hours are worked,
work-time intensity, and the degree of working-time autonomy. The workplace flexibility indicator is an index of work locations.
Work-life balance is analysed with work-hour fit. The analyses were based on the fifth wave of the European Working Conditions
Survey collected in 2010. We used data from 25 Member States of the European Union (n = 25,417). Based on the hierarchical cluster analysis, this study found various types of flexibility regimes in Europe. Country
clusters show a clear effect on perceived work-life balance even after controlling for flexibility measurements at the individual
level. This study contributes to the existing research in analysing several dimensions of temporal and spatial flexibility
at the same time, as well as their associations to work-life balance.
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