The Impact of Shift Work

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The Impact of Shift Work On Health and Diet
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Shiftwork Any work regularly undertaken outside
normal working hours 0700 1800 Nights Earl
y am Evening Fixed Rotating Eight hour Twelve
hour
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Statistics Approx 3.6m UK (1-7 of
workforce) men gt women ? Transport
Communication sector (26) Most common
occupational group of women working shifts
is nurses

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UK employees work longer hours than other
European workers UK mean for males in FT employ
is 45.8 hours per week (EU mean 41.3) UK mean
for females is 40.6 hours per week (EU mean 39.0)
Approx 2.7 million UK workers usually work gt 48
hours per week (mean 56 hours).
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Shift Work Health Specifics
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Circadian Rhythms

• Effects
• Circadian disruption
• Sleep loss/debt
• Fatigue
• Social disruption
• Health implications

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Adjustment to shiftworking
Stress
Strain
Sleep Disturbance
Organisational Implications
Mood changes
Functionality Reduced
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Adjustment to shiftworking
stress
strain
organisational effects
Phase-shifting of waking and sleeping hours
Impaired performance Impaired health Disturbed
relationships
gt Absenteeism gt Accidents gt Labour turnover lt
Productivity
modifying factors
Individual characteristics Job-related
factors Environment Domestic
Colquhoun Rutenfranz 1980
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• Studies show that staff can be prone to
• Serious illness
• Stress
• Sleep disorders
• Accidents

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The evidence points to The phase shift
experienced in night and rotating shift work
Involves desynchronization at the molecular
level in the circadian oscillators in the
central nervous tissue and in most peripheral
tissues of the body
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Desynchronization There is a change in the
coordination between oscillators with transient
loss of control by the master-oscillator The
Suprachiasmatic Nucleus (SCN) Located in the
hypothalamus
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Critical The bodys various Circadian Rhythms
are reset every 24 hours by environmental
cues e.g. light and darkness melatonin
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Positives

• Flexibility
• Financial
• Free time
• Family

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Positives Negatives

• Flexibility
• Financial
• Free time
• Family

• Sleep deprivation
• Acknowledgement
• Society still 9-5
• Spaced

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Extraneous Supports The ability to effectively
manage the juggling act between paid work and
the other activities that are important to
shift workers Family/Friends Recreation
Spiritual Health and Wellness Finances Work
colleagues
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Potential effects
cardiovascular
mental health
immune system
Stress
gastrointestinal
musculoskeletal
social effects
performance impairment
Fatigue
safety problems
Exposure
over-exposure
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Gastrointestinal disorders and shiftwork
Indigestion (Chan et al. 1987) (Poole et al.
1992) Reflux Peptic Ulceration (Waterhouse et
al. 1992) Related to irregular
hours circadian dysrhythmia poor catering
facilities inequality in GP access
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• Cardiovascular problems of shiftwork
• Liu Tanaka 2002
• Working hours related to Acute Myocardial
  Infarction
• increased risk in year prior to AMI
• increased risk in month prior to AMI
• x 2 increase in risk for overtime (gt61 hours)
• x 2-3 increase in risk for lt5 hours sleep
• x 2-3 increase for lack of sleep (2 or more days
  with lt5 hours sleep)
• Overtime work and lack of sleep may be related to
  AMI

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Energy Fatigue Cycle
Energy Slump
Guilty Ashamed Failure Angry
Exhausting
Fix it
Chocolate Alcohol Cigarettes Coffee Drugs
Nauseous Irritated Drunk Depressed Hostile
Dopamine Serotonin GABA Adrenalin
Physiological
Psychological
Boost Relaxed Calm Feels good
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Blood Sugar levels
Serotonin
ß-Endorphins
Lethargic
Depressed
Tired
Fuzzy
Isolated
Run Down
Edgy
Lost
Tearful
Irritable
Reactive
Stressed
Hopeless
Suicidal
Faint
Sleep problems
Craves Sugars
Sleep Problems
Low pain threshold
Poor concentration
Poor Concentration
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• Neurotransmitters
• Neurotransmitters are made from
  essential amino acids.
• There are hundreds of
  neurotransmitters 6 main ones
• Adrenalin
• Dopamine (Noradrenalin)
• Endorphins
• Serotonin
• Acetylcholine
• GABA

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Adrenalin
Has the opposite effect of insulin 1st
messenger hormone and will be released when the
glucose level in blood is low.
As neurotransmitter it has an effect on the
sympathetic nervous system. (heart, lungs,
blood vessels, bladder gut)
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Dopamine

• Associated with
• Pleasure
• Alertness
• Concentration
• Euphoria
• -ve PD Sc

all proteins (meat, milk products, fish, beans,
nuts, soy products). 
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Endorphins The brains natural opiates They
bind to specific opiate receptors in the brain
and induce pain relief. Also known as the
runners high
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• Serotonin
• Associated with
• Moods
• Sleep
• Dreams
• Bp
• Digestion
• Body temperature
• pasta, starchy vegetables, potatoes, cereals,
  breads. 

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• Acetylcholine
• Associated with
• Memory
• Alertness
• Learning ability
• Concentration
• -ve Alz
• Egg yolks, peanuts, wheat germ, liver, meat,
  fish, milk, cheese and vegetables (especially
  broccoli, cabbage and cauliflower)

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Essentials

• Niacin B3
• Folic acid
• Pyridoxine B6
• Vitamin C
• Zinc
• Magnesium
• EFAs
• Tryptophan tyrosine

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Lunches

• Core base of green salad
• Walnuts pecan nuts
• Peppers
• Tomatoes
• Fresh lemon

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Mood Enhancing Foods

• Eggs
• Fish meat
• Cottage cheese
• Rice pasta
• Crustacean vegetables
• Short grain brown organic rice
• Quinoa
• Avocado
• Legumes

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Nutrient Food sources NT Proposed effect
Protein Meat, Milk, Eggs, Cheese, Fish, Beans Dopamine, Norepinephrine Increased alertness, concentration
Carbohydrate (CHO) Grains, Fruits, Sugars Serotonin Increased calmness, relaxation
Calories All Foods Reduced blood flow to the brain Excess calories in a meal is associated with decreased alertness and concentration after the meal
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