Working a shift outside the usual 8-hour day shift does have some benefits such as an easier commute, fewer crowds in stores and other public areas during the day, and sometimes, more days off in a row.

But working a shift outside of the usual 8-hour day also has some drawbacks. You can be affected physically and psychologically. That’s because the human body functions on a programmed time clock that’s set for daytime activity and nighttime sleep. So when you work on some other schedule, it can have an impact on your sleep, diet, mood, family life, and alertness at work.

Because of these effects, shiftworkers have to take extra precautions to keep alert and work safely. Today, we’re going to talk about how your body is affected by working shifts and what steps you can take to stay healthy and safe on the job regardless of the hours you work.

Session Objectives

The main objective of this session is to talk about how to keep safe and healthy when working nontraditional shifts. By the time this session is over, you should be able to:

• Recognize the health, social, and safety effects of working outside the usual 8-hour day shift;
• Identify strategies for minimizing the negative impact of shiftwork; and
• Stay healthy and safe when working shifts.

Negative Effects Of Shiftwork

Shiftwork can affect you in many different ways, and some of them are potentially hazardous to your health and safety.

• Your body’s 24-hour cycle—or circadian rhythm—is upset by shiftwork. Your body is designed to be awake during the day and to shut down at night. Most of your body functions are controlled by this internal time clock. If you are awake when your body thinks you should be sleeping, your internal systems can be upset.
• Cardiovascular problems can also arise as a result of shiftwork because your heart rate and blood pressure also follow circadian rhythms. This means both are lower at night when you’re working and increase during the day when you’re trying to sleep.
• Shiftwork may increase your cancer risk, especially for women. Several studies have shown an increased risk for breast cancer among shiftworkers. There has also been evidence for increased risk of prostate and colon or colorectal cancer. Being exposed to light during the dark cycle of your circadian rhythm can interrupt the production of melatonin, which is a cancer-fighting antioxidant.
• In addition to possible cardiovascular problems, shiftwork can also cause gastrointestinal (GI) disorders such as heartburn and other digestive problems because your body’s digestive system slows down at night and is active during normal daytime eating hours. So if you work nights, properly digesting the food you eat during those hours can be a problem.

Negative Effects Of Shiftwork (cont.)

• Not getting enough sleep and feeling tired all the time are common complaints of shiftworkers. It’s more difficult to get good, sound sleep during the day when your body functions are awake.
• Family and social life may also be disrupted because your work schedule isn’t like those of your family or most of your friends.
• Finally, your safety on the job could be negatively affected because alertness and ability to concentrate are affected by circadian rhythms, too. Your body wants to shut down at night, which makes it more difficult to stay focused, awake, and alert while you work. One recent study estimated that the risk of an accident on a 10-hour shift is 13% higher than for an 8-hour shift. For a 12-hour shift, the risk increases to 27.5%.

Think about problems you’ve experienced as a result of shiftwork. Have you ever experienced any of the problems we’ve just discussed? What about any other problems?

Cardiovascular Disorders

Cardiovascular disorders can also be a problem for some shiftworkers. Again, we go back to the body’s circadian rhythms. Your heart rate and blood pressure follow these rhythms. As we’ve said, they normally increase during the day and slow down at night.

• If you’re working at night, however, blood pressure and heart rate stay high at night, too, because of your body’s activity. Then, during the day, because of circadian rhythms, blood pressure and heart rate remain high. This means the cardiovascular system has trouble getting into a regular pattern of activity and rest. This can increase the risk of cardiovascular disorders.
• In medical studies, rotating shiftworkers and nightshift workers have shown increased levels of triglycerides and glucose, which may contribute to coronary disease.
• Poor eating habits and lack of sleep that often go along with shiftwork also contribute to cardiovascular disorders.
• It’s important to note, however, that shiftwork is not absolutely associated with cardiovascular disease. No one’s saying that because you work shifts you’re going to have a heart attack 10 years from now. But studies have shown that men with a history of heart attack were more likely to have been shiftworkers than those with no history of heart attack.

Circadian Rhythms

As we’ve just pointed out, many of the human body’s functions follow a daily rhythm or 24-hour cycle. We’ve also identified these cycles as circadian rhythms.

• And as we’ve said, this internal clock regulates sleeping, waking, digestion, secretion of adrenaline, body temperature, blood pressure, and many other body functions. Human behavior is also affected by this 24- hour cycle.
• These rhythmical processes are coordinated to allow for high activity during the day and low activity at night. For example, body temperature is highest during the afternoon and early evening, and lowest in the early morning, just before sunrise.
• When circadian rhythms are disrupted by working at night, they can get out of sync with other body rhythms and activity patterns. This can make you feel tired and disoriented.
• Some rhythms can adapt in 2 or 3 days. Others may take much longer. Furthermore, people adapt to changes in work schedules at different rates. But permanent change of circadian rhythms rarely occurs for most people because on days off they often go back to a normal day schedule.

Gastrointestinal Disorders

Shiftworkers sometimes experience gastrointestinal disorders as well because food is not well digested at night. Your digestive system is most active in the morning, around noon, and in the early evening. That’s why most people eat breakfast, lunch, and dinner at those times.

• During the night, the digestive system is less active.
• Eating when the digestive system isn’t very active can cause indigestion, heartburn, stomachaches, and loss of appetite.
• Furthermore, shiftworkers may be more likely to eat prepared foods that are easy to microwave or foods from late-night fast food restaurants. These foods are often greasy, heavy, and difficult to digest. They may not provide very good nutrition either.
• Snacking on sugary or fatty junk food from the vending machine is also a problem. Candy bars, cookies, and so on may give you a temporary burst of energy, but it only lasts a short time. Once your body has adjusted to the higher energy level and the sugar high wears off, your energy level actually drops below what it was before the snack.
• And, carbonated drinks, such as cola, are often consumed by shiftworkers for their caffeine content. But while the caffeine might help keep you awake, the carbonation can irritate your stomach and cause indigestion and heartburn.

Sleep Deprivation

Disruption of both the quality and quantity of normal sleep is inevitable in shiftwork, particularly when night work is involved. Sleep deprivation is a common problem for shiftworkers, and that can leave you feeling constantly tired and affect your safety as well. In fact, sleep disorders among shiftworkers are so common that doctors have given this condition its own name: “Shift Work Sleep Disorder (SWSD)”.

• The circadian rhythms are probably primarily to blame for sleep deprivation. Your body wants to shut down at night and thinks it’s time to be awake during the day.
• So it’s hard to get a good sleep during the day when your blood pressure and body temperature are up, your digestive system is active, and your whole body is in high gear and raring to go.
• And, exposure to daylight and the relative warmth of daylight hours contribute to the sleep deprivation problem. The light and warmth also cause your body to think it’s time to wake up and get going.

Sleep Deprivation (cont.)

• To make things worse for many shiftworkers, the rest of the world is waking up just about the time they’re getting ready to turn in and get some sleep. The noise of traffic, neighbors, garbage trucks, children, phone calls, and family activity all have a negative impact on quality and quantity of sleep.
• And if you’ve been consuming caffeine at work to stay awake and maybe have a beer or glass of wine—or two—when you get home to help you sleep, that could negatively affect your system and keep you awake when you’re trying to fall asleep. The caffeine you consumed during your shift could still be in your system when you’re ready for bed. And if your body has to process alcohol while you sleep, it’ll probably interfere with your rest.
• With all of these disruptive problems, it’s hard to get a refreshing sleep during the day. Many shiftworkers report that they only get 4 or 5 hours of sleep in some 24-hour periods. Although that amount of sleep might be OK for some people or once in a while, most people need between 7 and 9 hours of sleep most days in order to function well.
• Finally, over time, unrelieved sleep deprivation can cause other health concerns as well—both physical and emotional.

Preexisting Conditions

Disruption of circadian rhythms brought about by shiftwork can also affect some preexisting medical conditions.

• For example, shiftwork can sometimes interfere with the treatment of certain diseases and medical conditions.
• A few workers have become physically ill when switched to night shift. They may vomit, suffer light-headedness, or even have seizures. Fortunately, such reactions are very rare.
• But just to be safe, before moving to a night or rotating shift, check with your doctor if you are being treated or taking medication for a preexisting medical condition.

Family and Social Life

Because shiftworkers are usually not on the same schedule as family and friends, their family and social lives may suffer.

• Time spent with spouses, children, other family members, and friends is reduced because shiftworkers are at work or sleeping when others are active.
• In addition, few sports, clubs, or other organized activities are geared toward shiftworkers. These group activities are usually arranged for the convenience of the normal dayshift worker. This limits the shiftworker’s opportunity for normal social interaction and extracurricular activities.
• The main problem here is that social interaction is related to both physical and emotional health. Most people need to spend time with family and friends in order to stay healthy and happy.
• And, as a result of not being able to have as much social interaction as they’d like, many shiftworkers suffer to some degree from at least occasional feelings of loneliness and isolation because of the lack of social interaction. In the worst cases, a person might even become depressed.

Workplace Safety

Along with health and social concerns, there is another very important concern about shiftwork—and that’s its effect on safety. Research has shown that mental performance levels are lowest between 3:30 a.m. and 5:30 a.m. This means that nightshift workers will have extra difficulty focusing and staying alert, particularly at the end of the shift. Even if your shift doesn’t go all night, you’re still likely to be more tired and less alert toward the end of your shift.

• Again, circadian rhythms are the shiftworker’s enemy. Your body and mind want to shut down at night, so concentration is reduced, which makes it harder to focus on a task for very long.
• If you work at night, you may also feel less motivated to follow safety procedures. There will generally be fewer workers, including supervisors and managers, around, so you may be more tempted to take shortcuts or be less diligent about safety procedures.
• You might also have reduced reaction time. This could make you more likely to have an accident because you can’t react as fast as you normally would.
• And, of course, simple fatigue is responsible for many shiftwork injuries.
• As a result of these circadian effects, the accident rate for shiftworkers is generally higher than for those who work the day shift.

Can you think of accidents caused by fatigue brought on by shiftwork?

Effects of Shiftwork: Yes or No?

Now let’s take a few minutes to review the effects of shiftwork that we’ve just discussed with a little test. Take a look at the list of effects on the screen and decide which of these might be caused by shiftwork. [PAUSE] OK, have you made your decision?

The possible effects of shiftwork include:

• Increased risk of cancer;
• Gastrointestinal disorders;
• Cardiovascular disorders;
• Interference with family and social life;
• Sleep deprivation; and
• Safety on the job.

How did you do? Did you get all the answers right?

Effects of Shiftwork

Now it’s time to ask yourself if you understand the information that has been presented so far. Do you understand about:

• Health effects of shiftwork?
• Social effects of shiftwork? and
• Safety effects of shiftwork?

It’s important for you to understand this information so that you can protect your health and safety when you work shifts.

Now let’s continue to the next slide and talk about how to reduce the negative effects of shiftwork.

How to Reduce the Negative Effects of Shiftwork

Fortunately, all of the negative health, social, and safety effects that we’ve discussed in the first part of this session can be minimized if you take the right precautions. So let’s focus now on reducing the negative effects of shiftwork so that you can remain safe and healthy regardless of your work schedule. Here’s what you need to do:

• Take steps to get more and better sleep;
• Adjust your eating habits to help reduce gastrointestinal problems;
• Exercise regularly;
• Find ways to increase interaction with friends and family; and
• Develop strategies for staying alert at work to prevent accidents.

In the next slides we’ll take a closer look at each of these important ways to reduce the negative effects of shiftwork.

Strategies for Better Sleep

Let’s begin with strategies for better sleep. Initially, you may need to try different sleep schedules to determine what works best for you, your family, and your social life.

• Once you find the best sleep schedule, stick to it. Stay on your sleep schedule every day—even on weekends and days off. Many workers revert to a normal day schedule on their days off. But this is a mistake because it prevents the body from fully adjusting its circadian rhythms.
• Find a quiet, cool, and darkened room where you won’t be disturbed so that you can get some quality sleep. Because your body wants to be awake during the day, you’ll be more easily awakened by noise, increases in temperature, and light. Turn on the air conditioner or a fan, wear earplugs, and install some good blinds.
• Make sure family, friends, and neighbors are aware of your sleeping needs and schedule. Make sure children understand the importance of your sleep schedule. Use a phone answering system. Ask neighbors to avoid operating lawn mowers and other loud equipment during your sleep schedule.
• Before going to sleep, take time to relax your mind and body. Consider reading a book or listening to relaxing music. Avoid stimulants such as caffeine before your scheduled sleep time.

Strategies for Better Sleep (cont.)

• Eat a light snack before sleep to prevent your active digestive system from waking you.
• Another effective strategy for getting enough sleep each 24 hours is to take naps outside of your routine sleeping schedule. This will help make up for any sleep you lose during scheduled sleep times. Limit commitments and appointments when you are awake and active at home so that you’ll have the opportunity for a nap if you need it.

Think about the strategies you use to get enough quality sleep. How effective are they? Have you tried all of the strategies we’ve just discussed?

Diet and Eating Habits

• When it comes to diet and eating habits, the secret is to maintain a regular eating pattern or schedule. This will help adjust your circadian rhythms to your shiftwork schedule. Your body will turn on your digestive system at your scheduled eating times rather than at the normal day times.
• Also, eat a balanced diet of vegetables, fruit, fish, dairy products, grains, and bread. Drink a lot of water each day because dehydration increases the effects of fatigue.
• Eat your main meal according to your work schedule. For example, workers on a swing, or second, shift should eat their main meal before going to work and then have a light meal for dinner at work. Nightshift workers should have their main meal when they get home—around normal breakfast time. But this meal should be moderate in size.
• Avoid heavy and greasy foods at night. They’ll sit in the less active digestive tract and contribute to heartburn and stomach pain.
• Finally, avoid candy bars and chips while working. Instead, eat fruit, nuts, or crackers. Although you may need caffeine to stay alert during your shift, avoid it at least 4 hours before your scheduled sleep time. And remember, drinking alcohol might cause drowsiness, but it won’t contribute to quality sleep.

Exercise

• All shiftworkers should develop and follow a consistent exercise and/or stretching routine. An exercise routine, in combination with a scheduled sleep time and a good nutritious diet, will help improve or adjust circadian rhythms of heart rate and blood pressure. Without exercise, the heart rate and blood pressure never have the opportunity to develop a scheduled time of increased and decreased activity. Their activity is always increased because of night work activity and normal increased activity during daytime hours.
• Exercise also helps improve energy and assists with a deeper and more relaxed sleep.
• Exercising before going to work or after waking up increases alertness during working hours, making you safer on the job.
• However, here’s one word of warning about exercise. Avoid exercising right before your scheduled sleep time. Exercise increases your heart rate and wakes up your body. So doing it too soon before bedtime will make it difficult to get to sleep.

Do you exercise regularly? You should. Think of some physical activity you enjoy and do it every day. Even a simple stretching routine will help keep you healthy and more alert on the job.

Family and Social Life

When you develop your sleep schedule, it’s important to take your family and social life into account.

• Try to arrange your sleep schedule so that you’re awake when your family is home. Keep meal times with your family, such as dinner, but adjust what you eat at those times according to your own eating schedule.
• Find some new friends that work the same or similar schedule so that you have the opportunity for enough social interaction, which is important to your health and well-being.
• You might also consider joining a fitness or hobby club that has a lot of activities during your normal awake time. Many fitness clubs are busy and full of people at all times of the day. Have your new shiftworker friends join you in the fitness or hobby club.
• Also, schedule weekend social functions with friends and family during your normal awake time. Make sure everyone understands that you won’t be able to attend functions scheduled during your normal sleep time. Remember, maintaining your sleep time is very important.

Think about the ways you arrange to spend quality time with family and friends. Maybe these ideas will help improve your social life.

Keeping Alert at Work

Staying alert when doing shiftwork, especially if you work all night, can be difficult because your circadian rhythms want to shut your body down. But that can be hazardous and make you more likely to have an accident on the job. So you need to take steps to keep alert. Here are some suggestions.

• Physically active work will help keep you alert because it increases your body temperature, heart rate, and pulse. This all helps to improve concentration and alertness.
• Changing tasks every couple of hours—or even more frequently—will also improve concentration and mental stimulation. If you have two main tasks to perform during your shift, alternate back and forth between the two, if possible.
• Also, stay in contact with other workers or work as a team. The conversation and interaction will help everybody stay awake and alert.

Keeping Alert at Work (cont.)

• If your job doesn’t require much physical activity, taking a few minutes to exercise or stretch will improve blood flow and alertness. You can do a short stretching routine right at your workstation or take a walk around the building during your break. You will feel more energized and alert.
• Drinking a modest amount of caffeine can stimulate your brain and improve concentration. But remember, not too much, and stop drinking caffeinated beverages at least 4 hours before your scheduled sleep time. And avoid other stimulants such as over-the-counter pills completely. They can make it difficult to get to sleep after work.
• Finally, try listening to music while you work, if this is permitted. Lively music or talk radio shows can help stimulate your brain and keep you alert. But remember, radios might not be appropriate in all work situations and could interfere with safety. So check with your supervisor first.

Think of the steps you take to keep alert at work. How effective are those strategies? What else could you do to keep alert and safe?

Other Shiftwork Tips

Now let’s look at a few more shiftwork safety tips.

• The commute for many shiftworkers can be hazardous because of fatigue. Nightworkers who get off at 6 or 7 a.m. are usually tired and their heart rate and body temperature are at a low point. This means that it’s easy for workers to nod off while driving home. If you’re in this situation and have a long commute ahead of you at the end of your workday, consider taking a short nap before getting behind the wheel. A 15-minute nap will reenergize you and make your drive home much safer.
• Sleeping pills and other medications taken to fall asleep or stimulate wakefulness can do more harm than good. Although they may be necessary for short periods of time under a doctor’s supervision, they can also lead to a cycle of pill taking to fall asleep and wake up. So be very careful, and only use these medications in consultation with your doctor.
• Finally, remember to never take shortcuts with safety procedures. As we said at the beginning of this session, shiftworkers are especially vulnerable to workplace accidents. So always follow safety procedures and company policies to the letter. When you’re tired and struggling to stay alert, it’s especially important to stick to established procedures.

Remember, fatigue and the effects of circadian rhythms can negatively affect your body and your mind. Be extra careful while you work and take the time to follow all safe work practices.

Shiftwork Strategies: True or False?

Now let’s try a quick true/false quiz to test your knowledge of strategies to counteract the negative effects of shiftwork.

• Set a regular sleep schedule and stick to it. True or false? The correct answer is true. You’ll get a better, more restful sleep.
• To stay alert when working late, drink a lot of caffeine and eat a couple of candy bars. True or false? The correct answer is false. Some caffeine is OK, but not too much, and not at least 4 hours before your sleep time. Sugar doesn’t provide sustained energy. A healthier snack, like some fruit, would be better.
• Have a light snack before going to bed. True or false? The correct answer is true. This will keep your active digestion system happy.
• Adjust your sleep time on days off to coincide with family activities. True or false? The correct answer is false. Schedule time with family during your normal awake time.
• Exercise right before going to bed. True or false? The correct answer is false. Exercising just before bed time will keep you awake. Exercise before work or after waking up.

How did you do? Did you get all the answers right?

Shiftwork Strategies

Do you understand the information presented in the previous slides?

• Do you understand the strategies we’ve suggested for minimizing the negative impact of shiftwork?

These strategies can improve your health, safety, and quality of life when you work shifts.

Now let’s conclude the session with some key points to remember.

Key Points to Remember

Here are the main points to remember from this session on shiftwork safety. To stay healthy and safe while working shifts:

• Maintain a regular sleep schedule;
• Eat a well-balanced, sensible diet;
• Get enough exercise;
• Spend time with family and friends; and
• Keep alert on the job and follow all safe work practices.

This concludes the shiftwork safety training session.