Standard daytime hours are 7am to 7pm. From a biology perspective the hours outside of 7am and 10pm are important. This relates to the human central body clock that determines the timing of many biological functions. These functions are timed to be optimal at certain times of the day and night. The release of melatonin which is a sleep-inducing hormone and has anti-cancer properties peaks at 4am but large quantities are found in the blood between 10pm and 7am. Work outside of these hours will affect the internal body clock. The consequence of this, is that it can make some existing health problems worse and increase the risk of developing some ill health.
There is continual research into the risk of cancer especially breast cancer increasing due to shift work that includes nights. The potential increase risk of cancer is due to the reduction of the release of the anti-cancer hormone – melatonin and night workers having less opportunity to do healthy lifestyles such as avoiding obesity, alcohol consumption out of guidelines and smoking.
The quality and quantity of sleep whilst doing night duty is lowered. Fatigue and sleep debt can occur. As well as health issues, adverse effects on performance and safety are common. Sleep deprivation results in lowered:
- vigilance and monitoring;
- decision making;
- awareness;
- fast reaction time;
- tracking ability;
- memory
So what could be done to reduce the risks to health, performance and safety? Examples:
Employer
Avoid permanent night shifts.
Provide healthy food choices at work during the night
Health promoting activities such as smoking cessation events and lifestyle checks
Limit shifts to a maximum of 12 hours which includes overtime
Use a forward-rotating schedule; early, late, nights.
Either do a rapid cycling shift (every 2-3 days) or slow 3-4 weeks rather than weekly or fortnightly.
Allow employee choice about set or rotating shifts.
Avoid scheduling safety critical, demanding or dangerous work during the night, early morning and at the end of a long shift.
Allow a minimum of 2 full night sleep when switching to days from nights.
Allow for short and frequent breaks during a night shift.
Offer annual night worker health assessments
Ensure that employees and line managers are aware of the performance, safety effects of nights and solutions
Employees who declare having health issues that they associate with shift work, consider referring them to occupational health for an assessment and provision of advice to you and them.
If roles are safety critical consider implementing methods of assessing fatigue as individuals may under estimate fatigue levels and overestimate performance and potential for serious harm. https://www.sleepapnea.org/assets/files/pdf/ESS%20PDF%201990-97.pdf
Employee
If due to start night shifts then have a sleep or rest period during the day
If coming off night shifts then have a short sleep and go to bed earlier that evening
Try and stick to a sleep schedule.
Have good sleep hygiene https://www.nhs.uk/live-well/sleep-and-tiredness/how-to-get-to-sleep/
Keep up health promoting activities of regular exercise, eat a healthy diet, keep alcohol consumption within guidelines, avoid smoking, socialise with friends and family.
During a shift go for walks during break times
Discuss with your line manager about having frequent and shorter breaks
If feeling fatigued talk to your line manager
Take up the offer from your employer (if they do so) of an annual night worker health assessment.
Inform your GP and/or other medical specialist who is advising you of treatment of you working shifts especially if you are working nights.
If you experience difficulties that you feel associate with shifts, then inform your line manager.
Valentine Occupational Health also have scheduled Webinar focusing on Night & Shift Working, productivity, safety and OH solutions.
This will take place on:
Wednesday 19th June, FOC entry. Please feel free in signing up via the link below.
https://www.eventbrite.co.uk/e/night-shift-working-occupational-health-tickets-57980075968
Anna Harrington – Clinical Lead
