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The risks of shift and extendedwork hours
Laurence Hartley
Murdoch University
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This talk
First half presents the hazards of
shiftwork
Second half presents the hazards of
extended work hours
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What is shift work?
Shift work: the alternation of teams ofworkers, usually performing the same tasks,so work can continue for longer than one workperiod
Some or all, work will occur outside of daytimehours
Work hours can be f ixed orro tate(change)and rotation can befast or s low
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Whats the problem for
shiftworkers?The rhythms of alertness & sleepiness
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The daily circadian rhythms
Rhythms driven by clock in brain
Alertness is max during the day
Sleepiness increases during the night
Maximum sleepiness in pre-dawn Clock is mainly set by day light
So clock time cannot be easily changed
So workers do not adapt much toshiftwork
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The 4 Hazards of Shiftwork
1. Increased risk of errors & accidents
when working or driving at night
2 Insufficient daytime sleep leads
to increased fatigue & sleepiness
3. Increase in health problems
4. Increase in social and domestic
problems
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1. Daytime sleep is
insufficient for night
shiftworkers
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alertness daytime sleep
Circadian rhythms(daily rhythms)in
body clock keeps body awake and alert
during the day; daytime not suitable forsleep!
Circadian rhythm of alertness meansnight workers are most sleepy at work
and driving home
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shiftwork sleep problems
Other disturbances during the day eg.noise, light, heat
Body rhythms and external
disturbances combine so that day
sleep is shorter (1-2hrs) and of poorer
quality than night sleep
Early shift start times cut down night
sleep
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sleep loss shiftwork
Insufficient sleep (
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Sleep loss leads to microsleeps
Insufficient sleep increases the likelihoodof microsleepsand nodding offoccurring
People are unaware of microsleeps
Loss of awareness and control ofsurroundings . an accident canhappen!
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2. More errors and
accidents at night
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Folkard (2003) Mean relative
risk across 3 shifts
SHIFT
Night (22-06)Af ternoon (14-22)Morning (06-14)
1.4
1.3
1.2
1.1
1.0
.9
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Folkard (2003) Mean relative risk
over 4 successive night shifts
Success ive Night Shifts
4321
1.5
1.4
1.3
1.2
1.1
1.0
.9
( ) f
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Folkard (2003) Relative risk of
different blocks of successive
night shifts
No of Successive Nights
7654321
1.5
1.4
1.3
1.2
1.1
1.0
.9
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driving
Three times risk of a crash with less 6 h sleep
Night workers are more likely to fal l asleepat the
wheel, and to have a crashor near-miss than dayworkers
Night workers are at 6 timesthe risk of a carcrash than day workers, especially at dawn
Fatigue and shift work is a major workplace road
safety issue
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staying awake and BAC
Long hours awake without sleep canimpair performance to a similar/greater
level than acceptable BAC for driving
17hrs awake leads to performance similar to
BAC 0.05%
20-25hrs awake leads to performance similarto BAC 0.1%
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3. More health problems
on the night shift
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adverse health concerns
Gastrointest inal complaints
- 20-75% night shift workers
- 10-20% day & evening workers
Card iovascu lar Disease
- a 40% increased risk for developingcardiovascular disease for shiftworkers
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4. Social and Domestic
Problems for the night
shift
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family and friends
Shift workers can have less suitabletime off and less quality time off
Shift workers often curtail their sleeptime to be with family and friends;this means they can be awake for along period of time, and they do notget enough sleep
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isks of extended hours
of work
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Folkard (2003) Relative risk
over hours on duty
Hours on Shift
121110987654321
2.5
2.0
1.5
1.0
.5
0.0
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Folkard (2003) Estimated relative
risk on different lengths of shift
Length of Shift (hours)
121110987654321
1.3
1.2
1.1
1.0
.9
.8
.7
.6
.5
.4
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Folkard (2003) Estimated relative
risk on different spans of 8, 12 h
No of Successive Nights
7654321
1.8
1.6
1.4
1.2
1.0
.8
8-hour
12-hour
H f k l ti t t
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Hours of work-relative transport
crash risk. Folkard, (1997)
H f k U S F M C S A
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Hours of work -U.S. F.M.C.S.A.
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Shift work hazard control
strategies
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Three Essential Shi f t Work
Hazard Con trol Measu res
1. Adequate, good quality sleep
2. Suitable shift work schedules
3. Appropriate work conditions
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1. Adequate, good qualitysleep
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sleep hygiene rules
Maintain pre-sleep routines similar to nightsleep
Bedroom dark and quiet
Avoid caffeine for 5 hrs before sleep
Avoid alcohol before sleep
Avoid exercise before sleep
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napping
Naps can help maintain alertness,
performance, and safety
Naps can supplement insufficient sleep,
but
BESTif taken after7-8hrs main sleep and
beforefeel ing fat igued:
Nap at home before night shift
Nap early in the night shift
Nap before driving home after night shift
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2. Suitable shift work
schedules
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shift work schedules
No one best shift work system
Employers should consider their
worker population and work tasks,and decide, in collaboration withworkers, on the most suitable
schedule for their work place
Then evaluate the schedule
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Recommendations
Rapid rotations are preferred to slow rotations
No more than 2 consecutive night shifts
Forward (clockwise) rotation of shifts
8hr shift length; 12hrs maximum
5-7 consecutive work days maximumFewer if shifts >8hrs or night shifts
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recommendations
2 days off minimum after a block of shifts
More if shifts >8hrs or night shifts
11hrs off minimum between
consecutive shifts
Keep schedules regular and predictable, butallow flexibility
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3. Appropriate work
conditions
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rest breaks
Regular rest breaks reduce accidents
Incorporate movement, stretching or
light exercise, social interaction
A proper meal break away from work
duties
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work schedule
Employers should tailor work tasksaccording to shi f t t ime; some tasks are
not suitable for night shift
Work tasks should vary during the shift
Schedule tasks so monotonous, boring,
dangerous, and safety critical tasks are
done early in the night shift
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work environment
Bright lighting, comfortable temperature,
and good ventilation
Background music may help temporarily
Appropriate facilities for healthy eating
Napping facilities
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Summary
Shift work is an OH&S hazard
employers and employees have a
du ty of careto control or minimisethe hazards
Mutual responsibility is essential
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Employersduty of care to provide an
appropriate work schedule and workenvironment, and continuing education
and training for workers about coping
strategies
Employeesduty of care to follow the
recommended strategies to manage their
sleep, health, and family life