Shiftwork

1. Shiftwork

2. Outline • What is shiftwork? • Shiftwork in Canada • Why there is a need for shiftwork • Health and safety concerns of shiftwork • Circadian Rhythm • Optimal shift scheduling • Shift work systems • Strategies for dealing with shiftwork

3. Shiftwork A shift worker is anyone who follows a work schedule that is outside of the typical "9 to 5" business day • National Sleep Foundation Shiftwork differs from a “normal” work day in two ways: • Work is performed regularly during times other than morning and afternoon • At a given workplace, more than one shift is worked during the 24-hour day • A shift often lasts 8 hours but may be shorter or longer • Approximately 25% of the North American working population work shiftwork • CCOHS stat

4. Shiftwork in Canada • In 2005, the General Social Survey conducted by Statistics Canada found that 28% of employed Canadians (4.1 million workers) were shift workers • 82% worked full time (>30 hrs/week)

5. Shiftwork in Canada • In 2005, women accounted for only 37% of full time shift workers, but made up 69% of part time shift workers • Men made up 57% of the total number of workers who do shift work (all full- and part-time)

6. Shiftwork in Canada • In 2005, rotating shifts and irregular schedules were the most common types of shift work, accounting for 2.3 million full-time workers • Even though these are considered among the most difficult shifts because the body cannot properly adjust to the sleep pattern changes, rotating child care is difficult to find and health effects can be profound

7. Types of Shiftwork in Canada

8. Shiftwork is not new! • Deliveries were made in ancient Rome at night in order to relieve street congestion • Bakers habitually work through the late night hours • Soldiers and firefighters have always been accustomed to night shifts • With industrialization came long working days with teams of workers relaying each other to maintain blast furnaces, rolling mills, glassworks, and other workplaces where continuous operations were required

9. Who works shiftwork Traditionally: shift work was required to provide vital services and emergency cover at all hours of the day and night and also to maintain long-term industrial processes Today: Shiftwork is found in financial and retail services where employees deliver services around the clock , supermarkets, newsroom and banks, call centres

10. Why the need for shiftwork? • The need for "around the- clock" workers has increased dramatically in industry during recent years • This reliance may be attributed to three main sources, namely technological, economic and social advancements • Economically: utilization of equipment/resources • If equipment is available 168 h per week and used for only 8h a day for 5 days a week gives only 24% utilization • Socially: convenience (24-hour shopping, restaurants, movies)

11. Why is shiftwork a problem? The problems associated with shiftwork fall under three areas: • Economic: people tend to dislike shiftwork which may require extra pay for workers • Social: many workers feel that shiftwork disrupts their personal and family life • Health and Safety: Rotating shifts have been blamed for the “human error” involved with nuclear power plants incidents, airplane accidents, and other catastrophic accidents • Individual health factors

12. The Interaction Between Personal Factors and Shiftwork “Some of the most serious and persistent problems shift workers face are frequent sleep disturbance and associated excessive sleepiness, which can lead to poor concentration, absenteeism, accidents, errors, injuries, and fatalities. The issue becomes more alarming when you consider that shift workers are often employed in the most dangerous of jobs, such as firefighting, emergency medical services, law enforcement and security” - National Sleep Foundation

13. Individual Health and Shiftwork Frequently changing work schedules can lead to: Shiftwork may also be independent predictor of • Increased body mass • Increased body mass index • Prevalence of obesity • Waist-to-hip ratio • Increased risk of insomnia • Chronic fatigue • Anxiety and depression • Cardiovascular and gastrointestinal problems • Impaired reproduction in women • Circadian rhythm disruption • Atkinson et al. (2008)

14. Fatigue Symptoms • Sleepiness • Irritability • Reduced alertness, concentration and memory • Lack of motivation • Increased susceptibility to illness • Depression • Headaches • Giddiness • Loss of appetite and digestive problems

15. Personal Factors • Many functions of the human body have long been recognized to exhibit periodic variations • Of concern are those fluctuations which occur on a daily basis called circadian rhythms • Among those body functions which show diurnal variations: • Sleep • Readiness to work • autonomic processes • heart rate • body temperature • Blood pressure

16. Circadian Rhythms

17. Circadian Rhythms • Circadian comes from the Latin word “circa dies” which means “about a day.” • Many human physical functions follow these daily rhythms or 24-25 hour cycles • Sleeping, walking, digestion, secretion of adrenalin, body temperature, blood pressure, pulse, other body functions • The body uses cues from its processes and from the environment such as clock time, social activities, the light/dark cycle, and meal times to keep the various rhythms on track

18. Circadian Rhythms • Involvement in shiftwork, in particular night work, results in a disruption of these inherent rhythms. • These phase shifts occur slowly over a considerable period. • Some people can start to adapt after 2-3 days while some take much longer. • Adjustment on “days off” does not happen because most individuals go back to normal day schedules

19. Circadian Rhythms • Circadian rhythm phase shifts induced by shiftwork can have significant effects on the worker in terms of: • performance efficiency • motivation • sleep patterns • family and social life • health

20. Shiftwork Disorder • Shift work sleep disorder is a circadian rhythm sleep disorder • The main complaint for people with shift work sleep disorder is excessive sleepiness. Other symptoms include: • Insomnia • Disrupted sleep schedules • Reduced performance • Difficulties with personal relationships • Irritability/depressed mood

21. Circadian Type • There are 2 broad classifications of personality associated with circadian type which are differentiated between the “morning larks” and the “night owls”: 1)Morning types (M-types) aka larks: • Have early bedtimes & wake times and are more alert in the morning hours 2)Evening types (E-types) aka owls: • Are more aroused later at night and experience difficulty waking up early

22. Circadian Type & Shiftwork • M-types have been found to be less tolerant of night shift for 3 reasons: • They find it extremely hard to stay awake at night, or to sleep late in the morning (standard night worker behaviors) • They appear to be more susceptible to environmental zeitgebers(time cues) • When M-types are isolated from all time cues, they exhibit "free-running" circadian rhythms with an approximate length of 24.3 hours in comparison to E-types who tend to have slower rhythms of approximately 25.5 hours

23. Circadian Type & Shiftwork • Night work is best suited to those individuals with a longer running period as this leads to a phase delay in behaviour (i.e.- a later bedtime) • It has been questioned whether morningness-eveningness is a stable, genetically determined trait, or simply a reflection of a recently developed habit • Example: An M-type individual could temporarily acquire E-type characteristics, but may revert back to their morningness tendency at a later stage

24. Shift Scheduling

25. What is the most optimal shift schedule? • There is no “golden” schedule that fits every operation’s needs • The schedules that perform the best: • balances operational requirements, employee preferences and lifestyle issues, and takes into account the human factors considerations that influence safety and employee performance • The best schedules can only be achieved by involving the employees in the shift schedule selection process

26. Why involve employees in shiftwork scheduling? • Through education, participatory design, and group implementation of employee involvement in schedule design/redesign financial and performance benefits increase substantially compared to schedules decided by management alone • Resulting in: • Better employee morale and satisfaction with scheduling • Lower absenteeism and turnover • Increased operational efficiency • Improved daytime sleep quality • Decreased physical and psychological circadian

27. General Notes on Scheduling • An early morning start (before 7:00am) for the morning shift should be avoided • Shifts should rotate forward: • The schedule should be simple and predictable – people want to plan their lives!

28. Shift Systems

29. Four Important Questions Regarding the Features of Shift Systems • Does a shift extend into hours that would be normally be spent asleep? • Is the shift worked throughout the entire seven-day week, or does it include days of rest, such as a free weekend? • Into how many shifts are the daily work hours divided? Are there two, three, or more shifts per day? • Do the shift crews rotate or do they work the same shifts permanently? • Kogi (1985)

30. Other Important Features of Shift Systems • The starting and ending time of a shift • The number of workdays in each week • The hours of work in each week • The number of shift teams • The number of free days per week or per rotation cycle • The number of consecutive days on the same shift, which may be a fixed or variable number • The schedule by which an individual works or has a free day or days

31. Types of Shift Systems • Rotational shiftwork • Rapidly rotating shift systems • weekly/monthly rotating systems • Permanent night shift systems

32. Rotational Shiftwork • Shifts rotate or change according to a set schedule • Shifts can be continuous (24/7) or semi-continuous (2-3 shifts/day without weekends) • Workers take turns working all of the shifts in the system

33. Rapidly Rotating Systems • Switches once or twice during a week • Found to cause the least disturbance to the endogenous body clock

34. Weekly/Monthly Rotating Systems • Changes every week or every month • Provide for both the physical and social needs of the worker • A forward direction (morning-afternoon/evening-night) is preferred for shift rotation • Means minimum disturbance of diurnal rhythms

35. Weekly/Monthly Rotating Systems • Weekly rotating shifts are generally regarded as being the worst system • Because disruptions to the circadian rhythms lead to a cumulative sleep debt • These systems tend to be the most commonly used (employment equity)

36. Permanent Night Shift System • An acceptable level of circadian rhythm adjustment can normally be achieved with this shift system • This nocturnal orientation may in turn improve sleep and performance • Permanent night shifts are preferred when safety is crucial

37. Permanent Night Shift System • Family units appear to prefer permanent night work as it facilitates the organization of domestic responsibilities • Some individuals working this shift feel socially isolated

38. Extended Workdays • One further variable to consider in terms of the design of shift systems is that of the length of the shift • Some suggest a shift should not exceed 8 hours (except where the work is low in physical and mental demands) while others recommended that extended work periods of 9 to 12 hours may be acceptable

39. Advantages of twelve hour shifts Management Perspective Employee Perspective • Increased productivity, reduced errors • Increased continuity and accountability • Reduced adaptation time • Higher project completion rates • Reduced absenteeism • Lower attrition and turnover • Improved morale • “Dedicated” employees • More days off • Longer/better breaks • Few consecutive days worked • Less commuting required • Twice as many weekends off • Improved family & social life • Improved Morale • More home study time • More frequent “recovery” days • Better use of vacation time • Better utilization of personal time • Elimination of double shifts/holdovers • Elimination of evening shifts

40. Disadvantages of 12 Hour Shifts Management Perspective Employee Perspective • Harder to sustain vigilance • Potential comprise in alertness and performance • Increased exposure to work-related stress • Diminished communication or personal interaction • Unequal distribution of work hours • Increased risk of getting “out of touch” • Increased “moonlighting” • Increased ergonomic risk • More difficult absence coverage • Difficulties of change • Limited social time during work days • Sleep schedule inflexibility • Irregular pay weeks • Concerns of older workers • Reduced tolerance of long commutes • Difficult to schedule meetings • Decreased tolerance to physically demanding jobs • Pay loss when day is missed • Driver fatigue • Fast-rotating 12-hour schedules • Longer hours away from home in evenings • Increased percentage of night shifts

41. Summary of Features for 8 and 12-Hour Shift Schedule

42. Strategies for Improving Problems Associated with Shiftwork • Most obvious solution? • There are two basic levels where improvements can be made: • The organizational level - primarily through the design of shift schedules, education and better facilities. • The individual level - helping workers to get better sleep, a healthier diet, and the reduction of stress.

43. Organizational Approaches • Talk to employees to see shift preferences • Consider time at which shift starts/ends • Provide time off during socially advantages times • Let employees know schedules well in advance • Allow some flexibility for staff to switch shifts but make sure people aren’t double-shifting • Provide same facilities & support for all shifts

44. Organizational Approaches • Educate employees on how to cope with shiftwork • Consider exposure limits, breaks required • Consider different lengths for shifts • Keep schedule regular and predictable • Keep long shifts and overtime to a minimum • Plan for some weekends or holidays off

45. Good Practice Guidelines for the Work Environment • Adequate lighting & proper heating • Same facilities available for each shift • Access to healthy meals • Encourage interaction between employees • Keep in contact about employees about their concerns • Encourage exercise • Encourage breaks when sleepy

46. Individual Approaches • Pay attention to food/nutrition • Exercise • Figure out how to optimize sleep time • Get information on shiftwork health risks • Have a social life • Seek advice from doctor if you have health conditions • Take more frequent breaks when fatigued

47. Individual Approaches • Talk to family and friends about sleep schedule • Restrict or avoid caffeine, cigarettes and alcohol consumption • Avoid long commutes when sleepy • Use co-workers to keep you awake on the job • Talk to co-workers for tips on how to cope • Don’t leave the boring tasks for the end of the shift when most fatigued • Try not to alter sleep schedule too much on “days off”

49. References: • Atkinson, G., Fulick, S., Grindey, C., & Maclaren, D. (2008). Exercise, energy balance and the shift worker. Sports Medicine, 38(8), 671-685. • Canadian Centre for Occupational Health and Safety. (2007). Rotational Shiftwork. Retreived from: http://www.ccohs.ca/oshanswers/ergonomics/shiftwrk.html • Carex Canada. (2008) Carcinogen profile: Shiftwork. IARC Monograph, 98. Retrieved from: http://www.carexcanada.ca/en/shiftwork.pdf • Davis, W., & Aguirre, A. (n.d). Shift scheduling and employee involvement: the key to successful schedules. Retrieved from: http:// www.circadian.com • The National Sleep Foundation. (2009). Shift work and sleep. Retrieved from: http://www.sleepfoundation.org/ • Konz, S., & Johnson, S.(2000). Work Design: Industrial Ergonomics. Scottsdale, Az: Holcomb Hathaway. • Kroemer, K., Kroemer, H., & Kroemer-Elbert, K. (2001). Ergonomics: How to design for ease and efficiency (2nd ed.). Upper Saddle River, NJ: Prentice Hall. • Moore-Ede, M., Davis, W., & Sirois, W. (n.d). Advantages and Disadvantages of twelve-hour shifts: A balanced perspective. Retrieved from: http://www.circadian.com • Occupational Safety and Health Branch, Labour Department.(n.d) Guide on shiftwork. Retrieved from: http://www.labour.gov.hk/eng/public/oh/ShiftWork.pdf • Williams, C. (2008) Work-life balance of shift workers. Statistics Canada Catologue number (75-001-X). http://www.statcan.gc.ca/pub/75-001-x/2008108/pdf/5215218-eng.pdf