Shift Work Health

SEMINAL STUDY

11.4

11.3 // Construction Worker Health

11.5 // Gig Employment Health

11 WORKPLACE & EMPLOYMENT

Disclosure Statement

The creators and presenters of this educational material have no actual or potential conflict of interest in relation to this program/presentation. All images are use by either permission and/or licensure.

Objectives

• Describe how shift work increases risk for disease and injury

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• Name specific diseases that shift work increases

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• Recognize how shift works affects the SDH domain of access to quality healthcare

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• Learn strategies to mitigate the negative effects of shift work

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• Understand the importance of personal and policy wellness advocacy for shift workers

Definitions and Primer

• Shift work refers to a work schedule that is performed in rotations. Often to cover a 24-hour period

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• Shift work is likely increasing due to globalization

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• Sufficient evidence to label shift work a ”probable” carcinogen*

*World Health Organization 2007

Primer

• Night Shifts & Rotating Shift = Greatest Disease Risk

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• Circadian disruption a primary cause of disease

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• Melatonin, Cortisol, and Immune surveillance play key roles

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• Negative effects increases with age & duration

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Primer

• Obesity
• Preventable Injury
• Substance Use Disorders
• Diabetes Mellitus
• Cancer (lung, breast, ovarian)

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• Cognitive Impairment
• Cardiovascular Disease
• Depression
• Stroke

Increased Risk

• Metabolic Syndrome
• Shift Work Sleep Disorder
• Miscarriage
• Preterm Birth
• Digestive Disorders
• Mortality (All Causes)

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Increased Risk

Worker Fatigue

Source: OSHA -United States Dept. of Labor

• Industrial disasters
• Injury Risk
• Medical Errors
• Increased Costs

Mitigation Strategies

• Try to stay on the same sleep schedule every day of the week, even on days off

• Sleep Schedule

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• Light Avoidance

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• Extra Time to adjust

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• Delay going to bed & waking up

Mitigation Strategies

• Sleep Schedule

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• Light Avoidance

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• Extra Time to adjust

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• Delay going to bed & waking up

• Wearing dark glasses or special goggles can help workers avoid daylight and other light cues after finishing a night shift

Mitigation Strategies

• Allow extra time to adjust to a new work schedule, without reducing time for sleeping

• Sleep Schedule

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• Light Avoidance

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• Extra Time to adjust

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• Delay going to bed & waking up

Mitigation Strategies

• On the last few days of an evening shift, delay going to bed and waking up

• Sleep Schedule

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• Light Avoidance

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• Extra Time to adjust

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• Delay going to bed & waking up

Work Needed

Work Needed

• Might miss appointments due to SWSD

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• No access to care due to working hours 

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• Might have childcare/caretaker issues

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• Might require extended or weekend hours for care

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• ED might be only access to care

Barriers to Access

Work Needed

• Advocate for healthy solutions (job site & extended hour primary care); evidence-based wellness scheduling

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• Recognize shift work = barrier to health in the form of access (SDH) & increases risk of injury, disease & death

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• Identify shift industries on our communities

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• Obtain a work history in the ED (simple screening question)

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• Talk to stakeholders making the financial argument for change (supply chain, injury prevention & productivity)

Our Job = A RIOT

Recognize and address the ongoing damage in our own field

One Last Thing…

�Costa G. Shift work and health: current problems and preventive actions. Saf Health Work. 2010 Dec;1(2):112-23. doi: 10.5491/SHAW.2010.1.2.112. Epub 2010 Dec 30. PMID: 22953171; PMCID: PMC3430894.

�Torquati L, Mielke GI, Brown WJ, Burton NW, Kolbe-Alexander TL. Shift Work and Poor Mental Health: A Meta-Analysis of Longitudinal Studies. Am J Public Health. 2019 Nov;109(11):e13-e20. doi: 10.2105/AJPH.2019.305278. Epub 2019 Sep 19. PMID: 31536404; PMCID: PMC6775929.

�Gehlert S, Clanton M, On Behalf Of The Shift Work And Breast Cancer Strategic Advisory Group. Shift Work and Breast Cancer. Int J Environ Res Public Health. 2020 Dec 20;17(24):9544. doi: 10.3390/ijerph17249544. PMID: 33419321; PMCID: PMC7767214.

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Yang L, Luo Y, He L, et al. Shift Work and the Risk of Cardiometabolic Multimorbidity Among Patients With Hypertension: A Prospective Cohort Study of UK Biobank. J Am Heart Assoc. 2022;11(17):25936. doi:10.1161/JAHA.122.025936

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References

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https://www.medicalnewstoday.com/articles/288310#What-can-be-done-to-protect-shift-workers-health

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https://doi.org/10.1136/bmj.k4641

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https://blogs.cdc.gov/niosh-science-blog/2021/04/27/nightshift-cancer/

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References

SEMINAL STUDY

11.6 // Conclusion of Workplace & Employment

12.1 // Food Insecurity

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