the impact of shift work on health and diet. shiftwork any work regularly undertaken outside...
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ShiftworkShiftwork
Any work regularly undertaken outside “normal” Any work regularly undertaken outside “normal” working hoursworking hours
07:00 – 18:0007:00 – 18:00
NightsNightsEarly amEarly amEveningEvening
FixedFixedRotatingRotating
Eight hourEight hourTwelve hourTwelve hour
StatisticsStatistics
Approx 3.6m UK Approx 3.6m UK (1-7 of workforce)(1-7 of workforce)
men > womenmen > women
↑ ↑ Transport & Communication Transport & Communication sector (26%)sector (26%)
Most common occupational Most common occupational group of women working group of women working shifts is nursesshifts is nurses
UK employees UK employees work longer work longer hours than other hours than other European European workersworkers
UK mean for UK mean for males in FT males in FT employ is 45.8 employ is 45.8 hours per week hours per week (EU mean 41.3)(EU mean 41.3)
UK mean for UK mean for females is 40.6 females is 40.6 hours per week hours per week (EU mean 39.0) (EU mean 39.0)
Approx 2.7 million UK Approx 2.7 million UK workers usually work > 48 workers usually work > 48 hours per week hours per week (mean 56 hours). (mean 56 hours).
Circadian RhythmsCircadian Rhythms
EffectsEffects
• Circadian disruptionCircadian disruption
• Sleep loss/debtSleep loss/debt
• FatigueFatigue
• Social disruptionSocial disruption
• Health implicationsHealth implications
Adjustment to shiftworkingAdjustment to shiftworking
Stress
Strain
Organisational
Implications
Sleep Disturbance
Mood changes
Functionality Reduced
Adjustment to shiftworkingAdjustment to shiftworking
stress strain organisational effects
Phase-shifting of waking and sleeping hours
Impaired performanceImpaired healthDisturbed relationships
> Absenteeism> Accidents> Labour turnover< Productivitymodifying
factors
Individual characteristicsJob-related factorsEnvironmentDomestic
Colquhoun & Rutenfranz 1980Colquhoun & Rutenfranz 1980
The evidence points to:
The ‘phase shift’ experienced in night and rotating shift work
Involves desynchronization at the molecular level in the circadian oscillators
in the central nervous tissue and in most peripheral tissues of the body
Desynchronization
There is a change in the coordination between oscillators
with transient loss of control by the master-oscillator
‘The Suprachiasmatic Nucleus’
(SCN) Located in the hypothalamus
Critical
The body’s various Circadian Rhythms are
“reset”
every 24 hours by environmental cues
e.g. light and darkness & melatonin
PositivesPositives NegativesNegatives
FlexibilityFlexibility FinancialFinancial Free timeFree time FamilyFamily
Sleep deprivationSleep deprivation AcknowledgementAcknowledgement Society still 9-5Society still 9-5 SpacedSpaced
Extraneous Supports
“The ability to effectively manage the juggling act between paid work and the other activities that are important to shift workers”
– Family/Friends– Recreation– Spiritual– Health and Wellness– Finances– Work & colleagues
Potential effectsPotential effects
StressStress
FatigueFatigue
ExposureExposure
cardiovascularcardiovascular
mental healthmental health
immune systemimmune system
gastrointestinalgastrointestinal
musculoskeletalmusculoskeletal
social effectssocial effects
performance impairmentperformance impairment
safety problemssafety problems
over-exposureover-exposure
Gastrointestinal disorders and shiftworkGastrointestinal disorders and shiftwork
IndigestionIndigestion (Chan (Chan et al.et al. 1987) 1987)(Poole (Poole et al.et al. 1992) 1992)
RefluxReflux
Peptic UlcerationPeptic Ulceration (Waterhouse (Waterhouse et al.et al. 1992) 1992)
Related to:Related to:
irregular hoursirregular hourscircadian dysrhythmiacircadian dysrhythmiapoor catering facilitiespoor catering facilitiesinequality in GP accessinequality in GP access
Cardiovascular problems of shiftworkCardiovascular problems of shiftwork
Liu & Tanaka 2002Liu & Tanaka 2002
Working hours related to Acute Myocardial Infarction:Working hours related to Acute Myocardial Infarction:
•increased risk in year prior to AMIincreased risk in year prior to AMI
•increased risk in month prior to AMIincreased risk in month prior to AMI
•x 2 increase in risk for overtimex 2 increase in risk for overtime (>61 hours) (>61 hours)
•x 2-3 increase in risk forx 2-3 increase in risk for <5 hours sleep <5 hours sleep
•x 2-3 increase for lack of sleepx 2-3 increase for lack of sleep (2 or more days with <5 hours sleep) (2 or more days with <5 hours sleep)
Overtime work and lack of sleep may be related to AMIOvertime work and lack of sleep may be related to AMI
PsychologicalNeurological
Energy Slump
ChocolateAlcoholCigarettesCoffeeDrugs
DopamineSerotoninGABAAdrenalin
PsychologicalBoostRelaxedCalmFeels good
Physiological
NauseousIrritatedDrunkDepressedHostile
GuiltyAshamedFailureAngry
Exhausting Fix it
Energy & Fatigue Cycle
Blood Sugar levels Serotonin ß-Endorphins
Tired
Fuzzy
Edgy
Irritable
Sleep Problems
Faint
Poor concentration
Depressed
Isolated
Lost
Suicidal
Stressed
Sleep problems
Poor Concentration
Lethargic
Run Down
Tearful
Reactive
Hopeless
Craves Sugars
Low pain threshold
Neurotransmitters
Neurotransmitters are made from essential amino acids.
There are hundreds of neurotransmitters: 6 main ones:
•Adrenalin•Dopamine (Noradrenalin)•Endorphins•Serotonin•Acetylcholine•GABA
Adrenalin
Has the opposite effect of insulin – 1st messenger hormone and will be released when the glucose levelin blood is low.
As neurotransmitter it has an effect on the sympathetic nervous system. (heart, lungs, blood vessels, bladder & gut)
Dopamine
Associated with:• Pleasure
• Alertness
• Concentration
• Euphoria
-ve = PD & Sc
all proteins (meat, milk products, fish, beans, nuts, soy products).
Endorphins
The brains natural opiates
They bind to specific opiate receptors in the brain and induce pain relief.
Also known as the runners ‘high’
SerotoninAssociated with:
• Moods
• Sleep
• Dreams
• Bp
• Digestion
• Body temperature
pasta, starchy vegetables, potatoes, cereals, breads.
Acetylcholine
Associated with:
• Memory
• Alertness
• Learning ability
• Concentration
• -ve Alz• Egg yolks, peanuts, wheat germ, liver, meat, fish, milk, cheese and vegetables (especially broccoli, cabbage and cauliflower)
EssentialsEssentials
Niacin BNiacin B33 Folic acidFolic acid Pyridoxine BPyridoxine B66 Vitamin CVitamin C ZincZinc MagnesiumMagnesium EFA’sEFA’s Tryptophan & tyrosineTryptophan & tyrosine
LunchesLunches
Core base of green saladCore base of green salad
Walnuts & pecan nutsWalnuts & pecan nuts
PeppersPeppers
TomatoesTomatoes
Fresh lemonFresh lemon
Mood Enhancing FoodsMood Enhancing Foods
EggsEggsFish & meatFish & meatCottage cheese Cottage cheese Rice pasta Rice pasta Crustacean vegetablesCrustacean vegetablesShort grain brown organic riceShort grain brown organic riceQuinoaQuinoaAvocadoAvocadoLegumesLegumes
Nutrient Food sources NT Proposed effect
Protein Meat, Milk, Eggs, Cheese, Fish, Beans
Dopamine, Norepinephrine
Increased alertness, concentration
Carbohydrate (CHO)
Grains, Fruits, Sugars
Serotonin Increased calmness, relaxation
Calories All Foods Reduced blood flow to the brain
Excess calories in a meal is associated with decreased alertness and concentration after the meal