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The Shift Workers Dilemma

About 20 precent of the American workforce are involved in some form of a shift-work system. This proportion is on the rise as more industries move to 24-hour operations to become more efficient and cost effective. Workers engage in shift work for a variety of different reasons ranging from convenience to availability of employment. Unconventional shifts are inherent in the nature of certain occupations such as bakers and newspaper printers, who must make their products daily before the morning deliveries. With the continuing trends of growing rural "bedroom communities," the loner commute times result in workers having to get up very early in spite of conventional work hours.

Shift work is not natural, however. Shift workers force themselves to be awake and active when their internal body rhythms are geared to sleep and rest. This can have wide-ranging effects on the individual. Shift workers suffer from impairment of sleep quality and alertness. In the 1999 Omnibus "Sleep in America" poll sponsored by the National Sleep Foundation and found 73 percent of shift workers experienced sleep problems a few times per week or more. Shift workers are significantly more often impaired in their work productivity and at a higher risk for accidents than non-shift workers. Furthermore, 41 percent of shift workers reported dozing off at the wheel of a car. Shift workers have a higher incidence of gastrointestinal disorders, hypertension, and coronary artery disease.

Compounding these physiologic factors are the social and emotional compromises shift workers must make. For married shift workers, family time is limited. There is compromise of the roles of spouse and parent. Although the evening shift worker may not sacrifice sleep quality, there is the loss of social companionship with the spouse. The male shift workers is often looked to as the protector-care giver, which can lead to feelings of loneliness and insecurity in a wife left home alone every night. Often the female shift worker is still expected to run the household and care for children resulting in a dual role that usually results in the sacrifice of sleep hygiene. In addition, social isolation can occur because of being cut off from day working friends and social groups whose schedules are opposite to the shift workers.

Several factors within an individual have been identified as likely to cause shift work coping problems. These include over 50 years of age, "moonlighting", heavy home workload, and "morning-type" individuals ("larks"). In addition, certain health problems are exacerbated by shift work resulting in poor tolerance to shift work schedules such as a history of sleep disorders, psychiatric illness, gastrointestinal complaints, epilepsy, diabetes, heart disease, and alcohol/drug abuse.

In- order for industrialized society to truly make shift work schedules work well, there must be a partnership between employers/management and workers. Management must become aware that there is a problem with coping with shift work. Current attitudes that this is just a "personal problem" the individual shift workers must learn to deal with on their own must be dismissed. Management has the moral and financial obligation to help their shift working employees by choosing optimal schedules and providing educational programs and counseling for coping with shift work. Without this commitment, the results are poor employee morale, high job turnover, and accident and absentee rates will be destructive to the company. Similarly, the employee who has chosen to engage in shift work must educate himself about the effects of shift work and coping skills to optimize his performance and preserve a quality lifestyle outside of work. The employee must realize that this not only improves his own quality of life, but ensures a safer and more productive work environment.

Ten Tips for Shift Workers

  • Avoid caffeine, greasy and spicy foods towards the end of your day. These can lead to restless and non-restorative sleep.
  • Block out noise and light in your bedroom. Remind friends and family of sleep hours. Use an answering machine and turn off the ringer on the phone.
  • A hot bath before bedtime and a cool bedroom can enhance sleep quality.
  • Avoid sunlight as much as possible, if you head home in daylight. Consider wrap around sunglasses. Bright light potentially points the biological clock towards alertness.
  • Consider the use of a light box (a source of very bright light - about 20 times brighter than average indoor room light) at the beginning of your work day.
  • Take short breaks to rest or exercise, or try working with a "buddy" to keep each other stimulated and watch for signs of fatigue.
  • When working rotating shifts, try to shift your schedule an hour or two each day before you switch to a new schedule, this will ease the transition.
  • Develop a network of friends, and organize activities with other shift workers that have a similar work schedule.
  • Set up a family bulletin board where family members can leave notes, schoolwork, drawings, photos, etc., and your schedule can be promptly displayed.
  • Develop new rituals like going to the midnight movie or on a breakfast date.

Inadequate sleep increases your risk for falling asleep behind the wheel and accidents - plus, it reduces your productivity. If changes in your lifestyle don't make a difference, see your doctor or contact your local sleep disorder center.