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The biological effects of shift work

The biological effects of shift work. Shift Work Overview of key effects. Shift work causes many health-related effects Disruption of circadian rhythms affects physiological function Shift work = health problems: poorer health habits increase vulnerability to illness

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The biological effects of shift work

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  1. The biological effects of shift work

  2. Shift Work Overview of key effects • Shift work causes many health-related effects • Disruption of circadian rhythms affects physiological function • Shift work = health problems: poorer health habits increase vulnerability to illness • Biggest effect: Sleep disruption • Three principal shifts: • night, morning & afternoon

  3. Shift Work & risk of Coronary Heart Disease in Women • The study - Kawachi et al. 1988 • 79 109 women • 42 to 67 years - free of diagnosed CHD and stroke • rotating night shifts - at least three nights p/m in addition to day and evening shifts • 6 or more years of shift work may increase the risk of CHD in women

  4. De-synchronisation of circadian rhythms Fast rotating shift work changes secretary patterns of melatonin, prolactin, cortisol and testosterone (Touitou et al, 1989)

  5. Shift work affectspatterns of sleep and wakefulness • Disrupts circadian rhythms & mechanism of sleep • The most troublesome symptoms are: • difficulty getting to sleep, • shortened sleep • drowsiness during working hours • No clear indication that long-term shift work causes chronic sleep problems (Åkerstedt, 2003)

  6. Risk of cancer in female Nurses • Night-shift work is linked with an increased risk of breast cancer ALSO • Exposure to light at night suppresses the production of melatonin, a hormone that inhibits intestinal cancers • Night shift at least 3 nights p/m for 15yrs or more may increase the risk of colorectal cancer (Schernhammer et al. 1988)

  7. Shift work: Impact on metabolic syndrome • Increased risk of cardiovascular disease • Obesity and high triglycerides levels in men & women • Obesity more prevalent among women in all groups, but only in two out of four age groups in men (Karlsson et al. 2003)

  8. Other health disorders • Peptic ulcers • Coronary heart disease • Compromised pregnancy outcome (Knutsson, 2001)

  9. Influence of night shift work on psychological state • Night shift - associated with psychological complaints • Study: 18 healthy nurses (age 29; +/-2 yrs) • Rapid shift rotation system (day work, 8:15-17:15; evening work, 16:00-22:00; night work, 21:30-8:30) • Assess psychologic states using a validated questionnaire. • High scores for confusion, depression, anger-hostility, fatigue and tension-anxiety • Lowest scores for energy after a night shift

  10. Does shift work lead to poorer health habits? • Sent out questionnaire - 2299 respondents • Selected 506 who has always done shift work • 183 workers who had never done shift work • Shift workers smoke more & tend to be more overweight than day workers (KivimÄki et al., 2001)

  11. The effects of short-term night-shift working • Short period (5 days) of night-shift • Ten nurses (8 female, 2 male; age 28.1 +/- 1.7 • Finding: • pituitary-adrenal responses to CRH are markedly disrupted • mimic abnormalities seen in patients with chronic fatigue syndrome

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