The Impact of Shift Work On Health and Diet

1. The Impact of Shift Work On Health and Diet

2. Shiftwork Any work regularly undertaken outside “normal” working hours 07:00 – 18:00 Nights Early am Evening Fixed Rotating Eight hour Twelve hour

3. Statistics • Approx 3.6m UK • (1-7 of workforce) • men > women • ↑ Transport & Communication sector (26%) • Most common occupational group of women working shifts is nurses

4. UK employees work longer hours than other European workers • UK mean for males in FT employ is 45.8 hours per week (EU mean 41.3) • UK mean for females is 40.6 hours per week (EU mean 39.0) • Approx 2.7 million UK workers usually work > 48 hours per week (mean 56 hours).

5. Shift Work Health Specifics

6. Circadian Rhythms • Effects • Circadian disruption • Sleep loss/debt • Fatigue • Social disruption • Health implications

7. Adjustment to shiftworking Stress Strain Sleep Disturbance Organisational Implications Mood changes Functionality Reduced

8. Adjustment to shiftworking stress strain organisational effects Phase-shifting of waking and sleeping hours Impaired performance Impaired health Disturbed relationships > Absenteeism > Accidents > Labour turnover < Productivity modifying factors Individual characteristics Job-related factors Environment Domestic Colquhoun & Rutenfranz 1980

9. Studies show that staff can be prone to: • Serious illness • Stress • Sleep disorders • Accidents

10. 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

11. 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

12. Critical The body’s various Circadian Rhythms are “reset” every 24 hours by environmental cues e.g. light and darkness & melatonin

13. Flexibility Financial Free time Family Positives

14. Flexibility Financial Free time Family Sleep deprivation Acknowledgement Society still 9-5 Spaced Positives Negatives

15. 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

16. Potential effects cardiovascular mental health immune system Stress gastrointestinal musculoskeletal social effects performance impairment Fatigue safety problems Exposure over-exposure

18. Gastrointestinal disorders and shiftwork Indigestion (Chan et al. 1987) (Poole et al. 1992) Reflux Peptic Ulceration (Waterhouse et al. 1992) Related to: irregular hours circadian dysrhythmia poor catering facilities inequality in GP access

19. Cardiovascular problems of shiftwork • Liu & Tanaka 2002 • Working hours related to Acute Myocardial Infarction: • increased risk in year prior to AMI • increased risk in month prior to AMI • x 2 increase in risk for overtime (>61 hours) • x 2-3 increase in risk for <5 hours sleep • x 2-3 increase for lack of sleep (2 or more days with <5 hours sleep) • Overtime work and lack of sleep may be related to AMI

20. Energy & Fatigue Cycle Energy Slump Guilty Ashamed Failure Angry Exhausting Fix it Chocolate Alcohol Cigarettes Coffee Drugs Nauseous Irritated Drunk Depressed Hostile Dopamine Serotonin GABA Adrenalin Physiological Psychological Boost Relaxed Calm Feels good

21. Blood Sugar levels ß-Endorphins Serotonin Lethargic Depressed Tired Fuzzy Isolated Run Down Edgy Lost Tearful Irritable Reactive Stressed Hopeless Suicidal Faint Sleep problems Craves Sugars Sleep Problems Low pain threshold Poor concentration Poor Concentration

22. Neurotransmitters • Neurotransmitters are made from essential amino acids. • There are hundreds of neurotransmitters: 6 main ones: • Adrenalin • Dopamine (Noradrenalin) • Endorphins • Serotonin • Acetylcholine • GABA

23. Adrenalin Has the opposite effect of insulin – 1stmessenger hormone and will be released when the glucose level in blood is low. As neurotransmitter it has an effect on the sympathetic nervous system. (heart, lungs, blood vessels, bladder & gut)

24. Dopamine • Associated with: • Pleasure • Alertness • Concentration • Euphoria • -ve = PD & Sc all proteins (meat, milk products, fish, beans, nuts, soy products). 

25. Endorphins The brains natural opiates They bind to specific opiate receptors in the brain and induce pain relief. Also known as the runners ‘high’

26. Serotonin • Associated with: • Moods • Sleep • Dreams • Bp • Digestion • Body temperature • pasta, starchy vegetables, potatoes, cereals, breads. 

27. 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)

28. Essentials • Niacin B3 • Folic acid • Pyridoxine B6 • Vitamin C • Zinc • Magnesium • EFA’s • Tryptophan & tyrosine

29. Lunches • Core base of green salad • Walnuts & pecan nuts • Peppers • Tomatoes • Fresh lemon

30. Mood Enhancing Foods Eggs Fish & meat Cottage cheese Rice pasta Crustacean vegetables Short grain brown organic rice Quinoa Avocado Legumes