Transcript Slide 1
The Impact of Shift Work On Health and Diet Shiftwork Any work regularly undertaken outside “normal” working hours 07:00 – 18:00 Nights Early am Evening Fixed Rotating Eight hour Twelve hour 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 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) Shift Work Health Specifics Circadian Rhythms Effects • Circadian disruption • Sleep loss/debt • Fatigue • Social disruption • Health implications Adjustment to shiftworking Stress Strain Sleep Disturbance Organisational Implications Mood changes Functionality Reduced Adjustment to shiftworking stress strain Phase-shifting of waking and sleeping hours Impaired performance Impaired health Disturbed relationships modifying factors organisational effects > Absenteeism > Accidents > Labour turnover < Productivity Individual characteristics Job-related factors Environment Domestic Colquhoun & Rutenfranz 1980 Studies show that staff can be prone to: •Serious illness •Stress •Sleep disorders •Accidents 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 Positives Flexibility Financial Free time Family Positives Flexibility Financial Free time Family Negatives Sleep deprivation Acknowledgement Society still 9-5 Spaced 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 effects cardiovascular mental health Stress immune system gastrointestinal musculoskeletal social effects Fatigue Exposure performance impairment safety problems over-exposure 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 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 Energy & Fatigue Cycle Energy Slump Guilty Ashamed Failure Angry Exhausting Fix it Psychological Chocolate Alcohol Cigarettes Coffee Drugs Neurological Nauseous Irritated Drunk Depressed Hostile Dopamine Serotonin GABA Adrenalin Physiological Psychological Boost Relaxed Calm Feels good Blood Sugar levels Serotonin Tired Depressed Lethargic Fuzzy Isolated Run Down Edgy Lost Tearful Irritable Stressed Reactive Faint Suicidal Hopeless Sleep Problems Sleep problems Craves Sugars Poor concentration Poor Concentration ß-Endorphins 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 level in 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’ Serotonin Associated 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) Essentials Niacin B3 Folic acid Pyridoxine B6 Vitamin C Zinc Magnesium EFA’s Tryptophan & tyrosine Lunches Core base of green salad Walnuts & pecan nuts Peppers Tomatoes Fresh lemon Mood Enhancing Foods Eggs Fish & meat Cottage cheese Rice pasta Crustacean vegetables Short grain brown organic rice Quinoa Avocado Legumes Nutrient Food sources NT Proposed effect Protein Meat, Milk, Eggs, Cheese, Fish, Beans Dopamine, Norepinephrine Increased alertness, concentration Carbohy drate (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