HD in Occupational Safety and Emergency
Operations (AS114111)
Workplace Safety II (SAS3707)
Chapter 5
Shift work
Lecturer: Dr Vic W K MOK
References: Managing Shiftwork, HSE, UK
P–1
Undesirable Effects of Shift Work
Research has shown that there can be undesirable
consequences for those working shifts outside standard
daytime hours, particularly those covering the night or with
early morning starts. Shift work may result in:
• disruption of the internal body clock;
• fatigue;
• sleeping difficulties;
• disturbed appetite and digestion;
• reliance on sedatives and/or stimulants;
• social and domestic problems;
• in turn can affect performance, increase the likelihood of
errors and accidents at work and might have a negative
effect on health. P–2
1
Disruption of the internal body clock
(Circadian Rhythm)
• By nature, humans are active and perform best during the
day and need to sleep at night when performance is
generally poorer;
• We follow this innate pattern because of an internal body
clock, located in the brain which sets the daily cycle of
biological activities, such as chemical and hormone release
that influence body activity;
• For example, heart rate, blood pressure and body
temperature are increased during the day. At night they are
reduced and we slow down and feel sleepy;
• This daily cycle is known as the circadian rhythm
P–3
Disruption of the internal body clock
(Circadian Rhythm)
• Circadian Rhythm explains why we eat and sleep at similar times
each day;
• External factors or cues such as daylight, meal times, clocks and
working hours help to regulate this internal body clock, and play
an important role in keeping our bodies in step with the world
around us;
• Our internal body clock can change gradually, but for most people
it is resistant to the abrupt changes in the sleep/wake cycle that
are required by shift-work schedules or flying across time zones;
• This can cause our natural daily rhythms to become out of tune
with those of the world around us. This is the reason why we can
feel less able to function to the best of our ability when we do not
get enough sleep
P–4
2
Disruption of the internal body clock
(Circadian Rhythm)
• The adjustment of our internal body clock to an abrupt change
in the sleep/wake cycle may take days or weeks.
• It will start to adjust body functions after a few days of shift
work, but at different rates, so behaviours that rely on a regular
cycle such as digestion, alertness and sleep are disturbed.
• The adjustment may be more successful in specialised work
environments where the effects of external cues are minimised.
• However, our internal body clock will never fully adjust, even
for workers on permanent night shifts. Those regular night
workers who change back to daytime routines during rest days
will continue to suffer the consequences of a disrupted internal
clock, as it attempts to reset to daylight rhythms during days
off. P–5
Lack of sleep
• Research reveals that when we are sleep deprived
and/or fatigued, performance is affected and errors are
more likely. This particularly applies to tasks that
require:
• monitoring;
• decision making;
• awareness;
• fast reaction time;
• tracking ability;
• memory.
P–6
3
The Risk of Errors, accidents and
injuries
• The risk of errors, accidents and injuries has been
found:
• to be higher on the night shift;
• to rise with increasing shift length over eight hours;
• to increase over successive shifts, especially if they
are night shifts;
• to increase when there are not enough breaks
P–7
Fatigue-related Errors and Accidents
• Poorly designed work schedules causing fatigue-
induced impairment of performance will increase the
risks. For example, a long night shift without breaks
after a succession of previous night shifts will increase
the likelihood of errors, accidents and injuries.
• It is important not to underestimate the potential risk for
serious fatigue-related errors and accidents. Sleepiness
is thought to be the cause of up to one in five accidents
on major roads in the UK;
• Contributing significantly to the approximate 3000 road
deaths recorded annually.
P–8
4
Fatigue-related Errors and Accidents
• After young men, shift workers are considered to be the
category of drivers most at risk from accidents and,
compared to day workers, night workers are more likely
to be involved in accidents while driving home from
work.
• Fatigue, night work and/or shift-working arrangements
have been cited as major contributory factors in
numerous well-documented accidents and incidents
including Three Mile Island in 1979, Challenger Space
Shuttle in 1986, Chernobyl in 1986
P–9
Health effects due to shift work
Exposure to shift work and the following ill health effects;
• gastrointestinal problems such as indigestion, abdominal
pain, constipation;
• cardiovascular problems such as hypertension, coronary
heart disease;
• increased susceptibility to minor illnesses such as colds,
flu and gastroenteritis.
• Reproductive problems in female shift workers have also
been reported;
P–10
5
Health effects due to shift work
Exposure to shift work and the following ill health
effects;
• Shift workers, particularly those who work at night,
may be at risk of ill health because shift work can
disrupt our body clock (by interfering with the
production of hormones by the body), disturb sleep
and cause fatigue;
• While the association for reproductive effects is less
strong, it would be wise to consider shift work,
especially night shifts, as a potential risk to
reproduction. Research into a possible link between
shift work and breast cancer has been inconclusive.
P–11
Disruption of family and social life
• A happy social and domestic life is an important foundation for
health and well-being.
• The amount and quality of time spent with family and friends
can, however, be affected by unusual patterns of work.
• A worker who experiences a disrupted social or domestic life
may feel isolated, moody or depressed, which can affect their
health and performance at work.
• A work schedule that clashes with domestic responsibility can
lead to a compromise between routines suited to work and those
suited to less conflict at home.
• Shift workers, especially those who are primary carers, may
spend more time with their family or fulfilling their domestic
duties at the cost of sleep. This will result in fatigue and its
consequent implications for health and safety. P–12
6
Who might be harmed by shift work
While all workers are potentially at risk from shift work, you should
consider certain groups who are more vulnerable than others.
These include:
• young workers, older workers, new and expectant mothers;
• workers with pre-existing health conditions, which may be made
worse by shift work, such as those with gastro-intestinal
problems, coronary heart disease and sleeping problems;
• workers taking time-dependent medication such as insulin;
• temporary and other workers, such as sub-contractors and
maintenance workers, who may not be familiar with or be able to
adhere to current shift work schedules, or who have been on a
different schedule with a previous employer;
• workers, who following a standard day’s work, have remained
on call through the subsequent night or weekend.
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