Resetting your body clock
Many shift workers experience health difficulties due to their irregular hours. Aileen Lee looks at how they can better manage eating, sleeping and waking patterns
“Medical studies have indicated shift workers are at a higher risk for certain cancers
“WORKING nine to five, what a way to make a livin” – Dolly Parton sang it, and the majority live it, but if we were faced with the choice of shift work (including the graveyard shift), we’d happily stick to the standard working week.
According to the Health and Safety Authority of Ireland, shift work can contribute to the following: cardiovascular disorders, gastrointestinal disorders, sleep loss/fatigue, increased accidents, and stress.
In Ireland, approximately 15% of the working population are shift workers. The HSA lists the sectors most commonly reliant on this type of work as: the emergency services, security services, utility services, production, leisure and entertainment activities, delivery services, and 24/7 retail services.
These shift workers, who provide key services and generally make our lives a lot easier, are faced with work realities that can undermine their health. Their jobs require them to work against their bodies’ natural clock, known as circadian rhythms, which regulate your body’s temperature, metabolism, digestion, blood pressure, secretion of adrenalin, sleeping and waking.
One man who can attest to the ill-effects of shift work is David Cryan, who recently completed Operation Transformation. Over the eightweek period of the show, he lost the most weight of the group, an impressive three stone and 4.5 pounds.
“Shift work is hard on the body. I’m 18 years a Garda. You never get used to it because you go from an early shift to a late shift to a night shift. It definitely would have helped me put on weight and would have made me tired. I would have found it hard to be more active and I would have been tied down because of the shift work,” he says.
Medical studies have worryingly indicated that shift workers are at a higher risk for certain cancers. A meta-analysis of 61 studies conducted in Europe, North America, Asia and Australia, which spanned 3.9m female participants, was published in January this year in Cancer Epidemiology, Biomarkers & Prevention. The review found that women in long-term night shift work had an increased risk of skin (41%), breast (32%), and gastrointestinal cancer (18%) compared with women who were not. Researchers also found that the risk of breast cancer increased by 3.3% for every five years of night shift work.
Disruption to shift workers’ sleep is such that it can result in shift work disorder, where workers fail to get a good quantity of sleep during the day, and as a result, cannot remain awake and alert at night when their work demands it.
Motty Varghese, senior sleep physiologist at St James’s Hospital, Dublin, says: “Shift work disorder is very common, because of the huge workforce doing shift work. It is a problem, but more than just addressing it, I think we should address the issue of sleep optimisation in people who are working shifts. What’s important for them is to limit or control light exposure when they finish their shift work”.
He offers some helpful tips on how shift workers can manage this: “One of the things that is advised is to wear dark sunglasses if it is bright outside on the way home — but you need to be really careful not to fall asleep while you are driving. When you get home, it is important that you don’t expose yourself to bright lights, like your LED reading light, smartphones, iPads or laptops — any of those things should be cut off two hours before you go to bed”.
Shift workers also need to manage their waking up time. Varghese recommends exposure to bright light when you wake up, to help stop melatonin production — the hormone that induces sleep — and limit tiredness as the day goes on. In lieu of bright natural sunlight, bright light therapy glasses or bright light boxes will also work.
Cryan’s sleep has also improved since participating in Operation Transformation. He credits this with learning to switch off more, much like what Varghese recommends: “It was Dr Eddie [Murphy] who helped me more in that sense, because I was probably bringing work home with me and thinking about different things. What I am learning to do now is switch off the phone and give yourself that hour or two break before bed. Of course, the shift work
help but when you come home, relax and turn the phone off, it’s amazing how well the body relaxes completely”.
In terms of Irish research, the 2016 safefood Ireland report, Managing Food on
Shift Work, looked at the three largest employment sectors on the island of Ireland reliant on shift work: accommodation and food services, health and social care, and manufacturing. It was a robust study, which included focus groups as well as a telephone survey of 1,300 shift workers, looking at participants’ work patterns, eating behaviours, specific lifestyle behaviours and workplace environments.
Most participants across the three sectors reported skipping meals on work days. It was noted that 66% were also not getting the recommended seven to nine hours sleep per 24 hours. Other external factors noted were erratic break times and issues with finishing on time at the end of a shift — these were common features of both the health and social care and accommodation and food sectors. Vending machines were reported to have the largest impact on workers’ diets.
On those findings, Dr Cliodhna Foley-Nolan, director of human health and nutrition at safefood, says: “There needs to be adequate facilities and time to use them, such as a canteen or a self-service kitchen with a microwave and fridge. Vending machines are just not enough for an eight to 12-hour shift. Facilities and access to them is one thing, but getting a breather is another. Short staffing often results in staff simply not having the time to take a break to eat”.
The HSA’s guidance for employers and employees on night and shift work offers a comprehensive overview of how to identify the hazards associated with shift work. It highlights some of the likely risk factors to consider and how to avoid or minimise them, for example, the potential for fatigue or difficulties for employees in adapting to shift patterns. It includes the recommendation that where reasonably practicable employers should provide the same access for shift workers to meal and welfare facilities, first aid occupation, health services and training and development as they do to daytime workers.
It also signposts the obligations that employers would have under the law.
Ibec says that it recognises the occupational health and safety challenges associated with night and shift work, and recommends the guidance provided by the HSA. In addition, it says that its Occupational Health and Safety advisory team offers a bespoke service to its member companies to help address spedoesn’t
cific queries that may arise.
Cryan credits his participation in Operation Transformation with helping him to turn around some bad habits, especially in relation to meal planning: “Aoife [Hearne] gave me a great plan. The whole idea on Operation Transformation is that you eat three meals and two snacks every 24-hour period, so when you’re working nights, you change the order around, which I would never have thought of, so say you’re in the middle of nights, and you’re getting up at 3pm, you have a little snack to get your body going. You have your big dinner then before you start. You have your lunch at 1am, and then the big thing I would never have done, you have your breakfast at 5.30am before you go home. You’re not starving your body”.
Fail to prepare and prepare to fail — David would certainly agree with the saying, as food preparation has been key to his weight loss.
“The biggest thing I have learned is planning and preparation, especially as I am never guaranteed a break when I go to work. If you have the food with you, you will eat it. If you don’t have it with you, at 2am you’re not going to be able to buy food that’s healthy”.
Dr Neil Stanley, an independent sleep expert who has been involved in sleep research for over 30 years, says that greater efforts need to be made to make shift work more workerfriendly. He also questions the necessity of the 24/7 practices we have brought into some service industries: “We have an expectation that some people should be working shifts and those people should be given every benefit and every advantage to make their shift as beneficial as possible, but I do not believe the ability to go to a supermarket at 2am is ample necessity for having that person work a shift”.
David Cryan: Operation Transformation has taught him the importance of switching off the phone and having a break for an hour or two after night work.