Shift Work May Be Hazardous to Your Health

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SHIFT WORK MAY BE HAZARDOUS TO YOUR HEALTH

John M. Violanti, Ph.D.

 

Police officers are charged with high responsibility. They must keep vigilance in a normally routine work environment, and are not allowed to commit “human error.” This article examines effects, alternatives, and methods to cope with shift work in policing.

Research suggests that working the night shift may have serious consequences for worker and society. An estimated 25% of the nation’s work force is employed on evening or night shifts. Shift work has been found to lead to fatigue, less than optimum job performance, worker dissatisfaction and increased health problems. Unfortunately, the need for police protection around the clock precludes elimination of shift work.

EFFECTS OF SHIFT WORK

Everyone has a “biological clock,” a 24-hour schedule on which the body functions. This schedule is known as the circadian cycle. This cycle is introduced, maintained and reinforced in every person’s life. If this cycle is disturbed for just one day, it will take:

  • Five days for urinary electrolytes to adjust
  • Eight days for the heart rate to adjust
  • Six days for body temperature to adjust

 

Imagine the deleterious effect on police officers who must make three or four shift changes in one week.

According to one study, officers who have spent entire careers working nights and alternating shifts are at particular risk. As the officer gets older and continues shift work, there is evidence that the cardiovascular system is adversely affected. Additional research indicates that officers who work nights tend to get less sleep than those on conventional shifts. Some get as little as four hours sleep per day. Studies conclude that increasing age, coupled with sleep deprivation, poses a high risk for early development of coronary heart disease. Recent research by the World Health Organization (WHO) has suggested that shift work is a “possible” carcinogen, that is, it may be a factor in cancer.


Photo by Rick Hall

Other studies have emphasized the effects of shift work. A study of air traffic controllers who normally worked 10-hour night shifts showed a marked decline in performance after six hours on the job. A Federal Transportation study found that truckers are three times as likely to have accidents after 10 hours of night driving as after four hours.

Research has found that people deprived of normal sleeping patterns can actually fall into “microsleep” for a few seconds and be unaware that they aren’t performing the task before them. Research by the National Institutes of Health suggests that disruption of biological sleep rhythms is associated with such disorders as depression and neurosis.

There are psychological and social problems associated with shift work as well. Perhaps the basic psychological problem stems from continual change. Changes in daily routine call for psychological “synchronization” of one’s self—how one views himself in relation to the rest of the world. This view must change as shifts change. Equally important is the effect of change on the officer’s social network—his family.  They, like the officer, must accept an altered view of relationships that accompany change.

Police officers who work nights may deprive themselves of sleep just to integrate into the family: they want to be awake and active when their wives and children are up. This activity leaves he night shift officer more fatigued than his counterpart on the day shift. In addition, the officers’ community involvement suffers. Night workers are less likely to attend church, union meetings, school functions, and family social gatherings.

One important finding regarding psychological processes involves memory. Researchers have found that disruption of the circadian cycle can produce “retrograde amnesia”. Individuals who suffer from this may forget something they learned prior to a shift change. This phenomenon can be especially dangerous for police officers, whose very lies depend on their ability to remember important information. Another noted problem concerns the ability to make coherent decisions.

SHIFT WORK: ALTERNATIVES

There are basically three major alternatives for shift work:  1) rapid rotation; 2) dedicated (permanent) shifts; and 3) slow rotation.

Perhaps the most disruptive type of shift work is rapid rotation. This protocol is common in police work, where an officer must change from afternoon to day to night shift in the space of one week. In terms of disturbing one’s “biological clock,” rapid rotation is devastating. Past experiments by Dr. C.F. Ehret have demonstrated that rapid rotation caused such high disruption in laboratory animals that no Circadian rhythm could be detected. Body temperature and blood chemistry of these animals were in a constant state of flux. Dr. Ehret concluded that individuals who must face critical decisions (such as police officers) should not work rapid rotation shifts. Their performance levels are seriously affected especially in the early morning hours.

Permanent shifts are effective for reducing the problems of shift work. Such shifts eliminated the major cause of disruption: change. There is increasing evidence that fixed shift systems are more cost-effective than other protocols. Recently, many departments are moving to extended fixed shifts consisting of either 10 or 12 hour shifts.  Officers appear to like these extended hour shifts because they allow for more time off duty. Research in several police departments indicated a dramatic decrease in sick leave and an increase in productivity as a direct result of permanent shifts. Other departments conclude that their permanent shift program makes it easier to plan schedules.

Of course, the fixed shift approach is not perfect.  Twelve hour shifts, for example, can increase the risk of fatigue, especially on the midnight tour. Such shifts may also cause a morale problem, especially among younger officers who are involuntarily assigned to night shifts.  Many officers who work nights permanently tend to deprive themselves of sleep and “burn both ends of the candle.” This could lead to individual health problems, as well as poor work performance.

A third type of shift protocol involves slow rotation. Slow rotation refers to changing shifts over an extended period of time. Dr. Ehret suggested that slow rotation is better than rapid rotation—better on the premise that it causes the least amount of disruption among officers who must change shifts. Ideally, Dr. Ehret states, slow rotation is the logical choice when permanent shifts are impossible. He recommends that officers not be required to change shifts for at least 4-5 weeks at a time. This allows for minimal disruption of the circadian cycle.

SURVIVING SHIFT WORK: HINTS

Below are listed some helpful hints concerning shift work survival from the Health and Safety Executive website http://www.hse.gov.uk/about/site_map/index.htm

Identify a suitable sleep schedule

  • If you work regular shifts, try going to bed at different times eg soon after you arrive back from work or stay up and sleep before the next shift;
  • Have a short sleep before your first night shift;
  • If coming off night shifts, have a short sleep and go to bed earlier that night;
  • Once you have identified a suitable sleep schedule try to keep to it.

Make the environment favorable for sleeping

  • Sleep in your bedroom and avoid using it for other activities such as watching television, eating and working;
  • Use heavy curtains, blackout blinds or eye shades to darken the bedroom;
  • Disconnect the phone or use an answer machine and turn the ringer down;
  • Ask your family not to disturb you and to keep the noise down when you are sleeping;
  • If it is too noisy to sleep consider using earplugs, white noise or background music to mask external noises;
  • Adjust the bedroom temperature to a comfortable level, cool conditions improve sleep.

Techniques to promote sleep

  • Go for a short walk, relax with a book, listen to music and/or take a hot bath before going to bed;
  • Avoid vigorous exercise before sleep as it is stimulating and raises the body temperature;
  • Avoid caffeine, ‘energy’ drinks and other stimulants a few hours before bedtime as they can stop you going to sleep;
  • Don’t go to bed feeling hungry: have a light meal or snack before sleeping but avoid fatty, spicy and/or heavy meals, as these are more difficult to digest and can disturb sleep;
  • Avoid alcohol as it lowers the quality of sleep.

Diet

  • Regular light meals/snacks are less likely to affect alertness or cause drowsiness than a single heavy meal;
  • Choose foods that are easy to digest such as pasta, rice, bread, salad, fruit, vegetables and milk products;
  • Avoid fatty, spicy and/or heavy meals as these are more difficult to digest. They can make you feel drowsy when you need to be alert. They may also disturb sleep when you need to rest;
  • Avoid sugary foods, such as chocolate – they provide a short-term energy boost followed by a dip in energy levels;
  • Fruit and vegetables are good snacks as their sugar is converted into energy relatively slowly and they also provide vitamins, minerals and fiber;
  • Drink plenty of fluid as dehydration can reduce both mental and physical performance but avoid drinking too much fluid before sleeping as this may overload the bladder.

Stimulants and sedatives

  • Caffeine is a mild stimulant present in coffee, tea and cola as well as in tablet form and in special ‘energy’ drinks. It can improve reaction time and feelings of alertness for short periods. Only use caffeine occasionally and don’t rely on it to keep you awake. If you do decide to take caffeine or other stimulants, you should consider what might happen when its effects wear off, e.g., when you are operating machinery or driving.
  • Avoid the use of alcohol to help you fall asleep. Although alcohol can promote the onset of sleep it is also associated with earlier awakenings, disrupted sleep and poorer sleep quality. Regularly drinking too much increases the risk of long-term damage to your physical and mental health, your work, social and personal relationships.
  • Regular use of sleeping pills and other sedatives to aid sleep are not recommended because they can lead to dependency and addiction.
  • New drugs have recently been developed that can alter our state of alertness. Although their use may be widespread abroad, the ways in which they work and their long-term effects are not yet fully understood and consequently their use is not advised unless under medical supervision.

Ways to improve your alertness at work

  • Take moderate exercise before starting work which may increase your alertness during the shift.
  • Keep the light bright;
  • Take regular short breaks during the shift if possible;
  • Get up and walk around during breaks;
  • Plan to do more stimulating work at the times you feel most drowsy;
  • Keep in contact co-workers as this may help both you and them stay alert.

 

Unfortunately, shift work cannot be avoided in police work. It is essential that police officers understand that disruption of the circadian cycle may have deleterious effects. By taking precautions, officers can better survive shift work and have a healthier, productive, and happier life. A good resource outlining research experiments dealing with police fatigue and shift work can be found in:

Bryan Vila. - Tired Cops: The Importance of Managing Police Fatigue, published by the Police Executive Research Forum.

 

Article from Badge of Life.com