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COPING WITH SHIFTWORK Neil Lewis Business Support Manager LINPAC Packaging.

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Presentation on theme: "COPING WITH SHIFTWORK Neil Lewis Business Support Manager LINPAC Packaging."— Presentation transcript:

1 COPING WITH SHIFTWORK Neil Lewis Business Support Manager LINPAC Packaging

2 What do I want to cover today? -Our learning experience -The “basics” of human fatigue -Some of the Health & Safety issues -Some tips for getting the issue right -How to educate your employees What I will not cover -What is the best shift pattern for you?

3 Fatigue a big but underrated safety issue Some high profile accidents where fatigue has been cited as a potential issue in their cause - Exxon Valdez -Three Mile Island -Bhopal -Chernobyl -USS Vincennes -Challenger Space Shuttle Clearly something not to be ignored

4 The LINPAC Packaging St Helens experience -Site acquired from another Division 1997 -Aimed at being Food Service centre of excellence -“Brown field site, Green field mentality” -Shift pattern included annualised hours -Aimed to give complete flexibility with minimal to zero overtime i.e. Business not human centred

5 The chosen shift pattern -8.5 hours in length, half hour for shift handover -M M A A N N O O rotating pattern -Seven rotations then 16 days leave -Annualised hours to be paid back in 16 day break -Was it successful? NO -People resigning cited it as a reason on exit interviews -Complained of sleep deprivation -Burnout at the end of the pattern etc, etc

6 Challenged to find new shift pattern in 1999 -Initially spent a lot of time locked away looking at shift pattern books and flipcharts - Lots of ideas but no real solution -Flyer received from a company called Circadian Technologies for two day course on “Shiftwork scheduling” - Attendance an epiphany on shiftwork fatigue leading to new ways of working including staff training and awareness

7 Did it work? -Shiftworkers voted 97% for new pattern -Shift pattern now seen as an attractive part of employment package -Working hours change gave more quality time at home -Fatigue no longer cited as “serious” issue -Introduction of “Coping with shifts” unit on induction as follows;

8 WHY DO WE HAVE PROBLEMS WORKING SHIFTS? Your body is conditioned to be awake during the day and asleep at night (Suprachiasmatic Nucleus)

9 NORMAL CIRCADIAN RHYTHMS WRONG? What are circadian rhythms? Definition: Circa = around Dies = day Around daily rhythms of your body clock, for example TEMPERATURE Other examples include growth hormone, cortisol, urination Whether we are awake or asleep, body functions continue to follow their circadian rhythms



12 FACTORS DETERMINING SHIFT WORKER ALERTNESS uTime of day (phase of circadian rhythm) uCircadian profile (morning or evening type) uHours since last consolidated sleep uDuration of last consolidated sleep uQuality of last consolidated sleep uCumulative sleep deprivation uStimulation/monotony of job task uStimulation/monotony of job environment uDay of shift uConsecutive hours on duty uConsecutive shifts on duty uAmount of overtime uSpeed or frequency of shift changes uContent and timing of last meal uIngested stimulants or depressants uAge of shift worker uPhysical inactivity

13 WHY DO SHIFT WORKERS HAVE SLEEP PROBLEMS? uDaytime sleeping is out of synchrony with biological rhythms uDaytime sleep is out of synchrony with family and social schedules uDaytime sleep is out of synchrony with the timing and content of food uThere is more ambient light during the daytime uThere is more ambient noise during the daytime

14 SHIFT WORKERS’ MOST COMMON SLEEP DIFFICULTIES uInsufficient sleep during the day before the first night shift uPoor daytime sleep when working night shifts (frequent awakenings, ‘light’ sleep) uEarly afternoon awakenings after the first night shifts, inability to go back to sleep uLess total sleep time per 24 hours when working night shifts, causing cumulative sleep debt uInability to fall asleep at regular bedtime when coming off the night shift


16 HOW TO PLAN SLEEP uSleep at the same time each day uAlways do the same thing before you sleep (read, bathe, etc) uKeep room cool and completely dark uUse white noise (fan, air conditioner, etc) uTurn off the phone and turn down the answering machine volume uTurn off the television and radio uPut a “Do Not Disturb” sign on the door uMake arrangements with your family and friends - Sleep time: do not disturb - Family time: after sleep uBeware of caffeine, alcohol and sleeping pills uTry to anchor sleep with an overlap period uWear wraparound sunglasses when driving home in the morning

17 PREPARING FOR SLEEP uDevelop a bedtime routine uFollow the same routine every time you retire uFollow the same routine even when preparing for naps or daytime sleep uExamples: 1. Light snack 2. Draw curtains 3. Shower or bath 4. Brush teeth 5. Read or watch TV (15 minutes) 6. Turn out lights

18 PREPARING FOR NIGHT SHIFT uStart adjusting ahead of time uStay up late for a few nights before the first night shift uSleep in progressively later uTake a nap before shift uGet exposure to bright light before and during shift

19 BETWEEN CONSECUTIVE NIGHT SHIFTS uAvoid caffeine during last four hours of shift uWear wraparound sunglasses during drive home (avoid bright light) uEat light meal if needed uPlan to sleep as soon as possible uTry to get 6-7 uninterrupted hours of sleep uSupplement with nap before shift

20 RECOVERY AFTER NIGHT SHIFTS uTry to avoid going completely back to daytime schedule uStay up late and sleep in late uTake short naps as needed

21 RECOVERING METHOD 1: NAP AFTER LAST NIGHT SHIFT uNap for 2-4 hours after last shift uDon’t sleep too long, or it will be difficult to sleep later that night uEat a light meal after waking uTry to get bright light exposure during the day uPlan afternoon activities uRetire at normal bedtime

22 RECOVERING METHOD 2: UP ALL DAY AFTER LAST NIGHT SHIFT uTry to stay awake all day and retire at normal bedtime uAvoid motorway driving uEat a protein-filled breakfast to provide energy for the day uAvoid sedentary activity uTake a short nap if feeling overly tired during the day uTry to get bright light exposure during the day uExpect some irritability uDo not over-exert yourself on this recovery day

23 NAPPING - THE KEY TO ALERTNESS Sleep consists of distinct brain activity cycles, with several clearly defined stages within each cycle: Stage W (Waking)Stage 3/4 (Deep Sleep) Stage 1 (Transitional)REM Sleep (Dream State) Stage 2 (Light Sleep) Quality sleep requires 4-5 uninterrupted sleep cycles of approximately 90 minutes each in length. Quantity of sleep needed is 6 to 8 hours for most people. Cumulative sleep debt occurs from insufficient quantity or quality of sleep over several consecutive days. Daytime sleep is less restful than night-time sleep because it does not provide the same quality of sleep architecture

24 SHORT versus LONG NAPS uUltra-short (5-20 minutes) naps are very effective at restoring alertness and giving a critical boost for 3-4 hours. uLonger (40-60 minutes) naps result in groggy-headed sleep inertia upon waking, with some impaired performance due to waking from deep stages of sleep. uVery-long naps (90-120 minutes) restore sleep debt and are often associated with little sleep inertia, due to waking from lighter stages of sleep.

25 SHIFT WORK AND NUTRITION Nutrition-related disorders of shift workers uHigh cholesterol/cardiac risk factors uChronic heartburn/indigestion uGastrointestinal disorders (constipation, diarrhoea) uWeight gain uLoss of appetite/overeating uUlcers

26 FOODS TO AVOID ON NIGHT SHIFT Foods that promote gastric secretion: uTomato juice uSpicy foods/strong seasonings uExcessive coffee uAlcohol High fat/hard to digest foods: uFatty meats (including chicken and turkey skin) uRed meat (steak/hamburger) uHigh-fat burgers and pizza uFried foods uCrisps and chips uPastries uWhole milk and dairy products

27 SO WHAT SHOULD I EAT ON NIGHT SHIFT? Eat healthier food, in smaller portions, more often. uHigh Complex Carbohydrates - Pasta, rice and potatoes - Whole grain breads and cereals - Fruits and vegetables (including juices) uLow Fat Protein - Lean meats, skinless chicken, fish and shellfish - Soya beans, tofu or other beans - Home-made/low fat pizza - Skimmed/low fat dairy products

28 WHAT ABOUT CAFFEINE? Positive Aspects of Caffeine uCan increase alertness uImproves reaction time uWorks quickly uCan improve performance uCan improve overall energy uPromotes clear flow of thought

29 Negative Aspects of Caffeine uRemains in the body for a long time (half-life of 7 hours) uCan cause nervousness, anxiety and restlessness uCan cause gastrointestinal problems uCaffeine is addictive (tolerance develops, withdrawal symptoms) uAffects sleep and sleep stages: - Can’t get to sleep - Shorter sleep period - Lower sleep quality - Frequent awakenings

30 Caffeine suggestions uUse caffeine in moderation uTime its use to when you need it most during your shift uAvoid caffeine 3-4 hours before sleep uReplace caffeine with other decaffeinated beverages uKeep track of how much you use uIf you are a heavy user, cut back slowly

31 OTHER ISSUES Alcohol uShould not be used as a sleeping aid uReduces the quality of sleep uActs as a diuretic, flushing fluids from your body uDon’t drink alcohol for at least four hours before planned sleep Nicotine uYour body craves nicotine while you sleep, which disturbs sleep uRelated health problems - Cancer - Heart disease - Hypertension - Emphysema, bronchitis

32 OTHER ISSUES Exercise uGives you energy uBurns off stress uHelps you sleep uProper approach:- - Start slowly - Find a routine you like - Exercise 3-5 times a week

33 OTHER ISSUES Sleeping Pills uMay initially help with sleep problems uTolerance creates the need for more uProlonged use can create the following: - Disrupted sleep - ‘Hangovers’ - Dependence Drugs uTranquillizers uAntihistamines uAntidepressants uAntipsychotics uAntihypertensives uLong-acting hypnotics uStimulants (withdrawal effects)

34 FAMILY AND SOCIAL ISSUES The Importance of Family/Social Issues uThe shift worker is not viewed as a whole person uDivorce rates are higher for shift workers uSleep deprivation leads to irritability and family problems uThe entire family is disrupted by the shift schedule uCreates high turnover/absenteeism uDecreases morale/motivation uNegative attitudes affect job performance

35 FAMILY AND SOCIAL ISSUES Improving Communication uKeep expectations realistic uBe specific about your feelings uDon’t suppress emotions uCompromise on differences uBe sure spouse, partner, family and friends understand your shift work schedule Planning Ahead Keep a schedule calendar –Keep it in a central location, near the phone –Write out shift schedule for the entire year –Identify RECOVERY DAYS –Identify QUALITY DAYS –Plan at least 2/3 quality days per month –Plan ahead as much as possible –Consider making a second calendar for your best friends

36 CONCLUSION Circadian rhythms have been considered for our shift pattern BUT It’s only half the battle... IT’S NOW DOWN TO YOU

37 What is our “new” shift pattern? 12.5 hours per day 30 minutes handover 4 days, 7 off, 4 nights, 3 off, 3 days, 3 off, 3 nights, 3 off Three rotations then 21 days off

38 Does shift work cause Cancer? Some studies have suggested this link -The University of Occupational & Environmental Health in Japan indicate prostate cancer four times more likely in rotating shift workers due to lower levels of melatonin which regulates sleep patterns ( -HSE Research Report (RR132) on Shift work and breast cancer - “Appreciable but not definitive” evidence that breast cancer maybe due to altered light exposure at night ( Watch this space for more research!

39 Sources of information RR446 – Fatigue/risk index for shiftworkers (also available on the above link) “The Twenty Four Hour Society” by Dr Martin Moore- Ede HSG 256: Managing Shift Work available from HSE books

40 Thanks for listening and any questions

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