SHIFTWORK General effects & effects on performance

What will be discussed Definition Shiftwork effects Case studies/ Articles: - Shiftwork experience, age and cognitive performance - Strategies for coping with shift work Recommendations

Definition No common definition exists However it can be described as a system ‘where people work organizationally defined different blocks of time on a regular basis’ (Pierce et al cited in Johnson 1999,p. 9). It is though mostly associated with working outside the standard day shift patterns. Usually characterised as ‘work hours that are scheduled outside daylight (6 am–6 pm) hours’, (Hughes & Stone, 2004).

What are the effects of shiftwork? Physiological effects: - Disturbed circadian rhythms and sleep; endogenous body clock (e.g. controlling body temperature) vs. exogenous factors (e.g. controlling sleep/wake cycles) - Chronic fatigue; fatigue is cumulative - Suppression of the immune system/health problems - Individual differences contribute to the severity/type of any physiological responses & problems Psychological effects: - Depression after a long term exposure - Stress

Effects of shiftwork (cont.) Effects on performance: -Performance level appears to be lowest between 3am & 6am - Short term memory is a vital factor of performance - More complex working memory tasks (e.g. logical reasoning) improve by midday & then decline (Folkard & Monk, 1980) - Immediate retention on a task is better in the morning, however delayed retention (>7 days) is generally better during the afternoon/evening (Folkard & Monk, 1985a) - Personality types are relevant to the psychosomatic adjustment in shiftwork thus affecting performance

SW experience, age and cognitive performance (Rouch, I., Wild, P., Ansiau, D., & Marquies, J- C. (2005)) Results: Current male shift workers cognitive score >workers never did SW SW have same effect on cognitive efficiency at every age Difference between speed & verbal memory performance; speed performance is rapidly affected by SW while verbal memory would be impaired after several years of exposure. Effect of shift duration; immediate recall performance decreases as SW experience increases Possible reversibility of effects: cognitive performance of participants who stopped SW more than 4 years, seemed to be increased

Strategies for coping with shift work (Peate, I., (2007)) Dingley 1996, Reid et al 1997; effects of fatigue; delayed reaction time, delayed responses, delayed thinking, diminished memory, failure to respond at the appropriate time, impaired efficiency & provision of false responses. Reduced alterness can lead to clinical errors, which may compromise patients well being (landrigan et al 2004, Lockley et al 2004) Sleep deprivation: Equivalent to a person with blood alcohol concentration of 0.10% (0.08% level in UK for driving) (Williamson and Feyer 2000) Lee et al (2003) investigated mortality rates in NICUs: Babies born at weeks were 60% more likely to die if born at night in comparison to babies with the same gestational age born during the day. Proposed 3 possible reasons : Performance of nursing and medical staff during night shifts linked to fatigue and circadian dysfunction resulted in inferior levels of alertness and performance.

Recommendations Take a nap during the night/ nap rooms Sleep in the afternoon Environmental considerations: - Ventilation - Luminosity level (adjustment of) Nutritional consideration: healthy well- balanced diet Fixed shift Rest Break Use curtains, eye shades, ear plugs, switch off phone…

References Hughes, R., & Stone, P. (2004). The perils of shiftwork: Evening shift, night shift and rotating shifts: Are they for you? American Journal of Nursing, 104(9), Johnson, K. (1999). Shiftwork from a work & family perspective. Applied Research Branch, Strategic Policy, Human Resources Development Canada, Hull, Quebec, Canada Warr, P. (2002). Psychology at work. London: Penguin books Twarog, J. (2005). Dealing with the dangers of shiftwork. Labour Department: Educating our members. Massachussets Nurse Rouch, I., Wild, P., Ansiau, D., & Marquies, J-C. (2005). Shiftwork experience, age and cognitive performance. Ergonomics, Vol. 48, No. 10, Peate, I., (2007). Strategies for coping with shiftwork. Nursing Standard. 22, 4,