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    27 views33 pages

    Chapter 10

    Uploaded by

    Wilco Rave

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
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    of 33
    irre sts ec byt Phenomenon of dil and seasonal agra ‘ation of symptoms or prevalence of ers | ies, The fret kaon Egyptian medial Y Senos yo MB tering res and sept clot ‘by human diversity of, | Tao improving the quali of ina time sense 10 The Relevance of Circadian Rhythms for Human Welfare Introduction: Circadian Rhythmicity Has Vital Implications for Many Aspects of Human Lifestyle in the World Today?" 326 choprer 10 (ver 190 tons of highly radioactive uranium and pulverized graphite coker rs wer expel na cov that traveled around the emire Norther Hemixphece. Local pat and Srefgher red vali toquench the explosion and impound al reactors in a mae a= Cophiagus of concrete dumped by relays of airplanes Fist reports were optinste eal 13 people dead. The ‘cual uth devanaing Residents of theory ie lage of Chernoby were exposed to deadly radiation 90 times greater than tat from the Hlrcehima bomb Estimates suggest that 9 milion human beings were ecto by the explosion andi fallout inclding 312 {milion children Mor than 4,000 people were evacuated from their homes in appronimatey 2,000 towns and villages in Belarus ad the Ukraine Anobee 1 lion continue tolivetn radioactive zane in Belarus and 3108 mon still veside in vacioactvely contaminated areas in the Uxzaine. One radiation specialist judges thatthe CChemobyt ncient wl cnuse 475,09 fatal cancers worldwide ae an ial numberof nonfatal cancers ‘The indirec eet ate equally tightening. n Belars ‘lone, 25% of pee fan and forests eal co taminted by adie and 10% is unsafe te Inti ature “The cost of ignorance about human deadian phys ‘logy very high A brie summary of areas of human fctivty affected by cicadionehythicty fel the ale “Themnny sepects of ceaian impact on human phys logy canbe divided for convenience int abot cate tories Table 101). Many of the ctegoces overap. Some fe, such ast ago reduce eeieney are merely Uncomfortable Others are deadly. Some of heels, esr ieptiten for wok hues such safc morality ae very dena, cue, dana vermin. Others may be eel lel ut ccc irsidiously over yeas o dead of tine ‘Chapter pointed ot thatthe fundamen principe fain physcigy sen throughout fhe plant and animal Kingdoms apply aso to humans. A mesh of moral and ethical oes protects human dignity and wellbeing rom seme vase ‘perimental meds hate ese in ower a ‘mas bt trough he tandacent vel of ea Fumors appear to resemble ater diurnal man ral Theumigu ference, cours, is human ineligence Curiosity sefawarenes, and great idee nd pply tne fo ly ie On the dates side, human ingenulty lows so degrade ou rvronment crete unusual ess and fo Sete gngraphi stron on ple at Te otherspecestan mat “This caper il conster the steses on ice dian erarzton athe malfnctons f s tine ieepng syste Notonly rust the cinal contents TEN ress of human behavior and physiology affected by ‘reagan ehythmiity Aetna and indy OEE ein nays Hh commer serves alone) we wont Nin and ident schedule eer (.Seepenake syndrome and mood dearer “Rpm see pcos mccant Seuss an id spi ak “Ghsopharacalgy (Lega mene or regulating work hours nd ‘cieding Tw kolovance of teaian Rhythms for Human Welle 337 be addressed, but als effects in esthy individuals who undertake the belgie sbsormal purus of [et setng across me zones oF working af might The tim illbe to minimize ceadian probly descr ing mechanism hat ac effectve in ely tiv I ivngin oral exeadian frameworks. The haper tated wih» shocking example of ie cedian malfunetion in work efceney a Chery! The cussion time now tothe fudarentl creadion properties tha are effective in both recgaition and Freatment of chronbioogcl malfunction A survey o the approximately 6areas of cada relevance for humans wl fellow oe abe 101) One category ce tersoncieadlanseated acu isaters Ase Boup concerns occupational and tavel stresses The ti group fares on esdan ting of medical diagnosis 8nd treatment fourth group considers te chrono Pathology of about 10 losely tlt sep ake sy ‘tomes nd mood disorders & ith section evaluates ‘ways treating cada dysfunction by light sched bles and deuga suchas melatonin. Te nal caepory leas with egal messurs for regulating work hours sed schedting in dusts that ave prc nerable ration considerations Several Fundamental Properties ‘of Circadian Systems Are Directly Applicable to Improvement of Human Performance’! The structure ofthe human SCN appears similar {otha of other mammale™ The structural detail ofthe human SCN (supeacias matic nucleus) pacemaker yt were consrdered in Chapters snd briety in Chapter 9, Only sketch will begiven here as review: The lckworks reside inthe SEN pee we Piate 5 Pho O) input or eta rent comes primary through specie ttinal a ln cel photoreceptors, hich connec via the ei Fypotolamic tact tobe SCN. Newa utp projections areboth inns within the SCN and etn oreo tude, th further neural lays to every part of Re Seay (ew Chapter). The general picture of circalan physiology in humans is similar o that of other dural ‘mammal SCN RECULATION, The SCN shythmicaly regulates snulide of functions in humans. Step-wake cycle, levels of specifi types of eli the blo body to perature slermess and effieny ad hormone eves a {hablo ae fost ew eamples One exam thre hoemones wiles the stat Fgute 102). The fee running eadian period of pasa ACTH, cov end ormome (ACTH) an eorts (8) Goh rane Ba {growth hormone in humans is bout 243 tn subjects living normaly entrained, However period of excl 24h prevais, adjuted by rhythmic environmental enralning agent (ee Caapers 1-3). ENTRANIVENT Most important aethelght-dack cycle nd the thymic secretion of melatonin. The elt of light depends on the dose, but even in subjects living itor hpi exposure lo deat and ofc igh ing 50 300k sulin to proce etait vtha noel lte-vering beste acd dks othe Slop period The ets fightin producing achstnent are describe bythe phase respon curve (PRC) igh (se Figo 35 Chapter) Light in the ours elon te ‘minimum cow body temperature process delay of ie "Sok an ig afer tha tamper nimm, proce phase advance Decse the period of the human nk. ‘a docks restr than 24, te advance portion of he ase resporse curve what normaly wed Melton, the darkness hormone lio an inipor tant synchronizer Sometime itis called an eral sy Chronizer because itis produced within the boy Homes tenths prucon normaly depends 328 Chapter 10 nthe igh cyclen tate must haven todulatory ater tan a pinay oe Melton ako hows efasonte cr ‘ek tat are pe dependents PRC Shetvesee sign Pe Athough normaly produced within the piel gland melanin ca to be tak ory ab pil gest of mel: ton nthe evening promotes a pate _sivancr: in the mortng phase ely Tecaos igh suppenes elcoin sce Monin dow dependent mane and tela normaly stn cnc Morag ightedvances te clock bot atc Oy causing vere pe sited ec ipby sppreing melatonin sre At Tighe elton efor sepne ard {henge deine noe oper Eropenous clon dung ihe doy tres trot dopo ant a ecg inca tempest ‘ihe socuonizers have ben popes nating shythmic od intake and exc, ahough the ev denote he inporance ot stong Hower the Concept that eye might cine aa yc: ‘thor valuable Hara ental pyacaly si ijand ental ace na beh sect cre tent inthe dayame;otigh ey sully Sp eating Sseek ret and Sp in ah, ult ntrcent Steha tse expan peopl to te iht-darh oe Serbs he oral psesof melon seen © take place As ren eneament of i clck 8 tehevioe physiology and biochemistry between day. tad igh Daas om carat oe teense of Soot ceadan uncon, Ignoring Circadian Rhythmicity May Increase Accident Rates)" Trafic accident rates appearrelated to circadian ining ‘The tll fom ca allison and crashes & great (Figure 103), Vehlculer aecidets cle have many eases, ranging fom driving under theinuence of alcool ot drugs recklessness ofeenoge divers, het atacks orfaling elep a the wheel However, the evidence ‘ery song for involvement of teasion element. Tea seedy of 82 traffic ccdents jg 19 be fatigue elated, the highest ele crured at an indi uns body temperture and ficleney lot the Bours shorty after might Values ctapulled mn about 200 {1600 ra, 19900 at midi, 1.100 at 200,90 a ‘eee aces ar very common andthe asta 4400 ast, and 700 a 600 a, then deopped ta day time fow Ofcourse darkness plays an important sle in {feral ond viet and the acient rte for night ‘rivers is undoubtedly affected by several actors in dion to the ceaian component The Buxon Valder supertanker accident had circa- dian connotations” Shorty alter midnight on March 24, 198, the super- Tanker Exon Valier started to this the nattow chat ‘ol across Bligh Rea in the pristine wilderness of rice iliem Sound, Alaska, She was cerying 13 milion bres of crud ol when se stack the ret an foe 9 Beping hole in her side. About 258/00 barrels of ei pled into the sound and soon spree! in an uly Sac ing lsc seaward for eves! hundred klrneters Beaches, verdant ores fringe, benthic substrate, and mytind creatures inthe sound weve costed with the toxiolly ce. Vsel damage was 25 lon and he ‘otf clesp ing 1989 alone wae $1 Stilion The ‘Semage to willife tas inestimable. Even today, 3 yeas ter efects are apparent in spite ofthe iene {Hors of volunteer and government cows 1 contain fd dean up thespl "Te causesof te Ex Vale's grounding have been, ‘examined and debstd at many levels Inthe opinion of the US. National Tansportation Safety Board, te thd ‘te fied t properly maneuver te ese ech of [eigue and eee workoad. The ese of senight our, fatgue excesive continuous work hours nd ‘lan effeny la pnt ga ome fo te fren this ‘sastous ante eadan dyshuncon ‘TheRelevance of Creadian Rhythms for Human Weare 329 The accident at Three Mile Island was the most serious in US. commercial ‘nuclear powerplant history” ‘At 400 a4 on March 28 179, chain of Incidents began that rested athe elt low ofl rods in the cond tects at Insoutheastem Peneayivann snd tow level radioactivity gaseous burst Were reansed fo sever days Catttophe as verted nthe ick of ime with deaths ries to plant workers oo mene, of the nearby Busting commusity of Midletown, Pennsylvania, Eventually. however, the cis ed to evacuation of mang local residents, massive cleanup tHfors she plant and decommissioning ofthe reactor (Figure 104). Aconing te the ofa ga repre alist tage sxe sweeping changes in sector oper tortraining, human factors engineeing, and change thoughout he US or emer 2neyrespose planning and changes of any other management polices or nuclear power plant ‘One ofthe key point in understanding the chain of ven of Thee Nile Islan i the Bureauratic phe ran factors engineering" The accident began (0 ‘ss Detals are ech but bial the plant une went aren the water coolant egulpment locate The monnaceac pat af he plant With igheing speed seam built up inthe generator, unt he tune ee Teeclor shut down. Te criss was spgtovated By prot Jems inthe emergency backupfeed water system i nother part the plat Without adequate cooling Ve ‘ucla ual overheated and started fo mel te eo {um cladding ofthe radionctive fue rds, which then ‘reacted with water Asa elt potently expose hydrogen bute bul up above the enctor coe “Although the even was nots fue lid some othe fel ros did melt and contaminate the wales Coolant Radioactivity wes ese both in watt tht Hlwed into the reactor building basement during the sccident, and in contaminated air releaed info the Smosplere during the Iter degassing procedure. The plant instruction manuel contained no advice for thee vents, which had never happened befor, but rede tonof the dangerous hydrogen bubble ws een reduce the potential for a explosion, “The important point eee that many’ com pliated steps were immediatly iniplemented by the peters tying wo solve problems in an unpreedente ‘tres of evens a 0 the morning. Some hel been working continuously on exende shi and were a9 FIGURE 194 Thee Mile stand males pore plan. The city shown wate acon (Couey ofthe U8 Natal Aras an eros ‘icadian ow point of heir internal temperature fiythm. Fatigue was ata maximum, and eliaency in ‘alving new problems with reat speed was aa rit rum. A conclusion af cireadian eficency malfunction Salmon unavoidabe ‘Occupational or Travel Stresses May Affect Performance? Modern expectations place 24-hour demands At presenta 24h supply of eves i demandes by the public echnologsealy advanced raion. Acces fo mergency mail services avaiable, gs land water utes, food supply, and tensportaten Services are deem eset or the Cock: fhe hour, luring which hops re open and banking flies ae Svailable have also increased, and these demands Extend work hours. Many instil posses must rut tinuous, an news gathering tdin must work on 1 2U boss Allof the neds give rise fo noctandand ‘working hors Factory shift work is necessary for industrialized befincmow oF aia WORKER. Fo the purpose ofthis chapier a sit workers defined asa nner worker ‘who doesnot regulary work standard daytine sched Ube. Needless o's the work hour of nonstandard 30 Chipter 40 schaduls vacy consiecaly This discussion wil cos fide astanand dayne schedule tbe approsinately Bhporday3 consecutive days a week, daring daytime hours ove the span fom roughly dawe until sk in ‘Temperate Zone counties A variation ofthe standard theo the compressed workweek, cong of four 10 [unite per week a willbe deserted shorty. Trakit work uric day work the majrty of work hours occur night when the strongly disral man ‘ns into any clradian problems Oten shit work Iroches eningingechofle thot rotate shor Between {Bry tod aight shits, or mong morning, evening rd right hs The change from one lta another si tly nade eck tervals in the United States, but ‘ore tequat changes, every week or even every day be guitecemmon in European other counties Sil anather varia of shift cor isthe extended work sche Inthe nadia profession, the extended ‘Seve wa former 9721 shit stended to provide Senfiray acre oa patent the sme Postal at. Telia extended work schedule sound in war tine mltary assignment or oops in combat zoe. Here the demands of active Sighting may cl for realy Continuous duty ove: peda of nay daye or eeks Shit werkand extended work sede are deen ‘ed by indestry and the medial professions on four trounde.fsome case an extended period of tine is oped compa portlet hospital env onments In her cases the bass is continuous ‘Semand for services in cceupations with limited ‘rmplayees a described akeady Anoter defense ofthe practice Isbaced on economic factors, such 5 the need {fully use expensive capital equipment in factories bound the clock Finally, technologialy advanced ‘suipmen buch as nce powerplant ce space shu fis requis 34h monitoring, The moat comprehensive data onthe use of shift workin the Unite Sats ste census, Which isco: {Toca 10-year intervals to cover demographics of very household According toa recent census, about Wis othe working populaon involved in fal-me fight wok or shift work inthe United Sats (igure 105) The penage aust higher or pact workers forthe average daytime employee, he social Implication of altered work hours for those ney one inte ule st workers are Bad imagine ‘umber ef hours or the me of day worked are the ‘ner demande an stresses impose by aspect. ‘Aerucia cements the degee of responsiby of the Jobat eects of inefckency of night worker hte Ing bole ns reigerior cannot compare with thos of sungeon undertaking bran suger or ear wansplant ‘Sra workschaul extended int the cicada chcal St ee ee one, Nor oes the responsibility associated with bolt tightening compare with the responsi of nueae power pant operon The late individuals duty is © Fegulate the power plant and avoid dissters such as {Chemobyl Bectuse of te element of carer esponsi- fyrsome specialized ht work willbe considered ait the ater inte chapter in trms of specie career IME COMPRESSED WORKWERK. Before the discussion time to shift work, the comprssed workweek schedule tll be considered bry Beas of growing prev [ence The workis usualy performed 10h per day ford Gays or 12h per day for days lenving ort days re tach week, but vty of other schedules ext Widely ‘fret occupations channpion the we of compressed Srorivesks. Among the mos common industes Using the compresed workweek ae the chemical industy, theory (especly on otore eligi) these! industry some mace power plans se ‘compressed work schedule Some arin plot and Siborne support staf are scheduled for long inter tinal hls ra compressed weckBeenze of nae torefur to home base ater x ong Fight ‘Asm problem the workers pont View i sigue ofconseatve lah days However workers The Relovance ofCircdian Rhythms for Human Welare 331 oer sae that this dove ist by mone et cays ‘nd by not having to experince the ssle ssncated ith travel to and rm the workplace, From the employer's point of view, moonlighting concer are important as are the decreased quality of work pro sce, particularly toward teed of the shite With Some types of employment, public concern may arse ‘worker na threanitrotaingshit. Blk fos Gente ‘Rieti ep ns tie aed OE tas owhiton partir Say Cauresy fF our) MAJOR PROBLEMS FOR TE SHIFT WORKER, Two ofthe rain concerns about 224 socely ae the quality of Performance onthe nigh shi andthe ost sleep. mn ‘dition, shift workers have an increased sik of Peat “iene and other major diseases Eventhough acedens inthe workplace ae comporatively rae pefrmance ten wor an rors more feuent nig sito Sng shi than on mln prranent day me asin rors leading ods acide ace rom sev eral nies: Envronental conditions of lighting tem perature noise, and weather must be considered, but fireaian Himeof day factors are certainly erically Important The amount tine since mwacening and 332 Chapter 10 panticulay the amount of tine on duty cannot be fred Wold ter aspects ose sep os, ‘Ra ceping inte ttn io cometh equ Tom The tes aco apply elf the ight ‘fine San act ep and te aan or those who work at ight, circadian shythms djs poorly Testor, he shit nla he ne of tert Severance with hernia of he Xempstre nd adrenaline yt sn the peak of themes yt, Acomparon of usar exc Mor of adrenaline of a worker ona swing sl of 3 teks day wor to 3 weds nigh work indents that TReadjastnent tonight works poo and slow During th aie values high cing wok andl {Ruane so gue 1074) lant carn he st tech nigh werk high levels arene ere ‘tahoe neo sep gue 1079) ond would Se ucla with cfeaes Sth ning seep fd inhavingcncaliated sep. Low values duting the work patio’ would be anovted with decreed Slertness end meta perornance Even by the hind tree (Figure 102), adjstnent incomplete with Gece sdrerlle levels during, work ne Moreover hen daytime work is wesmed (gure 1070), he ona any ate! ey rp (eb pare gure 107A aD} Tnaton subjects might be seep deprived and they av also working seo o the waking phase Indlpendent rosarc as asad enuromen eye movement snd mental performance tse ‘ec sa thu ot ekngof les te Huy dros fel blow 7 on ate see S71 oT etnias at wthcpard pee tong ake agony ns Tower and mote comprehensive models based on the concept of ccainn su homeo factors com trolng seep se Chap) have slo ban developed {optic sense diferent ccaianpharer-A ‘foe's slernss icc tltd othe ay 2 evo st witout ik Ales cetera by Fre the aumot acreadan component that in phase wits boy tempers snds honeatat com onent 5 tha alls exponentially wath tie awake {igure 10), Daring sep erator diate, probaly in asec ith slow-wave sleep, in 9 Proce designated SC ale bolow faeries cil promised for an niu perme ecto beat tak Te ight she te igure shows ‘fescue it worker on hist right shor "Sng sit Aer slop :20-120 ard then trorkng the ight shh serves lls it the ek ne: (eet Figse 102 for» typial swing shit Silo) May ofthese eat cneeuences fight work sel ens mismatch beeen the Sepak cy Ht FIGURE 30" The ciadian rythm of wary extn of “enti arwwoner during veioun para ing ‘hitachi. (8) During at weak sy 8) Dare eet vat 1 ving Ort ‘aig () Det he fst ek ek ork hots Ate ond Eber 975) 4 nd the iain timing system. Phase adjustment may bepoor noon eth angus, Bat als with ass ents of een schedules of night work, The mi ach cers because the natural light-dark cco Finuer in apite of the night worker's personal sleep-wake and arf! light-dark schedeles The fesultant cash prevents the individual's cvadion “hye tam aliging fly withthe schedule of ight ‘wore and doy sep. Elly bad isthe api aso ny ‘The Relevance of Cicadian Rhythms for Human Wellre 333, hacer tint decrees wiring awake ThesometSs C lows pct of thedepe ofan perforce Sleep ph ponnyehopeinc a alashianene cae afer changing to right shut work: Fr further explanation, Ertentand Hage $02 (rom Poland and Me 11) hard-won adjustment de io rottion toa new sift ‘Shoflr titrvening st day Gee Figure 1070). eng sleep deprived and saying awake longer should make slep easier fo inate and mates through the actions ofthe sleep homecsta. However, lished about nurses who worked at night in rapaly rotating shit systems nthe et, ight boxes Were licen rom hat was usd by themes a fe ar End end of the ight shift wel a curing rest breaks Inthseond sty the ries wore igh vc hough ‘ut the shift The phase-shifting fet in bath stais were all. ‘EONS. Graduate medal taining is called internship residency. Historilly, thls raining hae involved Tong, intensive hours for several yen night, on weekends, and on holidays The work schedules of these physicians have been grucling. The policy of ‘tended house eisent aining das Bock tose 100, when residents vet on the spt gouns The student doctors were an permanent alla a aubsitte focestablished phyicans who might be fending hei practices in the ois, ery ot suger nthe hae pals, oe making vista unde. Priors about 1950, the andar pode war day duty foe 56 daysa wen and onl ty for eights ater a day's work Ona buy nigh he eden worked ontnuousl without sep for 24h tore. I no als srase even the best of hemptals simply provid cot inv svall dorm room for catching eleep unt a al Arrived The most astounding par ofthe tory tha those young interns ere mostly in their mid Ms and often ere marie wit yung famille, bu they were hot given alr or compensation of ay her Kind Condons hve improved in 30 yes ut en par ‘ally Now most eigen ae pia sal living wage, [As eel a 190, hotever, the US. Congiese sped intoleisite work hous or hori nems The ees Foetht ne were compen Many inter in the gest US hospitals were working 72 extended shifts Many were offered substan ons to encourage them 0 sccept ong shift at ent ones moe The sical ree Son vas hat patent care egies cant. itl heed ‘as paid to Be eff physi igus pi cre Fortuna he work schol of spt ins as been shortened in the pas decade ar result of aera The Relevance of Cicadian Rhythms for Human Welfare 335 legislation regulating work hours forieter ant muse in hospitals con thebsis creaian princes rent ssidets working tus are much more sirngenty. con ‘len most wpa ith work sscignments basa on cicaion Paneples The new legislation re Sees hours but cos not complete bate was ld nf 00 y he American Media Assoiatin's CCounci on Madical Eaton In respons toa groundswell of con ern about sleep deprived nee ‘siden and ted pent sae The cual’ recommendations on rasan work hours nude the. * Total duty should not exceed th per week averaged over wees + Workcays that exced 1h shouldbe defined as cna and schedued oneal asgnents shoul potercend 0, + Residants may remain on duly for upto 30h to complete the taster of patent cre, bat hey may rot Be assigned nev patient fet 2 Tae list continues for considerable length. Residents apparently stil work very long hous XTENDAD WORK HOURS IN SURGE. Work deme for residents, nurses an physicians on surgery duty can beetremely great As tecnlogy extends the pes ts for emedi surgery the length sural sched tle exten to 181 or more (une 1010) ean Surgary has become relatively comm inte as ro decades. Suceses nude heat anepin. ethan transplant, key transplant. surgery on neonates, ad ven intauterine surgery to correct heart defects Clearly the outcome is more promising ithe lod ute eon and suppert tum complete the proce rh ‘am crating tt replacements, The continuity may become coumterproductive, however, fe surgery se lon nat eed on ciracion pri. Interstate trucking work schedules are very demanding The tricking industry has gst for many years that long-haul tucking has an enormous inspct on the pei with he mos demanding hoes. American economy Here ar a fe facts fo support * Over 75% of US. communis depend solely en eucking for delivery of thes goods and commodities, + By 208 the trucking industry will haul 93 biion toesof fight pr year oc more than Gof ial US tonnage 1 The industry involve 3:12 milion ruck divers and over UD tricking companies in the United Sites, + Atrctontile truck may cos fom $7000 te 512500, depending onthe equipment + Over23 milion age trailer racks ate on US. highways atany one Ue +The trucking industry uses 4 bilan gallons f

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