The risks of shift and

extended work hours

Laurence Hartley
Murdoch University

This talk
First half presents the hazards of
shiftwork
Second half presents the hazards of
extended work hours

What is shift work?

Shift work: the alternation of teams of
workers, usually performing the same tasks,
so work can continue for longer than one work
period
Some or all, work will occur outside of daytime
hours
Work hours can be fixed or rotate (change)
and rotation can be fast or slow

Whats the problem for

shiftworkers?
The rhythms of alertness & sleepiness

The daily circadian rhythms

Rhythms driven by clock in brain

Alertness is max during the day
Sleepiness increases during the night
Maximum sleepiness in pre-dawn
Clock is mainly set by day light
So clock time cannot be easily changed
So workers do not adapt much to
shiftwork

The 4 Hazards of Shiftwork

1. Increased risk of errors & accidents
when working or driving at night
2 Insufficient daytime sleep leads
to increased fatigue & sleepiness
3. Increase in health problems
4. Increase in social and domestic
problems

1. Daytime sleep is
insufficient for night
shiftworkers

alertness &daytime
sleep
Circadian rhythms (daily rhythms) in
body clock keeps body awake and alert
during the day; daytime not suitable for
sleep!
Circadian rhythm of alertness means
night workers are most sleepy at work
and driving home

shiftwork sleep
problems

Other disturbances during the day eg.

noise, light, heat

Body rhythms and external

disturbances combine so that day
sleep is shorter (1-2hrs) and of poorer
quality than night sleep
Early shift start times cut down night
sleep

sleep loss & shiftwork

Insufficient sleep (<7-8hrs) or poor quality sleep
leads to sleepiness & fatigue, and decreased
alertness & performance
A sleep debt of ~ 2 h per night shift
accumulates; 3 night shifts = 1 lost sleep.
2-3 nights needed to recover from debt.
Workers may not realise how sleepy they are at
work (masking) till driving home

Sleep loss leads to

microsleeps
Insufficient sleep increases the likelihood
of microsleeps and nodding off
occurring

People are unaware of microsleeps

Loss of awareness and control of
surroundings . an accident can
happen!

2. More errors and

accidents at night

Folkard (2003) Mean

relative risk across 3 shifts
1.4

Mean RR

1.3

1.2

1.1

1.0

.9
Morning (06-14)

A f ternoon (14-22)

SHIFT

Night (22-06)

Folkard (2003) Mean relative

risk over 4 successive night
shifts
1.5

Mean RR

1.4

1.3

1.2

1.1

1.0

.9
1

Successive Night Shifts

Folkard (2003) Relative risk

of different blocks of
successive night shifts
1.5

Mean RR

1.4

1.3

1.2

1.1

1.0

.9
1

No of Successive Nights

driving
Three times risk of a crash with less 6 h sleep
Night workers are more likely to fall asleep at the wheel,
and to have a crash or near-miss than day workers
Night workers are at 6 times the risk of a car crash than
day workers, especially at dawn
Fatigue and shift work is a major workplace road safety
issue

staying awake and

BAC
Long hours awake without sleep can
impair performance to a similar/greater
level than acceptable BAC for driving
17hrs awake leads to performance similar to
BAC 0.05%
20-25hrs awake leads to performance similar
to BAC 0.1%

3. More health problems

on the night shift

adverse health
concerns

Gastrointestinal complaints
- 20-75% night shift workers
- 10-20% day & evening workers
Cardiovascular Disease
- a 40% increased risk for developing
cardiovascular disease for shift
workers

4. Social and Domestic

Problems for the night
shift

family and friends

Shift workers can have less suitable
time off and less quality time off
Shift workers often curtail their sleep
time to be with family and friends;
this means they can be awake for a
long period of time, and they do not
get enough sleep

Risks of extended
hours of work

Folkard (2003) Relative risk

over hours on duty
2.5

Mean RR

2.0

1.5

1.0

.5

0.0
1

Hours on Shift

10

11

12

Folkard (2003) Estimated

relative risk on different
lengths of shift
1.3
1.2

Mean RR

1.1
1.0
.9
.8
.7
.6
.5
.4
1

Length of Shift (hours)

10

11

12

Folkard (2003) Estimated

relative risk on different
spans of 8, 12 h
1.8

Mean RR

1.6

1.4

1.2

1.0
8-hour
.8

12-hour
1

No of Successive Nights

Hours of work-relative
transport crash risk. Folkard,
(1997)

Hours of work -U.S.

F.M.C.S.A.

Shift work hazard control

strategies

Three Essential Shift Work

Hazard Control Measures
1. Adequate, good quality sleep
2. Suitable shift work schedules
3. Appropriate work conditions

1. Adequate, good quality

sleep

sleep hygiene
rules

Maintain pre-sleep routines similar to night

sleep
Bedroom dark and quiet
Avoid caffeine for 5 hrs before sleep
Avoid alcohol before sleep
Avoid exercise before sleep

napping
Naps can help maintain alertness,
performance, and safety
Naps can supplement insufficient sleep,
but
BEST if taken after 7-8hrs main sleep and
before feeling fatigued:
Nap at home before night shift
Nap early in the night shift
Nap before driving home after night shift

2. Suitable shift work

schedules

shift work
schedules
No one best shift work system
Employers should consider their
worker population and work tasks,
and decide, in collaboration with
workers, on the most suitable
schedule for their work place
Then evaluate the schedule

Recommendations
Rapid rotations are preferred to slow rotations
No more than 2 consecutive night shifts
Forward (clockwise) rotation of shifts
8hr shift length; 12hrs maximum
5-7 consecutive work days maximum
Fewer if shifts >8hrs or night shifts

recommendations
2 days off minimum after a block of shifts
More if shifts >8hrs or night shifts

11hrs off minimum between

consecutive shifts
Keep schedules regular and predictable, but
allow flexibility

3. Appropriate work
conditions

rest breaks
Regular rest breaks reduce accidents
Incorporate movement, stretching or
light exercise, social interaction
A proper meal break away from work
duties

work schedule
Employers should tailor work tasks
according to shift time; some tasks are
not suitable for night shift
Work tasks should vary during the shift
Schedule tasks so monotonous, boring,
dangerous, and safety critical tasks are
done early in the night shift

work environment
Bright lighting, comfortable temperature,
and good ventilation
Background music may help temporarily
Appropriate facilities for healthy eating
Napping facilities

Summary
Shift work is an OH&S hazard
employers and employees have a
duty of care to control or minimise
the hazards
Mutual responsibility is essential

 Employers duty of care to provide an

appropriate work schedule and work
environment, and continuing education
and training for workers about coping
strategies
Employees duty of care to follow the
recommended strategies to manage their
sleep, health, and family life