Dolly Parton may have sung that working nine to five was no way to make a living, but research published during the week suggests that those who do shift work are living far unhealthier lifestyles than the rest of the working population.
Skipping meals, lack of physical activity and insufficient sleep are among the worst habits of those who work irregular hours, according to the new study by Safefood.
Compared with the rest of the workforce, shift workers are more likely to smoke, have higher rates of alcohol consumption, and more likely to be overweight.
More than 1,300 people participated in the study, including those working in the health and social care, hospitality, and manufacturing sectors – believed to be the first of its kind to look at the habits of those who work shifts across the island of Ireland.
The findings are stark: more than two in three of those surveyed reported skipping meals on work days and almost eight in 10 reported getting insufficient sleep.
The implications of this are unsurprisingly grim. The review of research that accompanied the survey found unequivocally that shift workers appear to be at an increased mental and physical health risk, particularly in relation to chronic disease.
11-hour breaks
The Health and Safety Authority has specific guidance for employers and employees on shift work. Shifts should be regular “if possible”, it says, adding that some employees may prefer the flexibility of rotating shifts, so a choice should be offered if practicable.
Forward rotating shifts, where the employee moves from morning to afternoon to night shifts, are preferable as the internal body clock adjusts more quickly to this, says the authority. They also note that rotating every two to three days has been found to be optimal.
The Health and Safety Authority also suggests a minimum time of 11 hours between shifts and no more than five to seven days of consecutive work, in order to allow sufficient rest between shifts.
With 15 per cent of the workforce employed in shift work between Northern Ireland and the Republic, the latest study points to a pressing need for education and interventions targeted specifically at this cohort.
University College Dublin’s Dr Clare Corish led the research team. The associate professor at the school of public health, physiotherapy and sports science explains that the impact of shift work on a person’s health is significant, with evidence showing it leads to physiological, psychological and behavioural changes. These can be permanent.
“It’s clear that you don’t really get used to doing shift work. You can try to minimise it but you never get over it. If you are working out of sync with your body clock, no matter what you do then it is going to be problematic.”
Indeed, Corish says the research team were surprised to learn that there were not just extrinsic factors at play – shops being closed, the presence of a vending machine, for example – but that intrinsic factors, such as self-control and organisation, also played a significant role.
“People who work shifts can sometimes feel a bit sorry for themselves and want to give themselves treats, which are invariably poor choices.” She adds that many of those surveyed were quick to accept that they deserved some of the “blame”.
“Quite a few people recognised that they could probably do more to improve their habits, but just weren’t that organised.” Another problem was peer pressure; “if everyone is having a pizza during a shift, it’s harder to reach for your soup or sandwiches”.
The study found that while health and social care workers have poorer access to healthier food options, and often an erratic, stressful work schedule, they tended to have healthier patterns of food consumption and lower rates of smoking.
Yet within the manufacturing industry where shifts and breaks tended to be more defined and regular, and facilities such as canteens more plentiful, workers tended to be more overweight, at 64 per cent (compared with 51 per cent of healthcare workers), and more likely to smoke.
Practical advice
The stark findings of the report led Safefood to conclude that there is a need for targeted approaches to address the range of issues raised by shift workers. These may need to be sector-specific in order to address the specific issues in each group.
“Our qualitative work showed that people wanted and needed really practical advice, such as how to get to sleep, what kind of foods they should be eating, how to plan meals. From a workplace perspective, more facilities are needed, not necessarily all-night canteens, but at least somewhere to put your sandwiches or food,” says Corish.
Tom Coleman of My Nutrition Ireland works with companies who employ shift workers to provide sleep workshops based around the emerging area of “fatigue science”.
“These sleep workshops offer practical information to help people manage their sleep/lifestyle patterns, nutrition and sleep hygiene. This helps reduce fatigue, increase productivity, energy levels and deal with practical issues,” he explains, adding that he can use wearable technologies developed by the US military to predict and identify fatigue risk.
Coleman’s workshops are in demand as more employers realise the benefits of a well-rested workforce.
“From the point of view of the employer, people are more alert, productive and sick less often. There are fewer accidents and better morale in general.”
The nurse
Paula Morrin is a midwife who works at one of the Dublin maternity hospitals, and previously worked in general nursing for 13 years. She readily admits that she eats “crap” due to her erratic working hours and says the findings of the research were very familiar. “It’s exactly like that.”
As a health service worker, Morrin works a very changeable roster which changes from week to week, making planning almost impossible. “My body clock is destroyed from mixing days and nights the whole time. I have been exhausted for 13 years.”
Morrin says her main problem is trying to give up smoking. “God knows I’ve tried, but I find it so difficult as you are kind of isolated working on nights and the odd cigarette break is so welcome.”
She adds that hospitals have smoking cessation officers but these don’t work the nights, nor does she get time to visit them during day shifts.
Exercise is out the window; Morrin was a scout leader for many years but had to give it up as she couldn’t commit to regular meetings.
She would like to lose weight but finds it difficult as she can’t avail of any social support. “I can’t join Slimming World or any club like that as I would miss it so often, it wouldn’t be worth my while.”
The factory worker
Brendan Hartley from Waterford has been working 12-hour shifts as a machine operator in a local manufacturing facility for almost 16 years. These change between days and nights every two weeks. He admits that he is “an exception” to the general rule, and is mostly mindful of his diet. He plays football twice a week, shift permitting, and walks the family dog.
“I make sure that I eat but I do see other guys who just don’t eat on nights. We do get our breaks and there is a microwave and tea and coffee, but the canteen isn’t open at night.
“There are vending machines and if people aren’t organised to bring in proper food they do tend to grab junk.”
Hartley admits he doesn’t get enough sleep and also says feels “out of it” while doing night shifts.
“When I come home at 8am, my three kids are heading off to school and college, and my wife is going to work. My reaction time is poor – often if you asked me what day it is while I am on nights I genuinely wouldn’t be able to answer. You’re just not 100 per cent.”
The hospitality worker
Kate De Courcy is the manager of a busy Dublin restaurant and has worked in the restaurant industry since her early 20s. She says the notoriously antisocial hours are “pretty standard”.
“I work between three doubles and two other shifts or two doubles and three other shifts depending on the week. I try, now that I’m in my 30s, to do fewer nights and this is a priority for me.”
She freely admits she has had a poor diet for years, and says that “coffee, cigarettes and snatched food standing up are the typical diet of a restaurant worker”, although she never took up smoking.
“A weekly shop is redundant as I am never at home at the same time each day. Meal prep is the same. I can often work on my feet for long hours so exercise can feel like the very last thing I want to do when I clock off. Fitting any type of fixed exercise routine around shift work can feel impossible.”
The research found that those with insufficient sleep were also significantly more likely to report that shift work increases their alcohol intake. De Courcy agrees that many restaurant workers feel a few drinks is a helpful passage to sleep.
“Sleep can be an issue for shift workers as you can go from a very adrenaline-filled few hours to lying in your bed within a half an hour. I am very lucky – I sleep the second I go home and I don’t need much time to unwind.”
