Shift Working

1   Overview / Introduction

2   Strategies and Practical Advice for Shift Workers

1    Overview / Introduction

What is shift work?

There is no specific definition of shift work in law but it usually means work activity scheduled outside standard daytime hours (7am to 7pm) where one employee replaces another or there is a handover of duty.

Night shift duty will be involved in a 24 hour covering shift. In the UK about 1 in 7 of all workers are involved in shift work.

What are the potential undesirable effects of shiftwork?

• Disruption of the normal body clock
• Fatigue
• Sleeping difficulties
• Disturbed appetite and digestion
• Social and domestic problems
• Exacerbation of conditions such as epilepsy or diabetes

Why can shiftwork have these effects?

Humans have an internal body clock that sets the cycle of our daily activities such as sleeping and alertness. External cues such as when we eat meals, exposure to light, and clocks play an important role in keeping this internal body clock set.

Shiftwork, and particularly nightwork, will disrupt these external cues, and although people’s adaptability means that we can resist the change to our internal clock for a while, and can even go without sleep temporarily, there is likely to be a reduction of the length and/ or quality of sleep which can lead to fatigue and poor performance during waking hours.

Levels of fatigue are also affected by personal factors where shift work can clash with domestic responsibilities and shift workers can find themselves spending more time with their family, or fulfilling domestic duties, at the cost of sleep.

Poorly designed work schedules can contribute to tiredness and fatigue where there are long shifts without breaks, or long sequences of night shifts. It is therefore important to design good shift patterns (see guidance for managers)

Individual susceptibility:

Individuals vary in their tolerance to shift work because some find it easier to fall asleep and fall asleep for longer, may naturally feel more alert at different times of the day (early morning people known as ‘Larks’, and late night people known as ‘Owls’) or have better coping and organisation strategies. Whilst we cannot change our inbuilt characteristics it is possible to adopt coping strategies to help (see guidance for shift workers).

Some workers are entitled to free night work health assessments.  See myRisks page Night Working for further information

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2  Strategies and Practical Advice for Shift Workers

Driving to and from work:

Driving to and work needs to be considered, particularly after a long shift, a night shift, or before an early start:

• Consider using public transport where possible
• Exercise briefly before your journey
• Share driving if possible
• Drive carefully and defensively
• Try not to hurry
• Stop if you feel sleepy and take a short nap if it is safe to do so
• Make occasional use of caffeine or energy drinks

Identify a suitable sleep schedule:

Most adults need 7-8 hours sleep a day. If you can’t achieve this try to rest as this is still beneficial. Recording sleep patterns and problems in a sleep diary may help you find what strategies work for you.

• Have a short sleep before your first night shift
• If coming off nights have a short sleep and try to go to bed earlier that night
• Once you have identified a suitable sleep schedule try to keep to it.

Make the environment favourable for sleeping:

Daytime sleep is usually lighter, shorter, and of poorer quality than night time sleep. It is more frequently disturbed because of warmer temperatures and daytime noise – to help you can:-

• Use your bedroom for sleeping and avoid activities such as watching television, eating, gaming and working
• Use heavy curtains, blackout blinds to darken the room as much as possible. Or use eyeshades
• Disconnect the phone or use an answering machine and turn the ringer down
• Ask your family not to disturb you whilst sleeping
• Discuss your work pattern with your neighbours and ask them to try to avoid noisy activities during your sleep time.
• If it is too noisy to sleep you can try earplugs to block out the noise
• Cool conditions improve sleep – use a duvet of a lower tog value if you find you are woken up by warm temperatures during your sleep.

Techniques to promote sleep:

• Go for a short walk, relax with a book, listen to music, or take a hot bath before going to bed.
• Avoid vigorous exercise just prior to sleep time as this raises body temperature
• Avoid caffeinated drinks (tea coffee, soft drinks) in the run up to bedtime.
• Don’t go to bed feeling hungry. Have a light meal or snack before sleeping, but avoid fatty, spicy and heavy meals.

Diet:

• Regular light meals are less likely to affect alertness or cause drowsiness than a single heavy meal.
• Choose foods that are easy to digest such as pasta, rice, salad fruit, vegetables and milk products and avoid eating too much
• Avoid fatty, spicy and heavy meals as they are more difficult to digest. They can make you feel drowsy when you need to be alert, and interfere with sleep when you need to rest
• Avoid sugary foods such as chocolate which provides a short term energy boost followed by a dip in energy levels
• Fruit and vegetables are good snacks.
• Make sure you drink plenty of fluid as this can help mental and physical performance, but avoid drinking too much fluid before sleeping as this will overload the bladder.

Stimulants and sedatives:

• Caffeine is a mild stimulant found in Tea, coffee and soft drinks/energy drinks. It can improve alertness over a short period of time. Only use caffeine occasionally and don’t rely on it to keep you awake. If you do decide to take caffeine or other stimulants you should consider what might happen when its effects wear off.
• Avoid the use of alcohol to help you fall asleep. Whilst it can promote the onset of sleep, sleep is more disturbed and of a poorer quality which may leave you less refreshed when you wake. Regular drinking of alcohol of course risks long term damage to your physical and mental health.
• Regular use of sleeping pills and other sedatives is not recommended because they can lead to dependency and addiction.

Physical fitness and a healthier lifestyle:

• You can improve your fitness by spending 30 minutes a day on physical activity such as housework, swimming, walking etc. Or consider joining a gym or taking part in a regular exercise class.
• Eat healthy meals on a regular basis
• Cut down or give up smoking
• Reduce your alcohol intake
• Seek advice from your doctor if you require regular medication for a condition

Family and friends:

• Talk to family or friends about shift work. If they understand the problems you are facing it will be easier for them to be supportive and considerate
• Make your family and friends aware of your shift schedule, so they can include you when planning social activities
• Make the most of your time off and plan mealtimes, weekends and evenings together
• Plan your domestic duties around your shift schedule, and do not complete them at the cost of rest/sleep
• Invite others who work similar shifts to join you in social activities when others are at work and there are fewer crowds

Ways to improve your alertness at work:

• Take moderate exercise before starting work
• Keep the light bright
• Take regular short breaks during the shift if possible
• Get up and walk around during these breaks
• Plan to do more stimulating work at the times you feel most drowsy
• Keep in contact with co-workers as this may help both you and them stay alert

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Risk Assessment

Managers are responsible for considering shift work, as part of the normal risk assessment process.

It is important that individuals and representatives are informed and consulted about shift work and shift work changes. Explain to staff what you are doing.

Consider who might be harmed by shift work, and particularly susceptible individuals such as young workers, older workers, those with pre-existing health conditions and new and expectant mothers.

Gather data on what shift work is being done and what hours individuals are working.

Be aware of other data such as ill health, accident data, absence rates, staff survey results etc that may indicate issues.

Gather information on what staff think of the shifts they do – remember there are some counterintuitive issues to consider like whilst 12 hour shifts are not ideal they allow individuals to do less shifts and get more time off compared to working shorter shifts. This may be particularly important for those with long journeys into work.

Unfortunately there is no single optimal shift system that will meet everyone’s needs.

However there are some general principles around shift work design that can contribute to improving the situation for shift workers – not all of which are always practicable bearing in mind the nature of the work being undertaken.

Good practice guidelines  (Based on the HSE guidance)

1. WORKLOAD

Schedule demanding tasks for when staff are more alert and least likely to be fatigued. Any safety critical work should be avoided during the night and towards the ends of long shifts. When work is particularly demanding consider shortening the length of the shift.

2. WORK ACTIVITY

Schedule a variety of tasks into the shift plan and if possible allow workers some choice in the order of completion of tasks during the shift. Agree how, and allow time for transmitting handover information to the next shift team.

3. PERMANENT NIGHT SHIFTS

Should be avoided where possible – If not make sure that those who work permanent night shifts or early morning shifts are aware of the risks.

4. ROTATION OF SHIFTS

There is some evidence that forward rotating shifts (i.e. where the worker progresses from early morning shift to afternoon shift to night shift) may help reduce sleep loss and fatigue. This is because it is easier for the body to lengthen rather than shorten the normal daily cycle.

5. SPEED OF ROTATION

If the shifts are rotated every 2-3 days, then the forward rotation of shifts is not quite so important. If fast rotation is not possible then slowly rotating shifts over at least a 3 week period is the next best option.

6. REST TIME

Ensure there is adequate rest time between shifts - the minimum is 11 hours

7. NIGHT SHIFTS

Some workers are better than others at adapting to night shifts. Sometimes individuals require a temporary change away from nights and a gradual reintroduction to help them, especially if other factors such as health or social difficulties are involved at the time. Whilst short term changes to night shift duties may be possible, if individuals cannot adapt to night shift working in the long term, and this is a requirement of their position, then they will have to consider moving to work where night shifts are not a requirement. This will depend on the availability of non night shift work may not always be possible.

8. EARLY STARTS

Unless strictly necessary for business need avoid early morning 7am starts

Limit shifts to a maximum of 12 hours and where monotonous dangerous or safety critical roles are undertaken to 8 hours.

9. BREAKS

Where possible allow workers some discretion over when they take a break, but discourage them from saving up break time in order to leave earlier. Build regular free weekends into the shift schedule where possible for social and domestic activities.

10. CONSECUTIVE SHIFTS

Limit consecutive working days to a maximum of 5-7.

Where night shifts or early morning start shifts are > 8 hours it would be better to set a limit of 2-3 consecutive shifts. Make sure shift swapping is monitored, and controlled where necessary, so that individuals are not circumventing good practice on consecutive shifts and becoming too fatigued.

11. SLEEP BETWEEN SHIFT CHANGES

When switching from day to night shifts or vice versa allow workers a minimum of 2 nights full sleep.

12. WORKPLACE ENVIRONMENT

Ensure that workplace lighting is adequate and adjustable by workers. Try where possible to provide similar facilities and opportunities for shift workers as those available to daytime workers.

13. OCCUPATIONAL HEALTH SUPPORT

Ensure those who regularly work night shifts are made aware of their entitlement to a health check questionnaire. If individuals are having health problems which they believe are related to their performance of shift work/ night shift work, then you should refer them to Occupational Health for advice.

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Further information is available:

From the HSE: http://www.sro.hse.gov.uk/PublicPages/ShowArticle.aspx?id=65

From BBC People Policies: BBC Agreed Statement C1a3 on Conditions of Service