Our complex technological industries make shiftwork an inevitable fact of life. Yet, studies have found that long-term disruptions in Circadian rhythm can have serious physiologic impact on the employee. Approximately 20 percent of shiftworkers never adapt to the health and social strains. The remaining 80 percent experience some degree of negative effect on their quality of life.

Shiftworkers face considerable challenges. It is common knowledge that more on-the-job accidents occur among shiftworkers, but the affect on the shiftworkers’ health, family and social life is less appreciated. Shiftwork has been associated with an increased risk of cardiovascular disease, gastrointestinal disorders, obesity, diabetes and obstructive sleep apnea. Sleep quality and quantity is typically lower which compromises immunity. The increased prevalence of health problems often results in an increased use of medication.

Shiftworkers rarely receive training on how to cope with these challenges. Considering a pre- and post-training study by Circadian Technologies of Lexington, Mass., this is very short-sighted. Their program demonstrated improvements in health and fatigue measurements and an increase in daytime sleep length. Companies who provide shiftwork lifestyle training see lower rates of absenteeism and turnover compared to companies that do not provide training.

Healthy lifestyle practices are critically important to the shiftworker. For instance, eating and sleeping are interconnected. Rich or spicy foods at bedtime make the digestive system work overtime … when it should be resting. Protein stimulates the brain, helping maintain energy levels and alertness. Carbohydrates promote calm by stimulating conversion of the amino acid tryptophan into serotonin.

The quick energy burst that comes from consuming sugar products is quickly followed by a physical and mental "crash." The ideal shiftworker diet should have a high protein main meal going into the shift. Throughout the shift, sugar products should be avoided. As the sleep cycle approaches, a lighter, bland meal of complex carbohydrates will help sleep come easier and be sustained.

Other topics appropriate to a "Healthy Shiftworker" program would be:

• Understanding the role of sleep on body function and immunity
• Shiftwork health risks
• How much sleep is enough?
• The importance of a regular sleep schedule (regardless of when sleep occurs)
• Strategies for staying alert while on the job
• Positive (and negative) impact of exercise on sleep
• The impact of stimulants and alcohol
• Staying connected with family and friends
• Problem-solving skills
• Pre-sleep rituals: winding down before sleep
• What to do when sleep doesn’t come
• When to nap (and when not to)
• Modifying the bedroom environment for daytime sleeping
• Filtering out noise: ear plugs, white noise machines, etc.
• The connection between exposure to light and quality sleep
• Dealing with daytime distractions that disturb sleep
• Pros and cons of non-prescription sleep aids
• When insomnia requires professional help
• Sleep pattern strategies for each type of shiftwork

"Healthy Shiftworker" programs will have the most impact when families are invited. They gain an understanding of the employee’s need for sleep, proper nutrition, and how best to organize household chores and family activities around their sleeping schedule.

What Else Can Wellness Managers Do?

Beyond the "Healthy Shiftworker" program, become an employee advocate to management on shiftwork issues. For instance, the optimal work schedule balances operational requirements, employee preferences, lifestyle issues and human factors that influence safety and performance. Surveys of facility managers show that employee involvement in developing work schedules (versus management mandate) leads to lower levels of absenteeism and turnover. This includes the responsible management of overtime and pulling double shifts.

Evaluate the nutrition options in the workplace. Encourage cafeteria coverage for all shifts. Screen vending machines for light, digestible food alternatives. Is there easy access to refrigerators and microwaves to increase shiftwork food options?

What is being done to assist the exhausted employee? Are excessively fatigued employees screened before driving home? Create an area where at-risk employees can nap before leaving.

Explore environmental strategies for boosting alertness. Manage, rather than ban, napping. Train management and shiftworkers on how to effectively use brief 15- to 20-minute naps to boost alertness.

What kind of support can be provided to the family? Help employees organize and negotiate child care arrangements. Organize special family days in the workplace. Support social activities for single shiftworkers.

Address: Circadian Technologies Inc., 24 Hartwell Avenue, Lexington, MA 02421; (781) 676-6900, www.circadian.com.