NIGHT WORKERS FACE ARRAY OF DIFFICULTIES
By Carol Milano
Do you have members whose hours are on the "graveyard
shift"? Whether they’re assigned to a hospital, a bus, or
a police beat, night workers experience a unique set of problems, including
health, social, and safety issues.
More than three million Americans are on duty through
the night, but they’re just a tiny fraction (3.5%) of the total
work force. Adjusting to a schedule that’s so different from "normal
hours" is difficult. It works against the body’s natural
daily rhythms, as well as society’s: night workers find their
schedules interfere with routine activities like shopping, attending
their children’s school activities, and eating regular meals.
However, according to long-time graveyard workers, people
often do adapt to the unusual pattern. Some even grow to like it. A
50-year-old nurse in Oakland, who’s had the night shift for 17
years, has come to appreciate the flexibility of her unconventional
hours. "I can decide to go home and go to sleep, or I can do errands
and shop, then sleep later on," she says. But she’s seen
co-workers who were completely unable to adjust, and actually became
physically ill when they tried to maintain an overnight schedule.
That’s not surprising -- graveyard shift workers
have a significantly higher incidence of serious diseases and disorders.
The major health hazards of working nights or rotating shifts include:
Sleep Deprivation. Getting enough "quality sleep"
is a serious challenge for workers on the night shift. Sleep is vital,
because it restores the brain and organs to keep the body running
smoothly. Over time, too little sleep will raise the risks for high
blood pressure and stroke. The nerve and chemical messages that control
the heart’s activity follow a regular 24-hour pattern, which
doesn’t change even when the sleeping schedule does. One result:
levels of the hormones needed to help workers stay alert and handle
the problems they’ll encounter on their night shift do not naturally
adjust to unusual hours. This puts added stress on the heart, increasing
the incidence of cardiovascular diseases among those on the graveyard
shift. Their rate of heart disorders is 40% higher than that of daytime
Research shows that daytime sleep is lighter and not as restful as
nighttime slumber. The effects of sleep deprivation can include poor
coordination; irritability, anxiety or depression; and short-term
memory loss. The immune system may become run-down, increasing the
likelihood of becoming ill. This explains why graveyard workers have
more colds, flu, and even menstrual problems than people with traditional
Diet and Digestion. Members on the night shift will probably be more prone to upset stomachs, ulcers, indigestion and constipation than those who work conventional hours. The incidence of stress-related gastrointestinal disorders is up to 150% higher among people working the graveyard shift. They’re far less likely to eat a nutritious diet, partly because they don’t get a chance to have meals at home with their families. With cafeterias and restaurants apt to be closed, vending machines may be their main source of food at work. When choices are available, night workers will often choose fatty foods for their 3 a.m. "lunch" breaks.
Weight Problems. The incidence of obesity is significantly
higher among graveyard workers, which greatly increases their risk
of diabetes. People may gain 20 or 30 pounds during their first months
on the night shift. What’s the cause of all these difficulties?
The unusual sleep and eating patterns of working at night disrupt
normal digestive patterns, which follow a "circadian rhythm"
of the physiological changes in a 24-hour day.
Cancer. Strange as it seems, the graveyard shift
may even increase cancer risk. A major study by Harvard University
found that nurses who’ve been working at night at least three
times a week, for 15 or more years, are 35% more likely to develop
colorectal cancer than nurses who never have night duty. The researchers’
theory is that lower levels of melatonin, a hormone which helps to
regulate sleep, may be a possible cause of greater cancer risk.
Substance Abuse. Many shift workers turn to both
prescription or over-the-counter drugs to help keep them awake and
alert through the night. They may use sleeping pills, alcohol, or
barbiturates to encourage sleep, and then turn to caffeine or stronger
stimulants while they’re working, when they’re expected
to be productive. Unfortunately, no matter how many cups of coffee
a member drinks during the graveyard shift, the impact is minimal
because the body still knows it’s actually the time for sleep.
The drugs night workers use can become habit-forming.
Others dangers are that they may have adverse effects on sleep, work,
and emotional well-being.
Safety and Social Problems
Yet another important difficulty is marital and social problems.
* Stress on Relationships. Ongoing sleep deprivation often makes people irritable. Combining crankiness with a schedule that makes it difficult for a member to see friends and family can strain relationships and connections to a spouse or children. For many night workers, trivial everyday issues -- even doing the laundry -- can lead to arguments.
Some husbands, wives or other partners can be very understanding about the
emotional effects of working an unusual schedule. In other cases, their tolerance eventually wears out. Sadly, divorce rates are as high as 60% among all-night workers.
* Safety Issues. One more problem seen among night workers relates to safety.
Experts find that those on the graveyard shift make five times as many serious
mistakes as people working days. They are also 20% more likely to have serious accidents.
How You Can Help Members
With all the special needs facing members on duty overnight,
these steps can help make the graveyard shift more pleasant and productive
Install brighter lights that simulate daylight.
Consider hiring a food service to bring in hot meals.
Where budget constraints make that impossible, install a refrigerator
and microwave to encourage members to eat more healthfully on their
Provide an orientation session, or even a video,
that prepares members to cope with the changes to their bodies and
their social lives when they’re on the graveyard shift.
Double the number of allowable absences for night
workers -- it can help reduce the number of accidents by as much as
Schedule safety training sessions a few times a year
to remind members of precautions they can take.
If at all possible, offer transportation home for
members coming off the overnight shift.
Encourage the planning of social events, such as
daytime bowling games, so that co-workers on graveyard shifts can
spend time together the way that daytime colleagues do.
Remind night workers to have regular physical exams
so they can be screened for diabetes, colorectal cancer, and other
common problems of the graveyard shift.
How Members Can Help Themselves
Offer members assigned to the graveyard shift a "tip
sheet" with specific suggestions for making their night work
more comfortable and manageable. These are some of the most helpful:
Post your work schedule at home, so your family can
try to plan around your hours. Explain to them and to friends and
neighbors what time of day you’ll be sleeping, so that they
can try not to disturb you then.
Assure friends and loved ones that you do want to
see them, but getting together will need to be carefully planned because
of your work schedule.
Make "dates" with your spouse or partner.
Agree on times when you’ll call home to chat with your children
and partner. If they’re anxious about being alone at night,
install a security system. Carry a beeper or cell phone so your family
can always reach you.
To get the 7 or 8 hours of sleep most people need
each day, darken your bedroom (drapes block both sound and light)
and make it as peaceful as possible. Take a warm bath; play relaxing
music before turning in. Avoid alcohol, caffeine, heavy or greasy
food, and anything that stimulates your brain, such as reading a thriller
or balancing your checkbook.
Light blocks the brain’s production of melatonin,
a natural chemical that makes us sleepy. So avoid bright daylight
for two or three hours before trying to sleep. If you must be out
during that period, wear dark sunglasses.
It may be tempting to sleep "regular" hours
on your days off, but avoid the urge – it will only make it
harder to adjust to the next workweek.
Diet has a big effect on energy and mood. Avoid sugary
or carbohydrate-rich foods before and during your shift. You may think
they’ll give you an energy burst to keep you awake and alert,
but your body might "crash" a few hours later. Don’t
snack; just eat one balanced meal while at work. If the cafeteria
and nearby restaurants are closed at night, bring a healthy "brown
bag" meal from home.
With an unusual work schedule, you can ignore the
typical meal patterns. If you want pancakes for "dinner"
with your family when you get home from work, it’s fine. So
is having a salad while your kids eat cereal, if that’s your
Do not leave the most boring, tedious tasks for the
end of your shift (usually between 4 and 6 am), because that’s
when you’ll be feeling the most tired.
Why is it worth offering as much assistance as possible
to your members on the graveyard shift? Because experts find that people
who are successful at working nights are those who like their jobs and
adopt constructive ways to cope with their unusual hours. Remind your
members that the keys to coping with the graveyard shift are to have
a positive attitude and take care of yourself.
of these articles appear on the publication's website, which are often
password-protected or members-only. For your convenience, I've gathered
them on my own website.