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.

Health Problems

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 workers.
    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 hours.
  • 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 for them.

  • 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 late-night breaks.
  • 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 50%.
  • 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 preference.
  • 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.

Many 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.