(2008) 'Shifting schedules : the health e ects of reorganizing shift work.', American journal of preventive medicine., 34 (5). pp. 427-434. Further information on publisher's website:http://dx.doi.org/10.1016/j.amepre. 2007.12.023 Publisher's copyright statement:Additional information:
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INTRODUCTIONShift work is an increasingly common form of work organisation. Around one fifth of workers are engaged in some kind of shift work. 1 Technological advances, changes in the economy, and the emergence of 24 hour societies 2,3 mean that shift work is no longer confined to the manufacturing and industrial sectors, and it is now an important aspect of employment in the retail and service sectors. Shift work continues to be commonplace amongst health care and emergency services personnel, with up to 50% of hospital staff working on shifts. 4 However, it remains socially patterned with a higher prevalence amongst lower socio-economic groups, 5 and so it is they who most experience the adverse consequences of shift work on health and work-life balance (WLB).Possible negative effects of shift work on health and WLB are well known. 1,[6][7][8] Reported health problems include sleep disturbances, fatigue, digestive problems, emotional problems and stress-related illnesses, as well as increases in general morbidity, and in sickness absence. 9 These problems may derive from disruption to physiological, psychological and social circadian rhythms. 6,7 Shift work, particularly that involving night work, disrupts the natural circadian rhythm as it requires people to be active at times when they would normally be sleeping and vice versa. 7 This leads to sleep problems (as natural alerting mechanisms such as the cortisol surge and temperature rise will interrupt sleep) as well as daytime functioning (wakefulness at night will be reduced by temperature drops and melatonin surges Most existing research emphasises the physiological changes which shift work induces, but shift work also involves significant social desynchronisation, involving working at times and on days that may make it difficult to maintain a balanced domestic and social life. 15 The Work Foundation defines work-life balance (WLB) as:"people having a measure of control over when, where and how they work. It is achieved when an individual"s right to a fulfilled life inside and outside paid work is accepted and respected as the norm to the mutual benefit of the individual, business and society". 16 It has been suggested that wor...
