Shift Work and Health: Current Problems and Preventive Actions

Abstract

The paper gives an overview of the problems to be tackled nowadays by occupational health with regards to shift work as well as the main guidelines at organizational and medical levels on how to protect workers' health and well-being. Working time organization is becoming a key factor on account of new technologies, market globalization, economic competition, and extension of social services to general populations, all of which involve more and more people in continuous assistance and control of work processes over the 24 hours in a day. The large increase of epidemiological and clinical studies on this issue document the severity of this risk factor on human health and well being, at both social and psychophysical levels, starting from a disruption of biological circadian rhythms and sleep/wake cycle and ending in several psychosomatic troubles and disorders, likely also including cancer, and extending to impairment of performance efficiency as well as family and social life. Appropriate interventions on the organization of shift schedules according to ergonomic criteria and careful health surveillance and social support for shift workers are important preventive and corrective measures that allow people to keep working without significant health impairment.

Simulated Night Shift Disrupts Circadian Rhythms of Immune Functions in Humans

“…Thus, night shift leads to a disruption of the rhythmicity of the immune system, probably as a consequence of the desynchronization between the central and peripheral clocks, as we described previously when comparing central markers (e.g., cortisol and melatonin rhythms) with peripheral markers (e.g., clock gene expression in PBMCs) (35,39,40). Such a disruption might play a role in the increased incidence of various medical conditions in shift workers, such as the increased risk for infections, autoimmune diseases, cancer, and cardiovascular and metabolic disorders (2,(8)(9)(10)(11)(12)(13). Interestingly, an increased prevalence of autoimmune conditions, such as multiple sclerosis and autoimmune thyroid disorders, was associated with shift work (11,12,(60)(61)(62)(63).…”

“…In humans under a 28-h day protocol (forced desynchrony), altered leptin levels, as well as glucose and insulin response after meals (up to a prediabetic level), were observed when the circadian and behavioral cycles were misaligned compared with the days when they were well aligned (7). Thus, these circadian disturbances are thought to be an important contributor to shift work-associated medical disorders, such as increased risk for infection, autoimmune diseases, obesity, diabetes, cardiovascular disorders, and cancer (2,(8)(9)(10)(11)(12)(13).…”

Telework and health effects review

“…Metabolic disorders include hypertension, high cholesterol and higher fasting blood sugar levels. [49,50] Moreover, cancer is likely to be a negative effect of certain health imbalances created by work flexibility, and women's reproductive function is also potentially affected. [49] …”

Western lifestyle and immunopathology of multiple sclerosis

“…Shift work can be permanent or rotating, with or without night shifts. Importantly, an increasing amount of epidemiological studies have shown a strong evidence that shift work is associated with severe health conditions, including cardiovascular diseases, obesity, metabolic syndrome, type 2 diabetes, certain cancers, and gastrointestinal disorders and can bear a potential risk to reproduction 159. Research in the past decade also revealed the increased risk of autoimmune diseases, such as psoriasis,160 rheumatoid arthritis,161 systemic lupus erythematosus,162 and thyroid disorders163 linked to shift work.…”