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BACKGROUND: Whether hours on shift might impact adaptation to night shift work is still controversial. METHODS: We conducted a pooled analysis of two studies, including 170 hospital nurses working night shifts, 116 from a United Kingdom study working 12-hour rotating shifts, and 54 from Italy working 8-hour shifts. Both studies used the Epworth Sleepiness Scale (ESS) to detect sleepiness during routine daytime activities as an indicator of fatigue. We compared the prevalence of daytime sleepiness, as indicated by an ESS score≥11, resulting from either shift work schedule. We used logistic regression to calculate the risk of daytime sleepiness associated with 12-hour vs. 8-hour nightshifts, adjusting by age, sex, and parenting children aged≤4. RESULTS: When comparing similar work circumstances, nightshifts prolonged to 12 hours did not increase the risk of daytime sleepiness compared to 8 hours (OR=0.9, 95% CI 0.32, 2.59). CONCLUSIONS: Our results suggest that 12-hour rotating nightshifts with additional rest days and 8-hour rotating shift schedules do not differ in their impact on daytime sleepiness. Further research is warranted on what strategies might effectively contrast fatigue, circadian misalignment, and the related metabolic changes leading to adverse health outcomes, including cancer.
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Fadiga , Jornada de Trabalho em Turnos , Tolerância ao Trabalho Programado , Humanos , Itália/epidemiologia , Fadiga/epidemiologia , Fadiga/etiologia , Masculino , Feminino , Adulto , Reino Unido/epidemiologia , Jornada de Trabalho em Turnos/efeitos adversos , Pessoa de Meia-IdadeRESUMO
A growing body of evidence has placed an increasing emphasis on how sleep affects health. Not only does insufficient sleep make one subjectively feel worse, but is associated with chronic diseases that are considered epidemics in industrialized nations. This is partly caused by the growing need for prolonged work and social schedules, exemplified by shift work, late-night weekends, and early morning work/school start times (social jetlag). Here, we consider fundamental relationships between the circadian clock and biologic processes and discuss how common practices, such as shift work and social jetlag, contribute to sleep disruption, circadian misalignment, and adverse health outcomes.
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Síndrome do Jet Lag , Privação do Sono , Humanos , Síndrome do Jet Lag/fisiopatologia , Privação do Sono/fisiopatologia , Ritmo Circadiano/fisiologia , Tolerância ao Trabalho Programado , Relógios Circadianos/fisiologia , Sono/fisiologiaRESUMO
BACKGROUND: Working long consecutive hours' is common for anaesthesia and critical care physicians. It is associated with impaired medical reasoning's performance of anaesthesiology and serious medical errors. However, no study has yet investigated the impact of working long consecutive hours' on medical reasoning. OBJECTIVE: The present study evaluated the impact of working long consecutive hours' on the medical reasoning's performance of anaesthesiology and intensive care physicians (residents and seniors). METHODS: This multicentric, prospective, cross-over study was conducted in 5 public hospitals of Normandy region. Two groups of anaesthesia and critical care physicians were formed. One was in a rest group, RG (after a 48-hours weekend without hospital work) and the other in Sleep Deprivation Group (SDG) after a 24 h-consecutives-shift. Changes in medical reasoning's performance were measured by 69-items script concordance tests (SCT) through to the two tests. Group A completed the first part of the assessment (Set A) after a weekend without work and the second part (Set B) after a 24 h-shift; group B did the same in reverse order. The primary outcome was medical reasoning's performance as measured by SCT in RG and SDG. The secondary outcomes included association between the performance with the demographic data, variation of the KSS (Karolinska sleepiness scale) daytime alertness score, the number of 24 h-shift during the previous 30 days, the vacations during the previous 30 days, the presence of more or less than 4 h consecutives hours slept, the management of a stressful event during the shift, the different resident years, the place where the shift took place (University hospital or general hospitals) and the type of shift (anaesthesia or intensive care). RESULTS: 84 physicians (26 physicians and 58 residents) were included. RG exhibited significantly higher performance scores than SDG (68 ± 8 vs. 65 ± 9, respectively; p = 0.008). We found a negative correlation between the number of 24 h-shifts performed during the previous month and the variation of medical reasoning's performance and no significant variation between professionals who slept 4 h or less and those who slept more than 4 h consecutively during the shift (-4 ± 11 vs. -2 ± 11; p = 0.42). CONCLUSION: Our study suggests that medical reasoning' performance of anaesthesiologists, measured by the SCT, is reduced after 24 h-shift than after rest period. Working long consecutive hours' and many shifts should be avoided to prevent the occurrence of medical errors.
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Anestesiologia , Estudos Cross-Over , Internato e Residência , Privação do Sono , Humanos , Estudos Prospectivos , Masculino , Feminino , Anestesiologia/educação , Adulto , Médicos , Raciocínio Clínico , Pessoa de Meia-Idade , Tolerância ao Trabalho Programado , Competência ClínicaRESUMO
Importance: Extended work hours and night shifts are essential in health care, but negatively affect physician sleep, well-being, and patient care. Alternative schedules with shorter work hours and/or reduced irregularity might mitigate these issues. Objective: To compare sleep, well-being, and cognition between interns working irregular, extended shifts (call schedule), and those working a more regular schedule with restricted hours (float schedule). Design, Setting, and Participants: In this observational longitudinal cohort study, interns in a Singapore-based teaching hospital were studied for 8 weeks from January 2022 to July 2023. Data were analyzed from July 2023 to July 2024. Exposure: Participants worked either regular approximately 10-hour workdays, interspersed with 24 hour or more overnight calls 4 to 5 times a month, or a float schedule, which included regular approximately 10-hour workdays, and 5 to 7 consecutive approximately 12-hour night shifts every 2 months. Exposure was based on departmental training and operational needs. Main Outcomes and Measures: Sleep was measured with wearable sleep trackers and an electronic diary. Day-to-day well-being and cognitive assessments were collected through a smartphone application. Assessments included the Sleep Regularity Index (SRI; determines the probability of an individual being in the same state [sleep or wake] at any 2 time points 24 hours apart, with 0 indicating highly random sleep patterns and 100 denoting perfect regularity) and Pittsburgh Sleep Quality Inventory (PSQI; scores ranges from 0 to 21, with higher scores indicating poorer sleep; a score greater than 5 suggests significant sleep difficulties). Results: Participants (mean [SD] age, 24.7 [1.1] years; 57 female participants [59.4%]; 41 on call schedule [42.7%]; 55 on float schedule [57.3%]) provided 4808 nights of sleep (84.2%) and 3390 days (59.3%) of well-being and cognition assessments. Participants on a float schedule had higher SRI scores (mean [SD] score, 69.4 [6.16]) and had better quality sleep (PSQI mean [SD] score, 5.4 [2.3]), than participants on call schedules (SRI mean [SD] score, 56.1 [11.3]; t91 = 6.81; mean difference, 13.3; 95% CI, 9.40 to 17.22; P < .001; PSQI mean [SD] score, 6.5 [2.3]; t79 = 2.16; 95% CI, 0.09 to 2.15; P = .03). Overnight call shifts, but not night float shifts, were associated with poorer mood (-13%; ß = -6.79; 95% CI, -9.32 to -4.27; P < .001), motivation (-21%; ß = -10.09; 95% CI, -12.55 to -7.63; P < .001), and sleepiness ratings (29%; ß = 15.96; 95% CI, 13.01 to 18.90; P < .001) and impaired vigilance (21 ms slower; ß = 20.68; 95% CI, 15.89 to 25.47; P < .001) compared with regular day shifts. Night shifts with naps were associated with better vigilance (16 ms faster; ß = -15.72; 95% CI, -28.27 to -3.17; P = .01) than nights without naps. Conclusions and relevance: In this cohort study, 24-hour call schedules were associated with poorer sleep, well-being, and cognition outcomes than float schedules. Naps during night shifts benefited vigilance in both schedules.
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Cognição , Internato e Residência , Sono , Tolerância ao Trabalho Programado , Humanos , Feminino , Masculino , Adulto , Cognição/fisiologia , Tolerância ao Trabalho Programado/psicologia , Estudos Longitudinais , Sono/fisiologia , Singapura , Jornada de Trabalho em TurnosRESUMO
BACKGROUND: Working during the night interferes with the timing of normal daily activities and is associated with an increased risk of chronic diseases. Under controlled experimental conditions, interventions focusing on sleep and nutrition can mitigate the short-term adverse effects of shift work. However, it is unclear how these results translate to real-life, how they can be targeted to individual conditions, and how they relate to long-term health. Therefore, the current study aims to implement a personalized sleep and nutritional intervention among night shift workers in the field. METHODS: A non-blinded controlled intervention study is used, consisting of a run-in period, an intervention of 3 months, post-intervention measurements, and a follow-up after 12 months. Three study arms are included: sleep intervention, nutritional intervention, and control group (n = 25 each). Participants are healthy 18-60-year male night shift workers, with at least one year of experience in night shift work. Information from the run-in period will be used to personalize the interventions. The main outcomes are sleep measurements and continuous interstitial glucose levels. Furthermore, general health biomarkers and parameters will be determined to further evaluate effects on long-term health. DISCUSSION: This study aims to mitigate negative health consequences associated with night shift work by introducing two personalized preventive interventions. If proven effective, the personalized interventions may serve as practical solutions that can have a meaningful impact on the sustainable health and employability of night shift workers. This study will thereby contribute to the current need for high-quality data on preventative strategies for night shift work in a real-life context. TRIAL REGISTRATION: This trial has been registered under ClinicalTrials.gov Identifier NCT06147089. Registered 27 November 2023.
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Jornada de Trabalho em Turnos , Sono , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Sono/fisiologia , Adolescente , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Tolerância ao Trabalho Programado/fisiologiaRESUMO
This study aimed to determine the relationship between melatonin hormone levels, sleep, and factors affecting sleep, psychological resilience, and depression in nurses working with a shift work system. Conducted between February 5-12, 2021, at the Training and Research Hospital in Agri province, the descriptive study included 41 night shift nurses and 35 day shift nurses, totaling 76 participants. Blood samples for melatonin analysis were collected and data were gathered using the Sociodemographic Information Form, Epworth Sleepiness Scale, Sleep Disorder Scale Short Form, Brief Psychological Resilience Scale, and Beck Depression Scale Short Form. Melatonin analysis was performed using the ELISA method. Statistical significance was set at p < 0.05. Results showed that sleep disorders were present in all nurses with <7 h of daily sleep. Factors such as the use of sleeping pills, marital status, age, and gender affected sleep disorders. Mean scores for melatonin levels were 67.82 ± 40.20 for night shift nurses and 68.08 ± 39.62 for day shift nurses, with no significant difference between shifts. Similarly, no significant differences were found in daytime sleepiness (7.49 ± 4.47 vs. 7.51 ± 4.65), sleep disturbance (24.71 ± 7.33 vs. 25.23 ± 6.64), psychological resilience (18.42 ± 4.19 vs. 17.89 ± 4.74), or depression (3.22 ± 2.60 vs. 3.49 ± 3.35). Nurses exhibited mild sleep disturbances, low depression tendencies, and moderate psychological resilience. Increased daytime sleepiness and sleep disorders correlated with higher depression tendencies and lower psychological resilience. Hospital management and education units are recommended to conduct interventions on sleep quality, depression, and psychological resilience to raise awareness among nurses.
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Depressão , Melatonina , Humanos , Feminino , Melatonina/sangue , Masculino , Adulto , Depressão/psicologia , Depressão/sangue , Enfermeiras e Enfermeiros/psicologia , Turquia , Jornada de Trabalho em Turnos/psicologia , Inquéritos e Questionários , Resiliência Psicológica , Tolerância ao Trabalho Programado/psicologia , Tolerância ao Trabalho Programado/fisiologia , Transtornos do Sono-Vigília/sangue , SonoRESUMO
. Impact of 12-hour shifts on nurse, patient and organizational outcomes. A critical review. INTRODUCTION: The use of 12-hour shifts has been considered beneficial in reducing staffing costs, attracting more nurses, improving work-life balance, and organizing care more efficiently. OBJECTIVE: The aim of this review is to critically examine the available evidence on the impact of 12-hour shifts on nurse, patient, and organizational outcomes. METHODS: A critical review of the literature was undertaken. Quantitative, qualitative and mixed methods studies analyzing the effect of long shifts (>12 working hours) were included. The search was performed on MEDLINE through PubMed and Cinhal. RESULTS: Fifty-four articles were included, covering publications from 1976 to 2024. Evidence suggests that nursing care and patient safety may deteriorate with 12-hour shifts, with mixed findings on continuity of care. 12-hour shifts can lead to increased nurses' fatigue, without a decrease in job performance, and can have negative impacts on physical health, continuing education, burnout, and job satisfaction. While qualitative studies indicate improved work-life balance, this is not supported by empirical evidence. One study suggests a decrease in costs, but the effects on sick leave are inconclusive. Additionally, intention-to-leave among nurses appears to increase. CONCLUSIONS: The evidence generally does not support the use of 12-hour shifts. However, due to methodological limitations in the included studies, firm conclusions cannot be drawn. Organizations and nurses should carefully consider the introduction of 12-hour shifts, evaluating nurses' needs and implementing patient-centered care models that support nursing professionalism, along with a continuous monitoring of patient, nurse, and organizational outcomes.
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Satisfação no Emprego , Admissão e Escalonamento de Pessoal , Humanos , Admissão e Escalonamento de Pessoal/organização & administração , Recursos Humanos de Enfermagem Hospitalar/organização & administração , Segurança do Paciente , Esgotamento Profissional/prevenção & controle , Tolerância ao Trabalho Programado , Jornada de Trabalho em Turnos , Fadiga , Equilíbrio Trabalho-VidaRESUMO
OBJECTIVE: Surgical resident schedules are demanding. Despite ACGME requirements that residents be able to attend personal appointments, many residents put off essential health tasks due to work hours. We designed a method for surgical residents to request a "flex" or personal day utilizing an online system for requesting and tracking. DESIGN: Residents were given 5 days to use during 1 academic year. A float rotation was implemented to cover scheduled absences. We conducted an anonymous REDCap survey pre and postimplementation regarding resident ability to attend personal appointments and wellbeing. The results of these surveys were compared using descriptive statistics, t-test, and chi-square testing. SETTING: Single large academic training institution. PARTICIPANTS: Sixty general surgery residents. RESULTS: Over 9 months, we scheduled 195 flex days and 91% of residents had used the program. The most common uses were travel, time with family/friends, and attending personal health appointments Postimplementation, of residents who needed an appointment, an increased percentage attended a physician (92% vs. 71%, p 0.02), dental (94% vs. 65%, p < 0.01) or mental health (96% vs. 64%, p < 0.01) appointment. A decreased percentage delayed a necessary appointment due to work hours (45% vs. 19.5%, p 0.01), 94% reported improved schedule control, and 100% believed the program was important for wellbeing. When comparing Mayo Wellbeing Index scores pre and postimplementation there was a decrease in the number of trainees reporting high distress (18.8% vs. 29.3%, p 0.03). Postimplementation, our program noted an 80% decrease in the number of duty hours violations (16 vs. 3 violations) and a 12% increase in compliance with the ACGME survey for ability to attend personal appointments. CONCLUSION: "Flex" days offer surgical residents improved schedule control and the ability to schedule essential personal appointments. They are feasible, even within large training programs, with significant uptake in our sample.
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Agendamento de Consultas , Cirurgia Geral , Internato e Residência , Cirurgia Geral/educação , Humanos , Feminino , Masculino , Adulto , Tolerância ao Trabalho Programado , Educação de Pós-Graduação em Medicina/métodos , Admissão e Escalonamento de Pessoal , Inquéritos e Questionários , Carga de TrabalhoRESUMO
BACKGROUND: Night float rotations are associated with decreased feedback, educational conference attendance, and operative time. Interns are also more isolated and spend less time on teams. We therefore developed a novel post night shift initiative to address these shortcomings and examined its impact on the educational experience and sense of belonging among interns. METHODS: A program of weekly senior resident-led post night shift sessions was instituted at a university-based general surgery residency program for the first quarter of the academic year. Four interns and one senior resident participated in each session. Feedback surveys were administered. A previously validated Belonging in Surgery survey was also administered to all general surgery interns at the end of the quarter. RESULTS: Eleven interns had night float rotations within the first 3 months of the academic year. The intern feedback survey response rate was 93% (10/11). All intern respondents attended at least 3 sessions. Interns felt that the sessions increased familiarity with each other (85%) and senior residents (92%), improved clinical decision making (77%), and provided a safe space for discussion (69%). The senior resident survey response rate was 86% (nâ¯=â¯14). All senior residents enjoyed teaching the sessions and felt that they improved their familiarity with interns. The intern belonging survey response rate was 84% (16/19). Categorical interns had significantly higher belonging scores than preliminary interns at the end of the first quarter (mean 48.1 vs 41.6, pâ¯=â¯0.009). There was a trend toward decreased belonging scores for interns who had night float rotations early in the year which did not meet statistical significance (42.9 vs 47.4, pâ¯=â¯0.059). CONCLUSION: This novel program improved intern decision-making, familiarity with other residents, and comfort calling senior residents for assistance overnight. There was no statistically significant difference in belonging between interns who started residency on night float versus those who did not. Similar programs may help address concerns regarding missed learning opportunities and decreased sense of community during these rotations.
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Cirurgia Geral , Internato e Residência , Projetos Piloto , Cirurgia Geral/educação , Humanos , Jornada de Trabalho em Turnos , Educação de Pós-Graduação em Medicina/métodos , Masculino , Feminino , Competência Clínica , Tolerância ao Trabalho Programado , Inquéritos e Questionários , AdultoRESUMO
OBJECTIVES: This study aimed to investigate factors that influence the sleep quality and menstrual cycles of female rotating-shift nurses. METHODS: A cross-sectional study was conducted in which 213 female rotating-shift nurses between the ages of 20 and 45 were recruited from a medical center in Taiwan from November 1, 2023, to December 31, 2023. Binary logistic regression analysis was performed with regard to sleep quality or menstrual cycle. RESULTS: Female rotating-shift nurses who perceived a higher level of stress (P < .001), were late chronotypes (P = .020), or were working the night shift (P = .006) were more likely to have poor sleep quality. Late-type nurses working the day shift were more likely to have poor sleep quality than were early- and intermediate-type nurses (P < .001). With regard to menstrual cycles, female rotating-shift nurses who perceived a higher level of stress (P = .008), were working the night shift (P < .001), or had poor sleep quality (P = .001) were more likely to have irregular menstrual cycles. Late-type nurses working the day shift were more likely to have irregular menstrual cycles than were early- and intermediate-type nurses (P = .013). CONCLUSIONS: A higher likelihood of poor sleep quality was found in female rotating-shift nurses when they perceived high levels of stress, and the interactions between chronotype and shift type could influence sleep quality. Shift type and the interactions between chronotype and shift type could also influence menstrual regularity.
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Jornada de Trabalho em Turnos , Qualidade do Sono , Humanos , Feminino , Adulto , Estudos Transversais , Taiwan , Pessoa de Meia-Idade , Tolerância ao Trabalho Programado/fisiologia , Adulto Jovem , Ciclo Menstrual/fisiologia , Inquéritos e Questionários , Recursos Humanos de Enfermagem Hospitalar/psicologia , Estresse Ocupacional , Distúrbios Menstruais , Ritmo Circadiano/fisiologia , CronotipoRESUMO
OBJECTIVE: This study aimed to prospectively investigate associations of working night shifts with weight gain in the Nightingale Study, a large cohort of female nurses. METHODS: This study included 36 273 registered nurses, who completed questionnaires in 2011 and 2017. Cumulative number of nights, mean number of nights/month and consecutive number of nights/month in 2007-2011 were assessed. We used Poisson regression to estimate multivariable-adjusted incidence rate ratios (IRR) of >5% weight gain from 2011 to 2017 among all participants and assess risk of development of overweight/obesity (BMI≥25 kg/m2) among women with healthy baseline body mass index. The reference group consisted of women who never worked nights. RESULTS: Overall, working night shifts in 2007-2011 was associated with >5% weight gain [IRR 1.07, 95% confidence interval (CI) 1.01-1.13]. Associations differed by menopausal status in 2011, with an increased risk of gaining >5% weight limited to postmenopausal women who worked nights (IRR 1.23, 95% CI 1.10-1.38). Postmenopausal women had an increased risk of >5% weight gain when they worked on average ≥4 nights/month (4-5: IRR 1.29, 95% CI 1.09-1.52, ≥6: IRR 1.27, 95% CI 1.11-1.47) or ≥4 consecutive nights/month (IRR 1.37, 95% CI 1.19-1.58), compared to postmenopausal women who never worked nights. For postmenopausal women with healthy weight at baseline, night shift work was associated with an increased risk of overweight/obesity at follow-up (IRR 1.24, 95% CI 1.03-1.50). CONCLUSIONS: Working night shifts was associated with a slightly increased risk of weight gain and overweight/obesity development among women who were postmenopausal at study inclusion. Our findings emphasize the importance of health promotion to maintain a healthy weight among (postmenopausal) night workers.
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Enfermeiras e Enfermeiros , Jornada de Trabalho em Turnos , Aumento de Peso , Humanos , Feminino , Estudos Prospectivos , Jornada de Trabalho em Turnos/efeitos adversos , Países Baixos/epidemiologia , Adulto , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Inquéritos e Questionários , Tolerância ao Trabalho Programado/fisiologia , Obesidade/epidemiologia , Índice de Massa Corporal , Sobrepeso/epidemiologia , Fatores de RiscoRESUMO
Shift work tolerance (SWT) refers to the ability to adapt to shift work without significant adverse consequences. The present study aimed to examine the individual differences in SWT and their predictors and outcomes. Latent profile analyses were conducted using cross-sectional data collected form 448 Chinese male sailors who experienced a prolonged (>30 d) non-24-h rotating shift schedule at sea. Depression, anxiety, sleep disturbance, fatigue, domestic disruption, job satisfaction, work engagement, digestive and cardiovascular symptoms were included as indicators of SWT. The results showed that there existed 2 latent profiles of SWT named as High SWT group and Low SWT group. High SWT group was characterized by low levels on all negative bio-psycho-social outcomes but high levels of work engagement and job satisfaction, while Low SWT group exhibited completely opposite characteristics compared to High SWT group. The level of hardiness could predict profile membership that those with higher level of hardiness were more likely to belong to High SWT group. However, there were no significant differences observed in job performance between two groups. In conclusion, hardiness can serve as a predictor of personnel selection for shift work and hardiness-based intervention programs should be encouraged among the shift workers.
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Ritmo Circadiano , Jornada de Trabalho em Turnos , Tolerância ao Trabalho Programado , Humanos , Masculino , Adulto , Tolerância ao Trabalho Programado/fisiologia , Ritmo Circadiano/fisiologia , Estudos Transversais , Militares , Satisfação no Emprego , China , Fadiga , Navios , Adulto Jovem , Sono/fisiologia , Ansiedade , Inquéritos e Questionários , População do Leste AsiáticoRESUMO
INTRODUCTION: Rotating shiftwork schedules are known to disrupt sleep in a manner that can negatively impact safety. Consumer sleep technologies (CSTs) may be a useful tool for sleep tracking, but the standard feedback provided by CSTs may not be salient to shift-working populations. SleepTank is an app that uses the total sleep time data scored by a CST to compute a percentage that equates hours of sleep to the fuel in a car and warns the user to sleep when the "tank" is low. Royal Australian Navy aircraft maintenance workers operating on a novel rotational shift schedule were given Fitbit Versa 2s to assess sleep timing, duration, and efficiency across a 10-week period. Half of the participants had access to just the Fitbit app while the other half had access to Fitbit and the SleepTank app. The goal of this study was to evaluate differences in sleep behavior between shifts using an off-the-shelf CST and to investigate the potential of the SleepTank app to increase sleep duration during the 10-week rotational shift work schedule. MATERIALS AND METHODS: Royal Australian Navy volunteers agreed to wear a Fitbit Versa 2 with the SleepTank app (SleepTank condition), or without the SleepTank app (Controls), for up to 10 weeks from May to July 2023 during the trial of a novel shift rotation schedule. Participants from across 6 units worked a combination of early (6:00 AM to 2:00 PM), day (7:30 AM to 4:30 PM), late (4:00 PM to 12:00 AM), and night shifts (12:00 AM to 6:00 AM) or stable day shifts (6:00 AM to 4:00 PM). Differences in sleep behavior (time in bed, total sleep time, bedtime, wake time, sleep efficiency [SE]) between conditions and shift types were tested using Analysis of Variance. This study was approved by the Australian Departments of Defence and Veterans' Affairs Human Research Ethics Committee. RESULTS: Thirty-four participants completed the full study (n = 17 Controls; n = 17 SleepTank). There was a significant effect of shift type on 24-hour time in bed (TIB24; F(4,9) = 8.15, P < .001, η2 = 0.15) and total sleep time (TST24; F(4,9) = 8.54, P < .001, η2 = 0.18); both were shorter in early shifts and night shifts compared to other shift types. TIB24 and TST24 were not significantly different between conditions, but there was a trend for greater SE in the SleepTank condition relative to Controls (F(1,9) = 2.99, P = .08, η2 = 0.11). CONCLUSIONS: Sleep data collected by Fitbit Versa 2s indicated shorter sleep duration (TIB24, TST24) for Royal Australian Navy workers during early and late shifts relative to stable day shifts. Access to the SleepTank app did not greatly influence measures of sleep duration but may be protective against fatigue by affecting SE. Further research is needed to evaluate the utility of the SleepTank app as a means of improving sleep hygiene in real-world, shift-working environments.
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Militares , Aplicativos Móveis , Sono , Humanos , Masculino , Adulto , Austrália/epidemiologia , Aplicativos Móveis/estatística & dados numéricos , Aplicativos Móveis/normas , Feminino , Sono/fisiologia , Militares/estatística & dados numéricos , Tolerância ao Trabalho Programado/fisiologia , Tolerância ao Trabalho Programado/psicologia , Pessoa de Meia-Idade , Jornada de Trabalho em Turnos/estatística & dados numéricos , Jornada de Trabalho em Turnos/efeitos adversos , Jornada de Trabalho em Turnos/psicologiaRESUMO
This study aimed to investigate the change in diet quality in addition to dietary adherence to the planetary health diet during night shifts in healthcare workers. This observational follow-up study involved 450 healthcare workers working night shifts (327 females, 123 males). A survey form requesting sociodemographic information (gender, age, marital status), job title, sleeping duration during the night shift, 24 h dietary records for pre-night-shift, during night shift, and post-night-shift, and anthropometric measurements (body weight and height) was applied. The scores of the Planetary Health Diet Index (PHDI) and the Healthy Eating Index 2020 (HEI-2020) were calculated according to the dietary records. The total HEI-2020 and PHDI scores decreased significantly (p < 0.05) during the night shift (44.0 ± 8.8 and 48.3 ± 13.2, respectively) compared to pre-night-shift (46.1 ± 9.2 and 51.9 ± 13.4, respectively) and increased post-night-shift (44.7 ± 9.9 and 50.6 ± 14.9, respectively), with no statistically significant difference between pre- and post-night-shift. There was a significant main effect of night shift working on total PHDI (F(896, 2) = 8.208, p < 0.001, ηp2 = 0.018) and HEI-2020 scores (F(894, 2) = 6.277, p = 0.002, ηp2 = 0.014). Despite healthcare workers' knowledge of health factors, night shifts lead to poor dietary choices. To improve diet quality and sustainability, it is crucial to enhance access to healthy food options in their work environment.
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Dieta Saudável , Dieta , Pessoal de Saúde , Jornada de Trabalho em Turnos , Humanos , Feminino , Masculino , Adulto , Pessoal de Saúde/estatística & dados numéricos , Seguimentos , Dieta Saudável/estatística & dados numéricos , Dieta/estatística & dados numéricos , Pessoa de Meia-Idade , Tolerância ao Trabalho Programado/fisiologia , Sono , Comportamento AlimentarRESUMO
BACKGROUND: This study examines working hours, shift work, and remote work patterns by occupation and industry among U.S. full-time workers, along with the association between working and sleeping hours. METHODS: Utilizing data from 2011 to 2020 American Time Use Survey, this national household survey examines how individuals aged 15 years or older in the United States spend their time within a 24-hour period. FINDINGS: In 2011 to 2019, U.S. full-time workers averaged 8.1 hours of work and 7.8 hours spent sleep on workdays, increasing to 9.6 hours on non-workdays. Among all occupations, Emergency medical technicians and paramedics had the longest average working hours (10.4 hours). Protective services occupations had the highest percentage (41.7%) of workers reporting often working shifts other than daytime. Among all industries, truck transportation industry had the longest average working hours (9.2). Food services and drinking places industries had the highest percentage (28.6%) of workers reporting often working shifts other than daytime. Working hours showed a negative association with sleeping hours. In 2020, 34.0% of full-time workers reported remote work due to COVID-19, with the largest percentage (72.3%) occurring in business and financial operations. CONCLUSIONS: The study findings offer essential benchmarks for comparing working hours and schedules across diverse occupations and industries. These insights empower occupational health practitioners to advocate for prevention measures, addressing health concerns arising from prolonged working hours and shift work.
Assuntos
COVID-19 , Ocupações , Humanos , Estados Unidos , Adulto , Feminino , Masculino , Pessoa de Meia-Idade , COVID-19/epidemiologia , COVID-19/prevenção & controle , Ocupações/estatística & dados numéricos , Indústrias/estatística & dados numéricos , Tolerância ao Trabalho Programado , Teletrabalho/estatística & dados numéricos , Inquéritos e Questionários , Adolescente , Adulto Jovem , Jornada de Trabalho em Turnos/estatística & dados numéricosRESUMO
Bus driver sleepiness is commonplace but often goes unreported within the industry. Whilst past research has begun to shed a light on the prevalence, potential causes, and consequences of bus driver sleepiness, this is often done using self-report methods. This is the first study to investigate sleepiness amongst city bus drivers on-road using a live bus route with drivers' regular schedules. A total of 16 participants completed two drives of their regular bus route once during an early morning shift and once during a daytime shift whilst physiological and self-report measures of sleep and stress were taken. Prior to these drives, drivers recorded their sleep in a diary and wore an actigraph to obtain objective sleep measures. Results showed that most drivers did not obtain sufficient sleep prior to early morning shifts, and often did not obtain as much sleep as they would need in order to feel rested before work. Sleepiness and stress were observed in both shifts. During early morning shifts sleepiness was likely a result of working during circadian lows and not obtaining enough sleep prior to the shift. In contrast, sleepiness during the daytime shift was likely a result of completing a highly demanding task in complex traffic which not only contributed to fatigue, but also led to increased levels of stress. As well as demonstrating the prevalence of sleepiness amongst bus drivers, these findings show that the causes of sleepiness can be multifaceted and often come about due to a combination of work and personal factors. In addition, the experience of sleepiness is not the same for all drivers, with individual differences in the experience of sleepiness playing a large role. These differences highlight the need for individualised interventions which should be considered by policymakers alongside the combination of causal factors within a larger systems approach.
Assuntos
Condução de Veículo , Veículos Automotores , Humanos , Masculino , Adulto , Condução de Veículo/psicologia , Pessoa de Meia-Idade , Feminino , Londres/epidemiologia , Sonolência , Actigrafia , Fadiga/fisiopatologia , Estresse Psicológico , Tolerância ao Trabalho Programado/fisiologia , Sono/fisiologia , Estresse Ocupacional , AutorrelatoRESUMO
Recent studies suggest that shift working may trigger health issues through disrupted circadian rhythms and altered eating habits. This study aimed to examine the possible associations of shift work with sleep quality, diet quality and obesity-related parameters. This study was conducted with 150 males (75 shift and daytime workers) aged 24-50 years. Dietary intake was determined using the 24-hour recall method, and dietary quality was evaluated using the Healthy Eating Index-2010 (HEI-2010). Anthropometrical measurements and body composition were assessed. The Pittsburgh Sleep Quality Index was used to evaluate sleep quality. Fasting and postprandial glucose and insulin, and fasting lipid levels were analyzed. HOMA-IR was calculated, and blood pressure was measured. The total HEI-2010 score of shift workers (52.6 [45.4-58.8]) was lower than the daytime workers (55.9 [49.1-64.9]) (p = 0.016). Among individuals with good sleep quality, the total HEI-2010 score, seafood and plant proteins, fatty acids, and sodium scores were lower in shift workers compared to others (p < 0.05 for each). Non-obese shift workers had higher body weight, waist circumference, waist/hip ratio, VLDL-cholesterol, triglyceride, postprandial glucose, and insulin levels compared to daytime workers (p < 0.05 for each). This study demonstrates that shift working is associated with lower diet quality independent of sleep quality.
Assuntos
Ritmo Circadiano , Obesidade , Jornada de Trabalho em Turnos , Qualidade do Sono , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Ritmo Circadiano/fisiologia , Dieta , Adulto Jovem , Comportamento Alimentar/fisiologia , Glicemia/metabolismo , Sono/fisiologia , Tolerância ao Trabalho Programado/fisiologiaRESUMO
Burnout, stress and overwork are highly prevalent amongst junior training physicians worldwide, which explains the widespread phenomenon of physicians leaving the field and organised protests/strikes for better working conditions. Back in 2003, the mandatory duty hour restriction was a landmark intervention rolled out by the Accreditation Council for Graduate Medical Education that formally mandated limiting working hours of trainee residents to no more than 80 h per week, and not exceeding 24-h shifts with 6 added hours for education and handover. Nonetheless, 20 years later, this measure continues to be subject to multiple debates on its purported efficacy in achieving its intended objectives and fails to adequately prevent physician burnout and exodus. In our view, the current duty hour restriction model is, in and of itself, inadequate for combating burnout amongst medical residents for several reasons, including insignificant reduction in duty hours with suboptimal adherence/reporting, failure to account for off-site clinical and non-clinical duties, as well as nature of clinical work which typically involves high work intensity in less-than-optimal/unconducive work environments and significant psychoemotional stress. In this article, we offer our perspectives on pursuing a balanced approach towards both meaningful quantitative reduction in working hours as well as practical qualitative improvement in nature of clinical and non-clinical work that could collectively address resident burnout and improve work and training outcomes.
Assuntos
Esgotamento Profissional , Internato e Residência , Admissão e Escalonamento de Pessoal , Carga de Trabalho , Humanos , Esgotamento Profissional/prevenção & controle , Carga de Trabalho/psicologia , Tolerância ao Trabalho Programado/psicologia , Educação de Pós-Graduação em Medicina/métodos , Médicos/psicologiaRESUMO
OBJECTIVES: The association between occupational psychosocial factors and mental health has been studied in several systematic reviews. However, few systematic reviews exist that specifically address suicidal ideation. Therefore, this systematic review and meta-analysis aimed to examine the associations between long working hours, shift work, and suicidal ideation. METHODS: We systematically screened and collected studies published between January 1970 and September 2022 from three electronic databases and Google Scholar. We conducted a meta-analysis using a random-effects model and assessed the risk of bias using a navigation guide. Additionally, the grading of recommendations assessment, development and evaluation (GRADE) approach was used to consider five items, including the risk of bias and publication bias. RESULTS: Twenty-eight articles were included in this meta-analysis. After adjusting for covariates, the overall odds ratio (OR) for long working hours and shift work were 1.44 [95% confidence interval (CI) 1.26-1.63] and 1.34 (95% CI 1.22-1.47), respectively. Compared with those who worked <40 hours per week, those who worked >55 hours per week had a 1.65 (95% CI 1.37-1.98) higher risk of suicidal ideation, and fixed night shift workers had 1.37 (95% CI 1.03-1.83) higher risk than non-shift workers. CONCLUSIONS: Evidence has shown associations between long working hours, shift work, and suicidal ideation. Implementing evidence-based interventions to address these risk factors may help prevent the progression of suicidal ideation. However, further studies are critically needed, especially those using standardized exposure definitions and longitudinal data.