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      Health promotion and work: prevention of shift work disorders in companies

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          Abstract

          Workplace health promotion is a strategy to improve the health and well-being of people at work. The measures aim at the personal, organisational and work environment. Shift work is one of many reasons provoking increased job stress. According to worldwide epidemiological data, up to 30% of the working population are employed in shifts. Taking into consideration that shift work causes a large number of somatic and psychiatric diseases which bear considerable negative consequences for the health status and the quality of life, it seems to be important to initiate health promotion strategies for shift workers in the companies. The results of recent studies indicate that well-scheduled und targeted health programmes can change the lifestyle of shift working employees and have an impact on the risk factors involved. One problem, though, is a considerable time lag till effects become apparent; therefore, the long-term economic effects of workplace health promotion have not been evaluated sufficiently to date. These definitely positive effects highlight the demand for trainings and workshops for people in shift work. We urgently suggest a speedy implementation of the recommended strategies by companies with shift work systems. In our view, this poses a challenge to the “infant” interdisciplinary field of sleep medicine that should be solved.

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          Most cited references 24

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          Impact of sleep debt on metabolic and endocrine function.

          Chronic sleep debt is becoming increasingly common and affects millions of people in more-developed countries. Sleep debt is currently believed to have no adverse effect on health. We investigated the effect of sleep debt on metabolic and endocrine functions. We assessed carbohydrate metabolism, thyrotropic function, activity of the hypothalamo-pituitary-adrenal axis, and sympathovagal balance in 11 young men after time in bed had been restricted to 4 h per night for 6 nights. We compared the sleep-debt condition with measurements taken at the end of a sleep-recovery period when participants were allowed 12 h in bed per night for 6 nights. Glucose tolerance was lower in the sleep-debt condition than in the fully rested condition (p<0.02), as were thyrotropin concentrations (p<0.01). Evening cortisol concentrations were raised (p=0.0001) and activity of the sympathetic nervous system was increased in the sleep-debt condition (p<0.02). Sleep debt has a harmful impact on carbohydrate metabolism and endocrine function. The effects are similar to those seen in normal ageing and, therefore, sleep debt may increase the severity of age-related chronic disorders.
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            Health in a 24-h society.

            With increasing economic and social demands, we are rapidly evolving into a 24-h society. In any urban economy, about 20% of the population are required to work outside the regular 0800-1700 h working day and this figure is likely to increase. Although the increase in shiftwork has led to greater flexibility in work schedules, the ability to provide goods and services throughout the day and night, and possibly greater employment opportunities, the negative effects of shiftwork and chronic sleep loss on health and productivity are now being appreciated. For example, sleepiness surpasses alcohol and drugs as the greatest identifiable and preventable cause of accidents in all modes of transport. Industrial accidents associated with night work are common, perhaps the most famous being Chernobyl, Three Mile Island, and Bhopal.
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              Shift work sleep disorder: prevalence and consequences beyond that of symptomatic day workers.

              Although there are considerable data demonstrating the impact of shift work on sleep and alertness, little research has examined the prevalence and consequences of shift work sleep disorder in comparison to the difficulties with insomnia and excessive sleepiness experienced by day workers. The present study was designed to determine the relative prevalence and negative consequences associated with shift work sleep disorder in a representative sample drawn from the working population of metropolitan Detroit. Random-digit dialing techniques were used to assess individuals regarding their current work schedules and a variety of sleep- and non-sleep-related outcomes. Detroit tricounty population. A total of 2,570 individuals aged 18 to 65 years from a representative community-based sample including 360 people working rotating shifts, 174 people working nights, and 2036 working days. Using standardized techniques, individuals were assessed for the presence of insomnia and excessive sleepiness, based on DSM-IV and ICSD criteria. Those individuals with either insomnia or excessive sleepiness and who were currently working rotating or night schedules were classified as having shift work sleep disorder. Occupational, behavioral, and health-related outcomes were also measured. Individuals who met criteria for shift work sleep disorder had significantly higher rates of ulcers (odds ratio = 4.18, 95% confidence interval = 2.00-8.72), sleepiness-related accidents, absenteeism, depression, and missed family and social activities more frequently compared to those shift workers who did not meet criteria (P < .05). Importantly, in most cases, the morbidity associated with shift work sleep disorder was significantly greater than that experienced by day workers with identical symptoms. These findings suggest that individuals with shift work sleep disorder are at risk for significant behavioral and health-related morbidity associated with their sleep-wake symptomatology. Further, it suggests that the prevalence of shift work sleep disorder is approximately 10% of the night and rotating shift work population.
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                Author and article information

                Contributors
                Kneginja.Richter@gmx.de
                Journal
                EPMA J
                EPMA J
                The EPMA Journal
                Springer Netherlands (Dordrecht )
                1878-5077
                1878-5085
                8 December 2010
                December 2010
                : 1
                : 4
                : 611-618
                Affiliations
                Clinic for Psychiatry and Psychotherapy, Prof. Ernst-Nathan Str.1, 90419 Nuernberg, Germany
                57
                10.1007/s13167-010-0057-7
                3405355
                23199115
                © European Association for Predictive, Preventive and Personalised Medicine 2010
                Categories
                Review Article
                Custom metadata
                © European Association for Predictive, Preventive and Personalised Medicine 2010

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