Sleep, ageing and night work

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Control, shift, insert : living and enacting policy in teachers' day/night work

This thesis investigates the experiences of teachers who trialled an electronic curriculum and assessment tool in the wider context of text-mediated ruling relations organising their work. Problematised as policy and text, this tool is interrogated as a 'solution' to problems perceived in teachers' work in an era of increased accountability. It provides evidence that teachers' work is shaped by forces operating outside their control and mediated by the policy discourses and subjectivities available to them.

Total and domain-specific sitting time among employees in desk-based work settings in Australia

Objective: To describe the total and domain-specific daily sitting time among a sample of Australian office-based employees. Methods: In April 2010, paper-based surveys were provided to desk-based employees (n=801) in Victoria, Australia. Total daily and domain-specific (work, leisure-time and transport-related) sitting time (minutes/day) were assessed by validated questionnaires. Differences in sitting time were examined across socio-demographic (age, sex, occupational status) and lifestyle characteristics (physical activity levels, body mass index [BMI]) using multiple linear regression analyses. Results: The median (95% confidence interval [CI]) of total daily sitting time was 540 (531-557) minutes/day. Insufficiently active adults (median=578 minutes/day, [95%CI: 564-602]), younger adults aged 18-29 years (median=561 minutes/day, [95%CI: 540-577]) reported the highest total daily sitting times. Occupational sitting time accounted for almost 60% of total daily sitting time. In multivariate analyses, total daily sitting time was negatively associated with age (unstandardised regression coefficient [B]=-1.58, p<0.001) and overall physical activity (minutes/week) (B=-0.03, p<0.001) and positively associated with BMI (B=1.53, p=0.038). Conclusions: Desk-based employees reported that more than half of their total daily sitting time was accrued in the work setting. Implications: Given the high contribution of occupational sitting to total daily sitting time among desk-based employees, interventions should focus on the work setting.

Weight gain in relation to night work among nurses

Objective: To investigate the relationship between working at night and increased body weight in nursing. In addition, we evaluated the differences in the proportion of variables sociodemographic, work and health, according to the work shift and their association with body mass index. Methods: Based on questionnaires, we obtained data from 446 nursing professionals about aspects of their job, health and lifestyle. We performed linear and logistic regression analysis. Results: Working at night is associated with a weight gain greater than (beta=0.24 kg/m(2)) working during the day (beta=0.15 kg/m(2)), as well as with aging (beta=0.16 kg/m(2)) and duration of working in nursing (beta=0.18 kg/m(2)). Night workers have a higher educational level, have been working for more years in nursing and also in the current shift, do not have diabetes and have reported longer sleep than day workers. There are also a higher number of smokers among the night workers than day workers. Logistic regression analysis also showed the more time to work in nursing and as an assistant was more likely to develop overweight/obesity. Conclusion: Working at the night contributes to more weight gain than the day shift, aging and duration of working in nursing.

Digest of state laws relating to night work for women, Nov. 1, 1950.

Mode of access: Internet.

Evaluation of heat stress indices using physiological comparisons in an alumina refinery in a sub-tropical climate

The production of alumina involves the use of a process known as the Bayer process. This method involves the digestion of raw bauxite in sodium hydroxide at temperatures around 250°C. The resultant pregnant liquor then goes through a number of filtering and precipitation processes to obtain the aluminium oxide crystals which are then calcined to obtain the final product. The plant is situated in a sub tropical climate in Northern Australia and this combined with the hot nature of the process results in a potential for heat related illnesses to develop. When assessing a work environment for heat stress a heat stress index is often employed as a guideline and to date the Wet Bulb Globe Temperature (WBGT) has been the recommended index. There have been concerns over the past that the WBGT is not suited to the Northern Australian climate and in fact studies in other countries have suggested this is the case. This study was undertaken in the alumina plant situated in Gladstone Queensland to assess if WBGT was in fact the most suitable index for use or if another was more applicable. To this end three indices, Wet Bulb Globe Temperature (WBGT), Heat Stress Index (HSI) and Required Sweat Rate (SWreq) were compared and assessed using physiological monitoring of heart rate and surrogate core temperature. A number of different jobs and locations around the plant were investigated utilising personal and environmental monitoring equipment. These results were then collated and analysed using a computer program written as part of the study for the manipulation of the environmental data . Physiological assessment was carried out using methods approved by international bodies such as National Institute for Occupational Safety & Health (NIOSH) and International Standards Organisation (ISO) and incorporated the use of a ‘Physiological Factor’ developed to enable the comparison of predicted allowable exposure times and strain on the individual. Results indicated that of the three indices tested, Required Sweat Rate was found to be the most suitable for the climate and in the environment of interest. The WBGT system was suitable in areas in the moderate temperature range (ie 28 to 32°C) but had some deficiencies above this temperature or where the relative humidity exceeded approximately 80%. It was however suitable as a first estimate or first line indicator. HSI over-estimated the physiological strain in situations of high temperatures, low air flows and exaggerated the benefit of artificial air flows on the worker in certain environments ie. fans.

Enhanced preference for high-fat foods following a simulated night shift

Objectives Shift workers are prone to obesity and associated co-morbidities such as diabetes and cardiovascular disease. Sleep restriction associated with shift work results in dramatic endocrine and metabolic effects that predispose shift workers to these adverse health consequences. While sleep restriction has been associated with increased caloric intake, food preference may also play a key role in weight gain associated with shift work. This study examined the impact of an overnight simulated night shift on food preference. Methods Sixteen participants [mean 20.1, standard deviation (SD) 1.4 years; 8 women] underwent a simulated night shift and control condition in a counterbalanced order. On the following morning, participants were provided an opportunity for breakfast that included high- and low-fat food options (mean 64.8% and 6.4% fat, respectively). Results Participants ate significantly more high-fat breakfast items after the simulated night shift than after the control condition [167.3, standard error of the mean (SEM 28.7) g versus 211.4 (SEM 35.6) g; P=0.012]. The preference for high-fat food was apparent among the majority of individuals following the simulated night shift (81%), but not for the control condition (31%). Shift work and control conditions did not differ, however, in the total amount of food or calories consumed. Conclusions A simulated night shift leads to preference for high-fat food during a subsequent breakfast opportunity. These results suggest that food choice may contribute to weight-related chronic health problems commonly seen among night shift workers.

Work, aging, and retirement in Australia: Introduction to the special issue

Australia has an aging population and workforce, and policy makers and organizations increasingly encourage older workers to remain on the job longer and even beyond traditional retirement age. After a brief review of important demographic and political developments, we introduce the 8 articles included in this special issue on work, aging, and retirement in Australia. The articles include an overview of the Australian retirement income system, 6 articles reporting quantitative analyses of cross-sectional and longitudinal data provided by large samples of Australian workers and retirees, and a qualitative study which analyzes interviews with human resource managers. Overall, the articles demonstrate that research on work, aging, and retirement in Australia is flourishing, sophisticated, and diverse both in terms of content and methodologies. We close with a brief review of topics and research questions related to work, aging, and retirement that remain to be addressed in the Australian context in future research.

What does “futility” mean? An empirical study of doctors’ perceptions

Objective(s) To describe how doctors define and use the terms “futility” and “futile treatment” in end-of-life care. Design, Setting, Participants A qualitative study using semi-structured interviews with 96 doctors across a range of specialties who treat adults at the end of life. Doctors were recruited from three large Australian teaching hospitals and were interviewed from May to July 2013. Results Doctors’ conceptions of futility focused on the quality and chance of patient benefit. Aspects of benefit included physiological effect, weighing benefits and burdens, and quantity and quality of life. Quality and length of life were linked, but many doctors discussed instances when benefit was determined by quality of life alone. Most doctors described the assessment of chance of success in achieving patient benefit as a subjective exercise. Despite a broad conceptual consensus about what futility means, doctors noted variability in how the concept was applied in clinical decision-making. Over half the doctors also identified treatment that is futile but nevertheless justified, such as short-term treatment as part of supporting the family of a dying person. Conclusions There is an overwhelming preference for a qualitative approach to assessing futility, which brings with it variation in clinical decision-making. “Patient benefit” is at the heart of doctors’ definitions of futility. Determining patient benefit requires discussions with patients and families about their values and goals as well as the burdens and benefits of further treatment.

Relationship between sleeping on the night shift and recovery from work among nursing workers - the influence of domestic work

P>Aim. This paper is a report of a study on the association between sleep patterns during work nights and recovery from work among nursing workers, considering domestic work hours. Background. Several hospitals allow nursing workers to sleep during the night shift, but this is rarely evaluated from the workers` health perspective. The need for recovery from work concept can be useful for testing the impact of night work on sleep. Recovery is not a problem if workers have enough time to recover between periods of work. Therefore, domestic work would be likely to interfere in the recovery process. Methods. This cross-sectional study was carried out at three hospitals in 2005-2006, through a comprehensive questionnaire. All nursing teams engaged in assistance to patients were invited to participate. Analyses included female night workers with no incidence of insomnia. Participants (n = 396) were classified into those who did not sleep during night shifts, those who slept for up to 2 hours and those who slept for 2-3 hours. Results. Binomial logistic regression analysis showed that sleeping on the job for 2-3 hours during night shifts is related to a better recovery from work provided the workers do not undergo long domestic work hours. Conclusions. Being allowed to sleep at work during night shifts seemed to contribute to, but was not enough to guarantee, a good recovery from work in the studied population. Recommendations to deal with sleep-deprivation among night workers should consider the complexity of gender roles on the recovery process.

Working at night and work ability among nursing personnel: when precarious employment makes the difference

To test the association between night work and work ability, and verify whether the type of contractual employment has any influence over this association. Permanent workers (N = 642) and workers with precarious jobs (temporary contract or outsourced; N = 552) were interviewed and filled out questionnaires concerning work hours and work ability index. They were classified into: never worked at night, ex-night workers, currently working up to five nights, and currently working at least six nights/2-week span. After adjusting for socio-demography and work variables, current night work was significantly associated with inadequate WAI (vs. day work with no experience in night work) only for precarious workers (OR 2.00, CI 1.01-3.95 and OR 1.85, CI 1.09-3.13 for those working up to five nights and those working at least six nights in 2 weeks, respectively). Unequal opportunities at work and little experience in night work among precarious workers may explain their higher susceptibility to night work.