For other uses, see Shift work (disambiguation).

"Second shift" redirects here. For the concept in sociology, see double burden.
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Shift work is an employment practice designed to make use of, or provide service across, all 24
hours of the clock each day of the week (abbreviated as24/7). The practice typically sees the day
divided into "shifts", set periods of time during which different groups of workers take up their posts.
The term "shift work" includes both long-term night shifts and work schedules in which employees
change or rotate shifts.
[1][2][3]

In medicine and epidemiology, shift work is considered a risk factor for some health problems in
some individuals, as disruption to circadian rhythms may increase the probability of
developing cardiovascular disease, cognitive impairment, diabetes, and obesity.
[4][5]

Shift work can also contribute to strain of marital, family, and personal relationships.
[6]

Contents
[hide]
1 Epidemiology
2 Health correlations and consequences
o 2.1 Mitigating the health consequences of shift work
3 Cognitive effects of shift work
o 3.1 Cognitive effects of sleep deprivation
4 Safety and productivity
5 Management practices
o 5.1 Shift system
o 5.2 Shift schedule and shift plan
6 Industries
7 See also
8 References
9 Further reading
10 External links
Epidemiology[edit]
According to data from the National Health Interview Survey Occupational Health Survey, 29% of all
U.S. workers in 2010 worked an alternative shift (not a regular day shift). Prevalence rates were
higher for workers aged 18-29 compared to other ages. Those with a Bachelors degree and higher
had a lower prevalence rate of alternative shifts compared to workers with less education. Among all
occupations, food preparation and serving occupations had the highest prevalence of working an
alternative shift (63%).
[7]

One of the ways in which working alternative shifts can impair health is through decreasing sleep
opportunities. Among all workers, those who usually worked the night shift had a much higher
prevalence of short sleep duration (44.0%, representing approximately 2.2 million night shift
workers) than those who worked the day shift (28.8%, representing approximately 28.3 million day
shift workers). An especially high prevalence of short sleep duration was reported by night shift
workers in the transportation and warehousing (69.7%) and health-care and social assistance
(52.3%) industries.
[8]

Health correlations and consequences[edit]
Shift work increases the risk for the development of many disorders, including:
Shift work sleep disorder (SWSD): Shift work sleep disorder is a circadian rhythm sleep
disorder characterized by insomnia and/or excessive sleepiness. Shift work is considered
essential for the disorder.
[citation needed]

Breast cancer A 2005 review of earlier studies came to the result that women whose work
involve night shifts have a 50% increased risk of developing breast cancer.
[9]
This may be due to
alterations in circadian rhythm: melatonin, a known tumor suppressant, is generally produced at
night and late shifts may disrupt its production.
[10]
The WHO's International Agency for Research
on Cancer listed "shiftwork that involves circadian disruption" as a probable carcinogen in 2007
(IARC Press release No. 180).
[11][12]

Possibly other types of cancer
[13]

Cluster headache
[14]

Ischemic heart disease: Shift workers who had worked in that method for 15 years or more were
three times more likely to develop ischemic heart disease.
[15]

Fatigue
[16]

Stress
[16]

Poor sexual performance
[16]

Appetite control: Shift work has been associated with a higher disposition for developing
nutritional issues and obesity.
[17]



Children going to a 12-hour night shift in the United States, 1908
Shift work also can exacerbate symptoms and progression of chronic diseases, such as sleep
disorders, digestive diseases, heart disease,hypertension, epilepsy, mental disorders, substance
abuse, diabetes mellitus type 1, asthma, and health conditions that require medications with
circadian changes in effectiveness.
[6]

UCSF neurologist Louis Ptacek, who studies circadian rhythms, genes and sleep behaviors, has
been quoted: "It's not surprising, we have evolved on a planet that is rotating every 24 hours. Our
internal clock is more than just when we sleep and wake. It's related to cell division and it regulates
our immune systems. When we battle our internal clock, that has complications."
[18]
Artificial
lighting may additionally contribute to disturbedhomeostasis.
[19]

The health consequences of shift work may depend on one's chronotype, that is, whether one is
a day person or a night person, and what shift one is assigned to.
Many shift workers use stimulants such as caffeine to stay awake at work and/or sleeping pills to aid
with sleep during the day. However, both are addictive and should be used with care. There is
currently no research on shiftworkers and long-term use of sleeping pills.
[20]

Mitigating the health consequences of shift work[edit]
Though shift work itself remains necessary in many occupations, through various methods
employers can alleviate some of the negative health consequences of shift work. The United
StatesNational Institute of Occupational Safety and Health recommends employers avoid quick shift
changes, permanent night shifts, and several days of work offset by several days off. Employers
should also attempt to minimize the number of consecutive night shifts, long work shifts and
overtime work. Having a regular, predictable schedule can also diminish the negative health effects
of shift work. A poor work environment can exacerbate the strain of shiftwork. Adequate lighting,
clean air, proper heat and air conditioning, and reduced noise can all make shift work more bearable
for workers.
[20]
Also, appropriate sleep hygiene is recommended.
[6]

Employees can mitigate the effects of shift work by blocking out noise at home, maintaining a regular
sleep routine, and avoiding heavy foods and alcohol before sleep. Exercise in the three hours before
sleep can make it difficult to fall asleep, so workers might exercise before work instead.
Cognitive effects of shift work[edit]
Compared with the day shift, incidents have been estimated to increase by 15% on evening shifts
and 28% on night shifts.
[6]

One study suggests that, for those working a night shift (such as 23:00 to 07:00), it may be
advantageous to sleep in the evening (14:00 to 22:00) rather than the morning (08:00 to 16:00). The
study's evening sleep subjects had 37% fewer episodes of attentional impairment than the morning
sleepers.
[21]

There are four major determinants of cognitive performance and alertness in healthy shift-workers.
They are: circadian phase, sleep inertia, acute sleep deprivation and chronic sleep deficit.
[22]

The circadian phase is relatively fixed in humans; attempting to shift it so that an individual is alert
during the circadian bathyphase is difficult. Sleep during the day is shorter and less consolidated
than night-time sleep.
[23]

The effects of sleep inertia wear off after 24 hours of wakefulness,
[22]
such that most workers who
wake up in the morning and go to work suffer some degree of sleep inertia at the beginning of their
shift. The relative effects of sleep inertia vs. the other factors are hard to quantify; however, the
benefits of napping appear to outweigh the cost associated with sleep inertia.
Cognitive effects of sleep deprivation[edit]
Main article: Effects of sleep deprivation on cognitive performance
Acute sleep deprivation occurs during long shifts with no breaks, as well as during night shifts when
the worker sleeps in the morning and is awake during the afternoon, prior to the work shift. A night
shift worker with poor daytime sleep may be awake for more than 18 hours by the end of his shift.
The effects of acute sleep deprivation can be compared to impairment due to alcohol intoxication,
with 19 hours of wakefulness corresponding to a BAC of 0.05%, and 24 hours of wakefulness
corresponding to a BAC of 0.10%.
[24]
Much of the effect of acute sleep deprivation can be countered
by napping, with longer naps giving more benefit than shorter naps.
[25]
Some industries, specifically
the Fire Service, have traditionally allowed workers to sleep while on duty, between calls for service.
In one study of EMS providers, 24 hour shifts were not associated with a higher frequency of
negative safety outcomes when compared to shorter shifts.
[26]

Chronic sleep deficit occurs when a worker sleeps for fewer hours than is necessary over multiple
days or weeks. The loss of two hours of nightly sleep for a week causes an impairment similar to
those seen after 24 hours of wakefulness. After two weeks of such deficit, the lapses in performance
are similar to those seen after 48 hours of continual wakefulness.
[27]
The number of shifts worked in
a month by EMS providers was positively correlated with the frequency of reported errors and
adverse events.
[26]
A study conducted by Defense Research & Development Canada found that
"with respect to sustaining cognitive performance in the face of nocturnal alarms, clearly schedule 4
[24/72] is the best schedule and schedule 5 [another schedule with 24 hour shifts] is the second
best." The study also compared three schedules with day and night shifts, and found the deleterious
effects of multiple night shifts to be greater than those associated with long shifts.
[28]

Safety and productivity[edit]


Workplace safety signs
A meta-analysis of incident data across various shiftwork operations revealed a number of important
trends.
[29]

Concerning shift length, the combined data from three field studies indicated that ...risk [of injuries
and accidents] increased in an approximately exponential fashion with time on shift such that in the
twelfth hour it was more than double that during the first 8 h (42). The relative risk rises sharply over
the final four hours of the shift.
The effects of the circadian rhythm and circasemidian rhythm on accuracy and efficiency in the 24/7
workplace was obvious in the combined data from three field studies which showed that ... real-job
speed and accuracy measures are only above average between 0700 h and 1900 h [7 a.m. and 7
p.m.]; at all other times efficiency is likely to be relatively impaired, especially so during the early
hours of the morning. The data showed a nadir at 3 a.m. and a low spot at 2 p.m. These are the
predicted effects of the two combined rhythms.
The data from eight field studies showed that Risk [of injuries and accidents] was found to increase
in an approximately linear fashion across the three shifts, ... 18.3% on the afternoon shift ... 30.4%
on the night shift, relative to that on the morning shift.
Data from seven studies of night shifts revealed that ...risk [of injuries and accidents] was ~6%
higher on the second night, 17% higher on the third night and 36% higher on the fourth night. This
was compared to successive day shifts in five of the seven companies, where the increases were ...
~2% higher on the second morning/day, 7% higher on the third morning/day, and 17% higher on the
fourth morning/day than on the first shift. Thus, the relative penalty for successive night shifts,
compared to successive day shifts, was a factor of about 2.5 times greater safety risk.
Management practices[edit]


4 o'clock shift at the Ford Motor Company assembly plant in Detroit, Michigan, 1910s
The practices and policies put in place by managers of round-the-clock or 24/7 operations can
significantly influence shift worker alertness (and hence safety) and performance.
[30]

Air traffic controllers typically work an 8-hour day, 5 days per week. Research has shown that when
controllers remain "in position" for more than two hours, even at low traffic levels, performance can
deteriorate rapidly, so they are typically placed "in position" for 30-minute intervals (with 30 minutes
between intervals).
These practices and policies can be fairly obvious: selecting an appropriate shift schedule
or rota and using an employee scheduling software to maintain it, setting the length of shifts,
managing overtime, increasing lighting levels, or providing shift worker lifestyle training to help shift
workers better handle issues such as understanding basic circadian physiology, sleep and napping,
caffeine usage, social life issues, diet and nutrition, etc. They may also be more indirect: retirement
compensation based on salary in the last few years of employment (which can encourage excessive
overtime among older workers who may be less able to obtain adequate sleep), or screening and
hiring of new shift workers that assesses adaptability to a shift work schedule.
A day may be divided into three shifts, each of 8 hours, and each employee works just one of those
shifts; they might, for example, be midnight to 08:00, 08:00 to 16:00, 16:00 to midnight. Generally,
"first shift" refers to the day shift, with "second shift" running from late afternoon to midnight or so,
and "third shift" being the night shift. On occasion, more complex schedules are used, sometimes
involving employees changing shifts, in order to operate during weekends as well, in which case
there will be four or more sets of employees.
12-hour work shifts are also in use. In a modern steelworks, four sets of personnel are used, working
consecutive days in one 12-hour shift (06:00 18:00 and vice-versa). Shift A will work days, and
shift B nights, over a 48-hour period, before handing over to shifts C and D and taking 48 hours off.
In the offshore petroleum industry, employees may work 14 consecutive days or nights, 06:00
18:00 or 18:00 06:00, followed by three or four weeks free. The svingskift (literally: "swing shift") in
the offshore petroleum industry in Norway refers to a two-week tour during which employees work
12-hour days the first seven days and 12-hour nights the second (or vice versa).

Miners waiting to go to work on the 4 P.M. to midnight shift at the Virginia-Pocahontas Coal Co., 1974
Shift work was once characteristic primarily of the manufacturing industry, where it has a clear effect
of increasing the use that can be made of capital equipment and allows for up to three times the
production compared to just a day shift. It contrasts with the use of overtime to increase production
at the margin. Both approaches incur higher wage costs. Although 2nd-shift worker efficiency levels
are typically 35% below 1st shift, and 3rd shift 46% below 2nd shift, the productivity level, i.e. cost
per employee, is often 25% to 40% lower on 2nd and 3rd shifts due to fixed costs which are "paid"
by the first shift.
[31]

In general, requiring workers to live on a time-shifted schedule for extended periods is unpopular,
and this typically must be paid for at a premium. It is common in heavy industry,
particularly automobile and textile manufacturing and is becoming more common in locations where
a shut-down of equipment would incur an extensive restart process. Food manufacturing plants, in
particular, have extensive cleaning programs that are required before any restart. The use of shift
work in manufacturing varies greatly from country to country. Shift work is common in the
transportation sector as well. Some of the earliest instances appeared with the railroads, where
freight trains have clear (i.e. passenger-free) tracks to run on at night. Shift work has been traditional
in law enforcement and the armed forces: for example sailors must be available to handle a vessel
around the clock, and a system of naval watches organized to ensure enough hands are on duty at
any time. This is shift work by another name.
Service industries now increasingly operate on some shift system; for example a restaurant
or convenience store will normally each day be open for much longer than a working day. Shift work
is also the norm in governmental and private employment in fields related to public safety
and healthcare, such as Emergency Medical Services, police, fire prevention, security andhospitals.
Companies working in the field of meteorology, such as the National Weather Service and private
forecasting companies, also utilize shift work, as constant monitoring of the weather is necessary.
Much of the Internet services and Telecommunication industry relies on shift work to maintain
worldwide operations and uptime.
Shift system[edit]
Shiftwork investigators examined four-crew shift systems in great detail with respect to two
constraints: eight-hour work days and 104 days off per year (equal to 52 weekends per
year).
[32][33][30]
They showed that the 40-hour work week is cumbersome and limiting when you try to
create a shiftwork plan, and that the 42-hour work week allows even distributions of work time
across workers on all shifts. The latter is true because the week length, 168 hours, is factorable by
42 hours (4 x 42 hours = 168 hours).
Having established that the four-crew solution with a 42-hour work-week worked quite well, the
investigators went on to determine the best ratios of work days and free days. For eight-hour shifts,
use a ratio of 3 work days to 1 free day (3:1). For twelve-hour shifts, use a ratio of 2 work days to 2
free days (2:2)
The shift system sets the relative numbers of work and free periods that must be worked to support
24/7 operations. A system is expressed as a ratio. The investigators above specified two optimal
systems. The ratio of 3 work days to 1 free day (3:1) for eight-hour shifts is expressed as the system,
3nW:1nF. The ratio of 2 work days to 2 free days (2:2) for twelve-hour shifts is expressed as the
system, 2nW:2nF where n is an integer multiplier.
The shift system examination also provided two useful measures for determining the acceptability of
a shift system: the average number of hours worked per day and the number of free days per year.
Shift schedule and shift plan[edit]
Main article: Shift plan
The shift plan or rota is the central component of a shift schedule.
[30]
The schedule includes
considerations of shift overlap, shift change times and alignment with the clock, vacation, training,
shift differentials, holidays, etc., whereas the shift plan determines the sequence of work and free
days within a shift system.
Industries[edit]
Industries requiring 24/7 cover are those that employ workers on a shift basis:
Casino
Customer service including call centers
Death care (medical examiner or coroner)
Emergency response systems
Firefighting
Paramedic services
Police
Weather
Flight Test
Funeral
Health care
Hospitality
Logistics
Manufacturing
Military
Public utilities
Nuclear power
Fossil fuel
Solar, wind, and hydro power
Retail
Semiconductor
Telecommunications
Television
Radio broadcasting
Transportation
Railroads
Ship transport
Security
See also[edit]

Organized labour portal
Circadian rhythm sleep disorders
Eight-hour day
Fatigue Avoidance Scheduling Tool
Hospital
Schedule (workplace)
Shift work sleep disorder
Sleep
Split shift
Gantt chart
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Between Poor Sleep, Fatigue, and Safety Outcomes in Emergency Medical Services
Providers". Prehospital Emergency Care (16): 8697.
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physiology from chronic sleep restriction and total sleep deprivation". Sleep (26): 117126.
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productivity". Occupational Medicine (London) 53 (2): 95101. doi:10.1093/occmed/kqg047.
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Miller, JC (2013). "Fundamentals of Shiftwork Scheduling, 3rd Edition: Fixing
Stupid". Smashwords.
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Brace Jovanovich, San Diego, p. 687.
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Further reading[edit]
Knutsson, A., kerstedt, T., Jonsson, B.G. & Orth-Gomer, K. (1986) 'Increased risk of ischaemic
heart disease in shift workers'. Lancet, 2(8498), 8992.
Burr, Douglas Scott (2009) 'The Schedule Book', 'ISBN 978-1-4392-2674-2'.
Miller, James C. (2013) 'Fundamentals of Shiftwork Scheduling, 3rd Edition: Fixing Stupid',
Smashwords, .
External links[edit]
Scientific Symposium on the Health Effects of Shift Work, Toronto, 12 April 2010, hosted by the
Occupational Cancer Research Centre and the Institute for Work & Health (IWH).
CDC - Work Schedules: Shift Work and Long Work Hours - NIOSH Workplace Safety and
Health Topic
Three-hour night shift system, For a crew of three on a small boat at sea
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