Does shift work pose a risk to your health?

Our reporter Andrew Rochford is a shift worker in Accident and Emergency at Brisbane's Princess Alexandra Hospital.

"We're the ones that are still out there toiling away while you're tucked into bed at night and by the time I finish my shift the following morning, you're all enjoying a morning cuppa. So for me, the following question is a big one."

Andrew doesn't love nights, but aside from that, is working nights damaging to his health?

No question about it, says sleep researcher Dr Simon Smith at Queensland University. "The long term health risks may include things like increased risk of breast cancer, an increased risk of cardio-vascular consequences, heart attack risk and so forth down the track."

Add to that the earlier onset of stomach ulcers, plus the increased risk of depression, weight gain and social alienation and it's a pretty grim picture.

Anyone who works shifts will tell you sleep deprivation's the worst part and that fatigue affects your performance. So just how badly are our abilities affected by shift work?

To find out, we're going to run a test with two producers from channel Nine's Sydney newsroom.

The test

Lizzie Pearl and Asha Philips clock in for their nightshift at 1am — they spend the night writing the news we wake up to next day.

Asha: "I find it most difficult as soon as I come in at 1am — I'm usually quite tired, it takes me half an hour to wake up and to start to process things."

We tested how awake they really were by using a machine to measure how long it took them to react to a target appearing on a screen. They'll do the test at 1am, then again at 3am, 6am and when they finish their shift at 9am.

"I think the results of the alertness test will probably get better slightly I think until about 4am," says Lizzie.

Asha's first reaction time was 0.294 of a second
Lizzie's first reaction time was 0.261 of a second.

At 3am in the newsroom, Lizzie and Asha begin to look a little sleepy — so it's time for another test.

Most people's low point on a night shift is between three and four in the morning. But in some jobs, such as Andrew's for instance, you really can't afford to be off your game. In Andrew's experience the adrenalin gets him through — thankfully the experts agree with him.

Jim Huemer advises shift workers and their bosses on the best way to cope with this unnatural work pattern. "What the fatigue tends to affect is the routine decisions, so doctors, nurses will get the prescriptions right and get the procedures right, but they'll forget to check on somebody down the hall later."

Now a lot of us shift workers drink coffee to keep awake. Are we doing the right thing?

"Caffeine can raise our alertness short-term," says Jim. He advises us to limit it to two to three cups a shift and don't drink coffee too close to sleep time.

The trouble is that also on night shifts our cravings for sweet, fatty food can get the better of us too.

"It's really tempting when you're working nightshift to head to the vending machine and get all the junk you can eat. To be honest, it just makes you more tired and feel horrible the next day. So a bit of fruit, something decent to eat, tends to give me more energy and it'll probably serve you a little bit better as well," says Andrew.

Another good tip is to find time to exercise regularly, which can be a tough one when you're tired.

"My routine is, as soon as I come home from work I go to the gym and stay awake until two or three in the afternoon," says Asha.

Results

As dawn begins to break, Asha and Lizzie are focused on the morning news and are winding down to their 9am knock-off time. It's time to take their final reaction test.

Asha
Began her shift with close to 0.3 of a second reaction time, but took longer and longer as she headed into the wee small hours. She was 8.16 percent less alert at the end of her shift than she was at the beginning.

Lizzie
Started with a 0.261of a second reaction time, which got shorter at three and six o'clock in the morning. Amazingly, at the end of her shift she was 5.5 percent more alert than at the beginning! How come?

Well, the latest research from the UK shows some people have a gene that makes them more sensitive to sleep deprivation than others. Lizzie obviously doesn't have that gene but a lot of us do. The fact is we're just not meant to be working at night.

Conclusion

Dr Simon Smith, a sleep researcher, says: "Biologically we're designed to be diurnal animals, we're designed to be awake and running around during the day and be asleep at night. And functioning at night is limited — we can't perform at the same level as we can during the daytime."

Unfortunately, not a lot of us can change our jobs, so here are some strategies for coping with shift work:

• Car pool with your mates. Studies have shown you'll keep each other awake and increase your chances of getting home safely.
• Keep a sleep routine — it doesn't matter when you sleep, but creating a sleep routine to get that seven hours shut-eye is vital.

Jim suggests that shift workers try to create a dark, cool and quiet environment to aid in the amount of sleep and the quality of sleep that you can get.

One last tip, and this one's for employers — if employees have a rotating shift pattern, they adapt better if it rotates forward. So going from a morning to an evening to a night shift is the best pattern.

And some final advice from Andrew: "For me it's always been about getting plenty of exercise, keeping the caffeine down to a minimum and when I get the chance to get some sleep, I really make the most of it. It's the regime that always worked for me and let's face it, in my line of work, you want me as close to perfect as can be."

Fast facts

• What are our circadian rhythms and what do they do? It's a fancy name for our internal body clock which also controls body temperature. That's why we wake when our temperature rises in the morning and sleep when it falls at night.