Night Shift Work Research Articles

Significance of acupuncture treatment for medical staff with low back pain: A case report

AbstractA 24‐year‐old female nurse with a 4‐month history of low back pain (LBP) was treated with acupuncture because of difficulty to her working. At the first presentation, the numerical rating scale (NRS) value was 7. After 2 weeks, the NRS value improved to 2–3, and she could bend over better, including when working night shifts. After 4 months, the NRS value remained at 1–2 so her relocating or leaving of absence from the ICU department was avoided. Acupuncture treatment for medical staff with LBP could relieve their pain and improve decreased clinical performance in hospitals or clinics.

Pre-existing sleep disturbances and risk of COVID-19: a meta-analysis

Sleep disturbances are widespread but usually overlooked health risk factors for coronavirus disease 2019 (COVID-19). We aimed to investigate the influence of pre-existing sleep disturbances on the susceptibility, severity, and long-term effects of COVID-19. We searched PubMed, Web of Science, and Embase for relevant articles from inception to October 27, 2023 and updated at May 8, 2024. Sleep disturbances included obstructive sleep apnea (OSA), insomnia, abnormal sleep duration, night-shift work, and any other sleep disturbances. Outcomes were COVID-19 susceptibility, hospitalization, mortality, and long COVID. The effect sizes were pooled odds ratios (ORs) and 95% confidence intervals (95% CIs). This study is registered with PROSPERO (CRD42024503518). A total of 48 observational studies (n=8,664,026) were included. Pre-existing sleep disturbances increased the risk of COVID-19 susceptibility (OR=1.12, 95% CI 1.07-1.18), hospitalization (OR=1.25, 95% CI 1.15-1.36), mortality (OR=1.45, 95% CI 1.19-1.78), and long COVID (OR=1.36 95% CI 1.17-1.57). Subgroup analysis showed that younger individuals with sleep disturbances were associated with higher susceptibility and hospitalization and a lower risk of mortality than older individuals. Males with sleep disturbances were associated with higher mortality. For specific sleep disturbances, the susceptibility and hospitalization of COVID-19 were associated with OSA, abnormal sleep duration, and night-shift work; mortality of COVID-19 was linked to OSA; risk of long COVID was related to OSA, abnormal sleep duration and insomnia. Pre-existing sleep disturbances, especially OSA, increased the risk of COVID-19 susceptibility, hospitalization, mortality, and long COVID. Age and sex played important roles in the effect of sleep disturbances on COVID-19. The National Natural Science Foundation of China and the Key Laboratory of Respiratory Diseases of Liaoning Province.

A mixed-methods stress audit with midwives in the United Kingdom

ProblemUK midwives report high work-related stress, which can negatively impact their health and wellbeing, with many considering leaving the profession. BackgroundAn occupational stress audit guides the implementation of stress management intervention, by identifying which stressors have the most negative impact and why, and highlighting “at risk” groups. AimTo conduct a concurrent mixed-methods stress audit with UK midwives in an NHS Trust. MethodsSeventy-one midwives (Mage= 39 years, SD = 11) completed a survey assessing stressors (e.g., relationships), stress appraisals (i.e., challenge vs. threat), coping strategies (e.g., avoidance-focused), and outcomes (i.e., mental health, performance, and intention to leave). Ten midwives (Mage = 42 years, SD = 10) participated in semi-structured interviews. FindingsQuantitative data revealed that more work-related demands, poorer peer support and relationships, and threat appraisals predicted worse mental health. Moreover, less control and more work-related demands predicted poorer performance, while less control, poorer manager support, more change-related demands, and threat appraisals predicted greater intention to leave. Qualitative data generated three themes: organisational pressures exacerbated by unexpected changes; individualised responses but largely debilitative emotions; and personal coping and power of social support. Discussion and conclusionThis study offered a comprehensive and novel insight into the stress experiences of UK midwives, highlighting targets for future stress management interventions, including key stressors (e.g., manager support), underlying mechanisms (e.g., stress appraisals), and “at-risk” groups (e.g., night shift workers). Practical recommendations are provided for stakeholders operating at multiple levels (e.g., midwife, trust, policy) to better support midwives with work-related stress.

Cancer du sein : peut-on l’envisager comme une maladie professionnelle ?

ObjectiveBreast cancer is the leading cancer in women in terms of incidence and mortality. The literature currently identifies several risk factors, some modifiable and others not. Because of its multifactorial nature, the combination of factors either increases or reduces the risk of cancer. Since 2004, the first commission's rapport of the French National Environmental Health Plan has recognized the significant impact of occupational exposure on the development of breast cancer. However, neither primary nor secondary preventive measures have yet been implemented in work environment. MethodBased on available literature, we reviewed current knowledge of breast cancer risk factors associated with occupational exposure. ResultsThe risk factors identified were ionizing radiation, magnetic fields, certain endocrine disruptors, ethylene oxide and night shift work. ConclusionRecognition of breast cancer as an occupational disease is complicated. In some cases, however, it may be possible, particularly in cases of multifactorial exposure. This work should help to raise awareness among employers and reinforce preventive measures in the workplace.

Eating on the Night Shift: A qualitative study to understand what is important to UK night workers when designing nutritional research

The night-time economy contributed £93.7bn to the total UK economy in 2023(1) and relies on extensive employment of night workers. There is strong evidence to support the association between shift work, predominately involving night shifts, and adverse cardiometabolic health(2). However, there are limited evidence based dietary guidelines available for night workers or nutritional practitioners(3). Simulated shift work studies have significantly contributed to understanding how eating at night impacts physiology however, real world research is needed among shift workers. Engaging end users in research design is key to inform acceptable and feasible interventions.The aim of the Eating on The Night Shift study (King’s College London Ethics:LRM-22/23-35745) is to understand how UK night workers view working at night in relation to nutritional health and wellbeing and the barriers and enablers to participating in nutritional research studies.Semi-structured qualitative interviews were undertaken with a convenience sample (n=18) of UK night workers between June and September 2023. Interviews were held virtually and covered experiences of working night shifts, perceptions about night work and health, and perceptions of, and barriers and facilitators of engagement with, nutritional research. All interviews were audio recorded and transcribed verbatim. Transcripts were coded using an inductive thematic analysis approach to identify overarching themes and sub-themes(4).Of the final sample 13 were female (72%), 39% worked a rotating shift pattern, 50% had worked night shifts for between one to three years and 39% were employed in the healthcare sector. Four overarching themes were identified 1) The consequences of night work on health and wellbeing: this theme included concerns about the impact on physical and psychological wellbeing and on cognitive function during night shifts, 2) Eating at night means a less healthy diet: this theme highlighted the concerns about less healthy diets at night and how night work impacts meal planning and eating patterns, 3) Working at night has wider knock-on effects: sub themes were related to the negative impact on physical activity, sleep and social networks and 4) Nutritional research is perceived as important but there are barriers – barriers discussed were related to workload and the ability to change eating patterns, identified enablers were clear study instructions and financial compensation.The results suggest that night workers are aware of the negative long-term consequences working nights has on their health. Furthermore, efforts to maintain a healthy lifestyle are impeded by the nature of night work and its disruptions to the circadian rhythm. Although night workers support research to understand how diet during night work can impact long-term health, several barriers to taking part in research need to be considered in the design of research studies. This will ensure that studies are acceptable and feasible to the night shift population.

Critical reviews of exposure assessment in carcinogenic hazard identification: the IARC Monographs experience

ObjectivesTo summarise the rationale, workflow and recommendations for the conduct of exposure assessment critiques in key human studies evaluated for International Agency for Research on Cancer (IARC) Monographs on the...

Impact of Fatigue, Sleep Quality, and Drowsiness on Medical Laboratory Technologists’ Alertness During Night Shift

Medical Laboratory Technologists (MLTs) often work in shifts, with night shifts being much longer than morning or day shifts. As a result, many MLTs are exposed to high levels of fatigue, sleep problems, and drowsiness, while MLTs are always required to be alert for emergency analysis. This research aims to determine the impact of fatigue, sleep quality, and drowsiness on decreased alertness of MTLs working night shifts. Additionally, it describes the fatigue, sleep quality, drowsiness, and decreased alertness of MLTs. The method of analysis used was multiple linear regression. The research found that most MLTs working night shifts suffer from high fatigue levels, poor sleep quality, drowsiness, and decreased alertness. The findings suggest that fatigue and drowsiness have an impact on decreased alertness, while sleep quality has no impact on decreased alertness. These findings have implications for work scheduling and managing fatigue and drowsiness among MLTs.

Investigation of Insomnia Influencing Factors and Their Relationship with TCM Syndrome Elements in 621 Medical Staff Members

Objectives: Our study examined the incidence of insomnia among Chinese medical professionals, delved into associated factors, and examined its connection with Traditional Chinese Medicine (TCM) diagnostic elements. Methods: Between January 2020 and December 2022, our evaluation included 621 medical personnel, utilizing the Pittsburgh Sleep Quality Index (PSQI). Our team gathered data on demographics and occupations to pinpoint potential risks linked to insomnia. Furthermore, the components of TCM syndrome were assessed to understand their correlation with the quality of sleep. Results: Overall, 523 staff were classified as experiencing insomnia (PSQI score ≥ 8). We found statistically significant differences age, professional title, abnormal menstruation, night shift assignment, work intensity, and years of service between insomnia and non-insomnia groups. Logistic regression analysis revealed age over 40, senior professional title, night shift assignment, and high work intensity as risk factors for insomnia, while longer tenure was protective. Insomnia patients predominantly exhibited TCM syndromes such as phlegm-heat internally, heart-fire hyperactivity, and liver-depression fire. Conclusion: Our results reveal a high prevalence of insomnia among medical staff and its association with various demographic and occupational factors. They underscore the relevance of TCM syndrome elements in understanding sleep disorders and suggest personalized interventions targeting specific syndromes. Effective management of insomnia in medical staff is crucial for promoting both individual well-being and patient care quality.

Night shift work and myocardial infarction in the UK Biobank.

Shift work has become popular along with adverse effects such as disrupted biological rhythms, metabolic changes, sleep disorders and myocardial infarction. Studies have shown a link between myocardial infarction and shift work, but evidence is still lacking. We aim to explore the association between present and past shift work and risk of myocardial infarction in a large population of European workers. We analysed data from the UK Biobank with >500 000 participants and an average 12-year follow-up duration. Cox proportional hazard models were employed to analyse the relationship between present shift work (n = 265 064), lifetime duration or frequency of shift work (n = 71 428) and the risk of myocardial infarction, as well as the association between rest day during shift work and myocardial infarction incidents in night shift workers (n = 14 588). Night shift workers had a higher risk of myocardial infarction compared to day workers, including 'shift but never/rarely night shifts' (hazard ratio [HR] = 1.09, 95% confidence interval [CI] 1.00-1.20), 'some night shifts' (HR = 1.13, 95% CI 1.01-1.27) and 'usual/permanent night shifts' (HR = 1.21, 95% CI 1.07-1.37), respectively. Similarly, higher frequency and longer duration of night shift work were associated with the increased risk of myocardial infarction (<10 years: HR = 1.20, 95% CI 1.01-1.42; ≥10 years: HR = 1.51, 95% CI 1.28-1.77; or an average of more than eight nights per month: HR = 1.45, 95% CI 1.23-1.71). However, longer rest days couldn't decrease myocardial infarction risk compared to those who rest 1 day. Present and lifetime exposure to night shifts were associated with a risk of myocardial infarction and did not benefit from longer rest days.

Correlation Between Serum and Tear Fluid Interleukin 6 Levels in Day and Night Shift Health Care Workers

Background: Night shift work is associated with several long-term health complications including metabolic syndrome and cardiovascular disease along with various adverse health effects. This study was planned and conducted to learn the impact of Interleukin-6 (IL-6), a chronic inflammatory cytokine among day and night shift health care workers, and to correlate the relationship between the serum and tear fluid IL 6. Aim and Objective: To correlate the relationship between serum and tear fluid Interleukin-6 (IL-6) in day and night shift healthcare workers at a tertiary care hospital. Materials and Methods: This is a Cross-Sectional study with 100 (fifty-day shift and fifty-night shift) participants including medical, paramedical students, and lab technicians. Blood and tear samples were collected from both groups. SPSS version 26.0 was used to analyze the data using Pearson’s correlation, chi-square test, and ROC. An Independent student’s t-test was used to examine the differences between the mean scores. p-value &lt; 0.05 is considered significant. Results: Serum and tear IL-6 levels were significantly increased in night shift workers when compared to day shift workers with p-value &lt; 0.0001. There was a positive correlation between tear and serum IL-6 levels (r value 0.732 and 0.624) among day and night shift workers respectively. A high prevalence of dry eye syndrome in night shift workers (40%) when compared to day shift workers (14%). In ROC analysis, tear IL-6 shows the highest area under the curve (0.935) compared to serum IL-6 (0.883) which reveals the superiority of tear fluid analysis and suggests that tear fluid can be used as a minimally invasive technique to analyze IL-6 alternative to serum IL-6 analysis. Conclusion: This study concludes that tear and serum Interleukin-6 (IL-6) is proportionately increased in night shift workers compared to day shift workers with a positive correlation. It also suggests that tear fluid can be used as a minimally invasive technique and a superior method to analyze IL-6.

Understanding perceptions about the health effects of night working and the barriers and enablers to taking part in nutritional research: A qualitative study among night workers in England.

Working at night is associated with adverse cardiometabolic health outcomes. However, there are a lack of nutritional intervention studies conducted amongst night workers, subsequently contributing to a lack of evidence-based guidelines for night workers. The aim of The Eating on the Night Shift study was to understand how night shift workers view working at night in relation to nutritional health and wellbeing, the barriers and enablers to participate in research and what kind of guidance would be useful to them. Semi-structured qualitative interviews were conducted with a convenience sample (n = 18) of night workers based in England. The interview covered experiences of working night shifts, perceptions about night work and their health, and perceptions of and likely engagement with nutritional research. Interviews were audio recorded and transcribed verbatim. Transcripts were coded using an inductive thematic analysis approach. Of the final sample 13 were female (72%), 39% worked a rotating shift pattern and 78% had worked night shifts for 1 year or more. Four overarching themes were identified: (1) the consequences of night work on health and wellbeing, (2) eating at night means a less healthy diet, (3) working at night has wider knock-on effects on aspects of lifestyle and wellbeing and (4) nutritional research is perceived as important, but there are barriers to participation. Night workers are aware that working at night can negatively impact their diet as well as their health. Nutritional researchers need to engage with night workers when considering intervention design and implementation as well as in the development of any resultant evidence-based guidance to ensure its relevance.

Psychische Gesundheit am Arbeitsplatz – Welche Rolle spielen sozioökonomische, geschlechterspezifische und migrationsbedingte Ungleichheiten?

ZusammenfassungHintergrundRisikofaktoren für die psychische Gesundheit sind häufig in sozioökonomischen, geschlechter- und migrationsspezifischen Ungleichheiten begründet. Diese sowie die Ausprägung der Depressivität, Ängstlichkeit und Somatisierung von Beschäftigten wurden in der vorliegenden Studie untersucht.MethodenIm Rahmen der friaa-Studie („Frühe Intervention am Arbeitsplatz“) wurden psychisch belastete Beschäftigte an 5 Standorten in Deutschland zu soziodemografischen, arbeits-, migrations- und gesundheitsbezogenen Inhalten befragt. Mittels Regressionsanalysen wurde der Zusammenhang dieser Faktoren mit Depressivität (Patient-Health-Questionnaire-9, PHQ-9), Ängstlichkeit (Generalized Anxiety Disorder-2, GAD-2) und Somatisierung (Somatic Symptom Scale-8, SSS-8) an der gesamten Stichprobe sowie bei Personen mit Migrationshintergrund (MH) untersucht. Bei Letzteren wurden zusätzlich die Akkulturation (Frankfurter Akkulturationsskala, FRAKK) und das Belastungsempfinden gegenüber Migrationsanforderungen (Demands of Immigration Scale, DIS) berücksichtigt.ErgebnisseDie 550 Beschäftigten (12 % mit MH) wiesen im Durchschnitt eine klinisch relevante Depressivität (M = 13,0, SD = 5,1) (PHQ-9 ≥ 10), Ängstlichkeit (M = 3,5, SD = 1,7) (GAD ≥ 3) sowie Somatisierung (M = 13,0, SD = 5,8) (SSS-8 ≥ 12) auf. Das weibliche Geschlecht war mit höheren Werten für Ängstlichkeit und Somatisierung assoziiert. Höheres Alter und Nachtschichtarbeit hingen mit stärkerer Somatisierung zusammen.DiskussionDie Ergebnisse bestätigen die hohe psychische Belastung der Beschäftigten in dieser Stichprobe aus Deutschland. Um deren psychische Gesundheit aufrechtzuerhalten, sollten Unterstützungsmaßnahmen insbesondere für vulnerable Gruppen wie Frauen, ältere Beschäftigte und Nachtschichtarbeitende angeboten werden.

Long-term night-shift work is associated with accelerates brain aging and worsens N3 sleep in female nurses

BackgroundShift work disrupts circadian rhythms and alters sleep patterns, resulting in various health problems. To quantitatively assess the impact of shift work on brain health, we evaluated the brain age index (BAI) derived from sleep electroencephalography (EEG) results in night-shift workers and compared it with that in daytime workers. MethodsWe studied 45 female night shift nurses (mean age: 28.2 ± 3.3 years) and 44 female daytime workers (30.5 ± 4.7 years). Sleep EEG data were analyzed to calculate BAI. The BAI of night shift workers who were asleep during the daytime with those of daytime workers who were asleep at night were statistically compared to explore associations between BAI, duration of shift work, and sleep quality. ResultsNight-shift workers exhibited significantly higher BAI (2.14 ± 6.04 vs. 0 ± 5.35), suggesting accelerated brain aging and altered sleep architecture, including reduced delta and sigma wave frequency activity during non-rapid eye movement sleep than daytime workers. Furthermore, poor deep sleep quality, indicated by a higher percentage of N1, lower percentage of N3, and higher arousal index, was associated with increased BAI among shift workers. Additionally, a longer duration of night-shift work was correlated with increased BAI, particularly in older shift workers. ConclusionNight-shift work, especially over extended periods, may be associated with accelerated brain aging, as indicated by higher BAI and alterations in sleep architecture. Interventions are necessary to mitigate the health impacts of shift work. Further research on the long-term effects and potential strategies for sleep improvement and mitigating brain aging in shift workers is warranted.

Work environment adversity and non-communicable Disease risk among drivers working for application-based-cab-aggregators in an Indian metropolis

BackgroundBengaluru, a metropolis in Southern India, is one of the largest markets for cab aggregator companies. Drivers working for these companies play a vital role in urban transportation but unlike other drivers, their work pattern is stressful, which could increase their proneness to NCD risk factors. Understanding associations between work environment adversity and NCD risk factors among these drivers will help to plan specific health promotion and NCD prevention programs including provision of basic occupational health services.ObjectivesThe study aims to test for an association between work environment adversity and selected Non-communicable Disease (NCD) risk factors among Application Cab Aggregator drivers in Bengaluru city and to estimate the prevalence of selected NCD risk factors among the ABCA drivers.MethodologyThis cross-sectional study was conducted in Bengaluru city among 340 eligible and consenting ABCA drivers with at least one-year experience. Drivers were recruited through a multi-stage sampling procedure and time-period sampling, from transportation and leisure zones in the city. Data was collected through interviews using specifically developed semi-structured tools to assess work environment adversity and NCD risk factors. Prevalence of NCD risk factors is presented per 100 drivers with 95% confidence intervals. Multivariate Logistic regression analysis was conducted to quantify the strength of the association between work environment adversity categories and NCD risk factors. Ethical clearance was obtained from the NIMHANS Ethics Committee.ResultsNearly 97% of the 340 drivers reported having one or more NCD risk factors. Working more than 5 days a week, more than 7 + hours a day, staying away from family, and working night shifts were closely associated with higher risk for NCD risk factors among ABCA drivers. Drivers with work environment adversity scores between 5 and 10 were associated with higher odds of Physical Inactivity (OR = 3.1), Unhealthy diets (OR = 1.62), and Tobacco Use (OR = 3.06).ConclusionThe study highlights the association between work environment adversity and NCD risk factors and indicates a dire need for NCD prevention programs, basic occupational health services, and social security provisions for ABCA cab drivers.

Rotating Night Shift Work and Glycemic Control among Diabetic Nursing Staff in a University Hospital

Rotating Night Shift Work and Glycemic Control among Diabetic Nursing Staff in a University Hospital

Disruption of central and peripheral circadian clocks and circadian controlled estrogen receptor rhythms in night shift nurses in working environments.

Chronic disruption of circadian rhythms by night shift work is associated with an increased breast cancer risk. However, little is known about the impact of night shift on peripheral circadian genes (CGs) and circadian-controlled genes (CCGs) associated with breast cancer. Hence, we assessed central clock markers (melatonin and cortisol) in plasma, and peripheral CGs (PER1, PER2, PER3, and BMAL1) and CCGs (ESR1 and ESR2) in peripheral blood mononuclear cells (PBMCs). In day shift nurses (n = 12), 24-h rhythms of cortisol and melatonin were aligned with day shift-oriented light/dark schedules. The mRNA expression of PER2, PER3, BMAL1, and ESR2 showed 24-h rhythms with peak values in the morning. In contrast, night shift nurses (n = 10) lost 24-h rhythmicity of cortisol with a suppressed morning surge but retained normal rhythmic patterns of melatonin, leading to misalignment between cortisol and melatonin. Moreover, night shift nurses showed disruption of rhythmic expressions of PER2, PER3, BMAL1, and ESR2 genes, resulting in an impaired inverse correlation between PER2 and BMAL1 compared to day shift nurses. The observed trends of disrupted circadian markers were recapitulated in additional day (n = 20) and night (n = 19) shift nurses by measurement at early night and midnight time points. Taken together, this study demonstrated the misalignment of cortisol and melatonin, associated disruption of PER2 and ESR2 circadian expressions, and internal misalignment in peripheral circadian network in night shift nurses. Morning plasma cortisol and PER2, BMAL1, and ESR2 expressions in PBMCs may therefore be useful biomarkers of circadian disruption in shift workers.

Circadian-independent light regulation of mammalian metabolism.

The daily light-dark cycle is a key zeitgeber (time cue) for entraining an organism's biological clock, whereby light sensing by retinal photoreceptors, particularly intrinsically photosensitive retinal ganglion cells, stimulates the suprachiasmatic nucleus of the hypothalamus, a central pacemaker that in turn orchestrates the rhythm of peripheral metabolic activities. Non-rhythmic effects of light on metabolism have also been long known, and their transduction mechanisms are only beginning to unfold. Here, we summarize emerging evidence that, in mammals, light exposure or deprivation profoundly affects glucose homeostasis, thermogenesis and other metabolic activities in a clock-independent manner. Such light regulation could involve melanopsin-based, intrinsically photosensitive retinal ganglion cell-initiated brain circuits via the suprachiasmatic nucleus of the hypothalamus and other nuclei, or direct stimulation of opsins expressed in the hypothalamus, adipose tissue, blood vessels and skin to regulate sympathetic tone, lipolysis, glucose uptake, mitochondrial activation, thermogenesis, food intake, blood pressure and melanogenesis. These photic signalling events may coordinate with circadian-based mechanisms to maintain metabolic homeostasis, with dysregulation of this system underlying metabolic diseases caused by aberrant light exposure, such as environmental night light and shift work.

Chronic Mealtime Shift Disturbs Metabolic and Urinary Functions in Mice: Effects of Daily Antioxidant Supplementation.

Through their biological clocks, organisms on this rotating planet can coordinate physiological processes according to the time of the day. However, the prevalence of circadian rhythm disorders has increased in modern society with the growing number of shift workers, elevating the risk of various diseases. In this study, we employed a mouse model to investigate the effects of urinary rhythm disturbances resulting from dietary changes commonly experienced by night shift workers. We established 3 groups based on feeding time and the use of restricted feeding: ad libitum, daytime, and early nighttime feeding. We then examined the urinary rhythm in each group. In addition to the bladder rhythm, we investigated changes in mRNA patterns within the tissues constituting the bladder. Additionally, we assessed the urination rhythm in Per1 and Per2 double-knockout mice and evaluated whether the injection of antioxidants modified the impact of mealtime shift on urination rhythm in wild-type mice. Our study revealed that a shift in mealtime significantly impacted the circadian patterns of water intake and urinary excretion. In Per2::Luc knock-in mouse bladders cultured ex vivo, this shift increased the amplitude of Per2 oscillation and delayed its acrophases by several hours. Daily supplementation with antioxidants did not influence the mealtime shift-induced changes in circadian patterns of water intake and urinary excretion, nor did it affect the modified Per2 oscillation patterns in the cultured bladder. However, in aged mice, antioxidants partially restored the urinary rhythm. A shift in mealtime meaningfully impacted the urination rhythm in mice, regardless of the presence of circadian clock genes.

Doctors’ and nurses’ eating practices during shift work: Findings from a qualitative study

Doctors’ and nurses’ (DNs) wellbeing in the National Health Service is important for safe healthcare for those in need. However, their demanding duties, including irregular shift work, can significantly impact their health. Unfortunately, irregular working patterns are associated with higher sickness rates and stress among healthcare professionals due to the inherent challenges of the work(1,2). For example, shift work disrupts sleep and impairs cognitive function and performance, leading to poorer physiological and cardiovascular health(3), workforce shortages and difficulties adapting to a consistently demanding workload, which can impact patient care delivery(4). Despite the importance of workplace health and nutrition for DNs, our understanding of their dietary practices during shift work remains limited. Therefore, gaining insights into DNs’ eating habits during shifts is imperative to supporting their health. Our research aimed to understand DNs’ eating practices during their work, including the types of food consumed throughout the day.Online semi-structured interviews (n=16) were conducted with a convenience sample of current practising medical doctors (n=11) and nurses (n=5) in England. This provided an opportunity to compare and contrast the research data between DNs on workplace nutrition. All participants did shift work, encompassing varied working patterns, including day and night shifts, short and long days and weekends. Following Braun and Clarke’s(5) approach, an inductive thematic analysis presented the findings.Results elucidate six areas of DNs’ eating practices and dietary intake: before and during shifts, on long shifts, after shifts, during night shifts, and on non-working days. Our data suggests that DNs prioritise their clinical responsibilities over their dietary intake at work. Consequently, they often miss eating opportunities and consume caffeine to stay alert during their shifts. Furthermore, DNs viewed night shifts as involving less healthy food choices. While participants expressed their intention to eat healthily during their shifts, their clinical responsibilities made maintaining regular and nutritious dietary practices throughout the day challenging. Nevertheless, DNs value their meal after a shift as the most important, as this could be the only meal they eat throughout the day.Our results suggest that DNs’ eating practices and dietary intake are sub-optimal to recommended dietary guidelines. It also suggests that eating practices are varied, individualised and not applicable to all, considering the many environmental and occupational factors contributing to DNs’ nutritional behaviours. Therefore, dietary workplace interventions are recommended to improve DNs’ dietary behaviours at work. Future research should explore DNs’ eating practices through follow-up interviews at various time points. This approach will provide valuable insights into DNs’ dietary and nutritional behaviours during shift work, helping to uncover additional barriers and challenges beyond DNs’ daily experiences.

Consequences of chronodisruption on body weight regulation and metabolism

The prevalence of overweight and obesity has increased dramatically. At the same time, lack of sleep has become a part of the modern lifestyle, as well as shift and night work. As a result, chronodisruption, i. e. a change in physiological processes that are controlled by the internal clock, becomes commonplace. Epidemiological data show that too short but also too long sleep are associated with an increased risk of obesity, also seen for night shift work. Overweight and obesity are associated with metabolic syndrome and data likewise report an increased risk by both short and long sleep. It has not yet been conclusively clarified how chronodisruption influences the metabolic risks. Clinical experimental studies report on neuroendocrine and circadian mechanisms and it has been shown that lack of sleep increases the hunger-promoting hormone ghrelin as well as subjective feelings of hunger and increases leptin levels. Lack of sleep also increases hedonic hunger and food-related reward signals. Through preventive measures, chronodisruption and thus, the risk of obesity can be counteracted. The extent to which smartwatches and fitness trackers, which according to the manufacturer can measure and analyze sleep, provide an objective picture of sleep has not been sufficiently investigated. However, smartwatches and fitness trackers can - probably - increase awareness of sleep in the modern society.