Health impacts of working on shifts for women haven’t been studied closely, until recently
All Lindsay Warren wants is a good night’s rest.
So before every night shift, the 27-year-old Toronto nurse goes to the gym.
On the job, she eats regularly throughout the evening to ward off hunger pangs when she sleeps during the day later.
When it’s time for daytime shuteye, Warren turns off her phone, puts in earplugs and notifies her condo maintenance staff to make sure they don’t show up.
“It’s hard on your body. After a night shift, I feel like a zombie and I’m sluggish for a while,” said Warren. “I try my best to get caught up on sleep… but you can’t control everything.”
This is the reality for many hospital staff who work night shifts: They may be compromising their own health as they try to improve their patients’ health.
While the links between shift work and health have been well documented, only in recent years has there been more of a focus on the particular toll late nights take on female employees.
In October, Joan Tranmer told the Canadian Cardiovascular Congress 2011, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society, that women who work night shifts might be at a higher risk for developing cardiovascular disease.
Tranmer and her team of researchers at Queen’s University in Kingston, Ont., found about one in five middle-aged women who do shift work has at least three of the risk indicators for heart disease.
The signs connected with metabolic syndrome — a group of risk factors that together increase the risk for stroke, coronary artery disease and Type 2 diabetes — are abdominal obesity, high blood pressure, elevated blood glucose, elevated triglycerides and low levels of high-density lipoprotein cholesterol — also known as “good cholesterol.”
“Just how shift work contributes to the development of such risk factors isn’t clear,” said Tranmer, a former nurse of 30 years, in a statement. “It is possible that the disruption of biological rhythms, sleeping, eating and exercise patterns may be factors.”
The research looked at 227 women between the ages of 22 and 66 from two hospitals in southeastern Ontario. It included nurses, administrative employees and lab and equipment technicians who worked various shift rotations.
Within the group, 17 per cent had metabolic syndrome with at least three of the identified indicators.
High blood pressure was found in 38 per cent of participants, and a notable 60 per cent of the group had a high waist circumference. The greater the abdominal obesity, the higher the risk of developing heart disease, stroke and high blood pressure.
While much of the research on shift work and health have predominantly included men, Tranmer honed in on effects on females because “part of the concern is that women will develop heart disease later in life,” Tranmer told Canadian Safety Reporter.
“Women are protected by hormones until menopause, but we still develop the risks for heart disease during our working years. It’s a bit masked until the later years of life.”
There are also differences in work, home and life demands between men and women.
“What may be stressful for women, may not be stressful for men,” Tranmer said.
“One of the social stress factors is that after working a night shift, women may be waking up earlier from their daytime sleep because of household demands — whereas men may not.”
It’s a difference Warren, the Toronto nurse, observes at work as well. One of the biggest differences she sees is that “more male nurses work permanent night shifts — maybe because they don’t have the same family obligations as women.”
The study’s findings on the prevalence of these cardiovascular risk factors — particularly with abdominal obesity rates and the increasing age of the female hospital workforce — raises the need to assess workplace policies, said Beth Abramson, a Heart and Stroke Foundation spokesperson.
“All women should manage their weight and other risk factors, and this study shows women working shift work especially need to be aware,” said Abramson in a statement. “We spend so many of our hours and days at work, it is important for employers and employees to create as healthy a work environment as possible — especially for shift workers.”
Some workplaces have already intervened to mitigate health risks associated with working late nights.
Tranmer, for example, notes changes in scheduling that accommodate longer recovery times after night shifts, as well as the introduction of sleep pods at some hospitals.
Adopting a healthy lifestyle — which may include eating well, being active, maintaining a healthy body weight and not smoking — can reduce their risk by as much as 80 per cent.
Besides cardiovascular disease, other studies have said female shift workers may face further health risks.
The Nurses’ Health Study in the United States, for example, found women who worked on three night shifts per month for more than 20 years have an increased risk of breast cancer.
Researchers believe exposure to artificial light at night can affect the brain’s production of the hormone, melatonin, which may cause the ovaries to increase estrogen production.
High levels of estrogen may increase the risk of breast cancer.
More recently, the journal PLoS Medicine in December reported research that found women who work rotating night shifts might have a higher risk of developing Type 2 diabetes.
The survey found 6,165 cases of Type 2 diabetes in its analysis of more than 69,000 female shift workers aged 42 to 67, and 3,961 cases among the 107,000 women aged 25 to 42.
So before every night shift, the 27-year-old Toronto nurse goes to the gym.
On the job, she eats regularly throughout the evening to ward off hunger pangs when she sleeps during the day later.
When it’s time for daytime shuteye, Warren turns off her phone, puts in earplugs and notifies her condo maintenance staff to make sure they don’t show up.
“It’s hard on your body. After a night shift, I feel like a zombie and I’m sluggish for a while,” said Warren. “I try my best to get caught up on sleep… but you can’t control everything.”
This is the reality for many hospital staff who work night shifts: They may be compromising their own health as they try to improve their patients’ health.
While the links between shift work and health have been well documented, only in recent years has there been more of a focus on the particular toll late nights take on female employees.
In October, Joan Tranmer told the Canadian Cardiovascular Congress 2011, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society, that women who work night shifts might be at a higher risk for developing cardiovascular disease.
Tranmer and her team of researchers at Queen’s University in Kingston, Ont., found about one in five middle-aged women who do shift work has at least three of the risk indicators for heart disease.
The signs connected with metabolic syndrome — a group of risk factors that together increase the risk for stroke, coronary artery disease and Type 2 diabetes — are abdominal obesity, high blood pressure, elevated blood glucose, elevated triglycerides and low levels of high-density lipoprotein cholesterol — also known as “good cholesterol.”
“Just how shift work contributes to the development of such risk factors isn’t clear,” said Tranmer, a former nurse of 30 years, in a statement. “It is possible that the disruption of biological rhythms, sleeping, eating and exercise patterns may be factors.”
The research looked at 227 women between the ages of 22 and 66 from two hospitals in southeastern Ontario. It included nurses, administrative employees and lab and equipment technicians who worked various shift rotations.
Within the group, 17 per cent had metabolic syndrome with at least three of the identified indicators.
High blood pressure was found in 38 per cent of participants, and a notable 60 per cent of the group had a high waist circumference. The greater the abdominal obesity, the higher the risk of developing heart disease, stroke and high blood pressure.
While much of the research on shift work and health have predominantly included men, Tranmer honed in on effects on females because “part of the concern is that women will develop heart disease later in life,” Tranmer told Canadian Safety Reporter.
“Women are protected by hormones until menopause, but we still develop the risks for heart disease during our working years. It’s a bit masked until the later years of life.”
There are also differences in work, home and life demands between men and women.
“What may be stressful for women, may not be stressful for men,” Tranmer said.
“One of the social stress factors is that after working a night shift, women may be waking up earlier from their daytime sleep because of household demands — whereas men may not.”
It’s a difference Warren, the Toronto nurse, observes at work as well. One of the biggest differences she sees is that “more male nurses work permanent night shifts — maybe because they don’t have the same family obligations as women.”
The study’s findings on the prevalence of these cardiovascular risk factors — particularly with abdominal obesity rates and the increasing age of the female hospital workforce — raises the need to assess workplace policies, said Beth Abramson, a Heart and Stroke Foundation spokesperson.
“All women should manage their weight and other risk factors, and this study shows women working shift work especially need to be aware,” said Abramson in a statement. “We spend so many of our hours and days at work, it is important for employers and employees to create as healthy a work environment as possible — especially for shift workers.”
Some workplaces have already intervened to mitigate health risks associated with working late nights.
Tranmer, for example, notes changes in scheduling that accommodate longer recovery times after night shifts, as well as the introduction of sleep pods at some hospitals.
Adopting a healthy lifestyle — which may include eating well, being active, maintaining a healthy body weight and not smoking — can reduce their risk by as much as 80 per cent.
Besides cardiovascular disease, other studies have said female shift workers may face further health risks.
The Nurses’ Health Study in the United States, for example, found women who worked on three night shifts per month for more than 20 years have an increased risk of breast cancer.
Researchers believe exposure to artificial light at night can affect the brain’s production of the hormone, melatonin, which may cause the ovaries to increase estrogen production.
High levels of estrogen may increase the risk of breast cancer.
More recently, the journal PLoS Medicine in December reported research that found women who work rotating night shifts might have a higher risk of developing Type 2 diabetes.
The survey found 6,165 cases of Type 2 diabetes in its analysis of more than 69,000 female shift workers aged 42 to 67, and 3,961 cases among the 107,000 women aged 25 to 42.
