Shifting the rhythm
It’s 10pm, and the city is settling into sleep, but for the men and women of Roeland Street Fire Station, drama is only a bell ring away, and will be until the next shift takes over at 8am. Like many shift workers around the country, they have learnt to adjust and adapt their lives to fit into a shifted rhythm.
‘When it’s two in the morning, and everyone else is tucked up in bed, we are out on the street, helping someone who’s injured or putting out a fire,’ explains Senior Fire Fighter Sean Evans.
‘But I prefer working shifts, as I have for most of the past 11 years. At times when I’ve been studying and working a normal day shift I find it hard to adjust to getting up the same time every morning and sitting in traffic with everyone else.’
He’s one of the lucky ones. Some people not only find it mentally difficult to work shifts, but suffer physical ill-health too. According to a new study from the National Institute for Psychosocial Factors and Health in Sweden, physical changes to the body happen at a hormonal level when we meddle with the early-to-bed, early-to-rise rhythms passed down form our ancestors.
The study, done on male 42 shift workers, showed lower morning testosterone levels, particularly in those workers who had previously reported that they were not satisfied with their jobs. This may be because on the most basic level, some people need more sleep than others, and job satisfaction would be lower among those who need more rest.
According to chronobiologist Dr Jan Lochner of the University of Stellenbosch, there are two basic types of shift workers: ‘Some people are tolerant of night work and some are not tolerant ‘ and they will usually not stay in the job.’
The many variations on a shift cycle seem to suggest that employers have not quite settled on which is the most efficient way to have staff on duty 24 hours without working them too hard or losing productivity. ‘There are different types of shift cycles,’ explains Lochner. ‘For those who work in a rotating shift that changes rapidly, their bodies will not really adapt to the changes. But people who work on permanent night shift will find that their body rhythms adjust to the cycle.’
The circadian rhythm is a cycle in the body dictating our body temperature and levels of various hormones, and is governed by an internal ‘clock’ in our brains, located in the hypothalmus. In most people, this means we have a lower body temperature at night, and are naturally more active when it is light.
In permanent night shifters, however, the temperature cycle adapts and the endocrine cycle also changes, explains Lochner.
‘Cortisol levels are usually low at midnight and high in the morning, and this becomes opposite with permanent night shifters. Adaptation can be improved by playing around with light ‘ work under bright lights, but make sure you go home to bed in complete darkness. Also make sure to block off sound completely with ear-muffs.’
Hard when the sound you’re likely to hear is a clanging fire alarm, designed to jolt you out of bed and into your boots within a minute. The fire fighters are lucky, in that they sometimes do get a few hours of sleep at the normal time, so that their bodies only need to catch up on those hours that are disturbed by going out on a call. But even those who are not needed for a particular call have to slide down the pole and be ready as soon as the lights go on and the bells sound. This can happen up to a dozen times a night. Because they have meals at normal lunch and supper times, they also are less likely to suffer from the gastrointestinal upsets that are common in people working a more swiftly changing shift.
‘Two main health problems bothered me when I was working regular night shifts,’ says Saadikah Cassiem, a nurse who has since starting working a 12 hour daylight shift.
‘I used to struggle a lot with insomnia, and I also suffered from digestive problems from time to time, because you don’t eat at regular times,’ she says.
Eating at irregular hours is only part of what can cause bloatedness and indigestion, says Lochner. Boredom can lead to nibbling less healthy foods, and shift workers also generally tend to drink more coffee and smoke more. Some may also take more alcohol than they otherwise would, possibly in an attempt to unwind quickly after a long shift.
Getting the right amount of sleep can be problematic for some shift workers, although many report that they are able to get enough rest during their break times.
‘Your sleep pattern is altered depending on the shift and as with most people, you need a few minutes to relax and unwind when you get home before you can go to bed,’ says Lameeze Meyer, a duty manager at the Table Bay Hotel. Health problems are not a problem for Meyer, who enjoys the structure of her week, which allows for time off during the day to spend with her family.
The key to thriving on the night shift is learning to sleep properly in your rest periods. Because our bodies respond to hormones such as melatonin, which is released at night, we are programmed to want to sleep at night. For this reason, even those shift workers who make sure they spend enough time in bed may not get the same quality of rest as those on a normal work schedule. Trying to get to sleep when melatonin is declining and body temperature is rising ‘will usually result in shorter sleep episodes and more awakenings,’ says an article in the medical journal The Lancet, published in September 2001.
Among the more serious health problems that have been ascribed to shift work, says The Lancet, are increased incidence of cardiovascular disease, lipid intolerance, gastrointestinal disease, lipid intolerance and possibly an increased risk of type 2 diabetes. This last may relate to the hormonal changes evidenced in this year’s Swedish study, since the effects of the various hormones, including insulin, are inter-related.
Workers may also find that they do not function at the peak of their ability when they are on night duty: ‘Performance drops and productivity tends to drop,’ says Lochner, ‘and there is a higher prevalance of absenteeism in night shift workers than others.’
There’s no way to tell just by looking at someone whether or not they will be the type to suffer physical or mental problems relating to night shift work, but there are some known factors that influence who may struggle to adapt and who will sail through any shift changes.
People who are generally more rigid and hate change will not easily adjust to a swing shift arrangement. Motivation and commitment are also important in determining who will struggle and who will enjoy the variation.
‘You can see who’s here because they love what we do and who is just here to have a job,’ says Evans. ‘After a night on the mountain battling the smoke and flames, some of us will come back and sit around talking about the fire, while those who are less excited by the work will simply go off to bed.’
Managers indicate that those who really struggle with shift work tend to leave quite quickly, and the science supports this.
‘We know that people who are intolerant to shiftwork tend to select themselves out of such occupations’ says The Lancet.
Family circumstances will also have an influence on who can adjust, as will whether or not the work is challenging and rewarding. The age of the worker also has a part to play ‘ in general very young and older workers tend to be more intolerant of night shifts, says Lochner.
One young worker, who finds it difficult to find time to keep up his fitness level is Ismail Salie, who works as a setter for a company that prints packaging.
‘It’s not easy to fit in staying active around work, and work must always come first,’ he says, ‘so although I love sports, I don’t always do as much as I’d like to. The same applies to healthy eating ‘ I’m not always aware of what I’m eating and when.’
Meanwhile, the fire fighters are proving that the lower testosterone levels reported in the Swedish study aren’t yet affecting their ability to reproduce. Sean Evans is the son of a fire fighter, and his supervisor Dennis Smeda has a father, a brother and a son who’ve all ridden the big red ‘appliances’ as they call the fire engines.
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