Health and Safety ReportVolume 12, Issue 11

Products are ordered online and shipped immediately from anywhere in the world. There are 24-hour restaurants, manufacturing plants, and call centres that never close. We live in a global economy that requires products and services to be delivered around the clock. As a side effect, many workers are exposed to the strains and health effects that come with working at all hours of the day and night. Changing schedules can make it difficult to ever fully adapt. There is no doubt that shift work can have negative effects on workers' personal health and safety.

About shift work
Work that is scheduled outside "normal" daylight hours (i.e. 9 am to 5 pm) is called "shift work". Shift work schedules can vary from one workplace to another and workers may rotate through shifts or remain on a single shift (for example, permanent nights).

Shift work is a reality for about 25% of the North American working population and with more occupations and industries operating around the clock, this number is not likely to decrease. The growing numbers of shift workers include those in healthcare, railways, road work, manufacturing, just-in-time industries, trucking, security, emergency services, customs and immigration, public utilities, seasonal occupations, the military, gas stations, grocery stores, and restaurants.

Circadian rhythms are our body's biological clocks that manage various internal functions throughout a 24-hour day, using daylight and darkness as cues. Working during the night and sleeping during the day is contrary to our natural rhythm. This is what can make sleeping difficult for shift workers and can mean that the body cannot recover as quickly from physical and mental activity during these "opposite" hours.

Risks
Here are some key risks associated with shift work:

• People who work night shifts are likely to have shorter sleeps and/or poorer sleep quality than regular day workers.
• Night shift workers probably have a higher risk of breast cancer, as well as an elevated risk of other types of cancer.
• Shift workers have an increased risk of heart disease.
• Some studies indicate a higher risk of pre-term delivery, gastrointestinal disorders, and mental health problems among shift workers.
• Night shift workers face a higher risk of workplace injury than morning or afternoon shift workers.

Studies have shown that shifting schedules increases injury risk. A recent study found that not only do evening-shift and night shift workers have a higher injury risk than that of daytime workers, but workers are even more at risk when they switch between shift schedules.

Tips for employers

• Avoid permanent (fixed or non-rotating) night shifts.
• Keep consecutive night shifts to a minimum.
• Avoid quick shift changes.
• Free weekends are better than a single day off.
• Avoid several days of work followed by four- to seven-day "mini-vacations".
• Keep long work shifts and overtime to a minimum.
• Consider different lengths for shifts.
• Examine start-end times.
• Keep schedules regular and predictable.
• Conduct a risk assessment for every task to be performed during a specific shift.
• Night shifts should not be too long and should end as early as possible. In this way workers can get more and undisturbed sleep.
• Shift changes should be made in such a way that the worker can adapt easily to them. 'Rotating forward' (morning - afternoon - night) has been proven to be easier to adapt to than rotating backwards or having irregular shift changes.
• Morning shifts should not start too early. The earlier the shift starts, the earlier workers have to get up and the less sleep they get.
• Shift schedules should be set in consultation with the worker.
• Scheduling the same worker to more than one shift a day should be avoided.

Tips for shift workers

There are steps that shift workers can take with their diet, sleep and social life to help preserve their health.

DIET

• Afternoon workers should have a meal in the middle of the day instead of the middle of their work shift.
• Night workers should eat lightly throughout the shift.
• Relax during meals and allow time for digestion.
• Drink lots of water.
• Cut back on foods that are highly salted and those high in fat.
• Maintain regular eating patterns with well balanced meals.
• Minimize the intake of caffeine and alcohol.
• Avoid fast food and vending machine food.

SLEEP

• Have a comfortable, quiet place to sleep during the day.
• Air conditioning, foam ear plugs and good blinds may help.
• Make time for quiet relaxation before bed.
• Sleep on a set schedule to help establish a routine.
• Avoid strenuous exercise before sleeping.
• If you don't fall asleep after one hour, read a book or listen to quiet music.
• If you still can't sleep, reschedule sleeping hours for later in the day.

SOCIAL ACTIVITIES

• Schedule at least one daily meal with the family.
• Keep in touch with your spouse and children daily.
• Set time aside for just you and your spouse.
• Plan family activities.
• Pay close attention to physical fitness.
• Try to reduce your stress.

Along with the advantages of schedule flexibility, shift work brings health and safety risks associated with working 'non-traditional' and rotating hours. Recognizing and taking steps toward minimizing these risks can be beneficial to both workers and employers.

More information

• A summary of research on shift work and health: Update PDF, Institute for Work & Health (IWH)
• Rotational Shiftwork fact sheet, CCOHS
• Plain Language About Shiftwork, National Institute for Occupational Safety and Health (NIOSH)
• Risks of shift work, European Agency for Safety and Health at Work (EU-OSHA)
• Shiftwork: Health Effects & Solutions, Occupational Health Clinics for Ontario Workers (OHCOW)
• Changing shift types and work-injury, Scandinavian Journal of Work, Environment & Health

Martin finally wandered into the office almost an hour late and slumped into his seat. He didn't offer a reason. He just put his head set on and turned towards his computer. His manager noticed that Martin was quieter and more withdrawn than usual, and was having difficulty completing simple tasks. While this behaviour was previously unusual for Martin, it was beginning to become a pattern.

Martin is not alone. According to the Canadian Mental Health Association, 20% of Canadians will experience a form of mental illness at some point in their lifetime. A healthy Canadian economy - and a psychologically healthy workplace - relies on healthy minds.

A psychologically safe and healthy workplace promotes emotional well-being, and presents minimal risk to employee mental health. By making changes to your work environment, and offering support to employees, you can reduce the occurrence, duration and severity of mental illness, and enhance recovery. So how do we do that?

There is no one "right way" to create a mentally healthy workplace. Every workplace is different from the size of the organization, to the people doing the work, the work that needs to be done, and the leaders of the organization. All of these factors play a role in employee mental health. However, businesses can create and nurture a psychologically healthy workplace by including mental health in their business plan. Poor mental health not only hurts the individual, it also reduces corporate profits. It's important that all levels of the workplace - including the Board of Directors, management, finance, and human resources departments - get involved to incorporate mental health in the workplace.

Here are three things you can do to foster a psychologically safe and healthy workplace:

1. Create and implement a Comprehensive Workplace Health and Safety Program.
This program is a series of strategies and related activities, initiatives and policies developed by the employer, in consultation with employees, to continually improve or maintain the quality of working life, health, and the well-being of the workforce. These activities are developed as part of a continual improvement process to improve the work environment (physical, psychosocial, organizational, economic), and to increase personal empowerment and personal growth.

2. Commit to creating a workplace that promotes mental well-being.
It is essential to have strong and clear senior leadership and the meaningful involvement of leaders in the development of a mental health program. Organizational commitment is crucial. All levels of the organization play a role in designing, implementing, monitoring, and reviewing policies or practices. Form a corporate wellness working group with representation from senior management, employees, trade unions, human resources, and occupational health and wellness experts to lead this initiative.

3. Educate and train each member of the organization (managers, supervisors, employees and health and safety committee members) about the importance of mental health in the workplace. Provide education and training that ensures managers and employees know how to recognize hazards such as harassment, bullying, and psychologically unhealthy work conditions. This training provides concrete ways for co-workers to recognize and talk about mental health issues in general. Managers can additionally contribute to a positive work environment if they have the skills and knowledge to identify and respond to issues before they escalate.

More information from CCOHS

Healthy Minds at Work, portal

Mental Health at Work, fact sheet

Mental Health: Awareness, free e-course

Mental Health: Psychologically Healthy Workplaces, e-course

It is generally believed that some stress is okay ("positive stress") but when the level of stress is greater than you can handle, both mental and physical changes may occur. Factors in the workplace can cause, contribute to, or worsen our mental distress, which may affect our physical or mental health. Stress is also an important issue for employers who realize that when workers are not well, the business is affected.

CCOHS worked with the Occupational Health Clinics for Ontario Workers (OHCOW) to develop a free smartphone application (app) which allows you to answer the Copenhagen Psychosocial Questionnaire (COPSOQ) and measure your level of stress.

After starting the app, you are asked to respond to 25 questions about work demands, organizational factors, relationships, workplace values, health and safety concerns, stress symptoms and offensive behaviours. On the results page, each item is scored in comparison to a reference population so you can compare. For items where your score is worse than the reference population, you can click on an icon that takes you to some ideas on dealing with that particular factor.

The original Copenhagen Psychosocial Questionnaire was designed to be done collectively and analyzed on a group basis. This individually scored version lets you get a feel for what is in the survey as well as provides ideas on how to improve your workplace psychosocial conditions.

The app is available under OHCOW's name from the Apple App Store for iOS devices and Google Play store for Android devices. A BlackBerry version of the app is coming soon.

Try it out!

More information

Measure Workplace Stress App, OHCOW

Workplace stress fact sheet, CCOHS

Stress topic page, Advancing Healthy Workplaces portal

Stress in the Workplace e-course, CCOHS

Taking Action on Workplace Stress, webinar, CCOHS with OHCOW

This month's Health and Safety To Go! podcasts offer tips for creating and maintaining a safe work environment, and feature an encore presentation of what to do to prevent the flu.

Feature Podcast: Safe Environments: What Workplaces Need to Know
Gerry Culina, Manager, General Health and Safety Services at the Canadian Centre for Occupational Health and Safety (CCOHS), talks about the four things an organization needs to keep top of mind when creating and maintaining a safe work environment.

The podcast runs 5:57 minutes. Listen to the podcast now.

Encore Podcast: Preventing the Flu: What You Can Do
It's easy to catch the flu if you're not careful. CCOHS shares some helpful tips on how you can prevent catching (or spreading) the flu this season.

The podcast runs 4:49 minutes. Listen to the podcast now.

See the complete list of podcast topics. Better yet, subscribe to the series on iTunes and don't miss a single episode.

Workplace Health and Safety Matters is the blog of Steve Horvath, President and CEO of the Canadian Centre for Occupational Health and Safety. In a recent blog post, Steve shares his thoughts on the 25th anniversary of the Occupational Health Clinics for Ontario Workers (OHCOW) and the launch of their new smartphone app.

Recently, I had the honour of celebrating the Occupational Health Clinics of Ontario Workers (OHCOW) 25th anniversary at their event "Celebrating the Past and Looking Forward". Our organizations have had a long-standing history of collaborating and sharing information and resources with the common goal to help Ontario workers stay safe on the job. I truly believe the synergy of our organizations has served workers successfully over the years.

To show our appreciation of our 20 year affiliation, I presented OHCOW with a plaque recognizing our partnership, and shared some of my personal thoughts and reflections of their organization. I believe each clinician; pioneer and tireless workplace safety advocate at OHCOW have provided our country with an immense amount of value. I especially saw this when CCHST hosted a delegation from China a few years ago. We introduced the group to the staff at OHCOW and after reviewing their operations, the delegates returned to Chongqing and built a workers' health clinic inspired by what they saw at the OHCOW offices. Now, tens of thousands of workers are receiving clinical services and counseling for occupational issues as a result of the OHCOW model.

Another reason to celebrate OHCOW
The event marked the official launch of the "Mental Injury Toolkit (MIT)" and the "Measure Workplace Stress App". This special project was a collaborative effort between OHCOW and CCOHS to build a new smartphone application that provides a set of tools for workers to measure their level of workplace stress. It will also correlate the worker response input, highlight issues for focus, and provide direction for obtaining more information.

Congratulations to OHCOW on 25 years of commitment and caring and making a difference in the quality of Ontario workers' lives.

Read Steve's blog, Workplace Health and Safety Matters.