By Dr. Stefano Casali
The dissomnias are associated with other disorders in about half of the cases of intolerance to shift work (Andreoni D., 1991; G. Costa., 1999 .; Melino C., 1992). This suggests that dissomnia is the primary pathological sign of the desynchronization of circadian rhythms and of the phases of activity and rest. The study of the different forms of sleep disorders allows us to recognize a type more or less predisposed to adapt to work shifts . The coping mechanisms are very important , understood as that set of skills and abilities that modify the workload or directly affect the homeostatic and / or circadian factors that produce sleepiness in work situations (IG Aspinwall SE, Taylor Astitch, 1997; Asprea AM, Villone Betocchi G., 1998). Among the coping strategies there is the responsibility or commitment factor, which can strongly influence the availability and motivation, to adapt one's life habits to working hours. Availability in turn influenced by organizational factors such as monetary incentives, facilities and the possibility of career advancement (Lazarus RS, Monat A., 1991).
To sum up, attach diagrams of shift work taken from the preamble to the establishment of the WHO (Prof. A. Bergamaschi):
| "Health" | Do shift work |
Not simply absence of disease, | Gastrointestinal disorders Neuropsychic disorders Cardiovascular diseases |
but complete physical and mental well-being | Perturbation of circadian rhythms Sleep disorders and food Reduced psycho-physical efficiency e work performance |
and social | Family life difficulties Obstacles to social integration |
Health effects in the medium and long term:
Gastrointestinal disorders
gastroduodenitis
Duodenal ulcer
Irritable colon
Neuropsychic disorders
Chronic insomnia
Anxious-depresive syndromes
Cardiovascular diseases
Ischemic heart disease
Short term effects:
Jet-lag syndrome
Sleep disorders
Digestive disorders
Psychoneurotic disorders
Menstrual changes
> accident risk
> toxicological risk
Most vulnerable subjects: WOMEN
Menstrual disorders
Reduced fertility
Greater abortion
Perturbed fetal development
Chronic fatigue
/salute-benessere/sindrome-stanchezza-cronica.htmlChild care
Family loads
Relative risk of coronary heart disease
Daily work (%) | Do shift work(%) | |
Non-Smoking | 1 | 1.3 |
smoking | 1.6 | 2.7 |
Obesity | 1.3 | 2.3 |
Every age | 1 | 1.3 |
45-55 years: Men | 1.3 | |
Women | 3.0 | |
Most vulnerable subjects: ELDERLY WORKERS
Reduced psycho-physical efficiency
Greater mental rigidity
Lower restorative power of sleep
Greater tendency to internal desynchronization
Resistance to change
Impaired health
Ergonomic criteria for organizing shift work
Limit the fixed shift at night to the maximum
Clockwise rotation (phase delay)
As few consecutive nights as possible
Rest after the nights
Moreover
Postponing the morning start time
As many free weekends as possible
Regular cycles and not too long
Duration of shift in relation to workload
Timely information on the shift
