Shift work raises risk of heart attack and stroke

[teacher]

It's not easy in this business to be healthy but here's one more reason to make an effort.

Shift work raises risk of heart attack and stroke

CTVNews.ca Staff
Published Thursday, Jul. 26, 2012 5:59PM EDT
Last Updated Thursday, Jul. 26, 2012 7:57PM EDT

Shift work has long been associated with unhealthy lifestyles and sleep deprivation, but a new study has now linked irregular work hours to more serious problems -- increased risks of heart attacks and strokes.

A team of international researchers, including Canadian doctors and professors, analysed 34 studies involving more than two million people and found that shift work increases the risk of a heart attack by 25 per cent and stroke by 5 per cent.

Shift work was defined as evening shifts, irregular or unspecified shifts, mixed schedules, night shifts and rotating shifts – essentially anything but a standard 9-5 job. Control groups consisted of day workers or the general population.

Night shifts were associated with the biggest increase in risk for coronary problems -- 41 per cent.

The risks remained consistent even after researchers factored in study participants’ lifestyle choices and socioeconomic status, as well as the quality of the individual studies they analyzed.

However, there was no evidence that shift work increased death rates from any cause.

While the risk increases are not huge, one of the study authors says they still have a significant impact since an estimated 33 per cent of Canadians perform some type of shift work.

“To put it in that perspective, about 1 in 14 heart attacks and 1 in 40 strokes are directly related to the effects of shift work,” Dr. Daniel Hackam, who teaches at Western University in London, told CTV News. “So it’s quite big.”

Numerous studies and anecdotal evidence have associated shift work with sleep disorders, elevated cholesterol levels and high blood pressure, among other health problems.

The latest study, published Thursday on the British Medical Journal’s website, is the largest analysis yet of the link between shift work and vascular problems.

The authors noted several caveats, including the fact that all the studies they analysed were observational and that different studies adjusted for different risk factors.

But they note that previous studies have found that even a single overnight shift can increase a person’s blood pressure and heart rate.

“A human being is just not programmed to work at these odd hours,” Hackam said, noting that shift work disrupts the circadian rhythm, or the human body clock, often forces people to eat in the middle of the night and hinders regular exercise.

“And this is only going to continue because our society is moving ever more to a 24-hour system,” he said.

Leigh Anne Dunlop, a Toronto paramedic who typically works 12-hour shifts, said switching from day to night shifts can be hard on her body and affects her sleep.

“When you work night shifts, it’s more stress on your body…but if you can monitor that, I try to sleep more the night before,” she said.

Dunlop said she eats a healthy diet and works out in between shifts. She also focuses on the benefits of her job, such as more time off between stretches of long shifts.

Supervisor Gary Wright said Toronto EMS is considering an overhaul of the paramedics’ schedules to lessen the impact on their bodies and health.

“We’ve had the current schedule for 35 years and we are looking at redesigning a schedule that will better match their body’s own biological clock rhythm,” he said.

The latest study “really drives home the point that we need to look at change here,” he said.

“I have been a paramedic for 32 years, 25 years on the road. It is difficult,” he said. “I found night shifts very much a struggle. It does affect your health… Your body temperature starts to go down in the middle of the night.”

Dr. Derek So, a cardiologist at the University of Ottawa Heart Institute, said the new findings “might be a wake up call for a lot of shift workers to reflect on some of their habits that could be unhealthy at this point.”

Employers and family physicians should also take note of the study, So told CTV News.

“Now we have over two million patients in this study. That should be a signal that health care providers should take note of,” he said.

“This tells us these risk factors should be addressed, and it’s a good time to start thinking about it and start moving on it rather than waiting for more evidence.”

The key message, Hackam said, is that shift workers should be vigilant about their health and know their risks.

He recommends that shift workers:

•Get their blood pressure and cholesterol levels checked
•Get their waistlines measured
•Quit smoking if they do
•Take breaks at work to de-stress
•Talk to their employers about workplace health programs or other initiatives
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip

http://www.ctvnews.ca/health/shift-work ... e-1.894594

[Slats]

“To put it in that perspective, about 1 in 14 heart attacks and 1 in 40 strokes are directly related to the effects of shift work,” Dr. Daniel Hackam, who teaches at Western University in London, told CTV News.

What a load of malarkey. Directly related me arse. Sounds like some "doctor" blurring the lines between correlation and causation to get his name in the paper.

Want to know what REALLY causes heart attacks and stroke? Three things: bum luck, a genetic predisposition, and LAZINESS!! You can't do much about the first two, but if you don't turn off the tv / computer / video games and put down the beer and cigarettes in favour of getting outside for some exercise and eating right, I have no sympathy for you when you end up dying in the hospital while my tax dollars are spent trying to save your sorry self from the fate your own laziness and weak will sealed for you.

[iflyforpie]

Want to know what REALLY causes heart attacks and stroke? Three things: bum luck, a genetic predisposition, and LAZINESS!! You can't do much about the first two, but if you don't turn off the tv / computer / video games and put down the beer and cigarettes in favour of getting outside for some exercise and eating right, I have no sympathy for you when you end up dying in the hospital while my tax dollars are spent trying to save your sorry self from the fate your own laziness and weak will sealed for you.

Fair enough, but I'd say that shift work certainly makes a healthy lifestyle much more difficult.

I hate exercise for exercise sake.... you will never see me in a gym. But give me a bike or a canoe or a pair of skates or a snowboard or my own two feet and three thousand of vertical to climb and I'll do it gladly.

Shift work messes with all of that, you are sleeping when you can do things in daylight with other people, and when you are awake it is the middle of the night. Sure, gyms are open 24/7 for the time-poor body nazis, but no thanks.

Add to that the circadian rhythms out of whack and any wonder all people want to do is sit in front of the TV/computer/console and eat chips.

[Slats]

Don't take this personally, but those are just excuses of the weak-willed.

[iflyforpie]

Why would I take it personally? I don't work shift work, and according to my last medical I'm at absolutlely no risk of heart attack or stroke.

[Gannet167]

So we agree then, shift work is good for your health?

I've worked a few shift work jobs and it's virtually impossible to get caught up on your sleep - between work and all the necessities of life. You're perpetually tired, have little time or extra energy for exercise, don't get as much sleep as your body requires, your immune system is degraded, your cancer risk increases, risk of depression increases, personal relationships typically suffer and all the other niceties of a healthy lifestyle get sacrificed in the name of convenience (like shopping for, cooking and eating healthy food.) You're either asleep, at work, or everything is closed for business. So you tend to visit the McD's drive through and collapse into a coma whenever you have a chance. On your days off, your best bet is to remain on the same sleep schedule. But that means you can't play with your kids, hang out with your wife, mow the lawn, hit Rona while it's open for that project you need to finish etc. So you end up flip flopping between trying to pretend to be normal, and being nocturnal.

This study doesn't surprise me at all. Sleep is one of the most essential aspects of health and (as we all know) performance. If you're a shift worker, you typically get less sleep and your circadian rhythm is disrupted. That puts stress on your heart and reduces the amount of time it gets to regenerate at night. This study ranks up there with the one that suggests a link between tanning bed use and skin cancer.

I agree that many health issues are self induced and also get frustrated that people don't take more personal responsibility. But we're not talking about those obese diabetic alcoholic drug users. This study is about shift workers who overall, on average, are less healthy all other things being equal.

[Shiny Side Up]

Don't take this personally, but those are just excuses of the weak-willed.

Then you've never experienced real soul crushing shift work. In my opinion if we lived in a civilized country no one would be subjected to this subtle type of torture for any length of time, but we don't, we're all slaves to the almighty dollar. I would go as far to say that not only is this type of work a very large health problem for our country, but a very large social problem as well. I would be willing to bet that there is a direct corelation between shift work and substance abuse, there definitely is between shift work and domestic violence.

Living a sunless troglodyte existence really f@cks with you, though I think some can tolerate it better than others. Combine it with subtle cold torture, sleep deprivation, brute labour and typical work camp diet is a recipe for all sorts of issues. I was thankfully smart enough to get out of it before it killed me, or I killed someone else.

[azimuthaviation]

Shift work is what pushes most nurses out of their field. Maybe they're more aware of the health consequences and since its unavoidable to the job, they decide its not worth it for forty dollars an hour. Maybe more Ames should be aware, and make the decision whether or not its worth it for them.

[Slats]

Don't take this personally, but those are just excuses of the weak-willed.

Then you've never experienced real soul crushing shift work. In my opinion if we lived in a civilized country no one would be subjected to this subtle type of torture for any length of time, but we don't, we're all slaves to the almighty dollar. I would go as far to say that not only is this type of work a very large health problem for our country, but a very large social problem as well. I would be willing to bet that there is a direct corelation between shift work and substance abuse, there definitely is between shift work and domestic violence.

Living a sunless troglodyte existence really f@cks with you, though I think some can tolerate it better than others. Combine it with subtle cold torture, sleep deprivation, brute labour and typical work camp diet is a recipe for all sorts of issues. I was thankfully smart enough to get out of it before it killed me, or I killed someone else.

I don't need the sob story about how tough shift work is; I was well educated on an oil rig. But it's still no excuse. If your job is a physically demanding one it's not imperative that you exercise beyond that, as your body is burning plenty of calories. Simply ingest equal to or less than that of healthy foods and there is a baseline healthy lifestyle. And if your job isn't physical, it's still pretty simple. Walk or bike to work, or trade 30 minutes of tv/computer/video game time for taking a walk. I don't think there are too many flying jobs out there that make it that difficult to get daily exercise.
People make excuses to justify their sedentary lifestyles, but human beings were not meant to live so. The more physically fit and able bodied a person is, the better they will feel physically and mentally, even in spite of a soul sucking shift job.
It's all a matter of will.

[Cranium]

Yes, diet and exercise can reduce your risk factors, but that still can't totally compensate for the added baseline stress of trying to sleep during the day (daylight, traffic noise, lawn mowing, phone ringing), trying to adjust a sleep schedule by 16 hours over a two-day weekend, and not seeing family and friends while working night shift. It's this baseline, chronic stress that causes health issues. Some people turn to exercise for their dopamine rush to sleep, others turn to comfort food. One option helps, the other hurts. The chronic stress is still there, though.

Besides, humans are wired for daylight - I don't have the eyes of a cat or an owl, or the sonar of a bat to navigate at night.

[Shiny Side Up]

Yes, diet and exercise can reduce your risk factors, but that still can't totally compensate for the added baseline stress of trying to sleep during the day (daylight, traffic noise, lawn mowing, phone ringing), trying to adjust a sleep schedule by 16 hours over a two-day weekend, and not seeing family and friends while working night shift.

Its the lack of sleep and social needs that is the real problem. Fuelling that, people often resort to some sort of aid to maintain wakefulness when switching over, which say what you want, willpower alone just can't fight those urges. I used to think that, until someone woke me up sleeping in a snowbank one night. It was a big wake up call that something was wrong, being a reasonably healthy person (keep in mind that in my off time I used to cycle 40km a day and occasionally hump a 60lb pack into Landslide Lake for a weekend) I used to repeatedly have colds or the flu, and at the time was silly enough to power through them and work until the end of the 10 day shift. Magically when I stopped doing shift work I haven't been that ill since, even though I'm older now and considerably less fit (I doubt I could do that Landslide trek these days).

On the social side of things having a good crew to work with was a definite blessing while pulling off such shifts, having a bad one was nightmarish. I suspect these days though conditions have somewhat improved for workers, though I wouldn't bet those changes are sweeping. I remember the "penal gang" I had to work with once, where I was the only one allowed to drive the truck being the only employee without a DUI. Fun times. While that was probably an extreme case where stress levels ran high, shift type work obviously also tends to attract the people who must do it rather than those who can. Working with a good crew was the exception rather than the rule. The big kicker was the lack of contact outside of work with friends and family. The ammount of guys I saw who spiraled out of control when marital issues arose during the work was tough to watch. Even growing up in an oil-town, it was very notable that I knew far more people divorced than there were happily married. If you say "willpower" gets you through that stuff, I would only say yes, if part of that willpower is to get yourself out of that shift work to make yourself a better life. Sometimes that means making do with less money, but that's not always an easy choice to make.