Human Fatigue in Shift Work Operations – Causes and Solutions
“Weariness or exhaustion from labor, exertion, or stress.”
- Per Merriam-Webster
Fatigue is a lack of energy or motivation. It’s severity can range from the exhaustion resulting from chronic fatigue syndrome (CFS) to the weariness that results from working all day and taking care of a baby during the night – or for many shift workers, working all night and taking care of the home front during the day!
This posting looks at CFS and regular, everyday fatigue, assessing how working shift work causes fatigue and what shift workers can do about it.
CFS is a condition involving prolonged and severe fatigue that can’t be relieved by rest. It’s believed that about 17 million people have CFS world-wide and that 1 million Americans suffer from CFS. According to many medical reports, to be diagnosed with CFS, a person’s tiredness must be severe enough that they are unable to participate in ordinary activities 50% of the time or more.
The only problem with this diagnosis is that activity levels vary, so what’s a normal level to apply the 50% to?
Shift workers report that they exercise less than their day-time counterparts. Does this mean that they are less active? Most are not; in fact, they may actually be more active. Many shift workers have jobs that require physical work – lifting, walking, pushing, moving….. And the physically demanding nature of these positions means the worker is active most, if not all, of the time they are working. They may not be getting the aerobic exercise that helps condition the heart and lungs by pouring oxygen into the body. They may not be giving all the parts of their bodies an equal work out. But, the physical labor aspects of their job might actually result in an activity level greater than their daytime working associates. Even workers doing the same job during the day, that other workers do at night, are often involved in less active work at least part of the day, such as meetings, completing more paperwork, etc. Also, shift workers sleep less than day-time workers as they try to fit time in with family and friends, do errands, and keep up with other obligations while working nights. The combination of physical labor at work and reduced sleep time is directly related to fatigue levels. So, when a shift worker, or their health provider, assesses whether the workers fatigue is actually at a CFS level, the employees activity levels at work and home need to come into play.
Recent studies have indicated that CFS is linked to a virus. Last year, a study published in the journal Science reported that 68 of 101 patients with CFS, or 67%, were infected with an infectious virus, xenotropic murine leukemia virus-related virus (XMRV). XMRV is a member of the same family of viruses as the AIDS virus. These types of viruses remain on their hosts’ genetic material for life. After the paper was published, the researchers continued their work and found the virus in nearly 98 percent of about 300 patients with CFS. The study also found that 3.7% of 218 healthy people studied were also infected with XMRV.
More studies are needed to determine if the XMRV virus causes CFS or if there are some other underlying causes relating the virus and the disease. Researchers believe that the virus creates an underlying immune deficiency, which might make people susceptible to a range of diseases. For example, the study also presented preliminary data showing that 20 patients of the original 101 in the study had lymphoma, a rare form of cancer. And, another related study by researchers at the University of Utah and Columbia University Medical Center found XMRV in 27% of the prostate-cancer samples they examined! Does cancer make people more vulnerable to the virus? Or, what if the virus causes these cancers? Who knows? Researchers have also found XMRV in people with autism, atypical multiple sclerosis, and fibromyalgia. More research on XMRV is clearly needed.
CFS has been thought to be a psychiatric disease, much as fibromyalgia (long-standing, chronic, body-wide pain with defined tender points in joints, muscles, tendons, and other soft tissues) is often assigned a mental health diagnosis. The linking of CFS and fibromyalgia with the XMRV virus means that these diseases can now be viewed as biologically, not mentally based, causing some of the past stigma of these diseases to be reduced or go away.
Shift work can be a cause of less severe levels of fatigue. Here are some common causes of fatigue that are directly related to working, or coping with working, shift work and links to read more about them:
- Working rotating shifts – linking to coronary artery disease
- Sleep disorders, particularly sleep apnea and restless leg syndrome
- Caffeine and alcohol use
- Poor nutrition
- Obesity
- Diabetes
- Obesity
- Excessive physical activity (see discussion above)
- Medication use
- Mental disorders related to coping
Worker fatigue levels are important for both employees and employers to know about. A company’s costs can be materially, negatively impacted by fatigued employees; absenteeism, workers compensation, health care costs, accidents, injuries, and rates of workplace errors can all be impacted. For employees, the cost of fatigue is personal; satisfaction with and ability to perform work can be reduced and relationships at home can be stressed.
The next post will focus on fatigue management programs available to companies – what they are, how they work, what the benefits of them are, and who provides them.
©2010 Circadian Age, Inc. ‘Working Nights’
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Tags: chronic problems, diabetes, fatigue, stress
