E-mail updates
Follow on Twitter
Subscribe to RSS By Robert Bazell
Chief Science and Medical Correspondent
NBC News
How hard is shift work on a worker's body?
Research out Wednesday from Brigham and Women’s Hospital in Boston demonstrates very precisely the way fighting the body's natural sleep patterns can increase the risk of type 2 diabetes, the most common form of the disease.
More than 21 million Americans are “shift workers,” according to U.S. Census figures. That is, they labor during the hours that most of us set aside for rest or sleep, either all or part of the time. That number is increasing 3 percent a year because of the nature of our service economy and the need for ever more people to take whatever work they can.
The sleep research team at Brigham and Women’s, under the direction of Dr. Charles Czeisler, has spent decades documenting how shift work can lead to increased obesity, heart disease, diabetes and many other health problems. In this latest research in their sleep lab they show how one mechanism creates the risk.
Twenty-one healthy volunteers were subjected to varying hours of sleeping and waking, light and dark, all designed to disrupt the body’s natural internal clock (the circadian rhythm.)
Within a few days, when the subjects ate a normal meal, their bodies did not respond in a normal way.
“Glucose levels went much higher and stayed that way for several hours,” said neuroscientist Orfeu Buxton, Ph. D., the study's lead author. “This was because of decreased insulin released from the pancreas. Together these reflect an increased risk of diabetes.”
The stress was so severe that during the three-week experiment three of the healthy volunteers became pre-diabetic. Fortunately, after nine days of normal sleep and waking, all symptoms disappeared.
Still, the experiment clearly demonstrates that shift work can make people diabetic. For people who already have diabetes or are pre-diabetic, it can make the conditions worse.
The advice from the scientists for those who perform shift work -- either out of necessity or choice:
- Try to make your daily clock as normal as possible.
- Get good sleep during the day -- finding, if you can, a quiet, very dark room.
- Don’t eat big meals at a time when you feel your body clock is out of whack.
Sound advice, experts would agree. But anyone who works odd hours knows how challenging such simple routines can be in the demands of a normal family and social life. This latest research is further evidence out-of-whack sleep’s harm to our health.
The research is published in Science Translational Medicine. You can read an abstract here:
http://stm.sciencemag.org/lookup/doi/10.1126/scitranslmed.3003200
Robert Bazell is NBC's chief science and medical correspondent. Follow him on Facebook and on Twitter @RobertBazellNBC
More from Robert Bazell:
Dental X-rays linked to brain tumor risk
"False positive" mammogram can signal future cancer
Leave a Comment:
Is there anything that DOESN'T cause diabetes now-a-day? Jeeze every other story is about something causing some disease related to obesity.
Of course their body is going to be out of whack. Did the study do long term tests? Were people's bodies able to adapt? Did the pre-diabetic conditions go away after someone adapted?
Good points, Rado. I was wondering the same things.
The problem with most of these studies is that they are not well planned. The questions that you mention, as well as others, should have been addressed in the study to make it worthwhile. It's obvious that anyone's body will be under stress when the daily routine is disrupted.
What about out of whack FAT habits?
They might adapt but who wants to risk illness just finding out? The worst are the rotating shifts--I worked those in the Navy for about six years. NEVER got used to it.
How ignorant. You're questioning a study that you haven't even read. You have zero idea how it was conducted. But of course, everyone is an expert about everything on the Internet.
The last place I worked had swing or rotating shifts where they'd work 7 days on 1st shift, get three days off then go to 6 days on second shift then rotating to third shift. The turn over rate there was incredible and few made it more than 3 months. The human body isn't designed that way. What amazes me is that many employers continue this nonsense. You don't see the folks making these decisions working those shifts yet they expect those out doing the work to do it. Maybe it's a scheme to keep the wages down. No one lasts long enough to get one.
No, Robert Bazelle, the number of shift workers is not rising at 3 percent each year "because of the nature of our service economy and the need for ever more people to take whatever work they can," it is increasing because the population also increases at a similar rate. There always have been and always will be a large number of shift workers in the population, it is just the nature of the American machine.
The design of this test was unfortunate - they took people who normally had a certain pattern and subjected them to a different pattern, which of course causes stress on the body. People who are used to shift work get in a cycle with a rhythm just like the rest of us. Shift workers are usually paid less, have "lower" lifestyles, and tend to eat less healthy food, just like most people who work a lot for a little. So no, "shift work" does not "cause" diabetes - poor eating habits and time management, and stress in general are the cause of diabetes.
What if they changed shift to sh-t
I'll speak for myself, having worked third shift now for the longer part of 25 years. You do not "adapt." You manage. I never feel OK, have little energy, and on a day off, will sleep some 24 hours with heavy dreaming. When sleeping or trying to after a night shift, I sleep a couple of hours and then can't fall back asleep, and have the quiet house, dark room, no alcohol, etc. I have crazy food cravings and insulin surges/collapses and am getting closer to Type 2 than should be, and am finally fighting the good fight of not eating crazy because I'm tired. It makes sense that night workers would have increased Type 2, along with metabolic syndrome (carb cravings, elevated BP and cholesterol, and malfunctioning insulin mechanisms).
Shift workers in my world get paid a bit more ("shift diff"), not less. I don't know if there are similar effects for people who work second shift of some other permutation. My job is 7-3, 3-11p, 11p-7a. I could never work 7-3 and feel ill when I tried, but my job will not give straight 3-11 shifts- you have to work a mix of days and evenings. Physically, I do best working 3-11, but it is not available where I have senority and a pension.
It has nothing to do with "time management skills." At least, it doesn't for me and a lot of people I've known for years, and we're not more broke so we eat more cheap junk. We are metabolically deranged and have to struggle for any type of physical normalcy.
I'd like to know who Indepundit knows who adapts so well 'like the rest of us." I've known more night workers than most people ever will and there is not "adaptaton like the rest of us."
Ilene, I'll speak for myself. I used to work second shift at a lab for about a year (admittedly not much time). I got used to it. Sure, second shift isn't as bad as third, but I simply slept in and eventually settled down into new rhythms.
I don't know, maybe it has something to do with me being young still, who knows.
I work only days, and my circadian rhythms have been out of whack for the last ten years. I work days, but my body seems to want to be awake at night no matter how hard I try to sleep on a regular schedule. I am often awake until three or four o'clock in the morning when I have to get up at six, so I am tired and exhausted all the time. I'm in education so I don't work summers, and then I usually give in to whatever it is my body is trying to do. Consequently I am often awake for twenty or even twenty-four hours at a time and often sleep from three to fifteen hours at a time, no sleep at regular intervals. I was diagnosed type 2 diabetic two years ago, and in retrospect I'm not surprised now that I know diabetes can be caused by stress and I my body is extremely stressed because I don't sleep well. It's also very hard to manage regular decent meals with such a chaotic sleep pattern. Sometimes I can't even think what a decent meal consists of and eat whatever comes to hand. A person doesn't make good judgements when sleep deprived, and they say sleep deprivation is as bad for driving as alcohol. I'm retiring next year, and hope I can take back control of my life and better control of my diabetes. I can totally believe this study.
P.S. I don't drink caffeine, and I really work at what sleep specialists call good "sleep hygiene." It's an ongoing struggle to keep my days and nights right side up.
I wonder if there is also an effect for those who sleep in the midnight sun? Perhaps we should take steps to darken our bedrooms as much as possible.
One more thing to have to worry about.
Or, we can just not worry about any of it. I have no idea what my cholesterol level is because I just don't care. I figure the stress of worrying about all the numbers would kill me just as quickly.
You are right, Laura. Our only option is to do the best we can with exercising, consuming a balanced diet, controlling our weight, etc., and hope for the best. We will all die young if we worry about the result of every study that is published.
You are so right. No one seems to grasp the concept that life is a terminal event! Every single person born will die and they will die of something. So you do your best to remain as healthy as possible. But more important than that is to be a kind and decent person who lives each day as if it were his or her last and to live it in such a way that when your time does come, there will be people who were glad to have known you and glad that you were around to make their lives richer. Make the world a bit better because you were in it and go with a glad heart and smile.
@Cameron Ford,
Don't lose any sleep over it.
Forget the exercise and live to be 99 years old. My grandmother was raised on the old farm diet, lots of red fatty red meat, lots of other fats and bad carbs, and she was the most sedentary person I've ever known. Not lazy, just sedentary as a life style. Other people die after a lifetime of running. Life is a crapshoot. All we can do is give it our best shot.
A sample size of 21 with no controls! Statistically, this will never hold up. How does stuff like this get published! This is Harvard's hospital - and Harvard is supposed to be such a good school!!
It gets published because "diabetes" and "obesity" are two current buzz words. In other words, these are akin to fads. Any study that can point a finger in their direction will get published nowadays. Wait a few years and something else will come along on which the medical community and media will focus.
Sometimes a small sample study is done to find out if a larger more expensive study is warranted.
I turned diabetic in 1994 with a 1300 blood glucose after working a graveyard shift 23 days straight with one day off, then another 14 days and a lot of days before with few days off in between from a period between October 1st and Dec 31st, 1993. My vacation was cut in half due to lack of help. It was my shift at the time, but I had no time off to plan to do anything or rest so I started to cut sleeping time to do things I wanted to do. On Jan. 1st, 1994, Northshore Regional Hospital in Slidell, La., I was first admitted into the E.R., then to the I.C.U. by Jan. 2nd. I worked at a gas station.
I'm surprised this would get published - considering it points the finger at something other than obesity being the cause of diabetes. How much money will the diet industry lose if people find out that there's a possibility diabetes might not just be a symptom of being overweight, but that other things might actually cause it?
So.... what sleep pattern is normal for someone who is a night-owl? Certainly a "normal" daylight schedule isn't it. But you'd have a hard time convincing your average office to make exceptions for people who naturally gravitate to a midnight-or-later bedtime. And I don't know any desk workers who get assigned to shift work even if they want it!
There's been a very real impact on my health in the last few years, since I graduated college and started working an office job. I'm always exhausted and don't sleep well. But not showing up at the ridiculously early hour of 7am simply isn't an option...my boss would laugh me out of his office if I said I wanted to come in at noon because it was better for my health!
I work the midnight shift and I love it because I'm a night owl. I was offered the morning shift and turned it down because the 7am start would kill me
CJ-2001013, as a night owl, I can relate, but I wonder if the fact we sleep less hours can affect our metabolism to such a degree?
That is why shift workers got a pay premium on their salary. It is the risk they're willing to take in exchange for more pay. Whether it's worth it or not is up to the individuals or someone will cry foul on their freedom all over again.
CJ, I too was a night owl in college. I would sleep from 2 am to 9 am (7hrs). It may take a few years but you can retrain yourself to be comfortable retiring and waking earlier. Now I sleep from 10 30 to 5 30am.
I believe it because I did shift work before. You never knew when to eat because you never were hungry at the normal times. I always gained weight on midnights but lost it on 1st and 2nd.
This study uses the same specious logic as "People with dogs live longer." A typical MSN headline.
Uh, no, it doesn't.
You don't read very well, huh? Or you just like listening to yourself rant, like a toddler giggling to itself.
Oh, well, carry on.
What a crock of crapola. Diabetes is caused by all the prossessed foods we all eat. Why the hell do we need hundreds of ingredients for a friking loaf of bread or a box of cereal, or donuts, macdonalds, etc. Hey fat people, stop yiur complaining and put away that candy bar. What really cracks me up is seeing these fat slobs always have a "diet" coke in there hands.Makes them feel self rightous about being a fat pig.
Speaking of a crock of crapola. Your post qualifies. Diabetes is not caused alone by the food you eat. And it is not always fat people that are diagnosed. I am a Type 1 Diabetic with a healthy diet and excercise 5x a week. I know Type 2 Diabetics that eat healthy and excercise as well. Genes have an awful lot to do with who gets this disease. Obesity is a factor yes, but not the only factor.
Scott -- I may wash down my Big Mac with a diet drink, but at least I can spell, capitalize, and know my homonyms. Self-righteous much?
These doctors and scientist do not have a clue. They are legal drug pushers who push their posions on more and more people everyday. Stop posioning our food and pushing your deadly drugs on us. But then I guess the economy would truely take a down turn if they did that. We are what drive the economy. Take control of your lives and stop letting these people eradicate us like roaches. Once they are done with one they move on to the next. Listen to the commercials all the time "do you swing your legs while you are sitting dow must be restless leg syndrom". Give me a break. I do swing my legs when sitting down. Why because I like to be up doing things, cann't sit still and I like it that way. Oh and no I do not need a tranqualizer, rydalin or what ever to make me be still. I just like doing things. Why don't you do something good with your talent like actually help people. That was what you claim you signed on for anyway. Instead of working on a way to get your next vacation home by pushing drugs or inventing pink slime.
Do you have any idea how little your average scientist makes? In terms of pay-for-effort, science, especially biological sciences, are one of the least efficient ways to make money. The head of my lab is an internationally know (among scientists) research. They are asked to speak at conferenes nearly every year. They make $60,000 a year before taxes. Are some scientists in it for the money? Yes. The work at pharmacutical companies and engineering firms. Nobody gets rich scrounging for grant money, desperately trying to publish their research.
And on the subject of publishing, did anybody notice the journal the paper was in? Do you know how hard it is to get published in STM? Take a look at the locations of the authors on some of these studies. You'll see the words "University" and "College" a lot. These are not people working in a corporate office building. These people teach classes, mentor graduate students, and get paid insultingly small amounts of money. Your comments, along with many others, demonstrate a frankly embarassing lack of understanding about the realities of science. This study didn't get published so Merek can run more commercials. It got published because they were able to induce prediabetic conditions in ahealthy subject on a steady, calorie controlled diet in a matter of DAYS.
By the way, the diagnostic criteria for restless leg syndrome isn't "do you swing your legs", its "does not moving your limbs produce significant, physical discomfort or pain?". RLS is a nerve disorder with possible links to Parkinson's Disease. If you want to get mad, get mad at the people who don't want to fund research designed to find out how to reduce the dosage required for acute pain relief, or developing ways to mitigate the now unescapable effects climate change on the food supply. In short, get mad at Republicans.
Corporate america doesn't care about worker's sleep habits, they just assume kill us all. Their actions never take into considerations worker's health or human rights. That why we need a government for the 99%. Unless we take back our democracy, workers will have to continue to suffer from corporate decisions. Get out and Occupy or agree to their mistreatment!
Corporate america doesn't care about worker's sleep habits, they just assume kill us. Either get out and Occupy your democracy or continue to agree to corporate worker control and abuse. They aren't in it for your health, they are there to take everything they can from workers and pay nothing but suffering in return.
I worked three shift weeks for 9 years. Started with 3pm-11pm, worked 7am-3pm the next two days and came back for 11pm-7am the night of the second 7am-3pm. That counted as working the fourth day even though it started in the third. It got to the point where I couldn't eat, couldn't sleep and couldn't defecate. Exercise was hard to fit in and harder to be enthusiastic about. By the forth day I was so miserable that no one wanted to be around me. There is no way that could be healthy.
I can't figure out what kind of Adam-Henrys came up with these shifts. I have friends who work in oil refineries. 12 hours on, 12 off, work seven days and get two off, seven and three, seven and four, then start all over again. Mentally and physically unhealthy and in a dangerous line of work where a tired, run-down person could fall off high towers, get seriously burned, or worse. The worker and his family have no life at all. I suppose the good wages are the draw but money is not everything. The older you get, the more you figure that out.
Health, family, and peace of mind trump everything else, IMHO.
do you think that the obamacare will cover "shift-work disorder" as a legitimate claim, or will the bureaucrats that will make the decisions on coverages claim it is a hoax like RLS?
They will not cover it I bet but they will take it into consideration at the panel where they will decide whether you are worth fixing or not. It won't work in your favor either. People will be blamed for bringing it on themselves because they did shiftwork just like people get blamed for being fat when they eat too much.
So are all new moms at risk for diabetes? I haven't slept through the night since 1993. If it isn't my kids waking me up several times a night it's the stupid cat. I know I'm not the only one. When the kids are all in college I will get on a better sleep pattern but 20 years of interrupted sleep can't be good. And all the moms I know suffer from this. How come they haven't studied us?
This study paves the way for a more detailed study (or studies) by varies institutions. Then they can compare notes and draw a more realistic conclusion. Those of us that have worked these off hours already know what it can do, and most of us have developed ways around the problems. I don't see how the evidence will matter to corporations though, all they are concerned about is the bottom line.
these various institution you mention, you mean like the one (harvard) that wants to completely destroy the beef industry by faulsely claiming eating it will kill you? you mean we must trust these idiots?
S.Ulmer,
No, I was refering to organizations that have credible researches and Dr's on board to perform controlled studies across the nation and use the results for statistics.The one at harvard is led by a Dr. but the researchers are students that are still learning.
math,
yet reported on by the media as valid and accurate data, causing beef future to plumit.
So if I do shift work and become a type 2 diabetic can I sue my employer? Maybe with this new info there will have to be more incentives for shift work. Will we need to sign disclaimers too? I am finding through all these studies lately that nothing is good for you. This article will probably increase the stress rate of shift workers one hundred fold lol. I always knew that work was not good for you. That is why it is a four letter word. I can't wait to show this to my boss at raise time hahaha
I didn't need to see the study to tell you that. At my job, we have 1 person who works to 8 pm, 2 that work to 10 pm, and 2 that work to midnight. The person who works to 8 pm is a diabetic. One of the people that works to 10 pm is obese and diabetic, the other one is battling weight gain. Of the two that works to midnight, one is obese and diabetic, with Rheumatoid Arthritis, and the other is battling weight gain and losing. All except the one that works until midnight and is battling weight gain are over 40. The other one is in his 30's. The obese one that works to midnight is trying to lose weight and not succeeding very well. I honestly believe that it directly relates to the shift work. I believed that long before that study.
In most of the cases you cite obesity is most likely the cause. It is the number 1 cause actually.
I heard about a study last year that has type 2 eat 1200 calories a day for I believe it was around six weeks and a vast majority came out of it. Mentioned it to all the diabetics where I used to work and to a person they said "Sounds good"! Not one changed their eating habits, not even one twinkie. Go figure.
The human body by design is programmed to shut down at dark. Humans are not, nor will we ever be nocturnal creatures. It does cause harm to go against that. Does it cause diabetes? That I'm not sure about.
Next they will discover living long enough will eventually lead to death........ ; )
Been there done that. And the employer justified the need by paying the employee a shift diff. which is little more than the other shifts. Then the employer would not transfer the employee to another shift because the employer couldn't find anyone to work 3rd shift. Sould familiar??
well, I'm gonna die some day anyway, guess I will just enjoy myself !!!
I've been working mids (9:30pm to 7:30am) for 12 yrs. I am not not diabetic, and I monitor my eating habits. I simply don't believe a 3 week sample of 21 people can possibly tell the whole story. Thats not to say that shift work is easy and I do think that people should be advised how to live that lifestyle in a healthy manner.
One mistake I often see people make when they come to my shift is that they try to keep living a "normal" life outside of their work schedule. Those people burn out rather quickly. I live my life schedule 24/7 (even on my days off) and I don't eat at normal times hardly ever. It seems weird at times and it can affect the social life a bit...but i simply live my life on a different schedule.
More often than not, these types of studies INTENTIIONALLY induce environments that will most likely give the results they are looking for.
Living your working hours 24/7 is what makes the difference.