Shiftwork - Fundamentals and Assessment Tools for Occupational Ergonomics - page 647

and advised how they can manipulate zeitgebers to their advantage, enhancing those that are acting in
their favor and attenuating those acting against them. They should also be taught the benefit of prophy-
lactic naps and caveats about the use of caffeine. In some cases, family counseling may be indicated to
discuss solutions to some of the social and domestic problems. The creation of self-help networks can
often be of benefit, lessening some of the social and community isolation that many shiftworkers feel.
When educational strategies fail, and the shift schedule cannot be changed, the patient may require a
change to a day-working job.
The main task with regard to management education is that of first convincing managers that there is a
problem and that shiftwork concerns cannot simply be swept under the carpet or dismissed as a problem
confined to sick or disgruntled employees who are simply not trying hard enough. Second, management
must be informed of the wide range of different shift systems that are available, including the rapidly
rotating systems so popular in Europe. Third, managers must be taught to recognize the factors (e.g.,
type of job, nature of work force, average commuting time, male-female ratio, and preponderance of
moonlighting) that should influence the selection of the optimal schedule for that work group in that
situation. For management, the “carrot” is a happy, healthy, and productive work force; the “stick” is
the specter of human error failures, such as that at the Three Mile Island nuclear power plant, and of
litigation from a work force that might consider inappropriately selected work schedules to have
adversely affected their health or their safety.
A recent tool that may help management in creating a more “shiftworker tolerant” environment is the
mathematic model. Several authors (e.g., Folkard and Akerstedt 45 ) have developed models incorporating
both circadian and sleep loss effects as determinants of “on shift” alertness and performance. Such
models are currently in the early stages of development and need considerable refinement. Eventually,
though, they might allow for the effects of different shift schedule choices to be evaluated in computer
simulations, before they are actually imposed on the hapless shiftworker.
32.6 Conclusions
Although some people cope well with shiftwork, many others have significant problems that can
adversely affect their health and well-being. These problems can become a “shiftwork sleep disorder,”
which may be quite debilitating to the individual. Shiftwork problems can be usefully understood
using a multifaceted approach that recognizes the interaction of circadian rhythms, sleep, and social
and domestic factors in determining shiftwork coping ability.
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