The Consequences of Inadequate Sleep
Considerable evidence suggests that shift work and long hours lead to shorter time asleep and poorer sleep quality.[5,6] Sleep deprivation can impair job performance and increase risk for worker errors and injuries. Errors made by fatigued healthcare workers also can endanger patients.[7,8] Moreover, sleep deprivation endangers both workers and others on the road during commutes to and from work. An estimated 20% of vehicle crashes are attributed to drowsy driving.[9,10]
Laboratory studies have compared performance in healthy participants after being kept awake for long hours or after consuming alcohol.[11,12,13] In terms of performance, being awake for 17 hours was similar to having a blood alcohol level of 0.05%, and being awake for 24 hours was similar to a blood alcohol level of 0.10%. The blood alcohol level that defines drunk driving in the United States is 0.08%, but several other countries use a cut-off of 0.05% because of the decrements in performance seen at that level.
Shift type and length also influence performance. Compared with the day shift, incidents increased by 15% on the evening shift and 28% on the night shift. Compared with 8-hour shifts, incidents increased by 13% for 10-hour shifts and 28% for 12-hours shifts.
Shift work and long work hours are associated with a growing number of health risks: obesity; smoking; metabolic disturbances; cardiovascular, gastrointestinal, and musculoskeletal disorders; mental disturbances, and adverse reproductive outcomes.[16,17,18,19,20,21,22,23,24] In 2007, the International Agency for Research on Cancer of the World Health Organization identified shift work with circadian disruption as a probable carcinogen. The night shift is associated with a 40% increased risk for breast cancer, the most frequently studied cancer.[26,27]
Shift work also can exacerbate symptoms and progression of chronic diseases, such as sleep disorders, gastrointestinal disorders, heart disease, hypertension, epilepsy, psychiatric conditions, alcohol and other drug abuse, insulin-dependent diabetes, asthma, and health conditions that require medications with circadian changes in effectiveness. Shift work and long work hours also strain personal relationships, including marriage and family life.
Shift work, long work hours, and fatigue cost employers an estimated $116 billion or $2000 per employee per year owing to a variety of factors: reduced productivity; increased errors; absenteeism; increased healthcare and worker compensation costs; and worker attrition due to disability, death, and moving to jobs with less demanding work schedules.[30,31] Nurses said demanding work hours were a leading factor that drove them out of their jobs.
Public Information from NIOSH and Medscape
Cite this: Running on Empty: Fatigue and Healthcare Professionals - Medscape - Aug 02, 2012.