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Is shift work really a health hazard?

If so, what are employers supposed to do about it?
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Is shift work really a health hazard?

Is shift work really a health hazard?

12 August 2020

By Gaby Grammeno

In mines and medical facilities, road transport and retail operations, hospitality, horticulture and many other industries, Australia’s hundreds of thousands of shift workers can only dream of a cushy nine-to-five job where they can spend the evenings with their families and sleep at night.

But aside from the obvious social disadvantages of non-traditional working hours, can shift work actually harm people’s health? And, if so, what are employers supposed to do about it?

Health hazards of shift work

The evidence in the medical literature makes it clear that working night and evening shifts can be harmful to your health. There are well-documented associations between shift work and increased rates of type 2 diabetes, weight gain, depression, coronary heart disease, stroke and even cancer. There is also a link with higher rates of accidents and injuries.

Of course, not all shift workers experience these adverse consequences. The ‘healthy worker effect’ is very apparent in any group of shift workers – those who dislike it enough tend to move out of positions where they feel their social lives are disrupted too much or they are tired all the time. So people who stay in jobs with non-traditional hours are often the ones who are better able to tolerate work outside daytime hours, whether it’s night work, 12-hour shifts, fly-in, fly-out arrangements, or rotating shifts.

This is not always the case, however. Pressure to work extended shifts or other non-standard hours is increasing, as employers do what they can to survive and thrive in a highly competitive environment, and to deal effectively with whatever financial constraints they are faced with. For many workers though, shift work or extended hours is not their preferred choice, it’s a matter of economic necessity.

But people need to get enough sleep, and chronic fatigue is very wearing for the person with the problem. It can also be costly in other ways for employers, if levels of worker fatigue undermine safety as well as effectiveness and productivity. In the hospital sector, for example, extreme instances of extended working hours for doctors in training have often been blamed for adverse medical outcomes for patients, as well as doctors.

Long hours of work combined with inadequate breaks and insufficient time to recover between shifts can produce a rise in errors and lapses in attention, with flow-on effects on safety. According to the Transport Accident Commission, fatigue is four times more likely to contribute to impairment than drugs or alcohol and 20 per cent of all fatal road crashes in Victoria involve driver fatigue whereas estimates in Queensland are 20 to 30 per cent.  

Employers’ obligations

Employers have the same responsibilities in relation to the risks of shift work as they do for other hazards, namely they need to take whatever steps are reasonably practicable to eliminate or minimise foreseeable risks of illness, injury or other harm arising from the organisation’s activities.

In many cases, this will come down to the practicalities of rostering and shift arrangements.

Managing the risks starts with consultation involving the staff who will be affected. Employers should provide staff with information on why the present shift arrangements (or changes to them) are wanted, together with the benefits and acknowledgment of potential problems.

Though an employer has the final decision about rosters and timing of shifts, workers’ objections should be taken into account in order to meet the employer’s duty of care and minimise health and safety impacts. This can be vital when it comes to safety-critical jobs such as driving, working at heights or using dangerous equipment. What is needed is a best-fit solution that accommodates the needs of both the organisation and its employees.

WHS regulators and advisors generally recommend that employers ensure there are adequate breaks between shifts and longer time to recover after working extended hours. If possible it is best to avoid rapid shift changes, especially from night to day work, and good to build in scope for flexibility to help manage unforeseen circumstances and variations in workload. Shift and night workers should be allowed consecutive days off to enable them to have at least two full nights’ sleep each fortnight, and ideally, overtime should not be allocated after night or afternoon shifts.

Safe Work Australia has resources offering detailed practical guidance on shift work, rostering and fatigue management.

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