What can we do about shift work?
There has been a lot of research published in the past few years around the effect of shift work and our health since the World Health Organisation classified night shift work as a probable carcinogen back in 2007. In 2012 research for the HSE estimated that the additional breast cancer risk associated with night shift working would have translated into about 2,000 extra cases of breast cancer (out of a total of about 43,200 in Britain) in 2004. That would mean around 550 additional deaths and makes it the biggest occupational killer after asbestos. A study in 2013, based on 2,300 women in Vancouver found that women who worked night shifts for 30 years or more were twice as likely to develop breast cancer.
More research was published this week on the link between shift work and cancer. The new one comes from researchers in the Netherlands and Germany and appears to support previous research suggesting a link between night-shift work and breast cancer. Although this research is in mice it is important because it provides the first experimental proof that shift work increases breast cancer development.
However it is not just breast cancer that is more likely to be caused by shift working. Shift work has been shown to lead to heart problems, type2 diabetes and obesity. It is also linked to stomach problems and ulcers, depression, and an increased risk of accidents or injury. We have known about these problems for many years and researchers continue to find links between shift work and health concerns.
At the end of last year, a report in Occupational & Environmental Medicine looked at more than 3,000 people living in France, about half of whom had experience working shifts. Those who had done so, either in the past or present, had lower scores on tests of memory, processing speed and overall brain power than those who worked normal office hour, while earlier this year a US report into nurses found that death from all causes was 11 per cent higher for women who worked nights for more than five years and death from cardiovascular disease was 19 per cent higher for this group.
Various reasons have been given for the increase in cancer, heart problems and diabetes, including lack of sleep, hormone disruption and even changes to eating patterns, although last year researchers at the University of Surrey said blood tests showed that normally 6% of genes – the instructions contained in DNA – were precisely timed to be more or less active at specific times of the day. One of the researchers told the BBC “”It’s chrono-chaos. It’s like living in a house. There’s a clock in every room in the house and in all of those rooms those clocks are now disrupted, which of course leads to chaos in the household.”
So – what is happening about it? What should unions and employers be doing to protect workers from these health dangers? Some researchers have gone as far as recommending that women with a known predisposition to breast cancer (such as having genetic mutations linked to breast cancer) should avoid shift work. But not all workers have the luxury of picking and choosing what hours we work, nor do most women know their genetic makeup.
There is actually guidance from the HSE on shiftwork. It was published in 2006 before the link with breast cancer (or many of the other conditions) was known). It is an excellent guide, but is no longer necessarily the correct advice as it was written about the risks that were known about 10 years ago and so does not address any of the new research that has happened since then, including the remarkable revelation that night shifts are our second biggest occupational killer. That means that unions and employers have absolutely no idea what kind of shiftwork patterns we should be agreeing. Are rotating shifts better than permanent nights? If so what are the best type? What steps can employers take to reduce the effects of shiftwork?
The HSE say that they are awaiting more research, in particular the results from a study into a million women which may be available later this year. It is quite right that they should try to get as much data as possible, but the reality is that the WHO showed that there was a likely risk eight years ago. In that time an estimated 14,000 women will have developed breast cancer as a result of night shift working and 4,400 will have died.
We live in society that is increasingly 24 hours and having revised guidance from the HSE would not of course have stopped all, or even most of these cancers, as shift working will still continue. However we do have the right to make informed choices about what is best for us, and unions have to be able to negotiate agreements that protect their members as best they can. That means clear strong advice. And we need it sooner rather than later. There will always be new research coming out but that is no reason to keep on waiting. After all guidance can be revised.