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      Identifying shift worker chronotype: implications for health

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          Abstract

          Shift workers are at risk for developing serious health issues due to short sleep. One cause of short sleep is circadian misalignment: sleep time is not synchronized with the body’s natural circadian rhythms. Although circadian rhythms are strongly driven by the light/dark cycle, humans have individualized sleep time preferences (chronotypes) based on genetics, development, and external influences. Evening chronotype individuals fall asleep later than average and have a higher risk for developing various noncommunicable diseases. What is unclear is the association between chronotype, shift work, and risks for acquiring chronic conditions. This review is focused on shift worker chronotype and associations with obesity. Because of the paucity of research, other health issues connected with circadian misalignment were included, allowing for a total of 21 research studies. Evidence from this review supports chronotype and certain health issues are associated with shift work, even after adjusting for short sleep duration. In addition, there is evidence to support future research on how shift worker chronotype matched with shift timing impacts worker health. Through better understanding of this interface, occupational health providers can provide more comprehensive worker education on the risks associated with shift work and sleep disturbances.

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          Most cited references29

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          Circadian typology: a comprehensive review.

          The interest in the systematic study of the circadian typology (CT) is relatively recent and has developed rapidly in the two last decades. All the existing data suggest that this individual difference affects our biological and psychological functioning, not only in health, but also in disease. In the present study, we review the current literature concerning the psychometric properties and validity of CT measures as well as individual, environmental and genetic factors that influence the CT. We present a brief overview of the biological markers that are used to define differences between CT groups (sleep-wake cycle, body temperature, cortisol and melatonin), and we assess the implications for CT and adjustment to shiftwork and jet lag. We also review the differences between CT in terms of cognitive abilities, personality traits and the incidence of psychiatric disorders. When necessary, we have emphasized the methodological limitations that exist today and suggested some future avenues of work in order to overcome these. This is a new field of interest to professionals in many different areas (research, labor, academic and clinical), and this review provides a state of the art discussion to allow professionals to integrate chronobiological aspects of human behavior into their daily practice.
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            Evaluation of three circadian rhythm questionnaires with suggestions for an improved measure of morningness.

            Circadian rhythms, cyclic fluctuations in many physiological and psychological functions, are thought to influence adjustment to shiftwork. A widely acknowledged individual difference in circadian rhythms, commonly called morningness, indicates preferences associated with morning or evening activities. Various self-report instruments have been developed to measure morningness, although little measurement data have been published for these scales. Because morningness scales are being used to select workers for night shiftwork, psychometric evaluations of these scales are needed. Psychometric assessments of undergraduate responses (N = 501) on three widely used scales indicate internal (interitem) measurement deficiencies in all three. Therefore, a 13-item scale was developed that distills the best items from two of these scales. Relationships between the new composite scale and external criteria are comparable with or stronger than similar relationships between the published scales and external criteria.
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              Mortality associated with short sleep duration: The evidence, the possible mechanisms, and the future.

              This review of the scientific literature examines the widely observed relationship between sleep duration and mortality. As early as 1964, data have shown that 7-h sleepers experience the lowest risks for all-cause mortality, whereas those at the shortest and longest sleep durations have significantly higher mortality risks. Numerous follow-up studies from around the world (e.g., Japan, Israel, Sweden, Finland, the United Kingdom) show similar relationships. We discuss possible mechanisms, including cardiovascular disease, obesity, physiologic stress, immunity, and socioeconomic status. We put forth a social-ecological framework to explore five possible pathways for the relationship between sleep duration and mortality, and we conclude with a four-point agenda for future research. Copyright 2009 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Ind Health
                Ind Health
                INDHEALTH
                Industrial Health
                National Institute of Occupational Safety and Health, Japan
                0019-8366
                1880-8026
                03 July 2018
                November 2018
                : 56
                : 6
                : 512-523
                Affiliations
                [1 ]College of Nursing, University of Cincinnati, USA
                Author notes
                *To whom correspondence should be addressed. E-mail: neltnebm@ 123456mail.uc.edu
                Article
                2018-0018
                10.2486/indhealth.2018-0018
                6258747
                29973467
                3f2e4132-c332-414c-a464-2e213a603a1a
                ©2018 National Institute of Occupational Safety and Health

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License. (CC-BY-NC-ND 4.0: https://creativecommons.org/licenses/by-nc-nd/4.0/ )

                History
                : 22 January 2018
                : 25 June 2018
                Categories
                Review Article

                night shift,circadian misalignment,circadian rhythm,sleep,work schedule tolerance

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