Tuesday, November 12, 2024

Heart attacks, diabetes, divorce: tackling the dangers faced by UK’s army of night workers

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Peers and MPs will shortly receive a survey that asks: “How do you sleep at night?” It’s not a cheeky attempt to breach ­privacy – its aim is to encourage parliamentarians to clock their time asleep to raise awareness of the dangers experienced by the growing army of night workers: the ­“forgotten shift”.

In a 24-hour society, night work has expanded hugely, accelerated by the cost of living crisis and childcare fees. The night shift pays a premium – but it can also punish people in ways not experienced on day shifts. Night workers are 37% more likely than day workers to have a heart attack, 44% more likely to develop type 2 diabetes and 32% more likely to have a miscarriage, while obesity and memory loss are also factors.

In addition, night workers are six times more likely than daytime employees to divorce. “I was a part-timer in the house,” one night worker said.

Circadian rhythm is the 24-hour internal clock that regulates cycles of alertness and sleepiness by responding to light changes in the environment essential for regulating energy levels and the body’s internal physiology. Sleeping in daylight and working at night puts our biological clocks in a constant tug of war.

Yet two-thirds of adults in a recent report by the Liminal Space, a creative agency, said: “Everyone can get used to working shifts.” Research disagrees, saying 97% of night workers can never adjust. Night workers’ sleep deprivation is estimated to cost the economy £20bn a year. So what needs to be done?

In 2017, 19% of the total UK workforce worked at night. Now it is 27% – about 8.7 million people. The number of workers from ethnic minority backgrounds working at night has risen by an extraordinary 71% (360,000) over the past decade while the number of white workers has fallen by 19% (570,000). One in six workers from ethnic minorities and one in 11 white workers are part of the nocturnal workforce, some on permanent nights, others on rotas.

In 2018 the Wellcome Trust commissioned the Liminal Space to investigate how business could improve the health of employees. “What we discovered is night workers are out of sight, out of mind, even to management,” says Sarah Douglas, Liminal Space co-director. “For instance, we were told there was food on offer – but it’s not. It’s vending machines offering sweets and energy drinks. Some employees are drinking a dozen energy drinks a night just to keep going. Some of the solutions are so simple. Why not provide a microwave so workers can eat their own decent food?”

Douglas, working with the Co-op, and in collaboration with night workers, sleep researchers and psychologists, has now developed the Night Club initiative, which aims to bring expert advice for employers and employees into the workplace on such issues as diet, rest and travel. So far it has reached more than 10,000 night workers and bosses in industries as diverse as retail, transport, health and defence.

In the unlikely setting of Gate O at London Victoria bus station, a dimly lit Night Club station – a neon-decorated shipping container emblazoned with posters – took up residence for a weekend last month. Inside, night workers, in 45-minute slots, were given advice on diet (walnuts, peanut butter and chicken are better than chips and chocolate) and health, and tips to manage sleep and stress. A quiz establishes an employee’s chronotype: lark or owl?

Steve Welsh, who worked nights as a firefighter, is now a sleep scientist and Night Club facilitator. “I am an owl and didn’t like getting up early for the day shift,” he said. “But after nine years I’d lost my body clock. I’d be in a room full of people and feel so disconnected. My then partner said I was grumpy and difficult to live with, but I couldn’t see it.”

Night Club research indicates that 33% of night workers have second jobs (compared with 22% of day shift workers) and 52% have caring responsibilities (against 50% of day shift workers).

“The working poor make up a large proportion of night workers,” Douglas says. “We came across ­situations in which the mother puts the kids in a duvet in the car and drives an hour to meet her husband coming off the night shift in the warehouse car park. She starts on the day shift and he drives the kids back.”

Related: ‘It’s killing us all slowly’: how the night shift is taking a toll on US workers

Equipment for a Night Club presentation can be scaled down to fit into a suitcase or a hospital trolley. But Ben Lumley, co-head of Night Club, stresses that the onus isn’t on the individual alone to fix night working. Night Club is working with the universities of East Anglia and Oxford on the imminent Great Parliamentary Sleep Survey, and has four demands to make of the government. These are: setting up an annual health check of night workers; assigning a minister responsible for night workers; setting up an expert task force to inform best practice; and funding research on the impacts of nocturnal working, including investigating gender differences and age.

Last month five trade unions including the RMT transport union and Communication Workers Union also published a report on night work. Their demands include a higher minimum wage rate for nights and paid recovery time.

“It would be naive to say you can’t do shift work,” says professor Russell Foster of Oxford University, lead sleep scientist on Night Club. “But employers and government have a duty of care. In a survey of junior doctors, for instance, 57% had a crash or a near-miss driving home from a night shift. In Australia, junior doctors are sent home in taxis. We need action now to protect the health of a very substantial part of our workforce.”

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