Skip to main content
SpringerLink
Log in

Schichtarbeit in der modernen Industriegesellschaft und gesundheitliche Folgen

Shift work in the modern industrial society and consequences on health

  • Schwerpunkt
  • Published:
Somnologie - Schlafforschung und Schlafmedizin Aims and scope Submit manuscript

Zusammenfassung

Das Arbeiten außerhalb der normalen Arbeitszeiten, sog. Schichtarbeit, betrifft mehr als 15% der Beschäftigten in Deutschland, mit steigender Tendenz. Die unregelmäßigen Arbeitszeiten, sei es in Wechselschicht, v. a. mit Nachtschicht, oder in permanenter Nachtschicht, führen zu Diskrepanzen zwischen den äußeren Aktivitäts- und Erholungsphasen einerseits und dem inneren zirkadianen Schlaf-Wach-Rhythmus andererseits. Sie beeinflussen das gesundheitsrelevante Verhalten und das soziale Leben. Die chronobiologische Desynchronisation per se sowie die damit verbundenen Schlafstörungen üben einen erheblichen Einfluss auf die Leistungsfähigkeit und auf das Unfallrisiko der Beschäftigten aus, führen aber auch zu anderen Störungen der Gesundheit. Die Datenlage aus zahlreichen Untersuchungen weist darauf hin, dass Schichtarbeit mit Nachtschichten das Risiko für funktionelle gastrointestinale Beschwerden, Brustkrebs bei Frauen, Übergewicht und gestörte Glukosetoleranz sowie kardiovaskuläre Erkrankungen, insbesondere Herzinfarkt, erhöht.

Abstract

Work beyond normal work times, so-called shift work, affects more than 15% of people who work in Germany, with a trend towards a further increase. Irregular work times as rotating shifts, especially including night shifts, or permanent night shifts lead to a discrepancy between external activity–relaxation cycles and the inner circadian wake–sleep cycle; they influence health-related behavior and social life. The disturbed synchronicity of the internal and external circadian rhythm per se and the sleep disturbance that accompanies it have a relevant influence not only on performance and risk of accident, but can also lead to other health disturbances. There is empirical evidence that shift work with night shifts increases the risk for gastrointestinal complaints, breast cancer in women, overweight, impaired glucose tolerance, and cardiovascular disease, especially myocardial infarction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Abetz L, Allen R, Folet A et al (2004) Evaluating the quality of life of patients with restless legs syndrome. Clin Ther 26:925–935

    Article  PubMed  Google Scholar 

  2. Akerstedt T (1990) Psychological and psychophysiological effects of shift work. Scand J Work Environ Health 16(Suppl 1):67–73

    PubMed  Google Scholar 

  3. Akerstedt T, Knutsson A et al (2004) Mental fatigue, work and sleep. J Psychosom Res 57(5):427–433

    Article  CAS  PubMed  Google Scholar 

  4. Akerstedt T, Peters B et al (2005) Impaired alertness and performance driving home from the night shift: a driving simulator study. J Sleep Res 14(1):17–20

    Article  PubMed  Google Scholar 

  5. Akerstedt T (2003) Shift work and disturbed sleep/wakefulness. Occup Med (Lond) 53:89–94

    Article  Google Scholar 

  6. Angersbach D, Knauth P, Loskant H et al (1980) A retrospective cohort study comparing complaints and diseases in day and shift workers. Int Arch Occup Environ Health 45:127–140

    Article  CAS  PubMed  Google Scholar 

  7. Baier PC, Trenkwalder C (2007) Circadian variation in restless legs syndrome. Sleep Med 8:645–650

    Article  CAS  PubMed  Google Scholar 

  8. Bara AC, Arber S (2009) Working shifts and mental health – findings from the British Household Panel Survey (1995–2005). Scand J Work Environ Health 35:361–367

    PubMed  Google Scholar 

  9. Barger LK, Cade BE et al (2005) Extended work shifts and the risk of motor vehicle crashes among interns. N Engl J Med 352(2):125–134

    Article  CAS  PubMed  Google Scholar 

  10. Beaumont M, Batejat D et al (2004) Recovery after prolonged sleep deprivation: Residual effects of slow-release caffeine on recovery sleep, sleepiness and cognitive functions. Neuropsychobiology 51(1):16–27

    Article  CAS  Google Scholar 

  11. Biggi N, Consonni D, Galluzzo V et al (2008) Metabolic syndrome in permanent night workers. Chronobiol Int 25:443–454

    Article  PubMed  Google Scholar 

  12. Bøggild et al (1999) Scand J Work Environ Health 25:85

  13. Boivin DB, Tremblay GM et al (2007) Working on atypical schedules. Sleep Med 8(6):578–589

    Article  PubMed  Google Scholar 

  14. Chung SA, Wolf TK, Shapiro CMJ (2009) Sleep and health consequences of shift work in women. Womens Health

  15. Costa G (1997) The problem: shiftwork. Chronobiol Int 14(2):89–98

    Article  CAS  PubMed  Google Scholar 

  16. De Bacquer D, Van Risseghem M, Clays E et al (2009) Rotating shift work and the metabolic syndrome: a prospective study. Int J Epidemiol 38:848–854

    Article  Google Scholar 

  17. Deutsche Gesellschaft für Arbeits- und Umweltmedizin e.V, (DGAUM) (2006) Leitlinie „Nacht- und Schichtarbeit“: http://www.-dgaum.med.uni-rostock.de/leitlinien/nacht_schicht.htm

  18. DGSM (2009) S3-Leitlinie Nicht erholsamer Schlaf/Schlafstörungen. Somnologie 13(Suppl 1)

  19. Di Lorenzo L, Zocchetti C et al (1998) Minor and major work accidents in a puglia business in the food sector: a 10-year study. Med Lav 89(6):499–513

    Google Scholar 

  20. Dochi M, Suwazono Y, Sakata K et al (2009) Shift work is a risk factor for increased total cholesterol level: a 14-year prospective cohort study in 6886 male workers. Occup Environ Med 66:592–597

    Article  CAS  PubMed  Google Scholar 

  21. Drake CL, Roehrs T, Richardson G et al (2004) Shift work sleep disorder: Prevalence and consequences beyond that of symptomatic day workers. Sleep 27:1453–1462

    PubMed  Google Scholar 

  22. Dula DJ, Dula NL et al (2001) The effect of working serial night shifts on the cognitive functioning of emergency physicians. Ann Emerg Med 38(2):152–155

    Article  CAS  PubMed  Google Scholar 

  23. Fell DL, Black B et al (1997) Driver fatigue in the city sleep patterns of shiftworkers. Accid Anal Prev 29(4):463–469

    Article  CAS  PubMed  Google Scholar 

  24. Folkard S (1997) Black times: temporal determinants of transport safety. Accid Anal Prev 29(4):417–430

    Article  CAS  PubMed  Google Scholar 

  25. Folkard S (2008) Shift work, safety, and aging. Chronobiol Int 25(2):183–198

    Article  PubMed  Google Scholar 

  26. Folkard S, Akerstedt T (2004) Trends in the risk of accidents and injuries and their implications for models of fatigue and performance. Aviat Space Environ Med 75(Suppl 3):A161–A167

    PubMed  Google Scholar 

  27. Folkard S, Tucker P et al (2003) Shift work, safety and productivity rest breaks and accident risk. Occup Med (Lond) 53(2):95–101

    Article  Google Scholar 

  28. ICD-10, http://www.dimdi.de/static/de/klassi/diagnosen/icd10/index.htm Ziffer G 47.2

  29. Frey R, Decker K et al (2002) Effect of rest on physicians‘ performance in an emergency department, objectified by electroencephalographic analyses and psychometric tests. Crit Care Med 30(10):2322–2329

    Article  PubMed  Google Scholar 

  30. Frost P, Kolstad HA, Bonde JP (2009) Shift work and the risk of ischemic heart disease – a systematic review of the epidemiologic evidence. Scand J Work Environ Health 35(3):163–179. Epub Apr 22. Review

    PubMed  Google Scholar 

  31. Hakola T, Harma MI et al (1996) Circadian adjustment of men and women to night work. Scand J Work Environ Health 22(2):133–138

    CAS  PubMed  Google Scholar 

  32. Halvani GH, Zare M et al (2009) The relation between shift work, sleepiness, fatigue and accidents in Iranian Industrial mining group workers. Ind Health 47(2):134–138

    Article  PubMed  Google Scholar 

  33. Hanecke K, Tiedemann S et al (1998) Accident risk as a function of hour at work and time of day as determined from accident data and exposure models for the German working population. Scand J Work Environ Health 24(Suppl 3):43–48

    PubMed  Google Scholar 

  34. Harma M, Tenkanen L et al (1998) Combined effects of shift work and life-style on the prevalence of insomnia, sleep deprivation and daytime sleepiness. Scand J Work Environ Health 24(4):300–307

    CAS  PubMed  Google Scholar 

  35. Haupt CM, Alte D, Dörr M et al (2008) The relation of exposure to shift work with atherosclerosis and myocardial infarction in a general population. Atherosclerosis 201:205–211

    Article  CAS  PubMed  Google Scholar 

  36. Himashree G, Banerjee PK et al (2002) Sleep and performance–recent trends. Indian J Physiol Pharmacol 46(1):6–24

    PubMed  Google Scholar 

  37. Horne J, Reyner L (1999) Vehicle accidents related to sleep: a review. Occup Environ Med 56(5):289–294

    Article  CAS  PubMed  Google Scholar 

  38. Ingre M, Akerstedt T et al (2006) Subjective sleepiness, simulated driving performance and blink duration: examining individual differences. J Sleep Res 15(1):47–53

    Article  PubMed  Google Scholar 

  39. Kawada T, Suzuki S (2002) Monitoring sleep hours using a sleep diary and errors in rotating shiftworkers. Psychiatry Clin Neurosci 56(3):213–214

    Article  PubMed  Google Scholar 

  40. Kecklund G, Akerstedt T et al (1997) Morning work: effects of early rising on sleep and alertness. Sleep 20(3):215–223

    CAS  PubMed  Google Scholar 

  41. Knauth P (1998) Innovative worktime arrangements. Scand J Work Environ Health 24(Suppl 3):13–17

    PubMed  Google Scholar 

  42. Knauth P (2007) Schichtarbeit, B-IV-2. In: Letzel, Nowak (Hrsg) Handbuch der Arbeitsmedizin. 5. Erg. Lfg. 12/. Ecomed, München

  43. Knutsson A (2003) Health disorders of shift workers. Occup Med (Lond) 53:103–108

    Article  Google Scholar 

  44. Kolstad HA (2008) Nightshift work and risk of breast cancer and other cancers–a critical review of the epidemiologic evidence. Scand J Work Environ Health 34(1):5–22. Review

    PubMed  Google Scholar 

  45. Lingenfelser T, Kaschel R et al (1994) Young hospital doctors after night duty: their task-specific cognitive status and emotional condition. Med Educ 28(6):566–572

    Article  CAS  PubMed  Google Scholar 

  46. Lowden A, Kecklund G et al (1998) Change from an 8-hour shift to a 12-hour shift, attitudes, sleep, sleepiness and performance. Scand J Work Environ Health 24(Suppl 3):69–75

    PubMed  Google Scholar 

  47. Morgenthaler TI, Lee-Chiong T, Alessi C et al (2007) Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders: An American Academy of Sleep Medicine report. Sleep 30(11):1445–1459

    PubMed  Google Scholar 

  48. Mountain SA, Quon BS et al (2007) The impact of housestaff fatigue on occupational and patient safety. Lung 185(4):203–209

    Article  PubMed  Google Scholar 

  49. Murray Christopher JL, Lopez Alan D (1997) Alternative projections of mortality and disability by cause1990–2020: Global burden of disease study. Lancet 349:1498–1504

    Article  CAS  PubMed  Google Scholar 

  50. Nabe-Nielsen K, Garde AH, Tüchsen F et al (2008) Cardiovascular risk factors and primary selection into shift work. Scand J Work Environ Health 34(3):206–212

    PubMed  Google Scholar 

  51. Oginski A, Oginska H et al (2000) Internal and external factors influencing time-related injury risk in continuous shift work. Int J Occup Saf Ergon 6(3):405–421

    CAS  PubMed  Google Scholar 

  52. Ohayon MM, Lemoine P, Arnaud-Briant V, Dreyfus M (2002) Prevalence and consequences of sleep disorders in a shift worker population. J Psychosom Res 53(1):577–583

    Article  PubMed  Google Scholar 

  53. Petru R, Wittmann M et al (2005) Effects of working permanent night shifts and two shifts on cognitive and psychomotor performance. Int Arch Occup Environ Health 22:22

    Google Scholar 

  54. Philip P, Akerstedt T (2006) Transport and industrial safety, how are they affected by sleepiness and sleep restriction? Sleep Med Rev 10(5):347–356

    Article  PubMed  Google Scholar 

  55. Pietroiusti A, Neri A, Somma G et al (2009) Incidence of metabolic syndrome among night shift health care workers. Occup Environ Med 7:[Epub ahead of print], doi: 10.1136/oem.046797

  56. Pilcher JJ, Lambert BJ, Huffcutt AI (2000) Differential effects of permanent and rotating shifts on self-report sleep length: a meta-analytic review. Sleep 23(2):155–163

    CAS  PubMed  Google Scholar 

  57. Puttonen S, Kivimäki M, Elovainio M et al (2009) Shift work in young adults and carotid artery intima-media thickness: The cardiovascular risk in young finns study. Atherosclerosis 205:608–613

    Article  CAS  PubMed  Google Scholar 

  58. Rauchenzauner M, Ernst F, Hintringer F et al (2009) Arrhythmias and increased neuro-endocrine stress response during physicians‘ night shifts: a randomized cross-over trial. Eur Heart J 30:2606–2613

    Article  PubMed  Google Scholar 

  59. Richardson GS, Miner JD et al (1989) Impaired driving performance in shiftworkers: the role of the circadian system in a multifactorial model. Alcohol Drugs Driving 5–6(4–1):265–273

    Google Scholar 

  60. Richardson GS (2005) The human circadin system in normal and disordered sleep. J Clin Psychiatry 66(Suppl 9):3–9

    PubMed  Google Scholar 

  61. Roenneberg T, Wirz-Justice A et al (2003) Life between clocks: daily emporal patterns of human chronotypes. J Biol Rhythms 18(1):80–90

    Article  PubMed  Google Scholar 

  62. Scheer FAJL, Hilton MF, Mantzoros CS et al (2009) Adverse metabolic and cardiovascular consequences of circadian misalignement. Proc Natl Acad Sci U S A 106:4453–4458

    Article  CAS  PubMed  Google Scholar 

  63. Schernhammer ES, Laden F, Speizer FE et al (2001) Rotating night shifts and risk of breast cancer in women participating in the nurses‘ health study. J Natl Cancer Inst 93(20):1563–1568

    Article  CAS  PubMed  Google Scholar 

  64. Schernhammer ES, Laden F, Speizer FE et al (2003) Night-shift work and risk of colorectal cancer in the nurses‘ health study. J Natl Cancer Inst 95(11):825–828

    Article  PubMed  Google Scholar 

  65. Schernhammer ES, Kroenke CH, Laden F, Hankinson SE (2006) Night work and risk of breast cancer. Epidemiology 17(1):108–111

    Article  PubMed  Google Scholar 

  66. Schwartz JRL, Roth T (2006) Shift work sleep disorder. Burden of illness and approaches to management. Drugs 66:2357–2370

    Article  CAS  PubMed  Google Scholar 

  67. Schwarzbaum J, Ahlbom A, Feychting M (2007) Cohort study of cancer risk among male and female shift workers. Scand J Work Environ Health 33(5):336–343

    Google Scholar 

  68. Scott LD, Hwang WT et al (2007) The relationship between nurse work schedules, sleep duration, and drowsy driving. Sleep 30(12):1801–1807

    PubMed  Google Scholar 

  69. Segawa K, Nakazawa S, Tsukamoto Y et al (1987) Peptic ulcer is prevalent among shift workers. Dig Dis Sci 32:449–453

    Article  CAS  PubMed  Google Scholar 

  70. Sharifian A, Firoozeh M, Pouryaghoub G et al (2009) Restless legs syndrome in shift workers: A cross sectional study on male assembly workers. J Circadian Rhythms 7:12 (doi:10.1186/1740-3391-7-12)

    Article  PubMed  Google Scholar 

  71. Smith L, Folkard S et al (1994) Increased injuries on night shift. Lancet 344(8930):1137–1139

    Article  CAS  PubMed  Google Scholar 

  72. Statistisches Bundesamt (2004) Schichtarbeit ist in Osteuropa stärker verbreitet als im Westen. Ergebnisse der EU-Arbeitskräfteerhebung 2003. Pressemitteilung des Statistischen Bundesamtes vom 23.12.2004. http://www.destatis.de

  73. Straif K, Baan R, Grosse Y et al (2007) Carcinogenicity of shift-work, painting, and fire-fighting. Lancet Oncol 8(12):1065–1066

    Article  PubMed  Google Scholar 

  74. Suwazono Y, Dochi M, Sakata K et al (2008) Shift work is a risk factor for increased blood pressure in Japanese men: a 14-year historical cohort study. Hypertension 52:581–586

    Article  CAS  PubMed  Google Scholar 

  75. Suwazono Y, Sakata K, Okubo Y et al (2006) Long-term longitudinal study on the relationship between alternating shift work and the onset of diabetes mellitus in male Japanese workers. J Occup Environ Med 48:455–461

    Article  PubMed  Google Scholar 

  76. Suwazono Y, Dochi M, Sakata K et al (2008) A longitudinal study on the effect of shift work on weight gain in male Japanese workers. Obesity 16:1887–1893

    Article  PubMed  Google Scholar 

  77. Swaen GM, Amelsvoort LP van et al (2004) Psychosocial work characteristics as risk factors for being injured in an occupational accident. J Occup Environ Med 46(6):521–527

    Article  CAS  PubMed  Google Scholar 

  78. Takeyama H, Matsumoto S et al (2004) Effects of the length and timing of nighttime naps on task performance and physiological function. Rev Saude Publica 38(Suppl 6):32–37. Epub 2004 Dec 13

    Article  PubMed  Google Scholar 

  79. Tucker P, Smith L et al (1998) Shift length as a determinant of retrospective on-shift alertness. Scand J Work Environ Health 24(Suppl 3):49–54

    PubMed  Google Scholar 

  80. Tucker P, Smith L et al (2000) Effects of direction of rotation in continuous and discontinuous 8 hour shift systems. Occup Environ Med 57(10):678–684

    Article  CAS  PubMed  Google Scholar 

  81. Viitasalo K, Kuosma E, Laitinen J et al (2008) Effects of shift rotation and the flexibility of a shift system on daytime alertness and cardiovascular risk factors. Scand J Work Environ Health 34:198–205

    CAS  PubMed  Google Scholar 

  82. Wolk R, Gami AS, Garcia-Touchard A, Somers VK (2005) Sleep and cardiovascular disease. Curr Probl Cardiol 30(12):625–662

    Article  PubMed  Google Scholar 

  83. Yildiz FA, Esin MN (2009) Self reported gastrointestinal and cardiovascular symptoms in female Turkish nurses. Int Nurs Rev 56:491–497

    Article  CAS  PubMed  Google Scholar 

  84. Zhen Lu W, Ann Gwee K, Yu Ho K (2006) Functional bowel disorders in rotating shift nurses may be related to sleep disturbances. Eur J Gastroenterol Hepatol 18:623–627

    Article  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung(en) hin: Mitglied im Advisory Board der Fa. Cephalon, Martinsried.

Author information

Authors and Affiliations

  1. Institut und Poliklinik für Arbeits-, Sozial und Umweltmedizin, Klinikum der Universität München, Ziemssenstraße 1, 80336, München, Deutschland

    P. Angerer & R. Petru

Authors
  1. P. Angerer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Petru
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. Angerer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Angerer, P., Petru, R. Schichtarbeit in der modernen Industriegesellschaft und gesundheitliche Folgen. Somnologie 14, 88–97 (2010). https://doi.org/10.1007/s11818-010-0462-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11818-010-0462-0

Schlüsselwörter

Keywords

Search

Navigation