Everything '
rhythmic beating of the heart, the protoplasm of breath, menstruation, the alternation of day and night, seasons, tides, the equinoxes and solstices, and the heat cold, the positions of the planets or the sun, solar flares, etc.. The biorhythms of concern to the man and his body are called circadian, 'cause repeat every 24 hours and activated and are influenced by the action of light on the hypothalamus pituitary that induces the secretion of melatonin at night and not more 'day. This circadian biorhythm regulating endocrine glands and organs of the body, increasing the rate of glucose in the blood, urine volume, the change in blood pressure, the body temperature, the values \u200b\u200bof proteins, electrolytes, etc.. The rhythms of
Halberg
biological rhythms, discovered by Franz Halberg, following a sine curve, which grows to a maximum (acrophase) and then falls to a minimum, varying around a midpoint. The double curve ascending, descending, then again rising and falling is completed in a period of time and well-defined characteristics which may 'last a day (circadian rhythms), one week (circasettani rhythms), one month (circatrigintani rhythms), one year (circannuali rhythms). In particular, the circadian rhythm (from the words Latin "about" and "dies" cycle almost one day) and 'the fundamental component of what we commonly call the body clock
nursing has always been characterized by a joint organization in shifts to ensure continuity
of welfare benefits and care for 24 hours.
The "shift work", as is generally described in the literature, is an essential element of work in health care companies, whose mode of planning and management is not always regarded with due caution, as it leads to a desynchronization of physiological, psychological and social activities with negative effects on health and welfare of workers and also of legal repercussions.
a result of multiple interviews with colleagues from work experience and long history have managed to get back to the goal 'of the 60', where, since 'then played a round on the 24 h. descriptions on a consequential 'type counterclockwise, afternoon, evening and night the same day followed by two days of rest. A round structured so 'had advantages and disadvantages, an undeniable concentration of working hours for more' free time, but on the other side of the scale an undeniable psychological stress bio.
The night work is required because the anti-biological clock in our body helps sleep overnight in the dark and waking during the day with sole.L 'HOMO SAPIENS therefore has a biology that requires a temporal orientation to the day, in other words we are diurnal animals.
Shift work, particularly at night, is therefore a risk factor for health and welfare of workers. (1) - (6) The direct health effects, short-term mood change, the decrease efficiency, changes in eating habits and sleep, the long-term gastro-intestinal disorders, cardio-vascular and neuro-psychic. Age, level of neurosis, sleep habits, circadian rhythms, the social conditions of family, social support are all elements that identify a particularly critical of workers' exposure to this risk factor. The work at night increases the risk of injury (also increase production errors) for sleepiness due to the altered circadian rhythm that lowers the level of attention in working with the experience of repeated micro-sleep, more if the job is monotonous and repetitive or "pending." if there is a high workload and longer working hours. (1st) (The relative risk in this case increases with the number of hours worked, especially after the twelve hours). Studies indicate that some changes in the menstrual cycle alterations in pre-menstrual syndrome, but again, the difficulty to have epidemiological data Concluding, the speech can not 'be conclusivo.Sulle alterations in sexual life scientists are silent. (2)
interesting chronobiology studies have focused on plasma levels of cortisol, for those in the shift results in an increased incidence of mental illness, gastro-intestinal disorders associated with immune system response.
In a futuristic vision of the labor market, but no less certain, will occur in the coming years 'increase in the number of workers who are employed in activities' production 24-H, for both economic and organizational choices and should therefore be developed new organizational models of work which take account of these studies to develop better compliance and physical capacity to support these workers.
With a decades-long experience as a shift worker, personally I have developed "systems" of resistance to the bio-psycho-physical stress, some simple rules of behavior that have been refined in the years leading me to prefer such a meal a day towards the goal 'sent in the afternoon, or not to exceed in his sleep the morning after unmounting night (not to push yourself to the hours of 12 am), and other small details to avoid stressing further so many of our biological clocks.
Everyone must find in itself its own "compensation method", the answer is very individual, but for sure there is a 30% of workers in matters purely biological is not physiologically adapted to cope with this type of physical stress.
available studies revealed some factors that affect markedly on workers to night shifts:
The rapid rotation
The direction of rotation of the turn
The duration of exposure to shift
The rapid rotation in the regular round
'span of a few days, routionario. The system of rotation to fast rotation does not cause significant alterations in the sleep \\ wake, there is still the psychological aspect that affects the psychophysical state of the worker. It is therefore extremely important that the shift takes place in a short time in a few days. Without this' or irregular shift workers subjected to a show high incidences of fatigue, nervousness and inadequate rest, more accidents, minor adjustment to life. There is a clear reversal of circadian rhythms after the fifth night, with a net decrease of the hormone cortisol in the morning, while the peak of the rhythm of melatonin is delayed for 7 hours. (3) Direction of rotation
Rotating shifts must follow the clockwise (morning, afternoon, night) in this way has proved more adaptable unqa 'psychological and physical, would turn to avoid a syncopated like the one now in use. (4) Duration of exposure to shift
There is data compatible with the possibility of six or more years of work
shift workers may increase the risk of coronary heart disease in women, while
a period of ten years has shown an increased risk of cancer
breast. (4)
biological alterations
Studies selected primarily take into consideration the changes that occur
:
• The rate of secretion of salivary cortisol and plasma that.
(S. Shinkai, S., Y. Kurokawa, J. Toril)
• In the rhythm of melatonin secretion. (Humm C.)
• Sleep disorders-characterized quantitative and qualitative alterations
. (JL Wilson, S. Shinkai, S. Watanabe, Y. Kurokawa, J. Toril)
• Changes in dietary pattern (following the irregular
hour sleep / wake), which are reflected in the high proportion of duodenal ulcers
, and peptic gastroduodenitis in shift workers. (JL Wilson, -
Costa G., Lievore F, Casaletti G., E. Gaffney, Folkard S.)
• In the rhythm of thermoregulation. (JL Wilson, - Costa G., Lievore F,
Casaletti G., E. Gaffney, Folkard S.)
• In the rhythm of the secretion of catecholamines resulting in
modificazion blood pressure and heart rate.
(Shinkai S., S., Y. Kurokawa, J. Toril)
• circulatory problems and cardiovascular diseases: Is there a relationship between
myocardial infarction and shift workers, the risk increases progressively as
staying in turn reaches 6 / 15 years
. (5-Wilson JL, - I. Kawachi, GA Colditz, MJ Stampfer, WC
Willet, JE Manson, Speitzer FE, Hennekens CH)
• Increased risk of breast cancer in female population
. (Schehammer ES, Laden F, Speizer FE, Willett WC, Hunter DJ
, Kawachi I., Colditz GA)
• Psychological disorders of sleep-wake cycle (Wilson JL, - Costa G., Lievore F. ,
Casaletti G., E. Gaffney, Folkard S. - C. Humm, - S. Shinkai, S., Y. Kurokawa
, Toril J. - Coming, M., L. Barzaghi, C. Cavelier, T. prawns, Guaraldi GP
• psychological disorders such as anxiety, depression and neurosis,
increase in the consumption of psychotropic substances, increased consumption of alcohol and tobacco
(Wilson J. - L. Skipper JK, Jung FD, Coffey LC - S. Shinkai,
S., Y. Kurokawa, J. Toril)
• Loss of mental energy. (JL Wilson - Humm C.)
• Increased self-esteem due to an inability to play a constant role
domestic and social sphere of the affective and emotional.
(JL Wilson - L. Skipper JK, Jung F D., Coffey LC)
• Increased stress and burnout. (S. Shinkai, S., Y. Kurokawa, J.
Toril - Humm C.)
• Loss of mental concentration. (Humm C.)
• Alteration of personality. (Costa G., Lievore F, G. Casaletti,
E. Gaffney, Folkard S.)
social disruption
• Considerable work-family conflict. (JL Wilson - L. Skipper JK, Jung F
D., Coffey LC)
• Difficulty in managing personal time. (JL Wilson -
L. Skipper JK, Jung F D., Coffey LC)
• Nurses shift workers show lower performance and less motivated
in patient care. (JL Wilson - L. Skipper JK, Jung F
D., Coffey LC)
• Reduced ability to devote time to personal activities. (Costa G., Lievore
F., Casaletti G., E. Gaffney, Folkard S.)
According to a 2006 American study, conducted by a team of researchers from the National Centre for Epidemiology and Population Health and published in the Journal of Marriage and Family, night work also affects the balance of the entire family. In fact, parents have to exhausting night hours are more stressed and depressed and children are most at risk for emotional and social difficulties. CONCLUSIONS
Working life Employee health has lengthened significantly after 1992 and the Amato Law, but without 'taking into account the cost of bio \\ social work to those who would pay shifts, for information in the early 80' the "lifetime employment" a shift worker was slightly less than 18 years, then spent the years missing to reach the 25th year working recycled as daily, leaving the turn, since the difference was compensated for by the different incoming emoluments of length '.
From the above, it is clear that the peculiarities 'of hospital work and the obvious need' to ensure 24-hour coverage does not exist, currently, a certain recipe to clear this type of risk, besides the natural compensation that any shift worker puts in place a level of control over their circadian rhythms, but it certainly can do much health administrations to improve the status quo existing policies aimed at satisfaction of staff, monitoring of the conditions and workload, participation in the choices of career paths, but above all, change that is at no cost to the government, bring the round to a course in a clockwise direction, that change also would ensure compliance with the EU standard (7) the detachment of at least 11 hours between a shift to another. For this purpose, the undersigned
nurses offer a esperimento cronobiologico di inversione dell’attuale turno Pom. \Matt., articolato su 1 anno di tempo a partire dal 1marzo 2009, giorno dello scivolamento annuale della turnazione , con sistema di controllo dell’andamento dei bioritmi \ qualita’ della vita mediante apposito questionario di valutazione a risposta multipla di “tipo Likert” con rilevazioni trimestrali. Nel mese di febbraio 2010 , al termine della ricerca verra’ redatto e pubblicato su piattaforma web un report finale dei risultati emersi da questo studio infermieristico.
Bibliografia:
(1) G. Costa "Disagi e patologie da lavoro a turni" in La salute dei lavoratori della sanità , a cura di Antonio Cristofolini, Comano Terme 18 to 19 May 1989. Ed The Editor, Trento 1990.
(1st), Costa G. Shift work and occupational medicine: an overview. Occup Med (Lond) 2003; 53: 83-88.
(2) S. Garbarino Night work. Impact on the health and safety in the workplace. G Ital Med Lav Erg 2006, 28 (1): 89-105.
(3) JL Wilson - S. Shinkai, S. Watanabe, Y. Kurokawa, J. Toril)
(4) JL-Coming M. Wilson, L. Barzaghi, C. Cavelier, T. prawns, Guaraldi GP
( 5) JL Wilson, - I. Kawachi, GA Colditz, MJ Stampfer, WC Willett, JE Manson, Speitzer FE, Hennekens CH.
(6) H. Selye The general-adaptation-syndrome. Annu Rev Med 1951; 2:
327-342.
(7) European Parliament resolution 25 \\ 02 \\ 1999
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