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Biological Rhythms: Implications for the Worker

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Biological Rhythms: Implications for the Worker Biological Rhythms: Implications for the Worker September 1991 OTA-BA-463 NTIS order #PB92-117589 Recommended Citation: U.S. Congress, Office of Technology Assessment, Biological Rhythms: Implications for the Worker, OTA-BA-463 (Washington, DC: U.S. Government Printing Office, September 1991). For sale by the U.S. Government Printing office Superintendent of Document\, M~il SIop: SSOP, Washington, DC 20402-9328” ISBN 0–16-035497-8 Foreword Approximately 20 million Americans work some form of nonstandard work schedule. These schedules, which require that an individual work during nondaytime hours, noncontinuous hours, or for extended periods, are referred to as “shift work. ” Recent advances in the understanding of the biological rhythms of the body and their control by the brain indicate that shift work can disrupt these rhythms, with possible adverse consequences for the worker. This report is the third in a series of OTA studies being conducted under an assessment of “New Developments in Neuroscience. ” It was requested by the House Committees on Appropriations; Energy and Commerce; Science, Space, and Technology; Veterans Affairs; and the Senate Subcommittee on Science, Technology, and Space of the Committee on Commerce, Science, and Transportation. The report discusses biological rhythms: what they are, how they are controlled by the brain, and the role they play in regulating physiological and cognitive functions. The major focus of the report is the examination of the effects of nonstandard work hours on biological rhythms and how these effects can interact with other factors to affect the health, performance, and safety of workers. In addition, the report describes the Federal regulatory framework related to work hours and the current status of biological rhythm and shift work research. The report presents a range of options for congressional action related to the amount of research being conducted on these topics, the collection of relevant workplace statistical data, and the congressional role in ensuring the well-being of individuals engaged in nonstandard hours of work. The first publication in OTA’s assessment of “New Developments in Neuroscience” was Neurotoxicity: Identifying and Controlling Poisons of the Nervous System, published in April 1990, and the second was Neural Grafting: Repairing the Brain and Spinal Cord, which was published in September 1990. OTA was assisted in preparing this study by a panel of advisers, a workshop group, and reviewers selected for their expertise and diverse points of view on the issues covered by the assessment. OTA gratefully acknowledges the contribution of each of these individuals. As with all OTA reports, responsibility for the content of this report is OTA’s alone. The report does not necessarily constitute the consensus or endorsement of the advisory panel, the workshop group, the reviewers, or the Technology Assessment Board. AJ#d&- 2 /J’/JOHN H. GIBBONS Director Ill.!, New Developments in Neuroscience Advisory Panel Peter S. Spencer, Chair Center for Research on Occupational and Environmental Toxicology Oregon Health Sciences University Portland, OR Robert H. Blank Ronald Kartzinel Albert S. Moraczewski Social Science Research Institute CIBA-GIEGY Pharmaceuticals Pope John XXIII Medical, Moral Northern Illinois University Summit, NJ Research, and Education Center DeKalb, IL Houston, TX Alan Kraut James F. Childress American Psychological Society Herbert Paroles Department of Religious Studies Washington, DC Department of Psychiatry University of Virginia Columbia University Charlottesville, VA Laurane G. Mendelssohn New York, NY Lilly Research Laboratories Fred H. Gage Eli Lilly & Co. Richard M. Restak Department of Neuroscience Indianapolis, IN Neurological Associates University of California, San Diego Washington, DC La Jolla, CA Franklin E. Mirer Health and Safety Department Bernice Grafstein United Auto Workers Department of Physiology Detroit, MI Cornell University, School of Medicine New York, NY Biological Rhythms Study Panel J. Robert Carr (ad hoc) David F. Dinges Fred W. Turek Howard University Unit for Experimental Psychiatry Department of Neurobiology Washington, DC The Institute of Pennsylvania and Physiology Mary A. Carskadon Hospital Northwestern University Philadelphia, PA Evanston, IL Emma Pendelton Bradley Hospital East Providence, RI Alfred J. Lewy Frank A. White (ad hoc) Sleep and Mood Disorders Jones, Day, Reavis & Pogue Charles A. Czeisler Laboratory Washington, DC Laboratory for Circadian and Sleep Disorders Medicine The Oregon Health Sciences University Brigham & Women’s Hospital Portland, OR Boston, MA Patricia J. DeCoursey Department of Biology University of South Carolina Columbia, SC NOTE: OTA appreciates and is grateful for the valuable assistance and thoughtful critiques provided by the advisory and study panel members. The panels do not, however, necessarily approve, disapprove, or endorse this background paper. OTA assumes full responsibility for the report and the accuracy of its contents. iv OTA Project Staff—Biological Rhythms: Implications for the Worker Roger C. Herdman, Assistant Director, OTA Health and Life Sciences Division Michael Gough, Biological Applications Program Manager Gretchen S. Kolsrud, Biological Applications Program Managerl David R. Liskowsky, Project Director Laura Lee Hall, Analyst Joyce Ann Brentley, Legal Analyst Andrew A. Monjan, NIH Detailee Peter R. Andrews, Research Assistant Timothy P. Condon, Project Director Gary B. Ellis, Study Director Wendy S. Pachter, Legal Analysts Richard Chin, Legal Intern Katherine Kelly, Legal Intern Lawrence M. Sung, Legal Intern Jill Swerdloff, Legal Intern Support Staff Cecile Parker, Office Administrator Linda Rayford-Journiette, Administrative Secretary Jene Lewis, Secretary Contractors Scott S. Campbell, New York Hospital-Cornell Medical Center Kent S. Hull, Decision Science Consortium Benjamin W. Mintz, Catholic University of America Timothy H. Monk, University of Pittsburgh Harriet B. Presser, University of Maryland Carol S. Weisman, Johns Hopkins University Blair Burns Potter (editor), Bethesda, MD Julie Phillips (indexer), Oakton, VA lhough Septaer 1989. 2~ou@ January 1991. 3hou@ August 1989. q~ough May 1989. Shou@ September 1990. Contents Chapter 1: Summary, Policy Issues, and Options for Congressional Action . 3 Chapter 2: Introduction and Overview . 29 Chapter 3: Circadian Rhythms . .. 37 Chapter 4: The Prevalence and Use of Shift Work . .69 Chapter 5: Biological Rhythms and Work Schedules . 87 Chapter 6: Legal and Regulatory Issues . .. 123 Chapter 7: Case Study: Nuclear Powerplant Control Room Operators . .. 143 Chapter 8: Case Study: Registered Nurses and Resident Physicians . 155 Chapter 9: Case Study: The Military . .. 185 Appendix A: International Regulation of Shift Work . 199 Appendix B: Federal Research Activities . .. 217 Appendix C: Participants in Workshop on Shift Work and Extended Duty Hours . 222 Appendix D: Acknowledgments . .. 223 Appendix E: List of Contractor Documents . 227 Appendix F: Decade of the Brain . .. 228 Appendix G: Acronymns and Glossary of Terms . 230 Index . 237 Chapter 1 Summary, Policy Issues, and Options for Congressional Action 4*** ... ... ... ... ... ... .. CC*. * C . ..*.........,.....*+*****,+***,,+*** ;; w . ..........*....*.*,.***.,,*** 13 *E Tables Table Page 1-1. Shift Work in Various Employment Sectors ... ... ... .,. ... ,.. ... ... ,,, q., $**, ,* ,4**, 1-2. Demographic Profile of Shift Workers . 10 . ., . .., ..* 1- Chapter 1 Summary, Policy Issues, and Options for Congressional Action Biological rhythms are changes in various physio- effects. The results can be detrimental to some logical and behavioral functions of organisms that workers’ health and ability to perform their jobs, repeat at regular intervals and provide a framework which in turn can adversely affect their safety of temporal organization for them. Biological and that of society as a whole. rhythms in humans have cycles ranging from The term is often applied to minutes to months; for example, stages of sleep and “shift work” schedules that include nondaytime hours of work, the release of a number of hormones in the body but there is no consistent definition of the term. As cycle with a rhythm measured in minutes, while the used in this report, shift work refers to any female menstrual cycle is measured in days (box nonstandard work schedule. It includes evening l-A). Cycles in synchrony with the 24-hour or night work; a rotating shift, in which hours rotation of the Earth are probably the most change regularly (e.g., from day to evening to night); widely studied. External factors that disturb the a split shift, in which a period of work is followed internal clock can produce deleterious effects. A by a break and then a return to work; and extended common example is jet lag, the malaise associated duty hours, consisting of long periods of work with travel across time zones. In the case of jet lag, (usually over 12 hours). This report focuses on the the effect is short-lived and the body readjusts impact these schedules can have on the body’s relatively quickly to the local time at the new biological rhythms. location. Work schedules outside the standard daytime hours can disrupt the biological rhythms Diverse occupations require or involve 24-hour of the body. This disturbance can continue operations and use nonstandard work schedules. unabated while other factors, such as sleep loss They include manufacturing industries (e.g., chemi- and social
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