Brain and Work Research Center, Finnish Institute of Occupational Health, 00250 Helsinki.
Scand J Work Environ Health. 2010 Mar;36(2):121-33. doi: 10.5271/sjweh.2900. Epub 2010 Feb 1.
In this narrative review, we examined what level of research evidence is available that shift workers' sleep-wake disturbances can be minimized through ergonomic shift scheduling. We classified the pertinent studies conducted on real shift workers in field conditions by the type of shift system and study design (ie, whether the shift systems were modified or not - "treatment" versus "no treatment"). The results of the observational studies in which no changes to the shift system were made (ie, no treatment) showed that, irrespective of the shift system, night and early-morning shifts and quick returns are associated with short sleep and increases in sleepiness. The same is true for very long shifts (>16 hours) and extremely long weekly working hours (>55 hours). For all categories of shift systems, there was a lack of controlled intervention studies, limiting the possibility to provide solution-focused recommendations for shift scheduling. Most of the controlled intervention studies had been conducted on workers under regular 3-shift systems. These studies suggested that a change from slowly backward-rotating shifts to rapidly forward-rotating shifts is advantageous for alertness and, to some degree, sleep. We also found that a change from an 8- to 12-hour shift system does not necessarily result in impairments in the sleep-wake pattern. The level of research evidence was affected by many of the studies' frequent methodological limitations in measuring sleep and sleepiness. In all, to have reliable and solution-focused recommendations for shift scheduling, methodologically sound controlled intervention studies are required in different categories of shift systems.
在这篇叙述性评论中,我们研究了有多少研究证据表明,通过人体工程学的轮班安排,可以最大限度地减少轮班工人的睡眠-觉醒障碍。我们根据轮班系统的类型和研究设计(即轮班系统是否进行了修改——“治疗”与“非治疗”)对在现场条件下对实际轮班工人进行的相关研究进行了分类。在没有改变轮班系统的观察性研究中(即非治疗),结果表明,无论轮班系统如何,夜班和清晨班以及快速倒班都会导致睡眠时间缩短和嗜睡增加。对于非常长的班次(>16 小时)和每周工作时间极长(>55 小时)也是如此。对于所有类别的轮班系统,缺乏对照干预研究,限制了为轮班安排提供以解决方案为重点的建议的可能性。大多数对照干预研究都是在常规三班制工人中进行的。这些研究表明,从缓慢向后旋转的班次改为快速向前旋转的班次有利于提高警觉性,在一定程度上也有利于睡眠。我们还发现,从 8 小时到 12 小时的班次系统的改变不一定会导致睡眠-觉醒模式受损。研究证据水平受到许多研究在测量睡眠和嗜睡方面经常存在的方法学限制的影响。总的来说,为了提供可靠和以解决方案为重点的轮班安排建议,需要在不同类别的轮班系统中进行方法合理的对照干预研究。