title: Physical Activity, Energy Expenditure, Nutritional Habits, Quality of Sleep and Stress Levels in Shift-Working Health Care Personnel.
abstract: BACKGROUND
  Among health care personnel working regular hours or rotating shifts can affect parameters of general health and nutrition. We have investigated physical activity, sleep quality, metabolic activity and stress levels in health care workers from both groups.
  
  
  METHODS
  We prospectively recruited 46 volunteer participants from the workforce of a University Medical Department of which 23 worked in rotating shifts (all nursing) and 21 non-shift regular hours (10 nursing, 13 clerical staff). All were investigated over 7 days by multisensory accelerometer (SenseWear Bodymedia® armband) and kept a detailed food diary. Physical activity and resting energy expenditure (REE) were measured in metabolic equivalents of task (METs). Quality of sleep was assessed as Pittsburgh Sleeping Quality Index and stress load using the Trier Inventory for Chronic Stress questionnaire (TICS).
  
  
  RESULTS
  No significant differences were found for overall physical activity, steps per minute, time of exceeding the 3 METs level or sleep quality. A significant difference for physical activity during working hours was found between shift-workers vs. non-shift-workers (p<0.01) and for shift-working nurses (median = 2.1 METs SE = 0.1) vs. non-shift-working clerical personnel (median = 1.5 METs SE = 0.07, p<0.05). Non-shift-working nurses had a significantly lower REE than the other groups (p<0.05). The proportion of fat in the diet was significantly higher (p<0.05) in the office worker group (median = 42% SE = 1.2) whereas shift-working nurses consumed significantly more carbohydrates (median = 46% SE = 1.4) than clerical staff (median = 41% SE = 1.7). Stress assessment by TICS confirmed a significantly higher level of social overload in the shift working group (p<0.05).
  
  
  CONCLUSIONS
  In this prospective cohort study shift-working had no influence on overall physical activity. Lower physical activity during working hours appears to be compensated for during off-hours. Differences in nutritional habits and stress load warrant larger scale trials to determine the effect on implicit health-associated conditions.
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Frederick Charles
authors.identifier: http://orcid.org/0000-0002-6002-400X
authors.initials: FC
authors.lastname: Roskoden
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Janine
authors.initials: J
authors.lastname: Krüger
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Lena Johanna
authors.initials: LJ
authors.lastname: Vogt
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Gärtner
authors.affiliation: Institute of Medical Psychology, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Hans Joachim
authors.initials: HJ
authors.lastname: Hannich
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Steveling
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Markus M
authors.initials: MM
authors.lastname: Lerch
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Aghdassi
mesh_terms: D061725:Accelerometry; D000328:Adult; D015331:Cohort Studies; D004734:Energy Metabolism; D015444:Exercise; D005260:Female; D006282:Health Personnel / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009752:Nutritional Status; D010561:Personnel Staffing and Scheduling; D011446:Prospective Studies; D012890:Sleep / Q000502:physiology*; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D014940:Work Schedule Tolerance