The Night Shift at the Riverside Cannery
Riverside Cannery employs 240 workers across two shifts. The night shift (11pm–7am) has 90 workers, most of them recent migrants who speak limited English. Over 18 months, occupational health records show night-shift workers file 2.3 times more injury claims than day-shift workers, and 41% report sleeping fewer than five hours on work days. Management installed brighter lighting and free energy drinks in the break room, and posted a translated poster about safe lifting. Injury rates have not changed. A union delegate argues the problem is not awareness but scheduling: workers often pick up a second job or care for family during the day. The site nurse notes rising blood pressure readings among workers over 45. The company has budget for one intervention this financial year and wants measurable results within 12 months.
1. Explain why the current interventions have failed, using at least two concepts about influences on health and wellbeing.
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The interventions target individual behaviour while the drivers are structural and social. Two influences are at work:
- Structural/workplace determinants. Shift timing creates a physiological mismatch with circadian rhythms. Bright lighting and energy drinks may mask fatigue briefly but do not restore sleep; indeed caffeine can worsen sleep quality after shift end. The roster itself is the exposure.
- Social and cultural determinants. Limited English reduces access to training, advocacy and health services, and may concentrate workers in insecure roles where they fear reporting. A translated poster assumes the barrier is language alone, not power, trust or time.
Why no change: education-based approaches assume a rational individual choosing behaviour. Here, workers take second jobs and provide care because income and family obligations constrain choice. Energy drinks address a symptom (tiredness) while the cause (insufficient sleep opportunity) persists. Without changing the roster, break design, or access to support, injury risk stays constant. The nurse's blood pressure data suggest cumulative physiological strain, reinforcing that this is an exposure problem, not a knowledge problem.
2. Recommend one intervention the company should fund, and justify it against alternatives using evidence-based reasoning.
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Recommendation: redesign the night roster and add protected rest breaks, paired with a peer health advocate who speaks workers' languages.
Justification:
- It targets the causal exposure (sleep opportunity) rather than a proxy (awareness).
- Rotating forward (day→evening→night) and limiting consecutive night shifts reduces circadian disruption; protected naps of 20–30 minutes are feasible within a 7-hour shift.
- A paid peer advocate addresses the access and trust barrier better than posters, because information flows through relationships.
Against alternatives:
- More education: repeats a failed approach; no mechanism to change exposure.
- Free health screening: identifies problems but does not prevent them; may stigmatise.
- Energy drinks: potentially harmful to sleep and blood pressure.
Measurability within 12 months: track injury claims per 100 workers, self-reported sleep hours, and blood pressure readings at three points. Set a target such as a 25% reduction in claims. Acknowledge limitations: second jobs and care duties sit outside employer control, so pair the roster change with flexible shift-swap options and referral to community support.