BPO Call Centers – bane or boon?

Many jobless Filipino nurses work in call centers while awaiting employment, the Philippine Nurses Association (PNA) said, attributing the problem to a surge in supply of nurses and of salaries in both government and private hospitals that are lower than the pay given to call center agents. Nurses who are applying for employment abroad need at least two-year work experience in 250-bed hospitals. Since there are not enough hospitals to accommodate them all, some nurses were forced to defray P3,500 to pay health facilities in order to get their training and the required credentials. The monthly salary for nurses range from only P6,000 to P8,000 in private hospitals while the public sector offers P10,000, driving the licensed nurses to apply in call centers who pay salaries ranging from P15,000 to 30,000 plus relocation incentives.

In matters of health, the nurses are saved from starvation and potential malnourishment, but are exposed to the BPO syndrome -- Vitamin D sunshine deficiency, disrupted bioclock and sleep deprivation, denied normal social activity stress. Most agents work at night, communicating with overseas clients who are in daylight time zones.

BPO Syndrome
Working after sundown deprives the worker of the benefits of sunlight, the Vitamin D produced by Ultraviolet light (UV-B and UV-A), which is the main source of this vitamin essential to metabolize calcium for bone development. Food sources are inadequate to supply this nutrient. A deliberate exposure to early morning or late afternoon sunlight solves the problem, but must be a habitual regimen.
For most people it is more difficult to sleep during the day. And day sleeping is not as deep as night sleeping so this in turn decreases the ability to perform safely and efficiently. Other factors that may affect day sleeping include noise, light and social commitments. The disrupted Circadian clock (sleep-wake cycle) and the changed meal schedule takes several days for the body to adapt to the new rhythm of the sleep-wake cycle. This demands a new sleep regimen to ensure a healthy 8-hour sleep.

Working at night when the body wants to sleep, and then sleep when the body wants to be awake changes the wake times and disrupts the internal body clock (circadian rhythm).
Nightshift work affects social events that occur mostly during the evening provoking stresses from frustration of normal social activity.
Aside from the social aspect there is the health aspect. According to the New England Journal of Medicine shift workers appear to be at increased risk for peptic ulcer disease, coronary heart disease, insulin resistance, as well as for sleep deprivation, depression, and sleepiness-related accidents.

Certain things that can reduce any of the negative factors of night shift work: get enough good deep sleep (minimum 6 hours); reduce noise and other disturbances; darken bedroom to simulate nighttime; avoid heavy foods, caffeine, alcohol or tobacco (stimulants that may interfere with sleeping); avoid exercise or strenuous activity prior to sleeping (increases adrenaline)

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Reasons for Getting Good Sleep 

Knowing that a shortened period of sleep may contribute to various ills, including memory lapses, trouble learning and paying attention, heart disease, obesity, mood problems and a weakened immune system, night shift workers can benefit from these tips. One or two sleepless nights or a bout of insomnia may not be something to worry about, but not getting enough sleep frequently is a concern. Some people do well with six hours, others need nine or more. Experts think seven to nine hours is about right. Some reasons to consider changing current sleep habits.

 Learning and memory
Sleep helps the brain commit new information to memory. Studies seem to show that people are more insightful or creative in their problem solving after a full sleep.

Weight
A constant lack of sleep may cause weight gain by altering the way the body processes and stores carbohydrates, and by stimulating the release of cortisol, a stress hormone. Excess cortisol has been linked to an increase in abdominal fat. Loss of sleep also reduces levels of leptin, a hormone that suppresses appetite, and increases ghrelin (GRELL-in), an appetite-stimulating hormone — a combination that can encourage eating.

Safety
There’s no evidence that we ever adapt to chronic sleep loss, but sleep "debt" contributes to sleepiness, including “microsleeps,” (seconds-long dips into sleep). These lapses may cause falls, injury and road accidents.

Quality of life
Long- and short-term sleep loss causes irritability, impatience, inability to concentrate and moodiness. Poor sleep affects the ability to work. Sleep disorders such as insomnia and sleep apnea are associated with depression.

Heart and lung health
Insomnia and sleep apnea have been linked to high blood pressure and irregular heart beat. Lack of sleep increases stress hormone levels and inflammation, two factors associated with heart attacks.

Immunity
Although not all the facts are clear, scientists have found that sleep deprivation alters the body's immune system, which fights off illness. For example, sleep loss around the time of a flu shot has been shown to reduce the production of flu-fighting antibodies.

Loss Of Sleep, Even For A Single Night, Increases Inflammation In The Body

 (September 4, 2008) -- Loss of sleep, even for a few short hours during the night, can prompt one’s immune system to turn against healthy tissue and organs. Losing sleep for even part of one night can trigger the key cellular pathway that produces tissue-damaging inflammation according to new research. The findings suggest a good night’s sleep can ease the risk of both heart disease and autoimmune disorders such as rheumatoid arthritis.full story... 

Light at night and working the graveyard shift linked to increased risk of breast cancer
SEATTLE — Oct. 16, 2001 — Women who work the graveyard shift may face an up to 60 percent increased risk of breast cancer, according to a Fred Hutchinson Cancer Research Center study.
Results of the study, the first population-based investigation of the relationship between breast-cancer risk and exposure to light at night as determined by sleep habits, bedroom lighting and graveyard-shift work, will be published in the Journal of the National Cancer Institute. The NCI funded the study.
Led by Scott Davis, Ph.D., a member of the Hutchinson Center's Public Health Sciences Division, the study is one of two independent investigations to be published in JNCI that conclude sleep interruption, especially among women who work the night shift, is linked to a significant increase in breast-cancer risk. Read more

working the graveyard shift
In addition to a little grogginess, people who work the night shift endure a number of consequences.
A study conducted by Scott Davis, University of Washington professor and chairman of Epidemiology, is being done on males who work the night shift. According to Davis, studies observing the effects of exposure to electromagnetic fields, light-at-night and the risk of breast cancer were already being done in the early 1990s. They were the inspiration for the study.
“The exposures were thought to be related to disruption of the normal circadian rhythm and the production of the hormone melatonin at night,” Davis explained. “There was evidence at the time that lower levels of melatonin at night, when it is normally high, could affect the production of reproductive hormones in women, particularly estrogen, and actually increase circulating estrogens. We know from other studies that increased estrogen can increase the risk of breast cancer.”
As a result, Davis decided to delve further into the topic and actually compare the hormone levels of day and night shift workers.
Although the study is still underway, some effects of working the night shift are already clear.
A number of adverse health effects have been reported to be associated with working night shifts.
“These include increased gastrointestinal disorders, increased stress, perhaps an increase in some cardiovascular diseases, perhaps some increase in adverse pregnancy outcomes, and an increase in breast, prostate, colon and endometrial cancer. All of these cancer types are thought to be related to hormone levels,” Davis said.

Shiftwork - health effects
There is a small part of the brain called the ‘circadian clock’, which monitors the amount of light you see, moment by moment. In the evening, when the light starts to wane, your clock notices and prompts a flood of a brain chemical called melatonin, which gives the body the signal to fall asleep. Overnight, melatonin levels remain high. They drop at daybreak and remain low during the day.

During the day, other chemicals (neurotransmitters) – such as noradrenaline and acetylcholine – increase in the body and keep you awake. This system keeps you synchronised through the day–night cycle. Many other functions of the body – including temperature, digestion, heart rate and blood pressure – fluctuate through the day, tuned by the activity of the circadian clock.

This changing rate of activity over each 24-hour period is known as circadian rhythm. A person who works nights, or starts their working day before 6am, runs counter to their circadian rhythm. This may risk health problems.

Metabolism at night
An important body function, which follows the circadian rhythm, is the internal body temperature. This temperature increases through the day. It reaches the lower level in the early hours of the morning and reaches the maximum level late in the afternoon.

The tendency to fall asleep and stay asleep occurs during the decreasing phase of the temperature circadian rhythm (between midnight and 4am). As the body temperature rises, it is more difficult to stay asleep. This is why night workers who try to fall asleep at 8am find it very difficult and also find it difficult to remain asleep through the day.

Increased risks
A person working the night shift is at greater risk of various disorders, accidents and misfortunes, including:
Increased likelihood of obesity
Increased risk of cardiovascular disease
Higher risk of mood changes
Increased risk of gastrointestinal problems, such as constipation and stomach discomfort
Higher risk of motor vehicle accidents and work-related accidents
Increased likelihood of family problems, including divorce
In addition:
The sleep deprivation, which can be caused by shiftwork, may increase the risk of epilepsy in pre-disposed people.
Shiftworkers with diabetes can experience difficulties in controlling their blood sugar levels.
Sleep problems
Shiftworkers get, on average, two to three hours less sleep than other workers, often sleep through the day in two split periods, a few hours in the morning and then an hour or so before going to work at night. Night workers can find it difficult sleeping during the day It’s difficult to keep the sleep environment dark as well as free of noise.

Unintended consequences
Hundreds of thousands of young Filipinos, fresh out of graduate school are working in an aggressive and expanding industry that aims to attain over a million workforce. This enormous segment of Pinoy society will have a huge impact on the economy in terms of consumer spending, and on Filipino mores and customs, some good, some bad. For starters, their spending habits, particularly in fast food and the traffic of their indispensable toys, the cell phone, will adjust to their nocturnal behavior. Sidewalk vendors will feel the reduction of customers while malls may enjoy a boost in weekend sales. The sociological ramifications are worth watching.