Dr Dingle's Blog / sick

The Essential Sleep (Part 1)

The Essential Sleep (Part 1)

In today’s busy and hectic society many see sleep as a luxury rather than what it is – a necessity.  More and more people are working overtime, and shift work trying to juggle a busy family life around their work.  Along with this, it is not unusual for both parents to be working full time.  The advent of our 24/7 society has pushed regular sleep to the side. Because of this, many men and women (and even children) wrongly consider sleep a waste of time. 

Sleep is an essential element of the human body, without it we cannot survive. Getting enough sleep is associated with energy, joy, optimistic thinking and coping with negative emotions. Despite this almost 90 percent of Australians suffer from some type sleep disorder at some stage of their lives.  Of these, 30 percent suffer from severe sleep disorders.  Very few people regularly enjoy the amount or quality of sleep that they need.  The estimated economic costs to the country from this are between $3 billion and $7 billion annually.  There are also huge, unmeasured physical, psychological, emotional and social costs. 

Sleep is complicated in the way that there are many different factors that influence the effectiveness of sleep. It’s not just duration that determines the effectiveness of said sleep, factors such as quality, frame of mind and deepness all contribute to the maximum desired outcome and even our perception of how we sleep. Many factors can play a part in the quality and quantity of our sleep and to maximise our sleep time an understanding of this is essential.     

On average a healthy person will spend around one third of their life sleeping (Duman et al, 2009).  Sleep is considered a natural periodic state of rest for the mind and body, in which the eyes will usually close and consciousness is completely or partially lost resulting in a decrease in bodily movements and responsiveness to external stimuli (Blanch et al, 2009). Inadequate hours of good quality sleep leads to a disruption to vital biological processes resulting in a decrease in cognitive function mental and physical health (Anderson et al, 2009) including impaired work performance due to a decrease in attention, judgement and responsible decision making (Volkow, 2009). 

Why we sleep

Mammals are naturally diurnal animals and sleep for humans are broken into two distinct phases. These phases, Non Rapid Eye Movement (NREM) and Rapid Eye Movement (REM), represent the depth of sleep and electrical activity in the central nervous system (CNS) (Cirelli & Tononi, 2008). However, sleep is a heightened anabolic state where rejuvenation of many organ systems occurs, especially the immune and nervous systems. NREM is further broken into phases one to three during which have different waves of sleep and cognitive perceptions, phase one for example is associated with hyper‑CNS responses. During this phase the body may quickly jerk out of steep and this will be felt as a falling sensation (Walsh, 2009). Various genetic mutations have been associated with sleep including DEC2 mutations that lower the sleep requirement from eight hours to six and the 600072 prion gene that predisposes to Fatal Familial Insomnia (Kniff in, 2009; McKusick and Kniffin, 2009). The natural circadian rhythms of the body are a result of variations in levels of circulating melatonin hormone, from the pineal gland, and also adenosine levels which increase over the course of the day (Imeri & Opp, 2009).

Among the theories on why humans sleep, scientists have proposed the following:

Sleep may be a way of recharging the brain. The brain has a chance to shut down and repair neurons and to exercise important neuronal connections that might otherwise deteriorate due to lack of activity or over activity.

Sleep gives the brain an opportunity to reorganize data to help find a solution to problem, process newly learned information and organize and archive memories.

Sleep lowers a person’s metabolic rate and energy consumption.

The cardiovascular system also gets a break during sleep. People with normal or high blood pressure experience a 20 to 30% reduction in blood pressure and 10 to 20% reduction in heart rate.

During sleep, the body has a chance to replace chemicals and repair muscles, other tissues and aging or dead cells.

In children and young adults, growth hormones are released during deep sleep (World Federation of Sleep Research and Sleep Medicine Societies

Immune function is highest when we sleep

Detoxing. There appear to be “hidden caves” inside the brain, which open up during sleep, allowing cerebrospinal fluid (CSF) to flush out potential neurotoxins, like β-amyloid, which has been associated with Alzheimer’s disease. The research discovered “hidden caves” inside the brain, which open up during sleep, allowing cerebrospinal fluid (CSF) to flush out potential neurotoxins, like β-amyloid, which has been associated with Alzheimer’s disease. The interstitial spaces in the mouse’s brain took up only 14% of the brain’s volume while it was awake. Yet, while it slept, this increased by almost two-thirds to take up fully 23% of the brain’s total volume. The effect is that potential neurotoxins, like β-amyloid, are cleared twice as fast during sleep as during waking. While many neurological diseases, like strokes and dementia, are associated with problems sleeping. It could be that lack of sleep, and restriction of the brain’s cleaning system, may cause toxic metabolites to building up, leading to long-term damage.

Most likely we sleep for a combination of these reasons

 

Part 2 and more coming

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Essential Sleep (Part 2)

Essential Sleep (Part 2)

The benefits of sleep include:

Feeling rested;

Being physically and mentally alert;

Having more energy;

Making fewer mistakes (including causing accidents);

Feeling psychologically and emotionally recovered;

and to experience:

Improved cognitive function;

Improved memory;

Higher stress tolerance and resilience;

Increased productivity;

Normal body balance;

Healthier weight;

Reduced risk of CVD, diabetes and cancer;

Living longer; and

Feeling healthier. 

during sleep the mind is cataloguing our memories and deciding what to keep and what to throw away it is making memories stronger. It also seems to be reorganizing and restructuring memories.

It’s not possible to learn something new when you sleep, like a foreign language, but you can reinforce something you already know.One study found that students learned to play a series of musical notes better after listening to them during a 90-minute nap. The research shows that memory is strengthened for something you’ve already learned. Rather than learning something new in your sleep.

A review of studies on sleep found that we tend to hold on to the most emotional parts of our memories.

Getting enough sleep is associated with energy, joy, optimistic thinking and coping with negative emotions. 

Stages of Sleep                                                                           

Sleep Stage

Brain Waves

Common Characteristics

Frequency

Type

 

 

Stage 1

NREM

 

 

4 to 8

 

 

Alpha

& Theta

 

Transition between sleep and wakefulness

Eyes begin to roll and close

Consists of mostly theta waves with some brief periods of alpha waves (similar to waves of wakefulness)

Stage lasts 5-10 mins

 

 

 

Stage 2

NREM

 

 

8 to 15

 

 

Theta, Spindles,

k-complexes

 

Brain wave peaks become higher

Spontaneous periods of muscle tone mixed with periods of muscle relaxation

Heart rate  and temperature decrease

Stage last 5-10 mins

 

 

Stage 3

NREM

 

2 to 4

 

Delta, Theta

 

Deep Sleep or Delta sleep

Very slow brain waves

 

 

Stage 4

NREM

 

0.5 to 2

 

Delta, Theta

 

The last of deep sleep before REM begins.

Consist mostly of Delta waves

 

 

 

Stage 5

 REM

 

 

 

≥ 12

 

 

 

Beta

 

Beta waves have a high frequency and occur when the brain is active when asleep and awake.

Frequent bursts of rapid eye movement (REM) and muscle twitches.

Increase in heart and breathing rate

Vivid dreaming occurs here.

(Cook and Nendick, 2007)

Circadian Cycle

When a person falls asleep and wakes up is largely determined by their circadian rhythm, a day-night cycle of about 24 hours. Circadian rhythms greatly influence the timing, amount and quality of sleep (Lockley et al. 1997).

Literally hundreds of circadian rhythms have been identified in mammals (Campbell 1993). Among the numerous systems and functions mediated by the circadian timing system are, hormonal output, core body temperature and metabolism. The circadian clock is believed to sit in the suprachiasmatic nucleus (SCN) located in the hypothalamus of the brain. It was thought that processes now linked with circadian timing e.g. sleep wake cycles, were due solely to environmental cues, for example solar activity, it is now recognised however that these biological rhythms are regulated by factors inherent to the organism (Campbell 1993). A circadian rhythm displays a 24 hour cycle of wakefulness and sleep synchronised with the world’s night/day clock (Mansuy et al, 2003).  Everyone’s cycle will vary depending on behavioural and psychological factors (Mansuy et al, 2003).  The most typical pattern will be low alertness in the mornings as we wake, to highly alert mid afternoon (Swain et al, 2007).

The natural circadian rhythm in the body, which maintains a regular sleep-wake cycle, makes important contributions to physiological processes and psychological health. The normal rhythm is reset daily by the influence of bright light in the morning. Shift-workers, who may work at night and sleep in the daytime, and blind people may have difficulty maintaining a normal sleep-wake cycle because the natural environmental cues are miss-timed (Morris 1999). Studies show that shift work is one the greatest influencing factor causing an alteration in an individual’s cycle along with sleeping disorders (Baulk, 2008).  Altering the circadian cycle can lead to periods of decreased alertness leaving people extremely vulnerable to accidents and injuries (Andersen et al, 2009).

Our sleep patterns appear to be polyphasic. In one experiment, subjects were exposed to 14 hours of darkness; then they remained in a state of quiet rest for about two hours before falling asleep.  They then slept for four hours, awakened from a dream, spent another two-hour period in quiet rest, and then fell asleep again for four hours more.  The subjects awoke at 6 a.m. each morning from their dream sleep and then spent two hours in quiet rest before arising at 8 a.m.  These subjects followed their own natural rhythms, sleeping for eight hours with blocks of time at quiet rest (Wehr, S.E, 1996).  This polyphasic sleep appears to be a pattern in many mammals.  We experience hypnagogic imagery – a state described as dreaming, drowsy, floating, wandering – every night just before we fall asleep.  Every night before we go to sleep we spend a few minutes in a state of relaxed wakefulness characterised by drifting thoughts and alpha brainwaves.

Another interesting method for lessening the impact of sleep deprivation was through a study that found there were certain hours better to sleep through the night. A new Stanford University study on the science of sleep deprivation suggests that early­ morning sleep is more restful than a middle‑of‑the‑night nap. In a study of two groups of men they found that early‑morning sleepers scored higher on wakefulness tests and on measures of sleep efficiency. (Stratton, 2003) Although this study shows that there may some advantages to when you get your sleep it is more an avoidance of the problem rather than a solution.

We are also influenced not just by sleep but also our perceptions of its quality. If we think we’ve had a wonderful sleep last night, we feel and perform better, even if our sleep was actually the same as usual. In this study researchers randomly told some people they’d had better sleep than others after they were hooked up to some placebo brain sensors). When they were given a cognitive test the next day, those who’d been told they slept the best also did the best in the test.

 

Part 3 and more coming

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Common household disinfectants linked with birth defects, miscarriages and fertility.

Common household disinfectants linked with birth defects, miscarriages and fertility.

Quaternary ammonium compounds (QACs) are antimicrobial disinfectants commonly used in commercial and household settings and everyone is virtually exposed to these chemicals every day. Two common quaternary ammonium compounds, alkyldimethylbenzyl ammonium chloride (ADBAC) and didecyldimethyl ammonium chloride (DDAC), are combined in common cleaners and disinfectants.

In this study introduction of a cleaner containing ADBAC+DDAC in the living chambers caused neural tube defects (NTDs) in mice and rats. They found increased neural tube defects with exposure to the disinfectant combination in both rats and mice. The neural tube defects persisted for two generations after cessation of exposure.

They also found that male exposure alone was sufficient to cause neural tube defects. Equally significant, ambient exposure from disinfectant use in the cage they were kept in, influenced the levels of neural tube defects to a greater extent than oral dosing. So the ambient exposure through the air and surfaces had more impact than the feeding.

These results clearly demonstrate that ADBAC+DDAC in combination are teratogenic (birth defects) to rodents. Given the increased use of these disinfectants, further evaluation of their safety in humans and their contribution to health and disease is essential.

Quaternary ammonium compounds (QACs) are a large class of chemicals used for their antimicrobial and antistatic properties. They are common ingredients in cleaners and disinfectants, hand wipes, food preservatives, swimming pool treatments, laundry products, shampoos, conditioners, eye drops, and other personal care products. QACs have been in use for over 60 years, but the number of products containing QACs has increased recently as the versatility of these compounds is recognized. Over time, the chemical structure has been altered to increase antimicrobial and surfactant efficacy resulting in multiple generations of these products. Many products now contain a combination of two or more QACs. Extensive use of QACs results in ubiquitous human exposure, yet reproductive toxicity has not been evaluated.

Because chemical mixtures can act synergistically to produce greater toxic effects than the sum of the individual components, evaluation of common mixtures is essential in the evaluation of chemical risk.

This study was initiated because some laboratories which breed and test with mice and rats had noticed some anomalies. One laboratory noted abrupt declines in mouse colony productivity, along with declines in fetal health, that coincided with the introduction of disinfectants containing the QACs, alkyl dimethyl benzyl ammonium chloride (ADBAC) and didecyl dimethyl ammonium chloride (DDAC). Several years later, the laboratory encountered breeding problems and neural tube birth defects (NTDs) that began shortly after a change in room disinfectants. These experiences pointed to the QAC disinfectant but could not confirm toxicity because neither incident tested QACs under experimental conditions.

In an earlier study by the same team reproductive studies demonstrated that QACs adversely affect both male and female fertility and fecundity in rodents (Melin et al., 2014, 2016). Decreased reproductive performance in laboratory mice coincided with the introduction of a disinfectant containing both alkyl dimethyl benzyl ammonium chloride (ADBAC) and didecyl dimethyl ammonium chloride (DDAC). QACs were detected in caging material over a period of several months following cessation of disinfectant use. Breeding pairs exposed for six months to a QAC disinfectant exhibited decreases in fertility and fecundity: increased time to first litter, longer pregnancy intervals, fewer pups per litter and fewer pregnancies. Significant morbidity in near term dams was also observed. In summary, exposure to a common QAC disinfectant mixture significantly impaired reproductive health in mice.

 

Source 1

Ambient and dosed exposure to quaternary ammonium disinfectants causes neural tube defects in rodents. Hrubec TC et al 15 June 2017. http://onlinelibrary.wiley.com/doi/10.1002/bdr2.1064/full

Source 2

Exposure to common quaternary ammonium disinfectants decreases fertility in mice.

Melin VE1, Potineni H1, Hunt P2, Griswold J2, Siems B3, Werre SR4, Hrubec TC5.Reprod Toxicol. 2014 Dec;50:163-70. doi: 10.1016/j.reprotox.2014.07.071. Epub 2014 Aug 14.

 

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Common household disinfectants linked with birth defects, miscarriages and fertility.

Common household disinfectants linked with birth defects, miscarriages and fertility.

Quaternary ammonium compounds (QACs) are antimicrobial disinfectants commonly used in commercial and household settings and everyone is virtually exposed to these chemicals every day. Two common quaternary ammonium compounds, alkyldimethylbenzyl ammonium chloride (ADBAC) and didecyldimethyl ammonium chloride (DDAC), are combined in common cleaners and disinfectants.

In this study introduction of a cleaner containing ADBAC+DDAC in the living chambers caused neural tube defects (NTDs) in mice and rats. They found increased neural tube defects with exposure to the disinfectant combination in both rats and mice. The neural tube defects persisted for two generations after cessation of exposure.

They also found that male exposure alone was sufficient to cause neural tube defects. Equally significant, ambient exposure from disinfectant use in the cage they were kept in, influenced the levels of neural tube defects to a greater extent than oral dosing. So the ambient exposure through the air and surfaces had more impact than the feeding.

These results clearly demonstrate that ADBAC+DDAC in combination are teratogenic (birth defects) to rodents. Given the increased use of these disinfectants, further evaluation of their safety in humans and their contribution to health and disease is essential.

Quaternary ammonium compounds (QACs) are a large class of chemicals used for their antimicrobial and antistatic properties. They are common ingredients in cleaners and disinfectants, hand wipes, food preservatives, swimming pool treatments, laundry products, shampoos, conditioners, eye drops, and other personal care products. QACs have been in use for over 60 years, but the number of products containing QACs has increased recently as the versatility of these compounds is recognized. Over time, the chemical structure has been altered to increase antimicrobial and surfactant efficacy resulting in multiple generations of these products. Many products now contain a combination of two or more QACs. Extensive use of QACs results in ubiquitous human exposure, yet reproductive toxicity has not been evaluated.

Because chemical mixtures can act synergistically to produce greater toxic effects than the sum of the individual components, evaluation of common mixtures is essential in the evaluation of chemical risk.

This study was initiated because some laboratories which breed and test with mice and rats had noticed some anomalies. One laboratory noted abrupt declines in mouse colony productivity, along with declines in fetal health, that coincided with the introduction of disinfectants containing the QACs, alkyl dimethyl benzyl ammonium chloride (ADBAC) and didecyl dimethyl ammonium chloride (DDAC). Several years later, the laboratory encountered breeding problems and neural tube birth defects (NTDs) that began shortly after a change in room disinfectants. These experiences pointed to the QAC disinfectant but could not confirm toxicity because neither incident tested QACs under experimental conditions.

In an earlier study by the same team reproductive studies demonstrated that QACs adversely affect both male and female fertility and fecundity in rodents (Melin et al., 2014, 2016). Decreased reproductive performance in laboratory mice coincided with the introduction of a disinfectant containing both alkyl dimethyl benzyl ammonium chloride (ADBAC) and didecyl dimethyl ammonium chloride (DDAC). QACs were detected in caging material over a period of several months following cessation of disinfectant use. Breeding pairs exposed for six months to a QAC disinfectant exhibited decreases in fertility and fecundity: increased time to first litter, longer pregnancy intervals, fewer pups per litter and fewer pregnancies. Significant morbidity in near term dams was also observed. In summary, exposure to a common QAC disinfectant mixture significantly impaired reproductive health in mice.

 

Source 1

Ambient and dosed exposure to quaternary ammonium disinfectants causes neural tube defects in rodents. Hrubec TC et al 15 June 2017. http://onlinelibrary.wiley.com/doi/10.1002/bdr2.1064/full

Source 2

Exposure to common quaternary ammonium disinfectants decreases fertility in mice.

Melin VE1, Potineni H1, Hunt P2, Griswold J2, Siems B3, Werre SR4, Hrubec TC5.Reprod Toxicol. 2014 Dec;50:163-70. doi: 10.1016/j.reprotox.2014.07.071. Epub 2014 Aug 14.

 

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Dr Dingle’s Blood Pressure Smoothie

Dr Dingle’s Blood Pressure Smoothie

The reason I call it the blood pressure smoothie is all of the ingredients have been multiple shown in scientific studies to reduce blood pressure. By no way is this meant to replace advice from you GP but you can share it with them and see if they are interested in preventing the problem rather than just treating it with pharmaceuticals. Remember also that I am not a GP I am just the guy who does all the research which is why I have a PhD.

4 ingredients in order of importance

Beetroot

Almonds (soaked for at least 8 hours)

Linseed (flaxseed)

Filtered re-mineralised ionized water.

 

(equal amounts of each ingredient excerpt a more water)

 

Extras for taste and minerals

Banana

Coconut

Dates

 

Start by grinding the linseed and the almond in the smoothie maker.

Add the beetroot and the filtered water to make up to the constituency you need.

If you want to make it a bit sweeter add some ripe banana, dates or coconut water (and coconut meat if you have the whole coconut) as they are rich in Potassium (and other minerals) which is essential for muscle relaxation and tastes great. But wait till the banana is ripe for the best taste. You can also cold green tea instead of water to add to the antioxidant mix.

The properties that make this smoothie such a potent blood pressure mix is all of the ingredients have excellent antioxidant properties, rich in minerals and other nutrients liked with lowering blood pressure in scientific studies.

Background

High blood pressure or hypertension is having a blood pressure reading of above of around 90mm Hg on 140mm Hg. Hypertension itself is not a disease but a condition or as an indicator of ‘increased risk’ of cardiovascular disease. Patients who are hypertensive have an increased risk of heart attack and stroke due to the direct correlation between the two. Hypertension also contributes significantly to the increased risk of kidney failure and other chronic illness.

In healthy people the cells of blood vessels produce the substance called nitric oxide (NO) which instructs smooth muscles surrounding arteries to relax. If they cant relax they stay rigid and you end up with high blood pressure. The NO is produced in a single layer of cells that line the inside of the arteries called the endothelium. If this tissue is damaged in the case of too much pressure, oxidation or through other means it stops producing NO and blood pressure rises.

Many of the beneficial actions of nutrition on lowering blood pressure results both directly and indirectly through improving endothelial tissue and NO production and release from this tissue. Two major pathways to increase NO are increase the rates of nitrates in the diet, the building block for NO, and L-Arginine which stimulate the enzyme to manufacture NO. Endothelial-derived NO also inhibits platelet adhesion, activation, secretion, and aggregation and promotes platelet disaggregation so you are less likely to have a stroke. A third mechanism that is absolutely critical is to protect and repair the endothelium, remember it is only one cell thick and very susceptible to damage. Vitamin C and antioxidants are essential for this part.

Diets high in dietary nitrate such as beetroot are associated with reduced blood pressure increased exercise performance as a result of vasodilation (expansion) of the blood vessels and a decreased incidence in cardiovascular disease. 100-200mg of beetroot per day has been shown to produce immediate effects of lowering blood pressure by around 15 mm of Hg. Beetroot is also rich in vitamins, phytochemicals and contains large amounts of iron and folic acid Mg, Na and Ca. Apart from the nitrates the major bioactive molecules in beet are polyphenols, flavonoids, betalains, therapeutic enzymes, ascorbic acid, and dehydroascorbic acid (DHAA). So they not only provide the ingredients for NO production but also help in repair and protection of the endothelium.

Almonds have one of the highest sources of L-Arginine (most nuts have lots of L-Arginine so you can substitute the almonds if you want) which stimulates NO synthesis. Studies of almonds have shown reductions of 5-6 mm of blood pressure. It is important to soak the almonds as they (all nuts and seeds) have enzyme-inhibiting factors in them which stop them from germinating until they have enough water. These enzyme inhibitors also stop the absorption of some nutrients, particularly minerals. When you soak the nuts many of the nutrients also become more available for digestion.

Flaxseed is rich in Omega 3 fatty acids, L Arginine (about 20% less than almonds), lignans, antioxidants and fiber that together probably provide benefits to patients with cardiovascular disease. Studies on consuming 30g of flaxseed have been shown to reduce blood pressure by up to 15 mm Hg.

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Study shows it doesn’t matter when you take your probiotics.

Study shows it doesn’t matter when you take your probiotics.

A study of 20 volunteers, eight males and twelve females, who were given Bifidobacterium and Lactobacillus strains, either 30 min before breakfast (pre-prandial administration), or 30 min after breakfast (post-prandial administration) found no difference in the levels measured in the stools. Different theories have suggested the higher acidity in the empty stomach or the mixing in with the food might influence the amount of viable bacteria that populate the colon. While only a small number the study suggest take them any time.

The study also found probiotic supplement levels up to 1 month after the end of probiotic oral intake in both groups. It also reported a significant decrease in Firmicutes abundance which has been associated with weight gain and diabetes. The abundance of a particular stain Akkermansia muciniphila was increased compared to samples collected at the beginning of the experiment. This is important as it is the bacteria that increases with the diabetic drug metformin and is associated with breaking down the mucus build-up in the gut and stimulating energy production in the cells (the mitochondria). Yes that is how the drug metformin works. If they inject it directly into the blood it has no benefit at all. Yes the worlds most effective drug is just a prebiotic.

In this study the probiotic supplement showed the ability to modulate the gut microbiota composition, leading to a significant reduction of potentially harmful bacteria and an increase of beneficial ones. The two bacterial strains seemed able to exert a beneficial effect on the bacterial ecology of the gastrointestinal tract, as many significant positive changes in gut microbiota composition have been highlighted.

In the last years, their numerous beneficial properties and positive impact on human health have deeply been described. Nowadays, hundreds of different bacterial strains are available in the global probiotic market and consequently, the choice of the most suitable probiotic product becomes very difficult and fragmented. Lactobacilli and Bifidobacteria are the main microorganisms used as probiotics; indeed, numerous species belonging to these genera have been reported as safe and effective in improving the host’s health. Several studies showed that the combination of specific bacterial strains belonging to Lactobacillus and Bifidobacterium species can act in optimal synergy for restoring the intestinal balance.

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Wellness At Work

Wellness At Work

When health is absent, Wisdom cannot reveal itself, Art cannot manifest, Strength cannot be exerted, Wealth becomes useless, And reason is powerless." — Herophilus 300 B.C.

Our work places are either a great place to promote health or to contribute to the health problem. Our work environments are experiencing an emerging health crisis from longer workdays, deskbound occupations, access to poor quality foods and poor physical activity. In many cases they are contributing to a deterioration in employee health as our work and the workplace has the potential to have a significant affect on the mental, physical, economic and social well-being of workers. Major concerns in the work environment are work-related stress, obesity, diabetes, cardio vascular disease, fatigue , poor sleep and the many other conditions that come from these. Many of our workplaces for example have increased the risk of putting on weight due to sedentary practices, stress and long and awkward work hours. This of course has the potential to lead to many other chronic health conditions which cost the individual, community and employers. From an employers perspective poor health has the potential to reduce the quality of work and productivity within many workplaces and is likely costing the economy billions of dollars in workplace productivity alone. While the costs of workplace productivity are significant it is also likely that some obesogenic (increasing the risk of putting on weight) environments are likely to be the focus of legal action as the rates of illness and obesity increase. This is particularly the case for inflexible workplace, long hours and shiftwork.

An employee’s health and productivity at work is not only affected by their work environment but also by factors that are not work related. These factors vary between individuals and depend on the individuals chosen lifestyle outside of work. However, through empowering staff members on healthy lifestyles the overall health management of individuals will benefit not only the company but also the broader community. Wellness in the workplace is influenced by many different factors including the communication between co-workers and employers, physical demands especially in sedentary occupations and the eating habits, lifestyles of employees and much more.

When it comes to common health issues of most employees, wellness programs can provide an easy and cost effective solution. Fatigue, stress, depression and obesity are commonly interrelated and increasingly common in most workplaces. The workplace has been viewed as an attractive place for wellness programs as it has established communication channels and it provides a convenient, familiar physical and social setting. In addition, it serves to benefit the employers from the improved health of employees.

Many factors contribute towards the creation of a healthy employee who is able to work consistently at a high level of efficiency and productivity; however health is one of the most important determinants. The costs of unhealthy workers are usually measured by employers in terms of easily quantifiable direct health costs such as medical claims, disability funds and compensation payouts. In the US where figures are more easily accessed because the employer has been traditionally responsible for health care cost, compared with employees who are struggling, thriving employees have 41% lower health-related costs to the employer, a difference of $2,993 per person. For every 10,000 employees, this represents a difference of nearly $30 million to the employer. However, when looking at the health/productivity costs borne by employers, only a small portion of these expenditures are direct medical costs. Indirect costs are more difficult to distinguish and measure, they include those costs incurred from employee mortality, absenteeism and the reduced productivity and presenteeism including poor concentration and focus, low output, and disruption of other workers evident in an employee while still working.

An employee health behaviors are strong predictors of job performance and absenteeism. Many studies have demonstrated the link between poor health factors and absence from work including positive associations between absenteeism and obesity, stress, physical inactivity, and hypertension. While the frequency and severity of poor health are directly related to days absent from work. Healthier workers work more and are away less.

The loss of a qualified professional due to moving to a new job, illness or even death can often be difficult and costly for the organization to replace. The cost of rehiring and retraining a suitable replacement could result in large organizational outlays of time and money, well in excess of $100,000. Not only will a new candidate be difficult and costly to find, but an immense amount of expertise, experience and organizational knowledge will be lost. Karoshi is a term coined in Japan, literally translating into ‘death from overwork’ in English. Karoshi is described as ‘unexplained death’ thought to arise due to a combination of elevated working hours, high stress and poor health, with the major medical causes of death being heat attack and stroke. In Japan working weeks that exceed 60 hours are not an exception. The first case of karoshi was reported in 1969 where a 29 year old married man died from a stroke and his death could not be attributable to anything other than occupational stress and chronic overwork. In 1994 the Japanese Government’s Economic Planning Agency in the Institute of Economics estimated the number of karoshi deaths at around 1,000 or 5% of all deaths as a result of cerebrovascular and cardiovascular disease each year within the 25-59 age group.

In the US the cost of turnover per person employed who is healthier is 35% lower than that of those who are struggling. For every 10,000 employees, this represents $19.5 million. Although turnover is more common among younger employees, higher wellbeing was predictive of lower turnover and lower turnover costs in the next year for younger and older employees alike. Those who were struggling or suffering in overall wellbeing were more than twice as likely as those who were thriving to say they would look for another job if the job market improves. This means that the actions that employers take today to improve health — in addition to improving job performance — are likely to have important implications on the moves employees make in the future.

Presenteeism represents a cost that is difficult to quantity but a large contributor to lost productivity. Many people are under the flawed assumption that when people are at work that they are productive, however if employees are sick, injured, stressed or burned-out in the workplace, they are not working to full capacity. Presenteeism is the worker coming in who shouldn’t and in the process is not just less productive but may also be reducing the productivity of other employees. This doesn’t just occur over health but when a person is sick they may be slowing everyone else down. Presenteeisms result in a negative impact not only on the quantity of work completed, but also on the quality of products, services, decisions, and co-worker and customer interactions. Although presenteeism cannot be directly quantified in a straightforward manner many studies now suggest it may be one of the biggest costs to employees. So you might be better off staying away from work when you are sick.

Unhealthy workers are also more likely to have workplace accidents and healthy and focused employees is less likely to endanger themselves and other co-workers through negligent behavior caused by poor physical and psychological health. A number of studies have now found that investing in wellness programs and the health of employees can reduce accidents. This also includes accidents on the way home from work if an employee is fatigued or distracted with their health. Accidents are expensive for all companies because of downtime, the resources that need to be dedicated to investigation, lost productivity from injured workers and workers’ compensation. In Australia, workers’ compensation costs are unacceptably high, reflecting relatively high frequency rates of occupational injuries which may be prevented through a wellness program.

The direct cost of stress is more than $20 billion to the Australian economy, and around two thirds of that to Australian employers because of stress-related presenteeism and absenteeism. 95% of all claims for mental disorders in the past ten years are for mental stress. These claims are the most expensive type of workers’ compensation claim due to their typically lengthy periods of work absence. Professionals make more mental stress claims than any other occupation, mostly for work pressure. This is despite the fact that the Australian Bureau of Statistics (ABS) Work-related Injuries Survey 2009–10 which showed that 70% of workers who reported they experienced work-related mental stress did not apply for workers’ compensation.

Productivity is affected heavily by seasonal illnesses and their available treatments. Allergies are a highly prevalent condition in the general population affecting people in varying ways. Symptoms of allergies include itching and irritation of the nose; watery nasal discharge, nasal congestion, sneezing and are often accompanied by fatigue, weakness, malaise, irritability and decreased appetite. Studies now show that individuals with allergy disorders generally score lower on tests on social functioning, role limitation, mental health and energy / fatigue and pain compared to controls. In the US allergy disorders result more than 4 million workdays lost per/year in the United States.

However, it is not just the disorder the can have an effect on productivity; the drugs used to treat the illness may also affect productivity levels. Medications are also often a hidden cost in presenteeism, accidents and lost work productivity. The use of sedating antihistamines for allergies had a 50% higher risk of on-the-job injury than control subjects. Another study found that driving impairments exhibited due to the use of a sedating antihistamine were worse than that connected with a blood-alcohol concentration of 0.1%. In a study of nearly 6000 employees those who used sedating antihistamines experienced on average an 8% reduction in daily work out-put compared to those who used non-sedating antihistamines. Many other medications including pain killers and cholesterol lowering drugs can result in lost productivity. The fatigue and muscle soreness created by cholesterol lowering drugs may impact productivity especially those with more physical work. While their effect on memory may be even more problematic. A colleague of mine recalled the effect these drugs were having on the memory of police officers who were called to be witnesses. Awkward eh.

The message is that it is in everyone’s best interests to promote health, both the individual and the company they work for. The good thing in all of this is that companies are increasingly adopting workplace wellness programs which if adopted well can make a big difference to the health of their employees.

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