PhilSHIFT: Two years of working toward an understanding of the biological clock, shift work and health of Filipinos

The public’s interest in the health of shift workers has been continually engaged recently, particularly concerning workers in the call center industry. The state of health of this workforce, or occupational health, has been the subject of discussion in various reports that surfaced regarding the alleged health-related consequences of call center work and how factors of the workplace supposedly effect these. However, shift work is not unique to this industry, the same setup being found in health care facilities and manufacturing industries. Public awareness of shift work focuses on the call center industry because of the sheer number of individuals it employs, the encouragement this industry received from the government, and its economic impact as it spurs related businesses to meet the needs of its workforce.

Various initiatives have been organized abroad to study shift work and its effects, often using different perspectives. Locally, the PhilSHIFT Research Group (PhilSHIFT) has been working for the past two years to lay the groundwork for studying the effect of shift work on health, currently gearing toward studies about the call center workforce. It is an interdisciplinary group of researchers which started with a team primarily from the University of the Philippines Manila (UP Manila) and the Ludwig Maximilian University Munich (LMU). PhilSHIFT is set up uniquely in that it brings together researchers from the Philippine Health Sciences Center and a European university known for its pioneering work on the circadian (biological) clock and shift work.

PhilSHIFT recently celebrated its anniversary by looking back on its activities in the past two years. The original research group, called FilClockWork, first convened in February 2009. Similar to its forerunner, the European ClockWork Project, the group intended to explore the relationship of chronotype and shift work. The term “chronotype,” from the field of chronobiology, refers to the relationship between internal (biological) and external time, or what is called “phase of entrainment,” which has been shown to be different between individuals. At the time of the group’s conception, individual variation in chronotype had already been described for other populations, but not for Filipinos. Determining the Filipino chronotype is crucial to understanding the human circadian clock, and would also be an aspect of interest in an emergent issue begging for study — the effect of shift work on the Filipino call center workforce, majority of whom are constrained to work beyond typical daytime hours.

FilClockWork became PhilSHIFT just before the group’s first public event, a UPM/LMU symposium called “Shift Work and Health Research” on July 31, 2009. It was during the same occasion that the memorandum of agreement formalizing PhilSHIFT was signed by the collaborating universities. The group’s name takes after the European SHIFT Initiative (“SHIFT” standing for “Shiftwork and Health-Interdisciplinary concepts, Fieldwork, Translational research”). While the ClockWork Project concluded last year, and the SHIFT Initiative is no longer active, PhilSHIFT persists, with new collaborators diversifying the group’s composition and activities.

The history of PhilSHIFT tells of the variety of perspectives and resources that are needed to understand shift work and health in the country. PhilSHIFT was already more than a year old when I joined the project, and occupational health is just one perspective of the group. The UP Manila collaborators at that time included Prof. Maria Eliza Ruiz-Aguila, College of Allied Medical Professions, and Dr. D. Darwin Dasig, College of Medicine, while LMU researchers were Prof. Till Roenneberg and Celine Vetter, MSc, both from the Institute of Medical Psychology, and Eduardo Mendoza, Ph.D. I found out later that the Balik Scientist Program of the Department of Science and Technology (DOST) enabled Dr. Mendoza to bring together the network of researchers in the Philippines and Europe which eventually evolved into PhilSHIFT.

By the time I came on board, PhilSHIFT had already started implementing the first phase of the project — the formation of a database of Filipino chronotypes. To realize the database, PhilSHIFT enjoined the participation of non-shift working Filipinos in a survey using the Philippine Munich Chronotype Questionnaire (PhilMCTQ). This survey tool was tailored for Filipinos from the Munich Chronotype Questionnaire (MCTQ) developed by Prof. Roenneberg. PhilSHIFT was made accessible through TheWeP, an online research platform developed by information technology experts from the University of the Philippines Diliman (UP Diliman). Eventually, Roselyn Santos-Gabud from TheWeP team joined PhilSHIFT as liaison.

The DOST was instrumental in bringing the PhilMCTQ to the public, sponsoring its online launch on March 24, 2010 at a press conference in the premises of the Commission of Higher Education (CHED). Around this time, the media picked up the project. Among its early exposures was a feature in “Bago Yan Ah,” a TV-radio show, as well as an article by journalist Paul Icamina of the newspaper Malaya.

Aside from implementing PhilMCTQ online, PhilSHIFT also adopted the strategy of bringing an offline version of TheWeP to gatherings such as conferences, thus allowing another venue for participation among Internet-shy Filipinos. After one year online and a few conferences, PhilMCTQ has about 1,000 respondents, or 25 percent of PhilSHIFT’s target number. The PhilSHIFT group is scheduled to conduct offline data collection in upcoming conferences and school events. The online survey will continue until the target number is met, and interested participants may access PhilMCTQ at http://www.bioinfo.mpg.de/thewep/.

PhilSHIFT gained more collaborators in 2010 with the addition of Prof. Richard Bryann Chua, UP Manila College of Arts and Sciences, and Berlin-based epidemiologist Jingky Lozano-Kühne, Ph.D. In November 2010, they developed and launched the PhilSHIFT website — http://philshift.upm.edu.ph/. The year also saw the group conduct its first two research colloquia, which are organized to bring together researchers and practitioners interested in shift work and its impact on health. These activities are aside from speaking opportunities of PhilSHIFT collaborators in various schools and societies that are interested in the project.

One of PhilSHIFT’s defined strategies is to look for existing work on shift work and health in the country. By searching online databases and library resources that the team had access to, PhilSHIFT was able to find some studies from academic institutions and government agencies such as the Occupational Safety and Health Center (OSHC). From the group’s appraisal of the studies found, there were already pioneer studies on shift work in call centers from OSHC as well as Professor Howell Ho and colleagues at De La Salle University, the latter published in an online journal. The most recent related work PhilSHIFT came across was a research collaboration of the ILO and the University of the Philippines Population Institute. PhilSHIFT continues to look for other work and has archived some of the work it already knows of in EUCLIS, an online resource database which could be accessed at http://www.bioinfo.mpg.de/euclis/.

To date, PhilSHIFT continues to build the Filipino chronotype database and has done some preliminary analysis. It is also starting to move toward the phases of its research that intends to look into chronotype, shift work in call centers and human performance. Graduate students who came to know of the project have indicated interest to conduct thesis projects alongside PhilSHIFT. In addition, PhilSHIFT is involved in a productive discussion with call center industry representatives, particularly from the Contact Center Association of the Philippines (CCAP), regarding a collaborative implementation of the succeeding research phases.

This month, PhilSHIFT is scheduled to hold its third Research Colloquium tomorrow at the College of Public Health, University of the Philippines Manila. The program aims to provide an update on its ongoing research, as well as present existing shift work research in the Philippines. The CCAP participates in this colloquium to provide a report on the contact center industry. It shall also be a venue for discussing developments that will influence future research initiatives. Similar to its previous colloquia, PhilSHIFT hopes that this event will engage more interest and commitment to shift work research, toward the health of those in the industry and the worldwide community that relies on their services. –Gayline F. Manalang Jr., PTRP, MOH (The Philippine Star)