⚙ Two-Tier Platform Architecture — Shift Health MAP

Layer 1 — Educational Platform

All users · Privacy-first

Available to all workers — no institutional requirement

No external data sharing — session-only browser storage

Individual assessment + 3 PDF reports

CPSBC / CMPA compliant — educational health information tool

Mental health & reproductive data never individually reportable

Regulatory status: Educational Health Information Tool

Layer 2 — Institutional Safety Partnership

Requires dual consent + institutional agreement

Requires BOTH worker consent AND institutional agreement

Aggregate only — minimum N≥20 before any reporting

De-identified data — no individual attribution possible

Quality improvement framing — not surveillance

D5 mental health + D10 reproductive data excluded from Layer 2

D7 substance use — higher consent bar + never individually reportable

AI-Powered · Personalised

Ask Shift Health AI

Educational purpose only. This assessment provides health education and awareness. It does not diagnose conditions, prescribe treatments, or replace your healthcare provider. Domain scores are educational indicators — not validated clinical thresholds and not a diagnosis.

Complete privacy. Your responses are processed only in your browser and never transmitted. If you opt into Layer 2 aggregate reporting, only de-identified tier labels are shared — never your individual answers, scores, name, or identifier. Mental health (D5), reproductive health (D10), and substance use (D7) are always excluded from all reporting with no exceptions.

Crisis support is built in. If any response indicates you may need immediate support, the platform will pause and connect you with crisis resources before continuing. If you are in immediate danger, call 911 (Canada) or your local emergency number now.

Age 18+. This platform is designed for adults aged 18 and over. If you are under 18, please complete this assessment with a parent, guardian, or trusted healthcare provider present. Some questions cover sensitive health topics.

Do not change medications based on this platform. Do not start, stop, or change any medication or supplement based on information from this platform. All content referencing medications, supplements, or lab values is educational only. Medication and supplement decisions must be made with your prescribing physician, nurse practitioner, or pharmacist.

Not for employment or fitness-for-duty decisions. This platform is strictly an educational health information tool. Results must never be used for fitness-for-duty assessments, return-to-work decisions, employment decisions, disciplinary proceedings, or any occupational assessment. Your employer has no right to access your individual results.

Canadian platform · CPSBC / CMPA compliant. Designed for healthcare shift workers in Canada. Content references CPSBC, CMPA, CMA, CCFP, ACFP, WHO, and Canadian occupational health guidelines. PIPEDA compliant. This platform is not a medical device and does not establish a physician-patient relationship between you and Generation Health Inc.

Always discuss with your provider. Use your results as a starting point for a conversation with your family physician, occupational health provider, or nurse practitioner — not as medical advice.

🏛 Optional: Contribute to Shift Worker Health Research

If your organisation has a signed Generation Health institutional agreement, you may choose to have your de-identified, aggregate-only domain tier results contribute to your organisation's workforce health quality improvement data.

What this means if you opt in:

Only de-identified tier labels (Flourishing / Nurture / Room to Grow) are ever shared — never your individual answers, scores, name, or identifier.
Mental health (D5), reproductive health (D10), and substance use (D7) data are always excluded from any reporting, with no exceptions, regardless of this setting.
Reporting only occurs when 20 or more workers at your organisation have completed the same domain — otherwise results are suppressed.
You can withdraw your consent and request removal at any time at [email protected]

Yes — I voluntarily opt in to contributing de-identified aggregate tier data for workforce health quality improvement at my institution. I understand D5, D10, and D7 are always excluded and aggregate thresholds apply.

Not opting in has no effect on your assessment, your personal PDF reports, or any other feature of this platform.

📍 Your postal or zip code (optional)

First 3 characters e.g. V6B for Vancouver. Used to map health patterns by neighbourhood. Never linked to your name.

🆘

You don't have to face this alone

You indicated you may be experiencing thoughts of self-harm or suicide. This assessment has paused. Please reach out — help is available right now.

If you are in immediate danger, call 911 (Canada/US) · 112 (India) or go to your nearest emergency department.

Crisis Support — Canada

📞

988

Canada Suicide Crisis Helpline — call or text 988, 24/7, free, confidential

📞

1-833-456-4566

Talk Suicide Canada — 24/7, free, confidential

💬

Text 45645

Crisis Text Line Canada — text anytime

🌐

crisisservicescanada.ca

Online chat and resources

Crisis Support — India

📞

9152987821

iCall (TISS) — Mon–Sat 8am–10pm

📞

1800-599-0019

Vandrevala Foundation — free, 24/7

Shift Worker Mental Health

🏥

Employee & Family Assistance Program (EFAP)

Contact your HR department or union for your EFAP number

Append full patient report

💾 Auto-saved to this browser ⬆ Import session

AI-Powered · Personalised to your results

Ask Shift Health AI

⚠️ Platform scope and known limitations
Designed for Canadian healthcare shift workers. References CPSBC, CMPA, CMA, AASM, AHA, WHO, and Canadian occupational health guidelines. Domain scores are educational indicators — not validated clinical prediction tests. The MAP framework has not been submitted to peer review as a clinical instrument.

Acknowledged gaps: Intimate partner violence and domestic safety not screened (require in-person assessment). Indigenous health frameworks not represented — a gap Generation Health is committed to addressing through community co-design. STOP-BANG used in validated Yes/No binary form for educational awareness, not diagnosis. PHQ-9 and GAD-7 are validated instruments used for educational awareness only, not clinical diagnosis. D7 substance use data and D10 reproductive data are never included in any aggregate or organisational reporting.

⚠️ PHQ-9 Item 9 Crisis Protocol: Any answer other than "Not at all" to the self-harm item triggers a mandatory non-bypassable crisis screen. This is a patient safety feature — not a diagnostic finding. Canadian crisis lines are displayed (1-833-456-4566 · Text 45645 · 9-8-8). This protocol is implemented per CMPA guidance on PHQ-9 use in educational platforms.

🏛

Institutional Access — Layer 2

For health authorities and occupational health teams with a signed Generation Health institutional agreement. Aggregate data only — minimum N≥20. Individual worker data is never accessible.

Please enter a valid access code and confirm the agreement.

Try a demo code:

Workforce Shift Health Dashboard

Aggregate de-identified data from enrolled workers. N≥20 enforced per domain. D5 (mental health), D10 (reproductive), D7 (substances) are excluded from all institutional reporting by policy.

Report generated Assessment period: Jan–Mar 2026

⚠

N≥20 enforcement active. Any domain or subgroup with fewer than 20 responses is suppressed. Prevents re-identification through small cell sizes. This is a system-level control, not a policy preference.

147

Workers Enrolled

This period

38%

Room to Grow

≥1 domain

29%

Flourishing

All domains avg

6.4

Domains Completed

Avg per worker

4.2 yrs

Median Tenure

D1 aggregate

61%

Night Shift Exposed

D2 ≥1 night/mo

⚠ Priority Workforce Flags

QI Action Required

Domains where ≥35% of workforce scored Room to Grow — recommended for immediate occupational health program focus.

Domain	% Room to Grow	N	Top Driver	Recommended Action
🕐 Shift Pattern	52%	147	15+ nights/month prevalent · quick returns <11h in 41%	Scheduling policy review · cap consecutive nights · enforce 11h rest minimum
🏢 Work Exposure & Demands	48%	132	Short-staffing 71% · WPV exposure 38% · break deprivation prevalent	Staffing model audit · mandatory break protection · WorkSafeBC OHS compliance review
🌙 Sleep & Circadian	44%	147	ESS ≥10 in 31% · SWD prevalence elevated · light-at-night unmanaged	Fatigue management program · nap room access · sleep screening referral pathway
❤️ Cardiometabolic	39%	147	Activity below guideline 58% · BP unmonitored · screening gap 62%	Annual cardiometabolic screening program · on-site BP kiosk · activity incentive

Domain Breakdown — Tier Distribution

Aggregate · De-identified · N≥20

Workforce percentage per tier per domain. Striped domains are excluded from institutional reporting by privacy policy — no override possible.

👤 D1 — Profile & Demographics

Role distribution (aggregate only)

RN / RPN

48%71

Paramedic

22%32

Allied Health

18%26

Other

12%18

ℹ Individual D1 data never shared. Role + tenure aggregate only.

🕐 D2 — Shift Pattern

🌿 Flourishing

18%26

🌊 Nurture

30%44

🌱 Room to Grow

52%77

⚠ 41% quick returns <11h · 29% work 15+ nights/month

🌙 D3 — Sleep & Circadian Health

🌿 Flourishing

22%32

🌊 Nurture

34%50

🌱 Room to Grow

44%65

⚠ ESS ≥10 in 31% — fatigue management priority

❤️ D4 — Cardiometabolic Health

🌿 Flourishing

28%41

🌊 Nurture

33%49

🌱 Room to Grow

39%57

62% no recent fasting glucose/lipid panel — screening program recommended

💚 D5 — Mental Health & Burnout

🔒 Excluded — Absolute Privacy Protection PHQ-9, GAD-7, burnout scores, crisis responses are categorically excluded from all institutional reporting. No aggregate, no exception, no override. This is a system-level enforcement under PIPEDA and CPSBC guidelines.

🦴 D6 — Musculoskeletal Health

🌿 Flourishing

31%41

🌊 Nurture

42%55

🌱 Room to Grow

27%36

Body map aggregate: lower back 58% · shoulder 41% · knee 29%

💊 D7 — Medications & Substance Use

🔒 Higher Consent Bar — Restricted D7 requires a separate specific consent instrument beyond the standard Layer 2 agreement. Contact Generation Health for a D7 data protocol. Individual data never accessible under any circumstances.

🏢 D8 — Work Exposure & Demands

🌿 Flourishing

14%18

🌊 Nurture

38%50

🌱 Room to Grow

48%64

⚠ 71% short-staffing · 38% WPV exposure — OHS audit priority

🗺 D9 — Retention & Career Planning

Turnover intent index (aggregate)

Low risk

35%51

Moderate

42%62

High risk

23%34

⚠ 23% high turnover risk · OR 5.68 applicable · D9 industry caveat required

🌸 D10 — Hormonal & Reproductive Health

🔒 Excluded — Absolute Privacy Protection Reproductive, hormonal, and fertility data is categorically excluded alongside D5 mental health. No aggregate of any size. Pregnancy planning is privileged personal health information — no exceptions under any consent framework.

📊 Quality Improvement Metrics

Population-Level · Not Surveillance

Circadian Disruption Index — Workforce Avg

CDI 8.7

Nurture range (≤10). 34% of workforce in RTG CDI range (>10). Comparable health authority benchmark: CDI 7.2. Scheduling policy change is the primary lever.

SWD Prevalence Estimate (ESS ≥10)

31%

Literature: SWD affects 27–44% of shift workers. Your workforce is within expected range. A formal fatigue management program with nap access is indicated at this prevalence.

Quick Return Prevalence (<11h rest)

41%

41% report quick returns regularly. EU WTD and most Canadian provincial regulations require minimum 11h rest. This is a regulatory compliance risk — recommend scheduling audit.

Workplace Violence Exposure

38%

NIOSH: 73% of non-fatal violence injuries occur in healthcare. 38% exposure in your workforce is below sector average but warrants formal violence prevention audit (WorkSafeBC).

Cardiometabolic Screening Gap

62%

62% report no recent fasting glucose or lipid panel. Given shift work CVD risk (×1.23 MI, Vyas 2012), an annual cardiometabolic screening program for all workers with ≥2yr exposure is recommended.

High Turnover Risk — D9 Index

23%

23% high turnover risk. At OR 5.68 (Kiekkas), this represents a significant sustainability risk. Evidence-informed intervention: schedule control — workers with perceived schedule autonomy have 68% lower turnover intent.

🔐 Consent Architecture — How Data Reaches This View

Dual Consent · PIPEDA Compliant

Both conditions must be satisfied before any worker data contributes to this dashboard. Either party may withdraw at any time — withdrawal removes all historical data from aggregate views.

🛡 Data Rules — What Institutions Can and Cannot See

PIPEDA · CPSBC · CMPA

✅

Allowed — Aggregate tier distributions (N≥20 enforced)

D1 role/tenure aggregate · D2 shift pattern tiers · D3 sleep/ESS prevalence · D4 cardiometabolic tiers · D6 MSK body map aggregate · D8 workplace demands tiers · D9 turnover intent index. Shown as % per tier only — never individual scores.

✅

Allowed — Population QI metrics

CDI workforce average · ESS ≥10 prevalence · quick return rate · WPV exposure rate · cardiometabolic screening gap · turnover risk index. All computed from consented aggregate only.

⚠

Restricted — D7 Substance Use (separate consent instrument required)

AUDIT-C population distribution and medication use patterns require a specific D7 consent layer beyond the standard agreement. Not included by default. Contact Generation Health to initiate a D7 protocol.

🚫

Forbidden — D5 Mental Health (absolute, no exception)

PHQ-9, GAD-7, burnout scores, crisis protocol responses. Excluded from all institutional reporting in any form — aggregate or individual. No override is possible under any consent framework. System-level enforcement.

🚫

Forbidden — D10 Reproductive & Hormonal Health (absolute, no exception)

Menstrual data, pregnancy planning, fertility, hormonal status. Excluded absolutely alongside D5. Pregnancy information is privileged personal health information — no aggregate, no exception, ever.

🚫

Forbidden — Any individual worker data in any form

Individual scores, individual question responses, individual assessment IDs, names, or any other identifier. Institutions have zero access to individual-level data. This is enforced at the system level — not a policy preference.

⚙ Developer Implementation Notes

Backend Required for Production

This screen uses static demo data. In production, replace with the following API surface.

Endpoint	Method	Description
/api/org/auth	POST	Validate institutional access code. Returns org name + JWT. Rate-limited.
/api/org/aggregate	GET	Returns aggregate tier distributions per domain. N<20: returns {suppressed:true}. D5, D10 always excluded server-side regardless of request params.
/api/org/qi-metrics	GET	CDI avg, ESS prevalence, quick return rate, WPV rate, screening gaps, turnover index. Computed server-side from consented workers only.
/api/org/consent/status	GET	Returns N of consented workers for this org. Used to enforce N≥20 gate client-side (also enforced server-side).
/api/org/report/qi-pdf	POST	Generates QI report PDF server-side. Returns presigned S3 URL. Never includes individual data. Audit logged.
/api/org/report/csv	POST	Exports aggregate domain CSV. Same exclusions enforced. All exports audit-logged with org ID, timestamp, and requesting user.

Security requirements: All /api/org/* endpoints require JWT Bearer auth · Rate limited to 60 req/min · All responses strip any field that could identify an individual · D5 and D10 excluded at database query level (not filtering) · Audit log: every org data access logged with timestamp, endpoint, org ID, IP · Penetration tested before production launch.

Generate reports: All exports: aggregate only · No PII · PIPEDA compliant · Audit logged

Generation Health · Shift Health MAP

Shift Health
Calculator

Enter your shift pattern to estimate your Circadian Disruption Index. Optionally add your lab results for a cardiovascular health picture.

Live State

Formula

Handoff Doc

Shift Inputs

CDI Calculation Breakdown

— run the calculator to see breakdown —

Lab State

Tier & Repro

Circadian Disruption Index (CDI)

CDI = (nights × 0.6) + (nightHrs / 10) + qrScore + consecScore + sjlScore + ctScore

// Component calculations:
nightHrs = nights × hours
qrScore = min(qr × 0.4, 3) // quick returns <11h, capped at 3
consecScore = min(consec × 0.3, 2) // consecutive nights, capped at 2
sjlScore = min(sjl × 0.5, 2.5) // social jetlag hours, capped at 2.5
ctScore = evening→0.8 | intermediate→0.3 | morning→0

// Tier thresholds:
CDI ≤ 5 → Flourishing (#4A8C5C)
CDI ≤ 10 → Nurture (#2D7D7B)
CDI > 10 → Room to Grow (#D4A849)

CVD Risk — Pooled Cohort Equations (PCE, 2013 ACC/AHA)

baseRisk = 1 − S₀₁₀ ^ exp(Σ(coefficients) − meanCoeffSum)

// Shift-adjusted relative risk:
durationMult = years > 5 ? 1 + (0.071 × ((years−5)/5)) : 1.0 // Torquati 2018
sexMult = female → 1.1 | male → 1.0 // Vetter 2016 JAMA
adjustedRR = 1.17 × durationMult × sexMult // Ho 2022 (×1.17 base)
shiftRisk = 1 − (1 − baseRisk) ^ adjustedRR

// Biomarker thresholds (mmol/L inputs converted to mg/dL internally):
TyG = ln[(TG_mgdL × Glu_mgdL) / 2] // <4.68 normal | 4.68–8.46 IR | ≥8.46 high
TG/HDL = (TG_mgdL) / (HDL_mgdL) // M: >2.6 elev, >3.5 high | F: >1.7 elev, >2.5 high
TG → mg/dL: × 88.57 | HDL/TC → mg/dL: × 38.67 | Glu → mg/dL: × 18.02

1 — File Overview

Single-file HTML/CSS/JS application. No external dependencies except Google Fonts (preconnect). No data is transmitted, stored, or persisted — everything runs in browser memory. Session consent is stored in sessionStorage only.

File: shift-health-calculator-v4.html · ~1,550 lines · Generation Health Inc. · March 2026

Public JS namespace: SHCalc (IIFE). Dev namespace: SHDev (IIFE).

2 — Architecture

Layer	Location	Notes
Consent gate	`#consent-gate`	Checkbox required before calculator loads. Dismissed state stored in `sessionStorage('shCalcConsented')`
Inputs	`.calc-inputs`	All inputs write to `state` object and call `calculate()` on every change
Lab accordion	`#lab-accordion`	Optional. PCE inputs. Opens/closes with `SHCalc.toggleLabs()`
Results section	`#calc-results-section`	Hidden until first calculation. Animated via `max-height` transition
Quick wins grid	`#qw-grid`	Rendered by `renderResults()` from `TIERS[tierKey].wins` data object. Repro status affects which 6th card shows.
Dev panel	`#dev-panel`	Hidden by default. Toggle via `SHDev.toggle()`. Updates on every `renderResults()` call.

3 — State Object

Key	Type	Range	Description
`nights`	int	0–31	Night shifts per month
`hours`	int	8\|10\|12\|13\|24	Shift length in hours
`years`	float	0–50	Years in shift work
`qr`	int	0–20	Quick returns <11h per month
`consec`	int	0–14	Max consecutive nights in a row
`sjl`	int	0–6	Social jetlag in hours
`chronotype`	string	morning\|intermediate\|evening	Self-reported chronotype
`reproStatus`	string	none\|planning\|pregnant\|menopause	Reproductive status — controls 6th advice card
`labsOpen`	bool	—	Lab accordion open state
`age`	int\|null	30–79	PCE input
`sex`	string	female\|male	PCE equation selector
`tc`	float\|null	mmol/L	Total cholesterol
`hdl`	float\|null	mmol/L	HDL cholesterol
`sbp`	int\|null	mmHg	Systolic blood pressure
`bpMeds`	string	yes\|no	On antihypertensives
`smoker`	string	yes\|no	Current smoker
`diabetes`	string	yes\|no	Diabetes diagnosis
`tg`	float\|null	mmol/L	Triglycerides (optional biomarker)
`fg`	float\|null	mmol/L	Fasting glucose (optional biomarker)

4 — Public API (SHCalc)

Method	Signature	Description
`begin()`	`begin(skipAnim?)`	Dismiss consent gate, show calculator
`step()`	`step(field, delta)`	Increment/decrement nights\|qr\|sjl by delta
`setHours()`	`setHours(val, btn)`	Set shift length. val: 8\|10\|12\|13\|24
`setChronotype()`	`setChronotype(val, btn)`	val: morning\|intermediate\|evening
`setConsec()`	`setConsec(val, btn)`	Set consecutive nights (0–14)
`setYearsDirect()`	`setYearsDirect(val)`	Set years from direct input (0–50)
`jumpYears()`	`jumpYears(delta)`	Add delta to years (e.g. +5, −5)
`setReproStatus()`	`setReproStatus(val, btn)`	val: none\|planning\|pregnant\|menopause
`toggleLabs()`	`toggleLabs()`	Open/close lab accordion
`setSex()`	`setSex(val, btn)`	val: female\|male
`setBpMeds()`	`setBpMeds(val, btn)`	val: yes\|no
`setSmoker()`	`setSmoker(val, btn)`	val: yes\|no
`setDiabetes()`	`setDiabetes(val, btn)`	val: yes\|no
`labInput()`	`labInput()`	Fires on any lab field change, triggers PCE recalc if complete
`calculateLabs()`	`calculateLabs()`	Manual PCE calculation trigger
`reset()`	`reset()`	Clear all state and inputs back to defaults
`getResult()`	`getResult() → object`	Returns `lastResult`: {cdi, tierKey, tier, nightHrs, annualShifts, cumulativeHrs, cumulYears, years, sjl, chronotype}
`prefillFromAssessment()`	`prefillFromAssessment(answers)`	Accepts PPC/MAP assessment answer object, maps D1/D2 fields to calculator inputs and auto-calculates

5 — prefillFromAssessment() Answer Schema

Accepts an object with d1 and d2 keys, each containing answer strings in format "DOMAIN-Qn-INDEX":

Field	Answer Key	Mapping
`nights`	`d2['D2-Q1']`	0→0, 1→4, 2→7, 3→11, 4→15 shifts/month
`consec`	`d2['D2-Q2']`	0→0, 1→2, 2→4, 3→6, 4→7 nights
`hours`	`d2['D2-Q4']`	0→12, 1→12, 2→13 hours
`qr`	`d2['D2-Q5']`	0→0, 1→0, 2→1, 3→3, 4→6 per month
`years`	`d1['D1-Q1']`	0→0.5, 1→2.5, 2→7, 3→12, 4→17 years

6 — TIERS Data Structure

Each tier key (fl, nu, rg) contains:

Key	Type	Description
`label`	string	Display name: Flourishing \| Nurture \| Room to Grow
`icon`	string	Emoji icon
`color / bg / border`	hex	Tier colour system (locked — matches PPC/MAP)
`msg`	string	Hero paragraph text
`cite`	string	Tier-level evidence citation
`cta`	{label, href}	CTA button config
`wins.tonight`	{title, body, cite}	Tonight card
`wins.week`	{title, body, cite}	This Week card
`wins.provider`	{title, body, cite}	Ask Your Provider card
`wins.schedule`	{title, body, cite}	Your Schedule card
`wins.nutrition`	{title, body, cite}	Nutrition & Fuel card
`wins.precon`	{title, body, cite}	Preconception/Pregnancy card (shown if reproStatus ≠ none or years ≥ 2)

7 — Reproductive Status Card Logic

reproStatus	6th card shown
`none` + years < 2	Hidden
`none` + years ≥ 2	wins.precon (general awareness)
`planning`	wins.precon (preconception framing)
`pregnant`	wins.precon (pregnancy-specific, label changes to "Pregnancy")
`menopause`	Inline menopause card (hardcoded, not from TIERS data)

8 — Evidence Traceability

Claim	Source	Notes
CDI base weight nights × 0.6	Vyas et al., 2012 — BMJ	23% higher MI/coronary risk framework
SJL >30% CVD risk/hr	Gamboa Madeira et al., 2021 — J Sleep Research	Used for sjlScore weighting
+7.1% CVD per 5yr shift duration	Torquati et al., 2018 — Scand J Work Environ Health	durationMult after yr 5
×1.17 overall CVD shift work	Ho et al., 2022 — Int J Epidemiol (n=238,661)	Base RR for shift adjustment
×1.23 MI-specific	Vyas et al., 2012 — BMJ	Displayed in note, not multiplied separately
×1.1 women	Vetter et al., 2016 — JAMA	sexMult
PCE coefficients	Goff et al., 2014 — JACC	White female/male equations used as default per ACC/AHA guidance
TyG 4.68 cutoff	Guerrero-Romero et al., 2010 — JCEM	96.5% sensitivity vs euglycaemic clamp
TyG 8.46 cutoff	Mavraganis et al., 2025 — Diabetes Obes Metab	CVD risk threshold
TG/HDL sex-specific	Salazar 2012 AmJCardiol; von Bibra 2017 HormMetabRes	M >2.6/3.5; F >1.7/2.5 mg/dL
Early menopause 25% higher risk	Stock et al., 2019 — Human Reproduction	≥20 months rotating nights
≤1 night/wk in pregnancy	Garde et al., 2020 — Scand J Work Environ Health	International scheduling consensus
Caffeine 6h cutoff	Drake et al., 2013 — J Clin Sleep Med	Reduces slow-wave sleep
Meal timing in night work	Qian et al., 2022 — PNAS (n=19)	26% reduction in depression-like mood
Melatonin shift work	Liira et al., 2014 — Cochrane; Sletten et al., 2020 — Sleep	Timing and dosing

9 — Integration with PPC / Shift Health MAP

The calculator exposes SHCalc.prefillFromAssessment(answers) for embedding in assessment flows. Pass the full answer object from the parent platform — the function extracts D1 and D2 keys and populates all relevant fields automatically.

To embed in an iframe: <iframe src="shift-health-calculator-v4.html" width="640" height="900" frameborder="0"></iframe>

To read the result after calculation: SHCalc.getResult() returns the full lastResult object. For cross-frame communication use postMessage — Dinesh/Akhil to implement the listener on the parent platform side.

10 — CPSBC / CMPA Compliance Checklist

✅ No diagnostic language — all outputs framed as "educational estimates"
✅ No treatment recommendations — supplements framed as "discuss with your provider"
✅ No prescriptive commands — GDM screening framed as "worth discussing" not "request"
✅ PCE limitations disclosed (US-derived, White equations default, PREVENT named)
✅ Shift RR limitations disclosed inline with CVD result
✅ Consent gate with explicit educational-only framing required before use
✅ Footer disclaimer on every result view
✅ Melatonin: "discuss with provider before starting" on every instance
✅ Pregnancy fasting protocol explicitly contraindicated

11 — Known Limitations / Future Work

PCE: PREVENT equations not yet implemented (coefficients require peer-reviewed precision confirmation)
TyG and TG/HDL chips only display when both TG and fasting glucose are entered
CDI formula is custom-weighted, not a validated clinical instrument — disclose clearly
24h shift option included but no specific CDI adjustment for >16h shifts (Cochrane 2023 data) — consider adding penalty modifier in v5
Melatonin IR caveat (AHA 2025): "emerging data" framing — update if AHA publishes full statement
reproStatus does not modify CDI calculation — it only changes advice cards. A future version could weight the CDI differently for pregnant users.

12 — Colour System (Locked)

Tier	Hex	CSS var
Flourishing	#4A8C5C	`--flourishing`
Nurture	#2D7D7B	`--nurture / --teal-deep`
Room to Grow	#D4A849	`--rtg`
Educational	#A09080	warm taupe — used for dev/meta elements
Precon/Repro	#E8C0D4 / #FDF0F5	Rose — not a tier colour, context only

Enter your shift details below. Results appear as you type — nothing is saved or uploaded.

Your shift pattern

Night shifts per month

How many night shifts do you work each month? A night shift includes hours between midnight and 6am.

shifts / month

Typical shift length

How long is a typical shift? Include any overtime you regularly work.

Years working shifts

Total years in any shift work role. Includes all past jobs.

years

Quick returns / month

Times with less than 11 h between shifts. e.g. finish at 7am, back at 5pm.

Max consecutive nights in a row

What's the most night shifts you work back-to-back? Tap to select.

Circadian biology

Social jetlag (hours)

How many hours later do you wake up on days off vs. workdays? e.g. 7am on workdays, 10am off = 3 hrs. Each hour of social jetlag is linked to >30% higher cardiovascular risk.

hours difference

Your natural body clock (chronotype)

Without work commitments, when do you naturally feel most alert? Evening chronotype in shift workers independently elevates cardiometabolic risk.

Educational use only. CVD risk figures below use the 2013 ACC/AHA Pooled Cohort Equations, which were derived from US populations and may not fully represent all Canadian or international patients. The shift-adjusted figure applies a 23% relative risk increase from Vyas et al., 2012 (BMJ) — this is not a validated shift-specific equation. Discuss all results with your provider before making any health decisions.

Age (years)

PCE validated age 40–79 · PREVENT age 30–79

Sex assigned at birth

Used for published PCE equations · not a value judgment

Total Cholesterol (mmol/L)

mmol/L · normal: 2.0–5.2

HDL Cholesterol (mmol/L)

mmol/L · optimal: >1.0 (F) / >0.9 (M)

Systolic BP (mmHg)

top number · optimal: <120

On BP medication?

Current smoker?

Diabetes diagnosis?

Optional — shift-work specific biomarkers

If you have these values, adding them unlocks your TyG index (insulin resistance marker) and TG:HDL ratio — both specifically elevated in shift workers.

Triglycerides (mmol/L)

optimal: <1.7 mmol/L

Fasting Glucose (mmol/L)

optimal: <5.6 mmol/L

10-year CVD Risk

—

Based on your lab values alone (ACC/AHA PCE)

Shift-Adjusted Estimate
—
+23% relative risk for shift workers · Vyas 2012

Your Circadian Load Estimate

Circadian Load Tier

CDI Score

Flourishing Nurture Room to Grow

Night hours / month

hours of night work each month

Shifts / year

estimated night shifts annually

Cumulative lifetime night exposure

hours

0 years 10+ years = elevated risk threshold

Your quick wins — leave with answers

⚕ The Circadian Disruption Index (CDI) is an educational scoring formula informed by Vyas et al. 2012 (BMJ), Torquati et al. 2018 (Scand J Work Environ Health), Gamboa Madeira et al. 2021 (J Sleep Research), and Wanigasinghe et al. 2025 (Br J Nutr). CVD risk estimates use the 2013 ACC/AHA Pooled Cohort Equations (PCE; Goff et al., 2014 JACC), the current standard with real-world c-stat 0.78. Note: The 2023 AHA PREVENT equations are newer (race-free, age 30–79, includes eGFR/BMI) but systematically estimate lower risk than PCE; disclosure provided in results. Shift-adjusted figures: ×1.17 overall CVD (Ho et al., 2022 Int J Epidemiol, n=238,661); ×1.23 MI (Vyas et al., 2012 BMJ); +7.1%/5 yrs duration (Torquati 2018); ×1.1 women (Vetter et al., 2016 JAMA). TyG cutoffs: Guerrero-Romero 2010 JCEM (4.68 IR) and Mavraganis 2025 DOM (8.46 CVD). TG:HDL sex-specific cutoffs: Salazar 2012 AmJCardiol; von Bibra 2017 HormMetabRes. None of these outputs are clinical diagnoses. Discuss with your provider.

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Your shift workerhealth snapshot

Explore your shift health

You don't have to face this alone

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🔄 Retake Assessment

Your Domain Overview

📄 Your Free PDF Reports

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By Domain

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Discuss with your healthcare provider

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Before you start

Shift HealthCalculator

1 — File Overview

2 — Architecture

3 — State Object

4 — Public API (SHCalc)

5 — prefillFromAssessment() Answer Schema

6 — TIERS Data Structure

7 — Reproductive Status Card Logic

8 — Evidence Traceability

9 — Integration with PPC / Shift Health MAP

10 — CPSBC / CMPA Compliance Checklist

11 — Known Limitations / Future Work

12 — Colour System (Locked)

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Your shift worker
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Shift Health
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