Medical Implications of Shift-Work

• Published in: Annual review of medicine Vol. 36; no. 1; pp. 607 - 617
• Main Authors: Moore-Ede, Martin C, Richardson, Gary S
• Format: Journal Article
• Language: English
• Published: Palo Alto, CA 94303-0139 Annual Reviews 01-01-1985; 4139 El Camino Way, P.O. Box 10139; USA
• Subjects: Adaptation, Physiological; Aerospace Medicine; Biological and medical sciences; Cardiovascular Diseases - epidemiology; Circadian Rhythm; Cues; Epidemiology; Gastrointestinal Diseases - epidemiology; General aspects; Genetic Variation; Humans; Medical sciences; Occupational Diseases - epidemiology; Personnel Staffing and Scheduling; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk; Syndrome; Travel; Work; Work Schedule Tolerance; Human; Sleep; Risk factor; Cardiovascular disease; Digestive diseases; Biological rhythm; Adaptation disorder; Circadian rhythm; Adaptation; Shift work
• ISSN: 0066-4219; 1545-326X
• DOI: 10.1146/annurev.me.36.020185.003135

The circadian pacemakers, which time the approximately 24-hour rhythms in sleep and wakefulness, neuroendocrine, thermoregulatory, and other body functions, resynchronize only slowly after an abrupt phase shift in environmental time cues. While the symptoms of jet-lag are transient, the kinds of repeated shifts over a number of years experienced by shift-workers on rotating schedules induce sleep-wake disorders, gastrointestinal pathology, and an increased risk of cardiovascular disease. There is significant interindividual variation in the ability to adapt and also a deterioration with age. Evidence is accumulating that poor adapters present with a Shift Maladaption Syndrome with characteristic pathological manifestations.