Summary
Fifteen female nurses, aged between 21 and 29 years and employed in an intensive care unit, were examined with the aim of evaluating their psychophysical adaptation to one of the most commonly used, rapidly rotating shift systems, the “metropolitan rota” (2-2-2-2), with the length of the shifts modified according to the work load (including night shifts of 10h) and with the start of the morning shift delayed (to 7a.m.). Subjective evaluations of work load and psycho-physical conditions as well as performance measures (reaction time, search and memory test), blood pressure and heart rate were recorded at the start, middle and end of the work shifts on the last 4 days of the shift cycle, comprising one morning, one afternoon and two consecutive nights. During the shifts, plasma cortisol and urinary excretion rate of 6-sulphatoxymelatonin, adrenaline and noradrenaline were also recorded, as well as oral temperature and activity-sleep logs. The results showed that this rapidly rotating shift system including two consecutive night shifts does not significantly alter the normal circadian rhythms of the body, particularly as concerns performance levels, body temperature and hormone excretion. Moreover, the lengthening of the night shift to 10h can be considered acceptable in terms of work efficiency, provided that work load is reduced and there are sufficient rest pauses available to compensate for tiredness and sleepiness. On the other hand, the shortening of the day shifts to 7h and the delayed start of the morning shift to 7 a.m. appeared convenient in relation to both work load and sleep duration.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Akerstedt T (1984) Work schedules and sleep. Experientia 40:417–422
Akerstedt T, Gillberg M (1981) The circadian variation of experimentally displayed sleep. Sleep 4:159–169
Akerstedt T, Torsvall L (1985) Napping in shift work. Sleep 8(2):105–109
Attia M, Mustafa MKY, Khogali M, Mahmoud NA, Arar EI (1985) Optimization of night and shiftwork plans among policemen in Kuwait: a field experiment. Int Arch Occup Environ Health 56:81–90
Bojkowski CJ, Arendt J, Shih MC, Markey SP (1987) Melatonin secretion in humans assessed by measuring its metabolite 6-sulphametoxymelatonin. Clin Chem 33:1343–1348
Brown FM (1990) Sleep-nap behaviour of three permanent shifts of hospital nurses. In: Costa G, Cesana GC, Kogi K, Wedderburn A (eds) Shiftwork: health, sleep and performance. Lang, Frankfurt am Main, pp 173–178
Costa G, Lievore F, Casaletti G, Gaffuri E, Folkard S (1989) Circadian characteristics influencing interindividual differences in tolerance and adjustment to shiftwork. Ergonomics 32(4):373–385
Fibiger W, Wallace M, Singer G (1987) Salivary cortisol as a measure of “adaptation” to shiftwork. In: Oginski A, Pokorski J, Rutenfranz J (eds) Contemporary advances in shiftwork research. Medical Academy, Krakow, pp 87–97
Folkard S (1992) Is there a “best compromise” shift system? Ergonomics 35:1453–1463
Folkard S, Arendt J, Clark M (1990) Sleep and mood on a weekly rotating (7-7-7) shift system: some preliminary results. In: Costa G, Cesana GC, Kogi K, Wedderburn A (eds) Shiftwork: health, sleep and performance. Lang, Frankfurt am Main, pp 173–178
Folkard S, Knauth P, Monk TH, Rutenfranz J (1976) The effect of memory load on the circadian variation in performance efficiency under a rapidly rotating shift system. Ergonomics 19:478–88
Folkard S, Monk TH, Lobban MC (1978) Short and long-term adjustment of circadian rhythms in “permanent” night nurses. Ergonomics 21:785–799
Frese M, Harwich C (1984) Shiftwork and the length and quality of sleep. J Occup Med 26:561–566
Grandjean E, Wotzka G, Schaad R, Gilgen A (1971) Fatigue and stress in air traffic controllers. Ergonomics 14(1):159–165.
Halberg F, Johnson EA, Nelson W, Runge W, Sothern R (1972) Authorhythmometry procedures for physiologic self-measurement and their analysis. Physiol Teacher 1:1–12
Härmä M, Ilmarinen J, Knauth P, Rutenfranz J, Hänninen O (1988) Physical training intervention in female shift workers. II. The effects of intervention on the circadian rhythms of alertness, short-term memory, and body temperature. Ergonomics 31(1):51–63
Hart SG, Staveland LE (1988) Development of a NASA TLX (Task Load Index): Results of empirical and theoretical research. In: Hancock PS, Meshkati N (eds) Human mental workload. Elsevier, Amsterdam
Knauth P, Härmä M (1992) The relation of shift work tolerance to the circadian adjustment. Chronobiol Int 9(1):46–54
Knauth P, Rutenfranz J (1982) Development of criteria for the design of shiftwork systems. J Hum Ergol 11 [Suppl.]:337–367
Knauth P, Etude E, Rutenfranz J, Kiesswetter E, Smith P (1981) Re-entrainment of body temperature in field studies of shiftwork. Int Arch Occup Environ Health 49:137–139
Kolmodin-Hedman B, Swensson Ä (1975) Problems related to shift work. A field study of Swedish railroad workers with irregular work hours. Scand J Work Environ Health 1:254–262
Kolmodin-Hedman B, Andersson MC, Johnson E, Weibring J, Viskers A (1986) Sleep habits and health in 6-shift working Swedish paper pulp industry. In: Haider M, Koller M, Cervinka R (eds) Night and shift work: long-term effects and their prevention. Lang, Frankfurt am Main, pp 157–164
Minors DS, Waterhouse JM (1992) Investigating the endogenous component of human circadian rhythms: a review of some simple alternatives to constant routines. Chronobiol Int 9:55–78.
Minors DS, Waterhouse JM (1993) Separating the endogenous and exogenous components of the circadian rhythm of body temperature during night work using some “purification” models. Ergonomics 36:497–507
Smith P (1979) A study of weekly and rapidly rotating shiftworkers. Int Arch Occup Environ Health 43:211–220
Tilley AJ, Wilkinson RT, Drud M (1981) Night and day shifts compared in terms of the quality and quantity of sleep recorded in home and performance measured at work: a pilot study. In: Reinberg A, Vieux N, Andlauer P (eds) Night and shift work. Biological and social aspects. Pergamon, Oxford, pp 187–196
Torsvall L, Akerstedt T, Gillander K, Knuttson A (1986) Twenty-four-hour recordings of sleep/wakefulness in shift work. In: Haider M, Koller M, Cervinka R (eds) Night and shift work: long-term effects and their prevention. Lang, Frankfurt am Main, pp 37–41
Vieux N, Ghata J, Laporte A, Migraine C, Nicolai A, Reinberg A (1979) Adjustment of shift workers adhering to a three- to four-day rotation (study 2). Chronobiologia 6 [Suppl 1]:37–42
Wallace M, Fibiger W, Singer G, Rowland G (1986) Cortisol changes in workers on continuous and rotating shifts. In: Haider M, Koller M, Cervinka R (eds) Night and shift work: long-term effects and their prevention. Lang, Frankfurt am Main, pp 75–80
Wedderburn A (1992) How fast should the night shift rotate? A rejoinder. Ergonomics 35:1447–1451
Wilkinson RT (1992) How fast should the night shift rotate? Ergonomics 35:1425–1446
Winget CM, Hughes L, LaDou J (1978) Physiological effects of rotational work shifting: a review. J Occup Med 20:204–210
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Costa, G., Ghirlanda, G., Tarondi, G. et al. Evaluation of a rapidly rotating shift system for tolerance of nurses to nightwork. Int. Arch Occup Environ Heath 65, 305–311 (1994). https://doi.org/10.1007/BF00405694
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00405694