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Background Shirley Learthart examines the potential adverse effects to health of working on rotating shifts.
Conclusion Many studies indicate that shift work can cause health problems, including increased risk of coronary heart disease. Internal rotation is the reason given by many nurses for leaving the profession.
* Health and quality of life
* Shiftwork
* These key words are based on the subject headings from the British Nursing Index. This article has been subject to double-blind review.
THIS LITERATURE review examines the possible adverse health effects of internal rotation shift work. Health promotion is one of the many roles of a nurse; this should include the nurse's health as well as that of his or her patients/clients. The Code of Professional Conduct (UKCC 1992) states that nurses should: '...report to an appropriate person or authority where it appears that the health or safety of colleagues is at risk, as such circumstances may compromise standards of practice and care'. This review might provide useful ammunition for those wishing to initiate change in working conditions.
Detrimental effects on health
Internal rotation is the system by which staff are required to work a combination of day and night shifts. Research by Costa (1996) showed that rotating shift work can have a detrimental effect on the.health and wellbeing of workers in four main ways (Box 1 ).
Comperatore and Krueger (1990) studied 'jet lag' or 'shift lag' syndrome; which is characterised by feelings of fatigue, sleepiness, lethargy and insomnia, digestive problems and decreased mental agility and performance. Folkard et al (1978) showed that shift workers who sleep at the same time every day have better health than those who vary their sleeping habits.
Knauth et at (1982) state that the human body is exposed to a continuous stress in the attempt to adjust to the new working hours, and at the same time is invariably frustrated by the continuous changeover. In the long run, such conditions can not only give rise to permanent and severe sleep disturbances, but might be implicated in troubles of the nervous system, such as chronic fatigue, changes in behaviour patterns or persistent anxiety or depression, which often require medical treatment (Gordon et al 1986). A possible secondary cause of sleep disturbance among...