NIOSH Training for Nurses on Shift Work and Long Work Hours

Chronic Disorders

If you have a chronic health problem, you may have more difficulty controlling symptoms and disease progression when on shift work or long work hours.¹²

Some illnesses have a circadian rhythm component, and as a consequence, shift work can exacerbate their symptoms. These include rheumatoid arthritis^a, asthma^b, cancer^c, hypertension^d and other cardiovascular diseases^e, and gastrointestinal disorders^f. Working during the “wrong time of the day” (for example at night) may make your medication less effective for controlling your condition.

• When working shift schedules or when sleep deprived, nurses with sleep disorders may experience more symptoms such as excessive daytime sleepiness, apnea episodes, restless legs, and related symptoms.¹³
• In addition, researchers warn that workers with insulin-dependent diabetes, seizure disorders, psychiatric diseases, and alcohol/drug abuse could have more difficulties when working shift schedules.¹²
• Long work hours are linked to musculoskeletal disorders possibly because of longer exposure to physical demands and reduced recovery time.¹⁴

^aThis condition is usually most painful in the morning, in contrast to osteoarthritis, which gets more painful throughout the day.

^bLung function is usually worse during the night, when cortisol levels are low and histamine level is elevated, and this is when exacerbations of breathing often occur.

^cCorrect timing of antineoplastic agent dosing can influence susceptibility of cancer cells to the drug, while reducing the toxic effects on normal tissue.

^dBlood pressure is usually highest from 6 a.m. to early afternoon and is lowest at night; thus, timing of medication to follow this rhythm can be beneficial.

^eHeart attacks are most common in the morning, right after waking.

^fGI disorders are exacerbated by disturbances to circadian rhythms and poor sleep.