Correspondence
Decrease in Chronobiological Adaptability
In the literature review of the article I missed—at least in the discussion section—any mention of the problem of the different chronological sequences of shift work (duration of the respective shift, inset days without having to work) and of the age of the study participants (1).
From my own experience (one year of shift work on the intensive care ward in a university medical center‘s hospital for internal medicine in the early 1970s) I know that even in a scenario of weekly shift work (for example, a work pattern of early shift—late shift—night shift—free period) the chronobiological adjustment has to become quasi-permanent, and that for this reason, longer shift sequences (10–14 days) would make sense. As a hospital doctor I had patients under my care who were exposed to shift changes every three days or even daily. These patients experienced this as making them ill. In the context of hospital operation, shifts alternate usually on a weekly basis (except for the permanent night shifts, which, for family reasons, are taken over by mostly female nursing staff. Elsewhere in working environments, shifts alternate in briefer intervals, sometimes on a daily basis. This may go some way to explaining the different results of the research.
Prospective studies of the duration of the shift periods would therefore be instructive, as for health reasons (not only with regard to depression), shifts alternating too quickly would no longer be permissible in terms of occupational health. In my opinion, this would be an important outcome.
Studies of the age of the shift workers might show that from a certain age, the chronobiological ability to adapt may decrease so much that shift work will have to be regarded as no longer reasonable/appropriate.
DOI: 10.3238/arztebl.2017.0680a
Dr. med. Jürgen Bickhardt
Erding
juergen-bickhardt@t-online.de
| 1. | Angerer P, Schmook R, Elfantel I, Li J: Night work and the risk of depression—a systematic review. Dtsch Arztebl Int 2017; 114: 404–11 VOLLTEXT |
