[Shift work and health].

Shiftwork, in particular night work, causes disruption of biological rhythms, perturbation of social and family life, with a negative influence on performance efficiency, health and social well-being. Deterioration of health can manifest in the short-term as sleep disorders, jet-lag syndrome and accidents; in the long term there is an increased risk of gastrointestinal, psychoneurotic and cardiovascular diseases, and impairment of the female reproductive function. The evaluation of a worker's fitness for shift and night work should be strictly connected with a careful job analysis, as the primary requisite is to arrange shift schedules according to ergonomic principles and to assure suitable compensative measures. Occupational health physicians should advise shiftworkers about proper coping strategies and carefully evaluate health disorders with absolute or relative contraindications. Health checks should be aimed at detecting early signs of intolerance and their frequency should be set in relation to specific working conditions, individual characteristics, and social factors known to influence tolerance to shift work.