[Management of shift and night work in hospital]

Shift and night work are necessary in hospital work organization. They may have adverse effects on workers' health, due to disruption of biological rhythms, mainly as concerns sleep, digestive, fertility, psychoneurotic, metabolic, and cardiovascular disorders, besides being a probable (according to IARC) risk factor for cancer (breast in particular). Hence, the primary intervention deals with a proper organization of shift schedules according to ergonomic criteria, able to avoid or limit the circadian disruption and related consequences as much as possible. In addition, useful countermeasures should be adopted, dealing with reduction of night work, increase of rest pauses and rest days, improved social services, and temporary transfer to day work, as well as a careful medical surveillance, aimed at detecting early signs of intolerance and at counseling for improving self-care strategies for a better coping.