[Medical surveillance for shift and night work]

Shift and night work are recognized as risk factors for health and safety; they are related to a wide range of public health problems ranging from cardiovascular disease and cancer to mental disorders and accidents. Occupational health physicians should evaluate workers' fitness for shift and night work before their assignment, at regular intervals, and if health problems connected with shift work occur. The evaluation should be accompanied by a careful job analysis to ensure that shift schedules are arranged according to ergonomic criteria. This arrangement can reduce health problems and make coping with irregular working hours possible, even for people suffering from contraindicative illnesses. Both health disorders representing absolute or relative contraindication and actual work conditions should be taken into account. Health checks should be aimed at detecting early signs of intolerance, such as sleeping and digestive trouble, drug consumption, accidents, and female reproductive function problems.