• Sleep Medicine and Psychophysiology
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• v.7 no.2
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• pp.96-101
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• 2000

Objectives: Through comparing sleep variables and autonomic activities among three shifts in shift workers, the authors intended to clarify which shift is most tolerable and to identify the characteristics of their psychological and physical problems. This study is also expected to help shift workers to adapt themselves to their work more effectively. Methods: Fifty one shift workers took part in this study. They were working in a rapidly rotating system in which they worked for 3 days in one shift with one day off between each shift. Based on a sleep diary, sleep latency (SL), sleep period time (SPT), and number of wake after sleep onset (NWASO) were estimated and compared among the three shifts. In assessing sleepiness, Epworth sleepiness scale (ESS) and visual analogue scale (VAS) were used. To evaluate mood states among the three shifts, profile of mood states (POMS) was administered. Heart rate variability (HRV), and the level of adrenaline and noradrenaline were measured to assess autonomic activities. HRV included low frequency power (LF), high frequency power (HF), and LF/HF. Results: SPT was significantly lengthened during the evening shift and SL was shortened during the night shift. The workers showed a drop in alertness at wake-up during morning shift and a drop in alertness at work during night shift. During night shift the subjects complained of physical fatigue and cognitive decline. Comparison of HRV showed that parasympathetic activity was most prominent during the evening shift. Secretion of adrenaline and noradrenaline decreased during the evening shift, though statistically not significant. Conclusion: We found that the evening shift was most tolerable among the three shifts. It is recommended that morning light exposure be done during the morning shift and nocturnal light exposure during the night shift.

• Journal of Korean Academy of Nursing
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• v.28 no.4
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• pp.869-880
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• 1998

In order to investigate of the effects of rapid rotating shift work on physiological stress, the activities of urinary Na$^{+}$, $K^{+}$, Cl$^{[-10]}$ were measured in 14 rotational shift nurses, during day shifts(8AM-4PM, n=4), evening shifts(4PM-l2MN, n=5), and night shifts(12MN-8AM, n=5) in hospital twenty students attending nursing college a used as a control group. Urine specimens were collected in 30 minutes before and after work on the second day of shift work. In day shift nurses, Na$^{+}$ activity was 137mM at 8AM and increased to 206mM at 4PM, whereas $K^{+}$ activity was 42mM at 8AM and no significant change at 4PM. Cl$^{[-10]}$ activity was changed from 234mM to 344mM at 4PM at 8AM. In the evening shift, Na$^{+}$ activity was 117mM at 4PM and 140mM at 12MN, $K^{+}$ activity was 22mM and 32mM, respectively. Cl$^{[-10]}$ activity was 169mM and changed to 270mM. During the night shift, Na$^{+}$ activity was 128mM at 12MN and changed to 161mM at 8AM, $K^{+}$ activity was 42mM at 12MN and 8AM, and Cl$^{[-10]}$ activity was from 303mM and changed to 355mM. In general, the urinary ion activities seemed to increase after work, however there were no significant changes in ion activities except the Na$^{+}$ increase in day shift. The mean of the activities of $K^{+}$ and Cl$^{[-10]}$ before and after work during the day and night shift were significantly higher than those in control group (P＜0.05). $K^{+}$ activities were also higher than that of evening shift(P＜0.05). However, there was no difference in Na$^{+}$ activity among the control group and three shifts. There was a significant relationship among urinary Na$^{+}$, Cl$^{[-10]}$ and $K^{+}$ in the control group and rotating shift nurses except between Na$^{+}$ and $K^{+}$ in shift. The relationship between Na$^{+}$ and Cl$^{[-10]}$ was low in shift work and there was no significant relationship between Na$^{+}$ and $K^{+}$ in shift, suggesting that the active regulation $K^{+}$ and/or Na$^{+}$ in response to stress upon the shift work disruped the ratio of urinary Na$^{+}$ to $K^{+}$ and also lowered the relationship between $K^{+}$ and Cl$^{[-10]}$ . These results suggest that nurses working the day shift were overloaded and under stress, and the night shift interfered with the physiological rhythm of the nurses.red with the physiological rhythm of the nurses.

• Journal of Korean Biological Nursing Science
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• v.1 no.1
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• pp.100-114
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• 1999

This study was done to investigate the effects of rapidly-rotating shift work of two-day interval on fatigue level and the concentration of urinary 17-KS, $Na^+,\;Cl^-$. The subjects were 20 nursing college students(control group) and 15 nurses in a university hospital and the study was done from Apr. 21 to May 4th, 1999. In the test group, each 5 nurses were allocated to day shift(8 AM-4 PM), evening shift(4 PM-12 MN) and night shift(12 MN-8 AM) respectively. The fatigue level were measured 30 minutes after work start on the 2nd day of work shift. Urine specimens were collected at 8 AM, 4 PM and 12 MN on the 2nd day of work shift in the control group and 30 minutes before and after work on the 2nd day of work shift in the test group. The data were analyzed with SPSS(for Window, ver 7.5). Statistical analysis was performed by using t-test, paired t-test and ANOVA. The results were as follows. 1. The perceived fatigue level in shift work 1) The physical and mental fatigue level were significantly higher in night shift than that in day or evening shift(p<0.05). In the neuro-sensory fatigue level, night shift showed higher tendency than that in day or evening shift, but there were no significant differences between each shifts. 2) Comparison between the control group and the test group: Physical fatigue level was significantly higher in night shift than that in day or evening shift of the control group(P<.001). Mental fatigue level was significantly higher in day or night shift than that in evening shift of the control group(P<.05). In the neuro-sensory fatigue level, test group showed higher tendency than that in the control group, but there were no significant differences between two groups. 3) The total fatigue level was higher in night shift than that in day shift or evening shift(P<.05). In comparing with the control group, night shift and day shift showed higher total fatigue level than that in the control group(p<0.05). 2. The concentration of urinary 17-KS, $Na^+$ and $Cl^-$ In the control group, urinary 17-KS, $Na^+$ and $Cl^-$ showed higher level in afternoon that in morning and night. In the test group, cr in day and evening shift and $Na^+$ in evening shift showed higher level at the end of work. The 17-KS concentration at the begining and the end of work in three shift groups were lower than those in control group(p<0.05), however, $Cl^-$ concentration at the begining of work in day shift, and the end of work in day and evening shift were higher than those in control group(p<0.05). $Cl^-$ concentration at the begining and end of work in night shift were considerably higher than those in control group repectively(p<0.1, p<001). $Na^+$ concentration showed a higher tendency in three shift groups except at the begining of work in night shift, but there were no statistical difference. In comparing concentration of the 17-KS, $Na^+$ and $Cl^-$ among the shift groups, 17-KS concentration showed a lower tendency and $Na^+,\;Cl^-$ showed a higher tendency in night shift: The result of this study showes that biorhythm of shift work nurse was irregular. Fatigue level as the subjective index for evaluating the health problem concerning shift work was higher in night shift and proved to be in accordance with the concentration of urinary 17-KS, $Na^+$ and $Cl^-$ used as objective indices. Disturbation of biorhythm and work stress due to night shift seems to cause the health problem of nurses and decrease of work efficiency. It is considered that work regualtion is necessary for the rational management of the nursing administration.