Medical Implications of Shift-Work

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  • Martin C. Moore-Ede
    Department of Physiology and Biophysics, Harvard Medical School, Boston, Massachusetts 02115
  • Gary S. Richardson
    Department of Physiology and Biophysics, Harvard Medical School, Boston, Massachusetts 02115

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<jats:p> The circadian pacemakers, which time the approximately 24-hour rhythms in sleep and wakefulness, neuroendocrine, thermoregulatory, and other body functions, resynchronize only slowly after an abrupt phase shift in environmental time cues. While the symptoms of jet-lag are transient, the kinds of repeated shifts over a number of years experienced by shift-workers on rotating schedules induce sleep-wake disorders, gastrointestinal pathology, and an increased risk of cardiovascular disease. There is significant interindividual variation in the ability to adapt and also a deterioration with age. Evidence is accumulating that poor adapters present with a Shift Maladaption Syndrome with characteristic pathological manifestations. </jats:p>

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