Psychoneuroendocrinology (2010) 35, 1339—1347

a v a i l a b l e a t w w w. s c i e n c e d i r e c t . c o m

j o u r n a l h o m e p a g e : w w w. e l s e v i e r. c o m / l o c a t e / p s y n e u e n

Cortisol, reaction time test and health among offshore shift workers
˚se Marie Hansen c, Anette Harris a,b,*, Siri Waage b,d, Holger Ursin b, A Bjørn Bjorvatn d,e, Hege R. Eriksen a,b

Research Center for Health Promotion, Faculty of Psychology, University of Bergen, Norway Unifob Health, University Research Bergen, Norway c National Research Centre for the Working Environment, Denmark d Department of Public Health and Primary Health Care, University of Bergen, Norway e Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Norway

Received 29 September 2009; received in revised form 17 March 2010; accepted 18 March 2010

Cortisol; Reaction time test; Health; Shift work; Offshore workers

Summary Objective: The stress hormone cortisol shows a pronounced endogenous diurnal rhythm, which is affected by the sleep/wake cycle, meals and activity. Shift work and especially night work disrupts the sleep/wake cycle and causes a desynchronization of the natural biological rhythms. Therefore, different shift schedules may have different impact on performance at work and health. Aim: The purpose was to study if health, reaction time, and the cortisol rhythm were negatively affected when a group of shift workers changed their work schedule from ordinary day—night shift (fixed shift) to ‘‘swing shift’’. Methods and settings: 19 healthy workers on a Norwegian oil rig participated in the study. They worked 2 weeks offshore followed by 4 weeks off work. The ordinary schedule consisted of 12-h day shift and 12-h night shift every other work period (14 days or nights = fixed shift). ‘‘Swing shift’’ involved 1 week of night shift, followed by 1 week of day shift during the work period. All participants worked ordinary day—night shift when baseline data were collected (questionnaires, saliva cortisol, and reaction time during work). After collection of baseline data the workers changed their work schedule to ‘‘swing shift’’, for every working period, and 9 months later the same data were collected. Results: ‘‘Swing shift’’ did not give any negative health effects or any negative changes in reaction time during the day they shifted from night work to day work. Personnel adapted to night shift within a week regardless of schedule, but recovery from night shift took longer time. During swing shift the cortisol rhythm went back towards a normal rhythm in the second week, but it was not returned completely to normal values when they returned home for the 4 weeks off period.

* Corresponding author at: Unifob Health, University Research Bergen, Christies gate 13, 5015 Bergen, Norway. Tel.: +47 55 58 39 92; fax: +47 55 58 98 78. E-mail address: (A. Harris). 0306-4530/$ — see front matter # 2010 Elsevier Ltd. All rights reserved. doi:10.1016/j.psyneuen.2010.03.006

However. 2007). Conclusion: We found no increase in health complaints from swing shift or reaction time in the shift from night to day work.. In general shift work also appears to require more effort and time to recover from work than day work (Jansen et al. 2003) higher risk of cardiovascular and gastrointestinal diseases. The most important regulatory factor in humans is the light—dark cycle (Czeisler et al. 1989). The offshore period involves long hours of work mostly indoors with little exposure to sunlight and no commitments to daily family activities.. then 12-h day shift for the last week. It has been argued that swing shift is associated with greater problems of alertness and performance than a schedule were the workers alternate between day shift during one work period. reaction time.. after a request from the workers. and how the rhythms are reset. 1995). Kristenson et al. long term job strain (Rydstedt and Mark.. # 2010 Elsevier Ltd. cortisol adaptation was not complete after 1 week at home. During the 2 weeks offshore period the ordinary routine was to alternate between 12-h day shift during 1 work period and 12-h night shift on the next work period (fixed shift).. 2006). night shift.. night shift has been associated with low cortisol levels after awakening from sleep (Lac and Chamoux.. 2008). Harris et al. In addition to disturbance in the circadian rhythms (Fujiwara et al. 1997.. 2003). 2007). a decision was made to evaluate the effects of swing shift. Disturbance in the cortisol rhythm. Several studies have monitored diurnal cortisol rhythm in relation to shift work under naturalistic conditions (Hennig et al. 2005). Ross. 1990.. 1982. The endogenous rhythm in humans is normally adjusted to 24 h by external factors such as light (Czeisler et al. 1996)... but social factors are also of importance (Honma et al. differences in study design and sample size make it difficult to compare and evaluate how different shift schedules really affect the cortisol rhythm. 2004). 2004). 1992. the cortisol rhythms were readapted to normal values after 1 week at home. and then decreasing levels during the day (Weitzman et al. 1998) are reported. and chronic pain (McBeth et al.. Introduction Shift work interferes with biological functions and social rhythms. Recovery from night shift takes longer time. 1989). Offshore work on oil rigs offers particularly good opportunities to study these effects. The adrenal hormone cortisol shows a pronounced diurnal rhythm and is viewed as a robust marker of overall circadian rhythm (Born and Fehm.. 1991. These changes in rhythms introduce some concerns for the health and safety of the workers (Lauridsen and Tønnesen. sleep problems (Costa. 1994) that leads to changes in the normal social rhythms (eating and sleeping habits) (Costa. 1996. Data from this study with three different work schedules may give important objective data on the effects of shift work on the biological rhythms. 1992. 2007). The circadian rhythm is controlled by the suprachiasmatic nuclei (SCN) situated in the hypothalamus. Parkes. Kudielka et al. For personnel returning home directly from 14 consecutive night shifts. However. All rights reserved. and swing shift) affect the cortisol rhythm and the resetting of the rhythms. 1998. 1995). 2007) or laboratory conditions (Fujiwara et al. High cortisol levels in the evening are associated with low scores on decision authority (control) (Harris et al.. . Traditionally. 1993). It is therefore also of interest to investigate whether swing shift leads to any changes in reaction time. Costa et al. Many offshore workers prefer swing shift because they feel readapted to a normal day—night rhythm when they start their 4 weeks off work period at home (Parkes. In shift workers with a slow rotation schedule. and health. first at the beginning of the work period (getting adjusted to night work) and then in the middle of the work period (readjusting to day work).. 1997). It has been demonstrated already that offshore workers adapt faster to night work than night workers on shore (Barnes et al. this oil company does not use swing shift. A disadvantage of swing shift is that the workers need to adapt to a new rhythm twice on every 2 weeks work period. but also by habits and behavioural factors (Bjorvatn and Pallesen.. especially a blunted response in the morning. Under normal conditions the secretion of cortisol shows the lowest levels during the first half of a night’s sleep. 12-h night shift during the first week. This is particularly relevant for studies of shift work effects on the rhythm of saliva cortisol. 1998. The aim of the study was to examine how different work schedules (day shift. The underlying mechanisms linking shift work with health pro- blems are probably due to the desynchronization of the circadian rhythm (Regestein and Monk. followed by 4 weeks off work. and night shift on the next work period (Parkes.. 1997). impaired performance (Tilley et al. Most humans have an endogenous circadian rhythm with a period length of between 24 and 25 h (Czeisler et al. Wilhelm et al. 1998a.. Knutsson. However. Shinkai et al. we examined if implementing the new schedule (swing shift) was associated with health complaints or changes in perceived work environment compared to fixed shift. We compared these schedules with ‘‘swing shift’’. The link between shift work and health is complex.. a gradual elevation through the second half of the sleep. 2008). may be an indication of insufficient recovery... 2003).. 2000). In this paper we compared three shift work schedules for effects on the rhythm of saliva cortisol. an objective measure of sleepiness and performance (Lamond et al.. Therefore. 1. high levels in the evening (Sluiter et al. Knutsson.. Ordinary work schedule is 2 weeks work. Totterdell et al. the relatively isolated work environment on an oil rig eliminates at least some of the confounding social factors influencing diurnal rhythms on shore. and reduced alertness (Tucker et al. Bjorvatn et al. and how this is associated to reaction time (an objective measure of sleepiness). 1999). 1971. in a population of 19 healthy individuals working offshore on an oil rig in the North Sea. and high morning cortisol (Gustafsson et al. reaction time and health. Furthermore. a characteristic peak the first hour after waking.1340 A. 2009). 2009).

Totally there are 122 beds on the oil rig. then when they had worked swing shift for about 9 months. The cabins are adjusted to night work and sleeping at daytime (sound and light isolated). the follow up measurements were carried out during Fall 2008 (Table 1).2. The workers were screened with questionnaires. physical form and preferred working schedule. The questionnaires were filled in twice. This schedule also accounted for any seasonal changes in cortisol (Persson et al.. The questionnaires were handed out by the nurse at the oil rig the first day they arrived. To adjust to the same schedule as the fixed shift. years working on an oil rig. They were recruited from a sample of 32 employees working offshore in the process area on a small North Sea oil rig.. Half of the subjects started with day shift and the other half with night shift. and saliva was collected for cortisol analyses.1. They also filled out sleep diaries and used Actiwatch1.. participated in the study. 2007. and 5 worked only day shift on the same oil rig. Questionnaires Background variables include gender. experience with shift work. All 32 employees working in the process area were invited to participate in the study. The instrument consists of 5 Table 1 Study outline. 1999.5%) agreed to participate and were screened on baseline data before shifting from fixed shift schedule to swing shift. 10 catering personnel and up to 98 contractor personnel included drilling. Only one of the participants worked day shift because he did not cope with swing shift. Methods 2. Results from baseline data (questionnaire). 10— 11 workers in the process area. The workers collected saliva (at home and offshore) and performed a reaction time test (offshore) on three different working schedules. ‘‘pseudoneurology’’ (tiredness. The workers stay indoors most of the time (during work and free time) with only artificial light. 28 workers (87. 2 worked another place in the company (onshore). first before the fixed shift (day shift and night shift). they ended their night shift at 0400 h or 0600 h and started the day shift 8 h later at 1200 h or 1400 h. The questionnaire picks up any unspecific (or specific) health complaint arising during the free period at home. All workers gave their informed consent. 13 men and 6 women.. 3 managers. The baseline data were collected during Fall 2007 when the workers were working fixed shift (day shift and night shift every other work period). came both from the day shift and night shift workers. Of the 9 participants that did not work swing shift. Perceived work environment was measured with the short Swedish version of the Demand-Control and Social Support Inventory (Theorell. The questionnaires were filled in twice. In a similar oil rig the average light intensity inside the oil rig was reported to be 200—300 lx (range from 20 to 700) (Bjorvatn et al. and ‘‘flu’’ complaints. The work schedule was 2 weeks of work. musculoskeletal complaints. 1999). Meals are served at regular times and the workers have no commitments to daily family activities. and the workers normally report to have good sleeping conditions. reaction time test and health among offshore shift workers 1341 2. at baseline (day shift or night shift) and follow up (swing shift). when the workers had about 9 months of experience with swing shift. therefore. 19 participants were working swing shift 9 months later. which may occur as an effect of the work period. 1993). The day shift started at 0700 h and ended at 1900 h and the night shift started at 1900 h and ended at 0700 h. age. health. Wilhelmsen et al. this shift was reduced to 7 or 5 h and ended at 1900 h.3) and had been shift workers for 17 years (sd = 9. Participants and general experimental outline A total of 19 workers. the inventory yields five subscales. and 1 year later after having worked swing shift for about 9 months. The mean age was 44 years. At first measurement they had been working on an oil rig for 12 years (sd = 8. and are included in the analyses. gastrointestinal complaints. The rest of the drop out was due to reorganization for other reasons. range from 28 to 60 years. On the rotating day of the swing shift. at baseline. 1999). and collected within 3 days. Health complaints were measured with the Subjective Health Complaints inventory (SHC) (Eriksen et al. mood changes). Last day at the oil rig the day shift was also reduced and started at 0400 h or 0600 h and ended at 1200 h or 1400 h. . 2 did not want to participate in the study. The SHC inventory has been tested in different populations and has satisfactory validity and reliability (Eriksen et al.7).Cortisol. In addition to a sum score. when they were working day shift and night shift. ‘‘allergy’’.. 2008) and seasonal changes in the intensity of outdoor light. and reaction time tests (R) were performed only when they were working offshore. 2. 2007). The study was approved by the Regional Ethics Committee and the Norwegian Social Science Data Services National Register of Data.. followed by 4 weeks off work. these data will not be presented here. The instrument consists of 29 items and measures subjective somatic and psychological complaints experienced the last 30 days. they performed reaction time tests. Ihlebaek et al. cortisol (C) were collected in the workers leisure time (home) and when they were working offshore.

. Mean reaction time was calculated. The saliva samples were kept in freezer either at home or at the oil rig (À20 8C) until they were transported to the laboratory for analysis. after 2.3% for 5a-dihydrocortisol. 2003.3. in the middle of the offshore tour and the last night offshore. natural saliva samples (5. USA)1. 1 week before the work period. Cross-reactivity to cortisone was <0. 2..0 nmol/l. Finland. and the last day offshore.59 nmol/l. with recovery being 97% [95% CI: 94. 2005).0—100. and 1 week after the work period (between Tuesday and Friday).9% for 5b-dihydrocortisol. The mean ‘‘recovery’’ period between the end of dayshift and bedtime was 3. and brushing their teeth the last 30 min prior to the tests. and day/night 14. 2: 30 min after awakening (0 + 30 min). 2. and saliva. the Spectria Cortisol Coated Tube RIA. Harris et al. drink. the second day offshore.. 1998). Limit of detection (LOD) was 1. When a black square was displayed on the screen. Total workload is the sum of demands divided with the sum of control. 2003). the range of the standard solutions prepared was 1. Samples 1 and 2 were used to calculate the cortisol awakening response (CAR).0—100. etc. 6 items that measure control and 6 items that measure social support. The interaction of shift.5 nmol/l) were used as control materials and analyzed together with the samples. purchased from Orion Diagnostica. 3: 6 h after awakening (0 + 6 h). radio. saliva cortisol is a reliable marker of unbound cortisol in plasma (Kirschbaum and Hellhammer. .0) was used for all the statistical analyses. when they take the test. A. 3. The workers were instructed to sit down in a quiet room without any distractions from TV. Based on the subjective reports. 5: just before bedtime. Oral and written instructions on the sampling procedure were given when the salivettes were distributed.5 nmol/l and 16% at 49.0% for 6a-methylprednisolone (these components are not relevant in healthy individuals).3% for prednisolone. Espoo.. they collected saliva four times. Reaction time test Reaction time was measured with a 10 min simple serial reaction time test on a handheld computer (Palm Inc.3%. either in the room where they normally have the coffee break or in the medic room at the oil rig. the last night before rotating. 2.4%. Westgard control charts were used to document that the analytical method remained under analytical and statistical control–—in other words. 2008). 2003).8 nmol/l).2%. urine. 1981). workers were asked to respond to the stimulus by pressing a key to turn off the square. plasma. and note the exact time of awakening and saliva collection. time of day and shift for the cortisol measures. Geometric means were used in the figures. that the trueness and the precision of the analytical methods remained stable (Westgard et al. When the workers were offshore they performed the reaction time test at day/night 1. rotation when they were on swing shift).. an intra-assay variation of 5.8% for 21-desoxycortisol. 1989). When they were on night shift they collected saliva the second night offshore. 4: 12 h after awakening (0 + 12 h). Turku. Norway). the second night offshore. tobacco. To show equivalence between different runs.6. 78. The workers collected saliva samples five times: 1: on awakening. Cortisol levels at day shift were set as the reference category. A method evaluation of certified reference material in water showed no bias of the method. and 5 were used to calculate the level for cortisol decrease during the shift.4. Between-run coefficients of variation (CVs) were 19% at 11. If they pressed the key in advance or within 120 ms the response would be discarded and a warning signal would be displayed. and time were set as repeated measure and subjects were included as a random factor. Ski. The specifications given by the manufacturer were a sensitivity of twice the standard deviation of the zero binding value in saliva (0. Finland) was used for measurement of radioactivity. The workers were instructed to avoid food. If no response was given within 1750 ms a new interval was started. Samples 2. When they were on swing shift. 4. and an inter-assay variation of 7. CA. The sample volume was 150 ml.36 h (sd = 41 min) and the mean ‘‘recovery’’ period between end of night shift and bedtime was 42 min (sd = 46 min). The cross-reactivity of the antiserum used was tested by the manufacturer to be 84. in the middle of the offshore tour and the last whole working day. All five samples were used as a marker of cortisol rhythm.9]. 45. Statistical analyses SPSS (version 15. The performance of the methods has been further validated by participation in interlaboratory comparison schemes (Garde et al. a bias of 110% (103—115%).5. Hansen et al. The software measures reaction time in milliseconds (ms).2 nmol/l (Hansen et al. Hormonal analysis Determination of cortisol in saliva was carried out with a competitive radioimmunoassay (RIA) designed for quantitative in vitro measurement of cortisol in serum. Saliva sampling Salivettes1 with cotton rolls (Sarstedt. and the incubation time was 30 min at 37 8C. A 1470 Wizard gamma counter (Wallac.9 and 18. Shift differences in cortisol rhythm were tested by contrasting cortisol levels during the day shift with those during the night shift and swing shift. The mixed model routine was used to model fixed effect for day. The workers collected saliva at days off work for 2 consecutive days (between Tuesday and Friday). day/night 7 (day 8. The test has been validated as a measure of sleepiness and performance (Lamond et al.. 11.. and 11. the first day after rotating. Sample 5 (before bedtime) was used as a measure of recovery after a working day (Sluiter et al. The cortisol data were not normally distributed. according to the manufacturer’s specifications. Each day the test was performed at the start (within the two first hours) and the end of the shift (within the two last hours).. day. morning samples with a delay of more than 15 min (21 of 171 samples) were excluded from the analysis (Dockray et al.1342 items that measure work demands. Santa Clara. therefore the analyses were done on log transformed data. The mean scores from the different days are used in the statistical analysis and in the figure. When they were on day shift they collected saliva three times. were used to measure cortisol in saliva at home and at work.

(e) the last whole day/night offshore. Gender and age were adjusted in both models. the rest (18 workers (94.1. For the reaction time measures fixed effect for day and shift were modelled and the interaction of shift and day were set as the repeated measure. A number of different covariance structures were applied to the data in both models. *Mean of 2 consecutive days. Reaction time at day shift was set as the reference category. Swing shift was the preferred schedule at baseline (15 workers Figure 1 Cortisol rhythm (mean and 95% CI) at different time point in connection to the different working schedule. Results 3. reaction time test and health among offshore shift workers In the analysis of the reaction time we also used mixed models. (f) home 1 week after offshore tour*. Only one worker described his physical fitness as bad.7%) reported to have very good or good health. 5 workers (26.05 were considered as statistical significant. An autoregressive covariance structure gave the best fit (lowest Aikaikes value) and was therefore applied in both models (cortisol and reaction time). (c) in the middle of the offshore tour (before rotating day). Paired sample t-tests were used in all analyses for continuous variables from the questionnaire (subjective health complaints and demand/con- 1343 trol). (b) the first whole day/night offshore. p-Values less than .Cortisol.7%)) were in very good or good shape. fixed shift (14D/ 14N) and swing shift (7N + 7D): (a) home 1 week before offshore tour*.3%) reported to have average health. Descriptive statistics Fourteen workers (73. . (d) in the middle of the offshore tour (after rotating day). 3.

2752 1. the cortisol rhythm from the first day after rotating from night shift to day shift showed a ‘‘flat cortisol rhythm’’ with lower CAR ( p < . the cortisol response at awakening (CAR) was significantly lower ( p < .187 . Last day offshore working swing shift the CAR ( p < . Health and perceived work environment There were no differences in the mean scores for Subjective Health Complaints.373 .368) on this shift. compared to the levels measured when they were working day shift (Fig.68 1.1980 D2 . As expected. or in the level for cortisol decrease ( p = .2206 .431) between the shifts.4145 ** .1086 . Week Day CAR Night shift estimate Swing shift estimate 1 (Home) D1 .6330 ** S.58) (1.1%)).101).99 1.1344 A.53 0. 2d). the bedtime values were higher when they were on swing shift compared to day shift ( p = .57 20.2014 . When the workers woke up after the first night offshore after having worked swing shift. level for cortisol decrease and cortisol just before bedtime on different days. Fixed shift (14D/14N) (n = 19) Mean (sd) SHC sum score SHC-musculoskeletal SHC-gastrointestinal SHC-pseudoneurology SHC-allergy SHC-flu Demand/control Demand Control Social support 6.930) or the level for cortisol decrease ( p = . 1a. the bedtime values were higher ( p < .31 20.3625 .09) (1.9%)) and also after working the new schedule for 9 months (16 workers (84.60) (2.32 0.588 .001) was low compared to the CAR when working day shift.63 (4. With one exception.73) (1. the mean wake up time was approximately 0600 h and when they were on night shift they woke up approximately 1530 h. . 3.05.3460 * .6184 * 3 (Offshore) D1 D6 À.02) (0.1369 À.0115 À.12) (1. there were no significant differences in the cortisol rhythm between the different shift schedules in the middle of the offshore tour (before rotating) (Fig.1294 À.001).75) (1.2986 ** .01.494 . there were no differences in CAR ( p = .2879 * À.16 0.33) (0.33 0.3. Table 3). 3.43) (1.2078 D7 S.001).0172 ** p < .34) Swing shift (7N + 7D) (n = 19) Mean (sd) 5.00 0.889 .4666 ** D7 À.556 . Cortisol rhythm at home and work There were no significant differences between fixed shift (day shift and night shift) and swing shift (7 nights + 7 days) in cortisol rhythm at home before the offshore period (Fig.2620 ** 1.58 0.001).2056 . When the workers were on night shift and woke up after the first night offshore.51) (1.96) (0.0358 . The cortisol rhythm showed the characteristic peak levels after awakening followed by a decrease during the shift.05 (6.172 (78.1353 2 (Offshore) D2 S.0226 S.0191 À.88 17.2061 1.82 3. Harris et al.3011 À.0194 Swing shift estimate . Perceived Work Environment or social support between baseline and follow up (Table 2). 2c).00 1.1006 À.2. However.1031 .0265 À.72 12.1538 À. Significant differences are bold. at 2 weeks night shift and swing shift (7N + 7D) when cortisol levels at 2 weeks day shift where considered as reference category. Table 2 Mean score and standard deviation in subjective health complaints (SHC) and perceived work environment (demand.57) (1.371 .0758 S.70) (2.0152 . and corresponding higher bedtime values ( p < . However.26 1. 2b).5738 ** À. There were no differences in the level for cortisol decrease between night shift and day shift ( p = .0120 À.001) and the cortisol levels before bedtime were significantly higher ( p < . control and social support) at baseline (fixed shift) and 1 year later (swing shift).272 .36) (2.40) (3.0605 .2981 4 (Home) D6 S.77) (2.0854 .1045 Cortisol bedtime Night shift estimate Swing shift estimate * ** .024) compared to day shift (Fig. When they were working day shift.884).1282 À.0236 À. The cortisol rhythm showed the characteristic peak levels after awakening on all shifts and there were no differences in CAR ( p = .001) and lower level of cortisol decrease ( p = .75 12.6407 * . p < .8903 ** Level for cortisol decrease Night shift estimate À.37) (0.479 .97 2.035).1163 .58 17.23) (0.52) p-Value .0854 . There were no differences in the level for cortisol decrease Table 3 Multilevel estimates for the cortisol response after awakening (CAR).

4. there were no significant differences in reaction time between the different shift schedules (Fig. During swing shift the reaction time test in the middle of the work period were measured first day after rotation. Last night offshore working night shift there were no differences in CAR ( p = .. but significantly higher mean score on reaction time the first night offshore when they were on night shift compared to day shift. the circadian rhythm of cortisol was disturbed. However. 2002). Significant differences ( p < . but the level for cortisol decrease was low ( p = . Bjorvatn and Pallesen. 1998). expectancies and attributions connected to the work situation. when returning home from swing shift.. The adaptation from night work (at the oil rig when working swing shift and at home when working only night shift) took longer time than adaptation to night work. The adaptation to night work. When cortisol levels were tested 1 week after return from the swing shift offshore period. Variance in the cortisol rhythm. 1998). 1999.. may be related to psychological factors as. When they were on swing shift the cortisol rhythm the first day after rotation was totally flat. . assessed by the cortisol rhythm was complete within a week. Cortisol is not only a robust marker of overall circadian rhythm (Born and Fehm.011 and day 2: p = . Other studies from oil rigs have also found a complete adaptation within a week. reaction time test and health among offshore shift workers 1345 Figure 2 Mean reaction times (95% CI) were measured three separate days/nights (day 1.4. However. Reaction time test With one exception. 2009).. Gibbs et al.Cortisol. the cortisol rhythm was more disturbed after awakening when they were on their second night on a 2-week night shift than it was the second night on a swing shift tour.. 2004).211) or cortisol level before bedtime ( p = . As expected the results showed that during the second night on the oil rig.015). they were almost readapted to a normal day rhythm. The majority of the group preferred swing shift and it may be that the prospect of only 1 week with night shifts is easier to cope with than prospect of night work for the next 2 weeks (Ursin and Eriksen. 2004). This result may be related to random factors.... 2e).590) or cortisol at bedtime ( p = . Sluiter et al.134) between swing shift and day shift. but we may speculate that this result is related to expectation factors. Discussion The majority of the personnel (84%) preferred the new schedule with night shift during the first week and day shift for the last week.. This is a better situation for leisure time activities. The rapid readaptation in the onshore period agrees with the reason given for the preference for this schedule. 3. our data do not tell us whether swing shift has any long term health benefit compared with other shift schedules. It is also used a measurement of ‘‘stress’’. for instance.069). 2006). The CAR was significantly lower on both days (day 1: p = . since it is a sensitive indicator of phasic shifts in arousal (Ursin and Eriksen. day 7—8. as assessed by the aMT6S (melatonin) rhythm (Barnes et al. 1 week was not enough when returning from ordinary night shift (Fig. The workers had a small. 2f). One week later.. This is in accordance with previous studies (Parkes. which may be an important element in the potential ill effects of ‘‘stress’’ and shift work (Kristenson et al. and day 14 off shore) in relation to fixed shift (14D/14N) and swing shift (7N + 7D). 1998. However. 2006). 1997). In the recent ‘‘cognitive activation theory of stress’’ (CATS). 1998b) or lack of light exposure in the morning (Bjorvatn et al. the cortisol rhythm was readapted after 1 week. 1998a. A blunted response in the morning and high levels in the evening may be an indication of insufficient recovery. The fast adaptation to night work the first week on the oil rigs could probably be explained by a combination of environmental and social factors (Barnes et al. ( p = . 2002) and by sleep and sleepiness assessment (Bjorvatn et al. This result is in accordance with a previous study showing that the resetting of the rhythm after returning home from 2 weeks night shift was more difficult than the adaptation to night shift when they arrived on the installation (Bjorvatn et al.041) compared to cortisol levels at home when they had been on day shift. It is therefore easier to phase delay than phase advance the diurnal rhythm (Czeisler et al. The result indicates that direction and leisure time between the shifts are of importance. However. One explanation may be the fact that most people have a biological clock that is longer than 24 h.05) between night shift (D1) and day shift (D1). and is the reason given for the preference for this schedule. The low cortisol response after awakening (CAR) and high evening values after night shift (14 nights) indicate that the workers were not recovered 1 week after the offshore tour.005) compared to day shift (14 days) (Fig. The different shift schedules are separated by dotted lines. 1993). therefore. on the second day the cortisol levels before bedtime were also higher ( p = . 2000). Another study from offshore workers on a swing shift schedule have found that measured with melatonin (aMT6S) the readaptation from night shift to day shift in the second week was more difficult than the adaptation from day rhythm into night shift the first week (Gibbs et al. 2). The results are in accordance with a study from the industrial and service organizations showing that backward rotating shift (from night shift to day shift) was related to health and wellbeing problems when the shift system involved quick returns with less than 8 h between the shifts (Barton and Folkard. the rhythms were readapted to normal rhythms. expectancies associated with stimulus and response outcome are held to be decisive for the arousal (or ‘‘stress’’) levels of the organism. 2004.

. Results were presented. . Costa. only the healthiest and fittest. Minors. A. G. J. 1990. Arch. R.. the rhythm was totally reset 1 week after returning home from swing shift. trade unions. 179—182. 252. The impact of shift and night work on health. We thank all the volunteers for their patience and compliance and the medical personnel on the oil rig for their help.g. 1998b. D. the same individual was assessed under different shift work conditions. Conflict of interest None declared. Tarondi. The first night on the oil rig when they were on night shift. 2003). It seems reasonable to assume a ‘‘healthy worker effect’’ (Costa.. Personnel returning home from 14 consecutive night shifts need more than 1 week at home to recover their cortisol rhythm. 1993. G. 1998. 9—16. the Norwegian sector versus the UK sector) (Ross. Kecklund. (Lond. Barnes. 83—88. M. Folkard. Rapid adaptation to night work at an oil platform.. 40. It might therefore be less apprehension of potential problems for the swing shift schedule in the home period. J. 27. the mean reaction time was higher compared to first day on day shift.. The increases were especially marked during the first 2 days after rotation from night to day shift. Kecklund. Arendt. N. The overall findings from this study indicate that there was no increase in health complaints from swing shift. Stangenes. our workers worked in the processing division of the oil rig.. Lowden. Introduction of the new swing shift schedule was not associated with more subjective health problems or changes in perceived work environment. for the rest of the work period there were no differences between the different schedules. Ghirlanda. explained.. Ergonomics 36. S. Advancing versus delaying shift systems. 1997). 105—112. Reaction time appeared stable through the whole working period on the different schedules. Forbes. and the health service) accepted the design and offered logistic support and advice for the data collection. Akerstedt.. Neurosci. to go home from dayshift instead of from night shift to have better quality in their leisure time. Lett. 2009. Health 65. all workers were tested with fixed shift followed by swing shift. 601—608..) 53. 821—829. T.. B... our only objective measurement relevant for this type of performance risk. Rev. those who cope with shift work. 9—12. 1994. Also the workers in our study are highly selected. Costa. except for the fact that our workers wanted this particular shift system. Fehm.G. G. S. 2009).J. Med. T. 59—64. 25—38. Occup. The neuroendocrine recovery function of sleep. There are also differences in rules and regulations between different countries (e. G.... Sleep Med. Parkes. Parkes (1997) found that personnel working swing shift (7 nights + 7 days) showed moderate increases (10. 1998a. 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