The bad news

A recent study in the Journal of Immunology reminds us that night shift work is associated with an increased risk of (generally minor) infections, cancer and heart disease, stroke, diabetes and autoimmune diseases (e.g. rheumatoid arthritis, lupus and Crohn’s disease).

When is it a reasonable adjustment to come off nights?

My practice is to point out to individuals with any of these conditions (particularly those with rheumatoid arthritis or after a stroke or heart attack) that their health may be affected if they continue to work (rotating) night shifts.

It could reasonably be argued that we have a duty to advise anyone working night shifts of the higher risk of these conditions. At present however, I don’t and, for individuals with early symptoms of any of these conditions I encourage tight compliance with medication and rigorous application of self-help activities (exercise, diet, smoking…) while pointing out that working night shifts might be relevant, too.

Should an individual stay on nights after a heart attack, stroke, etc.?

The (barrister) advice I have received sensibly suggests pointing out these risks to individuals with established/active disease (after a heart attack or stroke or an individual with Crohn’s disease and rheumatoid arthritis). From a purely medical perspective I would support such individuals working daytime hours, only if they opt to and if operationally manageable and suggest they sign a statement of acceptance and understanding if they choose to continue to work nights despite their knowledge of the higher risks.

As always, feedback (particularly legal) appreciated.