The cognitive impact of guard shifts in physicians: a before-after study

The effects of work on cognitive functions: a systematic review

“…Among 64 studies included in the systematic review, 39 were related to the effect of shift work on cognitive functions ( Table 4 ) ( Deary and Tait, 1987 ; Orton and Gruzelier, 1989 ; Lingenfelser et al, 1994 ; Smith et al, 1995 ; Petru et al, 2005 ; Rouch et al, 2005 ; Saricaoğlu et al, 2005 ; Griffiths et al, 2006 ; Chang et al, 2011 , 2013a , b ; Anderson et al, 2012 ; Shwetha and Sudhakar, 2012 , 2014 ; Niu et al, 2013 ; Özdemir et al, 2013 ; Veddeng et al, 2014 ; Kazemi et al, 2016 , 2018 ; Maltese et al, 2016 ; Titova et al, 2016 ; Vajravelu et al, 2016 ; Haidarimoghadam et al, 2017 ; Soares and de Almondes, 2017 ; Williams et al, 2017 ; Persico et al, 2018 ; Taylor et al, 2019 ; Abdelhamid et al, 2020 ; Adams and Venter, 2020 ; Athar et al, 2020 ; James et al, 2021 ; Prasad et al, 2021 ; Stout et al, 2021 ; Sun et al, 2021 ; Zhao et al, 2021 ; An et al, 2022 ; Benítez-Provedo et al, 2022 ; Esmaily et al, 2022 ; Peng et al, 2022 ).…”

“… Athar et al (2020) investigated the influence of shift work on executive functions, finding impairment of areas deputed to executive functions, such as prefrontal area. Benítez-Provedo et al (2022) evaluated the change in several cognitive functions after a guard shift in physicians, noting lower performance in executive functions and attention. Chang and colleagues carried out three studies ( Chang et al, 2011 , 2013a , b ) on nurses: in the first one (2011) they compared cognitive performance at the time of maximum fatigue (3–4 a.m. on the last night shift of the rotation) among nurses who had been working for two, three, or four consecutive night shifts; the results showed greater impairment of perceptual and motor ability after two consecutive night shifts compared with four consecutive night shifts; in the second ( Chang et al, 2013a ), they explored changes in cognitive functions in the daytime of nurses working on fast rotating shifts and found a poorer performance on visual attentive task; in the third ( Chang et al, 2013b ), they explored the same changes as the previous study but after one block of fast forward rotating shift (2 days, 2 evenings, and 2 nights), finding no changes in cognitive performance.…”

“…Many studies focused their attention on the negative effects of shift work on circadian rhythm ( Schettini et al, 2023 ) and consequently on sleep and cognitive functions. Particularly, most studies highlighted detrimental effects: such among healthcare workers, medical professionals, as anaesthesiologists had a decline in reaction time, problem-solving, attention, and mental flexibility after night shift ( Saricaoğlu et al, 2005 ; Griffiths et al, 2006 ; Williams et al, 2017 ; Abdelhamid et al, 2020 ; Adams and Venter, 2020 ; Prasad et al, 2021 ), nurses had affected reaction time, motor ability, attention, cognitive flexibility, working memory, and decision making after work shift ( Chang et al, 2011 , 2013a , b ; Niu et al, 2013 ; James et al, 2021 ; Sun et al, 2021 ; An et al, 2022 ; Esmaily et al, 2022 ; Peng et al, 2022 ), other categories of physicians(intensivists, emergency doctors, gynaecologists, junior doctors, hospital doctors, medical house officers, postgraduate year one physicians) had a deficit in attention, executive function, memory, motor function, and reaction time after night shift ( Deary and Tait, 1987 ; Orton and Gruzelier, 1989 ; Lingenfelser et al, 1994 ; Anderson et al, 2012 ; Özdemir et al, 2013 ; Veddeng et al, 2014 ; Maltese et al, 2016 ; Persico et al, 2018 ; Benítez-Provedo et al, 2022 ). Other workers, such as security staff ( Vajravelu et al, 2016 ; Athar et al, 2020 ), control room operators ( Kazemi et al, 2016 , 2018 ; Haidarimoghadam et al, 2017 ), business process outsourcing employees ( Shwetha and Sudhakar, 2012 , 2014 ), power plant workers ( Smith et al, 1995 ), petrochemical workers ( Soares and de Almondes, 2017 ), firefighters ( Stout et al, 2021 ), police employees ( Taylor et al, 2019 ), miners ( Zhao et al, 2021 ), and generic groups of workers ( Rouch et al, 2005 ; Titova et al, 2016 ) had an impairment in one or more cognitive functions.…”