Apr 11, 2026

Short-Term Outcomes Following Night or Rotating Shift Work in Adult Workers: A Scoping Review Protocol

DOI
https://dx.doi.org/10.17504/protocols.io.kxygx83ozv8j/v1
  • Yusuke Hashimoto1,2,
  • Daisuke Kasugai1,2,
  • Yasuha Onishi1,
  • Yutaka Murase3,
  • Mami Akaba4,
  • Kasumi Shirasaki5,
  • Tomoki Kanda6,
  • Seiya Satoh7,
  • Naoya Hashimoto8,
  • Masashi Koiwa9,
  • Takanori Yamamoto10
  • 1Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.;
  • 2Institute of Nano-Life-Systems, Institutes of Innovation for Future Society, Nagoya University, Nagoya, Japan;
  • 3Department of Critical Care Nursing, Graduate School of Nursing, Nagoya City University, Japan;
  • 4Emergency and Medical Intensive Care Unit, Nagoya University Hospital, Nagoya, Japan.;
  • 5Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital, Tokyo, Japan;
  • 6Department of Emergency and Disaster Medicine, Kanazawa University Hospital, Kanazawa, Japan;
  • 7Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan.;
  • 8Division of Disaster and Emergency Medicine, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.;
  • 9Department of Nursing, Hokkaido University of Science, Sapporo, Japan.;
  • 10Department of Pediatrics, School of Medicine, Keio University, Tokyo, Japan.
  • Short Term Outcomes Following Night or Rotating Shift Work in Adult Workers A Scoping Review Protocol
靖葉 大西
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DOI: https://dx.doi.org/10.17504/protocols.io.kxygx83ozv8j/v1
Protocol Citation: Yusuke Hashimoto, Daisuke Kasugai, Yasuha Onishi, Yutaka Murase, Mami Akaba, Kasumi Shirasaki, Tomoki Kanda, Seiya Satoh, Naoya Hashimoto, Masashi Koiwa, Takanori Yamamoto 2026. Short-Term Outcomes Following Night or Rotating Shift Work in Adult Workers: A Scoping Review Protocol. protocols.io https://dx.doi.org/10.17504/protocols.io.kxygx83ozv8j/v1
License: This is an open access  protocol  distributed under the terms of the  Creative Commons Attribution License,  which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it's working
Created: January 16, 2026
Last Modified: April 11, 2026
Protocol  Integer ID: 238756
Keywords: night shift, rotating shift, short-term outcomes, measurement, timing, scoping review, rotating shift work in adult worker, shift work among adult worker, major concerns in shift, rotating shift work, shift work, rotating shift, reporting outcome, timing of assessment, term adverse health outcome, assessment time window, intensive occupation, relative to night, assessment timing, adverse health outcome, shift, night, schedule, work definition, using heterogeneous outcome definition, related impairment, adult worker, following night, including cardiometabolic disease, heterogeneous outcome definition, cochrane central register of controlled trial
Abstract
Background: Night and rotating shift work are essential in healthcare and many industries and are associated with long-term adverse health outcomes, including cardiometabolic disease, mental health problems, and increased overall morbidity. Burnout and stress-related impairment are also major concerns in shift-work–intensive occupations. However, evidence on short-term outcomes during and immediately after night/rotating shifts is dispersed across disciplines and reported using heterogeneous outcome definitions, measurement instruments, and assessment time windows.

Objective: This scoping review will comprehensively map the literature on short-term outcomes following night or rotating shift work among adult workers. Specifically, we will summarize (1) the short-term outcome domains reported, (2) how these outcomes have been measured and operationalized (including instruments/biomarkers), and (3) the timing of assessments relative to night/rotating shifts.

Methods: We will search MEDLINE (via PubMed), CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science using controlled vocabulary and free-text terms related to night/rotating shift work and short-term outcomes. Eligible studies will include primary quantitative, qualitative, or mixed-methods research involving adults (≥18 years) engaged in night or rotating shift work, reporting outcomes assessed during a shift or within 72 hours after the end of a night/rotating shift. Interventions/countermeasures are not required for inclusion; intervention studies will be included if they report eligible short-term outcomes. Two reviewers will independently screen records and chart data on study characteristics, shift-work definitions and schedules, outcome domains, measurement approaches, and assessment timing. Findings will be synthesized descriptively and presented in summary tables/figures with a narrative synthesis to describe patterns, heterogeneity, and evidence gaps.
Introduction
Night and rotating shifts are essential to the infrastructure of healthcare and industrial sectors [1-4]. Extensive evidence links chronic shift work to long-term adverse outcomes, including cardiometabolic disease, mental health disorders, and potential cancer risk associated with circadian disruption [5-10]. These long-term risks may, at least in part, reflect repeated short-term perturbations and insufficient recovery across shifts. However, standardized approaches to characterize this acute burden and to identify workers who are vulnerable to acute impairment and poor recovery remain underdeveloped.
 Evaluating acute biological and psychological responses during shifts and in the immediate post-shift period (e.g., within 72 hours) offers a promising pathway for risk stratification [11-15]. Short-term disturbances in sleep and circadian alignment, fatigue and cognitive performance, and transient physiological changes (e.g., autonomic or inflammatory responses) may signal inadequate recovery and underlying susceptibility [16]. These acute effects may also have operational implications for safety, service quality, and productivity in settings where performance lapses can lead to serious consequences [17,18]. Despite their importance, the evidence base on short-term outcomes remains fragmented. Studies vary widely in outcome domains, measurement instruments (from self-report scales to wearable devices), and assessment timing [19-22]. This heterogeneity hampers cross-study and cross-sector comparisons and limits the development of unified, practice-oriented frameworks for monitoring acute burden and recovery.
 Therefore, this scoping review aims to comprehensively map the literature on short-term outcomes following night or rotating shift work among adult workers. Specifically, we will characterize (1) the outcome domains reported, (2) the measurement instruments used, and (3) the timing of assessments relative to night or rotating shifts. By systematically organizing existing evidence, this review will highlight key gaps and inform priorities for future research and outcome harmonization.
Review question
  •         What short-term outcomes following night shift work or rotating shift work have been reported among adult workers?
  •         How have these short-term outcomes been measured and operationalized (e.g., instruments/biomarkers used and timing of assessment relative to the end of a shift)?
Methods
Reporting framework and protocol registration This scoping review will be conducted in accordance with the JBI methodology for scoping reviews and reported following PRISMA-ScR [23,24]. The protocol will be registered with protocols.io, and any amendments will be tracked and described in the final report [25,26].
Eligibility Criteria
Inclusion criteria Participants:  
  •         Adults (≥18 years) who are engaged in night shift work and/or rotating shift work in occupational settings (any industry/occupation and any country).
Concept: 
  •         Exposure: Night shift work and/or rotating shift work, as defined by each study.
  •         Eligible outcomes (short-term): Any outcomes assessed during a night/rotating shift or within 72 hours after the end of a night/rotating shift. Outcomes may be subjective, behavioral/performance-based, physiological/biological, sleep-related, or safety/work-functioning–related.
  •         Examples include (but are not limited to): sleepiness and fatigue; sleep duration/quality and recovery; mood and psychological symptoms (e.g., stress, anxiety, wellbeing); cognitive/psychomotor performance (e.g., attention, vigilance, reaction time); work functioning and safety outcomes (e.g., near-miss incidents, occupational injuries, medication errors, traffic/commuting incidents); and physiological/biological responses (e.g., autonomic measures such as HR/HRV, endocrine markers such as cortisol/melatonin, inflammatory markers, metabolic markers, actigraphy-based sleep–wake metrics).
  •         Interventions/countermeasures: Not required for inclusion. Studies evaluating countermeasures (e.g., light exposure, naps, scheduling interventions, behavioral/educational programs, pharmacological approaches) will be included if they report at least one eligible short-term outcome within the defined timeframe and provide sufficient outcome measurement information.
  •         Timing information: Studies will be included even if the timing of assessment is not fully specified; such cases will be coded as “unclear/not reported” during data extraction.
Context:
  •         Any occupational setting where night/rotating shift work is performed (e.g., healthcare, long-term care, manufacturing, logistics/warehousing, transportation, law enforcement, firefighting).
Exclusion criteria：
·       Studies focusing solely on overtime/extended working hours without night or rotating shift work.
·       Studies reporting only long-term/chronic outcomes (e.g., cancer incidence, chronic cardiovascular disease) without eligible short-term assessments within 72 hours of a night/rotating shift.
·       Studies exclusively involving children/adolescents (<18 years).
·       Laboratory/simulation studies in non-occupational samples (e.g., students/volunteers) that are not engaged in real-world night/rotating shift work.
·       Reviews, editorials/commentaries, conference abstracts without sufficient outcome information, and protocols without results.
Types of sources
Primary quantitative, qualitative, or mixed-methods studies (including observational studies and intervention studies meeting the criteria above).
Information sources
MEDLINE (via PubMed), CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science. Search strategy
The search strategy will be developed using a combination of controlled vocabulary (e.g., MeSH/CINAHL Headings) and free-text keywords related to night/rotating shift work and short-term outcomes. The full search strategies for all databases and the date of the final search will be reported in an Appendix.
 
Study selection  Following the searches, all records will be imported into Rayyan for centralized review management. Duplicate records will be identified and removed within Rayyan prior to screening. Two reviewers will independently screen records in Rayyan using predefined eligibility criteria, and any disagreements will be resolved through discussion (with third-reviewer adjudication if needed) to ensure consistent application of the criteria. Full texts of potentially relevant studies will be obtained and assessed independently by the same two reviewers in Rayyan. Reasons for exclusion at the full-text stage will be recorded and reported in the final review. Any disagreements at any stage will be resolved through discussion; if consensus cannot be reached, a third reviewer will adjudicate. The results of the search and the study selection process will be reported in the final manuscript using a PRISMA-ScR flow diagram.
 
Data extraction
Bibliographic information
  •         Author(s), year of publication, journal, and country/region
Study characteristics
  •         Study design (e.g., cross-sectional, cohort, pre–post, RCT, crossover, qualitative/mixed-methods)
  •         Setting/industry (e.g., healthcare, manufacturing, transportation) and workplace context
  •         Sample size (total and analytic), participant characteristics (age, sex/gender), and inclusion/exclusion criteria
  •         Recruitment method and study period
Exposure (shift work) characteristics
  •         Type of shift work (night shift, rotating shift) and definition used
  •         Shift schedule details (shift length, number of consecutive nights, rotation direction/speed, time of shift start/end)
  •         Comparator (if applicable): day shift, off-shift/rest day, within-person pre/post shift, or between-group comparison
Outcome domains and measurements (short-term focus)
  •         Outcome domains assessed (e.g., perceived stress, fatigue/sleepiness, sleep/recovery, mood/psychological symptoms, cognitive/psychomotor performance, work functioning/safety outcomes, physiological responses)
  •         Measurement instruments/markers (questionnaires/scales and/or biomarkers; device-based measures such as actigraphy if used)
  •         Outcome definition used by authors, including thresholds/cut-offs or case definitions when applicable (e.g., definition of “near-miss,” criteria for “excessive sleepiness,” error definitions)
  •         Timing of assessment relative to the end of a shift:
o    Timing category code (standardized): during shift / immediately post-shift (e.g., 0–2 h) / post-shift (2–24 h) / 24–48 h / 48–72 h / >72 h (if reported in studies that also include eligible ≤72 h assessments)  / unclear-not reported
o    Timing detail (as reported): clock time/shift segment and/or hours/days since shift end (when available)
o    Timing reporting status: fully reported / partially reported / not reported (coded as “unclear/not reported”)
  •         Key reporting unit (mean/SD, change from baseline, proportion above cut-off, etc.)
Interventions/countermeasures (if applicable)
  •         Intervention type and components (e.g., light exposure, naps, schedule modification, behavioral/educational, pharmacological)
  •         Dose/intensity and implementation details; comparator/control condition
Key findings (descriptive)
  •         Summary of main findings relevant to short-term outcomes (direction and magnitude when available)
  •         Notes on heterogeneity, feasibility, and gaps (e.g., inconsistent timing, varied instruments)
(Optional) Effect direction
  •         If intervention studies are included, record direction of effect for the primary short-term outcome (improved / not improved / mixed / unclear), without formal synthesis of effectiveness.
Data analysis and presentation
Findings will be charted and summarized descriptively in accordance with PRISMA-ScR. No meta-analysis is planned. We will map the evidence on short-term outcomes related to night or rotating shift work among adult workers, focusing on outcomes assessed during a night/rotating shift or within 72 hours after the end of a shift. Specifically, we will summarize (1) the short-term outcome domains reported (e.g., perceived stress, fatigue/sleepiness, sleep and recovery, mood/psychological symptoms, cognitive/psychomotor performance, work functioning/safety outcomes, and physiological/biological responses) and (2) how these outcomes have been measured and operationalized, including instruments/devices/biomarkers used, measurement types, and the timing of assessment relative to shift end.
Assessment timing will be organized into standardized categories (e.g., during shift, immediately post-shift, and post-shift within defined time windows), and the distribution of studies will be summarized across combinations of outcome domains, measurement approaches, and timing categories. Where applicable, studies will also be summarized by study design, occupational setting/sector, and shift-work exposure characteristics (e.g., shift length, rotation pattern, consecutive night shifts).
Results will be presented using summary tables and figures, accompanied by a narrative synthesis describing overall patterns, heterogeneity in outcome definitions, measurement approaches, and assessment timing, and key evidence gaps. If intervention/countermeasure studies are included, we will summarize intervention types and key implementation features and report the direction of short-term outcome findings descriptively, without formal effectiveness synthesis. Formal risk-of-bias appraisal is not planned; however, we will descriptively record selected study features relevant to interpretability (e.g., prospective vs cross-sectional design, emphasis on objective vs self-report measures, and completeness of timing reporting).
Appendix
Search strategy for Web of Science: TS=("night shift*" OR "shift work*" OR "rotating shift*" OR "night work*" OR shiftworker*) AND (sleepiness OR fatigue OR alertness OR vigilance OR performance OR accident* OR error* OR incident* OR "near miss" OR near-miss* OR nearmiss* OR stress OR "heart rate variability" OR HRV) AND ("post shift" OR postshift OR "post-shift" OR "after shift" OR "end of shift" OR "following shift" OR "between shifts" OR intershift OR recovery OR "next day" OR acute)).
Search strategy for Pubmed: ("Shift Work Schedule"[Majr] OR night shift*[ti] OR rotating shift*[ti] OR "shift work"[ti] OR shiftworker*[ti] OR "night work"[ti]) AND (sleepiness[tiab] OR fatigue[tiab] OR alertness[tiab] OR vigilance[tiab] OR "psychomotor vigilance"[tiab] OR PVT[tiab] OR "reaction time"[tiab] OR "heart rate variability"[tiab] OR HRV[tiab] OR melatonin[tiab] OR cortisol[tiab] OR actigraph*[tiab] OR wearable*[tiab] OR inflammation[tiab] OR CRP[tiab]) NOT (animals[mh] NOT humans[mh]).
Search strategy for CENTRAL: ("night shift" OR "shift work" OR "rotating shift") AND ( sleepiness OR fatigue OR vigilance OR "reaction time" OR performance OR accident* OR PVT OR actigraph* OR "heart rate variability" OR HRV OR melatonin OR cortisol) AND ( acute OR "post shift" OR immediat* OR "during shift" OR "shift work disorder").
Search strategy for CINAHL: ( TI ("night shift" OR "shift work" OR "rotating shift" OR "night work" OR "shift worker*") OR AB ("night shift" OR "shift work" OR "rotating shift" OR "night work" OR "shift worker*") ) AND ( TI (sleepiness OR fatigue OR vigilance OR alertness OR "reaction time" OR performance OR cognitive OR mood OR stress OR accident* OR PVT OR actigraph* OR melatonin OR cortisol) OR AB (sleepiness OR fatigue OR vigilance OR alertness OR "reaction time" OR performance OR cognitive OR mood OR stress OR accident* OR PVT OR actigraph* OR melatonin OR cortisol) ) AND ( TI (acute OR "post shift" OR immediat* OR "during shift" OR short-term) OR AB (acute OR "post shift" OR immediat* OR "during shift" OR short-term) ).
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