Five nurses have been investigated for the two nights of a rapidly rot
ating shift schedule on four occasions: once with normal ward lighting
(40 lux on average) and three times while wearing a light visor (Bio-
Brite Inc., MD, USA). The visor was worn for four periods of 40 minute
s each, at about 2 hour intervals during each night shift, the intensi
ty giving 400-600, 1500 and 3200 lux for the three studies. The nurses
recorded subjective evaluations of mood, physical fitness, sleepiness
and fatigue, and carried out some performance measures (Simple Audito
ry Reaction Time, Flicker Fusion Frequency, Search and Memory test) at
the start, middle and end of each night shift. Plasma cortisol was me
asured at the end of the shift, and 6-sulphatoxymelatonin was measured
in urine collected at the middle and end of each shift. Oral temperat
ure was also recorded for 48 h covering the two shifts. No significant
effects of light treatment (even at 3200 lux) upon within-shift decli
ne in mood and performance were seen. The acceptability of the wearer
of the visor was moderate since the upper visual field was impaired an
d, at the highest light intensity, there was difficulty in seeing clea
rly objects in the dimly-lit environment. Furthermore, no significant
falls in melatonin excretion and cortisol excretion were noted, but th
ere was some evidence that the circadian rhythm of oral temperature wa
s stabilised by the light visors. This is thoroughly desirable in rapi
dly rotating shift systems.