Changes since the early 1990s in international regulations on night and shift work were reviewed, including changes in complex shift systems, greater flexibility, increased female participation in night work and attention to health effects. Recent international regulations have focused on (i) a broadened scope of regulatory measures treating both genders equally, (ii) multifaceted protection, and (iii) consultation weighing many aspects of job design. The application of these international regulations depends on national laws and practice, with possible derogations. It calls for local support measures, including (i) guidelines for enterprise-level consultations on shift schedules, (ii) promotion of health and safety measures, and (iii) participatory strategies for locally adjusted shift work arrangements and social support.