Pain complaints after consecutive nights and quick returns in Norwegian nurses working three-shift rotation: an observational study

Relationship between shift work, night work, and headache and migraine risk: A meta-analysis of observational studies

BACKGROUND

To date, there is insufficient research on whether shift work and night work increase the risk of experiencing headaches and migraines.

OBJECTIVES

This study aimed to evaluate the potential association between shift work, night shift work, and headache/migraine.

METHODS

We conducted a thorough search of the PubMed, Embase, and Web of Science databases up until October 2023 to identify relevant studies. Our inclusion criteria focused on observational studies that investigated the association between shift work exposure and headache/migraine outcomes. We extracted adjusted risk estimates from each study and calculated pooled odds ratios using either fixed or random-effects models. Our methodology followed the Meta-Analysis Group guidelines for observational studies in epidemiology. To ensure accuracy and consistency, two investigators independently reviewed the retrieved records and extracted data based on the predefined inclusion criteria.

RESULTS

This meta-analysis included a total of seven studies involving 422,869 participants. The pooled analysis revealed a significant association between shift work and an increased risk of headaches (HR = 1.32, 95% CI: 1.15-1.52, P < 0.001). Specifically, individuals working night shifts had a 44% higher risk of developing headaches (HR = 1.44, 95% CI: 1.09-1.90, P = 0.011). Furthermore, shift work was also found to be associated with a higher incidence of migraines (HR = 1.63, 95% CI: 1.27-2.08, P < 0.001). Interestingly, night shift work was associated with a decreased incidence of migraines (HR = 0.74, 95% CI: 0.57-0.96, P = 0.024).

CONCLUSION

Our study found a noteworthy association between shift work/night work and the occurrence of headaches and migraines. However, it is important to note that our study does not establish a causal relationship. Future research should investigate potential common vulnerability factors, such as genetics or health behaviors. This knowledge can help inform the implementation of preventive measures and interventions to mitigate the health risks associated with shift work.

The association between proportion of night shifts and musculoskeletal pain and headaches in nurses: a cross-sectional study

BACKGROUND AND PURPOSE

Shift work is associated with musculoskeletal pain and headaches, but little is known about how the intensity of shift work exposure is related to musculoskeletal pain and headaches. This study aimed to investigate whether a higher proportion of night shifts is associated with a higher occurrence of musculoskeletal pain and headaches. Furthermore, to investigate whether sleep duration can mediate this potential association.

METHOD

The study included 684 nurses in rotating shift work who responded to a daily questionnaire about working hours, sleep, and pain for 28 consecutive days. The data were treated cross-sectionally.

RESULTS

A negative binomial regression analysis adjusted for age and BMI revealed that working a higher proportion of night shifts is not associated with a higher occurrence of musculoskeletal pain and headaches. On the contrary, those working ≥ 50% night shifts had a significantly lower occurrence of pain in the lower extremities than those who worked < 25% night shifts (IRR 0.69 95% CI 0.51, 0.94). There was no indication of a mediation effect with total sleep time (TST).

CONCLUSION

The results of this study indicate that working a higher proportion of night shifts is not associated with a higher occurrence of musculoskeletal pain and headaches.

Evaluation of work conditions of nurses employed in a shift system in hospital wards during the COVID-19 pandemic

BACKGROUND

Nurses work in a shift system that determines the provision of round-the-clock care of a patient in hospital conditions; however, it entails health consequences.

OBJECTIVE

The aim of the study was the evaluation of work conditions of nurses engaged in shift work in hospital wards during the COVID-19 pandemic.

METHODS

The study was conducted in 2020, and included 108 nurses working in a shift system in hospital wards. The research method was a diagnostic survey, using an author-constructed questionnaire.

RESULTS

88.9% nurses reported a negative effect of shift work on their physical health: 'musculoskeletal pain', 'elevated arterial blood pressure', and 'hormonal disorders' - 54.5% of respondents used pharmacological treatment. The causes of physical disorders were: 'microclimate', 'physical effort', 'noise', and 'forced body position'. Shift work exerted a negative effect on psychological health of the majority of respondents (75.0%): 'deconcentration', 'sleep disorders', 'feeling of occupational burnout' - treatment in 38.9% of respondents. Psychological health disorders were caused by: 'circadian rhythms disturbance by shift work', 'chronic stresses, and 'conflicts at work'. 69.7% of respondents reported that their shift work was disturbed by organizational factors, including: a 'badly planned work schedule', 'enhanced pace of work due to staff shortage', 'ambiguous division of duties, rights, responsibilities', 'shortages of equipment at the workplace'.

CONCLUSION

The examined nurses experienced a negative effect of shift work on their physical and psychological health which, for some of them, was the cause of pharmacological treatment. Many organizational factors hindered the work of nurses in a shift system in hospital wards.

Association of Low Back Pain with Shift Work: A Meta-Analysis

Shift work (SW) is the main working schedule worldwide, and it may cause sleep disorders, breast cancer, and cardiovascular disease. Low back pain (LBP) is a common problem in the workplace; however, the association between LBP and SW remains unclear. Therefore, we conducted a meta-analysis to determine the association between SW and LBP. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Embase, and Web of Science databases using a set of associated keywords were queried. The inclusion criteria were as follows: (1) adult employees hired by a company or organization; (2) SW exposure; and (3) the outcome of LBP according to examination or assessment. A total of 40 studies were included that met the inclusion criteria for the meta-analysis. SW was significantly associated with LBP (odds ratio [OR]: 1.31, 95% confidence interval [CI]: 1.18−1.47, p < 0.00001). Furthermore, it was observed that LBP was significantly associated with night shift (NS) (OR: 1.49, 95% CI: 1.24−1.82, p < 0.0001) but not with rotating shift (RS) (OR: 0.96, 95% CI: 0.76−1.22, p = 0.49). Moreover, LBP was significantly associated with SW in health care workers (HCWs) (OR: 1.40, 95% CI: 1.20−1.63, p < 0.0001) but not in non-HCWs (OR: 1.19, 95% CI: 0.94−1.50, p = 0.14). SW was significantly associated with LBP. Furthermore, the subgroup analysis showed that NS, but not RS, was associated with LBP. Compared with SW in non-HCWs, SW in HCWs was significantly associated with LBP.

American Helicopter Emergency Medical Service Pilots Report to Work Despite High Rates of Sleepiness

OBJECTIVE

Previous studies on helicopter emergency medical service (HEMS) pilots found a positive correlation among fatigue, nodding off in flight, and accidents. We sought to quantify the amount of sleepiness in HEMS pilots using the Epworth Sleepiness Scale (ESS).

METHODS

An anonymous survey was sent via the National EMS Pilots Association emergency medical services listserv including demographics, the ESS, and subjective effects of fatigue on flying. Statistical analyses were performed using the t-test and analysis of variance.

RESULTS

Thirty-one surveys were returned. Twenty-one (65%) reported an ESS > 10, indicating excessive daytime sleepiness. Twelve (39%) reported nodding off in flight; 20 (65%) indicated that they should have refused to fly, but only 14 (45%) actually did. En route was the most likely phase of flight to be affected by fatigue (23 [74%]), whereas takeoff (2 [7%]) and landing (2 [7%]) were the least likely to be affected.

CONCLUSION

Many HEMS pilots in this small study reported excessive daytime sleepiness. Most respondents indicated that they should have turned down a flight because of fatigue. More research is necessary to quantify the burden of fatigue among HEMS pilots.

Extended Work Shifts Increase Subjective Pain Complaints Among Cabin Crewmembers, but Not Among Airline Pilots or Healthcare Workers: A Repeated-Measures Study

OBJECTIVE

To determine whether four consecutive extended work shifts are associated with an increased risk of subjective pain complaints, sleep duration, and sleep disturbances.

METHODS

Forty-three healthcare workers, 41 cabin crewmembers, and 18 airline pilots working 4 consecutive extended workdays reported subjective pain complaints and sleep after the 1st and 4th workday.

RESULTS

The risk of headache (odds ratio [OR] 21.4, 95% confidence interval [CI] 1.85 to 246.5) and pain in the hands, arms, or wrists (OR 3.78, 95% CI 1.84 to 7.76) increased after workday 4 versus workday 1 in cabin crewmembers. Sleep duration was longer (0.6 to 1.1 hours), and sleep disturbances fewer, the night before the fourth extended workday, compared with before the first workday, in all occupations.

CONCLUSIONS

We found no general support for an association between extended work shifts and subjective pain, whereas sleep duration was improved, and sleep disturbances reduced after 4 consecutive extended workdays.