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Grøtting G, Øvergård KI. The relation between routines for shiftwork scheduling and sickness absence at a Norwegian hospital: A cross-sectional study. Int J Nurs Stud 2023; 141:104477. [PMID: 36940648 DOI: 10.1016/j.ijnurstu.2023.104477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/21/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Shift work is associated with negative health outcomes. Routines for scheduling of shift work can help reduce negative health outcomes of shift work and improve work-life balance and social well-being for nurses working shift work. OBJECTIVE To investigate the association between organizational units' routines for shift work scheduling and nurses' sickness absence at the unit level. DESIGN Cross-sectional study design combining quantitative questionnaire data on shift work scheduling routines with data of mean percentage of sickness absence at the unit, mean level of exhaustion at the unit, mean age and percentage of women working at the unit. PARTICIPANTS A total of 126 leaders at organizational units with nurses working shift work schedule at Oslo University Hospital answered a questionnaire about shift work scheduling. MEASURES Three aspects of health-promoting shift work scheduling (fatigue-reducing scheduling, organizational health measures, and individual adaptation) and the extent to which operational considerations were made during shift work scheduling were used as independent variables. Covariates were mean age of nurses at each unit, mean percent female nurses, and mean exhaustion at unit level. Percent sickness absence was used as a dependent variable. METHODS Questionnaire data on shift work scheduling routines was merged with information on average age of employees in the unit, ratio female nurses, and units' average score on exhaustion. Multivariable linear regression analyses were used to assess the contribution of routines for shift work scheduling after controlling for mean level of exhaustion, average age, and proportion of women at each unit. RESULTS The factors "fatigue reducing scheduling", "organizational health measures" and "operational considerations" had no observed total effect on mean sickness absence. Individual adjustment in shift work scheduling had a direct negative association with sickness absence after controlling for other shift work scheduling routines, exhaustion, age, and gender. CONCLUSIONS There is a relationship between the units' routines for shift work scheduling and mean sickness absence at the unit, and the possibility of individual adjustment was the only aspect of shift work scheduling that had an above-zero association with sickness absence.
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Affiliation(s)
- Gina Grøtting
- Department of Occupational and Environmental Health, Oslo University Hospital, Norway; Research Group for Health Promotion in Settings, Department of Health-, Social-, and Welfare Studies, University of South-Eastern Norway, Postboks 4, 3199 Borre, Norway
| | - Kjell Ivar Øvergård
- Research Group for Health Promotion in Settings, Department of Health-, Social-, and Welfare Studies, University of South-Eastern Norway, Postboks 4, 3199 Borre, Norway.
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Sagherian K, Derickson D, Geiger-Brown J, Springer CM, Mason JJ, Hinds PS. Nurses' Short-Term Sickness Absences Before and After the Implementation of a Brief Napping Opportunity During Night Shifts. Workplace Health Saf 2023:21650799221147177. [PMID: 36708014 DOI: 10.1177/21650799221147177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Nurses who work at night have used naps to alleviate their sleepiness and fatigue. Research has shown night shifts, sleepiness, and fatigue predict nurses' missed workdays. Thus, nighttime napping may have a beneficial consequence of reducing nurses' sickness absences. The purpose of this brief report was to describe the difference in rates of short-term sickness absence before and after implementation of a 30-min nap opportunity in one U.S. hospital for 12-hr shift nurses. METHODS The study was a retrospective pre-post evaluation design. Eight units provided nap opportunities for the nurses. Full-time nurses were classified into night and rotating shifts based on their 2 years of scheduling patterns. Absence data were extracted from the hospital's timekeeping system and annual absence rates were computed. A single linear mixed model with rank transformed data was conducted for each group. Median estimates, minimum and maximum, and p-values were reported. FINDINGS The median absence rates for night shift nurses were 4.3% and 4.0% for the pre-napping and post-napping implementation periods, respectively; however, this difference was not statistically significant (p = .241). The median absence rates for rotating shift nurses were 2.0% and 3.9% for the pre-napping and post-napping implementation periods, respectively; and the difference increase was statistically significant (p < .001). CONCLUSION/APPLICATION TO PRACTICE A nap policy which provides nurses with the opportunity to take nighttime naps did not benefit their sickness absence rates. Future research needs to examine the actual napping process on sickness absences, as well as explore other sickness management avenues.
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Affiliation(s)
- Knar Sagherian
- College of Nursing, The University of Tennessee Knoxville
| | - Debra Derickson
- System Analyst, Central Staffing Office-Patient Services, Children's National Hospital
| | | | - Cary M Springer
- Office of Information Technology, The University of Tennessee Knoxville
| | - Janice J Mason
- The George Washington University.,Department of Nursing Science, Professional Practice & Quality, Children's National Hospital
| | - Pamela S Hinds
- Department of Nursing Science, Professional Practice & Quality, Children's National Hospital.,School of Medicine and Health Sciences, The George Washington University
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Krutova O, Peutere L, Ervasti J, Härmä M, Virtanen M, Ropponen A. Sequence analysis of the combinations of work shifts and absences in health care - comparison of two years of administrative data. BMC Nurs 2022; 21:376. [PMID: 36585739 PMCID: PMC9801614 DOI: 10.1186/s12912-022-01160-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 12/23/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND In health care, the shift work is arranged as irregular work shifts to provide operational hours for 24/7 care. We aimed to investigate working hour trends and turnover in health care via identification of time-related sequences of work shifts and absences among health care employees. The transitions between the work shifts (i.e., morning, day, evening, and night shifts), and absences (days off and other leaves) over time were analyzed and the predictors of change in irregular shift work were quantified. METHODS A longitudinal cohort study was conducted using employer-owned payroll-based register data of objective and day-to-day working hours and absences of one hospital district in Finland from 2014 to 2019 (n = 4931 employees). The working hour data included start and end of work shifts, any kind of absence from work (days off, sickness absence, parental leave), and employee's age, and sex. Daily work shifts and absences in 2014 and 2019 were used in sequence analysis. Generalized linear model was used to estimate how each identified sequence cluster was associated with sex and age. RESULTS We identified four sequence clusters: "Morning" (60% in 2014 and 56% in 2019), "Varying shift types" (22% both in 2014 and 2019), "Employee turnover" (13% in 2014 and 3% in 2019), and "Unstable employment (5% in 2014 and 19% in 2019). The analysis of transitions from one cluster to another between 2014 and 2019 indicated that most employees stayed in the same clusters, and most often in the "Varying shift types" (60%) and "Morning" (72%) clusters. The majority of those who moved, moved to the cluster "Morning" in 2019 from "Employee turnover" (43%), "Unstable employment" (46%) or "Varying shift types" (21%). Women were more often than men in the clusters "Employee turnover" and "Unstable employment", whereas older employees were more often in "Morning" and less often in the other cluster groups. CONCLUSION Four clusters with different combinations of work shifts and absences were identified. The transition rates between work shifts and absences with five years in between indicated that most employees stayed in the same clusters. The likelihood of a working hour pattern characterized by "Morning" seems to increase with age.
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Affiliation(s)
- Oxana Krutova
- Finnish Institute of Occupational Health, P.O.Box 18, Helsinki, 00032, Finland
| | - Laura Peutere
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, P.O.Box 18, Helsinki, 00032, Finland
| | - Mikko Härmä
- Finnish Institute of Occupational Health, P.O.Box 18, Helsinki, 00032, Finland
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.,CNS, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Annina Ropponen
- Finnish Institute of Occupational Health, P.O.Box 18, Helsinki, 00032, Finland. .,CNS, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
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The Role of the Work Environment in the Relationship Between Shiftwork and Sickness Absence. J Occup Environ Med 2022; 64:e509-e520. [DOI: 10.1097/jom.0000000000002603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sunde E, Harris A, Nielsen MB, Bjorvatn B, Lie SA, Holmelid Ø, Vedaa Ø, Waage S, Pallesen S. Protocol for a systematic review and meta-analysis on the associations between shift work and sickness absence. Syst Rev 2022; 11:143. [PMID: 35842678 PMCID: PMC9287923 DOI: 10.1186/s13643-022-02020-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Shift work, i.e., non-standard work hours, has been associated with both short- and long-term sickness absence. However, findings are inconsistent and inconclusive. Thus far, no comprehensive meta-analytic synthesis on the relationship between shift work and sickness absence has been published. The aims of the planned systematic review and meta-analysis are (1) to establish whether shift work is associated with sickness absence, (2) to determine if specific shift work characteristics relate to sickness absence (e.g., length and frequency of spells), and (3) to identify moderating factors affecting the relationship between shift work and sickness absence. METHODS Eligible studies will be identified using a predefined search strategy in several electronic databases (MEDLINE, Web of Science, PsychInfo, EMBASE, and ProQuest) and comprise peer-reviewed papers reporting original empirical findings on the association between shift work and sickness absence. Mainly observational studies with cross-sectional, prospective, or retrospective research design and case-control studies will be included. Risk of bias will be assessed using an adapted checklist previously employed to evaluate studies on sickness absence. To carry out the meta-analytic synthesis, a random effects meta-analysis will be conducted using the Comprehensive Meta-Analysis software. The review and meta-analysis will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Heterogeneity will be evaluated by Cochran's Q test and the I2 statistics. DISCUSSION The review and meta-analysis will be the first to conduct a meta-analytic synthesis of the evidence on the association between exposure to shift work and sickness absence, as well as identify relevant moderators affecting the relationship between shift work and sickness absence. Aggregation of the existing evidence will improve the knowledge on the association between shift work and sickness absence. Such knowledge can be used to guide scheduling of shift work to promote work schedules that are less detrimental to health and contribute to reduced sickness absence and higher work- and leisure-time productivity. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022301200.
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Affiliation(s)
- Erlend Sunde
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway.
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway
| | - Morten Birkeland Nielsen
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway.,Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Norwegian National Advisory Unit on Arthroplasty and Hip Fractures, Haukeland University Hospital, Bergen, Norway
| | - Øystein Holmelid
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway
| | - Øystein Vedaa
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway.,Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Siri Waage
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Optentia, The Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
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Krutova O, Koskinen A, Peutere L, Ervasti J, Virtanen M, Härmä M, Ropponen A. A Longitudinal Study on Trajectories of Night Work and Sickness Absence among Hospital Employees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138168. [PMID: 35805827 PMCID: PMC9265793 DOI: 10.3390/ijerph19138168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 02/01/2023]
Abstract
This study aimed to investigate trajectories of night shift work in irregular shift work across a 12-year follow-up among hospital employees with and without sickness absence (SA). The payroll-based register data of one hospital district in Finland included objective working hours and SA from 2008 to 2019. The number of night shifts per year was used in group-based trajectory modeling (GBTM). The results indicate that, among those who had any sickness absence episodes, the amount of night work decreased prior to the first SA. In general, trajectories of night shift work varied from stably high to low-but-increasing trajectories in terms of the number of shifts. However, a group with decreasing pattern of night work was identified only among those with sickness absence episodes but not among those without such episodes. To conclude, the identified trajectories of night work with or without sickness absences may indicate that, among those with sickness absence episodes, night work was reduced due to increasing health problems. Hence, the hospital employees working night shifts are likely a selected population because the employees who work at night are supposed to be healthier than those not opting for night work.
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Affiliation(s)
- Oxana Krutova
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (A.K.); (L.P.); (J.E.); (M.H.); (A.R.)
- Correspondence: ; Tel.: +358-50-3573644
| | - Aki Koskinen
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (A.K.); (L.P.); (J.E.); (M.H.); (A.R.)
| | - Laura Peutere
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (A.K.); (L.P.); (J.E.); (M.H.); (A.R.)
- School of Educational Sciences and Psychology, University of Eastern Finland, 80101 Joensuu, Finland;
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (A.K.); (L.P.); (J.E.); (M.H.); (A.R.)
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, 80101 Joensuu, Finland;
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Mikko Härmä
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (A.K.); (L.P.); (J.E.); (M.H.); (A.R.)
| | - Annina Ropponen
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (A.K.); (L.P.); (J.E.); (M.H.); (A.R.)
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
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Peutere L, Rosenström T, Koskinen A, Härmä M, Kivimäki M, Virtanen M, Ervasti J, Ropponen A. Length of exposure to long working hours and night work and risk of sickness absence: a register-based cohort study. BMC Health Serv Res 2021; 21:1199. [PMID: 34740353 PMCID: PMC8571875 DOI: 10.1186/s12913-021-07231-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background There is inconsistent evidence that long working hours and night work are risk factors for sickness absence, but few studies have considered variation in the length of exposure time window as a potential source of mixed findings. We examined whether the association of long working hours and night work with sickness absence is dependent on the length of exposure to the working hour characteristics. Methods We analysed records of working hours, night work and sickness absence for a cohort of 9226 employees in one hospital district in Finland between 2008 and 2019. The exposure time windows ranged from 10 to 180 days, and we used Cox’s proportional hazards models with time-dependent exposures to analyse the associations between working-hour characteristics and subsequent sickness absence. Results Longer working hours for a period of 10 to 30 days was not associated with the risk of sickness absence whereas longer working hours for a period of 40 to 180 days was associated with a lower risk of sickness absence. Irrespective of exposure time window, night work was not associated with sickness absence. Conclusions It is important to consider the length of exposure time window when examining associations between long working hours and sickness absence, whereas the association between night work and sickness absence is not similarly sensitive to exposure times. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07231-4.
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Affiliation(s)
- Laura Peutere
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.
| | - Tom Rosenström
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland.,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Annina Ropponen
- Finnish Institute of Occupational Health, Helsinki, Finland.,Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Shiri R, Hakola T, Härmä M, Ropponen A. The associations of working hour characteristics with short sickness absence among part- and full-time retail workers. Scand J Work Environ Health 2021; 47:268-276. [PMID: 33755187 PMCID: PMC8091071 DOI: 10.5271/sjweh.3952] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: This study aimed to determine the associations of working hour characteristics with short (1–3 days) sickness absence (SA) among retail workers. Methods: As part of “RetailHours-project”, 4046 employees of 338 Finnish retail stores were included. Registry-based data on working hour characteristics and short SA were utilized. A case-crossover design was used and the odds ratios (OR) were controlled for the clustering effect and working hour characteristics. Results: There were strong dose–response relationships between percent of short (<11 hours) shift intervals and short SA among part- and full-time workers, men and women, and younger and older workers. Compared to workers without short shift intervals, the risk of SA was 1.47 times [95% confidence interval (CI) 1.29–1.68] higher among workers who had short shift intervals <10% of work times, 2.39 times (95% CI 2.03–2.82) higher among workers who had 10–25% of work times, and 4.03 times (CI 2.34–6.93) higher among workers who had short shift intervals >25% of work times. Weekly working hours >40 hours were associated with SA among part-time workers [odds ratio (OR) 2.22, CI 1.65–2.98], women (OR 1.62, CI 1.27–2.07) and among workers <30 years of age (OR 1.68, CI 1.20–2.35) as well as among workers aged ≥30 years (OR 1.43, CI 1.07–1.92). Furthermore, working mainly night shifts was associated with SA among full-time workers (OR 2.41, 95% CI 0.99–5.86) and women (OR 1.72, CI 1.02–2.89). Conclusions: A short shift interval is an important risk factor for short SA. Improving intervals between shifts and shortening long weekly working hours could reduce the risk of short SA among retail workers.
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Affiliation(s)
- Rahman Shiri
- Finnish Institute of Occupational Health, PO Box 18, FI-00032 Työterveyslaitos, Helsinki.
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Cho SS, Lee DW, Kang MY. The Association between Shift Work and Health-Related Productivity Loss due to Either Sickness Absence or Reduced Performance at Work: A Cross-Sectional Study of Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228493. [PMID: 33207798 PMCID: PMC7697117 DOI: 10.3390/ijerph17228493] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 01/01/2023]
Abstract
Background: The purpose of the present study was to investigate the association between shift work and health-related productivity loss (HRPL) due to either sickness absence or reduced performance at work. Methods: From January 2020 to February 2020, data were collected using the web-based questionnaire. Workers in Korea (n = 4197) were selected with the convenience sampling method. To evaluate HRPL, the Korean version of the “Work Productivity and Activity Impairment Questionnaire” was used. The nonparametric association between shift work and HRPL was determined. To estimate productivity loss by shift work, generalised linear models were used, and the productivity loss of workers who did not do shift work was used as the reference. Contrasts between the reference (non-shift work) and shift work, including the shift work subtype, were demonstrated. In the adjusted model, age, gender, and occupation were included as covariates. To test whether there were differences in this association by gender, a gender-stratified analysis was conducted. Results: Shift work significantly reduced productivity (2.5% points; 95% CI: 0.2–4.6). The fixed night shift had the largest productivity loss (7.7% points; 95% CI: 1.8–13.7), and the relationship between HRPL and shift work was more prominent among female workers. Conclusions: Shift work is related to an increase in HRPL, and there are gender differences in this association. Our study further indicated that a fixed night shift is most detrimental to workers’ health and productivity.
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Affiliation(s)
- Seong-Sik Cho
- Department of Occupational and Environmental Medicine, Dong-A University College of Medicine, Busan 49201, Korea;
| | - Dong-Wook Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea;
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence:
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