SHIFT WORK

Shift work and health

Background

Work has long been acknowledged as an important social determinant of health and health inequalities in industrialised societies. The past two decades have seen the development of labour market practices in which skills, working hours, contracts, conditions, pay and location are more flexible. The emergence of the 24 hour society has raised concerns about the effects of shift work on health and wellbeing Shift work involves working at times and on days that may make it difficult to maintain a balanced domestic and social life “work-life balance”. Shift work may therefore be an important determinant of health and wellbeing for many workers.

A range of interventions has sought to address the negative health effects of shiftwork, including reductions in shiftwork (especially night shift), redesign of the shift system according to ergonomic criteria, educational interventions (e.g. to help workers cope with shiftwork), improvements in working conditions (reducing noise or improving unfavourable working environments) and regular medical surveillance and counselling. However, no existing systematic review has evaluated the effects of changes in the organisation of shiftwork on health and well-being. This review aims (i) to summarise existing evidence about the effects and cost-effectiveness of organisational, and other interventions, (ii) to identify issues of differential effects - what works, in which groups of workers; and (iii) to contribute to the development of new interventions.

Findings

The past two decades have seen the development of labour market practices in which skills, working hours, contracts, conditions, pay and location are more flexible. The emergence of the 24-hour society has raised concerns about the effects of shift work on health and well-being. Shift work involves working at times and on days that may make it difficult to maintain a balanced domestic and social life, or work-life balance. Shift work may therefore be an important determinant of health and well-being for many workers. One common change to the organisation of shift work involves introducing a Compressed Working Week, in which the hours worked per day are increased whilst the days worked are decreased - in order to work the standard number of weekly hours in less than five days. Such a working pattern is a radical break with the traditional eight-hour working day. Introducing the Compressed Working Week seems to improve the work-life balance of shift workers, with few adverse health or organisational effects. It is also generally beneficial, or at least not detrimental, to health in the short-term. The Compressed Working Week could be an important tool for both policy-makers and employers in terms of promoting healthier work places and improving working practices.

Conducted by: C Bambra1, M Petticrew1, M Whitehead1, A Sowden1, J Akers1

1. Centre for Public Policy and Health, University of Durham; 2. MRC Social and Public Health Sciences Unit, Glasgow; 3. Division of Public Health, University of Liverpool; 4.Centre for Reviews and Dissemination

Publications

Bambra C, Petticrew M, Whitehead M, Sowden AJ, Akers J. The health and wellbeing effects of changing the organisation of shift work: a systematic review. PHRC Project Outputs. Executive Summary, Short Report and Final Report

Bambra C, Whitehead M, Sowden AJ, Akers J, Petticrew M. A hard day's night? - the effects of Compressed Work Week interventions on the health and work-life balance of shift workers: a systematic review. J Epidemiol Community Health. 2008; 62: 764-777

Bambra C, Petticrew M, Whitehead M, Sowden AJ, Akers J. Shifting schedules: A systematic review of the health and wellbeing effects of redesigning shift work schedules. Am J Prev Med. 2008;34(5):427-434

Presentations

Bambra C, Petticrew M, Whitehead M, Sowden AJ, Akers J. A hard days night? The effects of compressed work week interventions on the health and work-life balance of shift workers: a systematic review; 15th European Conference on Public Health; October 2007; Helsinki

Funding

Commissioned by the Department of Health Policy Research Programme, via The Public Health Research Consortium