Objectives Short time between consecutive work shifts (quick returns, ie, ≤11 hours between shifts) is associated with sleepiness and fatigue, both of which have been linked to risk of injury. This paper aims to study quick returns between work shifts and risk of injury among Danish hospital workers. Method The study population included 69 200 employees, primarily working at hospitals, corresponding to 167 726 person years at risk between 2008–2015. Information on working hours was obtained from payroll data in the Danish Working Hour Database and linked, at an individual level, with data on 11 834 injury records identified in the National Patient Register and the Danish Register of Causes of Death. Multivariate Poisson regression models were used to calculate incidence rate ratios (IRR) with 95% confidence intervals (CI). Results Results showed the shorter the time between shifts, the higher the risk of injury. Thus, an elevated risk of injury was observed after quick returns compared with the standard 15–17 hours between shifts (IRR 1.39, 95% CI 1.23–1.58). Furthermore, when assessing the number of days since a quick return, the risk of injury was especially high within the first two days (day 1: IRR 1.39, 95% CI 1.23–1.58; day 2: IRR 1.39, 95% CI 1.21–1.58) following a quick return. Conclusions Our results suggest that quick returns increased the risk of injury, in particular within the first two days following a quick return. These findings point towards avoiding or reducing the number of quick returns in order to lower employees’ risk of injury.
8 May 2018 in Scandinavian Journal of Work, Environment & Health
Objectives Evening and night work have been associated with higher risk of injury than day work. However, previous findings may be affected by recall bias and unmeasured confounding from differences between day, evening and night workers. This study investigates whether evening and night work during the past week increases risk of injury when reducing recall bias and unmeasured confounding. Methods We linked daily working hours at the individual level of 69 200 employees (167 726 person years from 2008–2015), primarily working at hospitals to registry information on 11 834 injuries leading to emergency room visits or death. Analyses were conducted with Poisson regression models in the full population including permanent day, evening and night workers, and in two sub-populations of evening and night workers, with both day and evening or night work, respectively. Thus, the exchangeability between exposure and reference group was improved in the two sub-populations. Results Risk of injury was higher after a week with evening work [incidence rate ratio (IRR) 1.32, 95% confidence interval (CI) 1.26–1.37] and night work (IRR 1.33, 95% CI 1.25–1.41) compared with only day work. Similar, although attenuated, estimates were found for evening work among evening workers (IRR 1.18, 95% CI 1.12–1.25), and for night work among night workers (IRR 1.10, 95% CI 1.01–1.20). Conclusion There is an overall increased risk of injury after a week that has included evening or night work compared with only day work. Though attenuated, the higher risk remains after reducing unmeasured confounding.
Objectives: This study aimed to evaluate characteristics of the work environment, job insecurity, and health of marginal part-time workers (8.0-14.9 hours/week) compared with full-time workers (32.0-40.0 hours/week). Methods: The study population included employees in the survey Work Environment and Health in Denmark (WEHD) in 2012, 2014, or 2016 (n = 34 960). Survey information from WEHD on work environment and health was linked with register-based information of exposure based on working hours 3 months prior to the survey, obtained from the register Labour Market Account. Associations between marginal part-time work and work environment and health were assessed using logistic regression models. Results: Marginal part-time workers reported less quantitative job demands, lower levels of influence at work, poorer support from colleagues and leaders, less job satisfaction and poorer safety, as well as more job insecurity. Results on negative social relations in the workplace and physical workload were more ambiguous. Marginal part-time workers were more likely to report poorer self-rated health, treatment-requiring illness, and depressive symptoms compared with full-time workers. Adjusting for characteristics of the work environment showed an indication of altered odds ratios for self-rated health and depressive symptoms, whereas job insecurity did not. Conclusions: This study finds that marginal part-time workers experience a poorer psychosocial work environment and safety, higher job insecurity, and poorer health than full-time workers. Work environment characteristics may confound or mediate the association between marginal part-time work and health. However, prospective studies are needed to determine the causal direction of the revealed associations.
14 April 2023 in Scandinavian Journal of Work, Environment & Health
OBJECTIVES: Working few hours a week, known as marginal part-time work, may increase both job and income insecurity, which have been linked to the risk of depression. This study examines the association between marginal part-time work and depression and the mediating role of job and income insecurity. METHODS: We included 30 523 respondents of the Danish Labor Force Survey (DLFS) between 2010 and 2017 and linked them to register-based information on weekly working hours, which was used to identify full-time workers and model group-based trajectories of marginal part-time. These data were linked with survey information on job and income insecurity, and register-based information on hospital-diagnosed depression or redeemed anti-depressant drugs in the following two years. We estimated hazard ratios (HR) by Cox proportional hazards models and conducted mediation analyses to estimate the natural direct and indirect effects using job and income insecurity as mediators. RESULTS: We identified three distinct trajectories of marginal part-time work: constant marginal part-time work, mobile towards marginal part-time work, and fluctuating in and out of marginal part-time work. Compared with full-time workers, the constant [HR 2.42, 95% confidence interval (CI) 1.83–3.20], mobile (HR 2.84, 95% CI 2.16–3.75), and fluctuating (HR 3.51, 95% CI 2.07–5.97) trajectories all had higher risks of depression. There was no evidence of mediation by either job (HR 1.02, 95% CI 0.92–1.12) or income (HR 0.98, 95% CI 0.89–1.08) insecurity. CONCLUSIONS: We found a higher risk of depression following marginal part-time work. The higher risk was not mediated by job or income insecurity.
Background: Night shift work often implies shorter sleep duration and this can lead to sleepiness, which has been associated with an increased risk of accidents and injuries. The aim is to study how the number of consecutive night shifts affects self-reported sleepiness. Participants and methods: The study was a quasi-experimental, within-subject crossover study with 73 police officers. Three work schedules of two, four, and seven consecutive night shifts followed by the same number of recovery days, i.e., days worked or days off, was performed by all participants. Sleepiness was self-reported using the Karolinska sleepiness scale (KSS) every fourth hour on the last night shift and the last recovery day in each sequence. Results: We observed differences in the level of sleepiness between recovery days and night shift days but no differences in the pattern of sleepiness levels on night shift days in the different work schedules. The highest levels of KSS were observed before bedtime (at 07:00 after a night shift and 23:00 on a recovery day). Conclusion: The number of consecutive night shifts did not affect the self-reported levels of self-reported sleepiness among Danish police officers.
This longitudinal study examined the labor market affiliations of marginal part-time workers (<15 working hours/week) compared with full-time workers (32–40 working hours/week) within gender and age groups. Analyses were based on 1,492,187 Danish employees with marginal part-time or full-time work at baseline using register data of working hours and labor market affiliation from the Labor Market Account. We used the Expected Labor Market Affiliation method within gender and age groups to estimate the time spent in different labor market states over a 5-year follow-up from 2012–2017. The multistate model included five recurrent labor market states: work, unemployment, long-term sickness absence, studying, and temporarily out, and the results were adjusted for education level, morbidity, and ethnicity. A marginal part-time worker generally had fewer days of work without social benefits and spent more days studying during follow-up compared with a full-time worker. In addition, marginal part-time workers ≥ 25 years old had more days of unemployment and more days of long-term sickness absence. These findings suggest that marginal part-time workers have fewer paid workdays without social benefits compared with full-time workers, depending on age. Further studies should explore whether marginal part-time work is a stepping stone into or out of the labor market.