WORK SCHEDULES: SHIFT WORK AND LONG WORK HOURS

A tired man, a man working in a hospital, and a taxi driver.

According to 2004 data from the Bureau of Labor Statistics, almost 15 million Americans work full time on evening shift, night shift, rotating shifts, or other employer arranged irregular schedules. The International Labor Office in 2003 reports that working hours in the United States exceed Japan and most of western Europe. Both shift work and long work hours have been associated with health and safety risks. This page provides links to NIOSH publications and other resources that address demanding work schedules.

NIOSHTIC-2 Search

NIOSHTIC-2 is a searchable bibliographic database of occupational safety and health publications, documents, grant reports, and journal articles supported in whole or in part by NIOSH.

NIOSHTIC-2 search results on work schedules

NIOSH Publications and Guidance

NIOSH DEEPWATER HORIZON RESPONSE Key Safety and Health Topics, Fatigue Prevention
http://www.cdc.gov/niosh/topics/oilspillresponse/
keytopics.html#fatigue

NIOSH OSHA Interim Guidance for Protecting Deepwater Horizon Response Workers and Volunteers, Fatigue Prevention

NIOSH Blog: Sleep and Work
http://blogs.cdc.gov/niosh-science-blog/2012/03/sleep-and-work/

NIOSH Blog: NIOSH Research on Work Schedules and Work-related Sleep Loss
http://blogs.cdc.gov/niosh-science-blog/2012/03/sleep/

Overtime and Extended Work Shifts: Recent Findings on Illnesses, Injuries and Health Behaviors
DHHS (NIOSH) Publication No. 2004-143
Presents a review of the methods and findings from 52 studies that examined the relationship between long work hours and selected health outcomes. Also provides recommendations on issues and priorities to consider in future research.

Medical Interns’ Risk for Car Crashes Linked With Extended Shifts in NIOSH-Funded Study—NIOSH Update
Information on this study can be found in the following journal articles in the New England Journal of Medicine.:

Barger LK, Cade BE, Ayas NT, Cronin JW, Rosner B, Speizer FE, Czeisler CA. 2005.
Extended Work Shifts and the Risk of Motor Vehicle Crashes among Interns. N Engl J Med 352:125-134.
Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E, Katz JT, Lilly CM, Stone
PH, Lockley SW, Bates DW, Czeisler CA. 2004. Effect of reducing interns' work hours on serious medical errors in intensive care units. N Engl J Med 351:1838-1848.
Lockley SW, Cronin JW, Evans EE, Cade BE, Lee CJ, Landrigan CP, Rothschild JM, Katz JT, Lilly CM, Stone PH, Aeschbach D, Czeisler CA. 2004. Effect of reducing interns' weekly work hours on sleep and attentional failures. N Engl J Med 351:1829-1837.

Work-related Roadway Crashes - Prevention Strategies for Employers
DHHS (NIOSH) Publication No. 2004-136

Work-related Roadway Crashes - Who’s at Risk?
DHHS (NIOSH) Publication No. 2004-137
Companion fact sheets provide information that employers and others can use for assessing risks for motor vehicle injuries and deaths in their work settings, and for taking effective steps to reduce those risks.

Work-Related Roadway Crashes - Challenges and Opportunities for Prevention
DHHS (NIOSH) Publication No. 2003-119
Provides a comprehensive view of issues impacting the prevention of work-related roadway crashes, identifies the groups of workers at greatest risk of traffic crashes, summarizes key issues that contribute to work-related roadway crashes, and recommends preventive measures for employers and other stakeholders.

Plain Language About Shiftwork [PDF - 572 KB]
DHHS (NIOSH) Publication No. 1997-145
Provides basic facts about shiftwork and talks about ways to make shiftwork life easier. The document is an educational document for the general public.

Conferences

Sleep Health & Safety 2012
The National Sleep Foundation’s Sleep Health & Safety 2012 will take place March 2-3 at the JW Marriott Hotel in downtown Washington, DC. Sleep profoundly affects our health and safety. Millions of people have sleep disorders, and most go undiagnosed and untreated. Many Americans are sacrificing their sleep health by working longer into the night. Thousands of fatigue-related car crashes occur each year. Sleep Health & Safety 2012 examines sleep from both clinical and public health perspectives. It offers two tracks—a Health Care Professional Track targeted to primary care physicians that provides CME credits for physicians and health care professionals and a Public Health and Safety Track targeted to public health, transportation, and safety professionals, as well as government officials and sleep researchers.

Past NIOSH-Sponsored Events

Long Working Hours, Safety, And Health: Toward A National Research Agenda
April 29 - 30, 2004, University of Maryland, Baltimore, Maryland
Using a multi-disciplinary approach, this conference explored the sociological, economic, and health dimensions of long work hours.

Extended Abstracts from Conference Presentations:
Conference Papers
- Long working hours, occupational health and the changing nature of work organization. Johnson JV, Lipscomb J. American Journal of Industrial Medicine. 2006; 49: 921-929.
- Long working hours, safety, and health: Toward a national research agenda. Caruso CC, Bushnell T, Eggerth D, Heitmann A, Kojola B, Newman K, Rosa RR, Sauter SL, Vila B. American Journal of Industrial Medicine. 2006; 49: 930-942.
- Long hours of work in the U.S.: Associations with demographic and organizational characteristics, psychosocial working conditions, and health. Grosch JW, Caruso CC, Rosa RR, Sauter SL. American Journal of Industrial Medicine. 2006; 49: 943-952.
- Modeling the impact of the components of long work hours on injuries and accidents. Folkard S, Lombardi DA. American Journal of Industrial Medicine. 2006; 49: 953-963.
- Longitudinal relationship of work hours, mandatory overtime, and on-call to musculoskeletal problems in nurses. Trinkoff AM, Le R, Geiger-Brown J, Lipscomb J, Lang G. American Journal of Industrial Medicine. 2006; 49: 964-971.
- Impact of long work hours on police officers and the communities they serve. Vila B. American Journal of Industrial Medicine. 2006; 49: 972-980.

Some Strategies Suggested for Coping with Shift Work

Fatigue Risk Management in the Workplace Lerman SE, Eskin E, Flower DJ, George EC, Gerson B, Hartenbaum N, Hursh SR, Moore-Ede M; ACOEM Presidential Task Force on Fatigue Risk Management. Fatigue risk management in the workplace. 2012. J Occup Environ Med. 54(2):231-58.

Measures to counteract the negative effects of night work. Pallesen S, Bjorvatn B, Magerøy N, Saksvik IB, Wage S, Moen BE. Scan J Work Environ Health 2010. 36 (2): 109-120.

Eating and shift work – effects on habits, metabolism and performance. Lowden A, Moreno C, Holmbäck U, Lennernäs M, Tucker P. Scan J Work Environ Health 2010. 36 (2): 150-162.

Strategies for Nurses to Prevent Sleep-Related Injuries and Errors. Caruso CC, Hitchcock EM. Rehabilitation Nursing 2010. 35 (5): 192-7 [PDF - 744.44 KB]

Fatigue countermeasures in aviation. Caldwell JA, Mallis MM, Caldwell JL, Paul MA, Miller JC, Neri DF; Aerospace Medical Association Fatigue Countermeasures Subcommittee of the Aerospace Human Factors Committee. Aviat Space Environ Med 2009. 80(1):29-59

Guidance for managing worker fatigue during disaster operations. U.S. National Response Team. 2009. [PDF - 670.71 KB]

Alertness Management Strategies for Operational Contexts
Caldwell JA, Caldwell JL, Schmidt RM. Sleep Medicine Reviews 2008; 12: 257-273

Circadian rhythm sleep disorders: Part 1, basic principles, shift work and jet lag disorders. Sack RL, Auckley D, Auger RR, Carskadon MA, Wright KP, Vitiello MV, Zhdanova I. Sleep 2007; 30:1460-1483.

Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. Morgenthaler TI, Lee-Chiong T, Alessi C, Friedman L, Aurora RN, Boehlecke B, Brown T, Chesson AL, Kapur V, Maganti R, Owens J, Pancer J, Swick TJ, Zak R. Sleep 2007; 30:1445-1459.

Burgess PA. 2007. Optimal shift duration and sequence: recommended approach for short-term emergency response activations for public health and emergency management. Am J Public Health 97 Suppl 1:S88-S92. [PDF - 95.25 KB]

How to trick Mother Nature into letting you fly around or stay up all night
Revell VL, Eastman CI. Journal of Biological Rhythms 2005; 20:353-365

Preventive and compensatory measures for shift workers
Knauth P, Hornberger S. Occupational Medicine (Ox) 2003; 53:109-116.

Plain Language About Shiftwork
DHHS (NIOSH) Publication No. 1997-145 [PDF - 572 KB]

Some Educational Resources For Workers Available on Other Web Sites

National Sleep Foundation

National Institute of Health, National Heart, Blood, and Lung Institute
Your Guide to Healthy Sleep. NIH Publication Number 06-5271. 2006.

Working the night shift: preparation, survival and recovery. Horrocks, N & Pounder, R. 2006. London, Royal College of Physicians. [PDF - 137.71 KB]

NORA Organization of Work Research Priority Area

The goal of the NORA Organization of Work Team is to define and implement a national occupational research agenda for the next decade. Organization of work refers to management and supervisory practices and production processes, and to their influence on the way jobs are designed and performed in the workplace. Organization of work includes the design of work schedules. A NORA Long Work Hours Subteam was formed to address overtime and extended work shifts issues.