Mikael Sallinen

• Adjunct Professor
• Research Manager at Finnish Institute of Occupational Health

Support is needed for the well-being of nurses and first responders in external crises. We aimed to synthesize the evidence between workload management strategies and well-being of nurses, paramedics, and firefighters during external crises in an umbrella review. The data sources OVID Medline, APA PsycInfo, CINAHL, Web of Science and the Cochrane L...

The aim of this scoping review was to provide an overview and classification of existing studies on strategies and measures to reduce the workload of nuclear industry main control room operators and emergency response organization personnel to support their wellbeing and functional capacity during crises. The Preferred Reporting Items for Systemati...

We aimed to investigate the associations of working hour characteristics based on the international and local definitions with sickness absence (SA) among airport security personnel. The payroll-based registry data of daily working hours for 2016–2019 at one airport was limited to those with ≥30 work shifts in a year (n=377–687 employees). The cond...

Introduction We produced recommendations for the prevention of adverse health effects of shift work in the social and health care sector in Finland. The recommendations on the length, timing, recovery and social aspects of working hours were embedded as an evaluation tool in a shift scheduling software. We investigated the utilization of the tool,...

We studied the effects of the Working Time Traffic Light Model used in shift planning software, the Working Time Act that came into force in 2020 and the COVID-19-pandemic on realized working hours, occupational safety, and well-being at work in the social and health care sector. The research data was based on the Working Hours in the Finnish Publi...

This project produced information on workload management strategies that workplaces in safety-critical sectors can use to support their employees' wellbeing and capacity in external crises. Research and empirical evidence suggest that workload can be managed, and recovery promoted using strategies that both shape work and strengthen employee resour...

This paper discusses the role of the workplace in digital occupational health as part of an increasingly digitalized working life. Digital occupational health can be considered to consist of at least the following digitalized components: a) occupational health services and data, b) human resource data, c) group-level field data collected from the w...

Stress is a common part of working life, but knowledge is lacking on how to identify it early and with little effort on the part of the employee. We investigated whether simple stress reports and computer usage data could be useful tools for long-term assessment of stress in real life. 38 experts responded to a baseline questionnaire on need for re...

The impact of continuing job education and professional development on early exit from the labor market is unclear. This systematic review examined how continuing job education or professional development influences the retention of current employment. We searched the PubMed and Embase databases from their start dates to January 2023. Two reviewers...

Introduction The objective of this study is to determine the effects of night work, Arctic seasonal factors and cold working environments on human functions relevant to safety. The study aims to quantify the contribution of (1) several consecutive night shifts, (2) seasonal variation on sleepiness, alertness and circadian rhythm and (3) whether a c...

Introduction: Good sleep and alertness in shift work can be supported both by developing healthy shift scheduling and by offering sleep coaching to workers. Digital tools have now been developed for these purposes. However, it is not known how well organizations can implement these tools and what factors influence the implementation. In this study,...

Objective: This study aimed to find out whether utilizing a shift schedule evaluation tool with ergonomics recommendations for working hours has favorable effects on the incidence of occupational injuries. Methods: This 4-year prospective cohort study (2015–2018) consisted of a dynamic cohort of healthcare shift workers (N=29 237) from ten hospita...

Participatory shift scheduling for irregular working hours can influence shift schedules and sickness absence. We investigated the effects of using participatory shift scheduling and shift schedule evaluation tools on working hour characteristics and sickness absence. We utilized a panel data for 2015−2019 with 16,557 hospital employees (6143 in th...

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-subjec...

Objective Shift work is associated with impaired health and safety but there is a lack of systematic knowledge of shift workers attitude to their shift systems. This may be important for the ability to retain valuable personnel in the company/organization, and to attract new employees. The purpose of the present study was to investigate: the preval...

Background National recommendations to decrease the health and safety risks of working hours are often given based on the increasing knowledge of the associations between working hour characteristics and health. However, the utilization of the recommendations, and their potential to change the actual working time patterns in healthcare sector is un...

Work stress may compromise professional drivers' health and driving capacity. Differences between driver groups in terms of on-duty stress are understudied. Therefore, we examined self-reported stress (Stockholm University Stress Scale) of shift-working tram and long-haul truck drivers (n = 75) across 2-3 weeks. Furthermore , stressors were self-re...

In shift work disorder (SWD), disturbed sleep acutely impairs employees' recovery, but little attention has been paid to sleep during longer recovery periods. We examined how holidays affect self-estimated sleep length, sleep debt, and recovery in cases of SWD. Twenty-one shift workers with questionnaire-based SWD and nine reference cases without S...

Employees often prefer 12-hour work shifts but they can increase sleepiness and injury risk. We assessed whether sleep, sleepiness, satisfaction and need for recovery changed after changing from an 8-hour to a 12-hour shift system. The participants were 178 employees of paper, pulp and chemical industry . Using a quasi-experimental controlled inter...

Experimental and epidemiological research has shown that human sleepiness is determined especially by the circadian and homeostatic processes. The present field study examined which work-related factors airline pilots perceive as causing on-duty sleepiness during short-haul and long-haul flights. In addition, the association between the perceived r...

Sleep loss is known to contribute to road traffic accidents. Professional drivers are vulnerable to curtailment of sleep due to long driving bouts and shift work. To fill in the gap in the literature related to the build-up of sleep loss in irregular shift systems, we recorded the sleep and working hours of 47 shift-working long-haul truck drivers...

Identifying the causes of sleepiness in various safety-critical work environments is necessary for implementing more efficient fatigue management strategies. In transportation, little is known about drivers' own perceptions of these causes. Therefore, we instructed shift-working tram (n = 23) and long-haul truck drivers (n = 52) to report at the en...

Aircrew fatigue constitutes a safety hazard in aviation, which authorities attempt to mitigate through flight time limitations. Some gaps in knowledge exist, however. The purpose of the present study was to investigate the associations of schedule characteristics with fatigue and amount of sleep in the acute 24‐h window, and as cumulative effects a...

This report summarizes the main findings and recommendations of a large Nordic project 'Working hours, health, well-being and participation in working life' (WOW, 2015-2021). The project has produced over 100 original publications on the societal and socio-economic differences and trends of Nordic working hours, and on the associations, countermeas...

Driver sleepiness contributes to traffic accidents. However, sleepiness in urban public transport remains an understudied subject. To fill this gap, we examined the sleepiness, sleep, and on-duty sleepiness countermeasures (SCMs) in 23 tram drivers working morning, day, and evening shifts for three weeks. Sleepiness was measured using Karolinska Sl...

Objectives This discussion paper aims to provide scientifically based recommendations on night shift schedules, including consecutive shifts, shift intervals and duration of shifts, which may reduce health and safety risks. Short-term physiological effects in terms of circadian disruption, inadequate sleep duration and quality, and fatigue were con...

INTRODUCTION: We examined aircrew fatigue during the following flight duty periods (FDPs) mentioned in the European Union (EU) Flight Time Limitations (FTLs): night FDPs longer than 10 h and FDPs typical of disruptive schedules (early starts, late finishes, and nights). An alternative way of classifying night FDPs was also examined to reveal possib...

In the original publication of the article, the first name and last name of the authors were interchanged.

Objectives We investigated the association of working hours with occupational injuries in hospital shift work. Methods Registry data of occupational injuries of hospital employees from 11 towns and 6 hospital districts were linked to daily payroll data to obtain working hours for 37 days preceding the first incidence of the injury (N=18 700). A ca...

Background: Recent studies suggest heavy vehicle drivers self-estimate their sleepiness unexpectedly low during night duties. The present study compared sleepiness ratings of long-haul truck drivers with those of long-haul airline pilots during night and non-night duties. In addition, the correspondence between self-rated manifest and predicted la...

LINK TO FULL-TEXT: https://rdcu.be/bcpyp PURPOSE: Although shift work disorder (SWD) affects a major part of the shift working population, little is known about its manifestation in real life. This observational field study aimed to provide a detailed picture of sleep and alertness among shift workers with a questionnaire-based SWD, by comparing...

The rapid development of modern society has resulted in a growing population of workers that have to work around the clock. However, working at different times comes at a cost. Night work is related to short sleep, increased fatigue, falling asleep at work, worse performance, and increased risk for injuries and accidents. Early morning work is also...

Introduction: We examined whether long-haul airline pilots without recurrent on-duty sleepiness obtain more prior sleep and use more effective in-flight alertness management strategies than their colleagues with recurrent on-duty sleepiness. Methods: There were 51 pilots who flew at least twice from Helsinki to Asia. Of them, 44 flew at least tw...

This study aimed to investigate working hours, sleep quality and alertness, and recovery and detachment in expert work using a mobile app. The study sample comprised members of The Finnish Business School Graduates and employees of an information technology (IT) company. The final study sample included 154 employees with at least four days of mobil...

Education is a frequently recommended remedy for driver sleepiness in occupational settings, although not many studies have examined its usefulness. To date, there are no previous on-road randomized controlled trials investigating the benefits of training on sleepiness among employees working in road transport. To examine the effects of an educatio...

Sleep restriction is increasingly common and associated with the development of health problems. We investigated how the neuroendocrine stress systems respond to prolonged sleep restriction and subsequent recovery sleep in healthy young men. After two baseline (BL) nights of 8h time in bed (TIB), TIB was restricted to 4h per night for five nights (s...

Human fatigue continues to threaten safe transport. There are claims that employers of operators should do more to mitigate the risks, and several regulators are promoting fatigue-risk management in the context of safety management systems (SMS). The current paper reviews fatigue-related risk and exposure factors and control measures for operators...

This study examined the consistency of salivary cortisol and alpha-amylase (sAA) total daily secretion between laboratory and field circumstances. The 95 participants were shift working female health care professionals with high (n = 53) or low (n = 42) psychosocial stress (job strain) measured by the Job Content Questionnaire (JCQ). The Trier Soci...

Airline pilots’ sleep and on-duty alertness are important focus areas in commercial aviation. Until now, studies pertaining to this topic have mainly focused on specific characteristics of flights and thus a comprehensive picture of the matter is not well established. In addition, research knowledge of what airline pilots actually do to maintain th...

Transparency document

We studied dietary patterns, physical activity (PA), and monthly goal setting in a weight reduction intervention in long-distance professional drivers. The study was conducted in Finland in 2009–2012. Male drivers with waist circumference > 100 cm were randomized to a lifestyle counseling (LIFE, N = 55) and a reference (REF, N = 58) group. During 1...

Background: Shift work is often associated with sleepiness and sleep disorders. Person-directed, non-pharmacological interventions may positively influence the impact of shift work on sleep, thereby improving workers' well-being, safety, and health. Objectives: To assess the effects of person-directed, non-pharmacological interventions for reduc...

Sleep loss and insufficient sleep are risk factors for cardiometabolic diseases, but data on how insufficient sleep contributes to these diseases are scarce. These questions were addressed using two approaches: an experimental, partial sleep restriction study (14 cases and 7 control subjects) with objective verification of sleep amount, and two ind...

Twelve-hour shift systems have become more popular in industry. Survey data of shift length, shift rotation speed, self-rated sleep, satisfaction and perceived health were investigated for the associations among 599 predominantly male Finnish industrial employees. The studied forward-rotating shift systems were 12-h fast (12fast, DDNN------, n = 26...

Re. Härmä M, Ropponen A, Hakola T, Koskinen A, Vanttola P, Puttonen S, Sallinen M, Salo P, Oksanen T, Pentti J, Vahtera J, Kivimäki M. Developing register-based measures for assessment of working time patterns for epidemiologic studies. Scand J Work Environ Health. 2015;41(3):268–279.

The 2014 workshop on "Co-ordination of research on working hours and health in the Nordic countries" was held at the Finnish Institute of Occupational Health on the 23rd-24th October 2014. The overall purpose of the workshop was to provide a platform for cooperation and development of high-quality research projects on working hours and health in th...

Background: Despite reports that long work shifts may result in increased sleepiness and fatigue and consequently risk of accidents, longer 12-h shifts have gained popularity and they are spreading also in the industrial sector in Finland. Long shifts can be especially demanding for older workers but research how older workers tolerate 12-h shifts...

The use of 12-hour shifts has become more popular in Finnish industry. Earlier studies suggest that 12-hour shift systems may increase fatigue and risk of occupational injuries. On the other hand, 12-hour shift systems associate with longer continuous free time and reduced commuting time. We studied the cross-sectional associations of 8- and 12-hou...

Knowledge of the factors that make the operator become fatigued is a founding pillar of fatigue risk management. In this chapter, we introduce a model of the fatigue-inducing factors especially in the context of road transportation. In addition to the person, organization, and industry- and society-related factors that may exacerbate fatigue, we in...

Although the prevalence of work-related stress has increased, knowledge on the contributions of that stress to long-term adverse health effects is still lacking. Stress biomarkers can reveal early signs of negative health effects, but no previous studies have measured both acute stress reactions and long-term exposure to job strain using both saliv...

Objectives Epidemiological studies suggest that long working hours and shift work may increase the risk of chronic diseases, but the “toxic” elements remain unclear due to crude assessment of working time patterns based on self-reports. In this methodological paper, we present and evaluate objective register-based algorithms for assessment of worki...

BACKGROUND: Shift work results in sleep-wake disturbances, which cause sleepiness during night shifts and reduce sleep length and quality in daytime sleep after the night shift. In its serious form it is also called shift work sleep disorder. Various pharmacological products are used to ameliorate symptoms of sleepiness or poor sleep length and qua...

The current study investigated what strategies long-haul truck drivers use to mitigate fatigue at the wheel. A group of 52 truck drivers participated in the study in which drivers’ fatigue at the wheel was measured by a well-validated self-rating scale (the Karolinska Sleepiness Scale) and the use of fatigue countermeasures by a diary for a period...

Objectives: We conducted a randomized trial among overweight long-distance drivers to study the effects of structured lifestyle counseling on body weight and cardiometabolic risk factors. Methods: Men with waist circumference >100 cm were randomized into a lifestyle counseling (LIFE, N=55) and a reference (REF, N=58) group. The LIFE group partic...

Within sample female nurses/nurse assistants in three shift work, we explored the association of job strain with heart rate variability before and during sleep. The participants (n = 95) were recruited from the Finnish Public Sector Study, from hospital wards that belonged either to the top (high job strain [HJS], n = 42) or bottom quartiles on job...

Objectives: Shift work disorder (SWD) is defined as insomnia or excessive sleepiness temporarily associated with a recurring work schedule that overlaps the usual time for sleep. In this field study we examined how alertness of employees with SWD varies in different shifts and days off compared to healthy counterparts. Methods: Participants were 31...

Background: Shift work results in sleep-wake disturbances, which cause sleepiness during night shifts and reduce sleep length and quality in daytime sleep after the night shift. In its serious form it is also called shift work sleep disorder. Various pharmacological products are used to ameliorate symptoms of sleepiness or poor sleep length and qu...

Sleep duration is genetically regulated, but the genetic variants are largely unknown. We aimed to identify such genes using a genome-wide association study (GWAS) combined with RNA expression at the population level, and with experimental verification. A GWAS was performed in a Finnish sample (n = 1941), and variants with suggestive association (P...

Study objectives: Examine the use of spectral heart rate variability (HRV) metrics in measuring sleepiness under chronic partial sleep restriction, and identify underlying relationships between HRV, Karolinska Sleepiness Scale ratings (KSS), and performance on the Psychomotor Vigilance Task (PVT). Design: Controlled laboratory study. Setting:...

The main idea behind supplementary rest breaks within a work shift is to promote recovery from work, a process known to be important for health in the long-run (1). Supplementary rest breaks are also used to promote occupational safety. In many industries and occupations, rest breaks are viewed as so important for safety that their use is determine...

Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment for persistent insomnia. The purpose of this study was to examine the effectiveness of and response patterns to CBT-I among daytime and shift workers with insomnia over a 24-month follow-up in occupational health services (OHS). The participants were 59 media workers with c...

The relationship between sleep and memory and learning has proved multifilament. Besides supporting cognitive functions needed to encode, storage and retrieve materials while awake, sleep is a state during which some of the memory traces are reactivated and consolidated. Also, sleep disorders such as insomnia, obstructive sleep apnea and insufficie...

Introduction Shift work disorder (SWD) is defined as complaints of insomnia or excessive sleepiness associated temporarily with work schedule overlapping the habitual sleep phase. Here we present the first results of an ongoing field study examining how sleep of employees with SWD differ from their non-SWD controls in connection with different shif...

Epidemiological studies have shown that short or insufficient sleep is associated with increased risk for metabolic diseases and mortality. To elucidate mechanisms behind this connection, we aimed to identify genes and pathways affected by experimentally induced, partial sleep restriction and to verify their connection to insufficient sleep at popu...

We explored the relationship of job strain with working hours, shift-dependent perceived workload, sleepiness and recovery. Nurses/nursing assistants (n = 95) were recruited from wards that belonged to either the top (high-strain group, HJS) or the bottom (low-strain group, LJS) job strain quartiles of a Job Content Questionnaire survey of employee...

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of adaptation of shift schedules for preventing and treating sleeping and alertness problems in shift workers.

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of person-directed, non-pharmacological interventions for preventing and treating sleeping and alertness problems in shift workers.

We explored the associations of job strain with sleep and alertness of shift working female nurses and nursing assistants. Participants (n=95) were recruited from the Finnish Public Sector Study, from hospital wards that belonged to the top or bottom quartiles on job strain. Participants' own job strain was at least as high in high-strain group or...

Objectives: The period of leisure is an appropriate time to recover from work-induced fatigue, though some recovery takes place during rest breaks at work. Recently, much attention has been paid to the critical role of leisure activity in recovery. However, the findings relevant to shiftwork nurses who cannot take a day-off regularly are limited....

This study addressed a rarely studied question of self-perceptions of performance and overall functional state during cumulative sleep restriction and the ensuing recovery period. Twenty healthy male volunteers, aged 19-29 years, were divided into a sleep restriction group (n = 13) and a control group (n = 7). On the first 2 nights, the sleep restr...

Objective: Shift work is a challenge in the screening and treatment of chronic insomnia. The aim of this study was to examine the implementation and effectiveness of a cognitive behavioral group intervention for insomnia (CBT-I) among shift workers with chronic insomnia. We also studied whether insomnia symptoms and intervention effects differed o...

The inability to obtain sufficient sleep is a common condition, and its causes are many. When the condition lasts for a long period, it leads to chronic sleep deprivation, increasing sleepiness and impairing cognitive function to a degree comparable to acute total sleep deprivation. People with behaviorally induced insufficient sleep (BIIS) volunta...

Introduction: The aim of this study was to examine the implementation and effectiveness of a cognitive behavioral group intervention model for chronic insomnia (CBT-I) in occupational health services (OHS). We also studied if insomnia symptoms and intervention effects differed on work days and days off. Methods: The study design was a non-random...

Epidemiological studies show association between sleep duration and lipid metabolism. In addition, inactivation of circadian genes induces insulin resistance and hyperlipidemia. We hypothesized that sleep length and lipid metabolism are partially controlled by the same genes. We studied the association of total sleep time (TST) with 60 genetic vari...

This study investigated in a laboratory setting the effects of long-term job strain on cognitive functions and stress regulation and in a field study the effects of long-term job strain on sleep, recovery and functioning. According to the results, long-term job strain had a negative effect on memory performance and strategies used. Short sleep dura...

Short and long self-reported sleep durations have been found to be associated with several seemingly disparate health risks and impaired functional abilities, including cognitive functioning. The role of long sleep is especially poorly understood in this context. Psychomotor slowness, shown to have analogous associations with cognitive performance...

The rapid development of the modern society has resulted in a growing population of workers that have to work around the clock. However, working at other times (which is what a shift-worker does) comes at a cost. Night work is related to short sleep, increased fatigue, intrusions of sleep, worse performance, and increased risk for injuries and acci...

Cognition and ageing in air traffic control Abstract Within the domain of air traffic control (ATC), cognitive abilities and limitations of human cognitive system are critical to job performance. The aim of this literature review is to investigate how chronological age affects the performance of demanding cognitive tasks. Age differences have been...

It is important to develop shift schedules that minimise the chance for sleep-related human error in safety-critical domains. Experimental data on the effects of sleep restriction (SR) play a key role in this development work. In order to provide such data, we conducted an experiment in which cognitively demanding and long-duration task performance...

Shift work results in sleep-wake disturbances, which cause sleepiness during night shifts and reduce sleep length and quality in daytime sleep after the night shift. In its serious form it is also called shift work sleep disorder. Various pharmacological products are used to ameliorate symptoms of sleepiness or poor sleep length and quality.

In this narrative review, we examined what level of research evidence is available that shift workers’ sleep–wake disturbances can be minimized through ergonomic shift scheduling. We classified the pertinent studies conducted on real shift workers in field conditions by the type of shift system and study design (ie, whether the shift systems were m...