The association between shift work and sick leave: A systematic review

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Occupational and environmental medicine (Impact Factor: 3.27). 07/2012; 69(10):701-12. DOI: 10.1136/oemed-2011-100488
Source: PubMed


Shift work is associated with a number of negative health outcomes, although it is not known whether it is associated with sick leave. This systematic review therefore aimed to determine whether an association exists between shift work and sick leave. A systematic literature search was conducted in six databases on observational studies. Two reviewers independently selected relevant articles and appraised methodological quality. Data extraction was performed independently by review couples. Articles were categorised according to shift work characteristics and summarised using a levels of evidence synthesis. In total, the search strategy yielded 1207 references, of which 24 studies met the inclusion criteria. Nine studies were appraised as high quality and used in the levels of evidence synthesis. Two high quality longitudinal studies found a positive association between fixed evening shifts and longer sick leave for female healthcare workers. The evidence was assessed as strong. Evidence was inconclusive for rotating shifts, shift work including nights, for fixed night work, and for 8-hour and 12-hour shifts. The association found between evening work and sick leave in female healthcare workers implies that the association between shift work and sick leave might be schedule and population specific. To study the association further, more high quality studies are necessary that assess and adjust for detailed shift work exposure.

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    • "It has been suggested that some of the effects of shift work on mental health may be mediated by social difficulties in terms of imbalance between work and private life (Haines et al. 2008). Shift work has also been inferred as a risk factor for sick leave; currently, however, this seems primarily to apply to female healthcare workers on fixed evening work (Merkus et al. 2012). One recent study also indicated that shift work was associated with a chronic impairment of cognition (Marquié et al. 2015). "
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    • "The findings are consistent with prior evidence that both obesity and shiftwork are risk factors for adverse health outcomes and their combined effect may lead to greater risk of sickness absence. This study adds to the body of knowledge regarding the association of long-term shiftwork with sickness absenteeism among high-stress occupations and may have future implications that ultimately lead to interventions that could improve shiftworkers' health and also alleviate the economic burden associated with sick leave absenteeism (Merkus et al., 2012). For example, obese workers cost 27.4% higher in health care costs (Goetzel et al., 2012). "
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    ABSTRACT: Shiftwork, regarded as a significant occupational stressor, has become increasingly prevalent across a wide range of occupations. The adverse health outcomes associated with shiftwork are well documented. Shiftwork is an integral part of law enforcement, a high-stress occupation with elevated risks of chronic disease and mortality. Sickness absence is an important source of productivity loss and may also serve as an indirect measure of workers' morbidity. Prior studies of shiftwork and sickness absenteeism have yielded varying results and the association has not been examined specifically among police officers. The objective of this study was to compare the incidence rate of sick leave (any, ≥3 consecutive days) among day-, afternoon-, and night-shift workers in a cohort of police officers and also examine the role of lifestyle factors as potential moderators of the association. Participants (N = 464) from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study examined between 2004 and 2009 were used. Daily work history records that included the shift schedule, number of hours worked, and occurrence of sick leave were available for up to 15 yrs starting in 1994 to the date of the BCOPS study examination for each officer. Poisson regression analysis for ungrouped data was used to estimate incidence rates (IRs) of sick leave by shift, and comparison of IRs across shifts were made by computing incidence rate ratios (IRRs) and their 95% confidence intervals (CIs). Sick leave occurred at a higher rate on the night shift (4.37 per 10 000 person-hours) compared with either day (1.55 per 10 000 person-hours) or afternoon (1.96 per 10 000 person-hours) shifts. The association between shiftwork and sickness absence depended on body mass index (BMI). For overweight individuals (BMI ≥ 25 kg/m(2)), the covariate-adjusted incidence rate of sick leave (≥1 day) was twice as large for night-shift officers compared with those working on the day (IRR = 2.29, 95% CI: 1.69-3.10) or afternoon (IRR = 1.74, 95% CI: 1.29-2.34) shift. The IR of three or more consecutive days of sick leave was 1.7 times larger for those working on night shift (IRR = 1.65, 95% CI: 1.17-2.31) and 1.5 times larger for those working on afternoon shift (IRR = 1.50, 95% CI: 1.08-2.08) compared with day shiftworkers. For subjects with normal BMI (<25 kg/m(2)), the incidence rates of sick leave did not differ significantly across shifts. In conclusion, shiftwork is independently associated with sickness absence, with officers who work the night shift having elevated incidence of sick leave. In addition, overweight officers who work the night shift may be at additional risk for sickness absence.
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