Kari Anne Holte

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

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.

The attribution of work environment in explaining gender differences in long-term sickness absence: results from the prospective DREAM study

Objectives To identify differences in risk of long-term sickness absence between female and male employees in Denmark and to examine to what extent differences could be explained by work environment factors. Methods A cohort of 5026 employees (49.1% women, mean age 40.4 years; 50.9% men, mean age 40.2 years) was interviewed in 2000 regarding gender, age, family status, socio-economic position and psychosocial and physical work environment factors. The participants were followed for 18 months in order to assess their incidence of long-term sickness absence exceeding 8 consecutive weeks. Results 298 workers (5.9%) received sickness absence compensation for 8 weeks or more. Women had an excess risk of 37% compared to men, when adjusting for age, family status and socio-economic position. Physical work environment exposures could not explain this difference, whereas differences in psychosocial work environment exposures explained 32% of the differences in risk of long-term sickness absence between men and women, causing the effect of gender to become statistically insignificant. The combined effect of physical and psychosocial factors was similar, explaining 30% of the gender difference. Conclusion Differences in psychosocial work environments in terms of emotional demands, reward at work, management quality and role conflicts, explained roughly 30% of womens excess long-term sickness absence risk. Assuming women and men had identical working conditions would leave the larger part of the gender difference in long-term sickness absence from work unexplained.

Young workers in the construction industry and initial OSH-training when entering work life

Studies have found that young workers are at risk for injuries. The risk for accidents is high within construction, indicating that young workers may be especially vulnerable in this industry. In Norway, it is possible to enter the construction industry as a full time worker at the age of 18. The aim of this paper was to explore how young construction workers are received at their workplace with regards to OHS-training. The study was designed as a qualitative case study. Each case consisted of a young worker or apprentice (< 25 years), a colleague, the immediate superior, the OHS manager, and a safety representative in the company. The interviews were recorded and analyzed through content analysis. The results showed that there were differences between large and small companies, where large companies had more formalized routines and systems for receiving and training young workers. These routines were however more dependent on requirements set by legislators and contractors more than by company size, since the legislation has different requirements with impact on OHS.

Nonstandard working schedules and health: the systematic search for a comprehensive model.

BackgroundTheoretical models on shift work fall short of describing relevant health-related pathways associated with the broader concept of nonstandard working schedules. Shift work models neither combine relevant working time characteristics applicable to nonstandard schedules nor include the role of rest periods and recovery in the development of health complaints. Therefore, this paper aimed to develop a comprehensive model on nonstandard working schedules to address these shortcomings.MethodsA literature review was conducted using a systematic search and selection process. Two searches were performed: one associating the working time characteristics time-of-day and working time duration with health and one associating recovery after work with health. Data extracted from the models were used to develop a comprehensive model on nonstandard working schedules and health.ResultsFor models on the working time characteristics, the search strategy yielded 3044 references, of which 26 met the inclusion criteria that contained 22 distinctive models. For models on recovery after work, the search strategy yielded 896 references, of which seven met the inclusion criteria containing seven distinctive models. Of the models on the working time characteristics, three combined time-of-day with working time duration, 18 were on time-of-day (i.e. shift work), and one was on working time duration. The model developed in the paper has a comprehensive approach to working hours and other work-related risk factors and proposes that they should be balanced by positive non-work factors to maintain health. Physiological processes leading to health complaints are circadian disruption, sleep deprivation, and activation that should be counterbalanced by (re-)entrainment, restorative sleep, and recovery, respectively, to maintain health.ConclusionsA comprehensive model on nonstandard working schedules and health was developed. The model proposes that work and non-work as well as their associated physiological processes need to be balanced to maintain good health. The model gives researchers a useful overview over the various risk factors and pathways associated with health that should be considered when studying any form of nonstandard working schedule.

On long term sick leave due to musculoskeletal diseases and disorders. Experiences of work demands

OBJECTIVE The rate of sick leave is higher in the public sector than in the private sector in several countries, making it essential to thoroughly investigate employees in the public sector. The following research question was investigated: How do employees on long-term sick leave (> 8 weeks) due to musculoskeletal disorders or diseases describe their work demands? METHODS This paper is from the larger Rogaland RTW case study. The informants were female employees (n=8) in the first-line public sector with different types of musculoskeletal diseases or disorders. Qualitative interviews were conducted using a semi-structured interview guide based on two measures: Worker Role Interview and Work Environmental Impact Scale. Data was analysed by condensing and categorizing meaning. RESULTS Fifty-one work demands were described, only five of which were physical demands. Demands were sometimes described as merely negative or positive for the work performance, but also as both. Most of the negative demands were emotional and cognitive challenges in mastering the work tasks. Most of the demands (n= 36) were experienced to be claimed by the employee herself, with only a few being claimed by the employer or environment (n=7) or by both (n=8). CONCLUSIONS Eight employees in the public sector on long-term sick leave due to musculoskeletal problems experienced mostly cognitive and emotional demands, and defined themselves as the work-demand claimer. The results of this study point to the importance of broadening the perspective in work rehabilitation for workers absent due to diagnosis of the musculoskeletal system.

Agriculture into the Future: New Technology, New Organisation and New Occupational Health and Safety Risks?

Agriculture is a hazardous industry, with a high frequency of injuries. As working life has changed over the last decades, so has also agriculture. In Norway, farm size has increased, and agriculture has become technology intensive with a high amount of automated milking systems (AMS) and is now more dependent on hired help. The aim of the study is by sociotechnical system theory to explore how a new generation of farmers describe their work organisation in relation to occupational health and safety. The study is an explorative interview study at five farms having implemented AMS. An open interview guide was used. The interviews were recorded and thereafter transcribed. Analyses were based on the balance-theory with the domains technology, organisation, physical environment, task design, and individual characteristics. The results show that AMS changes the farm as a sociotechnical work system. AMS is considered a relief with regards how tasks become less physically demanding, less time consuming, and with less animal contact. On the other hand, cognitive demands increase. The results indicate that the technology increases both complexity and vulnerability, these factors being less considered by the farmers. The findings underline the importance of farmers’ increasing awareness of their role as a manager and for an increased system perspective.

An active transition from offshore work to family life: Activities that may impact recovery

BACKGROUND Night shift workers, particularly those working offshore, take a long time to recover from their shifts. The activities that shift workers, such as offshore employees, pursue during their leisure time can influence the process of recovery from work-related fatigue, but little is known about these leisure time activities. OBJECTIVE To explore what leisure time activities are pursued that may be relevant to recovery for offshore employees. METHODS Sixty-one offshore working family men-20 night shift, 16 swing shift, and 25 day shift workers-reported on six predefined activities for 14 days following their offshore tours. Generalized estimating equations analysis was used to explore trends in the data. RESULTS From the start of the free period, almost all participants were involved in household chores and childcare; these activities declined over the 14 days. Throughout the study period, participants actively pursued social, volunteer, and leisure time physical activities. Work-related activities were pursued by half of the participants at some time during the 14 days. Night and swing shift workers were more physically active than day workers throughout the first 14 days of the free period. CONCLUSIONS The transition from offshore work to family life can be characterised as active. The activities engaged in by this sample of employees are likely to promote their recovery.