Härmä Mikko, Koskinen Aki, Ropponen Annina, Puttonen Sampsa, Karhula Kati, Vahtera Jussi, Kivimäki Mika
Modern Work and Leadership, Finnish Institute of Occupational Health, Helsinki, Finland.
ICT and Digital Services, Finnish Institute of Occupational Health, Helsinki, Finland.
Occup Environ Med. 2017 Mar;74(3):228-230. doi: 10.1136/oemed-2016-103902. Epub 2016 Sep 27.
To evaluate the validity of widely used questionnaire items on work schedule using objective registry data as reference.
A cohort study of hospital employees who responded to a self-administered questionnaire on work schedule in 2008, 2012 and 2014 and were linked to individual-level pay-roll-based records on work shifts. For predictive validity, leisure-time fatigue was assessed.
According to the survey data in 2014 (n=8896), 55% of the day workers had at least 1 year of earlier shift work experience. 8% of the night shift workers changed to day work during the follow-up. Using pay-roll data as reference, questions on 'shift work with night shifts' and 'permanent night work' showed high sensitivity (96% and 90%) and specificity (92% and 97%). Self-reported 'regular day work' showed moderate sensitivity (73%), but high specificity (99%) and 'shift work without night shifts' showed low sensitivity (62%) and moderate specificity (87%). In multivariate logistic regression analysis, the age-adjusted, sex-adjusted and baseline fatigue-adjusted association between 'shift work without night shifts' and leisure-time fatigue was lower for self-reported compared with objective assessment (1.30, 95% CI 0.94 to 1.82, n=1707 vs 1.89, 95% CI 1.06 to 3.39, n=1627). In contrast, shift work with night shifts, compared with permanent day work, was similarly associated with fatigue in the two assessments (2.04, 95% CI 1.62 to 2.57, n=2311 vs 1.82, 95% CI 1.28 to 2.58, n=1804).
The validity of self-reported assessment of shift work varies between work schedules. Exposure misclassification in self-reported data may contribute to bias towards the null in shift work without night shifts.
以客观登记数据为参照，评估广泛使用的工作时间表调查问卷项目的有效性。
对2008年、2012年和2014年回应了一份关于工作时间表的自填式问卷的医院员工进行队列研究，并将其与基于个人工资记录的轮班记录相联系。为评估预测效度，对闲暇时间疲劳进行了评估。
根据2014年的调查数据（n = 8896），55%的日班工人有至少1年的早班工作经历。8%的夜班工人在随访期间转为日班工作。以工资数据为参照，关于“有夜班的轮班工作”和“长期夜班工作”的问题显示出高敏感性（分别为96%和90%）和高特异性（分别为92%和97%）。自我报告的“常规日班工作”显示出中等敏感性（73%），但特异性高（99%），而“无夜班的轮班工作”显示出低敏感性（62%）和中等特异性（87%）。在多因素逻辑回归分析中，与客观评估相比，自我报告的“无夜班的轮班工作”与闲暇时间疲劳之间经年龄调整、性别调整和基线疲劳调整后的关联较低（1.30，95%可信区间0.94至1.82，n = 1707，对比1.89，95%可信区间1.06至3.39，n = 1627）。相比之下，有夜班的轮班工作与长期日班工作相比，在两种评估中与疲劳的关联相似（2.04，95%可信区间1.62至2.57，n = 2311，对比1.82，95%可信区间1.28至2.58，n = 1804）。
自我报告的轮班工作评估的有效性在不同工作时间表之间存在差异。自我报告数据中的暴露错误分类可能导致在无夜班的轮班工作中出现向无效假设的偏差。
