Finnish Institute of Occupational Health, Helsinki, Finland.
Finnish Institute of Occupational Health, Helsinki, Finland.
Int J Nurs Stud. 2019 Mar;91:14-21. doi: 10.1016/j.ijnurstu.2018.11.002. Epub 2018 Dec 31.
Shift work characteristics, such as the number of night shifts or quick returns, are linked to disturbed sleep and greater work-life conflict, but little is known about their association with short sickness absences. Studies utilizing objective working-hour characteristic data can provide knowledge on specific shift work characteristics that may associate with sick leave. We investigated the association between working-hour characteristics in shift work and the incidence of short (1-3 days) sickness absences.
The individual-level data were collected from the employers' electronic working time records of the Finnish Public Sector study. The final analytical sample was restricted to the first incidence of short sickness absence (1-3 days) from January 1, 2008 to the end of 2015. We studied employees with shift work contracts (n = 12 156) and day work contracts (n = 6225). Of these, 89% were female workers, with a mean age of 37.1 years, and 12% worked part-time. We calculated type of shift (morning, day, evening, and night), quick returns (< 11 h between two work shifts), length of work shift and weekly working time. We utilized case-crossover study design to compare the working-hour characteristics of the 28 days preceding sickness absence (exposure window) and those of the 28 days before the exposure window (control window), using conditional logistic regression models for odds ratios with 95% Confidence Intervals (95%CI).
Exposure to ≥ 2, and especially ≥ 4 consecutive night shifts associated with an increased likelihood of short sickness absence (OR 1.24, 95%CI 1.12-1.38 and OR 1.54, 95%CI 1.10-2.15, respectively) among shift workers, whereas a high number (> 25%) of evening shifts and having ≥ 2 consecutive evening shifts associated with lower odds of sickness absence. Over 40-hour weeks (OR 1.29, 95%CI 1.20-1.39), over 48-hour weeks (OR 1.24, 95%CI 1.01-1.54) and quick returns (OR 1.02, 95%CI 1.01-1.02) increased the likelihood of sickness absence. Having only a few (0-1 or 2-3) quick returns over 28 days decreased the likelihood of sickness absence (ORs 0.46 and 0.67), whereas having ≥ 5 quick returns over 28 days increased it (OR 1.88, 95%CI 1.76-1.99). These associations were similar among both shift and day workers.
Long working hours, several consecutive night shifts and quick returns increase the risk of short sickness absence. These working-hour characteristics should be avoided in shift scheduling to minimize sickness absence and increased costs for the employer.
轮班工作的特点，如夜班的数量或快速倒班，与睡眠紊乱和更大的工作生活冲突有关，但人们对它们与短期病假缺勤的关联知之甚少。利用客观的工作时间特征数据进行的研究可以提供与病假缺勤相关的特定轮班工作特征的知识。我们研究了轮班工作中的工作时间特征与短期（1-3 天）病假缺勤的发生率之间的关系。
从芬兰公共部门研究的雇主电子工作时间记录中收集个人层面的数据。最终的分析样本仅限于 2008 年 1 月 1 日至 2015 年底首次出现短期病假缺勤（1-3 天）的情况。我们研究了轮班工作合同（n=12156）和日班工作合同（n=6225）的员工。其中，89%为女性，平均年龄为 37.1 岁，12%为兼职。我们计算了班次类型（早班、白班、晚班和夜班）、快速倒班（两次工作班次之间间隔时间<11 小时）、工作班次长度和每周工作时间。我们利用病例交叉研究设计，使用条件逻辑回归模型比较了病假前 28 天（暴露窗口）和暴露窗口前 28 天（对照窗口）的工作时间特征，使用比值比（OR）和 95%置信区间（95%CI）进行分析。
在轮班工人中，暴露于≥2 次，尤其是≥4 次连续夜班与短期病假缺勤的可能性增加相关（OR 1.24，95%CI 1.12-1.38 和 OR 1.54，95%CI 1.10-2.15），而高比例（>25%）的晚班和≥2 次连续晚班与病假缺勤的可能性降低相关。每周工作超过 40 小时（OR 1.29，95%CI 1.20-1.39）、每周工作超过 48 小时（OR 1.24，95%CI 1.01-1.54）和快速倒班（OR 1.02，95%CI 1.01-1.02）都会增加病假缺勤的可能性。在 28 天内仅有几次（0-1 次或 2-3 次）快速倒班会降低病假缺勤的可能性（ORs 0.46 和 0.67），而在 28 天内有≥5 次快速倒班则会增加病假缺勤的可能性（OR 1.88，95%CI 1.76-1.99）。这些关联在轮班和日班工人中均相似。
长时间工作、连续多个夜班和快速倒班会增加短期病假缺勤的风险。为了最小化病假缺勤和雇主成本增加，应避免在轮班安排中出现这些工作时间特征。
