Ropponen Annina, Koskinen Aki, Puttonen Sampsa, Ervasti Jenni, Kivimäki Mika, Oksanen Tuula, Härmä Mikko, Karhula Kati
Finnish Institute of Occupational Health, Helsinki, Finland.
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Chronobiol Int. 2022 Feb;39(2):233-240. doi: 10.1080/07420528.2021.1993238. Epub 2021 Nov 1.
Physicians often work long hours and on-call shifts, which may expose them to circadian misalignment and negative health outcomes. However, few studies have examined whether these working hour characteristics, ascertained using objective working hour records, are associated with the physicians' risk of sickness absence. We investigated the associations of 14 characteristics of payroll-based working hours and on-call work with the risk of short sickness absence among hospital physicians. In this cohort study, 2845 physicians from six Finnish hospital districts were linked to electronic payroll-based records of daily working hours, on-call duty and short (1-3 days) sickness absence between 2005 and 2019. A case-crossover design was applied using conditional logistic regression with the 28 day case and control windows to estimate odds ratios (ORs) and 95% confidence intervals (CI) for short sickness absence. After controlling for weekly working hours and the number of normal (≤12 h) shifts, a higher number of long (>12 h) shifts (ORs for ≥5 versus none: 2.54, 95% CI 1.68-3.84), very long (>24 h) shifts (ORs for ≥5 versus none: 2.62, 95%CI 1.61-4.27), and on-call shifts (OR for ≥5 versus none: 2.15, 95% CI 1.44-3.21) and a higher number of short (<11 h) shift intervals (OR for ≥5 versus none: 12.61, 95% CI 8.88-17.90) were all associated with the increased risk of short sickness absence. These associations did not differ between male and female physicians or between age groups. To conclude, the findings from objective working hour records show that long work shifts, on-call shifts and short shift intervals are related to the risk of short (1-3 days) sickness absence among hospital physicians.
医生经常长时间工作并值随叫随到的班，这可能使他们面临昼夜节律失调和负面健康后果。然而，很少有研究探讨使用客观工作时间记录确定的这些工作时间特征是否与医生因病缺勤的风险相关。我们调查了基于工资的工作时间和随叫随到工作的14个特征与医院医生短期因病缺勤风险之间的关联。在这项队列研究中，来自芬兰六个医院区的2845名医生与2005年至2019年期间基于电子工资记录的每日工作时间、随叫随到值班和短期（1 - 3天）因病缺勤情况相联系。采用病例交叉设计，使用条件逻辑回归和28天的病例及对照窗口来估计短期因病缺勤的优势比（OR）和95%置信区间（CI）。在控制每周工作时间和正常（≤12小时）班次数量后，较多的长（>12小时）班次（≥5次与无长班次相比的OR：2.54，95%CI 1.68 - 3.84）、超长（>24小时）班次（≥5次与无超长班次相比的OR：2.62，95%CI 1.61 - 4.27）、随叫随到班次（≥5次与无随叫随到班次相比的OR：2.15，95%CI 1.44 - 3.21）以及较多的短（<11小时）班次间隔（≥5次与无短班次间隔相比的OR：12.61，95%CI 8.88 - 17.90）均与短期因病缺勤风险增加相关。这些关联在男性和女性医生之间或年龄组之间没有差异。总之，客观工作时间记录的结果表明，长工作班次、随叫随到班次和短班次间隔与医院医生短期（1 - 3天）因病缺勤风险有关。
