Overtime and need for recovery in relation to job demands and job control

Effects of Mentorship on Surgery Residents' Burnout and Well-Being: A Scoping Review

BACKGROUND

In surgical training, a mentor is a more senior and experienced surgeon who guides a surgical trainee to meet personal, professional, and educational goals. Although mentorship is widely assumed to positively affect surgical residents' professional development, a more nuanced understanding of mentorship's impact is lacking and urgently needed as burnout rates among residents increase. This study aims to summarize the current literature on the effects of mentorship on surgical residents' burnout and well-being.

METHODS

A comprehensive literature review was performed with key terms related to "surgical resident" and "mentor" using Pubmed, Embase, and ProQuest databases for primary studies published in the United States or Canada from January 1, 2010 to December 9, 2022 that measured outcomes related to burnout and well-being. Multiple reviewers screened titles and abstracts for relevance, then full-text articles for eligibility.

RESULTS

Initial search resulted in 1,468 unique articles, and 19 articles were included after review. Only one article was a randomized controlled trial. Twelve studies described a decrease in burnout rates or in outcomes related to burnout. In contrast, 4 studies identified negative outcomes related to burnout. Six studies showed improved well-being or related outcomes. One study was not able to show a change in self-valuation between coached and noncoached residents.

CONCLUSION

High quality mentorship can be associated with improved well-being and decreased burnout in surgical residents, but the key elements of effective and helpful mentorship remain poorly characterized. This summary highlights the importance of making mentorship accessible to surgical residents, and training faculty to be effective mentors.

Job stressors and burnout among clinical nurses: a moderated mediation model of need for recovery and career calling

BACKGROUND

Burnout is a major concern in healthcare professions. Although theory and empirical evidence support the relationship between job stressors and burnout, the question remains how and when the job stressors are related to burnout. Based on conservation of resources theory and effort recovery model, the current study aimed to provide a deeper understanding of the effect of job stressors on burnout by investigating the mediating role of need for recovery and the moderating role of career calling.

METHODS

A cross-sectional online survey was conducted among 709 nurses enrolled from eight public hospitals in China. The Work Stressors Scale, Psychological Detachment Scale, Brief Calling Scale, and Maslach Burnout Inventory were used to collect data. Hierarchical regression analysis with bootstrapping procedure was performed to test the proposed model.

RESULTS

The results showed that need for recovery mediated the job stressors-burnout relationship, and that high career calling buffered against the relationships between job stressors and need for recovery and burnout. Furthermore, the result revealed a moderated mediation model that career calling buffered the indirect effect of job stressors on burnout through need for recovery.

CONCLUSIONS

Our findings suggest that environmental demands and personal resource are important antecedents of nurses' burnout. Career calling as personal resources can serve as a protective factor that guards against burnout. Thus, nursing managers can reduce nurse burnout by focusing on effective strategies related to recovery experiences, as well as investing in training career calling.

Work Time Control and Job Crafting as Predictors of Work Method Control Among Health Workers

Introduction

Nigerian dilapidated health sector is confronted with unprecedented work method control challenges caused by the ongoing COVID-19 crisis, which has changed the world of work, health, and well-being attainment. The COVID-19 pandemic has challenged work method control employed by the Nigerian health sector as they seek to mobilize leftover resources from embezzlement required to accomplish desired tasks and, as a result, altered the work methods, job descriptions, characteristics, and demands the attainment of organizational and personal goals.

Objective

Based on Job Demands-Resources Theory (JD-R) and Self-Determination Theory (SDT), the researchers' principal objective was to investigate the moderating role of job crafting in the relationship between work time control and work method control among Nigerian health workers during the COVID-19 pandemic.

Methods

The participants for this study comprised (220) health employees sampled through the purposive and convenient method. Three instruments, Breaugh's Work Autonomy Scale, Work Time Control Scale, and Job Crafting Questionnaire, were used for data collection, and hierarchical multiple regression was employed for data analysis.

Results

Results of this study showed that work time control and job crafting were positively associated with work method control of Nigerian health workers. Job crafting moderated the relationship between work time control and work method control. This research deepened the knowledge of work method control while integrating work time control, and job crafting, with other health and work challenges of health workers in the face of the COVID-19 pandemic. Second, COVID-19 has turned neglected Nigerian health workers into heroes as their work time control and job crafting helped manage the pandemic despite the poor infrastructure, corruption, bigotry, and ethnocentrism.

Conclusion

During pandemics, the work method must be understood and used with work time and job crafting to improve patient recovery, health workers' well-being, the nation, and the universe.

A Work Time Control Tradeoff in Flexible Work: Competitive Pathways to Need for Recovery

Work time control may offer opportunities, but also implies risks for employee recovery, influenced by increased work-related ICT use and overtime work. However, this risk-opportunity tradeoff remains understudied. This study aimed to test two different models of associations between work time control, work-related ICT use, overtime work, and the need for recovery. These models were constructed based on data on office workers with flexible work arrangements. Cross-sectional data were obtained with questionnaires (n = 2582) from employees in a Swedish multi-site organization. Regression models treated the three determinants of the need for recovery either as independent, or as linked in a causal sequence. The test of independent determinants confirmed that more work time control was associated with less need for recovery, whereas more ICT use and overtime work were associated with a higher need for recovery. In a test of serial mediation, more work time control contributed to a greater need for recovery through more ICT use and then more overtime work. Work time control also had a competitive, indirect effect through a negative association with overtime work. Our results suggest that work time control is beneficial for employee recovery, but may for some be associated with more work-related ICT use after regular working hours, thus increasing recovery needs. Policies that support work time control can promote recovery, but employers must attend to the risk of excessive use of ICT outside of regular working hours.

Where is the limit for overtime? Impacts of overtime on employees' mental health and potential solutions: A qualitative study in China

Although Labor Law of the People's Republic of China stipulates the overtime system, overtime is still widespread in the IT industry. Through qualitative interviews, we explored the impact of overtime on employees' mental health and life. The current study identified four main themes, namely overtime reasons, outcomes of overtime, influential factors and solutions to overtime challenges. Besides work-related reasons and cultural influence, it was found that employees may work overtime due to personal reasons, such as capability and personal qualities; the most frequent impacts reported were fatigue, depression, stress and interference with life; three predominant influential factors were timing of overtime, control and rewards; and overtime conditions could be improved in practical and emotional ways. The study's findings highlight the importance of the design of flexible working time arrangements for avoiding fatigue and improving employees' work-life balance, enhancement of schedule arrangement for avoiding daily work interruption and last-minute tasks, and optimization of rewarding systems for avoiding complaints and facilitating voluntary overtime. Results suggest that mental health and work-life balance can be promoted by organizational initiatives focusing on minimizing excessive job demands, increasing psychosocial resources, supporting boundary management, and enhancing perceived flexibility.

Are Psychosocial Resources Buffering the Relation Between Physical Work Behaviors and Need for Recovery?

Objectives: We investigate whether job control and/or social support at work play a buffering role in the relation between various physical work behaviors and Need for Recovery (NFR) among employees with physically demanding jobs. Methods: Our findings are based on data from 332 workers. The Job Content Questionnaire was used to assess job control, social support and specific physically demanding tasks. General physical work behaviors were measured by two Axivity AX3 accelerometers. The NFR Scale (0-11) was used to assess NFR. We used multiple linear regression models. Results: Sitting at work turned out to be negatively associated with NFR, whereas physically demanding tasks were associated positively with NFR. Our results show a significant buffering role for job control on the correlation between sitting, physically demanding tasks and NFR, but not for social support. Conclusion: Our findings suggest that higher job control might be beneficial to reduce high NFR and eventually may help to reduce early drop-out and sickness absence. Further research is called for to confirm the buffering role of job control and to investigate the underlying mechanisms.

Job stress and loneliness among desk workers during the COVID-19 pandemic in Japan: focus on remote working

Background

Previous studies have reported an increase in loneliness since the outbreak of coronavirus disease 2019 (COVID-19), but there are few data on the relationship between job stress and loneliness. This study aimed to assess the relationship between job stress and loneliness among desk workers, with a focus on the impact of remote working.

Methods

This study was part of the Collaborative Online Research on the Novel-coronavirus and Work (CORoNaWork) project in Japan. We extracted data from 13,468 workers who indicated that they were doing desk work. Loneliness was assessed using a single question and job stress was valuated using the Job Content Questionnaire (JCQ). Multiple logistic regression was performed.

Results

Participants who worked remotely 4 or more days per week were marginally more likely to report feeling lonely compared with those who did not work remotely (adjusted odds ratio = 1.23, 95% CI: 0.99–5.84, P = 0.066). Remote working did not explain the interaction between JCQ scale scores and loneliness. Among remote workers, the level of support provided by co-workers and supervisors was strongly associated with feelings of loneliness as well as non-remote workers (co-worker support: AOR = 4.06, 95% CI: 2.82–5.84, P < 0.001; supervisor support: AOR = 2.49, 95% CI: 1.79–3.47, P < 0.001).

Conclusions

To reduce loneliness and the risk of associated mental health problems, high-frequency remote workers should interact with supervisors and co-workers using the information and communication technology developed for this purpose.

Well-Being Intervention in General Surgery: Multicenter Study of Program Director and Resident Perspectives

BACKGROUND

Physician well-being is critical for optimal care, but rates of psychological distress among surgical trainees are rising. Although numerous efforts have been made, the perceived efficacy of well-being interventions is not well understood.

STUDY DESIGN

This qualitative thematic study included online questionnaires to Program Directors (PDs) and residents at 16 ACGME-accredited General Surgery residency programs. PDs reported active well-being interventions for surgical residents or those under consideration at their institutions. Residents shared perspectives of available well-being interventions through open-ended responses. Conventional content analysis was used to analyze responses.

RESULTS

Fifteen PDs, or their proxies (94% response rate), responded. Responses revealed that a majority of available well-being interventions are focused on changing the individual experience rather than the underlying workplace. PD decision-making around well-being interventions is often not based on objective data. Three hundred residents (34% response rate) responded. Of available interventions, those that increase control (eg advanced and flexible scheduling), increase support (eg mentorship), and decrease demand (eg work hour limits) were consistently identified as beneficial, but interventions perceived to increase demand (eg held during unprotected time) were consistently identified as not beneficial. Group social activities, cognitive skills training, and well-being committees were variably seen as beneficial (increasing support) or not (increasing demand).

CONCLUSIONS

Our findings underscore the prevalence of individual-based well-being interventions and the paucity of system-level changes. This may explain, in part, the persistence of distress among residents despite abundant effort, highlighting the imperative for system-level transformation.

Is Work Time Control Good for Innovation? A Two-Stage Study to Verify the Mediating and Moderating Processes

As a part of job resources, work time control is essential for innovation. We examine how work time control impacts knowledge employees’ innovation in the workplace. A two-stage study was conducted to verify the mediating and moderating processes. In Study 1, adopting the job demands–resources model as a theoretical framework, we conducted a laboratory test to find the relation between work time control, job engagement, job burnout, and innovation, and verified the path between work time control and innovation. In Study 2, drawing on the job demands–resources model verified by Study 1 and self-regulation theory, it is proposed that during the psychological process in the workplace, job engagement plays a mediating role, and the vocational delay of gratification plays a moderating role between work time control and innovation. A total of 254 knowledge employees from diverse organizations participated in the survey study. After taking demographic variables, job demands, and neuroticism as control variables, the results showed that job engagement would mediate the relationship between work time control and innovation. A higher level of delay of gratification buffered the effect of a higher level of work time control on innovation. All these findings verified and expanded knowledge on work time control and innovation literature, showing that work time control is important for innovation. Based on Chinese cultural background, managers should offer employees the opportunity to conduct self-control training and encourage them with great freedom to foster employee innovation.

Boundaryless working hours and recovery in Germany

OBJECTIVE

Due to recent trends such as globalization and digitalization, more and more employees tend to have flexible working time arrangements, including boundaryless working hours. The aim of this study was to investigate the relationships of various aspects of boundaryless working hours (overtime, Sunday work, and extended work availability) with employees' state of recovery. Besides, we examined the mediating and moderating role of recovery experiences (psychological detachment, relaxation, mastery, and control) in these relationships.

METHODS

We used data from 8586 employees (48% women; average age of 48 years) who took part in the 2017 BAuA-Working Time Survey, a representative study of the German working population. Regression analyses were conducted to test main effects as well as mediation and moderation.

RESULTS

Overtime work, Sunday work, and extended work availability were negatively related to state of recovery. Psychological detachment mediated these relationships. Furthermore, we found that relaxation and control mediated the association between extended work availability and state of recovery. However, no relevant moderating effects were found.

CONCLUSIONS

Altogether, our findings indicate that various aspects of boundaryless working hours pose a risk to employees' state of recovery and that especially psychological detachment is a potential mechanism in these relationships. In addition, the results suggest that a high level of recovery experiences cannot attenuate these negative relationships in leisure time. Therefore, employers and employees alike should try to avoid or minimize boundaryless working hours.

More Than Just "Stressful"? Testing the Mediating Role of Fatigue on the Relationship Between Job Stress and Occupational Crashes of Long-Haul Truck Drivers

Introduction

Recent evidence consistently highlights the adverse work environment of long-haul professional drivers, whose task structure typically involves the performance of extensive shifts, driving under stressful working conditions. In this regard, job stress and fatigue - that are highly prevalent in this workforce - seem to play a crucial role in explaining this group's negative traffic safety outcomes. The aim of this study was to assess whether work-related fatigue is a mechanism that mediates the relationship between job stress, health indicators and occupational traffic crashes of long-haul truck drivers (LHTD).

Methods

The data used in this study were collected from 521 Spanish long-haul truck drivers (97% males) from all 17 regions of Spain, with a mean age of 47 years.

Results

Utilizing structural equation models (SEM), it was found that work-traffic crashes of long-haul truck drivers could be explained through work-related fatigue that exerts a full mediation between job stress (job strain), health-related factors and traffic crashes suffered during the previous two years.

Discussion

Overall, the findings of this research support that a) stressful working conditions and health issues of drivers have significant effects on traffic crashes, and b) fatigue is a mechanism relating stress-related factors and work-traffic crashes of long-haul drivers. This study highlights the need of stress- and fatigue-management policies and interventions, in order to reduce the crash risk of long-haul truck drivers.

Assessment of Need for Recovery and Its Relationship With Work Characteristics and Health in a Sample of Chinese Doctors: A Cross-Sectional Survey

Background: China is launching an unprecedented health care system reform. However, the long-term interests of doctors seem to have been ignored during this process especially considering that the work environment and work-life balance for doctors have severely deteriorated over the past decade.Their well-being and health are facing substantial threats due to heavy workloads and inadequate recovery opportunities. This study aimed to investigate the extent of need for recovery (NFR) among Chinese doctors and to examine their work-related fatigue. The study also examines the relationship of NFR with workplace satisfaction and health outcomes among Chinese doctors.

Methods: A total of 2,617 doctors from 30 administrative regions in China participated in this study to assess the need for recovery and its relationship with work characteristics and health. A cross-sectional survey was conducted using the Chinese version of the Need for Recovery Scale (NFRS). Participants were invited to complete an anonymous online survey during May 2016. Data were analyzed using descriptive statistics, one-way ANOVA, reliability analysis, Pearson correlations, and hierarchical multiple regression analysis.

Results: Significant differences in NFR scores were found across demographic characteristics such as age, service years, hospital levels, educational attainment, professional positions, work shifts, and working time. Regardless of any illnesses they might be experiencing, about 70.0% of participants remained at their job even though many doctors (22.1%) must continue working under the policies of the organization, which led to more pronounced NFR (P < 0.001). Further, a higher NFR was negatively related to workplace well-being and self-reported health outcomes of participants.

Conclusions: Work-induced fatigue is a growing threat to doctors in China and their recovery opportunities are extremely limited in the workplace. High NFR exerts a considerable effect on their workplace well-being and health. China's hospital managers should pay close attention to the fact that doctors have little chance of recovery, and should offer doctors' positive encouragement and support to enhance well-being. To improve doctors' working conditions, targeted prevention policies must be introduced by policymakers to control this spreading crisis.

Fatigue and recovery in shiftworking nurses: A scoping literature review

OBJECTIVES

To identify factors impeding or enhancing recovery from fatigue in shiftworking nurses.

DESIGN

Scoping literature review methodology was implemented to identify key concepts around recovery from fatigue in shiftworking nurses to provide a narrative around these paradigms.

DATA SOURCES

Five electronic data bases were searched: CINAHL, MEDLINE, PROQUEST Health and Medicine, ScienceDirect and PsycINFO to identify primary studies on fatigue and recovery in shiftworking nurses from 2000 to 2019 inclusive.

REVIEW METHODS

Preliminary searches were completed between September and December 2017 and finalised in January 2020. Research was drawn from nursing only samples employed under shiftwork scheduling.

RESULTS

31 studies were included in this scoping review. Factors impeding and enhancing recovery at work and home are identified as impacting on fatigue outcomes. Findings indicate recovery from fatigue in shiftworking nurses are most significantly affected by high work and job demands and the 'when' and 'how' of shiftwork scheduling; all reported to impede recovery from shiftwork related fatigue. The most noteworthy facilitators of recovery were work control and control over shiftwork scheduling, break opportunities at work, age and being part of a family structure. There was a dearth of research identified around the time frames of the progression from acute to chronic fatigue and the in-depth role of recovery in this transition. As chronic or long-term fatigue can develop from an acute or recoverable fatigue this may significantly impact on shiftworking nurses' health and wellbeing.

CONCLUSIONS

This scoping review highlights the complicated nature of shiftwork scheduling and the impact it can have on recovery from fatigue in shiftworking nurses. Multiple methods and ways of measuring fatigue, recovery and shiftwork were identified in the studies. The results describe factors impeding and enhancing recovery from fatigue as occurring within both the workplace and during time away from work. Thus, this review provides improved understanding of the barriers and facilitators in recovery from fatigue and the potential accumulation of fatigue over time. These findings are important for shiftworking nurses, nursing managers and hospital administrators, and society, who are dependant on nurses' care.

Long work hours and decreased glomerular filtration rate in the Korean working population

OBJECTIVES

We studied the association between long working hours and decreased kidney function, which was determined using estimated glomerular filtration rate (eGFR), among the working population in South Korea.

METHODS

We analysed nationally representative cross-sectional data for 20 851 Korean workers ≥20 years of age. A negative binomial regression model was used to test differences in the prevalence of chronic kidney disease (eGFR <60 mL/min/1.73 m²) among workers divided into groups according to weekly working hours (<30, 30-40, 41-51 and ≥52 hours/week). Multivariate linear regression analysis was performed to investigate the association between weekly working hours and eGFR, with adjustments made for age, sex/gender, income, education, shift work, occupation, smoking, alcohol use, hypertension, diabetes mellitus, body mass index, systolic blood pressure, fasting blood glucose and total serum cholesterol.

RESULTS

A 1-hour increase in weekly working hours was associated with 0.057 mL/min/1.73 m² (95% CI 0.005 to 0.109) decrease in eGFR among participants who worked ≥52 hours/week. Among participants without hypertension or diabetes, a 1-hour increase in weekly working hours was significantly associated with 0.248 and 0.209 mL/min/1.73 m² decrease in eGFR among participants who worked 30-40 hours/week and 41-51 hours/week, respectively.

CONCLUSION

Long working hours are associated with decreased kidney function. We expect that our findings could call for more research regarding this association and provide policy-oriented perspectives.

Factors influencing the need for recovery in employees with hearing loss: a cross-sectional study of health administrative data

Objective

Need for recovery is a predictor of work stress and health problems, but its underlying factors are not yet well understood. We aimed to identify hearing-related, work-related, and personal factors influencing need for recovery in hearing-impaired employees.

Methods

We retrospectively identified hearing-impaired employees (N = 294) that were referred to the Amsterdam University Medical Center between 2004 and 2019. Routinely obtained healthcare data were used, including a survey and hearing assessments. A directed acyclic graph was constructed, revealing the hypothesized structure of factors influencing need for recovery as well as the minimal set of factors needed for multiple regression analysis.

Results

Four variables were included in the regression analysis. In total, 46.1% of the variance in need for recovery was explained by the factors feeling that something should change at work (B = 19.01, p < 0.001), self-perceived listening effort (B = 1.84, p < 0.001), personal adaptations scale score (B = − 0.34, p < .001), and having a moderate/poor general health condition (B = 20.06, p < 0.001). Although degree of hearing loss was associated with self-perceived listening effort, the direct association between degree of hearing loss and need for recovery was not significant.

Conclusions

The results suggest that the way employees perceive their hearing loss and how they cope with it directly influence need for recovery, rather than their measured degree of hearing loss. Additionally, general health condition was found to be an independent factor for need for recovery. The results should be confirmed by future, longitudinal research.

The impact of occupational activities during pregnancy on pregnancy outcomes: a systematic review and metaanalysis

OBJECTIVE

Data: An increasing number of studies suggest that exposure to physically demanding work during pregnancy could be associated with increased risks of adverse pregnancy outcomes, but the results remain conflicted and inconclusive. The purpose of this study was to examine the influence of occupational activities during pregnancy on maternal and fetal health outcomes.

STUDY

Studies of all designs (except case studies and reviews) that contained information on the relevant population (women who engaged in paid work during pregnancy), occupational exposures (heavy lifting, prolonged standing, prolonged walking, prolonged bending, and heavy physical workload), comparator (no exposure to the listed physical work demands), and outcomes (preterm birth, low birthweight, small for gestational age, miscarriage, gestational hypertension, preeclampsia, gestational diabetes mellitus, stillbirth, and intrauterine growth restriction) were included.

STUDY APPRAISAL AND SYNTHESIS METHODS

Five electronic databases and 3 gray literature sources were searched up to March 15, 2019.

RESULTS

Eighty observational studies (N=853,149) were included. Low-to-very low certainty evidence revealed that lifting objects ≥11 kg was associated with an increased odds ratio of miscarriage (odds ratio, 1.31; 95% confidence interval, 1.08-1.58; I²=79%), and preeclampsia (odds ratio, 1.35; 95% confidence interval, 1.07-1.71; I²=0%). Lifting objects for a combined weight of ≥100 kg per day was associated with an increased odds of preterm delivery (odds ratio, 1.31; 95% confidence interval, 1.11-1.56; I²=0%) and having a low birthweight neonate (odds ratio, 2.08; 95% confidence interval, 1.06-4.11; I²=73%). Prolonged standing was associated with increased odds of preterm delivery (odds ratio, 1.11; 95% confidence interval, 1.02-1.22; I²=30%) and having a small-for-gestational-age neonate (odds ratio, 1.17; 95% confidence interval, 1.01-1.35; I²=41%). A heavy physical workload was associated with increased odds of preterm delivery (odds ratio, 1.23; 95% confidence interval, 1.07-1.41; I²=32%) and having a low birthweight neonate (odds ratio, 1.79; 95% confidence interval, 1.11-2.87; I²=87%). All other associations were not statistically significant. Dose-response analysis showed women stand for >2.5 hours per day (vs no standing) had a 10% increase in the odds of having a preterm delivery.

CONCLUSION

Physically demanding work during pregnancy is associated with an increased risk of adverse pregnancy outcomes.

The impact of occupational shift work and working hours during pregnancy on health outcomes: a systematic review and meta-analysis

BACKGROUD

An increasing number of original studies suggest that exposure to shift work and long working hours during pregnancy could be associated with the risk of adverse pregnancy outcomes, but the results remain conflicting and inconclusive.

OBJECTIVE

To examine the influences of shift work and longer working hours during pregnancy on maternal and fetal health outcomes.

DATA SOURCES

Five electronic databases and 3 gray literature sources were searched up to March 15, 2019.

METHODS OF STUDY SELECTION

Studies of all designs (except case studies and reviews) were included, which contained information on the relevant population (women who engaged in paid work during pregnancy); exposure (rotating shift work [shifts change according to a set schedule], fixed night shift [typical working period is between 11:00 pm and 11:00 am] or longer working hours [>40 hours per week]);comparator (fixed day shift [typical working period is between 8:00 am and 6:00 pm] or standard working hours [≤40 hours per week]); and outcomes (preterm delivery, low birthweight [birthweight <2500 g], small for gestational age, miscarriage, gestational hypertension, preeclampsia, intrauterine growth restriction, stillbirth, and gestational diabetes mellitus).

TABULATION, INTEGRATION, AND RESULTS

From 3305 unique citations, 62 observational studies (196,989 women) were included. "Low" to "very low" certainty evidence from these studies revealed that working rotating shifts was associated with an increased odds of preterm delivery (odds ratio, 1.13; 95% confidence interval, 1.00-1.28, I² = 31%), an infant small for gestational age (odds ratio, 1.18, 95% confidence interval, 1.01-1.38, I² = 0%), preeclampsia (odds ratio, 1.75, 95% confidence interval, 1.01-3.01, I² = 75%), and gestational hypertension (odds ratio, 1.19, 95% confidence interval, 1.10-1.29, I² = 0%), compared to those who worked a fixed day shift. Working fixed night shifts was associated with an increased odds of preterm delivery (odds ratio, 1.21; 95% confidence interval, 1.03-1.42; I² = 36%) and miscarriage (odds ratio, 1.23; 95% confidence interval, 1.03-1.47; I² = 37%). Compared with standard hours, working longer hours was associated with an increased odds of miscarriage (odds ratio, 1.38; 95% confidence interval, 1.08-1.77; I² = 73%), preterm delivery (odds ratio, 1.21; 95% confidence interval, 1.11-1.33; I² = 30%), an infant of low birthweight (odds ratio, 1.43; 95% confidence interval, 1.11-1.84; I² = 0%), or an infant small for gestational age (odds ratio, 1.16, 95% confidence interval, 1.00-1.36, I² = 57%). Dose-response analysis showed that women working more than 55.5 hours (vs 40 hours) per week had a 10% increase in the odds of having a preterm delivery.

CONCLUSION

Pregnant women who work rotating shifts, fixed night shifts, or longer hours have an increased risk of adverse pregnancy outcomes.

Solidarity, job satisfaction, and turnover intent in employees

Purpose

While the role of solidarity in the workplace has been examined in previous research, it is still an important component of the workplace for Japanese employees. The purpose of this paper is to integrate findings on solidarity at the workplace, job satisfaction and intent to turnover. A moderated mediation model is hypothesized where solidarity predicts intent to turnover via job satisfaction, but the strength of this whole mediation process is moderated by employees’ length of working overtime or working long hours.

Design/methodology/approach

The data analyzed in this study were acquired from the Japanese General Social Survey 2010, which was administered to 527 men and 278 women.

Findings

The results generally supported the assumptions; the proposed mediation model proved to be statistically significant, even when background covariates were introduced into the model to control for pre-existing differences. Also, the proposed moderated mediation model was supported; solidarity strongly increased job satisfaction when working overtime was low.

Research limitations/implications

Because of measurement of solidarity, this study results may limit the generalizability. Researchers should explore the relationship between the dimension of solidarity and job satisfaction.

Practical implications

The paper includes the implications for human resource management, the developing of solidarity at the workplace and for managing the strain of working overtime.

Originality/value

This study was the first to examine the relationship between solidarity at the workplace and job satisfaction and the moderating effects of working overtime.

Assessing and preventing low back pain in nurses. Implications for practice management

Background and aims:

The prevention of low back pain (LBP) among nurses employed in hospital departments represents a special concern for healthcare organizations globally. A growing literature evidences the need of workplace policy development related to organizational issues as strategic contribution to minimize the occurrence of LBP in healthcare sector. The purposes of this study were: 1) to analyze the relationship between shiftwork and acute LBP among female shift nurses; 2) to detect preventive interventions targeted on organizational issues.

Methods:

The authors conducted a cross-sectional nested case-control analysis of data concerning acute LBP and staffing data for 671 nurses employed in the Departments of General Practice and Elderly Care Medicine. The statistical analysis consisted of a logistic regression to calculate incidence odds ratios with 95% confidence intervals. Chi-square test and t-test were used to examine the relationship between categorical and continuous data, respectively.

Results:

The occurrence of acute LBP resulted significantly related to nightshift, extended shifts, obesity; the adoption of forward rotating schedules was found a protective factor in moderating the occupational risk of acute LBP in shift nurses.

Conclusions:

In this study the authors observed an association between shiftwork and acute LBP; improvement interventions should be aimed at: 1) moderating organizational risks linked with shiftwork schedules; 2) promoting healthy lifestyles. These interventions are suggested as a strategic way to effectively manage the phenomenon among female rotating shift nurses. (www.actabiomedica.it)

It's Been a Hard Day's Night and I've Been Working Like a Dog: Workaholism and Work Engagement in the JD-R Model

The study investigates if the job-demands resources (JD-R) model could be improved by including workaholism in its health impairment process. Salient predictors and antecedents of workaholism and work engagement are identified in a sample of 12170 employees at Norwegian universities and university colleges. Structural equation modeling suggested that job demands and job resources relate to workaholism and work engagement, respectively. The results also revealed that both workaholics and work-engaged employees put in more hours at work than was expected of them. We found that workaholism was negatively related to work-related health, whereas work engagement was positively related to work-related health. These findings support the notion of workaholism and work engagement as two different forms of working hard. Finally, we tested the buffer hypothesis that job resources would moderate the effect of job demands on workaholism. The moderations were in the expected direction, but effect sizes were weaker than those typically reported in previous investigations. In conclusion, the present study supports the expansion of including workaholism in the JD-R model.

Map Changes and Theme Evolution in Work Hours: A Co-Word Analysis

(1) Background: Work hours are the basic carrier impacting employees' work⁻life experience and organizational performance, and employees have greater anxiety in relation to work hours as new technology requires an increasingly faster work rhythm. However, scientific research on this topic lags far behind the practice, calling to attention the need for research on work hours from the perspective of historical evolution; (2) Methods: The Bibliometric method is used to analyze the 6364 articles and their contained 77 high-frequency keywords related to work hours from the Web of Science published between 1901 and 2017. Additionally, an individual⁻organization⁻society integrative perspective was adopted to describe the map changes and theme evolution of work hours; (3) Results and conclusions: The hot spots of research at the organizational level changed significantly around 1990, with the theme of "long work hours" becoming the core issue in recent years. Studies on the individual level have gradually moved from physiological aspects to the issues of burnout and psychological distress. Research topics related to the social level are somewhat loose, and mainly focused on work⁻life conflict areas. In addition, the cluster analysis based on the high-frequency keywords classifies six research types according to their research themes. Based on these findings, future trends are proposed to provide theoretical and practical reference for future studies.

The Relationship Between Working Time and Ill Health

Abstract: Several studies have investigated the relationship between working time and health; however, an adequate comparison of this relationship among full-time and part-time workers is still missing. Therefore, this study aimed to fill this gap in the literature. We investigated several aspects of working time: weekly overtime, monthly on-call duties, monthly shift work, and adherence to breaks. To assess health, we investigated sleeping problems, cognitive irritation, and emotional exhaustion. Data were collected from 812 hospital physicians. We tested our assumptions with a group comparison using structural equation modeling. Overtime and adherence to breaks were shown to be health-relevant factors, particularly for full-time workers, whereas night and weekend shifts were more relevant for part-time workers’ health. On-call duties were less relevant for both groups. The inclusion of time pressure and autonomy caused different changes. The results of this study illustrate that personal needs should be considered when scheduling working time to promote health.

Stress-related psychosocial factors at work, fatigue, and risky driving behavior in bus rapid transport (BRT) drivers

INTRODUCTION

There is consistent scientific evidence that professional drivers constitute an occupational group that is highly exposed to work related stressors. Furthermore, several recent studies associate work stress and fatigue with unsafe and counterproductive work behaviors. This study examines the association between stress-related work conditions of Bus Rapid Transport (BRT) drivers and risky driving behaviors; and examines whether fatigue is a mechanism that mediates the association between the two.

METHOD

A sample of 524 male Bus Rapid Transit (BRT) operators were drawn from four transport companies in Bogotá, Colombia. The participants answered a survey which included an adapted version of the Driver Behavior Questionnaire (DBQ) for BRT operators, as well as the Effort-Reward Imbalance and Job Content Questionnaires, the Subjective Fatigue subscale of the Checklist Individual Strength (CIS) and the Need for Recovery after Work Scale (NFR).

RESULTS

Utilizing Structural Equation Models (SEM) it was found that risky driving behaviors in BRT operators could be predicted through job strain, effort-reward imbalance and social support at work. It was also found that fatigue and need for recovery fully mediate the associations between job strain and risky driving, and between social support and risky driving, but not the association between effort/reward imbalance (ERI) and risky driving.

CONCLUSIONS

The results of this study suggest that a) stress related working conditions (Job Strain, Social Support and ERI) are relevant predictors of risky driving in BRT operators, and b) that fatigue is the mechanism which links another kind of stress related to working conditions (job strain and low social support) with risky driving. The mechanism by which ERI increases risky driving in BRT operators remains unexplained.

PRACTICAL APPLICATIONS

This research suggests that in addition to the individual centered stress-reduction occupational programs, fatigue management interventions aimed to changing some working conditions may reduce risky driving behaviors and promote safety in the professional drivers' jobs and on the road.

Work environment, overtime and sleep among offshore personnel

Personnel working on North Sea oil/gas installations are exposed to remote and potentially hazardous environments, and to extended work schedules (typically, 14×12h shifts). Moreover, overtime (additional to the standard 84-h week) is not uncommon among offshore personnel. Evidence from onshore research suggests that long work hours and adverse environmental characteristics are associated with sleep impairments, and consequently with health and safety risks, including accidents and injuries. However, little is known about the extent to which long hours and a demanding work environment combine synergistically in relation to sleep. The present study sought to address this issue, using survey data collected from offshore day-shift personnel (N=551). The multivariate analysis examined the additive and interactive effects of overtime and measures of the psychosocial/physical work environment (job demands, job control, supervisor support, and physical stressors) as predictors of sleep outcomes during offshore work weeks. Control variables, including age and sleep during leave weeks, were also included in the analysis model. Sleep duration and quality were significantly impaired among those who worked overtime (54% of the participants) relative to those who worked only 12-h shifts. A linear relationship was found between long overtime hours and short sleep duration; personnel who worked >33h/week overtime reported <6h/day sleep. Significant interactions were also found; sleep duration was negatively related to job demands, and positively related to supervisor support, only among personnel who worked overtime. Poor sleep quality was predicted by the additive effects of overtime, low support and an adverse physical environment. These findings highlight the need to further examine the potential health and safety consequences of impaired sleep associated with high overtime rates offshore, and to identify the extent to which adverse effects of overtime can be mitigated by favourable physical and psychosocial work environment characteristics.

The crossover effect of spouses' long working hours on depressive symptoms and suicidal ideation

To examine the association between spouses' weekly working hours (SWWH) and psychological symptoms such as depressive symptom and suicidal ideation. We used data from the fourth and fifth Korean National Health and Nutrition Examination Survey (2007-2012). We collected information about general characteristics, depressive symptoms, suicidal ideation, and working hours. After inclusion and exclusion criteria were applied, a sample of 8,056 house units was used for analysis. A multiple logistic regression was conducted to investigate the association between SWWH and depressive symptoms, as well as suicidal ideation, to estimate the odds ratio (OR). The relationship between SWWH and psychological symptoms were linear in husbands, and J-shaped in wives. ORs for husbands' depressive symptoms and suicidal ideation increased according to increase in SWWH (p-values for trend were 0.0045 and <0.001, respectively). Crude ORs for wives' depressive symptoms and suicidal ideation decreased until SWWH of 40 to 49 hours, but increased after SWWH of 40 to 49 hours (all p-values were below 0.01). Similar trends were observed after adjustment for age, obesity, household income, and one's own weekly working hours, up to 1.33 and 1.57 in husbands, and 1.29 and 1.32 in wives, respectively. SWWH is negatively associated with mental health.

Patients with burnout in relation to gender and a general population

Aims: The aims of this study were to describe gender differences in patients with burnout and compare these patients with a general population with respect to physical, psychosocial and work variables. Methods: Data were collected from a total of 136 patients (96 women and 40 men, 41,6 ± 7,4 years), diagnosed with stress-related disease and burnout at the Stress Clinic, University Hospital of Umeå. Data on burnout, physical, psychosocial and work characteristics were compared with similar data from a geographical and age-matched population based survey, the 2004 Northern Sweden MONICA study. The survey sample included a total of 573 participants (283 women and 290 men, 40,7 ± 8,5 years). Results: Women with burnout reported a higher rate of impaired awakening, lower job control, greater proportion of unpaid work and worked to a greater extent ``with people'' compared to men. Men with burnout had a more restricted social network and reported working more overtime than women. Patients with burnout reported a higher rate of unemployment, a more restricted social network and higher work demands compared to a general population. Women with burnout reported less emotional support, a more sedentary work situation, high job strain and worked to a greater extent ``with people'' than women from the general population. Conclusions: There are some differences in working conditions and social network between women and men with burnout. Patients with burnout differ from a general population regarding individual and social factors as well as work-related factors.

Long working hours may increase risk of coronary heart disease

OBJECTIVE

To evaluate the association between long working hours and risk of coronary heart disease (CHD) estimated by Framingham risk score (FRS) in Korean adults.

METHODS

This study evaluated adult participants in Korean National Health and Nutrition Examination Survey IV (2007-2009). After inclusion and exclusion criteria were applied, the final sample size for this study model was 8,350. Subjects were asked about working hours and health status. Participants also completed physical examinations and biochemical measurement necessary for estimation of FRS. Multiple logistic regression was conducted to investigate the association between working hours and 10-year risk for CHD estimated by FRS.

RESULTS

Compared to those who work 31-40 hr, significantly higher 10-year risk was estimated among subjects working longer hours. As working hours increased, odds ratio (OR) for upper 10 percent of estimated 10-year risk for CHD was increased up to 1.94.

CONCLUSIONS

Long working hours are significantly related to risk of coronary heart disease.

Negative impacts of shiftwork and long work hours

PURPOSE

Healthcare organizations often have to provide patient care around the clock. Shift work (any shift outside of 7 a.m. to 6 p.m) and long work hours increase the risk for short sleep duration and sleep disturbances. Thirty-two percent of healthcare workers report they do not get enough sleep. The purpose of the article is to give an overview of the wide range of risks to nurses, patients, and employers that are linked to shift work, long work hours, and poor sleep from other sources.

FINDINGS

Shift work and long work hours increase the risk for reduced performance on the job, obesity, injuries, and a wide range of chronic diseases. In addition, fatigue-related errors could harm patients. Fatigued nurses also endanger others during their commute to and from work.

CONCLUSION AND CLINICAL RELEVANCE

The key strategy to reduce these risks is making sleep a priority in the employer's systems for organizing work and in the nurse's personal life.

Associations between overweight, obesity, health measures and need for recovery in office employees: a cross-sectional analysis

Background

With both a high need for recovery (NFR) and overweight and obesity being a potential burden for organizations (e.g. productivity loss and sickness absence), the aim of this paper was to examine the associations between overweight and obesity and several other health measures and NFR in office workers.

Methods

Baseline data of 412 office employees participating in a randomised controlled trial aimed at improving NFR in office workers were used. Associations between self-reported BMI categories (normal body weight, overweight, obesity) and several other health measures (general health, mental health, sleep quality, stress and vitality) with NFR were examined. Unadjusted and adjusted linear regression analyses were performed and adjusted for age, education and job demands. In addition, we adjusted for general health in the association between overweight and obesity and NFR.

Results

A significant positive association was observed between stress and NFR (B = 18.04, 95%CI:14.53-21.56). General health, mental health, sleep quality and vitality were negatively associated with NFR (p < 0.001). Analyses also showed a significant positive association between obesity and NFR (B = 8.77, 95%CI:0.01-17.56), but not between overweight and NFR.

Conclusions

The findings suggest that self-reported stress is, and obesity may be, associated with a higher NFR. Additionally, the results imply that health measures that indicate a better health are associated with a lower NFR.

Trial registration

The trial is registered at the Dutch Trial Register (NTR) under trial registration number: NTR2553.

Avaliação de diferentes parâmetros para interpretar a necessidade de descanso em ergonomia

INTRODUÇÃO: A Escala de Necessidade de Descanso (Enede) tem sido amplamente utilizada na ergonomia. No entanto, não há ponto de corte validado na literatura que permita identificar de forma consensual altos níveis de necessidade de descanso. OBJETIVO: Comparar a utilização de diferentes parâmetros matemáticos para interpretação dos dados da Enede, sendo eles tercil, quartil e média, assim como pontos de corte já sugeridos pela literatura, no sentido de investigar o comportamento desses parâmetros na identificação de altos níveis de necessidade de descanso. MATERIAIS E MÉTODOS: Participaram do estudo 679 trabalhadores, sendo 192 trabalhadores da indústria, 128 profissionais de enfermagem e 359 operadores de teleatendimento. A coleta de dados foi realizada pela aplicação de questionários. RESULTADOS: A distribuição dos resultados variou consideravelmente entre os grupos. As separatrizes definidas com base na distribuição dos dados (tercil e quartil) apresentaram valores semelhantes a alguns pontos de corte descritos na literatura. Os diferentes pontos de corte propostos pela literatura não identificaram quantidades similares de trabalhadores com altos níveis de necessidade de descanso. A distribuição não normal de duas das populações mostrou que a média pode não ser um parâmetro adequado. DISCUSSÃO E CONCLUSÕES: Os diferentes parâmetros matemáticos utilizados para identificar altos níveis de necessidade de descanso não conduziram a resultados equivalentes, sugerindo cautela na sua seleção. Até que estudos com maiores populações estejam disponíveis, a utilização da própria distribuição dos dados de um grupo é mais recomendada que a utilização de pontos fixos para identificar altos níveis de necessidade de descanso.

Association of job strain with working hours, shift-dependent perceived workload, sleepiness and recovery

We explored the relationship of job strain with working hours, shift-dependent perceived workload, sleepiness and recovery. Nurses/nursing assistants (n = 95) were recruited from wards that belonged to either the top (high-strain group, HJS) or the bottom (low-strain group, LJS) job strain quartiles of a Job Content Questionnaire survey of employees in five health care districts and four cities in Finland. Three-week field measurements during naturally occurring shift schedules and a subset of pre-selected shift arrangements consisted of the Karolinska Sleepiness Scale, perceived workload and recovery. The HJS group (n = 42) had more single days off and quick returns than the LJS group (n = 53, p < 0.01), and both mental workload and physical workload were rated as higher (p < 0.01). During naturally occurring shift arrangements, severe sleepiness was more common in the HJS group only in quick returns (p = 0.04) and the HJS group recovered on average more poorly from work after all shifts (p = 0.01) and morning shifts (p = 0.02). During pre-selected shift arrangements, the differences between the groups were only minor. In conclusion, job strain-related differences in sleepiness and recovery were mostly attributable to differences in shift arrangements.

Job-related resources and the pressures of working life

Data from a 2011 representative sample of Canadian workers are used to test the resource versus the stress of higher status hypotheses. Drawing on the Job Demands-Resources model (JD-R), the resource hypothesis predicts that job-related resources reduce job pressure. The stress of higher status hypothesis predicts that job-related resources increase job pressure. Findings tend to favor the resource hypothesis for job autonomy and schedule control, while supporting the stress of higher status for job authority and challenging work. These findings help elaborate on the "resource" concept in the JD-R model and identify unique ways that such resources might contribute to the pressures of working life.

The influence of psychosocial work characteristics on the need for recovery from work: a prospective study among computer workers

PURPOSE

To investigate the influence of high job demands, low job control, and high social support on need for recovery (NFR) among computer workers.

METHODS

Data was obtained from a longitudinal cohort study, including 5 consecutive measurements, with an in-between period of 6 months. General estimating equations analyses were performed to assess the risk for high NFR 6 months later. Odds ratios (ORs) for high NFR were calculated for high job demands, low job control and low social support, separately. Likewise, ORs were calculated for combinations of job demands and job control, as well as for combinations of job demands, job control and social support.

RESULTS

High job demands resulted in an increased risk for high NFR 6 months later, particularly in older workers. Low social support showed also an increased risk for future high NFR, but this was not the case for low job control. Furthermore, a combination of high job demands and low job control, as well as a combination of high job demands, low job control and low social support demonstrated an increased risk for future high NFR where older workers showed higher risks.

CONCLUSION

This study demonstrated that adverse psychosocial work characteristics predicted future NFR among computer workers.

Excessive work and risk of haemorrhagic stroke: a nationwide case-control study

BACKGROUND

Adverse effect of excessive work on health has been suggested previously, but it was not documented in cerebrovascular diseases.

AIM

The authors investigated whether excessive working conditions would associate with increased risk of haemorrhagic stroke.

METHODS

A nationwide matched case-control study database, which contains 940 cases of incident haemorrhagic stroke (498 intracerebral haemorrhages and 442 sub-arachnoid haemorrhages) with 1880 gender- and age- (± 5-year) matched controls, was analysed. Work-related information based on the regular job situation, including type of occupation, regular working time, duration of strenuous activity during regular work and shift work, was gathered through face-to-face interviews. Conditional logistic regression analyses were used for the multivariable analyses.

RESULTS

Compared with white-collar workers, blue-collar workers had a higher risk for haemorrhagic stroke (odds ratio, 1.33 [95% confidence interval, 1.06-1.66]). Longer regular working time was associated with increased risk of haemorrhagic stroke [odds ratio, 1.38 (95% confidence interval, 1.05-1.81) for 8-12 h/day; odds ratio, 1.95 (95% confidence interval, 1.33-2.86) for ≥ 13 h/day; compared with ≤ 4 h/day]. Exposure to ≥ 8 h/week of strenuous activity also associated haemorrhagic stroke risk [odds ratio, 1.61 (95% confidence interval, 1.26-2.05); compared with no strenuous activity]. Shift work was not associated with haemorrhagic stroke (P = 0.98). Positive associations between working condition indices and haemorrhagic stroke risk were consistent regardless of haemorrhagic stroke sub-types and current employment status.

CONCLUSIONS

Blue-collar occupation, longer regular working time and extended duration of strenuous activity during work may relate to an increased risk of haemorrhagic stroke.

The associations between psychosocial workload and mental health complaints in different age groups

The objective of the present study was to explore associations between psychosocial workload and mental health complaints in different age groups. A questionnaire was sent to 2021 employees of a Dutch railway company. Six aspects of psychosocial workload (work pressure, mental workload, emotional workload, autonomy, social support from colleagues and social support from supervisors) and three mental health outcomes (work-related fatigue, stress and burnout) were assessed. Associations between the aspects of psychosocial workload (distributed into tertiles) and health complaints were analysed by logistic regression analysis in four age groups (22-35, 36-45, 46-55 and 56-66 years old). In all age groups, worse work pressure was a significant risk factor for having mental health complaints. Worse emotional load in the younger employees and lack of social support in older employees were associated with a higher risk of having mental health complaints. Age-specific preventive measures should be implemented on both individual and group levels. STATEMENT OF RELEVANCE: With an ageing workforce, understanding relationships between age and work-related health ailments is increasingly important. This study found that emotional workload in younger and lack of social support in older employees were associated with a higher risk of mental health complaints. Work pressure was a risk factor in all age groups.

Employment and work schedule are related to telomere length in women

OBJECTIVES

To examine the association of employment and work schedule with shorter DNA telomeres, a marker of cellular ageing and disease risk factor, and consider whether differences were related to health, behaviours and sociodemographic factors, or varied by stress levels or menopausal status.

METHODS

This cross-sectional analysis of 608 women aged 35-74 in the Sister Study examined determinants of relative telomere length (rTL) measured by quantitative PCR in leucocyte DNA. Age-adjusted regression models estimated base pair (bp) rTL differences for current and lifetime schedule characteristics (ie, part-time, full-time or overtime hours; multiple jobs; irregular hours; shiftwork; work at night). Covariates included race, smoking, perceived stress, sleep, physical activity, health and menopausal status, education, marital status, live births, children under 18, measured body mass index and urinary stress hormones.

RESULTS

Compared with non-employed women with moderate or substantial past work histories (n=190), those currently working full-time (n=247; median 40 h/week) had a shorter rTL, an age-adjusted difference of -329 bp (95% CI -110 to -548). Longer-duration full-time work was also associated with shorter rTL (age-adjusted difference of -472 bp, 95% CI -786 to -158 for 20+ vs 1-5 years). Findings were not explained by health and demographic covariates. However, rTL differences for working at least full-time were greater in women with higher stress and epinephrine levels.

CONCLUSIONS

Current and long-term full-time work were associated with shorter rTL, with differences of similar magnitude to smoking and history of heart disease or diabetes. Longitudinal data with specific stress measures are needed to further evaluate the impact of work schedule on rTL.

Demographic factors, fatigue, and driving accidents: An examination of the published literature

This article reviews the literature pertaining to the association between demographic variables (e.g., age, sex, race, socio-economic status) with fatigue, and when feasible, accident risk. It also explores their potential influence and interaction with some working arrangements, commute time, personality characteristics, and circadian chronotype. Fatigue has been implicated in a range of impairments that can have detrimental effects on individuals, and it is differentially associated with conventional demographic variables. However, several major methodological limitations prevent clear conclusions. First, there is absence of a shared definition both within and across disciplines. Second, although fatigue has been investigated using a variety of diverse designs, they have either been too weak to substantiate causality or lacked ecological validity. Third, while both subjective and objective measures have been used as dependent variables, fatigue has been more often found to be more strongly linked with the former. Fourth, with the exception of age and sex, the influence of other demographic variables is unknown, since they have not yet been concomitantly assessed. In instances when they have been assessed and included in statistical analyses, they are considered as covariates or confounders; thus, their contribution to the outcome variable is controlled for, rather than being a planned aspect of investigation. Because the interaction of demographic factors with fatigue is largely a neglected area of study, we recommend greater interdisciplinary collaborations, incorporation of multiple demographic variables as independent factors, and use of within-participant analyses. These recommendations would provide meaningful results that may be used to inform public policy and preventive strategies.

Relationship between sleeping on the night shift and recovery from work among nursing workers - the influence of domestic work

AIM

This paper is a report of a study on the association between sleep patterns during work nights and recovery from work among nursing workers, considering domestic work hours.

BACKGROUND

Several hospitals allow nursing workers to sleep during the night shift, but this is rarely evaluated from the workers' health perspective. The need for recovery from work concept can be useful for testing the impact of night work on sleep. Recovery is not a problem if workers have enough time to recover between periods of work. Therefore, domestic work would be likely to interfere in the recovery process.

METHODS

This cross-sectional study was carried out at three hospitals in 2005-2006, through a comprehensive questionnaire. All nursing teams engaged in assistance to patients were invited to participate. Analyses included female night workers with no incidence of insomnia. Participants (n = 396) were classified into those who did not sleep during night shifts, those who slept for up to 2 hours and those who slept for 2-3 hours.

RESULTS

Binomial logistic regression analysis showed that sleeping on the job for 2-3 hours during night shifts is related to a better recovery from work provided the workers do not undergo long domestic work hours.

CONCLUSIONS

Being allowed to sleep at work during night shifts seemed to contribute to, but was not enough to guarantee, a good recovery from work in the studied population. Recommendations to deal with sleep-deprivation among night workers should consider the complexity of gender roles on the recovery process.

Job strain among Malaysian office workers of a multinational company

BACKGROUND

Information on job strain exposure among Malaysian workers in multinational companies is limited.

AIMS

To investigate the prevalence and factors associated with high job strain among office workers of a multinational company in Malaysia.

METHODS

A cross-sectional study was conducted in November 2007 among 470 eligible workers. Respondents self-administered the Job Content Questionnaire downloaded from the company's intranet. A median-split procedure was applied to create four groups according to the Job Demand-Control Model: active, passive, high and low job strain. Logistic regression models were used to investigate the associations between socio-demographic, occupational and psychosocial factors and high job strain.

RESULTS

A total of 356 questionnaires were received (response rate 76%). Twenty-one per cent of respondents were in the high job strain group, 35% were in the passive group, whereas 26% and 17% of workers were in the low strain and active groups, respectively. After controlling for confounders, three factors were found to be associated with high job strain: male workers (adjusted OR 1.94, 95% CI 1.04-3.64), working >48 h per week (adjusted OR 2.51, 95% CI 1.44-4.39) and job insecurity (adjusted OR 1.14, 95% CI 1.02-1.27). One protective factor for high job strain was the scale 'created skill', which is part of skill discretion (adjusted OR 0.70, 95% CI 0.57-0.86).

CONCLUSIONS

About one in five workers in this study experience high job strain. Work improvement measures include reducing long working hours and job insecurity and giving workers the opportunity to learn, use creativity and develop abilities.

Need for recovery from work in relation to age: a prospective cohort study

Purpose

To investigate the impact of increasing age on the need for recovery (NFR) over time among day workers

Methods

The study is based on data from the first 2 years of follow-up of the Maastricht Cohort Study (n = 7,734). To investigate whether age predicted the onset of elevated NFR, multivariate survival analyses were conducted

Results

The highest levels of NFR were observed in the age group of 46–55 years. The relative risk for developing elevated NFR was highest in the age groups 36–45 years (RR 1.30; 1.07–1.58) and 46–55 years (RR 1.25; 1.03–1.52) in men and 46–55 years (RR 1.36; 1.04–1.77) in women when compared to the reference group

Conclusions

While NFR increased with age until the age of 55, this was followed by decreased levels of NFR among older employees. Explanations for the decreasing levels of NFR in the highest age group can be found in several domains such as the work environment, private situation and compensation strategies.

Occupational stressors and its organizational and individual correlates: a nationwide study of Norwegian ambulance personnel

Background

High levels of stress among ambulance personnel have been attributed to the conditions of ambulance work. However, there is little research to support this notion, and it has been questioned whether ambulance work is inherently stressful. We compared the severity and frequency level of organizational and ambulance-specific stressors, and studied their relationship to organizational conditions and individual differences

Methods

A comprehensive nationwide questionnaire survey of ambulance personnel (n = 1180) in operational duty. The questionnaire included the Job Stress Survey, the Norwegian Ambulance Stress Survey, the Basic Character Inventory, General Self-Efficacy Scale, and questions addressing organizational conditions.

Results

Serious operational tasks and physical demands were identified as the two most severe stressors. Lack of support from co-workers was the most severe and frequent organizational stressor. Higher frequency of stressors was most strongly associated with size of service districts (beta ranging between .18 and .30, p < .01) and working overtime (beta ranging from .13 to .27, p < .05). Stressor severity was related to lack of support after exposure to critical event (beta ranging from .11 to .24, p < .01) and working overtime. Neuroticism (beta ranging from .09 to .17, p < .01) and low general self-efficacy (beta ranging from -.12 to -.16, p < .001) were equally strongly related to severity of stressors, as were organizational conditions.

Conclusion

Ambulance-specific stressors were reported as both more severe and more frequently occurring stressors than were organizational stressors. Organizational working conditions were more strongly related to frequency of job stressors than were individual differences. In general, the relationship between occupational stressors and individual differences was weak.

Possible broad impacts of long work hours

The paper summarizes research linking long work hours to a wide range of risks to workers, families, employers, and the community. The risks are theorized to stem from less time to recover from work, longer exposure to workplace hazards, and less time to attend to non-work responsibilities. Risks to workers include sleep deprivation, poor recovery from work, decrements in neuro-cognitive and physiological functioning, illnesses, adverse reproductive outcomes, and injuries. Risks to families include delayed marriages and child bearing, and obesity in children. Risks to employers include reduced productivity and increases in workers errors. Mistakes by fatigued workers have broad reaching impacts to the community: medical errors, automobile crashes with other drivers on the road, and industrial disasters that damage the environment.