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  • 1.
    Albrecht, Sophie
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Investigating the factorial structure and availability of work time control in a representative sample of the Swedish working population2016In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 3, p. 320-328Article in journal (Refereed)
    Abstract [en]

    Aims: Past research has often neglected the sub-dimensions of work time control (WTC). Moreover, differences in levels of WTC with respect to work and demographic characteristics have not yet been examined in a representative sample. We investigated these matters in a recent sample of the Swedish working population. Methods: The study was based on the 2014 data collection of the Swedish Longitudinal Occupational Survey of Health. We assessed the structure of the WTC measure using exploratory and confirmatory factor analysis. Differences in WTC by work and demographic characteristics were examined with independent sample t-tests, one-way ANOVAs and gender-stratified logistic regressions. Results: Best model fit was found for a two-factor structure that distinguished between control over daily hours and control over time off (root mean square error of approximation = 0.06; 95% CI 0.04 to 0.09; Comparative Fit Index (CFI) = 0.99). Women, shift and public-sector workers reported lower control in relation to both factors. Age showed small associations with WTC, while a stronger link was suggested for civil status and family situation. Night, roster and rotating shift work seemed to be the most influential factors on reporting low control over daily hours and time off. Conclusions: Our data confirm the two-dimensional structure underlying WTC, namely the components 'control over daily hours' and 'control over time off'. Women, public-sector and shift workers reported lower levels of control. Future research should examine the public health implications of WTC, in particular whether increased control over daily hours and time off can reduce health problems associated with difficult working-time arrangements.

  • 2. Dahlgren, A.
    et al.
    Epstein, M.
    Söderström, M.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, United Kingdom.
    Nurses' strategies for managing sleep when starting shift work – implications for interventions targeting sleep behaviours in a shift work population2017In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 40, no Suppl. 1, article id e73Article in journal (Refereed)
    Abstract [en]

    Introduction: Shift work is related to short and disturbed sleep. Various aspects of a shift schedule will produce different opportunities and conditions for sleep depending on how they interact with circadian rhythms and the homeostatic drive for sleep. A third factor influencing sleep between shifts is the activation of the stress system. The aim of the current study was to examine sleep behaviours and strategies that nurses used when starting shift work and determine which sleep behaviours should be promoted when developing a programme for sleep interventions for newly graduated nurses.

    Material and methods: 11 (mean age 29.1±8) newly graduated nurses (3–12 months work experience) from different hospitals in Sweden were recruited for a semi-structured interview (approx. 45 min). Deductive content analysis was used to examine sleep strategies related to the homeostatic and circadian regulation of sleep, and to managing stress.

    Results: In relation to morning shifts (starting 6:45 h) most nurses perceived sleep as somewhat disturbed. Some had a strategy of undertaking activities that helped them unwind before bedtime, such as having a shower, watching TV, surfing the Internet or using relaxation techniques. One nurse had a strategy of getting up early in the morning before a morning shift in order to facilitate sleep in the evening, thereby enhancing the homeostatic drive for sleep. One nurse tried to keep her bed times constant despite irregular work hours in order to maintain a stable circadian rhythm.

    In relation to evening shifts, few experienced problems with sleep. Most had a lie-in before starting an evening shift and were being quite inactive before the shift started.

    Most nurses reported sleep problems when an evening shift was followed by a morning shift, i.e. a quick return, with many having problems unwinding and stopping thinking about work before bedtime. A few nurses described experiencing stress from knowing that their sleep would be short. Many had a strategy of undertaking other activities to unwind (see examples from morning shifts) before going to bed. A few went to bed straight away but described experiencing difficulties falling asleep. A few who reported no problems with sleep during quick returns said that they undertook activities that made them detach from work, with one regularly using a relaxation technique. The five nurses who worked night shifts had strategies of either sleeping in the evening before the nightshift, or staying up as long as possible the night before, thereby reducing the homeostatic drive for sleep during the shift.

    Conclusions: Newly graduated nurses would probably benefit from a sleep programme based on cognitive behavioural therapy techniques that are modified to fit shift workers. Behaviours and strategies that should be targeted are: routines and techniques for unwinding before bed time; sleep behaviours that promote building up enough homeostatic pressure for initiating sleep (e.g. not having long lie-ins before evening shifts that are followed by morning shifts); and sleep behaviours that promote a stable circadian rhythm.

  • 3.
    Dahlgren, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Gustavsson, Petter
    Rudman, Ann
    Quick returns and night work as predictors of sleep quality, fatigue, work-family balance and satisfaction with work hours2016In: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 33, no 6, p. 759-767Article in journal (Refereed)
    Abstract [en]

    Quick returns (intervals of <11 h between the end of one shift and the start of the next) are associated with short sleeps and fatigue on the subsequent shift. Recent evidence suggests that shift workers regard quick returns as being more problematic than night work. The current study explored quick returns and night work in terms of their impact on sleep, unwinding, recovery, exhaustion, satisfaction with work hours and work-family interference. Data from the 2006 cohort of Swedish nursing students within the national Longitudinal Analysis of Nursing Education (LANE) study were analysed (N = 1459). Respondents completed a questionnaire prior to graduation (response rate 69.2%) and 3 years after graduation (65.9%). The analyses examined associations between frequency of quick returns and night work and measures taken in year three, while adjusting for confounding factors (in year three and prior graduation). Frequency of quick returns was a significant predictor of poor sleep quality, short sleeps, unwinding, exhaustion, satisfaction with work hours and work-to-family interference, with higher frequency predicting more negative outcomes. Quick returns did not predict recovery after rest days. Frequency of night work did not predict any of the outcomes. In conclusion, quick returns were an important determinant of sleep, recovery and wellbeing, whereas night work did not show such an association.

  • 4. Folkard, Simon
    et al.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Shiftwork, metabolic dysfunction and safety: a review2013In: Sleep Science (1984-0659) volume 6, Supplement 1, 2013, São Paulo: Associação Brasileira do Sono , 2013, Vol. 6, no suppl 1, p. 27-27Conference paper (Refereed)
  • 5. Hall, A. L.
    et al.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Work schedule and prospective antidepressant prescriptions in the swedish workforce: a 2-year study using national drug registry data2018In: Occupational and Environmental Medicine, ISSN 1351-0711, Vol. 75, p. A482-A483Article in journal (Other academic)
    Abstract [en]

    Introduction Mood disorders affect millions of individuals worldwide and contribute to substantial morbidity and disability. A better understanding of modifiable work-related risk factors for depression could inform and advance prevention efforts in this area. This study used a large Swedish longitudinal occupational survey to prospectively examine the effect of self-reported work schedule on registry-based antidepressant prescriptions over a two-year period.

    Methods The analytic sample (n=8643) was obtained from the Swedish Longitudinal Occupational Survey of Health. Sex-stratified and unstratified analyses were conducted using logistic regression. For exposure, 8 categories were used to describe work schedule in 2008: ‘regular days’ (3 categories: night work history=none,≤3 years, or 4+years) ‘night work (regular, rostered, or rotating)’, ‘regular shift work (no nights)’, ‘rostered work (no nights)’, ‘flexible/non-regulated hours’, and ‘other’. For the outcome, all prescriptions coded N06A according to the Anatomical Therapeutic Chemical System were obtained from the Swedish National Prescribed Drug Register and dichotomized into ‘any’ or ‘no’ prescriptions between 2008 and 2010. Estimates were adjusted for potential sociodemographic, health, and work confounders, and for prior depressive symptoms.

    Results In unadjusted analyses, an increased odds ratio for depression was observed for ‘Other’ work hours in unstratified (OR=1.75, 95% CI: 1.21 to 2.51) and female (OR=1.62, 95% CI: 1.05 to 2.51) models; in adjusted models effects persisted but confidence intervals widened to non-significance at the p=0.05 level. In models adjusted for previous depressive symptoms, females in ‘flexible/non-regulated’ schedules showed an increased odds ratio for depression (OR=2.01, 95% CI: 1.08 to 3.76), while a decreased odds ratio was observed for the unstratified model ‘regular shift work (no nights)’ category (OR=0.61; 95% CI: 0.38 to 0.97).

    Discussion This study’s findings support prospective relationships between work schedule and antidepressant prescriptions in the Swedish workforce. Future research should continue to assess sex-stratified relationships, using detailed shift work exposure categories and objective registry data where possible.

  • 6.
    Hall, Amy L.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. International Agency for Research on Cancer, France.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Effect of work schedule on prospective antidepressant prescriptions in Sweden: a 2-year sex-stratified analysis using national drug registry data2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 1, article id e023247Article in journal (Refereed)
    Abstract [en]

    Introduction Depression-related mood disorders affect millions of people worldwide and contribute to substantial morbidity and disability, yet little is known about the effects of work scheduling on depression. This study used a large Swedish survey to prospectively examine the effects of work schedule on registry-based antidepressant prescriptions in females and males over a 2-year period. Methods The study was based on an approximately representative sample (n= 3980 males, 4663 females) of gainfully employed participants in the Swedish Longitudinal Occupational Survey of Health. Sex-stratified analyses were conducted using logistic regression. For exposure, eight categories described work schedule in 2008: ` regular days' (three categories of night work history: none, <= 3 years, 4+ years), 'night shift work', 'regular shift work (no nights)', 'rostered work (no nights)', 'flexible/non-regulated hours' and 'other'. For the primary outcome measure, all prescriptions coded N06A according to the Anatomical Therapeutic Chemical System were obtained from the Swedish National Prescribed Drug Register and dichotomised into 'any' or 'no' prescriptions between 2008 and 2010. Estimates were adjusted for potential sociodemographic, health and work confounders, and for prior depressive symptoms. Results In 2008, 22% of females versus 19% of males worked outside of regular daytime schedule. Registered antidepressant prescription rates in the postsurvey period were 11.4% for females versus 5.8% for males. In fully adjusted models, females in 'flexible/non-regulated' schedules showed an increased OR for prospective antidepressant prescriptions (OR= 2.01, 95% CI= 1.08 to 3.76). In males, odds ratios were most increased in those working 'other' schedules (OR= 1.72, 95% CI= 0.75 to 3.94) and 'Regular days with four or more years' history of night work' (OR= 1.54, 95% CI= 0.93 to 2.56). Conclusions This study's findings support a relationship between work schedule and prospective antidepressant prescriptions in the Swedish workforce. Future research should continue to assess sex-stratified relationships, using detailed shift work exposure categories and objective registry data where possible.

  • 7. Marquié, J-C
    et al.
    Tucker, Philip
    Department of Psychology, Swansea University, Swansea, UK.
    Folkard, S
    Gentil, C
    Ansiau, D
    Author response to "Time of day of cognitive tests might distort shift-work study results".2015In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 72, no 5, p. 382-Article in journal (Refereed)
  • 8. Marquié, Jean-Claude
    et al.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Folkard, Simon
    Gentil, Catherine
    Ansiau, David
    Chronic effects of shift work on cognition: findings from the VISAT longitudinal study2015In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 72, no 4, p. 258-64Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Shift work, like chronic jet lag, is known to disrupt workers' normal circadian rhythms and social life, and to be associated with increased health problems (eg, ulcers, cardiovascular disease, metabolic syndrome, breast cancer, reproductive difficulties) and with acute effects on safety and productivity. However, very little is known about the long-term consequences of shift work on cognitive abilities. The aim of this study was to assess the chronicity and reversibility of the effects of shift work on cognition.

    METHODS: We conducted a prospective cohort study of 3232 employed and retired workers (participation rate: 76%) who were 32, 42, 52 and 62 years old at the time of the first measurement (t1, 1996), and who were seen again 5 (t2) and 10 (t3) years later. 1484 of them had shift work experience at baseline (current or past) and 1635 had not. The main outcome measures were tests of speed and memory, assessed at all three measurement times.

    RESULTS: Shift work was associated with impaired cognition. The association was stronger for exposure durations exceeding 10 years (dose effect; cognitive loss equivalent to 6.5 years of age-related decline in the current cohort). The recovery of cognitive functioning after having left shift work took at least 5 years (reversibility).

    CONCLUSIONS: Shift work chronically impairs cognition, with potentially important safety consequences not only for the individuals concerned, but also for society.

  • 9.
    Moreno, Claudia R. C.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University of São Paulo, Brazil.
    Marqueze, Elaine C.
    Sargent, Charli
    Wright Jr, Kenneth P.
    Ferguson, Sally A.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Working Time Society consensus statements: Evidence-based effects of shift work on physical and mental health2019In: Industrial Health, ISSN 0019-8366, E-ISSN 1880-8026, Vol. 57, no 2, p. 139-157Article in journal (Refereed)
    Abstract [en]

    Potential effects of shift work on health are probably related to the misalignment between the light-dark cycle and the human activity-rest cycle. Light exposure at night mediates these ef- fects, including social misalignment and leads to an inversion of activity and rest, which, in turn, is linked to changes in behaviours. This article reviews the epidemiological evidence on the association between shift work and health, and possible mechanisms underlying this association. First, evidence from findings of the meta-analyses and systematic reviews published in the last 10 yr is presented. In addition, it reports the larger single-occupation studies and recent large population- based studies of the general workforce. Koch’s postulates were used to evaluate the evidence related to the development of disease as a result of exposure to shift work. Finally, we discussed limitations of the multiple pathways that link shift work with specific disorders and the methodological challenges facing shift work research. We concluded that the clearest indications of shift work being the cause of a disease are given when there is a substantial body of evidence from high quality field studies showing an association and there is good evidence from laboratory studies supporting a causal explanation of the link.

  • 10. Møller, S. V.
    et al.
    Axelsson, J.
    Bjorvatn, B.
    Hansen, J.
    Hansen, Å. M.
    Harris, A.
    Hjarsbech, P. U.
    Härmä, M.
    Ingre, M.
    Jensen, M. A.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kolstad, H. A.
    Lie, J. A. S.
    Lowden, Arne
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Matre, D.
    Nabe-Nielsen, K.
    Pallesen, S.
    Puttonen, S.
    Rugulies, R.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Vistisen, H. T.
    Garde, A. H.
    Co-ordination of research on working hours and health in the Nordic countries: Working hours and Health2015Report (Other academic)
  • 11. Nijp, Hylco H.
    et al.
    Beckers, Debby G. J.
    Geurts, Sabine A. E.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kompier, Michiel A. J.
    Systematic review on the association between employee worktime control and work-non-work balance, health and well-being, and job-related outcomes2012In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 38, no 4, p. 299-313Article, review/survey (Refereed)
    Abstract [en]

    Objectives The aim of this review was to assess systematically the empirical evidence for associations between employee worktime control (WTC) and work non-work balance, health/well-being, and job-related outcomes (eg, job satisfaction, job performance). Method A systematic search of empirical studies published between 1995-2011 resulted in 63 relevant papers from 53 studies. Five different categories of WTC measurements were distinguished (global WTC, multidimensional WTC, flextime, leave control, and other subdimensions of WTC). For each WTC category, we examined the strength of evidence for an association with (i) work non-work balance, (ii) health/well-being, and (iii) job-related outcomes. We distinguished between cross-sectional, longitudinal, and intervention studies. Evidence strength was assessed based on the number of studies and their convergence in terms of study findings. Results (Moderately) strong cross-sectional evidence was found for positive associations between global WTC and both work non-work balance and job-related outcomes, whereas no consistent evidence was found regarding health/well-being. Intervention studies on global WTC found moderately strong evidence for a positive causal association with work non-work balance and no or insufficient evidence for health/well-being and job-related outcomes. Limited to moderately strong cross-sectional evidence was found for positive associations between multidimensional WTC and our outcome categories. Moderately strong cross-sectional evidence was found for positive associations between flextime and all outcome categories. The lack of intervention or longitudinal studies restricts clear causal inferences. Conclusions This review has shown that there are theoretical and empirical reasons to view WTC as a promising tool for the maintenance of employees' work non-work balance, health and well-being, and job-related outcomes. At the same time, however, the current state of evidence allows only very limited causal inferences to be made regarding the impact of enhanced WTC.

  • 12. Salo, P
    et al.
    Ala-Mursula, L
    Rod, NH
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Pentti, J
    Kivimäki, M
    Vahtera, J
    Work time control and sleep disturbances2014In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 23, no Suppl. 1, p. 138-138Article in journal (Other academic)
  • 13. Salo, Paula
    et al.
    Ala-Mursula, Leena
    Hulvej Rod, Naja
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Pentti, Jaana
    Kivimäki, Mika
    Vahtera, Jussi
    Work Time Control and Sleep Disturbances: Prospective Cohort Study of Finnish Public Sector Employees2014In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 37, no 7, p. 1217-1225Article in journal (Refereed)
    Abstract [en]

    Objectives: Employee control over work times has been associated with favorable psychosocial and health-related outcomes, but the evidence regarding sleep quality remains inconclusive. We examined cross-sectional and prospective associations between work time control and sleep disturbances in a large working population, taking into account total hours worked. Methods: The data were from a full-panel longitudinal cohort study of Finnish public sector employees who responded to questions on work time control and sleep disturbances in years 2000-2001, 2004-2005, 2008-2009, and 2012. The analysis of cross-sectional associations was based on 129,286 person measurements from 68,089 participants (77% women) aged 17-73 years (mean 43.1). Data from 16,503 participants were used in the longitudinal analysis. Log-binomial regression analysis with the generalized estimating equations method was used. Results: Consistently in both cross-sectional and longitudinal models, less control over work time was associated with greater sleep disturbances in the total population and among those working normal 40-hour weeks. Among participants working more than 40 hours a week, work time that was both very high (cross-sectional prevalence ratio compared to intermediate work time control [PR] 1.32, 95% confidence interval [CI] 1.05-1.65) and very low (PR 1.23, 95% CI 1.08-1.39) was associated with sleep disturbances, after adjustment for potential confounding factors. Conclusions: These data suggest that having few opportunities to influence the duration and positioning of work time may increase the risk of sleep disturbances among employees. For persons working long hours, very high levels of control over working times were also associated with increased risk of sleep disturbances.

  • 14.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, United Kingdom.
    Albrecht, Sophie
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Beckers, Debby G. J.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Work time control, sleep & accident risk: A prospective cohort study2016In: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 33, no 6, p. 619-629Article in journal (Refereed)
    Abstract [en]

    We examined whether the beneficial impact of work time control (WTC) on sleep leads to lower accident risk, using data from a nationally representative survey conducted in Sweden. Logistic regressions examined WTC in 2010 and 2012 as predictors of accidents occurring in the subsequent 2 years (N = 4840 and 4337, respectively). Sleep disturbance and frequency of short sleeps in 2012 were examined as potential mediators of the associations between WTC in 2010 and subsequent accidents as reported in 2014 (N = 3636). All analyses adjusted for age, sex, education, occupational category, weekly work hours, shift work status, job control and perceived accident risk at work. In both waves, overall WTC was inversely associated with accidents (p = 0.048 and p = 0.038, respectively). Analyses of the sub-dimensions of WTC indicated that Control over Daily Hours (influence over start and finish times, and over length of shift) did not predict accidents in either wave, while Control over Time-off (CoT; influence over taking breaks, running private errands during work and taking paid leave) predicted fewer accidents in both waves (p = 0.013 and p = 0.010). Sleep disturbance in 2012 mediated associations between WTC/CoT in 2010 and accidents in 2014, although effects' sizes were small (effectWTC = -0.006, 95% confidence interval [CI] = -0.018 to -0.001; effectCoT = -0.009, 95%CI = -0.022 to -0.001; unstandardized coefficients), with the indirect effects of sleep disturbance accounting for less than 5% of the total direct and indirect effects. Frequency of short sleeps was not a significant mediator. WTC reduces the risk of subsequently being involved in an accident, although sleep may not be a strong component of the mechanism underlying this association.

  • 15.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Bejerot, Eva E
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Aronsson, Gunnar
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Doctors' work schedules and work time control2013Conference paper (Refereed)
  • 16.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, United Kingdom.
    Bejerot, Eva
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Aronsson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    The impact of work time control on physicians’ sleep and well-being2015In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 47, p. 109-116Article in journal (Refereed)
    Abstract [en]

    Physicians' work schedules are an important determinant of their own wellbeing and that of their patients. This study considers whether allowing physicians control over their work hours ameliorates the effects of demanding work schedules. A questionnaire was completed by hospital physicians regarding their work hours (exposure to long shifts, short inter-shift intervals, weekend duties, night duties, unpaid overtime; and work time control), sleep (quantity and disturbance) and wellbeing (burnout, stress and fatigue). Work time control moderated the negative impact that frequent night working had upon sleep quantity and sleep disturbance. For participants who never worked long shifts, work time control was associated with fewer short sleeps, but this was not the case for those who did work long shifts. Optimizing the balance between schedule flexibility and patient needs could enhance physicians' sleep when working the night shift, thereby reducing their levels of fatigue and enhancing patient care.

  • 17.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Byrne, A.
    The tiring anaesthetist2014In: Anaesthesia, ISSN 0003-2409, E-ISSN 1365-2044, Vol. 69, no 1, p. 6-9Article in journal (Refereed)
  • 18.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Department of Psychology, Swansea University, Swansea, UK.
    Byrne, Aidan
    The new junior doctors’ contract: an occupational health and safety perspective2016In: Occupational Medicine, ISSN 0962-7480, E-ISSN 1471-8405, Vol. 66, no 9, p. 686-688Article in journal (Refereed)
  • 19.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Folkard, Simon
    Work Scheduling2012In: The Handbook of Operator Fatigue / [ed] Gerald Matthews, Paula A. Desmond, Catherine Neubauer, P.A. Hancock, Farnham: Ashgate, 2012, 1, p. 457-468Chapter in book (Refereed)
  • 20.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Folkard, Simon
    Working time, health and safety: a research synthesis paper2012Report (Refereed)
    Abstract [en]

    It is hoped that this study will provide useful guidance regarding how to respond to new trends and developments in the area of working time and develop innovative, mutually beneficial working-time arrangements without compromising workers’ health and workplace safety.

  • 21.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, United Kingdom.
    Härmä, M.
    Ojajärvi, A.
    Kivimäki, M.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Vahtera, J:
    Shiftwork and the use of prescription medication for sleep, anxiety and depression: a prospective cohort study2017In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 40, no Suppl. 1, article id e330Article in journal (Refereed)
    Abstract [en]

    Introduction: There is only limited evidence to date linking shiftwork with clinical levels of sleep disturbance and mental health problems. Few studies have examined redeemed drug prescriptions using register data, which is the focus of this study.

    Materials and methods: Data were obtained from three waves of the Finnish Public Sector Study (2000, 2004, 2008. 66-68% response rate). Participants were from two cohorts; local government employees in 10 towns–a mixture of healthcare workers and employees from other occupational sectors ('10 Towns Cohort'); and employees of 21 hospitals ('Hospitals Cohort'). The overall sample was N=53,275 (mean age 43.6 (SD=9.8), range 18-69), with approximately 73% coming from the 10 Towns Cohort. Women made up 82% of the entire sample. Responses to surveys were linked to records on redeemed prescriptions (until December 2011).

    Data from the two cohorts were analysed separately to examine the associations between work schedule and drug purchase. Cox regressions were used to predict time to first incident use of:

    1. Hypnotics & Sedatives; and

    2. Anxiolytics & Antidepressants. We separately compared 2- and 3-shift workers (i.e. rotating shifts either without, or with, nights) with dayworkers, matched for occupational group.

    Each analysis was stratified by age (< = 39 years, 40-49 years and >= 50 years). HRs were calculated with adjustments for age, sex, socioeconomic status and marital status (Model 1); and with additional adjustments for alcohol consumption (Model 2). Participants were excluded if they had any recorded purchase of the drug in question prior to follow-up, or if they reported previous diagnosis of depression or other mental disease.

    Results: There were fewer significant associations in the Hospitals Cohort than in the 10 Towns Cohort. The 10 Towns Cohort showed significant positive associations between 3-shift work and the use of both categories of medication; with the exception of Anxiolytic & Antidepressant use among the middle-age group. Among the 2-shift workers, the only significant associations were with the use of Anxiolytics & Antidepressants in the lower- and upper-age groups. In the Hospitals Cohort, the majority of associations were either non-significant or negative (i.e. indicative of a protective effect). The main exception was positive associations between 3-shift work and use of Hypnotics & Sedatives among the upper-age group.

    Conclusions: The finding of greater use of hypnotics and sedatives by rotating nightshift workers adds to the limited evidence to date linking night with clinical levels of sleep disturbance. The finding of greater use of anxiolytics and antidepressants by some groups of shiftworkers provides limited evidence of a link between shiftwork and mental health problems.

    Sensitivity analyses indicated that the disparity between cohorts was neither due to the presence of non-healthcare workers in the 10 Towns Cohort, nor to the presence of former shiftworkers in the control sample of the Hospital Cohort. Other possible explanations are that: the cohorts differ with respect to type of shift schedule e.g. the intensity of nightwork; shiftworkers in the Hospital Cohort may be more selected as it may be easier for them to transfer to daywork.

  • 22.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, United Kingdom.
    Härmä, Mikko
    Ojajärvi, Anneli
    Kivimäki, Mika
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Oksanen, Tuula
    Salo, Paula
    Vahtera, Jussi
    Associations between shift work and use of prescribed medications for the treatment of hypertension, diabetes, and dyslipidemia: a prospective cohort study2019In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 5, p. 465-474Article in journal (Refereed)
    Abstract [en]

    Objective This study examined the associations between shift work and use of antihypertensive, lipid-lowering, and antidiabetic medications. Methods Survey data from two cohorts of Finnish men (N=11998) and women (N=49 944) working in multiple occupations where shift work was used were linked to national Drug Prescription Register data, with up to 11 years of follow-up. In each cohort, age-stratified Cox proportional hazard regression models were computed to examine any incident use of prescription medication for each of the three medical conditions, separately comparing each of two groups of rotating shift workers (those whose schedules included night shifts. and those whose schedules did not include night shifts) with day workers who worked in a similar range of occupations. Results In the larger cohort, among participants aged 40-49 at baseline, shift work without night shifts was associated with increased use of type-2 diabetes medication after adjustments for sex, occupational status, marital status, alcohol consumption, smoking, and physical activity [hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.01-1.62], while shift work with night shifts was associated with increased use of dyslipidemia medication after adjustments (HR 1.33, 95% CI 1.12-1.57). There were no such associations among younger and older shift workers. Also in the larger cohort, among those aged <50 years at baseline, both types of shift work were associated with increased use of hypertension medication after adjustments [up to HR 1.20 (95% CI 1.05-1.37)]. There were no positive associations in the smaller cohort. Conclusions There was mixed evidence regarding the use of medications for cardiovascular risk factors by shift workers. Selection effects may have affected the associations.

  • 23.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Salo, Paula
    Vahtera, Jussi
    A prospective study of the association between shiftwork & prescription drug use2014In: 11th EAOHP Conference: book of proceedings, Nottingham: EAOHP , 2014, p. 103-103Conference paper (Refereed)
  • 24. Vedaa, Øystein
    et al.
    Harris, Anette
    Bjorvatn, Bjørn
    Waage, Siri
    Sivertsen, Børge
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Pallesen, Ståle
    Systematic review of the relationship between quick returns in rotating shift work and health-related outcomes2016In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 59, no 1, p. 1-14Article in journal (Refereed)
    Abstract [en]

    A systematic literature search was carried out to investigate the relationship between quick returns (i.e. 11.0 hours or less between two consecutive shifts) and outcome measures of health, sleep, functional ability and work-life balance. A total of 22 studies published in 21 articles were included. Three types of quick returns were differentiated (from evening to morning/day, night to evening, morning/day to night shifts) where sleep duration and sleepiness appeared to be differently affected depending on which shifts the quick returns occurred between. There were some indications of detrimental effects of quick returns on proximate problems (e.g. sleep, sleepiness and fatigue), although the evidence of associations with more chronic outcome measures (physical and mental health and work-life balance) was inconclusive. Practitioner Summary: Modern societies are dependent on people working shifts. This study systematically reviews literature on the consequences of quick returns (11.0 hours or less between two shifts). Quick returns have detrimental effects on acute health problems. However, the evidence regarding effects on chronic health is inconclusive.

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