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Concept: Working time


The American Academy of Sleep Medicine and the Sleep Research Society have determined that adults require ≥7 hours of sleep per day to promote optimal health (1). Short sleep duration (<7 hours per day) has been linked to adverse health outcomes including cardiovascular disease, obesity, diabetes, depression, and anxiety, as well as safety issues related to drowsy driving and injuries (1,2). Additional research has found that sleep duration varies by characteristics such as race, education, marital status, obesity, and cigarette smoking (3). Work-related factors such as job stress, work hours, shift work, and physically demanding work have been found to be associated with sleep duration and quality (4-6). All of these work factors vary by industry and occupation of employment, and the prevalence of short sleep duration has been shown to vary by broad industry and occupation category (7). To provide updated and more detailed information about which occupation groups have the highest prevalences of short sleep duration, CDC analyzed data from currently employed adults surveyed for the 2013 and 2014 Behavioral Risk Factor Surveillance System (BRFSS) in 29 states. Among 22 major occupation groups, the highest prevalences of short sleep duration were among workers in the following five groups: Production (42.9%), Healthcare Support (40.1%), Healthcare Practitioners and Technical (40.0%), Food Preparation and Serving-Related (39.8%), and Protective Service (39.2%). The significant differences among occupation groups in the prevalence of short sleep duration suggest that work-related factors should be further evaluated as they might relate to sleep.

Concepts: Smoking, Cigarette, Employment, American Academy of Sleep Medicine, Medicine, Behavioral Risk Factor Surveillance System, Working time, Sleep


Working long hours might have adverse health effects, but whether this is true for all socioeconomic status groups is unclear. In this meta-analysis stratified by socioeconomic status, we investigated the role of long working hours as a risk factor for type 2 diabetes.

Concepts: Social status, Socioeconomic status, Diabetes mellitus, Working time, Sociology, Epidemiology, Diabetes mellitus type 2


This article sets out to investigate how flexitime and teleworking can help women maintain their careers after childbirth. Despite the increased number of women in the labour market in the UK, many significantly reduce their working hours or leave the labour market altogether after childbirth. Based on border and boundary management theories, we expect flexitime and teleworking can help mothers stay employed and maintain their working hours. We explore the UK case, where the right to request flexible working has been expanded quickly as a way to address work-life balance issues. The dataset used is Understanding Society (2009-2014), a large household panel survey with data on flexible work. We find some suggestive evidence that flexible working can help women stay in employment after the birth of their first child. More evidence is found that mothers using flexitime and with access to teleworking are less likely to reduce their working hours after childbirth. This contributes to our understanding of flexible working not only as a tool for work-life balance, but also as a tool to enhance and maintain individuals' work capacities in periods of increased family demands. This has major implications for supporting mothers' careers and enhancing gender equality in the labour market.

Concepts: Labour market flexibility, Woman, United Kingdom, Labour relations, Labour economics, Working time, Childbirth, Employment


We previously reported that compared with night sleep, day sleep among shift workers was associated with reduced urinary excretion of 8-hydroxydeoxyguanosine (8-OH-dG), potentially reflecting a reduced ability to repair 8-OH-dG lesions in DNA. We identified the absence of melatonin during day sleep as the likely causative factor. We now investigate whether night work is also associated with reduced urinary excretion of 8-OH-dG.

Concepts: Adenosine triphosphate, Circadian rhythms, Working time, Shift work


 To determine the accuracy of coding of admissions for stroke on weekdays versus weekends and any impact on apparent outcome.

Concepts: Saturday, Working time, Weekend, Workweek, Weeks


Studies suggest that people who work long hours are at increased risk of stroke, but the association of long working hours with atrial fibrillation, the most common cardiac arrhythmia and a risk factor for stroke, is unknown. We examined the risk of atrial fibrillation in individuals working long hours (≥55 per week) and those working standard 35-40 h/week.

Concepts: Working time, The Association, Cardiac dysrhythmia, Cardiac electrophysiology, Atrial flutter, Cardiac arrest, Heart, Atrial fibrillation


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.

Concepts: Working time, Shift work, Illness, Medicine, Health care, Patient, Employment, Health care provider


BACKGROUND: To examine sedentary time, prolonged sedentary bouts and physical activity in Australian employees from different workplace settings, within work and non-work contexts. METHODS: A convenience sample of 193 employees working in offices (131), call centres (36) and customer service (26) was recruited. Actigraph GT1M accelerometers were used to derive percentages of time spent sedentary (<100 counts per minute; cpm), in prolonged sedentary bouts (>=20 minutes or >=30 minutes), light-intensity activity (100–1951 cpm) and moderate-to-vigorous physical activity (MVPA; >=1952 cpm). Using mixed models adjusted for confounders, these were compared for: work days versus non-work days; work hours versus non-work hours (work days only); and, across workplace settings. RESULTS: Working hours were mostly spent sedentary (77.0%, 95%CI: 76.3, 77.6), with approximately half of this time accumulated in prolonged bouts of 20 minutes or more. There were significant (p<0.05) differences in all outcomes between workdays and non-work days, and, on workdays, between work- versus non-work hours. Results consistently showed "work" was more sedentary and had less light-intensity activity, than "non-work". The period immediately after work appeared important for MVPA. There were significant (p<0.05) differences in all sedentary and activity outcomes occurring during work hours across the workplace settings. Call-centre workers were generally the most sedentary and least physically active at work; customer service workers were typically the least sedentary and the most active at work. CONCLUSION: The workplace is a key setting for prolonged sedentary time, especially for some occupational groups, and the potential health risk burden attached requires investigation. Future workplace regulations and health promotion initiatives for sedentary occupations to reduce prolonged sitting time should be considered.

Concepts: Sitting, Working time, Employment, Physical exercise, Energy, Customer service, Overweight, Obesity


Long daytime and overnight shifts remain a major feature of working life for trainees in anaesthesia. Over the past 10 years, there has been an increase in awareness and understanding of the potential effects of fatigue on both the doctor and the patient. The Working Time Regulations (1998) implemented the European Working Time Directive into UK law, and in August 2009 it was applied to junior doctors, reducing the maximum hours worked from an average of 56 per week to 48. Despite this, there is evidence that problems with inadequate rest and fatigue persist. There is no official guidance regarding provision of a minimum standard of rest facilities for doctors in the National Health Service, and the way in which rest is achieved by trainee anaesthetists during their on-call shift depends on rota staffing and workload. We conducted a national survey to assess the incidence and effects of fatigue among the 3772 anaesthetists in training within the UK. We achieved a response rate of 59% (2231/3772 responses), with data from 100% of NHS trusts. Fatigue remains prevalent among junior anaesthetists, with reports that it has effects on physical health (73.6% [95%CI 71.8-75.5]), psychological wellbeing (71.2% [69.2-73.1]) and personal relationships (67.9% [65.9-70.0]). The most problematic factor remains night shift work, with many respondents commenting on the absence of breaks, inadequate rest facilities and 57.0% (55.0-59.1) stating they had experienced an accident or near-miss when travelling home from night shifts. We discuss potential explanations for the results, and present a plan to address the issues raised by this survey, aiming to change the culture around fatigue for the better.

Concepts: Health, Employment, Health care, Training, Working time, Doctor, Shift work, National Health Service


IMPORTANCE Short sleep duration is common in adolescents and young adults, and short sleep duration is a risk factor for motor vehicle crash. OBJECTIVES To assess the association between hours of sleep and the risk for motor vehicle crash, including the time of day of crash and types of crash (single, multiple vehicle, run off road, and intersection). DESIGN Prospective cohort study. SETTING New South Wales, Australia. PARTICIPANTS Questionnaire responses were obtained from 20 822 newly licensed drivers aged 17 to 24 years. Participants held a first-stage provisional license between June 2003 and December 2004 prospectively linked to licensing and police-reported crash data, with an average of 2 years of follow-up. Analyses were conducted on a subsample of 19 327 participants for which there was full information. EXPOSURE Sleeping 6 or fewer hours per night. MAIN OUTCOMES AND MEASURES The main outcome variable was police-reported crash. Multivariable Poisson regression models were used to investigate the role of sleep duration on the risk for crash. RESULTS On average, those who reported sleeping 6 or fewer hours per night had an increased risk for crash compared with those who reported sleeping more than 6 hours (relative risk [RR], 1.21; 95% CI, 1.04-1.41). Less weekend sleep was significantly associated with an increased risk for run-off-road crashes (RR, 1.55; 95% CI, 1.21-2.00). Crashes for individuals who had less sleep per night (on average and on weekends) were significantly more likely to occur between 8 PM and 6 AM (RR, 1.86; 95% CI, 1.11-3.13, for midnight to 5:59 AM and RR, 1.66; 95% CI, 1.15-2.39, for 8:00 PM to 11:59PM). CONCLUSIONS AND RELEVANCE Less sleep per night significantly increased the risk for crash for young drivers. Less sleep on weekend nights increased the risk for run-off-road crashes and crashes occurring in the late-night hours. This provides rationale for governments and health care providers to address sleep-related crashes among young drivers.

Concepts: New South Wales, Working time, Poisson regression, Epidemiology, Regression analysis, Cohort study, Sleep, Relative risk