Health effects of different shift work arrangements in the petroleum- and health care sector

More and more employees work beyond what has been normal working hours. In the health care and petroleum sector different working arrangements are widespread, which has both positive and negative consequences. We know from previous research that shift and night work leads to a higher risk of sleep deprivation, poor recovery from work, reduced cognitive and physiological performance, and musculoskeletal problems. Shift and night work may cause a greater risk of critical errors and accidents. However, we have too little knowledge of the biological, psychological, physical, and social factors that lead to poorer health for shift workers. In this project, an interdisciplinary research group will investigate the interaction between shift work, occupational health, and safety in the petroleum and health care sectors. A comprehensive survey on working hours, health, and work environment conditions both in the health care sector (registered nurses and licensed practical nurses) and the petroleum sector (offshore workers) has been carried out in the project. 3459 people from the health sector and 1935 people from the petroleum sector responded to the survey. These people have shared their birth and social security number in the survey and have given us permission to link their information from the Norwegian Prescription Database (NorPD) and the national social security register. An intervention study was carried out at a hospital where nurses at a newborn intensive- and gastro surgical unit worked 12-hour work shifts for one year. Data collection was done by interviewing 24 participants before, during, and after the intervention. This has given us a great overview of the pros and cons of working 12-hour work shifts in hospitals. The nurse's preferences for working 12-hour shifts are very diverse and depend on factors such as own health, family situation, work responsibilities, tolerance, degree of sleep problems, and personality. Although the experience of working 12-hour shifts was positive for many, it was not universally preferred. The study recommends that it should be voluntary to work 12-hour shifts in public hospitals. Few municipalities have carried out 12-hour work shifts in nursing homes. In this project, we interviewed the employees in a dementia special care unit at a nursing home which had 12.5 -hour work shift schedules. The employees had been working 12,5 -hour shifts for a year. Findings from the interviews show that this shift schedule could work well if the employees are highly motivated and have well-adjusted private lives to accommodate this type of shiftwork. The survey confirmed that many employees have sleep problems because of shift work in the petroleum sector. Many also reported impaired functioning because of working outdoors in the cold. The occurrence of musculoskeletal disorders seems to appear more frequently in cold compared to warm work environments. The physiological cost of work can greatly impact employees working shifts lasting 7 to 12 h for several consecutive days, year-round. We investigated further how work in the cold affected the physiological workload and manual function, which is particularly vulnerable in cold environments. Physiological experiments showed an increased muscular load during simulated work tasks in cold environments. Optimal cold-weather clothing is essential requirement to reduce heat loss to the surroundings and maintain optimal manual function and avoid an increased muscular load. Another study showed that the use of cold-weather clothing and equipment significantly increased the muscular and metabolic cost of physical work and that lighter clothing and equipment, especially shoes, can reduce this extra burden. The results are published as part of the doctoral work in the project. The project has conducted laboratory studies on cognitive performance during the night- and daywork at two different ambient temperatures (-2 and 23°C). The results show that circadian rhythm and ambient temperature have no effect on short-term memory, but we find an effect of circadian rhythm on reaction time, with reduced performance at night at -2°C compared to daytime. This effect was not observed at 23°C. Lower cortisol levels were observed at night, but there was no effect of ambient temperature. The new knowledge on the interaction between shift work, physical and mental performance, and employee preferences for a 12-hour shift can aid the definition of various types of occupational health and safety-enhancing measures and recommendations for shift work in the petroleum and healthcare sector. The project is a collaboration between SINTEF, NTNU, Vår Energi, Norwegian Nurses Association, Spekter, and the Norwegian Union of Municipal and General Employees.

Prosjektet har vært av strategisk betydning både for både petroleumsindustrien og partnerne fra offentlig sektor. Prosjektet har bidratt med økt kunnskap om helseeffekter av skiftarbeid i to vidt forskjellige sektorer (petroleum og helse). Gjennom å prøve ut 12 timers vakter på to avdelinger på ett sykehus og i sykehjem, har vi fremskaffet verdifull innsikt om ansattes preferanser som vil være av høy betydning for helsesektoren i sine videre vurderinger. For petroleumssektoren har dette prosjektet spesielt vært av relevant for ny innsikt i arbeidsmiljørisiko forbundet med økt aktivitet i nordlige områder. Prosjektet har gitt ny kunnskap om samspillet mellom skiftarbeid, arbeidsmiljø, tretthet og helsearbeideres preferanser for å arbeide 12-timers turnus. Resultatene fra prosjektet kan bidra til å definere ulike typer helse- og sikkerhetsfremmende tiltak, redusert sykefravær, økt produktivitet og anbefalinger for skiftarbeid i petroleum- og helsesektoren.

Understanding the health and safety effect of work schedules is important because an increasing number of people work outside standard working hours. There is a growing demand for flexible working hours in general. Different working hours and an increased demand for flexible working hours are especially important in occupations characterized by traditional rotation schemes, as in the health care sector and the petroleum sector. Despite this, there is a lack of research-based knowledge on the long-term eff ect of shift-work and work environment on health and safety. The proposed project is designed to investigate the interaction of these long-term effects, thus providing knowledge about shift-work related factors that might affect health and sick leave, as well as health promoting actions. A combination of quantitative and qualitative research methods will be applied. Register studies will identify diagnoses and prevalence of sick leave related to shift-work in both healthcare- and petroleum workers. The association between the working environment, health and sick leave is studied through both self-reported health-status questionnaires and through physiological measurements. An integrated analysis of all the collected data, aimed to identify how differen t shift-work arrangements affects employee`s health and safety, will be conducted. Further, gain understanding how this knowledge can be transferred from the petroleum sector to/from the healthcare sector. These goals will be achieved by a truly multidi sciplinary approach, combining qualitative and quantitative perspectives. The results are expected to add new knowledge on how the interaction between social, workplace related and individual factors are linked to both desired and undesired health outcome s of shift work. Some health outcomes might be superior and possible to transfer between sectors, while others might be more sectors specific."