Association of working hour characteristics and on-call work with risk of short sickness absence among hospital physicians: A longitudinal cohort study

Ropponen, Annina; Koskinen, Aki; Puttonen, Sampsa; Ervasti, Jenni; Kivimäki, Mika; Oksanen, Tuula; Härmä, Mikko; Karhula, Kati

doi:10.1080/07420528.2021.1993238

Cited by 9 publications

(10 citation statements)

References 39 publications

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“…Physicians were identified from other occupational groups by working time regime coding in registry-based working hour data. Similarly to our previous study [ 27 ], physicians’ regular working hour data was retrieved from the working time scheduling program Titania® and the on-call working hour data from Titania for physicians® software (CGI Finland Ltd., Helsinki, Finland). Altogether 728 physicians had combined data from survey and the two working time scheduling software.…”

Section: Methodsmentioning

confidence: 99%

Hospital physicians´ working hour characteristics and sleep quality: a cross-sectional analysis of realized working hour and survey data

Karhula

Koskinen

Ervasti

et al. 2022

BMC Health Serv Res

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Background Hospital physicians’ work includes on-call duties to provide 24/7 health care. Previous studies using self-reported survey data have associated long working hours and on-call work with sleep difficulties. To reduce recall bias, we complemented survey data with payroll-based objective data to study whether hospital physicians’ realized working hours are associated with sleep. Methods The study was nested within the Finnish Public Sector study. We used survey data on 728 hospital physicians (mean age 43.4 years, 62% females) from 2015 linked to realized daily working hour data from 3 months preceding the survey. The associations of working hour characteristics with sleep quantity and quality were studied with multinomial logistic regression analysis adjusted for demographics, overall stressfulness of life situation, control over scheduling of shifts, and hospital district. Results One fourth (26%) of the participants reported short (≤6.5 h) average sleep duration. Frequent night work (> 6 shifts/91 days) was associated with short sleep (OR 1.87 95%CI 1.23–2.83) compared to no night work. Approximately one third (32%) of the physicians reported insufficient sleep. Physicians with long weekly working hours (> 48 hours) had higher odds for insufficient sleep (OR 1.78 95%CI 1.15–2.76) than physicians with short weekly working hours (< 40 hours). Insufficient sleep was also associated with frequent on-call duties (> 12 shifts/3 months OR 2.00 95%CI 1.08–3.72), frequent night work (OR 1.60 95%CI 1.09–2.37), and frequent short shift intervals (≤11 hours; > 12 times/3 months OR 1.65 95%CI 1.01–2.69) compared to not having these working hour characteristics. Nearly half of the physicians (48%) reported at least one sleep difficulty at least two times a week and frequent night work increased odds for difficulties in initiating sleep (OR 2.43 95%CI 1.04–5.69). Otherwise sleep difficulties were not associated with the studied working hour characteristics. Conclusion We used realized working hour data to strengthen the evidence on on-call work and sleep quality and our results advice to limit the frequency of night work, on-call shifts, short shift intervals and long weekly working hours to promote hospital physicians’ sufficient sleep.

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Section: Methodsmentioning

confidence: 99%

Hospital physicians´ working hour characteristics and sleep quality: a cross-sectional analysis of realized working hour and survey data

Karhula

Koskinen

Ervasti

et al. 2022

BMC Health Serv Res

Self Cite

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“…Daily working‐hour and on‐call shift data (later working‐hour data) were retrieved from the Titania ® (CGI Finland Ltd) records on working‐hour characteristics without on‐call shifts, and the Titania ® for Physicians (CGI Finland Ltd) records on on‐call duties. 16 The working‐hour data included actual payroll‐based start/end times of work and absences, including days off, sickness, and other leaves. Based on the generally used proxies for long working hours and time for recovery, we created the following measures for this study: weekly working hours (mean), shift length (mean), and number of work shifts of various lengths (≤12 h, >12 h, and >24 h).…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Working hours, on-call shifts, and risk of occupational injuries among hospital physicians: A case-crossover study

Ropponen

Koskinen

Puttonen

et al. 2022

Journal of Occupational Health

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Objective To investigate the association of hospital physicians’ working hours and on‐call shifts with the risk of occupational injuries. Methods In this nested cohort study of 556 Finnish hospital physicians, we linked electronic records from working‐hour and on‐call duty payroll data to occupational injury data obtained from the Finnish Workers’ Compensation Center for the period 2005–2019. We used a case‐crossover design with matched intervals for a 7‐day ‘case window’ immediately prior to occupational injury and a ‘control window’ 7 days prior to the beginning of the case window, and analyzed their associations using conditional logistic regression models. Results We noted 556 occupational injuries, 281 at the workplace and 275 while commuting. Having three to four long (>12 h) work shifts on the preceding 7 days was associated with a higher probability of an occupational injury (odds ratio [OR] 2.14, 95% confidence interval [CI] 1.11, 4.09), and the OR for three to four on‐call shifts was 3.54 (95%CI 2.11, 5.92) in comparison to having none of these work shift types. A higher number of several consecutive working days was associated with a higher probability of injury in a dose‐response manner. Moreover, increasing weekly working hours was associated with an increased likelihood of injury (OR 1.03, 95%CI 1.01, 1.04), whereas the number of normal (≤12 h) work shifts reduced this likelihood (OR 0.79, 95%CI 0.64, 0.98). Conclusions Our findings suggest that accumulated working‐hour load, as opposed to single, very long (>24 h) work shifts, may increase the risk of occupational injury among hospital physicians.

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“…In einer Stichprobe mit 2845 Klinikärzt:innen konnte gezeigt werden, dass lange Arbeitsschichten, Bereitschaftsdienste und kurze Schichtintervalle mit dem Risiko kurzer Krankheitsausfälle von 1-3 Tagen bei Krankenhausärzt:innen in Zusammenhang stehen [ 55 ]. Eine weitere Studie untersuchte die Zusammenhänge zwischen Schlaf, Arbeitszeit und Bereitschaftsdienst von 728 Krankenhausärzt:innen.…”

Section: Arbeitszeitbezogene Auswirkungen Und Konsequenzenunclassified

Arbeitszeit bei Ärzt:innen und Auswirkungen auf Gesundheit, Zufriedenheit und Gesundheitsversorgung

2023

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ZusammenfassungVeränderungen der Arbeitswelt hinsichtlich innovativer Arbeitszeitmodelle erreichen zunehmend auch die Patient:innenversorgung, so steigt beispielsweise die Zahl der in Teilzeit arbeitenden Ärzt:innen kontinuierlich an. Gleichzeitig führt eine allgemeine Zunahme chronischer Erkrankungen und multimorbider Leiden, als auch der steigende ärztliche Personalmangel zu mehr Arbeitsbelastung und Unzufriedenheit. Die vorliegende Kurzübersicht fasst die aktuelle Studienlage hinsichtlich der Arbeitszeit von Ärzt:innen und damit verbundenen Konsequenzen zusammen und gibt einen ersten Überblick zu möglichen Lösungsansätzen.

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Association of working hour characteristics and on-call work with risk of short sickness absence among hospital physicians: A longitudinal cohort study

Cited by 9 publications

References 39 publications

Hospital physicians´ working hour characteristics and sleep quality: a cross-sectional analysis of realized working hour and survey data

Hospital physicians´ working hour characteristics and sleep quality: a cross-sectional analysis of realized working hour and survey data

Working hours, on-call shifts, and risk of occupational injuries among hospital physicians: A case-crossover study

Arbeitszeit bei Ärzt:innen und Auswirkungen auf Gesundheit, Zufriedenheit und Gesundheitsversorgung

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