Risk of injury after evening and night work – findings from the Danish Working Hour Database

Abstract

Objectives Evening and night work have been associated with higher risk of injury than day work. However, previous findings may be affected by recall bias and unmeasured confounding from differences between day, evening and night workers. This study investigates whether evening and night work during the past week increases risk of injury when reducing recall bias and unmeasured confounding. Methods We linked daily working hours at the individual level of 69 200 employees (167 726 person years from 2008-2015), primarily working at hospitals to registry information on 11 834 injuries leading to emergency room visits or death. Analyses were conducted with Poisson regression models in the full population including permanent day, evening and night workers, and in two sub-populations of evening and night workers, with both day and evening or night work, respectively. Thus, the exchangeability between exposure and reference group was improved in the two sub-populations. Results Risk of injury was higher after a week with evening work [incidence rate ratio (IRR) 1.32, 95% confidence interval (CI) 1.26-1.37] and night work (IRR 1.33, 95% CI 1.25-1.41) compared with only day work. Similar, although attenuated, estimates were found for evening work among evening workers (IRR 1.18, 95% CI 1.12-1.25), and for night work among night workers (IRR 1.10, 95% CI 1.01-1.20). Conclusion There is an overall increased risk of injury after a week that has included evening or night work compared with only day work. Though attenuated, the higher risk remains after reducing unmeasured confounding.

Short time between shifts and risk of injury among Danish hospital workers: a register-based cohort study

“…A sensitivity analysis tested for additional potential unmeasured confounding between employees with and without quick returns. This was done by restricting the population to employees with at least one quick return the past year, analogous to a previous study (40).…”

“…The study population has previously been described in detail (31). In brief, we included all employees in the DWHD from two regions of Denmark (urban and rural area), between 18 and 65 years old and with at least one year of work experience registered in the DWHD between 2007-2015.…”

“…In addition, information on occupation (administrative work, jobs with patient contact and technical staff) and socioeconomic status (SES) (high, intermediate and low) were included, based on main annual income described by the Danish classification of ISCO-codes from Statistic Denmark's Employment Classification Module (30). For exact categorization of DISCO-codes in occupation and SES, see (31).…”

Decreased psychomotor vigilance of female shift workers after working night shifts

“…Night-shift workers who, due to their work schedule, are forced to change their sleep cycles against their individual needs are particularly affected by psychomotor vigilance impairment. For example, shift workers are at an increased risk for work injuries, but also for drowsiness, car crashes or near-miss automobile incidents while commuting [11–13]. Risks for accidents appear to be most pronounced after the first night shift, followed by a subsequent decrease with additional night shifts.…”

Erreichbarkeit: Symptom oder Merkmal der Arbeit? Was bedeutet das Ergebnis für die Arbeitsgestaltung?

“…Letztlich besteht eine Möglichkeit, die sich durch Erreichbarkeit erhöhende Gesamtarbeitszeit zu reduzieren, indem die Zeiten, die für die Erreichbarkeit von Arbeitsanforderungen genutzt werden, auf die Arbeitszeit angerechnet werden. Dies sollte möglichst unter Berücksichtigung der elfstündigen Ruhezeit erfolgen, da mehrere Studien aus Skandinavien die fehlbeanspruchenden Auswirkungen der Reduzierung der elfstündigen Ruhezeiten belegen (Nielsen et al 2018;Vedaa et al 2017aVedaa et al , 2017b. Eine Neuorientierung bei der Anerkennung von Arbeitszeiten ist gerade vor dem Hintergrund relevant, dass die in dieser Untersuchung beschriebene Arbeit der Erreichbaren mit ihren hohen wissens-, kommunikations-und kooperationsintensiven Anforderungen typisch ist für die sich durch Digitalisierung und Vernetzung verändernde Arbeitswelt mit ihrer Verlagerung der Arbeitsanforderungen weg von einfachen hin zu qua-K lifikationsfordernder Arbeit (Hacker 2018;Hornung et al 2010).…”