Advertisement

Short rest between shifts (quick returns) and night work is associated with work-related accidents

  • Øystein VedaaEmail author
  • Anette Harris
  • Eilin K. Erevik
  • Siri Waage
  • Bjørn Bjorvatn
  • Børge Sivertsen
  • Bente E. Moen
  • Ståle Pallesen
Original Article
  • 59 Downloads

Abstract

Purpose

The aim of this study was to examine whether less than 11 h between shifts (i.e., quick returns, QRs) and night shifts is associated with self-reported work-related accidents, near accidents or dozing off at work in a sample of nurses.

Methods

The study was based on cross-sectional data from 1784 nurses (response rate = 60%; mean age = 40.1 years, SD = 8.4; 91% female). Negative binomial regression analyses were conducted to investigate the association between the shift exposures, and eight different self-reported work-related items on accidents, near accidents and dozing off at work, controlling for demographics and work factors.

Results

The number of QRs during a year was positively associated with seven of the eight items on work-related accidents, near-accidents and dozing off at work, and number of night shifts was positively associated with five items. Some of the key findings were that QRs were associated with nurses causing harm to themselves (incidence rate ratio [IRR] = 1.009; 95% CI = 1.005–1.013), causing harm to patients/others (IRR = 1.006; 95% CI = 1.002–1.010) and causing harm to equipment (IRR = 1.004; 95% CI = 1.001–1.007); while night shifts were associated with nurses involuntarily dozing off at work (IRR = 1.015; 95% CI = 1.013–1.018), dozing off while driving to/from work (IRR = 1.009; 95% CI = 1.006–1.011), and harming patients/others (IRR = 1.005; 95% CI = 1.001–1.009).

Conclusion

QRs and night shifts were both associated with the self-reported work-related accidents, near-accidents and dozing off at work. Studies that can establish the causal relationship between QRs and accidents are called for.

Keywords

Quick returns Night shifts Accidents Injury Near accidents Dozing off 

Notes

Funding

The study was partly funded from Nordforsk, Nordic Program on Health and Welfare (74809).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Åkerstedt T (1995) Work hours, sleepiness and the underlying mechanisms. J Sleep Res 4:15–22CrossRefGoogle Scholar
  2. Åkerstedt T, Kecklund G, Hörte L-G (2001) Night driving, season, and the risk of highway accidents. Sleep 24:401–406CrossRefGoogle Scholar
  3. Andreassen CS, Pallesen S, Moen BE, Bjorvatn B, Waage S, Schaufeli WB (2018) Workaholism and negative work-related incidents among nurses. Ind Health.  https://doi.org/10.2486/indhealth.2017-0223 Google Scholar
  4. Benavides FG, Benach J, Muntaner C, Delclos GL, Catot N, Amable M (2006) Associations between temporary employment and occupational injury: what are the mechanisms? Occup Environ Med 63:416–421CrossRefGoogle Scholar
  5. Connor J et al (2002) Driver sleepiness and risk of serious injury to car occupants: population based case control study.BMJ 324:1125  https://doi.org/10.1136/bmj.324.7346.1125 (Clinical research ed)CrossRefGoogle Scholar
  6. Dahlgren A, Tucker P, Gustavsson P, Rudman A (2016) Quick returns and night work as predictors of sleep quality, fatigue, work–family balance and satisfaction with work hours. Chronobiol Int  https://doi.org/10.3109/07420528.2016.1167725 Google Scholar
  7. de Cordova PB, Bradford MA, Stone PW (2016) Increased errors and decreased performance at night: a systematic review of the evidence concerning shift work and quality. Work 53:825–834 (reading mass)CrossRefGoogle Scholar
  8. DeLeire T, Levy H (2004) Worker sorting and the risk of death on the job. J Labor Econ 22:925–953CrossRefGoogle Scholar
  9. Demos K et al (2016) Partial sleep deprivation impacts impulsive action but not impulsive decision-making. Physiol Behav 164:214–219CrossRefGoogle Scholar
  10. Dinges DF (1995) An overview of sleepiness and accidents. J Sleep Res 4:4–14CrossRefGoogle Scholar
  11. DMV.org How marital status affects auto insurance rates. https://www.dmv.org/insurance/how-marital-status-affects-auto-insurance-rates.php
  12. Dorrian J, Tolley C, Lamond N, van den Heuvel C, Pincombe J, Rogers AE, Drew D (2008) Sleep and errors in a group of Australian hospital nurses at work and during the commute. Appl Ergon 39:605–613CrossRefGoogle Scholar
  13. Eldevik MF, Flo E, Moen BE, Pallesen S, Bjorvatn B (2013) Insomnia, excessive sleepiness, excessive fatigue, anxiety, depression and shift work disorder in nurses having less than 11 h in-between shifts. PLoS One 8:e70882CrossRefGoogle Scholar
  14. European Foundation for the Improvement of Living and Working Conditions (2016) Sixth European working conditions survey–overview report. Publications Office of the European Union, LuxembourgGoogle Scholar
  15. Flo E, Pallesen S, Moen BE, Waage S, Bjorvatn B (2014) Short rest periods between work shifts predict sleep and health problems in nurses at 1-year follow-up. Occup Environ Med 71:555–561CrossRefGoogle Scholar
  16. Folkard S, Tucker P (2003) Shift work, safety and productivity. Occup Med (Lond) 53:95–101CrossRefGoogle Scholar
  17. Kecklund G, Axelsson J (2016) Health consequences of shift work and insufficient sleep. BMJ 355:i5210.  https://doi.org/10.1136/bmj.i5210 CrossRefGoogle Scholar
  18. Knutsson A, Åkerstedt T (1992) The healthy-worker effect: self-selection among Swedish shift workers. Work Stress 6:163–167CrossRefGoogle Scholar
  19. Kunaviktikul W et al. (2015) Nurses’ extended work hours: patient, nurse and organizational outcomes. Int Nurs Rev 62:386–393CrossRefGoogle Scholar
  20. Macdonald II, Smith L, Lowe SL, Folkard S (1997) Effects on accidents of time into shift and of short breaks between shifts International. J Occup Med 3:S40–S45Google Scholar
  21. Nicoletti C, Spengler CM, Läubli T (2014) Physical workload, trapezius muscle activity, and neck pain in nurses’ night and day shifts: a physiological evaluation. Appl Ergon 45:741–746CrossRefGoogle Scholar
  22. Nielsen HB et al. (2018) Short time between shifts and risk of injury among Danish hospital workers: a register-based cohort study. Scand J Work Environ Health.  https://doi.org/10.5271/sjweh.3770 Google Scholar
  23. Richter K, Acker J, Adam S, Niklewski G (2016) Prevention of fatigue and insomnia in shift workers—a review of non-pharmacological measures. EPMA J 7:16.  https://doi.org/10.1186/s13167-016-0064-4 CrossRefGoogle Scholar
  24. Robb G, Sultana S, Ameratunga S, Jackson R (2008) A systematic review of epidemiological studies investigating risk factors for work-related road traffic crashes and injuries. Inj Prev 14:51–58CrossRefGoogle Scholar
  25. Rogne T et al. (2018) Rate of avoidable deaths in a Norwegian hospital trust as judged by retrospective chart review. BMJ Qual Saf.  https://doi.org/10.1136/bmjqs-2018-008053 Google Scholar
  26. Silbergleit R, Kronick SL, Philpott S, Lowell MJ, Wagner C (2006) Quality of emergency care on the night shift. Acad Emerg Med 13:325–330CrossRefGoogle Scholar
  27. Sorita A et al. (2014) Off-hour presentation and outcomes in patients with acute myocardial infarction: Systematic review and meta-analysis. BMJ Open 348:f7393Google Scholar
  28. Trinkoff AM, Le R, Geiger-Brown J, Lipscomb J (2007) Work schedule, needle use, and needlestick injuries among registered nurses Infection. Control Hosp Epidemiol 28:156–164.  https://doi.org/10.1086/510785 CrossRefGoogle Scholar
  29. Van Dongen HPA, Maislin G, Mullington JM, Dinges DF (2003) The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction. and total sleep deprivation Sleep 2:117–126CrossRefGoogle Scholar
  30. Vedaa Ø, Harris A, Bjorvatn B, Waage S, Sivertsen B, Tucker P, Pallesen S (2016) Systematic review of the relationship between quick returns in rotating shift work and health-related outcomes. Ergonomics 59:1–14.  https://doi.org/10.1080/00140139.2015.1052020 CrossRefGoogle Scholar
  31. Vedaa Ø et al. (2017a) Sleep detriments associated with quick returns in rotating shift work: a diary study. J Occup Environ Med 59:522–527CrossRefGoogle Scholar
  32. Vedaa Ø et al. (2017b) Short rest between shift intervals increases the risk of sick leave: a prospective registry study. Occup Environ Med 74:496–501.  https://doi.org/10.1136/oemed-2016-103920 CrossRefGoogle Scholar
  33. Weiss NS (1995) Analytic approaches for dealing with possible recall bias in case-control studies—reply. Am J Epidemiol 141:299CrossRefGoogle Scholar
  34. Williamson A, Lombardi DA, Folkard S, Stutts J, Courtney TK, Connor JL (2011) The link between fatigue and safety. Accid Anal Prev 43:498–515CrossRefGoogle Scholar
  35. Zhang T, Chan AH (2014) Sleepiness and the risk of road accidents for professional drivers: a systematic review and metaanalysis of retrospective studies. Saf Sci 70:180–188CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Øystein Vedaa
    • 1
    • 2
    • 3
    Email author
  • Anette Harris
    • 4
  • Eilin K. Erevik
    • 4
  • Siri Waage
    • 5
    • 6
  • Bjørn Bjorvatn
    • 5
    • 6
  • Børge Sivertsen
    • 1
    • 2
    • 7
  • Bente E. Moen
    • 5
  • Ståle Pallesen
    • 4
    • 6
  1. 1.Department of Mental HealthNorwegian University of Science and TechnologyTrondheimNorway
  2. 2.Department of Health PromotionNorwegian Institute of Public HealthBergenNorway
  3. 3.Division of Mental Health Care, Department of ØstmarkaSt. Olavs University HospitalTrondheimNorway
  4. 4.Department of Psychosocial ScienceUniversity of BergenBergenNorway
  5. 5.Department of Global Public Health and Primary Care, Centre for International HealthUniversity of BergenBergenNorway
  6. 6.Norwegian Competence Center for Sleep DisordersHaukeland University HospitalBergenNorway
  7. 7.Department of Research and InnovationHelse Fonna HFHaugesundNorway

Personalised recommendations