Trajectories of sleepiness and insomnia symptoms in Norwegian nurses with and without night work and rotational work

Numerous cross-sectional studies report high prevalence rates of sleepiness and insomnia in shift workers, but few longitudinal studies exist. We investigated trajectories of sleepiness and insomnia symptoms in a sample of Norwegian nurses across four measurements, spanning a total of four years (sleepiness) and five years (insomnia). The participants completed the Epworth Sleepiness Scale and the Bergen Insomnia Scale at each measurement instance. Latent growth curve models were used to analyse the data. Separate models examined night work (night work, entering and leaving night work) and rotational work (rotational work, entering and leaving rotational work) as predictors for trajectories of sleepiness and insomnia symptoms, respectively. Baseline values of sleepiness and insomnia were higher among rotational shift workers than among workers with fixed shifts (day or night). The results showed that night work throughout the period and entering night work during the period were not associated with different trajectories of sleepiness or insomnia symptoms, compared to not having night work. The same results were found for rotational work and entering rotational work, compared to not having rotational work. Leaving night work and leaving rotational work were associated with a decrease in sleepiness and insomnia symptoms, compared to staying in such work.     

The relationship between night work,chronotype, and cardiometabolic risk factors in female hospital employees

Night work has emerged as a risk factor for many chronic diseases, including obesity, diabetes, and cardiovascular disease. While night work is linked to a number of cardiometabolic indices, few studies have explored how different parameters, such as cumulative night work and intensity of night work, may influence cardiometabolic risk. Fewer studies have also explored the relationship while considering chronotype, a potential modifier between shift-induced circadian disruption and cardiometabolic outcomes. The main objective is to determine the association between night work parameters and cardiometabolic risk factors. The secondary objective is to assess how the association between night work parameters and cardiometabolic risk factors differs by chronotype. A cross-sectional study was conducted with 325 full- and part-time female hospital employees (168 rotating night workers, 157 day workers). Night work status, cumulative night work duration, and night work intensity were determined through self-report, and cardiometabolic risk factors were assessed through clinical exams. Chronotype was determined using the Munich Chronotype Questionniare (MCTQ). Multiple linear regression was used to examine the association between night work parameters and cardiometabolic risk factors. Current night work, cumulative night work, and night work intensity are associated with a number of cardiometabolic indices, including higher waist circumference, body mass index, fasting glucose, blood pressure, and cardiometabolic risk score. When stratified by chronotype, night work parameters are associated with a number of cardiometabolic risk factors in the evening-oriented chronotype subgroup. There is no difference in cardiometabolic risk factors in morning-oriented chronotypes when comparing night work parameters, with the exception of LDL cholesterol. These results suggest that night work parameters are associated with cardiometabolic risk, and night workers with an evening-oriented chronotype may be more susceptible to the adverse cardiometabolic impacts of night work. Future studies should consider chronotype when examining the relationship between night work and cardiometabolic risk.     

A comparison of the effects of mixed static and dynamic work with mainly dynamic work in hot conditions

Current physiological criteria for limiting work in hot conditions are frequently based on responses to mainly dynamic work (eg treadmill walking). Their applicability to industrial situations containing mixed static and dynamic work is questioned, since the physiological responses to static work are different from those of dynamic work. Each of eight subjects attempted a one hour uphill treadmill walk (mainly dynamic work), and an uphill treadmill walk whilst intermittently carrying a 20 kg weight in the arms (mixed static and dynamic work). The external work rates in the two conditions were equal, effected by lowering the treadmill gradient in the loaded condition. Experiments were conducted in a hot climate (33 degrees C dry bulb, 25 degrees C wet bulb). Oxygen consumption, minute ventilation, sweat rate and rated perceived exertion were all significantly higher (p less than 0.001) for the mixed static and dynamic work than for the dynamic work. This was also the case for heart rate and forearm skin temperature (p less than 0.01), and for auditory canal temperature (p less than 0.05). There was no significant difference between the two types of work for mean skin temperature, calf skin temperature and chest skin temperature. These results show that for the same external work, physiological strain and perceived exertion are greater for mixed static and dynamic work (carrying a load in the arms) than for mainly dynamic work (walking on a treadmill). They suggest that it is not appropriate to make direct comparisons of laboratory studies based on dynamic work, with practical situations containing mixed static and dynamic work in the heat.     

Recovery after Work: The Role of Work Beliefs in the Unwinding Process

According to the Effort-Recovery model, mental or physical detachment from work is an important mechanism of work related recovery, as delayed recovery has been associated with range of negative health symptoms. In this paper, we examine whether recovery from work (in the form of mentally disengagement from work) is affected by the concept of ‘work ethic’, which refers to beliefs workers hold about their work and leisure and the effects of experiencing interruptions at work. Two indices of post-work recovery were utilized: problem solving pondering and psychological detachment. The study was conducted with 310 participants employed from diverse occupational sectors. Main effects of positive and negative appraisal of work interruption and beliefs were analysed using mediated and moderated regression analysis on problem-solving pondering and detachment. Weakened belief in wasted time as a partial mediator, reduced problem-solving pondering post work when interruptions were appraised as positive, and a high evaluation of leisure partially mediated problem-solving pondering when interruptions were appraised as positive. The results also showed that a high evaluation of centrality of work and leisure moderated the effect of negative appraisal of work interruption on elevated problem-solving pondering. Positive appraisal of work interruption was related to problem-solving pondering, and the strength of this association was further moderated by a strong belief in delay of gratification. In addition, employees'' positive appraisal of work interruption was related to work detachment, and the strength of this association was further moderated by strong beliefs in hard work and self-reliance. These findings are discussed in terms of their theoretical and practical implications for employees who are strongly influenced by such work beliefs.     

Two biomechanical strategies for locomotor adaptation to split-belt treadmill walking in subjects with and without transtibial amputation

Locomotor adaptation is commonly studied using split-belt treadmill walking, in which each foot is placed on a belt moving at a different speed. As subjects adapt to split-belt walking, they reduce metabolic power, but the biomechanical mechanism behind this improved efficiency is unknown. Analyzing mechanical work performed by the legs and joints during split-belt adaptation could reveal this mechanism. Because ankle work in the step-to-step transition is more efficient than hip work, we hypothesized that control subjects would reduce hip work on the fast belt and increase ankle work during the step-to-step transition as they adapted. We further hypothesized that subjects with unilateral, trans-tibial amputation would instead increase propulsive work from their intact leg on the slow belt. Control subjects reduced hip work and shifted more ankle work to the step-to-step transition, supporting our hypothesis. Contrary to our second hypothesis, intact leg work, ankle work and hip work in amputees were unchanged during adaptation. Furthermore, all subjects increased collisional energy loss on the fast belt, but did not increase propulsive work. This was possible because subjects moved further backward during fast leg single support in late adaptation than in early adaptation, compensating by reducing backward movement in slow leg single support. In summary, subjects used two strategies to improve mechanical efficiency in split-belt walking adaptation: a CoM displacement strategy that allows for less forward propulsion on the fast belt; and, an ankle timing strategy that allows efficient ankle work in the step-to-step transition to increase while reducing inefficient hip work.     

Implications of flexible work systems for work studies

The relationship between changing work systems and work study methods is discussed by focusing on a recent trend toward more flexible work systems in different countries. These systems are commonly characterized by (a) uncoupling of working hours from business hours, (b) combining different atypical work forms and (c) individualized work patterns. Increased flexibility in working patterns is demanded because business hours may be covered by different workers and because special arrangements become necessary for unpopular shifts or linking separate jobs. Changes in work systems seem more successful when they are associated with (a) multiskilled work, (b) independent task implementation, (c) networked communication, (d) balanced or adjusted workload, and (e) accommodation of workers' preferences. Special attention is drawn to safety and health concerns and work-life effects. Many intervention studies done for work improvement are paying attention to multifaceted work aspects, locally available options, and participation by people. All these elements are important because prepackaged solutions do not exist. The following three views seem especially useful for action-oriented work studies: 1) Look at multiple aspects of the work, including work content and atypical work forms; 2) Know worker preferences and available options; and 3) Take into account work elements that may not be well defined, but important from local points of view. It is envisioned that these studies can provide support for a well-informed participatory process of work system changes in each local context.     

Fatigue complaints among female shift workers in a computer factory of Japan

For female workers in a computer factory in Japan, consisting of 41 daytime workers and 74 weekly-rotating shift workers (of whom, 37 each were engaged in, respectively, early-shift work and late-shift work during the survey week), within-day variations in the number of fatigue complaints were elucidated. Based on a repeated questionnaire survey, changes of fatigue complaints in a day were evaluated at three occasions, i.e., just before work, just after work, and before retiring, for three working days and one off day. The occasions of fatigue feelings differed among the three work groups: the complaints were significantly more frequent before work in the early-shift workers, after work in the late-shift workers, and before retiring in the daytime workers. Feeling of fatigue before and after work may be disadvantageous to safety and efficiency of work.     

Internal work and physiological responses during concentric and eccentric cycle ergometry

Internal mechanical work during cycling, required to raise and lower the legs and change their velocities, is shown to be an important factor when interpreting physiological responses to cycle ergometer exercise. The internal work required to move the legs during concentric and eccentric cycle ergometry at different speeds and workloads was calculated from segmental energy changes determined using cinematography and directly using an eccentric ergometer. The mean internal work rates obtained at pedal frequencies of 30, 60 and 90 min-1 were 11.5, 20 and 62 W respectively. When these estimates were added to the external work rates, they increased concentric and decreased eccentric work rates. The largest differences were seen at low work rates and high pedal frequencies during which concentric work rates increased by 51% and eccentric decreased 60% by the inclusion of internal work. When comparisons of concentric and eccentric cycling at equal uncorrected work rates were made, neglecting to include internal work introduced errors ranging from 12 to 97%. The calculated estimates of internal work agreed well with the power supplied by the eccentric ergometer to move the legs passively. The investigations show that the inclusion of internal work is important when comparing physiological responses during concentric and eccentric ergometry, especially when pedal frequencies exceed 60 min-1 and when work rates are small.     

Prioritizing sleep for healthy work schedules

ABSTRACT: Good sleep is advantageous to the quality of life. Sleep-related benefits are particularly helpful for the working class, since poor or inadequate amounts of sleep degrade work productivity and overall health. This review paper explores the essential role of sleep in healthy work schedules and primarily focuses on the timing of sleep in relation to the work period (that is, before, during and after work). Data from laboratory, field and modeling studies indicate that consistent amounts of sleep prior to work are fundamental to improved performance and alertness in the workplace. In addition, planned naps taken during work maintain appropriate levels of waking function for both daytime and night-time work. Clearly, sufficient sleep after work is vital in promoting recovery from fatigue. Recent data also suggest that the time interval between shifts should be adjusted according to the biological timing of sleep. Although sleep is more likely to be replaced by job and other activities in the real life, research shows that it is worthwhile to revise the work schedules in order to optimize sleep before, sometime during and after the work period. Therefore, we suggest establishing work-sleep balance, similar to work-life balance, as a principle for designing and improving work schedules.     

A method for assessing work productivity and flexibility in livestock farms

Changes affecting livestock farming systems have made farm work a central concern for both the sector and for farmers themselves. Increased pressure on farms to be competitive and productive together with farmers' demand for greater autonomy, holidays or time to spend on private activities and the family converge to underline the two key dimensions of work - productivity and flexibility - required for the assessment of work organization. This paper proposes a method called the QuaeWork (QUAlification and Evaluation of Work in livestock farms) to assess work productivity and flexibility on a farm, and its use to identify how livestock management can contribute to work organization on dairy farms. The QuaeWork method was set up through an iterative process combining surveys conducted with farmers in two regions of France, discussions with different experts and literature review. The QuaeWork was applied on a sample of seven dairy farms in the southern Massif Central in France to identify patterns of how livestock management contributes to work organization. The QuaeWork was used to analyse work organization over the year through a systemic approach to the farm, integrating interactions between herd and land management, workforce composition, equipment facilities and combinations of activities through a characterization of 'who does what, when and for how long'. The criteria for assessing work productivity were work duration (routine work, seasonal work) and work efficiency (per livestock unit or hectare of utilized agricultural area). The criteria for assessing work flexibility were room for manoeuvre and adjustments to internal and external events. The three main patterns of livestock management practices to work organization were identified. In pattern-1, farmers used indoor stable feeding practices with delegated work, with moderate room for manoeuvre and efficiency. In pattern-3, farmers used simplified milking, reproduction and breeding practices to seasonalize work and make it efficient with consistent room for manoeuvre. The method suggests social sustainability criteria to assess work productivity and flexibility, which are important for making reasoned decisions on livestock farm changes, especially innovations. Researchers could usefully exploit the QuaeWork to integrate work objectives (productivity, flexibility) into technical and economic goals.     

Factors Affecting Work Ability in Day and Shift‐Working Nurses

Satisfactory work ability is sustained and promoted by good physical and mental health and by favorable working conditions. This study examined whether favorable and rewarding work‐related factors increased the work ability among European nurses. The study sample was drawn from the Nurses' Early Exit Study and consisted of 7,516 nursing staff from seven European countries working in state‐owned and private hospitals. In all, 10.8% were day, 4.2% were permanent night, 20.9% were shift without night shift, and 64.1% were shift workers with night shifts. Participants were administered a composite questionnaire at baseline (Time 0) and 1 yr later (Time 1). The Work Ability Index (WAI) at Time 1 was used as the outcome measure, while work schedule, sleep, rewards (esteem and career), satisfaction with pay, work involvement and motivation, and satisfaction with working hours at Time 0 were included as potential determinants of work ability. Univariate and multivariate analyses were conducted after adjusting for a number of confounders (i.e., country, age, sex, type of employment, family status, and other job opportunities in the same area). Work schedule was not related to Time 1 changes in WAI. Higher sleep quality and quantity and more favorable psychosocial factors significantly increased work ability levels. Higher sleep quality and quantity did not mediate the effect of work schedule on work ability. No relevant interaction effects on work ability were observed between work schedule and the other factors considered at Time 0. As a whole, sleep and satisfaction with working time were gradually reduced from day work to permanent night work. However, scores on work involvement, motivation, and satisfaction with pay and rewards were the highest in permanent night workers and the lowest in rotating shift workers that included night shifts.     

A comparison of muscular mechanical energy expenditure and internal work in cycling

The hypothesis that the sum of the absolute changes in mechanical energy (internal work) is correlated with the muscular mechanical energy expenditure (MMEE) was tested using two elliptical chainrings, one that reduced and one that increased the internal work (compared to circular). Upper and lower bounds were put on the extra MMEE (work done by net joint torques in excess of the external work) with respect to the effect of intercompensation between joint torques due to biarticular muscles. This was done by having two measures of MMEE, one that allowed no intercompensation and one that allowed complete intercompensation between joints spanned by biarticular muscles. Energy analysis showed no correlation between internal work and the two measures of MMEE. When compared to circular, the chainring that reduced internal work increased MMEE, and phases of increased crank velocity associated with the elliptical shape resulted in increased power absorbed by the upstroke leg as it was accelerated against gravity. The resulting negative work necessitated additional positive work. Thus, the hypothesis that the internal work is correlated with MMEE was found to be invalid, and the total mechanical work done cannot be estimated by summing the internal and external work. Changes in the dynamics of cycling caused by a non-circular chainring may affect performance and must be considered during the non-circular chainring design process.     

Health effects of supplemental work from home in the European Union

Internationalization and technological developments have changed the work organization in developed and developing industrial economies. Information and communication technologies, such as computers and smartphones, are increasingly used, allowing more temporal and spatial flexibility of work. This may lead to an increase in supplemental work, i.e. constant availability or working in addition to contractually agreed work hours. This in turn extends work hours and leads to work hours in evenings and weekends, causing interferences of work hours with biological and social rhythms for sleep, recovery and social interaction. However, empirical findings on the effects of supplemental work and work hours on occupational health are rather scarce. Therefore, the aim of this study was to investigate the association between (1) work-related contacts outside of regular work hours and (2) working in the free time with self-reported work-related health impairments in the fourth and fifth European Working Conditions Surveys (EWCS 2005, EWCS 2010). Out of these cross-sectional, large-scale surveys, data on n?=?22?836 and n?=?34?399 employed workers were used for weighted logistic regression analyses. About half of the sample reported at least occasional supplemental work. The results showed an increased risk of reporting at least one health problem for employees who had been contacted by their employer (EWCS 2005), or worked in their free time to meet work demands (EWCS 2010) in the last 12 months, compared to those reporting no supplemental work or work-related contacts during free time. These results were controlled for demographic variables, physical and mental work load, worker autonomy, and several work hours characteristics (e.g. hours per week, unusual and variable hours). The risk of reporting health problems was increased by being contacted both sometimes (Odds Ratio [OR] 1.26, 95% Confidence Interval [CI] 1.14–1.39) and often (OR 1.13, 95% CI 1.02–1.25), whereas the frequency of working in the free time showed a clear dose-response effect (sometimes: OR 1.14, 95% CI 1.04–1.24; often: OR 1.60, 95% CI 1.47–1.75), both compared to the category “never”. The findings, thus, indicate that even a small amount of supplemental work beyond contractually agreed work hours may increase the risk of work-related health impairments. Working in the free time was associated with a substantial risk increase and might be a better indicator for actual work load than being contacted by the employer outside of contractually agreed work hours. Thus, in order to minimize negative health effects, availability requirements for employees outside their regular work hours should be minimized. While these effects definitely need further study, especially regarding a quantification of actual supplemental work and its temporal location, addressing the company culture and using incentives and policies might be options to reduce the amount of supplemental work and maintain the risks of health impairments in the working population at a lower level.     

Simultaneous positive and negative external mechanical work in human walking.

In human walking, the center of mass motion is similar to an inverted pendulum. Viewing double support as a transition from one inverted pendulum to the next, we hypothesized that the leading leg performs negative work to redirect the center of mass velocity, while simultaneously, the trailing leg performs positive work to replace the lost energy. To test this hypothesis, we developed a method to quantify the external mechanical work performed by each limb (individual limbs method). Traditional measures of external mechanical work use the sum of the ground reaction forces acting on the limbs (combined limbs method) allowing for the mathematical cancellation of simultaneous positive and negative work during multiple support periods. We expected to find that the traditional combined limbs method underestimates external mechanical work by a substantial amount. We used both methods to measure the external mechanical work performed by humans walking over a range of speeds. We found that during double support, the legs perform a substantial amount of positive and negative external work simultaneously. The combined limbs measures of positive and negative external work were approximately 33% less than those calculated using the individual limbs method. At all speeds, the trailing leg performs greater than 97% of the double support positive work while the leading leg performs greater than 94% of the double support negative work.     

The relative changes in isometric force and work during fatigue and recovery in isolated toad sartorius muscle

Toad sartorius muscle was subjected to sinusoidal varying length changes at 2 Hz to measure work. Both isometric tetanic force and work per cycle were measured before, during, and after a 3-min fatigue. Both isometric tetanic force and positive work, the work done by the muscle during the shortening part of the cycle, rapidly decreased in parallel in the first 40 s of fatigue. Thereafter, force continued to decrease, but at a slower rate, to about 10% of prefatigue values, whereas positive work levelled off at about 30% of prefatigue values. Negative work, the work done on the muscle during the lengthening part of the cycle, increased during fatigue to the extent that net work became negative. This was due to a prolonged relaxation, which resulted in active force still being generated while the muscle was being stretched. Work and force recovered at about the same rate. Isometric force measurements alone do not give any clear indication that net work will be negative under a particular set of experimental conditions.     

Objective working hour characteristics and work–life conflict among hospital employees in the Finnish public sector study

This epidemiological cohort study, based on Finnish public sector data, investigated the associations between objective working hour characteristics and work–life conflict in day and shift work. The comprehensive data of hospital workers (n = 8 931, 92% women, average age 45 years), consisted of survey responses from 2012, linked with the payroll data of working hour characteristics from 91 days preceding the survey. Logistic regression analysis was used to investigate the associations between working hour characteristics and experiencing work–life conflict often/very often. The analyses were adjusted for age (< 39, 40–49 and >50 years), sex, level of education, marital status, number of small (0–6 years) and school-aged (7–18 years) children, and the overall stressfulness of the life situation. We also conducted stratified analyses of age and sex on the basis of significant interactions. Difficulties in combining work and life were more often associated with shift work without night shifts and shift work with night shifts than with day work (41% and 34 versus 27%; OR for shift work with night shifts 1.78, 95% CI 1.59–2.00, OR for shift work without night shifts 1.42, 95% CI 1.26–1.60). A high proportion (> 25%) of long (> 40h, (OR 1.26, 95% 1.14–1.39) and very long (> 48h, OR 1.31, 95% CI 1.15–1.49) weekly working hours were associated with work–life conflict, and in the stratified analysis, the latter was also true among women (OR 1.54, 95% CI 1.25–1.89). Of the unsocial working hour characteristics, a relatively large amount (> 10% of all shifts) of evening (OR 1.56, 95% CI 1.41–1.72) and night shifts (OR 1.46, 95%CI 1.32–1.61), a high proportion (> 25% of all shifts) of quick returns (< 11h) (OR 1.46, 95% CI 1.31–1.63), and weekend work (OR 1.44, 95% CI 1.31–1.58) were associated with work–life conflict. A large amount of single days off (> 25% of all days off) was associated with work–life conflict among men (OR 1.90, 95% CI 1.11–3.25), but not in the whole sample. When the two types of shift work were analyzed separately, shift work without night shifts and very long work weeks had higher odds (OR 1.47, 95% CI 1.20–1.80) of work–life conflict than shift work with night shifts. Conversely, weekend work and evening shifts had higher odds of work–life conflict among shift workers with night shifts (OR 1.74, 95% 1.55–1.96; (OR 1.57, 95% CI 1.40–1.77) than among those without night shifts. To conclude, this study shows that shift workers with and without night shifts more often have difficulties combining work and life than day workers. Several unsocial working hour characteristics, including long work weeks, evening and night shifts, weekend work, and quick returns, are associated with work–life conflict.     

How a small enterprise improved the conditions of night and shift work using local resources

A small oxygen factory in Cantho Province located in the Mekong Delta Area in the southern part of Vietnam was studied to provide practical support measures to improve night and shift work. A direct observation study and a fatigue symptom survey during the work were conducted. The factory applied discontinuous two-shift systems in two teams. Depending on customers' demands, they frequently prolonged oxygen production until midnight. The study results showed work-related risks such as carrying heavy oxygen cylinders, workers' sleepiness during the night work, and increased fatigue feelings among production operators. Based on the study results, better strategies for night and shift work schedules such as regular work hours minimizing overtime and night work were discussed with the managers and workers. A follow-up visit three months later confirmed many improvements undertaken in the factory. Better work arrangements for night and shift workers were made including local lighting, resting corners, filling the height gaps on the work floors, and clear work instructions. Prolonged mid-night shift was stopped. It was concluded that local small enterprises in Vietnam have much potential to improve their conditions of shift and night work once practical support measures based on their local practice is given.     

Mechanical work performed by the individual legs during uphill and downhill walking

Previous studies of the mechanical work performed during uphill and downhill walking have neglected the simultaneous negative and positive work performed by the leading and trailing legs during double support. Our goal was to quantify the mechanical work performed by the individual legs across a range of uphill and downhill grades. We hypothesized that during double support, (1) with steeper uphill grade, the negative work performed by the leading leg would become negligible and the trailing leg would perform progressively greater positive work to raise the center of mass (CoM), and (2) with steeper downhill grade, the leading leg would perform progressively greater negative work to lower the CoM and the positive work performed by the trailing leg would become negligible. 11 healthy young adults (6 M/5 F, 71.0±12.3 kg) walked at 1.25 m/s on a dual-belt force-measuring treadmill at seven grades (0, ±3, ±6, ±9°). We collected three-dimensional ground reaction forces (GRFs) and used the individual limbs method to calculate the mechanical work performed by each leg. As hypothesized, the trailing leg performed progressively greater positive work with steeper uphill grade, and the leading leg performed progressively greater negative work with steeper downhill grade (p<0.005). To our surprise, unlike level-ground walking, during double support the leading leg performed considerable positive work when walking uphill and the trailing leg performed considerable negative work when walking downhill (p<0.005). To understand how humans walk uphill and downhill, it is important to consider these revealing biomechanical aspects of individual leg function and interaction during double support.