Influence of flexibility and variability of working hours on health and well-being

Flexible working hours can have several meanings and can be arranged in a number of ways to suit the worker and/or employer. Two aspects of “flexible” arrangement of working hours were considered: one more subjected to company control and decision (variability) and one more connected to individual discretion and autonomy (flexibility). The aim of the study was to analyze these two dimensions in relation to health and well-being, taking into consideration the interaction with some relevant background variables related to demographics plus working and social conditions. The dataset of the Third European Survey on working conditions, conducted in 2000 and involving 21,505 workers, was used. Nineteen health disorders and four psycho-social conditions were tested by means of multiple logistic regression analysis, in which mutually adjusted odds ratios were calculated for age, gender, marital status, number of children, occupation, mode of employment, shift work, night work, time pressure, mental and physical workload, job satisfaction, and participation in work organization. The flexibility and variability of working hours appeared inversely related to health and psycho-social well-being: the most favorable effects were associated with higher flexibility and lower variability. The analysis of the interactions with the twelve intervening variables showed that physical work, age, and flexibility are the three most important factors affecting health and well-being. Flexibility resulted as the most important factor to influence work satisfaction; the second to affect family and social commitment and the ability to do the same job when 60 years old, as well as trauma, overall fatigue, irritability, and headache; and the third to influence heart disease, stomachache, anxiety, injury, and the feeling that health being at risk because of work. Variability was the third most important factor influencing family and social commitments. Moreover, shift and night work confirmed to have a significant influence on sleep, digestive and cardiovascular troubles, as well and health and safety at work. Time pressure also showed a relevant influence, both on individual stress and social life. Therefore, suitable arrangements of flexible working time, aimed at supporting workers' coping strategies, appear to have a clear beneficial effect on worker health and well-being, with positive consequences also at the company and social level, as evidenced by the higher “feeling to be able to work until 60 years of age”.     

Flexible Working Hours,Health, and Well-Being in Europe: Some Considerations from a SALTSA Project

The project brought together researchers from 9 EU-Countries and resulted in a number of actions, in particular the following: (a) There is an urgent need of defining the concept of flexible working hours, since it has been used in many different and even counterintuitive ways; the most obvious distinction is where the influence over the working hours lies, that is between the “company-based flexibility” and the “individual-oriented flexibility”; (b) The review of the Legislation in force in the 15 European countries shows that the regulation of working times is quite extensive and covers (Council Directive 93/104/EC) almost all the various arrangements of working hours (i.e., part-time, overtime, shift, and night work), but fails to provide for flexibility; (c) According to the data of the Third EU Survey on Working Conditions, longer and “irregular” working hours are in general linked to lower levels of health and well-being; moreover, low (individual) flexibility and high variability of working hours (i.e., company-based flexibility) were consistently associated with poor health and well-being, while low variability combined with high autonomy showed positive effects; (d) Six substudies from different countries demonstrated that flexible working hours vary according to country, economic sector, social status, and gender; overtime is the most frequent form of company-based flexibility but has negative effects on stress, sleep, and social and mental health; individual flexibility alleviates the negative effects of the company-based flexibility on subjective health, safety, and social well-being; (e) The literature review was able to list more than 1,000 references, but it was striking that most of these documents were mainly argumentative with very little empirical data. Thus, one may conclude that there is a large-scale intervention ongoing in our society with almost completely unknown and uncontrolled effects. Consequently, there is a strong need for systematic research and well-controlled actions in order to examine in detail what flexible working hours are considered, what and where are their positive effects, in particular, as concerns autonomy, and what regulation seem most reasonable.     

Aging and shift work: a complex problem to face

The baby boomer generation is well into the 50+ age bracket, making it one of the largest demographic age cohorts. Whereas this cohort would have previously considered retirement, the evidence suggests that it will remain in the workforce for a longer period in response to a number of social and economic drivers. Mandatory retirement has either been abolished or is under consideration. An increased and healthier life expectancy means that people may work longer for financial and/or psychological reasons. In addition, a global shortage of skilled labor will result in efforts to keep employees in the workplace for longer periods. These trends have a number of implications for working time. What are the health implications of an aging workforce? How do we sustain good work ability into the latter years? What do we know about aging and shift work? What actions are required in the workplace to assist aging workers? This paper is not a comprehensive review of the literature but serves to highlight the complexities in understanding the relationship between shift work and aging. We discuss aging and human function and, in particular, the impact of aging on the circadian system. In addition, we outline new policy directions in this area and raise several suggestions to assist the well-being of aging workers.     

Flexible working hours, health, and well-being in Europe: some considerations from a SALTSA project

The project brought together researchers from 9 EU-Countries and resulted in a number of actions, in particular the following: (a) There is an urgent need of defining the concept of flexible working hours, since it has been used in many different and even counterintuitive ways; the most obvious distinction is where the influence over the working hours lies, that is between the “company-based flexibility” and the “individual-oriented flexibility”; (b) The review of the Legislation in force in the 15 European countries shows that the regulation of working times is quite extensive and covers (Council Directive 93/104/EC) almost all the various arrangements of working hours (i.e., part-time, overtime, shift, and night work), but fails to provide for flexibility; (c) According to the data of the Third EU Survey on Working Conditions, longer and “irregular” working hours are in general linked to lower levels of health and well-being; moreover, low (individual) flexibility and high variability of working hours (i.e., company-based flexibility) were consistently associated with poor health and well-being, while low variability combined with high autonomy showed positive effects; (d) Six substudies from different countries demonstrated that flexible working hours vary according to country, economic sector, social status, and gender; overtime is the most frequent form of company-based flexibility but has negative effects on stress, sleep, and social and mental health; individual flexibility alleviates the negative effects of the company-based flexibility on subjective health, safety, and social well-being; (e) The literature review was able to list more than 1,000 references, but it was striking that most of these documents were mainly argumentative with very little empirical data. Thus, one may conclude that there is a large-scale intervention ongoing in our society with almost completely unknown and uncontrolled effects. Consequently, there is a strong need for systematic research and well-controlled actions in order to examine in detail what flexible working hours are considered, what and where are their positive effects, in particular, as concerns autonomy, and what regulation seem most reasonable.     

The 24-hour society between myth and reality

The 24-hour society appears to be an ineluctable process towards a social organisation where time constraints are no more "restricting" the human life. But, what kind of 24-hour society do we need? At what costs? Are they acceptable/sustainable? Shift work, night work, irregular and flexible working hours, together with new technologies, are the milestone of this epochal passage, of which shift workers are builders and victims at the same time. The borders between working and social times are no more fixed and rigidly determined: not only the link between work place and working hours is broken, but also the value of working time changes according to the different economic/productive/social effects it can make. What are the advantages and disadvantages for the individual, the companies, and the society? What is the cost/benefit ratio in terms of physical health; psychological well-being, family and social life? The research on irregular working hours and health shows us what can be the negative consequences of non-human-centered working times organisations. Coping properly with this process means avoiding a passive acceptance of it with consequent maladjustments at both individual and social level, but adopting effective preventive and compensative strategies aimed at building a more sustainable society, at acceptable costs and with the highest possible benefits.     

Influence of Flexibility and Variability of Working Hours on Health and Well‐Being

Flexible working hours can have several meanings and can be arranged in a number of ways to suit the worker and/or employer. Two aspects of “flexible” arrangement of working hours were considered: one more subjected to company control and decision (variability) and one more connected to individual discretion and autonomy (flexibility). The aim of the study was to analyze these two dimensions in relation to health and well‐being, taking into consideration the interaction with some relevant background variables related to demographics plus working and social conditions. The dataset of the Third European Survey on working conditions, conducted in 2000 and involving 21,505 workers, was used. Nineteen health disorders and four psycho‐social conditions were tested by means of multiple logistic regression analysis, in which mutually adjusted odds ratios were calculated for age, gender, marital status, number of children, occupation, mode of employment, shift work, night work, time pressure, mental and physical workload, job satisfaction, and participation in work organization. The flexibility and variability of working hours appeared inversely related to health and psycho‐social well‐being: the most favorable effects were associated with higher flexibility and lower variability. The analysis of the interactions with the twelve intervening variables showed that physical work, age, and flexibility are the three most important factors affecting health and well‐being. Flexibility resulted as the most important factor to influence work satisfaction; the second to affect family and social commitment and the ability to do the same job when 60 years old, as well as trauma, overall fatigue, irritability, and headache; and the third to influence heart disease, stomachache, anxiety, injury, and the feeling that health being at risk because of work. Variability was the third most important factor influencing family and social commitments. Moreover, shift and night work confirmed to have a significant influence on sleep, digestive and cardiovascular troubles, as well and health and safety at work. Time pressure also showed a relevant influence, both on individual stress and social life. Therefore, suitable arrangements of flexible working time, aimed at supporting workers' coping strategies, appear to have a clear beneficial effect on worker health and well‐being, with positive consequences also at the company and social level, as evidenced by the higher “feeling to be able to work until 60 years of age”.     

Extending healthy ageing: nutrient sensitive pathway and centenarian population

Ageing is a challenge for any living organism and human longevity is a complex phenotype. With increasing life expectancy, maintaining long-term health, functionality and well-being during ageing has become an essential goal. To increase our understanding of how ageing works, it may be advantageous to analyze the phenotype of centenarians, perhaps one of the best examples of successful ageing. Healthy ageing involves the interaction between genes, the environment, and lifestyle factors, particularly diet. Besides evaluating specific gene-environment interactions in relation to exceptional longevity, it is important to focus attention on modifiable lifestyle factors such as diet and nutrition to achieve extension of health span. Furthermore, a better understanding of human longevity may assist in the design of strategies to extend the duration of optimal human health. In this article we briefly discuss relevant topics on ageing and longevity with particular focus on dietary patterns of centenarians and nutrient-sensing pathways that have a pivotal role in the regulation of life span. Finally, we also discuss the potential role of Nrf2 system in the pro-ageing signaling emphasizing its phytohormetic activation.     

The personal experience of aging. Multidimensionality and multidirectionality in relation to successful aging and well-being

The positive and negative aspects that aging persons distinguish in different dimensions of the experience of their own aging process were studied. To examine the role of the aging experience in individual functioning, its relation with indicators of successful aging and well-being was focused on. The Dutch Aging Survey, using a representative sample of the present and future generations of elderly (40-85 years; N = 975), provided data on the experience of aging (positive and negative aspects, own aging as physical and social decline as well as continued growth), successful aging (health problems, loneliness and hope), and well-being (life satisfaction and positive and negative affect). Physical and social decline are the most prominent negative aspects and social gains and psychological growth are the most prominent positive aspects of one's own aging experience. The relation between aging experience and indicators of successful aging shows that individuals interpret their life situation in terms of their own aging process. Both negative and positive aspects of the aging experience are related to well-being, in particular for the group in transition to old age (55-69 years).     

Separating vascular and neuronal effects of age on fMRI BOLD signals

Accurate identification of brain function is necessary to understand the neurobiology of cognitive ageing, and thereby promote well-being across the lifespan. A common tool used to investigate neurocognitive ageing is functional magnetic resonance imaging (fMRI). However, although fMRI data are often interpreted in terms of neuronal activity, the blood oxygenation level-dependent (BOLD) signal measured by fMRI includes contributions of both vascular and neuronal factors, which change differentially with age. While some studies investigate vascular ageing factors, the results of these studies are not well known within the field of neurocognitive ageing and therefore vascular confounds in neurocognitive fMRI studies are common. Despite over 10 000 BOLD-fMRI papers on ageing, fewer than 20 have applied techniques to correct for vascular effects. However, neurovascular ageing is not only a confound in fMRI, but an important feature in its own right, to be assessed alongside measures of neuronal ageing. We review current approaches to dissociate neuronal and vascular components of BOLD-fMRI of regional activity and functional connectivity. We highlight emerging evidence that vascular mechanisms in the brain do not simply control blood flow to support the metabolic needs of neurons, but form complex neurovascular interactions that influence neuronal function in health and disease.This article is part of the theme issue ‘Key relationships between non-invasive functional neuroimaging and the underlying neuronal activity’.     

The interference of flexible working times with the circadian temperature rhythm--a predictor of impairment to health and well-being?

In order to analyze whether impairments to health and well-being under flexible working hours can be predicted from specific characteristics of the work schedules, periodic components in flexible working hours and their interference with the circadian temperature rhythm were analyzed applying univariate and bivariate spectrum analyses to both time series. The resulting indicators of spectral power and phase shift of these components were then related to reported health impairments using regression analysis. The results show that a suppression of both the 24 and the 168 h components in the work schedules (i.e., a lack of periodicity) can be used to predict reported health impairments, and that if there are relatively strong 24 and 168 h components left in the work schedules, their phase difference with the temperature rhythm (as an indicator of the interference between working time and the circadian rhythm) further predicts impairment. The results indicate that the periodicity of working hours and the amount of (circadian) desynchronization induced by flexible work schedules can be used for predicting the impairing effects of flexible work schedules on health and well-being. The results can thus be used for evaluating and designing flexible shift rosters.     

Who is too old for shift work? Developing better criteria

Demographic and social trends in industrialized countries are expected to lead to increasing numbers of older shift workers, raising concerns about possible health and safety risks. For older night workers, the International Labour Organization has recommended options for transferring to day work or early retirement, but few States have adopted these measures. For commercial air transport pilots, the International Civil Aviation Organization has implemented a series of regulatory measures that could manage the risks associated with aging, including a mandatory retirement age, regular medical assessments for fitness to fly, and limits on the duration of duty and rest. Each of these approaches has strengths and weaknesses. The mandatory retirement age is effectively arbitrary, has been controversial, and was recently increased from 60 to 65 yrs for one member of a two-person cockpit crew. Medical assessments offer a more individualized approach, but to improve safety, they must address aspects of health and physical or mental function that affect work performance and safety outcomes. The traditional focus has been on cardiovascular risk factors, although cardiac incapacitation is not a cause of accidents in a two-person cockpit aircraft. On the other hand, while pilot fatigue is an acknowledged cause of accidents, there is currently no requirement to consider issues associated with fatigue or sleep problems in fitness-to-fly medical assessments. Older long-haul pilots show greater sleep fragmentation than their younger colleagues and those in the general population. Sleep becomes more fragmented with increasing age, but the functional significance of this remains unclear. Among younger adults, experimental sleep fragmentation leads to increased sleepiness and degradation of performance and mood. Greater sleep loss is reported by older long-haul pilots, as well as other older shift workers, compared to younger people working similar duty patterns. Experimental sleep restriction causes a degradation of performance and mood that is cumulative and dose-dependent. In addition, a recent large-scale flight simulation study indicates that the duration of sleep obtained by individual pilots is an independent predictor of crew performance in a two-person cockpit. Based on these considerations, we propose that fatigue and sleep-related issues should become a standard part of fitness-for-work medical assessments, particularly for older shift workers. A multi-layered approach is proposed, with a routine structured sleep history leading to referral to specialist sleep services where appropriate. Criteria for specialist referral and medical retirement should be related to the workplace risk represented by an older worker. Additional research is needed to develop and validate sleep-related criteria for assessing fitness for work. For example, a better understanding of the effects of sleep fragmentation on the waking function of older workers might lead to a fragmentation threshold for fitness for work. The potential negative effects of unemployment and early retirement also need to be taken into account when considering the options for managing the occupational health and safety needs of older shift workers.     

Who Is Too Old for Shift Work? Developing Better Criteria

Demographic and social trends in industrialized countries are expected to lead to increasing numbers of older shift workers, raising concerns about possible health and safety risks. For older night workers, the International Labour Organization has recommended options for transferring to day work or early retirement, but few States have adopted these measures. For commercial air transport pilots, the International Civil Aviation Organization has implemented a series of regulatory measures that could manage the risks associated with aging, including a mandatory retirement age, regular medical assessments for fitness to fly, and limits on the duration of duty and rest. Each of these approaches has strengths and weaknesses. The mandatory retirement age is effectively arbitrary, has been controversial, and was recently increased from 60 to 65 yrs for one member of a two‐person cockpit crew. Medical assessments offer a more individualized approach, but to improve safety, they must address aspects of health and physical or mental function that affect work performance and safety outcomes. The traditional focus has been on cardiovascular risk factors, although cardiac incapacitation is not a cause of accidents in a two‐person cockpit aircraft. On the other hand, while pilot fatigue is an acknowledged cause of accidents, there is currently no requirement to consider issues associated with fatigue or sleep problems in fitness‐to‐fly medical assessments. Older long‐haul pilots show greater sleep fragmentation than their younger colleagues and those in the general population. Sleep becomes more fragmented with increasing age, but the functional significance of this remains unclear. Among younger adults, experimental sleep fragmentation leads to increased sleepiness and degradation of performance and mood. Greater sleep loss is reported by older long‐haul pilots, as well as other older shift workers, compared to younger people working similar duty patterns. Experimental sleep restriction causes a degradation of performance and mood that is cumulative and dose‐dependent. In addition, a recent large‐scale flight simulation study indicates that the duration of sleep obtained by individual pilots is an independent predictor of crew performance in a two‐person cockpit. Based on these considerations, we propose that fatigue and sleep‐related issues should become a standard part of fitness‐for‐work medical assessments, particularly for older shift workers. A multi‐layered approach is proposed, with a routine structured sleep history leading to referral to specialist sleep services where appropriate. Criteria for specialist referral and medical retirement should be related to the workplace risk represented by an older worker. Additional research is needed to develop and validate sleep‐related criteria for assessing fitness for work. For example, a better understanding of the effects of sleep fragmentation on the waking function of older workers might lead to a fragmentation threshold for fitness for work. The potential negative effects of unemployment and early retirement also need to be taken into account when considering the options for managing the occupational health and safety needs of older shift workers.     

Aging and Shift Work: A Complex Problem to Face

The baby boomer generation is well into the 50+ age bracket, making it one of the largest demographic age cohorts. Whereas this cohort would have previously considered retirement, the evidence suggests that it will remain in the workforce for a longer period in response to a number of social and economic drivers. Mandatory retirement has either been abolished or is under consideration. An increased and healthier life expectancy means that people may work longer for financial and/or psychological reasons. In addition, a global shortage of skilled labor will result in efforts to keep employees in the workplace for longer periods. These trends have a number of implications for working time. What are the health implications of an aging workforce? How do we sustain good work ability into the latter years? What do we know about aging and shift work? What actions are required in the workplace to assist aging workers? This paper is not a comprehensive review of the literature but serves to highlight the complexities in understanding the relationship between shift work and aging. We discuss aging and human function and, in particular, the impact of aging on the circadian system. In addition, we outline new policy directions in this area and raise several suggestions to assist the well‐being of aging workers.     

Expert Perspectives on Western European Prison Health Services: Do Ageing Prisoners Receive Equivalent Care?

Health care in prison and particularly the health care of older prisoners are increasingly important topics due to the growth of the ageing prisoner population. The aim of this paper is to gain insight into the approaches used in the provision of equivalent health care to ageing prisoners and to confront the intuitive definition of equivalent care and the practical and ethical challenges that have been experienced by individuals working in this field. Forty interviews took place with experts working in the prison setting from three Western European countries to discover their views on prison health care. Experts indicated that the provision of equivalent care in prison is difficult mostly due to four factors: variability of care in different prisons, gatekeeper systems, lack of personnel, and delays in providing access. This lack of equivalence can be fixed by allocating adequate budgets and developing standards for health care in prison.     

Happy aged people are all alike, while every unhappy aged person is unhappy in its own way

Aging of the world's population represents one of the most remarkable success stories of medicine and of humankind, but it is also a source of various challenges. The aim of the collaborative cross-cultural European study of adult well being (ESAW) is to frame the concept of aging successfully within a causal model that embraces physical health and functional status, cognitive efficacy, material security, social support resources, and life activity. Within the framework of this project, we show here that the degree of heterogeneity among people who view aging in a positive light is significantly lower than the degree of heterogeneity of those who hold a negative perception of aging. We base this conclusion on our analysis of a survey involving 12,478 people aged 50 to 90 from six West European countries. We treat the survey database as a bipartite network in which individual respondents are linked to the actual answers they provide. Taking this perspective allows us to construct a projected network of respondents in which each link indicates a statistically validated similarity of answers profile between the connected respondents, and to identify clusters of individuals independently of demographics. We show that mental and physical well-being are key factors determining a positive perception of aging. We further observe that psychological aspects, like self-esteem and resilience, and the nationality of respondents are relevant aspects to discriminate among participants who indicate positive perception of aging.     

Successful ageing: from cell to self

Many people see ageing as a time of cognitive and physical decline. For the past three decades, most scientists and the general public have accepted this negative age-stereotype as the norm, but fortunately this view is now challenged. New findings show that well-being and a positive view of ageing are major protective factors against the effects of age on the organism. These results challenge the scientific studies that place emphasis on the negative side of ageing. This ageism view has been observed in each sphere of science, from genetics to social sciences. Perspectives from each domain are described, and new integrative views of successful ageing are summarized.     

Sleeping on the Job during Night Shifts May Be Associated with Extended Night Shifts and/or Variable Night Shift Onset Times

Continuous rotating shiftworkers temporarily working overtime slept at least once during the working hours of their night shifts. They worked at an electric power distribution plant in São Paulo (Brazil). In order to detect factors that could be associated with sleeping on the job, we compared those who slept (sleep group – S) with those who did not sleep (non-sleep group – NS) as to the number of night shifts, the average length of night shifts, the variability in night shift onset and offset times and the length of sleep episodes at home between consecutive night shifts. Data collection was based on dairies filled in by the workers for 30 consecutive days. For both S and NS groups, the number of night shifts for each worker varied from 5 to 9, no difference being found between groups. Individual means of night shifts length varied from 9.4 ± 0.3 hr to 14.2 ± 0.6 hr; they were significantly longer in the S than in the NS group. Night shift onset times were shown to be significantly more variable in the S than in the NS group, whereas offset times did not differ significantly between groups. Length of sleep episodes at home was not significantly different between groups. Workers who slept on the job were those who had longer working bouts and / or more variable night shift onset times. Differences among workers may be due to individual strategies to cope with a situation in which the work schedule included night shifts that were much longer than the established 8 hours, and with many changes in onset times from one night shift to the next.     

Extended Working Hours and Health

Statistical analyses of the relation between the amount of working hours and impairments to health, based on data from a European survey on working conditions in 2000, clearly reveal that there is a substantial correlation between the number of working hours per week and the frequencies of health complaints. This applies to both musculo‐skeletal disorders as well as to psycho‐vegetative complaints. The relationship of the duration of the exposure to working conditions to health impairments is moderated by a great number of individual (e.g., age) and situational (e.g., shift‐work) variables, showing additive or interactive effects for which selected examples have been presented. In general, however, there is a consistent functional relationship between the number or working hours and their effects on the workers that holds over a great variety of conditions. It is argued that requests for extending working hours should thus be handled with care.