Examining Exposure Assessment in Shift Work Research: A Study on Depression Among Nurses
Open accessAbstract
Introduction: Coarse exposure assessment and assignment is a common issue facing epidemiological studies of shift work. Such measures ignore a number of exposure characteristics that may impact on health, increasing the likelihood of biased effect estimates and masked exposure–response relationships. To demonstrate the impacts of exposure assessment precision in shift work research, this study investigated relationships between work schedule and depression in a large survey of Canadian nurses. Methods: The Canadian 2005 National Survey of the Work and Health of Nurses provided the analytic sample (n = 11450). Relationships between work schedule and depression were assessed using logistic regression models with high, moderate, and low-precision exposure groupings. The high-precision grouping described shift timing and rotation frequency, the moderate-precision grouping described shift timing, and the low-precision grouping described the presence/absence of shift work. Final model estimates were adjusted for the potential confounding effects of demographic and work variables, and bootstrap weights were used to generate sampling variances that accounted for the survey sample design. Results: The high-precision exposure grouping model showed the strongest relationships between work schedule and depression, with increased odds ratios [ORs] for rapidly rotating (OR = 1.51, 95% confidence interval [CI] = 0.91–2.51) and undefined rotating (OR = 1.67, 95% CI = 0.92–3.02) shift workers, and a decreased OR for depression in slow rotating (OR = 0.79, 95% CI = 0.57–1.08) shift workers. For the low- and moderate-precision exposure grouping models, weak relationships were observed for all work schedule categories (OR range 0.95 to 0.99). Conclusions: Findings from this study support the need to consider and collect the data required for precise and conceptually driven exposure assessment and assignment in future studies of shift work and health. Further research into the effects of shift rotation frequency on depression is also recommended.
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A large study of 11,450 Canadian nurses found that the strongest relationship between work schedule and depression was in those who work rapidly rotating schedules and undefined rotating schedules, as opposed to slowly rotating schedules.
“A large study of 11,450 Canadian nurses found that the strongest relationship between work schedule and depression was in those who work rapidly rotating schedules and undefined rotating schedules (as opposed to slowly rotating schedules)228.”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [228]
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- Authors
- Hall, A. L., Franche, R.-L., & Koehoorn, M.
- Affiliations
- University of British Columbia (CA)
- Corresponding author
- Hall, Amy L
- Venue
- Annals of Work Exposures and Health
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-01-11
- Volume
- 62
- Issue
- 2
- Pages
- 182-194
- ISSN
- 2398-7308 (ISSN-L)
- 2398-7316
- PMC
- PMC6788578
- OpenAlex
- W2783698990
- Cited by
- 28
- References
- 59
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 5 · 2022: 4 · 2021: 5 · 2020: 6 · 2019: 2 · 2018: 1
- FWCI
- 3.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of Work Exposures and Health (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
- Keywords
- shift work, exposure assessment, exposure misclassification, nurses, depression, shift timing, work schedules, exposure-response relationship, occupational health
- MeSH terms
- Shift Work Schedule, Adult, Canada, Depressive Disorder, Female, Humans, Male, Middle Aged, Nurses, Logistic Models, Odds Ratio, Occupational Exposure
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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