The impact of overtime and long work hours on occupational injuries and illnesses: new evidence from the United States
Open accessAbstract
Aims: To analyse the impact of overtime and extended working hours on the risk of occupational injuries and illnesses among a nationally representative sample of working adults from the United States. Methods: Responses from 10 793 Americans participating in the National Longitudinal Survey of Youth (NLSY) were used to evaluate workers’ job histories, work schedules, and occurrence of occupational injury and illness between 1987 and 2000. A total of 110 236 job records were analysed, encompassing 89 729 person-years of accumulated working time. Aggregated incidence rates in each of five exposure categories were calculated for each NLSY survey period. Multivariate analytical techniques were used to estimate the relative risk of long working hours per day, extended hours per week, long commute times, and overtime schedules on reporting a work related injury or illness, after adjusting for age, gender, occupation, industry, and region. Results: After adjusting for those factors, working in jobs with overtime schedules was associated with a 61% higher injury hazard rate compared to jobs without overtime. Working at least 12 hours per day was associated with a 37% increased hazard rate and working at least 60 hours per week was associated with a 23% increased hazard rate. A strong dose-response effect was observed, with the injury rate (per 100 accumulated worker-years in a particular schedule) increasing in correspondence to the number of hours per day (or per week) in the workers’ customary schedule. Conclusions: Results suggest that job schedules with long working hours are not more risky merely because they are concentrated in inherently hazardous industries or occupations, or because people working long hours spend more total time “at risk” for a work injury. Strategies to prevent work injuries should consider changes in scheduling practices, job redesign, and health protection programmes for people working in jobs involving overtime and extended hours.
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Many studies indicated that working long hours is associated with fatigue, a higher risk of injury, and (psycho)somatic health complaints.
“Whereas many studies indicated that working long hours is associated with fatigue, a higher risk of injury, and (psycho)somatic health complaints (5, 7-9)”
From A diary study to open up the black box of overtime work among university faculty members (2008) · cites this paper as [7]
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Cheng, Y., Du, C.-L., Hwang, J.-J., Chen, I.-S., Chen, M.-F., & Su, T.-C. (2014) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.12.035 · Cited by 76 · see citing works
“Accumulating epidemiologic evidences suggests that prolonged working hours are associated with numerous health risks, including hypertension, cardiovascular diseases, mental health problems, sleep disturbances, somatic complaints and occupational injuries [1–7].”
BackgroundErvasti, J., Pentti, J., Nyberg, S., Shipley, M., Leineweber, C., Sørensen, J., Alfredsson, L., Bjorner, J., Borritz, M., Burr, H., et al. (2021) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2021.100212 · Cited by 76 · see citing works
“Our finding on the relationship between long working hours and increased risk of injuries is in agreement with previous studies reporting elevations in injuries, accidents, and sleep problems (a potential mediator), as potential consequences of extensive working [40-47].”
ResultAnalysis of Injuries in the Ghanaian Mining Industry and Priority Areas for Research
Stemn, E. (2018) · Safety and Health at Work · doi:10.1016/j.shaw.2018.09.001 · Cited by 75 · see citing works
A structural equation modeling approach to fatigue-related risk factors for occupational injury.
Arlinghaus, A., Lombardi, D. A., Willetts, J. L., Folkard, S., & Christiani, D. (2012) · American Journal of Epidemiology · doi:10.1093/aje/kws219 · Cited by 74 · see citing works
Medical comorbidity of sleep disorders
Dikeos, D. G., & Georgantopoulos, G. (2011) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e3283473375 · Cited by 75 · see citing works
Ethical Issues Relating to the Health Effects of Long Working Hours
Dembe, A. (2009) · Journal of Business Ethics · doi:10.1007/s10551-008-9700-9 · Cited by 72 · see citing works
Self-citationClocking In: The Organization of Work Time and Health in the United States
Kleiner, S., & Pavalko, E. K. (2010) · Social Forces · doi:10.1353/sof.0.0301 · Cited by 71 · see citing works
“Recent research has linked the stress and fatigue of overtime work with a higher rate of work-related injury (Dembe et al. 2005), and greater subjective time pressure with depression (Roxburgh 2004).”
Shift work and work injury in the New Zealand Blood Donors’ Health Study
Fransen, M., Wilsmore, B., Winstanley, J., Woodward, M., Grunstein, R., Ameratunga, S., & Norton, R. (2006) · Occupational and Environmental Medicine · doi:10.1136/oem.2005.024398 · Cited by 71 · see citing works
Lee, J.-G., Kim, G. H., Jung, S. W., Kim, S. W., Lee, J.-H., & Lee, K. (2018) · Annals of Occupational and Environmental Medicine · doi:10.1186/s40557-018-0278-0 · Cited by 70 · see citing works
Overtime work as the antecedent of employee satisfaction, firm productivity, and innovation
Ko, Y.-J., & Choi, J. N. (2018) · Journal of Organizational Behavior · doi:10.1002/job.2328 · Cited by 70 · see citing works
Dong, X., Wang, X., & Largay, J. A. (2015) · International journal of occupational and environmental health · doi:10.1179/2049396714y.0000000107 · Cited by 70 · see citing works
Long Work Hours: Volunteers and Conscripts
Drago, R. W., Wooden, M., & Black, D. (2009) · Social Science Research Network · doi:10.1111/j.1467-8543.2009.00717.x · Cited by 70 · see citing works
Shi, W., Xia, C., & Meyer-Doyle, P. (2021) · Organization science (Providence, R.I.) · doi:10.1287/orsc.2021.1542 · Cited by 67 · see citing works
Baeriswyl, S., Bratoljic, C., & Krause, A. (2021) · Journal of School Psychology · doi:10.1016/j.jsp.2021.02.002 · Cited by 95 · see citing works
Fatigue in the workplace: causes and countermeasures
Williamson, A., & Friswell, R. (2013) · Fatigue Biomedicine Health & Behavior · doi:10.1080/21641846.2012.744581 · Cited by 67 · see citing works
“[64] reported 23% higher hazard ratios for occupational injury and illness among people working 60 or more hours a week than those working shorter hours.”
BackgroundNAKATA, A. (2011) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2011.00910.x · Cited by 65 · see citing works
“Several epidemiological studies have demonstrated that long work hours is a critical risk factor for workplace injury (Dembe et al., 2005; Dong, 2005; Folkard and Tucker, 2003; Grosch et al., 2006; Vegso et al., 2007).”
BackgroundGurubhagavatula, I., Barger, L. K., Barnes, C. M., Basner, M., Boivin, D. B., Dawson, D. E., Drake, C. L., Flynn‐Evans, E. E., Mysliwiec, V., Patterson, P. D., et al. (2021) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.9512 · Cited by 65 · see citing works
Examining the link between flexible working arrangement bundles and employee work effort
Avgoustaki, A., & Bessa, I. (2019) · Human Resource Management · doi:10.1002/hrm.21969 · Cited by 76 · see citing works
Kim, Y.-K., Ahn, Y., Kim, K., Yoon, J., & Roh, J. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-012002 · Cited by 65 · see citing works
- Authors
- Dembe, A. E., Erickson, J. B., Delbos, R. G., & Banks, S. M.
- Affiliations
- University of Massachusetts Chan Medical School (US)
- Corresponding author
- Dembe, A E
- ORCID
- Dembe, A E
- Venue
- Occupational and Environmental Medicine
- Publisher
- BMJ
- Published
- 2005-08-18
- Volume
- 62
- Issue
- 9
- Pages
- 588-597
- ISSN
- 0007-1072 (ISSN-L)
- 1351-0711
- 1470-7926
- PMC
- PMC1741083
- OpenAlex
- W2111942718
- Cited by
- 788
- References
- 0
- Citations by year
- 2026: 23 · 2025: 35 · 2024: 43 · 2023: 34 · 2022: 68 · 2021: 36 · 2020: 48 · 2019: 57 · 2018: 52 · 2017: 59 · 2016: 40 · 2015: 42 · 2014: 37 · 2013: 31 · 2012: 28
- FWCI
- 30.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Occupational and Environmental Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
- Funders
- National Institute for Occupational Safety and Health (R01-OH07576)
- 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 Safety in Workplaces
- Keywords
- overtime, long working hours, occupational injuries, occupational diseases, work schedules, dose-response relationship, injury risk, commuting time, job redesign, occupational injury prevention
- MeSH terms
- Accidents, Occupational, Adult, Epidemiologic Methods, Female, Humans, Male, Occupational Diseases, Time Factors, United States, Work Schedule Tolerance, Wounds and Injuries
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.
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