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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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“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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“This is similar to what was reported in a study done in USA, in which it was revealed that working for more than 8 hours per shift resulted in a 61% increased risk for occupational injuries [15].”
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“, 2008), injury (Ayas et al., 2006; Dembe et al., 2005), and motor vehicle accidents (Barger et al.”
BackgroundWorkaholism and negative work-related incidents among nurses
Andreassen, C. S., Pallesen, S., Moen, B., Bjorvatn, B., Waage, S., & Schaufeli, W. (2018) · Industrial Health · doi:10.2486/indhealth.2017-0223 · Cited by 30
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“It is important to note that since the year 2000, the research about time investment has been vast (e.g., Dembe et al., 2005; Caruso, 2006; Suzuki et al., 2017), but is lacking in regards to the investment of effort (to the best of our knowledge; see Green, 2008), the proportions of the inner the…”
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Whose Preferences are Revealed in Hours of Work?
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Development of a scale for assessing the organization's safety performance based fuzzy ANP
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BackgroundResultRisky work: accidents among Nepalese migrant workers in Malaysia, Qatar and Saudi Arabia
Adhikary, P., Sheppard, Z., Keen, S., & van Teijlingen, E. R. (2017) · doi:10.3126/hprospect.v16i2.18643 · Cited by 28
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“One critical point for occupational safety is to note that the risk of occupational injury is highest during the last working hour on an extended working day [6, 73, 74, 77].”
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“This trend is also consistent with time trends in work-related injuries seen in other settings.(8,9) Regarding the relationship between age of employee and accident risk, we observed relatively higher rates among younger than older employees.”
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“hours in a day, and continuous work without taking any rest are increased for the risk of musculoskeletal disorder [16].”
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“Given that longwork hours can lead to fatigue and make workers more injury prone (Dembe et al. 2005), limiting workers’ shifts can reduce injuries.”
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“, 1998), but are also found to increase the risk of accidents at work (Dembe et al., 2005; Folkard and Lombardi, 2006; Nachreiner, 2002) and are associated with a variety of health issues (Caruso, 2006; Grosch et al.”
BackgroundResultHeld captive in the office: an investigation into long working hours among Korean employees
Zhang, L., & Seo, J. (2016) · The International Journal of Human Resource Management · doi:10.1080/09585192.2016.1192053 · Cited by 27
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“We chose 60 hr as the cutoff point to assess the effect of very long work hours in concert with Dembe et al. (2005) who used same number of hours.”
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Factors affecting the occupational accident rates among nurses.
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A diary study to open up the black box of overtime work among university faculty members
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“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), other studies characterized overtime workers as nonfatigued and motivated employees (10, 11).”
Behind the flexibility: insufficient occupational injury protection of gig workers in China
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Kossek, E., & Lee, K.-H. (2020) · Behavioral Science & Policy · doi:10.1353/bsp.2020.0018 · Cited by 23
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Occupational injury burden among gold miners in Ghana
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“, 2010), long working hours, working at night, low work experience (Dembe et al., 2005), high physical activity without exercising at all (Smith and Mustard, 2004) and not using personal protective equipment (Kumar et al.”
BackgroundMap Changes and Theme Evolution in Work Hours: A Co-Word Analysis
Liu, B., Chen, H., & Huang, X. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15051039 · Cited by 22
“Occupational injuries were classified into two categories: acute and chronic [41], and the damage caused in work hours for employees mainly extended exposure time to hazards, thereby enhancing the possibility and severity of work hazards [8]; in addition, along with establishment of labor law, the negotiation between…”
BackgroundPark, J., Park, J.-S., Han, B., & Kim, Y. (2017) · American Journal of Industrial Medicine · doi:10.1002/ajim.22783 · Cited by 23
“Previous research indicated that long working hours are associated with adverse health effects, such as musculoskeletal symptoms and occupational injuries.(26,27) The micro-enterprise labor force was more likely to work fewer than 40 h per week consistent with their status as temporary TABLE 2 Work sectors and occupat…”
BackgroundNight work, long work weeks, and risk of accidental injuries. A register-based study.
Larsen, A. D., Hannerz, H., Møller, S., Dyreborg, J., Bonde, J., Hansen, J., Kolstad, H., Hansen, Å., & Garde, A. (2017) · Scandinavian Journal of Work, Environment and Health · doi:10.5271/sjweh.3668 · Cited by 23
“Firstly, Dembe et al's study included only workrelated injuries (7), where we in our study included all injuries covering both motor vehicle crashes, workrelated injuries (if treated at a hospital) as well as leisure time injuries.”
BackgroundResultInfluentialCauses of Health Care Workers' Exposure to Antineoplastic Drugs: An Exploratory Study.
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Shift Work and Long Work Hours
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“This pattern, though not conclusive, was similarly observed in a meta-analysis for coronary heart disease [43], while other studies reported a gradual increase of poor health in response to an increase of working hours [44, 45], where working hours shorter than a standard category was mostly neglected.”
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Chen, S.-W., Wang, P.-C., Hsin, P.-L., Oates, A., Sun, I.-W., & Liu, S.-I. (2011) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-010-0538-y · Cited by 22
“Although our object is to identify risk factors of depressive disorders primarily based on job stress models, previous research has proved that other psychosocial factors within work (working time, shift work) (Dembe et al. 2005; Seward and Larsen 2007) and outside work (life events, social support), as well as health…”
BackgroundHuman resource management practices and organizational injury rates.
Turner, N., Barling, J., Dawson, J., Deng, C., Parker, S., Patterson, M., & Stride, C. (2021) · Journal of Safety Research · doi:10.1016/j.jsr.2021.06.003 · Cited by 21
Shin, D., & Jeong, B. (2020) · Sustainability · doi:10.3390/su12198114 · Cited by 21
“Therefore, driving schedule planning, work redesign, and health protection programs should be considered to prevent collisions [35].”
BackgroundSafe rates and unpaid labour: Non-driving pay and truck driver work hours
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“In particular, as Williams and Monaco (2001) point out, truck drivers who violate the HOS regulation are more likely to have crashes.”
BackgroundInterrelation between Human Factor–Related Accidents and Work Patterns in Construction Industry
Wong, F., Chiang, Y., Abidoye, F. A., & Liang, S. (2019) · Journal of construction engineering and management · doi:10.1061/(asce)co.1943-7862.0001642 · Cited by 21
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“…were studies which investigated the effects of shift work on health and safety (Harrington 2001), the effects of overtime work on hazard rates (Dembe et al. 2005), the effects of different shift lengths (Ellis 2008), night shifts (Gander et al. 2007), rest days (Tucker et al. 1996), the…”
BackgroundDay Labourers' Work Related Injuries: An Assessment of Risks, Choices, and Policies
Meléndez, E., Visser, M., Valenzuela, A., & Theodore, N. (2016) · doi:10.1111/imig.12042 · Cited by 21
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Attractive workplaces in the mine of the future: 26 statements
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“In a recent study, Dembe et al. (2005) have investigated the impact of overtime and long working hours.”
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“of suVering an occupational injury or illness (Dembe et al. 2005; Smith et al. 1998).”
BackgroundThe relationships between sleep disturbance and falls: A systematic review
Knechel, N. A., & Chang, P. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13580 · Cited by 23
Cognitive fatigue in young, middle‐aged, and older: Breaks as a way to recover
Gilsoul, J., Libertiaux, V., & Collette, F. (2021) · Applied Psychology · doi:10.1111/apps.12358 · Cited by 30
“For example, Dembe et al. (2005) reported a higher risk of injuries after an increase in the number of working hours.”
BackgroundPark, S., Lee, J.-H., & Lee, W. (2019) · Safety and Health at Work · doi:10.1016/j.shaw.2019.10.003 · Cited by 20
Relationship between non-standard work arrangements and work-related accident absence in Belgium
Alali, H., Braeckman, L., Hecke, T. V., Clercq, B. D., Janssens, H., & Wahab, M. M. A. (2017) · Journal of Occupational Health · doi:10.1539/joh.16-0119-oa · Cited by 33
Bedno, S., Hauret, K., Loringer, K., Kao, T., Mallon, T. M., & Jones, B. (2014) · Military Medicine · doi:10.7205/milmed-d-14-00080 · Cited by 20
Non-invasive monitoring device to evaluate sleep quality at mining facilities
Pino, E. J., de la Paz, A. D., & Aqueveque, P. (2013) · IEEE Industry Applications Society Annual Meeting (IAS) · doi:10.1109/ias.2013.6682567 · Cited by 5
Hours of work and rest in the rail industry
Anderson, C., Grunstein, R. R., & Rajaratnam, S. (2013) · Internal medicine journal (Print) · doi:10.1111/imj.12159 · Cited by 20
Belenky, G. L., Wu, L. J., & Jackson, M. L. (2011) · Progress in brain research · doi:10.1016/b978-0-444-53817-8.00012-8 · Cited by 23
“Fatigue resulting from working long hours or overtime shifts increases the risk of accident (Dembe et al., 2005).”
BackgroundKang, H.-T., Kim, C.-J., Lee, D.-W., Park, S.-G., Lee, J., Youn, K., Kim, H.-C., Jeong, K., Song, H., Kim, S.-K., et al. (2023) · Annals of Occupational and Environmental Medicine · doi:10.35371/aoem.2023.35.e17 · Cited by 19
Performance pay, work hours and employee health in the UK
Green, C. P., & Heywood, J. S. (2023) · Labour Economics · doi:10.1016/j.labeco.2023.102387 · Cited by 22
Work-Related Sleep Disorders: Causes and Impacts
Gusman, E., Standlee, J., Reid, K. J., & Wolfe, L. F. (2023) · Seminars in Respiratory and Critical Care Medicine · doi:10.1055/s-0043-1767787 · Cited by 19
Work Characteristics, Body Mass Index, and Risk of Obesity: The National Quality of Work Life Survey
Myers, S., Govindarajulu, U. S., Joseph, M., & Landsbergis, P. A. (2020) · Annals of Work Exposures and Health · doi:10.1093/annweh/wxaa098 · Cited by 24
“We restricted the sample for current analysis to QWL participants employed in the civilian labor force for at least 20 h week−1, consistent with other occupational research studies (Dembe et al., 2005; Landsbergis et al., 2015).”
MethodJorgenson, A. K., Fitzgerald, J. B., Thombs, R. P., Hill, T. D., Givens, J. E., Clark, B., Schor, J. B., Huang, X., Kelly, O. M., & Ore, P. D. (2020) · Environmental Research · doi:10.1016/j.envres.2020.110117 · Cited by 21
Macdermid, J., Nazari, G., Rashid, C., Sinden, K., Carleton, N., & Cramm, H. (2019) · Work · doi:10.3233/wor-192882 · Cited by 19
Kahraman, E., Akay, Ö., & Kılıç, A. M. (2019) · Journal of Occupational Health · doi:10.1002/1348-9585.12021 · Cited by 19
Feigon, M., Block, C. K., Breting, L. M. G., Boxley, L., Dawson, E. L., & Cobia, D. J. (2017) · The Clinical Neuropsychologist · doi:10.1080/13854046.2017.1411977 · Cited by 20
Verma, S., Lombardi, D. A., Chang, W.-R., Courtney, T., Huang, Y.-H., Brennan, M. J., Mittleman, M., Ware, J., & Perry, M. (2010) · Occupational and Environmental Medicine · doi:10.1136/oem.2010.056226 · Cited by 19
“Several studies have reported an association between long work hours, fatigue and the risk of injury.(27) 28 Only a few studies have examined how fatigue is associated with changes in gait and the risk of slipping; one laboratory study has suggested that quadriceps fatigue could be associated with increased slip prope…”
BackgroundOccupational Racial Composition and Nonfatal Work Injuries
Berdahl, T. A., & McQuillan, J. (2008) · Social Problems · doi:10.1525/sp.2008.55.4.549 · Cited by 21
“A previous analysis of NLSY data (Dembe et al. 2005) showed that working long hours was associated with higher risk of injury for all workers, even after controlling for job hazards.”
BackgroundMethodQuantifying the effects of external factors on individual performance
Carneiro, D. R., & Nováis, P. (2016) · Future Generation Computer Systems · doi:10.1016/j.future.2016.05.019 · Cited by 19
“[2] analyze the impact of overtime and long work hours on occupational injuries and illnesses, to conclude that these variables depend more on the amount of time worked rather than on the level of risk of the job.”
BackgroundAssessment of Addictions among Fishermen in Southern-East Costal Area of Mumbai, India
Bhondve, A. (2013) · doi:10.9790/0853-0667179 · Cited by 19
“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.(10) Many studies all over the world have shown that alcohol and tobacco consumption is very prevalent among fishermen.”
BackgroundKim, B., Preethaa, K. R. S., Song, S., Lukacs, R. R., An, J.-W., Chen, Z.-S., An, E., & Kim, S. (2024) · Journal of Big Data · doi:10.1186/s40537-024-00978-7 · Cited by 18
“A 12-h workday is linked to a 37% higher risk of sustaining injuries [30, 31].”
BackgroundPerformance Pay and Work Hours: Us Survey Evidence
Artz, B., & Heywood, J. (2023) · Social Science Research Network · doi:10.2139/ssrn.4158725 · Cited by 18
“Instead, long hours genuinely increase the underlying risk of illness (Dembe et al 2005).”
An overview of compensated work-related injuries among Korean firefighters from 2010 to 2015
Kim, H. D., An, Y. S., Kim, D. H., Jeong, K. S., & Ahn, Y. (2018) · Annals of Occupational and Environmental Medicine · doi:10.1186/s40557-018-0268-2 · Cited by 18
Impact of Age and Hearing Impairment on Work Performance during Long Working Hours
Wagner-Hartl, V., Grossi, N. R., & Kallus, K. W. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15010098 · Cited by 18
Pouliakas, K., & Theodossiou, I. (2010) · Social Science Research Network · doi:10.2139/ssrn.1549210 · Cited by 18
“For instance, Dembe et al. (2005) argue, using a large sample of American workers from the National Longitudinal Survey of Youth (NLSY) database, that working at least 12 hours per day is associated with a 37% increased hazard injury rate and working at least 60 hours per week with a 23% increased…”
BackgroundWork intensity, work hours, satisfactions, and psychological well‐being among Egyptian managers
Burke, R., & El-Kot, G. (2009) · doi:10.1108/17537980910981787 · Cited by 18
“Issues related to work, including long work hours and work intensity, have been attracting increasing attention for both researchers and practitioners (Bell and Freeman, 2001; Burchell and Fagan, 2004; Burke, 2006; Burke and Cooper, 2008; Dembe et al., 2005; Eastman, 1998; Filer et al., 1996; Green, 2001, 2008; Feldma…”
BackgroundInfluentialWu, T., Tan, X., Li, Y., Liang, Y., & Fan, J. (2024) · Behavioral Sciences · doi:10.3390/bs14010032 · Cited by 19
Workplace Objectification Leads to Self-Harm: The Mediating Effect of Depressive Moods
Dai, Y., Jiang, T., Gaer, W., & Poon, K. (2023) · Personality and Social Psychology Bulletin · doi:10.1177/01461672231213898 · Cited by 13
“Excessive working hours reflect a disregard for employees’ need for rest and health (Dembe et al., 2005), implying a greater likelihood of denied humanness in the workplace.”
Nurse’s experience working 12-hour shift in a tertiary level hospital in Qatar: a mixed method study
Varghese, B., Joseph, C. M., Akkam, A. A. A. A., AL-Balawi, R. M. O. A. M., Swallmeh, E., & Singh, K. (2023) · BMC Nursing · doi:10.1186/s12912-023-01371-0 · Cited by 27
“Several studies have demonstrated that long work hours and overtime are consistently associated with shorter sleep duration and sleep disturbances [29].”
Background
Metadata
- 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 › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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
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