Cited by 788Sleep and Work-Related FatigueWorkplace Health and Well-beingOccupational Health and Safety in Workplaces

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The impact of overtime and long work hours on occupational injuries and illnesses: new evidence from the United States

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Dembe, A E, Erickson, J B, Delbos, R G, Banks, S M·2005·Occupational and Environmental Medicine

DOI 10.1136/oem.2004.016667PMC PMC1741083

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Abstract

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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Contributing effects of individual characteristics, behavioural and job-related factors on occurrence of mining-related injuries: A systematic review
Ajith, M. M., Ghosh, A. K., & Jansz, J. (2021) · Work · doi:10.3233/wor-205227 · Cited by 18
“In the USA, Dembe et al. [47] revealed that overtime work was related to 61 percent higher injury hazard rate when compared with those that did not work overtime.”
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Fassa, A. G., Fiori, N. S., Meucci, R. D., Faria, N. M. X., & de Carvalho, M. P. (2020) · Salud Colectiva · doi:10.18294/sc.2020.2307 · Cited by 11
“Working for many hours over long periods,(33) especially with exposure to physical workloads such as repetitive motions, vigorous physical exertion, poor posture, vibration or even a combination of these and other forms of exposure,(29,34) results in muscle,(35) mental and psychomotor fatigue.”
Background
Evaluation of safety trends in construction, mining and transportation sectors in Turkey
Yılmaz, F., & Tosun, S. (2018) · Sigurnost · doi:10.31306/s.60.1.2 · Cited by 11
“Incidence rate is also often used in health and safety issues and risk assessment processes (Last, 2001; Coggon, Rose and Barker, 1997; Dembe et al., 2005; Dunn and Clark, 2009; Turkkan and Pala, 2016).”
Method
Investigation of Psychophysiological and Subjective Effects of Long Working Hours – Do Age and Hearing Impairment Matter?
Wagner-Hartl, V., & Kallus, K. W. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.02167 · Cited by 11
“Other research groups also reported a negative impact on work performance and safety at work (e.g., Dembe et al., 2005; Folkard and Lombardi, 2006; Knauth, 2007).”
Background
Critical care nurses' perceptions of the outcomes of working overtime in Canada.
Lobo, V. M., Ploeg, J., Fisher, A., Peachey, G., & Akhtar-Danesh, N. (2017) · Nursing Outlook · doi:10.1016/j.outlook.2016.12.009 · Cited by 11
ASSESSMENT AND PREDICTION OF INDUSTRIAL WORKERS’ FATIGUE IN AN OVERHEAD ASSEMBLY JOB
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“Such long working hours are common all over the world, including in the so-called ‘developed’ countries; and they give rise to health and social problems for the employees [24-28].”
Background
Effects of personality on overtime work: a cross-sectional pilot study among Japanese white-collar workers
Uchida, M., Kaneko, M., & Kawa, S. (2014) · BMC Research Notes · doi:10.1186/1756-0500-7-180 · Cited by 12
“Long work hours are associated with adverse health effects, including cardiovascular disease [4-6], high blood pressure [7], mortality [8], and workrelated injuries [9].”
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Relationship between Work Hours and Smoking Behaviors in Korean Male Wage Workers
Jang, S.-M., Ha, E., Park, H., Kim, E., & Jung-Choi, K. (2013) · Annals of Occupational and Environmental Medicine · doi:10.1186/2052-4374-25-35 · Cited by 11
“Long work hours have also been linked to musculoskeletal disease, depression, obesity, decreased labor concentration, increased fatigue, decreased cognitive abilities and judgment, and increased injury [6-10].”
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Incidence of workers compensation indemnity claims across socio-demographic and job characteristics.
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Chapter 72 – Sleep Problems in First Responders and the Military
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Production automation upgrades and the mystery of workers' overwork: Evidence from a manufacturing employer-employee matching survey in China
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Acculturation, Work-Related Stressors, and Respective Coping Strategies among Male Indonesian Migrant Workers in the Manufacturing Industry in Taiwan: A Post-COVID Investigation
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“…and health training programs, employing young workers (Aderaw et al., 2011), low literacy among workers (Das, 2019b), sleep problems (Salminen et al., 2010), little work experience (Dembe et al., 2005; Gangopadhyay et al., 2005), and not using personal protective equipment (Kumar et al., 2010).”
BackgroundResult
Objective and subjective working hours and their roles on workers’ health among Japanese employees
Ochiai, Y., Takahashi, M., Matsuo, T., Sasaki, T., Fukasawa, K., Araki, T., Tsuchiya, M., & Otsuka, Y. (2019) · Industrial Health · doi:10.2486/indhealth.2019-0126 · Cited by 10
Trend analysis and factors associated with biological injuries among health care workers in Southern Italy
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“A limit of the study is that the collected data don’t allow us to correlate the injuries with the typology of treated patients, neither with the hours worked by the employees at the moment of the injury, that could represent an important risk factor (9).”
Background
WORKPLACE ACCIDENTS IN BRAZIL: ANALYSIS OF PHYSICAL AND PSYCHOSOCIAL STRESS AND HEALTH-RELATED FACTORS
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Occupational injuries reported in a Canadian university setting: A five year retrospective study
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Managerial and professional women in “extreme jobs”: Benefits and costs
Burke, R., & Fiksenbaum, L. (2009) · doi:10.1108/02610150910964277 · Cited by 10
Long work hours and occupational injuries: new evidence on upstream causes
Loomis, D. (2005) · Occupational and Environmental Medicine · doi:10.1136/oem.2005.021014 · Cited by 10
How safety leadership styles impact safety performance: A case study
Payne, M., Roache, D., Subero, J., & Zhang, G. P. (2025) · Journal of Safety Research · doi:10.1016/j.jsr.2025.02.006 · Cited by 19
Towards Operator Digital Twins in Industry 5.0: Design Strategies & Experimental Evaluation
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“Notably, prolonged working hours, leading to fatigue and stress, have been associated with an increased hazard rate among US workers [2].”
Background
Sleep Patterns of Pilots: An Objective Assessment
Abdelaziz, M., Alhejaili, F. F., Alnouri, L., Samman, A., Alzehairi, A., Balkhyour, M., Alsumrani, R., Pandi-Perumal, S., & Wali, S. (2023) · Cureus · doi:10.7759/cureus.38983 · Cited by 9
“In assessments of various modes of transportation, longer working hours have been associated with a higher risk of adverse incidents, regardless of the mode of transportation [3-9].”
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Effects of Serving as a State Functionary on Self-Rated Health: Empirical Evidence From China
He, L., Zhang, Z., Wang, J., Wang, Y., Li, T., Yang, T., Liu, T.-L., Wu, Y.-Y., Zhang, S., Zhang, S.-Q., et al. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.757036 · Cited by 9
Cambios normativos en la Digitalización del Trabajo: Comentario a la “Ley Rider” y los derechos de información sobre los algoritmos
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“Clinical examination parameters with their relevant statistical figures were as follows: (i) CAL: 1 was recorded for present and 2 for absent (Ennever et al. 1961); (ii) TW: 1 was recorded for present and 2 for absent (Tuominen and Tuominen 1992, Bardsley et al. 2004), (iii) PI: 0 was recorded for…”
Method
Can Workplace Rest Breaks Prevent Work-Related Injuries Related to Long Working Hours?
Park, S., Lee, W., & Lee, J.-H. (2019) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001772 · Cited by 9
“This result is similar to those from previous studies which indicated manual or blue-collar workers such as construction and extraction workers or production workers had the highest risk of occupational injury.(19,31) Many previous studies have suggested that manual workers are more likely to be exposed to adverse wor…”
Result
Solidarity, job satisfaction, and turnover intent in employees
Matsumoto, M., & Gopal, B. (2019) · International Journal of Workplace Health Management · doi:10.1108/ijwhm-09-2018-0118 · Cited by 9
Intergenerational income mobility and health in Japan: A quasi-experimental approach
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“Earlier studies, moreover, suggest that there is an association between long working hours and poor health (Dembe et al., 2005; Kivimäki et al., 2015; van der Hulst, 2003).”
Result
Occupational Stress in Helicopter Emergency Service Pilots From 4 European Countries
Bauer, H., & Herbig, B. (2019) · Air Medical Journal · doi:10.1016/j.amj.2018.11.011 · Cited by 9
Influence of Physical and Musculoskeletal Factors on Occupational Injuries and Accidents in Korean Workers Based on Gender and Company Size
Park, S. J., Jung, M.-S., & Joo, H. S. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16030345 · Cited by 9
Work related musculoskeletal disorders among adolescent girls and young women employees of textile industries in Tamil Nadu, India – a comparative study
Gnanaselvam, N. A., & Bobby, J. (2017) · International Journal of Adolescent Medicine and Health · doi:10.1515/ijamh-2016-0116 · Cited by 8
“Consequences of working more than the stipulated time have been studied extensively in literature [24], [25], [26], [27], [28], [29].”
Background
The Association between Work-Related Physical Activity and Depression
Asiamah, N., & Mensah, H. K. (2016) · doi:10.12691/jpar-2-1-1 · Cited by 9
“Nonetheless, working beyond a certain limit of time would not necessarily remedy depression owing to fatigue, occupational stress and strain [7].”
Background
Duty hours and incidents in flight among commercial airline pilots
O’Hagan, A. D., Issartel, J., Fletcher, R., & Warrington, G. D. (2016) · International Journal of Occupational Safety and Ergonomics · doi:10.1080/10803548.2016.1146441 · Cited by 14
“According to the authors, the findings of this study supported the hypothesis that long working hours indirectly influence workplace accidents through a causal process, by inducing fatigue or stress in affected workers.[3] However, their findings also coincide with alternative hypotheses and therefore cannot be certai…”
BackgroundResult
Wage compensation for risk: the case of Turkey
Polat, S. (2014) · Safety Science · doi:10.1016/j.ssci.2014.05.018 · Cited by 9
“There are no studies on workplace safety for Turkey based on micro data, however work safety studies show that long working hours increase the likeliness of workplace accidents (Dembe et al. (2005); Folkard and Tucker (2003); Vegso et al. (2007)).”
Changing Youth Labour Markets, Welfare Institutions and Young People's Control over Working Time
Harsløf, I. (2007) · doi:10.1177/0961463x07080268 · Cited by 9
Working Time and the Environmental Intensity of Well-Being
Fitzgerald, J. B., Givens, J. E., & Briscoe, M. D. (2024) · Sociology of Development · doi:10.1525/sod.2023.0048 · Cited by 9
Unveiling workplace safety and health empowerment: Unraveling the key elements influencing occupational injuries
Obeidat, M. S., Dweiri, H. Q., & Smadi, H. J. (2024) · Journal of Safety Research · doi:10.1016/j.jsr.2024.08.013 · Cited by 13

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
DOI: 10.1136/oem.2004.016667
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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The impact of overtime and long work hours on occupational injuries and illnesses: new evidence from the United States

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