Shift and night work and long working hours – a systematic review of safety implications
Open accessAbstract
OBJECTIVE: In order to devise effective preventive strategies, it is important to study workplace stressors that might increase the risk of workplace accidents - both affecting workers themselves as well as causing harm to third-parties. The aim of this report is to provide a systematic, updated overview and scientific review of empirical research regarding accidents in relation to long work hours and shift work, primarily based on epidemiological studies. METHODS: The search for articles was part of a large review study on the effects of work hours on various health outcomes, safety, and performance. The search strategy included 5 international scientific databases, and nearly 7000 articles were initially identified using our search string. Following the application of inclusion and exclusion criteria, 443 publications were found and evaluated using a pre-defined scoring system. Of these, 43 concerned safety and accidents but only 14 were considered to be of high quality (total score 2 or 3 on a scale from 0-3) and therefore used for this study. RESULTS: Both shift work and long working hours present a substantial and well-documented detrimental effect on safety - all the studies that are included in this review have one or more significant findings in this respect. The trends are quite coherent although the increases in accident rates are mostly from 50% to 100%. In epidemiological terms, this may be seen as rather small differences. The use of such data is therefore only of importance if the accident incidence is high or if accidents may have large effects. CONCLUSIONS: The findings are most relevant to safety-critical activities such as the transport and health sectors. Work periods >8 hours carry an increased risk of accidents that cumulates, so that the increased risk of accidents at around 12 hours is twice the risk at 8 hours. Shift work including nights carries a substantial increased risk of accidents, whereas "pure" night work may bring some protection against this effect due to resynchronization. The evaluated studies give no clear indications of any age or gender being specifically susceptible or protected against the effects of work times scheduling on accident risk.
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Nonstandard schedules more than double the risk for work-related injuries and safety-critical events.
“Nonstandard schedules more than double the risk for work‐related injuries and safety‐critical events (Wagstaff 2011; Wong 2011).”
From Adapting shift work schedules for sleep quality, sleep duration, and sleepiness in shift workers (2023) · cites this paper as Wagstaff 2011
The Concluding remarks (page not available in our copy) say that long hours and shift or night work affect accident risk, but specify a roughly doubled risk only for work periods around 12 hours compared with 8 hours. The discussion of nonstandard shifts reports injury hazard ratios of 1.30–1.43, not more than double. A greater-than-twofold estimate for errors applies to a specific comparison of nurses’ shift lengths, not nonstandard schedules generally. (LLM, conf=0.88)
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- Authors
- Wagstaff, A. S., & Sigstad Lie, J.-A.
- Affiliations
- National Institute of Occupational Health (NO)
- Venue
- Scandinavian Journal of Work, Environment & Health
- Published
- 2011-02-03
- Volume
- 37
- Issue
- 3
- Pages
- 173-185
- ISSN
- 0355-3140 (ISSN-L)
- 1795-990X
- OpenAlex
- W2089057387
- Cited by
- 367
- References
- 5
- Citations by year
- 2026: 15 · 2025: 28 · 2024: 15 · 2023: 23 · 2022: 24 · 2021: 23 · 2020: 45 · 2019: 31 · 2018: 30 · 2017: 24 · 2016: 25 · 2015: 28 · 2014: 22 · 2013: 19 · 2012: 12
- FWCI
- 2.35
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Scandinavian Journal of Work Environment & Health (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Health Professions › Radiological and Ultrasound Technology › Occupational Health and Safety Research
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Keywords
- shift work, night work, long working hours, occupational accidents, occupational safety, crash risk, safety-critical work, transport sector, health sector, work scheduling
- MeSH terms
- Accidents, Occupational, Humans, Work Schedule Tolerance, Wounds and Injuries, Occupational Health, Workload, Sleep Disorders, Circadian Rhythm
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