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      The association between shift work and sick leave: a systematic review

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          Abstract

          Shift work is associated with a number of negative health outcomes, although it is not known whether it is associated with sick leave. This systematic review therefore aimed to determine whether an association exists between shift work and sick leave. A systematic literature search was conducted in six databases on observational studies. Two reviewers independently selected relevant articles and appraised methodological quality. Data extraction was performed independently by review couples. Articles were categorised according to shift work characteristics and summarised using a levels of evidence synthesis. In total, the search strategy yielded 1207 references, of which 24 studies met the inclusion criteria. Nine studies were appraised as high quality and used in the levels of evidence synthesis. Two high quality longitudinal studies found a positive association between fixed evening shifts and longer sick leave for female healthcare workers. The evidence was assessed as strong. Evidence was inconclusive for rotating shifts, shift work including nights, for fixed night work, and for 8-hour and 12-hour shifts. The association found between evening work and sick leave in female healthcare workers implies that the association between shift work and sick leave might be schedule and population specific. To study the association further, more high quality studies are necessary that assess and adjust for detailed shift work exposure.

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          Systematic review of psychosocial factors at work and private life as risk factors for back pain.

          A systematic review of observational studies. To assess whether psychosocial factors at work and in private life are risk factors for the occurrence of back pain. Several reviews on risk factors for back pain have paid attention to psychosocial factors. However, in none of the published reviews was a strict systematic approach used to identify and summarize the available evidence. A computerized bibliographical search of several databases was performed, restricted to studies with a cohort or case-control design. A rating system was used to assess the strength of the evidence for various factors, based on the methodologic quality of the studies and the consistency of the findings. Eleven cohort and two case-control studies were included in this review. Strong evidence was found for low social support in the workplace and low job satisfaction as risk factors for back pain. Insufficient evidence was found for an effect of a high work pace, high qualitative demands, low job content, low job control, and psychosocial factors in private life. Evidence was found for an effect of low workplace social support and low job satisfaction. However, the result for workplace social support was sensitive to slight changes in the rating system, and the effect found for low job satisfaction may be a result of insufficient adjustment for psychosocial work characteristics and physical load at work. In addition, the combined evaluation of job content and job control, both aspects of decision latitude, led to strong evidence of a role for low job decision latitude. Thus, based on this review, there is evidence for an effect of work-related psychosocial factors, but the evidence for the role of specific factors has not been established yet.
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            Long term sickness absence.

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              Long workhours and health.

              This paper summarizes the associations between long workhours and health, with special attention for the physiological recovery and behavioral life-style mechanisms that may explain the relationship. The evidence for these mechanisms has not been systematically reviewed earlier. A total of 27 recent empirical studies met the selection criteria. They showed that long workhours are associated with adverse health as measured by several indicators (cardiovascular disease, diabetes, disability retirement, subjectively reported physical health, subjective fatigue). Furthermore, some evidence exists for an association between long workhours and physiological changes (cardiovascular and immunologic parameters) and changes in health-related behavior (reduced sleep hours). Support for the physiological recovery mechanism seems stronger than support for the behavioral life-style mechanism. However, the evidence is inconclusive because many studies did not control for potential confounders. Due to the gaps in the current evidence and the methodological shortcomings of the studies in the review, further research is needed.
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                Author and article information

                Journal
                Occup Environ Med
                Occup Environ Med
                oem
                oemed
                Occupational and Environmental Medicine
                BMJ Group (BMA House, Tavistock Square, London, WC1H 9JR )
                1351-0711
                1470-7926
                October 2012
                : 69
                : 10
                : 701-712
                Affiliations
                [1 ]Research Group Working life and Innovation, International Research Institute of Stavanger, Stavanger, Norway
                [2 ]Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
                [3 ]KLM Health Services, Schiphol Airport, Amsterdam, The Netherlands
                [4 ]Danish Ramazzini Centre at the Department of Occupational Medicine, Regional Hospital Herning, Herning, Denmark
                [5 ]National Centre for Occupational Rehabilitation, Rauland, Norway
                Author notes
                [Correspondence to ] Suzanne L Merkus, P.O. Box 8046, 4068 Stavanger, Norway; suzanne.merkus@ 123456iris.no
                Article
                oemed-2011-100488
                10.1136/oemed-2011-100488
                3597215
                22767871
                05655c12-e09c-44c7-aa44-f217322bd658
                © 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode

                History
                : 7 April 2012
                Categories
                1506
                Review
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                Occupational & Environmental medicine
                work schedule tolerance,shift work,sick leave,systematic review,epidemiology,materials,exposures and occupational groups,fatigue,methodology,speciality,sickness absence,ergonomics,health promotion,musculoskeletal,exposure assessment

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