Academic journal article Scandinavian Journal of Work, Environment & Health

The Ageing Shift Worker: A Prospective Cohort Study on Need for Recovery, Disability, and Retirement Intentions

Academic journal article Scandinavian Journal of Work, Environment & Health

The Ageing Shift Worker: A Prospective Cohort Study on Need for Recovery, Disability, and Retirement Intentions

Article excerpt

In industrialized countries, a substantial proportion of the labor force consists of shift workers who work irregular or unusual hours compared to employees involved in normal day work schedules (1). In 2010, 17% of the workers in the European Union performed shift work, a number which has been increasing due to economic and technical reasons and the demand for a 24-hour society (2). Another ongoing trend is that older workers have to be maintained in the labor force (eg, mandatory retirement age postponement) due to ageing of the (work) population and the high relevance of sustainable employment for society, which is necessary to maintain current pension systems (3). Overall, this will result in an increase of older shift workers (4).

The performance of shift work however, can have adverse effects on employees' health and social life (5). Some common effects include sleep complaints, fatigue (6, 7), diseases and somatic health problems, e.g. cardiovascular diseases (8). Some studies suggest associations between shift work and depressive symptoms (9, 10). Moreover, social marginalization and psychosomatic disorders are common among shift workers (5). These effects can be explained by two major mechanisms: first, disruption of the circadian rhythm, which controls the daily physiology and behavior of humans, is related to many of these health effects. This rhythm aims to time functions such as sleep and performance so that they are optimal during the most suitable phase of the day. If this rhythm is frequently desynchronized due to shift work, this can result in health problems (11). Second, shift work might cause social disruption: many social activities are arranged according to the day-oriented rhythms of the general population (5), causing an imbalance between working times and social activities among shift workers.

To date, mixed findings (12) exist on whether these mechanisms result in more biological and social problems as shift workers age. For example, a study (13) concluded that shift workers become more prone to the chronobiological and social mechanisms at the age of 45-50, possibly resulting in the inability to continue performing shift work from this age on. However, few longitudinal studies have investigated the role of age on shift work tolerance (14). Therefore, to investigate whether the performance of shift work is associated with adverse outcomes that possibly vary across the lifespan, this study will focus on the concept of need for recovery (NFR) among shift workers. NFR reflects the short-term effects of a working day (15) and high levels of NFR are characterized by feelings of overload, irritability, and reduced performance (16). As NFR involves both the intensity of work-induced fatigue and the time-period required to return to a normal or pre-stressor level of functioning (17), it will be a valuable concept to investigate among shift workers. An earlier cross-sectional study (18) demonstrated that shift workers reported higher levels of NFR as compared to day workers; however this association has not yet been investigated over time. Furthermore, over time elevated levels of NFR can result in poor health and sickness absence (19). As a review (20) pointed out that the association between shift work and sick leave is schedule-specific, this study will also investigate the risk of shift workers to become unfit for work due to sickness or disability among different shift work types.

Also, retirement intentions will be a relevant outcome to investigate among shift workers, as a disruption of the social life could be associated with the decision to retire early, eg, work-to-family conflict can encourage workers to choose early retirement (21).

When investigating these outcomes among shift workers, several selection effects might have taken place and should therefore be investigated. The "healthy worker effect" is an expected selection effect. This effect is a type of bias in which less-healthy workers accumulate less occupational exposure because they, eg, retire earlier compared to healthier workers or switch to a job with lower exposure levels (22). …

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