Abstract
PurposeA recent study among female nurses in Denmark found an increased mortality among night-time workers, which has raised concerns about the sufficiency of the EU Working Time Directive. The aim of the present study was to examine the relationship between night-time work and all-cause mortality among full-time employees in the general workforce of Denmark.MethodsInterview data from the Danish Labour Force Surveys, 1999–2013, were linked to national registers with individual-level data on occupation, industry, socioeconomic status (SES), emigrations and deaths. The participants (N = 159,933) were followed from the end of the calendar year of the interview until the end of 2014. Poisson regression was used to estimate rate ratios for all-cause mortality, with and without stratification by sex and socioeconomic status. A likelihood ratio test was used to test the overall null-hypothesis, which stated that the mortality rates were independent of night-time work, SES × night-time work and sex × night-time work.ResultsThe likelihood ratio test did not reject the null hypothesis (p = 0.14). The rate ratio for all-cause mortality among employees with vs. without night-time work was estimated at 1.07 (95% CI 0.97–1.19) after adjustment for age, sex, SES, calendar time, weekly working hours and time passed since the start of follow-up.ConclusionsThe present study did not find any statistically significant associations between night-time work and all-cause mortality among employees in the general workforce of Denmark.
Highlights
Night-time work has been associated with insufficient sleep as well as a wide range of safety and health problems (Itani and Kaneita 2016; Kecklund and Axelsson 2016)
To protect the safety and health of night-shift workers, the European Union (EU) Working Time Directive (Smet 1993) stipulates that the Member States shall take the measures necessary to ensure that night workers work no more than 8 h during a 24-h period, are offered a free health assessment and have access to appropriate health and safety protection
A total of 3374 deaths were observed during an average follow-up of 7.7 years, with a crude mortality rate at 3.5 and 1.8 among the men and women, respectively
Summary
Night-time work has been associated with insufficient sleep as well as a wide range of safety and health problems (Itani and Kaneita 2016; Kecklund and Axelsson 2016). To protect the safety and health of night-shift workers, the EU Working Time Directive (Smet 1993) stipulates that the Member States shall take the measures necessary to ensure that night workers work no more than 8 h during a 24-h period, are offered a free health assessment and have access to appropriate health and safety protection. If the intent of the directive is fulfilled, the nighttime regulations should be sufficient to protect against adverse health effects from night-time work. A recent study found an association between night-time work and all-cause mortality among female nurses in Denmark (Jorgensen et al 2017). They reported an age-standardised rate ratio of 1.74 (95% CI 1.48–2.07) among nurses who normally work at night, compared with nurses who normally work during the day (Jorgensen et al 2017).
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