Abstract
Shift work is associated with adverse chronic health outcomes. Addressing chronic disease risk factors including biomedical risk factors, behavioural risk factors, as well as sleep and perceived health status, affords an opportunity to improve health outcomes in shift workers. The present study aimed to conduct a systematic review, qualitative synthesis, and meta-analysis of non-pharmacological interventions targeting chronic disease risk factors, including sleep, in shift workers. A total of 8465 records were retrieved; 65 publications were eligible for inclusion in qualitative analysis. Random-effects meta-analysis were conducted for eight eligible health outcomes, including a total of thirty-nine studies. Interventions resulted in increased objective sleep duration (Hedges’ g = 0.73; CI: 0.36, 1.10, k = 16), improved objective sleep efficiency (Hedges’ g = 0.48; CI: 0.20, 0.76, k = 10) and a small increase in both subjective sleep duration (Hedges’ g = 0.11; CI: −0.04, 0.27, k = 19) and sleep quality (Hedges’ g = 0.11; CI: −0.11, 0.33, k = 21). Interventions also improved perceived health status (Hedges’ g = 0.20; CI: −0.05, 0.46, k = 8), decreased systolic (Hedges’ g = 0.26; CI: −0.54, 0.02, k = 7) and diastolic (Hedges’ g = 0.06; CI: −0.23, 0.36, k = 7) blood pressure, and reduced body mass index (Hedges’ g = −0.04; CI: −0.37, 0.29, k = 9). The current study suggests interventions may improve chronic disease risk factors and sleep in shift workers; however, this could only be objectively assessed for a limited number of risk factor endpoints. Future interventions could explore the impact of non-pharmacological interventions on a broader range of chronic disease risk factors to better characterise targets for improved health outcomes in shift workers.
Highlights
In a modern, 24/7 world, shift work has become a ubiquitous part of the workforce
This review found that non-pharmacological interventions such as fast forwardrotating shifts, timed use of bright light and light-blocking glasses, and targeting health behaviours including physical activity and diet yielded favourable outcomes for shift workers
Pharmacological interventions were largely not efficacious. These findings suggest that non-pharmacological interventions should be implemented to improve chronic disease risk factors for shift workers
Summary
24/7 world, shift work has become a ubiquitous part of the workforce. While work schedules vary across different occupations, locations and contexts, shift work can be defined as “work [that] usually encompasses work time arrangements outside of conventional daytime hours, which includes fixed early morning, evening, and night work, as well as roster work and rotating three shift work” [1]. The review [43] did not quantitatively examine the effect of specific interventions on chronic disease risk factors, or on sleep outcomes Such information is crucial for identifying and managing early risk before disease negatively impacts worker quality of life. The use of quantitative methods for examining the effect of non-pharmacological interventions on chronic disease risk factors, sleep and perceived health status is necessary to inform evidence-based, effective interventions to improve health outcomes in shift workers. The primary objective of the current systematic review and meta-analysis was to examine non-pharmacological interventions aimed at improving one or more chronic disease risk factors, sleep and/or perceived health status in shift workers. Addressing these research questions will allow us to provide empirically-based recommendations for shift workers, and identify important further research opportunities
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