Increase In Working Hours Research Articles

The Effects of Work Hours on Physical and Mental Health of Late Prime Age Men and Women

Our results show that negative returns to health outcomes set in at around 50 work hours per week, and that the negative effects of working long hours manifest earlier for women than men. Increased work hours are associated with higher incomes and better access to medical care. However, increased work hours also generate greater physical and mental stress, which may cause health problems. We examine these questions empirically with data from the 2006 wave of the National Longitudinal Survey of Youth (NLSY), using two-stage least squares to account for endogeneity of work hours and income in the health outcomes model. JEL Classifications: I10, J22, C36

Occupational stress and associated risk factors among nurses: a cross-sectional study

Background: Nursing can be a demanding and stressful occupation.Aims/Objectives: To determine the prevalence of nurses’ occupational stress and associated risk factors.Design: Cross-sectional survey.Methods: 5422 nurses in Iran were surveyed and demographic information and occupational stress assessed (2895 of returned surveys analysed).Results: Mean score for overall occupational stress was 3.48 indicating a stress level between moderate and high, with 78.4% of respondents reporting that their job was stressful. Nurses reported issues with shift work, staffing, pay, workplace discrimination, management, policy and excessive workloads. Risk factors in the multivariate analysis for higher occupational stress were; female gender (p = .002), being married (p = .008), lower educational levels (p < .001), increased work hours (p < .001), and working in emergency (p = .025), general wards (p = .012), and teaching hospitals (p < .001).Conclusions: The high prevalence of occupational stress demonstrates the extent of the issue, despite recent reforms. The risk factors identified allow for more targeted interventions.

&lt;i&gt;Bring your own device&lt;/i&gt; (BYOD): entendendo uma nova prática no ambiente acadêmico

Este artigo identifica os fatores percebidos a partir da prática de BYOD no contexto acadêmico. A popularização dos dispositivos móveis gerou um movimento do uso desses dispositivos pessoais no ambiente de trabalho. Esse fenômeno passou a ser conhecido como Bring your own device (BYOD). Esta prática chegou às instituições de ensino e envolve diversas discussões entre professores e estudantes. Não se sabe ao certo se o uso de dispositivos ajuda ou atrapalha o andamento das aulas e o processo de aprendizagem. Para entender esse fenômeno, realizamos entrevistas semiestruturadas com professores e alunos universitários. Inspirados na Grounded theory, desenhamos um modelo teórico que emergiu da análise dos dados. Esse modelo demonstra que a prática do BYOD no contexto acadêmico é determinada por fatores impulsionadores, de contexto e da prática. Os diversos fatores identificados no contexto acadêmico trazem resultados práticos, como a influência no processo de aprendizagem e a exposição ao aumento de jornada de trabalho. Os fatores da prática compreendem oito elementos: 1) interesse; 2) didática; 3) processo de aprendizagem; 4) ubiquidade; 5) produtividade; 6) responsabilidade; 7) padrões de uso; e 8) exposição. Este fenômeno pode estar relacionado ao contexto da sociedade e à modernidade tecnológica.

When Everyone Works Harder for Fewer Rewards, Is It Fair? Implications of “Organization-Wide Hardship” for Managing and Studying Organizational Fairness

As organizations compete in an increasingly global and challenging environment, “working” often requires working harder for fewer rewards. In this article, we introduce the concept of “organization-wide hardship,” which refers to workforce-shared hardship that results from an organization’s pursuit of a strategy associated with its industry-positioning goals. We propose a model for predicting and explaining employees’ reactions to organization-wide hardship. Our analysis and model make several contributions to the justice literature. First, we highlight the importance of organization-wide hardship (associated with pay freezes or pay cuts, increased working hours, or reduced work–family balance) as a potential contributor to the experience of low fairness for all employees in the organization. Second, we argue that research on the effects of management accounts (explanations) for their decisions should be extended by considering the effects of accounts from nonmanagement sources. Third, we highlight the potentially paradoxical effects of providing external (rather than internal) accounts to employees as these likely heighten the hardship’s perceived fairness yet also heighten employees’ concern for their organization’s future and hence their intended or actual turnover. Fourth, our article’s theorizing adds a temporal (future-oriented) perspective to the largely past-oriented perspective of organizational justice–related theorizing and research. We discuss the implications of our model for organizations and leaders and scholars who aim to study employees’ reactions to organization-wide hardship.

Sleep severity and fatigue manifestations in relation to the doctor–patient relationship

ObjectivesThe doctor–patient relationship has an important role in the delivery of high-quality healthcare. The aim of the present study was to explore and evaluate the impact of sleep severity and fatigue manifestations on doctor–patient relationships. MethodsThe present study was an analysis of a cross-sectional sample of a total of 123 physicians with different specialties and work in various shifts in Iraq. Sleep severity difficulty was measured by Athens Insomnia Scale (AIS) in accordance with the International Classification of Diseases (ICD-10) and the multidimensional nature of fatigue was assessed by the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). Moreover, the doctor–patient relationship was measured by Difficult Doctor–Patient Relationship Questionnaire (DDPRQ-10). ResultsIn this study, nearly half of the physicians (45.5%) were insomniacs. The total fatigue score was 9.46; general fatigue (Mean (M): 5.84 of 24); physical fatigue (M: 5.15 of 24); emotional fatigue (M: 6.04 of 24); mental fatigue (M: 5.45 of 24); and vigor (M: 12.98 of 24). The doctors felt slight irritation in their communications with patients (M: 2.33); had moderate dysphoria (M: 3.37); had slight compliance in their communications (M: 1.71), and slightly considered patients to be self-destructive (M: 1.97). In addition, the study showed that general and physical fatigue, night shift-work, and increased working hours in the public sector were predictors for doctors finding their patient irritating. Similarly, increased working hours by clinicians in the public sector was a predictor for having less compliance in their relationships with patients. ConclusionThe present investigation suggests that insomnia has an indirect association with negative categories of the doctor–patient relationship.

Women's Work-Life Balance: Compensation is the Key

The increase in the level of literacy, standard of living, changing societal attitudes, and a quest for economic independence are considered to increase female employment. However, elements, including responsibilities towards family, job demands, reduced autonomy in jobs, and increased work hours, are expected to reduce female employment. The education sector is the largest employer of women in India and is undergoing rapid changes because of multiple demands from stakeholders. This study investigates the status of work–life balance (WLB) among female non instructional staff at private universities. Moreover, motivations to work, challenges, work pressure, and their mental and physical health-related outcomes have been studied.

Legal Technology and the Future of Women in Law

Much has been written about how automation will change the legal profession as a whole, less so about how automation might affect women in legal practice. This paper briefly maps the likely changes that legal tech (legal technology) will bring to the provision of legal services, and explores how these changes might affect the barriers to advancement that women face in the profession. It determines that, while the use of legal tech may improve women’s work/life balance and overall job satisfaction by bringing about more flexible working hours, positive changes to the billing hours’ system, and fairer hiring and promotion mechanisms, an unfettered inclusion of legal tech might lead to increased working hours for less wages, increased competition for case files among associates, and the perpetuation of existing gender biases when using algorithms in the hiring and promotion process. Finally, the paper makes several recommendations on how law societies, bar associations and other relevant regulatory bodies could ensure that legal tech promotes rather than hinders Equality & Diversity in the legal profession. It proposes that: (1) detailed data on men and women lawyers should be collected to better inform equality and diversity policies; (2) law firms should be required to report on their progress in pursuing equality and diversity; (3) management techniques to promote work/life balance and more flexible pricing systems should be encouraged; (4) female entrepreneurship in legal tech should be promoted; and, (5) technological due process procedures should be required when using algorithms in law firm management to ensure fairness, accuracy and accountability.

Optimal Saving and Work Hours in the Heterogeneous Agent Neoclassical Growth Model

This paper introduces work - leisure choice into a constrained optimal policy problem in a neoclassical growth model with idiosyncratic risk and incomplete markets. The constrained planner cannot complete markets, but must improve welfare subject to agents’ budget constraints. As such, rather than addressing the market failure of incomplete markets, the planner addresses the pecuniary externalities of each agents’ saving and work decision on interest and wage rates. In an economy calibrated to U.S. wealth and income inequality, the paper finds the constrained planner increases aggregate capital and reduces aggregate hours worked. The resulting increase in wages and fall in interest rates shifts the distribution of consumption towards the consumption poor, since they rely more on labor income than capital income. However, in a constrained efficient allocation, only highly productive individuals increase saving, while less productive individuals reduce saving. Moreover, only the asset poor and less productive agents reduce work hours; the wealthy and highly productive increase work hours due to wealth effects. While total work hours fall, the increase in work hours by the most productive is sufficient to increase effective labor supply.

Subsidized Housing and Low-Income Mother’s School-Based Parent Involvement: Findings from the Fragile Families and Child Wellbeing Study Wave Five

School-based parent involvement is associated with child academic outcomes, positive behaviors, and social skills. Research on school-based parent involvement among low-income mothers is limited and even less understood for low-income mothers who receive financial housing assistance. This study examined the association between low-income mothers who receive housing assistance and school-based parent involvement when their child was 9-years-old. We investigated whether there is a difference in parent involvement for low-income mothers who receive a government housing subsidy (Housing Choice Voucher (HCV) and those who reside in a public housing project. Potential barriers to parental involvement are discussed. Using data from the Fragile Families and Child Wellbeing Study, Wave 5 (N = 1351), the current study employed multivariate ordinal logistic regression analyses to examine the above associations. Low-income mothers who receive an HCV are less likely to be involved in their child’s school-based activities than low-income mothers who live in a public housing project. Potential barriers to parental involvement include frequent housing moves and increased work hours. Findings suggest housing type has an important role in school-based parent involvement for low-income mothers. As housing policies move toward deconcentrating poverty by way of government housing subsidies, unintended consequences need to be considered. Considerations should include low-income mothers’ experience of frequent housing mobility and increased work hours as barriers to school-based parent involvement. Additional services and resources beyond financial housing assistance are essential to improve parent involvement among low-income mothers.

The Measurement of Orthopaedic Surgeon Quality and Quantity of Sleep Using a Validated Wearable Device.

Introduction:Recurrent episodes of partial sleep deprivation resulting from shift work or call schedules are commonly seen in physicians. This study measures the quantity and quality of sleep in orthopaedic surgeons and determines the factors that are correlated with decreased quantity and quality of sleep.Methods:Orthopaedic surgery residents and attending surgeons at a single institution were prospectively enrolled and provided with a validated wearable device to objectively determine sleep quantity (total hours of sleep) and quality (sleep disturbances; sleep latency; sleep efficiency; and amount of rapid eye movement [REM] sleep, deep sleep, and light sleep). Sleep deprivation was defined as getting less than 7 hours of sleep per day. Bivariate correlations were determined using Spearman rank correlation. Multiple linear regression models were constructed to determine the effect of independent variables (age, attending physician, resident, postgraduate year [PGY] level, sex, number of calls, and total hours worked) and sleep quantity and quality. All P values were reported, and a significance level of α = 0.05 was used (ie, P < 0.05).Results:Of 26 enrolled subjects, 21 (80.8%; 12 residents and 9 attending surgeons, where 15 were men and 6 women, with mean age of 37.2 ± 10.9 years) completed the 4-week duration of the study. Orthopaedic surgeons obtained 6.5 ± 0.8 hours of sleep per night (17.7% REM, 19.4% deep sleep, and 62.6% light sleep; 4.5 ± 1.1 minutes of sleep latency; 4.9 ± 1.7 sleep disturbances; and 89.9% sleep efficiency). Fourteen orthopaedic surgeons (66.7%) of the 21 slept less than the recommended 7 hours of sleep per night. The total hours worked had a moderate negative correlation (r = −0.550; P = 0.010) with total sleep. PGY level had a moderate positive correlation with sleep latency (r = 0.546; P = 0.010).Discussion:Diminished sleep quantity is considered sleeping less than 7 hours per night, whereas decreased sleep quality is associated with decreased REM sleep, decreased deep sleep, increased light sleep, decreased sleep latency, decreased sleep efficiency, and increased sleep disturbances. Sleep deprivation in orthopaedic surgeons poses notable health and safety risks for both surgeons and patients.Conclusion:Orthopaedic surgeons demonstrate poor sleep quantity and quality which is markedly worse than the general population, with increased work hours markedly correlated with decreased hours of sleep.

How injury incidence is associated with business cycles? Empirical evidence from Taiwan

Workplace injury incident rates are commonly reported to change in commensurate with economic situation. Although causal mechanisms, such as new employees, pace of work, and injury reporting behaviors have previously been proposed to explain this phenomenon, there is little empirical evidence supporting this relationship. Using monthly Taiwanese insurance payment data from four main sectors during 2002–2014, this paper examines the relationship by relating major and minor occupational injury to several macroeconomic variables. Regressions based on the first-differenced variables are used to explore how various factors related to the business cycles impact the incidences of major and minor injuries. The analysis is then supplemented with the Granger tests to establish the causality. We conclude that employee fatigue and operational errors that arise from increased working hours and intensified work pace during economic boom times contributed to the injury incidence. In addition, our longitudinal analyses also explain the ways in which firms respond to external demand shocks, thereby further illustrating the mechanism underlying the business cycle and injury incidence.

The Vicious Circle of Working Hours, Sleep, and Recovery in Expert Work.

This study aimed to investigate working hours, sleep quality and alertness, and recovery and detachment in expert work using a mobile app. The study sample comprised members of The Finnish Business School Graduates and employees of an information technology (IT) company. The final study sample included 154 employees with at least four days of mobile app data. For statistical analyses of the survey and mobile app data (cross-sectional setting), we used logistic regression, and for the day-to-day data, we used multi-level logistic regression to calculate the odds ratios (OR), and a general equation estimates model for regression coefficients with 95% confidence intervals (CI). The results showed that moderate to fair sleep quality or alertness at awakening were associated with longer working hours the following day (OR 1.07–1.14, 95% CI 1.01–1.22). Recovery and detachment during the preceding day were associated with longer working hours. These associations were the same in the opposite direction. To conclude, the day-to-day ratings of sleep quality and alertness at awakening, and recovery and detachment from work during leisure time were associated with increased working hours the following day. In addition, longer working hours the preceding day were associated with worse ratings of sleep quality, alertness, recovery, and detachment.

Opportunities for interventions to reduce the financial toxicity of treatment for childhood cancer.

e18797 Background: Cancer-related financial toxicity is an unaddressed side-effect of childhood cancer, with consequences for household financial health and quality of care, including increased risk for relapse, and decreased survival rates. This project identified opportunities along the cancer journey when interventions could reduce risk of cancer-related financial toxicity for families of children with cancer. Methods: Seventeen caregivers of children diagnosed with cancer attended focus groups (n = 3) to discuss how they navigated the financial side of cancer. We used the concept of “social navigation” to guide thematic analysis of transcripts. Social navigation is relevant to understanding the financial side of cancer because it acknowledges and examines how people act when unanticipated disruptions (e.g. health, financial) create instability in their lives. Results: Five major themes and twenty-three sub-themes emerged: 1. disruption experienced by family (emotional shock, hospital stay, travel for outpatient care, unpredictability of treatment); 2. caregiver’s management of disruption (time-off work, restructured routines); 3. financial consequences (reduced income, direct and indirect medical expenses, debt accumulation); 4. caregiver’s management of financial consequences (increased work hours, navigated insurance coverage, requested financial assistance, cut-back expenses, used financial reserves, “fight for everything”); 5. interventions (financial assistance, proactive support for insurance and resource navigation, credit advocacy, housing and meals for family during inpatient stays, parking support, online workshops, streamlined application process for financial assistance, expanded eligibility criteria for financial assistance, and research on treatment that can be administered at home). Conclusions: Focus groups identified opportunities for interventions to reduce cancer-related financial toxicity for families of children with cancer throughout the cancer journey. With collective actions from the ecosystem of for-profit, non-profit, and public sectors these opportunities can become programs that may benefit cancer patients, families, and society.

Sleep Architecture in Night Shift Workers Police Officers with Obstructive Sleep Apnea-hypopnea Syndrome.

IntroductionReduced sleep to increase work hours is common among police officers, when this situation is combined with Obstructive sleep apnea/hypopnea syndrome (OSAHS), health consequences are greater, therefore we believe there is a need of research for these alterations. The aim of this study was to measure the changes in sleep architecture (SA) in police officers who currently have Night shift work (NSW) and OSAHS.MethodsWe compared SA in 107 subjects divided in three groups: the first group included police officers with NSW and severe OSAHS (n = 48); the second group were non-police officers with diurnal work time and severe OSAHS (n = 48) and the third group was formed by healthy controls (n = 11). Polysomnography (PSG) variables and Epworth sleepiness scale (ESS) scores were compared.ResultsSA was more disrupted in the group of police officers with NSW and OSAHS than in patients with OSAHS only and in the control group. Police officers with NSW and OSAHS presented an increased number of electroencephalographic activations, apnea/hypopnea index, and sleep latency, and showed lower scores of oxygen saturation, and in the ESS. Multivariate analysis revealed significant influence of age and Body mass index (BMI).ConclusionsData suggested with caution an additive detrimental effect of NSW and OSAHS in SA and ESS of police officers. However age and BMI must be also taken into account in future studies.

Relation Between Lung Dysfunction and Blood Cadmium and Lead Levels Among Welders

Although welding is an industrial process with well-known health effects, the effects of heavy metal exposure on the respiratory system during welding are largely unknown. In this study, we investigated the correlation between blood lead and cadmium levels, and respiratory function among welders. The study investigates 207 male subjects who applied to Occupational Disease Hospital, Ankara, Turkey. These subjects were categorized into three groups: one, non-smoker office workers; and two exposed, non-smoker groups (n = 96) that comprised welders who had history of metal fume exposure for less and more than 4 h a day. Lung function test was performed on all groups. Correlations between blood cadmium and lead levels and lung function test were evaluated statistically. Forced vital capacity (FVC) % and forced expiratory volume in 1 s (FEV1) % increased, and FEV1/FVC ratio decreased in welders who were exposed to metal fumes for less than 4 h a day (p < 0.0001). The group that was exposed for more than 4 h/day had increased FVC % and decreased FEV1 % and FEV1/FVC ratio (p < 0.0001). Blood cadmium and lead levels were high in both the exposed groups (p < 0.0001). Welders who were exposed for more than 4 h/day had significantly decreased FVC %, FEV1 %, FEV1/FVC ratio, and peak expiratory flow (PEF) values (p < 0.0001). All lung function parameters (FVC, FEV1, FEV1/FVC, PEF) decreased in subjects with high blood cadmium levels (p < 0.0001). This study clearly shows the increased working hours of exposure to welding fumes and severity of metal exposure correlate with impaired lung functions.

The Relation between Maternal Work Hours and Primary School Students' Affect in China: The Role of the Frequency of Mother-Child Communication (FMCC) and Maternal Education.

Background: Although substantial evidence suggests that maternal work hours may have a negative effect on children’s cognitive development, the link between maternal work hours and children’s affect remains unclear. Some studies have observed that non-daytime maternal work hours are associated with more emotional problems among children. However, few studies have focused on the effects of maternal work hours on workdays and non-workdays. Therefore, this study separately investigated the relation between maternal work hours on workdays and on non-workdays and explored the mediating role of the frequency of mother-child communication (FMCC) and the moderating role of maternal education.Method: Using cluster sampling, this study selected 879 students in grades 4–6 at two primary schools in the Hebei and Shandong provinces in China and their mothers as the study subjects. A multi-group structural equation model (SEM) was used to test the relations between maternal work hours, FMCC and children’s affect and the moderating effect of maternal education.Results: (1) Non-college-educated mothers’ work hours on workdays negatively predicted FMCC, but there was no such effect for college-educated mothers; (2) non-workday work hours of all employed mothers negatively predicted FMCC; (3) the FMCC of all employed mothers positively predicted children’s positive affect; (4) the FMCC of college-educated mothers negatively predicted children’s negative affect although there was no such relation for non-college-educated mothers; (5) there was a significant mediating effect of FMCC on the relation between maternal work hours and children’s affect only for non-college-educated mothers; and (6) the workday work hours of non-college-educated mothers positively predicted children’s negative affect, but this correlation was negative for college-educated mothers.Conclusion: Maternal work hours have a marginally significant negative effect on children’s affect through FMCC only for non-college-educated mothers. Compared with non-college-educated mothers, college-educated mothers more easily compensate for the loss of communication opportunities caused by increased work hours on workdays, and children with college-educated mothers benefit more from this communication. However, compensating for the loss of communication opportunities caused by increased work hours on non-workdays is difficult for all employed mothers.

Qualitative study of burnout, career satisfaction, and well-being among US neurologists in 2016.

To understand the experience and identify drivers and mitigating factors of burnout and well-being among US neurologists. Inductive data analysis was applied to free text comments (n = 676) from the 2016 American Academy of Neurology survey of burnout, career satisfaction, and well-being. Respondents providing comments were significantly more likely to be older, owners/partners of their practice, solo practitioners, and compensated by production than those not commenting. The 4 identified themes were (1) policies and people affecting neurologists (government and insurance mandates, remuneration, recertification, leadership); (2) workload and work-life balance (workload, electronic health record [EHR], work-life balance); (3) engagement, professionalism, work domains specific to neurology; and (4) solutions (systemic and individual), advocacy, other. Neurologists mentioned workload > professional identity > time spent on insurance and government mandates when describing burnout. Neurologists' patient and clerical workload increased work hours or work brought home, resulting in poor work-life balance. EHR and expectations of high patient volumes by administrators impeded quality of patient care. As a result, many neurologists reduced work hours and call provision and considered early retirement. Our results further characterize burnout among US neurologists through respondents' own voices. They clarify the meaning respondents attributed to ambiguous survey questions and highlight the barriers neurologists must overcome to practice their chosen specialty, including multiple regulatory hassles and increased work hours. Erosion of professionalism by external factors was a common issue. Our findings can provide strategic direction for advocacy and programs to prevent and mitigate neurologist burnout and promote well-being and engagement.

Poor Employment Conditions Adversely Affect Mental Health Outcomes Among Surgical Trainees

Poor mental health in junior clinicians is prevalent and may lead to poor productivity and significant medical errors. We aimed to provide contemporary data on the mental health of surgical trainees and identify risk factors relating to poorer mental health outcomes. A detailed questionnaire was developed comprising questions based on the 36-item short-form health survey (SF-36) and Physical Activity Questionnaire. Each of the questionnaires has proven validity and reliability in the clinical context. Ethics approval was obtained from the Royal Australasian College of Surgeons. The questionnaire was aimed at surgical registrars. We used Physical Activity Questionnaire, SF-36 scores and linear regression to evaluate the effect of putative predictors on mental health. A total of 83 responses were collected during the study period, of which 49 (59%) were from men and 34 (41%) were from women. The mean Mental Component Summary (MCS) score for both sexes was significantly lower than the population mean at ages 25-34 (p < 0.001). Poor satisfaction with one's work culture and a feeling of a lack of support at work were extremely strong predictors of a lower MCS score (p < 0.001). Hours of overtime worked, particularly unpaid overtime, were also strong predictors of a poorer score. Australian surgical trainees reported lower MCS scores from the SF-36 questionnaire compared to the general population. Increasing working hours, unpaid overtime, poor job security, and job satisfaction were associated with poorer scores among trainees. Interventions providing improved working conditions need to be considered by professional training bodies and employers.

Attributes and features of a community health model from the perspective of practitioners

The Family and Community Health Model is based on three essential principles: user-centered care, comprehensive care and continuity of care. To describe the attributes and characteristics of the guiding principles of the Family and Community Health Model (FHM) from the perspective of primary care experts. This was a qualitative study. An electronic Delphi was conducted with 29 national experts on primary care. The experts agree that user centered care must be based on a psycho-social model integrating the multiple factors that influence health problems. It also must integrate patients' individual features, family and environmental issues. The proposed actions promote shared decision making. To promote integral care, anticipatory guidelines should be expanded and health care of patients with chronic conditions should be improved. Continuity of care should be promoted increasing working hours of medical centers and easing access to integrated electronic medical records, thereby generating efficient links between the different care levels. The results of the study can guide the clinical and administrative management of health teams, allowing the strengthening of primary health care according to the local realities.

Biomarkers of Secondhand Smoke Exposure in Waterpipe Tobacco Venue Employees in Istanbul, Moscow, and Cairo.

Most smoke-free legislation to reduce secondhand smoke (SHS) exposure exempts waterpipe (hookah) smoking venues. Few studies have examined SHS exposure in waterpipe venues and their employees. We surveyed 276 employees of 46 waterpipe tobacco venues in Istanbul, Moscow, and Cairo. We interviewed venue managers and employees and collected biological samples from employees to measure exhaled carbon monoxide (CO), hair nicotine, saliva cotinine, urine cotinine, urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and urine 1-hydroxypyrene glucuronide (1-OHPG). We estimated adjusted geometric mean ratios (GMR) of each SHS biomarker by employee characteristics and indoor air SHS measures. There were 73 nonsmoking employees and 203 current smokers of cigarettes or waterpipe. In nonsmokers, the median (interquartile) range concentrations of SHS biomarkers were 1.1 (0.2, 40.9) µg/g creatinine urine cotinine, 5.5 (2, 15) ng/mL saliva cotinine, 0.95 (0.36, 5.02) ng/mg hair nicotine, 1.48 (0.98, 3.97) pg/mg creatinine urine NNAL, 0.54 (0.25, 0.97) pmol/mg creatinine urine 1-OHPG, and 1.67 (1.33, 2.33) ppm exhaled CO. An 8-hour increase in work hours was associated with higher urine cotinine (GMR: 1.68, 95% CI: 1.20, 2.37) and hair nicotine (GMR: 1.22, 95% CI: 1.05, 1.43). Lighting waterpipes was associated with higher saliva cotinine (GMR: 2.83, 95% CI: 1.05, 7.62). Nonsmoking employees of waterpipe tobacco venues were exposed to high levels of SHS, including measurable levels of carcinogenic biomarkers (tobacco-specific nitrosamines and PAHs). Smoke-free regulation should be extended to waterpipe venues to protect nonsmoking employees and patrons from the adverse health effects of SHS.