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Short rest between shift intervals increases the risk of sick leave: a prospective registry study
  1. Øystein Vedaa1,2,
  2. Ståle Pallesen1,3,
  3. Siri Waage3,4,
  4. Bjørn Bjorvatn3,4,
  5. Børge Sivertsen2,5,6,
  6. Eilin Erevik1,
  7. Erling Svensen7,
  8. Anette Harris1
  1. 1 Department of Psychosocial Science, University of Bergen, Bergen, Norway
  2. 2 Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
  3. 3 Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
  4. 4 Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  5. 5 The Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
  6. 6 Department of Psychiatry, Helse Fonna HF, Haugesund, Norway
  7. 7 Haukeland University Hospital, Bergen, Norway
  1. Correspondence to Øystein Vedaa, Department of Psychosocial Science, University of Bergen, Christiesgt. 12, 5015 Bergen, Norway; oystein.vedaa{at}


Objectives The purpose of this study was to use objective registry data to prospectively investigate the effects of quick returns (QR, <11 hours of rest between shifts) and night shifts on sick leave.

Methods A total of 1538 nurses (response rate =41.5%) answered questionnaires on demographics and personality and provided consent to link this information to registry data on shift work and sick leave from employers' records. A multilevel negative binomial model was used to investigate the predictive effect of exposure to night shifts and QR every month for 1 year, on sick leave the following month.

Results Exposure to QR the previous month increased the risk for sick leave days (incidence rate ratio (IRR)=1.066, 95% CI 1.022 to 1.108, p<0.01) and sick leave spells (IRR=1.059, 95% CI 1.025 to 1.097, p<0.001) the following month, whereas night shifts did not. 83% per cent of the nurses experienced QR within a year, and on average they were exposed to 3.0 QR per month (SD=1.6). Personality characteristics associated with shift work tolerance (low on morningness, low on languidity and high on flexibility) were not associated with sick leave, and did not moderate the relationship between QR and sick leave.

Conclusions We found a positive linear relationship between QR and sick leave. Avoiding QR may help reduce workers' sick leave. The restricted recovery opportunity associated with QR may give little room for beneficial effects of individual characteristics usually associated with shift work tolerance.

  • Quick returns
  • Sick leave

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  • Contributors ØV, AH, SP, BB, SW, ES and BS took part in planning the study. ØV, AH, ES and SW took part in gathering the data. ØV, AH, SP, BB, SW, ES, BS and EE took part in writing up the manuscript and reporting the work.

  • Funding This project was funded by a PhD grant at the Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Regional Committee for Medical and Health Research Ethics, Northern-Norway (number 2013/526/REK nor) and by the Norwegian Data Inspectorate (13/00569-2/CGN).

  • Provenance and peer review Not commissioned; externally peer reviewed.