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Neurocognitive impairment in night and shift workers: a meta-analysis of observational studies
  1. Thomas Vlasak,
  2. Tanja Dujlovic,
  3. Alfred Barth
  1. Department of Psychology, Sigmund Freud Private University Linz, Linz, Austria
  1. Correspondence to Professor Alfred Barth, Department of Psychology, Sigmund Freud Private University Linz, 4020 Linz, Austria; alfred.barth{at}sfu.ac.at

Abstract

Objective Shift work is an essential element of modern labour, ensuring ideal conditions of service for today’s economy and society. Despite the beneficial properties, its impact on the neurobehavioural performance of exposed subjects remains controversial. This meta-analysis aimed to provide the first summarising effects regarding the association between shift work exposure and different cognitive functions.

Methods A literature search was performed using the databases PubMed, PsyINFO, PsyARTICLES, MedLine, PsycNET and Scopus including eligible studies up to April 2021 that compared shift workers with non-shift workers regarding neurobehavioural performance tests. We carried out a random-effects model using Hedges’ g as a meta-analytical effect size with a restricted likelihood estimator to summarise the mean differences between the exposure group and controls. Positive effect sizes indicate higher performance for non-shift workers. The heterogeneity of effect sizes was addressed by sensitivity analysis using funnel plots, Egger’s tests, p-curve analysis, meta-regressions and subgroup analysis.

Results We included 18 studies resulting in a total sample of 18 802 participants and 37 effect sizes concerning six different neurobehavioural outcomes. Our results showed significantly worse performance in shift workers compared with non-shift workers in the following cognitive functions with g (95% CI): processing speed 0.16 (0.02 to 0.30), working memory 0.28 (0.51 to 0.50), psychomotor vigilance 0.21 (0.05 to 0.37), cognitive control 0.86 (0.45 to 1.27) and visual attention 0.19 (0.11 to 0.26).

Conclusions We provide the first meta-analytical findings that associate shift work with decreased cognitive performance in processing speed, working memory, psychomotor vigilance, cognitive control and visual attention.

  • occupational health
  • shift work
  • meta-analysis

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Footnotes

  • Contributors TV designed the data collection tools, collected the data, wrote the statistical analysis plan, cleaned and analysed the data, and drafted the article. TD collected and analysed the data, and drafted the article. AB monitored data collection, carried out the data analysis, and drafted and revised the article. AB is the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.