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Ethical Issues Relating to the Health Effects of Long Working Hours

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Abstract

Considerable research evidence has accumulated indicating that there is an increased likelihood for illness and injury among employees working in long-hour schedules and schedules involving unconventional shift work (e.g., night and evening shifts). In addition, studies show that fatigue-related errors made by employees working in these kind of demanding schedules can have serious and adverse repercussions for public safety. As the result of these concerns, new protective legislation is being advocated in the United States, for instance, to restrict the hours of work among nurses and other health-care professionals. This article reviews the history of concerns about long working hours and the current scientific evidence regarding their effects on workers’ health. The ethical implications of unconventional shift work and long work-hour schedules are considered. Relevant ethical considerations involve mandatory or unpaid overtime and the possibility of employer coercion, the political basis for government regulation of working hours, potential limits on voluntary assumption of risk, societal benefits accruing from the equitable distribution of available working hours, gender-based inequities related to working hours, and employer responsibilities for protecting individuals who are not employees from the spillover effects of demanding work schedules.

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References

  • American Association of Insurance Services (AAIS): 2004, ‹Extended Hours, Extended Risks? Should Commercial Lines Underwriting and Rating Reflect a “24/7” World?’, AAIS Viewpoint 28(3). Retrieved December 27, 2006 at: http://www.aaisonline.com/Viewpoint/04win3.html

  • American Nursing Association (ANA): 2007, ‹Mandatory Overtime’, ANA Nursing World. Retrieved on December 26, 2007 at: http://www.nursingworld.org

  • American Organization of Nurse Executives (AONE): 2003, AONE Policy Statement on Mandatory Overtime. Retrieved on December 26, 2007 at: http://www.aone.org/aone/advocacy/ps_mandatory_ot.html

  • Åkerstedt T. E.: 2003, Shift Work and Disturbed Sleep/Wakefulness. Occupational Medicine 53, 89–94

    Article  Google Scholar 

  • Åkerstedt T. E., P. Fredlund, M. Gillberg, B. Jansson: 2002, A Prospective Study of Fatal Occupational Accidents: Relationship to Sleeping Difficulties and Occupational Factors. Journal of Sleep Research 11, 69–71

    Article  Google Scholar 

  • Åkerstedt T., A. Knutsson, P. Westerholm, T. Theorell, I. Alfredsson, G. Kecklund: 2002, Sleep Disturbances, Work Stress and Work Hours: A Cross-Sectional Study. Journal of Psychosomatic Research 53, 741–748

    Article  Google Scholar 

  • Andrews, A. R.: 2000, ‹What Every Student Should Know About Journalism’, The American Reporter 6 (1266W). Retrieved December 27, 2007 at: http://www.toad.net/~andrews/studentknow.htm

  • Atack, J. and F. Bateman: 1991, ‹Whom did Protectionist Legislation Protect? Evidence from 1880’, National Bureau of Economic Research Historical Working Paper No. 33, Cambridge, MA

  • Axelsson G., R. Rylander: 1989, Outcome of Pregnancy in Relation to Irregular and Inconvenient Work Schedules. British Journal of Industrial Medicine 46, 306–312

    Google Scholar 

  • Barger L. K., B. E. Cade, N. T. Ayas, J. W. Cronin, B. Rosner, F. E. Speizer C., A. Czeisler: 2005, Extended Work Shifts and the Risk of Motor Vehicle Crashes. New England Journal of Medicine 352(2), 125–134

    Article  Google Scholar 

  • Barton J., J. Aldridge, P. Smith: 1998, The Emotional Impact of Shift Work on the Children of Shift Workers. Scandinavian Journal of Work Environment and Health 24(Suppl 3), 146–150

    Google Scholar 

  • Bayley, D. H. and R. E. Worden: 1998, ‹Police Overtime: An Examination of Key Issues’, National Institute of Justice Research in Brief, May 1998, 1–8

  • Berney B., J. Needleman: 2005, Trends in Nurse Overtime, 1995–2002. Policy, Politics, and Nursing Practice 6(3), 183–190

    Article  Google Scholar 

  • Berney B., J. Needleman, C. Kovner: 2005, Factors Influencing the Use of Registered Nurse Overtime in Hospitals, 1995–2000. Journal of Nursing Scholarship 37(2), 165–172

    Article  Google Scholar 

  • Bøggild H., A. Knutsson: 1999, Shift Work, Risk Factors and Cardiovascular Disease. Scandinavian Journal of Work Environment and Health 25, 85–99

    Google Scholar 

  • Braver E. R., C. W. Preusser, D. F. Preusser, H. M. Baum, R. Beilock, R. Ulmer: 1992, Long Hours and Fatigue: A Survey of Tractor-Trailer Drivers. Journal of Public Health Policy 13(3), 341–366

    Article  Google Scholar 

  • Brogmus G., W. Maynard 2006, Safer Shift Work Through More Effective Scheduling. Occupational Health and Safety 75(12), 16

    Google Scholar 

  • Caruso, C., E. Hitchcock, R. Dick, J. M. Russo and J. M. Schmit: 2004, Overtime and Extended Work Shifts: Recent Findings on Illnesses, Injuries, and Health Behaviors (U.S. Centers for Disease Control, National Institute for Occupational Safety and Health, Cincinnati), Publication No. 2004-143

  • Circadian Technologies, Inc.: 2000, ‹The Costs of Human Breakdown’, Chapter 5 of 24 × 7 Operations: Optimizing Human Performance (Circadian Technologies, Inc., Cambridge, MA). Retrieved on December 24, 2007 at: http://www.tcrc355.com/legislative/shift_work_maladapation.pdf

  • Colligan M., R. Rosa: 1990, Shiftwork Effects on Social and Family Life. Occupational Medicine: State of the Art Reviews 5(2), 315–322

    Google Scholar 

  • Cornell University Institute for Workplace Studies: 1999, Overtime and the American Worker. Ithaca, NY: New York State School of Industrial and Labor Relations

    Google Scholar 

  • Costa G.: 2003, Shift Work and Occupational Medicine: An Overview. Occupational Medicine 53, 83–88

    Article  Google Scholar 

  • Davis S., D. K. Mirick, R. G. Stevens: 2001, Night Shift Work, Light at Night, and Risk of Breast Cancer. Journal of the National Cancer Institute 93, 1557–1562

    Google Scholar 

  • Dawson, D., K. McCulloch and A. Baker: 2001, Extended Working Hours in Australia—Counting the Costs (Centre for Sleep Research, The University of South Australia, The Adelaide). Retrieved December 19, 2007 at: http://www.deir.qld.gov.au/pdf/ir/extendedhours.pdf

  • Dembe, A. E., J. B. Erickson and R. G. Delbos: 2008, ‹Industry and Occupation Variations in the Injury Risks Related to Shift Work and Extended Work Hours’, Working Paper, The Ohio State University Center for Health Outcomes, Policy and Evaluation Studies

  • Dembe A. E., J. B. Erickson, R. G. Delbos, S. M. Banks: 2005, The Impact of Overtime and Long Work Hours on Occupational Injuries and Illnesses: New Evidence from the United States. Occupational and Environmental Medicine 62(9), 588–597

    Article  Google Scholar 

  • Dembe A. E., J. B. Erickson, R. G. Delbos, S. M. Banks 2006, Nonstandard Shift Work and the Risk of Job-Related Injuries: A National Study from the United States. Scandinavian Journal of Work Environment and Health 32(3), 232–240

    Google Scholar 

  • DeMoss C., M. McGrail, E. Haus, A. L. Crain, S. E. Asche: 2004, Health and Performance Factors in Health Care Shift Workers. Journal of Occupational and Environmental Medicine 46, 1278–1281

    Google Scholar 

  • Dorman, P.: 2000, ‹The Role of Economic Incentives for Occupational Safety and Health’, International Labor Organization, Geneva, Programme on Safety and Health at Work and the Environment (SafeWork)

  • Federal Railroad Administration, U.S. Department of Transportation (FRA): 2006, Validation and Calibration of a Fatigue Assessment Tool for Railroad Work Schedules, Summary Report (RFA, Washington, DC). Report DOT/FRA/ORD/06-21

  • Folkard S., D. A. Lombardi, P. T. Tucker: 2005, Shiftwork: Safety, Sleepiness and Sleep. Industrial Health 43(1), 20–23

    Article  Google Scholar 

  • Frankfurter, F. and J. Goldmark: 1915, The Case for the Shorter Work Day: Supreme Court of the United States, October Term, 1915, Franklin O. Bunting, Plaintiff in Error, vs. the State of Oregon, Defendant in Error: Brief for Defendant in Error. Reprinted by National Consumers League, New York, 1916

  • Glass J., T. Fujimoto: 1994, Housework, Paid Work, and Depression Among Husbands and Wives. Journal of Health Society and Behavior 135, 179–191

    Article  Google Scholar 

  • Golden L., B. Wiens-Tuers 2005, Mandatory Overtime Work in the United States: Who, Where, and What? Labor Studies Journal 30(1), 1–25

    Article  Google Scholar 

  • Goode J. H.: 2003, Are Pilots at Risk of Accidents Due to Fatigue? Journal of Safety Research 34(2), 309–313

    Article  Google Scholar 

  • Greenhouse, S.: 2002, ‹U.S. Jury Cites Unpaid Work at Wal-Mart’, New York Times, December 20, 2002

  • Grosch J. W., C. C. Caruso, R. R. Rosa, S. L. Sauter: 2006, Long Hours of Work in the U.S.: Associations with Demographic and Organizational Characteristics, Psychosocial Working Conditions, and Health. American Journal of Industrial Medicine 49, 943–952

    Article  Google Scholar 

  • Hänecke K., S. Tiedemann, F. Nachreiner, H. Grzech-Šukalo: 1998, Accident Risk as a Function of Hour at Work and Time of Day as Determined from Accident Data and Exposure Models for the German Working Population. Scandinavian Journal of Work Environment and Health 24(Suppl 3), 43–48

    Google Scholar 

  • Hansen J.: 2001, Increased Breast Cancer Risk Among Women Who Work Predominantly at Night. Epidemiology 12(1), 74–77

    Article  Google Scholar 

  • Hanson M. A.: 2001, Contemporary Ergonomics, 2001 (CRC Press, Boca Raton, FL)

    Google Scholar 

  • Härmä M., M. Sallinen, R. Ranta, P. Mutanen, K. Müller: 2002, The Effect of an Irregular Shift System on Sleepiness at Work in Train Drivers and Railway Traffic Controllers. Journal of Sleep Research 11(2), 141–151

    Article  Google Scholar 

  • Harrington J. M.: 2001, Health Effects of Shift Work and Extended Hours of Work. Occupational and Environmental Medicine 58, 68–72

    Article  Google Scholar 

  • Hayashi T., Y. Kobayashi, K. Yamaoka, E. Yano: 1996, Effect of Overtime Work on 24-Hour Ambulatory Blood Pressure. Journal of Occupational Medicine 38, 1007–1011

    Article  Google Scholar 

  • Hewlett, S. and C. B. Luce: 2006, ‹Extreme Jobs: The Dangerous Allure of the 70-Hour Workweek,’ Harvard Business Review, December 1, 2006

  • Horne J., L. Reyner: 1999, Vehicle Accidents Related to Sleep: A Review. Occupational and Environmental Medicine 56, 289–294

    Article  Google Scholar 

  • Horwitz I. B., B. McCall: 2004, The Impact of Shift Work on the Risk and Severity of Injuries for Hospital Employees: An Analysis Using Oregon Workers’ Compensation Data. Occupational Medicine 54, 556–563

    Article  Google Scholar 

  • Hughes R., P. Stone: 2004, The Perils of Shift Work. American Journal of Nursing 104, 60–63

    Google Scholar 

  • Iwasaki K., M. Takahashi, A. Nakata: 2006, Health Problems Due to Long Working Hours in Japan, Industrial Health, 44, 537–540

    Article  Google Scholar 

  • Jacobs J. A., K. Gerson: 2004, The Time Divide: Work, Family and Gender Inequality (Harvard University Press, Cambridge, MA)

    Google Scholar 

  • Japan Press Weekly: 2006, ‹Situation at Toyota Revealed by JCP Investigation’, Retrieved December 30, 2006 at: http://www.japan-press.co.jp/2006/2496/economy.html

  • Kawakami N., S. Araki, N. Takatsuka, H. Shimizu, H. Ishibashi: 1999, Overtime, Psychosocial Working Conditions, and Occurrence of Non-Insulin Dependent Diabetes Mellitus in Japanese Men, Journal of Epidemiology and Community Health 53, 359–363

    Article  Google Scholar 

  • Keese M.: 2006, Live Longer, Work Longer, Paris: OECD Publishing

    Google Scholar 

  • Kivimäki M., P. Kuisma, M. Virtanen, M. Elovainio: 2001, Does Shift Work Lead to Poorer Health Habits? A Comparison Between Women Who had Always done Shift Work with Those Who had Never done Shift Work. Work and Stress 15(1), 3–13

    Article  Google Scholar 

  • Kodz, J., S. Davis, D. Lain, M. Strebler and J. Rick: 2001, Working Long Hours in the U.K.: A Review of the Research Literature, Analysis of Survey Data, and Cross-National Organizational Case Studies. Employment Relations Research Series No. 16, Department of Trade and Industry

  • Knutsson A.: 2003, Health Disorders of Shift Workers. Occupational Medicine 53, 103–108

    Article  Google Scholar 

  • Kristensen T. S. 1989, Cardiovascular Diseases and the Work Environment: A Critical Review of the Epidemiologic Literature on Nonchemical Factors. Scandinavian Journal of Work Environment and Health 15, 165–179

    Google Scholar 

  • Kuhn, P. and F. Lozano: 2005, The Expanding Workweek? Understanding Trends in Long Work Hours Among U.S. Men, 1979–2004. National Bureau of Economic Research, Working Paper Number 11895

  • Lee K. A.: 1992, Self Reported Sleep Disturbances in Employed Women. Sleep 15, 493–498

    Google Scholar 

  • Lee S., D. McCann, J. C. Messenger: 2007, Working Time Around the World: Trends in Working Hours, Laws, and Policies in a Global Comparative Perspective. Geneva: International Labor Organization

    Google Scholar 

  • Lehmkuhl, L.: 1999, Health Effects of Long Work Hours. “32 Hours” Organization Report. Retrieved December 28, 2007 at: http://www.wen.net/32hours/Health%20Effects%20v2.htm

  • Lipscomb J. A., A. M. Trinkoff, J. Geiger-Brown, B. Brady: 2002, Work-Schedule Characteristics and Reported Musculoskeletal Disorders of Registered Nurses. Scandinavian Journal of Work Environment and Health 28, 394–401

    Google Scholar 

  • Liu, Y., H. Tanaka and The Fukuoka Heart Study Group: 2002, ‹Overtime Work, Insufficient Sleep, and Risk of Non-Fatal Acute Myocardial Infarction in Japanese Men’, Occupational and Environmental Medicine 59, 447–451

  • Mishel, L., J. Bernstein and S. Allegretto (eds.): 2006, The State of Working America, 2006/2007 (Cornell University Press, Ithaca, NY)

  • Mohren D. C., G. M. Swaen, I. J. Kant, P. J. Borm, J. M. Galama: 2001, Associations Between Infections and Fatigue in a Dutch Working Population: Results of the Maastricht Cohort Study on Fatigue at Work. European Journal of Epidemiology 17(12), 1081–1087

    Article  Google Scholar 

  • Motoyama, S.: 2000, ‹Time Crunch Hits Home’, The Penn Current. March 2, 2000. Retrieved on December 28, 2007 at: http://www.upenn.edu/pennnews/current/2000/030200/research.html

  • Nachreiner, F., S. Akkermann and K. Haenecke: 2000, ‹Fatal Accident Risk as a Function of Hours into Work’, in S. Hornberger, P. Knauth, G. Costa, and S. Folkard (eds.), Arbeitswissenschaft in der betrieblichen Praxis [Ergonomics in operational practice] 17: Shiftwork in the 21st Century (Peter Lang Publishers, Frankfurt), pp. 19–24

  • Nakanishi N., H. Yoshida, K. Nagano, H. Kawashimo, K. Nakamura, K. Tatara: 2001, Long Working Hours and Risk for Hypertension in Japanese Male White Collar Workers. Journal of Epidemiology and Community Health 55, 316–322

    Article  Google Scholar 

  • Ottmann W., M. J. Karvonen, K. H. Schmidt, P. Knauth, J. Rutenfranz: 1989, Subjective Health Status of Day and Shift-Working Policemen. Ergonomics 32, 847–854

    Article  Google Scholar 

  • Pfesser J.: 2001, What’s Wrong with Management Practices in Silicon Valley? A Lot. MIT Sloan Management Review 42(3), 101–102

    Google Scholar 

  • Pocock, B.: 2001, The Effect of Long Hours on Family and Community Life: A Survey of Existing Literature. Report for the Queensland Department of Industrial Relations, Adelaide, Australia: Adelaide University Centre for Labour Research

  • Presser H. 2000, Nonstandard Work Schedules and Marital Instability. Journal of Marriage and Family 62, 93–110

    Article  Google Scholar 

  • Robins P. K., T. L. Idson: 1991, Determinants of Voluntary Overtime Decisions, Economic Inquiry 29(1), 79–91

    Article  Google Scholar 

  • Rogers A. E., W. T. Hwang, L. D. Scott, L. H. Aiken, D. F. Dinges: 2004, The Working Hours of Hospital Staff Nurses and Patient Safety. Health Affairs 23(4), 202–212

    Article  Google Scholar 

  • Schernhammer E. S., F. Laden, F. E. Speizer, W. C. Willett, D. L. Hunter, I. Kawachi, C. S. Fuchs, G. A. Colditz 2003, Night-Shift Work and Risk of Colorectal Cancer in the Nurses’ Health Study. Journal of the National Cancer Institute 95, 825–828

    Article  Google Scholar 

  • Scott A.: 2000, Shift Work and Health. Primary Care 27, 1057–1079

    Google Scholar 

  • Scott A. J., LaDou J. 1990, Shiftwork: Effects on Sleep and Health with Recommendations for Medical Surveillance and Screening. Occupational Medicine 5(2), 273–299

    Google Scholar 

  • Segawa K., S. Nakazawa, Y. Tsukamoto, Y. Kurita, H. Goto, A. Fukui, K. Takano: 1987, Peptic Ulcer is Prevalent Among Shift Workers. Digestive Diseases and Sciences 32, 449–453

    Article  Google Scholar 

  • Shields M.: 1999, Long Working Hours and Health. Health Reports 11, 33–48

    Google Scholar 

  • Simon B. L.: 1990, Impact of Shift Work on Individuals and Families. Families in Society 71, 342–348

    Google Scholar 

  • Simpson R.: 1998, Presenteeism, Power and Organizational Change: Long Hours as a Career Barrier and the Impact on the Working Lives of Women Managers. British Journal of Management 9(s1), 37–50

    Article  Google Scholar 

  • Spurgeon, A.: 2003, Working Time: Its Impact on Safety and Health. International Labor Organization, Geneva. Retrieved December 18, 2007 at: http://www.ilo.org/public/english/protection/condtrav/publ/wtwo-as-03.htm

  • Staines G. L., J. H. Pleck: 1984, Nonstandard Work Schedules and Family Life. Journal of Applied Psychology 69(3), 515–523

    Article  Google Scholar 

  • Trinkoff A. M., R. Le, J. Geiger-Brown, L. Lipscomb, G. Lang: 2006, Longitudinal Relationship of Work Hours, Mandatory Overtime, and On-Call to Musculoskeletal Problems in Nurses. American Journal of Industrial Medicine 49(11), 964–971

    Article  Google Scholar 

  • Trinkoff A. M., C. L. Storr: 1998, Work Schedule Characteristics and Substance Use in Nurses. American Journal of Industrial Medicine 34(3), 266–271

    Article  Google Scholar 

  • Van der Hulst, M.: 2003, Long Workhours and Health. Scandinavian Journal of Work Environment and Health 29, 171–188

    Google Scholar 

  • Viscusi W. K.: 1983, Risk by Choice: Regulating Health and Safety in the Workplace. Cambridge, MA: Harvard University Press

    Google Scholar 

  • Webber, N.: 2002, ‹The Issue for 2002: An End to Mandatory Overtime’, New York State Nurses Association. Retrieved on December 31, 2007 at: http://www.legislativegazette.com/read_more.php?story=1350

  • Whaples, R.: 2001, ‹Hours of Work in U.S. History’, Retrieved December 31, 2007, from http://www.eh.net/encyclopedia/article/whaples.work.hours.us

  • White, J. and J. Beswick: 2003: Working Long Hours. Report HSL/2003/02. Health and Safety Laboratory, Sheffield, UK. Retrieved December 17, 2007 at: http://www.hse.gov.uk/research/hsl_pdf/2003/hsl03-02.pdf

  • Wright L. D.: 2007, Voluntary Overtime, Unsafe Nursing Practice, and the Quest for Institutional Accountability. JONA’s Healthcare Law, Ethics, & Regulation 9(2), 50–53

    Article  Google Scholar 

  • Yang H., P. L. Schnall, M. Jauregui, T.-C. Su, D. Baker: 2006, Work Hours and Self-Reported Hypertension Among Working People in California. Hypertension 48, 744–750

    Article  Google Scholar 

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  1. Division of Health Services Management & Policy, Center for Health Outcomes, Policy and Evaluation Studies, The Ohio State University College of Public Health, 472 Cunz Hall, 1841 Neil Avenue, Columbus, OH, 43210, U.S.A.

    Allard E. Dembe

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Dembe, A.E. Ethical Issues Relating to the Health Effects of Long Working Hours. J Bus Ethics 84 (Suppl 2), 195–208 (2009). https://doi.org/10.1007/s10551-008-9700-9

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