PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of oenvmedOccupational and Environmental MedicineVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
 
Occup Environ Med. 1997 June; 54(6): 367–375.
PMCID: PMC1128796

Health and safety problems associated with long working hours: a review of the current position.

Abstract

The European Community Directive on Working Time, which should have been implemented in member states of the European Community by November 1996, contains several requirements related to working hours, including the right of employees to refuse to work more than 48 hours a week. The United Kingdom government attempted to oppose the Directive, arguing that there is no convincing evidence that hours of work should be limited on health and safety grounds. Much of the research in this area has focused on the problems of shiftworking and previous reviews have therefore tended to emphasise this aspect of working hours. However, there is much less information about the effects of overtime work, which is a central element of the terms of the Directive. This paper reviews the current evidence relating to the potential effects on health and performance of extensions to the normal working day. Several gaps in the literature are identified. Research to date has been restricted to a limited range of health outcomes--namely, mental health and cardiovascular disorders. Other potential effects which are normally associated with stress--for example, gastrointestinal disorders, musculoskeletal disorders, and problems associated with depression of the immune system, have received little attention. Also, there have been few systematic investigations of performance effects, and little consideration of the implications for occupational exposure limits of extensions to the working day. Existing data relate largely to situations where working hours exceed 50 a week and there is a lack of information on hours below this level, which is of direct relevance to the European Community proposal. Finally, it is clear from investigations relating to shiftwork that a range of modifying factors are likely to influence the level and nature of health and performance outcomes. These include the attitudes and motivation of the people concerned, the job requirements, and other aspects of the organisational and cultural climate. It is concluded that there is currently sufficient evidence to raise concerns about the risks to health and safety of long working hours. However, much more work is required to define the level and nature of those risks.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.9M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Harrington JM. Shift work and health--a critical review of the literature on working hours. Ann Acad Med Singapore. 1994 Sep;23(5):699–705. [PubMed]
  • Kasl SV. Mental health and work environment: an examination of the evidence. J Occup Med. 1973 Jun;15(6):509–518. [PubMed]
  • Leino P. Symptoms of stress predict musculoskeletal disorders. J Epidemiol Community Health. 1989 Sep;43(3):293–300. [PMC free article] [PubMed]
  • House JS, McMichael AJ, Wells JA, Kaplan BH, Landerman LR. Occupational stress and health among factory workers. J Health Soc Behav. 1979 Jun;20(2):139–160. [PubMed]
  • Brown ID. Driver fatigue. Hum Factors. 1994 Jun;36(2):298–314. [PubMed]
  • Goyal R, Krishnan K, Tardif R, Laparé S, Brodeur J. Assessment of occupational health risk during unusual workshifts: review of the needs and solutions for modifying environmental and biological limit values for volatile organic solvents. Can J Public Health. 1992 Mar-Apr;83(2):109–112. [PubMed]
  • Bohle P, Tilley AJ. The impact of night work on psychological well-being. Ergonomics. 1989 Sep;32(9):1089–1099. [PubMed]
  • Oppenheim L. Factors related to occupational stress or burnout among music therapists. J Music Ther. 1987 Summer;24(2):97–106. [PubMed]
  • Ezoe S, Morimoto K. Behavioral lifestyle and mental health status of Japanese factory workers. Prev Med. 1994 Jan;23(1):98–105. [PubMed]
  • Hall EM. Double exposure: the combined impact of the home and work environments on psychosomatic strain in Swedish women and men. Int J Health Serv. 1992;22(2):239–260. [PubMed]
  • Westman M, Eden D, Shirom A. Job stress, cigarette smoking and cessation: the conditioning effects of peer support. Soc Sci Med. 1985;20(6):637–644. [PubMed]
  • Caplan RD, Cobb S, French JR., Jr Relationships of cessation of smoking with job stress, personality, and social support. J Appl Psychol. 1975 Apr;60(2):211–219. [PubMed]
  • Kawakami N, Araki S, Haratani T, Hemmi T. Relations of work stress to alcohol use and drinking problems in male and female employees of a computer factory in Japan. Environ Res. 1993 Aug;62(2):314–324. [PubMed]
  • Ford CV, Wentz DK. Internship: what is stressful? South Med J. 1986 May;79(5):595–599. [PubMed]
  • Campbell JM, Meadows PM. Therapeutic FES: from rehabilitation to neural prosthetics. Assist Technol. 1992;4(1):4–18. [PubMed]
  • Cooper CL, Davidson MJ, Robinson P. Stress in the police service. J Occup Med. 1982 Jan;24(1):30–36. [PubMed]
  • Maruyama S, Kohno K, Morimoto K. [A study of preventive medicine in relation to mental health among middle-management employees (Part 2)--effects of long working hours on lifestyles, perceived stress and working-life satisfaction among white-collar middle-management employees]. Nihon Eiseigaku Zasshi. 1995 Oct;50(4):849–860. [PubMed]
  • Watanabe S, Torii J, Shinkai S, Watanabe T. Relationships between health status and working conditions and personalities among VDT workers. Environ Res. 1993 May;61(2):258–265. [PubMed]
  • Carroll D, Harris MG, Cross G. Haemodynamic adjustments to mental stress in normotensives and subjects with mildly elevated blood pressure. Psychophysiology. 1991 Jul;28(4):438–446. [PubMed]
  • RUSSEK HI, ZOHMAN BL. Relative significance of heredity, diet and occupational stress in coronary heart disease of young adults; based on an analysis of 100 patients between the ages of 25 and 40 years and a similar group of 100 normal control subjects. Am J Med Sci. 1958 Mar;235(3):266–277. [PubMed]
  • BUELL P, BRESLOW L. Mortality from coronary heart disease in California men who work long hours. J Chronic Dis. 1960 Jun;11:615–626. [PubMed]
  • Hinkle LE, Jr, Whitney LH, Lehman EW, Dunn J, Benjamin B, King R, Plakun A, Flehinger B. Occupation, education, and coronary heart disease. Risk is influenced more by education and background than by occupational experiences, in the Bell System. Science. 1968 Jul 19;161(3838):238–246. [PubMed]
  • PELL S, D'ALONZO CA. ACUTE MYOCARDIAL INFARCTION IN A LARGE INDUSTRIAL POPULATION: REPORT OF A 6-YEAR STUDY OF 1,356 CASES. JAMA. 1963 Sep 14;185:831–838. [PubMed]
  • Alfredsson L, Spetz CL, Theorell T. Type of occupation and near-future hospitalization for myocardial infarction and some other diagnoses. Int J Epidemiol. 1985 Sep;14(3):378–388. [PubMed]
  • Starrin B, Larsson G, Brenner SO, Levi L, Petterson IL. Structural changes, ill health, and mortality in Sweden, 1963-1983: a macroaggregated study. Int J Health Serv. 1990;20(1):27–42. [PubMed]
  • Sorensen G, Pirie P, Folsom A, Luepker R, Jacobs D, Gillum R. Sex differences in the relationship between work and health: the Minnesota Heart Survey. J Health Soc Behav. 1985 Dec;26(4):379–394. [PubMed]
  • Thiel HG, Parker D, Bruce TA. Stress factors and the risk of myocardial infarction. J Psychosom Res. 1973 Jan;17(1):43–57. [PubMed]
  • FRIEDMAN M, ROSENMAN RH. Association of specific overt behavior pattern with blood and cardiovascular findings; blood cholesterol level, blood clotting time, incidence of arcus senilis, and clinical coronary artery disease. J Am Med Assoc. 1959 Mar 21;169(12):1286–1296. [PubMed]
  • Uehata T. Long working hours and occupational stress-related cardiovascular attacks among middle-aged workers in Japan. J Hum Ergol (Tokyo) 1991 Dec;20(2):147–153. [PubMed]
  • Gold DR, Rogacz S, Bock N, Tosteson TD, Baum TM, Speizer FE, Czeisler CA. Rotating shift work, sleep, and accidents related to sleepiness in hospital nurses. Am J Public Health. 1992 Jul;82(7):1011–1014. [PubMed]
  • Smith L, Folkard S, Poole CJ. Increased injuries on night shift. Lancet. 1994 Oct 22;344(8930):1137–1139. [PubMed]
  • Laundry BR, Lees RE. Industrial accident experience of one company on 8- and 12-hour shift systems. J Occup Med. 1991 Aug;33(8):903–906. [PubMed]
  • Ong SG, Fung SC, Chow SP, Kleevens JW. A study of major factors associated with severe occupational hand injury in Hong Kong island. J Soc Occup Med. 1982 Apr;32(2):82–88. [PubMed]
  • McCall TB. The impact of long working hours on resident physicians. N Engl J Med. 1988 Mar 24;318(12):775–778. [PubMed]
  • Ono Y, Watanabe S, Kaneko S, Matsumoto K, Miyao M. Working hours and fatigue of Japanese flight attendants (FA). J Hum Ergol (Tokyo) 1991 Dec;20(2):155–164. [PubMed]
  • McDonald AD, McDonald JC, Armstrong B, Cherry NM, Côté R, Lavoie J, Nolin AD, Robert D. Fetal death and work in pregnancy. Br J Ind Med. 1988 Mar;45(3):148–157. [PMC free article] [PubMed]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Group