Study | Design and critical appraisal (see criteria in box 3) | Setting and participants | Summary results | |
↑ = improvement ↓ = worsening ↔ = little change | ||||
Retrospective cohort studies with control group | ||||
Venne, 1993; 199769 70 | Historical data: 12-month pre-average, 24-month post-averageFinal sample: n = 102 (70 intervention, 32 control)Critical appraisal: 4 5 7 9 10 | Prison, CanadaPrison guardsFive eight-hour shifts, two days off to two/three 12-hour shifts, two/three days off | Absence | ↔ |
Yamada et al, 200171 | Historical data: 2-, 8-, 14- and 24-month follow-upsFinal sample: n = 205 (189 intervention, 16 control)Critical appraisal:2 4 5 6 9 | Electronic parts manufacturer, JapanProcessing machine operatorsFive eight-hour shifts, two days off to two/three 12-hour shifts, two/three days off | Lower back painStiff shoulderJoint painLimb painDimmed sightSore throatPoor sleepDiminished alertnessTirednessIrritationHead heavinessBMIWeightBlood pressure | ↔↔↔↔↔↔↔↔↔↔↔↔↔↔ |
Retrospective cohort studies | ||||
Laundry & Lees, 1989; 199172 73 | Historical data: 120-month pre-average, 120-month post-averageFinal sample: n = 247Critical appraisal: 2 4 5 7 8 9 10 | Synthetic yarn factory, CanadaFactory workers, 85% maleFive eight-hour shifts, two days off to 12-hour shifts | Morbidity (male)Morbidity (female)HeadachesGastric upsetDiarrhoeaAlcohol problemsGeneral malaiseNervous conditionsMinor injury rateSevere injury rateInjury rate (male)Injury rate (female) | ↑↔↑↑↑↑↔↔↑↔↑↔ |
Conrad-Beetschart, 199074 | After only recall data: one-month postFinal sample: n = 78Critical appraisal: 2 4 7 9 | Oil refinery, SwitzerlandOperators, mainly maleFive eight-hour shifts, two days off to two/three 12-hour shifts, two/three days off | SleepHealthLeisure timeTime with partner | ↑↔↑↑ |
Pollock et al, 199475 | Historical data: 18-month pre-average, 18-month post-average | Petrochemical manufacturer and fertiliser manufacturer, Australia | Injury rates | ↔ |
Final sample: n = 300 | Manufacturing workers. | |||
Critical appraisal: 2 4 5 9 | Five eight-hour shifts, two days off to four 12-hour shifts, four/six days off | |||
Barter-Trenholm, 199776 | After only recall dataFinal sample: n = 218Critical appraisal: 2 4 7 9 10 | Police Force, CanadaPolice officersFive eight-hour shifts, one in three weekends off to 12-hour shifts, one in two weekends off | Sleep patternsTirednessEffectiveness | ↔↔↔ |
Vega & Gilbert, 199777 | After only recall data: eight-month postHistorical data: 12-month pre-average, 12-month post-averageFinal sample: 34Critical appraisal: 2 7 9 10 | County Sheriff’s Department, USAPatrol officers, majority male and whiteFive eight-hour shifts, two days off to three 13.3-hour shifts, four days off | FatigueQuality of professional livesQuality of personal livesFamily and personal activitiesProductivity | ↔↑↑↑↑ |
Richbell et al, 1998*78 | After only recall dataHistorical data: 12-month pre-average, 12-month post-averageFinal sample: n = 90Critical appraisal: 2 9 | Police force, UKPolice officersFive eight-hour shifts to Ottawa system (9/10-hour days 10-hour nights). | HealthAbsenceQuality of lifeMoraleService | ↑↑↑↑↑ |
Wootten, 2000a, 2000b79 80 | Historical data: three-month pre-average, three-month post-averageFinal sample: n = 20Critical appraisal: 2 4 5 9 | Hospital, UKNurses7.5-hour to 12-hour shifts | AbsenceAccidentsStaffing costsErrors | ↓↑↑↑ |
Baker et al, 200081 | Historical data: nine-month pre-average, 12- and 24-month post-averagesFinal sample: not statedCritical appraisal: 2 4 5 7 10 | Coal Mine, AustraliaMiners, maintenance workers, preparation plant workersEight-hour shifts to A: four 12-hour shifts, two/six days off; then from A to B: as system A with addition of three consecutive night shifts and no cap on overtime | AbsenceInjury incident rate | ↓↑ |
Bloodworth et al, 200182 | After only recall dataHistorical data: two-month pre-average, two-month post-averageFinal sample: 16Critical appraisal: 2 4 | Hospital, UKNurses, all femaleFive 7.5-hour shifts, two days off to two 6.25-hour shifts, two 12-hour shifts, three days off | TirednessAbsenceChild carePerformanceStaff costsErrors and incidents | ↔↑↑↔↑↔ |
Retrospective repeat cross-section studies | ||||
Brinton, 198383 | Historical data: five-month pre-average, five-month post-averageFinal sample: 76Critical appraisal: 2 4 5 9 | Paper Mill, USAWood yard workers, all maleFive eight-hour shifts, two days off to four 12-hour shifts, three/four days off | Injury frequency rateAbsence | ↑↑ |
Effect sizes have been added to the text where appropriate and the detailed results are available in online table E3.
*This study also used qualitative focus groups.