Abstract
Purpose
The aim of this study was to investigate the effect of work-time influence on stress and energy, work–family conflicts, lifestyle factors, and biomarkers of cardiovascular disease risk.
Methods
The study was a quasi-experimental intervention study with a one-year follow-up among eldercare workers (baseline: n = 309; follow-up: n = 297). The nine work units in the intervention group designed their own intervention. We categorized these work units into three subgroups according to the interventions that they initiated: (A) self-scheduling via a computer program (n = 35), (B) setting up a task group that developed a questionnaire on work-time preference and participated in a one-day course on flexible working hours with the intention to increase employee influence on the fixed rota (n = 62), and (C) discussions of how employee work-time influence could be increased (n = 25). These subgroups were compared with a reference group consisting of ten work units (n = 187). Data consisted of questionnaires, blood samples, and measurements of waist and hip circumference.
Results
The employees in subgroup A became increasingly involved in the planning of their own work schedule. Nevertheless, we found no effect on health and well-being attributable to the intervention.
Conclusion
The introduction of self-scheduling can successfully increase employee work-time influence. Yet, this study does not support the theory that increased work-time influence leads to better health and well-being.
Similar content being viewed by others
References
Ala-Mursula L, Vahtera J, Pentti J, Kivimäki M (2004) Effect of employee worktime control on health: a prospective cohort study. Occup Environ Med 61:254–261
Ala-Mursula L, Vahtera J, Kouvonen A, Väänänen A, Linna A, Pentti J, Kivimäki M (2006) Long hours in paid and domestic work and subsequent sickness absence: does control over daily working hours matter? Occup Environ Med 63:608–616
Bambra CL, Whitehead MM, Sowden AJ, Akers J, Petticrew MP (2008) Shifting schedules: the health effects of reorganizing shift work [review]. Am J Prev Med 34:427–434
Björntorp P (2001) Do stress reactions cause abdominal obesity and comorbidities? Obes Rev 2:73–86
Bøggild H (2000) Shift work and heart disease. Epidemiological and risk factor aspects. Ph.D.-thesis, Centre for Working time Research, Department of Occupational Medicine, Aalborg Regional Hospital and Faculty of Health Sciences, University of Aarhus, Denmark
Bøggild H, Knutsson A (1999) Shift work, risk factors and cardiovascular disease. Scand J Work Environ Health 25:85–99
Casanueva FF, Moreno B, Rodriguez-Azeredo R, Massien C, Conthe P, Formiguera X, Barrios V, Balkau B (2010) Relationship of abdominal obesity with cardiovascular disease, diabetes and hyperlipidaemia in Spain. Clin Endocrinol (Oxf) 73(1):35–40
Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De BG, DeBacquer D, Ducimetière P, Jousilahti P, Keil U, Njølstad I, Oganov RG, Thomsen T, Tunstall-Pedoe H, Tverdal A, Wedel H, Whincup P, Wilhelmsen L, Graham IM (2003) Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24:987–1003
Costa G, Åkerstedt T, Nachreiner F, Baltieri F, Carvalhais J, Folkard S, Dresen MF, Gadbois C, Gartner J, Sukalo HG, Härmä M, Kandolin I, Sartori S, Silvério J (2004) Flexible working hours, health, and well-being in Europe: some considerations from a SALTSA project. Chronobiol Int 21:831–844
Costa G, Sartori S, Åkerstedt T (2006) Influence of flexibility and variability of working hours on health and well-being. Chronobiol Int 23:1125–1137
Deshmukh PR, Maliye C, Gupta SS, Bharambe MS, Dongre AR, Kaur S, Garg BS (2005) Does waist-hip ratio matter?—a study in rural India. Regional Health Forum 9:28–35
Dunham RB, Pierce JL, Castañeda MB (1987) Alternative work schedules: two field quasi-experiments. Pers Psychol 40:215–242
Frost P, Kolstad HA, Bonde JP (2009) Shift work and the risk of ischemic heart disease—a systematic review of the epidemiologic evidence [review]. Scand J Work Environ Health 35:163–179
Garde AH, Hansen AF, Persson R, Hansen ÅM, Hjortskov N, Schibye B, Ørbaek P (2007) Concentrations of cortisol, testosterone and glycosylated haemoglobin (HbA1c) among construction workers with 12-h workdays and extended workweeks. Int Arch Occup Environ Health 80:404–411
Garde AH, Nabe-Nielsen K, Aust B (2011) Influence on working hours among shift workers and effects on sleep quality—an intervention study. Appl Ergon 42:238–243
Geiger-Brown J, Muntaner C, Lipscomb JA, Trinkoff AM (2004) Demanding work schedules and mental health in nursing assistants working in nursing homes. Work Stress 18:292–304
Geurts SAE, Beckers DGJ, Taris TW, Kompier MAJ, Smulders PGW (2009) Worktime demands and work-family interference: does worktime control buffer the adverse effects of high demands? J of Bus Ethics 84:229–241
Giver H, Faber A, Hannerz H, Stroyer J, Rugulies R (2010) Psychological well-being as a predictor of dropout among recently qualified Danish eldercare workers. Scand J Public Health 38:239–245
Hansen ÅM, Larsen AD, Rugulies R, Garde AH, Knudsen LE (2009) A review of the effect of the psychosocial working environment on physiological changes in blood and urine. Basic Clin Pharmacol Toxicol 105:73–83
Härmä M (2006) Workhours in relation to work stress, recovery and health. Scand J Work Environ Health 32:502–514
Henderson LO, Saritelli AL, LaGarde E, Herbert PN, Shulman RS (1980) Minimal within-day variation of high density lipoprotein cholesterol and apolipoprotein A-I levels in normal subjects. J Lipid Res 21:953–955
Jansen NW, van Amelsvoort LG, Kristensen TS, van den Brandt PA, Kant IJ (2003) Work schedules and fatigue: a prospective cohort study. Occup Environ Med 60(1):i47–i53
Jansen NW, Kant I, Nijhuis FJ, Swaen GM, Kristensen TS (2004) Impact of worktime arrangements on work-home interference among Dutch employees. Scand J Work Environ Health 30:139–148
Johnson JV, Hall EM (1988) Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population. Am J of Public Health 78:1336–1342
Joyce K, Pabayo R, Critchley JA, Bambra C (2010) Flexible working conditions and their effects on employee health and wellbeing [review]. Cochrane Database Syst Rev 2:CD008009
Kandolin I, Huida O (1996) Individual flexibility: an essential prerequisite in arranging shift schedules for midwives. J Nurs Manag 4:213–217
Kjellberg A and Wadman C (2002) Subjektiv stress och dess samband med psykosociala förhållanden och besvär—En prövning av Stress-Energi-modellen, Arbetslivsinstitutet, Stockholm. Arbete och Hälsa 12
Knutsson A (2003) Health disorders of shift workers [review]. Occup Med (Lond) 53:103–108
Kristensen TS (1995) The demand-control-support model: methodological challenges for future research. Stress Med 11:17–26
Larsson A, Carlsson L, Axelsson J (2008) Low diurnal variability of apolipoprotein A1, apolipoprotein B and apolipoprotein B/apolipoprotein A1 ratio during normal sleep and after an acute shift of sleep. Clin Biochem 41:859–862
Lissner L, Björkelund C, Heitmann BL, Seidell JC, Bengtsson C (2001) Larger hip circumference independently predicts health and longevity in a Swedish female cohort. Obes Res 9:644–646
Lowden A, Åkerstedt T (2000) Introduction of self-selected work hours in retail work—effects on work satisfaction, health and social life. Arb Wiss 54:300–305
McQueen MJ, Hawken S, Wang X, Ounpuu S, Sniderman A, Probstfield J, Steyn K, Sanderson JE, Hasani M, Volkova E, Kazmi K, Yusuf S (2008) Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study): a case-control study. Lancet 372:224–233
Nabe-Nielsen K, Garde A, Jensen JN, Borg V, Høgh A (2007) Arbejdstider i ældreplejen (Working hours in the eldercare) [report], The National Research Centre for the Working Environment, Copenhagen. SOSU-report 15
Nabe-Nielsen K, Tüchsen F, Christensen KB, Garde AH, Diderichsen F (2009) Differences between day and noonday workers in exposure to physical and psychosocial work factors in the Danish eldercare sector. Scand J Work Environ Health 35:48–55
Nabe-Nielsen K, Garde AH, Albertsen K, Diderichsen F (2010) The moderating effect of work-time influence on the effect of shift work: a prospective cohort study. Int Arch Occup Environ Health. doi:10.1007/s00420-010-0592-5
National Institutes of Health (2000) The practical guide: identification, evaluation and treatment of overweight and obesity in adults [report], National Institutes of Health, USA
Pejtersen J, Kristensen TS, Bjorner JB, Borg V, Christensen KB (2010) The second version of the Copenhagen psychosocial questionnaire. Scand J Public Health 38:8–24
Pryce J, Albertsen K, Nielsen K (2006) Evaluation of an open-rota system in a Danish psychiatric hospital: a mechanism for improving job satisfaction and work-life balance. J Nurs Manag 14:282–288
Puttonen S, Härmä M, Hublin C (2010) Shift work and cardiovascular disease—pathways from circadian stress to morbidity. Scand J Work Environ Health 36:96–108
Rexrode KM, Carey VJ, Hennekens CH, Walters EE, Colditz GA, Stampfer MJ, Willett WC, Manson JE (1998) Abdominal adiposity and coronary heart disease in women. JAMA 280:1843–1848
Rönnberg E, Larsson T (2010) Automating the self-scheduling process of nurses in Swedish healthcare: a pilot study. Health Care Manag Sci 13:35–53
Ross R, Berentzen T, Bradshaw AJ, Janssen I, Kahn HS, Katzmarzyk PT, Kuk JL, Seidell JC, Snijder MB, Sørensen TI, Despres JP (2008) Does the relationship between waist circumference, morbidity and mortality depend on measurement protocol for waist circumference? Obes Rev 9:312–325
Saltin B, Grimby G (1968) Physiological analysis of middle-aged and old former athletes. Comparison with still active athletes of the same ages. Circulation 38:1104–1115
Smith L, Hammond T, Macdonald I, Folkard S (1998) 12-h shifts are popular but are they a solution? Int J Ind Med 21:323–331
Thompson A, Danesh J (2006) Associations between apolipoprotein B, apolipoprotein AI, the apolipoprotein B/AI ratio and coronary heart disease: a literature-based meta-analysis of prospective studies. J Intern Med 259:481–492
Vahtera J, Laine S, Virtanen M, Oksanen T, Koskinen A, Pentti J, Kivimaki M (2010) Employee control over working times and risk of cause-specific disability pension: the Finnish Public Sector Study. Occup Environ Med 67:479–485
Viitasalo K, Kuosma E, Laitinen J, Härma M (2008) Effects of shift rotation and the flexibility of a shift system on daytime alertness and cardiovascular risk factors. Scand J Work Environ Health 34:198–205
Wang J, Thornton JC, Bari S, Williamson B, Gallagher D, Heymsfield SB, Horlick M, Kotler D, Laferrere B, Mayer L, Pi-Sunyer FX, Pierson RN Jr (2003) Comparisons of waist circumferences measured at 4 sites. Am J Clin Nutr 77:379–384
Wirtz A, Giebel O, Schomann C, Nachreiner F (2008) The interference of flexible working times with the utility of time: a predictor of social impairment? Chronobiol Int 25:249–261
Zhang C, Rexrode KM, van Dam RM, Li TY, Hu FB (2008) Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women. Circulation 117:1658–1667
Acknowledgments
We thank laboratory technicians Ulla Tegner, Anne Abildtrup, Inge Christiansen, and Dorrit Meinche for their invaluable assistance with the data collection.
Conflict of interest
This study was financed by the national budget through a special 3-year grant to the SOSU research program at the National Research Centre for the Working Environment. The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nabe-Nielsen, K., Garde, A.H. & Diderichsen, F. The effect of work-time influence on health and well-being: a quasi-experimental intervention study among eldercare workers. Int Arch Occup Environ Health 84, 683–695 (2011). https://doi.org/10.1007/s00420-011-0625-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00420-011-0625-8