Night-shift workers at greater risk of injury, ill health

Friday, 12 June, 2020

Night-shift workers at greater risk of injury, ill health

British research from the Institution of Occupational Safety and Health (IOSH) has indicated that shift workers who are working night shifts are approximately 25–30% more at risk of injury than those working day shifts.

The study examined five aspects of wellbeing, including chronic fatigue, emotional reactivity, social isolation, stress and overall health.

IOSH study

Findings revealed that working a 12-hour shift rather than an eight-hour shift increased the risk of injury by 25–30%, with risk increasing evenly over four consecutive shifts. Shift workers reported higher levels of chronic fatigue, as a result of the disturbance of biological rhythms that occur as a result of shift work. Over time, the disruption of these biological and social factors could have negative long-term effects.

This is of considerable concern amid the coronavirus (COVID-19) pandemic, as shift patterns for key workers in the healthcare, utility and transport sectors are extended. Disruptions to the body clock can result in acute effects on mood and performance, which may lead to long-term effects on mental health, impacting workers’ physical, psychological and psycho-social health as well as safety.

Royal College of Nursing

The Royal College of Nursing (RCN) has raised concerns for healthcare workers working 12-hour shifts in critical care. The RCN urges that the risks for those working 12-hour shifts in a critical care environment during the COVID-19 pandemic should not be ignored. The risks include wearing personal protective equipment (PPE) for long periods, which is physically demanding and can result in potential heat stress and errors when donning or removing PPE.

High levels of moving and handling activity when positioning patients, and increased exposure to patients with infection, leading to a potentially increased viral exposure, are also considerable risks, alongside the potential for errors caused by fatigue. The RCN provided a solution-based response to mitigate the increased risk of injury or ill health to shift workers, specifically during increased shift patterns amid COVID-19. 

“Where staff are working long hours, employers should provide an appropriate level of supporting facilities such as rest areas, accommodation, access to food and drink, [and] toiletries as required, to enable the safe and effective provision of services during this period,” the RCN said.


The IOSH research found that shift work was associated with impaired cognitive abilities, especially after 10 years’ exposure. However, it also seems that these effects can be temporary and reversible. Based on this study and on existing best practice, the IOSH recommends a mixture of common-sense changes by individuals to their lifestyles and practical measures by employers to the working environment. 

These changes include evaluating shift schedule design such as lengths of breaks and start and finish times — allowing adequate time between shifts for sleep and meal preparation, providing at least 48 hours between shift changes and to provide regular (annual) health checks for shift workers, with a transfer to day work if required.

The full report, titled ‘The effects of shift work on health’, is available here.

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