I urval från Stockholms universitets publikationsdatabas

• Development and performance of a sleep estimation algorithm using a single accelerometer placed on the thigh: an evaluation against polysomnography

  2023. Peter J. Johansson (et al.). Journal of Sleep Research 32 (2)

  Artikel

  Accelerometers placed on the thigh provide accurate measures of daily physical activity types, postures and sedentary behaviours, over 24 h and across consecutive days. However, the ability to estimate sleep duration or quality from thigh-worn accelerometers is uncertain and has not been evaluated in comparison with the 'gold-standard' measurement of sleep polysomnography. This study aimed to develop an algorithm for sleep estimation using the raw data from a thigh-worn accelerometer and to evaluate it in comparison with polysomnography. The algorithm was developed and optimised on a dataset consisting of 23 single-night polysomnography recordings, collected in a laboratory, from 15 asymptomatic adults. This optimised algorithm was then applied to a separate evaluation dataset, in which, 71 adult males (mean [SD] age 57 [11] years, height 181 [6] cm, weight 82 [13] kg) wore ambulatory polysomnography equipment and a thigh-worn accelerometer, simultaneously, whilst sleeping at home. Compared with polysomnography, the algorithm had a sensitivity of 0.84 and a specificity of 0.55 when estimating sleep periods. Sleep intervals were underestimated by 21 min (130 min, Limits of Agreement Range [LoAR]). Total sleep time was underestimated by 32 min (233 min LoAR). Our results evaluate the performance of a new algorithm for estimating sleep and outline the limitations. Based on these results, we conclude that a single device can provide estimates of the sleep interval and total sleep time with sufficient accuracy for the measurement of daily physical activity, sedentary behaviour, and sleep, on a group level in free-living settings.

  Läs mer om Development and performance of a sleep estimation algorithm using a single accelerometer placed on the thigh

• Disturbed sleep and its attribution to stress and other causes: A population-based survey

  2023. Helena Petersen, Göran Kecklund, Torbjörn Åkerstedt. Scandinavian Journal of Psychology 64 (2), 99-104

  Artikel

  This study explores the prevalence of attributed causes of disturbed sleep and the association between stress-disturbed sleep and age, sex, and sleep duration on weekdays as well as weekends in a representative sample. A nationally representative sample (n = 1,128, response rate 72.8%), stratified for sex and age, completed a computer-assisted phone survey that included questions about sleep disturbances and attributed causes. Stress was the main attributed cause of sleep disturbance (35.1%), most frequently attributed by younger women (χ² = 26.5, p < 0.001). Prevalence of stress-disturbed sleep was higher with lower age (B = −0.05, odds ratio (OR) = 0.94, CI = 0.91, 0.98). There was a trend, however, toward a significant interaction between age and sex, with women in the older age-groups more frequently reporting stress-disturbed sleep than older men (B = −0.02, OR = 1.022, CI = 1.003, 1.042). Weekday sleep duration decreased with increased stress-disturbed sleep, with an inverse relationship on weekends except for those reporting stress-disturbed sleep more than 5 days per week (F = 10.5, p < 0.001), who also had the shortest weekend sleep duration. Sleep disturbances were commonly attributed to stress, and more strongly so in women younger than 46 years. Stress-disturbed sleep during weekdays seems to be potentially compensated for with extended sleep on weekends, except for those with continuous stress-disturbed sleep. 

  Läs mer om Disturbed sleep and its attribution to stress and other causes

• Prospective effects of work-time control on overtime, work-life interference and exhaustion in female and male knowledge workers

  2023. Sophie C. Albrecht (et al.). Scandinavian Journal of Public Health, 140349482211500

  Artikel

  Aims: Employee-based flexible working hours are increasing, particularly among knowledge workers. Research indicates that women and men use work–time control (WTC; control over time off and daily hours) differently: while men work longer paid hours, women use WTC to counteract work–life interference. In a knowledge-worker sample, we examined associations between WTC and overtime, work–life interference and exhaustion and tested whether gender moderates the mediating role of overtime. Methods: The sample contained 2248 Swedish knowledge workers. Employing hierarchical regression modelling, we examined effects of control over time off/daily hours on subsequent overtime hours, work–life interference and exhaustion in general and in gender-stratified samples. Using conditional process analysis, we tested moderated mediation models. Results: Control over time off was related to less work–life interference (β_men= −0.117; 95% confidence interval (CI): −0.237 to 0.003; β_women= −0.253; 95% CI: −0.386 to −0.120) and lower exhaustion (β_men= −0.199; 95% CI: −0.347 to −0.051; β_women= −0.271; 95% CI: −0.443 to −0.100). For control over daily hours, estimates were close to zero. While men worked more overtime (42 min/week), we could not confirm gender moderating the indirect effect of control over time off/daily hours on work–life interference/exhaustion via overtime. Independent of gender, effects of control over time off on work–life interference were partly explained by working fewer overtime hours. Conclusions: Control over time off was related to lower exhaustion and better work–life balance (in particular for women). We found no evidence for men’s work–life interference increasing with higher WTC owing to working more overtime. Knowledge workers’ control over time off may help prevent work–life interference and burnout.

  Läs mer om Prospective effects of work-time control on overtime, work-life interference and exhaustion in female and male knowledge workers

• Sleep in everyday life – relationship to mood and performance in young and older adults: a study protocol

  2023. Johanna F. A. Schwarz (et al.). Frontiers in Psychology 14

  Artikel

  Laboratory based sleep deprivation studies demonstrate that lack of sleep impairs well-being and performance ability, but suggest that these effects are mitigated in older adults. Yet, much less is known whether day-to-day variations of sleep have similar consequences in the context of everyday life. This project uses an intensive longitudinal design to investigate the occurrence of day-to-day variations in sleep and their impact on mood and performance in everyday life and to examine whether effects differ between young and older adults. We aim to include 160 young (18–30 years) and 160 older adults (55–75 years) to complete a 21-day experience sampling method (ESM) protocol. During the ESM period, participants are asked to fill in (i) a brief morning questionnaire, (ii) 8 short daytime questionnaires addressing momentary well-being, sleepiness, stress, and mind wandering, followed by a 1 min cognitive task and (iii) a brief evening questionnaire, all delivered via a mobile phone application. Sleep will be measured using self-reports (daily questions) and objectively with wrist actigraphy. The impact of adult age on mean levels and intraindividual variability of sleep will be analyzed using mixed-effects location scale models. The impact of sleep on daily cognitive performance will be analyzed using multilevel linear mixed models. The relationship of sleep to mean values and variability of positive and negative affect in young and older adults will be analyzed using mixed-effects location scale modeling. The overarching purpose of the project is improving the current knowledge on the occurrence of day-to-day variations in sleep and their relationship to performance as well as positive and negative affect in young and older adults.

  Läs mer om Sleep in everyday life – relationship to mood and performance in young and older adults

• Behavioral factors predict all-cause mortality in female coronary patients and healthy controls over 26 years – a prospective secondary analysis of the Stockholm Female Coronary Risk Study

  2022. Hans-Christian Deter (et al.). PLOS ONE 17 (12)

  Artikel

  Objective

  The prognosis of coronary artery disease (CAD) is related to its severity and cardiovascular risk factors in both sexes. In women, social isolation, marital stress, sedentary lifestyle and depression predicted CAD progression and outcome within 3 to 5 years. We hypothesised that these behavioral factors would still be associated with all-cause mortality in female patients after 26 years.

  Methods

  We examined 292 patients with CAD and 300 healthy controls (mean age of 56 ± 7 y) within the Fem-Cor-Risk-Study at baseline. Their cardiac, behavioral, and psychosocial risk profiles, exercise, smoking, and dietary habits were assessed using standardized procedures. Physiological characteristics included a full lipid profile, the coagulation cascade and autonomic dysfunction (heart rate variability, HRV). A new exploratory analysis using machine-learning algorithms compared the effects of social and behavioral mechanisms with standard risk factors. Results: All-cause mortality records were completed in 286 (97.9%) patients and 299 (99.7%) healthy women. During a median follow-up of 26 years, 158 (55.2%) patients and 101 (33.9%) matched healthy controls died. The annualized mortality rate was 2.1% and 1.3%, respectively. After controlling for all available confounders, behavioral predictors of survival in patients were social integration (HR 0.99, 95% CI 0.99–1.0) and physical activity (HR 0.54, 95% CI 0.37–0.79). Smoking acted as a predictor of all-cause mortality (HR 1.56, 95% CI 1.03–2.36). Among healthy women, moderate physical activity (HR 0.42, 95% CI 0.24–0.74) and complete HRV recordings (≥50%) were found to be significant predictors of survival.

  Conclusions

  CAD patients with adequate social integration, who do not smoke and are physically active, have a favorable long-term prognosis. The exact survival times confirm that behavioral risk factors are associated with all-cause mortality in female CAD patients and healthy controls.

  Läs mer om Behavioral factors predict all-cause mortality in female coronary patients and healthy controls over 26 years – a prospective secondary analysis of the Stockholm Female Coronary Risk Study

• Evaluation of truck driver rest locations and sleep quality

  2022. Felipe Pereira Rocha (et al.). Sleep Science 15 (1), 55-61

  Artikel

  OBJECTIVES: Truck drivers’ work organization requires that rest and sleep be taken in various locations, where sleep quality might be affected by the discomfort of these environments. The purpose of this study was to evaluate truck drivers’ rest locations and their association with sleep quality utilizing an ergonomic approach. MATERIAL AND METHODS: The sleep quality of 81 truck drivers was assessed using the Pittsburgh sleep quality index (PSQI). An adapted version of the ergonomics workplace analysis (EWA) instrument was used to evaluate 44 rest locations. RESULTS: Half of the workers preferred sleeper berths (51.2%) as a rest place. Sleep was classified as poor by 71.6% of the drivers. Dorms were rated more positively (p<0.001) by truck drivers (2.0±1.1) than by the analyst (2.6±0.6). Sleeper berths and dorms were rated statistically different by truck drivers (p=0.002), as well as by the analyst (p=0.003). No correlation was found between EWA evaluations and total score for sleep quality. Separate analyses of dorms and truck berths showed very few correlations. The higher the noise of roommates in dorms, the worse the sleep quality. Conversely, noise in corridors or outside the room positively impacted sleep quality. CONCLUSION: Noise in the rest place may affect sleep in both directions, negatively or positively. Sleep was classified as poor regardless of resting place. The quality of resting places seemed to have little effect on sleep quality of truck drivers. Factors other than rest place, such as work scheduling, are probably more important for promoting good sleep quality.

  Läs mer om Evaluation of truck driver rest locations and sleep quality

• Shiftworkers’ attitude to their work hours, positive or negative, and why?

  2022. Torbjörn Åkerstedt, Mikael Sallinen, Göran Kecklund. International Archives of Occupational and Environmental Health

  Artikel

  Objective Shift work is associated with impaired health and safety but there is a lack of systematic knowledge of shift workers attitude to their shift systems. This may be important for the ability to retain valuable personnel in the company/organization, and to attract new employees. The purpose of the present study was to investigate: the prevalence of shift characteristics (nights, long shifts, short rest, etc.) in traditional shift systems, the workers’ attitude to their shift systems, if combinations of problematic shift characteristics are associated with the workers’ attitude, and if work stress and poor sleep, fatigue, or social difficulties are associated with attitudes to shift systems.

  Methods A representative sample of 3,500 individuals with non-day work in the general population of Sweden were asked to participate in the study. A total of 1965 workers remained after drop-outs. The material was analyzed by Chi2 analysis and hierarchical multiple regression.

  Results The results showed that traditional shift systems included many more shift characteristics than those constituting the core of the systems. All included day work, for example. 90.2% of those with roster work had shifts > 10 h at least once a month. 66.9% of those with roster work without nights had < 11 h rest between shifts at least once a month. Less than 25% of the respondents had a rather or very negative attitude to their shift system, with the lowest level for those who work either fixed days or nights (7.6 and 5.7%, respectively) and highest for three-shift work (21.2%) and roster work without night work (24.4%). Shiftwork or roster work with nights had highest levels (> 50%) of sleep problems and fatigue. The difference across shift systems was significant at p < .001 in all cases. Combinations of the most problematic shift characteristics were associated with some increase in negative attitude to the shift schedule. Among schedule characteristics, only long weeks turned out significant in the multivariable regression. The strongest predictor of negative attitude to work hours were social difficulties due to work schedule [ß = 4.98 (95% Confidence interval (Ci) = 3.41, 7.27; p < .001], fatigue caused by schedule (ß = 3.20 Ci = 2.03, 5.05; p < .001), sleep problems caused by schedule (ß = 2.10 Ci = 1.46, 3.01; p = .01), and stressful work (ß = 1.52 Ci = 1.10, 2.11; p < .05).

  Conclusion It was concluded that shift systems often included many different shift characteristics, that night shift systems had a large proportion of long shifts, and that split shifts mainly occurred in roster day work. Furthermore, it was concluded that the attitude to the worker’s present shift systems seems to be positive for the majority, with the highest level for those who work either fixed days or nights, compared to those who work alternating shifts (including night shifts). Negative attitude to shift systems was more linked to social difficulties, fatigue or sleep problems due to the shift schedule, than to schedule characteristics per se.

  Läs mer om Shiftworkers’ attitude to their work hours, positive or negative, and why?

• Sleepy drivers on a slippery road

  2022. Igor Radun (et al.). Journal of Sleep Research 31 (2)

  Artikel

  Sleepy drivers have problems with keeping the vehicle within the lines, and might often need to apply a sudden or hard corrective steering wheel movement. Such movements, if they occur while driving on a slippery road, might increase the risk of ending off road due to the unforgiving nature of slippery roads. We tested this hypothesis. Twelve young men participated in a driving simulator experiment with two counterbalanced conditions; dry versus slippery road x day (alert) versus night (sleepy) driving. The participants drove 52.5 km on a monotonous two-lane highway and rated their sleepiness seven times using the Karolinska Sleepiness Scale. Blink durations were extracted from an electrooculogram. The standard deviation of lateral position and the smoothness of steering events were measures of driving performance. Each outcome variable was analysed with mixed-effect models with road condition, time-of-day and time-on-task as predictors. The Karolinska Sleepiness Scale increased with time-on-task (p < 0.001) and was higher during night drives (p < 0.001), with a three-way interaction suggesting a small increased sleepiness with driving time at night with slippery road conditions (p = 0.012). Blink durations increased with time-on-task (p < 0.01) with an interaction between time-of-day and road condition (p = 0.040) such that physiological sleepiness was lower for sleep-deprived participants in demanding road conditions. The standard deviation of lateral position increased with time-on-task (p = 0.026); however, during night driving it was lower on a slippery road (p = 0.025). The results indicate that driving in demanding road condition (i.e. slippery road) might further exhaust already sleepy drivers, although this is not clearly reflected in driving performance.

  Läs mer om Sleepy drivers on a slippery road

• Comparing the acute effects of shiftwork on mothers and fathers

  2021. Philip Tucker, Constanze Leineweber, Göran Kecklund. Occupational Medicine 71 (9), 414-421

  Artikel

  Background: Shift work may impact women more negatively than men due to the increased burden of coping with demanding work schedules while also undertaking more of the domestic chores, including childcare.

  Aims: To examine whether the combination of shift working and caring for children affects the sleep, fatigue and work–family conflict experienced by women more than it affects men.

  Methods: Using data from a survey of the Swedish working population, mixed linear regression models examined work schedule (daywork, shift work with nights, shift work without nights), gender and presence of children <13 years at home as predictors of sleep insufficiency, sleep disturbance, fatigue and work–family conflict, over up to three successive measurement occasions. Adjustments were made for age, education, full/part-time working and baseline year.

  Results: In fully adjusted models (N = 8938), shift work was associated with insufficient sleep (P < 0.01), disturbed sleep (P < 0.01), fatigue (P < 0.05) and work–family conflict (P < 0.001). Interactions in the analyses of sleep disturbance (P < 0.001) and work–family interference (P < 0.05) indicated that among participants with no children, females reported more disturbed sleep and more work–family conflict than their male counterparts, irrespective of schedule; while among participants with children, female dayworkers reported more disturbed sleep than their male counterparts, and females working shifts without nights reported more work–family interference.

  Conclusions: Having young children did not exacerbate negative effects of shift work, in either men or women. This may reflect high levels of gender equality and childcare provision in Sweden.

  Läs mer om Comparing the acute effects of shiftwork on mothers and fathers

• Considerations on how to light the night-shift

  2021. Arne Lowden, Göran Kecklund. Lighting Research and Technology 53 (5), 437-452

  Artikel

  Electric lighting has decreased dependence on natural light to illuminate the workplace. Humans are genetically predisposed to be day-oriented (diurnal) and depend on daylight to regulate circadian rhythms. Shift work will force workers to sleep and work at non-biological times, inducing circadian disruption with implications for workers' safety and health. The scientific literature may be used in practice in shift work settings to improve safety, performance and health in the workplace by reducing circadian misalignment. Alertness profiles at work and degree of melatonin suppression may indicate degree of circadian disruption among workers. However, when considering lighting solutions at night, there are several factors that need consideration. Light measures based on biological effectiveness should be used rather than room illuminance giving better predictions of performance and long-term health among workers. Also, large individual differences in light sensitivity and preferences suggest not only to rely on common lighting alone but also to implement complementary individual lighting solutions at work. Lighting advice should consider shift scheduling characteristics such as speed of turnover and shift timing to guide decisions of preferred circadian phase influence. Lighting should also include the flexibility to be fit for morning, afternoon and evening work.

  Läs mer om Considerations on how to light the night-shift

• Fysisk aktivitet vid insomni

  2021. Göran Kecklund, John Axelsson. FYSS 2021, 363-368

  Kapitel

  Läs mer om Fysisk aktivitet vid insomni

• How does cessation of work affect sleep? Prospective analyses of sleep duration, timing and efficiency from the Swedish Retirement Study

  2021. Johnna Garefelt (et al.). Journal of Sleep Research 30 (3)

  Artikel

  Several strands of research indicate that work competes for time with sleep, but to what extent the timing and duration of sleep is affected by work is not known. Retirement offers a quasi-experimental life transition to study this in a within-individual study design. The few existing studies report that people sleep longer and later after retirement but mainly rely on self-reported data or between-individual analyses. We recruited 100 participants aged 61–72 years who were in paid work but would soon retire and measured them in a baseline week with accelerometers, diaries and questionnaires. After 1 and 2 years, the measurements were repeated for the now retired participants. Changes in sleep duration, timing, efficiency, chronotype and social jetlag were analysed using multilevel modelling. Gender, chronotype at baseline and partner's working status were analysed as potential effect modifiers. Sleep duration increased by 21 min, whereas sleep efficiency remained similar. Time of sleep onset and final awakening were postponed by 26 and 52 min, respectively, pushing midsleep forward from 03:17 to 03:37 hours. Changes in duration and timing of sleep were driven by weekday sleep, whereas weekend sleep stayed about the same. Social jetlag decreased but still occurred after retirement. Changes at retirement in sleep duration and timing were smaller for participants with a later chronotype and who had full-time working partners. These findings indicate that paid work generates sleep loss and hinders people from sleeping in line with their biological time.

  Läs mer om How does cessation of work affect sleep? Prospective analyses of sleep duration, timing and efficiency from the Swedish Retirement Study

• How does work impact daily sleep quality? A within-individual study using actigraphy and self-reports over the retirement transition

  2021. Johanna Garefelt (et al.). Journal of Sleep Research

  Artikel

  This study examined how the cessation of work at retirement affects daily measures of actigraphy-measured and self-rated sleep quality. Time in bed or asleep and stress at bedtime were examined as potential mechanisms. In total 117 employed participants who were aged 60-72 years and planned to retire soon were recruited to the Swedish Retirement Study. Sleep quality was measured in a baseline week using accelerometers, diaries, and questionnaires. Subjective sleep measures were sleep quality, restless sleep, restorative sleep, getting enough sleep, estimated wake after sleep onset, difficulties falling asleep, too early final awakening, and difficulties waking up. Actigraphy measures were sleep efficiency, wake after sleep onset, and average awakening length. After 1 and 2 years, the measurements were repeated for the now retired participants. Daily variations in sleep quality before and after retirement were analysed using multilevel modelling, with time in bed or asleep and stress at bedtime as potential mediators. We found that several self-reports of sleep improved (e.g., +0.2 standard deviations for sleep quality and +0.5 standard deviations for restorative sleep) while objective sleep quality remained unchanged or decreased slightly with retirement (e.g., -0.8% for sleep efficiency). Increased time in bed or asleep and stress at bedtime accounted partially for the improvements in self-rated sleep quality at retirement. In conclusion, actigraph-measured and self-reported sleep quality do not change in concert at retirement, highlighting the interest of studying both outcomes. The main effects of retirement from work concern subjective experiences of recovery more than sleep quality per se.

  Läs mer om How does work impact daily sleep quality? A within-individual study using actigraphy and self-reports over the retirement transition

• Mathematical modelling of sleep and sleepiness under various watch keeping schedules in the maritime industry

  2021. Wessel M. A. van Leeuwen (et al.). Marine Policy 130

  Artikel

  Ships typically operate on a 24/7 basis giving rise to a wide variety of working time arrangements and watch keeping schedules. Typically, these can be divided into 2-watch systems (where two watch keepers/teams share the 24-h period) and 3-watch systems (where three watch keepers/teams share the 24-h period). The current study uses the three-process model of alertness regulation to compare these systems in terms of the amount of severe sleepiness that is predicted to take place on watch and the amount of sleep that is predicted to occur while off watch. Separate predictions are calculated for individuals characterised as morning and evening chronotypes. Comparing 2-watch systems, highest levels of severe sleepiness were seen for evening types working 0000-1200 within the 12on12off system. The longest sleep per 24 h day was also found for evening types, but for those working the 1200-0000 watch within the 12on12off system. Total daily sleep duration ranged between 268 and 445 min. However, the picture is complex and the lowest risk of severe sleepiness while on watch is not necessarily correlated with the maximal time available for rest and recuperation when off watch. For 3-watch systems, the five-and-dime system (changeover times: 02-07-12-17-22) stands out having the lowest prevalence of severe sleepiness on watch and the longest amount of predicted daily sleep off watch. Considerable differences exist between morning and evening types offering the opportunity for considerable improvement in sleep amount for fixed (but not rotating) systems when individual chronotype is considered in watch scheduling. It is concluded that 3-watch systems, although economically costlier, have clear advantages over 2-watch systems, but that a perfect system that fits all does not exist due to the considerable impact of individual differences related to sleep/wake regulation.

  Läs mer om Mathematical modelling of sleep and sleepiness under various watch keeping schedules in the maritime industry

• Real-Time Adaptation of Driving Time and Rest Periods in Automated Long-Haul Trucking

  2021. Christer Ahlström (et al.). IEEE transactions on intelligent transportation systems (Print)

  Artikel

  Hours of service regulations govern the working hours of commercial motor vehicle drivers, but these regulations may become more flexible as highly automated vehicles have the potential to afford periods of in-cab rest or even sleep while the vehicle is moving. A prerequisite is robust continuous monitoring of when the driver is resting (to account for reduced time on task) or sleeping (to account for the reduced physiological drive to sleep). The overall aims of this paper are to raise a discussion of whether it is possible to obtain successful rest during automated driving, and to present initial work on a hypothetical data driven algorithm aimed to estimate if it is possible to gain driving time after resting under fully automated driving. The presented algorithm consists of four central components, a heart rate-based relaxation detection algorithm, a camera-based sleep detection algorithm, a fatigue modelling component taking time awake, time of day and time on task into account, and a component that estimates gained driving time. Real-time assessment of driver fitness is complicated, especially when it comes to the recuperative value of in-cab sleep and rest, as it depends on sleep quality, time of day, homeostatic sleep pressure and on the activities that are carried out while resting. The monotony that characterizes for long-haul truck driving is clearly interrupted for a while, but the long-term consequences of extended driving times, including user acceptance of the key stakeholders, requires further research.

  Läs mer om Real-Time Adaptation of Driving Time and Rest Periods in Automated Long-Haul Trucking

• Workplace violence and health in human service industries

  2021. Anna Nyberg (et al.). Occupational and Environmental Medicine 78 (2), 69-81

  Artikel

  Objectives To provide systematically evaluated evidence of prospective associations between exposure to physical, psychological and gender-based violence and health among healthcare, social care and education workers.

  Methods The guidelines on Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. Medline, Cinahl, Web of Science and PsycInfo were searched for population: human service workers; exposure: workplace violence; and study type:prospective or longitudinal in articles published 1990–August 2019. Quality assessment was performed based on a modified version of the Cochrane’s ‘Tool to Assess Risk of Bias in Cohort Studies’.

  Results After deduplication, 3566 studies remained, of which 132 articles were selected for full-text screening and 28 were included in the systematic review. A majority of the studies focused on healthcare personnel, were from the Nordic countries and were assessed to have medium quality. Nine of 11 associations between physical violence and poor mental health were statistically significant, and 3 of 4 associations between physical violence and sickness absence. Ten of 13 associations between psychological violence and poor mental health were statistically significant and 6 of 6 associations between psychological violence and sickness absence. The only study on gender-based violence and health reported a statistically non-significant association.

  Conclusion There is consistent evidence mainly in medium quality studies of prospective associations between psychological violence and poor mental health and sickness absence, and between physical violence and poor mental health in human service workers. More research using objective outcomes, improved exposure assessment and that focus on gender-based violence is needed.

  Läs mer om Workplace violence and health in human service industries

• How to schedule night shift work in order to reduce health and safety risks

  2020. Anne Helene Garde (et al.). Scandinavian Journal of Work, Environment and Health 46 (6), 557-569

  Artikel

  Objectives This discussion paper aims to provide scientifically based recommendations on night shift schedules, including consecutive shifts, shift intervals and duration of shifts, which may reduce health and safety risks. Short-term physiological effects in terms of circadian disruption, inadequate sleep duration and quality, and fatigue were considered as possible links between night shift work and selected health and safety risks, namely, cancer, cardio-metabolic disease, injuries, and pregnancy-related outcomes.

  Method In early 2020, 15 experienced shift work researchers participated in a workshop where they identified relevant scientific literature within their main research area.

  Results Knowledge gaps and possible recommendations were discussed based on the current evidence. The consensus was that schedules which reduce circadian disruption may reduce cancer risk, particularly for breast cancer, and schedules that optimize sleep and reduce fatigue may reduce the occurrence of injuries. This is generally achieved with fewer consecutive night shifts, sufficient shift intervals, and shorter night shift duration.

  Conclusions Based on the limited, existing literature, we recommend that in order to reduce the risk of injuries and possibly breast cancer, night shift schedules have: (i) ≤3 consecutive night shifts; (ii) shift intervals of ≥11 hours; and (iii) ≤9 hours shift duration. In special cases – eg, oil rigs and other isolated workplaces with better possibilities to adapt to daytime sleep – additional or other recommendations may apply. Finally, to reduce risk of miscarriage, pregnant women should not work more than one night shift in a week.

  Läs mer om How to schedule night shift work in order to reduce health and safety risks

• Må bra i skiftarbete

  2020. Göran Kecklund (et al.).

  Rapport

  Projektet ”Må bra i skiftarbete” handlar om sambandet mellan skiftschemats utformning och förekomst av sömn och hälsobesvär. Projektet består av fyra delstudier:

  1) en enkätstudie med syfte att undersöka samband mellan objektiva arbetstider och sömn, trötthet, hälsa och välbefinnande bland sjukvårdspersonal, exklusive läkare

  2) i samma population undersöka skillnader i hälsa och välbefinnande mellan tre olika arbetstidsmodeller – fast schema, reducerad arbetstid (med bibehållen lön) samt individuell schemaplanering (ISP)

  3) en klusterrandomiserad interventionsstudie där personalen vid tre avdelningar erbjöds utbildning om skiftarbete, sömn och hälsa. Dessa avdelningar jämfördes med tre avdelningar där personalen förutom utbildning även fick individuell schemaåterkoppling. Samtliga avdelningar hade ISP.

  4) en pilotstudie på läkare som använder ISP. Pilotstudien omfattade en enkät samt objektiva arbetstidsdata bland ett litet urval läkare.

  Undersökningen är baserad på enkäter och objektiva arbetstider. De viktigaste resultaten var:

  (1) De besvärligaste arbetstidskomponenterna var kort dygnsvila, roterande treskift, och helgarbete. Kort dygnsvila innebar otillräcklig sömn och ungefär 2,5 timmes sömnbrist.

  (2) Det fanns inga samband mellan förekomst av kort dygnsvila respektive nattarbete (baserade på objektiva arbetstidsdata) och psykisk ohälsa, otillräcklig återhämtning, att arbetet stör privatlivet och uppfattning om att inte orka arbeta fram till pension.

  (3) Däremot fanns det tydliga samband mellan att uppleva stora besvär med kort dygnsvila och nattarbete, och psykisk ohälsa, otillräcklig återhämtning, att arbetet stör privatlivet och att inte orka arbeta fram till pension (under rådande arbetsförhållanden).

  (4) Även hög arbetsbelastning, att uppleva att arbetet är emotionellt krävande, samt att inte få tillräckliga raster, visade samband med psykisk ohälsa och att inte orka arbeta fram till pension.

  (5) Jämförelsen av arbetstidsmodellerna – fast schema, reducerad arbetstid och ISP – visade marginella skillnader när det gäller hälsa, återhämtning och arbetsrelaterade störningar av privatlivet.

  (6) Interventionen, särskilt utbildning, var uppskattad av deltagarna men hade ingen effekt på hälsa, återhämtning och störningar i privatlivet. Interventionen innebar en ökning av mindre personalkonflikter relaterade till de valda arbetstiderna.

  (7) Pilotstudien om ISP för läkare visade att många uppskattade att kunna påverka sitt arbetstidsschema och rekommenderade andra avdelningar att pröva ISP. Däremot påverkade inte ISP förekomsten av hälso- och sömnbesvär.

  Läs mer om Må bra i skiftarbete

Visa alla publikationer av Lars Göran Kecklund vid Stockholms universitet