Shift work and sickness absence—the mediating roles of work–home conflict and perceived health

• Published date: 01 September 2018
• DOI: http://doi.org/10.1002/hrm.21894
• Date: 01 September 2018
• Author: Dag Ingvar Jacobsen,Elin M. Fjeldbraaten

ORIGINAL ARTICLE

Shift work and sickness absence—the mediating roles of

work–home conflict and perceived health

Dag Ingvar Jacobsen

1

| Elin M. Fjeldbraaten

2

1

Department of Political Science and

Management, Agder University, Kristiansand,

Norway

2

Sørlandet Hospital/Agder University,

Kristiansand, Norway

Correspondence

Dag Ingvar Jacobsen, Agder University,

Department of Political Science and

Management, Servicebox 422, N-4604

Kristiansand, Norway.

Email: dag.i.jacobsen@uia.no

This study investigates the relationship between sickness absence and shift work. It is hypothe-

sized that the effect of shift work is linked to sickness absence by two mediators: perceived

health and work-family conflict (WFC). Shift work was hypothesized to have an adverse effect

on health, as well as makingwork-family balance harder to obtain, bothin turn resulting in higher

sickness absence.The study distinguishes betweenself-declared (short-term) anddoctor declared

(long-term) sickness absence. A survey was conducted covering all employees in a Norwegian

hospital workingmore than 30 % of a full position (N=5272) in January 2012,yielding 1864 valid

responses (% response = 36). Survey data was coupled with register data on days of sickness

absence in 2014. A model with perceived health and WFC as mediating variables between shift

work and sickness absence was tested. The findings indicate no direct effect of shift work on

sickness absence,but indirect effects both throughWFC and perceived health.

KEYWORDS

Shift work, sickness absence, work life conflict, hospital, Norway

1|INTRODUCTION

The emergence of the so-called “24/7 economy”demands businesses

and public organizations to be available for customers and users all

week, 24 hours a day. Associated with this change, combined with an

increasing employment rate in the service industry relative to

manufacturing, is an increasing demand for employment at nonstan-

dard times (Presser, 2003). In 2015, 22% of the European Union

workforce worked at nonstandard times, that is, shift work outside a

normal working day (usually between 7 a.m. and 6 p.m.) or working

weekends, an increase from both 2005 and 2010 (Eurofound, 2015).

For the United States (in 2004) the number was 15% (Chung, Wolf, &

Shapiro, 2009), while more general studies estimate 15% to 20% of

the workforce in any industrialized country to be engaged in some

sort of shift work (Bonnefond, Tassi, Roge, & Muzet, 2004). Over

time, the use of shift work also seems to increase (Anderson, Bros-

nan, & Walsh, 1996; Eurofound, 2015; Rubery & Horrell, 1992; Rub-

ery, Keizer, & Grimshaw, 2016; Supiot & Meadows, 2001).

Moreover, there seems to be an increase in the number of work-

ing days lost due to sickness absence in many countries (Livanos &

Zangelidis, 2013). In 2013, it was estimated that 131 million working

days were lost due to sickness absence in the United Kingdom,

equaling approximately 4.3 days per worker per year (Statistics, 2016).

While the United Kingdom has among the lowest levels of sickness

absence in Europe, the Scandinavian countries place themselves on

the other extreme of the continuum (Gimeno et al., 2014). In Norway,

for instance, the sickness absence rate has been around 6.5% in the

last few years (SSB, 2015). In 2014, disbursement related to sickness

absence, work assessment allowance, and disability pension counted

for 13.8% of the total Norwegian public expenses (SSB, 2016).

Even if both shift work and absenteeism are phenomena with

significant implications for HRM, especially within health care organi-

zations where shift work is extensively used (Cooke & Bartram,

2015), there are surprisingly few studies linking shift work to sickness

absence (Tüchsen, Christensen, & Lund, 2008). Furthermore, recent

studies find no clear direct links between shift work and sickness

absence (Merkus et al., 2012). In this study, we argue that shift work

can have more subtle, indirect effects on sickness absence. We iden-

tify two potentially important mediators—work–family conflict and

perceived health—and test whether they link shift work to sickness

absence. Several studies show shift work to be associated with

increased conflict between family and work obligations (Presser,

2003), while conflicts between work and family obligations also seem

to be positively correlated with both psychic and physical health, as

DOI: 10.1002/hrm.21894

Hum Resour Manage. 2018;57:1145–1157. wileyonlinelibrary.com/journal/hrm © 2017 Wiley Periodicals, Inc. 1145