Medical program for shift workers--impacts on chronic disease and mortality outcomes

Scand J Work Environ Health. 2009 Jul;35(4):309-18. doi: 10.5271/sjweh.1332. Epub 2009 May 27.


Objective: In 1983, global chemical company BASF SE implemented a supplemental health protection program to help its employees cope with the stressors associated with shift work. The program included comprehensive medical examinations and health promotion activities targeted at shift workers.

Methods: To assess the possible long-term health impacts of the program, cohorts of 14,128 male rotating shift and 17,218 male day wage employees were established via electronic job history searches. Health examination and mortality records were linked to job histories and studied over an 11-year period.

Results: Between 1996 and 2006, there were 414 and 463 deaths among rotating shift and day work employees, respectively. Mortality risks were marginally lower among shift working employees when taking age and job level into consideration, and remained so when cigarette smoking, alcohol intake, and existing chronic disease conditions were included as explanatory factors. The incidence of obesity, diabetes, and diseases of the circulatory and digestive system, as diagnosed or reported during health examinations, was higher among shift work employees, possibly as a consequence of enhanced medical surveillance or a direct effect of shift work.

Conclusion: Incorporation of extensive occupational medical examinations, health seminars, and other intervention programs may help mitigate the long-term health consequences of shift work.

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Alcohol Drinking
  • Chronic Disease
  • Circadian Rhythm / physiology*
  • Confidence Intervals
  • Efficiency
  • Germany / epidemiology
  • Health Promotion
  • Humans
  • Male
  • Occupational Diseases / etiology
  • Occupational Diseases / mortality*
  • Occupational Exposure
  • Occupational Health*
  • Program Evaluation
  • Risk
  • Risk Factors
  • Stress, Psychological
  • Time Factors
  • Work Schedule Tolerance*
  • Workplace*