European Working Time Directive and doctors’ health: a systematic review of the available epidemiological evidence
Objective To summarise the available scientific evidence on the health effects of exposure to working beyond the limit number of hours established by the European Working Time Directive (EWTD) on physicians.Design A systematic literature search was conducted in PubMed and EMBASE. Study selection, qu...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2014-07-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/4/7/e004916.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823857000126087168 |
|---|---|
| author | Consol Serra Evangelia Demou Ewan B Macdonald Sergio Vargas-Prada Maria Cruz Rodriguez-Jareño Kaveh A Sanati Alenka Škerjanc Pedro G Reis Ritva Helimäki-Aro |
| author_facet | Consol Serra Evangelia Demou Ewan B Macdonald Sergio Vargas-Prada Maria Cruz Rodriguez-Jareño Kaveh A Sanati Alenka Škerjanc Pedro G Reis Ritva Helimäki-Aro |
| collection | DOAJ |
| description | Objective To summarise the available scientific evidence on the health effects of exposure to working beyond the limit number of hours established by the European Working Time Directive (EWTD) on physicians.Design A systematic literature search was conducted in PubMed and EMBASE. Study selection, quality appraisal and data extraction were carried out by independent pairs of researchers using pre-established criteria.Setting Physicians of any medical, surgical or community specialty, working in any possible setting (hospitals, primary healthcare, etc), as well as trainees, residents, junior house officers or postgraduate interns, were included.Participants The total number of participants was 14 338.Primary and secondary outcome measures Health effects classified under the International Classification of Diseases (ICD-10).Results Over 3000 citations and 110 full articles were reviewed. From these, 11 studies of high or intermediate quality carried out in North America, Europe and Japan met the inclusion criteria. Six studies included medical residents, junior doctors or house officers and the five others included medical specialists or consultants, medical, dental, and general practitioners and hospital physicians. Evidence of an association was found between percutaneous injuries and road traffic accidents with extended long working hours (LWH)/days or very LWH/weeks. The evidence was insufficient for mood disorders and general health. No studies on other health outcomes were identified.Conclusions LWH could increase the risk of percutaneous injuries and road traffic accidents, and possibly other incidents at work through the same pathway. While associations are clear, the existing evidence does not allow for an established causal or ‘dose–response’ relationship between LWH and incidents at work, or for a threshold number of extended hours above which there is a significantly higher risk and the hours physicians could work and remain safe and healthy. Policymakers should consider safety issues when working on relaxing EWTD for doctors. |
| format | Article |
| id | doaj-art-a24fc7782dc64cd78a3c315e0feacf75 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2014-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-a24fc7782dc64cd78a3c315e0feacf752025-02-12T01:50:10ZengBMJ Publishing GroupBMJ Open2044-60552014-07-014710.1136/bmjopen-2014-004916European Working Time Directive and doctors’ health: a systematic review of the available epidemiological evidence 0Consol Serra1Evangelia Demou2Ewan B Macdonald3Sergio Vargas-Prada4Maria Cruz Rodriguez-Jareño5Kaveh A Sanati6Alenka Škerjanc7Pedro G Reis8Ritva Helimäki-Aro9UEMS Section of Occupational Medicine47 Centre of Research in Occupational Health, University Pompeu Fabra, Barcelona, Spain1 MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UKHealthy Working Lives Group, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UKCiSAL—Centre for Research in Occupational Health, Universitat Pompeu Fabra, Barcelona, SpainCatalan and Spanish Societies of Occupational Medicine, Barcelona, SpainHealthy Working Lives Group, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UKClinical Institute of Occupational, Traffic and Sports Medicine, University Medical Centre, Ljubljana, SloveniaCollege of Occupational Medicine, Portuguese Medical Association, Lisbon, PortugalHelsinki City Occupational Health Centre, Helsinki, FinlandObjective To summarise the available scientific evidence on the health effects of exposure to working beyond the limit number of hours established by the European Working Time Directive (EWTD) on physicians.Design A systematic literature search was conducted in PubMed and EMBASE. Study selection, quality appraisal and data extraction were carried out by independent pairs of researchers using pre-established criteria.Setting Physicians of any medical, surgical or community specialty, working in any possible setting (hospitals, primary healthcare, etc), as well as trainees, residents, junior house officers or postgraduate interns, were included.Participants The total number of participants was 14 338.Primary and secondary outcome measures Health effects classified under the International Classification of Diseases (ICD-10).Results Over 3000 citations and 110 full articles were reviewed. From these, 11 studies of high or intermediate quality carried out in North America, Europe and Japan met the inclusion criteria. Six studies included medical residents, junior doctors or house officers and the five others included medical specialists or consultants, medical, dental, and general practitioners and hospital physicians. Evidence of an association was found between percutaneous injuries and road traffic accidents with extended long working hours (LWH)/days or very LWH/weeks. The evidence was insufficient for mood disorders and general health. No studies on other health outcomes were identified.Conclusions LWH could increase the risk of percutaneous injuries and road traffic accidents, and possibly other incidents at work through the same pathway. While associations are clear, the existing evidence does not allow for an established causal or ‘dose–response’ relationship between LWH and incidents at work, or for a threshold number of extended hours above which there is a significantly higher risk and the hours physicians could work and remain safe and healthy. Policymakers should consider safety issues when working on relaxing EWTD for doctors.https://bmjopen.bmj.com/content/4/7/e004916.full |
| spellingShingle | Consol Serra Evangelia Demou Ewan B Macdonald Sergio Vargas-Prada Maria Cruz Rodriguez-Jareño Kaveh A Sanati Alenka Škerjanc Pedro G Reis Ritva Helimäki-Aro European Working Time Directive and doctors’ health: a systematic review of the available epidemiological evidence BMJ Open |
| title | European Working Time Directive and doctors’ health: a systematic review of the available epidemiological evidence |
| title_full | European Working Time Directive and doctors’ health: a systematic review of the available epidemiological evidence |
| title_fullStr | European Working Time Directive and doctors’ health: a systematic review of the available epidemiological evidence |
| title_full_unstemmed | European Working Time Directive and doctors’ health: a systematic review of the available epidemiological evidence |
| title_short | European Working Time Directive and doctors’ health: a systematic review of the available epidemiological evidence |
| title_sort | european working time directive and doctors health a systematic review of the available epidemiological evidence |
| url | https://bmjopen.bmj.com/content/4/7/e004916.full |
| work_keys_str_mv | AT europeanworkingtimedirectiveanddoctorshealthasystematicreviewoftheavailableepidemiologicalevidence AT consolserra europeanworkingtimedirectiveanddoctorshealthasystematicreviewoftheavailableepidemiologicalevidence AT evangeliademou europeanworkingtimedirectiveanddoctorshealthasystematicreviewoftheavailableepidemiologicalevidence AT ewanbmacdonald europeanworkingtimedirectiveanddoctorshealthasystematicreviewoftheavailableepidemiologicalevidence AT sergiovargasprada europeanworkingtimedirectiveanddoctorshealthasystematicreviewoftheavailableepidemiologicalevidence AT mariacruzrodriguezjareno europeanworkingtimedirectiveanddoctorshealthasystematicreviewoftheavailableepidemiologicalevidence AT kavehasanati europeanworkingtimedirectiveanddoctorshealthasystematicreviewoftheavailableepidemiologicalevidence AT alenkaskerjanc europeanworkingtimedirectiveanddoctorshealthasystematicreviewoftheavailableepidemiologicalevidence AT pedrogreis europeanworkingtimedirectiveanddoctorshealthasystematicreviewoftheavailableepidemiologicalevidence AT ritvahelimakiaro europeanworkingtimedirectiveanddoctorshealthasystematicreviewoftheavailableepidemiologicalevidence |