Shift work, safety, and aging.

It has long been recognized that older shift workers may have shorter and more disturbed day sleeps between successive night shifts than their younger colleagues. This has given rise to considerable concern over the safety of aging shift workers because of the increasing age of the work force and increases in retirement age. Because there have been no direct studies of the combined effects of shift work and age on safety, the present paper begins by reviewing the literature relating safety to features of shift systems. It then considers the general effect of age on occupational injury rates before examining existing evidence of the combined effects of shift work and age on performance capabilities. The results of the literature review indicate that when the a priori risk is constant, there is reasonably clear evidence that injury rates are higher at night, and that they increase over successive night shifts more rapidly than over successive day shifts. Further, although occupational injuries are less frequent in older workers, those that do occur tend to be more serious. Finally, there is some suggestive evidence from studies of objectively measured performance capabilities that older workers may be less able to both maintain their performance over the course of a night shift and cope with longer spans of successive night shifts. It is concluded that it seems possible, even though unproven as yet, that older workers may be at greater risk both to injury and accident on the night shift. There is a strong need for future epidemiological studies of the combined effects of shift work and age on injuries and accidents, and that these should attempt to separate the effects of age per se from those of generation.