Research priorities to reduce risks from work hours and fatigue in the healthcare and social assistance sector

Background The services of Healthcare and Social Assistance (HCSA) workers are needed by society around the clock. As a result, these workers are exposed to shift work and long work hours. The combination of demanding work schedules and other hazards in the HCSA work environment increases the health and safety risks to these workers, as well as to their patients/clients and the public. Methods This paper has three aims: (1) provide an overview of the burden of shift work, long hours, and related sleep and fatigue problems in this sector; (2) suggest research priorities that would improve these; and (3) discuss potential positive impacts of addressing these research priorities for the health and safety of workers and the public. The authors used a modified Delphi approach to anonymously rank‐order priorities for improving HCSA worker health and safety and public safety. Input was also obtained from attendees at the 2019 National Institute for Occupational Safety and Health (NIOSH) Work Hours, Sleep, and Fatigue Forum. Results The highest rated research priorities were developing better designs for work schedules, and improving the HCSA culture and leadership approaches to shift work and long work hours. Additional priorities are identified. Conclusion Research in these priority areas has the potential to benefit HCSA workers as well as their patients/clients, employers, and society. Key Messages 1. Of all Healthcare and Social Assistance (HCSA) sector workers, 28% have shiftwork schedules, and 17% work 48 hours or more a week to provide vital services around the clock. 2. Compared to other sectors, HCSA workers have a significantly higher prevalence of fatigue, job stress, depression, anxiety, burnout, substance abuse, suicide, and nonfatal injuries and illnesses. 3. Inadequate sleep quantity is common; 52% of healthcare workers on night shifts report sleeping 6 h or less per day. Sleeping less than 7 hours on a regular basis is associated with numerous adverse health and safety outcomes. 4. The highest research priorities are to design better work schedules and to improve the workplace culture and leadership approach to shiftwork, long work hours, and fatigue. Additional research priorities include promoting education for workers and managers, developing fatigue countermeasures, reducing drowsy driving, developing fitness for duty tests, developing technologies to reduce workload and fatigue, and studying individual differences that influence‐workers' heal