Health impacts of shift work and night work: An International comparison of regulations and an interview study of nurses in Taiwan

Background and objective: Existing epidemiologic evidences show that shift work and night work are associated with increased health risks, including sleep disorders, metabolic diseases, cardiovascular or cerebrovascular diseases and depression. In Taiwan, long working hours and shift work are common among health care workers. In this occupational group, diseases associated with overwork problems have been a public health issue. The labor authority of Taiwan has taken measures to regulate working hours in attempt to safeguard occupational health of health care workers. Since January 1 of 2014, nurses are no longer exempted from working hour regulations of the Labor Standard Act. This study was conducted to compare with international regulations of shift work and night work, and to explore the patterns of shift work and night work status as well as hospital management concerning shift work and night work among nurses working in hospitals of Taipei City and New Taipei. Nurses’ perceived health impacts associated with night work and shift work and their attitudes toward organizational policies and governmental policies were examined. Methods: Literature review and in-depth interviews were conducted. In interview study, study subjects were female nurses in hospitals of the Taipei city or New Taipei city, with work tenure of 1 year or longer. Those who were pregnant or had given birth within a year were excluded. A total of 23 nurses were interviewed during the study period from November 2015 to December 2016. Results: Comparions with international regulations indicated that regulations on shift work and night work of Western countries are more comprehensive as compared to that of Taiwan. Results from interviews with nurses suggested that violations of the Labor Standards Law were commonplace, but many nurses chose to tolerate unlawful practices due to unbalance labor relation. Several nurses did not even know their rights had been infringed. Conclusion and recommendation: Labor authority should pay attention to the safety and health risks with night work and shift work. We suggest that regulations should be revised and guidelines should be promulgated to help workers to better adapt to night and shift work. In addition, labor right and occupational health education should be provided, and labor inspection should be forcefully implemented with sufficient level of punishment to truly safeguard the labor and health rights of working people in Taiwan.