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NIOSH Training for Nurses on Shift Work and Long Work Hours
DHHS (NIOSH) Publication No. 2015-115
Online, multimedia, and interactive training can help nurses and their managers better cope with the demands of shift work and long work hours. Other persons with a health science background may also find the training helpful. Part 1 and 2 of the course take about 1.5 hours each to complete. Continuing education certificates are available.

According to 2004 data from the Bureau of Labor Statistics, almost 15 million Americans work full time on evening shift, night shift, rotating shifts, or other employer arranged irregular schedules. The International Labor Office in 2003 reports that working hours in the United States exceed Japan and most of western Europe. Both shift work and long work hours have been associated with health and safety risks. This page provides links to NIOSH publications and other resources that address demanding work schedules.


NIOSHTIC-2 is a searchable bibliographic database of occupational safety and health publications, documents, grant reports, and journal articles supported in whole or in part by NIOSH.

NIOSHTIC-2 search results on work schedules

NIOSH Publications and Guidance

NIOSH Training for Nurses on Shift Work and Long Work Hours
DHHS (NIOSH) Publication No. 2015-115
Online, multimedia, and interactive training can help nurses and their managers better cope with the demands of shift work and long work hours. Other persons with a health science background may also find the training helpful. Part 1 and 2 of the course take about 1.5 hours each to complete. Continuing education certificates are available.

Interim NIOSH Training for Emergency Responders: Reducing Risks Associated with Long Work Hours
A 30-minute online training relays strategies to reduce risks linked to working long hours. It is designed for emergency workers and their managers in healthcare, public safety, utilities, construction, humanitarian aid, and clean-up services who deploy to disaster sites caused by weather, earthquakes, and other catastrophic events like Ebola.

Materials for Truck Drivers and Trucking Companies – Sleep is important for the long haul

Deepwater Horizon Response: Key Safety and Health Topics

Long Hours of Working

NIOSH OSHA Interim Guidance for Protecting Deepwater Horizon Response Workers and Volunteers, Fatigue Prevention

NIOSH Blog: Sleep and Work

NIOSH Blog: NIOSH Research on Work Schedules and Work-related Sleep Loss

Overtime and Extended Work Shifts: Recent Findings on Illnesses, Injuries and Health Behaviors
DHHS (NIOSH) Publication No. 2004-143
Presents a review of the methods and findings from 52 studies that examined the relationship between long work hours and selected health outcomes. Also provides recommendations on issues and priorities to consider in future research.

Medical Interns' Risk for Car Crashes Linked With Extended Shifts in NIOSH-Funded Study
Information on this study can be found in the following journal articles in the New England Journal of Medicine.:

  • Barger LK, Cade BE, Ayas NT, Cronin JW, Rosner B, Speizer FE, Czeisler CA. 2005.
    Extended Work Shifts and the Risk of Motor Vehicle Crashes among Interns. N Engl J Med 352:125-134.
  • Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E, Katz JT, Lilly CM, Stone
    PH, Lockley SW, Bates DW, Czeisler CA. 2004. Effect of reducing interns' work hours on serious medical errors in intensive care units. N Engl J Med 351:1838-1848.
  • Lockley SW, Cronin JW, Evans EE, Cade BE, Lee CJ, Landrigan CP, Rothschild JM, Katz JT, Lilly CM, Stone PH, Aeschbach D, Czeisler CA. 2004. Effect of reducing interns' weekly work hours on sleep and attentional failures. N Engl J Med 351:1829-1837.

Work-related Roadway Crashes - Prevention Strategies for Employers
DHHS (NIOSH) Publication No. 2004-136

Work-related Roadway Crashes - Who’s at Risk?
DHHS (NIOSH) Publication No. 2004-137
Companion fact sheets provide information that employers and others can use for assessing risks for motor vehicle injuries and deaths in their work settings, and for taking effective steps to reduce those risks.

Work-Related Roadway Crashes - Challenges and Opportunities for Prevention
DHHS (NIOSH) Publication No. 2003-119
Provides a comprehensive view of issues impacting the prevention of work-related roadway crashes, identifies the groups of workers at greatest risk of traffic crashes, summarizes key issues that contribute to work-related roadway crashes, and recommends preventive measures for employers and other stakeholders.

Plain Language About Shiftwork
DHHS (NIOSH) Publication No. 1997-145
Provides basic facts about shiftwork and talks about ways to make shiftwork life easier. The document is an educational document for the general public.


22nd Symposium on Shift Work and Working Time: Challenges and solutions for healthy working hours, June 8 to 12, 2015.
Location: Elsinore 40 km north of Copenhagen, Denmark. The Symposium is organized by members of the Working Time Society, and of the Scientific Committee on Shiftwork and Working Time of the International Commission on Occupational Health (ICOH). Visit the conference homepage for more information.

Past NIOSH-Sponsored Events

Long Working Hours, Safety, And Health: Toward A National Research Agenda
April 29 - 30, 2004, University of Maryland, Baltimore, Maryland
Using a multi-disciplinary approach, this conference explored the sociological, economic, and health dimensions of long work hours.

Conference Papers
  • Long working hours, occupational health and the changing nature of work organization. Johnson JV, Lipscomb J. American Journal of Industrial Medicine. 2006; 49: 921-929.
  • Long working hours, safety, and health: Toward a national research agenda. Caruso CC, Bushnell T, Eggerth D, Heitmann A, Kojola B, Newman K, Rosa RR, Sauter SL, Vila B. American Journal of Industrial Medicine. 2006; 49: 930-942.
  • Long hours of work in the U.S.: Associations with demographic and organizational characteristics, psychosocial working conditions, and health. Grosch JW, Caruso CC, Rosa RR, Sauter SL. American Journal of Industrial Medicine. 2006; 49: 943-952.
  • Modeling the impact of the components of long work hours on injuries and accidents. Folkard S, Lombardi DA. American Journal of Industrial Medicine. 2006; 49: 953-963.
  • Longitudinal relationship of work hours, mandatory overtime, and on-call to musculoskeletal problems in nurses. Trinkoff AM, Le R, Geiger-Brown J, Lipscomb J, Lang G. American Journal of Industrial Medicine. 2006; 49: 964-971.
  • Impact of long work hours on police officers and the communities they serve. Vila B. American Journal of Industrial Medicine. 2006; 49: 972-980.

Some Strategies Suggested for Coping with Shift Work

Shift work: health, performance and safety problems, traditional countermeasures, and innovative management strategies to reduce circadian misalignment. Smith M & Eastman CI. 2012. Nature and Science of Sleep. 4: 111-32.

Fatigue Risk Management in the Workplace Lerman SE, Eskin E, Flower DJ, George EC, Gerson B, Hartenbaum N, Hursh SR, Moore-Ede M; ACOEM Presidential Task Force on Fatigue Risk Management. Fatigue risk management in the workplace. 2012. J Occup Environ Med. 54(2):231-58.

Measures to counteract the negative effects of night work. Pallesen S, Bjorvatn B, Magerøy N, Saksvik IB, Wage S, Moen BE. Scan J Work Environ Health 2010. 36 (2): 109-120.

Eating and shift work – effects on habits, metabolism and performance. Lowden A, Moreno C, Holmbäck U, Lennernäs M, Tucker P. Scan J Work Environ Health 2010. 36 (2): 150-162.

Strategies for Nurses to Prevent Sleep-Related Injuries and Errors. Caruso CC, Hitchcock EM. Rehabilitation Nursing 2010. 35 (5): 192-7 [PDF - 744.44 KB]

Fatigue countermeasures in aviation. Caldwell JA, Mallis MM, Caldwell JL, Paul MA, Miller JC, Neri DF; Aerospace Medical Association Fatigue Countermeasures Subcommittee of the Aerospace Human Factors Committee. Aviat Space Environ Med 2009. 80(1):29-59

Guidance for managing worker fatigue during disaster operations. U.S. National Response Team. 2009. [PDF - 670.71 KB]

Alertness Management Strategies for Operational Contexts
Caldwell JA, Caldwell JL, Schmidt RM. Sleep Medicine Reviews 2008; 12: 257-273

Circadian rhythm sleep disorders: Part 1, basic principles, shift work and jet lag disorders. Sack RL, Auckley D, Auger RR, Carskadon MA, Wright KP, Vitiello MV, Zhdanova I. Sleep 2007; 30:1460-1483.

Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. Morgenthaler TI, Lee-Chiong T, Alessi C, Friedman L, Aurora RN, Boehlecke B, Brown T, Chesson AL, Kapur V, Maganti R, Owens J, Pancer J, Swick TJ, Zak R. Sleep 2007; 30:1445-1459.

Burgess PA. 2007. Optimal shift duration and sequence: recommended approach for short-term emergency response activations for public health and emergency management. Am J Public Health 97 Suppl 1:S88-S92. [PDF - 95.25 KB]

How to trick Mother Nature into letting you fly around or stay up all night
Revell VL, Eastman CI. Journal of Biological Rhythms 2005; 20:353-365

Preventive and compensatory measures for shift workers
Knauth P, Hornberger S. Occupational Medicine (Ox) 2003; 53:109-116.

Plain Language About Shiftwork
DHHS (NIOSH) Publication No. 97-145

Some Educational Resources For Workers Available on Other Web Sites

American Academy of Sleep Medicine Education:
National Sleep Foundation:

National Institute of Health, National Heart, Blood, and Lung Institute Your Guide to Healthy Sleep. NIH Publication Number 11-5271. 2011.

Online training/education program for the aviation industry. Federal Aviation Administration Course (2011) ALC-174: Fatigue Countermeasure Training

Online training/education program for the trucking industry: North American Fatigue Management Program: A Comprehensive Approach for Managing Commercial Driver Fatigue

Working the night shift: preparation, survival and recovery. Horrocks, N & Pounder, R. 2006. London, Royal College of Physicians.

NORA Organization of Work Research Priority Area

The goal of the NORA Work Organization and Stress-Related Disorders Team is to define and implement a national occupational research agenda for the next decade. Work organization refers to management and supervisory practices and production processes, and to their influence on the way jobs are designed and performed in the workplace. Work organization includes the design of work schedules. A NORA Long Work Hours Subteam was formed to address overtime and extended work shifts issues.

Other Resources

CDC: Sleep and Sleep Disorders

Agency for Healthcare Research and Quality

Drowsy Driving

Healthy People 2020 Sleep Health

National Institutes for Health, National Center for Sleep Disorders Research

National Sleep Foundation

Sleep Research Society

Society for Light Treatment and Biological Rhythms

Society for Research on Biological Rhythms

Working Time Society

Finding a Sleep Disorders Specialist or Accredited Sleep Disorders Center

American Academy of Sleep Medicine (AASM)
Professional information on AASM-accredited center and laboratory members. Verification of accredited status can be obtained by contacting the AASM National Office at (630) 737-9700 or

American Board of Sleep Medicine

American Academy of Dental Sleep Medicine (AADSM)
A searchable directory of dentists who specialize in treating certain sleep problems.

Vital Signs Truck Driver Safety Widget
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  • Page last updated: June 16, 2015 The U.S. Government's Official Web PortalDepartment of Health and Human Services
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