{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:53:35Z","timestamp":1759971215952,"version":"build-2065373602"},"reference-count":40,"publisher":"BMJ","funder":[{"name":"The Danish Working Environment Research Fund","award":["26-2020-09"],"award-info":[{"award-number":["26-2020-09"]}]},{"name":"European Union\u2019s Horizon 2020 research and innovation programme","award":["874703"],"award-info":[{"award-number":["874703"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2025,7,15]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Night work disrupts sleep, which may increase inflammatory processes, pain sensitivity and pain perception. We investigated effects of night shifts on musculoskeletal pain (MSP) and other mental and somatic symptoms using day-to-day measurements in a within-person design. We also disentangled the effect of night work from the effects of shift-related differences in job demands and sleep.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included 522 hospital employees with data on \u22651\u2009day shift (n=1926) and \u22651 night shift (n=1422). Participants reported their working hours, MSP, other mental and somatic symptoms, sleep and psychosocial and physical job demands daily for 14 days. We estimated prevalence ratios (PRs) of MSP and symptoms when working night shifts compared with day shifts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>After adjusting for age and job demands, night shifts were associated with pain in the lower extremities (PR 1.12; 95%\u2009CI 1.01 to 1.25), gastrointestinal symptoms (PR 2.12; 95%\u2009CI 1.26 to 3.53) and other mental and somatic symptoms (PR 2.54; 95%\u2009CI 1.31 to 4.91). Adjustment for sleep duration did not alter these findings. However, longer shift duration may explain the higher occurrence of lower extremity pain during night shifts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We found no evidence of a general effect of night work on MSP. Only an acute effect on lower extremity pain was observed, which may be attributable to longer night shift duration. Employees also more frequently reported other types of symptoms when working night shifts, even after adjusting for job demands and sleep duration. Thus, physiological effects related to circadian misalignment may be a plausible explanation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/oemed-2025-110260","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T13:04:36Z","timestamp":1759928676000},"page":"oemed-2025-110260","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Day-to-day association of night work with musculoskeletal pain and other symptoms: results from the 1001 nights-cohort"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4298-1420","authenticated-orcid":false,"given":"Kirsten","family":"Nabe-Nielsen","sequence":"first","affiliation":[{"name":"National Research Centre for the Working Environment, Copenhagen, Denmark"},{"name":"Department of Public Health Science, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0042-6389","authenticated-orcid":false,"given":"Dagfinn","family":"Matre","sequence":"additional","affiliation":[{"name":"National Institute of Occupational Health, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6143-4085","authenticated-orcid":false,"given":"Marie Tolver","family":"Nielsen","sequence":"additional","affiliation":[{"name":"National Research Centre for the Working Environment, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1553-2291","authenticated-orcid":false,"given":"Anne Helene","family":"Garde","sequence":"additional","affiliation":[{"name":"National Research Centre for the Working Environment, Copenhagen, Denmark"},{"name":"Department of Public Health Science, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"2025091507215426000_oemed-2025-110260v1.1","doi-asserted-by":"crossref","first-page":"107636","DOI":"10.1016\/j.ypmed.2023.107636","article-title":"Musculoskeletal pain intensity and risk of long-term sickness absence in the general working population: A prospective cohort study with register follow-up","volume":"174","author":"Skovlund","year":"2023","journal-title":"Prev Med"},{"key":"2025091507215426000_oemed-2025-110260v1.2","unstructured":"GBD 2021 Disease and Injuries Collaborators . Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2021."},{"key":"2025091507215426000_oemed-2025-110260v1.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2015.08.002"},{"key":"2025091507215426000_oemed-2025-110260v1.4","unstructured":"Eurofound . European working conditions telephone survey. 2021. Available: https:\/\/www.eurofound.europa.eu\/en\/data-catalogue\/european-working-conditions-telephone-survey-2021-0"},{"key":"2025091507215426000_oemed-2025-110260v1.5","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1093\/occmed\/kqab133","article-title":"Shift work, inflammation and musculoskeletal pain-The HUNT Study","volume":"71","author":"Matre","year":"2021","journal-title":"Occup Med (Lond)"},{"key":"2025091507215426000_oemed-2025-110260v1.6","doi-asserted-by":"crossref","DOI":"10.1002\/1348-9585.12208","article-title":"Differences between fixed day shift nurses and rotating and irregular shift nurses in work-related musculoskeletal disorders: A literature review and meta-analysis","volume":"63","author":"Chang","year":"2021","journal-title":"J Occup Health"},{"key":"2025091507215426000_oemed-2025-110260v1.7","doi-asserted-by":"crossref","first-page":"749","DOI":"10.3109\/07420528.2016.1167730","article-title":"Musculoskeletal pain and insomnia among workers with different occupations and working hours","volume":"33","author":"Moreno","year":"2016","journal-title":"Chronobiol Int"},{"key":"2025091507215426000_oemed-2025-110260v1.8","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1093\/eurpub\/ckx084","article-title":"Night work as a risk factor of future disability pension due to musculoskeletal diagnoses: a prospective cohort study of Swedish twins","volume":"27","author":"K\u00e4rkk\u00e4inen","year":"2017","journal-title":"Eur J Public Health"},{"key":"2025091507215426000_oemed-2025-110260v1.9","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph17207477","article-title":"The Impact of a Change in Employment on Three Work-Related Diseases: A Retrospective Longitudinal Study of 10,530 Belgian Employees","volume":"17","author":"Maniscalco","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2025091507215426000_oemed-2025-110260v1.10","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph17239092","article-title":"Impact of Decreased Night Work on Workers\u2019 Musculoskeletal Symptoms: A Quasi-Experimental Intervention Study","volume":"17","author":"Lee","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2025091507215426000_oemed-2025-110260v1.11","doi-asserted-by":"publisher","DOI":"10.1080\/00140139.2010.489651"},{"key":"2025091507215426000_oemed-2025-110260v1.12","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.i5210","article-title":"Health consequences of shift work and insufficient sleep","volume":"355","author":"Kecklund","year":"2016","journal-title":"BMJ"},{"key":"2025091507215426000_oemed-2025-110260v1.13","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2023-108902"},{"key":"2025091507215426000_oemed-2025-110260v1.14","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.neubiorev.2020.03.028","article-title":"The effects of recovery sleep on pain perception: A systematic review","volume":"113","author":"Stroemel-Scheder","year":"2020","journal-title":"Neurosci Biobehav Rev"},{"key":"2025091507215426000_oemed-2025-110260v1.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2022.101695"},{"key":"2025091507215426000_oemed-2025-110260v1.16","doi-asserted-by":"crossref","first-page":"2455","DOI":"10.1097\/j.pain.0000000000003279","article-title":"The bidirectional relationship between sleep problems and chronic musculoskeletal pain: a systematic review with meta-analysis","volume":"165","author":"Runge","year":"2024","journal-title":"Pain"},{"key":"2025091507215426000_oemed-2025-110260v1.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2023.101835"},{"key":"2025091507215426000_oemed-2025-110260v1.18","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2019.305278"},{"key":"2025091507215426000_oemed-2025-110260v1.19","doi-asserted-by":"crossref","first-page":"66","DOI":"10.2486\/indhealth.2020-0153","article-title":"Differences between fixed day shift workers and rotating shift workers in gastrointestinal problems: a systematic review and meta-analysis","volume":"59","author":"Chang","year":"2021","journal-title":"Ind Health"},{"key":"2025091507215426000_oemed-2025-110260v1.20","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1080\/07420528.2024.2303986","article-title":"The associations between different types of infections and circadian preference and shift work","volume":"41","author":"Bjorvatn","year":"2024","journal-title":"Chronobiol Int"},{"key":"2025091507215426000_oemed-2025-110260v1.21","doi-asserted-by":"crossref","first-page":"233","DOI":"10.5271\/sjweh.4157","article-title":"Working hours and health - key research topics in the past and future","volume":"50","author":"H\u00e4rm\u00e4","year":"2024","journal-title":"Scand J Work Environ Health"},{"key":"2025091507215426000_oemed-2025-110260v1.22","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s00420-018-1373-9","article-title":"Sleep duration mediates abdominal and lower-extremity pain after night work in nurses","volume":"92","author":"Katsifaraki","year":"2019","journal-title":"Int Arch Occup Environ Health"},{"key":"2025091507215426000_oemed-2025-110260v1.23","doi-asserted-by":"publisher","DOI":"10.1177\/21650799231193578"},{"key":"2025091507215426000_oemed-2025-110260v1.24","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.1307"},{"key":"2025091507215426000_oemed-2025-110260v1.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2020.106349"},{"key":"2025091507215426000_oemed-2025-110260v1.26","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s10654-025-01201-4","article-title":"The 1001 nights-cohort - paving the way for future research on working hours, night work, circadian disruption, sleep, and health","volume":"40","author":"Nabe-Nielsen","year":"2025","journal-title":"Eur J Epidemiol"},{"key":"2025091507215426000_oemed-2025-110260v1.27"},{"key":"2025091507215426000_oemed-2025-110260v1.28","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1080\/07420528.2018.1466797","article-title":"Payroll data based description of working hours in the Danish regions","volume":"35","author":"Garde","year":"2018","journal-title":"Chronobiol Int"},{"key":"2025091507215426000_oemed-2025-110260v1.29","doi-asserted-by":"crossref","first-page":"356","DOI":"10.5271\/sjweh.3793","article-title":"The Danish Psychosocial Work Environment Questionnaire (DPQ): Development, content, reliability and validity","volume":"45","author":"Clausen","year":"2019","journal-title":"Scand J Work Environ Health"},{"key":"2025091507215426000_oemed-2025-110260v1.30","unstructured":"The Danish Working Environment Authority . National survey of the working environment among employees 2021 and 2023. 2023. Available: https:\/\/at.dk\/arbejdsmiljoe-i-tal\/national-overvaagning-af-arbejdsmiljoeet-blandt-loenmodtagere"},{"key":"2025091507215426000_oemed-2025-110260v1.31","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-024-07196-5","article-title":"The association between proportion of night shifts and musculoskeletal pain and headaches in nurses: a cross-sectional study","volume":"25","author":"Stav\u00e5s","year":"2024","journal-title":"BMC Musculoskelet Disord"},{"key":"2025091507215426000_oemed-2025-110260v1.32","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1007\/s00420-020-01626-2","article-title":"Shift work, low-grade inflammation, and chronic pain: a 7-year prospective study","volume":"94","author":"Christensen","year":"2021","journal-title":"Int Arch Occup Environ Health"},{"key":"2025091507215426000_oemed-2025-110260v1.33","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1007\/s00420-019-01481-w","article-title":"Pain complaints are associated with quick returns and insomnia among Norwegian nurses, but do not differ between shift workers and day only workers","volume":"93","author":"Matre","year":"2020","journal-title":"Int Arch Occup Environ Health"},{"key":"2025091507215426000_oemed-2025-110260v1.34","doi-asserted-by":"crossref","first-page":"152","DOI":"10.5271\/sjweh.3861","article-title":"Shift work and the risk of knee osteoarthritis among Chinese workers: a retrospective cohort study","volume":"46","author":"Zhou","year":"2020","journal-title":"Scand J Work Environ Health"},{"key":"2025091507215426000_oemed-2025-110260v1.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2016.09.002"},{"key":"2025091507215426000_oemed-2025-110260v1.36","doi-asserted-by":"crossref","first-page":"2463","DOI":"10.1007\/s11135-013-9901-x","article-title":"Methods of soliciting self-reported chronic conditions in population surveys: don\u2019t ask, don\u2019t report?","volume":"48","author":"Bielecky","year":"2014","journal-title":"Qual Quant"},{"key":"2025091507215426000_oemed-2025-110260v1.37","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph20020918","article-title":"Association of Low Back Pain with Shift Work: A Meta-Analysis","volume":"20","author":"Chen","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"2025091507215426000_oemed-2025-110260v1.38","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0b013e3182398dec"},{"key":"2025091507215426000_oemed-2025-110260v1.39","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1539\/joh.14-0201-OA","article-title":"Job characteristics and musculoskeletal pain among shift workers of a poultry processing plant in Southern Brazil","volume":"57","author":"Barro","year":"2015","journal-title":"J Occup Health"},{"key":"2025091507215426000_oemed-2025-110260v1.40","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0b013e3182572e6a"}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oemed-2025-110260","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T13:04:41Z","timestamp":1759928681000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oemed-2025-110260"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,19]]},"references-count":40,"alternative-id":["10.1136\/oemed-2025-110260"],"URL":"https:\/\/doi.org\/10.1136\/oemed-2025-110260","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"value":"1351-0711","type":"print"},{"value":"1470-7926","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,19]]}}}