Health risk solarium medspecialists magazine

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Gray days without sun, which occur frequently during the colder months of the year, dampen the mood of many people. Warming sunlight on the other hand provides for feelings of happiness and more vitality. In addition, tanned skin is still considered by many to be a sign of attractiveness, fitness and health.

No wonder, then, that many want to keep their beautiful summer tan all year round and regularly visit a solarium, especially in autumn and winter. It has long been known that artificial sunlight damages the skin and greatly increases the risk of cancer.

In this post, learn why tanning bed visits are so harmful to your health, what alternatives are available for a healthy tan, and what effect tanning beds actually have on vitamin D levels.

How does a skin tan develop??

When ultraviolet (UV) radiation penetrates the skin, whether through natural light or in a tanning salon, it stimulates the production of the pigment melanin in the skin cells, making the skin appear darker. However, this tanning is nothing more than a Protection and repair mechanism of the skin: the tanned protective layer absorbs the UV rays so that they cannot penetrate into deeper skin layers and damage them. By secreting melanin, the skin thus attempts to protect itself against penetrating UV radiation The skin is protected against UV radiation, but this is only possible to a very limited extent. If the UV rays penetrate into deeper layers of the skin, they cause lasting damage to the cells.

What are the risks of the solarium for our health??

If we are exposed to UV radiation for too long, first of all acute damage at. In this case, after a few hours, there is Redness as the first sign of sunburn. In the further course the skin swells, itches and hurts. What is worse, however, is that after a sunburn the skin recovers only superficially. If the dangerous UV rays are not absorbed by the outer layer of skin and can thus penetrate deeper into the skin, they lead there to Cell damage. While a sunburn disappears after a few days, the Sdamage to the cells in the long term exist. Only after years to decades do the actual cell damage show up Effects of sun exposure through increased Wrinkle formation, an increased occurrence of Pigment spots and a higher likelihood of Skin cancer.

If the skin is frequently exposed to dangerous UV radiation, the body's own repair system fails increasingly. The genetic material of the skin cells is changed. Damaged cells can now multiply in an uncontrolled manner. The risk of developing skin cancer increases.

For Solarium users the risk of developing black skin cancer is twice as high as for people who do not use a tanning bed. It increases by 75% for those who regularly visit a solarium from the age of under 30, because the skin of young people is particularly easily damaged by UV light. For this reason in Germany for young people under 18 years the attendance of Solarien is forbidden.

Whereas the natural UV radiation of sunlight consists of UV-A rays and UV-B rays, the artificial UV rays in solariums differently composed. Here the UV-B radiation is largely filtered out. So that particularly quickly produces the desired tan in the artificial light, the dose of the UV-A rays was increased in return. This is also the reason why the tan from the solarium appears more orange than brown. In addition, a small amount of UV-B radiation can also promote the development of skin cancer, as can UV-A radiation, as is now known.

Last but not least, artificial (as well as natural) UV light promotes a premature skin agingThe UV-A rays in particular penetrate deep into the skin, causing the formation of so-called "pigments" free radicals form. On the one hand, these damage the collagen in the connective tie and, on the other hand, prevent the renewal of the tie – leading to damage to connective tie. The skin increasingly loses elasticity, it dries out and wrinkles form.

Misconceptions about the solarium

Pre-tanning protects the skin

It is unfortunately wrong that a pre-tanning of winter-pale skin in the solarium protects the skin in the summer vacation, because for the melanin formation the UV-B radiation is responsible. Although the UV-A light used in solariums causes the skin to tan quickly, the UV-A rays are not able to stimulate the formation of a protective layer in the uppermost layers of the skin. And anyway it is true: the tanning of the skin is only a Protection mechanism and a warning, that the skin has already been exposed to the sun for too long.

Bio-solariums are healthier

So-called bio or bio light solariums advertise that thanks to specially filtered UV radiation, i.e. by using only the harmless parts of UVA-1 and visible light, they are not harmful but even healthy for the skin. Different skin diseases, as for example Neurodermitis, Psoriasis or acne, could be treated in such a way, rheumatism could be alleviated and also depressions. However, it is a fact that the long-wave UVA radiation used in the devices of bio or bio-light tanning beds can also lead to premature aging of the skin and increase the risk of skin cancer. Bio solariums are thus also not healthier than conventional tanning salons.

Visits to the solarium replenish the vitamin D store

Many tanning salon operators emphasize that in the solarium the formation of vitamin D is stimulated, which especially in winter depressive moods and prevent sluggishness. However, it is the UV-B component of sunlight that is responsible for the formation of vitamin D. So exactly the part of the artificial 'sunlight' of the solariums is filtered out. Accordingly a attendance in the Solarium does not contribute at all to it the Vitamin D memory again to refill but increases instead the skin cancer risk. For those who suffer from a vitamin D deficiency, vitamin D in tablet form offers the ideal alternative – without the risk of skin cancer.

For which groups of people can tanning salons be medically helpful?

In some Exceptional cases can have a light therapy provide relief for certain underlying diseases. For example, people suffering from neurodermatitis, psoriasis or acne can benefit from UV light therapy. However, this should always be prescribed exclusively by a specialist and cared for accordingly. In these cases, UV light therapy is used in exceptional cases medical exposure systems take place in a clinic and not in a solarium. Also Depression can be achieved with medically initiated light therapy, in combination with antidepressants and psychotherapy, be alleviated. Also here a specialist is to be consulted.

What are the alternatives to the solarium?

In order not to have to do without summery tan of the skin also in the winter, there are quite alternatives, which get along without the dangerous UV rays, for example self tanner or sun showers.

Self tanner Are available in the form of creams, sprays or wipes and in different color variations. Without damaging the skin through harmful UV radiation, they help to achieve a light brown complexion. In the meantime high-quality self tanners offer Natural looking and streak-free Results. Also a gentle peeling before the application can optimize natural results additionally.

Some tanning and cosmetic studios also offer so-called Sun showers at. These work on the same principle as the self-tanners from the tube. However, the Tanning substance (mostly dihydroxyacetone, DHA) sprayed directly onto the skin in sun showers with the aid of small nozzles. It only takes a minute. The tanning effect lasts for about a week. In this way the body can holistically. So that particularly natural. Also different Tanning levels can be individually adjusted here as desired. In principle, solarium visits are associated with a high health risk. Therefore not recommended for health reasons. Especially people with fair skin, blond or red hair, freckles and/or liver spots or. conspicuous pigment marks. Who was already once ill at skin cancer, for which attendance on the sun bank is anyway taboo. However, anyone who does not belong to these particularly vulnerable risk groups and does not want to forego visits to the solarium should in any case only certified studios with expert staff visit. It is also important to wear a UV eye protection goggles and to keep an interval of at least one week between visits. As a rule of thumb for the number of hours of sunbathing, do not enjoy more than a total of 50 artificial and natural sunbaths per year.

What is multiple sclerosis actually?Hardly any disease is as complex as multiple sclerosis. It manifests itself in a variety of symptoms. Proceeds differently in each affected person. In any case, however, a malfunction of our immune system is behind the chronic disease with the 1.000 faces.

What MS is and what it is not

Multiple sclerosis (MS) – it has something to do with nerves and the brain, causes a lot of discomfort, is contagious, is not curable. Surely you have heard many true, half-true and untrue things in connection with MS.

But what is multiple sclerosis actually?? MS is a chronic inflammatory disease of the central nervous system (CNS). This leads to multiple inflammation foci in the brain and spinal cord. These in turn lead to the destruction of nerve fibers and, in the long term, to hardening and scarring (scleros = hard) of nerve tie.

Sometimes the term "encephalomyelitis disseminata" is also used for MS. It is derived from the Greek words "enkephalos" for brain, "myelos" for marrow, and the Latin word "disseminare", meaning to spread. The term describes an inflammation spread over different parts of the central nervous system.

The consequence of the inflammations: Commands and stimuli sent by our brain cells to muscles or organs are delayed or no longer reach their destination at all. Conversely, stimuli that are received do not reach the brain as quickly as possible and can therefore no longer be processed properly. This is why multiple sclerosis can lead to movement-. Sensory disturbances come. But the disease can also manifest itself in many other symptoms – in 1.000 faces.

Causes still unknown

Although the exact causes of multiple sclerosis are not yet known, it is now clear that it is a so-called autoimmune disease. And therefore MS is not contagious. It is not triggered by pathogens, but by our immune system. Instead of protecting us from viruses and bacteria, it suddenly attacks healthy, endogenous tie. In the case of MS, these are the so-called myelin sheaths. They surround the nerve processes like an insulating layer. Thus ensure the smooth transmission of sensory stimuli.

MS progresses very differently

A typical characteristic of MS is that the course of the disease varies from patient to patient. This applies to the occurrence of symptoms as well as to the frequency and duration of so-called relapses.

Thrust

Characteristic feature of MS, characterized by

– a sudden onset of symptoms lasting more than 24 hours. – a time interval between two episodes of at least 30 days.

The disease also progresses at different rates. Nevertheless, MS can be divided into three basic forms:

Your doctor can tell you which form you have. He also knows how MS and the possibly occurring complaints can be treated.

In short& Just under

Multiple sclerosis is a disease of the central nervous system. Due to inflammations in the brain and spinal cord, sensory stimuli are no longer transmitted and processed correctly. This leads to numerous complaints, which occur very differently from patient to patient. A malfunction of the immune system is considered to be the trigger for the inflammations.

Shift work, work-life balance, and psychosomatic complaints – A mediation analysis based on the 2018 BIBB/BAuA survey of employed personsThe health effects of shift work are intensively researched, but there are deficits in the study of social effects, which are discussed as a cause of health consequences of shift work. This study uses a mediation analysis to examine the relationship between work-life balance and the health status of shift workers compared to employees with normal working hours. Data from the 2018 BIBB/BAuA survey of employed persons, which is representative for Germany, is used for this purpose. Employees who work shifts are more likely to experience difficulty in reconciling work and family life. Psychosomatic complaints affected than employees in normal working hours. It is shown that work-life balance acts as a mediator in the relationship between shift work and psychosomatic complaints. This applies to women. For men. The results confirm the importance of social effects of shift work as a possible cause of health complaints.

Practical relevance: Shift workers are less likely to succeed in balancing the demands of work and family life. This conflict is accompanied by a health risk. Knowledge of this risk is of practical relevance, as companies can explicitly take work-life balance into account in workplace health promotion measures or in the regular organization of working hours. Managers and employees in shift work should also be aware that problems in balancing work and private life represent a significant stressor.

Abstract

Health consequences of shift work have been intensively investigated, while there is a lack of research on social consequences of shift work, although social consequences have been discussed as a reason for health consequences of shift work. In this present study, we investigate the association between compatibility of work and private life and health status of shift workers compared to employees with regular working hours in a mediation analyses. To do so, we applied data from the German representative BIBB/BAuA employment survey 2018. Employees in shift work showed more often difficulties in the compatibility of work and private life and psychosomatic complaints than employees with regular working hours. The compatibility of work and private life partially mediated the relationship between shift work and psychosomatic complaints. This was the case for men and women. Our results support the importance of social consequences of shift work, one of the possible causes for negative health consequences of shift work.

Practical Relevance: Shift workers face more often difficulties in balancing the demands of the areas of work and family life. This conflict has health consequences. The knowledge of this risk is of practical relevance, because companies could explicitly target the compatibility of work and private life in interventions of workplace health promotion or in the regular organization of working time. Leaders and shift workers should be aware that difficulties in the compatibility of work and private life are an important stressor.

Introduction

The world of work is undergoing a transformation that has been driven in recent decades primarily by processes such as demographic change and the associated changes in the structure of the workforce, the globalization of the economy (Eichhorst and Buhlmann 2015; Trinczek 2011), digitalization, and the development into a knowledge and communication society (Eichhorst and Buhlmann 2015). This structural change is accompanied by flexibilization processes, which lead to changes in working hours in terms of duration, location and distribution and a dissolution of boundaries between the worlds of work and family (Jurgens 2003).

Special working time conditions, such as shift work, weekend work, evening work or night work have increased in frequency since 1996. According to figures from the Federal Statistical Office, among all dependent employees in Germany in 2016, a good 16% (1996: 11%) work in shifts, almost 24% (1996: 19%) of employees work on Saturdays, 14% (1996: 10%) work on Sundays and/or public holidays, 24% (1996: 16%) work in the evening, and 9% (1996: 7%) work at night (BMAS and BAuA 2017). In the European Union in 2015, 18% of employees work in shifts, almost 40% of employees work on Saturdays and 23% on Sundays (Eurofound 2017). In connection with the expansion of working hours, the 24-hour society is often spoken of. In addition to indispensable social services such as the provision of health and nursing care for the population or the supply of electricity, there are sectors of the economy that produce around the clock for technical and/or economic reasons. Shift work is now no longer limited to these economic sectors, but is increasingly found in the service sector, where services are offered and used 24 hours a day, including jobs in security services or in the communications industry (Angerer and Petru 2010).

Shift work places special demands on the compatibility of work and private life, since socially significant hours of the day are often occupied by work. While research is intensively addressing the health effects of shift work (Angerer and Petru 2010), the state of knowledge on the social effects must be considered limited. Few studies have been published on the long-term consequences for the family life of shift workers (Arlinghaus et al. 2019; Jansen et al. 2003, 2004; Presser 2000). Here, the disruption of social and family life due to shift work is discussed as a possible cause of negative health consequences of shift work (Tucker and Folkard 2012). This is also referred to as a social explanatory approach (Haines et al. 2008). Costa (2003) even describes work-life balance challenges as the main cause of maladjustment to shift work and sees a link with the development of psychosomatic illnesses.

Work-life balance among shift workers

The life domains of work and family usually have the highest rankings in the life of a middle-aged adult. The private sphere of life offers space for recreation, social integration and support, but is also associated with demands. Ideally, employees manage to balance the demands of the two spheres of life (Deutsche Gesetzliche Unfallversicherung 2012). When demands from the life domains of work, private life, and family life are difficult to reconcile or. are incompatible, this is understood as interrole conflict. Constructs such as work-family conflict or work-life conflict describe this interrole conflict as a state in which work role demands and expectations are incompatible with family and personal life role demands and expectations, and vice versa. In this context, family roles are not limited to obligations in caring for and looking after children. Inter-role conflict can likewise arise between the demands of paid work and a volunteer role (Greenhaus and Beutell 1985).

For shift workers, balancing demands is complicated by a shift in social rhythm, social desynchronization (Angerer and Petru 2010), because a shift worker's daily rhythm differs from that of the social environment in which individuals generally follow a normal daily rhythm (Arlinghaus and Nachreiner 2016). This can result in a lack of shared time with family or friends during the day, or in the inability to meet childcare obligations, as childcare options are difficult to reconcile with shift work schedules (Jurgens 2003). Due to the higher demands, compatibility requires an increased effort in terms of organizational arrangements and division of labor in partnerships, especially when there are care obligations for children (Deutsche Gesetzliche Unfallversicherung 2012).

Although shift work is predominantly seen as a challenge to compatibility, there are cases where shift work is deliberately included to improve compatibility (German Social Accident Insurance 2012). Jurgens (2003) sees this as posing health risks to employees, as couples often work opposite "work shifts" to take turns caring for each other, and this would be accompanied by physical and psychological strain.

A number of studies already provide evidence that employees in staggered work schedules or shift work are more likely to experience work-life balance problems (Carlson et al. 2011; Haines et al. 2008; Heponiemi et al. 2010; Jansen et al. 2004). Arlinghaus et al. (2019) summarized study findings on work schedule types and the impact on family and leisure life, concluding that shift work and excessive work hours are associated with greater conflicts in balancing work, family, and leisure time. Jansen et al. (2004), for example, examined the relationship between work schedule patterns and work-family conflict in the Maastricht Cohort Study and found stronger reconciliation problems for women and men in shift work compared with workers with normal work schedules. When examining reconciliation problems, women and men should be considered separately to account for gender differences in work-related and personal demands. Jurczyk (1998), for example, identified different ways of dealing with time on the basis of qualitative interviews, each of which is largely male or female in character. A particular problem, he argues, is that women, driven by their greater social involvement in work and family life, have to manage several professional and private activities synchronously, whereas men can segment them more frequently because they are more self-determined (Jurczyk 1998). Research also reveals evidence of differential expression of reconciliation problems between the sexes (Byron 2005; Haines et al. 2008).

Health effects of shift work

Shift work is associated with a variety of health consequences, such as an increase in work disability days (Merkus et al. 2012), weight gain (Proper et al. 2016; Van Drongelen et al. 2011), obesity, and impaired glucose tolerance (Proper et al. 2016), diseases such as diabetes (Knutsson and Kempe 2014), myocardial infarction and stroke (Vyas et al. 2012). The disruption of the body's endogenous circadian rhythm is understood to be the main cause of health stress due to shift work. The circadian rhythm sets the sleep-wake rhythm, controls physiological processes in the body such as hormone releases and blood prere, and is primarily influenced by the day-night or. Light-dark rhythm controlled. In particular, shift work results in a large divergence between the employee's circadian rhythm and activity rhythm (Angerer and Petru 2010).

Beyond this biomedical explanatory pathway, two other explanatory approaches are also discussed. In Tucker and Folkard's (2012) conceptual model of the relationship between work schedule patterns and short- and long-term health outcomes, the causes of negative health outcomes, in addition to disrupted circadian rhythms, are disruption and shortening of nighttime sleep and disrupted social and family life. The social explanatory approach to health outcomes has been largely ignored in research to date (Haines et al. 2008). In this regard, Work-Family Conflict is recognized as a work-related stressor (Bellavia and Frone 2005; Haines et al. 2008) and can lead to psychological, physiological, and behavioral stresses. Theoretical justifications for this relationship are provided by the Effort-Recovery Model, According to which high work-related demands lead to stresses that are compensated for by recreation during free time. If there is a lack of time to recover from work-related demands, stress responses accumulate and can lead to health complaints (Meijman and Mulder 1998; Nohe et al. 2015). Accordingly, the interrole conflict between the work and family domains causes stress by limiting opportunities and time for recovery after work (Nohe et al. 2015).

Health consequences of interrole conflict have already been shown (Frone et al. 1996; Frone et al. 1992, 1997; Heponiemi et al. 2010). Frone (2000) examined the relationship between Work-Family Conflict and the psychiatric disorders affective disorder, anxiety disorder, substance dependence, and substance abuse. Work-family and family-work conflict is related to an increase in the odds of affective disorder, anxiety disorder, and substance dependence. In addition, associations have been found with depression, physical health status (Frone et al. 1996, 1997), self-reported health status (Griep et al. 2016), neck and back pain (Baur et al. 2018), heavy drinking (Frone et al. 1994, 1996, 1997) and cigarette use (Frone et al. 1994) and reduced quality of life were shown (Rice et al. 1992).

Haines et al. (2008) examined the interaction of work-family conflict, shift work, and depression. According to the results, Work-Family Conflict is a mediator in the relationship between shift work and depression, equally for women and men. Fein and Skinner (2015) were able to show the mediation of work-life conflict for excessive working hours and health, measured by stress perception and general health status. Wirtz and Nachreiner (2010) considered this relationship for psychovegetative limitations and confirmed the role of work-life balance as a significant mediator in the relationship between excessive working hours, weekend work, and shift work and health. Other studies show an interaction of work intensity, low work time control, greater work-life conflict, and an increase in health limitations among employees in shift work (Bohle et al. 2011; McNamara et al. 2011).

In this study, the relationship between shift work, work-life balance, and employee health is examined. There are three questions that are explored:

Are there differences in work-life balance between shift workers and employees with normal working hours between 7 a.m. and 7 p.m? Does an aggravated compatibility of work. Work-life conflict on the health status of employees? Is a more difficult compatibility of work. Private life among shift workers a potential cause of negative health outcomes?

To answer these research questions, we conduct a mediation analysis based on the Germany-wide representative BIBB/BAuA survey of employed persons from 2018. We consider an index of psychosomatic complaints as a health outcome measure. Employees in normal working hours serve as a comparison group for employees in shift work.

Data and Methods

Study population

This study uses data from the 2018 BIBB/BAuA Survey of Employed Persons, which surveyed 20 employees across Germany.012 employed persons aged 15 years and older who work at least 10 hours per week were interviewed by telephone and computer-assisted telephone interview, i.e., computer-assisted telephone interview. In addition to people with a landline, people who can only be reached via a cell phone were also contacted (dual-frame method). The sampling of fixed-. Mobile phone numbers was done using the random digit dialing method. The field period began on 2. October 2017. Ended on 5. April 2018. October 2017. Ended on 5. April 2018. April 2018. The interview duration was on average about 42 min. Due to the sampling situation, the survey data were corrected for the different chances of selection. Adjusted for demographic variables with the help of a default weighting to the labor force determined in the 2017 microcensus. In addition to work requirements and working conditions, the topics covered in the survey include health complaints and stresses experienced by employees (Gensicke and Tschersich 2019). For the mediation analysis, the unweighted sample was restricted to dependent employees between the ages of 15 and 65 (n = 17.608). Because shift workers are considered in comparison with employees working normal hours, employees with staggered work schedules who did not report working shift work were excluded (n = 1193). Due to missing values, further n = 347 employees were not included in the analysis, so a total of n = 16.068 employees are the basis of our analyses, including n = 2100 shift workers and n = 13.968 Employees working normal hours. Analyses are gender-stratified, as both compatibility ies and the impact of these and work schedule location on health may differ between genders.

Study variables

Measurements of work schedule, health status, work-life balance and various control variables are used in the analyses of this survey.

Working time situation

To record the Working time situation a specially contoured item was used. If respondents indicated that their working hours are normally between 7 a.m. and 7 p.m., this is amed to be a "normal working hour". If the respondents reported in a subsequent question that they work in shift work, the working time situation "shift work" is amed here. It should be noted here that the question "Do you work in shifts??" was asked only to those who answered the question "Are your working hours usually between 7 a.m. and 7 p.m.??" had denied or refused.

Psychosomatic complaints

The Health status was represented by an index of psychosomatic complaints containing 8 different items, including nervousness/irritability, dejection and emotional exhaustion (see table 5 in the appendix). The index indicates how many of the integrated complaints were reported as "yes" in the categories 0 (no complaints) to 8 (all complaints).

Compatibility of work and private life

The Work-life balance was constructed with the item "How often do you manage to take your family and work interests into account when planning your work schedule??" recorded in the categories (1) "frequently" to (4) "never". The variable was included as a metric in the analysis.

Control variables

To rule out alternative explanations, a number of Control variables integrated into the analyses, which are known to influence work-life balance and health complaints, including age, hours of work, education level, working conditions, and care and nurturing of children or dependents. With age, the state of health deteriorates. Work-life balance takes on a different importance in middle age than in younger or older years, in part because of increased care of children (Keller and Haustein 2013) and care of relatives. With increased working hours, work-life balance becomes more difficult and health complaints occur more frequently (Wohrmann et al. 2016). In lower educational groups, health burdens and chronic diseases are increased, the reported health status is worse than in middle or upper educational groups (Mielck 2012). It is also known that shift work is associated with increased physical, psychological and work environment stress due to the difference in activity compared to normal working hours, leading to a high risk of adverse health effects (Beermann 2010; Leser et al. 2013). respondents was determined with a query in the interview. Integrated into the models as a metric variable. Also the actual working time was asked in the interview and, subdivided into part-time (10 to 34 hours) and full-time (35 hours or more), was taken into account in the following analyses. The Education level was mapped using the "International Standard Classification of Education 97" (ISCED-97), an internationally recognized classification of UNCESCO (UNESCO 1997), which was constructed from the highest general school-leaving qualification and the highest vocational training qualification. Overall, the ISCED classification distinguishes between levels (1) "Primary education or first stage of basic education/primary school" to (6) "Second stage of tertiary education/promotion", with the preschool sector covered by level (0) "Pre-primary education/kindergarten" (Schroedter et al. 2006). ISCED-97 was included in its full scope as a metric variable in the mediation analysis. For a better overview, the descriptive analysis contains a scale based on Hippach-Schneider et al. (2007) and Van der Velden& Wolber's (2003) summarized ISCED classification in levels (1) "primary and secondary" (ISCED 0-2), (2) "upper secondary" (ISCED 3-4), and (3) "tertiary" (ISCED 5-6). In order to take account of the aspect of Care for and look after children or relatives In order to do justice to the question "Do you care for someone in your private environment??" and "Do children under 18 live in your household?" with the response options (0) "No" and (1) "Yes" adjusted. Summation scales were also formed from a set of surveyed working conditions to Physical working conditions (α = 0,81), Working environment conditions (α = 0.80) and Monotony (α = 0.58) as well as a mean scale to Work intensity (α = 0.71) were formed, which were included in the models as a control. The construction of these scales is adapted from Franke (2015). An overview of the items integrated into scales can be found in tab. 5 in the appendix.

Description of the study population

The descriptive analyses of the 2018 BIBB/BAuA Survey of Employed Persons were calculated with design and correction weighting (Tab. 1). Accordingly, 20% of men and 14% of women work shifts. In contrast, 80% of men and 86% of women are in paid employment with normal working hours between 7 a.m. and 7 p.m. Men and women who work shift work report psychosomatic complaints more frequently than men and women who work normal working hours. In addition, it becomes clear that men and women in shift work are more frequently affected by stressful monotonous, physical and environmental working conditions than employees with normal working hours. Among employees who work shift work, 6% of men and 4% of women never succeed in balancing work and private life. In contrast, 3% of men and 2% of women working normal hours of 7 a.m. to 7 p.m. report never successfully balancing work and personal life. The average age of shift workers. Employees with normal working hours is 43 years. Men and women in shift work, compared to employees with normal working hours, are in the majority working full-time hours. Shift workers are more likely to have a medium (upper secondary) and low (primary and lower secondary) level of education according to ISCED-97 compared to male and female employees with normal working hours.

Statistical evaluations

The following uses a mediation analysis to examine how shift work exerts its effect on the health status of workers. Here we examine whether and to what extent the relationship between shift work and health is mediated by work-life balance. A simple mediation with latent variables is similar to the typical application of a structural equation model, which usually consists of a measurement model and a structural model (Berning 2018). Latent constructs on work-life balance could not be formed from the available data, so manifest variables were primarily used for the analyses. For this reason, only the structural model is postulated. Verified with a mediation analysis. Such directed models with manifest variables are considered a special case of structural equation models (Backhaus et al. 2016; Reinecke 2014).

Fig. 1 shows the conceptual recursive path model of the mediation analysis underlying this study. The names of the population parameters are given next to the paths. To estimate and test the coefficients of this pathway model, two linear regressions were run separately by gender in each of two models (model 1: univariate, model 2: adjusted for age, working hours, education level, working conditions, and care and maintenance of children or dependents). In the mediation analysis, we distinguish between a direct (γ′), indirect (αβ) and total effect (γ =γ′ +αβ) from X at Y differentiated. The mediation null hypothesis is tested

Using two-sided bootstrap confidence interval.

Conceptual model of the mediation analysis

The mediation analysis was calculated on the basis of unweighted data from the 2018 BIBB/BAuA survey of employed persons. The SPSS macro PROCESS developed by Hayes (2018) with SPSS 25 was used. To assess the variance homogeneity of the residuals from the regression of "shift work" on "work-life balance" and "health," a modified Breusch-Pagan test for heteroskedasticity was performed in advance. As a result, the null hypothesis of variance homogeneous residuals was clearly rejected for the model used here (p < 0,001). For this reason, the models were calculated with heteroskedasticity-consistent standard errors.

Results

To examine the relationship between shift work, work-life balance, and health, a mediation analysis was performed. Here, the coefficients of the conceptual path model (Fig. 1) estimated. Tested. In the following, the results of the linear regressions underlying this analysis are presented for men and women in each of two models. In addition, the result of the mediation null hypothesis is presented.

In the linear regression from "shift work" to "compatibility of work and private life" (tab. 2), the coefficient α of the underlying path model is estimated. This reveals positive and statistically significant regression weights for men and women in model 1 (univariate). Even after adjustment in model 2, the effects remain highly significant. Shift workers are consequently less likely to be able to take their family and work interests into account when planning their working hours than men and women who work normal hours between 7 a.m. and 7 p.m., even after accounting for the influence of age, amount of time worked, level of education, working conditions, and care for children or dependents. The proportion of variance explained by the dependent variable by the independent variables increases in the second model for both men and women, suggesting that the measures fit the adjusted model better than the univariate model.

Tab. 2 Table 2 Results of the linear regression on the association between shift work and compatibility of work and private life (target variable)Results of the linear regression on the association between shift work and compatibility of work and private life

The tab. 3 and 4 show the results of the linear regression of "shift work" and "work-life balance" on "health" for men and women, respectively. For the coefficient β of the path model, model 1 shows significant compatibility effects for men and women. These effects remain highly significant even after adjustment in model 2. Men and women who experience increasing difficulties with work-life balance exhibit increased psychosomatic complaints, even after accounting for the influence of the covariates. For the direct effect by the coefficient γ′ show positive and statistically significant effects for men and women in model 1. After adjustment in model 2, the regression weights decrease but remain significant only for men. According to both models, men in shift work are more affected by psychosomatic complaints than men with normal working hours of 7 am to 7 pm. In the second model, the variance explanation of the dependent variable "health" is increased by the independent variables "shift work" and "work-life balance. For men as well as for women, the adjusted model thus shows a better model fit than the univariate model.

Tab. 3 Table 3 Results of the mediation analysis in men: association between shift work, compatibility of work and private life and psychosomatic health complaints (target variable)Results of the mediation analysis in men: association between shift work, compatibility of work and private life and psychosomatic health complaints

Tab. Regression weights in the first. Second model (Tab. 3 and 4). Effects for men are statistically significant in both models, effects for women reach significance level only without considering covariates. For the indirect effect mediated by "work-life balance" (αβ) of "shift work" on "health", positive estimates are shown for men and women in the univariate and in the adjusted model (Tab. 3 and 4). Since the two-sided bootstrap confidence interval does not contain the value 0 in either group, the significance test based on it rejects the mediation null hypothesis for both the univariate and the adjusted model. Accordingly, partial mediation by work-life balance occurs in the relationship between shift work and health. Consequently, it can be amed that a more difficult work-life balance can be a potential causal factor for negative health outcomes among male and female shift workers.

Discussion

The aim of this study was to investigate the relationship between shift work, work-life balance and health in a Germany-wide representative survey of employees. The aim was to investigate whether there are differences in the compatibility of work and private life between shift workers and employees with normal working hours, how a difficult compatibility affects the health status of employees, and whether a difficult compatibility in shift workers can be a potential cause for negative health consequences.

Work-life balance challenges represent a possible explanation for health consequences of shift work (Tucker and Folkard 2012). Our study is the first to examine the interaction of shift work, work-family conflict, and psychosomatic health for the German workforce, taking psychological and physical working conditions into account comprehensively. The analyses conducted in this study are thereby based on current data from a large representative, Germany-wide sample of dependent employees from 2018. Since operational and family conditions vary across countries, for example in terms of childcare coverage or regular working hours, our study can be used to derive targeted action measures at the national level.

In this study, we have shown that shift workers are more often affected by work-life balance challenges than employees who have a job that is performed between 7 a.m. and 7 p.m. Employees who report more difficult reconciliation are more likely to have psychosomatic complaints. In addition, the association between shift work and psychosomatic complaints is partially explained by the difficulty in balancing work and private life. This is the case for both women and men.

Our results thus confirm the findings reported in the literature on difficult work-life balance among employees in shift work and with staggered working hours (Carlson et al. 2011; Haines et al. 2008; Heponiemi et al. 2010; Jansen et al. 2004). The authors Heponiemi et al. (2010), for example, examined compatibility problems in a cohort of Finnish nurses and showed that, in addition to overtime, organizational equity, number of children, and partnership status, shift work was an important determinant of compatibility problems. In a longitudinal analysis, Jansen et al. (2010) investigates the extent to which work-family conflict influences the organization of working hours. Regarding shift work, the authors showed that employees with Work-Family Conflict had a higher risk of working in day jobs after the 32-month follow-up. Differentiated by shift model, this relationship was found for 3-shift systems, which were more often characterized by slow, backward rotations and longer working hours. Shifted work schedules and shift work are also associated with lower quality of family relationships and child rearing (Strazdins et al. 2006).

Conflict between the demands of work and home life is a significant stressor (Bellavia and Frone 2005) and is related to physical (e.g. Baur et al. 2018; Frone et al. 1996) and mental health status (e.g. Frone 2000; Frone et al. 1997). Our findings on the higher complaint frequency among shift workers are thus in line with the findings of the research. The mediation of work-life balance in the relationship between shift work and health has been addressed in few studies to date (Haines et al. 2008; Wirtz and Nachreiner 2010), which, however, also point to a connection between this chain of effects. Other studies provide results on similar relationships between working hours, compatibility, and health with a focus on excessive working hours (Fein and Skinner 2015) or low work time control (Bohle et al. 2011; McNamara et al. 2011). In addition, there are studies (Falco et al. 2013; Geurts et al. 2003; Lingard and Francis 2005), which did not focus on shift work but did look at other work-related conditions. Falco et al. (2013) examined the role of work-family conflict as a mediator in the relationship between workload and opportunities for influence on the side of influencing variables and strain as a target variable, and showed that work-family conflict is a mediator in the relationship between workload and strain, while mediation between the work-related resource opportunities for influence and strain could not be confirmed.

Our investigation has weaknesses, which are discussed at this point. The analyses presented here are based on cross-sectional data, which do not allow any conclusions to be drawn about causal cause-and-effect relationships. These data are based on subjective assessments of the respondents and are therefore, in contrast to objective measurements, subject to the psychological processes of a question-answer process (Tourangeau 1984). In principle, this processing process can be affected in its result by survey details such as z. B. Response specifications and sequences of questions, but also influenced by recall errors, content-independent agreement tendencies, or socially desirable responses (Schnell 2019). Since work-life balance is only measured with a single item, it may not be possible to fully map the construct and is associated with lower reliability. When measuring work-life balance, we consider only the direction of impact of work on family and personal life. However, since work-related influencing factors are mainly related to compatibility problems of this direction of action (Bellavia and Frone 2005), it can be considered as the significant one for the study of the social explanatory approach of health burdens of shift work. The underlying definition of normal working hours from 7 a.m. to 7 p.m. extends into the evening and may also occupy socially valuable time. Given this definition of the comparison group, the relationship between shift work can be. Health to be underestimated in our study.

Implications

Our study presented here contributes to the state of research on health effects of shift work. The focus is on the role of social effects of shift work. Their significance for the health of employees. This explanatory approach has received little attention in research to date. Difficulty in balancing work and personal life should be recognized as a psychosocial stressor in working life, especially because of its health effects (e.g. Baur et al. 2018; Frone 2000; Frone et al. 1994; Griep et al. 2016). In order to be able to make concrete deductions about socially designed shift models, shift type-specific studies with suitable comparison groups are required.

One approach discussed in the context of reducing the social impact of staggered working hours and shift work is to expand employees' ability to influence their working hours to better adapt them to personal needs (Arlinghaus and Nachreiner 2016; Kelly et al. 2014). Shift schedules can be designed individually in consultation with employees to take into account social and family conditions in addition to commuting and personal preferences (Gartner et al. 2008). However, Arlinghaus and Nachreiner (2016) argue that there are only a limited number of employees who can determine their own working hours, and that even self-determined staggered working hours or shift work can only prevent social effects to a limited extent. Other approaches to address the compatibility problem include adequate child care services, a fast-forward rotating shift system that allows the shift worker at least some work-free evenings per week, but also appropriate information and training services that provide, for example, knowledge about supportive neighborhood services or healthy and social working hours, as far as these can be influenced by the employee (Arlinghaus et al. 2019).

Conclusions

The study presented here examined the relationship between shift work and psychosomatic complaints and the importance of difficult work-life balance as a mediator in this relationship. Shift workers are more often affected by work-life balance problems than employees with normal working hours and show more frequent psychosomatic complaints. Work-life balance is a partial mediator in the relationship between shift work and psychosomatic complaints.

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Muller, G., Luck, M. Shift work, work-life balance, and psychosomatic complaints – A mediation analysis based on the 2018 BIBB/BAuA survey of employed persons. Z. Arb. Wiss. 73, 439-452 (2019).