CDC logoSafer Healthier People  CDC HomeCDC SearchCDC Health Topics A-Z
NIOSH - National Institute for Occupational Safety and Health

Skip navigation links Search NIOSH  |  NIOSH Home  |  NIOSH Topics  |  Site Index  |  Databases and Information Resources  |  NIOSH Products  |  Contact Us

NIOSH Safety and Health Topic:

Work Schedules: Shift Work and Long Work Hours

Organized Labor’s Response to Long Work Hours

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

Bill Kojola
AFL-CIO, Washington , DC


Rapid changes in the organization of work are underway in the United States . These new forms of work organization are being introduced with little attention paid to the potential adverse health and safety consequences for workers (NIOSH, 2002). Among the changes occurring is the number of hours that workers spend on their jobs. Some of the work organization changes, including long hours of work, have been demonstrated to contribute significantly to the risk of workers experiencing occupational injuries and illnesses. In order to protect workers from hazards posed by long hours at work, various responses and intervention measures have been initiated by organized labor to address this problem.


Over the past couple of decades in the United States , the number of hours worked annually has been steadily increasing to the point where US workers now work more hours than workers in many Western European countries (ILO, 1999). Within various US industries, such as mining, manufacturing, and wholesale trade among others, more than a quarter of the workforce work in excess of 40 hours per week (Golden and Jorgensen, 2001). Unfortunately, many workers find that the overtime hours their employer asks them to work are mandatory hours that they are forced to work under the threat of reprisal if they refuse. At some unionized workplaces, workers are being compelled to work crushing numbers of hours that, for example, require working 10 hour shifts seven days a week for weeks on end without a day off. For most hourly wage earners, there are no limits to the hours they can be forced to work, so long as they are paid time-and-a half for all hours worked beyond 40 in a work week as required under the Fair Labor Standards Act (FLSA).

Long Work Hours As A Hazard

In the view of organized labor, we believe that it is most appropriate to view extended or excessive hours of work as a hazard that may pose risks to workers developing injuries or illnesses. Using this perspective and framework, one can then assess the workplace for hazards and risks and once identified, implement intervention measures to reduce risks and protect workers.

Evidence that long hours of work is associated with adverse health and safety outcomes is growing. This confirms our view that long hours should be treated as a hazard. An association between working long hours and worker job injuries has been reported (Landsbergis, 2003: Spurgeon, Harrington & Cooper, 1997). The risk of experiencing a workplace injury has been shown to increase with long work hours and increases exponentially beyond the ninth hour of work (Hanecke, et al., 1998).

Long work hours also appears to have an adverse impact on the cardiovascular system. Overtime work has been demonstrated to increase twenty-four hour average blood pressure in workers who worked 60 or more hours of overtime per month compared to those working 30 or fewer hours of monthly overtime (Hayashi, et al., 1996). Recent work has demonstrated an increased risk of having an acute myocardial infarction (AMI) associated with working greater than 11 hours per day in the month prior to the event while another study reported a twofold increased risk of experiencing an AMI when working 61 hours or more on a weekly basis (Sokejima & Kagamimori, 1998; Liu & Tanaka, 2002).

Organized Labor’s Response

To address the safety and health issues surrounding long hours of work specifically, and work organization more broadly, the unions of the AFL-CIO have been active on a variety of fronts:

  • Overtime Work Group. In response to sharp increases in the hours being worked by union members in certain industries and occupations, particularly due to mandatory overtime, and concern for its impact on safety and health, interested unions affiliated with the AFL-CIO formed the Overtime Work Group in 2001. The work group serves as a focal point for labor movement activity on this issue. Its objective is to gather and disseminate information on health and safety hazards associated with long work hours, develop materials for unions and their members to educate and assist them in addressing problems with excessive hours at work, draft model legislation, encourage research, and to initiate other efforts that will protect workers. This group includes nearly 50 representatives from unions covering workers across a wide variety of industries (manufacturing, construction, health care, service, transportation) and with a wide range of expertise and responsibility (safety and health, legislation, public policy, field mobilization). In 2004, the name of the group was changed to the Work Organization Work Group to reflect a broader focus on the organization of work, including extended hours
  • Encouraging Research. Labor unions have been actively encouraging NIOSH and academic scientists to conduct scientific studies that deepen our understanding of the relationships between long work hours and worker health and safety and to identify effective intervention measures that protect workers. Two union representatives, Nancy Lessin of the Massachusetts AFL-CIO and David LeGrande of the Communications Workers of America served on the original NIOSH NORA Organization Work Team that wrote The Changing Organization of Work and the Safety and Health of Working People that included discussion of long hours of work (NIOSH, 2002). Organized labor continues to be engaged in new research initiatives that are being spun off from the initial NORA work organization report such as this conference on long work hours. Soon, the Overtime Work Group will be preparing a fact sheet for workers on the health and safety hazards of overtime and extended work shifts based on the upcoming NIOSH publication of its summary of recent scientific research findings on overtime.
  • Collective Bargaining. Labor organizations frequently address issues and problems with their employers by negotiating contract language in their collective bargaining agreements. In response to excessive overtime that workers have been forced to work under threat of disciplinary measures, a number of unions have negotiated language in their contracts that place some limitations and restrictions on the employers’ ability to make working overtime hours mandatory. The language would, instead, permit workers to make a voluntary choice to accept an offer to work additional hours. The Overtime Work Group reviewed the language addressing this issue in a number of existing union contracts and prepared a fact sheet that provides examples of contract clauses that place limits on the employer’s use of mandatory overtime and protects workers when they refuse. The fact sheet was distributed to affiliates of the AFL-CIO to help unions negotiate improved protection for their members. The fact sheet can also be viewed on the AFL-CIO’s web page (AFL-CIO, 2004).
  • Strikes. The final strategy in contract negotiation disputes with employers which is at the disposal of organized labor is the withholding of its labor. Strikes have historically been used to advance gains on a wide variety of issues critical to workers. While strikes occur far less frequently today than they did just a few decades ago (for a host of reasons far too complicated to discuss here), recent strikes have been conducted around the United States where the issue provoking the strike included mandatory overtime. These strikes have occurred primarily among nurses at hospitals where they were being forced to work excessive amounts of overtime with no ability to refuse without fear of retaliatory disciplinary measures. Citing concerns for the health of their patients and themselves, striking nurses have been able to strengthen their own resolve while building community support for their demands to place language in their contracts that permit nurses to refuse overtime under certain conditions. The strikes have been a successful approach for nurses to win these protections.
  • Legislation. Labor unions and other organizations have been active recently in various legislative efforts at the state level to successfully place limits on mandatory overtime. This activity has led to six states now having statutes that place some limits on mandatory overtime for nurses or health care workers. The six states include Maine , Maryland , Minnesota , New Jersey , Oregon , and Washington . Bills with similar provisions have been introduced in a number other states as well. The Overtime Work Group has also developed model state legislation on mandatory overtime for health care workers. Bills restricting mandatory overtime for nurses have been introduced in the House and Senate of the US Congress. Legislative activity on excessive overtime is likely to continue in the future, particularly in the health care sector.

Where Do We Go From Here?

Researchers have a need to pose scientific questions that are constructed so as to be answerable within the two-fold constraints of time and money. So, it makes sense that some of the questions that we need to answer as we put forward a research agenda on long hours of work will be relatively narrow in their scope. For example, it is essential that we reach a common set of terms and definitions that apply to long work hours. We certainly need to understand what industries and occupations are working long hours and what proportion of overtime hours are worked voluntarily/involuntarily. We’ll also certainly need to examine the relationship with long work hours and workers injuries, illnesses, and measures of stress and fatigue.

But we also need to place, and study, long work hours within the context under which those hours are being worked. It will be necessary not to merely examine the time being spent working but to look simultaneously at how that work is organized. For example, researchers will need to examine both the time spent on a job as well as the nature and intensity of the work being performed during that time. The intensity, a measure of how the work is organized, governs variables such as workload, pace, staffing levels, length and number of rest breaks, etc. These various parameters could have significant influence related to measures of outcomes like injuries, illnesses, and stress.

However, from our perspective, it is research on intervention and prevention that is most critically needed for workers. While we recognize that it can be difficult to conduct intervention research, it is ultimately essential if workers are to be protected. The prominence of intervention research needs to be raised, not only regarding long working hours, but across the entire spectrum of workplace safety and health. The interventions used and studied must be focused on making changes in the workplace that reduce or eliminate exposure to hazards rather than at the level of the individual worker and his or her coping skills. We must also be extremely careful not to advocate or implement injury and illness intervention programs that blame victims or discipline those who are injured or made sick.

Organized labor will continue its efforts at the bargaining table to address issues of long hours of work, mandatory overtime and work organization through contract language with its employers. And we’ll remain involved in legislative efforts to resolve problems such as mandatory overtime in the health care industry. But dealing with individual employers and small sectors of our economy will not likely move the ball forward enough to address these problems for all workers who are impacted. To ultimately be successful, we’ll need to have broader public policy discussions and decisions over these matters. At this point in time, our colleagues in Europe and Canada are far ahead of us in this regard. They’re examining issues of work organization and work-family balance, including long working hours, on a policy scale that far surpasses what we’re doing in the United States .

Making these issues more prominent won’t be easy to do in the U.S. , however. Many employers in this country view how they organize their workplaces and the number of hours they assign to workers as an exclusive core management function largely immune from outside influences. And the upcoming revisions to the Fair Labor Standards Act, estimated to remove more than 8 million workers from their right to overtime pay, raises our concern that employers will assign workers to even greater numbers of hours, thus compounding the problem (Eisenbrey & Bernstein, 2004). If long hours are the problem, then the solutions need to revolve around reducing working hours and changing the manner in which the work is organized. If we use the framework that long hours of work constitute a hazard, then we can overcome these impediments to prevention and argue that exposure to the hazard needs to be reduced in order to protect workers. To help us achieve this objective, we need additional research to identify those aspects of long working hours that do pose hazards and risks to workers so that we can take the action to intervene and prevent adverse health and safety outcomes. It is with this approach that workers can be assured of their right to a safe and healthy workplace.


AFL-CIO. (2004). Restrictions on mandatory overtime. Examples of contract language. Retrived from

Eisenbrey, R., & Bernstein, J. (2003). Eliminating the right to overtime pay. Briefing paper. Washington , DC : Economic Policy Institute. Available at

Golden, L., & Jorgensen, H. (2001). Time after time: Mandatory overtime in the U.S. economy . Briefing paper. Washington , DC : Economic Policy Institute. Available at

Hanecke, K., Tiedemann, S., Nachreiner, F., & Grzech-Sukalo, H. (1998). Accident risk as a function of hour at work and time of day as determined from accident data and exposure models for the German working population. Scandinavian Journal of Work and Environmental Health,24 Suppl. 3, 43-48.

Hayashi, T., Kobayashi, Y., Yamaoka, K., & Yano, E. (1996). Effect of overtime work on 24-hour ambulatory blood pressure. Journal of Occupational and Environmental Medicine, 38, 1007-1011.

International Labor Office. (1999). Key indicators of the labour market. Geneva : ILO.

Landsbergis, P.A. (2003). The changing organization of work and the safety and health of working people: a commentary. Journal of Occupational and Environmental Medicine, 45, 61-72.

Liu, Y., & Tanaka, H. (2002). Overtime work, insufficient sleep, and risk of non-fatal acute myocardial infarction in Japanese men. Occupational and Environmental Medicine, 59, 447-451.

NIOSH (2002). The Changing Organization of Work and the Safety and Health of Working People. Cincinnati : Department of Health and Human Services, National Institute for Occupational Safety and Health , Publication No. 2002-116.

Sokejima, S., & Kagamimori, S. (1998). Worj=king hours as a risk factor for acute myocardial infarction in Japan : case-control study. British Medical Journal, 317, 775-780.

Spurgeon, A., Harrington, J.M., & Cooper, C.L. (1997). Health and safety problems associated with long working hours: a review of the current position. Occupational and Environmental Medicine, 54, 367-375.

Work Schedules

tired worker, taxi, hospital worker

< Work Schedules Main Page

Extended Abstracts from Conference Presentations:

Filling the Workware Warehouse: What to Store with Regard to Long Work Hours

Industry Trends, Costs and Management of Long Working Hours

Modelling the Impact of the Components of Long Work Hours on Injuries and "Accidents"

Organized Labor’s Response to Long Work Hours

Overtime, Occupational Stress, and Related Health Outcomes: A Labor Perspective

Work Hours as a Predictor of Stress Outcomes

Working in a 24/7 Economy: Challenges for American Families

On This Page...