Flexible work tied to some health benefits

NEW YORK (Reuters Health) - People who have some control over their work schedules may enjoy better physical and mental well-being than those in less-flexible jobs, a new research review suggests.

In an analysis of 10 previously published studies, researchers found that certain work conditions that gave employees some control -- self-scheduling of shift work, and gradual or partial retirement -- were linked to health benefits.

Those benefits included lower blood pressure and heart rate, and better quality sleep and less fatigue during the day.

The findings, published in the Cochrane Database of Systematic Reviews, do not prove that flexible work schedules lead to better health. But they support the theory that "control at work is good for health," say the researchers.

According to that theory, reduced stress may be what bestows the benefits -- though there are other possibilities as well, explained Dr. Clare Bambra of Durham University in the UK, the lead researcher on the review.

A flexible work schedule might, for instance, make it easier for people to find time for exercise, Bambra told Reuters Health in an email.

For years, studies have found links between "high job strain" and heightened rates of heart disease, depression and other ills. Researchers define high job strain as work that is demanding but allows employees little to no control over how they work.

So there is increasing interest in whether there are health benefits to be gained from non-traditional work conditions -- like self-scheduling, "flextime," telecommuting from home and job sharing (where two or more people split one full-time position).

For their review, Bambra and her colleagues identified 10 studies involving a total of 16,603 workers that met certain quality criteria; all had to follow workers over time -- for at least six months -- and had to compare employees who had flexible work conditions with a group that did not.

Four studies focused on self-scheduling policies that allowed shift workers to help control the rotation of their work hours. Three found evidence of health benefits. In one, for example, airline maintenance workers' systolic blood pressure (the first number in a blood-pressure reading) dipped by an average of six points after seven to eight months, while their resting heart rate declined by an average of 6 beats per minute.

Two studies examined the effects of partial or gradual retirement, finding that workers who chose that type of retirement -- rather than having it forced upon them -- reported better emotional well-being over one year than workers who had less control over their retirement.

There was only one study of "flextime" work conditions, where employees have some say in when their daily work schedule begins and ends. The researchers found no changes in workers' self-rated physical health or stress levels over six months.

The researchers found no studies of telecommuting or job sharing that met their quality criteria -- pointing to a need for more research into those types of work conditions, according to Bambra.

A shortcoming of all the studies in the review is that none was a randomized controlled trial -- where one group of employees would be randomly assigned to a flexible work situation, then compared over time with a group of similar employees who stayed with the standard work routine.

Those types of studies, Bambra said, "are needed before we can make any real conclusions. The data we have is indicative rather than definitive."

Still, she and her colleagues say, there is no evidence that flexible work conditions stand to harm employees' well-being. So for now, they conclude, employers and policy makers can consider self-scheduling and gradual retirement to be "plausible means" for promoting employee health.

SOURCE: Cochrane Database of Systematic Reviews, online February 17, 2010.