Research into the effects of on-call work

These are my working notes on the effects that on-call work has on personal health and well-being. This is based purely on academic literature and I have done my best to keep my personal experiences of being on-call out of these notes.

Also, “on-call work” in this sense means being on stand-by, where one may be alerted 24/7 during a shift and expected to be available for work activities on short notice (let’s say within 30 minutes) in response to an alert.

As such, these conclusions likely do not apply, or apply to a much lesser extent, within companies that are able to run a “follow the sun” rotation where there is little to no on-call expectation outside of regular working hours.

General conclusions

  1. The uncertainty and unpredictability which comes from the knowledge that at any given moment, an alert might trigger to which you will be expected to respond, is likely to be a greater source of stress and fatigue than the actual work of responding to incidents. (Bamberg et al. 2012; Ziebertz et al. 2015; Dettmers et al. 2016)

    People with a higher tendency to worry might be extra sensitive to this. (Bamberg et al. 2012)

  2. Being on-call reduces the opportunities people have to disengage fully from work-related topics, limiting their ability to recover from work. As such, time spent on-call, even when there are no incidents at all, should not be considered leisure time. (Dettmers et al. 2016)

  3. Being on-call makes it more likely people avoid activities that are complex and/or require planning. This includes social activities like meeting friends as well as household activities such as cleaning. (Bamberg et al. 2012)

    In at least one study (Bamberg et al. 2012), there was no effect on people’s physical activities (sports).

  4. Women are likely impacted more greatly than men. A paper which analyzed 228 Australian respondents to an anonymous online survey (Roberts et al. 2019) concludes that on average, women are more significantly impacted by on-call work than men. It suggests this is caused by the imbalanced domestic burden that exists between males and females in Australia (which can likely be extrapolated to any modern western society).

  5. Irregular working hours/on-call shifts are more likely to lead to work-family conflict than regular working hours.

  6. In at least one study (Bamberg et al. 2012), on-call work had no significant effect on sleep quality.

Source notes
  • Ziebertz et al. (2015)
    • This study examined the relationship between on-call duty exposure (active and total on-call hours a month, number of calls per duty) and employees' experiences of being on-call (stress due to unpredictability, ability to relax during inactive on-call periods, restrictions during on-call duties, on-call work demands, and satisfaction with compensation for on-call duties) on the one hand and fatigue, strain-based and time-based work-home interference (WHI), and perceived on-call performance difficulties (PPD) on the other hand.
    • Our results suggest that it is employees' experience of being on-call, especially the experience of stress due to the unpredictability, rather than the amount of exposure, that is related to fatigue, WHI, and perceived on-call performance difficulties.
  • Dettmers et al. (2016)
    • This study investigates the relation of daily extended work availability with psychological and physiological well-being and the mediating role of recovery experiences. We hypothesized that recovery is limited under conditions of extended work availability, which may impair well-being.
    • This diary study provided evidence that extended work availability is associated with impaired psychological and physiological well-being and fewer daily recovery experiences. Consistent with hypothesis 1a, the participants reported less energetic arousal, valence, and calmness on days with extended availability requirements.
    • extended work availability had an independent effect after controlling for job contacts.
    • consistent with hypotheses 2a and 2b, participants reported less control over nonwork activities and less psychological detachment on days with ex- tended availability requirements relative to days without extended availability requirements.
    • As demonstrated by our test of hypothesis 2, extended work availability significantly diminished the recovery experiences of control and detachment, and control and detachment have been demonstrated to affect well-being (Sonnentag, Binnewies, et al., 2010; Sonnentag & Fritz, 2007).
    • Unlike other studies on recovery experiences that focus on detachment (Fritz, Yankelevich, et al., 2010; Park et al., 2011; Sonnentag, Binnewies, et al., 2010), this study revealed the particular role of control, which appears to be important in contexts of extended availability.
    • This study provides evidence that extended work availability during nonwork hours negatively affects employee well-being and recovery. Nonwork hours during which employees are expected to respond to work issues constrain employee behavior and cannot be considered leisure time because recovery—a crucial function of leisure time—is restricted under such circumstances. The effort– recovery model (Meijman & Mulder, 1998) and previous studies have demonstrated that sufficient recovery is crucial for the maintenance of health (Kivimäki et al., 2006) and work capability (Sonnentag, Binnewies, et al., 2010).
    • These findings suggest that it is preferable to have shorter periods of availability for fewer employees who are contacted more frequently than longer periods during which more employees are available and are contacted less frequently.
    • If extended availability is indispensable for organizations because of customer demands or technical requirements, then organizations should design availability requirements to minimize behavioral restrictions on employees and reduce the effects of availability on control.
  • Roberts et al. (2019)
    • On-call work is prevalent worldwide and is associated with adverse outcomes, including disrupted sleep, impaired leisure time, and difficulties in mentally detaching from work. Limited studies specifically explored whether men and women experience on-call differently; therefore, our aim was to investigate whether sex differences exist in terms of both the impacts of and coping strategies to deal with on-call work.
    • Respondents indicated their use of eight basic coping strategies in response to the question, “To what extent do you use the following strategies when you experience problems?”. The eight basic coping strategies were problem solving, cognitive restructuring, social support, expressing emotions, problem avoidance, wishful thinking, self-criticism, and social withdrawal when faced with problems.
    • A greater percentage of females (42.9% compared with 21.5%) indicated that they agreed/strongly agreed that they were solely responsible for running their household/caring for their family compared to the male respondents, who were more likely to work full-time. This information is important for workers and employers managing on-call work; the unpredictable burden of on-call work may be more difficult to manage for individuals who are also managing their household—in this sample, this was largely the female respondents.
    • Perceived interference was higher in female respondents across all three aspects (leisure time use, domestic activities in time off, non-domestic activities in time off). This was most pronounced in leisure time, with female respondents indicating that their on-call work interferes a lot/very much (57.1%) or somewhat (29.6%) with the sorts of things they would like to do in their leisure time.
    • Results indicated that female respondents were more likely to be responsible for running their household, and reported that being on call disturbed leisure, domestic, and non-domestic activities “a lot/very much”. While both males and females adopted engaged coping styles, a greater proportion of males used “problem solving” and a greater proportion of females “talked about their feelings” when managing on-call work. These findings provide valuable insight into how males and females are differentially impacted and cope with on-call work.
    • Findings suggest that females perceive the impact of on-call work to be greater on all fronts (domestic, non-domestic, and leisure) and we propose that these differences may be related to the imbalanced domestic burden that exists between males and females in Australia.
  • Golden (2015)
    • Less than 11 percent of workers on “regular” work schedules report “often” experiencing work-family conflict in contrast with as many as 26 percent of irregular/on-call shift employees, and 19 percent of rotating/split shift workers. Similar differences appear for reporting that they “never” experience work-family interference.
    • Overtime work that is required by the employer increases the likelihood of having an irregular schedule and particularly of working on rotating/split shifts.
    • Work-family conflict is worsened not only by longer weekly hours of work, but also by having irregular shift work.
    • The association between work-family conflict and irregular shift work is particularly strong for salaried workers, even when controlling for their relatively longer work hours.
    • Irregular/on-call work is moderately associated with higher work stress, but rotating and split-shift times are not.
    • Mandatory overtime work contributes to both work-family conflict and work stress.
  • Bamberg et al. (2012)
    • Using a daily survey method, 31 employees from an Information Technology Service Organisation filled out a questionnaire four times a week while they were on call and another four times a week while they were not on call.
    • Results showed increases in irritation and negative mood and decreases in social activities, household activities, and low-effort activities.
    • There were no significant differences between those employees who were actually called in to work during the on-call period and those who were not.
    • In the current paper, we focus on on-call work that occurs within a regular employment contract in addition to a fixed work schedule.
    • Because they have to be available, there are restrictions on their locations and leisure activities. Being on call may mean fewer possibilities for recreation and more work.
    • The connection between work and health has often been discussed within the realm of stress at work
    • Within this field of research, the need for recovery has been emphasised
    • When there are calls within the on-call period, additional work demands for the employees arise. Without calls, being on call includes the possibility of interruptions. It is more difficult to achieve a cognitive distance from work, a cognitive switch-off is rarely possible, and relaxation is severely restricted. We can therefore assume that experiencing an on-call period has detrimental effects on employees.
    • Unpredictable needs or emergency cases are frequent causes of on-call work. Employees have to work effectively, and errors may have serious consequences and may be more visible than errors in everyday working life. Thus, during the on-call period, failures may be attributed more to the quality of the work and to the competences of the employees than during regular work
    • Calling colleagues for help is connected with the risk of disturbing their leisure and recreation time. Moreover, asking for help can be interpreted by others as a sign of incompetence. Therefore, on-call work can be connected with an apprehension of social stress.
    • Sonnentag and Jelden (2009) reported that job stressors are negatively related to sports activities and positively related to low-effort activities
    • During the on-call period, it is not certain whether the need to work will arise or how demanding the job will be. Several authors have emphasised that this uncertainty creates stress (McGrath, 1976)
    • When on-call work is accepted and even taken for granted and when employees are not restricted, being on call has fewer negative health consequences.
    • Most of the participants (84%) felt severely restricted by on-call work. They mostly stayed at home or avoided doing activities that were demanding or time-consuming.
    • With regard to the hypotheses, we can state that in contrast to H1, the results of our study revealed no effect of on-call work on cortisol levels
    • With respect to activities, no significant effects on work-related activities but significant effects on household activities were found.
    • [..] significant negative effects on social activities (H3.2) and low-effort activities (H3.3), which were in line with our hypotheses. However, we found no effect on physical activities.
    • Different kinds of activities were influenced by being on call: Being on call influenced relaxation because low-effort activities were shortened. In addition, social activities such as meeting friends, and household activities such as cleaning were reduced during the on-call period.
    • Coping with being on call can be seen as a process of self-regulation that impedes further self-regulation. In particular, being on call affects some activities that are comparatively complex, such as social activities, or some that need planning and are less common, such as household activities maybe for men (e.g. Lundberg & Frankenhaeuser, 1999), who mainly comprised our sample.
    • For employees with a higher tendency to worry, the effects of on-call work on irritation and on social activities were stronger.

References

Bamberg, Eva, Jan Dettmers, Hannah Funck, Birgit Krähe, and Tim Vahle-Hinz. 2012. “Effects of On-Call Work on Well-Being: Results of a Daily Survey.” Applied Psychology: Health and Well-Being 4 (3): 299–320. https://doi.org/10.1111/j.1758-0854.2012.01075.x.

Dettmers, Jan, Tim Vahle-Hinz, Eva Bamberg, Niklas Friedrich, and Monika Keller. 2016. “Extended Work Availability and Its Relation with Start-of-Day Mood and Cortisol.” Journal of Occupational Health Psychology 21 (1): 105–18. https://doi.org/10.1037/a0039602.

Golden, Lonnie. 2015. “Irregular Work Scheduling and Its Consequences.” Economic Policy Institute (blog). April 9, 2015. https://www.epi.org/publication/irregular-work-scheduling-and-its-consequences/.

Roberts, Bernadette, Grace Vincent, Sally Ferguson, Amy Reynolds, and Sarah Jay. 2019. “Understanding the Differing Impacts of On-Call Work for Males and Females: Results from an Online Survey.” International Journal of Environmental Research and Public Health 16 (3): 370. https://doi.org/10.3390/ijerph16030370.

Ziebertz, Carla M., Madelon L. M. van Hooff, Debby G. J. Beckers, Wendela E. Hooftman, Michiel A. J. Kompier, and Sabine A. E. Geurts. 2015. “The Relationship of On-Call Work with Fatigue, Work-Home Interference, and Perceived Performance Difficulties.” BioMed Research International 2015. https://doi.org/10.1155/2015/643413.