8285950 Shift work and prescriptions of psychotropic medication among healthcare workers: a prospective cohort study

<h3>Objective</h3> To investigate the associations between shift work and the risk of psychotropic medication prescriptions (PMPs), specifically, neuroleptics, sedatives, hypnotics, and antidepressants, among nursing staff in Region Stockholm. <h3>Material and Methods</h3> Using register-based data, 32,275 nurses and nursing assistants employed for at least one year by Region Stockholm between 2008 and 2019 were included. Exposures were obtained from a computerised employee register while PMPs were obtained from a pharmaceutical register. With one year follow-up, discrete time proportional hazard models were used to estimate hazard ratios (HR), adjusting for covariates. <h3>Results</h3> Increased risks of PMPs were recorded among those who only worked night shifts (HR 1.14, 95% CI 1.08–1.20) compared to those who worked day shifts, and those who worked night shift frequently (&gt;121 times) compared to those who never worked nights (HR 1.04, 95% CI 1.02–1.05) in the preceding year. Among night workers, increased risks were recorded for those who worked 3 or more consecutive nights 13-21 times and &gt;21 times (HR 1.04, 95% CI 1.02–1.07, and HR 1.08, 95% CI 1.06–1.11 respectively) compared to those with none. Night workers who had quick returns from night shift (&lt;28hrs) of &gt;69 times recorded an increased risk compared to those who had 0-9 times (HR 1.06, 95% CI 1.04–1.09). Lastly, decreased risks were recorded for quick returns from afternoon (&lt;11hrs) 18-32 times, 33-49 times, and &gt;49 times (HR 0.94, 95% CI 0.92–0.95, HR 0.94, 95% CI 0.92–0.95, and HR 0.98, 95% CI 0.96–0.99 respectively) compared to day shift only. <h3>Conclusion</h3> Exclusive night work is associated with a small but statistically significant increase in risk of PMPs compared to day work. However, day work only is associated with increased risks compared to afternoon shift.