Despite extensive research showing that shift work compromises employee health, jobs that require work outside the traditional daytime hours of 8:00 AM to 6:00 PM have become ubiquitous across economically developed nations. Employers enact work scheduling policies based on the needs of company stakeholders and without evidence of the effect of shift work on health care costs, even though the companies ultimately bear the majority of those costs. Researchers Megan McHugh, Dustin D. French, Mary M. Kwasny, Claude R. Maechling, and Jane L. Holl examined the additional health care costs incurred by two large manufacturing companies due to their shift work requirements in this brief published in the Journal of Occupational and Environmental Medicine. 


The research team combined health care claims data from two large manufacturers with risk ratios on the increased risk of several chronic conditions with shift work. 

They found that: 

  • In a manufacturing company of 2,600 shift workers, there were 78 excess cases of diabetes due to shift work and 97 excess cases of obesity. 
  • The company incurred over $1.4 million per year in excess healthcare costs due to chronic illnesses engendered by the company’s shift work policies. 

The researchers concluded that, overall, employers incur substantial excess health care costs due to shift work policies. 

Implications for Policy and Practice 

Although excess health care costs associated with shift work is substantial, it is unlikely to be large enough to compel companies to alter their shift work policies as these changes could cause significant challenges. For example, if companies sought to accommodate daytime-only shifts by eliminating overnight production, doing so would likely reduce revenues by half. For large manufacturing plants like those included in this study, revenues could drop by hundreds of millions of dollars per year. 

Nevertheless, these results may serve as a “wake up call” to employers that rely on shift workers, and encourage them to invest in prevention and disease management. Offerings like intensive behavioral counseling related to improved nutrition, healthy eating behaviors, and increased physical activity to reduce risk of cardiovascular disease would serve the dual purpose of potentially improving quality of life for employees while also reducing healthcare costs for the company. 

Related Evidence

  • Published April 2, 2020

    Jobs that require work outside the traditional daytime hours of approximately 8 AM to 6 PM have become ubiquitous across economically developed nations, but extensive research shows that shift work and long work hours may compromise employee health. Although employers recognize the potential harmful effects of shift work, many argue in favor of maintaining it, citing the nature of the work requiring a 24/7 schedule (e.g., public safety), maximization of production capacity in response to consumer demand, and in some cases, employee preference for long shifts to maximize days off and pay. In recent publications, P4A researcher Megan McHugh, doctoral student Adovich Rivera, and their colleagues from Northwestern’s Manufacturing and Health Research Program provide evidence on how shift work affects the incidence of chronic illness and overall worker well-being.

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