Interventions to mitigate fatigue in shift workers: a systematic review
Year: 2026
Type: article
Study design: Systematic Review
Abstract: Shift work disrupts circadian regulation, impairs sleep quality, and hinders recovery, increasing occupational safety risks. Most existing reviews focus on single occupations or isolated countermeasures, limiting cross-industry synthesis. This systematic review synthesized workplace fatigue management interventions across diverse shift-working occupations, classified them by mechanism of action, and evaluated both their reported effectiveness and underlying methodological rigor. Following PRISMA guidelines, systematic searches were conducted across PubMed, Scopus, and Web of Science through November 8, 2025. Eligible peer-reviewed studies evaluated workplace interventions among active shift workers without confounding health conditions and measured fatigue outcomes. Study quality was evaluated using the Downs and Black checklist. Given substantial clinical and methodological heterogeneity, findings were narratively synthesized using an effect-direction vote-counting framework. Eighty-nine studies were included (1988–2025), with healthcare accounting for 46 studies. Sleep and recovery interventions, primarily scheduled workplace napping, showed the highest reported success rate, reducing fatigue in 15 of 16 studies (93.8%). Digital and technology-assisted tools were effective in 8 of 9 studies (89%), lifestyle and behavioral interventions in 10 of 12 studies (83%), and work organization or environmental redesign in 29 of 44 studies (66%, with 9 finding no effect and 6 reporting increased fatigue). Pharmacological and complementary countermeasures yielded mixed results (5 of 8 effective); modafinil was a consistently effective for acute vigilance deficits, but was tested only in small medical undergraduates, military, and aviation samples. Crucially, high reported effectiveness did not correlate with study quality. Only 19 of 89 studies (21.35%) were randomized controlled trials, and fewer than half demonstrated good or excellent methodological quality. While sleep interventions lacked randomized designs entirely, pharmacological studies had the highest proportion of high-quality trials (75%). Intervention effectiveness must be interpreted alongside evidence quality. Scheduled napping showed the most reliable fatigue reduction, although this finding requires confirmation in randomized trials. Job-centered schedule redesign remains the fundamental, system-wide approach because it avoids reliance on individual compliance, despite moderate empirical rigor. Digital and behavioral interventions serve as valuable, context-dependent approaches. Future research should emphasize standardized fatigue metrics, randomized designs, and underrepresented, high-risk occupational sectors.
Source: BMC Public Health
Authors: Mohammad Rahdar, Soheyla Ahmadi Charkhabi, Morteza Zare, Niloofar Rahgoshay, Reza Kazemi
Institution: Shiraz University of Medical Sciences
Language: English
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,290
OpenAlex ID: W7214444270
FWCI:
Cites:
Cited by:
Related to: