flexible working hours essay

Flexible Working Hours: The Main Benefits Essay

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Over the past few decades, an evident tradition has developed, dictating the norms of the working regime. Working hours from 9 to 5 have become a kind of anthem for many office workers. However, the latest trends force people to increasingly pay attention to alternatives. In light of these developments, the key issue is the widespread adoption of flexible working hours. Currently, workers are leaving work searching for more profitable alternatives and paying more attention to the balance of life and work. On the other hand, employers are forced to adapt, trying to respond correctly. However, current conditions show that the only option for employers is to offer flexible working hours. This paper aims to confirm this thesis by analyzing the literature.

The need to take some action in changing the working regime is highly relevant to employers. Moreover, if they do not take some timely measures, difficult times can come for most organizations. The reason for this is the phenomenon that has been called the Great Resignation. In half of 2021, about 20 million American workers voluntarily left their jobs searching for other positions (Smith, 2021). Although the pandemic partly caused this phenomenon, many people left, not agreeing with their environment. For many, work flexibility not only means not showing up to the office at set times but also the ability to have more meaningful interactions with colleagues. Pursuing these values drives people out of work, and organizations that do not implement modifications will soon be at a disadvantage.

The value of changes in the working regime and the availability of a more flexible schedule become more relevant for the workers themselves. First, such advantages allow them to realize many different opportunities. One of the most basic of these concepts is the balance between professional activities and private life. Studies show that achieving the right proportions between them can improve a person’s physical, emotional, and mental condition (Fletcher, 2021). Thus, a more flexible working regime is closely related to the quality of human life. The value of this factor has increased significantly in recent years. Consequently, the demands for a more flexible regime are also dictated by the desire to live better, which society cannot ignore.

Thus, it is clear that providing workers with flexible hours is necessary for employees to improve their life’s quality and for employers who depend on the environment. From the first perspective, a flexible regime will allow professionals to better build their lives and carry out their duties more efficiently. For employers, such changes will be just another adaptation to an ever-changing market, which the state must further promote. This transition can be achieved by borrowing remote and outsourced work techniques, combining them with a more responsive structure devoid of elements that complicate communication. With the successful implementation of such techniques, flexible working hours and the absence of the need to be in the office from 9 to 5 may soon become a new traditional form of professional activity.

Smith, J. (2021). Is flexibility key to addressing the Great Resignation?

Fletcher, M. (2021). How to improve work-life balance.

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Flexible working conditions and their effects on employee health and wellbeing

Flexible working conditions are increasingly popular in developed countries but the effects on employee health and wellbeing are largely unknown. 

To evaluate the effects (benefits and harms) of flexible working interventions on the physical, mental and general health and wellbeing of employees and their families.  

Search methods

Our searches (July 2009) covered 12 databases including the Cochrane Public Health Group Specialised Register, CENTRAL; MEDLINE; EMBASE; CINAHL; PsycINFO; Social Science Citation Index; ASSIA; IBSS; Sociological Abstracts; and ABI/Inform. We also searched relevant websites, handsearched key journals, searched bibliographies and contacted study authors and key experts.

Selection criteria

Randomised controlled trials (RCT), interrupted time series and controlled before and after studies (CBA), which examined the effects of flexible working interventions on employee health and wellbeing. We excluded studies assessing outcomes for less than six months and extracted outcomes relating to physical, mental and general health/ill health measured using a validated instrument. We also extracted secondary outcomes (including sickness absence, health service usage, behavioural changes, accidents, work‐life balance, quality of life, health and wellbeing of children, family members and co‐workers) if reported alongside at least one primary outcome.

Data collection and analysis

Two experienced review authors conducted data extraction and quality appraisal. We undertook a narrative synthesis as there was substantial heterogeneity between studies.   

Main results

Ten studies fulfilled the inclusion criteria. Six CBA studies reported on interventions relating to temporal flexibility: self‐scheduling of shift work (n = 4), flexitime (n = 1) and overtime (n = 1). The remaining four CBA studies evaluated a form of contractual flexibility: partial/gradual retirement (n = 2), involuntary part‐time work (n = 1) and fixed‐term contract (n = 1). The studies retrieved had a number of methodological limitations including short follow‐up periods, risk of selection bias and reliance on largely self‐reported outcome data. 

Four CBA studies on self‐scheduling of shifts and one CBA study on gradual/partial retirement reported statistically significant improvements in either primary outcomes (including systolic blood pressure and heart rate; tiredness; mental health, sleep duration, sleep quality and alertness; self‐rated health status) or secondary health outcomes (co‐workers social support and sense of community) and no ill health effects were reported. Flexitime was shown not to have significant effects on self‐reported physiological and psychological health outcomes. Similarly, when comparing individuals working overtime with those who did not the odds of ill health effects were not significantly higher in the intervention group at follow up. The effects of contractual flexibility on self‐reported health (with the exception of gradual/partial retirement, which when controlled by employees improved health outcomes) were either equivocal or negative. No studies differentiated results by socio‐economic status, although one study did compare findings by gender but found no differential effect on self‐reported health outcomes.  

Authors' conclusions

The findings of this review tentatively suggest that flexible working interventions that increase worker control and choice (such as self‐scheduling or gradual/partial retirement) are likely to have a positive effect on health outcomes. In contrast, interventions that were motivated or dictated by organisational interests, such as fixed‐term contract and involuntary part‐time employment, found equivocal or negative health effects. Given the partial and methodologically limited evidence base these findings should be interpreted with caution. Moreover, there is a clear need for well‐designed intervention studies to delineate the impact of flexible working conditions on health, wellbeing and health inequalities.

Plain language summary

Flexible working arrangements, such as flexitime and teleworking, are becoming more common in industrialised countries but the impacts of such flexibility on employee health and wellbeing are largely unknown. This review examined the health and wellbeing effects of flexible working arrangements which favour the worker as well as those dictated by the employer (for example, fixed‐term contracts or mandatory overtime). 

Ten controlled before and after studies were found which evaluated the effects of six different types of flexible working arrangement on employee health and wellbeing: self‐scheduling (n = 4); flextime (n = 1); overtime (n = 1); gradual retirement (n = 2); involuntary part‐time (n = 1) and fixed‐term contract (n = 1). 

Self‐scheduling of shift interventions and employee controlled partial/early retirement were found to improve health (including systolic blood pressure and heart rate; tiredness; mental health, sleep duration, sleep quality and alertness; and self‐rated health status) and/or wellbeing (co‐workers' social support and sense of community) and no ill health effects were observed.

The studies of overtime working, flexitime and fixed‐term contracts found no significant effects on physical, mental or general health or on any of the wellbeing outcomes examined. Importantly, however, the study on overtime failed to provide detailed information on either the amount or duration of overtime worked, so it is therefore difficult to draw any conclusions regarding the effects of overtime on workers' health and wellbeing.

Overall, these findings seem to indicate that flexibility in working patterns which gives the worker more choice or control is likely to have positive effects on health and wellbeing. However, given the small number of studies included in the review and their methodological limitations, caution should be applied to this conclusion. Well‐designed studies are therefore needed to further explain the relationship between flexible working and health and wellbeing.

Summary of findings

Summary of findings for the main comparison.

BP = blood pressure; Con = control; CWW = compressed working week; ESS = Epworth Sleepiness Scale; GHQ = General Health Questionnaire; HDL = high‐density lipoprotein; Int = intervention; LDL = low‐density lipoprotein; SD = standard deviation

Summary of findings 2

Summary of findings 3

CWW = compressed working week; PA = physical activity

It is well established that work and the workplace are important social determinants of health ( Acheson 1998 ; CSDH 2008 ; Townsend 1992 ). Not only is work vital in terms of personal income, adequate quality work also fulfils human needs by shaping personal identity, securing social status and giving structure and purpose to daily life ( Black 2008 ; Waddell 2006 ). According to Karasek’s demand‐control model ( Karasek 1979 ; Karasek 1990 ) jobs characterised by excessive psychological demands coupled with low decision latitude (low decision authority and low skill utilisation) are stressful as they do not enable individual autonomy, are conducted in high‐pressure contexts and can thus lead to an increased risk of stress‐related morbidity. A considerable body of evidence from the Whitehall studies supports the influence of the psychosocial work environment on health (see Bosma 1997 ; Kuper 2003 ; Marmot 1991 ). For example, high psychological job demands combined with low control or decision latitude (a combination known as high job strain) in the workplace have been associated with adverse outcomes relating to risk of coronary heart disease ( Bosma 1997 ), mental health ( Stansfeld 1999 ) and sickness absence ( North 1996 ). Conversely, social support from co‐workers and supervisors in the workplace has been shown, in some studies, to reduce ill health effects ( Stansfeld 1997 ). The term high ‘iso‐strain’ is used to refer to working conditions defined by high demands, low control and low social support.

Occupations in both the industrial and service sectors tend to be associated with high strain and iso‐strain ( Marmot 2006 ). The distribution of low control and low support has been shown to follow the social gradient (with high strain and iso‐strain being found in low status workers) although the same its not true for high job demands which tend to be disproportionately spread amongst higher occupational grade or managerial status workers ( Bosma 1997 ; Siegrist 2009 ). Importantly, the risk of stress‐related diseases is heightened with prolonged exposure over the life course ( Marmot 2006 ).

Critics of the Karasek model have prioritised certain aspects of the model, for example by arguing that control may be more important than psychological demands ( Godin 2003 ; Siegrist 2004 ) and others have drawn attention to mediating factors such as mastery, self‐efficacy or social support in the pathway between psychosocial work factors and physical or psychological morbidity ( Marmot 2006 ). In addition, researchers have cautioned against the reliance on workplace psychosocial models in isolation to explain health outcomes and have emphasised the importance of non‐work related, individual level factors such as income, status in the community and health behaviours ( Bartley 2004 ). The effort‐reward imbalance model represents an alternative but nonetheless complementary hypothesis which takes account of the concept of social reciprocity ( Marmot 2006 ). The premise of the effort‐reward imbalance model is that psychosocial stress results from a mismatch between the efforts made by workers and the rewards they receive from their employer in terms of pay, esteem, job security and career opportunities ( Siegrist 1996 ). Working with low rewards is thought to induce stress responses which lead to adverse health outcomes ( Siegrist 2009 ). 

In acknowledgement of these relationships, policymakers are increasingly targeting interventions to improve health and reduce health inequalities in the workplace ( Black 2008 ; CSDH 2008 ). Interventions can be targeted at either the individual level (e.g. improving individual coping strategies), the micro‐organisational level (e.g. re‐structuring work tasks) or the macro‐organisational level (e.g. changing the dynamics of decision‐making) level ( Bambra 2007 ).  Karasek 1992 suggests that work tasks can be restructured in three key ways: (i) job enrichment and enlargement (task variety); (ii) collective coping and decision‐making (teamworking); or (iii) the use of autonomous production groups, all of which are likely to increase levels of control and possibly supervisor and co‐worker support. Based on the demand‐control‐support model, it is suggested that interventions of this nature which increase levels of worker control are likely to have positive effects on health outcomes, particularly psychological health. Indeed, two systematic reviews which considered the effects of both macro‐ ( Egan 2007 ) and micro‐organisational ( Bambra 2007 ) (task restructuring) level changes to the work environment found that interventions which increased worker control and autonomy were associated with some positive changes in health outcomes, most notably reductions in anxiety and depression ( Egan 2007 ). In terms of differential effects by socio‐economic status, little evidence was found ( Bambra 2007 ).

Description of the intervention

In this review flexible working conditions are characterised by three working principles: contractual flexibility (employer or employee fluidity regarding employment contracts), spatial flexibility (employer or worker control and choice regarding place of work) and temporal flexibility (employer and worker choice regarding the distribution of worked hours) ( Hill 2008 ). By way of illustration, examples include (but are not limited to): teleworking and home working (working off site and communicating with the office by telecommunication links); job sharing (two or more people sharing the responsibilities of a full‐time job by working part‐time on an ongoing basis); flexitime (a variable work schedule which deviates from traditional 'office' hours) and other non‐standard working schedules, such as annualised hours (hours averaged over a year). 

Flexible working conditions are becoming increasingly common within modern economies, and in many countries legislation has been introduced enabling certain groups of employees to request flexible working. For example, Scandinavian countries in particular grant extensive flexible working rights, such as parental leave, flexitime and other family friendly provisions to employees ( Brandth 2001 ; Pärnänen 2007 ). Similarly, since 2003 the right to request flexible working conditions has been granted to all UK employees with children aged under six years or to those with caring responsibilities ( BERR 2008 ). This right has recently been extended to employees with children aged up to 16 years ( BERR 2009 ). Many of these legislative changes have been explicitly or implicitly underpinned by the assumption that flexible working will have positive effects on employee adaptability, performance ( Artazcoz 2005 ), work‐life balance and health ( MacEachen 2008 ). In a number of low and middle‐income countries flexible working hours is a relatively new concept which tends to be restricted to large multi‐national companies (see for example Eurofound 2009 ). Conversely, employment in informal labour is much more commonplace in developing countries, where employer‐orientated forms of flexibility, such as causal labour, tend to be the norm rather than the exception ( Benach 2007 ).

Against this backdrop, the World Health Organization (WHO) Commission on the Social Determinants of Health recognises the need for policy development to address issues relating to work‐life balance including, amongst others, the right to flexible working arrangements ( CSDH 2008 ). The consequences of flexible working policies also have equity implications, which need to be better understood ( Artazcoz 2005 ).

How the intervention might work

It is important to acknowledge that flexible working arrangements may have positive or negative impacts depending partly on whether the flexibility is employee‐negotiated or employer‐orientated ( Pärnänen 2007 ). For example, where employers dictate conditions in terms of contracts, work hours, salary forms or work places, uncertainty leading to possible job insecurity and reduced autonomy may be introduced into employees’ everyday lives ( Artazcoz 2005 ; Benach 2002 ; MacEachen 2008 ; Pärnänen 2007 ). Employers may introduce flexible working arrangements for a number of different reasons, such as to improve productivity and performance ( Artazcoz 2005 ). Conversely, workers’ requests for flexible working conditions may be driven by the need to better manage work and domestic or childcare responsibilities ( Webster 1996 ). In this instance the intended positive effects could be improved work‐life balance or increased choice and control over work hours. It is therefore important to capture the reason for adopting such practices to assess whether the arrangements are dictated by the employer or requested by the employee.

Several commentators have highlighted the beneficial effects of employee‐negotiated flexible working on health and wellbeing, such as reduced stress and stress‐related illnesses, reduced sickness absence and improved work‐life balance (including time spent with children and marital satisfaction) ( Albertson 2008 ; MacEachen 2008 ). Organisational arrangements, such as home working and staggered working hours, are promoted by employers as a way of negotiating the conflicting demands of work and domestic responsibilities. However, as Webster 1996 observes, such policies place the onus for childcare provision on the individual, usually women, and absolve the state of responsibility. Further, the promotion of home working can result in reduced social interaction and ‘intensification’ of work ( Webster 1996 ) as the traditional boundaries between work and domestic life become blurred. Researchers have also questioned how flexible working arrangements continue to be treated as a concession rather than a right ( Truman 1992 ), including in legislation (for example in the UK there is a right to request flexible working but not to receive it).

In terms of gender equity, a number of authors maintain that there is potential for flexible working policies to result in women becoming a source of disposable flexible labour and any gains offered by flexibility are likely to be polarised towards men rather than women ( Truman 1992 ; Webster 1996 ). As Truman 1992 argues the benefits of employer‐orientated flexibility are likely to be limited and the deregulation of working conditions could instead have adverse consequences in terms of reduced job security, lower compensation and poorer working conditions. In summary, the literature suggests that employee‐negotiated flexible working interventions are expected to have more positive effects on health and wellbeing than employer‐orientated interventions. 

Why it is important to do this review

Although reviews of the effects of work patterning have been conducted, there is little synthesised evidence available on the effects of flexible working arrangements on employee health and wellbeing and on health inequalities ( Artazcoz 2005 ; Benach 2002 ;). An earlier systematic review on the health and wellbeing effects of changing the organisation of shift work showed that three types of intervention (switching from slow to fast rotation; changing from backward to forward rotation; and self‐scheduling of shifts) can improve the health of employees, their work‐life balance, or both ( Bambra 2008a ). Similarly, a related systematic review has shown that ‘Compressed Working Week’ interventions (an alternative work schedule in which the hours worked per day are increased, whilst the days worked are decreased in order to work the standard number of weekly hours in less than five days ( Ronen 1981 )) can improve work‐life balance, and that they may do so with a low risk of adverse health or organisational effects ( Bambra 2008b ).

In addition, the equity implications of flexible working conditions are largely unknown. For example, Artazcoz 2005 draws attention to lacunae in the evidence base relating to how flexible working practices impact on the health of different groups across the socio‐economic strata and by occupational group, ethnicity or gender ( Artazcoz 2005 ).  Indeed, it can be seen in the health promotion literature more generally that population interventions tend to be taken up (and benefits are experienced) differentially by individuals in high socio‐economic/occupational groups compared with those people with lower income, status or skills ( Frohlich 2008 ). In this way flexible working arrangements have the potential to exacerbate existing patterns of inequity. 

It is therefore important that the international evidence base relating to flexible working is synthesised and appraised to ascertain whether or not the health effects of flexibility vary by socio‐economic status or demographic characteristics (that is by age, ethnicity or gender). The review is funded by the Department of Health Cochrane Review Incentive Scheme and is particularly topical at this time with the recognition that flexible working is "now endemic in modern economies" ( MacEachen 2008 ) and countries are beginning to legislate on workplace flexibility. For example, as of 6 April 2009 the UK government extended the right to request flexible working conditions to all parents with children aged 16 or under ( BERR 2009 ). Thus, there is potential for the findings of this review to directly impact on policy development both within the UK and internationally ( Bambra 2008c ). The findings will also be of interest to employee advocacy groups and employer representative organisations.

The main review objective was to evaluate the effects (benefits and harms) of flexible working interventions on the physical and mental health and wellbeing of employees working in formal labour.   

The secondary objectives were a) to compare whether there were any differential effects on physical and mental health and wellbeing in terms of job type, gender, age, ethnicity or socio‐economic status; and b) to examine how flexible working arrangements impact on the social wellbeing and work‐life balance of employees and their families.

Criteria for considering studies for this review

Types of studies.

Searches were conducted for the following study types:

• randomised controlled trials;
• interrupted time series;
• controlled before and after studies (prospective cohort studies).

We excluded uncontrolled studies and studies that reported outcomes for less than six months.

Types of participants

Study participants were defined as adults of working age working for profit or pay in formal labour. Studies were included if the mean age of participants was within the common working age range (16 to 64 years). The age range of 16 to 64 reflects the typical employment age in developed countries worldwide and has been used in a number of other Cochrane Reviews (see, for example, Turner‐Stokes 2005 ).

Types of interventions

Box 1 outlines the six different types of intervention included in this review: self‐scheduling/flexible scheduling of shift work; flexitime; overtime; gradual/partial retirement; involuntary part‐time work and fixed‐term contract. They are underpinned by the three principles of flexibility: contractual flexibility, spatial flexibility and temporal flexibility. Some interventions involved one of these principles exclusively, while others involved a combination of principles. For example, gradual or partial retirement relates to contractual flexibility whereas flexitime might be contractual but implicitly it offers choice and control regarding hours worked. The unifying aspect of these forms of flexibility is increased choice or control for either the employer or worker with respect to where, when or how work is undertaken. We have therefore excluded interventions which involve a transition from one fixed working arrangement to another different but nonetheless fixed working arrangement (e.g. changing from a fixed eight‐hour shift schedule to a fixed 12‐hour schedule (see Bambra 2008b for a review of compressed working week interventions)).         

We also examined whether interventions were determined by the employer or negotiated by the worker. Where possible we extracted data on the underlying reason for adopting flexible working arrangements. For example, the decision to implement flexible working might have related to an employer’s efforts to decrease costs, maximise workflow or to respond to production requirements. Conversely, the decision may have been motivated by the worker in terms of negotiating a better work‐life balance, accommodating childcare demands or travelling at off peak times. In some instances it was difficult to assess whether flexibility was defined by the employer or employee. With this in mind we used a number of different measures to capture data on the orientation and favourability of flexible working arrangements. These included arrangements apparently actively chosen by the worker (Y/N), reasons for practices (open text) and worker or employer favourable (Y/N) (please refer to Appendix 2 for further details). In the instance that it was not possible to complete these criteria ‘no motivation given’ was reported on the data extraction form.  

Box 1: Flexible working interventions included in the search strategy for this review

Types of outcome measures

Primary outcomes.

The primary outcome measures included physical health/ill health, mental health/ill health and general health/ill health indicators measured using validated instruments (some possible examples are listed in Table 1).  

Table 1: Examples of primary outcomes measured

Secondary outcomes

We extracted data on sickness absence, health service usage and health/lifestyle behavioural effects when reported alongside the primary outcomes (for examples see Table 2).  These outcomes are reported as secondary rather than primary health outcomes as it is recognised that these types of outcomes may not be reliable proxies of employee health/ill health due to the range of possible confounders involved. For example, sickness absence is thought to be affected by a range of factors such as job satisfaction, personality traits, work‐home interference, childcare arrangements, cultures of presenteeism and local norms about the social acceptability of sickness absence ( Moreau 2004 ).  

We also extracted outcomes relating to social wellbeing, specifically work‐life balance, but only when reported alongside primary outcomes and when work‐life balance was measured using a validated instrument. It is acknowledged that there are limitations associated with the subjective nature of measurements of work‐life balance. Work‐life balance is conceptualised here in terms of the impacts of the interventions on social and domestic life, for example time spent with family or sufficient time for social life ( Bambra 2008b ). Possible measures of work‐life balance included work related reduction/increase in time spent on domestic chores/social life/family or any kind of social/domestic disruption due to work. We also extracted data on outcomes relating to the effects of flexible working interventions on the health and wellbeing of children and family members and co‐workers when measured using a validated instrument and reported alongside primary outcomes. 

We noted but did not extract data pertaining to organisational and economic outcomes, such as staff turnover rates, job performance, job satisfaction and employee morale, in this review as we were interested, specifically, in the impact of flexible working on employee health and wellbeing. Organisational outcomes including productivity, performance, job satisfaction and satisfaction with work schedule have been considered in an earlier meta‐analysis by Baltes 1999 .

Table 2: Examples of secondary outcomes measured

Search methods for identification of studies

Electronic searches.

We conducted systematic searches using the following 12 electronic databases (host sites and search dates given in parentheses): the Cochrane Public Health Group Specialised Register (26 June 2009); the Cochrane Central Register of Controlled Trials (CENTRAL) ( The Cochrane Library 2009, issue 2) (1 July 2009); MEDLINE (Ovid, 30 March 2009); EMBASE (Ovid, 1 May 2009); CINAHL (NHS Evidence Health Information Resources, 13 May 2009); PsycINFO (NHS Evidence Health Information Resources, 15 May 2009); Social Science Citation Index (Web of Science, 22 May 2009); ASSIA (CSA, 16 June 2009); IBSS (EBSCO, 19 June 2009); Sociological Abstracts (CSA, 16 June 2009); ABI/Inform (Proquest, 21 May 2009); Evidence for Policy and Practice Information and Co‐ordinating (EPPI) Centre; and Evidence Library of Reviews (22 June 2009). The search concepts were combined as follows: Interventions (flexible working interventions) AND Setting (workplace/workers) AND Outcomes (relating to health and wellbeing). We did not exclude documents on the basis of language, country or publication date. The individual search strategies are reproduced in Appendix 1 .   

Searching other resources

We handsearched the bibliographies of all included studies (as well as excluded but closely related studies, that is studies of the effects of a flexible working intervention on health which did not use a CBA design), and requested relevant information on unpublished and in‐progress research from study authors and key experts in the field. This involved contacting the authors of all included and excluded but closely related studies. The number of key experts contacted snowballed, as contact with one author signposted the need for communication with additional experts in the field. In addition, we handsearched the most common journals revealed by searches (including Journal of Epidemiology and Community Health ; Scandinavian Journal of Work, Environment and Health ; Journal of Occupational and Environmental Medicine ; American Journal of Preventive Medicine ; and Ergonomics ) for the past 12 months (July 2008 to July 209). We also searched the following English language websites:

• Department of Work and Pensions (http://www.dwp.gov.uk);
• Department of Health (http://www.dh.gov.uk);
• Department for Business Enterprise and Regulatory Reform (http://www.berr.gov.uk);
• Trade Union websites (including http://www.tuc.org.uk/; http://www.dol.gov/; http://www.actu.asn.au/; http://www.canadianlabour.ca/home)
• Confederation of British Industry (http://www.cbi.org.uk);
• Joseph Rowntree Foundation (http://www.jrf.org.uk/);
• European Union (http://europa.eu/index_en.htm);
• World Health Organization (http://www.who.int/en/); 
• Guideline sites (National Institute for Health and Clinical Excellence (NICE, http://www.nice.org.uk/), Scottish Intercollegiate Guidelines Network (SIGN, http://www.sign.ac.uk/); and
• European Foundation for the Improvement of Living and Working Conditions (http://www.eurofound.europa.eu/). 

We also consulted Peter Schnall's job stress network for signposts to relevant studies: http://www.workhealth.org/. The importance of supplementary searching in relation to this topic area has been illustrated in two related systematic reviews of shift work ( Bambra 2008a ; Bambra 2008b ) which showed that after searching 27 different databases, 40 out of 66 studies were identified through MEDLINE or EMBASE and half of the remainder were located through citation follow up ( Bambra 2009c ).

Selection of studies

Two authors (KJ and CB) independently screened the title and abstract for relevance of all publications identified by the searches. The inclusion criteria were: (i) randomised controlled trial, interrupted time series or controlled before and after study; (ii) physical, mental or general health/ill health measured using a validated instrument; and (iii) length of follow up six months or greater. Where it was difficult to make a selection decision on the basis of the title and abstract alone, we retrieved the full article for screening. We recorded the reason for exclusion of studies which appeared to fulfil the eligibility criteria systematically (see Characteristics of excluded studies ). 

Data extraction and management

Two experienced systematic reviewer authors (KJ and RP) extracted data from studies meeting the inclusion criteria independentlyusing a standardised form (see Appendix 2 ) adapted from the Cochrane checklist ( Higgins 2008a ). Any discrepancies were resolved through discussion between the authors and if consensus was not reached with a third author (CB). We then entered the extracted data into the Characteristics of included studies tables ( RevMan 2008 ).   

Assessment of risk of bias in included studies

Given the complexity of the interventions and the need to consider controlled before and after studies due to the absence of randomised controlled trials in this area, we deemed the Cochrane endorsed system of domain based risk of bias evaluation ( Higgins 2008b ) to be inappropriate. Instead we appraised the methodological quality of included studies using a tool (see Appendix 3 ) which has previously been employed in related reviews of the health effects of complex social interventions ( Bambra 2008a ; Bambra 2008b ; Bambra 2007 ; Egan 2007 ). The tool is based on established guidance for the evaluation of non‐randomised studies ( CRD 2001 ; Deeks 2003 ). Two authors (KJ and RP) independently appraised the included studies according to these criteria which included, among other things, an examination of sampling strategy, response and follow‐up rates, and assessment of adjustment for confounders such as demographic, lifestyle or job content factors. We used the quality appraisal criteria for descriptive purposes and to highlight variations between studies and we calculated no quality score. Any differences in assessment were resolved through discussion with the third author (CB). 

Dealing with missing data

We contacted study authors by email if methodological details or statistical data were missing and in the instance that further information regarding methodology could not be retrieved, we recorded details as unclear in the data extraction and critical appraisal forms.

Assessment of heterogeneity

Earlier reviews in this area identified considerable heterogeneity in terms of populations, outcomes and study designs ( Bambra 2008a ; Bambra 2008b ). In this review the studies identified were not considered to be sufficiently homogenous (that is, in relation to population, intervention, control group, outcome measure and design) to enable meta‐analysis to be undertaken. We identified only a small number of studies for each flexible working intervention and few studies used the same primary and secondary outcome measures. By way of illustration, six different flexible working interventions were considered, meaning that in only two instances more than one study was retrieved per intervention type (self‐scheduling (n = 4) and gradual/partial retirement (n = 2)). In relation to the studies on self‐scheduling there were no shared outcomes measured using validated instruments that could be pooled (see Table 1 ). Although two studies ( Kandolin 1996 and Pryce 2006 ) considered the outcome 'stress' they used different instruments and constructed this outcome in different ways: the former referred to mental stress (measured in the Occupational Stress Questionnaire, Elo 1992 ) while the latter measured stress symptoms, using three validated four‐item scales: behavioural cognitive and somatic symptoms (developed by Setterlind 1995 ). Equally, the two studies on gradual/partial retirement assessed different validated health outcomes (general health status ( de Vaus 2007 ) and depression ( Calvo 2009 ) (see Table 2 ). 

Data synthesis

A meta‐analysis was precluded due to the heterogeneity of the studies, particularly in terms of the interventions and the outcome measures used. Deeks 2008 warns against the use of meta‐analysis in the instance that the statistical combination of results is unlikely to give meaningful results, for example if study outcomes are highly diverse. In addition, the pooling of effect sizes of studies where risk of bias is identified is likely to produce erroneous results ( Deeks 2008 ). While we recognise that there is an element of subjectivity in decision‐making regarding the appropriateness of meta‐analysis ( Deeks 2008 ), we believe that the reasons listed above justify the use of narrative synthesis to summarise results in this particular review. In our narrative synthesis we reported study findings separately by type of flexibility intervention and described the main characteristics of included studies along with information regarding the study quality and estimates of effect with relevant statistics. To avoid introducing bias into the narrative synthesis, we reported the results of each study judiciously and made efforts to avoid inappropriate emphasis on the findings of any one particular study or author ( Deeks 2008 ).

Subgroup analysis and investigation of heterogeneity

We contacted the authors of all included studies to determine whether unpublished data on differential outcomes by socio‐economic status or demographic characteristics were available. The rationale for undertaking subgroup analyses by age is underpinned by the recognition that the population of many industrialised countries is ageing and flexible working arrangements may be significant for older workers. Similarly, it is important to understand the socio‐economic patterning of flexible working arrangements and the impacts such inequalities might have on health and wellbeing. For example, shift work tends to be more common in manual occupations and workers employed in the manufacturing and healthcare sectors ( McOrmond 2004 ; Siegrist 2009 ). Equity implications ( Ueffing 2008 ) have also been highlighted in relation to gender and ethnicity as women and ethnic minorities tend to be overrepresented in jobs with flexible conditions ( Need 2005 ). For these reasons subgroup analyses were planned but (with the exception of one study which provided data by gender) were not undertaken due to an absence of data.

Description of studies

See: Characteristics of included studies ; Characteristics of excluded studies ; Characteristics of ongoing studies .

Electronic searches of 12 databases yielded 14,384 hits. Citation follow up, handsearches and author/key expert contact generated an additional 29 publications which, when combined with the electronic searches, left 11,954 papers after duplicates were removed. In total, 214 publications (185 from the electronic databases and 29 from additional searches) relating to flexible working were retrieved for full paper analysis (see Figure 1 ). Only 10 publications fulfilled our inclusion criteria in that they examined a flexible working intervention (as listed in Box 1), used a suitable study design with a follow‐up period of at least six months, and reported on primary health outcomes using a validated instrument. Of these, four papers were retrieved from MEDLINE ( De Raeve 2007 ; Kandolin 2001 ; Rodriguez 2002 ; Viitasalo 2008 ), one paper was identified in PyscINFO ( Dunham 1987 ), one from Social Science Citation Index ( Calvo 2009 ) and one paper was found in the Cochrane Central Register of Controlled Trials (CENTRAL) ( Pryce 2006 ). We identified a further three papers through citation follow up ( de Vaus 2007 ; Dooley 2000 ; Smith 1998 ). Contact with experts in the field highlighted an additional two ongoing studies ( Garde 2008‐2011 ; Nabe‐Nielsen 2006‐2010 ) which are listed in the Characteristics of ongoing studies table but are not data extracted or appraised. Searches of EMBASE, CINAHL ASSIA, IBSS, Sociological Abstracts, ABI/Inform, EPPI Centre, Evidence Library of Reviews and the Cochrane Public Health Group Specialised Register did not yield any hits that satisfied our specific inclusion criteria. Likewise, we retrieved no relevant publications fulfilling our inclusion criteria from the website searches. The reasons for excluding studies which appeared to fulfil the eligibility criteria but were excluded after full paper analysis are listed in the Characteristics of excluded studies table.    

Flowchart of search process

Type of flexible working interventions

Ten controlled before and after studies, involving 16,603 participants were included. Of the 10 publications fulfilling our inclusion criteria, six reported on interventions relating to temporal flexibility:  self‐scheduling/flexible scheduling of shift work (n = 4), flexitime (n = 1) and overtime (n = 1). The remaining four studies considered a form of contractual flexibility: gradual/partial retirement (n = 2), involuntary part‐time work (n = 1) and fixed‐term contract (n = 1). No studies fulfilling the review inclusion criteria were found on either teleworking (spatial flexibility) or job sharing (contractual flexibility).

Regarding the type of flexibility associated with the interventions, seven of the studies considered changes that appeared to be motivated with the worker in mind (either to improve health, work‐life balance or the psychosocial work environment) ( Calvo 2009 ; de Vaus 2007 ; Dunham 1987 ; Kandolin 1996 ; Pryce 2006 ; Smith 1998 ; Viitasalo 2008 ).  Conversely, two studies reported on interventions where the motivation for the intervention aligned more with organisational or employer interests ( Dooley 2000 (involuntary part‐time contracts); Rodriguez 2002 (fixed‐term contracts)). In one study ( De Raeve 2007 ) where the intervention involved a transition from working no overtime to overtime working, it was unclear as to whether the workers elected to work overtime or whether overtime was dictated by the employer. Few papers gave detailed information regarding the motivation for, or the objectives of, the interventions, for example whether or not they were developed in response to policy initiatives or alternatively whether they were implemented for economic reasons. There were two exceptions: a study by Kandolin 1996 provided some details regarding how the intervention was designed and implemented and a study by Pryce 2006 included a good level of detail on the study context. None of the studies provided information on whether or not worker representative organisations were involved in the development and/or delivery of the interventions.

Characteristics of setting and participants

All of the studies were conducted in the developed world, with the majority of studies taking place in Europe (Denmark n = 1; Finland n = 2; UK n = 1; UK and Germany n = 1; the Netherlands n = 1) or the United States (n = 3).  One further study was conducted in Australia. We located no studies conducted in low or middle‐income countries. The studies were based in various occupational settings: healthcare organisations (n = 2); the police force (n = 1); a utilities organisation (office workers) (n = 1); airline company (line maintenance workers) (n = 1); and the general working population/various companies or organisations (n = 5). The majority of studies involved homogenous samples in terms of sex and ethnicity. For further details regarding the study populations and settings see Characteristics of included studies .

Risk of bias in included studies

The representativeness of the study sample was satisfactory in all but five studies ( De Raeve 2007 ; Dunham 1987 ; Pryce 2006 ; Smith 1998 ; Viitasalo 2008 ).  De Raeve 2007 noted that the cohort used did not constitute a representative sample of the working population and studies by Pryce 2006 and Viitasalo 2008 involved self‐selection of participants. In studies by Dunham 1987 and Smith 1998 the process of sampling was unclear. Concerns regarding the appropriateness of the control group were apparent in relation to three studies ( Kandolin 1996 ; Smith 1998 ; Viitasalo 2008 ). Very low baseline response rates (less than 60%) were noted in two of the included studies ( De Raeve 2007 ; Viitasalo 2008 ) and response rates were unclear in a further seven studies ( Calvo 2009 ; de Vaus 2007 ; Dooley 2000 ; Dunham 1987 ; Pryce 2006 ; Rodriguez 2002 ; Smith 1998 ). Adequate follow‐up rates (greater than 80%) were reported in only four studies ( Dooley 2000 ; Dunham 1987 ; Pryce 2006 ; Viitasalo 2008 ). Where details of the method were unclear, the study authors were contacted for clarification of methods used but no responses were received.

The short follow‐up periods (12 months or less) employed in five of the studies reviewed ( Dunham 1987 ; Kandolin 1996 ; Smith 1998 ; Rodriguez 2002 ; Viitasalo 2008 ) may not be sufficient to detect clinical changes, for example changes in biomarkers of cardiovascular disease or accumulated fatigue and stress. In the study by Kandolin 1996 comparison of the control and experimental groups at baseline showed that the groups differed in relation to social conflict, with the control group having a higher score for conflict between workmates (P = 0.03). In two studies ( Dunham 1987 ; Pryce 2006 ) there were no data or only sparse data presented to assess the possibility of baseline differences between the experimental and control groups in terms of demographics, health status and flexible working experience. However, seven studies did account for differences between the intervention and control groups at baseline ( Calvo 2009 ; De Raeve 2007 ; de Vaus 2007 ; Dooley 2000 ; Rodriguez 2002 ; Smith 1998 ; Viitasalo 2008 ).

The risk of self‐reporting bias affected all but one study ( Viitasalo 2008 ), where experimental physiological measures were used to assess some of the health outcomes. Limitations relating to outcome data in the form of misclassification bias were also of concern in a study by De Raeve 2007 in which an arbitrary cut‐off point was used to classify cases of ‘need for recovery’. 

In the study by Pryce 2006 there was a clear risk of contamination as five concurrent interventions to enhance work and wellbeing were ongoing at the study site during the same period. It is possible, since the authors make no reference to protection against contamination, that participants in the control group may have been affected by these other interventions, thus biasing the intervention effect towards the null hypothesis (that is that flexible working has no effect on health outcomes). Concerns regarding the appropriateness of the statistical tests employed in the study analyses were apparent in the study by Dunham 1987 .

Importantly, there was no adjustment for potentially confounding factors such as demographic or lifestyle variables, job content or flexible working experience in three of the included studies ( Dunham 1987 ; Kandolin 1996 ; Pryce 2006 ). Smith 1998 drew attention to the effect of motivational issues (that is whether or not workers support the intervention) on the acceptance and adjustment to work schedule changes. This type of bias (the Hawthorne effect) is likely to confound the findings of at least four of the studies reviewed ( Dunham 1987 ; Kandolin 1996 ; Pryce 2006 ; Smith 1998 ) which use self‐reported outcome data and is difficult to control for when evaluating a complex intervention such as flexible working.

The remaining studies ( Calvo 2009 ; de Vaus 2007 ; Dooley 2000 ; Rodriguez 2002 ) scored highly in terms of methodological quality with representative samples, good response and follow‐up rates, adequate adjustment for relevant confounders, adjustment for drop‐out and use of appropriate statistical tests, but the appraisal process did highlight some concerns relating to possible misclassification bias in two of these studies ( Calvo 2009 ; de Vaus 2007 ). Both studies examine a form of contractual flexibility (gradual/partial retirement) but exposure data are ascertained by self‐report with no checking mechanism and the definition of cases is complex leading to the possible incorporation of error. 

In summary, the main sources of bias in the included studies were short follow‐up periods, reliance on self‐reported outcomes and limited adjustment for confounding factors such as demographic variables, job content or flexible working experience. These limitations were coupled with a sparse level of detail reported on study methodology making it difficult to ascertain whether or not study samples were sufficiently representative and control groups were adequately matched and whether or not there were any differences between intervention and control groups at baseline.

Table 3: Quality appraisal of evidence

  Key: Quality appraisal criteria*

* The numbers 1 to 9 represent satisfactory fulfilment of the corresponding criterion. Where it is unclear from the study whether a quality criterion has been achieved no score is given.

Effects of interventions

See: Table 1 ; Table 2 ; Table 3

For more detailed statistical information on effects in relation to primary outcomes see Table 1 and Table 2 .

Interventions offering temporal flexibility 

Only one controlled before and after study fulfilling our inclusion criteria examined the impacts of flexitime on workers ( Dunham 1987 ). This flexitime intervention involved working a core period between 1.30pm and 3.30pm, but with flexibility regarding start and finish times and timing and duration of lunch breaks. Workers were required to plan their schedules one week in advance and supervisors could request changes to facilitate departmental functioning. The study was conducted in a population of office workers (n = 102), which consisted of both supervisory and non‐supervisory personnel and the setting was the United States. Subjects were randomly assigned to the experimental or control group and self‐rated physiological and psychological health was measured using a seven‐item, scale validated by Patchen 1970 .  No changes were noted between the experimental or control group over time (Dunn Bonferroni statistics for physiological stress pretest and first post‐test: ‐0.487 pretest and second post‐test: ‐0.708, second and first post‐test: ‐0.262.  Dunn Bonferroni statistics for psychological stress: pretest and first post‐test: ‐0.757, pretest and second post‐test: ‐0.778, second and first post‐test: ‐0.099).

Self‐scheduling

Four controlled before and after studies examined the effects of self‐scheduling on shift workers ( Kandolin 1996 ; Pryce 2006 ; Smith 1998 ; Viitasalo 2008 ). Three of these studies reported significant improvements in a subset of primary health outcomes while the fourth study reported no statistically significant differences between the control and intervention groups over time with respect to the primary health outcomes studied ( Pryce 2006 ). 

Viitasalo 2008 considered the effects of flexibility of shift scheduling in a study conducted in a line maintenance unit of a Finnish airline company. The flexibility delivered in the intervention aimed to benefit the worker, principally, by increasing individual flexibility and control over work hours but also the employer, by encouraging variability in shift schedules to take account of changing operational needs. Schedules were issued four weeks in advance and the employer was unable to make changes in the first two weeks of the rotas without negotiation with the workers and suitable compensation.  As well as a comparison group which retained the old shift system, a third group changed to a rapidly forward rotating shift system (a rapid forward rotating system is characterised as one which rotates in a clockwise direction from morning (M), to evening (E), to night (N) shifts and the cycles of change are more rapid (change from EEE ‐ ‐ MMM ‐ ‐ NNN ‐ ‐ to MEN ‐ ‐)). Physiological measures (that is, non self‐reported measures) were used to examine health related outcomes (change in blood pressure, heart rate and biomarkers of cardiovascular disease) and validated instruments were used to measure general health‐related outcomes (sleepiness using the Epworth Sleepiness Scale (ESS), Johns 1991 ) and secondary outcomes (physical activity using the International Physical Activity Questionnaire). The authors reported significant decreases in systolic blood pressure in the experimental group when compared with the comparison groups. Decreases in systolic blood pressure are known to be associated with a reduction in the risk of stroke and ischaemic heart disease. Mean systolic blood pressure in the intervention group decreased from 142 mm Hg to 136 mm Hg (P = 0.049) and heart rate showed a decreasing trend from 66 to 60 beats/minute which persisted when compared with the control groups (P = 0.06). Changes in diastolic blood pressure were non‐significant (numerical data reported graphically only). Likewise, changes in the ESS scale decreased but the changes were not statistically significant when compared with the control groups (the ESS score in the experimental group decreased from 7.5 (SD 5.3) to 7.1 (SD 4.4) while the control group ESS score increased from 7.8 (SD 3.8) to 8.3 (SD 3.9)).

Smith 1998 looked at the effects of flexibility within a compressed working week (CWW) shift system in the UK police service. The intervention enabled police officers to take flexible starts while working four 12‐hour shifts followed by four days off and was implemented with the aim of improving workers’ work‐life balance by allowing participants to negotiate shifts to fit with domestic life. The comparison group was on fixed‐start 12‐hour shifts. Both intervention and comparison group had previously worked eight‐hour shifts with fixed starts. A range of physical and mental health outcomes, as well as work‐life balance, were measured using validated instruments including the General Health Questionnaire (GHQ‐12, Goldberg 1972 ) and the Standard Shiftwork Index ( Barton 1992 ). When the flexible CWW was compared to the fixed CWW no significant changes were reported for physical health measures. However, a significant interaction effect on psychological wellbeing was found (F = 5.11, P < 0.05) with mental health improving on the flexible system and deteriorating on the fixed rota system.  Interaction effects were also observed for day shift sleep quality (F = 4.59, P < 0.05) and night shift alertness (F = 4.21, P < 0.05) and night shift sleep durations (F = 6.49, P < 0.05). No significant interaction effect was observed for day shift alertness (F = 1.75, P > 0.05) or night shift sleep quality (data not given).

Pryce 2006 examined the effects of an open rota scheduling system implemented in a psychiatric hospital in Denmark on a range of health and wellbeing outcomes. This was one of only two controlled before and after studies located which provided comprehensive details of how the flexible working intervention was operationalised (the other study with implementation details is by Kandolin 1996 ). A participatory approach underpinned how the self‐scheduling system was conceived, designed, implemented and evaluated and the motivation for the intervention was transparent: to improve levels of health, wellbeing, job satisfaction and work‐life balance of nursing staff. Well‐validated measures of health outcomes included: stress symptoms (three four‐item scales of behavioural, cognitive and somatic symptoms ( Setterlind 1995 ); global self‐rated health ( Borg 2000 ) and vitality (four‐item scale, Setterlind 1995 ).  No significant benefits to health were found when comparing the experimental and control groups over time, although non‐significant trends were noted for somatic symptoms and vitality. For somatic symptoms the mean score for the control group increased from 34.75 (SD 10.81) to 38.45 (SD 10.75) whereas the corresponding change in the intervention group was much smaller, 33.53 (SD 13.33) to 34.33 (SD 13.65), F(175) = 1.25.  Scores for vitality improved in the intervention group from 54.47 (SD 15.90) to 56.67 (SD not reported) whereas in the control group vitality scores decreased from 63.50 (SD 16.23) to 57.36 (SD 17.36) F(174) = 1.72.

Multiple intervention study

Kandolin 1996 reported on a multiple intervention study which included changes to the direction and speed of shifts as well as the introduction of self‐scheduling. The intervention was explicitly designed to reduce workers’ levels of fatigue. Mental health (mental strain and mental stress) and general health (tiredness) outcomes were recorded using the Standard Shiftwork Index ( Barton 1992 ) and the Occupational Stress Questionnaire ( Elo 1992 ). Subjects were midwives (100% female) and the setting was a hospital in Finland. In terms of general health outcomes, a significant decrease in tiredness during the night shift (from 53% to 44% in the intervention group) was demonstrated with a time x group interaction P = 0.02. No significant differences in mental health outcomes were reported although non‐significant reductions in three primary health outcomes were experienced in the intervention group: mental stress (from 27% to 15%, P = 0.07); mental strain in the  morning shift (from 27% to 11%, P = 0.09); mental strain in the evening shift (from 17% to 9%, P = 0.29). Since self‐scheduling was part of a multiple intervention, the findings are subject to the caveat that it is not possible to separate out the effects of each of the concurrent interventions. 

One study considered the impacts of overtime working on health and wellbeing.  De Raeve 2007 examined changes in overtime in a population of blue and white collar workers in various settings. No subgroup analyses by job type were undertaken but the authors did explore the results by gender. When comparing workers who moved from working no overtime at baseline to working overtime at follow up they found no statistically significant associations between overtime work and need for recovery or psychological distress in either men or women. (Need for recovery from work refers to the extent that work tasks induce a need to recuperate from work induced effort (characterised by emotional cognitive and behavioural symptoms). Need for recovery was measured using an 11‐item scale from the Dutch Questionnaire on the Experience and Evaluation of Work (VBBA) and cases of need for recovery were classified as those scoring in the upper tertile on the VBBA scale ( van Veldhoven 2003 ). For men after undertaking overtime work the odds of becoming a need for recovery case were 1.31 (95% CI 0.87 to 1.98) and the odds of men becoming a psychological distress case were 1.16 (95% CI 0.83 to 1.64). Equally for women, after undertaking overtime work the odds of becoming a need for recovery case or a psychological distress case were also non‐significant: OR 1.47 (95% CI  0.64 to 3.38) and OR 0.81 (95% CI 0.40 to 1.62) respectively. They also examined workers making the transition from working overtime at baseline to not working overtime at follow up and found that after adjusting for known confounders there was an increased risk of being a need for recovery case at follow up. The authors explain this unexpected and counterintuitive observation by suggesting that if overtime is at the discretion of the employer and it is not made available for economic reasons then workers may have to increase their productivity during normal work hours and therefore might be under greater levels of stress and strain leading to increased scores for need for recovery. Indeed, when comparing male participants who worked overtime at both time points with those not working overtime at either time point, the risk of being a psychological distress case or a need for recovery case was significantly lower in those working overtime (psychological distress case OR 0.69 (95% CI 0.49 to 0.98) and need for recovery case OR 0.58 (95% CI 0.36 to 0.93)). These findings are limited, however, in that health outcomes are measured after a transition to overtime and there is no data on the amount of overtime worked (i.e. overtime hours per week) and the temporal duration of overtime working (the period may be less than six months). Also, we have no information on past exposures, for example although participants state that they were not working overtime at baseline we cannot ascertain whether they had recently worked overtime from the data collected. The authors did attempt to capture this information using an item within the questionnaire on whether the change in work hours was at the employee’s request but response to this particular item was low. It is therefore unclear as to whether overtime working was dictated by the employer or requested by the worker.

Interventions offering contract flexibility

Four studies considered contract flexibility interventions ( Calvo 2009 ; de Vaus 2007 ; Dooley 2000 ; Rodriguez 2002 ). 

Partial/gradual retirement

Two studies fulfilling our inclusion criteria were identified on partial or gradual retirement ( Calvo 2009 ; de Vaus 2007 ), both of which compared participants retiring gradually with those who retired abruptly. The study by Calvo 2009 used data from the Health Retirement Study, a nationally representative survey conducted in the United States between 1992 and 2004. The authors examined the mental health outcome depression using a validated instrument ( Diener 1999 ; Frey 2002 ; Perreira 2005 ; Veenhoven 1991 ) with a maximum follow‐up period of 12 years.  Calvo 2009 found no significant changes in depression for either the gradual or the abrupt retirement group between time points. For individuals in the gradual retirement group, mean depression score was 0.120 (SD 0.326) before and 0.165 (SD 0.371) after the transition. Similarly, for those in the control group mean depression was 0.118 (SD 0.322) before and 0.149 (SD 0.357) after abrupt retirement. However, the authors suggested that the effects of retirement (both partial and abrupt) on health were related to whether retirement was forced or voluntary, that is whether or not the individual had control over their choice. 

de Vaus 2007 used data from an Australian study (the Australian Healthy Retirement Project) spanning three years (1998 to 2001) and examined general health status and a range of mental health indicators measured using validated tools: positive affect ( Lawton 1992 ), negative affect ( Lawton 1992 ) and self‐image ( Adelmann 1994 ; Rosenberg 1965 ; Scheier 1985 ). The authors reported a significant improvement in health at 12 months follow up for participants retiring gradually when compared with the control group (Beta coefficient 0.14, P < 0.01) but this effect disappeared at 36 months (Beta coefficient 0.04, P > 0.05). There were no significant differences between gradual and abrupt retirees in the following mental health outcomes: levels of positive affect (Beta coefficient ‐0.04 at 12 months, 0.03 at 36 months), negative affect (Beta coefficient ‐0.02 at 12 months, ‐0.02 at 36 months) and self‐image (Beta coefficient ‐0.02 at 12 months, ‐0.03 at 36 months. The authors also examined the degree of control over retirement pathway but these models did not compare gradual with abrupt retirees and the two groups were pooled. 

Both Calvo 2009 and de Vaus 2007 found that control over retirement was related to better health outcomes. Calvo 2009 found that having control over retirement had a significant effect on depression scores (coefficient ‐0.470, P < 0.01) when comparing those retirees with control and those without control. de Vaus 2007 found that at 12 months follow‐up, participants with greater control over their retirement decision had significant increases in positive affect (Beta coefficient 0.12, P < 0.01), decreases in negative affect (Beta coefficient 0.15, P < 0.01) and improvements in self‐image (Beta coefficient 0.19, P < 0.001). These effects attenuated at 36 months follow up. The authors also considered the interaction between retirement pathway and degree of control and found that the following interaction terms were significant: change in positive affect at 36 months (Beta coefficient ‐0.38, P < 0.05) and change in negative affect at 12 months (Beta coefficient ‐0.38, P < 0.05). The group exhibiting the smallest improvement in either score was the low control, abrupt retirement group. 

Involuntary part‐time employment

A study by Dooley 2000 considered the effects of involuntary part‐time employment on psychological functioning as measured using the Center for Epidemiologic Studies Depression Scale (CES‐D).  Becoming inadequately employed was associated with increased depression when compared with remaining adequately employed and after adjusting for depression at baseline (b = 0.67, Beta = 0.04, t = 2.80, P < 0.05).  This association remained significant after controlling for family poverty status and marital status (b = 0.71, Beta = 0.04, t = 2.98, P < 0.05). However, the authors pooled participants on involuntary part‐time contracts with those working on a poverty wage into a group categorised as inadequately employed. It is therefore not possible to disentangle the effects of involuntary part‐time employment from employment on a poverty wage. 

Fixed‐term employment

A study by Rodriguez 2002 looked at the effects of fixed‐term employment compared with permanent employment on self‐reported health status. Data from the Household Panel Comparability Project from Britain and Germany (1991 to 1993) were used to examine the impact of change in employment stability (from permanent to fixed‐term contract) over time. Perceived health status as validated by Bjorner 1996 was the dependent variable under investigation here. In both Britain and Germany no statistically significant differences were noted in perceived health status (likelihood of reporting of fair, poor or very poor health) in those moving from permanent contract at baseline to fixed‐term or no contract at follow up when compared with those with permanent contracts at both time points. In Britain and Germany the odds of having no permanent contract at follow up were OR 0.73 (95% CI 0.42 to 1.28) and OR 0.81 (95% CI 0.44 to 1.53) respectively.

Interventions offering spatial flexibility

Teleworking.

No studies meeting our inclusion criteria were found for teleworking interventions.

For more detailed statistical information on effects in relation to secondary outcomes, see Table 3 .

Four of the ten studies reviewed measured secondary outcomes as defined in this review (see Table 2, Examples of secondary outcomes measured). Measures of quality of life featured in two studies. Pryce 2006 used scales on sense of community and social support, and de Vaus 2007 incorporated a measure called life satisfaction. Work‐life balance was also explored in two studies: one study ( Smith 1998 ) used interference with social and family life to assess work‐life balance, while the other study used marital cohesion ( de Vaus 2007 ). Finally, lifestyle/behavioural changes such as physical activity levels and diet were measured by Viitasalo 2008 . None of the studies reviewed here examined the effects of a flexible working intervention on sickness absence, health service usage or the health and wellbeing of children, family members or co‐workers. 

In a study of an open rota scheduling system (temporal flexibility) implemented in a psychiatric hospital in Denmark, Pryce 2006 measured the secondary outcomes, sense of community and social support (both from the Copenhagen Psycho‐social Questionnaire, Kristensen 1998 ). Significant increases were observed for social support (F (174) = 4.05, P = 0.001) and sense of community (F (176) = 4.44, P = 0.001) when comparing the intervention and control groups before and after the self‐scheduling system was implemented.

In a study of gradual/partial retirement, de Vaus 2007 used life satisfaction as a quality of life outcome measured using a scale validated by Campbell 1976 . Similarly, marital cohesion (validated by Spanier 1976 ) was adopted as a work‐life balance outcome. When comparing abrupt and gradual retirees the authors found no statistically significant differences in life satisfaction or marital cohesion over time. At 12‐month follow up, participants with greater control over their retirement decision had significant increases in life satisfaction (Beta coefficient 0.15, P < 0.01). Similarly, at 36 months follow up participants with greater control over their retirement decision were more likely to report increases in marital cohesion (Beta coefficient 0.12, P < 0.05). The authors also considered the interaction between retirement pathway and degree of control and found that the interaction term change in marital cohesion was statistically significant at 36 months (Beta coefficient ‐0.53, P < 0.05). The group with the lowest marital cohesion scores was the low‐control, abrupt retirement group.

In a study of a compressed working week intervention with flexible start and finish times (temporal flexibility), Smith 1998 measured work‐life balance using the “interference with social and family life” item from the Standard Shiftwork Index ( Barton 1995 ). Participants in the intervention or control groups did not differ in terms of interference with social and family life at follow up.

Viitasalo 2008 measured physical activity using the International Physical Activity Questionnaire ( Craig 2003 ) and also recorded intake of alcohol, caffeine, fats and fibre in a study of a self‐scheduling intervention. No significant differences in the interaction between time and group were observed for any of these lifestyle/behavioural changes.

Planned subgroup analyses

None of the included studies reported the effects of flexible working interventions on health and wellbeing by different subgroups on the basis of socio‐economic status, job type, age or ethnicity. One study of overtime working (temporal flexibility) by De Raeve 2007 did report results differentially by gender but found no significant effect of overtime working on need for recovery or psychological distress in either males or females.

None of the studies conducted separate subgroup analyses by different types of worker, for example managerial or supervisory staff versus manual worker. In several studies managers/supervisors were pooled with general workers and analysed as a homogenous group (e.g. Viitasalo 2008 ). Similarly, analysis was not sex segregated or studies were conducted on single sex samples. 

Summary of main results

We included ten CBA studies which examined six flexible working interventions (self‐scheduling; flexitime; overtime; gradual/partial retirement; involuntary part‐time employment; fixed‐term contracts) relating to contractual and temporal flexibility. We identified no studies fulfilling the study design inclusion criteria on job shares (contractual flexibility) or on spatial flexibility interventions, specifically teleworking. Whilst remaining cognisant of the limitations of the review in terms of the ability to combine our findings and to make generalisations, we observed that studies examining the effects of temporal flexibility interventions tended to report at least some improvements in health and wellbeing outcomes ( Kandolin 1996 ; Pryce 2006 ; Smith 1998 ; Viitasalo 2008 ) while contractual flexibility interventions (with the exception of gradual/partial retirement) reported equivocal or negative health effects when comparing intervention and control groups before and after the interventions were implemented ( Dooley 2000 ; Rodriguez 2002 ).

Due to heterogeneity in terms of study design and outcomes assessed it was not possible to undertake a meta‐analysis. Based on a narrative synthesis of the study findings we tentatively suggest that interventions enabling flexibility which is orientated towards the worker and increases employee control over working conditions are likely to improve some aspects of health and wellbeing ( Kandolin 1996 ; Smith 1998 ; Viitasalo 2008 ). Two other studies reporting on the effects of worker‐orientated flexibility found no significant improvements in primary health outcomes but tellingly no negative health outcomes were observed ( Dunham 1987 ; Pryce 2006 ) and positive effects on secondary outcomes, including quality of life, were seen in the study by Pryce 2006 . Similarly, in the studies of gradual retirement, having control over the retirement decision was associated with improvements in the measured health outcomes ( Calvo 2009 ; de Vaus 2007 ). Interventions which implemented employer‐defined flexibility were either associated with no significant changes in health outcomes ( De Raeve 2007 ; Rodriguez 2002 ) or, in one instance, adverse effects on mental health outcomes ( Dooley 2000 ). Given the limitations associated with the size and quality of the evidence base these conclusions are made with caution.

In relation to secondary outcomes, only four of the included studies examined any of the following secondary outcomes: sickness absence, health service usage, health/lifestyle behavioural effects, work‐life balance, health and wellbeing of children, family members and co‐workers. Statistically significant effects were reported only in relation to improvements in social support and a sense of community in one study of self‐scheduling of shifts ( Pryce 2006 ).  This intervention was also worker‐orientated and enabled increased levels of control for the worker.

Since there was an absence of studies which conducted subgroup analyses it is unclear how flexible working impacts on health inequalities. Unfortunately this is a common problem for systematic reviews of the effects of interventions on health inequalities ( Bambra 2009a ). Future research should attempt to address this gap by differentiating outcomes by occupational grade or socio‐economic group. Due to the social patterning of shift work, flexible working interventions like self‐scheduling are likely to be relevant to workers from lower socio‐economic groups and may have the potential to help to address the gap in health between low and high socio‐economic groups ( Bambra 2008b ). Clearly more research is needed to explore this possibility further.  

Overall completeness and applicability of evidence

The evidence base was small with only ten controlled before and after studies of flexible working interventions fulfilling our inclusion criteria. No randomised controlled trial or time series analyses were retrieved. The small number of studies identified may indicate that publication bias is an issue here, where studies reporting equivocal or negative findings are less likely to be published. Many of the studies were undertaken in homogenous groups, such as female healthcare workers, so generalisability to the wider population is limited. No studies fulfilling our inclusion criteria were conducted in low or middle‐income countries. This underlines an observation asserted in the Commission on Social Determinants of Health's final report to the WHO ( Benach 2007 ) that few studies examining the relationships between work and health and the impacts on health inequalities have been conducted in developing countries.

Quality of the evidence

The studies retrieved which satisfied the inclusion criteria were limited in a number of methodological aspects. The follow‐up period was 12 months or less in five of the studies so it was not possible to examine the longer term effects on physical, mental and general health. Regarding the suitability of the length of follow up, Jansen 2003 drew attention to differences in the length of time required before changes to health outcomes might be observed. They highlight that outcomes like fatigue are likely to develop relatively soon after an intervention has started whereas other health outcomes might take longer to emerge at a measurable level.

Concerns regarding whether or not the sample was representative were apparent in five studies and three studies did not use a matched or randomly allocated control group. With the exception of one study where experimental measures of blood pressure and biomarkers of cardiovascular disease were used ( Viitasalo 2008 ), all of the studies used self‐reported outcome data and the measurements varied widely between studies.  The reliance on self‐reported outcome data increases the possibility of confounding as in half (5/10) of the studies participants were aware of the study and its aims and in at least one instance ( Pryce 2006 ) participants were involved in the design and implementation of the intervention. Three studies did not undertake suitable adjustment for potential confounding factors, such as demographic variables, lifestyle factors, job content and flexible working experience ( Dunham 1987 ; Kandolin 1996 ; Pryce 2006 ). In addition, two of the reviewed studies ( Dooley 2000 ; Kandolin 1996 ) reported on multiple interventions, making it difficult to separate out the effects of flexible working from other organisational changes. 

Sparse data were included on the rationale for the interventions and on the implementation process. This is in line with an observation by Egan and colleagues that the implementation of complex interventions in the workplace is often poorly reported in primary studies ( Egan 2009 ). Few studies presented important contextual information relating to why the intervention was developed, how it was planned and delivered and who were the intended beneficiaries. Crucially, there was a dearth of information on whether or not the intervention was designed to improve employee health, work‐life balance or the psychosocial work environment or conversely whether the intervention was motivated by economic or other organisational interests. Similarly, none of the studies included adequate information on the presence or absence of employee, union or managerial support for the intervention and whether or not those implementing the intervention had appropriate experience and access to the necessary resources to deliver the intervention effectively. 

Potential biases in the review process

Given the contested nature of the term ‘flexible working’, difficulties have arisen regarding establishing what is and what is not flexible working. Here we have taken as our point of departure the notion of choice and control as being of paramount importance but others may define flexible working more broadly by arguing that any working arrangement that deviates from the norm (for example, workplace based, 9 am to 5 pm, permanent contract employment) would constitute flexible working. Since this is the first review in the area a precise and restricted working definition has been operationalised but future systematic reviews might consider wider organisational changes including, for example, reduced working hours, compressed working weeks, and changes to the direction and speed of rotation of shift schedules. 

Despite conducting searches across multiple electronic databases spanning biomedical, social science and business and management disciplines, it is possible that we have not been able to capture all studies published in the subject area. The findings of this review should, therefore, be interpreted with caution with the caveat that the studies were retrieved using the search strategy presented in Appendix 1 and by applying the inclusion criteria defined in the Methods section. Although the search strategy was developed in conjunction with an experienced information researcher and was piloted and checked by a Cochrane Information Researcher there are limitations regarding the sensitivity of the search strategy especially given the wide range of meanings attached to the term ‘flexible working’. This problem is well‐recognised for any review of complex and difficult‐to‐define interventions ( Ogilvie 2005 ). While we did attempt to incorporate a diverse and representative range of terms and synonyms relating to flexible working it is likely that we have not captured all possible derivations of this generic term and may have missed specific colloquial or country‐specific terms. It should be noted, however, that in order to capture any in progress research and to increase the sensitivity of the search process we also contacted key experts in the field, which identified an additional two in progress studies (see Characteristics of ongoing studies ). Publication bias relating to commercial studies outside of the public domain may also limit conclusions regarding the size of the available evidence base. Further, it should be noted that although searches were conducted of relevant internet sites these were limited to English language only.   

Agreements and disagreements with other studies or reviews

In line with an established body of research around the positive health effects of high levels of control in the workplace ( Bosma 1997 ; North 1996 ; Stansfeld 1999 ), the findings of this review tentatively suggest that flexible working interventions that increase control and choice are likely to have a beneficial effect on at least some health and wellbeing outcomes. The studies of worker‐orientated flexibility (specifically self‐scheduling of shifts and gradual/partial retirement) reported statistically significant improvements in health outcomes when comparing experimental and control groups before and after the intervention. It is well recognised that interventions which increase workers’ autonomy or decision latitude and lead to greater alignment between employee needs and the work environment are likely to increase job satisfaction ( Baltes 1999 ), reduce stress and the likelihood of stress‐related morbidity and ultimately lead to improvements in workers’ health ( Bosma 1997 ; Kuper 2003 ; Marmot 2006 ). Although the study on flexitime reported no significant effects in this review it should not be assumed that flexitime interventions have no health impacts as it is not possible to draw conclusions on the basis of one study alone, especially since the study considered only self‐reported measures of physiological and psychological health and the follow‐up period may not have been sufficient to discern any small changes in outcomes. In contrast, the effects of employer‐orientated forms of flexibility, such as casual employment and labour hire, are likely to play out differently with the worker lacking job security, protection and choice and control ( Benach 2007 ). Since we did not include studies of the informal labour market in our inclusion criteria it is not possible to comment further on how these effects might be observed.

Our findings correspond with those published in an earlier systematic review on changes in shift work ( Bambra 2008a ) which reported that self‐scheduling of shifts was beneficial to health and work‐life balance. Similarly, a systematic review of the compressed working week (CWW) ( Bambra 2008b ) found evidence to suggest that the CWW improved work‐life balance in employees with little or no adverse health effects. These reviews also found few studies which differentiated their results by socio‐economic status or demographic characteristics. Moreover, both reviews draw attention to the limitations of the existing evidence base and call for well‐designed intervention studies to address these deficits. 

An earlier meta‐analysis of flexitime and the compressed working week ( Baltes 1999 ) considered only organisational outcomes (productivity, performance, job satisfaction, satisfaction with work schedule) and absenteeism. In relation to absenteeism (which we define in our review as a secondary outcome due to the complexity of sickness absence as an outcome and the possible array of confounding factors thought to influence it, such as psychological/personality traits, family situation/childcare arrangements, work‐home interference and cultures of presenteeism and local norms about the acceptability of sickness absence (see Moreau 2004 )) the authors found that flexitime had a positive effect (mean weighted effect size 0.93, 95% CI 0.83 to 1.03). The meta‐analysis also revealed that managers and professionals were less affected by flexitime than general employees.  The authors suggest that flexitime schedules are unlikely to benefit those workers who already have high levels of control and choice ( Baltes 1999 ). Due to the small number of studies retrieved in our review and the absence of outcome reporting by occupational grade we are unable to provide data to support or oppose these hypotheses.

Implications for practice

The evidence in this review suggests that interventions which increase employee control by offering worker‐orientated flexibility (specifically self‐scheduling and partial/gradual retirement) are likely to be associated with health improvements including improvements in physical health (reduced systolic blood pressure and heart rate), mental health (e.g. reduced psychological stress) and general health (e.g. tiredness and sleep quality) measures. Importantly, interventions which increased worker flexibility were not associated with any adverse health effects in the short term.  Kandolin 1996 reported significant reductions in tiredness during the night shift when comparing intervention and control group participants, although it should be noted that this study reported on the effects of multiple interventions.  Smith 1998 demonstrated improvements in mental health, sleep quality on day shift, sleep duration on night shift and alertness during night shift in the intervention group compared with the comparison group.  Viitasalo 2008 found statistically significant decreases in systolic blood pressure and heart rate for workers with flexible scheduling compared with those in the control group.  Pryce 2006 found no significant changes in primary health outcomes, although improvements in some secondary outcomes were noted when comparing intervention and control groups.  

The evidence base evaluating the effectiveness of flexible working interventions in the form of well‐designed controlled before and after studies is small and methodologically limited. If the benefits and harms of flexible working are to be fully understood, then prospective, well‐controlled intervention studies of the health and wellbeing effects of flexible working are urgently required, particularly those that examine differences in health outcomes by socio‐economic status, occupational grade or demographic characteristics. However, bearing in mind the limitations of the studies, it is fair to suggest that, given the absence of ill health effects associated with worker‐defined flexibility and the evidence of some improvements in a subset of health and wellbeing outcomes, certain types of worker‐orientated flexible arrangements (specifically self‐scheduling and partial/gradual employment) represent a plausible means through which policymakers and employers can promote healthier workplaces and improve work practices.

Implications for research

Given the increasing importance accorded to the work environment as a determinant of health by policymakers and practitioners ( Black 2008 ), it is disappointing that this review has highlighted a paucity of high quality intervention studies relating to the effects of flexible working on health and wellbeing. To date much of the research examining the effects of flexible working conditions on health has adopted a cross‐sectional design, which does not enable exploration of causality. Future empirical studies should involve a prospective design with matched control groups, objective measures of health outcomes, and adequate follow‐up periods to examine long‐term health effects. In addition, given the small number of intervention studies on the health effects of flexitime (only one study on flexitime was retrieved that fulfilled our inclusion criteria) we call for studies to address this specific deficit. Further, it is important that future studies make explicit information regarding the background to and the motivation for the intervention as well as details on how the intervention was delivered and the extent to which workers and managers supported the arrangements. Echoing calls made elsewhere ( Bambra 2009b ; Mackenbach 2003 ; Tugwell 2004 ), we would urge future studies to undertake analyses by different subgroups to assess any possible effects on health inequalities. 

This review has concentrated on examining the effects of flexible working interventions on health and wellbeing outcomes. Future reviews could extend this focus to consider the organisational or economic effects of these interventions by considering outcomes such as staff turn‐over, worker performance, job satisfaction and employee morale. There is also a need to consider the cost‐effectiveness of flexible working arrangements. Given the dearth of controlled before and after studies, there is a case for the next levels of evidence (including retrospective cohort studies and non‐intervention studies which examine the impacts of flexible working using a comparative approach) to be interrogated. This would be particularly fruitful for the analysis of the health effects of spatial flexibility interventions, namely teleworking.

Acknowledgements

We wish to thank Elizabeth Blenkinsopp for assistance with the searches and Ruth Turley for checking the search strategy and for advice on the search process. We would also like to acknowledge Danielle Dixey who provided administrative assistance in terms of contacting authors, undertaking website searches and obtaining studies. We are grateful also to our review advisory group members: Professor Antony Lamontagne, Professor Martin White, Professor Carolyn Summerbell, Dr Else Nygaard and Dr Dheeraj Bansal for their insightful comments on the protocol and review. Finally, we appreciate the invaluable advice and support of the Public Health Review Group Editorial base in the preparation of this review.

Appendix 1. Electronic database searches (in alphabetical order)

Abi inform (1971 ‐ ) (proquest).

Searched 21 May 2009

128 records retrieved

((physical health or mental health or health or wellbeing or sickness absence* or work life balance or quality of life or illness or stress) ) AND ((flex* work* or work schedule tolerance or job‐shar* or self schedul* or shiftwork* or telework* or home work* or overtime or flex* contract*)) AND ((follow‐up or longitudinal or prospective* or cohort or evaluation))

(43 records retrieved)

((physical health or mental health or health or wellbeing or sickness absence* or work life balance or quality of life or illness or stress) ) AND ((flex* time* or workplace flexibility or piecework* or marginal employ* or contingent employ* or atypical employ* or irregular work* hours)) AND ((follow‐up or longitudinal or prospective* or cohort or evaluation))

(10 records retrieved)

((physical health or mental health or health or wellbeing or sickness absence* or work life balance or quality of life or illness or stress) ) AND ((compress* work* hours or compress* work* week or annuali?ed hours or stagger* hours or zero hours or work life polic*)) AND ((follow‐up or longitudinal or prospective* or cohort or evaluation))

(75 records retrieved)

ASSIA  (1987 ‐ ) (CSA Illumina)

Searched 16 June 2009

715 records retrieved 

((DE=(health or wellbeing or well‐being) or DE=morbidity) or(KW=((back pain) or Backpain or lbp) or KW=((low back pain) or lumbago or (cardiovascular diseases)) or KW=((heart diseases) or hypertension or (mental health))) or(KW=((psychological outcome*) or Anxiety or (Professional burnout)) or KW=((Psychological stress) or depression or ("quality of life")) or KW=((job satisfaction) or Empower* or (decision latitude))) or(KW=((work life balance) or (work‐life balance) or (work family conflict*)) or KW=(musculoskeletal within 2 disorder*)) or(KW=(musculo within 2 skeletal within 2 disorder*)) or(KW=((promot* or manag* or facilitat* or enable*1 or enabling or barrier*1 or increas* or obstruct* or encourag* or prevent* or time or free or disrupt* or relationship* or conflict) within 2 (health or healthy or healthier))) or(KW=(mental health or physical health or health risk* or general health)) or(KW=((employee* or staff) within 2 (health))) or(KW=((health of worker*) or illness or ill) or KW=((sick* absence*) or (sick* leave))) or(KW=((days off) or (quality of life) or (general health questionnaire)) or KW=((mcGill pain questionnaire) or (blood pressure) or (obesity or obese or overweight)) or KW=((functional limitations profile) or (short form 36 or SF‐36) or (euroqol or EQ‐5d))) or(KW=((facilitat* or enable*1 or enabling or barrier*1 or obstruct* or encourag* or prevent* or time or free or disrupt* or relationship* or conflict) within 3 (household work or house work or chores or hobbies or hobby or friends or family))) or(KW=(social activit* or social network* or social life or free‐time or free time)) or(KW=cholesterol) or(KW=(stress or burnout or depression or depressed))) and(((KW=((flexible work*) or shiftwork* or (shift work*)) or DE=((flexible work*) or shiftwork* or (shift work*))) or(KW=((non standard work*) or (non‐standard work*) or (flexible time)) or DE=((non standard work*) or (non‐standard work*) or (flexible time))) or(KW=((flexible workplace) or (flexible work* condition*)) or DE=((flexible workplace) or (flexible work* conditions) or (flexible time))) or(KW=((flexible work* time*) or (flexi time*) or flexitime*) or KW=((flex time*) or flextime* or flexi‐time*) or KW=((flexible work* arrangement*) or (flexible work* hour*) or (work schedule tolerance))) or(KW=(("self schedule*") or self‐schedule* or (unusual hour*)) or KW=((study leave) or (part‐time work*) or (part time work*)) or KW=(weekend work*)) or(KW=(job* share*)) or(KW=((compress* work* hour*) or job‐shar* or (stagger* hour*)) or KW=((annual* hour*) or (annualised hour*) or (annualized hour*)) or KW=((compress* work* week*) or overtime or (shift work*))) or(KW=(shiftwork* or (night work*) or nightwork*) or KW=((parental leave) or (long term leave) or sabbatical) or KW=(secondment or (home work*) or homework*)) or(KW=((work* from home) or telework* or (irregular work* hours)) or KW=((irregular work*) or (phase within 2 retire*) or (retirement scheme*)) or KW=((pension scheme*) or (early retirement) or (maternity leave))) or(KW=((non standard* employ* contract*) or (non‐standard* employ* contract*) or (freelance* work*)) or KW=(free‐lance* or (freelance* work*) or freelance*)) or(KW=((workplace flexibility) or (work place flexibility) or (flexible contract*)) or KW=((flexible salary form*) or (working time directive*) or (zero hours)) or KW=(daywork* or (day work*) or piecework*)) or(KW=((piece work*) or (adjust* hours) or (core hours)) or KW=((stagger* hours) or (time in lieu) or (time bank*)) or KW=((flexi break*) or flexibreak*)) or(KW=((reduc* hours) or (job split*) or (on call)) or KW=(oncall or (as needed hour*) or (casual hour*)) or KW=((weekday* swap*) or (week* day* swap*) or (weekday* swap*))) or(KW=((shift self select*) or (shift self‐select*) or (week* on week* off)) or KW=((term time work*) or (term‐time work*) or (buyable leave)) or KW=((flexi week*) or (flexi year*) or (performance related pay))) or(KW=((performance‐related pay) or (adoption leave) or (adoption leave scheme*)) or KW=((flexi* lunch hour*) or (paternity scheme*) or (parental leave scheme*)) or KW=((dependent* leave) or (dependent* leave scheme*) or (special leave))) or(KW=((fixed term contract*) or (fixed‐term contract*) or (temp* employ* or temp* contract*))) or(KW=((marginal employ*) or (contingent employ*) or (atypical employ*)) or KW=((carer* leave) or (unpaid leave) or (precarious work*)) or KW=((work life polic*) or (occasional flexibil*))) or(KW=(work within 2 life within 2 polic*)) or(KW=((reduc* within 2 hours) or (job*1 sharing))) or(KW=((compress* within 2 hours) or (annualized within 2 hours) or (annualised within 2 hours))) or(KW=((day or night or late or early or evening or core or stagger* or compress* or irregular) within 2 (work* or shift*1 or hours*))) or(KW=(sabbatical* or secondment* or (career* within 3 break*)) or KW=((home working) or (work* within 2 home))) or(KW=((maternal leave) or (paternal leave) or (adapt* hours)) or KW=(time banking)) or(KW=((work life or worklife) within 2 (balance*))) or(KW=(flexible within 2 contract*))) and((KW=(work or workplace or employment)) or(KW=((company or companies) within 5 (work* or employ* or job* or staff or personnel or business*))) or(KW=(factory or factories or human resource* or Business*)) or(KW=("Small and medium enterprises" or SMEs)) or(KW=(worker* or workplace* or worksite* or staff or personnel)) or(KW=(employee* or employer*)) or(KW=(work within 3 office*)) or(KW=(work place* or work site* or work location* or work setting*)) or(KW=((job* or employment) within 2 (place* or site* or location* or setting*)))))

CINAHL (1981 ‐ ) (Ebsco)

Searched 13 May 2009

918 records retrieved 

1      exp MORBIDITY/

2      Morbidity.ti,ab

3      exp BACK PAIN/

4      BackPain.ti,ab

5      LOW BACK PAIN/

6      lbp.ti,ab

7      lumbago.ti,ab

8      exp CARDIOVASCULAR DISEASES/ OR exp CARDIOVASCULAR  

       ABNORMALITIES/

9      exp HEART DISEASES/

10    exp HYPERTENSION/

11    MENTAL HEALTH/

12    "psychological outcome$".ti,ab

13    exp ANXIETY/

14    BURNOUT, PROFESSIONAL/

15    exp STRESS, PSYCHOLOGICAL/

16    Wellbeing.ti,ab

17    PSYCHOLOGICAL WELL‐BEING/

18    (Well AND being).ti,ab

19    exp DEPRESSION/

20    well‐being.ti,ab

21    QUALITY OF LIFE/

22    exp JOB SATISFACTION/

23    EMPOWERMENT/

24    "decision latitude".ti,ab

25    "work life balance".ti,ab

26    "work‐life balance".ti,ab

27    "work family conflict$".ti,ab

28    ((musculoskeletal adj2 disorder$)).ti,ab

29    ((musculo adj2 skeletal adj2 disorder$)).ti,ab

30    exp HEALTH/

31    (promot$ OR manag$ OR facilitat$ OR enable$1 OR enabling OR barrier$1 OR

        increas$ OR obstruct$ OR encourag$ OR prevent$ OR time OR free OR disrupt$ OR

        relationship$ OR conflict).ti,ab

32    (health OR healthy OR healthier).ti,ab

33    (31 adj2 32).ti,ab

34    ((mental health OR physical health OR health risk$ OR general health)).ti,ab

35    ((employee$ OR staff)).ti,ab

36    health.ti,ab

37    (35 adj2 36).ti,ab

38    "Health of worker$".ti,ab

39    Illness.ti,ab

40    Ill.ti,ab

41    (sick$ AND absence$).ti,ab

42    SICK LEAVE/

43    ((GP OR hospital OR doctor OR gps)).ti,ab

44    ((consultation$1 OR appointment$1)).ti,ab

45    (43 adj2 44).ti,ab

46    (days AND off).ti,ab

47    exp QUALITY OF LIFE/

48    (general AND health AND questionnaire).ti,ab

49    MCGILL PAIN QUESTIONNAIRE/

50    exp BLOOD PRESSURE/

51    exp HYPERTENSION/

52    ((obesity OR obese OR overweight)).ti,ab

53    exp BACK PAIN/

54    (functional AND limitations AND profile).ti,ab

55    "SHORT FORM‐36 HEALTH SURVEY (SF‐36)"/

56    ((euroqol OR EQ‐5d)).ti,ab

57    ((facilitat$ OR enable$1 OR enabling OR barrier$1 OR obstruct$ OR encourag$ OR

        prevent$ OR time OR free OR disrupt$ OR relationship$ OR conflict)).ti,ab

58    ((household work OR house work OR chores OR hobbies OR hobby OR friends OR

        family)).ti,ab

59    (57 adj3 58).ti,ab

60    ((social activit$ OR social network$ OR social life OR free‐time OR free time)).ti,ab

61    exp CHOLESTEROL/

62    ((facilitat$ OR enable$1 OR enabling OR barrier$1 OR obstruct$ OR encourag$ OR

       prevent$ OR time OR free OR disrupt$ OR relationship$ OR conflict)).ti,ab

63    ((cooking OR cleaning)).ti,ab

64    (62 adj2 63).ti,ab

65    ((stress OR burnout OR depression OR depressed)).ti,ab

66   1 OR 2 OR 3 OR 4 OR 5 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR

       15 OR 16 OR 17 OR 18 OR 19 OR 20 OR 21 OR 22 OR 23 OR 24 OR 25 OR 26 OR 27

       OR 28 OR 29 OR 30 OR 33 OR 34 OR 37 OR 38 OR 39 OR 40 OR 41 OR 42 OR 45

       OR 46 OR 47 OR 48 OR 49 OR 50 OR 51 OR 52 OR 53 OR 54 OR 55 OR 56 OR 59

       OR 60 OR 61 OR 64 OR 65

67    (flexible AND work$).ti,ab

68    "flexible workplace".ti,ab

69    "flexible work$ condition$".ti,ab

70    "flexible work$ time$".ti,ab

71    "flexi time$".ti,ab

72    flexitime$.ti,ab

73    "flex time$".ti,ab

74    flextime$.ti,ab

75    flexi‐time$.ti,ab

76    "flexible work$ arrangement$".ti,ab

77    "flexible work$ hour$".ti,ab

78    "Work Schedule Tolerance".ti,ab

79    "self schedul$".ti,ab

80    self‐schedule$.ti,ab

81    "unusual hour$".ti,ab

82    PART TIME EMPLOYMENT/

83    "part‐time work$".ti,ab

84    "part time work$".ti,ab

85    "weekend work$".ti,ab

86    "Job$1 share$".ti,ab

87    "compress$ work$ hour$".ti,ab

88    "job‐shar$".ti,ab

89    "stagger$ hour$".ti,ab

90    "annual$ hour$".ti,ab

91    "annualised hour$".ti,ab

92    "compress$ work$ week$".ti,ab

93    overtime.ti,ab

94    shiftwork$.ti,ab

95    "shift work$".ti,ab

96    "night work$".ti,ab

97    nightwork$.ti,ab

98    PARENTAL LEAVE/

99    "long term leave".ti,ab

100  SABBATICALS/

101  secondment.ti,ab

102  "home work$".ti,ab

103  homework$.ti,ab

104  "work$ from home".ti,ab

105  TELECOMMUTING/

106  telework$.ti,ab

107  "irregular work$ hours".ti,ab

108  "irregular work$".ti,ab

109  ((phase$ adj2 retire$)).ti,ab

110  "retirement scheme$".ti,ab

111  "pension scheme$".ti,ab

112  "early retirement".ti,ab

113  PARENTAL LEAVE/

114  "maternity leave".ti,ab

115  "paternity leave".ti,ab

116  "non standard$ employ$ contract$".ti,ab

117  "non‐standard employ$ contract$".ti,ab

118  "freelance$ work$".ti,ab

119  "free‐lance$ work$".ti,ab

120  free‐lance$.ti,ab

121  freelance$.ti,ab

122  "professional$ help$ with childcare".ti,ab

123  "professional$ help$ with housework".ti,ab

124  "professional$ help$ with household work$".ti,ab

125  "workplace flexibility".ti,ab

126  "work place flexibility".ti,ab

127  "flexible contract$".ti,ab

128  "flexible salary form$".ti,ab

129  "working time directive$".ti,ab

130  "zero hours".ti,ab

131  daywork$.ti,ab

132  "day work$".ti,ab

133  piecework$.ti,ab

134  "piece work$".ti,ab

135  "adjust$ hours".ti,ab

136  "core hours".ti,ab

137  "stagger$ hours".ti,ab

138  "time in lieu".ti,ab

139  "time bank$".ti,ab

140  "flexi break$".ti,ab

141  flexibreak$.ti,ab

142  ((reduc$ ADJ hours)).ti,ab

143  "job split$".ti,ab

144  "on call".ti,ab

145  oncall.ti,ab

146  "as needed hour$".ti,ab

147  "casual hour$".ti,ab

148  "weekday$ swap$".ti,ab

149  "week day$ swap$".ti,ab

150  "weekend swap$".ti,ab

151  "shift self select$".ti,ab

152  "shift self‐select$".ti,ab

153  "week$ on week$ off".ti,ab

154  "term time work$".ti,ab

155  "term‐time work$".ti,ab

156  "buyable leave".ti,ab

157  "flexi week$".ti,ab

158  "flexi year$".ti,ab

159  "performance related pay".ti,ab

160  "performance‐related pay".ti,ab

161  "adoption leave".ti,ab

162  "adoption leave scheme$".ti,ab

163  "flexi$ lunch hour$".ti,ab

164  "paternity scheme$".ti,ab

165  "parental leave scheme$".ti,ab

166  "dependent$ leave".ti,ab

167  "dependent$ leave scheme$".ti,ab

168  "special leave".ti,ab

169  "fixed term contract".ti,ab

170  "fixed‐term contract$".ti,ab

171  ((temp$ employ$ OR temp$ contract$)).ti,ab

172  "marginal employ$".ti,ab

173  "contingent employ$".ti,ab

174  "atypical employ$".ti,ab

175  "carer$ leave".ti,ab

176  "unpaid leave".ti,ab

177  "precarious work".ti,ab

178  "work life polic$".ti,ab

179  "occasional flexibil$".ti,ab

180  ((work adj2 life adj2 polic$)).ti,ab

181  ((occasional adj2 flexibil$)).ti,ab

182  ((reduc$ ADJ 2hours)).ti,ab

183  "job$1 sharing".ti,ab

184  ((Compress$ adj2 hours)).ti,ab

185  ((Stagger$ adj2 hours)).ti,ab

186  ((Annuali?ed adj2 hours)).ti,ab

187  ((compress$ adj2 week)).ti,ab

188  ((day OR night OR late OR early OR evening OR core OR stagger$ OR compress$ OR

       irregular)).ti,ab

189  ((work$ OR shift$1 OR hours$)).ti,ab

190  (188 adj2 189).ti,ab

191  SABBATICALS/

192  secondment.ti,ab

193  ((career$ adj3 break$)).ti,ab

194  "home working".ti,ab

195  ((work$ adj2 home)).ti,ab

196  "maternal leave".ti,ab

197  "Maternity leave".ti,ab

198  "paternal leave".ti,ab

199  "paternity leave".ti,ab

200  (((work life OR worklife) adj2 balance$)).ti,ab

201  ((work life OR worklife)).ti,ab

202  Balance.ti,ab

203  (201 adj2 202).ti,ab

204  "adapt$ hours".ti,ab

205  "time banking".ti,ab

206  "work hour$1 restriction$".ti,ab

207   67 or 68 or 69 or 70 or 71 or 72 or 73 or 74 or 75 or 76 or 77 or 78 or 79 or 80 or 81 or

         82 or 83 or 84 or 85 or 86 or 87 or 88 or 89 or 90 or 91 or 92 or 93 or 94 or 95 or 96 or

         97 or 98 or 99 or 100 or 101 or 102 or 103 or 104 or 105 or 106 or 107 or 108 or 109 or

         110 or 111 or 112 or 113 or 114 or 115 or 116 or 117 or 118 or 119 or 120 or 121 or 122

         or 123 or 124 or 125 or 126 or 127 or 128 or 129 or 130 or 131 or 132 or 133 or 134 or

         135 or 136 or 137 or 138 or 139 or 140 or 141 or 142 or 143 or 144 or 145 or 146 or 147

         or 148 or 149 or 150 or 151 or 152 or 153 or 154 or 155 or 156 or 157 or 158 or 159 or

         160 or 161 or 162 or 163 or 164 or 165 or 166 or 167 or 168 or 169 or 170 or 171 or 172

         or 173 or 174 or 175 or 176 or 177 or 178 or 179 or 180 or 181 or 182 or 183 or 184 or

         185 or 186 or 187

208  work.ti,ab

209  workplace.ti,ab

210  employment.ti,ab

211  (company OR companies).ti,ab

212  (work$ OR employ$ OR job$ OR staff OR personnel OR business$).ti,ab

213  (211 adj5 212).ti,ab

214  211 and 212

215  (factory OR factories OR human AND resource$ OR Business$).ti,ab

216  (("Small and medium enterprises" OR SMEs)).ti,ab

217  ((worker$ OR workplace$ OR worksite$ OR staff OR personnel)).ti,ab

218  ((employee$ OR employer$)).ti,ab

219  ((work$ adj3 office$)).ti,ab

220  ((work place$ OR work site$ OR work location$ OR work setting$)).ti,ab

221  ((job$ OR employment)).ti,ab

222  ((place$ OR site$ OR location$ OR setting$)).ti,ab

223  (221 adj2 222).ti,ab

224  208 or 209 or 210 or 213 or 214 or 215 or 216 or 217 or 218 or 219 or 220 or 223

225   224 and 207 and 66

COCHRANE (1988 ‐ ) (Wiley)

Searched 1 July 2009

99 records retrieved

#1  MeSH descriptor Mortality explode all trees

#2  (facilitat* or enable* or enabling or barrier* or obstruct* or encourag* or prevent* or time or free or disrupt* or relationship* or conflict) adj2 (cooking or cleaning)

#3  cholesterol

#4  ("social activit*" or "social network" or "social life" or free‐time or "free time")

#5  (facilitat* or enable* or enabling or barrier* or obstruct* or encourag* or prevent* or time or free or disrupt* or relationship* or conflict) adj3 ("household work" or "house work" or chores or hobbies or hobby or friends or family)

#6  ("short form 36" or SF‐36)

#7  "back pain"

#8  (euroqol or EQ‐5d)

#9  (obesity or obese or overweight)

#10  "functional limitations profile"

#11  hypertension

#12  "blood pressure"

#13  "mcGill pain questionnaire" 

#14  "general health questionnaire"

#15  "quality of life"

#16  "days off"

#17  (GP or hospital or doctor or gp) adj2 (consultation* or appointment*)

#18  (GP or hospital or doctor or gps) adj2 (consultation$1 or appointment$1)

#19  "sick* leave"

#20  "sick* absence*"

#21  ill

#22  illness

#23  "health of worker*"

#24  (employee* or staff) adj2 health

#25  "mental health" or "physical health" or "health risk*" or "general health"

#26  (promot* or manag* or facilitat* or enable* or enabling or barrier* or increas* or obstruct* or encourag* or prevent* or time or free or disrupt* or relationship* or conflict) adj2 (health or healthy or healthier)

#27  MeSH descriptor Health explode all trees

#28  "musculo adj2 skeletal adj2 disorder*"

#29  "musculoskeletal adj2 disorder*"

#30  "work family conflict*"

#31  "work‐life balance"

#32  "work life balance"

#33  "decision latitude"

#34  empower*

#35  MeSH descriptor Job Satisfaction explode all trees

#36  MeSH descriptor Quality of Life explode all trees

#37  "well‐being"

#38  MeSH descriptor Depression explode all trees

#39  wellbeing

#40  MeSH descriptor Stress, Psychological explode all trees

#41  MeSH descriptor Burnout, Professional explode all trees

#42  MeSH descriptor Anxiety explode all trees

#43  "psychological outcome*"

#44  MeSH descriptor Mental Health explode all trees

#45  MeSH descriptor Hypertension explode all trees

#46  MeSH descriptor Heart Diseases explode all trees

#47  MeSH descriptor Cardiovascular Diseases explode all trees

#48l  umbago

#49  MeSH descriptor Low Back Pain explode all trees

#50  lbp

#51  backpain

#52  MeSH descriptor Back Pain explode all trees

#53  MeSH descriptor Mortality explode all trees

#54  (#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12 OR #13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #19 OR #20 OR #21 OR #22 OR #23 OR #24 OR #25 OR #26 OR #27 OR #28 OR #29 OR #30 OR #31 OR #32 OR #33 OR #34 OR #35 OR #36 OR #37 OR #38 OR #39 OR #40 OR #41 OR #42 OR #43 OR #44 OR #45 OR #46 OR #47 OR #48 OR #49 OR #50 OR #51 OR #52 OR #53)

#55  mortality

#56  (#54 OR #55)

#57  "flexible work"

#58  "flexible workplace"

#59  "flexible work* condition*"

#60  "flexible work* time*"

#61  "flexi time*"

#62  flexitime*

#63  "flex time*"

#64 flextime*

#65  flexi‐time*

#66  "flexible work* arrangement*"

#67  "flexible work* hour*"

#68  MeSH descriptor Work Schedule Tolerance explode all trees

#69  "self schedul*"

#70  self‐schedule*

#71  "unusual hour*"

#72  "part‐time work*"

#73  "part time work*"

#74  "weekend work*"

#75  "Job* share*"

#76  "compress* work* hour*"

#77  "job‐shar*"

#78  "stagger* hour*"

#79  "annual* hour*"

#80  "annualised hour*"

#81  "annualized hour*"

#82  "compress* work* week*"

#83  overtime

#84  shiftwork*

#85  "shift work*"

#86  "night work*"

#87  nightwork*

#88  MeSH descriptor Parental Leave explode all trees

#89  "long term leave"

#90  sabbatical

#91  secondment

#92  "home work*"

#93  homework*

#94  "work* from home"

#95  telework*

#96  "irregular work* hours"

#97  "irregular work*"

#98  ("phase* adj2 retire*")

#99  "retirement scheme*"

#100 "pension scheme*"

#101 "early retirement"

#102 "maternity leave"

#103 "paternity leave"

#104 "non standard* employ* contract*"

#105 "non‐standard employ* contract*"

#106 "freelance* work*"

#107 "free‐lance* work*"

#108 free‐lance*

#109 freelance*

#110 "professional* help* with childcare"

#111 "professional* help* with housework"

#112 "professional* help* with household work*"

#113 "workplace flexibility"

#114 "work place flexibility"

#115 "flexible contract*"

#116 "flexible salary form*"

#117 "working time directive*"

#118 "zero hours"

#119 daywork*

#120 "day work*"

#121 piecework*

#122 "piece work*"

#123 "adjust* hours"

#124 "core hours"

#125 "stagger* hours"

#126 "time in lieu"

#127 "time bank*"

#128 "flexi break*"

#129 flexibreak*

#130 ("reduc* adj hours")

#131 "job split*"

#132 "on call"

#133 oncall

#134 "as needed hour*"

#135 "casual hour*"

#136 "weekday* swap*"

#137 "week day* swap*"

#138 "weekend swap*"

#139 "shift self select*"

#140 "shift self‐select*"

#141 "week* on week* off"

#142 "term time work*"

#143 "term‐time work*"

#144 "buyable leave"

#145 "flexi week*"

#146 "flexi year*"

#147 "performance related pay"

#148 "performance‐related pay"

#149 "adoption leave"

#150 "adoption leave scheme*"

#151 "flexi* lunch hour*"

#152 "paternity scheme*"

#153 "parental leave scheme*"

#154 "dependent* leave"

#155 "dependent* leave scheme*"

#156 "special leave"

#157 "fixed term contract*"

#158 "fixed‐term contract*"

#159 ("temp* employ*" or "temp* contract*")

#160 "marginal employ*"

#161 "contingent employ*"

#162 "atypical employ*"

#163 "carer* leave"

#164 "unpaid leave"

#165 "precarious work*"

#166 "work life polic*"

#167 "occasional flexibil*"

#168 ("work adj2 life adj2 polic*")

#169 ("reduc* adj2 hours")

#170 "job* sharing"

#171 ("Compress* adj2 hours")

#172 ("Stagger* adj2 hours")

#173 ("Annuali?ed adj2 hours")

#174 ("compress adj2 week")

#175 (day or night or late or early or evening or core or stagger* or compress* or irregular)    adj2 (work* or shift* or hours*)

#176 Sabbatical*

#177 Secondment*

#178 ("career* adj3 break*")

#179 "home working"

#180 ("work* adj2 home")

#181 "maternal leave"

#182 "paternal leave"

#183 (work life or worklife) adj2 balance

#184 ("flexible adj2 contract*")

#185 "adapt* hours"

#186 "time banking"

#187 "work hour* restriction*"

#188 "flexible work* condition"

#189 (#57 OR #58 OR #59 OR #60 OR #61 OR #62 OR #63 OR #64 OR #65 OR #66 OR #67 OR #68 OR #69 OR #70 OR #71 OR #72 OR #73 OR #74 OR #75 OR #76 OR #77 OR #78 OR #79 OR #80 OR #81 OR #82 OR #83 OR #84 OR #85 OR #86 OR #87 OR #88 OR #89 OR #90 OR #91 OR #92 OR #93 OR #94 OR #95 OR #96 OR #97 OR #98 OR #99 OR #100 OR #101 OR #102 OR #103 OR #104 OR #105 OR #106 OR #107 OR #108 OR #109 OR #110 OR #111 OR #112 OR #113 OR #114 OR #115 OR #116 OR #117 OR #118 OR #119 OR #120 OR #121 OR #122 OR #123 OR #124 OR #125 OR #126 OR #127 OR #128 OR #129 OR #130 OR #131 OR #132 OR #133 OR #134 OR #135 OR #136 OR #137 OR #138 OR #139 OR #140 OR #141 OR #142 OR #143 OR #144 OR #145 OR #146 OR #147 OR #148 OR #149 OR #150 OR #151 OR #152 OR #153 OR #154 OR #155 OR #156 OR #157 OR #158 OR #159 OR #160 OR #161 OR #162 OR #163 OR #164 OR #165 OR #166 OR #167 OR #168 OR #169 OR #170 OR #171 OR #172 OR #173 OR #174 OR #175 OR #176 OR #177 OR #178 OR #179 OR #180 OR #181 OR #182 OR #183 OR #184 OR #185 OR #186 OR #187 OR #188)

#190 work or workplace or employment

#191 (company or companies) adj5 (work* or employ* or job* or staff or personnel or business*)

#192 (factory or factories or "human resource*" or Business*)

#193 "Small and medium enterprises" or SMEs

#194 (worker* or workplace* or worksite* or staff or personnel)

#195 (employee* or employer*)

#196 ("work* adj3 office*")

#197 "work place*" or "work site*" or "work location*" or "work setting*"

#198 (job* or employment) adj2 (place* or site* or location* or setting*)

#199 (#190 OR #191 OR #192 OR #193 OR #194 OR #195 OR #196 OR #197 OR #198)

#200 (#54 AND #189)

#201 (#200 AND #199)

#202 (#200 AND #199)

#203 MeSH descriptor Work explode all trees

#204 MeSH descriptor Employment explode all trees

#205 MeSH descriptor Occupational Health explode all trees

#206 (#203 OR #204 OR #205)

#207 (#189 AND #206)

Cochrane Public Health Group Specialised Register of Studies (register is in development)

Searched June 2009

18 studies identified as potentially relevant.

Flexi or Work or Shift or Hour or Schedule or Job or Time or Sabbatical or Secondment or Scheme or Leave or Freelance or Pay or Contract or Compress

EMBASE ( 1980 to 2009 Week 17) (Ovid)

Searched 1 May 2009

2382 records retrieved  

1 exp Morbidity/ or morbidity.ti,ab.

2 exp Back Pain/

3 backpain.mp.

5 exp Low Back Pain/

6 lumbago.mp.

7 exp Cardiovascular Diseases/

8 exp Heart Diseases/

9 exp Hypertension/

10 exp Mental Health/

11 psychological outcome$.mp.

12 exp Anxiety/

13 exp Burnout, Professional/

14 exp Stress, Psychological/

15 wellbeing.mp.

16 exp Depression/

17 well‐being.mp.

18 exp "Quality of Life"/

19 exp Job Satisfaction/

20 empower$.mp.

21 decision latitude.mp.

22 work life balance.mp.

23 work‐life balance.mp.

24 work family conflict$.mp.

25 (musculoskeletal adj2 disorder$).mp.

26 (musculo adj2 skeletal adj2 disorder$).mp.

27 exp health/

28 ((promot$ or manag$ or facilitat$ or enable$1 or enabling or barrier$1 or increas$ or obstruct$ or encourag$ or prevent$ or time or free or disrupt$ or relationship$ or conflict) adj2 (health or healthy or healthier)).ti,ab.

29 (mental health or physical health or health risk$ or general health).ti,ab.

30 ((employee$ or staff) adj2 health).ti,ab.

31 health of worker$.ti,ab.

32 illness.ti,ab.

33 ill.ti,ab.

34 sick$ absence$.ti,ab.

35 sick$ leave.ti,ab.

36 ((GP or hospital or doctor or gps) adj2 (consultation$1 or appointment$1)).ti,ab.

37 days off.ti,ab.

38 quality of life.ti,ab.

39 general health questionnaire.ti,ab.

40 mcGill pain questionnaire.ti,ab.

41 blood pressure.ti,ab.

42 hypertension.ti,ab.

43 (obesity or obese or overweight).ti,ab.

44 back pain.ti,ab.

45 functional limitations profile.ti,ab.

46 (short form 36 or SF‐36).ti,ab.

47 (euroqol or EQ‐5d).ti,ab.

48 ((facilitat$ or enable$1 or enabling or barrier$1 or obstruct$ or encourag$ or prevent$ or time or free or disrupt$ or relationship$ or conflict) adj3 (household work or house work or chores or hobbies or hobby or friends or family)).ti,ab.

49 (social activit$ or social network$ or social life or free‐time or free time).ti,ab.

50 cholesterol.ti,ab.

51 ((facilitat$ or enable$1 or enabling or barrier$1 or obstruct$ or encourag$ or prevent$ or time or free or disrupt$ or relationship$ or conflict) adj2 (cooking or cleaning)).ti,ab.

52 (stress or burnout or depression or depressed).ti,ab.

53 or/1‐52

54 flexible work$.ti,ab.

55 flexible workplace.ti,ab.

56 flexible work$ condition$.ti,ab.

57 flexible work$ time$.ti,ab.

58 flexi time$.ti,ab.

59 flexitime$.ti,ab.

60 flex time$.ti,ab.

61 flextime$.ti,ab.

62 flexi‐time$.ti,ab.

63 flexible work$ arrangement$.mp.

64 flexible work$ hour$.mp.

65 exp Work Schedule Tolerance/

66 "self schedul$".ti,ab.

67 self‐schedule$.ti,ab.

68 unusual hour$.ti,ab.

69 part‐time work$.ti,ab.

70 part time work$.ti,ab.

71 weekend work$.ti,ab.

72 Job$1 share$.ti,ab.

73 compress$ work$ hour$.ti,ab.

74 job‐shar$.ti,ab.

75 stagger$ hour$.ti,ab.

76 annual$ hour$.ti,ab.

77 annualised hour$.mp.

78 annualized hour$.mp.

79 compress$ work$ week$.mp.

80 overtime.mp.

81 shiftwork$.mp.

82 shift work$.mp.

83 night work$.mp.

84 nightwork$.mp.

85 exp Parental Leave/

86 long term leave.mp.

87 sabbatical.mp.

88 secondment.mp.

89 home work$.ti,ab.

90 homework$.ti,ab.

91 work$ from home.mp.

92 telework$.mp.

93 irregular work$ hours.mp.

94 irregular work$.mp.

95 (phase$ adj2 retire$).ti,ab.

96 retirement scheme$.mp.

97 pension scheme$.mp.

98 early retirement.mp.

99 maternity leave.mp.

100 paternity leave.mp.

101 non standard$ employ$ contract$.ti,ab.

102 non‐standard employ$ contract$.ti,ab.

103 freelance$ work$.mp.

104 free‐lance$ work$.mp.

105 free‐lance$.mp.

106 freelance$.mp.

107 professional$ help$ with childcare.mp.

108 professional$ help$ with housework.mp.

109 professional$ help$ with household work$.mp.

110 workplace flexibility.mp.

111 work place flexibility.mp.

112 flexible contract$.mp.

113 flexible salary form$.mp.

114 working time directive$.mp.

115 zero hours.mp.

116 daywork$.mp.

117 day work$.mp.

118 piecework$.mp.

119 piece work$.mp.

120 adjust$ hours.mp.

121 core hours.mp.

122 stagger$ hours.mp.

123 time in lieu.mp.

124 time bank$.mp.

125 flexi break$.mp.

126 flexibreak$.mp.

127 (reduc$ adj hours).mp.

128 job split$.mp.

129 on call.ti,ab.

130 oncall.mp.

131 as needed hour$.mp.

132 casual hour$.mp.                   

133 weekday$ swap$.mp.

134 week day$ swap$.mp.

135 weekend swap$.mp.

136 shift self select$.mp.

137 shift self‐select$.mp.

138 week$ on week$ off.mp.

139 term time work$.mp.

140 term‐time work$.mp.

141 buyable leave.mp.

142 flexi week$.mp.

143 flexi year$.mp.

144 performance related pay.mp.

145 performance‐related pay.mp.

146 adoption leave.mp.

147 adoption leave scheme$.mp.

148 flexi$ lunch hour$.mp.

149 paternity scheme$.mp.

150 parental leave scheme$.mp.

151 dependent$ leave.mp.

152 dependent$ leave scheme$.mp.

153 special leave.mp.

154 fixed term contract$.mp.

155 fixed‐term contract$.mp.

156 (temp$ employ$ or temp$ contract$).ti,ab.

157 marginal employ$.mp.

158 contingent employ$.mp.

159 atypical employ$.mp.

160 carer$ leave.mp.

161 unpaid leave.mp.

162 precarious work$.mp.

163 work life polic$.mp.

164 occasional flexibil$.mp.

165 (work adj2 life adj2 polic$).mp.

166 (occasional adj2 flexibil$).

167 (reduc$ adj 2hours).ti,ab.

168 job$1 sharing.mp.

169 (Compress$ adj2 hours).mp

170 (Stagger$ adj2 hours).mp.

171 (Annuali?ed adj2 hours).mp.

172 (compress$ adj2 week).mp.

173 ((day or night or late or early or evening or core or stagger$ or compress$ or irregular) adj2 (work$ or shift$1 or hours$)).

174 Sabbatical$.mp.

175 Secondment$.mp.

176 (career$ adj3 break$). 177 home working.mp.

178 (work$ adj2 home).mp179 maternal leave.mp.

180 paternal leave.mp.

181 ((work life or worklife) adj2 balance$).

182 (flexible adj2 contract$).

183 adapt$ hours.mp.

184 time banking.mp.

185 work hour$1 restriction$.mp.

186 or/54‐185

187 work/ or workplace/ or employment/

188 ((company or companies) adj5 (work$ or employ$ or job$ or staff or personnel or business$)).ti,ab.

189 (factory or factories or human resource$ or Business$).ti,ab.

190 ("Small and medium enterprises" or SMEs).ti,ab.

191 (worker$ or workplace$ or worksite$ or staff or personnel).ti,ab.

192 (employee$ or employer$).ti,ab.

193 (work$ adj3 office$).ti,ab.

194 (work place$ or work site$ or work location$ or work setting$).ti,ab.

195 ((job$ or employment) adj2 (place$ or site$ or location$ or setting$)).ti,ab.

196 or/187‐195

197 196 and 186 and 53

IBSS (International Bibliography of the Social Sciences) (1951 ‐ ) (Ebsco)

Searched 19 June 2009

428 records retrieved 

S226     (S224 and S225)

S225     (S64 and S199)

S224     S200 or S201 or S202 or S204 or S205 or S206 or S207 or S208 or S209 or S210 or

             S212 or S213 or S214 or S215 or S216 or S217 or S218 or S219 or S220 or S221 or

             S222

S223     TX ((job* or employment) w2 (place* or site* or location* or setting*))

S222     TX work setting*

S221     TX work location*

S220     TX work site* 

S219     TX work place*

S218     TX (work* w3 office*)

S217     TX employer*

S216     TX employee* 

S215     TX personnel

S214     TX staff

S213     TX worksite*    

S212     TX workplace*

S211     TX workerplace*

S210     TX worker* 

S209     TX Business*

S208     TX human resource*

S207     TX factories

S206     TX factory

S205     TX SMEs

S204     TX "Small and medium enterprises"

S203     TX ((company or companies) w5 (work* or employ* or job* or staff or personnel or

               business*))

S202     TX employment

S201     TX workplace

S200     TX work

S199     (S65 or S66 or S67 or S68 or S69 or S70 or S71 or S72 or S73 or S74 or S75 or S80

                or S81 or S82 or S85 or S87 or S88 or S89 or S90 or S91 or S92 or S93 or S94 or

                S95 or S96 or S97 or S98 or S99 or S100 or S101 or S102 or S103 or S105 or S106

                or S107 or S108 or S109 or S110 or S111 or S112 or S113 or S114 or S115 or S116

                or S117 or S121 or S123 or S125 or S126 or S127 or S128 or S129 or S130 or S131

                or S135 or S138 or S139 or S140 or S150 or S151 or S155 or S156 or S162 or S162

                or S166 or S167 or S168 or S169 or S170 or S171 or S172 or S173 or S174 or S175

                or S176 or S178 or S180 or S183 or S184 or S185 or S187 or S188 or S189 or S190

                or S191 or S194 or S196 or S198)(S65 or S66 or S67 or S68 or S69 or S70 or S71

                or S72 or S73 or S74 or S75 or S80 or S81 or S82 or S85 or S87 or S88 or S89 or

                S90 or S91 or S92 or S93 or S94 or S95 or S96 or S97 or S98 or S99 or S100 or

                S101 or S102 or S103 or S105 or S106 or S107 or S108 or S109 or S110 or S111 or

                S112 or S113 or S114 or S115 or S116 or S117 or S121 or S123 or S125 or S126 or

                S127 or S128 or S129 or S130 or S131 or S135 or S138 or S139 or S140 or S150 or

                S151 or S155 or S156 or S162 or S162 or S166 or S167 or S168 or S169 or S170 or

                S171 or S172 or S173 or S174 or S175 or S176 or S178 or S180 or S183 or S184 or

                S185 or S187 or S188 or S189 or S190 or S191 or S194 or S196 or S198)(S65 or

                S66 or S67 or S68 or S69 or S70 or S71 or S72 or S73 or S74 or S75 or S80 or S81

                or S82 or S85 or S87 or S88 or S89 or S90 or S91 or S92 or S93 or S94 or S95 or

                S96 or S97 or S98 or S99 or S100 or S101 or S102 or S103 or S105 or S106 or

                S107 or S108 or S109 or S110 or S111 or S112 or S113 or S114 or S115 or S116 or

               S117 or S121 or S123 or S125 or S126 or S127 or S128 or S129 or S130 or S131 or

               S135 or S138 or S139 or S140 or S150 or S151 or S155 or S156 or S162 or S162 or

               S166 or S167 or S168 or S169 or S170 or S171 or S172 or S173 or S174 or S175 or

               S176 or S177 or S178 or S179 or S180 or S181 or S182 or S183 or S184 or S185 or

               S186 or S187 or S188 or S189 or S190 or S191 or S192 or S193 or S194 or S195 or

               S196 or S197 or S198)

S198     TX study leave

S197     TX work hour*1 restriction*

S196     TX time banking

S195     TX adapt* hours

S194     TX (flexible w2 contract*)

S193     TX (work life or work life) w2 (balance*)

S192     TX (work life or worklife) w2 (balance*)

S191     TX paternal leave

S190     TX maternal leave

S189     TX (work* w2 home)

S188     TX home working

S187     TX (career* w3 break*)

S186     TX ((day or night or late or early or evening or core or stagger* or compress* or

                irregular) w2 (work* or shift*1 or hours*))

S185     TX (compress* w2 week)

S184     TX (Annuali?ed w2 hours)

S183     TX (Stagger* w2 hours)

S182     TX (Compress* w2 hours)

S181     TX job*1 sharing

S180     TX (reduc* w2 hours)

S179     TX (occasional w2 flexibil*)

S178     TX (work w2 life w2 polic*)

S177     TX occasional flexibil*

S176     TX work life polic*

S175     TX precarious work*

S174     TX unpaid leave

S173     TX carer* leave

S172     TX atypical employ*

S171     TX contingent employ*

S170     TX marginal employ*

S169     TX temp* contract*

S168     TX temp* employ*

S167     TX fixed‐term contract*

S166     TX fixed term contract*

S165     TX special leave

S164     TX dependent* leave scheme*

S163     TX dependent* leave

S162     TX parental leave scheme*

S 161    TX paternity scheme*

S160     TX paternity leave scheme*

S159     TX flexi* lunch hour*

S158     TX adoption leave scheme*

S157     TX adoption leave

S156     TX performance‐related pay

S155     TX performance related pay

S154     TX flexi year*

S153     TX flexi week*

S152     TX buyable leave

S151     TX term‐time work*

S150     TX term time work*

S149     TX week* on week* off

S148     TX shift self‐select*

S147     TX shift self select*                                                                             

S146     TX weekend swap*

S145     TX week day* swap*

S144   TX weekday* swap*

S143     TX casual hour*

S142     TX as needed hours

S141   TX oncall

S140     TX on call

S139     TX job split*

S138   TX (reduce* hours)

S137     TX flexibreak*

S136     TX flexi break*

S135     TX time bank*

S134    TX time in lieu

S133     TX stagger* hours

S132     TX core hours

S131     TX adjust* hours

S130     TX piece work*

S129     TX piecework*

S128     TX day work*

S127     TX daywork*

S126     TX zero hours

S125     TX working time directive*

S124     TX flexible salary form*

S123     TX flexible contract*

S122     TX work place flexibility

S121     TX workplace flexibility

S120     TX professional* help* with household work*

S119     TX professional* help* with housework

S118     TX professional* help* with childcare

S117     TX freelance*

S116     TX free‐lance*

S115     TX free‐lance* work*

S114     TX freelance* work*

S113     TX non‐standard employ* contract*

S112     TX non standard* employ* contract*

S111     TX paternity leave

S110     TX maternity leave

S109     TX early retirement

S108     TX pension scheme*

S107     TX retirement scheme*

S106     TX (phase* w2 retire*)

S105     TX irregular work*

S104     TX irregular work* hours

S103     TX telework*

S102     TX work* from home

S101     TX homework*

S100     TX home work*

S99       TX secondment

S98       TX sabbatical

S97       TX long term leave

S96       TX parental leave

S95       TX nightwork*

S94      TX night work*

S93      TX shift work*

S92      TX shiftwork*

S91      TX overtime

S90       TX compress* work* week*

S89       TX annualized hour*

S88       TX annualised hour*

S87       TX annual* hour*

S86       TX stagger* hour*

S85      TX job‐shar*

S84       TX compress* work* hour*

S83       TX Job*1 share*

S82       TX weekend work*

S81      TX part time work*

S80       TX part‐time work*

S79       TX unusual hour*

S78       TX self‐schedul*

S77      TX "self schedul*"

S76       TX work schedule tolerance

S75       TX flexible work* hour*

S74       TX flexible work* arrangement*

S73       TX flexi‐time*

S72      TX flextime*

S71      TX flex time*

S70      TX flexitime*

S69      TX flexi time*

S68       TX flexible work* time*

S67       TX flexible work* condition*

S66       TX flexible workplace

S65       TX flexible work*

S64       S1 or S2 or S3 or S4 or S6 or S7 or S9 or S10 or S11 or S12 or S13 or S14 or

               S15 or S16 or S17 or S18 or S19 or S20 or S21 or S22 or S23 or S24 or S25

               or S26 or S27 or S29 or S30 or S31 or S35 or S36 or S37 or S38 or S39 or

               S41 or S42 or S43 or S44 or S45 or S46 or S47 or S48 or S50 or S51 or S52

               or S53 or S55 or S56 or S57 or S58 or S59 or S61 or S62 or S63                                                                         Search modes ‐

S63      TX depressed

S62      TX burnout

S61      TX stress

S60      TX ((facilitat* or enable*1 or enabling or barrier*1 or obstruct* or encourage* or

                prevent* or time or free or disrupt* or relationship* or conflict) w2 (cooking or

                cleaning))

S59      TX cholesterol

S58      TX free time

S57      TX free‐time

S56      TX social network*

S55      TX social activit*

S54      TX ((facilitat* or enable*1 or enabling or barrier*1 or obstruct* or encourage* or

               prevent* or time or free or disrupt* or relationship* or conflict) w3 (household work

               or house work or chores or hobbies or hobby or friends or family))

S53      TX EQ‐5d

S52      TX euroqol

S51      TX SF‐36

S50      TX short form 36

S49      TX functional limitations profile

S48      TX overweight

S47      TX obese

S46      TX obesity

S45      TX blood pressure

S44      TX mcGill pain questionnaire

S43      TX general health questionnaire

S42      TX quality of life

S41      TX days off

S40      TX ((GP or hospital or doctors or gps) w2 (consultation*1 or appointment*1))

S39      TX sick* leave

S38      TX sick* absence*

S37      TX ill

S36      TX illness

S35      TX health of worker*

S34      TX (employee* or staff) w2 (health)

S33      TX ((employee* or staff) w2 health))

S32      TX ((employee* or staff) w2 health)

S31      TX general health

S30      TX health risk*

S29      TX physical health

S28      TX ((promot* or manag* or facilitat* or enable*1 or enabling or barrier*1 or

               increas* or obstruct* or encourag* or prevent* or time or free or disrupt* or

               relationship* or conflict) w2 (health or healthy or healthier))

S27      TX health

S26      TX (musculo w2 skeletal w2 disorder*)

S25      TX (musculoskeletal w2 disorder*)

S24      TX work family conflict*

S23      TX work‐life balance

S22      TX work life balance

S21      TX decision latitude

S20      TX empower*

S19      TX job satisfaction

S18      TX "quality of life"

S17      TX well‐being

S16      TX depression

S15      TX wellbeing

S14      TX psychological stress

S13      TX professional burnout

S12      TX anxiety

S11      TX psychological outcome*

S10      TX mental health

S9        TX hypertension

S8        TX heart diseases

S7        TX heart diseases

S6        TX cardiovascular diseases

S5        TX lumbago

S4        TX low back pain

S3        TX lbp

S2        TX back pain

S1        TX morbidity 

MEDLINE  (1950 ‐ ) (Ovid)

Searched 30 March 2009

3055 records retrieved

1          exp Morbidity/ or morbidity.ti,ab.

2          exp Back Pain/

3          backpain.mp.

4          lbp.mp.

5          exp Low Back Pain/

6          lumbago.mp.

7          exp Cardiovascular Diseases/

8          exp Heart Diseases/

9          exp Hypertension/

10         exp Mental Health/

11         psychological outcome$.mp.

12         exp Anxiety/

13         exp Burnout, Professional/

14         exp Stress, Psychological/

15         wellbeing.mp.

16         exp Depression/

17         well‐being.mp.

18         exp "Quality of Life"/

19         exp Job Satisfaction/

20         empower$.mp.

21         decision latitude.mp.

22         work life balance.mp

23         work‐life balance.mp

24         work family conflict$.mp.

25         (musculoskeletal adj2 disorder$).mp.

26         (musculo adj2 skeletal adj2 disorder$).mp.

27         exp health/

28         ((promot$ or manag$ or facilitat$ or enable$1 or enabling or barrier$1 or increas$ or 

              obstruct$ or encourag$ or prevent$ or time or free or disrupt$ or relationship$ or  

              conflict) adj2 (health or healthy or healthier)).ti,ab.

29         (mental health or physical health or health risk$ or general health).ti,ab.

30         ((employee$ or staff) adj2 health).ti,ab.

31         health of worker$.ti,ab.

32         illness.ti,ab.

33         ill.ti,ab.

34         sick$ absence$.ti,ab.

35         sick$ leave.ti,ab.

36         ((GP or hospital or doctor or gps) adj2 (consultation$1 or appointment$1)).ti,ab.

37         days off.ti,ab.

38         quality of life.ti,ab.

39         general health questionnaire.ti,ab.

40         mcGill pain questionnaire.ti,ab.

41         blood pressure.ti,ab.

42       hypertension.ti,ab.

43         (obesity or obese or overweight).ti,ab.

44         back pain.ti,ab.

45         functional limitations profile.ti,ab.

46         (short form 36 or SF‐36).ti,ab.

47         (euroqol or EQ‐5d).ti,ab.

48         ((facilitat$ or enable$1 or enabling or barrier$1 or obstruct$ or encourag$ or prevent$

              or time or free or disrupt$ or relationship$ or conflict) adj3 (household work or

              house work or chores or hobbies or hobby or friends or family)).ti,ab.

49         (social activit$ or social network$ or social life or free‐time or free time).ti,ab.

50         cholesterol.ti,ab.

51         ((facilitat$ or enable$1 or enabling or barrier$1 or obstruct$ or encourag$ or prevent$

              or time or free or disrupt$ or relationship$ or conflict) adj2 (cooking or

              cleaning)).ti,ab.          

52         (stress or burnout or depression or depressed).ti,ab.

53         or/1‐52

54         flexible work$.ti,ab.

55         flexible workplace.ti,ab.

56         flexible work$ condition$.ti,ab.

57         flexible work$ time$.ti,ab.

58         flexi time$.ti,ab.

59         flexitime$.ti,ab.

60         flex time$.ti,ab.

61         flextime$.ti,ab.

62         flexi‐time$.ti,ab

63         flexible work$ arrangement$.mp.

64         flexible work$ hour$.mp.

65         exp Work Schedule Tolerance/

66         "self schedul$".ti,ab.

67         self‐schedule$.ti,ab.

68          unusual hour$.ti,ab.

69         part‐time work$.ti,ab.

70         part time work$.ti,ab.

71         weekend work$.ti,ab.

72         Job$1 share$.ti,ab.

73         compress$ work$ hour$.ti,ab.

74         job‐shar$.ti,ab.

75         stagger$ hour$.ti,ab.

76         annual$ hour$.ti,ab.

77         annualised hour$.mp.

78         annualized hour$.mp.

79         compress$ work$ week$.mp.

80         overtime.mp.

81         shiftwork$.mp.

82         shift work$.mp.

83         night work$.mp.

84         nightwork$.mp.

85         exp Parental Leave/

86         long term leave.mp.

87         sabbatical.mp.

88         secondment.mp

89         home work$.ti,ab.

90         homework$.ti,ab.

91         work$ from home.mp.

92         telework$.mp.

93         irregular work$ hours.mp.

94         irregular work$.mp.

95         (phase$ adj2 retire$).ti,ab.

96         retirement scheme$.mp.

97         pension scheme$.mp.

98         early retirement.mp.

99         maternity leave.mp.

100       paternity leave.mp.

101       non standard$ employ$ contract$.ti,ab.

102       non‐standard employ$ contract$.ti,ab.

103       freelance$ work$.mp.

104       free‐lance$ work$.mp

105       free‐lance$.mp.

106       freelance$.mp.

107       professional$ help$ with childcare.mp.

108       professional$ help$ with housework.mp.

109       professional$ help$ with household work$.mp.

110       workplace flexibility.mp.

111       work place flexibility.mp.

112       flexible contract$.mp.

113       flexible salary form$.mp.

114       working time directive$.mp.

115       zero hours.mp.

116       daywork$.mp.

117       day work$.mp

118       piecework$.mp.

119       piece work$.mp.

120       adjust$ hours.mp.

121       core hours.mp.

122       stagger$ hours.mp.

123       time in lieu.mp.

124       time bank$.mp.

125       flexi break$.mp.

126       flexibreak$.mp.

127       (reduc$ adj hours).mp.

128       job split$.mp.

129       on call.ti,ab.

130       oncall.mp.

131       as needed hour$.mp.

132       casual hour$.mp.

133       weekday$ swap$.mp.

134       week day$ swap$.mp.

135       weekend swap$.mp.

136       shift self select$.mp.

137       shift self‐select$.mp.

138       week$ on week$ off.mp.

139       term time work$.mp.

140       term‐time work$.mp

141       buyable leave.mp.

142       flexi week$.mp.

143       flexi year$.mp.

144       performance related pay.mp.

145       performance‐related pay.mp.

146       adoption leave.mp.

147       adoption leave scheme$.mp.

148       flexi$ lunch hour$.mp.

149       paternity scheme$.mp.

150       parental leave scheme$.mp.

151       dependent$ leave.mp.

152       dependent$ leave scheme$.mp.

153       special leave.mp.

154       fixed term contract$.mp.

155       fixed‐term contract$.mp.

156       (temp$ employ$ or temp$ contract$).ti,ab.

157       marginal employ$.mp.

158       contingent employ$.mp.

159       atypical employ$.mp.

160       carer$ leave.mp.

161       unpaid leave.mp.

162       precarious work$.mp.

163       work life polic$.mp.

164       occasional flexibil$.mp.

165       (work adj2 life adj2 polic$).mp.

166       (occasional adj2 flexibil$).mp.

167       (reduc$ adj 2hours).ti,ab.

168       job$1 sharing.mp.

169       (Compress$ adj2 hours).mp.

170       (Stagger$ adj2 hours).mp.

171       (Annuali?ed adj2 hours).mp.

172       (compress$ adj2 week).mp.

173       ((day or night or late or early or evening or core or stagger$ or compress$ or

             irregular) adj2 (work$ or shift$1 or hours$)).mp.

174       Sabbatical$.mp.

175       Secondment$.mp.

176       (career$ adj3 break$).mp.

177       home working.mp.

178       (work$ adj2 home).mp.

179       maternal leave.mp.

180       paternal leave.mp.

181       ((work life or worklife) adj2 balance$).mp.

182       (flexible adj2 contract$).mp.

183       adapt$ hours.mp.

184       time banking.mp.

185       work hour$1 restriction$.mp.

186       or/54‐185

187       work/ or workplace/ or employment/

188        ((company or companies) adj5 (work$ or employ$ or job$ or staff or personnel or

             business$)).ti,ab.

189        (factory or factories or human resource$ or Business$).ti,ab.

190        ("Small and medium enterprises" or SMEs).ti,ab.

191        (worker$ or workplace$ or worksite$ or staff or personnel).ti,ab

192       (employee$ or employer$).ti,ab.

193       (work$ adj3 office$).ti,ab.

194       (work place$ or work site$ or work location$ or work setting$).ti,ab.

195       ((job$ or employment) adj2 (place$ or site$ or location$ or setting$)).ti,ab.

196       or/187‐195

197        196 and 186 and 53

PsycINFO (1806 ‐ ) (Ovid)

Searched 15 May 2009

1868 records retrieved

2      MORBIDITY.ti,ab

5      (LOW AND BACK AND PAIN).ti,ab

8      exp CARDIOVASCULAR DISORDERS/

9      exp HEART DISORDERS/

11    exp MENTAL HEALTH/

14    burnout.ti,ab

15    exp PSYCHOLOGICAL STRESS/

17    exp WELL BEING/

18    "psychological well being".ti,ab

19    (Well AND being).ti,ab

20    exp ATYPICAL DEPRESSION/ OR exp "DEPRESSION (EMOTION)"/ OR exp MAJOR DEPRESSION/ OR exp RECURRENT DEPRESSION/

21    well‐being.ti,ab

22    exp "QUALITY OF LIFE"/

23    exp JOB SATISFACTION/

24    exp EMPOWERMENT/

25    "decision latitude".ti,ab

26    "work life balance".ti,ab

27    "work‐life balance".ti,ab

28    "work family conflict$".ti,ab

29    (musculoskeletal adj2 disorder$).ti,ab

30    ((musculo adj2 skeletal adj2 disorder$)).ti,ab

31    exp HEALTH/

32    (promot$ OR manag$ OR facilitat$ OR enable$1 OR enabling OR barrier$1 OR increas$ OR obstruct$ OR encourag$ OR prevent$ OR time OR free OR disrupt$ OR relationship$ OR conflict).ti,ab

33    (health OR healthy OR healthier).ti,ab

34    (32 adj2 33).ti,ab

35    ((mental health OR physical health OR health risk$ OR general health)).ti,ab

36    (employee$ OR staff).ti,ab

37    health.ti,ab

38    (36 adj2 37).ti,ab

39    "Health of worker$".ti,ab

40    Illness.ti,ab

41    Ill.ti,ab

42    (sick$ AND absence$).ti,ab

43    (SICK AND LEAVE).ti,ab

44    (GP OR hospital OR doctor OR gps).ti,ab

45    (consultation$1 OR appointment$1).ti,ab

46    (44 adj2 45).ti,ab

47    (days AND off).ti,ab

48    exp "QUALITY OF LIFE"/

49    "general health questionnaire".ti,ab

50    "MCGILL PAIN QUESTIONNAIRE".ti,ab

51    exp BLOOD PRESSURE/

52    exp HYPERTENSION/

53    ((obesity OR obese OR overweight)).ti,ab

54    exp BACK PAIN/

55    "functional limitations profile".ti,ab

56    "SHORT FORM‐36".ti,ab

57    "SF‐36".ti,ab

58    ((euroqol OR EQ‐5d)).ti,ab

59    facilitat$.ti,ab

60    enable$.ti,ab

61    enabling.ti,ab

62    barrier$.ti,ab

63    obstruct$.ti,ab

64    encourag$.ti,ab

65    prevent$.ti,ab

66    time.ti,ab

67    free.ti,ab

68    disrupt$.ti,ab

69    relationship$.ti,ab

70    conflict.ti,ab

71    59 OR 60 OR 61 OR 62 OR 63 OR 64 OR 65 OR 66 OR 67 OR 68 OR 69 OR 70

72    "household work".ti,ab

73    "house work".ti,ab

74    chores.ti,ab

75    hobbies.ti,ab

76    hobby.ti,ab

77    friends.ti,ab

78    family.ti,ab

79    72 OR 73 OR 74 OR 75 OR 76 OR 77 OR 78

80    (71 adj3 72).ti,ab

81    ((social activit$ OR social network$ OR social life OR free‐time OR free time)).ti,ab

82    cholesterol.ti,ab

83    ((facilitat$ OR enable$1 OR enabling OR barrier$1 OR obstruct$ OR encourag$ OR prevent$ OR time OR free OR disrupt$ OR relationship$ OR conflict)).ti,ab

84    cooking.ti,ab

85    cleaning.ti,ab

86    84 OR 85

87    (83 adj2 86).ti,ab

88    ((stress OR burnout OR depression OR depressed)).ti,ab

89    1 OR 2 OR 3 OR 4 OR 5 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 18 OR 19 OR 20 OR 21 OR 22 OR 23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31 OR 34 OR 35 OR 38 OR 39 OR 40 OR 41 OR 42 OR 43 OR 46 OR 47 OR 48 OR 49 OR 50 OR 51 OR 52 OR 53 OR 54 OR 55 OR 56 OR 57 OR 58 OR 80 OR 81 OR 82 OR 87 OR 88

90    "flexible work$".ti,ab

91    "flexible workplace".ti,ab

92    "flexible work$ condition$".ti,ab

93    "flexible work$ time$".ti,ab

94    "flexi time$".ti,ab

95    flexitime$.ti,ab

96    "flex time$".ti,ab

97    flextime$.ti,ab

98    flexi‐time$.ti,ab

99    "flexible work$ arrangement$".ti,ab

100  "flexible work$ hour$".ti,ab

101  "Work Schedule Tolerance".ti,ab

102  "self schedul$".ti,ab

103  "self‐schedule$".ti,ab

104  "unusual hour$".ti,ab

105  "part‐time work$".ti,ab

106  "part time work$".ti,ab

107  "weekend work$".ti,ab

108  "Job$1 share$".ti,ab

109  "compress$ work$ hour$".ti,ab

110  job‐shar$.ti,ab

111  "stagger$ hour$".ti,ab

112  "annual$ hour$".ti,ab

113  "annualised hour$".ti,ab

114  "annualized hour$".ti,ab

115  "compress$ work$ week$".ti,ab

116  overtime.ti,ab

117  shiftwork$.ti,ab

118  "shift work$".ti,ab

119  "night work$".ti,ab

120  nightwork$.ti,ab

121  "Parental Leave".ti,ab

122  "long term leave".ti,ab

123  sabbatical.ti,ab

124  secondment.ti,ab

125  "home work$".ti,ab

126  homework$.ti,ab

127  "work$ from home".ti,ab

128  telework$.ti,ab

129  "irregular work$ hours".ti,ab

130  "irregular work$".ti,ab

131  ((phase$ adj2 retire$)).ti,ab

132  "retirement scheme$".ti,ab

133  "pension scheme$".ti,ab

134  "early retirement".ti,ab

135  "maternity leave".ti,ab

136  "paternity leave".ti,ab

137  "non standard$ employ$ contract$".ti,ab

138  "non‐standard employ$ contract$".ti,ab

139  "freelance$ work$".ti,ab

140  "free‐lance$ work$".ti,ab

141  free‐lance$.ti,ab

142  freelance$.ti,ab

143  "professional$ help$ with childcare".ti,ab

144  "professional$ help$ with housework".ti,ab

145  "professional$ help$ with household work$".ti,ab

146  "workplace flexibility".ti,ab

147  "work place flexibility".ti,ab

148  "flexible contract$".ti,ab

149  "flexible salary form$".ti,ab

150  "working time directive$".ti,ab

151  "zero hours".ti,ab

152  daywork$.ti,ab

153  "day work$".ti,ab

154  piecework$.ti,ab

155  "piece work$".ti,ab

156  "adjust$ hours".ti,ab

157  "core hours".ti,ab

158  "stagger$ hours".ti,ab

159  "time in lieu".ti,ab

160  "time bank$".ti,ab

161  "flexi break$".ti,ab

162  flexibreak$.ti,ab

163  ((reduc$ ADJ hours)).ti,ab

164  "job split$".ti,ab

165  "on call".ti,ab

166  oncall.ti,ab

167  "as needed hour$".ti,ab

168  "casual hour$".ti,ab

169  "weekday$ swap$".ti,ab

170  "week day$ swap$".ti,ab

171  "weekend swap$".ti,ab

172  "shift self select$".ti,ab

173  "shift self‐select$".ti,ab

174  "week$ on week$ off".ti,ab

175  "term time work$".ti,ab

176  "term‐time work$".ti,ab

177  "buyable leave".ti,ab

178  "flexi week$".ti,ab

179  "flexi year$".ti,ab

180  "performance related pay".ti,ab

181  "performance‐related pay".ti,ab

182  "adoption leave".ti,ab

183  "adoption leave scheme$".ti,ab

184  "flexi$ lunch hour$".ti,ab

185  "paternity scheme$".ti,ab

186  "parental leave scheme$".ti,ab

187  "dependent$ leave".ti,ab

188  "dependent$ leave scheme$".ti,ab

189  "special leave".ti,ab

190  "fixed term contract".ti,ab

191  "fixed‐term contract$".ti,ab

192  ((temp$ employ$ OR temp$ contract$)).ti,ab

193  "marginal employ$".ti,ab

194  "contingent employ$".ti,ab

195  "atypical employ$".ti,ab

196  "carer$ leave".ti,ab

197  "unpaid leave".ti,ab

198  "precarious work$".ti,ab

199  "work life polic$".ti,ab

200  "occasional flexibil$".ti,ab

201  ((work adj2 life adj2 polic$)).ti,ab

202  occasional.ti,ab

203  flexibil$.ti,ab

204  (202 adj2 203).ti,ab

205  "job$1 sharing".ti,ab

206  ((Compress$ adj2 hours)).ti,ab

207  ((Stagger$ adj2 hours)).ti,ab

208  ((Annuali?ed adj2 hours)).ti,ab

209  ((compress$ adj2 week)).ti,ab

210  ((day OR night OR late OR early OR evening OR core OR stagger$ OR compress$ OR irregular)).ti,ab

211  ((work$ OR shift$1 OR hours$)).ti,ab

212  (210 adj2 211).ti,ab

213  Sabbatical$.ti,ab

214  Secondment$.ti,ab

215  ((career$ adj3 break$)).ti,ab

216  "home working".ti,ab

217  ((work$ adj2 home)).ti,ab

218  "maternal leave".ti,ab

219  "paternal leave".ti,ab

220  ((work life OR worklife)).ti,ab

221  balance$.ti,ab

222  (220 adj2 221).ti,ab

223  ((flexible adj2 contract$)).ti,ab

224  "adapt$ hours".ti,ab

225  "time banking".ti,ab

226  "work hour$1 restriction$".ti,ab

227  90 OR 91 OR 92 OR 93 OR 94 OR 95 OR 96 OR 97 OR 98 OR 99 OR 100 OR 101 OR 102 OR 103 OR 104 OR 105 OR 106 OR 107 OR 108 OR 109 OR 110 OR 111 OR 112 OR 113 OR 114 OR 115 OR 116 OR 117 OR 118 OR 119 OR 120 OR 121 OR 122 OR 123 OR 124 OR 125 OR 126 OR 127 OR 128 OR 129 OR 130 OR 131 OR 132 OR 133 OR 134 OR 135 OR 136 OR 137 OR 138 OR 139 OR 140 OR 141 OR 142 OR 143 OR 144 OR 145 OR 146 OR 147 OR 148 OR 149 OR 150 OR 151 OR 152 OR 153 OR 154 OR 155 OR 156 OR 157 OR 158 OR 159 OR 160 OR 161 OR 162 OR 163 OR 164 OR 165 OR 166 OR 167 OR 168 OR 169 OR 170 OR 171 OR 172 OR 173 OR 174 OR 175 OR 176 OR 177 OR 178 OR 179 OR 180 OR 181 OR 182 OR 183 OR 184 OR 185 OR 186 OR 187 OR 188 OR 189 OR 190 OR 191 OR 192 OR 193 OR 194 OR 195 OR 196 OR 197 OR 198 OR 199 OR 200 OR 201 OR 204 OR 205 OR 206 OR 207 OR 208 OR 209 OR 212 OR 213 OR 214 OR 215 OR 216 OR 217 OR 218 OR 219 OR 222 OR 223 OR 224 OR 225 OR 226

228  (work OR workplace OR employment).ti,ab

229  ((company OR companies) adj5 (work$ OR employ$ OR job$ OR staff OR personnel OR business$)).ti,ab

230  ((factory OR factories OR human resource$ OR Business$)).ti,ab

231  (("Small and medium enterprises" OR SMEs)).ti,ab

232  ((worker$ OR workplace$ OR worksite$ OR staff OR personnel)).ti,ab

233  ((employee$ OR employer$)).ti,ab

234  ((work$ adj3 office$)).ti,ab

235  ((work place$ OR work site$ OR work location$ OR work setting$)).ti,ab

236  ((job$ OR employment)).ti,ab

237  ((place$ OR site$ OR location$ OR setting$)).ti,ab

238  (236 adj2 237).ti,ab

239  228 OR 229 OR 230 OR 231 OR 232 OR 233 OR 234 OR 235 OR 238

240  89 and 227 and 239

Sociological Abstracts (1963 ‐ ) (CSA Illumina)

1654 records retrieved 

((DE=(health or wellbeing or well‐being) or DE=morbidity)

or(KW=((back pain) or Backpain or lbp) or KW=((low back pain) or lumbago

or (cardiovascular diseases)) or KW=((heart diseases) or hypertension or

(mental health))) or(KW=((psychological outcome*) or Anxiety or

(Professional burnout)) or KW=((Psychological stress) or depression or

("quality of life")) or KW=((job satisfaction) or Empower* or (decision

latitude))) or(KW=((work life balance) or (work‐life balance) or (work

family conflict*)) or KW=(musculoskeletal within 2 disorder*))

or(KW=(musculo within 2 skeletal within 2 disorder*)) or(KW=((promot* or

manag* or facilitat* or enable*1 or enabling or barrier*1 or increas* or

obstruct* or encourag* or prevent* or time or free or disrupt* or

relationship* or conflict) within 2 (health or healthy or healthier)))

or(KW=(mental health or physical health or health risk* or general

health)) or(KW=((employee* or staff) within 2 (health))) or(KW=((health

of worker*) or illness or ill) or KW=((sick* absence*) or (sick* leave)))

or(KW=((days off) or (quality of life) or (general health questionnaire))

or KW=((mcGill pain questionnaire) or (blood pressure) or (obesity or

obese or overweight)) or KW=((functional limitations profile) or (short

form 36 or SF‐36) or (euroqol or EQ‐5d))) or(KW=((facilitat* or enable*1

or enabling or barrier*1 or obstruct* or encourag* or prevent* or time or

free or disrupt* or relationship* or conflict) within 3 (household work or

house work or chores or hobbies or hobby or friends or family)))

or(KW=(social activit* or social network* or social life or free‐time or

free time)) or(KW=cholesterol) or(KW=(stress or burnout or depression or

depressed))) and(((KW=((flexible work*) or shiftwork* or (shift work*))

or DE=((flexible work*) or shiftwork* or (shift work*))) or(KW=((non

standard work*) or (non‐standard work*) or (flexible time)) or DE=((non

standard work*) or (non‐standard work*) or (flexible time)))

or(KW=((flexible workplace) or (flexible work* condition*)) or

DE=((flexible workplace) or (flexible work* conditions) or (flexible

time))) or(KW=((flexible work* time*) or (flexi time*) or flexitime*) or

KW=((flex time*) or flextime* or flexi‐time*) or KW=((flexible work*

arrangement*) or (flexible work* hour*) or (work schedule tolerance)))

or(KW=(("self schedule*") or self‐schedule* or (unusual hour*)) or

KW=((study leave) or (part‐time work*) or (part time work*)) or

KW=(weekend work*)) or(KW=(job* share*)) or(KW=((compress* work* hour*)

or job‐shar* or (stagger* hour*)) or KW=((annual* hour*) or (annualised

hour*) or (annualized hour*)) or KW=((compress* work* week*) or overtime

or (shift work*))) or(KW=(shiftwork* or (night work*) or nightwork*) or

KW=((parental leave) or (long term leave) or sabbatical) or

KW=(secondment or (home work*) or homework*)) or(KW=((work* from home) or

telework* or (irregular work* hours)) or KW=((irregular work*) or (phase

within 2 retire*) or (retirement scheme*)) or KW=((pension scheme*) or

(early retirement) or (maternity leave))) or(KW=((non standard* employ*

contract*) or (non‐standard* employ* contract*) or (freelance* work*)) or

KW=(free‐lance* or (freelance* work*) or freelance*)) or(KW=((workplace

flexibility) or (work place flexibility) or (flexible contract*)) or

KW=((flexible salary form*) or (working time directive*) or (zero hours))

or KW=(daywork* or (day work*) or piecework*)) or(KW=((piece work*) or

(adjust* hours) or (core hours)) or KW=((stagger* hours) or (time in

lieu) or (time bank*)) or KW=((flexi break*) or flexibreak*))

or(KW=((reduc* hours) or (job split*) or (on call)) or KW=(oncall or (as

needed hour*) or (casual hour*)) or KW=((weekday* swap*) or (week* day*

swap*) or (weekday* swap*))) or(KW=((shift self select*) or (shift

self‐select*) or (week* on week* off)) or KW=((term time work*) or

(term‐time work*) or (buyable leave)) or KW=((flexi week*) or (flexi

year*) or (performance related pay))) or(KW=((performance‐related pay) or

(adoption leave) or (adoption leave scheme*)) or KW=((flexi* lunch hour*)

or (paternity scheme*) or (parental leave scheme*)) or KW=((dependent*

leave) or (dependent* leave scheme*) or (special leave))) or(KW=((fixed

term contract*) or (fixed‐term contract*) or (temp* employ* or temp*

contract*))) or(KW=((marginal employ*) or (contingent employ*) or

(atypical employ*)) or KW=((carer* leave) or (unpaid leave) or

(precarious work*)) or KW=((work life polic*) or (occasional flexibil*)))

or(KW=(work within 2 life within 2 polic*)) or(KW=((reduc* within 2 hours)

or (job*1 sharing))) or(KW=((compress* within 2 hours) or (annualized

within 2 hours) or (annualised within 2 hours))) or(KW=((day or night or

late or early or evening or core or stagger* or compress* or irregular)

within 2 (work* or shift*1 or hours*))) or(KW=(sabbatical* or secondment*

or (career* within 3 break*)) or KW=((home working) or (work* within 2

home))) or(KW=((maternal leave) or (paternal leave) or (adapt* hours)) or

KW=(time banking)) or(KW=((work life or worklife) within 2 (balance*)))

or(KW=(flexible within 2 contract*))) and((KW=(work or workplace or

employment)) or(KW=((company or companies) within 5 (work* or employ* or

job* or staff or personnel or business*))) or(KW=(factory or factories or

human resource* or Business*)) or(KW=("Small and medium enterprises" or

SMEs)) or(KW=(worker* or workplace* or worksite* or staff or personnel))

or(KW=(employee* or employer*)) or(KW=(work within 3 office*))

or(KW=(work place* or work site* or work location* or work setting*))

or(KW=((job* or employment) within 2 (place* or site* or location* or

setting*))))) 

SSCI (Social Science Citation Index) (1970 ‐ ) (ISI Web of Knowledge)

Searched 22 May 2009 

#26   #25 AND #24

#25   Topic=(follow‐up or longitudinal or prospective* or cohort or evaluation or "before and

         after")

#24   #23 AND #22

#23   #19 AND #4

#22   #21 OR #20

#21   Topic=(worker or personnel or employee or employer or work setting* or work

         location*)

#20   Topic=(work or workplace or employment or compan* or business* or staff or job* or

         factory or factories or worksite*)

#19   #18 OR #17 OR #16 OR #15 OR #14 OR #13 OR #12 OR #11 OR #10 OR #9 OR #8

        OR #7 OR #6 OR #5

#18   Topic=(reduc* hours or career break* or "working from home" or adapt* hours or time

          banking)

#17   Topic=(atypical employ* or carer* leave or unpaid leave or precarious work* or work

         life polic* or occasional flexibil*)

#16   Topic=(fixed term contract* or temp* employ* or temp* contract* or marginal employ*

         or contingent employ*)

#15   Topic=(flexi week* or flexi year* or flexi day* or performance related pay or parental

          leave scheme* or dependent* leave or special leave)

#14   Topic=(shift self select* or shift self‐select* or "week* on week* off" or term‐time

         work* or term time work* or buyable leave)

#13   Topic=(job split* or on call or oncall or on‐call or "as needed hours" or casual hours or

         weekday* swap* or weekend swap*)

#12   Topic=(day work or daywork or piecework* or piece work* or adjust* hours or core

         hours or stagger* hours or tme in lieu or time bank* or flexi break* or flexibreak* or

         reduc* hours)

#11   Topic=(work* flexibility or flexible contract* or flexible salary form* or working time

         directive*)

#10   Topic=(maternity leave or paternity leave or adoption leave or non‐standard employ*

         contract* or freelanc*)

#9      Topic=(home work* or homework* or work* from home or telework* or irregular

          work* or phase* retire*)

#8     Topic=(shiftwork* or shift work* or nightwork* or night work* or parental leave or

         long term leave or sabbatical or secondment)

#7    Topic=(job‐shar* or job shar* or compress* work* hour* or stagger* hour* or annual*

        hour* or compress* work* week or overtime)

#6    Topic=(work schedule tolerance or self‐schedul* or self schedul* or unusual hour* or

        part‐time work* or part time work* or weekend work*)

#5    Topic=(flex* work* or flex* workplace or flex* work* condition* or flex* work* time*

        or flex* work* hours)

#4    #3 OR #2 OR #1

#3    Topic=(illness or ill or sick* absence* or sick leave or gp or hospital appointment* or

        medical consultation or doctor* appointment or days off or cholesterol or blood pressure

        or obesity or obese or "social wellbeing" or social life or free time)

#2    Topic=(wellbeing or well‐being or depression or "quality of life" or job satisfaction or

        empower* or decision latitude or "work life balance" or work family conflict* or

        musculoskeletal disorder* or health or physical health or health risk* or "general health"

        or health behaviour*)

#1     Topic=(morbidity or backpain or back pain or lbp or lumbago cardiovasular or heart

        disease* or hypertension or mental health or psychological outcome* or anxiety or

        burnout or stress) 

Appendix 2. Study eligibility and data abstraction form

Appendix 3. Quality appraisal criteria

1. Is there a representative sample? (e.g. random samples, adequately justified purposive sampling, or 100% samples)

2. Is there an appropriate control group? (e.g. random allocation, matched control)

3. Is the baseline response greater than 60%?

4. Is the follow‐up response greater than 80%?

5. Have the authors adjusted for non‐response and drop‐out?

6. Are the authors’ conclusions substantiated by the data presented?

7. Is there adjustment for the majority of known confounders (e.g. demographic, lifestyle, job content or flexible working experience)?

8. Is there evidence of protection from contamination?

9. Were appropriate statistical tests used?

Adapted from Bambra 2007 ; Bambra 2008a ; Bambra 2008b ; CRD 2001 ; Deeks 2003 ; Egan 2007 .

Characteristics of studies

Characteristics of included studies [ordered by study id].

ESS = Epworth Sleepiness Scale; HDL = high‐density lipoprotein; LDL = low‐density lipoprotein

Characteristics of excluded studies [ordered by study ID]

Characteristics of ongoing studies [ordered by study ID]

Differences between protocol and review

With regard to handsearching a selection of relevant journals in the field, we searched Ergonomics rather than the Journal of Human Ergology as the searches retrieved more hits from the latter publication.

Contributions of authors

Kerry Joyce: content and methodological experience, screened titles and abstracts, screened full text articles, undertook data extraction and critical appraisal, co‐ordinated authors and lead writing of the review. Roman Pabayo: methodological and statistical expertise, undertook data extraction and critical appraisal, contributed to writing of the review. Julia Critchley: methodological and statistical expertise, contributed to writing of the review. Clare Bambra: content and methodological expertise, conceived and designed the project, secured funding for the review, screened titles and abstracts, undertook critical appraisal where disagreements between authors occurred; contributed to writing the review. 

Abbreviations

CBA = controlled before and after study; CES‐D = Center for Epidemiologic Studies Depression Scale; CI = confidence interval; Con = control; CWW = compressed working week; ESS = Epworth Sleepiness Scale; GHQ‐12 = General Health Questionnaire; Int = Intervention; IPAQ = International Physical Activity Questionnaire; NS = non‐significant; OR = odds ratio; PA = physical activity; RR = risk ratio; SD = standard deviation; SE = standard error; VBBA = Dutch Questionnaire on the Experience and Evaluation of Work; WLB = work‐life balance; WHO World Health Organization

Sources of support

Internal sources.

• No sources of support supplied

External sources

Award Reference Number: 17‐08‐N

Declarations of interest

None known.

References to studies included in this review

Calvo 2009 {published data only}.

• Calvo E, Haverstick K, Sass SA. Gradual retirement, sense of control, and retirees' happiness . Research on Aging 2009; 31 ( 1 ):112‐35. [ Google Scholar ]

De Raeve 2007 {published data only}

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Dooley 2000 {published data only}

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Dunham 1987 {published data only}

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Kandolin 1996 {published data only}

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References to studies excluded from this review

Abbott 1995 {published data only}.

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Adamson 1994 {published data only}

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Akerstadt 1978 {published data only}

• Åkerstadt T, Torsvall L. Experimental changes in shift schedules: their effects on well‐being . Ergonomics 1978; Vol. 21:849‐56. [ PubMed ]

Akerstedt 1996 {published data only}

• Åkerstedt TW, Anderson G. Mot bättre tider: en utvärdering av några av vårdens arbetstidsmodeller med avseende på välbefinnande och hälsa . Stressforskningsrapporter 1996; Vol. 271:1‐26.

Andrews 2005 {published data only}

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Bardasi 2004 {published data only}

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Barton 1993 {published data only}

• Barton J, Smith L, Totterdell P, Spelten E. Does individual choice determine shift system acceptability . Ergonomics 1993; Vol. 36, issue 1:93‐9.

Boggild 2001 {published data only}

• Boggild H, Jeppesen HJ. Intervention in shift scheduling and changes in biomarkers of heart disease in hospital wards . Scandinavian Journal of Work, Environment & Health 2001; Vol. 27, issue 2:87‐96. [0355‐3140] [ PubMed ]

Breaugh 2008 {published data only}

• Breaugh JA, Frye NK. Work‐family conflict: the importance of family‐friendly employment practices and family‐supportive supervisors . Journal of Business and Psychology 2008; Vol. 22, issue 4:345‐53.

Brisson 1989 {published data only}

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Buddendick 1999 {published data only}

• Buddendick A, Leo P‐E, Hell W. Introduction of alternating telework in a local government administration ‐ an evaluation . Zeitschrift fur Arbeits‐ und Organisationspsychologie 1999; Vol. 43, issue 3:165‐70.

Casey 2008 {published data only}

• Casey PR, Grzywacz JG. Employee health and well‐being: the role of flexibility and work‐family balance . Psychologist‐Manager Journal 2008; Vol. 11, issue 1:31‐47.

Choi 1986 {published data only}

• Choi T, Jameson H, Brekke ML, Podratz RO, Mundahl H. Effects on nurse retention. An experiment with scheduling . Medical Care 1986, issue 11:1029‐43. [ PubMed ]

Dahlgren 2006 {published data only}

• Dahlgren A, Kecklund G, Akerstedt T. Overtime work and its effects on sleep, sleepiness, cortisol and blood pressure in an experimental field study . Scandinavian Journal of Work, Environment & Health 2006; Vol. 32, issue 4:318‐27. [ PubMed ]

Davis 2008 {published data only}

• Davis KD, Goodman WB, Pirretti AE, Almeida DM. Nonstandard work schedules, perceived family well‐being, and daily stressors . Journal of Marriage and the Family 2008; Vol. 70, issue 4:991‐1003. [0022‐2445] [ PMC free article ] [ PubMed ]

de Haan 1990 {published data only}

• Haan E. Improving shift work schedules in a bus company: towards more autonomy . Shiftwork: Health, Sleep and Performance . Frankfurt: Peter Lang Publishing Group, 1990.

Evans 1973 {published data only}

• Evans MG. Notes on the impact of flextime in a large insurance company: I. Reactions of non‐supervisory employees . Occupational Psychology 1973; Vol. 47, issue 3‐4:237‐40.

Evans 1975 {published data only}

• Evans MG. A longitudinal analysis of the impact of flexible working hours . Studies in Personnel Psychology 1975; Vol. 6, issue 2:1‐10.

Finch 1997 {published data only}

• Finch MD, Mortimer JT, Ryu S. Transition into part‐time work: health risks and opportunities . Health risks and developmental transitions during adolescence. 1997:321‐44.

Gauderer 2004 {published data only}

• Gauderer P, Knauth P. Pilot study with individualised duty rotas in public local transport . Le Travail Humain 2004; Vol. 67:87‐100.

Gelfand 2004 {published data only}

• Gelfand DV, Podnos YD, Carmichael JC, Saltzman DJ, Wilson SE, Williams RA, et al. Effect of the 80‐hour workweek on resident burnout . Archives of Surgery 2004; Vol. 139, issue 9:933‐8; discussion 938‐40. [0004‐0010] [ PubMed ]

Gomez‐Mejia 1978 {published data only}

• Gomez‐Mejia LR, Hopp MA, Sommerstad CR. Implementation and evaluation of flexible work hours: a case study . The Personnel Administrator 1978; Vol. 23, issue 1:39. [ PubMed ]

Gopal 2005 {published data only}

• Gopal R, Glasheen JJ, Miyoshi TJ, Prochazka AV. Burnout and internal medicine resident work‐hour restrictions . Archives of Internal Medicine 2005; Vol. 165, issue 22:2595‐600. [0003‐9926] [ PubMed ]

Grzywacz 2007 {published data only}

• Grzywacz JG, Casey PR, Jones FA. The effects of workplace flexibility on health behaviors: a cross‐sectional and longitudinal analysis . Journal of Occupational and Environmental Medicine 2007; Vol. 49, issue 12:1302‐9. [ PubMed ]

Grzywacz 2008 {published data only}

• Grzywacz JG, Carlson DS, Shulkin S. Schedule flexibility and stress: linking formal flexible arrangements and perceived flexibility to employee health . Community, Work & Family 2008; Vol. 11, issue 2:199‐214.

Harrick 1986 {published data only}

• Harrick EJ, Vanek GR, Michlitsch JF. Alternate work schedules, productivity, leave usage, and employee attitudes: a field study . Public Personnel Management 1986; Vol. 15, issue 2:159‐69.

Hartig 2007 {published data only}

• Hartig T, Kylin C, Johansson G. The telework tradeoff: stress mitigation vs. constrained restoration . Applied Psychology: An International Review 2007; Vol. 56, issue 2:231‐53.

Hauburger 1997 {published data only}

• Hauburger NM. Implementation of self‐scheduling in the poison center . Veterinary & Human Toxicology 1997; Vol. 39, issue 3:175‐7. [0145‐6296] [ PubMed ]

Hicks 1981 {published data only}

• Hicks WD, Klimoski RJ. The impact of flexitime on employee attitudes . Academy of Management Journal 1981; Vol. 24, issue 2:333‐41.

Holdsworth 2003 {published data only}

• Holdsworth L, Mann S. The psychological impact of teleworking: stress, emotions and health . New Technology, Work and Employment 2003; Vol. 18, issue 3:192‐211.

Hsueh 2007 {published data only}

• Hsueh J, Yoshikawa H. Working nonstandard schedules and variable shifts in low‐income families: associations with parental psychological well‐being, family functioning, and child well‐being . Developmental Psychology 2007; Vol. 43, issue 3:620‐32. [ PubMed ]

Hutter 2006 {published data only}

• Hutter MM, Kellogg KC, Ferguson CM, Abbott WM, Warshaw AL, Hutter MM, et al. The impact of the 80‐hour resident workweek on surgical residents and attending surgeons . Annals of Surgery 2006; Vol. 243, issue 6:864‐71; discussion 871‐5. [0003‐4932] [ PMC free article ] [ PubMed ]

Imai 2004 {published data only}

• Imai H, Nakao H, Tsuchiya M, Kuroda Y, Katoh T. Burnout and work environments of public health nurses involved in mental health care . Occupational & Environmental Medicine 2004; Vol. 61, issue 9:764‐9. [ PMC free article ] [ PubMed ]

Imbrechts 1995 {published data only}

• Imbrechts W. Teleworking in terms of the R.G.P.T. . Revue du Travail 1995, issue 20:27‐32. [0035‐2705]

Jansen 2003 {published data only}

• Jansen NW, Amelsvoort LG, Kristensen TS, Brandt PA, Kant IJ, Jansen NWH, et al. Work schedules and fatigue: a prospective cohort study . Occupational & Environmental Medicine 2003; Vol. 60 Suppl 1:i47‐53. [1351‐0711] [ PMC free article ] [ PubMed ]

Janssen 2004 {published data only}

• Janssen D, Nachreiner F. Health and psychosocial effects of flexible working hours . Revista de Saude Publica 2004; Vol. 38, issue Suppl:11‐8. [ PubMed ]

Kandolin 2001 {published data only}

• Kandolin I, Harma M, Toivanen M. Flexible working hours and well‐being in Finland . Journal of Human Ergology 2001; Vol. 30, issue 1‐2:35‐40. [0300‐8134] [ PubMed ]

Kane 1999 {published data only}

• Kane D. Job sharing: a retention strategy for nurses . Canadian Journal of Nursing Leadership 1999; Vol. 12, issue 4:16‐22. [1481‐9643] [ PubMed ]

Kelloway 1998 {published data only}

• Kelloway EK, Gottlieb BH. The effect of alternative work arrangements on women's well‐being: a demand‐control model . Womens Health 1998; Vol. 4, issue 1:1‐18. [1077‐2928] [ PubMed ]

Konradt 1999 {published data only}

• Konradt U, Schmook R. Telework ‐ stress and strain in a longitudinal study . Zeitschrift Fur Arbeits‐Und Organisationspsychologie 1999; Vol. 43, issue 3:142‐50. [0932‐4089]

Lee 1983 {published data only}

• Lee RA. Flexitime and conjugal roles . Journal of Occupational Behaviour 1983; Vol. 4, issue 4:297‐315.

Lowden 2000a {published data only}

• Lowden A, Åkerstedt T. Self‐selected work hours ‐ work satisfaction, health and social life . Shiftwork in the 21st Century . Frankfurt am Main: Peter Lang GmbH, 2000:345‐50.

Lowden 2000b {published data only}

• Lowden A, Åkerstedt T. Introduction of self‐selected work hours in retail work ‐ effects on work satisfaction, health and social life . Zeitschrift für Arbeitswissenschaft 2000; Vol. 5:300‐5.

Martens 1999 {published data only}

• Martens MFJ, Nijhuis FJN, Boxtel MPJ, Knottnerus JA. Flexible work schedules and mental and physical health: a study of a working population with non‐traditional working hours . Journal of Organizational Behavior 1999; Vol. 20, issue 1:35‐46.

Martimo 2008 {published data only}

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Narayanan 1982a {published data only}

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Narayanan 1982b {published data only}

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Narayanan 1984 {published data only}

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Orpen 1981 {published data only}

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Parker 2002 {published data only}

• Parker SK, Griffin MA, Sprigg CA, Wall TD. Effect of temporary contracts on perceived work characteristics and job strain: a longitudinal study . Personnel Psychology 2002; Vol. 55, issue 3:689‐719. [0031‐5826]

Patrick 2008 {published data only}

• Patrick RC, Joseph GG. Employee health and well‐being: the role of flexibility and work‐family balance . The Psychological‐Manager Journal 2008; Vol. 11, issue 1:31.

Sullivan 2002 {published data only}

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Vinet 1986 {published data only}

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Vinet 1989 {published data only}

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Virtanen 2005 {published data only}

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Zheng 2006 {published data only}

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References to ongoing studies

Garde 2008‐2011 {unpublished data only}.

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Nabe‐Nielsen 2006‐2010 {unpublished data only}

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Flexible Working, Work–Life Balance, and Gender Equality: Introduction

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• Volume 151 , pages 365–381, ( 2020 )

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• Heejung Chung   ORCID: orcid.org/0000-0002-6422-6119 1 &
• Tanja van der Lippe 2  

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This special brings together innovative and multidisciplinary research (sociology, economics, and social work) using data from across Europe and the US to examine the potential flexible working has on the gender division of labour and workers’ work–life balance. Despite numerous studies on the gendered outcomes of flexible working, it is limited in that the majority is based on qualitative studies based in the US. The papers of this special issue overcome some of the limitations by examining the importance of context, namely, family, organisational and country context, examining the intersection between gender and class, and finally examining the outcomes for different types of flexible working arrangements. The introduction to this special issue provides a review of the existing literature on the gendered outcomes of flexible working on work life balance and other work and family outcomes, before presenting the key findings of the articles of this special issue. The results of the studies show that gender matters in understanding the outcomes of flexible working, but also it matters differently in different contexts. The introduction further provides policy implications drawn from the conclusions of the studies and some thoughts for future studies to consider.

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1 Introduction

Flexible working, that is worker’s control over when and where they work, has increased substantially over the years across most industrialised countries. Furthermore there is increasing demand for more flexibility in the workplace especially from the younger generation. Recent reports note that the majority of millennials would like the opportunity to work from home and/or have flexitime (Finn and Donovan 2013 ; Deloitte 2018 ). It is highly likely that in the future, flexible working will become the norm rather than the exception in many jobs. The question this special issue aims to examine concerns the gender discrepancies in the outcomes of flexible working for the division of labour and workers’ work–life balance. Flexible working can be used as a positive capability spanning resource useful for workers, especially women, to adapt their work to family demands (Singley and Hynes 2005 ). Previous studies have shown that flexible working allows mothers to maintain their working hours after childbirth (Chung and Van der Horst 2018b ), and to remain in human-capital-intensive jobs in times of high family demand (Fuller and Hirsh 2018 ). This ability may increase women’s satisfaction with work–life balance by allowing women to maintain both. In this sense, flexible working can be a useful tool to further enhance gender equality in our societies. However, due to our society’s pre-existing views on gender roles and the gender normative views we have towards men and women’s roles and responsibilities, flexible working can potentially traditionalise gender roles in the labour market and the household (Lott and Chung 2016 ; Sullivan and Lewis 2001 ). Men use and are expected to use flexible working for performance enhancing purposes, increase their work intensity/working hours, and are rewarded more through income premiums (Lott and Chung 2016 ), which can increase their work–family conflict through the expansion of work. Women (are expected to) increase their responsibility within the family when working flexibly (Hilbrecht et al. 2008 ), which can also potentially increase their work–family conflict, but unlike men not rewarded due to the different expectations.

Although some studies already examine such gendered nature of flexible working, most are based on qualitative case studies predominately based on professional workers in the US (for example, Cech and Blair-Loy 2014 ). Thus we need more evidence based on large scale data, on a more representative sample from a wide range of countries and from different contexts. Country contexts matter in determining who gets access to flexible working arrangements (Chung 2017 , 2018a ) and in shaping the nature of flexible working (Lott 2015 ). National contexts can thus be expected to shape how flexible working relates to gender equality and workers’ work–life balance. Similarly, organisational contexts matter in shaping flexible working, yet is often ignored. We also need more empirical evidence encompassing larger groups of workers beyond professionals. By looking at large scale data we are able to examine how gender, class, and household structures intersect when we talk about varying outcomes of flexible working. Finally, we need to be more critical about the definitions of flexible working. Many studies conflate different types of flexible working as one, which may deter our understanding of exactly why flexible working may or may not be a useful tool in eliminating gender inequalities in the labour market.

This special issue aims to overcome these limits by bringing together innovative and multidisciplinary research (from sociology, economics, and social work) using data from across Europe and the US to address the issue of the potential flexible working has on the gender division of labour and workers’ work–life balance.

In the next section, we provide a brief overview of the existing literature to come to some of their limitations, especially in light of providing a comprehensive outlook on what flexible working can mean for gender equality. Next, we introduce the articles in the special issue and how they overcome many of the limitations mentioned previously. The introduction of this special issue finishes with a discussion, policy implications on what we can learn from these studies to ensure a better use of flexible working arrangements, and finally some notes on what is still left for us to uncover to enhance our understanding of flexible working on worker’s work-life balance and gender equality.

2 Summary of Existing Literature and Their Limitations

2.1 what is flexible working and the prevalence of flexible working in europe.

Flexible working can entail employee’s control over when or where they work (Kelly et al. 2011 ; Glass and Estes 1997 ). More specifically, flexitime is having control over the timing of one’s work. This can entail worker’s ability to change the timing of their work (that is, to alternate the starting and ending times), and/or to change the numbers of hours worked per day or week—which can then be banked to take days off in certain circumstances. Working time autonomy, which is used in two of the papers of this special issue, is when workers have larger freedom to control their work schedule and their working hours. The biggest difference between flexitime and working time autonomy is that some constraints still remain in flexitime, in terms of adhering to core hours (e.g., 10 to 4 pm), and/or the number of hours workers can work in a day or a week (e.g. 37 h per week), unlike working time autonomy where such restrictions in many cases do not exist. Flexiplace, i.e., tele- or homework, allows workers to work outside of their normal work premises, e.g., working from home. In addition to this, flexible working can also entail workers having control over the number of hours they work, mainly referring to the reduction of hours of work (temporarily) to meet family demands. This includes part-time working, term-time only working, job sharing and temporary reduction of hours. The majority of the papers in this special issue will focus on flexitime and flexiplace, although some compare the outcomes of flexitime and flexiplace for full- and part-time workers.

Figures  1 and 2 provide us with the data on the extent to which flexible working is being used in Europe in 2015 based on the most recent European Working Conditions Survey. Schedule control includes workers who can adapt their working hours within certain limits (flexitime) and those with working time autonomy—i.e., where your working hours are entirely determined by yourself. Those who work from home are defined here as those who have worked in their home several times a month in the past 12 months. As we can see, about a quarter of workers had access to flexible schedules across 30 European countries and about 12% did paid work from home several times a month in the past year. There are large variations in both, where the Northern European countries are those where both schedule control and working from home are prevalent, while this is not the case in Southern and Eastern European countries. We can also see some gender differences in access/use of flexible working. At the European average the gap between men and women is not as noticeable for both schedule control and home working, although on average, men have slightly more access to schedule control while women are more likely to have worked from home. A number of countries where workers generally have more access to schedule control, it was men who were especially more likely to have access—namely, Norway, Finland, Austria, and Switzerland. However, the gender gap favourable towards men were also observed in countries with low access in general, such as Portugal, Slovakia, and Lithuania. There were only few countries where women had better access to schedule control, the Netherlands, Malta, and Hungary being some of them. For home working, with the exception of countries such as Norway, Ireland and Czech Republic, women were more likely to have worked from home regularly, or there were no discernible gender gap.

Proportion of dependent employed with schedule control across 30 European countries in 2015 ( Source : EWCS 2015). Note : weighted averages/sorted by women’s %

Proportion of dependent employed who work from home at least several times a month in the past 12 months across 30 European countries in 2015 ( Source : EWCS 2015). Note : weighted averages/sorted by women’s %

2.2 Flexible Working and Work–Family Conflict and Gender

The relation between flexible working and work–family conflict is not as self-evident as one may expect. Of course there are several theoretical arguments to relate flexible working to less work–family conflict, and therewith higher well-being since conflict and well-being are clearly related (Back-Wiklund et al. 2011 ). Schedule control, that is workers’ control over when they work, provides workers with the flexibility but also control over the time boundaries between work and family spheres, enabling them to shift the time borders between work and family/care time, allowing for less conflict between the two (Clark 2000 ). Especially given the fact that normal fixed working hours (e.g., 9 a.m. till 5 p.m.) and family schedules/demands (e.g., school pick up times at 3 p.m.) are not necessarily compatible, control over the borders of work and home may help workers resolve some of the conflict arising from this incompatibility. Working from home allows workers to address family demands by providing a possibility to integrate the work and family domains, allowing parents to potentially combine childcare with paid work at the same time, e.g., taking care of a sick child whilst working from home. In addition, employees with long commutes are argued to have more time for childcare and/or work when they do not need to travel when they can work from home (Peters et al. 2004 ).

However, there is not a consistent empirical relation between flexible working and work–family conflict, and even less when gender is taken into account. Many studies show that working from home actually leads to more work–family conflict (Golden et al. 2006 ; Duxbury et al. 1994 ; Allen et al. 2013 ). Control over when to work in addition to working from home is also only partly related to less work–family conflict (Michel et al. 2011 ).

Still, there are studies that provide evidence that flexible working relieves work-to-family conflict (e.g., Allen et al. 2013 ; Kelly et al. 2014 ; Michel et al. 2011 ) especially during the transition into parenthood (Erickson et al. 2010 ). Ten Brummelhuis and Van der Lippe ( 2010 ) reported that employees’ family situation matters, and that working from home and flexible work schedules were only effective in relieving work–family conflict for singles and not for employees with a partner and/or children. Demerouti et al. ( 2014 ) argue in their overview study on the impact of new ways of working, including working from home and flexible schedules, that these mixed findings for work–family balance and conflict are not surprising. Due to the fact that the permeability of boundaries between work and nonwork domains increases when workers work flexibly, as physical boundaries between the two environments are eliminated. Instead of facilitating balance, flexible working can thus also lead to increased multitasking and boundary blurring (Schieman and Young 2010 ; Glavin and Schieman 2012 ).

The relationship between flexible working and work–family conflict have different outcomes for men and women, as women are often still more responsible for housework and childcare and spend more time on these chores (Van der Lippe et al. 2018 ; and also see the next section). The effect of work role ambiguity on work–family conflict is also different for men and women (Michel et al. 2011 ). Moreover, different arrangements may have different outcomes for men and women. Peters et al. ( 2009 ) showed that female workers gained better work life balance from more control over their work schedule leading to a better work–family balance. However, home-based teleworking|women did not experience a better work–life balance than employees not working from home. Nevertheless, there are only a few studies where, in a systematic and rigorous way, the differences between men and women are studied, and most results rely on qualitative studies (Emslie and Hunt 2009 ). Most studies are also constrained by the gender neutral assumption of work–life balance (see for an excellent overview, Lewis et al. 2007 ). The next section explores further why this is the case.

2.3 Flexible Working and the Expansion of Work and Domestic Spheres and Gender

One of the reasons why flexible working may not reduce work–family conflict of workers is because it is likely to lead to an expansion of work and/or increase the domestic burden upon workers.

Unlike what many studies that look at flexible working as a family-friendly arrangement would assume, flexible working have been shown to result in the expansion of the work sphere rather than the contraction of it, resulting in paid work encroaching on family life (Glass and Noonan 2016 ; Lott and Chung 2016 ; Kelliher and Anderson 2010 ; Schieman and Young 2010 ). Several theories can explain why such expansion occur (see for more detailed theories, Kelliher and Anderson 2010 ; Chung and Van der Horst 2018a ; Lott 2018 ) but this can be summarised into gift exchange—workers feeling a need to reciprocate for the gift of flexibility back to employers; enabled intensification—blurring of boundaries allowing workers to work harder/longer than they otherwise would have; or enforced intensification where employers may increase workload alongside providing workers more flexibility over their work.

Clark ( 2000 ) argues that the flexibility between the borders of the work and home domain will result in different outcomes, for example, expansion of one sphere and the contraction of others, depending on the strength of the border, the domain the individual identifies with most, and the priority each domain takes in one’s life. In other words, for those who prioritise paid work above home and other aspects of their life, the flexibility in the border is more likely to result in the expansion of paid work, while for those whose priorities lie in the home spheres, flexibility may result in the expansion of domestic activities, such as housework and care giving. One important point to raise here, is that it isn’t necessarily an individual’s choice to prioritise paid work or home spheres, and external demands and social norms shape one’s capacities to do so.

The ability to prioritise work and adhere to the ideal worker culture, that is a worker that has no other obligation outside of work and privileges work above everything else, is gendered (Acker 1990 ; Williams 1999 ; Blair-Loy 2009 ). Although there have been some developments, men still do and are expect to take on the breadwinning role especially after childbirth (Miani and Hoorens 2014 ; Knight and Brinton 2017 ; Scott and Clery 2013 ) and women are thus left to and are expected to take the bulk of caregiving for both children and ill relatives as well as housework (Hochschild and Machung 2003 ; Bianchi et al. 2012 ; Hook 2006 ; Dotti Sani and Treas 2016 ). Such gendered divisions of labour and social normative views about women and men, and more specifically mothers’ and fathers’ roles shape how flexible working is performed and viewed by society, including employers but also colleagues, friends, families etc., and consequently on the outcomes of flexible working.

It is true that previous studies that examined the gender discrepancies in the expansion of working hours, more specifically overtime hours, due to flexible working find that men are more likely to expand their working hours than women (Glass and Noonan 2016 ; Lott and Chung 2016 ).

On the other hand, flexible working is likely to be used by women for caregiving purposes (Singley and Hynes 2005 ) and those who do work flexibly are likely to expand their care/housework (Sullivan and Lewis 2001 ; Hilbrecht et al. 2013 ). Clawson and Gerstel ( 2014 ) argue that, flexible working allows workers—especially middle class workers, to ‘do gender’ (West and Zimmerman 1987 ) in that they are able to fulfil the social normative roles prescribed within societies. This then feeds into what people believe flexible working will result in for men and women. For example, qualitative studies have shown that when women take up flexible working arrangement, for example working from home, those around them expect women to carry out domestic work simultaneously whilst working (Sullivan and Lewis 2001 ; Hilbrecht et al. 2013 ; Shaw et al. 2003 ). This consequently shapes how people provide and reward/stigmatise flexible working of men and women. Lott and Chung ( 2016 ) using longitudinal data from Germany show how even when women work longer overtime when taking up flexible schedules, they are still less likely compared to men to gain any financial premiums. Furthermore, mothers seem to be exchanging the opportunity to work flexibly with longer overtime, i.e. not even gaining an ‘overtime premium’ for the additional hours worked. Similarly, several recent experimental studies based in the US have shown that women, especially mothers, are less likely to gain access to flexible working arrangements, even when not used for care purposes, and more likely to be stigmatised for its use compared to men (Brescoll et al. 2013 ; Munsch 2016 ). For fathers, on the other hand, there seems to be a “progressive badge of merit” (Gerstel and Clawson 2018 ) where they are generally looked favourably upon for using flexible working arrangements for care purposes. Again this is largely down to the expectations people hold regarding how men and women will use their flexibility. In other words, in countries where traditional gender norms are prevalent, even when fathers take up flexible working for care purposes, there is a general expectation that the fathers will still maintain their work devotion/protect their work spheres and prioritise it over family time/care roles. On the other hand, for mothers, people expect them to use their control over their work for care purposes, even when it is explicitly requested for other more performance enhancing purposes. This can explain why flexible working arrangements that provide workers more control over their work are less likely to be provided in female dominated workplaces (Chung 2018a , c ).

Such preconceived notions of where worker’s priority lies and how they will use the increased control over their work will naturally shape the consequences of flexible working for one’s career. Leslie et al. ( 2012 ) show how flexible working for performance enhancing purposes is likely to be rewarded, while that for family-friendly purposes will not. Williams et al. ( 2013 ) provide evidence on how flexible working for family purposes can actually lead to negative career consequences, again largely due to the fact that  flexible working for family purposes makes workers deviate away from the ideal worker image. In this sense, flexible working can potentially increase gender inequalities in the labour market, due to the preconceived notion people will make about women’s flexible working. However, this is not always the case. Several studies have shown that flexible working may allow women to work longer hours than they would have otherwise after childbirth (Chung and Van der Horst 2018b ) and stay in relatively stressful yet high paying occupations (Fuller and Hirsh 2018 ) and workplaces with flexible working arrangements are those where the gender wage gap is smaller (Van der Lippe et al. 2018 ). Thus the picture is rather complex in terms of what flexible working can mean for gender equality.

3 About the Special Issue: Addressing the Gaps in the Literature

Despite the large number of studies that deal with flexible working and the nuanced gendered ways in which it may mean different things for men and women, there are some limitations which the papers of this special issue will try to overcome.

One of the biggest limitations of previous studies on this topic is that they are mostly based on qualitative data—mostly interviews and observations. In addition, many of the studies also focus on professionals. Although there have been some studies using quantitative time use data (Craig and Powell 2011 , 2012 ; Wight et al. 2008 ) most have been using data from Anglo-Saxon countries, namely US, UK and Australia. Given that work cultures as well as gender norms are expected to heavily shape the way in which people perceive how workers will use flexibility in their work, and how workers perform flexibility, we need more evidence from a broader range of countries to be able to understand how flexible working can lead to different outcomes for men and women.

3.1 Role of Contexts

Investigating the role of contexts is the core of the contribution from Kurowska ( 2018 ). Here the main aim is to examine the gender differences in how working from home deters or enhances one’s work life balance comparing dual earner couples in Sweden and Poland, two very different countries in terms of their gender relations and family policy support. Sweden is well known to be a country with gender egalitarian norms, generous family policies including ear-marked paternity leaves that promote fathers’ involvement in childcare. Poland is known as a typical conservative/traditional care regime, where mothers (are expected to) take on the bulk of care roles of children. Another unique contribution of this paper is its use of the theoretical concept, ‘total burden of responsibilities’ to capture the engagement in both unpaid domestic work responsibilities in addition to one’s time spent on paid work, to provide the capability of an individual to balance work with leisure. She finds that men in both countries have higher capabilities to balance work with leisure than women, but the difference between genders is smaller in Sweden than in Poland. She further finds that working from home is related to lower capability to balance work with leisure for mothers in both countries, while this is not the case for fathers in Poland. The results of this study show how gender norms of the country, and the respective expectations towards mothers and fathers shape the extent to which flexible working can lead to increasing or decreasing the gender gap in domestic work.

The importance of context does not only lie at the country level. One main area most studies fail to incorporate is the extent to which organisational level contexts matter in shaping how flexible working relate to different work–family outcomes for men and women. Van der Lippe and Lippényi’s ( 2018 ) paper aims to tackle this issue in more depth. Their main contribution is to examine how organisational culture and context can play a role in the way working from home may reduce or exacerbate one’s work-to-family conflict for men and women. Here organisational contexts include supportive and family-friendly organisational culture as well as the normalisation of flexible working, as indicated by the number of colleagues working from home. These organisational contexts are expected to moderate the relation between working from home and work–family conflict. Using the unique dataset European Sustainable Workforce Survey, they are able to compare workers from across 883 teams, in 259 organisations, across nine countries (Bulgaria, Finland, Germany, Hungary, Netherlands, Portugal, Spain, Sweden, UK). Results show that working from home leads to more work–family conflict, especially when workers perceive an ideal worker culture at their workplace and less so when there are more colleagues working from home. The influence of culture seems to be more important for women than men, for whom work culture matters less.

These studies shine an important light on how the importance of the context in which flexible working is used matters in determining not only its outcome but also the gender discrepancy in the outcomes.

3.2 Defining Flexible Working, Discrepancies Between Arrangements

Another limitation of previous research is the way flexible working is operationalised. Many studies do not distinguish between different types of flexible working, in the extent to which control is given, and for which purpose.

Lott ( 2018 ) aims to tackle this issue by distinguishing between the different types of flexible schedules to see how they relate to work-to-home spill-over for men and women. Using the German Socio-Economic Panel Study in 2011 and 2012, she distinguishes between three different types of working time arrangements. Namely, she distinguishes between flexitime—i.e., a certain degree of self-determination of daily working hours within a working time account, and working-time autonomy—no formally fixed working hours and where workers choose their own working hours, and for the lack of control, fixed schedules against employer-oriented flexible schedules—namely, working hours fixed by employer, which may vary from day to day. She finds that employees experience the most work-to-home spillover with working-time autonomy and employer-oriented schedules, and the least with flexitime and fixed schedules. However, she also finds gender differences. Working-time autonomy’s association with higher cognitive work-to-home spillover only holds for men, and mainly due to the increased overtime hours men work when having working-time autonomy. Another unique contribution of this paper is the inclusion of employer-oriented flexible schedule—i.e. how unpredictability and unreliable schedules influence work–life balance. Here she finds that such unpredictability and unreliability is especially problematic for women; only women seem to suffer from higher spillover with employer-oriented schedules. This relationship holds above and beyond job pressure and overtime hours. Lott argues that the main cause for this is due to women’s position as the main person responsible for the day to day management of the household, for which such unpredictability of working hours can be extremely problematic. For similar reasons women seem to suffer less with flexitime—in that they have more control over their schedules.

Chung and Van der Horst’s ( 2018a ) study also aims to distinguish between different types of flexible working arrangements—namely schedule control, flexitime, and teleworking. One of the main contribution of their study is to distinguish between workers’ control over their working hours, but for different purposes—namely those primarily used for family-friendly goals (flexitime), against those provided mostly for performance enhancing goals (here for convenience referred to as “schedule control”). They examine how these different types of workers’ control over their work are associated with an increase in unpaid overtime hours of workers for men and women in the UK using the Understanding Society data from 2010 to 2015 and fixed effects panel regression models. Results show that flexitime and teleworking do not increase unpaid overtime hours significantly. On the other hand, the more performance enhancing schedule control increases unpaid overtime hours, but with variations across different populations. Unsurprisingly, mothers, especially those working full-time, appear to be less able to increase their unpaid overtime as much as other groups of the population. This can be mostly explained through the fact that many mothers working full time would not have any more time to give to their companies, unlike many men, including fathers, and women without children. On the other hand, part-time working mothers increased their unpaid overtime hours significantly when using schedule control. This discrepancy in the ability to work longer hours can potentially increase gender inequality in the labour market due to overtime being seen as one of the most explicit forms of commitment towards the company. Yet in the case of part-time working mothers, it is unlikely that these increased hours will result in additional career premiums as evidenced in another contribution of the special issue (Chung 2018c ).

Chung (2018c) distinguishes between flexitime, working from home, and part-time work when examining workers’ experiences with flexibility stigma, that is the negative perception towards those who work flexibly, using the 4th wave of the Work–Life Balance Survey conducted in 2011 in the UK. She finds that men are more likely to agree with the statement that those who work flexibly generate more work for others, and say that they themselves have experienced negative outcomes due to co-workers working flexibly. On the other hand, women and especially mothers are likely to agree that those who work flexibly have lower chances for promotion and say they experienced negative career consequences due to themselves working flexibly. One reason behind mother’s experience with flexibility stigma is due to the fact that most mothers use some sort of working time reducing arrangement, e.g. part-time work. On the other hand, men and fathers are more likely to use flexitime and teleworking, which are less likely to lead to negative career outcomes. Chung further argues that it might be simplistic to completely attribute the differences found between men and women in the negative career outcomes experienced when working flexibly, only to the types of arrangements they use. In other words, the negative career outcomes experienced by part-time workers may partly have to do with the fact that it is widely used by mothers to balance work with family life (see also, Lewis and Humbert 2010 ). Thus, the stigma towards part-time workers’ commitment towards work and productivity may be better understood as a reflection of the stigma towards mothers’ commitment towards work and their productivity.

Kim ( 2018 ) examines how flexible working policies increase parental involvement with children and also distinguishes between different types of flexible working policies, namely access to flexitime/flexible schedules, ability to work at home, and working part-time. Using the longitudinal data from the US Early Childhood Longitudinal Survey-Birth Cohort (ECLS-B), he finds that working from home was associated with more frequent enrichment parent–child interactions, but only for mothers, echoing what was found in Poland by Kurowska ( 2018 ). Part-time working for mothers was also associated with more frequent enrichment parent–child interactions, and for father’s access to flexitime were associated with greater daily routine interactions. The result of increased routine care of fathers through flexitime is most likely due to tag-team parenting (Craig and Powell 2012 ) where parents use flexible schedules to increase the time both parents spend with children. By enabling men to take up a larger share of routine care of children flexitime of male partners can help women build their careers—which explains why men’s flexitime has been shown to increase women’s career perspectives (Langner 2018 ).

These studies provide us with evidence that we need to look at the intersection between gender and different types of flexible working to better understand how flexible working leads to different outcomes. Furthermore, they enable a better understanding of how different types of flexible working may result in different outcomes for gender equality. Working from home, working time autonomy/schedule control for performance purposes may not necessarily provide much benefit to even out the playing fields for men and women. On the other hand, flexitime—especially with a more defined/clear working hours boundaries, seems to be a better option if we are to ensure flexible working does not lead to further traditionalisation of gender roles.

3.3 Incorporation of Class

Another contribution the papers in this special issue is to examine the intersection between gender and class when examining the outcomes of flexible working. Many of the existing studies on flexible working focus on professionals (e.g., Cech and Blair-Loy 2014 ), which to some extent relate to the access these groups have towards flexible working arrangements and control over their work (Chung 2018a ). However, the intersection between gender and class has been shown to be of great importance in understanding how flexible working enables workers to do or undo gender (Clawson and Gerstel 2014 ; Deutsch 2007 ). The articles in this special issue also try to engage in the analysis of class, to see how there may be distinctions between classes in the way flexible working relate to gendered outcomes.

Kim ( 2018 ) in his analysis of how flexible working may lead to different levels of parent–child interactions, incorporates household structures and income as well as gender. The results indicate that the positive impacts of flexible working vary depending on income levels and for single/dual earner households. For example, the positive association between working from home and parent–child interactions was more pronounced among low-income mothers than mid- and high-income mothers. Part-time working only increased enrichment interactions with children for mothers in two-parent families, perhaps reflecting the limited capacity of single-mothers to expand their time on such activities. Part-time working increases parent–child interactions only for fathers from dual-earner households and not for those from single-earner households. This finding reflects the results found in previous studies regarding gender division of labour within households of female-breadwinner families (Bittman et al. 2003 ).

By examining the lack of schedule control, Lott ( 2018 ) also focussed on the less privileged, mostly non-professional, lower-class workers whose work schedule are more often determined by the employer and changed on a daily basis. She found that work–life spill-over is highest for these workers, especially women. Women of the lower working class have fewer financial resources in order to cope with unpredictable and unreliable work hours, for example to pay for public or private childcare. They alone carry the double burden of balancing paid and unpaid work.

Chung and Van der Horst ( 2018a ) examine the differences between different occupational groups in their analysis of how flexible working leads to increased unpaid overtime hours for men and women, parents and non-parents. They find that the increase in unpaid overtime hours when workers have control over their schedule was largely driven by the professionals in the model, especially for men. In closer inspection, there seems to be a division within professionals in terms of gender when we consider parenthood. Professional men with and without children seem to increase their unpaid overtime hours especially when they have a lot of schedule control, while professional women with children do not. On the other hand, professional women without children increase their overtime hours similar to that of men, yet again it is questionable whether they will benefit from the same career premium from it (Lott and Chung 2016 ).

4 Discussion, and Policy Implications and Future Challenges

The results of the papers in this special issue point to one conclusion; flexible working can be useful in enabling a better work–life balance and family functioning, yet we need to be aware of the potential gendered ways in which it is being/and is expected to be used. In other words gender matters when it comes to understanding the consequences of flexible working. Men and women use flexible working in different ways that leads to different outcomes for wellbeing, work–life balance and work intensification. A recurring finding is that women are more likely to (or expected to) carry out more domestic responsibilities whilst working flexibly, while men are more likely to (or are expected to) prioritise and expand their work spheres. Consequently, it is women who will fear and are more likely to face negative career outcomes due to flexible working as Chung (2018c) shows. However, we need to be careful about understanding such patterns as a matter of choice. As Lott ( 2018 ) has argued, family and domestic responsibilities may be understood more as a constraint under which women need to navigate and negotiate their work spheres.

Furthermore, we must also conclude that gender is a too general distinction to gain insight in the consequences of flexible working on work–life balance outcomes. A common thread found in all articles in this special issue is that gender must be studied in context; in the organisational, country, family, as well as class context. First of all, the culture of the organisation matters, such as the prevalence of flexible working in the organisation as well as supervisory support etc., yet perhaps more for women as Van der Lippe and Lippényi ( 2018 ) show. Second, country contexts matter in that flexible working allows workers to “do gender” in a more traditional gender cultures such as Poland, and where a more gender egalitarian culture exists, such as in Sweden, the gender discrepancies due to flexible working may not be as evident, as Kurowska ( 2018 ) shows. Third, the household structures appears to be important in the outcomes of flexible working. There are differences in single versus dual earners, as well as low- versus higher income families for both men and women as Kim ( 2018 ) shows us. The occupation of the worker also matters, where the gender discrepancies in the negative spill-over effects, namely working long unpaid overtime hours, of schedule control depend on the occupation you look at as Chung and Van der Horst ( 2018a ) show. Overall, the findings in this special issue seem to indicate that especially in contexts where traditional norms on gender roles are prevalent and where ideal worker culture exists, flexible working may promote a more traditionalised division of labour resulting in hindering rather than supporting gender equality. This is likely because in such contexts, flexible working can lead to women being able to (but also having to) expand their household burdens, while men expand their work loads. This may reinforce the (unconscious) biases employers and co-workers have towards flexible working of men and women, and more female oriented and male oriented flexible working arrangements, which can increase the wage gap between the genders as Chung’s (2018c) work indicates.

So what can be done to prevent such increase in traditionalisation through flexible working? At the macro level, there needs to be changes in our gender norms and ideal working culture. In other words, flexible working is not used in a vacuum and as long as our gender normative views about mothers and fathers roles do not change, the way people perceive flexible working will be used by men and women is unlikely to change and will feed into how they will in fact be used. Attention is required, for example via the European Institute for Gender Equality (EIGE) at the European level, but also other national level bodies for promotion of gender equality in Europe and its member states through delivering expertise and knowledge, and enhancing policies to change normative views of gender roles. Policy changes, such as increase in well paid ear-marked paternity leaves, such as the ones found in Sweden, has been shown to increase father’s involvement in childcare and domestic work not only in the period during the leave but many years after (Nepomnyaschy and Waldfogel 2007 ). Thus it can be used as a useful tool to help reduce the gender division in childcare and household tasks, and consequently help shift the gender norms of the country. Consequently such policies can also be useful in ensuring that flexible working is not used as a tool to enforce traditional gender roles. Providing better protective mechanisms for workers to ensure that flexible working and blurring of boundaries do not lead to encroachment of family life would also be important policies to be implemented at the national level. Current labour laws, which is based on a more traditional 9 to 5 job done in the office, may not be sufficient to ensure such protections.

One key finding of our research was that when flexible working becomes more of a norm, rather than the exception, this may help workers use flexible working arrangements for work–life balance purposes. Changing the right to request flexible working legislations to ensure that flexible working is more of a right from day 1 on the job, that flexible working is more of a default rather than an exception would be useful in ensuring that it does not lead to stigma or work–life conflict.

At the mezzo and micro level, we need to make sure both workers and managers are aware of the risks of flexible working. For companies, providing good role models of senior managers, especially male senior managers, taking up flexible working for family-purposes and without work spilling over to other spheres of life will be important to show how best to utilise flexible working. The notion of ‘the healthy organisation’ might be helpful here. Healthy organisations take into account the wellbeing and work family balance of employees, as well as workplace effectiveness (Lewis et al. 2011 ). Building better collective practices of flexible working, where work is not done everywhere and all the time, is crucial. It implies that organisations implement flexible work options under the condition that it is rewarding (in a material and unmaterial way) for employees and such that it commensurate with it success (Lewis et al. 2011 ). Workers themselves should also be reflective of how some of their own expectations in how flexible working should and can be used is shaped by our prevailing gender norms and assumptions on whose job it is to care/do the breadwinning. To question some of the gendered assumption would be important.

One of the challenges is how to take the family situation better into account when implementing work flexibility in such a way that it enhances work–life balance. One of the ways could be to relieve work and household burden, often a double burden for women when they also have a paid job (Hochschild and Machung 2003 ). Arrangements for example regulating working hours and applying flexible time-management models suited to the needs of the employee and his or her family. Other options are a professional network of family support services, including public childcare, elderly care services, different forms of leaves, as well as arrangements to outsource housework (De Ruijter and Van der Lippe 2007 ). Of course a discussion is needed who is responsible for these arrangements and to what extent. Is it the individual employee, the country individuals live in, or the organisation of the employee? Most likely this will be a combination of all three, also partly dependent on the welfare regime of the country, and the sector the organisation of the employee belongs to. Public policies and interventions are for example deeply embedded in Scandinavian culture. They may fit less with the cultures, habits and structures of other European welfare states, but organisations might take the lead more in these welfare states.

There are some issues that this special issue has not been able to address. Firstly, we still know very little about how flexible working relate to informal care capacities. Majority existing studies, including the ones in this special issue, deal with flexible working for childcare purposes. More research is thus needed to see how flexible working is gendered (or not) in increasing workers’ care capacities in times when informal care demands arise, or how it allows workers to combine work with informal care demands. Secondly, longer career consequences of flexible working, especially relating to flexitime and tele/home working, would be useful to investigate, especially in order to understand how flexible working relate to gender wage gaps. Some of the studies here and  other previous studies have shown that flexible working can increase men's working hours/overtime hours and other commitment towards work which may increase their wage premiums, and consequently the gender wage gap between men and women. On the other hand, flexible working also helps women reduce work family conflict and allow them to work longer than they would've otherwise. In this sense, exactly how these two rather conflicting dynamics add up in the longer run would be important to examine. Thirdly, more analysis is needed to fully understand the importance of context in not only shaping the outcomes of flexible working, but also how it shapes the gendered nature of flexible working. Our studies have shown that gender norms and long hours cultures have been shown to be important contexts that shape such outcomes. Examining these and other contextual factors, such as the strength of the legal right to flexible working, its prevelance, and workers’ negotiation power, both at the national and organisational levels will help us find out more about under which context can we expect a better use of flexible working so that it enhances both workers' work life balance and gender equality. We hope that this special issue has provide some useful steps in the right direction to find these answers out, and that it helps pave the way for future scholars to follow. Flexible working is likely to become more common in the future as demands for flexible working increases among both new and older generations of workers for diverse reasons. It provides us with great opportunities to tackle some of societies’ most pressing challenges. However, as this special issue has shown, this will only be the case if it used in the right way. 

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Acknowledgements

The authors are grateful for the funding provided by the Economic & Social Research Council Future Research Leader funding (ES/K009699/1) and the European Research Council under the European Union’s Seventh Framework Programme (FP/2007-2013) / ERC Grant Agreement n. 340045. The authors would also like to thank the contributors of this special issue who have provided high quality, excellent, and interesting contributions for the issue, and have provided useful feedback on this introduction. They are namely, Mariska van der Horst, Yvonne Lott, Anna Kurowska, Jaeseung Kim, and Zoltán Lippényi.

UK Economic and Social Research Council Future Research Leader funding—Work Autonomy, Flexibility, and Work-life Balance (ES/K009699/1) and the European Research Council under the European Union’s Seventh Framework Programme (FP/2007-2013)/ - Project: Sustainable Workforce. ERC Grant Agreement No. 340045.

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Chung, H., van der Lippe, T. Flexible Working, Work–Life Balance, and Gender Equality: Introduction. Soc Indic Res 151 , 365–381 (2020). https://doi.org/10.1007/s11205-018-2025-x

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Advantages and Disadvantages of Flexible Working Hours

Flexible working hours have become increasingly popular in recent years, as employees seek greater work-life balance and employers strive to attract and retain top talent. However, this approach also has its share of advantages and disadvantages that need to be considered before implementing it. In this article, we will explore the advantages and disadvantages of flexible working hours.

Advantages of Flexible Working Hours

Increased Productivity Flexible working hours can help boost productivity by allowing employees to work during their most productive hours. This may mean they can work earlier or later in the day, or from a different location altogether. As a result, they may be able to complete tasks more efficiently and effectively.

Improved Work-Life Balance Flexible working hours can help employees to better balance their work and personal life. This can be particularly beneficial for those with family responsibilities, as it allows them to meet their commitments without sacrificing their career aspirations.

Higher Employee Satisfaction and Motivation By offering flexible working hours, employers can show their employees that they value their personal lives and are committed to supporting their well-being. This can lead to higher levels of job satisfaction and motivation, which in turn can result in increased productivity and improved performance.

Reduced Absenteeism and Turnover Flexible working hours can help reduce absenteeism and turnover rates. When employees are able to manage their work and personal responsibilities more effectively, they are less likely to need time off or to leave their jobs.

Better Recruitment and Retention of Talent Flexible working hours can be a major selling point for prospective employees. Employers who offer flexible working arrangements may find it easier to attract and retain top talent, particularly in industries where competition for skilled workers is high.

Improved Relations between the Workers and Supervisors Flexible working hours can improve the relationship between workers and supervisors. When employees have more control over their schedules, they may feel more valued and respected, which can lead to better communication, collaboration, and overall job satisfaction.

Disadvantages of Flexible Working Hours

Difficulty in Managing and Supervising Employees Managing and supervising employees who work flexible hours can be challenging. Employers may need to invest in new technologies or strategies to ensure that employees are working effectively and that communication lines remain open.

Potential for Reduced Collaboration and Communication Flexible working hours can reduce the opportunities for face-to-face interaction and collaboration between team members. This can lead to communication breakdowns and misunderstandings, which can negatively impact productivity and teamwork.

Increased Risk of Burnout and Overwork Flexible working hours can lead to an increased risk of burnout and overwork, as employees may feel pressure to work longer hours or to be available outside of normal business hours.

Difficulty in Maintaining Work-Life Boundaries Flexible working hours can make it difficult for employees to maintain a healthy work-life balance. Without clear boundaries, they may find it challenging to switch off from work and disconnect from technology.

Potential for Decreased Job Security and Benefits Employers may be less inclined to offer the same level of job security and benefits to employees who work flexible hours. This can make it difficult for workers to plan for their future and to make long-term career decisions.

Flexible working hours have both advantages and disadvantages. By weighing up these factors and developing a strategy that addresses them, employers can create a more productive, engaged, and satisfied workforce.

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The Pros and Cons of a Flexible Work Schedule

A Flexible Schedule Can Benefit Employers and Employees

Employee Flexibility

Employee commute, employee empowerment, employee childcare costs, employers gain commitment.

• Business Improvements

Disadvantages for Employees

Disadvantages for employers.

The Balance

Advantages for employers and employees exist when the employer  allows employees to work flexible schedules . Whether the flexible work schedule involves compressing work days, flexible daily hours, or telecommuting, challenges exist for the employer and the employee.

These are the advantages for employers and employees that  negotiating a flexible work schedule provides.

With flexible work schedules, employees stand to experience a good number of benefits. One that many workers point to first is the flexibility to meet family needs, personal obligations, and life responsibilities conveniently. If you have a flexible schedule, you can go to a parent-teacher conference during the day, take a yoga class, or wait at home until the washing machine repair person comes.

Flexible work configurations allow employees to work when they accomplish most, feel freshest, and enjoy working. Many managers feel that early birds are hard workers and night owls are slackers. Evidence is not readily available that this is the case—in fact, much evidence to the contrary exists with either night owl or early bird personal choice yielding positives—it's simply cultural and preferential to a person's needs.

Flexible scheduling includes the ability to adjust the days and hours of being in the office and also allows workers to work remotely. Of course, with the commute to a home workspace, employees avoid the traffic and the stresses of commuting during rush hours. You might be amazed at how much faster a commute can be if you can drive to the office at 10 a.m. instead of at 8 a.m. during rush hour.

Employees save money by having a reduced consumption of commuting time and fuel costs. In some areas, commutes of more than an hour each way are not uncommon. If these employees are allowed to work from home, that saves two hours of time, gas, and wear and tear on the road. Fewer people driving means the drive is easier for those people who are commuting.

Employees get an increased feeling of personal control over their schedule and work environment. One reason people like to work for themselves is the control issue. By allowing employees to determine their own schedule and work environment, you appeal to the entrepreneurial spirit—which can be good for your employees.

Built-in flexibility also reduces employee burnout due to overload. Flexibility means employees can take a break when they need it without incurring the wrath of a manager.

Depending on the flexible work schedule chosen, it may decrease external childcare hours and costs. You need to make clear to employees that for all but a handful of jobs, working from home still requires childcare because you can't work effectively while also entertaining a toddler.

However, if a couple both have flexible schedules, one party can go into the office at 6:00 a.m. and the other can get the kids ready for school. One person's 8-hour day is finished by 2:00 p.m. and can meet the bus at 3:00 p.m., while the other start their workday at 9:30 a.m. The result is two full-time jobs and incomes with no childcare costs.

FOR EMPLOYEES:

Flexibility to better meet family and personal needs

Reduced commuting time and gas expenses

Have more control over your time schedule and working environment

Can work during the hours that fit your energy cycles best

FOR EMPLOYERS:

Boosts employee morale

Reduces tardiness and absenteeism

Reduces employee turnover

Enhances company image as a family-friendly place to work

Difficult for office-based staff to work as effectively with telecommuting staff

Working from home may mislead loved ones about your availability

No clear dividing line between home and work

Some employees may not work efficiently without supervision

Compressed work weeks may mean client availability suffers

Feelings of unfairness when only certain employees have work that can be done remotely

With flexible work schedules, employers experience benefits as well. Giving up some control of work schedules gives increased employee morale, engagement, and commitment to the organization. The option also reduces employee turnover, absenteeism, and tardiness by allowing workers to flex hours around home and family obligations. The flow of projects and work may increase as employees are able to work when they accomplish most, feel freshest, and enjoy working.

Employer Business Improvements

Offering flexible work schedules will increase your ability to recruit outstanding employees. You will develop an image as an employer of choice with family-friendly flexible work schedules. Providing options can extend your hours of operation which is especially important for departments such as customer service or technical support.

Cloud technology allows workers to touch documents outside the office environment. In some businesses, this allows the company to expand its area of service to other time zones or even globally. Using remote worker options, the business can hire workers from areas where hourly wages are lower and reduce their compensation overhead. However, care must be taken that the drive to lower wages does not harm the quality product of the service you provide.

Overhead costs may drop when you employ remote workers. You will reduce the square footage requirements of office space and the cost of desks, chairs, computers, and other necessary equipment.

Employees who thrive in an office environment may find it difficult to work when colleagues don't hold the same schedule. Team efforts may require advanced planning and coordination of the employee's scheduled workdays and hours. This is why many employers require core days and core hours during which everyone is in the office or available for Zoom meetings. 

No clear delineation between work and home exists with a flexible schedule. When you use flexible schedules sometimes that means work all of the time. If your manager allows you the flexibility to go to your child's soccer game, then the manager may not feel guilty about calling you at 9:30 p.m.

Remote workers can make neighbors and friends think you aren't actually working, thus causing problems with relationships. Family and friends can become upset when you say you can't watch their child, or let the repairman into their houses—because, after all, you're home all day.

Working from home—while becoming more common prior to the global health crisis—is still a foreign concept to many people. Working life may be altered forever as employers and employees became convinced of the efficacy of remote work.

Some managers, who are used to seeing when their staff members come to work, watching what staff do all day at work, and knowing when people leave for home, have trouble adjusting to the new management style which requires trusting relationships. Also, in team-oriented departments, teams still need to meet, which requires set guidelines and the juggling of schedules.

Some people take advantage of the flexibility and the ability to work from home. If an employee requires structure, they may find it difficult to focus on work and not the household chores and entertainment. Office-oriented people sometimes view their work-at-home colleagues as slackers because they can't physically see their activity and productivity.

Compressed workweeks can make client handovers complicated—clients expect service 5 days a week during business hours and can be fussy when a particular employee isn't in on Friday. For this customer-centric reason, jobs that require customer-facing responsibilities only allow certain types of flextime. Whole days working from home are not an option. Other kinds of jobs such as assembly-line manufacturing and hands-on healthcare such as nursing share the same disadvantages. Employers struggle with fairness when only certain employees can work remotely.

The Bottom Line

Overall, the advantages generally outweigh the disadvantages and a good manager can handle the disadvantages. Flexible scheduling has become part of what employees are looking for in their comprehensive employee benefits packages . Your employees will love you; the employer will benefit from the overall positive morale which is linked to increased productivity. Best? You will retain your superior employees.

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Research: Flexible Work Is Having a Mixed Impact on Employee Well-Being and Productivity

• Jeremie Brecheisen

To be truly engaged, employees must thrive in both their personal and professional lives.

According to Gallup research, workers around the world who are working in hybrid or remote roles say they experience more stress and anger than their colleagues who work onsite full-time. At the same time, these remote and hybrid employees say they’re consistently more engaged than full-time onsite workers. This presents a complicated challenge for company leaders: Full flexibility means employee well-being might be in jeopardy. But if you’re going to require employees to be in the office full-time, you may need to mitigate lower engagement and lower productivity. So what can organizations do to promote both well-being and productivity wherever employees are working? This article offers three strategies.

Flexible work is having an impact on employee well-being, according to recent Gallup data. In our 2023 Global State of the Workplace Report , which represents more than 140 countries, employed individuals who were working remotely either full time or part-time (hybrid) said they were experiencing more stress and more anger than employees who were working onsite full-time.

• Jeremie Brecheisen is a partner and managing director of The Gallup CHRO Roundtable.

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The 9-to-5 Schedule Should Be the Next Pillar of Work to Fall

By Emily Laber-Warren

Ms. Laber-Warren leads the health and science reporting program at the Craig Newmark Graduate School of Journalism at the City University of New York.

Thirty percent of workers around the world surveyed last year said they would consider seeking a new job if their current employer required them to return to the office full time. Millennials are especially resistant . In response to the Covid pandemic, PepsiCo , Meta and General Motors , among others, have incorporated remote work into their corporate cultures.

But in a truly flexible workplace, people would control not just where they work but also when. Southwest Airlines allows pilots to choose between morning and evening flight schedules. A few tech companies, including Automattic and DuckDuckGo, have work-anytime policies that enable employees to become nomadic and travel the world or simply run weekday errands. But such opportunities remain rare.

“I think it’s really a shame that more companies don’t take advantage of it,” said Azad Abbasi-Ruby, the senior market research analyst at DuckDuckGo. He added, “We get so much done, and I think a lot of it has to do with this flexibility, letting people work when they’re most productive.”

Flextime is an employee handbook buzzword, but in practice it is not widely used. Whereas some roles are legitimately time-dependent (teachers need to be at school in the morning), many are not. If more employers truly embraced flexible schedules and allowed employees to work at the times that are best for them, experts say, the benefits would be a healthier and more productive, creative and loyal work force.

There are any number of reasons workers might want more control over when they work. People may live in one time zone and work in another; for example, financial analysts in Seattle or Los Angeles might not want to start their day at 6:30 a.m. to coincide with the opening of the New York Stock Exchange.

Or they may have a life situation, such as a disability or caregiving responsibility, that requires attention during standard work hours. Some 700,000 parents of young children left the U.S. work force in 2020, many of them because their children were suddenly schooling from home. Surveys by the Pew Research Center indicate that even before the pandemic , many mothers, in particular, felt that conflicts between work and family obligations had damaged their careers.

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