title: Mediating pathways and gender differences between shift work and subjective cognitive function.
abstract: OBJECTIVE
  Increased injury risk among shift workers is often attributed to cognitive function deficits that come about as a result of sleep disruptions. However, little is known about the intermediate influences of other factors (eg, work stress, health) which may affect this relationship. In addition, gender differences in these the complex relationships have not been fully explored. The purpose of this study is to (1) identify the extent to which work and non-work factors mediate the relationship between shift work, sleep and subsequent subjective cognitive function; and (2) determine if the mediating pathways differ for men and women.
  
  
  METHODS
  Data from the 2010 National Population Health Survey was used to create a cross-sectional sample of 4255 employed Canadians. Using path modelling, we examined the direct and indirect relationships between shift work, sleep duration, sleep quality and subjective cognitive function. Multigroup analyses tested for significantly different pathways between men and women. Potential confounding effects of age and self-reported health and potential mediating effects of work stress were simultaneously examined.
  
  
  RESULTS
  Work stress and sleep quality significantly mediated the effects of shift work on cognition. Age and health confounded the relationship between sleep quality and subjective cognition. No differences were found between men and women.
  
  
  CONCLUSIONS
  Occupational health and safety programmes are needed to address stress and health factors, in addition to sleep hygiene, to effectively address cognitive function among shift workers.
authors.affiliation: National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.
authors.forename: Imelda S
authors.identifier: http://orcid.org/0000-0003-4224-5092
authors.initials: IS
authors.lastname: Wong
authors.affiliation: Institute for Work and Health, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Smith
authors.affiliation: Institute for Work and Health, Toronto, Ontario, Canada.
authors.forename: Selahadin
authors.initials: S
authors.lastname: Ibrahim
authors.affiliation: Institute for Work and Health, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Cameron A
authors.initials: CA
authors.lastname: Mustard
authors.affiliation: Institute for Work and Health, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Monique A M
authors.initials: MA
authors.lastname: Gignac
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D057566:Self Report; D017678:Sex Distribution; D012890:Sleep; D013315:Stress, Psychological / Q000523:psychology*; D014940:Work Schedule Tolerance / Q000523:psychology*; D017132:Workplace / Q000523:psychology*; D055815:Young Adult
keywords: path analyses; subjective cognitive function