PEARLS No. 253, May 2010, written by Brian R McAvoy

Clinical question
How effective are flexible working interventions on the physical, mental and general health and wellbeing of employees?  

Bottom line
Interventions that increased employee control by offering worker-orientated flexibility (specifically self-scheduling and partial/ gradual retirement) were likely to be associated with health improvements, including improvements in physical health (reduced systolic blood pressure and heart rate), mental health (eg, reduced psychological stress) and in general health measures (eg, tiredness and sleep quality). Importantly, interventions that increased worker flexibility were not associated with any adverse health effects in the short term. In contrast, interventions that were motivated or dictated by organisational interests, such as fixed-term contracts and involuntary part time employment, found equivocal or negative health effects.  

Caveat
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.  

Context
Flexible working conditions are increasingly popular in developed countries but the effects on employee health and wellbeing are largely unknown. 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 studies that examine differences in health outcomes by socioeconomic status, occupational grade or demographic characteristics.

Cochrane Systematic Review
Joyce K et al. Flexible working conditions and their effects on employee health and wellbeing. Cochrane Reviews 2010, Issue 2. Article No. CD008009. DOI: 10.1002/14651858. CD008009.pub2. This review contains 10 studies involving 16,603 participants.