Association between work schedule type, mental health and quality of life in Greek firefighters. (Protocol number accepted by ethical comitee: 223/ 27-05-2020)

Background: Firefighters are exposed to chronic occupational stress, circadian disruption, and traumatic events, placing them at increased risk for sleep disturbances and mental health impairment. Within resilience frameworks, occupational outcomes are conceptualized as the result of the interaction between risk factors and protective factors. However, the role of work schedule-related protective mechanisms remains insufficiently explored.

Aim: This study examined the association between work schedule type, mental health, and quality of life among Greek firefighters, while situating the findings within a resilience-based conceptual framework.

Methods: A cross-sectional quantitative study was conducted among 191 permanent firefighters working 24-hour shifts, rotating 8-hour shifts, or working fixed morning 8-hour schedules. Participants completed validated self-report measures assessing health-related and overall quality of life and mental health.

Results: Work schedule type was significantly associated with psychological outcomes. Firefighters working fixed morning 8-hour schedules exhibited significantly lower general and psychological health, social functioning, environmental quality of life, and resilience compared with those working rotating 8-hour or 24-hour shifts. Across all schedules, sleep disturbances were strongly associated with poorer mental health and reduced quality of life.

Limitations of the study: The cross-sectional design precludes causal inferences regarding the relationship between work schedule type, sleep disturbances, and mental health outcomes. In addition, data were collected exclusively through self-report questionnaires. Finally, no objective sleep assessments or biological markers of stress and circadian disruption were included.

Conclusions: Fixed morning schedules did not appear to confer protection against mental health impairment. Within a resilience framework, it is plausible that the close interpersonal bonds formed among firefighters working shared shifts, combined with collective exposure to traumatic events and a strong shift-based occupational culture, may act as psychosocial buffering mechanisms that mitigate mental health risk. These findings highlight the importance of addressing both risk and protective factors when designing resilience-enhancing interventions for firefighters.