Rotation work in the resources sector: a systematic review of the impact on workers’ families

Abstract

Objective

Rotation work involves travelling to work in remote areas for a block of time and alternate with spending another block of time at home; such work arrangements have become common in the resources sector. The intermittent absence of workers from the home may adversely affect the health of the workers’ families. This study synthesises research on mental and physical health outcomes in partners and children of rotation workers in the resources sector.

Design

A systematic review was conducted. Studies were retrieved from PubMed, Medline, EMBASE, CINAHL, PsycINFO, and Scopus. Nineteen studies were included and findings were summarised narratively.

Results

The impact of rotation work on the mental health and well-being of partners and children of rotation workers remains unclear. However, on days where workers are away, partners may experience greater loneliness and poorer sleep quality.

Conclusion

Partners may benefit from support, particularly when they have younger children and/or their spouses first begin rotation work. Research is limited, particularly regarding the impact on health-related behaviours and physical health outcomes.

Registration

This review was registered on PROSPERO (ID: CRD42020167649).

Keywords:

• Rotation work
• FIFO
• long distance commute
• families
• systematic review

Introduction

Definition of rotation work and the impact on families

Rotation work, also known as Fly-In Fly-Out (FIFO) (Storey, 2016), involves travelling to work for a typical 12 hour day or night shift and staying for a specified number of days, ranging from 5 days to 6 weeks, after which the worker returns home to spend another specified period at home (Meredith et al., 2014; Storey, 2016). Rotation work arrangements initially developed for serving offshore oil and gas installations in the Gulf of Mexico, are nowadays increasingly used globally in the onshore mining and construction industry (Storey, 2016).

Rotation work arrangements present families with benefits including higher incomes, the maintenance of social networks and urban settlements, and chance to spend blocks of time with family and friends during leave periods (Gallegos, 2006). However, the rotation work lifestyle of alternating presence and absence from home over some time also has disadvantages for social and family life, and workers’ wellbeing. These include workers missing family and social events (Langdon et al., 2016), potentially overburdening partners with their home obligations (Gallegos, 2006; Langdon et al., 2016), and recurrently having to emotionally and functionally adjust to separations and reunions (Gallegos, 2006; Meredith et al., 2014) often leading to disruption of family lives (Parker et al., 2018).

A literature review suggested that the partners experience more stress, social isolation and loneliness, and that the absence of the worker could negatively impact children’s development, wellbeing and family functioning (Parker et al., 2018). Another review reported that children of rotation workers may experience more adverse emotions including anger, sadness, and hate; and more behavioural problems such as hyperactivity, conduct and peer problems due to the long absence of rotation work parent from the home (Meredith et al., 2014).

Theoretical frameworks

Little effort has been made to consider the effects of rotation work on families within the available theories and frameworks (Dittman, 2018; Parker et al., 2018). Both Work-Family Conflict Theory (Greenhaus & Beutell, 1985) and the Spillover-Crossover Model (Bakker & Demerouti, 2013) could explain how the pressures of rotation work demands impact the wellbeing of partners and children of workers. Studies have employed the aforementioned theories to explain in what ways the pressures of job demands and resources of spouses who both earn income influence the wellbeing of their partners (Shimazu et al., 2009) and children (Shimazu et al., 2020).

Furthermore, Attachment Theory (Bowlby, 1980) and Social Ecological Theory (Bronfenbrenner, 1994) could offer the means to understand potential effects on partners and children of temporary separations due to rotation work. Studies acknowledge the significance of Attachment Theory (Diamond et al., 2008; Medway et al., 1995) and Social Ecological Theory (Dittman, 2018; Orthner & Rose, 2009) in explaining the effects of temporary parental and partner separations; for instance, due to military deployment on children and partners’ wellbeing (Orthner & Rose, 2009). Full descriptions of frameworks are presented in supplementary Appendix 1.

Aim of the present study

Rotation work in relation to family life differ from other work arrangements. The intermittent absence of workers from the home may adversely affect the health of the families of workers. As rotation work becomes more popular globally, it is necessary to explore the impact of this work on the health and wellbeing of workers and their families. We conducted a systematic review of studies examining the impact of rotation work on the health and wellbeing of workers’ partners and children, including psychological health and well-being, physical health, sleep and health-related behavioural patterns, and emotional and behavioural patterns of children. Providing a comprehensive review in global resource and related construction sectors could provide clarity and highlight the consequences of rotation work arrangement on families.

Methods

This systematic review of the literature was conducted in line with Joanna Briggs Institute (JBI) for quantitative and qualitative reviews guidelines (Lizarondo et al., 2020), and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Page et al., 2020). This review was part of a broader review of which the protocol was pre-registered on PROSPERO (ID: CRD42020167649) assessing the overall mental and physical health of rotation workers, reported elsewhere (Asare et al., 2021).

Eligibility criteria

Original articles of quantitative, qualitative and/or mixed-method studies published in peer-reviewed journals and English were included. Qualitative findings can give in-depth insights into the health outcomes of rotation workers’ partners and children, and support the understanding of quantitative findings. The study population were partners (with or without children) and/or children (of any age) of rotation workers who worked in the resource (offshore oil and gas, and mining) and related construction industry. Rotation workers were defined as workers who work on rotational schedules of travelling away from home to work for a block of time and alternate with spending another block of time at home. Quantitative studies were included, if they reported psychological health outcomes, children’s behavioural and emotional problems, physical health outcomes, sleep problems or health-related behaviours. Qualitative studies that reported the perceptions of the impact of rotation work arrangement on the physical and mental wellbeing of partners and children of rotation workers were included. We also included studies that reported parents’ perceptions about the impact of rotation work on children. The clearly defined quantitative and qualitative components of mixed-method studies were included. Studies were excluded if they were reviews, letters, book chapters, study designs were not clearly defined, and only reported on family relationships and functioning, and parenting (but not on any health-related outcomes).

Data sources and search procedure

Searches were conducted in PubMed, Medline, EMBASE, CINAHL with Full Text, PsycINFO, and Scopus on 1^st May 2020 for relevant articles as part of a bigger review (Asare et al., 2021) and updated on 21st April 2021, using search strategies presented in Supplement Appendix 2. Searches were not restricted by study design, publication dates and geographic location. The references of the included studies were also hand searched.

Study screening and selection

Figure 1 shows the PRISMA flow diagram for the selection of studies into the review. Studies identified were screened for inclusion/exclusion in the Covidence software. The titles and abstracts of articles and then full texts for all potentially eligible studies were retrieved and screened by two of the authors (BYAA and DK) for suitability. The agreement between raters (interrater reliability) for screening of studies at both the title and abstract, and full text stages were high with a Cohen’s Kappa statistic of 0.98 and 0.92 respectively. Disagreements at all stages of the screening were resolved through discussion until consensus between the two authors (BYAA and DK) and any that could not be agreed were referred to the other two authors (DP and SR) to resolve by consensus. Articles excluded at the full-text screening were recorded and the reasons that informed the exclusion of studies per the inclusion criteria reported (Figure 1).

Figure 1. Flow diagram of identifying and selecting studies for the systematic review.

Assessment of methodological quality

Two of the authors (BYAA and DK) independently evaluated included studies for methodological quality using tools for appraisal of quantitative descriptive studies in the Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MASt ARI) and Qualitative Assessment and Review Instrument (JBI-QARI) (Lockwood et al., 2015; Moola et al., 2017), and rating discrepancies were deliberated on and resolved. Checklist items of the assessment tools were rated and scored ‘Yes’ (1), ‘No’ (0) and ‘Not clear’ (0), excluding not applicable items. Analytical cross-sectional and cohort studies were rated for methodological quality on 9 to 11 items such as the validity and reliability of exposure and outcome measurements, identifying and stating strategies to dealing with confounding factors, and appropriateness of statistical analysis used (Moola et al., 2017) with possible scores between 0 and 11.

Qualitative studies were rated for methodological quality on 10 items such as research methodology agreement with data collection methods used, the representation and analysis of data, and the interpretation of results, and the ample representation of participants and their voices (Lockwood et al., 2015) and a study potentially scored between 0 and 10.

For mixed-method studies, each component of the method (quantitative and qualitative) was assessed separately as outlined above. Any inconsistencies in scores that arose were discussed and resolved through consensus. Studies scoring ≥ 7 were categorised as of high quality, scores 4–6 considered medium quality and scores <4 classified low quality and reported in the review. No study was excluded based on quality assessment (Duran, 2013; Lucas et al., 2007) since there are few available studies examining the outcomes of interest (Duran, 2013), and that strict exclusion based on quality assessment may exclude appropriate studies based on not following a particular reporting standard (Lucas et al., 2007).

Data extraction

Using the templates from the JBI-MAStARI data extraction tool for quantitative data and JBI-QARI for the qualitative studies, a data extraction sheet was developed and piloted. The key information extracted included study authors, publication year, study design, aims/objectives, study setting (country and industry) and participants (number of study participants, gender, age), health outcomes and measurement tools used and the key findings. One reviewer (BYAA) conducted the data extraction and another reviewer (DK) double-checked 10% of the extracted data; all inconsistencies were discussed and resolved through consensus.

Strategy for data synthesis and analysis

Quantitative and qualitative data extracted in terms of the studies characteristics and key findings were presented in tables and a narrative summary of the included studies done. Based on previous literature (Langdon et al., 2016; Meredith et al., 2014; Parker et al., 2018) studies were categorized into four main themes: psychological health outcomes, physical health outcomes, sleep, and ‘lifestyle’ behaviours. Studies were narratively reviewed within these themes, and based on study findings were further organised into subthemes. A quantitative summary of the study outcomes (meta-analysis) was not feasible due to the largely descriptive nature of studies that did not provide comparable quantitative data and the high heterogeneity of included studies and study outcomes. The effect sizes where available and further statistical details were extracted and are presented in Tables 1–4.

Table 1. Summary of studies characteristics and quantitative findings for partners.

Author (methodological quality)	Funding source	Study design	Aim/objective	Study population/ setting and industry	Health outcome/ Phenomenon	Measurements/analysis plan	Summary of findings	Take away message
Cooke et al. (2019) (High)	None Declared	Cross-sectional survey	To compare the levels of stress experienced by pregnant women whose partners FIFO and whose partners did not work away.	394 families in a pregnancy cohort; 77 FIFO families; 100% female; mean age 29.79 ± 5.10yrs Country: Australia Industry: General FIFO	Depression, anxiety and stress; Alcohol	Beck Depression Inventory II BDI; Spielberger State-Trait Anxiety Inventory STAI; Perceived Stress Scale; List of Threatening Experiences checklist. Analysis plan: ANOVA	No difference between women with FIFO partners and women with non-FIFO partners (regular and irregular schedules) for depression (8.41 ± 4.64 vs 7.37 ± 4.33 & 8.09 ± 4.57; p = 0.169), anxiety (35.55 ± 11.04 vs 34.79 ± 10.17 & 36.08 ± 10.59; p = 0.955), perceived stress (23.13 ± 8.64 vs 21.10 ± 7.27 & 22.10 ± 8.00; p = 0.137), and alcohol/drug problems (11% vs 6% & 12%; p = 0.188). Women’s perceived stress high when partner work FIFO (β=-1.944; 95%CI=-3.51, −0.38, p = 0.015).	Partners of rotation work showed similar levels of depression, anxiety and stress and alcohol use as partners of non-rotation workers.
Dittman et al. (2016) (High)	University/research institution	Cross-sectional survey	To examine the impact of Fly-In/Fly-Out (FIFO), on children and families	232 FIFO partners & 294 non-FIFO partners; mean age 36.32 ± 6.13 years. Country: Australia; Industry: General FIFO	Depression, Anxiety, stress; Alcohol	DASS-21; Alcohol AUDIT; Analysis plan: ANCOVA; Pearson’s correlations and Hierarchical multiple	Depression (3.63 ± 4.57 vs 2.48 ± 3.67; p < 0.001), anxiety (2.00 ± 3.12 vs 1.37 ± 2.35; p < 0.01), stress (5.69 ± 4.90 vs 4.52 ± 4.03; p < 0.01), and worries about partner’s wellbeing (2.45 ± 2.12 vs 1.81 ± 1.92; p < 0.001) higher in FIFO partners than non-FIFO partners. No difference in alcohol use between FIFO partners and non-FIFO partners.	Partners of rotation work showed higher levels of depression, anxiety and stress than in partners of non-rotation work, but alcohol use was similar in both groups.
Lester et al. (2015) (Medium)	Western Australian Health Promotion Foundation (Healthway)	Mixed method study (Cross-sectional study)	To explore the parenting patterns of families exposed to the fly-in–fly-out (FIFO) work pattern in raising adolescent children,	23 at home parents with FIFO partners, 23 FIFO workers; Age 30 years and over. Country: Australia; Industry: General FIFO	Mental health	assessed by K10 assessed partner’s mental health; Analysis plan: Kruskall–Wallis non-parametric tests	More FIFO partners (32%) had very high levels of psychological distress than general population (2.6%). FIFO partners psychological distress was not related with FIFO work roster (p = 0.093).	Partners showed high levels of psychological distress.
Morrice et al. (1985) (Low)	Social Science Research Council	Mixed method study (Cross-sectional study)	To examine the prevalence Intermittent Husband Syndrome	200 offshore wives and 103 on-shore wives; mean age 31.7 yrs. Setting: UK Industry: offshore oil and gas	General health; Anxiety, depression and intermittent husband syndrome	General Household Survey (GHS) Symptom lists and Zuckerman Adjective Checklist. Analysis plan: NR	Partners self-reported general health was good and similar to onshore wives and general population. Anxiety and depression higher when husband is absence (10 cases) than presence (2 cases); 10% presented with ‘‘Intermittent Husband Syndrome’’ characterized by change in mood and behaviours	Partners show good general health status, but showed high cases of anxiety/depression in the absence of workers
Parkes et al. (2005) (Medium)	UK Health and Safety Executive	Mixed method study (Cross-sectional survey)	To explore spouses’ perceptions of offshore lifestyles	245 respondents; aged 22 to 59 yrs. Setting: UK; Industry: offshore oil and gas	Psychological wellbeing	Self-develop questionnaire. Analysis plan: descriptive statistics (t-test)	Large proportion of partners (58.5%) reported problems including concerns/worries about workers’ safety (84.4%), loneliness (66.4%), difficulties adjusting to intermittent absence (58.9%), and coping with domestic emergencies (57.4%).	A large proportion of partners have high levels of anxiety, loneliness and difficulties adopting/coping with the absence of workers.
Rebar et al. (2018) (High)	LIVIN Australia	Longitudinal diary study	To compare health behaviours between on-shift and off-shift periods	42 FIFO partners; mean age 38.58 ± 9.22 years Country: Australia; Industry: General FIFO	Health behaviours and wellbeing (sleep and nutrition quality, alcohol intake, smoking, physical activity and relaxation time, and medication for physical and mental problems)	Self-developed online diary for 7 consecutive days each on- and off-shift. Analysis plan: Multilevel models	Partners tended to have poorer nutrition (γ= −0.17 (−0.33 to −0.02), sleep quality (γ= −0.56; 95%CI= −0.72 to −0.40), less exercise time (γ= −10.78; 95%CI= −0.36 to −0.00) and less relaxation time (γ= −1.22; 95%CI= −1.87 to −0.61) during on-shift days than off-shift days. Partners drank significantly less alcohol than workers (γ= −0.91; 95%CI= −1.50 to −0.26) and drink less alcohol during on-shift than off-shift days (γ= −1.12; 95%CI= −1.48 to −0.76). Partners smoke significantly more during on-shift than off-shift days (γ = 24.20; 95%CI = 0.86 to 45.88). Medication use for mental and physical health impairments were not common, but partners took more physical health medication during on-shift days than off-shift days (γ = 1.44; 95%CI = 0.36 to 2.54).	Partners show poorer nutrition and sleep quality, less exercise and relaxation time, and smoked more in the absences of workers; but drink more in the presence of workers.
Taylor et al. (1985) (Low)	Social Science Research Council	Cross-sectional survey	To examine the psycho-social effects on wives of their husbands’ intermittent absence on offshore oil rigs	200 wives of offshore oil workers; mean age 31.7 years. Country: UK; industry: offshore oil and gas	Anxiety and depression; Perceived health status, perceived sleep pattern	The Zuckerman Adjective Checklist, General Household survey checklist. Analysis plan: Not reported	Self-reported health status was good (61%) and similar to onshore wives (59%) and general population. Similar proportions of offshore wives and wives in general population (18% vs 16%) reported nervy, tense and depressed symptoms. Higher anxiety ‘caseness’ in offshore wives when partners are away (10 cases) than onshore wives (0 cases). High stress in offshore wives was associated with married for less than 5 years (p < 0.05), wife working outside the home (p < 0.01), no previous experience of husband absence (p < 0.05), having at least one pre-school child (p < 0.05) and irregular work pattern of husband (p < 0.05).	Partners general health status was good, but showed high cases of anxiety in the absence of the workers.
Wilson et al. (2020) (High)	None Declared	Cross-sectional survey	To describe and compare partners’ sleep problems and loneliness when the FIFO/DIDO workers were at home and away	199 partners of the FIFO/DIDO Workers; 74.9% aged 18–44yrs; Country: Australia; Industry: mining	Sleepiness, sleep duration and quality, and loneliness	The Epworth Sleepiness Scale; The Pittsburgh Sleep Quality Index (PSQI) (score > 5= poor sleep quality); UCLA Loneliness Scale. Analysis plan: Repeated-measures ANCOVA	Sleep quality was poorer when worker is away than present at home (8.8 ± 3.1 vs 7.8 ± 3.3; p = 0.001). No difference in partners’ sleep duration (m = 7.2 ± 1.5 vs 6.9 ± 1.6; p = 0.486) and sleepiness (m = 15 ± 4.1 vs 15.4 ± 4.6; p = 0.960) when workers are at home than when workers are away. High loneliness when workers are away than at home (m = 27.9 ± 6.4 vs 22.2 ± 6.2; p < 0.001). Short sleep duration, poor sleep quality, excessive sleepiness and extreme loneliness in FIFO partners than general population.	Partners showed shorter sleep duration, poorer sleep quality, excessive sleepiness and extreme loneliness in FIFO partners than general population whether the workers is present at home or away

Table 2. Summary of studies characteristics and qualitative findings for partners.

Author (methodological quality)	Funding source	Study design	Aim/objective	Study population/ setting and industry	Health outcome/ Phenomenon	Measurements/analysis plan	Summary of findings	Take away message
Gardner et al. (2018) (High)	LIVIN (Australia)	Qualitative study	To investigate how workers and their partners negotiate the impact of fly-in fly-out (FIFO) on their mental health and well-being	26 conveniently selected partners of FIFO workers; mean age 40 ± 9 yrs; Country: Australia Industry: General FIFO	Mental health and wellbeing	Open ended questions via email. Analysis plan: Thematic analysis	FIFO work imposes the sense of living two lives, which comes with the difficulties of adjusting to the differences and pace of the domestic and work lives, and create tension and frustrations; Some partners indicated being trapped in undesired job by high wages. Partners reported worries of sole parenting and about the absence of FIFO worker on the wellbeing of children; FIFO puts strain on relationships due to physical and psychological distance leading to disconnect and tension; Partners feel emotional strains and worried about workers’ physical and mental health	Rotation work impact was generally described as having a negative impact on the psychological well-being of at-home partners
Mayes (2020) (Medium)	None declared	Qualitative study	To examine how FIFO workers’ rhythms of physical absence and presence in family life shape the everyday mobilities and temporalities of their emplaced spouses	20 women FIFO partners; aged 22–59 years. Country: Australia. Industry: mining	Psychological wellbeing	In-depth, semi-structured interviews	Partners experience “living two separate lifestyles” with disruption to routine life leading to recurrent tension. Increase burden of sole parenting in the absence of workers, limiting the social mobility of partners with young children. Some partners experience weekends in the absence of workers as ‘depressing’ and ‘lonely’ and tended to social isolate by avoiding places (e.g. parks, homes of non-FIFO families). Some partners without children get free time to socialise with others in the absence of the workers.	Partners show negative impact of rotation work on their psychological well-being
Morrice et al. (1985) (Low)	Social Science Research Council	Mixed method study (Qualitative study)	To explore nature of the stresses and the adaptation in Intermittent Husband Syndrome	30 wives and 17 Husband; Country: UK Industry: offshore oil and gas	Intermittent Husband Syndrome	Extensive interview. Analysis plan: Thematic analysis	Some wives have adapted successfully to husband absence lifestyle and found it a preferable way of life; take advantage of husband’s absences to increase their own competence and to enlarge their network of relationships. Other partners experienced distress and felt miserable; Partners reported feeling of loneliness when husband is away; overburden of single parenting and domestic chores; intermittent readaptation to home life by workers bring tension and domestic conflict; experience of worries/anxiety before husband leave for work tour; disruption of family life as partners feel neglected and separated from husband when at home	Partners show mixed impact of rotation work on their psychological well-being
Parkes et al. (2005) (Medium)	UK Health and Safety Executive	Mixed method study (Qualitative study)	To examine the perceptions, attitudes, and concerns of the spouses of offshore workers	39 telephone interviews; aged 22 to 59 yrs. Country: UK; Industry: offshore oil and gas	Psychological wellbeing	Telephone interview, and self-reported measure. Thematic analysis	Difficulties adjusting to the lifestyle of presence and absence of workers (‘‘living two lives’’) characterised by irritation and tension; intermittent absence and presence leads to role conflicts and disruption to ‘single life’ leading to tension and irritation; experience of anxiety and tension prior to worker leaving home (stressfulness caused by sense of worker leaving home for work); experience loneliness and anxiety associated with bringing up children alone. Partners develop greater independence, personal confidence, and coping ability; becoming self-reliance in the absence of workers.	Partners show mixed impact of rotation on their psychological well-being.
Pini and Mayes (2012) (Medium)	None declared	Qualitative study	To explore the emotional life of fly‑in fly‑out (FIFO) workers and their families	513 posts on Mining Families Matters website from February 2010 to December 2011;Age: NR Country: Australia Industry: General FIFO	Psychological wellbeing	Posts on Mining Families Matters website. Analysis plan: Thematic analysis	Feeling ‘independent, resourceful, strong and sometime unemotional’ by long/experienced FIFO partners. FIFO provides the chance to make new friends and increase social network. Experience emotions of sadness, ‘loneliness and despair’ by some partners. Emotional experiences of ‘loss, loneliness and uncertainty’ was linked to having younger children and new to the FIFO lifestyle. Tensions between women’s expression of pride in their emotional strength and the need to temper this capacity when FIFO men returned home. Anxiety with becoming ‘too independent’ among new FIFO partners	Partners showed mixed impact of rotation on their psychological well-being
Silva-Segovia and Salinas-Meruane (2016) (High)	Comisión nacional de investigación Científica y Tecnológica; Fondecyt projects	Qualitative study	To explore the emotional adjustments and imbalances experienced by female partners of Chilean mining workers	Six women between the ages of 30 and 56, with 1–4 children. Country: Chile Industry: Mining	Emotional adjustments and imbalances	In-depth interview. Analysis plan: Thematic analysis with Critical Discourse Analysis	Family modify daily routine to suit worker’s routine of working, resting or recreational times, creating tension and feelings of frustration, resentment, and unsatisfied demands in family. Partners experience tension caused by suspicion of infidelity and disruption to sexual intimacy	Partners experienced a negative impact of rotation on their emotional well-being
Whalen and Schmidt (2016) (High)	None declared	Qualitative study	To explore the lived experiences of women whose partners commute to the Alberta oil sands for work	8 partners of LDC workers; age 37–50yrs; Country: Canada; Industry: mining/petroleum	Psychological wellbeing;	Interviews; Analysis plan: Thematic analysis	Partner reported increased workload of look after children and work outside of home, feelings loneliness and loss of companionship in the absence of workers; some partners expressed nervousness about workers job security; some partners develop sense of control and empowerment regarding family decision-making. Some partners indicated the sense of high financial rewards help them cope with rough patches in the absence of workers.	Partners and children experienced mixed impact of rotation work on their psychological well-being

Table 3. Summary of studies characteristics and quantitative findings for children.

Author (methodological quality)	Funding source	Study design	Aim/objective	Study population/ setting and industry	Health outcome/ Phenomenon	Measurements/analysis plan	Summary of findings	Take away message
Dittman et al. (2016) (High)	University/research institution	Cross-sectional survey	To examine the impact of Fly-In/Fly-Out (FIFO), on children and families	232 FIFO partners & 294 non-FIFO partners; mean age 36.32 ± 6.13 years. Country: Australia; Industry: General FIFO	Children behaviour and Emotional difficulties	Child Adjustment and Parent Efficacy Scale (CAPES) Analysis plan: ANCOVA; Pearson’s correlations and Hierarchical multiple	No difference in behavioural (19.83 ± 11.84 vs 18.36 ± 9.88) and emotional (3.25 ± 2.60 vs 2.87 ± 2.61) difficulties between children in FIFO families and children in non-FIFO families (p > 0.05). Poor parental emotional adjustment (β = 0.22; p < 0.01), lower weekly work hours (β=-0.16; p < 0.01) and perceived rotation work lifestyle negative impact on family (β = 0.18; p < 0.01) predicted children’s behaviour problems in FIFO families. Poor parental emotional adjustment (β = 0.19; p < 0.001) and perceived rotation work lifestyle negative impact on family (β = 0.34; p < 0.01) predicted emotional problems	Children of rotation work showed similar levels of behaviour and emotional difficulties as children in non-FIFO families. Parent worker’s long working hours, and poor emotional adjustment were associated with children’s emotions and behaviours
Kaczmarek and Sibbel (2008) (High)	None declared	Cross-sectional survey	To examine the effects of employment-related father absence on children’s psychological well-being and perceptions of family functioning	90 primary school aged children and their mothers (30 FIFO children & mothers; mean age 10.16 ± 1.29 years. Country: Australia; Industry: General FIFO	Depression; Anxiety	Children’s Depression Inventory (CDI); Children’s Manifest Anxiety Scale (RCMAS). Analysis plan: ANOVA	No difference between children of FIFO families and children from non-FIFO families for depression [M = 7.60 ± 5.60 vs 5.00 ± 3.66; F(2,81)=03.68, p = 0.02], anxiety [M = 11.00 ± 6.77 vs 8.12 ± 6.07; F(2,81)=.76, p = 0.18] and general functioning [M = 1.87 ± 0.42 vs 1.82 ± 0.38; F(2,81)=0.91, p = 0.41]; were within the healthy functioning limits.	Children of rotation work showed healthy levels of depression, anxiety and general functioning similar to children of non-rotation workers.
Lester et al. (2015) (Medium)	Western Australian Health Promotion Foundation (Healthway)	Mixed method study (Cross-sectional study)	To explore the parenting patterns of families exposed to the fly-in–fly-out (FIFO) work pattern in raising adolescent children,	41 adolescent children of FIFO parents; Age: 0–24; Country: Australia; Industry: General FIFO	Mental health	Strengths and Difficulties Questionnaire (SDQ) to assessed adolescent mental health. Analysis plan: Kruskall–Wallis non-parametric tests	Few adolescents from FIFO homes (2%) showed mental health concerns, compared to Australian norms (10%). Adolescent mental health was not related with FIFO parent’s work roster (p = 0.507). 73% adolescents reported no emotional difficulties	Adolescent children showed low levels of mental health and emotional difficulties
Lester et al. (2016) (High)	None declared	Cross-sectional study	To explore the mediation of parental presence and family connectedness on the association between fly-in fly-out employment and adolescent well-being	618 students; Age: NR; Country: Australia Industry: General FIFO	Depression; Emotional and Behavioural difficulties	DASS-21; Strengths and Difficulties Questionnaire (SDQ). Analysis plan: Multilevel mediation	More adolescents of FIFO parents reported significantly mild (7.4% vs 6.2%), moderate (9.1% vs 6.9%) and severe (3.0% vs 2.8%) depressive symptoms (p = 0.02) and emotional and behavioural difficulties (9.6% vs 7.5%; p = 0.02) compared to adolescent from non-FIFO families. Greater parental presence predicted lower depressive symptoms (β=-0.16; p < 0.01) and emotional and behavioural problems (β=-0.17; p < 0.01). Greater family connectedness predicted lower depressive symptoms (β=-0.11; p < 0.01) and emotional and behavioural problems (β=-0.11; p < 0.01)	Adolescent children of rotation workers had higher levels of depressive symptoms and emotional and behavioural difficulties than children of non-rotation workers.
Robinson et al. (2017) (Low)	None declared	Cross-sectional survey	To examine the relationships between the working arrangements of mineworkers and behavioural issues in their children	1961 partners and 1798 mineworkers Age: NR Country: Australia Industry: Mining	Child’s emotions and behaviours	SDQ assessed parent perception of child’s emotions and behaviours. Analysis plan: Pearson correlation	Parent working excessive hours related with hyperactivity behaviour (r = 0.108; p < 0.001), emotional (r = 0.128; p < 0.001), conduct (r = 0.108; p < 0.01) and peer problems (r = 0.090; p < 0.001). Parental emotional exhaustion was related with hyperactivity behaviour (r = 0.109; p < 0.001), emotional (r = 0.174; p < 0.001), conduct (r = 0.116; p < 0.01) and peer problems (r = 0.158; p < 0.001). Parental tiredness associated with hyperactivity behaviour (r = 0.115; p < 0.001), emotional (r = 0.141; p < 0.001), conduct (r = 0.080; p < 0.01) and peer problems (r = 0.106; p < 0.001). Parental sleep disruption associated with emotional (r=-0.147; p < 0.01), conduct (r=-0.079; p < 0.05) and peer problems (r=-0.080; p < 0.05).	Parent worker’s long working hours, emotional exhaustion, and sleep disruption were associated with children’s emotions and behaviours. However, all associations were small in size.
Zargham-Boroujeni et al. (2015) (High)	None declared	Cross-sectional survey	To assess anxiety in children of offshore staff	160 students (64 offshore staff’s children; mean age 9.83 ± 0.16yrs. Country: Iran; Industry: offshore oil and gas	Anxiety	Revised Children’s Manifest Anxiety Inventory. Analysis plan: t-test and logistic regression tests	Offshore staff’s children significantly experienced anxiety (56.2%) than based staff’s children (32.3%) (p = 0.03). Parent working offshore increased children’s anxiety by 2 times (AOR = 2.140; 95%CI = 1.001–4.576, p = 0.049)	Children of rotation workers show higher anxiety than children of non-rotation workers

Table 4. Summary of studies characteristics and qualitative findings for children.

Author (methodological quality)	Funding source	Study design	Aim/objective	Study population/ setting and industry	Health outcome/ Phenomenon	Measurements/analysis plan	Summary of findings	Take away message
MacBeth and Sibbel (2012) (High)	None declared	Qualitative study	To understand the lived experiences of adolescent boys whose fathers were currently employed in a FIFO	8 adolescent males, aged 13 to 21 years Country: Australia Industry: General FIFO	Psychological Wellbeing	Semi-structured interviews. Thematic analysis	FIFO provide high financial benefits and enough free days to spend and socialised with dad during the leave period. Adolescents expressed feeling relaxed and less stressful when dad is away as they have the freedom and can have friends come over	Rotation work impact was generally positive on the psychological well-being of adolescent males
Mauthner et al. (2000) (Medium)	Economic and Social Research Council	Qualitative study	To explore children’s accounts of parental work and the work ± family interface	33 children (10 from offshore family & 23 onshore family); aged 8–12 yrs; 22 girls. Country: UK Industry: oil and gas	Children behaviour and emotions	Focus group discussion; Thematic analysis	Children reported getting annoyed seeing their mothers do their father’s house chores and also get upset by father missing special family events and feel hurt by parent absence. Some children worry/anxious about the safety of their father when away at work. Children sometimes feel happy being able to avoid parents taking out their frustration on them or punishment in the absence of their fathers. Offshore children reported seeing their fathers more (during leave days) than onshore office workers children, but miss their father when away at work and would want to see them more often	Children show mixed psychological well-being, and behaviour and emotions
Parkes et al. (2005) (Medium)	UK Health and Safety Executive	Mixed method study (Qualitative study)	To examine the perceptions, attitudes, and concerns of the spouses of offshore workers	39 telephone interviews; aged 22 to 59 yrs. Country: UK; Industry: offshore oil and gas	Psychological wellbeing	Telephone interview, and self-reported measure. Thematic analysis	Children get to spend enough time with parents during leave period. Some children become independent and resilient whereas some develop emotional strain and rejection behaviour to workers (missing parent and feeling upset by absence of parent)	Rotation work showed a mixed impact on the behaviour and emotions of children
Whalen and Schmidt (2016) (High)	None declared	Qualitative study	To explore the lived experiences of women whose partners commute to the Alberta oil sands for work	8 partners of LDC workers; age 37–50yrs; Country: Canada; Industry: mining/petroleum	Children behaviour and emotional	Interviews; Analysis plan: Thematic analysis	Partners reported children exhibit no severe behavioural or emotional issues, but children experience sadness and loneliness in the beginning of father commuting job	Children experienced mixed impact of rotation work on their psychological well-being

Results

Characteristics of studies

A total of 19 studies, (9 quantitative, 7 qualitative and 3 mixed-method studies) were included in the review. Twelve studies examined outcome data among partners; all 12 studies (5 quantitative, 5 qualitative and 2 mixed-method studies) examined psychological health and wellbeing, 3 quantitative studies investigated sleep, 3 quantitative studies assessed perceived physical health status, and 4 quantitative studies examined health-related behaviours. The majority of the partners in the sample were female (average 99.38%). The age of partners ranged between 18 and 59 years (mean age 35.87 years).

Ten studies investigated outcomes data among children; seven of the studies (4 quantitative and 3 qualitative) investigated children’s psychological health and wellbeing and seven studies (4 quantitative and 3 qualitative) examined children’s behavioural and emotional outcomes. Five studies (3 quantitative and 2 qualitative) included data from parents rating the behavioural and emotional impact of partners’ rotation work on children. The summaries of study characteristics and key findings are presented in Tables 1–4.

Out of the 11 quantitative studies (including 2 quantitative clearly defined components of mixed-method studies), seven were rated as high quality, 1 medium, and 3 low. Of the 9 qualitative studies (including 2 qualitative clearly defined components of mixed-method studies), 4 were rated high quality, 4 medium and 1 rated low (see Tables 1–4).

Overall, the majority of studies (84.2%) were of medium to high methodological quality. Almost all of the quantitative studies used and reported common validated scales/scoring for measuring outcomes and showed psychometric analysis of the validity and reliability of scales or pointed to original or previous studies where the validity and reliability of scales had been confirmed. Nine (47.4%) out of the nineteen included studies received external funding; 3 from university/research institutions, 2 each from a governmental agency and non-for-profit organization and industry regulator, but were not involved in the study designs and processes (see Tables 1–4).

Psychological health and wellbeing of partners

Psychological distress and wellbeing

Studies’ findings on partners’ psychological distress compared to the general population were mixed. Two cross-sectional studies used validated scales to examine the prevalence of distress symptoms (Lester et al., 2015; Taylor et al., 1985). One of the studies reported a higher prevalence of psychological distress (32.0% vs 2.6%) among partners of on-shore rotation workers compared to secondary data source of the general population (Lester et al., 2015). Whilst the other study reported comparable proportions of partners of offshore rotation workers to other married women in the general population from a secondary data source (18% vs 16%) showed ‘nervy’, ‘tension’ and ‘depressed’ symptoms (Taylor et al., 1985). Two other cross-sectional studies examined the levels of distress using symptoms checklist scores, recruiting comparison groups. One of the studies showed significantly higher levels of depression, anxiety, and stress among partners of rotation workers compared to partners of non-rotation workers (Dittman et al., 2016) whereas the other study found no significant differences in levels of depression, anxiety, and stress between partners of rotation workers and partners of non-rotation workers (Cooke et al., 2019).

Quantitative evidence was not clear on partners’ experience of psychological distress, depression and anxiety in the absence of their partner. Out of three studies, two cross-sectional studies using symptoms checklist scores on validated scale reported higher levels of anxiety among partners in the absence of rotation workers than when at home (Morrice et al., 1985; Taylor et al., 1985): in one study, 10% were classified as having ‘Intermittent Husband Syndrome’ characterised by changes in mood and behaviour in the partner in the absence of workers (Morrice et al., 1985). One other daily study using self-reported diagnosis of mental health problems reported the daily use of medications for mental health problems among partners was not common; and the finding was not significantly different in the absence and presence of rotation workers (Rebar et al., 2018).

Quantitative evidence show partners can experience loneliness in the absence of rotation workers. One cross-sectional study examined the levels of social isolation and/or loneliness among partners using symptom checklist scores on a validated scale and reported significantly higher loneliness in the absence of workers than in the presence of workers and when compared to the general population (Wilson et al., 2020). Another cross-sectional study using self-reported measure on validated scale reported high proportion of partners (66.4%) indicating loneliness in the absence of workers (Parkes et al., 2005).

Qualitative studies emphasise the enhanced emotional strain, anxiety, and burden felt among partners in the absence of workers. The burden highlighted was generally around having to bring up children and do domestic chores alone (Gardner et al., 2018; Morrice et al., 1985; Parkes et al., 2005; Whalen & Schmidt, 2016). Partners also reported feeling anxious and frustrated about workers’ physical and psychological health (Gardner et al., 2018; Parkes et al., 2005), safety (Parkes et al., 2005), job insecurity (Parkes et al., 2005; Whalen & Schmidt, 2016), infidelity (Silva-Segovia & Salinas-Meruane, 2016), and long roster patterns (Pini & Mayes, 2012) particularly whilst workers were away on rotation.

Again, partners reported feeling anxious about the physical and psychological distance created by rotation work arrangement, which leads to disconnect and tension in relationships (Gardner et al., 2018), and were frustrated by poor communication network with partners when at work (Pini & Mayes, 2012). There was also evidence to suggest high anxiety among partners who are new to the rotation work lifestyle about becoming too independent as they cope with the rotation work lifestyle (Pini & Mayes, 2012).

Qualitative evidence showed partners of rotation workers also indicated experiencing emotions of sadness, loneliness and hopelessness when rotation workers are away from home (Mayes, 2020; Morrice et al., 1985; Parkes et al., 2005; Pini & Mayes, 2012; Whalen & Schmidt, 2016), and that tended to be magnified in partners with younger children (Pini & Mayes, 2012). Partners reported the lack of sympathy from community members and even other FIFO families, and lack of support from organizations toward negotiating the health of FIFO families (Gardner et al., 2018).

Evidence also showed partners experience emotional strains and distress during reunions and prior to separations. Four qualitative studies discussed partners are faced with the difficulties in adjusting to this lifestyle of presence and absence of workers, some studies referred to ‘living two lives’, causing role conflicts and disruption to life leading to tension and irritation (Gardner et al., 2018; Mayes, 2020; Morrice et al., 1985; Parkes et al., 2005; Silva-Segovia & Salinas-Meruane, 2016). Some partners expressed experiencing tensions between showing of and the need to play down their developed emotional capability when FIFO worker returns home (Pini & Mayes, 2012). Some partners indicated experiencing emotional strain due to disruption of family life as partners feel separated from workers when at home (Morrice et al., 1985; Parkes et al., 2005), citing the need for workers to recover from fatigue (Parkes et al., 2005) or catching up with lost social events (Morrice et al., 1985). Partners also consistently expressed stress and anxiety in the periods prior to workers going away from home to work (Morrice et al., 1985; Parkes et al., 2005).

Despite the concerns and strains expatiated, there was evidence to show rotation work lifestyle could have positive effects on partners’ personal and emotional development, particularly among those without children/younger children or of long-serving rotation workers. Three of the qualitative studies showed rotation partners, particularly those of long-serving rotation workers, can become more independent and resourceful (developing coping abilities and skills) and overcome emotions as they adapt to the rotation work lifestyle (Morrice et al., 1985; Parkes et al., 2005; Pini & Mayes, 2012). Furthermore, studies indicated that some partners in the absences of workers develop their own capabilities (Morrice et al., 1985), personal confidence (Parkes et al., 2005) and the sense of control and empowerment in making decision regarding the family (Whalen & Schmidt, 2016) over time. Other studies indicated that in the absence of the workers some partners get free time to socialise with others and increase their social networks (Mayes, 2020; Morrice et al., 1985; Pini & Mayes, 2012).

Sleep problems among partners

Three studies examined sleep problems among partners in the absence of rotation workers. Two of the studies examined sleep quality, specifically, and both indicated poorer sleep quality in the absence of workers. One cross-sectional study showed significantly poorer sleep quality among partners in the absence of workers than in their presence at home (Wilson et al., 2020). Similarly, a daily diary study examining within-person differences in the sleep quality found significantly poorer sleep quality among partners when workers were on-shift away from home (Rebar et al., 2018).

One of the studies examined partners’ sleep duration and reported sleep duration was not significantly longer in the presence of workers than in the absence of workers (Wilson et al., 2020). One of the studies examined general sleep difficulties and found more partners of offshore rotation workers experience sleep difficulties when workers were away at work (20%) than when at home (14%) (Taylor et al., 1985).

Evidence on partners’ sleep compared to general population was unclear. Of two cross-sectional studies, one study reported statistically significantly shorter sleep duration, excessive sleepiness and poor sleep quality among partners of onshore rotation workers compared to the general population, in the presence or absence of rotation workers (Wilson et al., 2020). The other study using symptoms checklist scale found similar proportions of partners (20%) in the absences of workers and less proportion of partners (14%) in the presence of workers compared to a secondary data source of the general population (20%) experience sleep difficulties (Taylor et al., 1985).

Physical health

Three quantitative studies that investigated the physical health of partners of rotation workers found perceived good physical health status. Of the studies, two cross-sectional studies reported comparable proportions of partners of rotation workers perceived to have good physical health status as measured by self-rating of general health to that of the comparing group of partners of onshore non-rotation workers (Morrice et al., 1985; Taylor et al., 1985). Another daily study reported partners’ daily intake of medication for physical impairments (as a self-reported measure of physical health) was not common, but significantly higher during workers’ on-shift than off-shift days (Rebar et al., 2018).

Health-related lifestyle behaviours (alcohol intake, smoking, exercise and relaxation)

Alcohol intake

Three quantitative studies examined alcohol intake, and the results suggested some partners may consume more alcohol in the presence than absence of rotation workers, but that alcohol intake or alcohol-related problems were similar to partners of other workgroups and women in the general population. Of the three studies, two examined alcohol intake using checklists scales; one of the study found no statistically significant difference in proportions of alcohol intake problems between partners and comparison groups of partners of non-rotation workers (Cooke et al., 2019). Similarly, the other study also found levels of alcohol intake was not statistically significantly different between partners and comparison groups of women in the general population of women (Dittman et al., 2016). The third study using self-reported measure examined within-person differences between presence and absence of workers, and found alcohol consumption was significantly higher in the presence of workers (Rebar et al., 2018).

Smoking, diet, exercise and relaxation

One daily study examined within-person differences between presence and absence of workers and found partners were more likely to consume foods with poorer nutrition quality, carry out fewer exercises, and have less time to relax in the absence of rotation workers (Rebar et al., 2018). The study also reported partners smoke significantly more in the absence of onshore rotation workers (Rebar et al., 2018).

Mental health and wellbeing of children

Psychological distress and wellbeing

Evidence of the impact of rotation work on the mental health and wellbeing of children was unclear. Two quantitative studies found high symptoms of mental health outcomes whereas two other studies did not. Three cross-sectional studies using cut-off points on validated scales, examined the prevalence of mental health outcomes. One of the studies reported a significantly higher prevalence of symptoms of anxiety among children of offshore rotation workers than a comparison group of children of onshore based workers (56.2% vs 32.3%, p = 0.03) (Zargham-Boroujeni et al., 2015). Another study established prevalence of symptoms of moderate (9.1% vs 6.9%, p = 0.02) and severe (3.0% vs 2.8%, p = 0.03) depression significantly higher in adolescents of onshore rotation parents than in a comparison group of adolescent from non-rotation work families (Lester et al., 2016).

The other study established lower proportions of adolescents of onshore rotation parents (2%) show mental health level of clinical significance compared to a secondary data source of the general population (10%) (Lester et al., 2015). Similarly, one cross-sectional study using symptoms checklist scores on validated scales reported children of onshore rotation workers had depression and anxiety levels within healthy functioning and found no significant difference between them and the children of military and community families (Kaczmarek & Sibbel, 2008).

Qualitative evidence was also unclear. Studies revealed many children enjoy the rotation work lifestyle as it provides enough free days to spend and socialise with parents during the leave period (MacBeth & Sibbel, 2012; Parkes et al., 2005), expressed feeling relaxed and less stressed when rotation parent was away as they can have friends come over (MacBeth & Sibbel, 2012) and feel happy being able to avoid parents taking out their frustration on them or punishment (Mauthner et al., 2000). Furthermore, children of offshore rotation workers indicated to see their fathers more (during leave days) than children of onshore office workers (Mauthner et al., 2000). However, some children were experiencing incidences of sadness or loneliness when their fathers started working on long-distance commuting job arrangements or rotation job in a qualitative study (Whalen & Schmidt, 2016). Some children also indicated feeling hurt by their parent’s absence and expressed worries/anxieties about the safety of their father when away at work (Mauthner et al., 2000).

Behavioural and emotional problems

Studies investigated the rotation work impact on children’s behavioural and emotional issues, and findings were unclear. Three quantitative studies examined behaviours and emotions using checklist scores on validated scales. Out of the three studies, one cross-sectional study showed significantly higher levels of emotional and behavioural difficulties including conduct problems, hyperactivity, and peer problems were found among adolescents of onshore rotation parents than in comparison group of adolescents from non-rotation families (Lester et al., 2016). However, other two cross-sectional studies reported parents rated their adolescent children as not suffering from emotional difficulties (Lester et al., 2015), and that levels of behaviour and emotional difficulties were statistically similar among children in rotation families and a recruited comparison group of non-rotation families (Dittman et al., 2016).

However, three cross-sectional studies found parental rotation work characteristics and associated wellbeing were related to children’s behaviour and emotional difficulties. Rotation parent working excessive working hours and being too emotional and exhausted were related to emotional and peer problems in children; working excessive hours was also related to worse hyperactivity in children whereas parental tiredness and sleep disruption were associated with conduct and emotional problems among children (Robinson et al., 2017). Similarly, poor parental emotional adaptation, parental weekly working hours and perceived effect of rotation work lifestyle on family were found to predict children’s behaviour and emotional problems (Dittman et al., 2016). Parental presence (which is limited by rotation work intermittent presence and absence) was established to be related to adolescents’ behavioural and emotional problems (Dittman et al., 2016) and mediated the negative effect of working rotation on adolescents’ emotional and behavioural problems (Lester et al., 2016).

Qualitative evidence on emotional and behavioural outcomes also remains unclear. Evidence from two qualitative studies suggested some children of offshore rotation workers develop emotional strain and rejection behaviours towards workers as a result of missing parent and feeling upset about the absence of parent (Mauthner et al., 2000; Parkes et al., 2005) and parent missing special family events (Mauthner et al., 2000); tended to perceive their mother as being bad towards them (Parkes et al., 2005); and get annoyed seeing their mothers carry out their father’s house chores (Mauthner et al., 2000). However, two qualitative studies reported partners of rotation workers indicated some children become independent and well-adjusted (Parkes et al., 2005) and do not exhibit any serious behavioural and emotional problems (Whalen & Schmidt, 2016).

Discussion

Impact of rotation work arrangement on mental health and wellbeing of partners

Evidence on the mental health and wellbeing of partners remains unclear. The inconsistencies in the findings of quantitative studies could be attributed to the methodological differences between the included studies, including differences in measurement tools used. However, several qualitative studies suggested some partners of rotation workers experience emotional distress and anxiety, and social isolation and/or loneliness, particularly in the absence of workers. Other studies have found similar results highlighting the negative impact of rotation work on the mental health of partners (Dittman, 2018; Parker et al., 2018). Evidence from our review is in line with the Work-Family Conflict Theory, and its focus on the inter-role conflicts and the associated stress outcomes (Allen et al., 2000; Greenhaus & Beutell, 1985). For instance, studies in the review reported that in the absences of workers, at-home partners take up additional domestic and parental roles increasing their demands/burden and the likelihood of work-family conflicts (Greenhaus & Beutell, 1985) and could result in stress-related outcomes such as psychological strains and depressive symptoms (Allen et al., 2000).

Evidence from our review also showed a spillover of workers’ strains from work into the home domain and in turn cross over to the partner in line with the Spillover Crossover Model. For instance, studies in the current review identified that workers’ job demands make workers tired and exhausted upon their return home (increasing their spillover or work-family conflict), and that impact negatively on their interaction with the family (affecting relationship quality) resulting in feelings of isolation and emotion strains among the at-home partners. It has been demonstrated that workers’ high job demands increased work-family conflicts and poor relationship quality which in turn resulted in increased depressive symptoms and physical complaints among their partners (Shimazu et al., 2009).

The findings in our review are also consistent with the Attachment Theory; in the absence of a romantic partner, at-home partners’ sense of safety may be threatened due to the unavailability of their ‘secure base’ and ‘safe haven’, and their need for ‘proximity maintenance’ is diminished (Mikulincer et al., 2002); causing them to experience anxiety and depression (Bowlby, 1980). The intermittent absence of partners due to rotation work suggests constant disruptions to the accustomed pattern of family life including ‘changes in parenting roles and responsibilities, family dynamics, and day-to-day interactions among family members’ (Dittman, 2018, p. 528) which could cause insure attachments.

Similar temporary work-related separations from romantic partners in military families are found to be associated with emotional distress, including increased anxiety, depression, loneliness, and anger in at-home partners (Medway et al., 1995). Furthermore, consistent separations over a long period suggesting workers may consistently not be responsive to their partners’ needs and seem neglectful when away, could make at-home partners develop insecure-avoidant attachment where partners exhibit emotional detachment and seems unaffected by separations or reunion (Rholes & Simpson, 2004). As reflected in our review, some partners particularly those with long experience of rotation work lifestyle of intermittent separations, expressed overcoming emotions, developing own capabilities, personal confidence and sense of control and empowerment in decision making and becoming more resourceful over time.

The current review findings can also be considered within the framework offered by Social Ecological Theory. At the individual level, the partner’s history/long experience of rotation lifestyle and coping abilities (Pini & Mayes, 2012) were notably highlighted to shape the experience of emotional distress. Rotation work is regarded as temporary employment for many families but those who decide to stay on may actively develop and engage in strategies that help them deal with the associated stressors (Gallegos, 2006). Interpersonal level factors such as having children and disruptions to routine and parental roles were also noted. Having children could keep at-home partners companion thus mitigating against issues of social isolation and loneliness (Parkes et al., 2005; Pini & Mayes, 2012), but could also be stressful in helping them (particularly younger children) understand and deal with the rotation lifestyle of an intermittent absence of a parent (Parkes et al., 2005). It can also be stressful raising children alone and taking on new parental roles such as ensuring discipline (Parkes et al., 2005).

Notable at the community level, there was a general lack of appropriate social support. Support from extended families, community and other rotation work families are suggested to help mitigate against negative stressors of rotation work (Gardner et al., 2018). There are now, for example in Australia, several online support networks such as FIFO families that have been indicated to provide support on mental health and family issues (Gardner et al., 2018; Lester et al., 2015; Meredith et al., 2014). Encouraging strong social networks could provide suitable support during separations to reduce the high psychological distress among partners.

At the organisational level, work schedule, communication infrastructure (Pini & Mayes, 2012), and the level of job risk and security (Gardner et al., 2018; Parkes et al., 2005) were highlighted to influence the development of psychological distress among at-home partners. Work schedules allowing for more days for recovery and reducing commuting time could allow workers to spend more time with their families (Gallegos, 2006). Improvement in communication infrastructure allows for families to regularly interact, which fosters family relationships (Gardner et al., 2018; Whalen & Schmidt, 2016) and alleviate the worries of partners’ safety at work (Parkes et al., 2005). Organisations could promote a supportive climate for families such as healthcare services (Orthner & Rose, 2009), and reliable and quality communication infrastructure to aid and/or improve regular communication with families to foster family connectedness when workers are away (Diamond et al., 2008).

There was evidence in the current review to suggest that some partners may experience poor sleep quality in the absence of rotation workers, consistent with the finding of a study that reported at-home partners to experience sleep problems on separation of a romantic partner (Diamond et al., 2008). Sleep is a ‘shared behaviour’ in which sleeping together with a partner could provide a sense of security, comfort and the sharing of assurances (Hislop, 2007), and as such, the absence of rotation workers could impact negatively on the sleep of their partners. According to the Attachment Theory, inconsistent or neglectful caregiving, which could result from the intermittent absence of rotation workers from home, creates insecure attachment (Holden, 2010). Studies have demonstrated partners with insecure attachment (particularly high anxious partners) tend to have poorer sleep quality (Carmichael & Reis, 2005; Diamond et al., 2008) as they worry over the emotional inaccessibility and responsiveness of attachment figures (Carmichael & Reis, 2005).

Furthermore, in the absence of rotation workers, partners are also engaged in multiple roles and the stresses from these roles could contribute to sleep disturbances: partners have indicated ‘stress of work and children’ prevented them from taking a nap or getting enough sleep (Wilson et al., 2020). This is in line with the Work-Family Conflict Theory, where high demands increase the likelihood of partners’ work-family conflict which have been demonstrated to be associated with poor sleep outcomes (Borgmann et al., 2019).

Our findings also suggest perceived good physical health among at-home partners of rotation workers. However, there are too few studies (which relied on self-rated physical health on single items) to justify overall conclusions about the physical health of partners of rotation workers. This emphasises the necessity for more robust research to explore the physical health of partners of rotation workers, given that in the absence of workers, partners’ job demands increase and in turn experience work-family conflict, which has been indicated to be associated with poor physical health (Allen et al., 2000).

Our review suggests level of alcohol consumption among partners of rotation workers is similar to partners of non-rotation workers, and some partners may consume more alcohol when workers are at home (Rebar et al., 2018), however studies examining alcohol consumption were few. Drinking alcohol is often a shared experience influenced by family, friends and social groups (Morris et al., 2020). Evidence suggests having a spouse who consumes a high level of alcohol is associated with high alcohol consumption in their partners (Polenick et al., 2018), and rotation workers are reported to consume high levels of alcohol during off-shift days (Asare et al., 2021). The Attachment Theory stipulates persons are more likely to engage in exploration or ‘novelty seeking’ when in environments they feel safe due to the availability and responsiveness of their attachment figures (Holden, 2010). Further, negative emotions/distress due to the high job demands of rotation workers (Asare et al., 2021) could spillover and crossover to their partners during reunions and that could promote the high intake of alcohol, as studies have demonstrated crossover negative emotions during reunions to be associated with binge drinking behaviour (Liu & Visher, 2019).

Limited studies examined partners’ smoking, exercise and relaxation, and nutrition behaviours and again evidence is scarce to make definite conclusions. These findings suggest a need for more research looking at the effects of rotation work arrangements and workers’ presence and absence, and wellbeing on the health-related behaviours of partners owing to their known long-term health consequences. As speculated by Rebar et al. (2018), partners in the absence of workers may have additional responsibilities limiting their time to engage in exercises or relaxation in line with the Work-Family Conflict Theory; and the increased stress in the absence of workers may increase the urges for smoking and influence eating behaviour.

Impact of rotation work arrangement on mental health and wellbeing of children

The findings regarding rotation work impact on the mental health of the children of rotation workers remain unclear. Children form emotional bonds with their parents, and separations from them are indicated to threaten these bonds, which may lead to the experience of anxiety and depressive symptoms (Bowlby, 1980). Furthermore, parental job demands through spillover (work-family conflict) and reduced quality of relationship (crossover) could affect the wellbeing of their children (Shimazu, 2015). More research is therefore required to examine the influence of rotation workers’ job demands and absence on the mental health of children of rotation workers and the mechanisms employed by at-home parents to mitigate the effects of workers’ absence on children.

The impact of rotation work on the emotions and behaviours of children in rotation workers’ families remains unclear. However, evidence from the current review support the Spillover Crossover Model; in that rotation work demands and their consequential strains were reported to be related to the emotional and behavioural problems of children. As has been suggested, parental work demands could lead to work-family conflict which sequentially could affect parental behaviour (e.g. negative parenting), impart emotions, and family functioning (e.g. poor relationship quality), which potentially affect the wellbeing of children (Shimazu et al., 2020).

Evidence also supports the Attachment Theory and its focus on the impact of distressing separations and reunions. For example, studies in the current review suggest that rotation work lifestyle can result in insecure attachment relationships between parents and children, as rotation parents may be inconsistent in responding to the needs of their children, whereby children may ‘show signs of emotional disengagement and withdrawal, and engage in behaviours that keep them distracted from the distress they are feeling’ (Rholes & Simpson, 2004, p.6). Children with parents working non-standard work schedules have been found to have emotional and behavioural problems at high levels (Strazdins et al., 2006), and as a result of ‘worse family functioning, more parent distress and ineffective parenting’ (Strazdins et al., 2006, p.403).

Strategies to reduce the impact of rotation work on the emotions and behaviours of children could include decreasing parental job demands and improving their job resources to promote work-family facilitation and in turn improve parental happiness, which may in-turn reduce the emotional and behavioural problems of their children (Shimazu et al., 2020). Secondly, supporting at-home partners where there are challenges with emotions and behaviours of their children. Positive strategies including specifying and reinforcing boundaries, regular open and significant communication; spending quality family time together during leave periods; and maintenance of family routines even in the absence of rotation parent (Lester et al., 2015). Social support networks have also been identified to assist in the nurturing of adolescent children of rotation workers (Lester et al., 2015). These may be in line with ways of maintaining and reassuring children of the secure attachment relationships between rotation parents and children, where children trust parents to be responsive to their needs when required (Rholes & Simpson, 1997).

Strengths and limitations of the study

The inclusion of qualitative findings alongside quantitative studies is a strength of the current review and can support the understanding of quantitative findings by giving in-depth insights into the health outcomes of rotation workers’ partners and children. This was the first review that investigated the impact of rotation work on workers’ families in the global resource and related construction sectors. Due to nature of data collected and heterogeneity of the included studies, we could not produce a funnel plot to demonstrate potential risk of publication bias. The findings of the review could be limited by publication bias, as only peer-review publications in English were included; however, their quality is potentially higher than the quality of non-peer reviewed studies. There were generally few studies examining the health outcomes and lifestyle behaviours of partners and children of rotation workers in relation to rotation work. The available cross-sectional studies were limited in making causal interpretations of the findings. Additional longitudinal studies are required to give insights into how partners and children experience the health impact of intermittent absence and presence of rotation workers and how their predictors change over time.

Other limitations were small sample sizes in some included studies (Kaczmarek & Sibbel, 2008; Lester et al., 2015; Rebar et al., 2018) and studies have generally recruited study sample through convenience sampling, which may affect the representativeness of recruited samples. A few of the included studies (15.8%) had low methodological quality which may limit the accuracy of the study findings, but such studies are relevant for inclusion into narrative reviews (Duran, 2013; Lucas et al., 2007), particularly with fewer studies examining the outcomes of interest (Duran, 2013).

Implications for policy and research

The current review identified a number of key areas for organisations employing rotation work arrangements and research to consider. Organisations wishing to promote the mental health and wellbeing of workers should also extend the support mechanisms to the families of the workers, as evidence suggests at-home partners and children can be negatively impacted by the intermittent presence and absence of the rotation workers, and this, in turn, can impact negatively on workers. Interventions could include the development of training and mentoring programs aimed at increasing the capacity to understand and manage the demands and challenges of rotation work lifestyles (Pini & Mayes, 2012); and to deal with the family demands (Parkes et al., 2005). Programs could also include developing partners’ stress management skills and their ability to cope with the associated emotions around the intermittent presence and absence of spouses (Parkes et al., 2005; Pini & Mayes, 2012). Such programs could target partners of new/young rotation work families to support their balancing domestic and family demands in the absence of their spouses, in order to help minimise any distress among partners.

Furthermore, organisations should help facilitate improved communication strategies between workers and their partners to help in reducing the associated sense of loneliness and isolation, and the anxieties of at-home partners in dealing with family demands in the absence of rotation workers (Gardner et al., 2018; Parkes et al., 2005). The findings suggest that interventions could also include approaches to support at-home parents, where there are challenges with emotions and behaviours of children because of the demands of the rotation work lifestyle. Research suggests that, in general, enhancing positive parenting skills reduces child behavioural problems (Sanders et al., 2014). Programs including the Triple P-positive parenting program, which enhances ‘the knowledge, skills, and confidence of parents’ ‘to prevent and treat social, emotional, and behavioural problems in children’ (Sanders et al., 2014, p. 339) could be exploited in the rotation work parents.

Additional research is needed, particularly in examining the absence and presence of workers and family demands on the mental health, physical health, sleep problems and health-related behaviours among partners of rotation workers, as limited studies and mixed findings exist to understand the impact of rotation work on the families of workers. Future studies are also required in examining the parental absences and separation, and parental wellbeing influence on mental health and the behaviours and emotional functioning of children, and the parenting strategies that assist to alleviate the effects of workers’ absence on children. Particularly, longitudinal studies with large samples are essential to explore the short and long-term health effects of rotation work on the health outcomes of partners and children of rotation workers to give insight into how partners and children of rotation workers experience health and to determine the factors that influence the health outcomes over time.

Acknowledgements

We express our sincere gratitude to Ms Diana Blackwood and Ms Vanessa Varis, Librarians for the Faculty of Health Sciences at Curtin University for their professional assistance in developing the review search strategy.

Conclusion

The impact of rotation work on the mental health and wellbeing of the partners and children of rotation workers remains unclear. On days where spouses are away, partners may experience greater loneliness and poorer sleep quality. Partners may benefit from support in balancing the increased domestic and family demands, particularly when they have younger children and/or their spouses first begin rotation work jobs. Research is limited, particularly in regard to the impact on health-related behaviours and physical health outcomes.

Disclosure statements

No potential conflict of interest declared by the authors.

Data availability statement

All data are included in the article or uploaded as supplementary information.

Additional information

Funding

The study was funded by the Aberdeen-Curtin Alliance International Postgraduate Research Scholarship and Research Stipend Scholarship awarded to Bernard Yeboah-Asiamah Asare (Curtin ID: 17619778; Aberdeen ID: 51987326).