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Background: Rotating shift work is common in high-hazard industries, despite documented associations with sleep disturbance and impairment. In the oil industry, where rotating and extended shift schedules are used to staff safety-sensitive positions, work intensification and increasing overtime rates have been broadly documented over the last few decades. Research on the impacts of these work schedules on sleep and health has been limited for this workforce. Methods: We examined sleep duration and quality among rotating shift workers in the oil industry and explored associations between schedule characteristics, sleep, and health outcomes. We recruited hourly refinery workers from the West and Gulf Coast oil sector members of the United Steelworkers union. Findings: Impaired sleep quality and short sleep durations were common and associated with health and mental health outcomes common among shift workers. Shortest sleep durations followed shift rotations. Early rise and start times were associated with shorter sleep duration and poorer sleep quality. Drowsiness and fatigue-related incidents were common. Conclusion/Application to Practice: We observed lower sleep duration and quality and increased overtime in 12-hour rotating shift schedules. These long workdays with early start times may reduce available hours for quality sleep; here they were associated with reduced exercise and leisure activity which correlated with good sleep. This safety-sensitive population appears severely impacted by poor sleep quality, which has broader implications for process safety management. Later start times, slower rotation, and a reconsideration of two-shift schedules are interventions to consider for improving sleep quality among rotating shift workers. [ABSTRACT FROM AUTHOR]