1
|
Chang Q, Zhu Y, Liang H, Cheng J, Li D, Lin F, Zhou X, Pan P, Ma F, Zhang Y. Night Shift Work Associates with All-Cause and Cause-Specific Mortality: A Large Prospective Cohort Study. J Gen Intern Med 2024:10.1007/s11606-024-08946-w. [PMID: 39254778 DOI: 10.1007/s11606-024-08946-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 07/08/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND Health problems associated with shift work and night shift work are gaining increasing public attention. OBJECTIVE To investigate the association between night shift work and the hazard of mortality. DESIGN Prospective cohort study. PARTICIPANTS A total of 283,579 individuals with paid employment or self-employment aged 37-73 years were included from the UK Biobank with a median follow-up period of 14.0 years. MAIN MEASURES Participants were divided into day workers and shift workers, including the frequency of night shifts, to evaluate the association between baseline work schedules and all-cause and cause-specific mortality using the Cox proportional hazards model. Additionally, 75,760 participants with work histories were assessed for the association between average frequency and cumulative years of exposure to night shift work and all-cause and cause-specific mortality. KEY RESULTS Compared with that of day workers, the adjusted hazard of all-cause mortality was increased by 12.0% (hazard ratio [HR], 1.12; 95% confidence interval [CI], 1.07-1.18) in shift workers, particularly in those with no or rare night shifts (approximately 16.1%; HR, 1.16; 95% CI, 1.08-1.25) and those with irregular night shifts (approximately 9.2%; HR, 1.09; 95% CI, 1.00-1.19). Moreover, a non-linear relationship was identified between cumulative night shift years and all-cause and cause-specific mortality. Only individuals who worked night shifts for 20-30 years exhibited a substantially increased hazard of all-cause (HR, 1.52; 95% CI, 1.15-2.00) and cardiovascular disease (CVD; HR, 2.08; 95% CI, 1.16-3.71) mortality. CONCLUSIONS Shift workers, particularly those with rare or irregular night shifts, exhibited an increased hazard of mortality. Additionally, participants who worked night shifts for 20-30 years exhibited a substantially increased hazard of all-cause and CVD mortality.
Collapse
Affiliation(s)
- Qinyu Chang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, 410008, Hunan, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, 410008, Hunan, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, 410008, Hunan, China
| | - Yiqun Zhu
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, 410008, Hunan, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, 410008, Hunan, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, 410008, Hunan, China
| | - Huaying Liang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, 410008, Hunan, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, 410008, Hunan, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, 410008, Hunan, China
| | - Jun Cheng
- Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Dianwu Li
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, 410008, Hunan, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, 410008, Hunan, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, 410008, Hunan, China
| | - Fengyu Lin
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, 410008, Hunan, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, 410008, Hunan, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, 410008, Hunan, China
| | - Xin Zhou
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, 41000, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, 410008, Hunan, China
| | - Pinhua Pan
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, 410008, Hunan, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, 410008, Hunan, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, 410008, Hunan, China
| | - Fangyu Ma
- Health Management Center, Xiangya Hospital of Central South University, Changsha, 41000, Hunan, China
| | - Yan Zhang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, 410008, Hunan, China.
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, 410008, Hunan, China.
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, 410008, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, 410008, Hunan, China.
| |
Collapse
|
2
|
McHill AW, Melanson EL, Wright KP, Depner CM. Circadian misalignment disrupts biomarkers of cardiovascular disease risk and promotes a hypercoagulable state. Eur J Neurosci 2024. [PMID: 39053917 DOI: 10.1111/ejn.16468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 06/24/2024] [Accepted: 07/01/2024] [Indexed: 07/27/2024]
Abstract
The circadian system regulates 24-h time-of-day patterns of cardiovascular physiology, with circadian misalignment resulting in adverse cardiovascular risk. Although many proteins in the coagulation-fibrinolysis axis show 24-h time-of-day patterns, it is not understood if these temporal patterns are regulated by circadian or behavioral (e.g., sleep and food intake) cycles, or how circadian misalignment influences these patterns. Thus, we utilized a night shiftwork protocol to analyze circadian versus behavioral cycle regulation of 238 plasma proteins linked to cardiovascular physiology. Six healthy men aged 26.2 ± 5.6 years (mean ± SD) completed the protocol involving two baseline days with 8-h nighttime sleep opportunities (circadian alignment), a transition to shiftwork day, followed by 2 days of simulated night shiftwork with 8-h daytime sleep opportunities (circadian misalignment). Plasma was collected for proteomics every 4 h across 24 h during baseline and during daytime sleep and the second night shift. Cosinor analyses identified proteins with circadian or behavioral cycle-regulated 24-h time-of-day patterns. Five proteins were circadian regulated (plasminogen activator inhibitor-1, angiopoietin-2, insulin-like growth factor binding protein-4, follistatin-related protein-3, and endoplasmic reticulum resident protein-29). No cardiovascular-related proteins showed regulation by behavioral cycles. Within the coagulation pathway, circadian misalignment decreased tissue factor pathway inhibitor, increased tissue factor, and induced a 24-h time-of-day pattern in coagulation factor VII (all FDR < 0.10). Such changes in protein abundance are consistent with changes observed in hypercoagulable states. Our analyses identify circadian regulation of proteins involved in cardiovascular physiology and indicate that acute circadian misalignment could promote a hypercoagulable state, possibly contributing to elevated cardiovascular disease risk among shift workers.
Collapse
Affiliation(s)
- Andrew W McHill
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University, Portland, Oregon, USA
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon, USA
| | - Edward L Melanson
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Kenneth P Wright
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Christopher M Depner
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
3
|
Agarwal I, MacVane CZ. Shift Scheduling and Overnight Work Among Pregnant Emergency Medicine Residents. Ann Emerg Med 2024; 83:598-602. [PMID: 38402481 DOI: 10.1016/j.annemergmed.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 02/26/2024]
Affiliation(s)
- Isha Agarwal
- Department of Emergency Medicine, Maine Medical Center, Portland, Maine.
| | - Casey Z MacVane
- Department of Emergency Medicine, Maine Medical Center, Portland, Maine
| |
Collapse
|
4
|
Takada M, Hirouchi J, Kujiraoka I, Takahara S, Schneider T, Kai M. Temporal changes in cumulative mortality risks of cancer, by occupation, in the working population of Japan from 1995 to 2020: a benchmark for radiation risk comparison. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2024; 44:011514. [PMID: 38422516 DOI: 10.1088/1361-6498/ad2ebc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/29/2024] [Indexed: 03/02/2024]
Abstract
The purpose of this study was to provide benchmark data for discussing the tolerability of cancer risk associated with occupational radiation exposure. It focused on differences in cancer mortality risk by occupation among Japan's working population and examined baseline cancer mortality risks and its variations from 1995 through 2020. Data were collected every five years from national vital statistics sources. By focusing on the same types of cancer among radiation induced effects, cumulative mortality risks were calculated for colorectal, lung, and breast cancer (females only) for those aged 15-74. The average cumulative mortality risk for the working population in Japan has decreased by 30%-60% over the past 25 years. Service workers and male managers were at an average risk, among all workers, while clerical workers and transportation and manufacturing workers had about half the average risk. The risks were higher for professionals and female managers, about 1.5-2 times the average for professionals and up to 5 times the average for female managers. The decrease in the average cancer mortality risk in the working population as a baseline suggests that risk tolerance in society might have changed over time. Since differences in mortality by occupation were confirmed, the usefulness of occupational data as a benchmark needs further investigation, as high-risk/low-risk occupations vary by country and region. The results of this study contribute to put radiation risks into perspective with the background risk of cancer.
Collapse
Affiliation(s)
- Momo Takada
- National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
| | - Jun Hirouchi
- Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki, Japan
| | - Ikuo Kujiraoka
- Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki, Japan
| | - Shogo Takahara
- Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki, Japan
| | - Thierry Schneider
- Nuclear Protection Evaluation Centre (CEPN), Fontenay-aux-Roses, France
| | | |
Collapse
|
5
|
Yu W, Ma J, Guo W, Xu J, Xu J, Li S, Ren C, Wu L, Wu C, Li C, Chen J, Duan J, Ma Q, Song H, Zhao W, Ji X. Night shift work was associated with functional outcomes in acute ischemic stroke patients treated with endovascular thrombectomy. Heliyon 2024; 10:e25916. [PMID: 38390161 PMCID: PMC10881325 DOI: 10.1016/j.heliyon.2024.e25916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/09/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
Objective This study aimed to explore the impact of late night shift work on the functional outcomes of patients with acute ischemic stroke (AIS) treated with endovascular thrombectomy (EVT). Methods Consecutive AIS patients who underwent EVT between June 2019 and June 2021 were enrolled and divided into non-night shift work and night shift work groups based on their occupational histories. The primary outcome was the modified Rankin Scale score defined 3-month functional outcome. The secondary outcomes were 3-month mortality, symptomatic intracerebral hemorrhage (sICH), ICH and early recanalization. Results A total of 285 patients were enrolled, 35 patients (12.3%) were night shift workers, who were younger (P < 0.001) and had a significantly higher prevalence of smoking (P < 0.001), hyperlipidemia (P = 0.002), coronary heart disease (P = 0.031), and atrial fibrillation (P < 0.001). The 3-month favorable outcomes were achieved in 44.8% and 25.7% of patients in the non-night shift work and night shift work groups, respectively (adjusted odds ratio [OR]: 0.24, 95% CI: 0.10-0.57; adjusted P = 0.001). No difference was found in 3-month mortality (adjusted OR: 0.43; 95% CI: 0.14-1.25, adjusted P = 0.121), rates of ICH (adjusted OR: 0.73; 95% CI: 0.33-1.60; adjusted P = 0.430), sICH (adjusted OR: 0.75; 95% CI: 0.34-1.67; adjusted P = 0.487), or early successful recanalization (adjusted OR: 0.42; 95% CI: 0.12-1.56; adjusted P = 0.197). These results were consistent after PSM analysis. Conclusion Our findings suggest that late night shift work is significantly associated with unfavorable outcomes in patients with AIS after EVT.
Collapse
Affiliation(s)
- Wantong Yu
- Department of Neurology, Xuanwu Hospital, Capital Medical University Beijing, China
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu Hospital, Capital Medical University Beijing, China
| | - Jin Ma
- Department of Neurology, Xuanwu Hospital, Capital Medical University Beijing, China
| | - Wenting Guo
- Department of Neurology, Xuanwu Hospital, Capital Medical University Beijing, China
| | - Jiali Xu
- Department of Neurology, Xuanwu Hospital, Capital Medical University Beijing, China
| | - Jun Xu
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu Hospital, Capital Medical University Beijing, China
| | - Sijie Li
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu Hospital, Capital Medical University Beijing, China
- Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Changhong Ren
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu Hospital, Capital Medical University Beijing, China
| | - Longfei Wu
- Department of Neurology, Xuanwu Hospital, Capital Medical University Beijing, China
| | - Chuanjie Wu
- Department of Neurology, Xuanwu Hospital, Capital Medical University Beijing, China
| | - Chuanhui Li
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu Hospital, Capital Medical University Beijing, China
| | - Jian Chen
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jiangang Duan
- Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qingfeng Ma
- Department of Neurology, Xuanwu Hospital, Capital Medical University Beijing, China
| | - Haiqing Song
- Department of Neurology, Xuanwu Hospital, Capital Medical University Beijing, China
| | - Wenbo Zhao
- Department of Neurology, Xuanwu Hospital, Capital Medical University Beijing, China
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu Hospital, Capital Medical University Beijing, China
| | - Xunming Ji
- Department of Neurology, Xuanwu Hospital, Capital Medical University Beijing, China
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu Hospital, Capital Medical University Beijing, China
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorder, Capital Medical University, Beijing, China
| |
Collapse
|
6
|
Mok H, Ostendorf E, Ganninger A, Adler AJ, Hazan G, Haspel JA. Circadian immunity from bench to bedside: a practical guide. J Clin Invest 2024; 134:e175706. [PMID: 38299593 PMCID: PMC10836804 DOI: 10.1172/jci175706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
The immune system is built to counteract unpredictable threats, yet it relies on predictable cycles of activity to function properly. Daily rhythms in immune function are an expanding area of study, and many originate from a genetically based timekeeping mechanism known as the circadian clock. The challenge is how to harness these biological rhythms to improve medical interventions. Here, we review recent literature documenting how circadian clocks organize fundamental innate and adaptive immune activities, the immunologic consequences of circadian rhythm and sleep disruption, and persisting knowledge gaps in the field. We then consider the evidence linking circadian rhythms to vaccination, an important clinical realization of immune function. Finally, we discuss practical steps to translate circadian immunity to the patient's bedside.
Collapse
Affiliation(s)
- Huram Mok
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Elaine Ostendorf
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Alex Ganninger
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Avi J. Adler
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Guy Hazan
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
- Research and Innovation Center, Saban Children’s Hospital, Beer-Sheva, Israel
| | - Jeffrey A. Haspel
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| |
Collapse
|
7
|
Liu Y, Wang C, Zhang P, Fu W, Zhang J, Zhang Z, Mao J, Yang Y, Zou L. Association Between the Frequency of Tooth Brushing and the Risk of Cardiovascular Disease: A Systematic Review and Meta-analysis. Angiology 2024:33197231219836. [PMID: 38179951 DOI: 10.1177/00033197231219836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Several epidemiological studies suggested that frequency of tooth brushing may be associated with cardiovascular disease (CVD) risk, but the results remain inconclusive. Therefore, the aim of this study was to synthesize frequency of tooth brushing and CVD risk using meta-analysis. Science Direct, PubMed, CINAHL, and OVID were searched through October 15, 2022. The random-effects model was used to quantitatively assess the combined risk estimation. In addition, we performed the sensitivity analysis to evaluate the robustness of the study results by excluding the included studies one by one. A total of 9 cohort studies containing 10 reports with 803,019 individuals were included in the meta-analysis. Pooled results showed that compared with the lowest brushing frequency, the highest brushing frequency (relative risk = 0.85, 95% confidence interval: 0.80-0.90) significantly reduced the risk of cardiovascular disease. There was moderate heterogeneity among included studies (P = .002, I2 = 65.4%). The exclusion of any one study did not materially change the combined risk estimates. Our meta-analysis supported the hypothesis that higher frequency of tooth brushing can reduce the risk of CVD, which may have important implications for conducting research on the prevention strategies of CVD.
Collapse
Affiliation(s)
- Yifang Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao Wang
- School of Public Health, Wuhan University, Wuhan, China
| | - Pu Zhang
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Wenning Fu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Zhang
- Department of Endocrinology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Zeyu Zhang
- Institute for Hospital Management of Tsinghua University, Beijing, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Yang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Zou
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| |
Collapse
|
8
|
Konkol M, George EL, Scott PW, Imes CC. Examining Nurses' Perception of Shift Work and Evaluating Supportive Interventions. J Nurs Care Qual 2024; 39:10-17. [PMID: 36917831 DOI: 10.1097/ncq.0000000000000704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Health care requires a delicate equilibrium of nurse health safety and patient safety outcomes. Shift work can disrupt this balance, resulting in poor outcomes for staff and patients. PROBLEM Limited evidence exists on nurses' perceptions of shift work, fatigue countermeasures use, and interest in risk-mitigating interventions. METHODS An online survey of nurses was conducted. Survey questions assessed perceptions of shift work, use of fatigue countermeasures, and potential interventions. RESULTS The participants perceived multiple differences between day and night shifts when asked about their ability to complete both work- and life-oriented tasks. Use of fatigue countermeasures was more common while working night shift. Potential interventions included the use of blackout curtains, an on-site exercise facility, consulting a nutritionist, and block scheduling. CONCLUSIONS Health care leaders should consider nurses' perceptions and interests when incorporating initiatives to mitigate the negative effects of shift work.
Collapse
Affiliation(s)
- Megan Konkol
- University of Pittsburgh Medical Center Presbyterian Shadyside, Pittsburgh, Pennsylvania (Ms Konkol and Dr George) and University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania (Drs Scott and Imes)
| | | | | | | |
Collapse
|
9
|
Vestergaard JM, Dalbøge A, Bonde JPE, Garde AH, Hansen J, Hansen ÅM, Larsen AD, Härmä M, Costello S, Böttcher M, Kolstad HA. Night shift work characteristics and risk of incident coronary heart disease among health care workers: national cohort study. Int J Epidemiol 2023; 52:1853-1861. [PMID: 37741924 DOI: 10.1093/ije/dyad126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/13/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Night work has been associated with coronary heart disease. The present study examined exposure-response relations between quantitative night work characteristics and coronary heart disease (angina pectoris or myocardial infarction) with the aim to contribute to evidence-based recommendations for low-risk night work schedules. METHODS We followed 100 149 night workers (80% women) and 153 882 day workers (78% women), all health care workers in Denmark with day by day payroll information on night shifts from 2007 to 2015. We analysed data with Poisson regression stratified by sex and adjusted for age, calendar year, diabetes, family history of cardiovascular disease, educational level, occupation, indicators for obesity, hypercholesterolaemia, and hypertension. RESULTS Female and male night workers worked on average 1.7 and 1.8 night shifts per month for an average duration of less than 4 years. During follow-up, 1198 night and 2128 day workers were hospitalized with first-time coronary heart disease. When compared with day workers, the overall incidence rate ratios for female and male night workers were 1.06 [95% confidence interval (CI): 0.97, 1.17] and 1.22 (95% CI 1.07, 1.39). Highest risks were observed in top exposure categories for several night work characteristics. However, no consistent exposure-response relations by number of monthly night shifts, cumulative night shifts, years with rotating night shifts, years with any night shift and consecutive night shifts were observed among the night workers of either sex. CONCLUSIONS This study of a population with low exposure to night work does not indicate that reducing extent of monthly night shifts, cumulative night shifts, years with rotating night shifts, years with any night shift and consecutive night shifts would reduce the risk of coronary heart disease.
Collapse
Affiliation(s)
- Jesper Medom Vestergaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Goedstrup Hospital, Herning, Denmark
| | - Annett Dalbøge
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Peter Ellekilde Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Anne Helene Garde
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Johnni Hansen
- Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
| | - Åse Marie Hansen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Mikko Härmä
- Finnish Institute for Occupational Health, Helsinki, Finland
| | - Sadie Costello
- Environmental Health Science, School of Public Health, University of California, Berkeley, CA, USA
| | - Morten Böttcher
- Department of Cardiology, Gødstrup Hospital, NIDO, Herning, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| |
Collapse
|
10
|
Wang KY, Chien CM, Lee HF, Yobelina Y. The mediation of health-promoting lifestyle on self-perceived health status and quality of life among nurses: a cross-sectional study. BMC Nurs 2023; 22:447. [PMID: 38017421 PMCID: PMC10683133 DOI: 10.1186/s12912-023-01608-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/14/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Nurses with busy workloads lack the time to maintain health, leading to a decline in physical and mental health and quality of life. It is widely accepted that self-perception of health triggers health-promoting behaviors and impacts the quality of life; however, the relationship between these factors among nurses is unclear. The purpose of this study was to investigate the ability of a health-promoting lifestyle to mediate the relationship between self-perceived health and quality of life among nurses. METHODS A cross-sectional survey was conducted in four regional Taiwanese teaching hospitals with over 500 beds. The survey used stratified random sampling of 600 nurses who had worked for more than six months. The Self-Perceived Health Questionnaire, the Health-Promoting Lifestyle Profile, and the World Health Organization Quality of Life Scale were used to measure nurses' self-perceived health (SPH), health-promoting lifestyle (HPL), and quality of life (QoL). A Hayes PROCESS analysis and bootstrapping method were used for the mediation analysis. RESULTS A total of 518 nurses' data was included in the analysis. Nurses perceived their health status as less favorable than their colleagues, but frequently adopted health promotion behaviors. Nurses reported a moderate QoL. QoL and SPH were correlated (r = .33) and a high correlation between QoL and HPL (r = .64) was found. SPH and HPL both affect QoL (B = 0.077 and 0.070). SPH and HPL explained 42.6% of the variation in QoL. HPL played a partial mediation role. CONCLUSIONS The study confirmed that HPL has an important role in mediating nurses' SPH and QoL. Nurse administrators are advised to encourage nurses to monitor their health status and provide health promotion mechanisms to improve their quality of life.
Collapse
Affiliation(s)
- Kuei-Ying Wang
- Department of Nursing, College of Health Sciences, Chang Jung Christian University, No.1, Changda Rd., Gueiren District, Tainan City, 711301, Taiwan (Republic of China)
| | - Ching-Ming Chien
- Department of Medical Science Industries, College of Health Sciences, Chang Jung Christian University, No.1, Changda Rd., Gueiren District, Tainan City, 711301, Taiwan (Republic of China)
| | - Huan-Fang Lee
- Department of Nursing, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan (Republic of China).
| | - Yohana Yobelina
- Department of Translation and Interpretation Studies, College of Humanities and Social Sciences, Chang Jung Christian University, No.1, Changda Rd., Gueiren District, Tainan City, 711301, Taiwan (Republic of China)
| |
Collapse
|
11
|
Kaakour D, Fortin B, Masri S, Rezazadeh A. Circadian Clock Dysregulation and Prostate Cancer: A Molecular and Clinical Overview. Clin Med Insights Oncol 2023; 17:11795549231211521. [PMID: 38033743 PMCID: PMC10683379 DOI: 10.1177/11795549231211521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/15/2023] [Indexed: 12/02/2023] Open
Abstract
Circadian clock dysregulation has been implicated in various types of cancer and represents an area of growing research. However, the role of the circadian clock in prostate cancer has been relatively unexplored. This literature review will highlight the potential role of circadian clock dysregulation in prostate cancer by examining molecular, epidemiologic, and clinical data. The influence of melatonin, light, night shift work, chronotherapy, and androgen independence are discussed as they relate to the existing literature on their role in prostate cancer.
Collapse
Affiliation(s)
- Dalia Kaakour
- Division of Hematology/Oncology, Department of Medicine, University of California, Irvine, Orange, CA, USA
| | - Bridget Fortin
- Department of Biological Chemistry, University of California, Irvine, Irvine, CA, USA
| | - Selma Masri
- Department of Biological Chemistry, University of California, Irvine, Irvine, CA, USA
| | - Arash Rezazadeh
- Division of Hematology/Oncology, Department of Medicine, University of California, Irvine, Orange, CA, USA
| |
Collapse
|
12
|
Daniels LJ, Kay D, Marjot T, Hodson L, Ray DW. Circadian regulation of liver metabolism: experimental approaches in human, rodent, and cellular models. Am J Physiol Cell Physiol 2023; 325:C1158-C1177. [PMID: 37642240 PMCID: PMC10861179 DOI: 10.1152/ajpcell.00551.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/15/2023] [Accepted: 07/19/2023] [Indexed: 08/31/2023]
Abstract
Circadian rhythms are endogenous oscillations with approximately a 24-h period that allow organisms to anticipate the change between day and night. Disruptions that desynchronize or misalign circadian rhythms are associated with an increased risk of cardiometabolic disease. This review focuses on the liver circadian clock as relevant to the risk of developing metabolic diseases including nonalcoholic fatty liver disease (NAFLD), insulin resistance, and type 2 diabetes (T2D). Many liver functions exhibit rhythmicity. Approximately 40% of the hepatic transcriptome exhibits 24-h rhythms, along with rhythms in protein levels, posttranslational modification, and various metabolites. The liver circadian clock is critical for maintaining glucose and lipid homeostasis. Most of the attention in the metabolic field has been directed toward diet, exercise, and rather little to modifiable risks due to circadian misalignment or disruption. Therefore, the aim of this review is to systematically analyze the various approaches that study liver circadian pathways, targeting metabolic liver diseases, such as diabetes, nonalcoholic fatty liver disease, using human, rodent, and cell biology models.NEW & NOTEWORTHY Over the past decade, there has been an increased interest in understanding the intricate relationship between circadian rhythm and liver metabolism. In this review, we have systematically searched the literature to analyze the various experimental approaches utilizing human, rodent, and in vitro cellular approaches to dissect the link between liver circadian rhythms and metabolic disease.
Collapse
Affiliation(s)
- Lorna J Daniels
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Danielle Kay
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Thomas Marjot
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom
| | - David W Ray
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom
- Kavli Centre for Nanoscience Discovery, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
13
|
Imes CC, Tucker SJ, Trinkoff AM, Chasens ER, Weinstein SM, Dunbar-Jacob J, Patrician PA, Redeker NS, Baldwin CM. Wake-up Call: Night Shifts Adversely Affect Nurse Health and Retention, Patient and Public Safety, and Costs. Nurs Adm Q 2023; 47:E38-E53. [PMID: 37643236 DOI: 10.1097/naq.0000000000000595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
The purpose of this mini review is to (1) summarize the findings on the impact of night shift on nurses' health and wellness, patient and public safety, and implications on organizational costs and (2) provide strategies to promote night shift nurses' health and improve organizational costs. The night shift, compared with day shift, results in poorer physical and mental health through its adverse effects on sleep, circadian rhythms, and dietary and beverage consumption, along with impaired cognitive function that increases nurse errors. Nurse administrators and health care organizations have opportunities to improve nurse and patient safety on night shifts. Low-, moderate-, and higher-cost measures that promote night nurses' health and well-being can help mitigate these negative outcomes. The provided individual and organizational recommendations and innovations support night shift nurses' health, patient and public safety, and organizational success.
Collapse
Affiliation(s)
- Christopher C Imes
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania (Drs Imes, Chasens, and Dunbar-Jacob); College of Nursing, The Ohio State University, Columbus (Dr Tucker); School of Nursing, University of Maryland, Baltimore (Dr Trinkoff); School of Nursing, Purdue University Global, West Lafayette, Indiana (Ms Weinstein); School of Nursing, The University of Alabama at Birmingham (Dr Patrician); School of Nursing, University of Connecticut, Storrs (Dr Redeker); and Edson College of Nursing and Health Innovation, Arizona State University, Phoenix (Dr Baldwin)
| | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Csoma B, Bikov A. The Role of the Circadian Rhythm in Dyslipidaemia and Vascular Inflammation Leading to Atherosclerosis. Int J Mol Sci 2023; 24:14145. [PMID: 37762448 PMCID: PMC10532147 DOI: 10.3390/ijms241814145] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Cardiovascular diseases (CVD) are among the leading causes of death worldwide. Many lines of evidence suggest that the disturbances in circadian rhythm are responsible for the development of CVDs; however, circadian misalignment is not yet a treatable trait in clinical practice. The circadian rhythm is controlled by the central clock located in the suprachiasmatic nucleus and clock genes (molecular clock) located in all cells. Dyslipidaemia and vascular inflammation are two hallmarks of atherosclerosis and numerous experimental studies conclude that they are under direct influence by both central and molecular clocks. This review will summarise the results of experimental studies on lipid metabolism, vascular inflammation and circadian rhythm, and translate them into the pathophysiology of atherosclerosis and cardiovascular disease. We discuss the effect of time-respected administration of medications in cardiovascular medicine. We review the evidence on the effect of bright light and melatonin on cardiovascular health, lipid metabolism and vascular inflammation. Finally, we suggest an agenda for future research and recommend on clinical practice.
Collapse
Affiliation(s)
- Balazs Csoma
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK;
- Department of Pulmonology, Semmelweis University, 1083 Budapest, Hungary
| | - Andras Bikov
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK;
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| |
Collapse
|
15
|
Lopez-Santamarina A, Mondragon ADC, Cardelle-Cobas A, Santos EM, Porto-Arias JJ, Cepeda A, Miranda JM. Effects of Unconventional Work and Shift Work on the Human Gut Microbiota and the Potential of Probiotics to Restore Dysbiosis. Nutrients 2023; 15:3070. [PMID: 37447396 DOI: 10.3390/nu15133070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023] Open
Abstract
The work environment is a factor that can significantly influence the composition and functionality of the gut microbiota of workers, in many cases leading to gut dysbiosis that will result in serious health problems. The aim of this paper was to provide a compilation of the different studies that have examined the influence of jobs with unconventional work schedules and environments on the gut microbiota of workers performing such work. As a possible solution, probiotic supplements, via modulation of the gut microbiota, can moderate the effects of sleep disturbance on the immune system, as well as restore the dysbiosis produced. Rotating shift work has been found to be associated with an increase in the risk of various metabolic diseases, such as obesity, metabolic syndrome, and type 2 diabetes. Sleep disturbance or lack of sleep due to night work is also associated with metabolic diseases. In addition, sleep disturbance induces a stress response, both physiologically and psychologically, and disrupts the healthy functioning of the gut microbiota, thus triggering an inflammatory state. Other workers, including military, healthcare, or metallurgy workers, as well as livestock farmers or long-travel seamen, work in environments and schedules that can significantly affect their gut microbiota.
Collapse
Affiliation(s)
- Aroa Lopez-Santamarina
- Laboratorio de Higiene Inspección y Control de Alimentos, Departamento de Química Analítica, Nutrición y Bromatología, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - Alicia Del Carmen Mondragon
- Laboratorio de Higiene Inspección y Control de Alimentos, Departamento de Química Analítica, Nutrición y Bromatología, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - Alejandra Cardelle-Cobas
- Laboratorio de Higiene Inspección y Control de Alimentos, Departamento de Química Analítica, Nutrición y Bromatología, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - Eva Maria Santos
- Área Académica de Química, Universidad Autónoma del Estado de Hidalgo, Carretera Pachuca-Tulancingo km. 4.5, Pachuca 42076, Hidalgo, Mexico
| | - Jose Julio Porto-Arias
- Laboratorio de Higiene Inspección y Control de Alimentos, Departamento de Química Analítica, Nutrición y Bromatología, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - Alberto Cepeda
- Laboratorio de Higiene Inspección y Control de Alimentos, Departamento de Química Analítica, Nutrición y Bromatología, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - Jose Manuel Miranda
- Laboratorio de Higiene Inspección y Control de Alimentos, Departamento de Química Analítica, Nutrición y Bromatología, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| |
Collapse
|
16
|
Abstract
An integrative review of 21 studies found mixed results on the associations of work schedule and nurse fatigue. Suggestions for nurse leaders include monitoring fatigue in shift workers, ensuring supportive work design, promoting a healthy lifestyle, and implementing scheduling interventions.
Collapse
Affiliation(s)
- Melita Peršolja
- Melita Peršolja is an associate professor, Vipava Unit of Faculty of Health Sciences at the University of Primorska, Slovenia
| |
Collapse
|
17
|
Okechukwu CE, Colaprico C, Di Mario S, Oko-Oboh AG, Shaholli D, Manai MV, La Torre G. The Relationship between Working Night Shifts and Depression among Nurses: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:healthcare11070937. [PMID: 37046864 PMCID: PMC10094007 DOI: 10.3390/healthcare11070937] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/15/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND For many years, occupational physicians have debated whether there is a link between working the night shift and depression and other co-occurring mental health issues, with an emphasis on work-related, biological, individual, and environmental factors. We performed this systematic review and meta-analysis to estimate the overall association between sleep deprivation and depression among nurses working night shifts. METHODS A systematic search was carried out across the electronic databases PubMed, Scopus, and Web of Science from inception to 30 September 2022, for studies that reported a relationship between estimated night shift work and depression in nurses. The outcomes were measured using the odds ratio (OR) and matching 95% confidence interval (CI). The I2 statistic was used to assess heterogeneity. The Grading of Recommendations Assessment, Development and Evaluation technique was used to evaluate the quality of the evidence, and the Newcastle-Ottawa Scale was utilized to assess the methodological quality of each of the included studies. We determined the overall relationship between working nights and the onset of depression. RESULTS A total of 20 studies were included in the systematic review. Furthermore, 8 studies were included in the meta-analysis due to their common use of the OR as an effect measure. The 8 studies gave an overall estimate indicating a statistically significant association between night shift work and depression among nurses (OR = 1.49 95% CI: 1.26, 1.76). The prediction interval for the overall estimate was (0.995, 2.231). This implies that the true OR in a future study would most likely fall within this range, with a 95% certainty. CONCLUSIONS The outcome of this systematic review and meta-analysis showed a significant association between night shift work, the circadian and sleep disruption it causes, and the risk of depression in nurses. This demonstrates that nurses who work night shifts are at risk of developing depression.
Collapse
Affiliation(s)
- Chidiebere Emmanuel Okechukwu
- Department of Public health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Corrado Colaprico
- Department of Public health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Sofia Di Mario
- Department of Public health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | | | - David Shaholli
- Department of Public health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Maria Vittoria Manai
- Department of Public health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Giuseppe La Torre
- Department of Public health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| |
Collapse
|
18
|
Teglia F, Collatuzzo G, Boffetta P. Occupational Cancers among Employed Women: A Narrative Review. Cancers (Basel) 2023; 15:cancers15041334. [PMID: 36831675 PMCID: PMC9954144 DOI: 10.3390/cancers15041334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
The facts that occupational cancer in women is under-investigated, with few in-depth analyses are well known. In recent decades the workforce has changed, with an increasing number of women employed. Therefore, the inclusion of women in occupational cancer studies has become more urgent and feasible than in the past decades. The difficulties to evaluate occupational causes of female gynecologic tumors in most past cohorts and the potential variation in outcome responses between men and women must be taken into consideration. This narrative review discusses women's occupational cancer as a current area of research, focusing on three groups of workers characterized by peculiar exposure to occupational carcinogens and where women are often employed: beauticians and hairdressers; farmers; and healthcare workers. We discuss the most relevant cancers in each working category, with a particular focus on female breast cancer. In the three industries reviewed in detail, there are some risk factors which may affect primarily women, inducing breast cancer and cervical cancer, as well as risk factors that are carcinogenic in both genders, but whose effects are less well known in women.
Collapse
Affiliation(s)
- Federica Teglia
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, New York, NY 11794, USA
- Correspondence:
| |
Collapse
|
19
|
Al-Rfooh OF, Khater W. The impact of chronotype on physical health, psychological health, and job performance among health care providers in acute care settings. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2023. [DOI: 10.1080/20479700.2023.2177665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- Omar Faisal Al-Rfooh
- Faculty of Nursing/Jordan University of Science and Technology, School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - Wejdan Khater
- Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Amman, Jordan
| |
Collapse
|
20
|
Golisch KB, Sanders JM, Rzhetsky A, Tatebe LC. Addressing Surgeon Burnout Through a Multi-level Approach: A National Call to Action. CURRENT TRAUMA REPORTS 2023; 9:28-39. [PMID: 36688090 PMCID: PMC9843106 DOI: 10.1007/s40719-022-00249-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/19/2023]
Abstract
Purpose of Review Physician burnout is an epidemic and there are unique aspects of surgery that dictate rates of burnout among general surgeons and surgical trainees. This review characterizes the scope of burnout and its drivers within the field of surgery and advocates for strategies to address burnout at the individual, institutional, and national levels. Recent Findings Rates of burnout in surgery are increasing with higher numbers of young and female surgeons affected. Contributing factors are generally related to work-life balance, longer hours, and mistreatment in the workplace. Attempts have been made at implementing structured initiatives in an effort to combat work dissatisfaction and emotional exhaustion. Still, rates of burnout continue to increase. Summary General surgeons and trainees are at high risk for burnout with resulting attrition, depression, and suicidal ideation. The solution to burnout must be addressed at individual, institutional, and national levels. Further research into the factors leading to surgeon burnout and enactment of effective strategies to mitigate burnout must be pursued.
Collapse
Affiliation(s)
- Kimberly B. Golisch
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Jes M. Sanders
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | | | - Leah C. Tatebe
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| |
Collapse
|
21
|
Murray JM, Magee M, Giliberto ES, Booker LA, Tucker AJ, Galaska B, Sibenaller SM, Baer SA, Postnova S, Sondag TA, Phillips AJ, Sletten TL, Howard ME, Rajaratnam SM. Mobile app for personalized sleep–wake management for shift workers: A user testing trial. Digit Health 2023; 9:20552076231165972. [PMID: 37009306 PMCID: PMC10064476 DOI: 10.1177/20552076231165972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 03/10/2023] [Indexed: 04/01/2023] Open
Abstract
Objective Development of personalized sleep–wake management tools is critical to improving sleep and functional outcomes for shift workers. The objective of the current study was to test the performance, engagement and usability of a mobile app ( SleepSync) for personalized sleep–wake management in shift workers that aid behavioural change and provide practical advice by providing personalized sleep scheduling recommendations and education. Methods Shift workers ( n = 27; 20 healthcare and 7 from other industries) trialled the mobile app for two weeks to determine performance, engagement and usability. Primary outcomes were self-reported total sleep time, ability to fall asleep, sleep quality and perception of overall recovery on days off. Secondary performance outcomes included sleep disturbances (insomnia and sleep hygiene symptoms, and sleep-related impairments) and mood (anxiety, stress and depression) pre- and post-app use. Satisfaction with schedule management, integration into daily routine and influence on behaviour were used to determine engagement, while the usability was assessed for functionality and ease of use of features. Results Total sleep time ( P = .04), ability to fall asleep ( P < .001), quality of sleep ( P = .001), insomnia ( P = .02), sleep hygiene ( P = .01), sleep-related impairments ( P = .001), anxiety ( P = .001), and stress ( P = .006) were all improved, with non-significant improvements in recovery on days off ( P = .19) and depression ( P = .07). All measures of engagement and usability were scored positively by the majority of users. Conclusions This pilot trial provides preliminary evidence of the positive impact of the SleepSync app in improving sleep and mood outcomes in shift workers, and warrants confirmation in a larger controlled trial.
Collapse
Affiliation(s)
- Jade M. Murray
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, Australia
| | - Michelle Magee
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, Australia
| | - Emma S. Giliberto
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, Australia
| | - Lauren A. Booker
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
| | - Andrew J. Tucker
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, Australia
| | - Beth Galaska
- Philips RS North America LLC f/k/a Respironics Inc, Murrysville, USA
| | | | - Sharon A. Baer
- Philips RS North America LLC f/k/a Respironics Inc, Murrysville, USA
| | - Svetlana Postnova
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, Australia
- School of Physics, University of Sydney, Sydney, Australia
| | | | - Andrew J.K. Phillips
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, Australia
| | - Tracey L. Sletten
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, Australia
| | - Mark E. Howard
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
| | - Shantha M.W. Rajaratnam
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, Australia
- Shantha M.W. Rajaratnam, Turner Institute for Brain and Mental Health, School of Psychological Sciences, 18 Innovation Walk, Monash University, Clayton, Victoria 3800, Australia.
| |
Collapse
|
22
|
Johnson DA, Cheng P, FarrHenderson M, Knutson K. Understanding the determinants of circadian health disparities and cardiovascular disease. Chronobiol Int 2023; 40:83-90. [PMID: 34547974 PMCID: PMC8934749 DOI: 10.1080/07420528.2021.1966026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
Emerging research suggests that sleep contributes to racial disparities in cardiovascular disease (CVD). Racial/ethnic minorities are disproportionately affected by poor cardiovascular outcomes including obesity, hypertension and diabetes. Although circadian rhythms affect sleep patterns, few studies have examined disparities in circadian health or the contribution of circadian disparities to CVD. In this paper, we provide an overview of the relation between circadian health and CVD in the context of health disparities. We discuss (1) the current knowledge on racial disparities in circadian health; (2) social and environmental determinants of circadian health disparities; (3) the cardiovascular consequences of circadian disparities; and (4) future opportunities to advance the field of circadian disparities. In brief, our findings demonstrated that among a small literature, racial minorities (mainly African American) were more likely to have a shorter circadian period, delayed phase shifts, and were more likely to be shift workers, which are associated with CVD risk factors. Given racial minorities are disproportionately affected by CVD and CVD risk factors, it is important to further understand circadian health as an intervention target and support more research among racial minorities to understand circadian health in these populations.
Collapse
Affiliation(s)
- Dayna A. Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Philip Cheng
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, 39450 W 12 Mile Road, Detroit MI 48197 USA
| | - Maya FarrHenderson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kristen Knutson
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| |
Collapse
|
23
|
Lee KW, Yang CC, Chen CH, Hung CH, Chuang HY. Shift work is significantly and positively associated with dementia: A meta-analysis study. Front Public Health 2023; 11:998464. [PMID: 36875407 PMCID: PMC9978382 DOI: 10.3389/fpubh.2023.998464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
Background Shift work may disrupt the sleep and wake cycles and negatively affect physical and mental health. Dementia is a neurodegenerative disorder with progressively declining cognition that is receiving increasing attention. Studies on the association between shift work and dementia are rare. Herein, we conducted a meta-analysis to investigate the association between shift work and dementia. Materials and methods This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the PubMed, Embase, and Web of Science databases using a related set of keywords. The inclusion criteria were as follows: (1) adult employees working in a factory, company, or organization; (2) exposure to shift work/non-shift work; and (3) outcome of dementia based on examination or assessment. A meta-analysis using a fixed-effects model was performed. The hazard ratio of dementia was compared between shift workers and non-shift workers. Results Five studies were included in the quantitative synthesis, and two were selected for further meta-analysis. A random-effects model showed a modest association between shift work and an increase in dementia cases (pooled hazard ratio = 1.13; 95% confidence interval: 1.04-1.23; p = 0.04). This association also occurred in night workers for more than 1 year. Conclusion Shift work and long-term night work were modestly associated with a higher risk of developing dementia. Avoiding long-term night shifts may be effective in reducing dementia risk. Further studies are required to confirm this hypothesis.
Collapse
Affiliation(s)
- Kuo-Wei Lee
- Department of Neurology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,College of Medicine, Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chen-Cheng Yang
- College of Medicine, Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Occupational and Environmental Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hung Chen
- Department of Neurology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Hsing Hung
- Environmental and Occupational Medicine Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Yi Chuang
- Department of Occupational and Environmental Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Public Health and Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
24
|
Krutova O, Peutere L, Ervasti J, Härmä M, Virtanen M, Ropponen A. Sequence analysis of the combinations of work shifts and absences in health care - comparison of two years of administrative data. BMC Nurs 2022; 21:376. [PMID: 36585739 PMCID: PMC9801614 DOI: 10.1186/s12912-022-01160-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 12/23/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND In health care, the shift work is arranged as irregular work shifts to provide operational hours for 24/7 care. We aimed to investigate working hour trends and turnover in health care via identification of time-related sequences of work shifts and absences among health care employees. The transitions between the work shifts (i.e., morning, day, evening, and night shifts), and absences (days off and other leaves) over time were analyzed and the predictors of change in irregular shift work were quantified. METHODS A longitudinal cohort study was conducted using employer-owned payroll-based register data of objective and day-to-day working hours and absences of one hospital district in Finland from 2014 to 2019 (n = 4931 employees). The working hour data included start and end of work shifts, any kind of absence from work (days off, sickness absence, parental leave), and employee's age, and sex. Daily work shifts and absences in 2014 and 2019 were used in sequence analysis. Generalized linear model was used to estimate how each identified sequence cluster was associated with sex and age. RESULTS We identified four sequence clusters: "Morning" (60% in 2014 and 56% in 2019), "Varying shift types" (22% both in 2014 and 2019), "Employee turnover" (13% in 2014 and 3% in 2019), and "Unstable employment (5% in 2014 and 19% in 2019). The analysis of transitions from one cluster to another between 2014 and 2019 indicated that most employees stayed in the same clusters, and most often in the "Varying shift types" (60%) and "Morning" (72%) clusters. The majority of those who moved, moved to the cluster "Morning" in 2019 from "Employee turnover" (43%), "Unstable employment" (46%) or "Varying shift types" (21%). Women were more often than men in the clusters "Employee turnover" and "Unstable employment", whereas older employees were more often in "Morning" and less often in the other cluster groups. CONCLUSION Four clusters with different combinations of work shifts and absences were identified. The transition rates between work shifts and absences with five years in between indicated that most employees stayed in the same clusters. The likelihood of a working hour pattern characterized by "Morning" seems to increase with age.
Collapse
Affiliation(s)
- Oxana Krutova
- Finnish Institute of Occupational Health, P.O.Box 18, Helsinki, 00032, Finland
| | - Laura Peutere
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, P.O.Box 18, Helsinki, 00032, Finland
| | - Mikko Härmä
- Finnish Institute of Occupational Health, P.O.Box 18, Helsinki, 00032, Finland
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.,CNS, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Annina Ropponen
- Finnish Institute of Occupational Health, P.O.Box 18, Helsinki, 00032, Finland. .,CNS, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
| |
Collapse
|
25
|
Cordina-Duverger E, Uchai S, Tvardik N, Billmann R, Martin D, Trédaniel J, Wislez M, Blons H, Laurent-Puig P, Antoine M, Guénel P, Radoï L. Sleep Traits, Night Shift Work and Lung Cancer Risk among Women: Results from a Population-Based Case-Control Study in France (The WELCA Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16246. [PMID: 36498320 PMCID: PMC9740028 DOI: 10.3390/ijerph192316246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/21/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Circadian rhythm disruption due to night shift work and/or sleep disorders is associated with negative health outcomes including cancer. There is only scant evidence of an association with lung cancer, unlike breast and prostate cancer. We explore the role of sleep disorders and night shift work in lung cancer risk among women in a population-based case-control study, including 716 lung cancer cases and 758 controls. Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) associated with sleep duration per day (<7 h, 7−7.9 h, ≥8 h), a summary index of sleep disorders, chronotype, and night shift work exposure metrics. When compared to women with an average sleep duration of 7−7.9 h per day, the OR was 1.39 (95% CI 1.04−1.86) in long sleepers (≥8 h) and 1.16 (95% CI 0.86−1.56) in short sleepers (<7 h). Overall, lung cancer was not associated with the sleep disorder index, nor with night shift work, regardless of the duration of night work or the frequency of night shifts. However, elevated OR associated with the sleep disorder index were found in the subgroup of current smokers. The U-shaped association of lung cancer with sleep duration was more particularly pronounced among women who worked at night ≥5 years. Our findings suggested that sleep patterns are associated with lung cancer risk in women with a potential modifying effect by night shift work duration or tobacco smoking.
Collapse
Affiliation(s)
- Emilie Cordina-Duverger
- Équipe Exposome et Hérédité, Inserm U 1018, Center for Research in Epidemiology and Population Health (CESP), University Paris-Sud, Université Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, 94807 Villejuif, France
| | - Shreeshti Uchai
- Équipe Exposome et Hérédité, Inserm U 1018, Center for Research in Epidemiology and Population Health (CESP), University Paris-Sud, Université Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, 94807 Villejuif, France
- École des Hautes Etudes en Santé Publique (EHESP), 93210 Paris, France
| | - Nastassia Tvardik
- Équipe Exposome et Hérédité, Inserm U 1018, Center for Research in Epidemiology and Population Health (CESP), University Paris-Sud, Université Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, 94807 Villejuif, France
| | - Régine Billmann
- Équipe Exposome et Hérédité, Inserm U 1018, Center for Research in Epidemiology and Population Health (CESP), University Paris-Sud, Université Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, 94807 Villejuif, France
| | - Diane Martin
- Équipe Exposome et Hérédité, Inserm U 1018, Center for Research in Epidemiology and Population Health (CESP), University Paris-Sud, Université Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, 94807 Villejuif, France
| | - Jean Trédaniel
- Unité INSERM UMR-S 1124, Toxicologie, Pharmacologie et Signalisation Cellulaire, Groupe Hospitalier Paris Saint Joseph, Université de Paris, 75014 Paris, France
| | - Marie Wislez
- Unité d’Oncologie Thoracique, Institut du Cancer Paris Carpem, Assistance Publique Hôpitaux de Paris (AP-HP Centre), Université Paris Cité, 75014 Paris, France
- Centre de Recherche des Cordeliers, UMRS 1138 Complement, Inflammation and Cancer, Université de Paris, 75006 Paris, France
| | - Hélène Blons
- Department of Biology Physiology and Genetics, Institut du Cancer Paris Carpem, Assistance Publique Hôpitaux de Paris (AP-HP Centre), Université Paris Cité, 75005 Paris, France
- Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, 75006 Paris, France
| | - Pierre Laurent-Puig
- Department of Biology Physiology and Genetics, Institut du Cancer Paris Carpem, Assistance Publique Hôpitaux de Paris (AP-HP Centre), Université Paris Cité, 75005 Paris, France
- Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, 75006 Paris, France
| | - Martine Antoine
- AP-HP, Tenon Hospital, Pathology, 4 Rue de la Chine, 75020 Paris, France
- UPMC Université Paris 06, GRC No. 04, Theranoscan, 75020 Paris, France
| | - Pascal Guénel
- Équipe Exposome et Hérédité, Inserm U 1018, Center for Research in Epidemiology and Population Health (CESP), University Paris-Sud, Université Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, 94807 Villejuif, France
| | - Loredana Radoï
- Équipe Exposome et Hérédité, Inserm U 1018, Center for Research in Epidemiology and Population Health (CESP), University Paris-Sud, Université Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, 94807 Villejuif, France
- UFR d’Odontologie, Assistance Publique Hôpitaux de Paris (AP-HP Nord), Hôpital Louis Mourier, Université Paris Cité, 92700 Paris, France
| | | |
Collapse
|
26
|
MacVane CZ, Puissant M, Fix M, Strout TD, Bonney C, Welsh L, Mittelman A, Ricker J, Agarwal I. Scheduling practices for pregnant emergency medicine residents. AEM EDUCATION AND TRAINING 2022; 6:e10813. [PMID: 36425789 PMCID: PMC9677363 DOI: 10.1002/aet2.10813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/22/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Background Night shift work is associated with adverse pathophysiologic effects on maternal and fetal well-being. Although emergency medicine (EM) residents work frequent night shifts, there is no existing guidance for residency program directors (PDs) regarding scheduling pregnant residents. Our study assessed scheduling practices for pregnant EM residents, differences based on program and PD characteristics, barriers and attitudes toward implementing a formal scheduling policy, and PDs' awareness of literature describing adverse effects of night shifts on maternal-fetal outcomes. Methods We conducted an anonymous, web-based survey of U.S. EM residencies (N = 276). Quantitative data were summarized; chi-square analysis and logistic regression were used to assess relationships between program and PD characteristics and schedule accommodations. Qualitative description was used to analyze an open-ended question, organizing findings into major and minor themes. Results Of the 167 completed surveys (response rate 61%), 67% of programs reported no formal policy for scheduling pregnant residents but made adjustments on an individual basis including block changes (85%), decreased (46%) or no night shifts (34%), and working shifts earlier in pregnancy to cover later shifts (20%). Barriers to adjustments included staffing constraints (60%), equity concerns (45%), or impact on wellness (41%) among all residents and privacy (28%). PDs endorsed scheduling adjustments as important (mean 8.1, 0-10 scale) and reported guidance from graduate medical education governance would be useful (60%). Larger program size, but not PD gender or proportion of female residents, was associated with an increased likelihood of scheduling modifications. Twenty-five percent of PDs reported little knowledge of literature regarding night shift work and pregnancy. Qualitative themes supported quantitative findings. Conclusions Most EM residency programs do not have formal scheduling policies for pregnant residents, but most PDs support making adjustments and do so informally. More education and guidance for PDs are needed to promote the development of formal policies.
Collapse
Affiliation(s)
- Casey Z. MacVane
- Department of Emergency Medicine, Maine Medical CenterTufts University School of MedicinePortlandMaineUSA
| | | | - Megan Fix
- Department of Emergency MedicineUniversity of Utah School of MedicineSalt Lake CityUtahUSA
| | - Tania D. Strout
- Department of Emergency Medicine, Maine Medical CenterTufts University School of MedicinePortlandMaineUSA
| | - Caitlin Bonney
- Department of Emergency MedicineUniversity of New Mexico Health Sciences CenterAlbuquerqueNew MexicoUSA
| | - Laura Welsh
- Department of Emergency Medicine, Boston Medical CenterBoston University School of MedicineBostonMassachusettsUSA
| | - Andrew Mittelman
- Department of Emergency Medicine, Boston Medical CenterBoston University School of MedicineBostonMassachusettsUSA
| | - Jana Ricker
- Department of Emergency MedicineMaine Medical CenterPortlandMaineUSA
| | - Isha Agarwal
- Department of Emergency Medicine, Maine Medical CenterTufts University School of MedicinePortlandMaineUSA
| |
Collapse
|
27
|
Ngai ZN, Chok KC, Ng KY, Koh RY, Chye SM. Potential role of melatonin in prevention and treatment of lung cancer. Horm Mol Biol Clin Investig 2022; 43:485-503. [PMID: 35728260 DOI: 10.1515/hmbci-2022-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/14/2022] [Indexed: 12/24/2022]
Abstract
Lung cancer is the second most common cancer and the most lethal cancer worldwide. Melatonin, an indoleamine produced in the pineal gland, shows anticancer effects on a variety of cancers, especially lung cancer. Herein, we clarify the pathophysiology of lung cancer, the association of circadian rhythm with lung, and the relationship between shift work and the incidence of lung cancer. Special focus is placed on the role of melatonin receptors in lung cancer, the relationship between inflammation and lung cancer, control of cell proliferation, apoptosis, autophagy, and immunomodulation in lung cancer by melatonin. A review of the drug synergy of melatonin with other anticancer drugs suggests its usefulness in combination therapy. In summary, the information compiled may serve as a comprehensive reference for the various mechanisms of action of melatonin against lung cancer, as a guide for the design of future experimental research and for advancing melatonin as a therapeutic agent for lung cancer.
Collapse
Affiliation(s)
- Zi Ni Ngai
- School of Health Science, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Kian Chung Chok
- School of Health Science, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Khuen Yen Ng
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Rhun Yian Koh
- Division of Applied Biomedical Science and Biotechnology, School of Health Science, International Medical University, Kuala Lumpur, Malaysia
| | - Soi Moi Chye
- Division of Applied Biomedical Science and Biotechnology, School of Health Science, International Medical University, Kuala Lumpur, Malaysia
| |
Collapse
|
28
|
Freni-Sterrantino A, Fiorito G, d’Errico A, Virtanen M, Ala-Mursula L, Järvelin MR, Vineis P, Robinson O. Association between work characteristics and epigenetic age acceleration: cross-sectional results from UK - Understanding Society study. Aging (Albany NY) 2022; 14:7752-7773. [PMID: 36202116 PMCID: PMC9596217 DOI: 10.18632/aging.204327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/17/2022] [Indexed: 11/25/2022]
Abstract
Occupation-related stress and work characteristics are possible determinants of social inequalities in epigenetic aging but have been little investigated. Here, we investigate the association of several work characteristics with epigenetic age acceleration (AA) biomarkers. The study population included employed and unemployed men and women (n = 631) from the UK Understanding Society study. We evaluated the association of employment and work characteristics related to job type, job stability; job schedule; autonomy and influence at work; occupational physical activity; and feelings regarding the job with four epigenetic age acceleration biomarkers (Hannum, Horvath, PhenoAge, GrimAge) and pace of aging (DunedinPoAm, DunedinPACE). We fitted linear regression models, unadjusted and adjusted for established risk factors, and found the following associations for unemployment (years of acceleration): HorvathAA (1.51, 95% CI 0.08, 2.95), GrimAgeAA (1.53, 95% CI 0.16, 2.90) and 3.21 years for PhenoAA (95% CI 0.89, 5.33). Job insecurity increased PhenoAA (1.83, 95% CI 0.003, 3.67), while working at night was associated with an increase of 2.12 years in GrimAgeAA (95% CI 0.69, 3.55). We found effects of unemployment to be stronger in men and effects of night shift work to be stronger in women. These results provide evidence of associations between unemployment with accelerated ageing and suggest that insecure employment and night work may also increase age acceleration. Our findings have implications for policies relating to current changes in working conditions and highlight the utility of biological age biomarkers in studies in younger populations without long-term health information.
Collapse
Affiliation(s)
- Anna Freni-Sterrantino
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, United Kingdom,The Alan Turing Institute, John Dodson House, London NW1 2DB, United Kingdom
| | - Giovanni Fiorito
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, United Kingdom,Laboratory of Biostatistics, Department of Biomedical Sciences, University of Sassari, Sassari 07100, Italy
| | - Angelo d’Errico
- Department of Epidemiology, Local Health Unit TO 3, Turin 10095, Italy
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu FI-80101, Finland,Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm 17177, Sweden
| | - Leena Ala-Mursula
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu 90014, Finland
| | - Marjo-Riitta Järvelin
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, United Kingdom,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu 90014, Finland
| | - Paolo Vineis
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, United Kingdom
| | - Oliver Robinson
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, United Kingdom,Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College of London, London W2 1PG, United Kingdom
| |
Collapse
|
29
|
Rohwer E, Velasco Garrido M, Herold R, Preisser AM, Terschüren C, Harth V, Mache S. Police officers' work-life balance, job satisfaction and quality of life: longitudinal effects after changing the shift schedule. BMJ Open 2022; 12:e063302. [PMID: 36127115 PMCID: PMC9490605 DOI: 10.1136/bmjopen-2022-063302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To evaluate mental health-related outcomes of police officers 5.5 years after implementing a new alternating shift schedule which was supposed to improve their health and work-life balance. DESIGN Pre-post study design with a baseline survey at the beginning of the piloting of the new shift schedule in 2015 and another survey 5.5 years later in 2020. SETTING Police departments of a German metropolitan police force piloting the new shift schedule. PARTICIPANTS 116 shift-working police officers out of a population of 1673 police officers at the follow-up date. INTERVENTIONS New shift schedule based on occupational health recommendations. OUTCOMES MEASURES Work-life balance, job satisfaction and quality of life. METHODS Mixed analyses of variances were used to test the hypotheses of within-subject and between-subject differences regarding time and gender. RESULTS We found partly significant differences between the baseline and follow-up survey for work-life balance (F(1, 114) = 6.168, p=0.014, ηp² = 0.051), job satisfaction (F(1, 114) = 9.921, p=0.002, ηp² = 0.080) and quality of life (F(1, 114) = 0.593, p=0.443, ηp² = 0.005). Neither significant differences between male and female police officers nor interaction effects of time and gender were found. CONCLUSION An increase was found for each of the three outcomes 5.5 years after implementing the new shift schedule. The results contribute to the current state of research on mental health-related outcomes of working conditions in shift work. On this basis, recommendations for designing shift schedules can be deduced to promote mental health and job satisfaction for employees in shift work.
Collapse
Affiliation(s)
- Elisabeth Rohwer
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marcial Velasco Garrido
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Robert Herold
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexandra Marita Preisser
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Terschüren
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
30
|
Yang L, Luo Y, He L, Yin J, Li T, Liu S, Li D, Cheng X, Bai Y. Shift Work and the Risk of Cardiometabolic Multimorbidity Among Patients With Hypertension: A Prospective Cohort Study of UK Biobank. J Am Heart Assoc 2022; 11:e025936. [PMID: 36036170 PMCID: PMC9496406 DOI: 10.1161/jaha.122.025936] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Although the association between shift work and individual cardiometabolic diseases has been well studied, its role in the progression to cardiometabolic multimorbidity (CMM) remains unclear. In this study, we investigate the association between shift work and the incidence of CMM in patients with hypertension. Methods and Results This study is a population-based and prospective cohort study on 36 939 UK Biobank participants. We used competing risk models to examine the association between shift work and the risk of CMM, which was defined as coexistence of hypertension and diabetes, coronary heart disease, or stroke in our study. We also investigated the association between the frequency and duration of shift work and CMM risks. In addition, we conducted a cross-classification analysis with the combination of frequency and duration of shift work, chronotype and sleep duration as the exposure metrics. During a median follow-up of 11.6 years, a total of 5935 participants developed CMM. We found that usually/always night shift workers were associated with a 16% higher risk of CMM compared with day workers (hazard ratio [HR], 1.16 [95% CI, 1.02-1.31]). We also found that a higher frequency of night shifts (>10/month) was associated with increased risk of CMM (HR, 1.19 [95% CI, 1.06-1.34]) that was more pronounced for >10/month in combination with a morning chronotype or <7 hours or >8 hours of sleep duration (HR, 1.26 [95% CI, 1.02-1.56]; HR, 1.43 [95% CI, 1.19-1.72], respectively). Conclusions We find that night shift work is associated with higher CMM risk in patients with hypertension.
Collapse
Affiliation(s)
- Liu Yang
- Xiangya International Medical Center Xiangya Hospital, Central South University Changsha Hunan China.,Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Yi Luo
- Department of Cardiovascular Medicine The Third Xiangya Hospital, Central South University Changsha Hunan China.,Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China
| | - Lingfang He
- Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Jinghua Yin
- Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Tie Li
- Department of Cardiovascular Medicine Changsha County Second People's Hospital Changsha Hunan China
| | - Shuai Liu
- Department of General and Vascular Surgery Xiangya Hospital, Central South University Changsha Hunan China
| | - Dongjie Li
- Xiangya International Medical Center Xiangya Hospital, Central South University Changsha Hunan China.,Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Yongping Bai
- Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| |
Collapse
|
31
|
Fenwick MJ, Oftedal S, Kolbe-Alexander TL, Duncan MJ. Comparison of adult shift and non-shift workers’ physical activity and sleep behaviours: cross-sectional analysis from the Household Income and Labour Dynamics of Australia (HILDA) cohort. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01738-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Abstract
Aim
This study compares the pattern of physical activity and sleep between shift and non-shift workers using a novel physical activity–sleep index. By drawing from a diverse occupational population, this research aims to reduce any occupational specific biases which are prevalent in shift-work research.
Subject and methods
Current data included 7607 workers (shift workers n = 832) from the Household Income and Labour Dynamics of Australia cohort study. The combined physical activity–sleep index comprised three physical activity components and three sleep health components: achieving moderate (1pt) or high (2pts) IPAQ classification; accruing ≥30% of physical activity as vigorous intensity (1pt); meeting sleep duration recommendations on a work night (1pt); and non-work night (1pt); and reporting no insomnia symptoms (1pt) (higher score = healthy behaviour, max. 6). Generalised linear modelling was used to compare behaviours of shift and non-shift workers.
Results
Findings showed shift workers reported significantly lower activity–sleep scores (3.59 vs 3.73, p < 0.001), lower sleep behaviour sub-score (2.01 vs. 2.22, p < 0.001) and were more likely to report insomnia symptoms (p < 0.001) compared to non-shift workers. No difference was reported for overall physical activity (shift = 1.58 vs. non-shift = 1.51, p = 0.383).
Conclusion
When viewed in conjunction using the combined activity–sleep index, shift workers displayed significantly poorer combined behaviours when compared to non-shift workers.
Collapse
|
32
|
Work Conditions of Italian Nurses and Their Related Risk Factors: A Cohort Investigatory Study. Diseases 2022; 10:diseases10030050. [PMID: 35997355 PMCID: PMC9397050 DOI: 10.3390/diseases10030050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 12/04/2022] Open
Abstract
(1) Background: Nursing is a satisfying employment pathway, as nurses preserve lives, but it is also considered one of the most stressful care professions. Nursing is a lifesaving and highly satisfying profession, yet it is considered one of the most stressful occupations. This study aimed to assess differences in anxiety, depression and stress states among nurses according to gender, work history, shift and body mass index (BMI) characteristics. (2) Methods: An online questionnaire was addressed to all Italian nurses during May 2022, investigating anxiety, depression and stress conditions according to the Depression, Anxiety and Stress Scale-21 Items (DASS-21) and sampling characteristics, such as sex, work experience, shift and BMI values. (3) Results: A total of 408 Italian nurses answered the questionnaire. Significant differences between the following were reported: anxiety levels and work experience, since nurses employed over 6 years reported higher anxiety levels than their younger colleagues (p = 0.035); depression levels and sex (p = 0.017), as females reported higher depression levels than males; and also between depression levels and BMI levels (p = 0.003), as 5.90% of overweight and 2.50% of obese participants reported extremely severe depression. By considering stress levels according to sampling characteristics, significant differences were registered according to BMI levels (p < 0.001), as overweight subjects reported higher stress levels (7.40%) than the other subgroups. Finally, significant associations were recorded between anxiety, depression and stress conditions with sex, work experience, shift and BMI. (4) Conclusions: The data were in agreement with the current literature, indicating that nurses might take care not only of their patients but also of themselves, in both the physical and mental aspects.
Collapse
|
33
|
Moretti Anfossi C, Ahumada Muñoz M, Tobar Fredes C, Pérez Rojas F, Ross J, Head J, Britton A. Work Exposures and Development of Cardiovascular Diseases: A Systematic Review. Ann Work Expo Health 2022; 66:698-713. [PMID: 35237787 PMCID: PMC9250287 DOI: 10.1093/annweh/wxac004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/20/2021] [Accepted: 01/25/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Cardiovascular diseases (CVDs) are the number one cause of death, and there is evidence that work exposures could be associated with their development. This study aimed to systematically review observational studies of adults exposed to job strain, effort-reward imbalance, long working hours, job insecurity, shift work, and occupational noise, and assess the association of those work exposures with CVDs. METHODS The Navigation Guide framework was applied. The population were adults of working age (18-65), and cohort and case-control studies were included. The work exposures were job strain, effort-reward imbalance, long working hours, job insecurity, shift work, and occupational noise. The outcomes were cerebrovascular diseases, ischaemic heart disease, and hypertensive diseases. The selection, data extraction, risk of bias assessment, and quality assessment were carried out by two reviewers independently and disagreements were solved by a third reviewer or by consensus. The synthesis of the results was done by applying the 'vote counting based on direction' method, and the results were summarized in an effect direction plot. The strength of the evidence for every risk factor and CVD was defined by consensus. RESULTS A total of 17 643 papers were initially identified in the literature search, but after applying the filters by title and abstract, and full text, 86 studies were finally included. From the included studies, sufficient evidence was found of the harmfulness of job strain for cerebrovascular disease and ischemic heart disease. Furthermore, there was sufficient evidence of the harmfulness of shift work for ischemic heart disease. Evidence of no relationship was found between long working hours and shift work with ischaemic heart disease and hypertensive disease, respectively. The other associations of work exposures and CVDs had limited or inadequate evidence of harmfulness. CONCLUSIONS In this comprehensive review, there was sufficient evidence of a harmful relationship between job strain, shift work, and CVDs. For the other work exposures, more high-quality studies are needed. In order to improve current prevention strategies for CVDs, the findings of this review imply that job strain and shift work are work exposures that constitute additional risk factors that could be approached as targets for worksite interventions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020179972.
Collapse
Affiliation(s)
- Christian Moretti Anfossi
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK
| | | | - Christian Tobar Fredes
- Facultad de Ciencias de la salud, Campus Los Leones, Universidad San Sebastián, Lota 2465, Providencia, Santiago, Chile
| | | | - Jamie Ross
- Department of Primary Care and Population Health, University College London, London, UK
| | - Jenny Head
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK
| | - Annie Britton
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK
| |
Collapse
|
34
|
Shi H, Huang T, Schernhammer ES, Sun Q, Wang M. Rotating Night Shift Work and Healthy Aging After 24 Years of Follow-up in the Nurses' Health Study. JAMA Netw Open 2022; 5:e2210450. [PMID: 35507343 PMCID: PMC9069254 DOI: 10.1001/jamanetworkopen.2022.10450] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/17/2022] [Indexed: 01/16/2023] Open
Abstract
Importance Rotating night shift work is associated with higher mortality. Whether it is also associated with overall health among those who survive to older ages remains unclear. Objective To examine whether rotating night shift work is associated with healthy aging after 24 years of follow-up in the Nurses' Health Study, a cohort study among registered female nurses. Design, Setting, and Participants For this cohort study, a composite healthy aging phenotype was ascertained among 46 318 participants who were aged 46 to 68 years and free of major chronic diseases in 1988 when the history of night shift work was assessed. In a secondary analysis in which cognitive function decline was considered in the healthy aging definition, 14 273 nurses were involved. Data were analyzed from March 1 to September 30, 2021. Exposures Duration of rotating night shift work. Main Outcomes and Measures Healthy aging was defined as reaching at least 70 years of age and being free of 11 major chronic diseases, memory impairment, physical limitation, or deteriorated mental health. Results Of 46 318 female nurses (mean [SD] age at baseline, 55.4 [6.1] years), 3695 (8.0%) achieved healthy aging after 24 years of follow-up. After adjusting for established and potential confounders, compared with women who never worked rotating night shifts, the odds of achieving healthy aging decreased significantly with increasing duration of night shift work. The odds ratios were 0.96 (95% CI, 0.89-1.03) for 1 to 5 years, 0.92 (95% CI, 0.79-1.07) for 6 to 9 years, and 0.79 (95% CI, 0.69-0.91) for 10 or more years of night shift work (P = .001 for trend). This association did not differ substantially by age and lifestyles and was consistent for 4 individual dimensions of healthy aging. Results were similar in a secondary analysis, with an odds ratio of 0.73 (95% CI, 0.60-0.89; P < .001 for trend) comparing 10 or more years of night shift work vs no night shift work. Conclusions and Relevance In this cohort study, rotating night shift work was associated with decreased probability of healthy aging among US female nurses. These data support the notion that excess night shift work is a significant health concern that may also lead to deteriorated overall health among older individuals.
Collapse
Affiliation(s)
- Hongying Shi
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Wenzhou Medical University, Zhejiang, China
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Eva S. Schernhammer
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Center for Public Health, Vienna, Austria
| | - Qi Sun
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Molin Wang
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|
35
|
Impact of Rotating Shifts on Lifestyle Patterns and Perceived Stress among Nurses: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095235. [PMID: 35564629 PMCID: PMC9101667 DOI: 10.3390/ijerph19095235] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 02/05/2023]
Abstract
Although rotating shifts have a negative health impact, their association with hospital nurses’ health risks remains controversial due to incomplete adjustment in lifestyle patterns and heterogeneity of work schedules. However, whether work schedule characteristics are associated with lifestyle patterns and perceived stress remains undetermined. We assessed the correlations of work schedule characteristics, lifestyle patterns, and perceived stress among hospital nurses. This cross-sectional study included 340 nurses from two hospitals. Final data from 329 nurses regarding work schedule characteristics, lifestyle patterns (physical activity, dietary behavior, and sleep pattern), and perceived stress were analyzed via linear regression models. Fixed-day-shift nurses had reduced perceived stress (β = 0.15, p = 0.007) compared with rotating-shift nurses. Additionally, among rotating-shift nurses, fixed-evening- and fixed-night-shift nurses had longer sleep duration (β = 0.27, p < 0.001; β = 0.25, p < 0.001) compared to non-fixed-rotating-shift nurses. Longer rotating-shift work was associated with healthier dietary behaviors (β = 0.15, p = 0.008), better sleep quality (β = −0.17, p = 0.003), lower perceived stress (β = −0.24, p < 0.001), and shorter sleep duration (β = −0.17, p = 0.003). Hospital nurses’ work schedule characteristics were associated with lifestyle patterns, dietary behavior, sleep pattern, and perceived stress. Fixed-shifts were beneficial for lifestyle and lower perceived stress. Longer rotating shifts could help nurses adjust their lifestyles accordingly.
Collapse
|
36
|
Zhang C, Tait C, Minacapelli CD, Bhurwal A, Gupta K, Amin R, Rustgi VK. The Role of Race, Sex, and Age in Circadian Disruption and Metabolic Disorders. GASTRO HEP ADVANCES 2022; 1:471-479. [PMID: 39131676 PMCID: PMC11307930 DOI: 10.1016/j.gastha.2022.02.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/15/2022] [Indexed: 08/13/2024]
Abstract
Circadian rhythms are 24-hour internal biological cycles that play an important role in metabolism, and their disruption has been implicated in the development of diseases such as diabetes mellitus type 2, obesity, coronary artery disease, hypertension, and metabolic syndrome. This phenomenon is illustrated by increased rates of risk factors for cardiovascular disease in night shift workers. Race, sex, and age are factors that play a role in circadian rhythms and metabolic disorders. The focus of this review article is to assess the link between circadian rhythm physiology and metabolic disorders from a race, sex, and age perspective. Black Americans were noted to have shorter free-running circadian periods, or tau, increased cortisol levels, and poorer sleep habits compared to white Americans, possibly contributing to increased rates of obesity, hypertension, and hyperlipidemia. Women were also noted to have shorter tau, increased levels of proinflammatory gut bacteria, and reduced sleep quality compared to men, possibly leading to higher rates of obesity, metabolic syndrome, hypertension (in postmenopausal women), and nonalcoholic fatty liver disease. Older people were noted to have decreased expression of anti-inflammatory clock genes compared to younger people, possibly leading to increased rates of obesity, diabetes, hyperlipidemia, and hypertension. Groups that are at a higher risk for metabolic disorders such as black Americans, women, and the elderly may have internal time keeping systems that place them at a higher risk for developing abnormal hormonal and/or inflammatory pathways.
Collapse
Affiliation(s)
- Clark Zhang
- Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Christopher Tait
- Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
- Center for Liver Diseases and Masses, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey
| | - Carlos D. Minacapelli
- Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
- Center for Liver Diseases and Masses, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey
| | - Abhishek Bhurwal
- Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
- Center for Liver Diseases and Masses, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey
| | - Kapil Gupta
- Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
- Center for Liver Diseases and Masses, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey
| | - Rajan Amin
- Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
- Center for Liver Diseases and Masses, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey
| | - Vinod K. Rustgi
- Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
- Center for Liver Diseases and Masses, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey
| |
Collapse
|
37
|
Trott AJ, Greenwell BJ, Karhadkar TR, Guerrero-Vargas NN, Escobar C, Buijs RM, Menet JS. Lack of food intake during shift work alters the heart transcriptome and leads to cardiac tissue fibrosis and inflammation in rats. BMC Biol 2022; 20:58. [PMID: 35236346 PMCID: PMC8892784 DOI: 10.1186/s12915-022-01256-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 02/16/2022] [Indexed: 12/14/2022] Open
Abstract
Background Many epidemiological studies revealed that shift work is associated with an increased risk of a number of pathologies, including cardiovascular diseases. An experimental model of shift work in rats has additionally been shown to recapitulate aspects of metabolic disorders observed in human shift workers, including increased fat content and impaired glucose tolerance, and used to demonstrate that restricting food consumption outside working hours prevents shift work-associated obesity and metabolic disturbance. However, the way distinct shift work parameters, such as type of work, quantity, and duration, affect cardiovascular function and the underlying mechanisms, remains poorly understood. Here, we used the rat as a model to characterize the effects of shift work in the heart and determine whether they can be modulated by restricting food intake during the normal active phase. Results We show that experimental shift work reprograms the heart cycling transcriptome independently of food consumption. While phases of rhythmic gene expression are distributed across the 24-h day in control rats, they are clustered towards discrete times in shift workers. Additionally, preventing food intake during shift work affects the expression level of hundreds of genes in the heart, including genes encoding components of the extracellular matrix and inflammatory markers found in transcriptional signatures associated with pressure overload and cardiac hypertrophy. Consistent with this, the heart of shift worker rats not eating during work hours, but having access to food outside of shift work, exhibits increased collagen 1 deposition and displays increased infiltration by immune cells. While maintaining food access during shift work has less effects on gene expression, genes found in transcriptional signatures of cardiac hypertrophy remain affected, and the heart of shift worker rats exhibits fibrosis without inflammation. Conclusions Together, our findings unraveled differential effects of food consumption on remodeled transcriptional profiles of the heart in shift worker rats. They also provide insights into how shift work affects cardiac function and suggest that some interventions aiming at mitigating metabolic disorders in shift workers may have adverse effects on cardiovascular diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12915-022-01256-9.
Collapse
Affiliation(s)
- Alexandra J Trott
- Department of Biology, Texas A&M University, College Station, TX, 77843, USA.,Program of Genetics, Texas A&M University, College Station, TX, 77843, USA.,Center for Biological Clock Research, Texas A&M University, College Station, TX, 77843, USA
| | - Ben J Greenwell
- Department of Biology, Texas A&M University, College Station, TX, 77843, USA.,Program of Genetics, Texas A&M University, College Station, TX, 77843, USA.,Center for Biological Clock Research, Texas A&M University, College Station, TX, 77843, USA
| | - Tejas R Karhadkar
- Department of Biology, Texas A&M University, College Station, TX, 77843, USA.,Program of Genetics, Texas A&M University, College Station, TX, 77843, USA
| | - Natali N Guerrero-Vargas
- Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
| | - Carolina Escobar
- Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
| | - Ruud M Buijs
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
| | - Jerome S Menet
- Department of Biology, Texas A&M University, College Station, TX, 77843, USA. .,Program of Genetics, Texas A&M University, College Station, TX, 77843, USA. .,Center for Biological Clock Research, Texas A&M University, College Station, TX, 77843, USA.
| |
Collapse
|
38
|
Cocco P, Piro S, Meloni F, Montagna A, Pani M, Pilia I, Padoan M, Miligi L, Magnani C, Gambelunghe A, Muzi G, Ferri GM, Vimercati L, Zanotti R, Scarpa A, Zucca M, Latte GC, Angelucci E, De Matteis S, Puligheddu M. Night shift work and lymphoma: results from an Italian multicentre case-control study. Occup Environ Med 2022; 79:452-459. [PMID: 35027441 DOI: 10.1136/oemed-2021-107845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 12/22/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Night shift work can disrupt circadian rhythm and cause chronic sleep deprivation, which might increase the risk of lymphoma through immunosuppression and oxidative stress. MATERIAL AND METHODS We investigated the association between night shift work and risk of lymphoma subtypes in 867 incident cases and 774 controls, who participated in a multicentre Italian study between 2011 and 2017. Based on questionnaire information, occupational experts assessed the lifetime probability of night shift work, the total number of night shifts and years of night shift work among study participants. OR and 95% CI for lymphoma and its major subtypes associated with night shift work was calculated with logistic regression, adjusting by age, gender, education, study area, marital status and family history of haemolymphatic cancer. RESULTS Ever working night shifts was associated with an increase in the risk of chronic lymphocytic leukaemia (CLL) (OR 1.9, 95% CI 1.14 to 3.32), which was highest after a 15-34 years latency. However, there was not a linear increase in risk by probability of exposure, years of night shift work, nor lifetime number of night shifts whether under rotating or permanent work schedules. Risk of lymphoma overall, B cell lymphoma (BCL), its major subtypes other than CLL, and other less prevalent BCL subtypes combined did not show an association. CONCLUSIONS We found conflicting evidence of an association between night shift work and the risk of CLL. We did not observe an association with other lymphoma subtypes.
Collapse
Affiliation(s)
- Pierluigi Cocco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy .,Centre for Occupational and Environmental Health, Division of Population Health, The University of Manchester, Manchester, UK
| | - Sara Piro
- Environmental and Occupational Epidemiology Branch - Cancer Risk Factors and Lifestyle Epidemiology Unit, ISPRO - Institute for Prevention, Research, and Cancer Network, Florence, Italy
| | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Andrea Montagna
- Department of Medicine and Surgery, Occupational Medicine, Respiratory Diseases and Toxicology Section, University of Perugia, Perugia, Italy
| | - Michele Pani
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Ilaria Pilia
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marina Padoan
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont Amedeo Avogadro School of Medicine, Novara, Italy
| | - Lucia Miligi
- Environmental and Occupational Epidemiology Branch - Cancer Risk Factors and Lifestyle Epidemiology Unit, ISPRO - Institute for Prevention, Research, and Cancer Network, Florence, Italy
| | - Corrado Magnani
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont Amedeo Avogadro School of Medicine, Novara, Italy
| | - Angela Gambelunghe
- Department of Medicine and Surgery, Occupational Medicine, Respiratory Diseases and Toxicology Section, University of Perugia, Perugia, Italy
| | - Giacomo Muzi
- Department of Medicine and Surgery, Occupational Medicine, Respiratory Diseases and Toxicology Section, University of Perugia, Perugia, Italy
| | - Giovanni Maria Ferri
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University of Bari, Bari, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University of Bari, Bari, Italy
| | - Roberta Zanotti
- Department of Haematology, University of Verona, Verona, Italy
| | - Aldo Scarpa
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Mariagrazia Zucca
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Emanuele Angelucci
- Deaprtment of Haematology, IST - National Institute for Cancer Research, Genova, Italy
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Monica Puligheddu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| |
Collapse
|
39
|
Stenger S, Grasshoff H, Hundt JE, Lange T. Potential effects of shift work on skin autoimmune diseases. Front Immunol 2022; 13:1000951. [PMID: 36865523 PMCID: PMC9972893 DOI: 10.3389/fimmu.2022.1000951] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/29/2022] [Indexed: 02/16/2023] Open
Abstract
Shift work is associated with systemic chronic inflammation, impaired host and tumor defense and dysregulated immune responses to harmless antigens such as allergens or auto-antigens. Thus, shift workers are at higher risk to develop a systemic autoimmune disease and circadian disruption with sleep impairment seem to be the key underlying mechanisms. Presumably, disturbances of the sleep-wake cycle also drive skin-specific autoimmune diseases, but epidemiological and experimental evidence so far is scarce. This review summarizes the effects of shift work, circadian misalignment, poor sleep, and the effect of potential hormonal mediators such as stress mediators or melatonin on skin barrier functions and on innate and adaptive skin immunity. Human studies as well as animal models were considered. We will also address advantages and potential pitfalls in animal models of shift work, and possible confounders that could drive skin autoimmune diseases in shift workers such as adverse lifestyle habits and psychosocial influences. Finally, we will outline feasible countermeasures that may reduce the risk of systemic and skin autoimmunity in shift workers, as well as treatment options and highlight outstanding questions that should be addressed in future studies.
Collapse
Affiliation(s)
- Sarah Stenger
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Hanna Grasshoff
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
| | - Jennifer Elisabeth Hundt
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
| | - Tanja Lange
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany.,Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany.,Center of Brain, Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| |
Collapse
|
40
|
Wei F, Chen W, Lin X. Night-shift work, breast cancer incidence, and all-cause mortality: an updated meta-analysis of prospective cohort studies. Sleep Breath 2021; 26:1509-1526. [PMID: 34775538 DOI: 10.1007/s11325-021-02523-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/23/2021] [Accepted: 11/02/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Night-shift work exposure is proposed to link to a wide range of health issues, especially cancer incidence, cancer-specific death, and all-cause death. However, the epidemiological associations among night-shift work exposure, breast cancer, breast cancer-specific death, and all-cause mortality remain inconclusive. METHODS We performed an updated systematic review and meta-analysis to confirm potential associations among night-shift work exposure, breast cancer, and all-cause mortality. RESULTS A total of 31 prospective cohort studies, involving 9.3 million participants, 31,244 incident breast cancer cases, 12,728 cancer-related deaths, 7882 cardiovascular deaths, and 30,807 all-cause mortalities were included. Overall, the summary RR of incident breast cancer in females for an increase of night-shift work was 1.029 (95% CI 1.003-1.055). Compared with standard day workers, night-shift workers had a statistically significantly increased RR (1.086, 95% CI 1.032-1.142) for breast cancer incidence in the subgroup of > 10 years exposure. Furthermore, a positive association was revealed in subgroup studies of rotating night-shift work (RR = 1.053, 95% CI 1.018-1.090). A significant increased risk of cardiovascular mortality was demonstrated in the night-shift work group (RR = 1.031; 95% CI 1.006-1.057). CONCLUSION Our systematic review and meta-analysis provided convincing evidence supporting positive associations among night-shift work exposure, breast cancer incidence, and cardiovascular mortality. Taken together, night-shift work exposure significantly increased the risk of breast cancer morbidity by 2.9% for total, 8.6% for the subgroup of more than 10 years night-shift work, and 5.3% for rotating night-shift work. In addition, night-shift work increased the risk of cardiovascular mortality by 3.1%.
Collapse
Affiliation(s)
- Fengqin Wei
- Department of Geriatrics, Fujian Provincial 2Nd People's Hospital, Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Weiyu Chen
- Department of Physiology, Zhongshan Medical School, Sun Yat-Sen University, Guangzhou, China
| | - Xiaoti Lin
- Department of Breast Surgery, Fujian Provincial Maternity and Children's Hospital of Fujian Medical University, Fuzhou, China.
| |
Collapse
|
41
|
Benzo R, Farag A, Whitaker K, Xiao Q, Carr L. A comparison of occupational physical activity and sedentary behavior patterns of nurses working 12-h day and night shifts. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2021. [DOI: 10.1016/j.ijnsa.2021.100028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
|
42
|
Wang N, Sun Y, Zhang H, Wang B, Chen C, Wang Y, Chen J, Tan X, Zhang J, Xia F, Qi L, Lu Y. Long-term night shift work is associated with the risk of atrial fibrillation and coronary heart disease. Eur Heart J 2021; 42:4180-4188. [PMID: 34374755 DOI: 10.1093/eurheartj/ehab505] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/01/2021] [Accepted: 07/15/2021] [Indexed: 01/05/2023] Open
Abstract
AIMS The aim of this study was to test whether current and past night shift work was associated with incident atrial fibrillation (AF) and whether this association was modified by genetic vulnerability. Its associations with coronary heart disease (CHD), stroke, and heart failure (HF) were measured as a secondary aim. METHODS AND RESULTS This cohort study included 283 657 participants in paid employment or self-employed without AF and 276 009 participants free of CHD, stroke, and HF at baseline in the UK Biobank. Current and lifetime night shift work information was obtained. Cox proportional hazard models were used. Weighted genetic risk score for AF was calculated. During a median follow-up of 10.4 years, 5777 incident AF cases were documented. From 'day workers', 'shift but never/rarely night shifts', and 'some night shifts' to 'usual/permanent night shifts', there was a significant increasing trend in the risk of incident AF (P for trend 0.013). Usual or permanent night shifts were associated with the highest risk [hazard ratio (HR) 1.16, 95% confidence interval (CI) 1.02-1.32]. Considering a person's lifetime work schedule and compared with shift workers never working nights, participants with a duration over 10 years and an average 3-8 nights/month frequency of night shift work exposure possessed higher AF risk (HR 1.18, 95% CI 0.99-1.40 and HR 1.22, 95% CI 1.02-1.45, respectively). These associations between current and lifetime night shifts and AF were not modified by genetic predisposition to AF. Usual/permanent current night shifts, ≥10 years and 3-8 nights/month of lifetime night shifts were significantly associated with a higher risk of incident CHD (HR 1.22, 95% CI 1.11-1.35, HR 1.37, 95% CI 1.20-1.58 and HR 1.35, 95% CI 1.18-1.55, respectively). These associations in stroke and HF were not significant. CONCLUSION Both current and lifetime night shift exposures were associated with increased AF risk, regardless of genetic AF risk. Night shift exposure also increased the risk of CHD but not stroke or HF. Whether decreasing night shift work frequency and duration might represent another avenue to improve heart health during working life and beyond warrants further study.
Collapse
Affiliation(s)
- Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Ying Sun
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Haojie Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Bin Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Yuying Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Jie Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, 33 A Kung Kok Street, Sha Tin District, Hong Kong SAR 000000, China
| | - Xiao Tan
- Department of Neuroscience, Uppsala University, BMC, 3 Husargatan, Uppsala 75124, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Nobels vag 9, 17165, Stockholm, Sweden
| | - Jihui Zhang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 123 Huifu West Road, Yuexiu District, Guangzhou 510000, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 1724, New Orleans, LA 70112, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
| |
Collapse
|
43
|
Carugno M, Maggioni C, Ruggiero V, Crespi E, Monti P, Ferrari L, Pesatori AC. Can Night Shift Work Affect Biological Age? Hints from a Cross-Sectional Study on Hospital Female Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10639. [PMID: 34682384 PMCID: PMC8535512 DOI: 10.3390/ijerph182010639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/28/2021] [Accepted: 10/08/2021] [Indexed: 12/19/2022]
Abstract
Disruption of age-related processes seems to play a relevant role in health effects related to night shift (NS) work. We aim to verify whether NS work can influence biological age (BA), estimated through Zbieć-Piekarska's epigenetic signature, based on methylation of five CpG sites in ELOVL2, C1orf132/MIR29B2C, TRIM59, KLF14, and FHL2. Forty-six female nurses working in NS were matched by age and length of employment with 51 female colleagues not working in NS. Each subject filled in a questionnaire (including the Effort Reward Imbalance (ERI) index to assess job stress) and gave a blood sample. Age acceleration (AA) was estimated by regressing BA on chronological age and taking the residuals. Multivariate linear regression models were applied. BA was not associated with NS. However, we did observe an increase in AA per each year in NS in subjects with overweight/obesity (β = 0.46, 95% CI: 0.05; 0.87, p = 0.03), experiencing work-related stress (β = 0.58, 95% CI: 0.10; 1.06, p = 0.018), or both (β = 0.66, 95% CI: 0.03; 1.29, p = 0.041). Although based on a small sample size, our findings suggest an increased BA only among hypersusceptible subjects and is worth further investigation, also in light of recent results suggesting a higher breast cancer risk in women with increased AA.
Collapse
Affiliation(s)
- Michele Carugno
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via San Barnaba, 8, IT-20122 Milan, Italy; (C.M.); (L.F.); (A.C.P.)
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via San Barnaba, 8, IT-20122 Milan, Italy;
| | - Cristina Maggioni
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via San Barnaba, 8, IT-20122 Milan, Italy; (C.M.); (L.F.); (A.C.P.)
| | - Vincenzo Ruggiero
- Faculty of Medicine, Università degli Studi di Milano, Via Festa del Perdono, 7, IT-20122 Milan, Italy;
| | - Eleonora Crespi
- Occupational Health Unit, ASST Santi Paolo e Carlo, Via Antonio di Rudinì, 8, IT-20142 Milan, Italy;
| | - Paola Monti
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via San Barnaba, 8, IT-20122 Milan, Italy;
| | - Luca Ferrari
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via San Barnaba, 8, IT-20122 Milan, Italy; (C.M.); (L.F.); (A.C.P.)
| | - Angela Cecilia Pesatori
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via San Barnaba, 8, IT-20122 Milan, Italy; (C.M.); (L.F.); (A.C.P.)
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via San Barnaba, 8, IT-20122 Milan, Italy;
| |
Collapse
|
44
|
Su F, Huang D, Wang H, Yang Z. Associations of shift work and night work with risk of all-cause, cardiovascular and cancer mortality: a meta-analysis of cohort studies. Sleep Med 2021; 86:90-98. [PMID: 34479052 DOI: 10.1016/j.sleep.2021.08.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/27/2021] [Accepted: 08/13/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Epidemiological studies on the relationship of shift work or night work with risk of total and cause-specific mortality have given conflicting results. We aimed at conducting a meta-analysis to summarize the evidence from cohort studies. METHODS Embase, PubMed, Web of Science and Scopus databases were searched for eligible studies up to Mar 2021. Cohort studies evaluating the associations of shift work or night work with risk of all-cause, cardiovascular or cancer mortality were reviewed. Study-specific risk estimates were pooled by fixed-effect models when the heterogeneity was not detected; otherwise, random-effect models were employed. RESULTS We identified seventeen eligible articles (sixteen cohorts). A total of 958,674 cohort participants were included, with 38,413 total deaths, 24,713 cardiovascular deaths and 10,219 cancer deaths during follow-up. According to the Newcastle-Ottawa Scale, fifteen studies were considered as relatively high quality with low risk of bias. Compared with regular daytime workers, the pooled relative risks for all-cause, cardiovascular and cancer mortality were 1.02 (95% CI: 0.99, 1.06), 1.18 (95% CI: 0.94, 1.47) and 1.05 (95% CI: 0.83, 1.34) for those ever exposing to shift work, respectively. Compared with daytime workers or those never exposing to night work, the pooled relative risks for all-cause, cardiovascular and cancer mortality were 1.06 (95% CI: 1.03, 1.08), 1.15 (95% CI: 1.03, 1.29) and 1.04 (95% CI: 1.00, 1.08) for those ever exposing to night work, respectively. Moderate to high level of heterogeneity across the studies was detected. Publication bias was not detected. CONCLUSION Night work may be associated with higher risk of all-cause, cardiovascular and cancer mortality, suggesting that night workers compared with daytime workers may be at higher risk of death, especially due to cardiovascular disease.
Collapse
Affiliation(s)
- Fuxiang Su
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ding Huang
- Department of Cardiology, The Fourth People's Hospital of Shenyang, Shenyang, China
| | - Hongyu Wang
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhiyong Yang
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China.
| |
Collapse
|
45
|
Kenig A, Kolben Y, Asleh R, Amir O, Ilan Y. Improving Diuretic Response in Heart Failure by Implementing a Patient-Tailored Variability and Chronotherapy-Guided Algorithm. Front Cardiovasc Med 2021; 8:695547. [PMID: 34458334 PMCID: PMC8385752 DOI: 10.3389/fcvm.2021.695547] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/21/2021] [Indexed: 01/12/2023] Open
Abstract
Heart failure is a major public health problem, which is associated with significant mortality, morbidity, and healthcare expenditures. A substantial amount of the morbidity is attributed to volume overload, for which loop diuretics are a mandatory treatment. However, the variability in response to diuretics and development of diuretic resistance adversely affect the clinical outcomes. Morevoer, there exists a marked intra- and inter-patient variability in response to diuretics that affects the clinical course and related adverse outcomes. In the present article, we review the mechanisms underlying the development of diuretic resistance. The role of the autonomic nervous system and chronobiology in the pathogenesis of congestive heart failure and response to therapy are also discussed. Establishing a novel model for overcoming diuretic resistance is presented based on a patient-tailored variability and chronotherapy-guided machine learning algorithm that comprises clinical, laboratory, and sensor-derived inputs, including inputs from pulmonary artery measurements. Inter- and intra-patient signatures of variabilities, alterations of biological clock, and autonomic nervous system responses are embedded into the algorithm; thus, it may enable a tailored dose regimen in a continuous manner that accommodates the highly dynamic complex system.
Collapse
Affiliation(s)
- Ariel Kenig
- Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Yotam Kolben
- Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Rabea Asleh
- Department of Cardiology, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Offer Amir
- Department of Cardiology, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
- The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Yaron Ilan
- Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| |
Collapse
|
46
|
Comparison of Psychological and Physiological Stress in NICU Nurses: Effects of Unit Design and Shift. Adv Neonatal Care 2021; 21:E93-E100. [PMID: 33427752 DOI: 10.1097/anc.0000000000000837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Effects of unit design and shift worked on stress in neonatal intensive care unit (NICU) nurses have not been fully studied. PURPOSE To compare stress in NICU nurses who work in single-family room (SFR) or open bay (OBY) units and on nonrotating day or night shift. METHODS Full-time registered nurses (RNs) (n = 72) from a 42-bed SFR and a 131-bed OBY NICU participated in this comparative cross-sectional study. The Nurse Stress Scale (NSS) and within-shift repeated salivary cortisol levels were used to measure stress. The relationship between NSS score and salivary cortisol level was examined using multiple linear regression. Salivary cortisol levels of day versus night shift were compared with mixed-effects linear models. RESULTS NSS scores were similar for SFR and OBY units (P = .672) and day versus night shift (P = .606). Changes in cortisol level over time (P = .764) and final cortisol level (P = .883) for SFR versus OBY were not significantly different after controlling for shift. Salivary cortisol level of day-shift nurses decreased significantly over time compared with night-shift nurses (P < .001). The final cortisol level was significantly higher for night-shift compared with day-shift nurses (P < .001). IMPLICATIONS FOR PRACTICE Psychological (NSS) and physiologic (salivary cortisol) stress of NICU nurses is similar in established SFR and OBY units. Cortisol levels are higher at the end of shift in nurses who work night shift and may reflect increased physiologic stress. IMPLICATIONS FOR RESEARCH Strategies are needed for reducing stress in NICU nurses who work night shift.
Collapse
|
47
|
Nizamuddin J, Tung A. Con: 24/7 In-House Intensivist Coverage is Not Required for CTICU Management. J Cardiothorac Vasc Anesth 2021; 35:3437-3439. [PMID: 34376344 DOI: 10.1053/j.jvca.2021.07.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 07/11/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Junaid Nizamuddin
- Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL
| | - Avery Tung
- Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL.
| |
Collapse
|
48
|
Vitale E, Galatola V, Mea R, Dio FD, Canonico A. The linkage "Body Mass Index-Insomnia Levels-Eating Disorder Flexibility" in Italian nurses during the Covid-19 outbreak: a psychoendocrinological employment disease. Endocr Metab Immune Disord Drug Targets 2021; 22:490-501. [PMID: 34269670 DOI: 10.2174/1871530321666210715125939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/31/2021] [Accepted: 04/27/2021] [Indexed: 11/22/2022]
Abstract
AIM To evaluate differences between insomnia condition and flexibility attitude to eating in Italian nurses directly involved in the care of patients affected by Covid-19 according to sex, Body Mass Index, shift working condition and incidence of new Covid-19 cases in the region of participants. Moreover, any correlations between the insomnia condition and the flexible attitude to eat have been investigated. METHODS An online questionnaire was administered in October 2020, including the socio-demographic section, the insomnia condition assessment, and the behavioral flexibility evaluation to develop an eating disorder. RESULTS 341 Italian nurses answered the questionnaire. Regarding the insomnia condition levels, nurses belonging to regions with a higher incidence rate of the Covid-19 pandemic recorded higher levels of insomnia than others (p=.004). Females and nurses belonging to areas with lower Covid-19 incidence rate recorded a significantly higher total eating flexibility attitude (p=.003; p<.001), also, in the Food and Exercise flexibility (p=.007; p<.001). As regards the flexible attitude for weight and shape, significant differences were recorded among nurses according to their BMI values (p<.001) and to their incidence rate of the belonging region (p<.001). The insomnia condition levels significantly correlated with the eat flexibility attitude both in its total score (p=.010), in the general score (p=.010), and the weight and shape score (p<.001). All correlations between the insomnia conditions and the flexibility to eat were significantly inverse except for the food and exercise dimension. All the eat flexibility sub-dimensions significantly correlated among them (p<.001). CONCLUSION There was a direct correlation among socio-demographic factors, BMI values, insomnia, and behavioral flexibility scores in Italian nurses. So, it could be assumed that the nursing profession is at risk of developing a metabolic syndrome condition. Therefore, it could be considered a psychoendocrinological employment disease during the Covid-19 outbreak.
Collapse
Affiliation(s)
- Elsa Vitale
- Centre of Mental Health, Modugno, Local Health Company Bari, Italy
| | - Vito Galatola
- Occidental Hospital in Castellaneta, Local Health Company Taranto, Italy
| | | | | | - Anna Canonico
- Cardiology Unit, Di Venere Hospital, Local Health Company Bari, Italy
| |
Collapse
|
49
|
The Impact of Stress Within and Across Generations: Neuroscientific and Epigenetic Considerations. Harv Rev Psychiatry 2021; 29:303-317. [PMID: 34049337 DOI: 10.1097/hrp.0000000000000300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The impact of stress and trauma on biological systems in humans can be substantial. They can result in epigenetic changes, accelerated brain development and sexual maturation, and predisposition to psychopathology. Such modifications may be accompanied by behavioral, emotional, and cognitive overtones during one's lifetime. Exposure during sensitive periods of neural development may lead to long-lasting effects that may not be affected by subsequent environmental interventions. The cumulative effects of life stressors in an individual may affect offspring's methylome makeup and epigenetic clocks, neurohormonal modulation and stress reactivity, and physiological and reproductive development. While offspring may suffer deleterious effects from parental stress and their own early-life adversity, these factors may also confer traits that prove beneficial and enhance fitness to their own environment. This article synthesizes the data on how stress shapes biological and behavioral dimensions, drawing from preclinical and human models. Advances in this field of knowledge should potentially allow for an improved understanding of how interventions may be increasingly tailored according to individual biomarkers and developmental history.
Collapse
|
50
|
Veal BM, Mu CX, Small BJ, Lee S. Subjective cognitive abilities correlate with poor sleep among day-shift and night-shift nurses. J Sleep Res 2021; 30:e13359. [PMID: 33987895 DOI: 10.1111/jsr.13359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/16/2021] [Accepted: 03/29/2021] [Indexed: 11/28/2022]
Abstract
Experimental studies have shown that sleep deprivation may lead to worse performance on cognitive tests. However, few studies have considered how sleep is associated with perceived cognitive performance in the daily lives of hospital nurses who require high cognitive abilities to deliver high-quality patient care. The current study examined the relationship between sleep and subjective cognition in nurses, and whether the relationship differed by work shift and workdays. Sixty in patient nurses working full-time (M = 35 years; 39 day-shift nurses, 21 night-shift nurses) reported their sleep characteristics and daily subjective cognition using ecological momentary assessment for 14 days. Concurrently, objective sleep characteristics were measured with a sleep actigraphy device for 14 days. Using multilevel modelling, results indicated that at the within-person and between-person level, better sleep quality and higher sleep sufficiency were associated with better subjective cognition at the daily-level and on average. Moderation analyses indicated at the within-person level, better sleep quality and longer time in bed were associated with better next-day cognition; these associations were stronger for night-shift nurses compared with day-shift nurses. At the between-person level, better sleep quality and higher sleep sufficiency were also associated with better subjective cognition overall; these associations were significant for day-shift nurses, but not for night-shift nurses. The sleep-subjective cognition relationships were more apparent on workdays versus non-workdays. Findings suggest that sufficient sleep recovery is important for nurses' reports of daily and overall cognitive functioning. Night-shift nurses' subjective cognitive abilities may be more protected on days following better sleepquality and more sufficient sleep.
Collapse
Affiliation(s)
- Britney M Veal
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Christina X Mu
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| |
Collapse
|