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Matthews TA, Liu X, Chen L, Li J. Prospective associations of occupational and leisure-time physical activity with risk of diabetes: a cohort study from the United States. Ann Work Expo Health 2024; 68:581-592. [PMID: 38785318 DOI: 10.1093/annweh/wxae034] [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: 07/15/2023] [Accepted: 04/21/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVES Leisure-time physical activity (LTPA) can reduce the risk of incident diabetes, whereas the role of occupational physical activity (OPA) in developing diabetes is still unclear due to conflicting evidence. Moreover, the joint associations of OPA and LTPA with incident diabetes among US workers have not yet been systematically examined. The objective of this study was to assess the independent and joint associations of OPA and LTPA with incident diabetes. METHODS This prospective cohort study included 1406 workers free from diabetes at baseline (2004-2006) from the national, population-based Mid-life in the United States (MIDUS) study. Associations of OPA and LTPA at baseline with incident diabetes during 9 years of follow-up were examined using Poisson regression models. High OPA was defined based on engagement in physical demands at work, and high LTPA was defined as participation in moderate or vigorous LTPA at least once per week. RESULTS High OPA was associated with an increased risk of diabetes compared to low OPA (adjusted risk ratios and 95% confidence interval = 1.52 [1.04, 2.22]), while high LTPA was associated with a decreased risk of diabetes compared to low LTPA (0.66 [0.44, 0.97]). Diabetes risk was the highest among workers with high OPA and low LTPA (2.30 [1.30, 4.07]). CONCLUSIONS In a national, population-based prospective cohort study of US workers, high OPA was associated with an elevated risk of diabetes, while high LTPA was associated with a decreased diabetes risk. The combination of high OPA and low LTPA exhibited the greatest risk of diabetes.
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Affiliation(s)
- Timothy A Matthews
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, United States
- Department of Environmental & Occupational Health, College of Health & Human Development, California State University Northridge, Northridge, CA 91330, United States
| | - Xinyue Liu
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, United States
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, United States
- School of Nursing, University of California Los Angeles, Los Angeles, CA 90095, United States
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2
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Ippolito M, Einav S, Giarratano A, Cortegiani A. Effects of fatigue on anaesthetist well-being and patient safety: a narrative review. Br J Anaesth 2024; 133:111-117. [PMID: 38641516 DOI: 10.1016/j.bja.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 04/21/2024] Open
Abstract
The elements that render anaesthesia a captivating profession can also foster stress and fatigue. Professionals considering anaesthesia as a career choice should have a comprehensive understanding of the negative consequences of fatigue and its implications for clinical performance and of the available preventive measures. Available evidence suggests that factors unrelated to patient characteristics or condition can affect clinical outcomes where anaesthetists are involved. Workload, nighttime work, and fatigue are persistent issues in anaesthesia and are perceived as presenting greater perioperative risks to patients. Fatigue seems to negatively affect both physical and mental health of anaesthetists. Existing evidence justifies specific interventions by institutions, stakeholders, and scientific societies to address the effects of anaesthetist fatigue. This narrative review summarises current knowledge regarding the effects of fatigue on anaesthetist well-being and patient safety, and discusses potential preventive solutions.
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Affiliation(s)
- Mariachiara Ippolito
- Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy; Department of Anaesthesia Intensive Care and Emergency, University Hospital Policlinico 'Paolo Giaccone', Palermo, Italy
| | - Sharon Einav
- Maccabi Healthcare Services Regional Director Hod HaSharon, Jerusalem, Israel; Hebrew University Faculty of Medicine, Jerusalem, Israel
| | - Antonino Giarratano
- Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy; Department of Anaesthesia Intensive Care and Emergency, University Hospital Policlinico 'Paolo Giaccone', Palermo, Italy
| | - Andrea Cortegiani
- Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy; Department of Anaesthesia Intensive Care and Emergency, University Hospital Policlinico 'Paolo Giaccone', Palermo, Italy.
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Hong HC, Kim YM. Multimorbidity and its Associated Factors in Korean Shift Workers: Population-Based Cross-Sectional Study. JMIR Public Health Surveill 2024; 10:e55014. [PMID: 38857074 PMCID: PMC11196912 DOI: 10.2196/55014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/11/2024] [Accepted: 05/14/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Multimorbidity is a crucial factor that influences premature death rates, poor health, depression, quality of life, and use of health care. Approximately one-fifth of the global workforce is involved in shift work, which is associated with increased risk for several chronic diseases and multimorbidity. About 12% to 14% of wage workers in Korea are shift workers. However, the prevalence of multimorbidity and its associated factors in Korean shift workers are rarely reported. OBJECTIVE This study aimed to assess multimorbidity prevalence, examine the factors associated with multimorbidity, and identify multimorbidity patterns among shift workers in Korea. METHODS This study is a population-based cross-sectional study using Korea National Health and Nutrition Examination Survey data from 2016 to 2020. The study included 1704 (weighted n=2,697,228) Korean shift workers aged 19 years and older. Multimorbidity was defined as participants having 2 or more chronic diseases. Demographic and job-related variables, including regular work status, average working hours per week, and shift work type, as well as health behaviors, including BMI, smoking status, alcohol use, physical activity, and sleep duration, were included in the analysis. A survey-corrected logistic regression analysis was performed to identify factors influencing multimorbidity among the workers, and multimorbidity patterns were identified with a network analysis. RESULTS The overall prevalence of multimorbidity was 13.7% (302/1704). Logistic regression indicated that age, income, regular work, and obesity were significant factors influencing multimorbidity. Network analysis results revealed that chronic diseases clustered into three groups: (1) cardiometabolic multimorbidity (hypertension, dyslipidemia, diabetes, coronary heart disease, and stroke), (2) musculoskeletal multimorbidity (arthritis and osteoporosis), and (3) unclassified diseases (depression, chronic liver disease, thyroid disease, asthma, cancer, and chronic kidney disease). CONCLUSIONS The findings revealed that several socioeconomic and behavioral factors were associated with multimorbidity among shift workers, indicating the need for policy development related to work schedule modification. Further organization-level screening and intervention programs are needed to prevent and manage multimorbidity among shift workers. We also recommend longitudinal studies to confirm the effects of job-related factors and health behaviors on multimorbidity among shift workers in the future.
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Affiliation(s)
- Hye Chong Hong
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Young Man Kim
- College of Nursing, Jeonbuk National University, Jeonju, Republic of Korea
- Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Republic of Korea
- Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Republic of Korea
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Albakri U, Smeets N, Drotos E, Kant IJ, Gabrio A, Meertens R. Sleep quality and the need for recovery among nurses working irregular shifts: A cross-sectional study. Work 2024:WOR230500. [PMID: 38848155 DOI: 10.3233/wor-230500] [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: 06/09/2024] Open
Abstract
BACKGROUND Shift work affects the mental and physical health of nurses, yet the effect of working irregular shifts on sleep and its association with the need for recovery is under-explored. OBJECTIVE The purpose of this study was to investigate the sleep quality of nurses working irregular shifts, including night shifts, and to determine whether sleep quality is associated with the need for recovery. METHODS This cross-sectional study included 405 nurses working irregular shifts. Data were collected using an online questionnaire that included sociodemographic characteristics, the Sleep-Wake Experience List, sleep problems, sleep duration, and the Need for Recovery scale. Data analyses included descriptive statistics, chi-square tests, t-tests, logistic and multiple linear regressions. RESULTS Nurses who worked irregular shifts had poor sleep quality. Those who also worked night shifts, had significantly poorer sleep quality and experienced more difficulties in daily functioning than those who did not work night shifts. Sleep quality was significantly associated with the need for recovery and this remained so after controlling for confounding variables (β= .554, p = .001). CONCLUSION The findings indicate that in nurses who work irregular shifts, the sleep quality is low. In this group, the sleep quality in nurses who work night shifts is lower than in nurses who do not work night shifts. Furthermore, better sleep quality was associated with lower need for recovery. These findings suggest that improving sleep quality in nurses working irregular shifts may lower their need for recovery, which may improve health, and reduce burnout and sickness absence.
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Affiliation(s)
- Uthman Albakri
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Public Health, Faculty of Applied Medical Sciences, Albaha University, Albaha, Saudi Arabia
| | - Nick Smeets
- Department Human Resources. Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Elizabeth Drotos
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - IJmert Kant
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Andrea Gabrio
- Methodology and Statistics, School for Public Health and Prim Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Ree Meertens
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Salzman S, Wiser A, Morris MB, Veksler BZ, Byrd K, Wagner T, Prestwood J. Silver Lining Study: Missileer Fatigue Mitigation During 2020 Coronavirus Pandemic. Mil Med 2024; 189:e1201-e1209. [PMID: 37936257 DOI: 10.1093/milmed/usad415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/22/2023] [Accepted: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
INTRODUCTION The U.S. Air Force's Intercontinental Ballistic Missile (ICBM) force stands ready to launch weapons 365 days per year. Since its inception, missileers vigilantly operate launch consoles on a 3-day cycle: minimum 24-hour alert-shift/24-hour travel-admin/24-hour off, leading to concerns that health, morale, and alertness are chronically impacted. In 2020, a Missileer Occupational Health Assessment (OHA) revealed 76% of respondents struggle with being rested for duty and 29% of respondents never feel adequately rested for duty. Later that year, 20th Air Force initiated long-duration operations to safeguard from the SARS CoV-2 (COVID-19) Pandemic, resulting in increased operations tempo, and exacerbating crew fatigue.341st Operations Group and 341st Medical Group at Malmstrom Air Force Base enacted interventions to mitigate crew fatigue and support continued readiness during pandemic operations. They recorded, analyzed, and compiled findings in this report, including recommendations for long-term ICBM operations at Missile Wings. MATERIALS AND METHODS All participants were Nuclear and Missile Operations Officers, or missileers, were continuously evaluated with qualitative and quantitative measures to ensure safety of the force during a period of unprecedented change. Interventions implemented and evaluated during the 9-month period included: environmental modifications, scheduling changes, and crew education on fatigue management, nutrition, anticipatory sleep preparation, and fitness. Most notably, the 341st Operations Group examined various 3-person and 4-person shift-length and alert duration schedules. Psychomotor vigilance testing results validated safety of operators and delta between pre- and post-shift measurements. Crew force readiness trends were analyzed for force-health awareness. Pre- and post-OHA results were compared for subjective changes. Fatigue and health-related outcomes were collected from a safety monitoring effort during standard and COVID-19 operations at 341st Missile Wing. RESULTS Findings from qualitative and quantitative data indicate the optimal schedule is a 3-week cycle:7-day alert/7-day recovery/7-day training-administrative utilizing 4-member or 3-member crews for low tempo operations. Crews experimented with shift-lengths of 24hrs-on/24hrs-off, 16hrs-on/8hrs-off, and 12hrs-on/12hrs-off. Maximum safe alert duration is 7 days due to task fatigue onset between 8 and 10 days. Short and long duration Duties Not to Include Flight (DNIF) (also known as Duties Not to Include Alert (DNIA) among missileers) rates decreased from the first to last month of the period by 74.6% and 79.2%, respectively. The number of alerts missed per month decreased 86% from baseline. The 2021 OHA found a 7% decline in members seeking separation, and absence of sleep, fatigue, and physical or mental health as missileer concerns. CONCLUSIONS This analysis has identified a sustainable alert rotation of 7/7/7 with emphasis on protected recovery and training time and has been continued after concluding pandemic operations, creating consistent schedule stability where there once was none. If executed properly, this alert rotation, regardless of shift-length selected, has potential to improve trust between crews and leadership, provides adequate recovery time between alerts to maintain health, and improves wellness, family stability, morale, unit cohesion, and crew force retention. Notably, all Air Force Global Strike Missile Operations Groups adjusted scheduling practices to align with these findings.
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Affiliation(s)
- Sandra Salzman
- 341st Missile Wing, Malmstrom Air Force Base, MT 50405, USA
| | - Ashley Wiser
- 341st Missile Wing, Malmstrom Air Force Base, MT 50405, USA
| | - Megan B Morris
- Airman Systems Directorate, Air Force Research Laboratory, Wright Patterson Air Force Base, OH 45433, USA
| | | | - Kevin Byrd
- 341st Missile Wing, Malmstrom Air Force Base, MT 50405, USA
| | - Tyler Wagner
- 341st Missile Wing, Malmstrom Air Force Base, MT 50405, USA
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Fattori A, Comotti A, Barnini T, Di Tecco C, Laurino M, Bufano P, Ciocan C, Serra D, Ferrari L, Bonzini M. Exploring workability in an older working population: associations with cognitive functioning, sleep quality, and technostress. Front Public Health 2024; 12:1303907. [PMID: 38741912 PMCID: PMC11089127 DOI: 10.3389/fpubh.2024.1303907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/12/2024] [Indexed: 05/16/2024] Open
Abstract
Objective This observational study investigates workability and its associations with cognitive functioning, sleep quality and technostress among an older working population, also shedding light on potential differences between two occupational categories with different work schedules. Methods Workers aged over 50, employed in different working sectors (banking/finance, chemical and metal-mechanic industry) were administered a self- report questionnaire including Work Ability Index (WAI), cognitive tests (Stroop Color Task, Corsi Blocks, Digit Span), sleep quality questionnaires (Pittsburgh Sleep Quality Index-PSQI; Insomnia Severity Index-ISI; Ford Insomnia Response to Stress Test-FIRST) and technostress scale. Linear regression models evaluated associations among variables, interaction effects investigated potential moderators. Results A total of 468 aged workers categorized as white (WCWs; N = 289, 62%) or blue collars (BCWs; N = 179, 38%) were enrolled; most BCWs (N = 104; 58%) were night shift workers. WCWs reported higher workability, cognitive functioning, sleep quality and lower technostress (except for invasion and privacy subscales) than BCWs. Associations between cognitive functioning and workability were statistically significant only for BCWs [slopes equal to 0.2 (0.33), 0.8 (0.34), -0.02 (0.001) for Memory Span Corsi, Block Span Digit and Interference Speed respectively]; additionally, sleep quality significantly moderated this association (p = 0.007). Higher levels of technostress were associated with lower workability, and this relationship was stronger for BCWs. Conclusion The aging of the workforce has important implications for occupational health and safety. Our findings suggest potential interventions and protective measures to promote older workers' wellbeing; blue-collar workers particularly should benefit from tailored intervention to sustain workability and prevent technostress, considering the role of healthy sleep habits promotion.
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Affiliation(s)
- Alice Fattori
- Occupational Medicine Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Comotti
- Occupational Medicine Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Teresa Barnini
- Occupational Medicine Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristina Di Tecco
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Marco Laurino
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Pasquale Bufano
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Catalina Ciocan
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Daniele Serra
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Luca Ferrari
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Matteo Bonzini
- Occupational Medicine Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
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Chen S, Liu Q, Yan J. The influence of shift work: A bibliometric analysis of research progress and frontiers on health effects. Chronobiol Int 2024; 41:577-586. [PMID: 38588406 DOI: 10.1080/07420528.2024.2337885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
Shift work has been found to disrupt the circadian system, leading to negative health effects. The objective of this study was to assess the progress and frontiers in research on the health-related influence of shift work. The study analyzed 3,696 data points from Web of Science, using the bibliometric software CiteSpace to visualize and analyze the field. The results showed a steady increase in annual publications, particularly in the last 5 years, with a rapid increase in publications from China. The United States contributed the most to the number of publications and worldwide collaborations. The most prolific institution and author were the Brigham and Women's Hospital and Professor Bjorn Bjorvatn, respectively. The Journal of Chronobiology International ranked at the top and focused primarily on shift worker research. In the first decade of study, the primary focus was on the associations between shift work and cardiovascular disease and metabolic disorders. Over time, research on the health effects of shift work has expanded to include cancer and mental health, with subsequent studies investigating molecular mechanisms. This study provides a comprehensive and intuitive analysis of the negative health impacts of shift work. It highlights existing research hotspots and provides a roadmap for future studies. Further research is needed to explore the adverse health consequences and related mechanisms of shift work exposure, as well as interventions to mitigate its health effects.
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Affiliation(s)
- Shibo Chen
- Department of Blood Purification Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qingquan Liu
- Department of Blood Purification Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jianjun Yan
- Department of Blood Purification Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Jankowiak S, Rossnagel K, Bauer J, Schulz A, Liebers F, Latza U, Romero Starke K, Seidler A, Nübling M, Riechmann-Wolf M, Letzel S, Wild P, Arnold N, Beutel M, Pfeiffer N, Lackner K, Münzel T, Schulze A, Hegewald J. Night shift work and cardiovascular diseases among employees in Germany: five-year follow-up of the Gutenberg Health Study. Scand J Work Environ Health 2024; 50:142-151. [PMID: 38258536 PMCID: PMC11006091 DOI: 10.5271/sjweh.4139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVE This study aimed to determine if there is an increased risk of incident cardiovascular diseases (CVD) resulting from cumulative night shift work in the German population-based Gutenberg Health Study (GHS). METHODS We examined working participants of the GHS at baseline and after five years. Cumulative night shift work in the 10 years before baseline was assessed and categorized as low (1-220 nights ≙ up to 1 year), middle (221-660 nights ≙ 1-3 years), and high (>660 nights ≙ more than 3 years) night shift exposure. Hazard ratios (HR) were estimated for incident "quality-assured CVD events" using Cox proportional hazard models. RESULTS At baseline, 1092 of 8167 working participants performed night shift work. During the follow-up, 202 incident cardiovascular events occurred. The crude incidence rates for CVD per 1000 person-years were 6.88 [95% confidence interval (CI) 4.80-9.55] for night shift workers and 5.19 (95% CI 4.44-6.04) for day workers. Cumulative incidence curves showed a higher cumulative incidence in workers exposed to night shift work compared to day workers after five years. The adjusted HR for incident CVD events were 1.26 (95% CI 0.68-2.33), 1.37 (95% CI 0.74-2.53) and 1.19 (95% CI 0.67-2.12) for employees in the low, middle and high night shift categories compared to employees without night shift work, respectively. CONCLUSIONS The observed tendencies indicate that night shift work might be negatively associated with cardiovascular health. We expect the continued follow-up will clarify the long-term impact of night shift work.
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Romanenko M, Schuster J, Piven L, Synieok L, Dubiley T, Bogomaz L, Hahn A, Müller M. Association of diet, lifestyle, and chronotype with metabolic health in Ukrainian adults: a cross-sectional study. Sci Rep 2024; 14:5143. [PMID: 38429516 PMCID: PMC10907368 DOI: 10.1038/s41598-024-55715-0] [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: 06/27/2023] [Accepted: 02/27/2024] [Indexed: 03/03/2024] Open
Abstract
Morning chronotypes are associated with healthier metabolic profiles and lifestyles compared to evening chronotypes. However, limited research examined the relationship between chronotype, dietary intake, and metabolic health using accurate measures such as food records. This cross-sectional study aimed to investigate the association between chronotype, dietary intake, and metabolic health markers in a cohort of Ukrainian individuals. Chronotypes were determined using the Morningness-Eveningness Questionnaire (MEQ) in 110 healthy to obese individuals (30-75 years) without type 2 diabetes. Dietary intake was derived from weighed seven days food diaries, anthropometrics and blood markers of glucose and lipid metabolism were measured. Morning chronotypes were significantly older and exhibited distinct dietary patterns, including lower intake of fat and animal protein and higher intake of carbohydrates when compared to evening chronotypes (p < 0.01). Higher MEQ scores, reflecting a tendency toward a morning chronotype, were associated with lower BMI, waist circumference, fasting triglycerides, and glucose (p < 0.05). Further, being of morning chronotype predicted better overall metabolic health. These associations remained significant after adjusting for confounders. The findings suggest that morning chronotypes have a different dietary pattern characterized by a more balanced diet and favorable metabolic profile. Synchronizing daily routines with morning preferences could positively influence metabolic health.
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Affiliation(s)
- Mariana Romanenko
- D.F. Chebotarev State Institute of Gerontology, NAMS of Ukraine, Vyshgorodska Str. 67, Kyiv, 04114, Ukraine.
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, 30167, Hannover, Germany.
| | - Julius Schuster
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, 30167, Hannover, Germany
| | - Liubov Piven
- D.F. Chebotarev State Institute of Gerontology, NAMS of Ukraine, Vyshgorodska Str. 67, Kyiv, 04114, Ukraine
| | - Liudmyla Synieok
- D.F. Chebotarev State Institute of Gerontology, NAMS of Ukraine, Vyshgorodska Str. 67, Kyiv, 04114, Ukraine
| | - Tetyana Dubiley
- D.F. Chebotarev State Institute of Gerontology, NAMS of Ukraine, Vyshgorodska Str. 67, Kyiv, 04114, Ukraine
| | - Liudmyla Bogomaz
- D.F. Chebotarev State Institute of Gerontology, NAMS of Ukraine, Vyshgorodska Str. 67, Kyiv, 04114, Ukraine
| | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, 30167, Hannover, Germany
| | - Mattea Müller
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, 30167, Hannover, Germany
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Dong Y, Wu X, Dong Y, Li Y, Qiu K. Alterations of functional brain activity and connectivity in female nurses working on long-term shift. Nurs Open 2024; 11:e2118. [PMID: 38436535 PMCID: PMC10910870 DOI: 10.1002/nop2.2118] [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: 05/11/2023] [Revised: 01/22/2024] [Accepted: 02/07/2024] [Indexed: 03/05/2024] Open
Abstract
AIM To investigate the alterations of functional brain activity and connectivity in female nurses working on long-term shifts and explore their correlations with work-related psychological traits. DESIGN An exploratory cross-sectional study. METHODS Thirty-five female nurses working on long-term shifts (shift nurses) and 35 female nurses working on fixed days (fixed nurses) were enrolled. After assessing the work-related psychological traits, including burnout, perceived stress, anxiety, and depression of nurses, the fractional amplitude of low-frequency fluctuations (fALFF) and region of interest (ROI)-based functional connectivity (FC) analyses were performed to investigate the differences of brain spontaneous activity and functional connectivity between these two groups of nurses. Thereafter, correlations between the functional brain parameters (fALFF and FC) and clinical metrics were investigated among the shift nurses. RESULTS Compared to fixed nurses, shift nurses had higher burnout, perceived stress and depression scores, lower fALFF in the right dorsolateral prefrontal cortex (dlPFC), left and right superior parietal lobule (SPL), bilateral anterior cingulate cortex (ACC), and higher fALFF in the right superior/middle temporal gyrus, as well as decreased FC between the right dlPFC (the selected ROI) and bilateral ACC, left and right inferior frontal/orbitofrontal gyrus (IFG/IOFG), right SPL, and left middle occipital gyrus (voxel-level p < 0.001, cluster level p < 0.05, GRF correction). Correlation analyses demonstrated that the fALFF value of the right dlPFC was significantly correlated with the burnout and anxiety scores, the FC value of the right dlPFC-right SPL was correlated with the perceived stress and burnout scores, the FC value of the right dlPFC-right IFG/IOFG was correlated with the burnout score in shift nurses (p < 0.05). CONCLUSION Shift nurses had work-related altered functional activity and connectivity in the right frontoparietal network, which provided objective and visualised evidence to clarify the hazards of long-term shift work on female nurses. PATIENT OR PUBLIC CONTRIBUTION Seventy nurses participated deeply as subjects in this study. These findings are expected to draw managers' attention to the harmful influences of shift work on nurses.
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Affiliation(s)
- Yujie Dong
- Department of NursingLeshan Vocational and Technical CollegeLeshanChina
| | - Xiaohong Wu
- Department of RadiologyLeshan Hospital of Traditional Chinese MedicineLeshanChina
| | - Yuqin Dong
- Department of NursingLeshan Vocational and Technical CollegeLeshanChina
| | - Yuwei Li
- Department of NursingLeshan Vocational and Technical CollegeLeshanChina
| | - Ke Qiu
- Department of NursingLeshan Vocational and Technical CollegeLeshanChina
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11
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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.
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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
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12
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Redfern N, Bilotta F. Fatigue in anesthesia workers. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ELSEVIER) 2024; 74:744462. [PMID: 37690608 PMCID: PMC10877323 DOI: 10.1016/j.bjane.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Affiliation(s)
- Nancy Redfern
- Newcastle upon Tyne Hospitals, Department of Anaesthesia, Newcastle upon Tyne, UK.
| | - Federico Bilotta
- "Sapienza" University of Rome, Department of Anesthesiology and Critical Care, Rome, Italy
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13
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Andra JV, Silveira CA, Terra FDS. Chronicity and its impact on workers' health: a call for concrete actions. Rev Bras Enferm 2023; 76Suppl 3:e76suppl301. [PMID: 38055532 DOI: 10.1590/0034-7167.202376suppl301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
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14
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Sletten TL, Weaver MD, Foster RG, Gozal D, Klerman EB, Rajaratnam SMW, Roenneberg T, Takahashi JS, Turek FW, Vitiello MV, Young MW, Czeisler CA. The importance of sleep regularity: a consensus statement of the National Sleep Foundation sleep timing and variability panel. Sleep Health 2023; 9:801-820. [PMID: 37684151 DOI: 10.1016/j.sleh.2023.07.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE To develop and present consensus findings of the National Sleep Foundation sleep timing and variability panel regarding the impact of sleep timing variability on health and performance. METHODS The National Sleep Foundation assembled a panel of sleep and circadian experts to evaluate the scientific evidence and conduct a formal consensus and voting procedure. A systematic literature review was conducted using the NIH National Library of Medicine PubMed database, and panelists voted on the appropriateness of 3 questions using a modified Delphi RAND/UCLA Appropriateness Method with 2 rounds of voting. RESULTS The literature search and panel review identified 63 full text publications to inform consensus voting. Panelists achieved consensus on each question: (1) is daily regularity in sleep timing important for (a) health or (b) performance? and (2) when sleep is of insufficient duration during the week (or work days), is catch-up sleep on weekends (or non-work days) important for health? Based on the evidence currently available, panelists agreed to an affirmative response to all 3 questions. CONCLUSIONS Consistency of sleep onset and offset timing is important for health, safety, and performance. Nonetheless, when insufficient sleep is obtained during the week/work days, weekend/non-work day catch-up sleep may be beneficial.
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Affiliation(s)
- Tracey L Sletten
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Matthew D Weaver
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Russell G Foster
- Sleep & Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - David Gozal
- Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, USA
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Till Roenneberg
- Institutes for Occupational, Social, and Environmental Medicine and Medical Psychology, LMU Munich, Munich, Germany
| | - Joseph S Takahashi
- Department of Neuroscience, The University of Texas Southwestern Medical Center, Dallas, Texas, USA; Howard Hughes Medical Institute, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Fred W Turek
- Center for Sleep and Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, Illinois, USA
| | - Michael V Vitiello
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Michael W Young
- Laboratory of Genetics, The Rockefeller University, New York City, New York, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.
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15
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de Melo Gomides L, Abreu MNS, Assunção AÁ. Long working hours and self-rated health in the national Brazilian working population: gender and employment status differences, 2019. BMC Public Health 2023; 23:2095. [PMID: 37880646 PMCID: PMC10601203 DOI: 10.1186/s12889-023-16973-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND The regulation of working hours is governed by legal standards in formal employment. While the association between long working hours and various health outcomes has been extensively studied, there is limited evidence regarding Brazil. The objective of this study was to investigate the association among working hours, employment status, and self-rated health (SRH), taking into account differences between men and women in a national representative sample of the working population in Brazil. METHODS A cross-sectional study was conducted among a representative sample of 33,713 workers in Brazil to assess self-rated health (SRH). We examined the associations between working hours and employment status, categorizing working hours as standard (40-44 h per week) or long (> 44 h per week), and employment status as formal or informal. Logistic regression models were employed, adjusting for sociodemographic, occupational characteristics, and health behaviors. Probabilities of negative SRH were calculated for men and women in different exposure profiles. Results were stratified by gender, and 95% confidence intervals (CIs) were applied to the findings. RESULTS The prevalence of long working hours was higher among informal workers for both men and women. Adjusted odds ratio (AOR) results revealed that informal employment (AORwomen = 1.53; 95% CI: 1.13-2.07 and AORmen = 1.55; 95% CI: 1.22-1.96) and long working hours (AORwomen = 1.23; 95% CI: 1.06-1.43 and AORmen = 1.14; 95% CI: 1.00-1.30) were independently associated with negative SRH. Significant interactions between long working hours and informal employment were observed. Among individuals with the same exposure profile, women who engaged in long working hours had a higher probability of reporting negative SRH compared to men. CONCLUSIONS The results of this study are in line with the literature, as differences between men and women in the likelihood of negative self-rated health were observed. The adverse health effects underscore the importance of implementing intersectoral actions to inform the revision of regulations concerning weekly working hours and the expansion of informal employment in low- and middle-income countries.
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Affiliation(s)
- Luciana de Melo Gomides
- Graduate Program in Public Health, Department of Preventive and Social Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
- Institute of Pure and Applied Sciences. Health and Safety Engineering, University of Itajubá, Itabira, MG, Brazil.
| | - Mery Natali Silva Abreu
- Department of Applied Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ada Ávila Assunção
- Graduate Program in Public Health, Department of Preventive and Social Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
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16
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Seo JW, Lee J, Jeon S, Hwang Y, Kim J, Lee S, Kim SJ. Fatigue and somatization in shift-workers: Effects of depression and sleep. J Psychosom Res 2023; 173:111467. [PMID: 37619432 DOI: 10.1016/j.jpsychores.2023.111467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/12/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE We investigated the differences in fatigue and somatization between shift and non-shift workers and explored the effects of sleep and depression on fatigue and somatization in shift workers. METHODS In total, 4543 shift workers and 2089 non-shift workers completed self-reported questionnaires. The Center for Epidemiologic Studies Depression Scale (CESD), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), and Somatization subscale of the Symptom Checklist 90-item version (SCL-SOM) were used to measure depression, sleep quality, fatigue, and somatization, respectively. Fatigue and somatization were compared between shift and non-shift workers after controlling for different sets of covariates. RESULTS Compared to non-shift workers, shift workers reported higher FSS (mean difference: 2.19 ± 0.30, p < 0.01) and SCL-SOM (mean difference: 1.77 ± 0.21, p < 0.01) scores after controlling for age, gender, presence of medical illness, occupational category, monthly income, length of service, and weekly working hours. The between-group difference in FSS score was no longer significant after additionally controlling for CES-D (p = 0.15) or PSQI (p = 0.18). The between-group difference in SCL-SOM score showed only non-significant trends after additionally controlling for CES-D (p = 0.09) or PSQI (p = 0.07). The group difference in SCL-SOM scores disappeared after controlling for both CES-D and PSQI scores (p = 0.99). CONCLUSIONS Shift workers had higher fatigue and somatization levels than non-shift workers and the group difference was associated with disturbed sleep and depressed mood in shift workers.
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Affiliation(s)
- Jin Won Seo
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jooyoung Lee
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yunjee Hwang
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jichul Kim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Somi Lee
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea.
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17
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Bell CN, Owens-Young JL, Thorpe RJ. Self-Employment, Working Hours, and Hypertension by Race/Ethnicity in the USA. J Racial Ethn Health Disparities 2023; 10:2207-2217. [PMID: 36068481 DOI: 10.1007/s40615-022-01400-9] [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: 05/10/2022] [Revised: 08/12/2022] [Accepted: 08/19/2022] [Indexed: 10/14/2022]
Abstract
There is a large literature on work-related characteristics and hypertension, but studies on self-employment, longer working hours, and hypertension are mixed. Assessments of self-employment should be extended to account for people with part-time self-employment (i.e., employees also earning income from self-employment). The aim of this study was to determine the association of different types of self-employment with hypertension among adults by race/ethnicity and to assess whether longer working hours moderated these associations. Using data from the 2007-2018 National Health and Nutrition Examination Survey, measured hypertension (blood pressure ≥ 140/90 mm Hg) was assessed and employment categories included employees, part-time self-employment (i.e., employee with self-employment income), or full-time self-employment. Modified Poisson regressions and multiplicative interaction terms were used. Having full-time self-employment was associated with lower relative risk (RR) of hypertension compared to employees among Black (RR = 0.77, 95% confidence interval (CI) = 0.61-0.96) and White men (RR = 0.77, 0.65-0.93) compared to employees. Full-time self-employment was associated with higher risk of hypertension (RR = 1.36, 95% CI = 1.01-1.82) compared to employees among Hispanic women, while part-time self-employment was associated with lower risk (RR = 0.69, 95% CI = 0.48-0.98). Among White women, part-time self-employment was associated with higher relative risk of hypertension (RR = 1.27, 95% CI = 1.05-1.53) compared to employees. There were significant interactions between employment categories and longer working hours among Hispanic women as well as Black women and men. The results suggest that self-employment categories and longer working hours impact hypertension by race/ethnicity and sex. Because the number of full-time and part-time self-employed adults has increased, the health of this particular subgroup of workers should be further addressed.
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Affiliation(s)
- Caryn N Bell
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
| | | | - Roland J Thorpe
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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18
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Gonzalez-Garcia J, Mayordomo-Colunga J, Gorostidi M, Gomez-Gonzalez B, Canteli E, Rey C. Non-dipping blood pressure pattern in pediatricians during on-duty. Nefrologia 2023; 43:616-621. [PMID: 36564227 DOI: 10.1016/j.nefroe.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/30/2022] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION People with a reduced nighttime dip in blood pressure have an increased cardiovascular risk. Our objective was to describe the different patterns in blood pressure (BP) among pediatricians who work in long on-duty shifts in relation with sex, medical rank and sleeping time. METHODS Descriptive, cross-sectional, two-center study. On duty pediatric Resident physicians and pediatric Consultants were recruited between January 2018 and December 2021. RESULTS Fifty-one physicians were included in the study (78.4% female, 66.7% Resident physicians). Resident physicians had a higher night/day ratio (0.91 vs 0.85; p<0.001) and a shorter nighttime period (3.87 vs 5.41, p<0.001) than Consultants. Physicians sleeping less than 5h had a higher night/day ratio (0.91 vs 0.87, p=0.014). Being a Resident showed a ∼4.5-fold increased risk of having a non-dipping BP pattern compared to Consultants. CONCLUSION We found a potential link between both being a Resident and, probably, having shorter sleeping time, and the non-dipping BP pattern in physicians during prolonged shifts.
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Affiliation(s)
| | - Juan Mayordomo-Colunga
- Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Network Biomedical Research Center, Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain; Health Research Institute of the Principado de Asturias, Oviedo, Spain
| | - Manuel Gorostidi
- Department of Nephrology, Hospital Universitario Central de Asturias, Oviedo, Spain; Department of Nephrology, University of Oviedo, Oviedo, Spain
| | | | - Eva Canteli
- Department of Nephrology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Corsino Rey
- Health Research Institute of the Principado de Asturias, Oviedo, Spain; Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain; Department of Pediatrics, University of Oviedo, Oviedo, Spain; Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS), Institute of Health Carlos III, Madrid, Spain
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Demareva V, Zayceva I, Viakhireva V, Zhukova M, Selezneva E, Tikhomirova E. Home-Based Dynamics of Sleepiness-Related Conditions Starting at Biological Evening and Later (Beyond Working). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6641. [PMID: 37681781 PMCID: PMC10487394 DOI: 10.3390/ijerph20176641] [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: 07/15/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023]
Abstract
Shift work requires round-the-clock readiness to perform professional duties, and the workers' performance highly depends on their sleepiness level, which can be underestimated during a shift. Various factors, including the time of day, can influence sleepiness in shift workers. The objective of this study was to explore the dynamics of sleepiness-related conditions assessed through heart rate variability analysis, starting from the biological evening and continuing in vivo (at home), without the need for artificial alertness support. The participants solely performed regular evening household duties. A total of 32 recordings were collected from the Subjective Sleepiness Dynamics Dataset for analysis. At 8:00 p.m. and every 30 min thereafter, the participants completed cyclic sleepiness scales (the KSS and the SSS) until the time they went to bed, while their heart rate was recorded. The results of the study indicated that during the biological evening, high sleepiness is associated with a 'stressed' condition characterized by higher sympathetic activation. Later on, it is associated with a 'drowsy' condition characterized by higher parasympathetic activation and a decline in heart rate variability. Our findings provide evidence that the type of condition experienced during high sleepiness depends on the biological time. This should be taken into account when managing work regimes in shift work and developing alertness detectors.
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Affiliation(s)
- Valeriia Demareva
- Faculty of Social Sciences, Lobachevsky State University of Nizhny Novgorod, 603022 Nizhny Novgorod, Russia
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Debets MPM, Tummers FHMP, Silkens MEWM, Huizinga CRH, Lombarts KMJMH, van der Bogt KEA. Doctors' alertness, contentedness and calmness before and after night shifts: a latent profile analysis. HUMAN RESOURCES FOR HEALTH 2023; 21:68. [PMID: 37605244 PMCID: PMC10441714 DOI: 10.1186/s12960-023-00855-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 08/08/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND While night shifts are crucial for patient care, they threaten doctors' well-being and performance. Knowledge of how the impact of night shifts differs for doctors is needed to attenuate the adverse effects of night shifts. This study aimed to obtain more precise insight into doctors' feelings surrounding night shift by: identifying profiles based on doctors' alertness, contentedness and calmness scores before and after night shifts (research question (RQ) 1); assessing how doctors' pre- and post-shift profiles change (RQ2); and determining associations of doctors' demographics and shift circumstances with alertness, contentedness and calmness change (RQ3). METHODS Latent Profile Analysis using doctors' pre- and post-shift self-rated alertness, contentedness and calmness scores was employed to identify pre- and post-shift profiles (RQ1). A cross-tabulation revealed pre- and post-shift profile changes (RQ2). Multiple regressions determined associations of demographics (i.e. age, sex, specialty) and night shift circumstances (i.e. hours worked pre-call, hours awake pre-call, shift duration, number of consecutive shifts, total hours of sleep) with alertness, contentedness and calmness change (RQ3). RESULTS In total, 211 doctors participated with a mean age of 39.8 ± 10 years; 47.4% was male. The participants included consultants (46.4%) and trainees (53.6%) of the specialties surgery (64.5%) and obstetrics/gynaecology (35.5%). Three pre-shift (Indifferent, Ready, Engaged) and four post-shift profiles (Lethargic, Tired but satisfied, Excited, Mindful) were found. Most doctors changed from Ready to Tired but satisfied, with alertness reducing most. Age, specialty, sleep, shift duration and the number of consecutive shifts associated with alertness, contentedness and calmness changes. CONCLUSIONS The results provided nuanced insight into doctors' feelings before and after night shifts. Future research may assess whether specific subgroups benefit from tailored interventions.
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Affiliation(s)
- Maarten P M Debets
- Research Group Professional Performance and Compassionate Care, Department of Medical Psychology, Amsterdam University Medical Centres, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Fokkedien H M P Tummers
- Centre for Human Drug Research, Leiden, The Netherlands
- Department of Gyneacology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Milou E W M Silkens
- Department of Health Services Research and Management, City University of London, London, United Kingdom
| | - Coen R H Huizinga
- Centre for Human Drug Research, Leiden, The Netherlands
- Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - Kiki M J M H Lombarts
- Research Group Professional Performance and Compassionate Care, Department of Medical Psychology, Amsterdam University Medical Centres, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Koen E A van der Bogt
- Centre for Human Drug Research, Leiden, The Netherlands
- Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Surgery, Haaglanden Medical Centre, The Hague, The Netherlands
- University Vascular Centre Leiden, The Hague, The Netherlands
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21
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Frosch ZAK, Hasler J, Handorf E, DuBois T, Bleicher RJ, Edelman MJ, Geynisman DM, Hall MJ, Fang CY, Lynch SM. Development of a Multilevel Model to Identify Patients at Risk for Delay in Starting Cancer Treatment. JAMA Netw Open 2023; 6:e2328712. [PMID: 37578796 PMCID: PMC10425824 DOI: 10.1001/jamanetworkopen.2023.28712] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/05/2023] [Indexed: 08/15/2023] Open
Abstract
Importance Delays in starting cancer treatment disproportionately affect vulnerable populations and can influence patients' experience and outcomes. Machine learning algorithms incorporating electronic health record (EHR) data and neighborhood-level social determinants of health (SDOH) measures may identify at-risk patients. Objective To develop and validate a machine learning model for estimating the probability of a treatment delay using multilevel data sources. Design, Setting, and Participants This cohort study evaluated 4 different machine learning approaches for estimating the likelihood of a treatment delay greater than 60 days (group least absolute shrinkage and selection operator [LASSO], bayesian additive regression tree, gradient boosting, and random forest). Criteria for selecting between approaches were discrimination, calibration, and interpretability/simplicity. The multilevel data set included clinical, demographic, and neighborhood-level census data derived from the EHR, cancer registry, and American Community Survey. Patients with invasive breast, lung, colorectal, bladder, or kidney cancer diagnosed from 2013 to 2019 and treated at a comprehensive cancer center were included. Data analysis was performed from January 2022 to June 2023. Exposures Variables included demographics, cancer characteristics, comorbidities, laboratory values, imaging orders, and neighborhood variables. Main Outcomes and Measures The outcome estimated by machine learning models was likelihood of a delay greater than 60 days between cancer diagnosis and treatment initiation. The primary metric used to evaluate model performance was area under the receiver operating characteristic curve (AUC-ROC). Results A total of 6409 patients were included (mean [SD] age, 62.8 [12.5] years; 4321 [67.4%] female; 2576 [40.2%] with breast cancer, 1738 [27.1%] with lung cancer, and 1059 [16.5%] with kidney cancer). A total of 1621 (25.3%) experienced a delay greater than 60 days. The selected group LASSO model had an AUC-ROC of 0.713 (95% CI, 0.679-0.745). Lower likelihood of delay was seen with diagnosis at the treating institution; first malignant neoplasm; Asian or Pacific Islander or White race; private insurance; and lacking comorbidities. Greater likelihood of delay was seen at the extremes of neighborhood deprivation. Model performance (AUC-ROC) was lower in Black patients, patients with race and ethnicity other than non-Hispanic White, and those living in the most disadvantaged neighborhoods. Though the model selected neighborhood SDOH variables as contributing variables, performance was similar when fit with and without these variables. Conclusions and Relevance In this cohort study, a machine learning model incorporating EHR and SDOH data was able to estimate the likelihood of delays in starting cancer therapy. Future work should focus on additional ways to incorporate SDOH data to improve model performance, particularly in vulnerable populations.
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Affiliation(s)
- Zachary A. K. Frosch
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
- Cancer Prevention and Control Research Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Jill Hasler
- Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Elizabeth Handorf
- Cancer Prevention and Control Research Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
- Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Tesla DuBois
- Cancer Prevention and Control Research Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Richard J. Bleicher
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Martin J. Edelman
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Daniel M. Geynisman
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Michael J. Hall
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
- Cancer Prevention and Control Research Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Carolyn Y. Fang
- Cancer Prevention and Control Research Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Shannon M. Lynch
- Cancer Prevention and Control Research Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
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22
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Moon D, Kim H. The impacts of working time flexibilization on occupational safety and health: an expert survey. Ann Occup Environ Med 2023; 35:e20. [PMID: 37928376 PMCID: PMC10622249 DOI: 10.35371/aoem.2023.35.e20] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/21/2023] [Accepted: 06/21/2023] [Indexed: 11/07/2023] Open
Abstract
The policy proposal by the current Korean government that proposes flexible overtime rules is causing social controversy. This study has explored the 612 experts' opinions on the occupational safety and health impacts of the policy using an online self-report survey. They expected short-term overwork (87.25%), overwork inequality (86.44%), irregular working hours (84.31%), chronic overwork (84.15%), long working hours (83.66%), and unpredictability of working hours (81.86%) as a result of the policy change. They also responded that the policy change would increase industrial accident deaths (87.25%), mental illnesses (87.09%), deaths due to overwork or cardiovascular diseases (83.84%), and accidents (83.33%). They disagreed that the government's flexibilization policy, while agreeing that the necessity of policies on regulating night work (94.77%), guaranteeing wages to eliminate overtime (90.36%), establishing working time regulations for the bogus self-employed (82.84%), and applying the 52-hour workweek system to all workplaces (76.47%). These expert opinions are consistent with previous research on the health effects of working hours.
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Affiliation(s)
- Daseul Moon
- Center for Labour and Health Research, People's Health Institute, Seoul, Korea
- Serious Accidents Scholars and Experts Network, Seoul, Korea
| | - Hyunjoo Kim
- Serious Accidents Scholars and Experts Network, Seoul, Korea
- Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
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Selander K, Korkiakangas E, Toivanen M, Yli-Kaitala K, Kangas H, Nevanperä N, Laitinen J. Engaging Leadership and Psychological Safety as Moderators of the Relationship between Strain and Work Recovery: A Cross-Sectional Study of HSS Employees. Healthcare (Basel) 2023; 11:healthcare11071045. [PMID: 37046972 PMCID: PMC10093905 DOI: 10.3390/healthcare11071045] [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: 02/23/2023] [Revised: 03/22/2023] [Accepted: 04/01/2023] [Indexed: 04/14/2023] Open
Abstract
Work in the health and social sector (HSS) is highly straining and therefore recovery from work needs to be promoted. Less is known on how job resources can be used to alleviate job strain and increase recovery from work. Thus, we analyzed the following: the association between job demands and work recovery; the connections of engaging leadership and psychological safety to recovery from work; and the moderating effects of engaging leadership and psychological safety on the relationship between strain and recovery from work. This cross-sectional study of 18,155 HSS and 4347 eldercare employees in 2020 using linear regression analysis showed that job strain (p < 0.001) and moral distress (p < 0.001) were associated with decreased recovery from work. Engaging leadership (p < 0.001) and psychologically safe work community (p < 0.001) enhanced recovery from work independently. Engaging leadership mitigated the harmful effect of job strain (p < 0.01) and moral distress (p < 0.05), and psychological safety mitigated the effect of job strain (p < 0.001), but not moral distress (p > 0.05). Thus, it is important to reduce job strain so that employees recover from work. Further job resources such as engaging leadership and psychological safety are important in themselves as they support recovery from work and employees' well-being, but also as they alleviate job demands.
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Affiliation(s)
- Kirsikka Selander
- Finnish Institute of Occupational Health, Työterveyslaitos, 70032 Kuopio, Finland
| | | | - Minna Toivanen
- Finnish Institute of Occupational Health, Työterveyslaitos, 00032 Helsinki, Finland
| | - Kirsi Yli-Kaitala
- Finnish Institute of Occupational Health, Työterveyslaitos, 00032 Helsinki, Finland
| | - Hilpi Kangas
- Finnish Institute of Occupational Health, Työterveyslaitos, 00032 Helsinki, Finland
| | - Nina Nevanperä
- Finnish Institute of Occupational Health, Työterveyslaitos, 90032 Oulu, Finland
| | - Jaana Laitinen
- Finnish Institute of Occupational Health, Työterveyslaitos, 90032 Oulu, Finland
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Bardhan R, Byrd T. Psychosocial Work Stress and Occupational Stressors in Emergency Medical Services. Healthcare (Basel) 2023; 11:healthcare11070976. [PMID: 37046903 PMCID: PMC10093884 DOI: 10.3390/healthcare11070976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023] Open
Abstract
Emergency medical service (EMS) professionals often experience work stress, which escalated during COVID-19. High job demand in the EMS profession may lead to progressive decline in physical and mental health. We investigated the prevalence of psychosocial job stress in the three levels of EMS: basic, advanced, and paramedic, before and during the COVID-19 pandemic. EMS professionals (n = 36) were recruited from EMS agencies following the Institutional Review Board approval. Participants took surveys on demographics, personal characteristics, chronic diseases, and work schedules. Job stress indicators, namely the effort–reward ratio (ERR) and overcommitment (OC), were evaluated from survey questionnaires using the effort–reward imbalance model. Associations of job stress indicators with age, sex, body mass index, and working conditions were measured by logistic regression. Psychosocial work stress was prevalent with effort reward ratio > 1 in 83% of participants and overcommitment scores > 13 in 89% of participants. Age, body mass index, and work hours showed strong associations with ERR and OC scores. The investigation findings suggested that a psychosocial work environment is prevalent among EMS, as revealed by high ERR, OC, and their correlation with sleep apnea in rotating shift employees. Appropriate interventions may be helpful in reducing psychosocial work stress in EMS professionals.
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25
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Amiri S. Longer working hours and musculoskeletal pain: a meta-analysis. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:1-16. [PMID: 35098904 DOI: 10.1080/10803548.2022.2036488] [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: 10/19/2022]
Abstract
Objectives. Musculoskeletal pain is the most common health problem in the workplace, and one of the most important risk factors for this pain is longer working hours. This study aimed to investigate the association between long working hours and musculoskeletal pain. Methods. Based on the keywords, two scientific sources - PubMed and Embase - were reviewed. The time limit search included articles that were published until May 2020 and only studies published in English were eligible. The results of the studies were combined based on random effects and pooled odds ratio (OR) reported. The degree of heterogeneity in all analyses was investigated and reported based on χ2 and I2 tests. Publishing bias was also measured using statistical tests. Results. Longer working hours are associated with increased musculoskeletal pain with OR = 1.11 and 95% confidence interval (CI) [1.08, 1.14]. The result was OR = 1.52 and 95% CI [1.14, 2.03] in men and OR = 1.11 and 95% CI [1.00, 1.24] in women. Conclusion. Long working hours are an important and threatening factor for musculoskeletal health. Therefore, this issue should be considered in health policy as well as treatment and prevention.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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26
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Ybañez WS, Bagamasbad PD. Krüppel-like factor 9 (KLF9) links hormone dysregulation and circadian disruption to breast cancer pathogenesis. Cancer Cell Int 2023; 23:33. [PMID: 36823570 PMCID: PMC9948451 DOI: 10.1186/s12935-023-02874-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/14/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Circadian disruption is an emerging driver of breast cancer (BCa), with epidemiological studies linking shift work and chronic jet lag to increased BCa risk. Indeed, several clock genes participate in the gating of mitotic entry, regulation of DNA damage response, and epithelial-to-mesenchymal transition, thus impacting BCa etiology. Dysregulated estrogen (17β-estradiol, E2) and glucocorticoid (GC) signaling prevalent in BCa may further contribute to clock desynchrony by directly regulating the expression and cycling dynamics of genes comprising the local breast oscillator. In this study, we investigated the tumor suppressor gene, Krüppel-like factor 9 (KLF9), as an important point of crosstalk between hormone signaling and the circadian molecular network, and further examine its functional role in BCa. METHODS Through meta-analysis of publicly available RNA- and ChIP-sequencing datasets from BCa tumor samples and cell lines, and gene expression analysis by RT-qPCR and enhancer- reporter assays, we elucidated the molecular mechanism behind the clock and hormone regulation of KLF9. Lentiviral knockdown and overexpression of KLF9 in three distinct breast epithelial cell lines (MCF10A, MCF7 and MDA-MB-231) was generated to demonstrate the role of KLF9 in orthogonal assays on breast epithelial survival, proliferation, apoptosis, and migration. RESULTS We determined that KLF9 is a direct GC receptor target in mammary epithelial cells, and that induction is likely mediated through coordinate transcriptional activation from multiple GC-responsive enhancers in the KLF9 locus. More interestingly, rhythmic expression of KLF9 in MCF10A cells was abolished in the highly aggressive MDA-MB-231 line. In turn, forced expression of KLF9 altered the baseline and GC/E2-responsive expression of several clock genes, indicating that KLF9 may function as a regulator of the core clock machinery. Characterization of the role of KLF9 using complementary cancer hallmark assays in the context of the hormone-circadian axis revealed that KLF9 plays a tumor-suppressive role in BCa regardless of molecular subtype. KLF9 potentiated the anti-tumorigenic effects of GC in E2 receptor + luminal MCF7 cells, while it restrained GC-enhanced oncogenicity in triple-negative MCF10A and MDA-MB-231 cells. CONCLUSIONS Taken together, our findings support that dysregulation of KLF9 expression and oscillation in BCa impinges on circadian network dynamics, thus ultimately affecting the BCa oncogenic landscape.
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Affiliation(s)
- Weand S. Ybañez
- grid.11134.360000 0004 0636 6193National Institute of Molecular Biology and Biotechnology, University of the Philippines Diliman, Quezon City, Metro Manila 1101 Philippines
| | - Pia D. Bagamasbad
- grid.11134.360000 0004 0636 6193National Institute of Molecular Biology and Biotechnology, University of the Philippines Diliman, Quezon City, Metro Manila 1101 Philippines
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Marsters CM, Stafl L, Bugden S, Gustainis R, Nkunu V, Reimer R, Fletcher S, Smith S, Bruton Joe M, Hyde C, Dance E, Ruzycki SM. Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review. BMJ Open 2023; 13:e064483. [PMID: 36813500 PMCID: PMC9950931 DOI: 10.1136/bmjopen-2022-064483] [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: 02/24/2023] Open
Abstract
OBJECTIVE Evidence is needed to guide organisational decision making about workplace accommodations for pregnant physicians. Our objective was to characterise the strengths and limitations of current research examining the association between physician-related occupational hazards with pregnancy, obstetrical and neonatal outcomes. DESIGN Scoping review. DATA SOURCES MEDLINE/PubMed, EMBASE, CINAHL/ EBSCO, SciVerse Scopus and Web of Science/Knowledge were searched from inception to 2 April 2020. A grey literature search was performed on 5 April 2020. The references of all included articles were hand searched for additional citations. ELIGIBILITY CRITERIA English language citations that studied employed pregnant people and any 'physician-related occupational hazards', meaning any relevant physical, infectious, chemical or psychological hazard, were included. Outcomes included any pregnancy, obstetrical or neonatal complication. DATA EXTRACTION AND SYNTHESIS Physician-related occupational hazards included physician work, healthcare work, long work hours, 'demanding' work, disordered sleep, night shifts and exposure to radiation, chemotherapy, anaesthetic gases or infectious disease. Data were extracted independently in duplicate and reconciled through discussion. RESULTS Of the 316 included citations, 189 were original research studies. Most were retrospective, observational and included women in any occupation rather than healthcare workers. Methods for exposure and outcome ascertainment varied across studies and most studies had a high risk of bias in data ascertainment. Most exposures and outcomes were defined categorically and results from different studies could not be combined in a meta-analysis due to heterogeneity in how these categories were defined. Overall, some data suggested that healthcare workers may have an increased risk of miscarriage compared with other employed women. Long work hours may be associated with miscarriage and preterm birth. CONCLUSIONS There are important limitations in the current evidence examining physician-related occupational hazards and adverse pregnancy, obstetrical and neonatal outcomes. It is not clear how the medical workplace should be accommodated to improve outcomes for pregnant physicians. High-quality studies are needed and likely feasible.
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Affiliation(s)
- Candace M Marsters
- Department of Neurology, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Lenka Stafl
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sarah Bugden
- Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | | | - Victoria Nkunu
- Department of Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Renee Reimer
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah Fletcher
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephanie Smith
- Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Moss Bruton Joe
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christine Hyde
- Department of Pediatrics, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Erica Dance
- Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Shannon M Ruzycki
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Skogstad M, Goffeng E, Skare Ø, Zardin E. The Prolonged Effect of Shift Work and the Impact of Reducing the Number of Nightshifts on Arterial Stiffness-A 4-Year Follow-Up Study. J Cardiovasc Dev Dis 2023; 10:jcdd10020070. [PMID: 36826566 PMCID: PMC9961201 DOI: 10.3390/jcdd10020070] [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: 01/09/2023] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
AIM To assess changes in blood pressure (BP) and arterial stiffness among 84 rotating shift and 25 dayworkers (control subjects) at two industrial plants during a 4-year follow-up, and to assess changes in outcome variables among shift workers at the two plants after a reduction in the number of night shifts during the last year of follow-up in one of the plants. METHODS We collected demographic data using a questionnaire, examined systolic and diastolic blood pressure (sBP, dBP), central systolic and diastolic aorta pressure (cSP, cDP), augmentation pressure (AP), central pulse pressure (cPP), and pulse wave velocity (PWV). We registered sleep quality. The last 4-14 months of follow-up one plant implemented a 12-week shift plan reducing the total number of night shifts and consecutive night shifts from 16.8 to 14 and from 7.2 to 4. To assess differences in change of outcomes between study groups we applied linear mixed models. RESULTS The dayworkers were older, more hypertensive, reported less sleep disturbance, and smoked/snuffed less than the shift workers did. The adjusted annual increase in PWV was 0.34 m/s (95%CI, 0.22, 0.46) among shift workers and 0.09 m/s (95%CI, -0.05, 0.23) in dayworkers, yielding a significant difference of change of 0.25 m/s (95%CI, 0.06, 0.43). No significant differences were found between the two groups of shift workers in any cardiovascular disease (CVD) outcome during the last year of follow-up. CONCLUSIONS Shift work in industry is associated with arterial stiffness, reflecting an increased risk of future CVD. No significant changes in arterial stiffness were identified as a consequence of a small reduction in the number of night shifts and consecutive night shifts.
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Sutherland C, Smallwood A, Wootten T, Redfern N. Fatigue and its impact on performance and health. Br J Hosp Med (Lond) 2023; 84:1-8. [PMID: 36848155 DOI: 10.12968/hmed.2022.0548] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
An increasing body of evidence suggests that fatigue among healthcare staff is widespread, owing to a combination of high work intensity, long daytime hours and night-shift working. This has been linked to poorer outcomes for patients and longer inpatient stays, and to increased risks of work-related accidents, errors and injuries for practitioners. These include needlestick injuries and motor vehicle accidents, and other impacts on practitioner health, ranging from cancer, mental health problems, metabolic disorders to coronary disease. Other 24-hour safety-critical industries have fatigue policies that acknowledge the risks of staff fatigue and provide a system to manage it and mitigate harm, but these are still lacking within healthcare. This review explains the basic physiology behind fatigue and outlines its impacts on healthcare practitioners' clinical practice and wellbeing. It proposes methods to minimise these effects for individuals, organisations and the wider UK health service.
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Affiliation(s)
- Ceri Sutherland
- Sleep Service, James Cook University NHS Foundation Trust, Middlesbrough, UK
| | - Aidan Smallwood
- Department of Anaesthesia, Royal Victoria Infirmary, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Tom Wootten
- Department of Intensive Care, Hawke's Bay Fallen Soldier's Memorial Hospital, Hastings, New Zealand
| | - Nancy Redfern
- Department of Anaesthesia, Royal Victoria Infirmary, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Association between medication adherence to chronic diseases and shift-work schedules in the Korean working population. Sci Rep 2022; 12:22595. [PMID: 36585432 PMCID: PMC9803658 DOI: 10.1038/s41598-022-26618-9] [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: 06/24/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022] Open
Abstract
Shift-working schedules are closely linked to chronic diseases, and only a few studies have investigated the association between working schedules and medication adherence in chronic diseases targeting workers. This study aimed to investigate whether shift-work schedules are associated with medication adherence in a working population with chronic conditions. The study participants (n = 11,460 person-years) were identified from the Korea Health Panel Study conducted from 2008 to 2018. Medication adherence was classified as good (2+) or poor (0 or 1) based on the 4-item Morisky Medication Adherence Scale. Work schedules were categorized as shifts and fixed daytime work. Its association with medication adherence was investigated using a generalized estimating equation model, generating odds ratios (OR) with 95% confidence intervals (CI). According to work schedules, shift workers were more likely than fixed-day workers to have poor medication adherence (adjusted OR = 1.16, 95% CI: 1.02-1.33). Regarding occupational classification, manual workers had a significantly higher risk of poor medication adherence than those in other occupational categories (adjusted OR = 1.27, 95% CI: 1.13-1.43). Among shift workers, the major reason for poor medication adherence was forgetting to take medication (SPR = 1.23, 95% CI: 1.07-1.38). Workers with irregular shift times are more vulnerable to poor medication adherence. Future studies are required to understand the mechanisms underlying this association and develop strategies to enhance medication adherence in the working population.
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de Almeida LY, Strobbe S, de Oliveira JL, Baldassarini CR, Zanetti ACG, de Souza J. Psychosocial factors and physical activity among workers in Brazil. Work 2022; 75:243-252. [PMID: 36591676 DOI: 10.3233/wor-211411] [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: 12/31/2022] Open
Abstract
BACKGROUND Complex behaviors, such as physical activity (PA), may be related to different levels of influence. OBJECTIVE To analyze the role of social support, mood and alcohol consumption as psychosocial predictors on the engagement in PA among Brazilian workers. METHODS This is a quantitative, cross-sectional analytical study. A sample of 395 participants answered a sociodemographic questionnaire, the Alcohol Use Disorder Identification Test (AUDIT), the Baecke Habitual Physical Activity Questionnaire, the Social Support Scale for Physical Activities (SSSPA) and the Brunel Mood Scale (BRUMS). RESULTS Analysis via Pearson's Correlation Test indicated a negative correlation between PA and depression and fatigue, and a positive correlation between PA and alcohol consumption, vigor and the four variables of social support (support of family members for walking; support of friends for walking; support of family members for moderate and vigorous physical activity; support of friends for moderate and vigorous physical activity). A positive relationship between PA and low-risk alcohol consumption was also identified. A hierarchical multiple regression analysis showed that family support for walking, friends support for moderate and vigorous physical activity, vigor and alcohol consumption are predictors of PA. Hayes' moderation analysis indicated that social support has a moderating effect on the relationship between alcohol use and PA. CONCLUSION Different factors may be involved in engaging in PA. A broader approach that addresses the singularities of individuals, especially in actions for different patterns of alcohol consumption, is recommended.
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Affiliation(s)
- Letícia Yamawaka de Almeida
- Ribeirão Preto College of Nursing, Universityof São Paulo, Ribeirão Preto, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Stephen Strobbe
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | | | | | | | - Jacqueline de Souza
- Ribeirão Preto College of Nursing, Universityof São Paulo, Ribeirão Preto, Brazil
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Chen HT, Chuang HY, Hsieh TY, Wu PS, Lin FJ, Huang HC, Yang CC, Kuo CH. Shift work is significantly and positively associated with possible gastro-esophageal reflux disease: A meta-analysis study. Front Public Health 2022; 10:980603. [PMID: 36504996 PMCID: PMC9732673 DOI: 10.3389/fpubh.2022.980603] [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: 06/28/2022] [Accepted: 10/31/2022] [Indexed: 11/27/2022] Open
Abstract
Background One of the health issues related to shift work patterns is possible gastro-esophageal reflux disease (GERD) symptoms. However, the association between shift work and possible GERD symptoms through meta-analysis has not been developed in the current literature field. Therefore, the purpose of this study is to analyze the association between shift work and possible GERD symptoms through meta-analysis. Methods Studies containing target keywords were found in three datasets, and four articles were selected for further analysis after examining the title, abstract, and text. All prevalence odds ratios (ORs) among different groups of the population and the standard error (SE) from each included study were calculated for conducting meta-analysis. Result The pooled OR has shown a significant positive association between shift work and possible GERD (OR 1.53; 95% confidence interval [CI] 1.33-1.77, p-value 0.003). Compared to non-shift workers, the subgroup analysis indicates there are positive associations between possible GERD and the night shift (OR 1.39; 95% CI 1.16-1.66), and the rotating shift (OR 1.83; 95% CI 1.44-2.33). The subgroup analysis has also shown similar trends in shift working men (OR 1.28; 95% CI 1.03-1.60) and shift workers of both genders (OR 1.75; 95% CI 1.45-2.11). Conclusion This study has shown a positive association between shift work and possible GERD.
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Affiliation(s)
- Hsiang-Tai Chen
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Hung-Yi Chuang
- Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan,Department of Public Health and Environmental Medicine, and Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Tsung-Yu Hsieh
- Department of Occupational and Environmental Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Pei-Shan Wu
- Department of Occupational and Environmental Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Fang-Jiun Lin
- Department of Human Resource, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Huan-Chih Huang
- Department of Family Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chen-Cheng Yang
- Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan,Department of Occupational and Environmental Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan,Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan,*Correspondence: Chen-Cheng Yang ;
| | - Chao-Hung Kuo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
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Boini S, Bourgkard E, Ferrières J, Esquirol Y. What do we know about the effect of night-shift work on cardiovascular risk factors? An umbrella review. Front Public Health 2022; 10:1034195. [PMID: 36504944 PMCID: PMC9727235 DOI: 10.3389/fpubh.2022.1034195] [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: 09/01/2022] [Accepted: 10/26/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To evaluate the existing evidence on the effect of night-shift work and its subtypes (permanent and rotating) on cardiovascular risk factors: diabetes, lipid disorders, being overweight, hypertension, smoking habits, sedentariness, and occupational psychosocial stressors. Method A Web of Sciences and Cochrane review library search was conducted to identify systematic reviews with or without meta-analysis dealing with the quantification of the link between night-shift work and the studied cardiovascular risk factors in working populations. We used the AMSTAR 2 to evaluate the quality of each review. The main results of the included systematic reviews were compiled in a summary structured around the different cardiovascular risk factors. Results After selection, 33 systematic reviews were included: nine for diabetes, four for lipid disorders, nine for being overweight, four for hypertension, two for smoking habits, three for occupational psychosocial stressors and two for sedentariness. The results confirmed an excess risk of diabetes of about 10% regardless of the type of night work. A stated excess risk of being overweight at around 25% was also highlighted for shift workers overall, which could reach 38% among night-shift workers. An increased risk of obesity, estimated at 5% for night-shift workers and at 18% for rotating shift workers, was observed. An excess risk of hypertension was estimated at around 30% when considering the broad definition of shift work and when night periods were included in rotating shifts. The literature provided inconsistent results for the link between lipid disorders and night-shift work. Shift workers appeared to be more likely to smoke. The link between shift work and occupational psychosocial stressors was scarcely explored in the available studies. Sedentariness was scarcely considered in systematic reviews, which prevents any firm conclusions. Conclusion The consequences of night work in terms of diabetes, being overweight/obesity and hypertension are established. Monitoring of these cardiovascular risk factors for these night-shift workers could be implemented by practitioners. In contrast, the links with lipid disorders, sedentariness, smoking habits, and occupational psychosocial stressors warrant further investigation. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021275212, PROSPERO (ID CRD42021275212).
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Affiliation(s)
- Stephanie Boini
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), Vandœuvre-les-Nancy, France
| | - Eve Bourgkard
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), Vandœuvre-les-Nancy, France
| | - Jean Ferrières
- UMR1295, Paul Sabatier III University – INSERM CERPOP: Centre for Epidemiology and Research in POPulation Health, Toulouse, France,Department of Cardiology, CHU Toulouse, Toulouse, France
| | - Yolande Esquirol
- UMR1295, Paul Sabatier III University – INSERM CERPOP: Centre for Epidemiology and Research in POPulation Health, Toulouse, France,Occupational Health Department, CHU Toulouse, Toulouse, France,*Correspondence: Yolande Esquirol
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Association between working evening shifts and mental health among Korean employees: data from the 5th Korean Working Conditions Survey. Ann Occup Environ Med 2022; 34:e36. [PMID: 36544885 PMCID: PMC9748216 DOI: 10.35371/aoem.2022.34.e36] [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: 04/20/2022] [Revised: 09/16/2022] [Accepted: 10/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Many studies have been conducted to investigate the harmful effect of shift work on physical and mental health. Although, by definition, "working evening shift" is included in the scope of shift work, most related studies conducted thus far have focused on working night shifts, overtime work, or different types of shift work, with little research effort dedicated to "working evening shifts." Therefore, to fill this research gap, we investigated the effect of working evening shifts on workers' mental health. Methods The participants of this study were 16,692 employees of the 50,205 that participated in the 5th wave of the Korean Working Conditions Survey. We performed χ2 test and logistic regression analysis to analyze the effects of independent variables on health problems and calculated odds ratios and 95% confidence intervals (CIs). Results In the logistic regression analysis adjusted for sociodemographic characteristics, health-related factors, and work-related characteristics, employees who worked evening shifts showed higher levels of depression and anxiety compared to those that did not. In particular, the adjusted odds ratios of the group working evening shifts between one and nine times a month were the highest with 2.723 (95% CI: 2.014-3.682) for depression, 3.294 (95% CI: 2.547-4.259) for anxiety. Conclusions The results of our study suggest that working evening shifts has a negative effect on employees' mental health. This trend decreased with an increase in the monthly frequency of evening work.
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Turunen J, Karhula K, Ropponen A, Koskinen A, Shiri R, Sallinen M, Ervasti J, Pehkonen J, Härmä M. The Time-Varying Effect of Participatory Shift Scheduling on Working Hour Characteristics and Sickness Absence: Evidence from a Quasi-Experiment in Hospitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14654. [PMID: 36429372 PMCID: PMC9690287 DOI: 10.3390/ijerph192214654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Participatory shift scheduling for irregular working hours can influence shift schedules and sickness absence. We investigated the effects of using participatory shift scheduling and shift schedule evaluation tools on working hour characteristics and sickness absence. We utilized a panel data for 2015-2019 with 16,557 hospital employees (6143 in the intervention and 10,345 in the control group). Difference-in-differences regression with ward-level clustered standard errors was used to estimate the average treatment effect on the treated coefficients relative to timing of the intervention with 95% confidence intervals (CI). Using participatory scheduling tool increased long working hours and weekend work and had delayed effects on the short (1-3 days) sickness absences. Increased effects were observed: 0.2 [95% CI 0.0-0.4] days for the second, and 0.8 [95% CI 0.5-1.0] for the third year after the onset of intervention. An average increase of 0.5 [95% CI 0.1-0.9] episodes on all sickness absence episodes was observed for the third year. Using the shift schedule evaluation tool with the participatory shift scheduling tool attenuated the adverse effects. To conclude, participatory shift scheduling increased some potentially harmful working hour characteristics but its effects on sickness absence were negligible, and further attenuated by using the shift schedule evaluation tool.
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Affiliation(s)
- Jarno Turunen
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00032 Helsinki, Finland
- Jyväskylä University School of Business and Economics, FI-40014 Jyväskylä, Finland
| | - Kati Karhula
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00032 Helsinki, Finland
| | - Annina Ropponen
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00032 Helsinki, Finland
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Aki Koskinen
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00032 Helsinki, Finland
| | - Rahman Shiri
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00032 Helsinki, Finland
| | - Mikael Sallinen
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00032 Helsinki, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00032 Helsinki, Finland
| | - Jaakko Pehkonen
- Jyväskylä University School of Business and Economics, FI-40014 Jyväskylä, Finland
| | - Mikko Härmä
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00032 Helsinki, Finland
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Ella K, Sűdy ÁR, Búr Z, Koós B, Kisiczki ÁS, Mócsai A, Káldi K. Time restricted feeding modifies leukocyte responsiveness and improves inflammation outcome. Front Immunol 2022; 13:924541. [PMID: 36405720 PMCID: PMC9666763 DOI: 10.3389/fimmu.2022.924541] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022] Open
Abstract
Time restricted eating, the dietary approach limiting food intake to a maximal 10-hour period of daytime is considered beneficial in metabolic dysfunctions, such as obesity and diabetes. Rhythm of food intake and parallel changes in serum nutrient levels are also important entrainment signals for the circadian clock, particularly in tissues involved in metabolic regulation. As both the metabolic state and the circadian clock have large impact on immune functions, we investigated in mice whether time restricted feeding (TRF) affects systemic inflammatory potential. TRF slackened the symptoms in K/BxN serum-transfer arthritis, an experimental model of human autoimmune joint inflammation. Compared to ad libitum conditions TRF reduced the expression of inflammatory mediators in visceral adipose tissue, an integrator and coordinator of metabolic and inflammatory processes. Furthermore, TRF strengthened the oscillation of peripheral leukocyte counts and alongside decreased the pool of both marginated and tissue leukocytes. Our data suggest that the altered leukocyte distribution in TRF mice is related to the attenuated expression of adhesion molecules on the surface of neutrophils and monocytes. We propose that TRF modifies both rhythm and inflammatory potential of leukocytes which contribute to the milder reactivity of the immune system and therefore time-restricted eating could serve as an effective complementary tool in the therapy of autoinflammatory processes.
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Ahn CW, Shin S, Lee S, Park HS, Hong N, Rhee Y. Association of Shift Work with Normal-Weight Obesity in Community-Dwelling Adults. Endocrinol Metab (Seoul) 2022; 37:781-790. [PMID: 36327987 PMCID: PMC9633218 DOI: 10.3803/enm.2022.1532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/08/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGRUOUND Shift work is associated with obesity and metabolic syndrome. However, this association in the normal-weight population remains unclear. This study aimed to investigate whether shift work is associated with normal-weight obesity (NWO). METHODS From the nationally representative Korea National Health and Nutrition Examination Survey (KNHANES) dataset (2008 to 2011), 3,800 full-time workers aged ≥19 years with a body mass index (BMI) ≤25 kg/m2 were analysed. We defined NWO as BMI ≤25 kg/m2 and body fat percentage ≥25% in men and ≥37% in women. Working patterns were classified into "daytime," "other than daytime," and "shift." Multivariable logistic regression analysis was performed to evaluate the relationship between shift work and NWO. RESULTS Shift work was associated with higher odds of NWO than daytime work (adjusted odds ratio [aOR], 1.47; 95% confidence interval [CI], 1.04 to 2.09) and night/evening work (aOR, 1.87; 95% CI, 1.11 to 3.14) after adjustment for type of work, working hours, age, sex, BMI, 25-hydroxyvitamin D levels, homeostatic model assessment for insulin resistance, and other sociodemographic factors. In subgroup analyses, the association between shift work and NWO was more robust in those aged ≥60 years and those working ≥56 hours/week. CONCLUSION Shift work was associated with NWO in community-dwelling Korean adults, independent of age, sex, BMI, and other covariates.
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Affiliation(s)
- Chul Woo Ahn
- Yonsei University College of Medicine, Seoul, Korea
| | - Sungjae Shin
- Department of Internal Medicine, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Seunghyun Lee
- Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hye-Sun Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Corresponding author: Hye-Sun Park. Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea Tel: +82-2-2019-3313, Fax: +82-2-3463-3882, E-mail:
| | - Namki Hong
- Department of Internal Medicine, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Yumie Rhee
- Department of Internal Medicine, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Petersen MC, Gallop MR, Flores Ramos S, Zarrinpar A, Broussard JL, Chondronikola M, Chaix A, Klein S. Complex physiology and clinical implications of time-restricted eating. Physiol Rev 2022; 102:1991-2034. [PMID: 35834774 PMCID: PMC9423781 DOI: 10.1152/physrev.00006.2022] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/16/2022] [Accepted: 07/07/2022] [Indexed: 11/22/2022] Open
Abstract
Time-restricted eating (TRE) is a dietary intervention that limits food consumption to a specific time window each day. The effect of TRE on body weight and physiological functions has been extensively studied in rodent models, which have shown considerable therapeutic effects of TRE and important interactions among time of eating, circadian biology, and metabolic homeostasis. In contrast, it is difficult to make firm conclusions regarding the effect of TRE in people because of the heterogeneity in results, TRE regimens, and study populations. In this review, we 1) provide a background of the history of meal consumption in people and the normal physiology of eating and fasting; 2) discuss the interaction between circadian molecular metabolism and TRE; 3) integrate the results of preclinical and clinical studies that evaluated the effects of TRE on body weight and physiological functions; 4) summarize other time-related dietary interventions that have been studied in people; and 4) identify current gaps in knowledge and provide a framework for future research directions.
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Affiliation(s)
- Max C Petersen
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri
- Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, Missouri
| | - Molly R Gallop
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Stephany Flores Ramos
- Division of Gastroenterology, University of California, San Diego, La Jolla, California
| | - Amir Zarrinpar
- Division of Gastroenterology, University of California, San Diego, La Jolla, California
- Department of Veterans Affairs San Diego Health System, La Jolla, California
| | - Josiane L Broussard
- Division of Endocrinology, Metabolism, and Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado
| | - Maria Chondronikola
- Departments of Nutrition and Radiology, University of California, Davis, California
- Departments of Nutrition and Dietetics, Harokopio University of Athens, Kallithea, Greece
| | - Amandine Chaix
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Samuel Klein
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri
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Kader M, Selander J, Andersson T, Albin M, Bodin T, Härmä M, Ljungman P, Bigert C. Night and shift work characteristics and incident ischemic heart disease and atrial fibrillation among healthcare employees - a prospective cohort study. Scand J Work Environ Health 2022; 48:520-529. [PMID: 35723926 PMCID: PMC10539110 DOI: 10.5271/sjweh.4045] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE This study aimed to examine the effects of various aspects of night and shift work on the risk of incident ischemic heart disease (IHD) and atrial fibrillation (AF) using detailed and registry-based exposure data. METHODS This prospective cohort study included >30 300 healthcare employees (eg, nurses, nursing assistants) employed for at least one year in Region Stockholm 2008-2016. Information on daily working hours was obtained from a computerized administrative employee register and outcomes from national and regional registers. Using discrete-time proportional hazard models, we analyzed the outcomes as functions of working hour characteristics the preceding year, adjusted for sex, age, country of birth, education, and profession. RESULTS We observed 223 cases of IHD and 281 cases of AF during follow-up 2009-2016. The risk of IHD was increased among employees who the preceding year had permanent night shifts compared to those with permanent day work [hazard ratio (HR) 1.61, 95% confidence interval (CI) 1.06-2.43] and among employees working night shifts >120 times per year compared to those who never worked night (HR 1.53, 95% CI 1.05-2.21). When restricted to non-night workers, the risk of IHD was increased for employees having frequent quick returns from afternoon shifts. No increased risks were observed for AF. CONCLUSIONS Night work, especially working permanent night shifts and frequent night shifts, is associated with an increased risk of incident IHD but not AF. Moreover, frequent quick returns from afternoon shifts (among non-night workers) increased IHD risk. Organizing work schedules to minimize these exposures may reduce IHD risk.
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Affiliation(s)
- Manzur Kader
- Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4 10th floor, SE-113 65 Stockholm, Sweden.
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Richardson L, Minh A, McCormack D, Laing A, Barbic S, Hayashi K, Milloy MJ, Huyser KR, Leahy K, Li J. Cohort Profile: The Assessing Economic Transitions (ASSET) Study-A Community-Based Mixed-Methods Study of Economic Engagement among Inner-City Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610456. [PMID: 36012091 PMCID: PMC9408769 DOI: 10.3390/ijerph191610456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 05/07/2023]
Abstract
The Assessing Economic Transitions (ASSET) study was established to identify relationships between economic engagement, health and well-being in inner-city populations given that research in this area is currently underdeveloped. This paper describes the objectives, design, and characteristics of the ASSET study cohort, an open prospective cohort which aims to provide data on opportunities for addressing economic engagement in an inner-city drug-using population in Vancouver, Canada. Participants complete interviewer-administered surveys quarterly. A subset of participants complete nested semi-structured qualitative interviews semi-annually. Between April 2019 and May 2022, the study enrolled 257 participants ages 19 years or older (median age: 51; 40% Indigenous, 11.6% non-Indigenous people of colour; 39% cis-gender women, 3.9% transgender, genderqueer, or two-spirit) and 41 qualitative participants. At baseline, all participants reported past daily drug use, with 27% currently using opioids daily, and 20% currently using stimulants daily. In the three months prior to baseline, more participants undertook informal income generation (75%) than formal employment (50%). Employed participants largely had casual jobs (42%) or jobs with part-time/varied hours (35%). Nested qualitative studies will focus on how inner-city populations experience economic engagement. The resulting evidence will inform policy and programmatic initiatives to address socioeconomic drivers of health and well-being.
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Affiliation(s)
- Lindsey Richardson
- Department of Sociology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
- Correspondence:
| | - Anita Minh
- Department of Sociology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA
| | - Deb McCormack
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
| | - Allison Laing
- Department of Sociology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
| | - Skye Barbic
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC V6T 2B5, Canada
- Providence Research, 1190 Hornby, Vancouver, BC V6Z 2K5, Canada
| | - Kanna Hayashi
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - M.-J. Milloy
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
- Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Kimberly R. Huyser
- Department of Sociology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
| | - Kathleen Leahy
- UBC Learning Exchange, University of British Columbia, 612 Main St., Vancouver, BC V6A 2V3, Canada
| | - Johanna Li
- EMBERS Eastside Works, 57 E Hastings St., Vancouver, BC V6A 0A7, Canada
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Ranking the effect of chronodisruption-based biomarkers in reproductive health. Neural Comput Appl 2022. [DOI: 10.1007/s00521-022-07563-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
AbstractChronodisruption alters circadian rhythms, which has negative consequences on different pathologies and mental disorders. This work studies whether factors related to chronodisruption of circadian rhythms motivated by shift works influence on reproductive health or not. In particular, this influence is studied on four particular aspects related to reproductive health: reproductive health disease, first pregnancy attempt, problems during pregnancy and gestation period. Some explainable machine learning models based on trees have been employed. These methods provided information about the importance of each predictor. The most important variables provided by each method were aggregated using a ranking aggregation function in order to reach a consensus ranking of variables that made possible to understand whether the chronodisruption factors had an effect on each of the aspects studied. The data have been obtained from 697 health professionals. Information about classical biomarkers, sleep quality indices and also other new variables related to eating jet lag, sleep hygiene and how the sleep is affected by shift works were considered as input data. Experiments have shown how some of these novel biomarkers are ranked in the top positions of the issues studied in relation to reproductive health. In particular, the light level and the use of electronic devices, which are features related to chronodisruption, are highlighted as biomarkers.
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Granholm Valmari E, Ghazinour M, Nygren U, Gilenstam K. A systematic review of lifestyle and health among patrolling police officers. Scand J Occup Ther 2022:1-24. [PMID: 35704703 DOI: 10.1080/11038128.2022.2083013] [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: 10/18/2022]
Abstract
BACKGROUND The police profession is a high-strain and high-risk profession, sometimes resulting in poor physical, mental and social health. This systematic review aims to identify and describe crucial areas for a healthy and sustainable lifestyle among patrolling police officers in Europe, an area not previously studied. METHODS The review was conducted according to the PRISMA guidelines. A protocol was published and registered with PROSPERO beforehand. Searches were carried out in eight databases. Two independent authors screened articles and critically appraised the included studies. A narrative synthesis was conducted to analyse the results. The review's total body of evidence was assessed with GRADE-CERQaul. RESULTS A total of 16 articles were located, representing 13 studies. Barriers and resources for a healthy and sustainable lifestyle were linked to a theoretical framework of life balance. Subsequently, a linkage model was created to explain different aspects of patrolling police officers' life balance and its relation to health (physical, social and mental). CONCLUSIONS Several crucial areas for a healthy and sustainable lifestyle were found and described, indicating that patrolling officers' working life affects their possibilities of living a balanced lifestyle, which might disturb different aspects of health, depending on which aspect is compromised.
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Affiliation(s)
| | | | - Ulla Nygren
- Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Kajsa Gilenstam
- Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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Zhidkova EA, Shlipakov SV, Gutor EM, Gurevich MV, Pankova VB, Vilk MF, Gurevich KG, Drapkina OM. Prevalence of elevated blood pressure among locomotive workers according to the long-term assessment of pre-trip health screening. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Hypertension is considered as one of the leading cardiovascular diseases in transport workers.Aim. In the context of epidemiological prospective study, to assess the prevalence of elevated blood pressure (BP) detected at pre-trip health screening (PTHS).Material and methods. We analyzed records of the database of PTHS automatic system for 15 years (2006-2020) to reveal elevated systolic (140 mm Hg) and/or diastolic (90 mm Hg) BP.Results. For 15 years, the detection rate of systolic BP >140 mm Hg has decreased by 4 times. For diastolic BP, the detection rate of values >90 mm Hg decreased by 8 times. The detection rate of non-normal systolic BP among railway staff correlates with the detection rate of non-normal diastolic BP (r=0,92; p<0,05) on different railways. Over the 15-year period, the number of suspensions from the trip due to PTHS has decreased by 2 times, while the number of suspensions due to hypertension decreased by 2,5 times.Conclusion. The conducted study may indicate the effectiveness of primary and secondary prevention of hypertension among Russian Railways staff.
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Affiliation(s)
- E. A. Zhidkova
- Central Healthcare Directorate — branch of the Russian Railways; A.I. Evdokimov Moscow State University of Medicine and Dentistry
| | | | - E. M. Gutor
- Central Healthcare Directorate — branch of the Russian Railways
| | - M. V. Gurevich
- Ambulatory clinic Central Clinical Hospital RZD-Medicine
| | | | - M. F. Vilk
- All-Russian Research Institute of Railway Hygiene
| | - K. G. Gurevich
- A.I. Evdokimov Moscow State University of Medicine and Dentistry; Research Institute for Healthcare and Medical Management
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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Non-dipping blood pressure pattern in pediatricians during on-duty. Nefrologia 2022. [DOI: 10.1016/j.nefro.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Niedhammer I, Coutrot T, Geoffroy-Perez B, Chastang JF. Shift and Night Work and All-Cause and Cause-Specific Mortality: Prospective Results From the STRESSJEM Study. J Biol Rhythms 2022; 37:249-259. [PMID: 35502698 PMCID: PMC9149517 DOI: 10.1177/07487304221092103] [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] [Indexed: 11/15/2022]
Abstract
The literature remains sparse and inconclusive about the impact of shift and
night work on mortality, and still more on specific causes of death. The
objectives were to explore the prospective associations between exposure to
shift and night work and all-cause and cause-specific mortality. The study was
based on a large national representative French prospective cohort of 1,511,456
employees followed up from 1976 to 2002. Exposure to shift and night work relied
on a job-exposure matrix, and 3 time-varying measures (current, cumulative, and
recency-weighted cumulative exposure) were constructed. Mortality and causes of
death were provided by the national registry, and all-cause, cardiovascular,
cancer and preventable mortality, and suicide were studied. Cox proportional
hazards models were performed to study the associations between shift and night
work and mortality. During follow-up, 22,105 deaths occurred for all-cause
mortality. In the study of mortality until the end of last job during follow-up,
shift and/or night work were associated with all-cause, cardiovascular, cancer
and preventable mortality, and suicide (except night without shift work with
cancer mortality and suicide) among men. Shift work (especially shift without
night work) was associated with all-cause, cancer and preventable mortality
among women. The results were similar for current, cumulative, and
recency-weighted cumulative exposure. Associations were found for more detailed
causes of death: cerebrovascular diseases for both genders, ischemic heart
diseases, respiratory cancers, smoking-related mortality, and external causes of
death among men, and breast cancer among women. In the study of mortality until
the end of follow-up, some additional associations were found among women
between night work and all-cause and preventable mortality, and suicide,
suggesting long-term or delayed exposure effects. The study may, however, be
underpowered to detect all the exposure-outcome associations, especially among
women. More research and prevention are needed to reduce mortality among shift
and night workers.
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Affiliation(s)
- Isabelle Niedhammer
- INSERM, Univ Angers, Univ Rennes, EHESP, Institut de Recherche en Santé, Environnement et Travail (IRSET) - UMR_S 1085, Epidemiology in Occupational Health and Ergonomics Team (ESTER), Angers, France
| | - Thomas Coutrot
- Direction de l'Animation de la Recherche, des Etudes et des Statistiques (DARES), Ministère du Travail, Paris, France
| | | | - Jean-François Chastang
- INSERM, Univ Angers, Univ Rennes, EHESP, Institut de Recherche en Santé, Environnement et Travail (IRSET) - UMR_S 1085, Epidemiology in Occupational Health and Ergonomics Team (ESTER), Angers, France
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Erickson ML, Wang W, Counts J, Redman LM, Parker D, Huebner JL, Dunn J, Kraus WE. Field-Based Assessments of Behavioral Patterns During Shiftwork in Police Academy Trainees Using Wearable Technology. J Biol Rhythms 2022; 37:260-271. [PMID: 35416084 DOI: 10.1177/07487304221087068] [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: 11/16/2022]
Abstract
Circadian misalignment, as occurs in shiftwork, is associated with numerous negative health outcomes. Here, we sought to improve data labeling accuracy from wearable technology using a novel data pre-processing algorithm in 27 police trainees during shiftwork. Secondarily, we explored changes in four metabolic salivary biomarkers of circadian rhythm during shiftwork. Using a two-group observational study design, participants completed in-class training during dayshift for 6 weeks followed by either dayshift or nightshift field-training for 6 weeks. Using our novel algorithm, we imputed labels of circadian misaligned sleep episodes that occurred during daytime, which were previously were mislabeled as non-sleep by Garmin, supported by algorithm performance analysis. We next assessed changes to resting heart rate and sleep regularity index during dayshift versus nightshift field-training. We also examined changes in field-based assessments of salivary cortisol, uric acid, testosterone, and melatonin during dayshift versus nightshift. Compared to dayshift, nightshift workers experienced larger changes to resting heart rate, sleep regularity index (indicating reduced sleep regularity), and alterations in sleep/wake activity patterns accompanied by blunted salivary cortisol. Salivary uric acid and testosterone did not change. These findings show wearable technology combined with specialized data pre-processing can be used to monitor changes in behavioral patterns during shiftwork.
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Affiliation(s)
| | - Will Wang
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
| | - Julie Counts
- Duke Molecular Physiology Institute, Duke University, Durham, North Carolina
| | - Leanne M Redman
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Daniel Parker
- Duke Molecular Physiology Institute, Duke University, Durham, North Carolina
| | - Janet L Huebner
- Duke Molecular Physiology Institute, Duke University, Durham, North Carolina
| | - Jessilyn Dunn
- Department of Biomedical Engineering, Duke University, Durham, North Carolina.,Department of Biostatistics & Bioinformatics, Duke University, Durham, North Carolina
| | - William E Kraus
- Duke Molecular Physiology Institute, Duke University, Durham, North Carolina.,Department of Biomedical Engineering, Duke University, Durham, North Carolina
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Forcada-Parrilla I, Reig-Garcia G, Serra L, Juvinyà-Canal D. The Influence of Doing Shift Work on the Lifestyle Habits of Primary Care Nurses. NURSING REPORTS 2022; 12:291-303. [PMID: 35466249 PMCID: PMC9036203 DOI: 10.3390/nursrep12020029] [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: 02/13/2022] [Revised: 03/30/2022] [Accepted: 04/06/2022] [Indexed: 11/16/2022] Open
Abstract
Nurses’ lifestyle habits play a key role in promoting healthy lifestyles; although, they may not always be entirely healthy and can be influenced by working conditions. This paper aims to analyze the influence of doing shift work on nurses’ lifestyle habits. Participants (n = 219) were recruited from 27 primary health care centres in Spain. Data were collected on socio-demographic characteristics, working conditions and lifestyle behaviour, assessed by use of an adhoc questionnaire including validated measures. Descriptive analysis and logistic regression models were performed. A total of 95% of the nurses reported having an adequate diet; 45.2% did not engage in any type of physical activity; and 85.8% did not smoke, especially women. A total of 60.3% did shift work, especially the younger ones (80.8%; p < 0.001), these nurses being the ones with the worst food habits (81.8%). In contrast, nurses who did shift work, exercised more days a week (69.5%; p < 0.001). The dietary habits of the nurses were adequate. Low tobacco consumption and low adherence to physical activity were observed, especially among women. Shift work harmed eating habits and obesity rates, but was a protective factor in terms of adherence to physical exercise.
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Affiliation(s)
- Iris Forcada-Parrilla
- Primary Health Care Nurse, Institut Català de la Salut, 17003 Girona, Spain;
- Department of Nursing, Faculty of Nursing, University of Girona, 17003 Girona, Spain;
| | - Glòria Reig-Garcia
- Department of Nursing, Faculty of Nursing, University of Girona, 17003 Girona, Spain;
- Health and Health Care Research Group, University of Girona, 17003 Girona, Spain
- Correspondence:
| | - Laura Serra
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, 17003 Girona, Spain;
- CIBER of Epidemiology and Public Health (CIBERESP), 17003 Girona, Spain
| | - Dolors Juvinyà-Canal
- Department of Nursing, Faculty of Nursing, University of Girona, 17003 Girona, Spain;
- Health and Health Care Research Group, University of Girona, 17003 Girona, Spain
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48
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Voglino G, Savatteri A, Gualano MR, Catozzi D, Rousset S, Boietti E, Bert F, Siliquini R. How the reduction of working hours could influence health outcomes: a systematic review of published studies. BMJ Open 2022; 12:e051131. [PMID: 35365508 PMCID: PMC8977802 DOI: 10.1136/bmjopen-2021-051131] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The health effects of work-time arrangements have been largely studied for long working hours, whereas a lack of knowledge remains regarding the potential health impact of reduced work-time interventions. Therefore, we conducted this review in order to assess the relationships between work-time reduction and health outcomes. DESIGN Systematic review of published studies. Medline, PsycINFO, Embase and Web of Science databases were searched from January 2000 up to November 2019. OUTCOMES The primary outcome was the impact of reduced working time with retained salary on health effects, interventional and observational studies providing a quantitative analysis of any health-related outcome were included. Studies with qualitative research methods were excluded. RESULTS A total of 3876 published articles were identified and 7 studies were selected for the final analysis, all with a longitudinal interventional design. The sample size ranged from 63 participants to 580 workers, mostly from healthcare settings. Two studies assessed a work-time reduction to 6 hours per day; two studies evaluated a weekly work-time reduction of 25%; two studies evaluated simultaneously a reduced weekly work-time reduction proportionally to the amount of time worked and a 2.5 hours of physical activity programme per week instead of work time; one study assessed a reduced weekly work-time reduction from 39 to 30 hours per week. A positive relationship between reduced working hours and working life quality, sleep and stress was observed. It is unclear whether work time reduction determined an improvement in general health outcomes, such as self-perceived health and well-being. CONCLUSIONS These findings suggest that the reduction of working hours with retained salary could be an effective workplace intervention for the improvement of employees' well-being, especially regarding stress and sleep. Further studies in different contexts are needed to better evaluate the impact of work-time reduction on other health outcomes.
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Affiliation(s)
- Gianluca Voglino
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Armando Savatteri
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Maria Rosaria Gualano
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Dario Catozzi
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Stefano Rousset
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Edoardo Boietti
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Fabrizio Bert
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
- Health Direction, University Hospital City of Science and Health, Turin, Italy
| | - Roberta Siliquini
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
- Health Direction, University Hospital City of Science and Health, Turin, Italy
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49
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Santos HO, Genario R, Tinsley GM, Ribeiro P, Carteri RB, Coelho-Ravagnani CDF, Mota JF. A scoping review of intermittent fasting, chronobiology, and metabolism. Am J Clin Nutr 2022; 115:991-1004. [PMID: 34978321 DOI: 10.1093/ajcn/nqab433] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/29/2021] [Indexed: 12/19/2022] Open
Abstract
Chronobiology plays a crucial role in modulating many physiologic systems in which there is nutritional synergism with meal timing. Given that intermittent fasting (IF) has grown as a flexible dietary method consisting of delayed or early eating windows, this scoping review addresses the effects of IF protocols on metabolism as they relate to clinical nutrition and the circadian system. Although nocturnal habits are associated with circadian misalignments and impaired cardiometabolic profile-and nutritional physiology is better orchestrated during the day-most findings are based on animal experiments or human studies with observational designs or acute meal tests. Well-controlled randomized clinical trials employing IF protocols of delayed or early eating windows have sometimes demonstrated clinical benefits, such as improved glycemic and lipid profiles, as well as weight loss. However, IF does not appear to be more effective than traditional diets at the group level, and its effects largely depend on energy restriction. Thus, efforts must be made to identify patient biological rhythms, preferences, routines, and medical conditions before individual dietary prescription in clinical practice.
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Affiliation(s)
- Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Rafael Genario
- School of Medicine, University of São Paulo (USP), São Paulo, Brazil
| | - Grant M Tinsley
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Poliana Ribeiro
- Institute of Genetics and Biochemistry, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Randhall B Carteri
- Methodist University Center-Porto Alegre Institute, Porto Alegre, Brazil
| | | | - João F Mota
- Clinical and Sports Nutrition Research Laboratory, Faculty of Nutrition, Goiás Federal University, Goiânia, GO, Brazil
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50
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Lu DW, Lee J, Alvarez A, Sakamoto JT, Bird SB, Sundaram V, Lall MD, Nordenholz KE, Manfredi RA, Blomkalns AL. Drivers of professional fulfillment and burnout among emergency medicine faculty: A national wellness survey by the Society for Academic Emergency Medicine. Acad Emerg Med 2022; 29:987-998. [PMID: 35304931 DOI: 10.1111/acem.14487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/03/2022] [Accepted: 03/13/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Professional fulfillment and the mitigation of burnout can enhance clinician well-being and the resiliency of the health care organization. This study examined the extent to which specific individual and workplace factors are associated with professional fulfillment and burnout among a national sample of academic emergency physicians. METHODS This was a cross-sectional survey of faculty members of the Society for Academic Emergency Medicine. Primary outcomes were professional fulfillment and burnout. The survey also examined individual and workplace factors as well as faculty's thoughts of attrition from academic and clinical medicine. Logistic regression was performed to determine the relationships between each outcome and each factor, respectively. RESULTS A total of 771 of 3130 faculty completed the survey (response rate 24.6%). A total of 38.7% reported professional fulfillment and 39.1% reported burnout. Meaningfulness of work (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.9-2.5), perceived appreciation (OR 1.9, 95% CI 1.7-2.1), and the academic work environment (OR 1.7, 95% CI 1.5-1.9) had the highest odds of being associated with professional fulfillment. In contrast, low score responses for meaningfulness of work (OR 0.6, 95% CI 0.5-0.6), self-compassion (0.6, 95% CI 0.5-0.6), and control over schedule (OR 0.6, 95% CI 0.6-0.7) were most associated with burnout. Faculty with professional fulfillment were less likely to report plans for attrition from academics (OR 0.1, 95% CI 0.1-0.2) and from clinical medicine (OR 0.2, 95% CI 0.1-0.4). Faculty with burnout were more likely to report plans for attrition from academics (OR 7, 95% CI 4.8-10.4) and clinical medicine (OR 5.7, 95% CI 3.9-8.6). CONCLUSIONS Individual and workplace factors that contributed to professional fulfillment and burnout were identified, with meaningfulness of clinical work demonstrating the strongest association with both occupational phenomena. Knowledge of which factors are most impactful in promoting professional fulfillment and mitigating burnout may be useful in guiding efforts to enhance clinician well-being.
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Affiliation(s)
- Dave W. Lu
- Department of Emergency Medicine University of Washington School of Medicine Seattle Washington USA
| | - Justin Lee
- Quantitative Sciences Unit, Department of Medicine Stanford University School of Medicine Stanford California USA
| | - Alai Alvarez
- Department of Emergency Medicine Stanford University School of Medicine Stanford California USA
| | - Jeffrey T. Sakamoto
- Department of Emergency Medicine Stanford University School of Medicine Stanford California USA
| | - Steven B. Bird
- Department of Emergency Medicine UMass Memorial Healthcare and University of Massachusetts Medical School Worcester Massachusetts USA
| | - Vandana Sundaram
- Quantitative Sciences Unit, Department of Medicine Stanford University School of Medicine Stanford California USA
| | - Michelle D. Lall
- Department of Emergency Medicine Emory University Atlanta Georgia USA
| | | | - Rita A. Manfredi
- Department of Emergency Medicine The George Washington University School of Medicine and Health Sciences Washington District of Columbia USA
| | - Andra L. Blomkalns
- Department of Emergency Medicine Stanford University School of Medicine Stanford California USA
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