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Sunde E, Harris A, Olsen OK, Pallesen S. Moral decision-making at night and the impact of night work with blue-enriched white light or warm white light: a counterbalanced crossover study. Ann Med 2024; 56:2331054. [PMID: 38635448 PMCID: PMC11028009 DOI: 10.1080/07853890.2024.2331054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 02/24/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Cognitive function, including moral decision-making abilities, can be impaired by sleep loss. Blue-enriched light interventions have been shown to ameliorate cognitive impairment during night work. This study investigated whether the quality of moral decision-making during simulated night work differed for night work in blue-enriched white light, compared to warm white light. METHODS Using a counterbalanced crossover design, three consecutive night shifts were performed in blue-enriched white light (7000 K) and warm white light (2500 K) provided by ceiling-mounted LED luminaires (photopic illuminance: ∼200 lx). At 03:30 h on the second shift (i.e. twice) and at daytime (rested), the Defining Issues Test-2, assessing the activation of cognitive schemas depicting different levels of cognitive moral development, was administered. Data from 30 (10 males, average age 23.3 ± 2.9 years) participants were analysed using linear mixed-effects models. RESULTS Activation of the post-conventional schema (P-score), that is, the most mature moral level, was significantly lower for night work in warm white light (EMM; estimated marginal mean = 44.3, 95% CI = 38.9-49.6; pholm=.007), but not blue-enriched white light (EMM = 47.5, 95% CI = 42.2-52.8), compared to daytime (EMM = 51.2, 95% CI = 45.9-56.5). Also, the P-score was reduced for night work overall (EMM = 45.9, 95% CI = 41.1-50.8; p=.008), that is, irrespective of light condition, compared to daytime. Neither activation of the maintaining norms schema (MN-score), that is, moderately developed moral level, nor activation of the personal interest schema (i.e. the lowest moral level) differed significantly between light conditions. The MN-score was however increased for night work overall (EMM = 26.8, 95% CI = 23.1-30.5; p=.033) compared to daytime (EMM = 23.1, 95% CI = 18.9-27.2). CONCLUSION The results indicate that moral decisions during simulated night work in warm white light, but not blue-enriched white light, become less mature and principle-oriented, and more rule-based compared to daytime, hence blue-enriched white light may function as a moderator. Further studies are needed, and the findings should be tentatively considered.Trial registration: ClinicalTrials.gov (ID: NCT03203538) Registered: 26/06/2017; https://clinicaltrials.gov/study/NCT03203538.
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Affiliation(s)
- Erlend Sunde
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Olav Kjellevold Olsen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Department of Leadership and Organizational Behaviour, BI Norwegian Business School, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
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Sato Y, Yoshioka E, Saijo Y. Association of rotating night shift work with tooth loss and severe periodontitis among permanent employees in Japan: a cross-sectional study. PeerJ 2024; 12:e17253. [PMID: 38646481 PMCID: PMC11027908 DOI: 10.7717/peerj.17253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/26/2024] [Indexed: 04/23/2024] Open
Abstract
Background The modern 24/7 society demands night shift work, which is a possible risk factor for chronic diseases. This study aimed to examine the associations of rotating night shift work duration with tooth loss and severe periodontitis. Methods This cross-sectional study used data from a self-administered questionnaire survey conducted among 3,044 permanent employees aged 20-64 years through a Japanese web research company in 2023. The duration of rotating night shift work was assessed using a question from the Nurses' Health Study. Tooth loss was assessed based on self-reported remaining natural teeth count. Severe periodontitis was assessed using a validated screening questionnaire comprising four questions related to gum disease, loose tooth, bone loss, and bleeding gums. We employed linear regression models for tooth loss and Poisson regression models for severe periodontitis, adjusting for demographic, health and work-related variables and socioeconomic status. Results Among participants included, 10.9% worked in rotating night shifts for 1-5 years, while 11.0% worked in such shifts for ≥6 years. In fully adjusted models, rotating night shift work duration of 1-5 years was associated with tooth loss (beta -0.74, 95% confidence interval (CI) [-1.55 to 0.08]) and severe periodontitis (prevalence ratio 1.80, 95% CI [1.33-2.43]); however, the association with tooth loss was not statistically significant. Conclusions This study supports that employees who work short-term rotating night shifts may experience poor oral conditions. Further research is needed to determine whether long-term rotating night shift work is associated with deteriorated oral health.
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Affiliation(s)
- Yukihiro Sato
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Eiji Yoshioka
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yasuaki Saijo
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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3
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Darvishi E, Osmani H, Aghaei A, Moloud EA. Hidden risk factors and the mediating role of sleep in work-related musculoskeletal discomforts. BMC Musculoskelet Disord 2024; 25:256. [PMID: 38566113 PMCID: PMC10985854 DOI: 10.1186/s12891-024-07387-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE Musculoskeletal discomforts (MSDs) are prevalent occupational health issues that are associated with a wide range of risk factors. This study aimed to investigate some of the occupational hidden risk factors and the mediating role of sleep in work-related musculoskeletal discomforts. METHODS In a cross-sectional study, the role of job stress and shift work as two hidden risk factors and sleep problems as the mediator in work-related musculoskeletal discomforts was investigated in 302 healthcare workers using the path analysis models. For this aim, healthcare workers' Occupational Stress and musculoskeletal discomforts were evaluated using the Health and Safety Executive questionnaire and Cornell questionnaire, respectively. Moreover, the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI) were used to examine the sleep characteristics of participants. Shift work and job stress as predictor variables and sleep characteristics as mediating variables were analyzed. RESULTS The results showed that the path coefficients of job stress on indexes of quality sleep and insomnia severity were significant. Also, the path coefficient of shift work on quality sleep index was significant. In return, the path coefficients of shift work on the insomnia severity index were not significant. Additionally, there was a mutually significant association between indexes of quality sleep and the severity of insomnia and musculoskeletal discomforts. The direct effect coefficient of job stress on MSDs was significant, whereas the direct effect coefficient of shift work on MSDs was insignificant. This means that shift work alone does not significantly impact these disorders. CONCLUSION It would seem that shift work and job stress as two occupational hidden risk factors can mediate sleep indexes and indirectly play a critical role in the incidence of musculoskeletal discomforts. Moreover, sleep disorders and musculoskeletal discomforts are mutually related and have a bidirectional relationship.
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Affiliation(s)
- Ebrahim Darvishi
- Department of Occupational Health Engineering, Faculty of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Hiva Osmani
- Student research committee, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Abbas Aghaei
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Emran Ali Moloud
- Student research committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Tauman R, Henig O, Rosenberg E, Marudi O, Dunietz TM, Grandner MA, Spitzer A, Zeltser D, Mizrahi M, Sprecher E, Ben-Ami R, Goldshmidt H, Goldiner I, Saiag E, Angel Y. Relationship among sleep, work features, and SARS-cov-2 vaccine antibody response in hospital workers. Sleep Med 2024; 116:90-95. [PMID: 38437781 DOI: 10.1016/j.sleep.2024.02.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 02/28/2024] [Indexed: 03/06/2024]
Abstract
STUDY OBJECTIVES Immunity is influenced by sleep and the circadian rhythm. Healthcare workers are predisposed to both insufficient sleep and circadian disruption. This study aimed to evaluate the relationship between sleep and work characteristics and the antibody response to the mRNA SARS-CoV-2 vaccine BNT162b2. METHODS The authors' prospective cohort study ("COVI3") evaluated the effect of a third (booster) dose of the BNT162b2 vaccine. A subset of participants provided information on anthropometric measures, sleep, stress and work characteristics including shift work and number of work hours per week. Blood samples for anti-S1-RBD IgG antibody levels were obtained 21 weeks following receipt of the third dose of the vaccine. RESULTS In total, 201 healthcare workers (73% women) were included. After adjustment for age, body mass index (BMI), shift work, smoking status, and perceived stress, short sleep duration (<7 h per night) was associated with lower anti-S1-RBD IgG levels (Odds ratio 2.36 [95% confidence interval 1.08-5.13]). Participants who performed shift work had higher odds of lower anti-S1-RBD IgG levels compared to those who did not work in shifts [odds ratio = 2.99 (95% confidence interval 1.40, 6.39)] after accounting for age, short sleep duration, BMI, smoking status and perceived stress. CONCLUSIONS Shift work and self-reported short sleep duration were associated with a lower antibody response following a booster dose of the SARS-CoV-2 vaccine. These findings suggest that the efficacy of vaccination, particularly among healthcare workers, may be augmented by addressing both sleep and circadian alignment.
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Affiliation(s)
- Riva Tauman
- Sieratzki-Sagol Institute for Sleep Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Oryan Henig
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Or Marudi
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Anesthesia, Pain Management and Intensive care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Talia M Dunietz
- Sieratzki-Sagol Institute for Sleep Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michael A Grandner
- Department of Psychiatry, Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ, United States
| | - Avishay Spitzer
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Departments of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - David Zeltser
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michal Mizrahi
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eli Sprecher
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Research and Development, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronen Ben-Ami
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Hanoch Goldshmidt
- Department of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ilana Goldiner
- Department of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Esther Saiag
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Information Systems and Operations, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yoel Angel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Anesthesia, Pain Management and Intensive care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Physician Affairs, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Dutheil F, Fournier A, Perrier C, Richard D, Trousselard M, Mnatzaganian G, Baker JS, Bagheri R, Mermillod M, Clinchamps M, Schmidt J, Bouillon-Minois JB. Impact of 24 h shifts on urinary catecholamine in emergency physicians: a cross-over randomized trial. Sci Rep 2024; 14:7329. [PMID: 38538760 PMCID: PMC10973468 DOI: 10.1038/s41598-024-58070-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/25/2024] [Indexed: 04/01/2024] Open
Abstract
24-h shift (24 hS) exposed emergency physicians to a higher stress level than 14-h night shift (14 hS), with an impact spreading on several days. Catecholamines are supposed to be chronic stress biomarker. However, no study has used catecholamines to assess short-term residual stress or measured them over multiple shifts. A shift-randomized trial was conducted to study urinary catecholamines levels of 17 emergency physicians during a control day (clerical work on return from leave) and two working day (14 hS and 24 hS). The Wilcoxon matched-pairs test was utilized to compare the mean catecholamine levels. Additionally, a multivariable generalized estimating equations model was employed to further analyze the independent relationships between key factors such as shifts (compared to control day), perceived stress, and age with catecholamine levels. Dopamine levels were lower during 24 hS than 14 hS and the control day. Norepinephrine levels increased two-fold during both night shifts. Epinephrine levels were higher during the day period of both shifts than on the control day. Despite having a rest day, the dopamine levels did not return to their normal values by the end of the third day after the 24 hS. The generalized estimating equations model confirmed relationships of catecholamines with workload and fatigue. To conclude, urinary catecholamine biomarkers are a convenient and non-invasive strong measure of stress during night shifts, both acutely and over time. Dopamine levels are the strongest biomarker with a prolonged alteration of its circadian rhythm. Due to the relation between increased catecholamine levels and both adverse psychological effects and cardiovascular disease, we suggest that emergency physicians restrict their exposure to 24 hS to mitigate these risks.
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Affiliation(s)
- Frédéric Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Occupational and Environmental Medicine, Wittyfit, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Alicia Fournier
- Psy-DREPI Laboratory UR 7458, University of Bourgogne, Dijon, France
| | | | - Damien Richard
- Unité INSERM 1107 Neuro-Dol, CHU Clermont-Ferrand, Université Clermont-Auvergne, 63000, Clermont-Ferrand, France
| | - Marion Trousselard
- Neurophysiology of Stress, Neuroscience and Operational Constraint Department, French Armed Forces Biomedical Research Institute (IRBA), 91223, Brétigny-sur-Orge, France
| | - George Mnatzaganian
- Rural Department of Community Health, La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
| | - Julien S Baker
- Department of Sport, Physical Education and Health, Center for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, 81746-73441, Iran
| | - Martial Mermillod
- CNRS, LPNC, Grenoble, France Institut Universitaire de France, Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, Paris, France
| | - Maelys Clinchamps
- CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Occupational and Environmental Medicine, Wittyfit, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jeannot Schmidt
- Emergency Department, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Université Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Jean-Baptiste Bouillon-Minois
- Emergency Department, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Université Clermont Auvergne, 63000, Clermont-Ferrand, France.
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7
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Harris R, Kavaliotis E, Drummond SPA, Wolkow AP. Sleep, mental health and physical health in new shift workers transitioning to shift work: Systematic review and meta-analysis. Sleep Med Rev 2024; 75:101927. [PMID: 38626702 DOI: 10.1016/j.smrv.2024.101927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/03/2024] [Accepted: 03/19/2024] [Indexed: 04/18/2024]
Abstract
This systematic review and meta-analysis (PROSPERO registration CRD42022309827) aimed to describe how shift work impacts new workers' sleep, mental health, and physical health during the transition to shift work and to consolidate information regarding predictors of shift work tolerance (SWT) during this transition period. Inclusion criteria included: new shift workers; sleep, mental health, or physical health outcomes; prospective study design with the first timepoint assessing workers within three months of starting shift work; and written in English. Searches from six databases returned 12,172 articles as of August 2023. The final sample included 48 papers. Publication quality and risk of bias was assessed using the critical appraisal skills program. Forty-five studies investigated longitudinal changes in sleep, mental health, or physical health outcomes and 29 studies investigated predictors of SWT (i.e., better sleep, mental and physical health). Sleep and mental health outcomes worsened following the onset of shift work, while physical health did not significantly change. Pre-shift work mental health, sleep, and work characteristics predicted SWT later in workers' careers. Shift work adversely impacts new workers' sleep and mental health early in their career, and interventions before beginning shift work are needed to promote better SWT.
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Affiliation(s)
- Rachael Harris
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, 3800, Australia
| | - Eleni Kavaliotis
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, 3800, Australia
| | - Sean P A Drummond
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, 3800, Australia
| | - Alexander P Wolkow
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, 3800, Australia.
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8
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Wang Z, Zhu T, Gong M, Yin L, Zheng H. Relationship between shift work, night work, and headache and migraine risk: A meta-analysis of observational studies. Sleep Med 2024; 115:218-225. [PMID: 38377838 DOI: 10.1016/j.sleep.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/22/2024] [Accepted: 02/03/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND To date, there is insufficient research on whether shift work and night work increase the risk of experiencing headaches and migraines. OBJECTIVES This study aimed to evaluate the potential association between shift work, night shift work, and headache/migraine. METHODS We conducted a thorough search of the PubMed, Embase, and Web of Science databases up until October 2023 to identify relevant studies. Our inclusion criteria focused on observational studies that investigated the association between shift work exposure and headache/migraine outcomes. We extracted adjusted risk estimates from each study and calculated pooled odds ratios using either fixed or random-effects models. Our methodology followed the Meta-Analysis Group guidelines for observational studies in epidemiology. To ensure accuracy and consistency, two investigators independently reviewed the retrieved records and extracted data based on the predefined inclusion criteria. RESULTS This meta-analysis included a total of seven studies involving 422,869 participants. The pooled analysis revealed a significant association between shift work and an increased risk of headaches (HR = 1.32, 95% CI: 1.15-1.52, P < 0.001). Specifically, individuals working night shifts had a 44% higher risk of developing headaches (HR = 1.44, 95% CI: 1.09-1.90, P = 0.011). Furthermore, shift work was also found to be associated with a higher incidence of migraines (HR = 1.63, 95% CI: 1.27-2.08, P < 0.001). Interestingly, night shift work was associated with a decreased incidence of migraines (HR = 0.74, 95% CI: 0.57-0.96, P = 0.024). CONCLUSION Our study found a noteworthy association between shift work/night work and the occurrence of headaches and migraines. However, it is important to note that our study does not establish a causal relationship. Future research should investigate potential common vulnerability factors, such as genetics or health behaviors. This knowledge can help inform the implementation of preventive measures and interventions to mitigate the health risks associated with shift work.
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Affiliation(s)
- Zhenzhi Wang
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Avenue, Wenjiang District, Chengdu, 611100, China.
| | - Tao Zhu
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Avenue, Wenjiang District, Chengdu, 611100, China.
| | - Meng Gong
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Avenue, Wenjiang District, Chengdu, 611100, China.
| | - Lin Yin
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Avenue, Wenjiang District, Chengdu, 611100, China.
| | - Hui Zheng
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Avenue, Wenjiang District, Chengdu, 611100, China.
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Batur M, Özdemir PG, Bilmez Tan R, Şahin Taş Z. Assessment of metacognition and retinal optical coherence tomography findings in shift workers. Chronobiol Int 2024; 41:393-405. [PMID: 38438316 DOI: 10.1080/07420528.2024.2325017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/25/2024] [Indexed: 03/06/2024]
Abstract
It is known that working in the shift system, especially the night shift, affects physical, mental, and social well-being. We investigated the changes in the inner retinal layers and choroidal layer of the eyes of nurses working night and day shifts using optical coherence tomography (OCT). We also explored the effect of night shift work on metacognition and the relationships between these variables. A total of 79 nurses participated in the study, of whom 40 worked night shifts. The researcher gave the participants sociodemographic information and the Metacognition Questionnaire-30 (MCQ-30) form. Retinal nerve fiber layer (RNFL) thickness, ganglion cell layer (GCL) thickness, inner nuclear layer (INL) thickness, inner plexiform layer (IPL) thickness, central macular thickness (CMT), and subfoveal choroidal thickness (SFCT) were measured with OCT. It was found that the level of metacognitive activity associated with cognitive confidence was higher (p = 0.044) for nurses who worked night shifts and that the level of metacognitive activity associated with cognitive awareness was lower (p = 0.015) for nurses who worked night shifts. RNFL-nasal superior (NS) thickness was lower in night shift workers than the day shift group (p = 0.017). Our study revealed significant relationships between metacognition and the OCT findings among night and day shift workers. Our study revealed that RNFL measurements and metacognitive activity may differ and there may be a relationship between these parameters in nurses who work shifts. Further research is needed to investigate the long-term effects of night shift work on retinal health.
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Affiliation(s)
- Muhammed Batur
- Medical Faculty Department of Ophthalmology, Yuzuncu Yıl University, Van, Turkey
| | - Pınar Güzel Özdemir
- Medical Faculty Department of Psychiatry, Yuzuncu Yil University, Van, Turkey
| | - Rumeysa Bilmez Tan
- Medical Faculty Department of Ophthalmology, Yuzuncu Yıl University, Van, Turkey
| | - Zeynep Şahin Taş
- Medical Faculty Department of Psychiatry, Yuzuncu Yil University, Van, Turkey
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Deprato A, Maidstone R, Cros AP, Adan A, Haldar P, Harding BN, Lacy P, Melenka L, Moitra S, Navarro JF, Kogevinas M, Durrington HJ, Moitra S. Influence of light at night on allergic diseases: a systematic review and meta-analysis. BMC Med 2024; 22:67. [PMID: 38355588 PMCID: PMC10865638 DOI: 10.1186/s12916-024-03291-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/09/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Allergic diseases impose a significant global disease burden, however, the influence of light at night exposure on these diseases in humans has not been comprehensively assessed. We aimed to summarize available evidence considering the association between light at night exposure and major allergic diseases through a systematic review and meta-analysis. METHODS We completed a search of six databases, two registries, and Google Scholar from inception until December 15, 2023, and included studies that investigated the influence of artificial light at night (ALAN, high vs. low exposure), chronotype (evening vs. morning chronotype), or shift work (night vs. day shift work) on allergic disease outcomes (asthma, allergic rhinitis, and skin allergies). We performed inverse-variance random-effects meta-analyses to examine the association between the exposures (ALAN exposure, chronotype, or shiftwork) and these allergic outcomes. Stratification analyses were conducted by exposure type, disease type, participant age, and geographical location along with sensitivity analyses to assess publication bias. RESULTS We included 12 publications in our review. We found that exposure to light at night was associated with higher odds of allergic diseases, with the strongest association observed for ALAN exposure (OR: 1.88; 95% CI: 1.04 to 3.39), followed by evening chronotype (OR: 1.35; 95% CI: 0.98 to 1.87) and exposure to night shift work (OR: 1.33; 95% CI: 1.06 to 1.67). When analyses were stratified by disease types, light at night exposure was significantly associated with asthma (OR: 1.62; 95% CI: 1.19 to 2.20), allergic rhinitis (OR: 1.89; 95% CI: 1.60 to 2.24), and skin allergies (OR: 1.11; 95% CI: 1.09 to 1.91). We also found that the association between light at night exposure and allergic diseases was more profound in youth (OR: 1.63; 95% CI: 1.07 to 2.48) than adults (OR: 1.30; 95% CI: 1.03 to 1.63). Additionally, we observed significant geographical variations in the association between light at night exposure and allergic diseases. CONCLUSIONS Light at night exposure was associated with a higher prevalence of allergic diseases, both in youth and adults. More long-term epidemiological and mechanistic research is required to understand the possible interactions between light at night and allergic diseases.
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Affiliation(s)
- Andy Deprato
- Alberta Respiratory Centre and Division of Pulmonary Medicine, University of Alberta, Edmonton, AB, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Robert Maidstone
- Division of Immunology, Immunity to Infection, and Respiratory Medicine, University of Manchester, Manchester, UK
| | - Anna Palomar Cros
- Non-Communicable Diseases and Environment Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Department of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Madrid, Spain
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Prasun Haldar
- Department of Medical Laboratory Technology, Supreme Institute of Management and Technology, Mankundu, India
| | - Barbara N Harding
- Non-Communicable Diseases and Environment Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Department of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Madrid, Spain
| | - Paige Lacy
- Alberta Respiratory Centre and Division of Pulmonary Medicine, University of Alberta, Edmonton, AB, Canada
| | - Lyle Melenka
- Synergy Respiratory and Cardiac Care, Sherwood Park, Alberta, Canada
| | - Saibal Moitra
- Department of Allergy and Immunology, Apollo Multispeciality Hospitals, Kolkata, India
| | - José Francisco Navarro
- Department of Psychobiology and Methodology of Behavioural Sciences, University of Málaga, Málaga, Spain
| | - Manolis Kogevinas
- Non-Communicable Diseases and Environment Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Department of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Hannah J Durrington
- Division of Immunology, Immunity to Infection, and Respiratory Medicine, University of Manchester, Manchester, UK
| | - Subhabrata Moitra
- Alberta Respiratory Centre and Division of Pulmonary Medicine, University of Alberta, Edmonton, AB, Canada.
- Canadian VIGOUR Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
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11
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Bostock F, Mortimore G. Considering the impact of shift working on health. Br J Nurs 2024; 33:120-124. [PMID: 38335102 DOI: 10.12968/bjon.2024.33.3.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Shift work is necessary for the provision of health services, especially in hospitals as it is the only way to provide continuous care to patients. Working at night is inconsistent with the body's biological clock and night shift working hugely disrupts the circadian and sleep wake cycles. In 2020, the World Health Organization classified night shift working as being a 'probable' class 2A carcinogen and a number of independent cohort studies of both night workers and shift workers have observed increased incidence of certain cancers. Altered sleep timing, food timing and light exposure typical for shift workers leads to an acute circadian disruption and misalignment of regulatory hormones. This straying from synchronisation has been shown to result in individuals being more vulnerable to a number of chronic health conditions. Night shift work disrupts the normal sleep-wake cycle, often leading to shortened sleep duration and excessive fatigue and the results of this are far reaching. This article will explore the full impact of shift working, questioning if current practices employed within the NHS should continue.
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Affiliation(s)
- Faye Bostock
- Trainee Advanced Clinical Practitioner, University Hospitals of Derby and Burton Foundation Trust
| | - Gerri Mortimore
- Associate Professor in Advanced Practice, Department of HPSC, University of Derby
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12
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Poormoosa Y, Amerzadeh M, Alizadeh A, Kalhor R. The effect of circadian on the productivity of nurses with the mediating role of quality of work life. BMC Nurs 2024; 23:89. [PMID: 38308251 PMCID: PMC10835810 DOI: 10.1186/s12912-024-01746-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/19/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Circadian rhythms, as an integral part of daily life, govern the scheduling, management, and coordination of living organisms. Given the irregular nature of shift patterns in nurses' work schedules, investigating their implications is paramount to increasing Quality of Work Life (QWL) and productivity. The study aimed to investigate the impact of circadian rhythm on the efficiency of nurses working in hospitals in Qazvin, Iran, with QWL serving as a mediating variable. METHODS This study employed a descriptive-analytical research design, utilizing cross-sectional data collected in 2022-2023 based on the implementation of Structural Equation Modeling (SEM). The number of participants was 378 nurses. The data were obtained by administering a questionnaire and various tools, organized into four sections: demographic information, the Circadian Questionnaire, the Quality of Work Life Questionnaire, and the Nurses' Efficiency Questionnaire. The collected data were subsequently analyzed using SEM techniques within the R software. RESULTS The findings demonstrated statistically significant variations in mean scores about gender and efficiency (p = 0.008), marital status and efficiency (p = 0.000), and employment type and efficiency (p = 0.002) among the study participants. There was a significant association between shift patterns and QWL (p = 0.004). Expressly, the confirmed results indicated a direct impact of circadian on QWL (with a path coefficient of 0.013), as well as an indirect impact on efficiency mediated by the variable QWL (with a path coefficient of 0.037) (p < 0.05). CONCLUSION Due to the critical role of nurses in the healthcare system, implementing strategies that promote their efficiency is paramount. Therefore, managers can create an environment that enhances nurses' productivity by improving methods that positively impact their QWL.
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Affiliation(s)
- Yasaman Poormoosa
- Student Research Committee, School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Amerzadeh
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, , Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ahad Alizadeh
- Medical Microbiology Research Center, , Qazvin University of Medical Sciences, Qazvin, Iran
| | - Rohollah Kalhor
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, , Qazvin University of Medical Sciences, Qazvin, Iran.
- School of Public Health , Qazvin University of Medical Sciences, Qazvin, Iran.
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Lammers-van der Holst HM, Qadri S, Murphy A, Ronda JM, Zhang Y, Barger LK, Duffy JF. Evaluation of sleep strategies between night shifts in actual shift workers. Sleep Health 2024; 10:S108-S111. [PMID: 37940478 PMCID: PMC11031311 DOI: 10.1016/j.sleh.2023.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/31/2023] [Accepted: 08/31/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES The aim of this observational study was to examine sleep obtained between consecutive night shifts from shift workers in their natural environment. The goal was to identify the various sleep strategies and the timing, duration, regularity, and quality of sleep associated with the strategies. METHODS Participants (N = 33, 23 women, aged 40 ± 15years) reported their sleep information in daily diaries over 2weeks while working at least one series of consecutive night shifts. Sleep timing, duration, quality, and regularity were calculated for each sleep episode between consecutive night shifts. RESULTS Based on the reported sleep behavior, shift workers were categorized as either morning, delayed, split- or mixed sleepers. We found significant differences between the groups in timing of sleep, feeling refreshed, and regularity of sleep between consecutive night shifts, whereas duration and subjective soundness of sleep did not show significant differences. CONCLUSIONS In this sample, four sleep strategies were observed between consecutive night shifts in actual shift workers. These observations may help design future interventions to improve sleep that are individualized to the worker.
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Affiliation(s)
| | - Salim Qadri
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Audra Murphy
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Joseph M Ronda
- 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
| | - Yuan Zhang
- Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Laura K Barger
- 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
| | - Jeanne F Duffy
- 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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14
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Grant LK, Gooley JJ, St Hilaire MA, Joffe H, Brainard GC, Van Reen E, Rüger M, Rajaratnam SMW, Lockley SW, Czeisler CA, Rahman SA. A pilot study of light exposure as a countermeasure for menstrual phase-dependent neurobehavioral performance impairment in women. Sleep Health 2024; 10:S34-S40. [PMID: 37748973 PMCID: PMC10959759 DOI: 10.1016/j.sleh.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE To examine effects of menstrual phase and nighttime light exposure on subjective sleepiness and auditory Psychomotor Vigilance Task performance. METHODS Twenty-nine premenopausal women (12 =Follicular; 17 =Luteal) completed a 6.5-hour nighttime monochromatic light exposure with varying wavelengths (420-620 nm) and irradiances (1.03-14.12 µW/cm2). Subjective sleepiness, reaction time, and attentional lapses were compared between menstrual phases in women with minimal (<33%) or substantial (≥33%) light-induced melatonin suppression. RESULTS When melatonin was not suppressed, women in the follicular phase had significantly worse reaction time (mean difference=145.1 ms, 95% CI 51.8-238.3, p < .001, Cohen's D=1.9) and lapses (mean difference=12.9 lapses, 95% CI 4.37-21.41, p < .001, Cohen's D=1.7) compared to women in the luteal phase. When melatonin was suppressed, women in the follicular phase had significantly better reaction time (mean difference=152.1 ms, 95% CI 43.88-260.3, p < .001, Cohen's D=1.7) and lapses (mean difference=12.3 lapses, 95% CI 1.14-25.6, p < .01, Cohen's D=1.6) compared to when melatonin was not suppressed, such that their performance was not different (p > .9) from women in the luteal phase. Subjective sleepiness did not differ by menstrual phase (mean difference=0.6, p > .08) or melatonin suppression (mean difference=0.2, p > .4). CONCLUSIONS Nighttime light exposure sufficient to suppress melatonin can also mitigate neurobehavioral performance deficits associated with the follicular phase. Despite the relatively small sample size, these data suggest that nighttime light may be a valuable strategy to help reduce errors and accidents in female shift workers.
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Affiliation(s)
- Leilah K Grant
- 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; Mary Horrigan Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
| | - Joshua J Gooley
- 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
| | - Melissa A St Hilaire
- 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 Computer and Data Sciences, School of Science and Engineering, Merrimack College, North Andover, Massachusetts, USA
| | - Hadine Joffe
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Mary Horrigan Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Women's Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - George C Brainard
- Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Eliza Van Reen
- 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
| | - Melanie Rüger
- 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
| | - Shantha M W Rajaratnam
- 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
| | - Steven W Lockley
- 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
| | - 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
| | - Shadab A Rahman
- 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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Hilditch CJ, Pradhan S, Costedoat G, Bathurst NG, Glaros Z, Gregory KB, Shattuck NL, Flynn-Evans EE. An at-home evaluation of a light intervention to mitigate sleep inertia symptoms. Sleep Health 2024; 10:S121-S129. [PMID: 37679265 DOI: 10.1016/j.sleh.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES Under laboratory settings, light exposure upon waking at night improves sleep inertia symptoms. We investigated whether a field-deployable light source would mitigate sleep inertia in a real-world setting. METHODS Thirty-six participants (18 female; 26.6 years ± 6.1) completed an at-home, within-subject, randomized crossover study. Participants were awoken 45 minutes after bedtime and wore light-emitting glasses with the light either on (light condition) or off (control). A visual 5-minute psychomotor vigilance task, Karolinska sleepiness scale, alertness and mood scales, and a 3-minute auditory/verbal descending subtraction task were performed at 2, 12, 22, and 32 minutes after awakening. Participants then went back to sleep and were awoken after 45 minutes for the opposite condition. A series of mixed-effect models were performed with fixed effects of test bout, condition, test bout × condition, a random effect of the participant, and relevant covariates. RESULTS Participants rated themselves as more alert (p = .01) and energetic (p = .001) in the light condition compared to the control condition. There was no effect of condition for descending subtraction task outcomes when including all participants, but there was a significant improvement in descending subtraction task total responses in the light condition in the subset of participants waking from N3 (p = .03). There was a significant effect of condition for psychomotor vigilance task outcomes, with faster responses (p < .001) and fewer lapses (p < .001) in the control condition. CONCLUSIONS Our findings suggest that light modestly improves self-rated alertness and energy after waking at home regardless of sleep stage, with lower aggression and improvements to working memory only after waking from N3. Contrary to laboratory studies, we did not observe improved performance on the psychomotor vigilance task. Future studies should include measures of visual acuity and comfort to assess the feasibility of interventions in real-world settings.
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Affiliation(s)
- Cassie J Hilditch
- Fatigue Countermeasures Laboratory, San José State University, San José, California, USA.
| | - Sean Pradhan
- Fatigue Countermeasures Laboratory, San José State University, San José, California, USA; School of Business, Menlo College, Atherton, California, USA
| | - Gregory Costedoat
- Fatigue Countermeasures Laboratory, San José State University, San José, California, USA
| | - Nicholas G Bathurst
- Fatigue Countermeasures Laboratory, NASA Ames Research Center, Moffett Field, California, USA
| | - Zachary Glaros
- Fatigue Countermeasures Laboratory, NASA Ames Research Center, Moffett Field, California, USA
| | - Kevin B Gregory
- Fatigue Countermeasures Laboratory, NASA Ames Research Center, Moffett Field, California, USA
| | - Nita L Shattuck
- Operations Research Department, Naval Postgraduate School, Monterey, California, USA
| | - Erin E Flynn-Evans
- Fatigue Countermeasures Laboratory, NASA Ames Research Center, Moffett Field, California, USA
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16
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Zimberg IZ, Ftouni S, Magee M, Ferguson SA, Lockley SW, Rajaratnam SMW, Sletten TL. Circadian adaptation to night shift work is associated with higher REM sleep duration. Sleep Health 2024; 10:S112-S120. [PMID: 37914630 DOI: 10.1016/j.sleh.2023.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To investigate the influence of the degree of circadian adaptation to night work on sleep architecture following night shift. METHODS Thirty four night workers (11 females; 33.8 ± 10.1years) completed a simulated night shift following 2-7 typical night shifts. Participants completed a laboratory-based simulated night shift (21:00-07:00 hours), followed by a recovery sleep opportunity (∼09:00-17:00 hours), recorded using polysomnography. Urinary 6-sulphatoxymelatonin (aMT6s) rhythm acrophase was used as a marker of circadian phase. Sleep duration and architecture were compared between individuals with aMT6s acrophase before (unadapted group, n = 22) or after (partially adapted group, n = 12) bedtime. RESULTS Bedtime occurred on average 2.16 hours before aMT6s acrophase in the partially adapted group and 3.91 hours after acrophase in the unadapted group. The partially adapted group had more sleep during the week before the simulated night than the unadapted group (6.47 ± 1.02 vs. 5.26 ± 1.48 hours, p = .02). After the simulated night shift, both groups had similar total sleep time (partially adapted: 6.68 ± 0.80 hours, unadapted: 6.63 ± 0.88 hours, p > .05). The partially adapted group had longer total rapid eye movement sleep duration than the unadapted group (106.79 ± 32.05 minutes vs. 77.90 ± 28.86 minutes, p = .01). After 5-hours, rapid eye movement sleep accumulation was higher in the partially adapted compared to the unadapted group (p = .02). Sleep latency and other stages were not affected by circadian adaptation. DISCUSSION Partial circadian adaptation to night shift was associated with longer rapid eye movement sleep duration during daytime sleep, highlighting the influence of entrainment between the sleep-wake cycle and the circadian pacemaker in night workers. The findings have important implications for sleep and subsequent alertness associated with shift work.
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Affiliation(s)
- Iona Z Zimberg
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Suzanne Ftouni
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Michelle Magee
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Sally A Ferguson
- Central Queensland University, Appleton Institute, Goodwood, South Australia, Australia
| | - Steven W Lockley
- 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
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, 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
| | - Tracey L Sletten
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.
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Wang Z, Xu H, Teng C, Wang C. Effects of a simulated maritime shift schedule on vigilance, sleep, and sleepiness. Chronobiol Int 2024; 41:237-247. [PMID: 38148569 DOI: 10.1080/07420528.2023.2298279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 12/17/2023] [Indexed: 12/28/2023]
Abstract
Shift work is associated with circadian misalignment, which causes sleep loss, impairs performance, and increases the risk of accidents. Shorter, more frequently shifting watch schedules, widely used in industries such as maritime operation, defense, and mining, may mitigate these risks by reducing shift length and providing sleep opportunities for all workers across the biological night. However, the effects of frequently shifting work on sleep and performance still need to be clarified. The current study investigated the vigilance, sleepiness, and sleep patterns of fifteen participants who lived in a controlled and confined laboratory that mimicked a maritime environment for 14 d following a simulating frequent shift schedule. The results of psychomotor vigilance tasks (PVT) suggest that this shift schedule may lead to an accumulation of vigilance detrimental across watch days, with both reaction speed impairment and error growth. Furthermore, the circadian phase significantly affects PVT performance, with the afternoon shift section showing relatively better performance. Overall, more working hours per day resulted in poorer PVT performance. As the shift progressed, total sleep duration reduced slightly, and wake after sleep onset (WASO) increased. Sleep during the biological night was generally longer than sleep in the daytime. Less on-watch time was linked to longer overall sleep duration. Additionally, although the subjective sleepiness obtained by the Karolinska Sleepiness Scale (KSS) varied insignificantly across days, the KSS score was negatively correlated with PVT performance. This research can serve as a foundation for developing countermeasures to mitigate frequently shifting schedules' potentially detrimental effects and safety risks.
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Affiliation(s)
- Ziying Wang
- Naval Medical Center of PLA, Naval Medical University (Second Military Medical University), Shanghai, China
- Key Laboratory of Molecular Neurobiology of Ministry of Education, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Haodan Xu
- Naval Medical Center of PLA, Naval Medical University (Second Military Medical University), Shanghai, China
- Key Laboratory of Molecular Neurobiology of Ministry of Education, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Chen Teng
- Naval Medical Center of PLA, Naval Medical University (Second Military Medical University), Shanghai, China
- Key Laboratory of Molecular Neurobiology of Ministry of Education, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Chuan Wang
- Naval Medical Center of PLA, Naval Medical University (Second Military Medical University), Shanghai, China
- Key Laboratory of Molecular Neurobiology of Ministry of Education, Naval Medical University (Second Military Medical University), Shanghai, China
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Gonzalez M, Mathelin C. [Breast cancer: An occupational disease for healthcare workers exposed to night work?]. Gynecol Obstet Fertil Senol 2024; 52:65-67. [PMID: 38036285 DOI: 10.1016/j.gofs.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Affiliation(s)
- M Gonzalez
- Service de pathologie professionnelle et médecine du travail, CHRU de Strasbourg, 67092 Strasbourg cedex, France
| | - C Mathelin
- Service de chirurgie, ICANS, CHRU de Strasbourg, 17, rue Albert-Calmette, 67033 Strasbourg cedex, France.
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Izadi N, Aminian O, Ghafourian K, Aghdaee A, Samadanian S. Reproductive outcomes among female health care workers. BMC Womens Health 2024; 24:44. [PMID: 38229075 PMCID: PMC10792822 DOI: 10.1186/s12905-024-02890-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 01/06/2024] [Indexed: 01/18/2024] Open
Abstract
OBJECTIVE Occupational exposures may be associated with reproductive health and pregnancy outcomes. This study investigated the association between occupational exposures and reproductive health, pregnancy outcomes, and the lactation period among hospital staff. MATERIALS AND METHODS Seven hundred thirty-three female healthcare workers from hospitals affiliated with the Tehran University of Medical Sciences were invited to participate in this cross-sectional study. The measurement method for fertility consequences was self-report. Demographic characteristics, occupational data, medical history, and reproductive history were collected via data collection form. Finally, reproductive outcomes were evaluated in different occupational hazard categories. RESULT Chemical exposures (solvents) were a risk factor for stillbirth. Prolonged working hours were associated with spontaneous abortion and breastfeeding periods. Shift workers did not have a higher frequency of reproductive and pregnancy outcomes, but the breastfeeding period was significantly decreased in shift workers. Psychiatric disorders were associated with preterm labour, low birth weight, and stillbirth in sequence with nervousness, depression, and mood disturbance. Furthermore, depression affects the breastfeeding period. Moreover, we found a link between job titles and infertility. In addition, socioeconomic status was related to stillbirth and infertility. CONCLUSION The study revealed that chemical and ergonomic exposures have associations with some reproductive outcomes. We also conclude that shift work could adversely affect the breastfeeding period. So, implementing some organizational strategies to control adverse health effects of occupational hazards and modifying shift work and working hours for nursing mothers is recommended.
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Affiliation(s)
- Nazanin Izadi
- Center for research on occupational diseases, Tehran University of medical sciences, Tehran, Iran
| | - Omid Aminian
- Center for research on occupational diseases, Tehran University of medical sciences, Tehran, Iran
| | - Kiana Ghafourian
- School of medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - AmirHossein Aghdaee
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shadi Samadanian
- Center for research on occupational diseases, Tehran University of medical sciences, Tehran, Iran.
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20
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Stavås JA, Nilsen KB, Matre D. The association between proportion of night shifts and musculoskeletal pain and headaches in nurses: a cross-sectional study. BMC Musculoskelet Disord 2024; 25:67. [PMID: 38229099 DOI: 10.1186/s12891-024-07196-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/11/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND AND PURPOSE Shift work is associated with musculoskeletal pain and headaches, but little is known about how the intensity of shift work exposure is related to musculoskeletal pain and headaches. This study aimed to investigate whether a higher proportion of night shifts is associated with a higher occurrence of musculoskeletal pain and headaches. Furthermore, to investigate whether sleep duration can mediate this potential association. METHOD The study included 684 nurses in rotating shift work who responded to a daily questionnaire about working hours, sleep, and pain for 28 consecutive days. The data were treated cross-sectionally. RESULTS A negative binomial regression analysis adjusted for age and BMI revealed that working a higher proportion of night shifts is not associated with a higher occurrence of musculoskeletal pain and headaches. On the contrary, those working ≥ 50% night shifts had a significantly lower occurrence of pain in the lower extremities than those who worked < 25% night shifts (IRR 0.69 95% CI 0.51, 0.94). There was no indication of a mediation effect with total sleep time (TST). CONCLUSION The results of this study indicate that working a higher proportion of night shifts is not associated with a higher occurrence of musculoskeletal pain and headaches.
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Affiliation(s)
- Jon Are Stavås
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- National Institute of Occupational Health (STAMI), Oslo, Norway
| | - Kristian Bernhard Nilsen
- Neuroscience Clinic, Department of Neurology and Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
| | - Dagfinn Matre
- National Institute of Occupational Health (STAMI), Oslo, Norway.
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Khosravipour M, Gharagozlou F, Kakavandi MG, Nadri F, Barzegar A, Emami K, Athar HV. Association of prolonged occupational co-exposures to electromagnetic fields, noise, and rotating shift work with thyroid hormone levels. Ecotoxicol Environ Saf 2024; 270:115837. [PMID: 38104436 DOI: 10.1016/j.ecoenv.2023.115837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/03/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023]
Abstract
The purpose of this study was to determine the association of prolonged occupational co-exposure to extremely low-frequency electromagnetic fields (ELF-EMFs), noise, and rotating shift work with the levels of thyroid hormones (triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH). From 2016 to 2017, we enrolled all male workers without a history of thyroid disorders and followed them until 2020. To measure ELF-EMFs and noise exposures, we calculated the 8-hour equivalent sound pressure levels (Leq) and the 8-hour average of ELF-EMFs, respectively. Shift work schedules involved 8-hr fixed day and 8-hr clockwise 3-rotating night schedules. The participant's thyroid hormone levels were obtained from blood test results in their medical records. The percentage change in the levels of T3, T4, and TSH was estimated by using different mixed-effects linear regression models. The TSH levels were significantly elevated per a 10-dB increment of noise. The levels of T4 hormone were significantly changed per a unit increase in the levels of ELF-EMFs. Compared to the fixed-day workers, we observed workers exposed to shift work had a significantly lower T4 level. For T4 and TSH hormones, we found significant interactions among noise, ELF-EMFs, and shift work variables. In summary, this study warranted that prolonged exposure to ELF-EMFs, noise, and rotating shift work might be associated with thyroid dysfunction.
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Affiliation(s)
- Masoud Khosravipour
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences. Tehran, Iran.
| | - Faramarz Gharagozlou
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran; Research center for environmental determinant of health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Ghanbari Kakavandi
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran; Research center for environmental determinant of health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farshad Nadri
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran; Research center for environmental determinant of health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Akbar Barzegar
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran; Research center for environmental determinant of health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Khosro Emami
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Valadi Athar
- Department of Occupational Health Engineering, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
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Chang MJ, Vidafar P, Birk JL, Shechter A. The relationship of shift work disorder with symptoms of depression, anxiety, and stress. J Affect Disord Rep 2024; 15:100713. [PMID: 38288275 PMCID: PMC10824514 DOI: 10.1016/j.jadr.2023.100713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024] Open
Abstract
Shift workers commonly suffer from disturbed sleep, which is known to affect mental health in other populations. Shift work disorder (SWD) is characterized by complaints of insomnia and/or excessive daytime sleepiness temporally associated with working non-standard schedules that occur during the usual time for sleep. Few studies have explored the extent to which workers with vs. without SWD experience worse mental health. We administered the Shift Work Disorder Screening Questionnaire to 60 adults engaged in various shift work schedules to categorize workers as being at high or low risk for SWD. Mental health outcomes were measured using the Depression Anxiety Stress Scale-21 (DASS-21). Linear regression was performed for each DASS-21 subscale, adjusting for age, sex, shift type, sleep duration, and frequency of alcohol use. Most participants (55 %) were at high risk for SWD. High-risk participants had higher depressive symptoms than low-risk participants, B = 3.59, 95 % CI [0.54, 6.65], p = .02. The estimated value for those at high risk for SWD corresponded to clinically significant mild depressive symptoms, (M = 13.43), compared to those at low risk, (M = 9.84). High risk for SWD was marginally associated with increased stress symptoms, B = 2.48, 95 % CI [-0.06,5.02], p = .06. Our findings add to the body of evidence that SWD is associated with poor mental health outcomes. Providing interventions specific to the sleep impacts of SWD, including tailored cognitive behavioral therapy for insomnia, may improve shift workers' mental health.
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Affiliation(s)
- Melinda J. Chang
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, USA
| | - Parisa Vidafar
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Australia
- Australian Research Council Centre of Excellence for Children and Families over the Life Course, Australia
| | - Jeffrey L. Birk
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, USA
| | - Ari Shechter
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, USA
- Center of Excellence for Sleep & Circadian Research, Columbia University Irving Medical Center, New York, NY, USA
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23
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Fijačko N, Masterson Creber R, Metličar Š, Gosak L, Štiglic G. Nurses' occupational physical activity and workload in a perioperative intensive care unit in Slovenia. Prev Med Rep 2024; 37:102543. [PMID: 38179440 PMCID: PMC10764244 DOI: 10.1016/j.pmedr.2023.102543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/06/2024] Open
Abstract
The field of nursing includes heavy occupational physical demands, including walking and standing for longer periods of time, in addition to moving and lifting. As such, in the context of a typical work shift, many nurses generally achieve the World Health Organization's recommended 10,000 steps per day. This study aimed at estimating the daily physical activity and workload of nurses in a perioperative intensive care unit. The data sources for this study included data from the hospital information system on various procedures and interventions, and the Silva Ex3 Plus pedometers for measuring steps, kilometers, calories, and activity time across various shifts in a perioperative intensive care unit. Twenty nurses from Slovenia volunteered to participate in this observational study. Over 13 weeks, a nurse working an 8-hour shift walked an average of 5,938 steps (4.4 km). However, nurses who worked a 12-hour weekend day shift came very close to the World Health Organization's recommendation with an average of 9,003 steps (6.5 km). A total of 227 patients were admitted and an average of 80 nursing interventions were performed per day and there was a positive relationship between physical activity, workload, and patient admissions in the perioperative intensive care unit (p = 0.001). Results of this study could help managers better understand nurses' physical activity and workload during various shifts in the perioperative intensive care unit.
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Affiliation(s)
- Nino Fijačko
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
- Maribor University Medical Centre, Maribor, Slovenia
| | | | - Špela Metličar
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
- Medical Dispatch Centre Maribor, University Clinical Centre Ljubljana, Ljubljana, Slovenia
| | - Lucija Gosak
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | - Gregor Štiglic
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
- Usher Institute, University of Edinburgh, Edinburgh, UK
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Shafer BM, Kogan SA, McHill AW. Pressure Building Against the Clock: The Impact of Circadian Misalignment on Blood Pressure. Curr Hypertens Rep 2024; 26:31-42. [PMID: 37837518 PMCID: PMC10916535 DOI: 10.1007/s11906-023-01274-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE OF REVIEW Misalignment between the endogenous biological timing system and behavioral activities (i.e., sleep/wake, eating, activity) contributes to adverse cardiovascular health. In this review, we discuss the effects of recurring circadian misalignment on blood pressure regulation and the implications for hypertension development. Additionally, we highlight emerging therapeutic approaches designed to mitigate the negative cardiovascular consequences elicited by circadian disruption. RECENT FINDINGS Circadian misalignment elicited by work schedules that require individuals to be awake during the biological night (i.e., shift work) alters 24-h blood pressure rhythms. Mechanistically, circadian misalignment appears to alter blood pressure via changes in autonomic nervous system balance, variations to sodium retention, dysregulation of endothelial vasodilatory responsiveness, and activation of proinflammatory mechanisms. Recurring circadian misalignment produced by a mismatch in sleep timing on free days vs. work days (i.e., social jetlag) appears to have no direct effects on prevailing blood pressure levels in healthy adults; though, circadian disruptions resulting from social jetlag may increase the risk of hypertension through enhanced sympathetic activation and/or obesity. Furthermore, social jetlag assessment may be a useful metric in shift work populations where the magnitude of circadian misalignment may be greater than in the general population. Circadian misalignment promotes unfavorable changes to 24-h blood pressure rhythms, most notably in shift working populations. While light therapy, melatonin supplementation, and the timing of drug administration may improve cardiovascular outcomes, interventions designed to target the effects of circadian misalignment on blood pressure regulation are warranted.
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Affiliation(s)
- Brooke M Shafer
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Sophia A Kogan
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Andrew W McHill
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA.
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA.
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25
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Zhou M, Zhang J, Zhao J, Liao M, Wang S, xu D, Zhao B, Yang C, Hou G, Tan J, Liu J, Zhang W, Yin L. Sex difference in cardiac performance in individuals with irregular shift work. Int J Cardiol Cardiovasc Risk Prev 2023; 19:200219. [PMID: 37841448 PMCID: PMC10569979 DOI: 10.1016/j.ijcrp.2023.200219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/10/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
Background: sex differences existed in animal behavioral adaption and activity rhythms when exposed to chronic disruption of the circadian rhythm. Whether these differences extend to cardiac performance has not been fully investigated by cardiac imaging technology. Methods One hundred and thirty patients enrolled in this study. Patients were divided into the day shift (DS) group and the irregular shift (IRS) group based on whether involved in the night shift and the frequency of the night shift. Comparisons of clinical data and cardiac imaging parameters were performed to identify the sex difference in cardiac function in the participants with day shift work or irregular shifts. Results The absolute value of GLS was significantly lower in male IRS group than in male DS group. In females, no significant difference was tested in left ventricular function between the two groups. In male participants, Weekly work hours (WWH) was positively correlated with HR (r = 0.51, p = 0.02) and QTc duration (r = 0.68, p < 0.00), and weakly negatively correlated with the GLS (r = -0.38, p = 0.05). Amongst patients, there was a 2.67-fold higher relative risk (RR) for impaired GLS in males than in females, with a 95 % confidence interval (CI) of 1.20-5.61. Moreover, there was an increased risk in the male IRS group compared to the female IRS group to develop impaired GLS (RR:3.14, 95 % CI 1.20-7.84). Conclusions The present study suggests that chronic circadian disruption brings cardiac dysfunction in people with night-shift work. Gender differences exist in the impact of circadian rhythmicity on cardiac function and may help to guide the work schedule and breaks in shift workers and bring forward prevention strategies in response to chronic circadian disruption.
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Affiliation(s)
- Mi Zhou
- Department of Ultrasound in Medicine, Sichuan Provincial People's Hospital Wenjiang Hospital, Chengdu, China
| | - Junqing Zhang
- Department of Ultrasound in Medicine, Sichuan Provincial People's Hospital Wenjiang Hospital, Chengdu, China
| | - Jinyi Zhao
- Department of Ultrasound in Medicine, Sichuan Provincial People's Hospital Wenjiang Hospital, Chengdu, China
| | - Mingjiao Liao
- Department of Ultrasound in Medicine, Sichuan Provincial People's Hospital Wenjiang Hospital, Chengdu, China
| | - Siming Wang
- Department of Ultrasound in Medicine, Sichuan Provincial People's Hospital Wenjiang Hospital, Chengdu, China
| | - Da xu
- Department of Ultrasound in Medicine, Sichuan Provincial People's Hospital Wenjiang Hospital, Chengdu, China
| | - Bingyan Zhao
- Department of Ultrasound in Medicine, Sichuan Provincial People's Hospital Wenjiang Hospital, Chengdu, China
| | - Chuan Yang
- Department of Ultrasound in Medicine, Sichuan Provincial People's Hospital Wenjiang Hospital, Chengdu, China
| | - Guoqing Hou
- Department of Cardiology, Sichuan Provincial People's Hospital Wenjiang Hospital, China
| | - Jing Tan
- Department of Ultrasound in Medicine, Sichuan Provincial People's Hospital Wenjiang Hospital, Chengdu, China
| | - Jun Liu
- Department of Ultrasound in Medicine, Sichuan Provincial People's Hospital, China
| | - Wenjun Zhang
- Department of Ultrasound in Medicine, Sichuan Provincial People's Hospital Wenjiang Hospital, Chengdu, China
| | - Lixue Yin
- Cardiovascular Ultrasound and Non-Invasive Cardiology Department, Sichuan Provincial People's Hospital, Chengdu, China
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Lim J, Lee J, Jeon S, Lee S, Kim SJ. Effects of co-sleeping with a shift worker on sleep, mood and cognition. SSM Popul Health 2023; 24:101530. [PMID: 37869583 PMCID: PMC10587613 DOI: 10.1016/j.ssmph.2023.101530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/24/2023] Open
Abstract
Objective Although the negative effects of shift work on workers' sleep and mood are well-known, the effects of shift work on their sleep partners' sleep and mood have rarely been investigated. The current study explored the effects of co-sleeping with a shift worker (SW) on the partner's subjective sleep quality, daytime sleepiness, depressive symptoms, and cognitive disturbances. Methods Online sleep and work-environment self-report questionnaires (e.g., including the presence of co-sleepers, work schedules of the co-sleepers, and their work schedules) were administered. The questionnaires also included the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Cognitive Failures Questionnaire (CFQ), and the short-term Center for Epidemiologic Studies-Depression scale (CES-D). Participants consisted of co-sleepers of SWs (n = 657), co-sleepers of non-SWs (n = 2186), and solo sleepers (n = 2432). Results Significant between-group differences in the PSQI, ESS, CFQ, and CES-D were observed after controlling for age, gender, work shift, and parenting (p < 0.001). Co-sleepers of SWs showed higher PSQI, ESS, CFQ, and CES-D scores than co-sleepers of non-SWs and solo sleepers. Solo sleepers reported significantly higher PSQI and CES-D scores than co-sleepers of non-SWs. The PSQI, ESS, CFQ, and CES-D scores were significantly correlated in all groups. The association between the ESS and PSQI was stronger in co-sleepers of SWs than in solo sleepers. The association between the ESS and CES-D was stronger in co-sleepers of SWs than in solo sleepers. Conclusions Co-sleeping with SWs is associated with poor sleep quality, daytime sleepiness, depressive symptoms, and cognitive disturbances in the partner.
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Affiliation(s)
- Joonyoung Lim
- 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
| | - 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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Hu F, Wu C, Jia Y, Zhen H, Cheng H, Zhang F, Wang L, Jiang M. Shift work and menstruation: A meta-analysis study. SSM Popul Health 2023; 24:101542. [PMID: 37954014 PMCID: PMC10632107 DOI: 10.1016/j.ssmph.2023.101542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 11/14/2023] Open
Abstract
Background Shift work is a potential risk factor for women's reproductive health. Evidence suggests that shift work is associated with menstrual disorders, reproductive disturbances, and adverse pregnancy outcomes. However, previous studies did not systematically examine the results of menstrual irregularities, dysmenorrhea, and early menopause at the same time. Objective To determine the relationship between shift work and women's menstrual characteristics (e.g., irregular menstruation, dysmenorrhea, and early menopause). Methods Four databases (PubMed, Embase, Cochrane, and Web of Science) were searched up to December 2022. The study characteristics and risk assessment values of the literature were extracted from 21 studies that met the criteria. Odds ratios (ORs), relative risks (RRs), hazard ratios (HRs), and 95% confidence intervals (CIs) were calculated to assess the relationship between shift work exposure and menstruation. The included studies were evaluated for heterogeneity, publication bias, sensitivity analysis, and subgroup analysis. Results A total of 21 studies with 195,538 female participants, including 16 cross-sectional studies and 5 cohort studies, were included in this meta-analysis. According to the quality evaluation, the included research had high methodological quality. The overall ORs of shift work for the likelihood of irregular menstruation and dysmenorrhea were 1.30 (95% CI, 1.23-1.36) (I2 = 41.9%, P < 0.05) and 1.35 (95% CI, 1.04-1.75) (I2 = 73.0%, P < 0.05), respectively. There was a significant positive association between shift work and the risk of early menopause (HR = 1.09, 95% CI, 1.04-1.14), without significant heterogeneity (I2 = 0.0%, P > 0.05). Conclusions This meta-analysis indicated that shift workers have significantly higher odds of menstrual disorders, dysmenorrhea, and early menopause. This study focuses on female reproductive health and has broad implications for adjusting optimal working hours and shift schedules for female workers.
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Affiliation(s)
- Fengying Hu
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Cuiyun Wu
- The Third People's Hospital of Hefei, Hefei Third Clinical College of Anhui Medical University, Hefei, 230022, China
| | - Yunfei Jia
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Hualong Zhen
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Hengshun Cheng
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Fan Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Liuqing Wang
- The Third People's Hospital of Hefei, Hefei Third Clinical College of Anhui Medical University, Hefei, 230022, China
| | - Minmin Jiang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, 230032, China
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Machado GDS, Menezes-Júnior LAAD, Neto RMDN, Freitas SND, Oliveira FLPD, Pimenta FAP, Machado-Coelho GLL, Ribeiro SMLT. Arterial hypertension in rotating shift workers: The role of hypertriglyceridemic waist and hypertriglyceridemic waist-to-height ratio phenotypes. Clin Nutr ESPEN 2023; 58:235-241. [PMID: 38057012 DOI: 10.1016/j.clnesp.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE To examine the association of arterial hypertension and the hypertriglyceridemic waist phenotype (HWP) and hypertriglyceridemic waist-to-height phenotype (HWHP). METHODOLOGY This cross-sectional study was conducted with 1422 male rotating shift workers in Brazil. The HWP was defined as having a waist circumference ≥94 cm and serum triglycerides ≥150 mg/dL, whereas the HWHP was determined by having a waist-to-height ratio ≥0.5 and serum triglycerides ≥150 mg/dL. To provide a characterization of the sample, data were presented in both absolute and relative values, and Pearson's chi-square test was employed. To investigate the potential association between arterial hypertension and the presence of HWP or HWHP, multivariate logistic regression was conducted, accounting for sociodemographic, behavioral, and clinical variables. Furthermore, we conducted a stratified multivariate logistic regression analysis, considering the duration of shift work, to assess whether the results remained consistent depending on the length of work experience in shifts. RESULTS A noteworthy association was observed between arterial hypertension and both HWP and HWHP, with HWHP exhibiting a stronger association with the disease. Furthermore, a positive association between arterial hypertension and these phenotypes was identified in workers with five or more years of shift work. CONCLUSION We recommend the utilization of HWHP as a screening tool, as it indicates a stronger association with arterial hypertension compared to HWP. Additionally, the duration of time spent working in shifts emerged as a significant factor influencing the presence of these phenotypes.
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Affiliation(s)
| | - Luiz Antônio Alves de Menezes-Júnior
- School of Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil; Post-Graduate in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil.
| | | | | | | | | | - George Luiz Lins Machado-Coelho
- Post-Graduate in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil; School of Medicine, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil
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Leung GK, Huggins KE, Bonham MP, Kleve S. Exploring Australian night shift workers' food experiences within and outside of the workplace: a qualitative photovoice study. Public Health Nutr 2023; 26:2276-2287. [PMID: 37548181 DOI: 10.1017/s1368980023001519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
OBJECTIVE Night shift workers are at a 20 to 40 % increased risk of metabolic diseases, which may be associated with their disrupted eating patterns. This qualitative study explores factors that influence night shift workers' eating habits, within and outside of the workplace, to identify target areas for health promotion strategies. PARTICIPANTS AND SETTING Eligible participants resided in Australia, working at least three overnight shifts per month. DESIGN The photovoice method was used, whereby participants were asked to take photos that represent their typical eating habits. These photos were incorporated as prompts in a semi-structured interview, which explored factors influencing eating habits on night shifts and days-off and perceptions and enablers to healthy eating. RESULTS Ten participants completed the study. Thematic analysis generated four main themes, which were mapped onto the Social Ecological Model (SE Model). Aligned with the SE Model, our results show night shift workers' eating habits are influenced by intrapersonal, interpersonal and (work) organisational levels. Participants reported that at work, appropriate food preparation facilities are required to enable healthy food choices. Poor shift work rostering leads to prolonged fatigue on days-off, limiting their ability and motivation to engage in healthy eating. Consequently, night shift workers seem to require additional supports from their social networks and enhanced food literacy skills, in order to adopt/ maintain healthy eating behaviours. CONCLUSIONS Night shift work creates individual and environmental barriers to healthy eating, which are present during and outside of work. Health promotion strategies for this population should include multiple approaches to address these barriers.
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Affiliation(s)
- Gloria Kw Leung
- Department of Nutrition, Dietetics and Food, Monash University. Level 1, 264 Ferntree Gully Road, Notting Hill, VIC3168, Australia
| | - Kate E Huggins
- Department of Nutrition, Dietetics and Food, Monash University. Level 1, 264 Ferntree Gully Road, Notting Hill, VIC3168, Australia
| | - Maxine P Bonham
- Department of Nutrition, Dietetics and Food, Monash University. Level 1, 264 Ferntree Gully Road, Notting Hill, VIC3168, Australia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, Monash University. Level 1, 264 Ferntree Gully Road, Notting Hill, VIC3168, Australia
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Najafi A, Safari-Faramani R, Selk-Ghaffari M, Najafi F, Ghafouri M, Darbandi M, Mahdaviani B, Nakhostin-Ansari A. Comparison of the physical activity levels between shift workers and non-shift workers in a large-scale cross-sectional study in Iran. BMC Public Health 2023; 23:2034. [PMID: 37853359 PMCID: PMC10585870 DOI: 10.1186/s12889-023-16895-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 10/04/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Shift work has been related to adverse health outcomes that can partially be attributed to physical inactivity. However, our knowledge of the influence of shift work on physical activity and sedentary behavior is inconclusive. Therefore, this study aimed to assess physical activity levels among shift and non-shift workers among a sample of Iranian adults. METHODS Baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort study were used. All participants of RaNCD except those excluded due to unemployment or considerable disability were included in the study. We evaluated participants' physical activity levels using the PERSIAN cohort questionnaire and examined its associations with being a shift worker. RESULTS A total of 4695 participants with a mean age of 46.1 (SD = 7.74) were included in the study. In total, 1108 (23.6%) participants were shift workers, 1420 (30.2%) had insufficient physical activity levels, and 4283 (91.2%) were male. The prevalence of physical inactivity was significantly lower among shift workers compared to non-shift workers (21% vs. 33.1%, p < 0.001). Multiple backward stepwise binary logistic regression tests indicated that being a shift worker was significantly associated with a lower chance of having insufficient physical activity levels (OR = 0.77, 95% CI = 0.65-0.92, p = 0.003). CONCLUSIONS The prevalence of insufficient physical activity was higher among non-shift workers than shift workers in our study. By providing the factors associated with insufficient physical activity among the workers in a region of Iran, the current study findings might help policymakers target groups at higher risk of physical activity in Iran and design interventions to improve physical activity, especially among non-shift workers.
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Affiliation(s)
- Anahita Najafi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Safari-Faramani
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Selk-Ghaffari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Ghafouri
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Darbandi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behnaz Mahdaviani
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Ye HT, Lu CQ, Wang C, Zhang D, Li YF, Feng XY, Wang HP, Mao YY, Ji MH, Yang JJ. Plasma Aβ level alterations after sleep deprivation correspond to brain structural remodeling in medical night shift workers. Brain Res Bull 2023; 203:110776. [PMID: 37805053 DOI: 10.1016/j.brainresbull.2023.110776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/30/2023] [Accepted: 10/04/2023] [Indexed: 10/09/2023]
Abstract
The relationship between brain structure alteration and metabolic product clearance after night shift work with total sleep deprivation (SD) remains unclear. Twenty-two intensive care unit staff on regularly rotating shift work were implemented with structural and diffusion MRI under both rest wakefulness (RW) and SD conditions. Peripheral blood samples were collected for the measurement of cerebral metabolites. Voxel-based morphometry and diffusion tensor imaging analysis were used to investigate the alterations in the gray matter density (GMD) and mean diffusivity (MD) within the participants. Furthermore, correlation analysis was performed to investigate the relationship between the neuroimaging metrics and hematological parameters. A significant increase in the GMD values was observed in the anterior and peripheral areas of the brain under SD. In contrast, a decrease in the values was observed in the posterior regions, such as the bilateral cerebellum and thalamus. In addition, a significant reduction in the total cerebrospinal fluid volume was observed under SD. The Aβ42/Aβ40 levels in participants under SD were significantly lower than those under RW. The mean MD increment values extracted from the region of interest (ROI) of the anterior brain were negatively correlated with the increment of plasma Aβ42/Aβ40 levels (r = -0.658, P = 0.008). The mean GMD decrement values extracted from the posterior ROI were positively correlated with the increment of plasma Aβ-40 levels (r = 0.601, P = 0.023). The findings of this study suggest that one night of shift work under SD induces extensive and direction-specific structural alterations of the brain, which are associated with aberrant brain metabolic waste clearance.
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Affiliation(s)
- Hao-Tian Ye
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Chun-Qiang Lu
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China; Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Medical School of Southeast University, Nanjing 210009, China
| | - Cong Wang
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Di Zhang
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yan-Fei Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Xiang-Yun Feng
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Hua-Peng Wang
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yuan-Yuan Mao
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Mu-Huo Ji
- Department of Anesthesiology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210003, China.
| | - Jian-Jun Yang
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
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Seo J, Lee S, Lee J, Jeon S, Hwang Y, Kim J, Kim SJ. Effects of sleep and impulsivity on suicidality in shift and non- shift workers. J Affect Disord 2023; 338:554-560. [PMID: 37393955 DOI: 10.1016/j.jad.2023.06.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 06/06/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023]
Abstract
INTRODUCTION Shift workers are known to have a higher suicide risk than non-shift workers. Sleep disturbance and impulsivity are also risk factors for suicidality. This study investigated the effects of poor sleep and impulsivity on suicidality in shift and non-shift workers. METHODS In total, 4572 shift workers (37.0 ± 9.84 years, 2150 males) and 2093 non-shift workers (37.8 ± 9.73 years, 999 males) participated in an online self-report survey. Suicidality was assessed using the Suicidal Behaviors Questionnaire. The Pittsburgh Sleep Quality Index was employed to explore subjective sleep quality, the Insomnia Severity Index to detect insomnia, the Epworth Sleepiness Scale (ESS) to evaluate excessive daytime sleepiness (EDS), the Center for Epidemiological Studies-Depression (CES-D) Scale to assess depressive symptoms, and the Impulsive Behavior Scale (UPPS-P) to explore impulsivity. RESULTS Shift workers showed poorer sleep quality, and greater impulsivity and suicidality, than non-shift workers. Impulsivity, sleep duration, sleep quality, and insomnia were significantly associated with suicidality, independent of depression. For both shift and non-shift workers, sleep quality moderated the association between impulsivity and suicidality. However, the moderating effects of sleep duration and EDS on the association between impulsivity and suicidality were apparent only in non-shift workers, while a moderating effect of insomnia was observed only in shift workers. CONCLUSION Shift work, sleep disturbances and impulsivity may exacerbate suicide risk. In addition, the interrelationships among insomnia, EDS, impulsivity, and suicidality may differ between shift and non-shift workers.
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Affiliation(s)
- Jihyo Seo
- 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
| | - 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 Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Jichul Kim
- 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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Wichert K, Hoppe R, Ickstadt K, Behrens T, Winter S, Herold R, Terschüren C, Lo WY, Guénel P, Truong T, Bolla MK, Wang Q, Dennis J, Michailidou K, Lush M, Andrulis IL, Brenner H, Chang-Claude J, Cox A, Cross SS, Czene K, Eriksson M, Figueroa JD, García-Closas M, Goldberg MS, Hamann U, He W, Holleczek B, Hopper JL, Jakubowska A, Ko YD, Lubiński J, Mulligan AM, Obi N, Rhenius V, Shah M, Shu XO, Simard J, Southey MC, Zheng W, Dunning AM, Pharoah PDP, Hall P, Easton DF, Brüning T, Brauch H, Harth V, Rabstein S. Polymorphisms in genes of melatonin biosynthesis and signaling support the light-at-night hypothesis for breast cancer. Eur J Epidemiol 2023; 38:1053-1068. [PMID: 37789226 PMCID: PMC10570222 DOI: 10.1007/s10654-023-01048-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/30/2023] [Indexed: 10/05/2023]
Abstract
Light-at-night triggers the decline of pineal gland melatonin biosynthesis and secretion and is an IARC-classified probable breast-cancer risk factor. We applied a large-scale molecular epidemiology approach to shed light on the putative role of melatonin in breast cancer. We investigated associations between breast-cancer risk and polymorphisms at genes of melatonin biosynthesis/signaling using a study population of 44,405 women from the Breast Cancer Association Consortium (22,992 cases, 21,413 population-based controls). Genotype data of 97 candidate single nucleotide polymorphisms (SNPs) at 18 defined gene regions were investigated for breast-cancer risk effects. We calculated adjusted odds ratios (ORs) and 95% confidence intervals (CI) by logistic regression for the main-effect analysis as well as stratified analyses by estrogen- and progesterone-receptor (ER, PR) status. SNP-SNP interactions were analyzed via a two-step procedure based on logic regression. The Bayesian false-discovery probability (BFDP) was used for all analyses to account for multiple testing. Noteworthy associations (BFDP < 0.8) included 10 linked SNPs in tryptophan hydroxylase 2 (TPH2) (e.g. rs1386492: OR = 1.07, 95% CI 1.02-1.12), and a SNP in the mitogen-activated protein kinase 8 (MAPK8) (rs10857561: OR = 1.11, 95% CI 1.04-1.18). The SNP-SNP interaction analysis revealed noteworthy interaction terms with TPH2- and MAPK-related SNPs (e.g. rs1386483R ∧ rs1473473D ∧ rs3729931D: OR = 1.20, 95% CI 1.09-1.32). In line with the light-at-night hypothesis that links shift work with elevated breast-cancer risks our results point to SNPs in TPH2 and MAPK-genes that may impact the intricate network of circadian regulation.
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Grants
- C12292/A11174 Cancer Research UK
- C5047/A15007 Cancer Research UK
- UM1 CA164920 NCI NIH HHS
- R01CA100374 NIH HHS
- C1281/A12014 Cancer Research UK
- C5047/A10692 Cancer Research UK
- R01 CA100374 NCI NIH HHS
- C490/A16561 Cancer Research UK
- C8197/A16565 Cancer Research UK
- C490/A10124 Cancer Research UK
- R01 CA128978 NCI NIH HHS
- C1287/A10118 Cancer Research UK
- P30 CA068485 NCI NIH HHS
- U01 CA164920 NCI NIH HHS
- CA128978 NIH HHS
- U19 CA148112 NCI NIH HHS
- C1287/A10710 Cancer Research UK
- C5047/A8384 Cancer Research UK
- European Union's Horizon 2020 Research and Innovation Programme
- Genome Canada
- Canadian Institutes of Health Research
- Ministère de l’Économie et de l'Innovation du Québec
- Government of Canada
- Génome Québec
- Fondation du cancer du sein du Québec
- Confluence project by National Cancer Institute Intramural Research Program, National Institutes of Health
- European Community's Seventh Framework Programme
- Cancer Research UK
- National Institutes of Health
- Post-Cancer GWAS initiative
- Department of Defence
- Canadian Institutes of Health Research (CIHR) for the CIHR Team in Familial Risks of Breast Cancer
- Susan G. Komen for the Cure
- Breast Cancer Research Foundation
- Ovarian Cancer Research Fund
- National Cancer Institute (USA)
- National Health and Medical Research Council of Australia
- Cancer Council NSW
- Victorian Health Promotion Foundation (Australia)
- Victorian Breast Cancer Research Consortium
- National Health and Medical Research Council
- Fondation de France
- Institut National du Cancer (INCa)
- Ligue Nationale contre le Cancer
- Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail
- Agence Nationale de la Recherche
- Ministerium für Wissenschaft, Forschung und Kunst Baden-Württemberg
- Deutsche Krebshilfe
- Bundesministerium für Bildung und Forschung
- Robert Bosch Stiftung
- Deutsches Krebsforschungszentrum
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA)
- Department of Internal Medicine, Johanniter GmbH Bonn, Johanniter Krankenhaus, Bonn, Germany
- Märit and Hans Rausings Initiative Against Breast Cancer
- Hamburger Krebsgesellschaft
- Canadian Institutes of Health Research for the “CIHR Team in Familial Risks of Breast Cancer” program
- Ministry of Economic Development, Innovation and Export Trade
- NIH
- Survey and Biospecimen Shared Resource
- USA National Cancer Institute of the National Institutes of Health
- Intramural Research Funds of the National Cancer Institute, Department of Health and Human Services, USA
- Agency for Science, Technology and Research of Singapore
- US National Institute of Health
- Susan G. Komen
- Sheffield Experimental Cancer Medicine Centre
- Breast Cancer Now Tissue Bank
- UK National Institute for Health Research Biomedical Research Centre at the University of Cambridge
- NHS in the East of England through the Clinical Academic Reserve
- Minister of Science and Higher Education, Regional Initiative of Excellence, project number 002/RID/2018/19
- Ruhr-Universität Bochum (1007)
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Affiliation(s)
- Katharina Wichert
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - Katja Ickstadt
- Department of Statistics, TU Dortmund University, Dortmund, Germany
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Stefan Winter
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - Robert Herold
- Institute for Occupational and Maritime Medicine Hamburg (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Claudia Terschüren
- Institute for Occupational and Maritime Medicine Hamburg (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Wing-Yee Lo
- Department of Clinical Pathology, University of Melbourne Centre for Cancer Research Victorian Comprehensive Cancer Centre Melbourne, Melbourne, VIC, Australia
| | - Pascal Guénel
- Team "Exposome and Heredity", CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France
| | - Thérèse Truong
- Team "Exposome and Heredity", CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Kyriaki Michailidou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Biostatistics Unit, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
| | - Michael Lush
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, ON, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Angela Cox
- Sheffield Institute for Nucleic Acids (SInFoNiA), Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Simon S Cross
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jonine D Figueroa
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, The University of Edinburgh, Edinburgh, UK
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montréal, QC, Canada
- Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University, Montréal, QC, Canada
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Wei He
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Anna Jakubowska
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Yon-Dschun Ko
- Department of Internal Medicine, Johanniter GmbH Bonn, Johanniter Krankenhaus, Bonn, Germany
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Anna Marie Mulligan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Laboratory Medicine Program, University Health Network, Toronto, ON, Canada
| | - Nadia Obi
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Valerie Rhenius
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Jacques Simard
- Genomics Center, Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, Canada
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, VIC, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
- iFIT-Cluster of Excellence, University of Tübingen, Tübingen, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Tübingen, Tübingen, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine Hamburg (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Sylvia Rabstein
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
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34
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Gao Y, Fu X, Hu H, Li T, Yuan L, Zhang J, Wu Y, Wang M, Ke Y, Li X, Hu F, Zhang M, Sun L, Wen H, Guan R, Gao P, Chai W, Zhao Y, Hu D. Impact of shift work on dementia: a systematic review and dose-response meta-analysis. Public Health 2023; 223:80-86. [PMID: 37625271 DOI: 10.1016/j.puhe.2023.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/26/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVES Although shift work has been reported as having a link to dementia, evidence remains inconsistent, and a comprehensive dose-response meta-analysis of the association is still lacking. We therefore conducted this meta-analysis to explore the association between shift work and the risk of dementia. STUDY DESIGN Systematic review and dose-response meta-analysis. METHODS PubMed, Embase, and Web of Science databases were systematically searched. Fixed or random-effects models were used to estimate the summary relative risks (RRs) and 95% confidence intervals (95% CIs). Generalized least squares regression was used to estimate dose-response associations, and restricted cubic splines were used to examine possible linear or non-linear associations. RESULTS Five articles (10 studies) with 72,999 participants and 23,067 cases were eventually included in the meta-analysis. The summary RRs and 95% CIs of dementia risk with shift work and night shift work versus daytime work were 1.13 (95% CI: 1.05-1.21, I2 = 46.70%) and 1.13 (95% CI: 1.03-1.24, I2 = 9.20%), respectively. The risk of dementia increased by 1% (RR = 1.01, 95% CI: 1.01-1.02, I2 = 41.3%) with each 1-year increase in the duration of shift work. We found a non-linear dose-response association between the duration of shift work and the risk of dementia (Pnon-linearity = 0.006). Though the shape of the curve was steeper with the duration of shift work <7 years, the increase was more gradual after 7 years. CONCLUSION Our findings suggest that shift work may be a risk factor for future dementia and that controlling the length of shift work is a feasible measure that may contribute to prevent dementia.
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Affiliation(s)
- Y Gao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - X Fu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - H Hu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - T Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - L Yuan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - J Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - Y Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - M Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - Y Ke
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - X Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - F Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, 518060, People's Republic of China
| | - M Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, 518060, People's Republic of China
| | - L Sun
- Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - H Wen
- Department of Clinical Medicine, Zhengzhou Shuqing Medical College, 6 Gongming Road, Erqi District, Zhengzhou, Henan, 450064, People's Republic of China
| | - R Guan
- Department of Famarcy, Shenzhen University General Hospital, Shenzhen, Guangdong, 518055, People's Republic of China
| | - P Gao
- Department of Neurology, Shenzhen University General Hospital, Shenzhen, Guangdong, 518055, People's Republic of China
| | - W Chai
- Department of Neurology, Shenzhen University General Hospital, Shenzhen, Guangdong, 518055, People's Republic of China
| | - Y Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - D Hu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China.
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Santos LZADA, Menezes-Júnior LAAD, Freitas SND, Pimenta FAP, Machado-Coelho GLL, Oliveira FLPD, Neto RMDN, Turbino-Ribeiro SML. Vitamin D deficiency and hyperglycemia in male rotating shift workers: A disturbed circadian rhythms influence. Clin Nutr ESPEN 2023; 57:258-265. [PMID: 37739666 DOI: 10.1016/j.clnesp.2023.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 06/13/2023] [Accepted: 06/26/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Shift work is related to several negative impacts on the health of workers. This study aimed to evaluate the association between vitamin D deficiency (VDD) and hyperglycemia in shift workers. METHODOLOGY This cross-sectional study included male rotating shift workers in an iron ore extraction company. Participants were classified as VDD when 25(OH)D < 20 ng/mL for a healthy population and 25(OH)D < 30 ng/mL for groups at risk for VDD. Hyperglycemia was classified when fasting glucose ≥100 mg/dL or HbA1c ≥ 5.7%. Data were compared using chi-square analysis with Cramer's V as effect size, and Bonferroni correction. Multivariate logistic regression, from a model of determination, was performed to investigate whether VDD was associated with hyperglycemia. RESULTS The study evaluated 1411 workers, most workers were aged 30-39 years (53.2%), and 77.5% self-declared as black, brown, with up to complete high school (71.4%) and working alternate shifts for more than 5 years (76.1%). Regarding glucose and vitamin D, 32.0% and 29.1% of the workers had hyperglycemia and VDD, respectively. In multivariate analysis, controlled for confounding factors, workers with VDD had a 119% increased chance of hyperglycemia (OR: 2.19; IC95%: 1.56-3.08). Furthermore, vitamin D levels in distribution quintiles showed a dose-response gradient in relation to hyperglycemia, where increased vitamin D values were associated with a reduction in the occurrence of hyperglycemia. CONCLUSION Rotating shift workers with vitamin D deficiency are more likely to have hyperglycemia.
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Affiliation(s)
| | - Luiz Antônio Alves de Menezes-Júnior
- School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Post-graduate Program in Health and Nutrition, Nutrition School, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil.
| | - Sílvia Nascimento de Freitas
- School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Post-graduate Program in Health and Nutrition, Nutrition School, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | | | - George Luiz Lins Machado-Coelho
- Post-graduate Program in Health and Nutrition, Nutrition School, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Medical School, Federal University of Minas Gerais, Ouro Preto, Minas Gerais, Brazil
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Atwater AQ, Castanon-Cervantes O. Uncovering Novel Biomarkers of Inflammation as Potential Screening Targets of Disease Risk in Healthcare Shift Workers: A Pilot Study. Int J Nurs Health Care Res (Lisle) 2023; 6:1466. [PMID: 37886726 PMCID: PMC10601993 DOI: 10.29011/2688-9501.101466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Shift work, experienced by nearly 30% of the U.S. workforce, is hazardous to health and has become a pervasive labor practice in the healthcare sector worldwide. It increases the risk of stroke, diabetes, cancer, and cardiovascular disease. Nonetheless, specific screening targets for shift workers still need to be defined. In this study, we have begun uncovering these targets as specific low-grade systemic inflammation markers and functional endotoxin-elicited responses that may foreshadow disease risk in shift workers. One hundred four participants (normothermic and normotensive) were healthy, non-smoking, and drug- and medication-free volunteers recruited from Atlanta area hospitals and medical schools. We assessed the concentration of three proteins in plasma samples from day workers and shift workers (lipopolysaccharide-binding protein, IL-10, and TNF-α), and the relationship between these baseline biomarkers and their response to an ex-vivo endotoxin challenge. We show that shift work increases low-grade systemic inflammation and disrupts discrete endotoxin responses. As shift work exposure increases, the correlation between low-grade systemic inflammation markers and their endotoxin responses was disrupted; this effect was more robust for TNF-α than for IL-10. With increased shift work exposure, these events, alone or combined, represent potential systemic and functional signals that may be harnessed to develop screening tools to identify at-risk individuals.
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Affiliation(s)
- Aisha Q Atwater
- Department of Neurobiology and Neuroscience Institute, Morehouse School of Medicine; Atlanta, GA. USA
| | - Oscar Castanon-Cervantes
- Department of Neurobiology and Neuroscience Institute, Morehouse School of Medicine; Atlanta, GA. USA
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Mateo-Gallego R, Pérez-Calahorra S, Bea AM, Gracia-Rubio I, Rodrigo-Carbo C, Moreno-Franco B, Civeira F, Laclaustra M, Lamiquiz-Moneo I. Absence of the influence of the APOE gene on the incidence of type 2 diabetes mellitus in a cohort of workers: Effect of diet and shift work. Clin Investig Arterioscler 2023; 35:226-235. [PMID: 37211496 DOI: 10.1016/j.arteri.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND APOE gene encoded a multifunctional protein in lipid metabolism, also associated with inflammatory markers. Type 2 diabetes (T2D) is a complex metabolic disease related to increased blood glucose, triglycerides and VLDL and associated with different dyslipidaemias. The aim of this study was to analyze whether the APOE genotype could determining the risk of developing T2D in a large cohort of workers. MATERIAL AND METHODS Data from the Aragon Workers Health Study (AWHS) (n=4895) were used to investigate the relationship between glycemic levels and APOE genotype. All patients in the AWHS cohort had their blood drawn after an overnight fast and laboratory tests were performed on the same day as the blood drawn. Dietary and physical assessment was assessed by face-to-face interview. APOE genotype was determined by the Sanger sequencing method. RESULTS The relationship between APOE genotype and glycemic profile showed that glucose, Hb1Ac, insulin and HOMA levels did not seem to be associated with the APOE genotype (p=0.563, p=0.605, p=0.333 and p=0.276, respectively). In addition, the T2D prevalence did not show an association with the APOE genotype (p=0.354). Along the same lines, blood glucose levels and T2D prevalence did not show association with the APOE allele. Shift work had some effect on the glycaemic profile, showing that night shift workers have significantly lower levels of glucose, insulin and HOMA (p<0.001). However, the APOE genotype did not show difference in the concentration of glycaemic parameters adjusting by sex, age and BMI, work shift and dietary parameters. CONCLUSION Glycemic profile and T2D prevalence did not show any significant association with the APOE genotype. Besides, individuals, who worked in non-rotating night shift showed significantly lower glycemic levels, while workers in the morning-afternoon-night shift showed significantly higher values.
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Affiliation(s)
- Rocío Mateo-Gallego
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain; Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, Huesca, Spain
| | - Sofía Pérez-Calahorra
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, Huesca, Spain
| | - Ana M Bea
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
| | - Irene Gracia-Rubio
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
| | - Carmen Rodrigo-Carbo
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
| | - Belen Moreno-Franco
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain; Departamento de Medicina, Microbiología, Pediatría, Radiología y Salud Pública, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
| | - Fernando Civeira
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain; Departamento de Medicina, Psiquiatría y Dermatología, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
| | - Martín Laclaustra
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain; Departamento de Medicina, Psiquiatría y Dermatología, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
| | - Itziar Lamiquiz-Moneo
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain; Departmento de Anatomía Humana e Histología, Escuela de Medicina, Universidad de Zaragoza, Spain.
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Hwang Y, Jang H, Lee J, Jeon S, Kim J, Lee S, Kim SJ. Sleep Reactivity and Sleep Efforts in Shift Workers. Psychiatry Investig 2023; 20:880-887. [PMID: 37794670 PMCID: PMC10555516 DOI: 10.30773/pi.2023.0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/20/2023] [Accepted: 07/09/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE The current study aimed to investigate the differences in sleep reactivity and sleep effort differs among late night shift workers (LSWs) and non-late night shift workers (non-LSWs), and non-shift workers (non-SWs). METHODS In total, 6,023 participants (1,613 non-SWs, 3,339 LSWs, and 1,071 non-LSWs) were recruited. Non-SWs was defined as those who works at fixed schedules during standard daylight. LSWs was defined as who work late night hours (10 PM-6 AM), while non-LSWs was SWs who did not work during late night. All completed the Ford Insomnia Response to Stress Test (FIRST), the Glasgow Sleep Effort Scale (GSES), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Insomnia Severity Index (ISI), and the short-term Center for Epidemiologic Studies-Depression scale (CES-D) through online survey. RESULTS LSWs and non-LSWs reported higher FIRST, GSES scores than non-SWs. In addition, LSWs reported higher FIRST, GSES scores than non-LSWs. FIRST scores were correlated with CES-D, PSQI, ISI, and ESS for LSWs, non-LSWs, and non-SWs alike. GSES scores were also correlated with CES-D, PSQI, ISI, and ESS for LSWs, non-LSWs, and non-SWs alike. CONCLUSION SWs showed higher sleep reactivity and sleep effort than non-SWs. LSWs had higher sleep reactivity and sleep effort than non-LSWs, and these variables are associated with insomnia, daytime sleepiness, and depressive symptoms. Our findings suggests that late night schedule, may increase sleep reactivity and sleep effort, which are associated with sleep and mood disturbances.
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Affiliation(s)
- Yunjee Hwang
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Hyeyeon Jang
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jooyoung Lee
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jichul Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Somi Lee
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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Wu JY, Li H, Shuai JK, He Y, Li PC. Evidence summary on the non-pharmacological management of sleep disorders in shift workers. Sleep Breath 2023:10.1007/s11325-023-02901-5. [PMID: 37587356 DOI: 10.1007/s11325-023-02901-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE This study aimed to evaluate, and integrate the relevant evidence on the non-pharmacological management of sleep disorders in shift workers to provide a reference for improving sleep of shift workers. METHODS According to the "6S" pyramid model of evidence, a comprehensive search was conducted in evidence-based databases, including BMJ-Best Practice, UpToDate, DynaMed, Cochrane Library, and Joanna Briggs Institute (JBI); clinical practice guideline websites, such as the Guidelines International Network; professional association websites, such as the World Sleep Society; and literature databases, including PubMed, Embase, CINAHL, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Biology Medicine disc (CBM) from inception to November 30, 2022. Two researchers independently evaluated the literature in accordance with the evaluation standards; conducted the extraction, classification, and synthesis of the evidence; and evaluated its grade and recommendation grade. RESULTS A total of 18 studies were included, including 2 clinical decisions, 2 guidelines, 3 expert consensuses, and 11 systematic reviews. In total, 25 pieces of evidence were summarized from 6 aspects: sleep assessment, sleep scheduling, sleep hygiene, light therapy, workplace intervention, and other managements. CONCLUSION This study summarized the best evidence for the non-pharmacological management of sleep disorders in shift workers. Shift workers should reasonably arrange their sleep time and develop good sleep hygiene. Additionally, work organizations should jointly promote sleep to improve the sleep conditions of shift workers and promote their physical and mental health.
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Affiliation(s)
- Jin-Yu Wu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China
- West China School of Nursing, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China
| | - Hui Li
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China
- West China School of Nursing, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China
| | - Jun-Kun Shuai
- Department of Emergency Medicine, Affiliated Hospital of Chengdu University, No.82, North 2nd Section, 2nd Ring Road, Chengdu, 610081, Sichuan, China
| | - Yue He
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China
- West China School of Nursing, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China
| | - Peng-Cheng Li
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China.
- West China School of Nursing, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China.
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Makris KC, Heibati B, Narui SZ. Chrono-modulated effects of external stressors on oxidative stress and damage in humans: A scoping review on night shift work. Environ Int 2023; 178:108048. [PMID: 37463540 DOI: 10.1016/j.envint.2023.108048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Oxidative stress and tissue damage (OSD) play a pivotal role as an early-stage process in chronic disease pathogenesis. However, there has been little research to better understand the temporal (χρόνος[chronos]) dimensions of OSD process associated with environmental (non-genetic, including behaviors/lifestyle) and/or occupational stressors, like night shift work. OSD processes have recently attracted attention in relation to time-resolved external stressor trajectories in personalized medicine (prevention) initiatives, as they seem to interact with circadian clock systems towards the improved delineation of the early stages of (chronic) disease process. OBJECTIVES This work critically reviewed human studies targeting the temporal dynamics of OSD and circadian clock system's activity in response to environmental/occupational stressors; the case of night shift work was examined. METHODS Being a key stressor influencing OSD processes and circadian rhythm, night shift work was evaluated as part of a scoping review of research in OSD, including inflammatory and metabolic processes to determine the extent of OSD research undertaken in human populations, methodologies, tools and biomarkers used and the extent that the temporal dimensions of exposure and biological effect(s) were accounted for. Online databases were searched for papers published from 2000 onwards, resulting in the selection of 53 original publications. RESULTS AND DISCUSSION The majority of studies (n = 41) took place in occupational settings, while the rest were conducted in the general population or patient groups. Most occupational studies targeted outcomes of oxidative stress/damage (n = 19), followed by the combination of OSD with inflammatory response (n = 10), and studies focused on metabolic outcomes (n = 12). Only a minor fraction of the studies measured biomarkers related to circadian rhythm, such as, melatonin, its metabolite, or cortisol. Night shift work was associated with select biomarkers of OSD and inflammation, albeit with mixed results. Although much progress in delineating the biological mechanisms of OSD process has been made, an equally thorough investigation on the temporal trajectory of OSD processes as triggered by environmental/occupational stressors in human studies has yet to fully evolve.
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Affiliation(s)
- Konstantinos C Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.
| | - Behzad Heibati
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus; Department of Research, Cancer Registry Norway, Oslo, Norway
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Quan SF, Weaver MD, Czeisler MÉ, Barger LK, Booker LA, Howard ME, Jackson ML, Lane RI, McDonald CF, Ridgers A, Robbins R, Varma P, Rajaratnam SM, Czeisler CA. Association of Chronotype and Shiftwork with COVID-19 Infection. medRxiv 2023:2023.07.06.23292337. [PMID: 37461617 PMCID: PMC10350136 DOI: 10.1101/2023.07.06.23292337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Objective This study assesses whether chronotype is related to COVID-19 infection and whether there is an interaction with shift work. Methods Cross-sectional survey of 19,821 U.S. adults. Results COVID-19 infection occurred in 40% of participants, 32.6% morning and 17.2% evening chronotypes. After adjusting for demographic and socioeconomic factors, shift work, sleep duration and comorbidities, morning chronotype was associated with a higher (aOR: 1.15, 95% CI 1.10-1.21) and evening chronotype with a lower (aOR: 0.82, 95% CI: 0.78-0.87) prevalence of COVID-19 infection in comparison to an intermediate chronotype. Working exclusively night shifts was not associated with higher prevalence of COVID-19. Morning chronotype and working some evening shifts was associated with the highest prevalence of previous COVID-19 infection (aOR: 1.87, 95% CI: 1.28-2.74). Conclusion Morning chronotype and working a mixture of shifts increase risk of COVID-19 infection.
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Affiliation(s)
- Stuart F. Quan
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Matthew D. Weaver
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Mark É. Czeisler
- Francis Weld Peabody Society, Harvard Medical School, Boston, MA
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Laura K. Barger
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Lauren A. Booker
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- University Department of Rural Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Mark E. Howard
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Melinda L. Jackson
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Rashon I. Lane
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
| | - Christine F. McDonald
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- Faculty of Medicine, Monash University, Melbourne Australia
| | - Anna Ridgers
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Rebecca Robbins
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Prerna Varma
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Shantha M.W. Rajaratnam
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Charles A. Czeisler
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
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Jang TW. Working hours and the regulations for night shift workers. Ann Occup Environ Med 2023; 35:e19. [PMID: 37928372 PMCID: PMC10622251 DOI: 10.35371/aoem.2023.35.e19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/18/2023] [Accepted: 06/21/2023] [Indexed: 11/07/2023] Open
Abstract
There are several types of shift work in Korea: rotating shift, 24-hour shift, day-night shift, fixed night work, and.so on. As a result of analyzing the 8th Korea National Health and Nutrition Examination Survey and the 6th Korean Working Condition Survey, Korean shift workers accounted for 11.6%-13.9% of wage workers. Weekly working hours of shift workers were 57.69 ± 1.73 (24-hours shift) and 49.97 ± 0.67 (fixed night shift), which were significantly longer than day workers. To prevent health consequences of night work, many countries regulate the working hours of night work not to exceed 7-9 hours a day. However, Korea does not regulate working hours for night work, and some occupations may work more hours than the prescribed overtime hours. To prevent health consequences and reduce working hours for Korean night shift workers, it is necessary to regulate the working hours of night shift workers by law.
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Affiliation(s)
- Tae-Won Jang
- Department of Occupational and Environmental Medicine, Hanyang University College of Medicine, Seoul, Korea
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Wang L, Ma Q, Fang B, Su Y, Lu W, Liu M, Li X, Liu J, He L. Shift work is associated with an increased risk of type 2 diabetes and elevated RBP4 level: cross sectional analysis from the OHSPIW cohort study. BMC Public Health 2023; 23:1139. [PMID: 37312059 DOI: 10.1186/s12889-023-16091-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 06/09/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Shift work, with its growing prevalence globally, disrupts the body's inherent circadian rhythm. This disruption may escalate the risk of chronic diseasesxacerbate chronic disease risk by dysregulating physiological, behavioral, and psychosocial pathways. This study aimed to evaluate the effect of shift work on type 2 diabetes (T2DM) and Retinol binding protein 4 (RBP4) level. METHODS The current study employed a multi-stage stratified cluster sampling technique, examining 1499 oilfield workers from the OHSPIW cohort who participated in occupational health assessments between March 2017 and June 2018.The evaluation involved shift work, sleep quality, T2DM status with questionnaires and plasma RBP4 levels in blood samples. Statistical analysis includes, Chi-square tests, t-tests, multivariate logistic regression analyses, and multivariate linear mixed models. RESULTS The prevalence rate of T2DM in shift workers (6.56%) was significantly higher than in day workers (4.21%) (OR = 1.60, 95% CI: 1.01-2.53), with no significant difference found in the family history of diabetes, hypertension, or other chronic heart diseases (P = 0.378). The shift worker (6.89 ± 3.35) also exhibited distinctly higher PSQI scores than day workers (5.99 ± 2.87) (P < 0.001). Adjusting the age, gender, BMI, family income, tobacco smoking, alcohol drinking and PSQI, hailed shift work as a risk factor for T2DM (OR = 1.91, 95% CI: 1.17-3.14). The pairwise comparison revealed significant differences in RBP4 levels across different groups: shift and non-shift workers both with and without T2DM (P < 0.001). The RBP4 level of the shift group without T2DM was higher than the non-shift group without T2DM (P < 0.05). The levels of RBP4 level in shift and non-shift groups with T2DM was higher than those without T2DM (P < 0.05). The multivariate linear mixed model showed that when age, gender, BMI, diabetes, PSQI, family income, smoking and drinking remained unchanged, the RBP4 level of the shift workers increased by an average of 9.51 μg/mL compared with the day workers. CONCLUSIONS Shift work is associated with an increased risk of T2DM and high levels of RBP4. Follow-up of RBP4 could facilitateearly detection of T2DM among shift workers.
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Grants
- 82060589 the National Natural Science Foundation of China
- 82060589 the National Natural Science Foundation of China
- 82060589 the National Natural Science Foundation of China
- 82060589 the National Natural Science Foundation of China
- 82060589 the National Natural Science Foundation of China
- 82060589 the National Natural Science Foundation of China
- 82060589 the National Natural Science Foundation of China
- 82060589 the National Natural Science Foundation of China
- 82060589 the National Natural Science Foundation of China
- SKL-HIDCA-2021-17 the State Key Laboratory Pathogenesis, Prevention and Treatment of High Incidence Diseases in Asia Fund
- SKL-HIDCA-2021-17 the State Key Laboratory Pathogenesis, Prevention and Treatment of High Incidence Diseases in Asia Fund
- SKL-HIDCA-2021-17 the State Key Laboratory Pathogenesis, Prevention and Treatment of High Incidence Diseases in Asia Fund
- SKL-HIDCA-2021-17 the State Key Laboratory Pathogenesis, Prevention and Treatment of High Incidence Diseases in Asia Fund
- SKL-HIDCA-2021-17 the State Key Laboratory Pathogenesis, Prevention and Treatment of High Incidence Diseases in Asia Fund
- SKL-HIDCA-2021-17 the State Key Laboratory Pathogenesis, Prevention and Treatment of High Incidence Diseases in Asia Fund
- SKL-HIDCA-2021-17 the State Key Laboratory Pathogenesis, Prevention and Treatment of High Incidence Diseases in Asia Fund
- SKL-HIDCA-2021-17 the State Key Laboratory Pathogenesis, Prevention and Treatment of High Incidence Diseases in Asia Fund
- SKL-HIDCA-2021-17 the State Key Laboratory Pathogenesis, Prevention and Treatment of High Incidence Diseases in Asia Fund
- SKL-SEHR-2021-05 the open project of Key Laboratory of Special Environment and Health Research, Department of Science and Technology, Xinjiang Uygur Autonomous Region
- SKL-SEHR-2021-05 the open project of Key Laboratory of Special Environment and Health Research, Department of Science and Technology, Xinjiang Uygur Autonomous Region
- SKL-SEHR-2021-05 the open project of Key Laboratory of Special Environment and Health Research, Department of Science and Technology, Xinjiang Uygur Autonomous Region
- SKL-SEHR-2021-05 the open project of Key Laboratory of Special Environment and Health Research, Department of Science and Technology, Xinjiang Uygur Autonomous Region
- SKL-SEHR-2021-05 the open project of Key Laboratory of Special Environment and Health Research, Department of Science and Technology, Xinjiang Uygur Autonomous Region
- SKL-SEHR-2021-05 the open project of Key Laboratory of Special Environment and Health Research, Department of Science and Technology, Xinjiang Uygur Autonomous Region
- SKL-SEHR-2021-05 the open project of Key Laboratory of Special Environment and Health Research, Department of Science and Technology, Xinjiang Uygur Autonomous Region
- SKL-SEHR-2021-05 the open project of Key Laboratory of Special Environment and Health Research, Department of Science and Technology, Xinjiang Uygur Autonomous Region
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Affiliation(s)
- Li Wang
- Departments of Public Health, Xinjiang Medical University, Urumqi, 830011, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Qi Ma
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - BinBin Fang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - YinXia Su
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, 830011, China
| | - Wanxian Lu
- Departments of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Mengdi Liu
- Departments of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Xue Li
- Departments of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Jiwen Liu
- Departments of Public Health, Xinjiang Medical University, Urumqi, 830011, China.
| | - LiJuan He
- Departments of Public Health, Xinjiang Medical University, Urumqi, 830011, China.
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Li Y, Peng X, Wang X, Lin R, Liu X, Meng F, Liu X, Li L, Bai R, Wen S, Ruan Y, Tang R, Liu N. Association of shift work and dietary inflammatory potential with all-cause death among us hypertensive population: national health and nutrition examination study, 2005-2010. BMC Public Health 2023; 23:1094. [PMID: 37280597 DOI: 10.1186/s12889-023-15740-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/23/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND & AIMS The individual effect of working schedule on survival in the hypertensive population has not been adequately studied. Shiftworkers are also prone to unhealthy lifestyles like pro-inflammatory diet. Therefore, we assessed the effect of shift work and its joint association with dietary inflammatory potential on mortality risk among the large US nationally representative sample of adult hypertensive population. METHODS Data were from a nationally representative prospective cohort among US hypertensive population (n = 3680; weighted population, 54,192,988). The participants were linked to the 2019 public-access linked mortality archives. The working schedule were self-reported using the Occupation Questionnaire Section. Dietary inflammatory index (DII) scores were equally calculated using the 24-hour dietary recall (24 h) interviews. Multivariable Cox proportional hazards regression models were used to estimate hazard ratio and 95% confidence intervals (95%CI) for survival of hypertension individuals by work schedule and dietary inflammatory potential. The joint effect of work schedule and dietary inflammatory potential was then examined. RESULTS Among the 3680 hypertension individuals (39.89% female [n = 1479] and 71.42% white [n = 1707]; weighted mean [SE] age, 47.35 [0.32] years), 592 individuals reported shift work status. 474 (10.76%) reported shift work status with pro-inflammatory dietary pattern (DII scores > 0). 118 (3.06%) reported shift work status with anti-inflammatory dietary pattern (DII scores < 0). 646 (19.64%) reported a non-shift working schedule with anti-inflammatory dietary pattern, while 2442 (66.54%) reported non-shift working schedule with pro-inflammatory dietary pattern. After a median follow-up of 11.67 years (140 months), 317 deaths (cardiovascular diseases (CVD), 65; cancer, 104) were registered. Cox regression analysis showed that shift work was associated with higher risk of all-cause mortality (hazard ratio [HR], 1.48; 95% CI, 1.07-2.06) compared with non-shift workers. In the joint analysis, shift work status combined with pro-inflammatory dietary pattern was associated with the highest all-cause mortality risk. Moreover, adopting the anti-inflammatory diet significantly attenuates the deleterious effect of shift work on mortality risk. CONCLUSIONS In this large representative sample of adults with hypertension in the U.S., the combination of shift work status with pro-inflammatory dietary pattern was highly prevalent and was associated with the highest risks of death from all causes.
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Affiliation(s)
- Yukun Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Xiaodong Peng
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Xuesi Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Rong Lin
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- North China Medical & Health Group XingTai Genernal Hospital, Xingtai, 054000, China
| | - Xinmeng Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Fanchao Meng
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Xiaoying Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Linling Li
- Department of Cardiology, Bejing Chuiyangliu Hospital, Beijing, 100012, China
| | - Rong Bai
- Banner University Medical Center Phoenix, College of Medicine University of Arizona Phoenix, Arizona, 85123, USA
| | - Songnan Wen
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Yanfei Ruan
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Ribo Tang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China.
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China.
| | - Nian Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China.
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China.
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Cyr M, Artenie DZ, Al Bikaii A, Lee V, Raz A, Olson JA. An evening light intervention reduces fatigue and errors during night shifts: A randomized controlled trial. Sleep Health 2023; 9:373-380. [PMID: 37080863 DOI: 10.1016/j.sleh.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE Shift work causes circadian rhythms to misalign with the demands of the environment, which has been associated with sleep difficulties and cognitive impairments. Although bright light exposure during night shifts can improve circadian alignment, its implementation is often infeasible. Here, we tested whether light exposure in the evening, before the night shift, could improve fatigue, work performance, mood, and sleep. METHODS Fifty-seven healthy nurses who worked full-time rapidly rotating shift schedules completed the study. In a mixed-design randomized controlled trial, participants completed a baseline observation period before following 1 of 2 interventions. The experimental intervention aimed to improve circadian alignment using evening light exposure and morning light avoidance; the control intervention aimed to improve alertness and reduce sleep disturbances by modifying diet. Every morning and evening for 30 days, participants completed measures of fatigue, work-related errors, sleepiness, mood, sleep duration, and sleep quality. RESULTS Compared to the baseline observation period, the experimental intervention reduced errors by 67%, while the control intervention reduced them by only 5%. This reduction was partially mediated by fatigue; experimental participants reported less fatigue on work days than control participants (d = 0.25 [0.10, 0.38]). The experimental group also showed a small improvement in mood. Both groups showed reductions in fatigue (d = 0.29 [0.20, 0.36]) and sleepiness (d = 0.21 [0.12, 0.28]) as well as a small increase in sleep duration. CONCLUSIONS Interventions based on evening light may be a feasible and effective strategy to reduce fatigue and errors in night-shift workers.
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Affiliation(s)
- Mariève Cyr
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Despina Z Artenie
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | | | - Virginia Lee
- McGill University Health Centre, Montreal, QC, Canada
| | - Amir Raz
- Institute for Interdisciplinary Behavioral and Brain Sciences, Chapman University, Irvine, CA, USA
| | - Jay A Olson
- Department of Psychology, McGill University, Montreal, QC, Canada; Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada.
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Bijnens S, Depoortere I. Controlled light exposure and intermittent fasting as treatment strategies for metabolic syndrome and gut microbiome dysregulation in night shift workers. Physiol Behav 2023; 263:114103. [PMID: 36731762 DOI: 10.1016/j.physbeh.2023.114103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/09/2023] [Accepted: 01/28/2023] [Indexed: 02/01/2023]
Abstract
The mammalian circadian clocks are entrained by environmental time cues, such as the light-dark cycle and the feeding-fasting cycle. In modern society, circadian misalignment is increasingly more common under the guise of shift work. Shift workers, accounting for roughly 20% of the workforce population, are more susceptible to metabolic disease. Exposure to artificial light at night and eating at inappropriate times of the day uncouples the central and peripheral circadian clocks. This internal circadian desynchrony is believed to be one of the culprits leading to metabolic disease. In this review, we discuss how alterations in the rhythm of gut microbiota and their metabolites during chronodisruption send conflicting signals to the host, which may ultimately contribute to disturbed metabolic processes. We propose two behavioral interventions to improve health in shift workers. Firstly, by carefully timing the moments of exposure to blue light, and hence shifting the melatonin peak, to improve sleep quality of daytime sleeping episodes. Secondly, by timing the daily time window of caloric intake to the biological morning, to properly align the feeding-fasting cycle with the light-dark cycle and to reduce the risk of metabolic disease. These interventions can be a first step in reducing the worldwide burden of health problems associated with shift work.
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Affiliation(s)
- Sofie Bijnens
- Gut Peptide Research Lab, Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - Inge Depoortere
- Gut Peptide Research Lab, Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium.
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Lee S, Lee J, Jeon S, Hwang Y, Kim J, Kim SJ. Sleep disturbances and depressive symptoms of shift workers: Effects of shift schedules. J Psychiatr Res 2023; 161:371-376. [PMID: 37012196 DOI: 10.1016/j.jpsychires.2022.12.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 11/26/2022] [Accepted: 12/19/2022] [Indexed: 04/05/2023]
Abstract
This study explored sleep disturbances and depression among various types of shift workers (SWs) and non-SWs, focusing on work schedule diversity. We enrolled 6,654 adults (4,561 SWs, 2,093 non-SWs). Based on self-report questionnaires on work schedules, the participants were classified according to shift work type: non-shift work; and fixed evening, fixed night, regularly rotating, irregularly rotating, casual, and flexible shift work. All completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies-Depression scale (CES-D). SWs reported higher PSQI, ESS, ISI, and CES-D than non-SWs. Fixed SWs (fixed evenings and fixed nights) and true SWs (regularly and irregularly rotating SWs) scored higher on the PSQI, ISI, and CES-D than non-SWs. True SWs scored higher on the ESS than fixed SWs and non-SWs. Among fixed SWs, fixed night SWs scored higher on the PSQI and ISI than fixed evening SWs. Among true SWs, irregular SWs (irregularly rotating and casual SWs) scored higher on the PSQI, ISI, and CES-D compared to regularly rotating SWs. The PSQI, ESS, and ISI independently were associated with the CES-D of all SWs. We found an interaction between the ESS and the work schedule on the one hand, and the CES-D on the other, which was stronger in SWs than non-SWs. Fixed night and irregular shifts were linked with sleep disturbances. The depressive symptoms of SWs are associated with sleep problems. The effects of sleepiness on depression were more prominent in SWs than non-SWs.
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Affiliation(s)
- Somi Lee
- 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 Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Jichul Kim
- 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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Schernhammer E, Bogl L, Hublin C, Strohmaier S, Zebrowska M, Erber A, Haghayegh S, Papantoniou K, Ollikainen M, Kaprio J. The association between night shift work and breast cancer risk in the Finnish twins cohort. Eur J Epidemiol 2023; 38:533-543. [PMID: 36964875 PMCID: PMC10164004 DOI: 10.1007/s10654-023-00983-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 02/28/2023] [Indexed: 03/26/2023]
Abstract
Breast cancer is highly prevalent yet a more complete understanding of the interplay between genes and probable environmental risk factors, such as night work, remains lagging. Using a discordant twin pair design, we examined the association between night shift work and breast cancer risk, controlling for familial confounding. Shift work pattern was prospectively assessed by mailed questionnaires among 5,781 female twins from the Older Finnish Twin Cohort. Over the study period (1990-2018), 407 incident breast cancer cases were recorded using the Finnish Cancer Registry. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusting for potential confounders. Within-pair co-twin analyses were employed in 57 pairs to account for potential familial confounding. Compared to women who worked days only, women with shift work that included night shifts had a 1.58-fold higher risk of breast cancer (HR = 1.58; 95%CI, 1.16-2.15, highest among the youngest women i.e. born 1950-1957, HR = 2.08; 95%CI, 1.32-3.28), whereas 2-shift workers not including night shifts, did not (HR = 0.84; 95%CI, 0.59-1.21). Women with longer sleep (average sleep duration > 8 h/night) appeared at greatest risk of breast cancer if they worked night shifts (HR = 2.91; 95%CI, 1.55-5.46; Pintx=0.32). Results did not vary by chronotype (Pintx=0.74). Co-twin analyses, though with limited power, suggested that night work may be associated with breast cancer risk independent of early environmental and genetic factors. These results confirm a previously described association between night shift work and breast cancer risk. Genetic influences only partially explain these associations.
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Affiliation(s)
- Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, 1090, Austria.
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
- Complexity Science Hub Vienna, Josefstädter Straße 39, Vienna, 1080, Austria.
| | - Leonie Bogl
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, 1090, Austria
- Institute for Molecular Medicine (FIMM), University of, Helsinki, Tukholmankatu 8, P.O. Box 20, Helsinki, 00014, Finland
| | - Christer Hublin
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 b, Helsinki, 00250, Finland
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, 1090, Austria
| | - Magda Zebrowska
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, 1090, Austria
| | - Astrid Erber
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, 1090, Austria
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Roosevelt Drive, Oxford, OX3 7LG, UK
| | - Shahab Haghayegh
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Kyriaki Papantoniou
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, 1090, Austria
| | - Miina Ollikainen
- Institute for Molecular Medicine (FIMM), University of, Helsinki, Tukholmankatu 8, P.O. Box 20, Helsinki, 00014, Finland
- Minerva Foundation Institute for Medical Research, Biomedicum Helsinki 2U, Tukholmankatu 8, Helsinki, 00290, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine (FIMM), University of, Helsinki, Tukholmankatu 8, P.O. Box 20, Helsinki, 00014, Finland
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Grøtting G, Øvergård KI. The relation between routines for shiftwork scheduling and sickness absence at a Norwegian hospital: A cross-sectional study. Int J Nurs Stud 2023; 141:104477. [PMID: 36940648 DOI: 10.1016/j.ijnurstu.2023.104477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/21/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Shift work is associated with negative health outcomes. Routines for scheduling of shift work can help reduce negative health outcomes of shift work and improve work-life balance and social well-being for nurses working shift work. OBJECTIVE To investigate the association between organizational units' routines for shift work scheduling and nurses' sickness absence at the unit level. DESIGN Cross-sectional study design combining quantitative questionnaire data on shift work scheduling routines with data of mean percentage of sickness absence at the unit, mean level of exhaustion at the unit, mean age and percentage of women working at the unit. PARTICIPANTS A total of 126 leaders at organizational units with nurses working shift work schedule at Oslo University Hospital answered a questionnaire about shift work scheduling. MEASURES Three aspects of health-promoting shift work scheduling (fatigue-reducing scheduling, organizational health measures, and individual adaptation) and the extent to which operational considerations were made during shift work scheduling were used as independent variables. Covariates were mean age of nurses at each unit, mean percent female nurses, and mean exhaustion at unit level. Percent sickness absence was used as a dependent variable. METHODS Questionnaire data on shift work scheduling routines was merged with information on average age of employees in the unit, ratio female nurses, and units' average score on exhaustion. Multivariable linear regression analyses were used to assess the contribution of routines for shift work scheduling after controlling for mean level of exhaustion, average age, and proportion of women at each unit. RESULTS The factors "fatigue reducing scheduling", "organizational health measures" and "operational considerations" had no observed total effect on mean sickness absence. Individual adjustment in shift work scheduling had a direct negative association with sickness absence after controlling for other shift work scheduling routines, exhaustion, age, and gender. CONCLUSIONS There is a relationship between the units' routines for shift work scheduling and mean sickness absence at the unit, and the possibility of individual adjustment was the only aspect of shift work scheduling that had an above-zero association with sickness absence.
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Affiliation(s)
- Gina Grøtting
- Department of Occupational and Environmental Health, Oslo University Hospital, Norway; Research Group for Health Promotion in Settings, Department of Health-, Social-, and Welfare Studies, University of South-Eastern Norway, Postboks 4, 3199 Borre, Norway
| | - Kjell Ivar Øvergård
- Research Group for Health Promotion in Settings, Department of Health-, Social-, and Welfare Studies, University of South-Eastern Norway, Postboks 4, 3199 Borre, Norway.
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Huang RS, Chen YC, Tsai SY, Huang YE, Guo YL. Incomplete off-duty work hours and sleep quality among firefighters: a cross-sectional study, Taiwan. Int Arch Occup Environ Health 2023; 96:247-57. [PMID: 36063231 DOI: 10.1007/s00420-022-01918-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/24/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE We examined whether firefighters in Taiwan have a sleep problem and investigated the related factors of poor sleep quality. METHODS In this cross-sectional study, 2123 male shift firefighters in the Greater Taipei area were invited, and 37.7% of them satisfactorily completed the questionnaire online. The Chinese version of Pittsburgh sleep quality index (PSQI) was used to evaluate sleep quality. Multiple logistic and linear regression analyses were used to determine the associations among demographic characteristics, work-related characteristics, and poor sleep quality. RESULTS As revealed by 801 valid questionnaires, 77.2% were poor sleepers (PSQI cutoff score > 6), and 61.2% reported incomplete off-duty in the past month. Moreover, 42.6% of incomplete off-duty workers reported extended overtime of more than 5 h on off-duty days in the past month. Poor sleep quality was associated with the following factors: (1) demographic characteristics: age, working tenure, having children, and chronotype and (2) work-related characteristics: shift schedule and incomplete off-duty. The final model for poor sleep quality as per PSQI included age, chronotype, shift schedule, and incomplete off-duty hours in the past month. Longer hours of incomplete off-duty work were associated with increased risks of overall poor sleep quality and of poor subjective sleep quality, long sleep latency, sleep disturbances, and daytime dysfunction. CONCLUSION Firefighters are advised to have a complete off-duty day to avoid poor sleep quality, long sleep latency, short sleep duration, sleep disturbances, and daytime dysfunction. Our results confirm the need for implementing appropriate shift schedules to ensure adequate rest time for firefighters.
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