Research progress on the effect of shift-work on the physical health of nurses / 中国职业医学

Good health status is an important prerequisite for nurses to provide quality nursing services for patients. Shift-work is an important work style of nurses. Studying the effect of shift-work on the physical health of nurses is helpful for planning a reasonable shift-work system, formulating health promotion strategies, and improving the personal health and quality of life of nurses. Shift-work can disrupt circadian rhythms and lead to dysfunction autonomic and endocrine system, indirectly increasing the risk of disease for nurses. Some research suggests that shift-work may have an impact on the endocrine system, leading to an increased risk of diabetes, metabolic syndrome and sleep disorders. Shift-work can cause dysregulation of the parasympathetic nervous system, leading to an increased risk of cardiovascular disease and increased mortality from cardiovascular disease in nurses. Shift-work may cause acid-base imbalance and changes in digestive enzyme secretion, leading to an increased risk of digestive diseases. However, the current research on the effect of shift-work on the physical health of nurses is lacking and more rigorous studies are needed.

Relación entre estrés percibido y calidad de sueño en enfermeras de turnos nocturno y rotativo / Relationship between perceived stress and sleep quality in night-shift and rotating nurses

Objetivo: determinar si existe relación entre el estrés percibido y la calidad de sueño en las enfermeras de los turnos nocturno y rotativo de la empresa social del Estado Hospital San Rafael de Facatativá. Metodología: estudio transversal con alcance correlacional donde se evaluó el estrés percibido y la calidad de sueño por medio de la escala de estrés percibido - versión 14 y el índice de calidad de sueño de Pittsburg -versión colombiana, respectivamente, en una muestra de 98 enfermeras que cumplieron con los criterios de inclusión. Resultados: se presentó una prevalencia del 72,45% de estrés percibido y del 79,59% de mala calidad de sueño; entre estas dos variables se halló una correlación baja (r=0,258; p=0,010). Se puede asegur ar con un 95 % de confianza que mientras una variable aumenta, la otra también lo hace, queriendo decir que a mayor puntaje en la escala de estrés percibido, mayor puntaje en el índice de calidad de sueño de Pittsburgh, lo que sugiere que el nivel de estrés es un factor que tiene relación directamente proporcional con el sueño, es decir, entre mayor estrés, peor calidad de sueño. Conclusiones: se concluye que sí existe relación entre el estrés percibido y la calidad de sueño, lo cual evidencia, por un lado, que en las enfermeras a mayor estrés, peor calidad de sueño, y por otro, que a peor calidad de sueño, mayor estrés.

Objective: To determine if there is a relationship between perceived stress and sleep quality in nurses in the night and rotating shifts of the social enterprise of the State Hospital San Rafael of Facatativá. Methodology: Study cross-sectional with a correlational scope where the perceived stress was assessed through the Perceived Stress Scale, Version 14, and sleep quality using the Pittsburg Sleep Quality Index, Colombian Version, in a sample of 98 nurses who met the inclusion criteria. Results: a prevalence of 72.45% of stress and 79.59% of poor sleep quality were perceived; there was a low correlation between these two variables (r= 0.258; p=0.010). It may be ensured with 95% of confidence that while a variable increases, the other one does the same; this means that higher stress level in the perceived stress scale implies a higher score in the Pittsburgh Sleep Quality Index; which suggests that stress level is a factor that has directly proportional relationship with sleep; so, higher stress level is equal to worse sleep quality. Conclusions: It is concluded that there is a relationship between perceived stress and sleep quality, showing that, the greater the stress in the nurses, the worse the quality of sleep, as well as the worse the quality of sleep, the greater the stress

Night shiftwork and prostate-specific antigen level in a tire manufacturing factory

BACKGROUND: Recent studies suggest that night shiftwork may increase the risk of prostate cancer and elevated serum prostate-specific antigen (PSA) level. The purpose of this study was to verify whether rotating night shiftwork affects serum PSA level. METHODS: This study included 3,195 male production workers who work in a large tire manufacturing factory. Serum PSA levels were measured and the data on related factors were obtained. RESULTS: The mean serum PSA level was 0.98 ± 0.79 ng/mL. PSA levels were significantly lower in the younger age group, the obese group, and regular exercise group. PSA levels were lower in night shift workers (n = 2,832) compared to day workers (n = 363), but the difference was not statistically significant. CONCLUSIONS: Unlike previous studies, we did not find any evidence that night shiftwork results in an increase in serum PSA levels. Further research and consistent results are needed to elucidate the association between night shiftwork and the effect on the prostate.

Association of Sleep Disturbance, Fatigue, Job Stress and Exposure to Blood and Body Fluid in Shift-work Nurses

PURPOSE: The purpose of this study was to identify associations among the sleep disturbance, fatigue, job stress, and blood and body fluid (BBF) exposure of shift-work nurses. METHODS: A total of 299 shift-work nurses from two tertiary hospitals were enrolled in this study. We used the Insomnia Severity Index (ISI), and the Fatigue Severity Scale (FSS), and the Korean Occupational Stress Scale-Short Form (KOSS-SF) to evaluate sleep disturbance, fatigue, and job stress, respectively. The data were analyzed using t-test or chi-squared test and Logistic regression analysis using the SPSS 23.0 program. RESULTS: We found that 43.8% of participants reported BBF exposure over the past year. Splash or exposure to broken skin of BBF were most frequent (56.9%), and followed by needlestick injuries (30.4%) and sharp injuries (12.8%). Age, hospital, working period, level of stress, sleep disturbance (ISI≥15), fatigue (FSS score≥4), job demand and organizational climate subset in KOSS-SF were significantly associated with BBF exposure in shift-work nurses. In multivariate analysis after adjusting age and hospital, the risk factors of BBF exposure in shift-work nurses were the level of stress and fatigue (FSS score≥4). CONCLUSION: Fatigue and job stress were related to BBF exposure in shift-work nurses. Our results suggest that management of sleep disturbance, fatigue, and high job stress in shift-work nurses is needed to reduce risk of BBF exposure.

Relationship between subjective fatigue, physical activity, and sleep indices in nurses working 16-hour night shifts in a rotating two-shift system / Journal of Rural Medicine

Objective: We clarified the relationship between the degree of subjective fatigue, sleep, and physical activity among nurses working 16-hour night shifts in a rotating two-shift system.Materials and Methods: We investigated 15 nurses who were surveyed regarding their individual attributes, physical activity level (consumed calories), hours of sleep, sleep efficiency, sleep onset latency, sleep diary, and subjective symptoms. Nurses wore a Fitbit One (Fitbit Inc., San Francisco, CA, USA) for 7 consecutive days to measure sleep and physical activity.Results: Results were analyzed for nine participants, excluding those who withdrew or had missing data. The years of nursing experience, nurses’ age, and the length of nocturnal awakening time of the high fatigue group were significantly longer than of the low fatigue group (p < .05). Years of nursing experience in the affiliated department of the high fatigue group was significantly shorter than of low fatigue group (p < .05). The number of nightshifts during the survey period was significantly higher in the high fatigue group than in the low fatigue group. Fatigue after work and body mass index (r = 0.46, p < .001), consumed calories (r = 0.30, p < .05), bedtime (r = –0.36, p < .05), and hours of sleep (r = –0.37, p < .01) were significantly correlated; however, the sleep indices were not correlated.Conclusion: We clarified that the degree of fatigue in nurses working 16-hour night shifts in a rotating two-shift system was related to individual factors, such as age, years of nursing experience, years of nursing experience in the affiliated department, number of nightshifts, and length of nocturnal awakening time. Nurses with greater fatigue had significant differences in their bedtime on days off and work days, which suggests that sleep rhythm may also affect fatigue.

Associação da expressão circadiana do cortisol de enfermeiros segundo trabalho em turnos, estresse ocupacional e fadiga / Association of circadian expression of cortisol in nurses accordingly to shiftwork, occupational stress and fatigue

O trabalho noturno e a alternância de turnos são identificados como fatores de maximização de efeitos negativos na saúde do trabalhador, como o estresse e a fadiga, por dificultarem a adaptação do ritmo circadiano do cortisol ao de trabalho. Objetivo: investigar o efeito do esquema de trabalho em turnos fixo e alternante e noturno de enfermeiros nos índices de estresse ocupacional e fadiga e na expressão circadiana do cortisol salivar. Método: estudo observacional de corte transversal e abordagem quantitativa dos dados estruturado com base no referencial teórico de Cooper. Realizado com 104 enfermeiros das Unidades de Emergência e Bloco Cirúrgico de hospital de ensino público do Estado de São Paulo e outro de Minas Gerais, no período de janeiro a março de 2017. Índices de estresse e fadiga foram mensurados por meio da aplicação de dois instrumentos: o Inventário de Estresse em Enfermeiros e a Escala de Avaliação de Fadiga, ambos validados para utilização no Brasil. A quantificação do cortisol salivar foi realizada por meio da técnica de ELISA. O projeto foi aprovado pelo Comitê de Ética em pesquisa sob protocolo. 55695416.7.0000.5393. Resultados: 66,67% dos enfermeiros trabalhavam em esquema de turnos alternantes e 39,39% eram fixos no turno matutino. Constatou-se 50,8% apresentaram alto índice de estresse e 46,03% fadiga. Não foram observadas associações estatisticamente significativas entre índices de cortisol salivar, turno de trabalho, esquema de turno fixo ou alternante, estresse e fadiga. Entretanto, profissionais de enfermagem de unidades críticas que trabalhavam em esquema de turnos alternante e matutino apresentaram tendência a mais altos índices de estresse e fadiga e menor secreção de cortisol ao longo do dia de trabalho do que aqueles dos turnos fixo e noturno. A fadiga mostrou-se significativa e positivamente correlacionada com a secreção total de cortisol no período da manhã. Conclusão: Os achados do presente estudo fornecem evidências de uma dessincronização do eixo HipotálamoHipófise-Adrenal em enfermeiros dos turnos alternante e matutino e, consequentemente, maior susceptibilidade destes ao desenvolvimento de doenças cardíacas, metabólicas e imunológicas

Night-work and shiftwork are identified as maximizing negative effects on worker health, such as stress and fatigue, by making it difficult to adapt the circadian rhythm of cortisol to work. Objective: to investigate the effect of the fixed and alternating and nocturnal shifts of nurses on the occupational stress index, fatigue and circadian expression of salivary cortisol. Method: observational, cross-sectional and quantitative study based on Cooper's theoretical framework. Performed with 104 nurses from the emergency units and surgical center of a public teaching hospital in the State of São Paulo and another from Minas Gerais, from January to March, 2017. Stress and fatigue indexes were measured using two instruments, the Nurses' Stress Inventory and the Fatigue Assessment Scale, both of which were validated and salivary cortisol quantification was performed by ELISA assay. The project was approved by the Research Ethics Committee under protocol. 55695416.7.0000.5393. Results: 66.67% of the nurses worked on alternating shifts and 39.39% were fixed on the morning shift. It was found that 50.8% of the nurses had a high stress index and 46.03% presented fatigue. There were no statistically significant associations between salivary cortisol index, shiftwork, fixed or alternating shift scheme, stress and fatigue. However, nursing professionals from critical units who worked in an alternating and morning shift schedule showed a trend towards higher levels of stress and fatigue and lower cortisol secretion throughout the workday than fixed and night shift workers. Fatigue was significantly and positively correlated to overall morning cortisol. Conclusions: The findings of the present study provide evidence of a hypothalamic-pituitary-adrenal axis desynchronization in nurses of the alternating and morning shift and, consequently, a greater susceptibility of these to the development of cardiac, metabolic and immunological diseases

Sleepiness while driving and shiftwork patterns among Korean bus drivers

BACKGROUND: Sleepiness while driving has been regarded as a major cause of death due to traffic accidents. We compared the degree of sleepiness across five different working time periods (first, morning, post-lunch, afternoon, and last) among Korean bus drivers with different shift types (Daily two shift/Alternating day shift). METHOD: We interviewed 332 bus drivers with two shift types (Daily two shift, 128; Alternating day shift, 204). The questionnaire included demographic information (age, alcohol consumption and history of disease), a sleep disorder diagnosed by a doctor, job duration, the number of workdays in the past month, average working hours per workday and week, sleepiness while driving (Karolinska Sleepiness Scale), and sleeping time for both workdays and off-days. We conducted log-binomial regression analyses and produced prevalence ratios (PRs) of severe sleepiness (KSS ≥ 7) while driving with 95% confidence intervals (95% CI) to identify the difference in sleepiness for five working times between both groups. RESULTS: For the first and morning periods, there were no statistically significant differences in the KSS scores between the two groups. However, from lunch to last driving, drivers with Alternating day shift had a much larger proportion of severe sleepiness than those on Daily two shift. Thirteen (10.2%), 2 (1.6%) and 7 (5.5%) Daily two shift workers reported severe sleepiness in the post-lunch, afternoon and last periods. In contrast, 81 (39.7%), 63 (30.9%) and 64 (31.4%) of Alternating day shift drivers experienced severe sleepiness during the post-lunch, afternoon and last driving periods (p < 0.0001). According to the log-binomial regression analyses, Alternating day shift was associated with severe sleepiness from lunch to last driving. After adjusting for job duration, alcohol consumption and sleeping time on workdays, the PRs were 3.97 (95% CI: 2.29–6.90) post-lunch, 18.26 (95% CI: 4.51–73.89) in the afternoon and 5.71 (95% CI: 2.51–12.99) for the last driving period. CONCLUSION: We found that Alternating day shift bus drivers suffered from more sleepiness while driving from lunch to last driving than Daily two shift bus drivers. This difference may be because Alternating day shift drivers had more irregular work schedules and longer working hours per day and week.

A Comparison of Standard Shiftwork Index between Night Shift Fixed Nurses and Rotating Shift Nurses / 임상간호연구

PURPOSE: The purpose of this study was to compare the working status and Standard Shiftwork Index (SSI) between night shift-fixed nurses and rotating shift nurses. METHODS: Participants were 367 nurses working as registered nurses at 7 different medical institutions. The data were collected from August 8, 2016 to September 30, 2016. RESULTS: Night shift fixed nurses were more satisfied with work schedule than rotating shift nurses. Rotating shift nurses reported higher SSI scores, such as chronic fatigue, musculoskeletal problems, than night shift fixed nurses. In SSI's sub-items, rotating shift nurses reported higher scores, such as the amount of sleep, feeling well after sleep, heartburn or stomach-ache and heartbeat irregularities, than night shift fixed nurses. CONCLUSION: The results indicated that night shift fixed system might be an effective method to improve nurses' work satisfaction. It is necessary to figure out any suitable night shift fixed system based on the characteristics of each nursing organization. The SSImight be an useful tool tomeasure the nurses' satisfaction in reference to their work shift.

Perfil dos profissionais de enfermagem de terapia intensiva de acordo com seu turno de trabalho, sono, cronotipo e qualidade de vida / Profile of intensive care nursing professionals according to their shift work, sleep, chronotype and quality of life

Atualmente, vê-se grande influência da atividade profissional no cotidiano dos indivíduos, o que impacta em seu comportamento socio-familiar, fisiológico e em sua qualidade de vida. A Enfermagem na Unidade de Terapia Intensiva, como campo profissional, liga-se diretamente ao âmbito produtivo do trabalho. Considerando a assistência ininterrupta a pacientes graves, essa área profissional tem suas jornadas laborais organizadas em diferentes turnos. Porém, essa forma de divisão do trabalho pode alterar significativamente os ritmos biológicos e o padrão circadiano, sobretudo do ciclo vigília-sono, impactando na saúde e na qualidade de vida desses profissionais. Nesse contexto, esta pesquisa descritiva, transversal, de caráter quantitativo, buscou descrever o perfil dos profissionais de enfermagem de terapia intensiva, de acordo com seu turno de trabalho, cronotipo e sono, relacionando essas características aos escores de qualidade de vida, através de três instrumentos de coleta de dados: questionário de dados individuais, que incluiu aspectos sociodemográficos, do turno e trabalho, sono e saúde; Questionário de Matutinidade-Vespertinidade de Horne e Östberg, para classificação da preferência cronotípica; e o instrumento de avaliação de qualidade de vida WHOQOL-Bref. Responderam aos questionários 224 profissionais de enfermagem, auxiliares, técnicos e enfermeiros, de seis unidades de terapia intensiva, nas cidades de Sorocaba, Votorantim, Salto e Campinas. Os dados foram analisados por meio de estatística descritiva e testes de comparação e associação, adotando-se o nível de significância p>0,05. Houve predomínio de sujeitos do sexo feminino, casados, com mais de dez anos de profissão, com, pelo menos, cinco anos de experiência em UTI e com único emprego. Quanto ao cronotipo, prevaleceram os indivíduos indiferentes (58,93%) e apenas 7,58% dos sujeitos estavam em turnos discordantes de sua preferência cronotípica. Na avaliação geral sobre a qualidade de vida, o domínio físico apresentou média de 69,53 (dp=14,56) enquanto o meio ambiente, média de 56,82 (dp=13,86). Na comparação entre os turnos, os trabalhadores da manhã apresentaram menores médias no domínio social e em facetas dos domínios físico e psicológico, em relação aos outros sujeitos. Na comparação entre as categorias, os enfermeiros apresentaram melhor qualidade de vida geral, médias superiores no domínio meio ambiente e psicológico em relação às outras categorias de enfermagem. Algumas variáveis cofundidoras foram comparadas em relação aos domínios e facetas do WHOQOL-Bref. A prática de atividade física influenciou positivamente todos os itens, exceto a satisfação com a saúde; os sujeitos que tinham menor tempo médio de sono diário apresentaram menores escores para todos os itens, exceto para o domínio meio ambiente; trabalhar em mais de um emprego reduziu a percepção de satisfação com o sono, qualidade de vida geral e o domínio social; os problemas de saúde e o uso de substâncias estimulantes influenciaram negativamente os resultados da percepção de qualidade de vida geral, satisfação com a saúde e o sono. Conclui-se que os hábitos da vida diária, condições de saúde, o tempo médio de sono e o duplo vínculo empregatício influenciam diretamente a percepção de qualidade de vida dos trabalhadores de UTI-Adulto, contudo, esta não foi influenciada naqueles indivíduos em turno de trabalho discordante de sua preferência circadiana. (AU)

Nowadays, there is a great influence of the professional activity in daily life, which impacts on their social, family and physiological behavior, and in their quality of life. Nursing in Intensive Care Unit, as a professional field, is connected directly to the productive work environment. Considering the continuous care of the critically ill patients, this area has its working days organized in different work shifts. This form of division of labor can significantly alter the biological rhythms and the circadian pattern, especially the sleep-wake cycle impacting on health and quality of life of these professionals. In this context, this descriptive, cross-sectional and quantitative research, sought to describe the profile of intensive care nursing professionals, according to their work shift, chronotype and sleep, relating these characteristics to quality of life scores, through three data collection instruments as follows: questionnaire of individual data , which included sociodemographic characteristics, and the shift work, sleep and health; Morningness-Eveningness Questionnaire of Horne and Östberg, to classification of chronobiological preference; and the assessment instrument of quality of life WHOQOL-Bref. Replied to these questionnaires, 224 professionals of nursing, auxiliary, technicians and nurses, in six Intensive Care Units in the cities of Sorocaba, Votorantim, Salto and Campinas, in São Paulo State. Data were analyzed using descriptive statistics and comparison and association tests, adopting the significance level of p>0.05. There were female subjects prevalence, married , with over ten years of professional experience, with at least five years of experience in ICU and working in only one job. In assessing the chronotype prevail individuals of indifferent type (58.93%) and only 7.58% of the subjects were in discordant shifts of their chronobiological preference. In the general assessment of the quality of life, the physical domain averaged 69.53 (SD = 14.56) while domain environment, mean 56.82 (SD = 13.86). Comparing the shifts, the morning workers had lower averages in the social domain and in aspects of physical and psychological domains, in relation to the other subjects. Comparing the different categories, the nurses showed better overall quality of life, higher averages in the environment domain and facets of psychological and environmental fields, in relation to other categories of nursing Some confused variables were compared in relation to domains of WHOQOLBref facets. The physical activity positively influenced all items except the satisfaction with health; the subjects who had lower average daily sleep time had lower scores for all items except for the environmental domain; work in more than one job reduced the perception of satisfaction with sleep, general quality of life and the social field; health problems, average sleep time and the use of stimulants negatively affected the results of the perception of overall quality of life, satisfaction with health and sleep. It follows that the habits of daily life, health and the double employment directly influence the perception of quality of life of the adult workers of the Intensive Care Unit, but it was not affected in individuals in discordant shift their circadian preference.(AU)

La comida por la noche como factor inductor de obesidad / Food during the night is a factor leading to obesity

Resumen: Esta revisión tiene como objetivo presentar evidencias obtenidas mediante observaciones clínicas y modelos animales que señalan la relevancia que tiene el horario de alimentación sobre el metabolismo y el mantenimiento del peso corporal. Hallazgos recientes han puesto en evidencia que la misma cantidad de alimento ingerida durante el día o la noche afecta diferencialmente el metabolismo, lo que determina una diferencia significativa en el desarrollo del sobrepeso y la obesidad. Este conocimiento se fundamenta en el estudio del sistema circadiano, regido por el reloj biológico del hipotálamo anterior, que le transmite tiempos a todas las funciones del cuerpo, incluyendo aquellas para el gasto y el ahorro de energía. A pesar de que estos ciclos circadianos están normalmente regulados por los cambios de iluminación resultantes de la alternancia del día y la noche, los cambios metabólicos que resultan de una comida han mostrado también ser señales de tiempo que modifican el orden temporal de algunos sistemas y grupos celulares. De ello se desprende que para que el sistema circadiano funcione sincronizado, las horas de alimentación deben coincidir con los ciclos dictados por el reloj biológico. De tal manera, comer durante las horas normalmente asignadas al reposo lleva a la pérdida de coordinación de los ritmos circadianos metabólicos con respecto al reloj biológico. Esta desincronización sucede a diferentes niveles, tanto entre las células de los tejidos como en una misma célula a nivel molecular. En esta revisión se enfatizarán los efectos adversos de las comidas por la noche sobre el metabolismo energético, además se presentarán resultados recientes que describen los cambios circadianos y metabólicos a diversos niveles de regulación.

Abstract: The present review aims to present evidence obtained in clinical surveys and experimental studies that point out the relevance of meal schedules on metabolism and body weight. Recent findings indicate that in spite of ingesting equivalent amounts, food ingestion during the day or during the night can have completely different effects on metabolism determining bodyweight gain and propensity to obesity. Such findings find support in studies of the circadian rhythms, driven by a biological clock located in the anterior hypothalamus, which transmits temporal signals to the body including functions for energy balance. Circadian cycles are normally driven by the alternation of the day- night luminosity cycles, however metabolic changes resulting from food have proven to be powerful temporal signals capable of modifying de temporal order in tissues and cells. Considering the power of food elicited signals, the feeding schedule must coincide with the timing signals driven by the biological clock. Thus eating during the hours normally assigned for sleep and rest leads to a loss of coordination between metabolic rhythms and the biological clock. This circadian disruption occurs at different levels, among cells in a specific tissue as well as in the molecular processes in cells. The aim of this review is to emphasize the adverse effects that meals during the night can exhert on metabolism, we provide evidence about circadian and metabolic alterations at different regulatory levels.

Comparison of sleep quality based on direction of shift rotation in electronics workers

BACKGROUND: Previous studies have reported the effects of direction of shift rotation on sleep, however, the findings are inconsistent. In this study, we investigated sleep quality related to direction of shift rotation using large-scale data from shiftwork-specific health examinations of electronics workers. METHODS: This study included 4750 electronics workers working in a rotating 3-shift system who completed a medical examination for shift workers survey from January 1 to December 31, 2014, at a general hospital. The subjects were categorized into one of two groups according to direction of shift rotation. We compared sleep quality index between the subjects who worked in forward rotation and backward rotation systems. RESULTS: Backward rotation was positively associated with prevalence of poor sleep quality. In the multivariable-adjusted model, when comparing backward rotation to forward rotation, the odds ratio (OR) with 95 % confidence interval (95 % CI) for poor sleep quality was 1.95 (1.58–2.41). After stratifying by gender, the ORs (95 % CIs) for poor sleep quality in male and female was 1.92 (1.47–2.49) and 2.13 (1.47–3.08), respectively. In subgroup analyses, backward rotation was significantly associated with poor sleep quality in workers ≥30 years of age compared with workers <30 years of age (adjusted OR 2.60 vs. 1.89, respectively; P for interaction <0.001). CONCLUSIONS: Our study supports that a backward rotation system is associated with poor sleep quality. Forward rotation systems should be considered to reduce sleep problems.

Maquinistas ferroviários: trabalho em turnos e repercussões na saúde / Train drivers: shiftwork and health impacts

Objetivo descrever o impacto do trabalho em turnos na saúde, no sono e na qualidade de vida de maquinistas ferroviários. Métodos foram avaliados 611 maquinistas (escalas de trabalho 4 x 1 e 6 x 2), por meio de polissonografia, Índice da Qualidade do Sono de Pittsburgh, Índice de Gravidade de Insônia, Questionário de Qualidade de Vida SF-36, Questionário de Horne e Östberg, Capacidade de Trabalho e Escala de Sonolência de Epworth. Resultados os maquinistas apresentaram idade média de 36,6 ± 15,1 anos, 22% apresentaram obesidade e 38,1% risco para doenças cardiovasculares. Em relação ao sono, 64,2% dos maquinistas relataram qualidade ruim de sono, 11,6% apresentaram distúrbios do sono e 29,3% sonolência excessiva. Os resultados da polissonografia mostraram que 36,1% deles apresentaram apneia do sono e 47,2% demonstraram eficiência do sono reduzida. Além disso, os maquinistas apresentaram baixos índices de qualidade de vida, especialmente os da escala 4 x 1. Conclusão é possível afirmar, na população estudada, que a exposição ao trabalho em turnos, a rotatividade inversa, pouco tempo dispensado às folgas e horas extras de trabalho estão associados a danos ao bem-estar, saúde, sociabilização e ao sono de qualidade desses trabalhadores e que provavelmente os fatores relacionados aos turnos de trabalho contribuem para esses danos. .

Objective to describe the impact of shiftwork on the health, sleep and quality of life of railway drivers. Methods six hundred eleven railway drivers (schedule 4x1 and 6x2) were evaluated by polysomnography, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Work Capacity Index, Quality of Life questionnaire (SF-36), Morningness-eveningness questionnaire (MEQ), and Epworth Sleepiness Scale. 
Results railway drivers assessed were 36.6 ± 15.1 years of age, 22% were obese, and 38.1% presented risks for cardiovascular disease. Poor sleep quality 64.2%, 11.6% had sleep disorders and 29.3% excessive sleepiness. The polysomnography results showed that 36.1% of them presented sleep apnea and 47.2% had significant reduction in sleep efficiency. The railway drivers showed low levels of quality of life, especially those working under the 4x1 schedule. Conclusion it is possible to assert that exposure to shiftwork, reverse rotation schedule, few days off, and working overtime are associated with impairment to well-being, health, sociability and workers’ sleep quality, and the factors related to shiftwork probably contribute to these findings. .

Slow and fast orthodromic and antidromic variants in acute 9-h jet-lagged pygmy field mice.

Biological clocks help organism to adapt temporally to a variety of rhythmic environmental cues. Acute changes in the rhythmicity of entraining cues causes short- to long-term physiological distress in individuals, for example, those occurring during jet-lag after long-haul transmeridial flights, or shift work. Variations in the rate of re-entrainment to a 9 h advanced schedule (simulation of acute Jet-lag/shift work) in the Indian pygmy field mouse, Mus terricolor are reported. Wheel- and lab-acclimated adult male mice were entrained to a 12:12 h light:dark (LD) cycles, followed by a 9 h advance in the LD cycle. In response, these mice either advanced or delayed their activity onsets, with individual variation in the rate and direction. Rapid orthodromic (advancing) re-entrainers exhibited a coincidence of activity onsets with the new dark onset in <=3 days, while gradually advancing re-entrainers took ~9 days or more. Delayers (antidromic) also either re-entrained very rapidly (<=2 days), or gradually (~9 days). Acrophase measurement confirmed the direction of the transients, which did not depend on the free-running period. Such different patterns might determine the differential survival of individuals under the pressure of re-entrainment schedules seen in jet-lag and shift work.

Experiences of Clinical Nurses Aged over 40 as Shift Workers / 간호행정학회지

PURPOSE: The purpose of this study was to explore the experiences of clinical nurses over 40 years of age who were shift workers. METHODS: Data were collected from in-depth interviews with 10 clinical nurses over 40 years of age who had at least 10 years of clinical experience and who worked in 5 acute care hospitals. The data were analyzed using Braun & Clark's thematic analysis. RESULTS: One main theme, 3 themes, and 9 subthemes were derived. The main theme was "Sustaining a position still in conflict", and themes were as follows; "Being trained as a professional nurse", "Having unfavorable working conditions and damaged self-esteem", "Trying hard to get a sense of value as an experienced nurse" CONCLUSION: The results of this study show the issues of age and generational diversities in nurses in acute care hospitals. It is necessary to explore various ways to utilize the experience of older clinical nurses for the integrity of nursing organization and the development of the nursing profession.

Influence of Shiftwork on Greek Nursing Personnel

BACKGROUND: The aim of this study was to investigate the burden experienced by nursing personnel working irregular shifts in Greece and to conduct the first test of a Greek version of the Standard Shiftwork Index (SSI). METHODS: A cross-sectional survey was carried out. The SSI was completed by 365 nurses and nursing assistants working shifts, including nights. RESULTS: Female nursing personnel and those suffering from a chronic disease were most affected by working rotating shifts as they had elevated scores on the majority of the SSI scales, such as sleep, chronic fatigue, digestive and cardiovascular problems, general health questionnaire, cognitive and somatic anxiety, shift time satisfaction, engagement and disengagement strategies, languidity, flexibility, and neurotisicm. Nurses with longer working experience and those with family responsibilities also scored higher on some of the SSI scales, such as the sleep, shift time satisfaction, social and domestic disruption, disengagement strategies, morningness, and languidity scales. CONCLUSION: Shiftwork affects female nurses, those with chronic disease, older age, and domestic responsibilities more severely. Therefore management should take these factors into account when designing work schedules to alleviate the burden caused by shiftwork.

Efeitos do trabalho em turnos na saúde e em dimensões do contexto social e organizacional: um estudo na indústria eletrônica / Shiftwork effects on health and on social and organizational life: a study in the electronics industry

O estudo ocorreu em uma empresa industrial localizada em Portugal e teve como objetivo principal compreender os efeitos do trabalho em turnos. Especificamente, os turnos foram comparados ao nível da saúde, da vida familiar e social e da satisfação geral com o horário de trabalho (turno). Os dados foram recolhidos por meio de questionário junto a 490 trabalhadores, distribuídos por turnos fixos - manhã, tarde e noite - e turnos alternados. Os resultados indicam que os trabalhadores que realizam trabalho noturno apresentam maiores queixas de sono. Quanto às implicações na vida familiar e social, são os trabalhadores do turno da tarde os que referem maior interferência. A satisfação com o horário de trabalho também difere entre turnos, sendo que os de turnos alternados se encontram menos satisfeitos e manifestam maior desejo de mudança para o horário de trabalho considerado normal, caso as condições salariais se mantivessem. O trabalho termina com a referência a possibilidades de intervenção passíveis de serem utilizadas pelas organizações no sentido de gerirem a adaptação aos diferentes horários de trabalho...

The study took place in a manufacturing company located in Portugal with the primary goal of understanding the effects of shiftwork, in each shift. Specifically, the shifts were compared in order to understand the implications of shiftwork for health, for family and social life, and for general satisfaction with working hours (shift). Data were collected by a survey of 490 workers, spread across fixed shifts - morning, afternoon, and night - and rotating shifts. The results indicate that workers on the night shift, compared with those on other work schedules, have more sleep complaints. Regarding the implications for social and family life, the afternoon shift workers are the ones who report greater interference. Satisfaction with the work schedule also differs between shifts, with the rotating shift workers being the least satisfied and expressing the greatest desire to change to working a standard schedule if wage conditions were maintained. The study concludes with a reference to possibilities for intervention that can be used by organizations to manage workers' adaptation to different work schedules...

Health-related Factors and Nutritional Status in Shift-workers at Coffee Shops: Focused on Single Women in Twenties in Seoul / 대한지역사회영양학회지

This study examined the health-related factors and nutritional status of 89 single women workers in their 20's who work night and day shift at the take-out coffee shops and the 89 single women office workers. The results of the study are summarized as follows: The shift-workers showed lower rate of office tenure (p < 0.001), income (p < 0.001), job satisfaction (p < 0.05), weight (p < 0.05), and higher rate of weight change (p < 0.001) than the non shift-workers. The shift-workers showed lower rate of of exercise (p < 0.001), sleeping hours (p < 0.01), and good health condition (p < 0.01), and higher rates of smoking (p < 0.001), presence of disease (p < 0.001), gastric and intestinal illnesses (p < 0.001) than the non shift-workers. More than 88.8% of the shift workers answered that they ate alone (p < 0.001). The shift workers showed lower rate of regularity of meal (p < 0.001), balanced diet (p < 0.001), and mealtime (p < 0.001), and higher rate of skipping breakfast (p < 0.001), consumption of salty and spicy food (p < 0.001), and overeating (p < 0.01) than the non shift-workers. The shift workers consumed (p < 0.001) less frequently rice, soup and side dishes, and more frequently noodles and snack, bread than the non-shift-workers. The shift workers showed lower rate of consumption of beer (p < 0.01), and higher rate of consumption of coffee (p < 0.001), tea (p < 0.01) and soju (p < 0.001) in once a week or more intakes than the non-shift-workers. The shift workers showed higher rate of consumption of carbohydrates (p < 0.05), and calcium (p < 0.05) and lower rate of consumption of protein (p < 0.05), fiber (p < 0.05), vitamin C (p < 0.05), and folate (p < 0.05) intakes than the non-shift-workers.

Impact of Shiftwork on Irritable Bowel Syndrome and Functional Dyspepsia

Disturbances in biological rhythms could lead to unfavorable health impact. This study aimed to evaluate the prevalence of functional dyspepsia (FD) and irritable bowel syndrome (IBS) in rotating shift workers, and to determine the factors that have significant association with the prevalence of FD and IBS. The research had been carried out among nurses and nursing assistants working at Ewha Womans University Mokdong Hospital between December 2010 and February 2011. The subjects completed self-reported questionnaires, including the quality of the sleep and the level of stress. The prevalence of FD and IBS defined by ROME III criteria, and factors associated the disorders in rotating shift workers were compared with those of day workers. A total of 207 subjects were included in the study with 147 rotating shift workers (71.0%), and 60 (29.0%) day workers. The prevalence of IBS in rotating shift workers was higher than that in day workers (32.7% vs 16.7%, P = 0.026). However, no significant difference in the prevalence of FD was observed between the two groups (19.7% vs 20.0%, P = 0.964). In the multivariate analysis, the risk factors for IBS were rotating shift work (OR, 2.36; 95% CI, 1.01-5.47) and poor sleep quality (OR, 4.13; 95% CI, 1.82-9.40), and the risk factors for FD were poor sleep quality (OR, 2.31; 95% CI, 1.01-5.28), and severe stress (OR, 2.19; 95% CI, 1.06-4.76). A higher prevalence of IBS among rotating shift workers could be directly associated with the circadian rhythm disturbance. The circadian rhythm disturbance may be related with the pathogenesis of IBS.

Role of Circadian Types and Depressive Mood on Sleep Quality of Shift Work Nurses / 대한정신약물학회지

OBJECTIVE: This study was done to explore the relationship between circadian types, depressive mood, and sleep quality and to identify the mediating effect of depression between circadian types and sleep quality in shift work nurses. METHODS: Participants were 510 females selected by convenience sampling. Data were collected from October to November 2008 using the Composite Scale for Morningness, Beck Depression Inventory, and Pittsburgh Sleep Quality Index-Korean. The data were analyzed using descriptive statistics, Pearson correlation coefficients, logistic regression and multiple regression. RESULTS: There were significant relationships between sleep quality and circadian types(r=-0.160, p<0.001), and depressive mood (r=0.438, p<0.001). In addition, the circadian types was significantly correlated with depressive mood (r=-0.236, p<0.001). Depressive mood showed mediating effect between circadian types and sleep quality (beta=0.424, p<0.001). Evening type subjects showed higher scores in depressive mood and sleep quality than morning type ones. CONCLUSION: These results suggest that depression and circadian rhythm management in nurses with evening type would contribute to the prevention of sleep disturbance.

Occupational Cancer Update / 대한산업의학회지

This article reviews newly available knowledge regarding occupational cancer based on an assessment of International Agency for Research on Cancer (IARC) Monograph program from 2006 to 2010. The IARC reviewed the agents to evaluate the carcinogenicity in humans according to their priority. During the last five years, the IARC has reviewed many kinds of agents, including all of the Group 1 carcinogenic agents. Agents belonging to groups other than Group 1 were also reviewed. A few agents, such as shiftwork and firefighting, were reviewed for the first time after introducing the IARC Monograph Program. Most of the reassessed Group 1 agents were reaffirmed, showing that there was sufficient evidence to prove their carcinogenicity to human beings. However, some carcinogens were correlated to the new cancer site, since it was deemed that sufficient evidence was present. For example, larynx and ovary cancer deemed to have sufficient evidence of carciongenicity relating to asbestos exposure, joining lung cancer and mesothelioma. Some agents, such as benzo(a)pyrene, ortho-toluidine, 1,3-butadiene, and others belonging to Group 2A were upgraded to Group 1 based on newly identified epidemiologic findings, along with sufficient animal and mechanistic evidence. Benzo(a)pyrene and benzidine-based dyes were classified as human carcinogens based on sufficient animal and pervasive mechanistic evidence. This new data shows that not only chemical agents but also working conditions, such as stress and shiftwork were found to apply to human carcinogenicity. The IARC listed these agents in order to prioritize their review regarding their carcinogenicity to humans. There is a great need to study these newly emerging agents suspected to relate human carcinogenicity, and deem they are worthy of notice.