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Original Article
- Association between shift work and the risk of hypothyroidism in adult male workers in Korea: a cohort study
- Seonghyeon Kwon, Yesung Lee, Eunhye Seo, Daehoon Kim, Jaehong Lee, Youshik Jeong, Jihoon Kim, Jinsook Jeong, Woncheol Lee
- Ann Occup Environ Med 2023;35:e41. Published online October 19, 2023
- DOI: https://doi.org/10.35371/aoem.2023.35.e41
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Abstract
Abstract in Korean
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Supplementary Material
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ePub Background Shift work has been reported to have several harmful effects on the human body. However, a small number of studies have evaluated the association between shift work and adverse effects on the thyroid. In our longitudinal study, we examined the causal association between shift work and the risk of hypothyroidism.
Methods A Kangbuk Samsung Cohort Study was conducted on 112,648 men without thyroid disease at baseline who were followed up at least once between 2012 and 2019. Shift work status and shift schedule types were categorized using standardized questionnaires. Hypothyroidism was defined using the reference ranges of serum thyroid-stimulating hormones and free thyroxine levels. Hazard ratios (HRs) and 95% confidence intervals (CIs) for incident hypothyroidism were estimated using Cox proportional hazards regression analyses with the daytime work group as the reference.
Results During the 501,237 person-years of follow-up, there were 6,306 incident cases of hypothyroidism (incidence density, 1.26 per 100 person-years). The multivariable-adjusted HR of incident hypothyroidism for the shift work total group that included all shifts compared with the daytime work group was 1.27 (95% CI: 1.15–1.40). For the fixed evening, fixed night, rotating shift, and other shift workers, the multivariable-adjusted HRs (95% CI) were 1.11 (0.76–1.61), 2.18 (1.20–3.93), 1.39 (1.23–1.56), and 1.00 (0.82–1.22), respectively. In subgroup analyses by age, the association between shift work and hypothyroidism was more pronounced in younger participants (< 40 years; HR: 1.31; 95% CI: 1.16–1.47).
Conclusions Our large-scale cohort study showed an association between shift work and the incidence of hypothyroidism, especially in younger workers with night shifts.
- 한국 성인 남성 근로자에서 교대근무와 갑상선 기능 저하증 위험의 연관성: 코호트 연구
목적
교대 근무는 인체에 여러 가지 해로운 영향을 미치는 것으로 보고되어 왔다. 그러나 소수의 연구만이 교대 근무와 갑상선에 대한 이상 반응 사이의 연관성을 평가하였다. 따라서 이번 종단 연구에서는, 교대 근무와 갑상선 기능 저하증의 위험 간의 인과 관계를 평가하고자 한다.
방법
본 강북삼성 코호트 연구는 2012년과 2019년 사이에 최소 한 번 이상 추적 검사를 받았고, 연구 시작 시점에서 갑상선 질환이 없는 112,648명의 남성을 대상으로 수행되었다. 표준화된 설문지를 이용하여 교대근무 현황 및 교대근무 유형을 분류하였다. 갑상선 기능 저하증은 혈청 갑상선 자극 호르몬과 유리 티록신 수치의 참고치를 기준으로 정의되었다. 갑상선 기능 저하증에 대한 위험비(HR)와 95% 신뢰구간(CI)은 주간 근무 그룹을 기준으로 콕스 비례위험 회귀분석을 사용하여 추정되었다.
결과
501,237인년의 추적 조사 기간 중 6,306건의 갑상선 기능 저하증 케이스가 발생하였다 (발생밀도, 100인년당 1.26). 주간 근무 그룹과 비교하여 모든 교대 근무 유형을 포함한 그룹에 대한 갑상선 기능 저하증의 다변량 조정 위험비는 1.27 (95% 신뢰구간, 1.15–1.40)이었다. 고정 저녁, 고정 야간, 윤번 교대 및 기타 교대 근무 그룹의 경우 다변량 조정 위험비 (95% 신뢰구간)는 각각 1.11 (0.76–1.61), 2.18 (1.20–3.93), 1.39 (1.23–1.56) 및 1.00 (0.82–1.22)이었다. 연령에 따른 하위집단 분석에서 교대근무와 갑상선 기능 저하증의 연관성은 젊은 참가자들에게서 더 두드러졌다 (<40세; 위험비, 1.31; 95% 신뢰구간, 1.16–1.47).
결론
본 대규모 코호트 연구를 통해 특히 야간 근무를 하는 젊은 근로자들에서, 교대 근무와 갑상선 기능 저하증 발생 사이의 연관성을 확인할 수 있었다.
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Original Article
- The relationship between shift work pattern and thyroid stimulating hormone in female workers
- Hun Jeong, Chang Ho Chae, Jun Ho Lee, Hyo Won Chong
- Ann Occup Environ Med 2023;35:e14. Published online June 22, 2023
- DOI: https://doi.org/10.35371/aoem.2023.35.e14
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Abstract
Abstract in Korean
PDFPubReaderePub
Background Shift work is known to cause changes in the circadian rhythm of the human body and adversely affect not only physical health but also mental health. Some studies have demonstrated the correlation between shift work and thyroid stimulating hormone (TSH), a hormone that changes according to the diurnal rhythm, but few studies have reported the different TSH levels according to the shift work type. This study aimed to investigate changes in TSH according to the shift work type.
Methods This study included 1,318 female workers who had a medical checkup at a university hospital in Changwon from 2015 to 2019. Shift work types were classified as non-shift work, regular 2 shifts, and irregular three shifts, and a TSH ≥ 4.2 mIU/L was defined as abnormal. A general linear model (GLM) was used to compare the TSH levels and the risk of subclinical hypothyroidism in each year, and a binary logistic analysis was performed using a generalized estimation equation (GEE) to compare the risk of subclinical hypothyroidism over the 5-year period.
Results Of the 1,318 participants included in this study, 363, 711, and 244 were non-shift, two-shift, and irregular three-shift workers, respectively. In the GEE analysis, after adjusting for age, body mass index, smoking, and alcohol consumption, the odds ratios (ORs) were 1.81 (95% confidence interval [CI]: 1.15–2.86;
p = 0.011) in 2 shifts and 2.02 (95% CI: 1.23–3.32;p = 0.006) in irregular three shifts, compared to non-shift.Conclusions Our results showed that shift work had a higher risk of subclinical hypothyroidism than non-shift work and that there was a significant difference in the risk of subclinical hypothyroidism according to the shift work type. These findings suggest that the shift work type can be considered in future thyroid function tests and evaluations.
- 여성근로자에서 교대근무유형과 갑상선 자극 호르몬과의 연관성
목적
교대근무는 인체의 일중리듬에 변화를 일으키고 심혈관 질환, 소화기 질환 및 대사증후군과 같은 신체적 건강 뿐만 아니라 수면장애, 우울감 등을 포함한 정신건강에도 유해한 영향을 끼치는 것으로 알려져 있다. 일중리듬에 의해 변화하는 호르몬 중 하나인 갑상선 자극 호르몬(TSH)의 농도가 교대근무와의 연관성을 보여주는 연구들이 있으나 교대근무 유형에 따른 차이를 살펴본 연구는 부족한 실정이다. 본 연구는 교대근무의 유형에 따른 TSH의 변화를 알아보고자 하였다.
방법
2015년부터 2019년까지 창원의 일개 대학병원의 건강진단을 받은 1,318명의 여성근로자를 대상으로 연구를 진행하였다. 교대근무유형은 비교대근무, 규칙적 2교대 및 불규칙 3교대로 분류하였으며 TSH ≥ 4.2mIU/L인 경우 이상이 있는 것으로 정의하였다. 연도별로 TSH의 농도를 비교하기 위하여 일반선형모델을 사용하였으며 5년간의 불현성 갑상선기능저하증의 위험도를 비교하기 위하여 일반화추정방정식을 사용하여 이분형 로지스틱 분석을 시행하였다.
결과
연구 대상자 1,318명 중 비교대근무자는 총 363명, 2교대 근무자는 총 711명, 불규칙 3교대 근무자는 총 244명이었다. 연령, 체질량지수(BMI), 흡연, 음주를 보정하고 일반화추정방정식을 사용하여 이분형 로지스틱 분석을 시행한 결과, 비교대근무자를 기준으로 하였을 때, OR은 2교대 근무자에서 1.81(95% CI 1.15-2.86, P=0.011), 불규칙 3교대 근무자에서 2.02(95% CI 1.23-3.32, P=0.006)로 나왔다.
결론
본 연구의 결과는 교대근무가 비교대근무에 비해 불현성 갑상선기능저하증의 위험도가 높았으며 교대근무의 유형에 따른 불현성 갑상선기능저하증의 위험도에 있어 유의미한 차이를 보였다. 이는 이전 연구들의 결과를 뒷받침할 뿐만 아니라 향후 갑상선 기능 검사 및 평가에 있어 교대근무의 유형이 고려대상이 될 수 있을 것으로 생각된다.
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Research Article
- Relationship between thyroid stimulating hormone and night shift work
- So-Hyun Moon, Bum-Joon Lee, Seong-Jin Kim, Hwan-Cheol Kim
- Ann Occup Environ Med 2016;28:53. Published online October 6, 2016
- DOI: https://doi.org/10.1186/s40557-016-0141-0
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Abstract
PDFPubReaderePub
Background Night shift work has well-known adverse effects on health. However, few studies have investigated the relationship between thyroid diseases and night shift work. This study aimed to examine night shift workers and their changes in thyroid stimulating hormones (TSH) levels over time.
Methods Medical check-up data (2011–2015) were obtained from 967 female workers at a university hospital in Incheon, Korea. Data regarding TSH levels were extracted from the records, and 2015 was used as a reference point to determine night shift work status. The relationships between TSH levels and night shift work in each year were analyzed using the general linear model (GLM). The generalized estimating equation (GEE) was used to evaluate the repeated measurements over the 5-year period.
Results The GEE analysis revealed that from 2011 to 2015, night shift workers had TSH levels that were 0.303 mIU/L higher than the levels of non-night shift workers (95 % CI: 0.087–0.519 mIU/L,
p = 0.006) after adjusting for age and department. When we used TSH levels of 4.5 ≥ mIU/L to identify subclinical hypothyroidism, night shift workers exhibited a 1.399 fold higher risk of subclinical hypothyroidism (95 % CI: 1.050–1.863,p = 0.022), compared to their non-night shift counterparts.Conclusions This result of this study suggests that night shift workers may have an increased risk of thyroid diseases, compared to non-night shift workers.
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Citations
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