Annals of Occupational and Environmental Medicine

Original Article

Associations of chronotype and insomnia with menstrual problems in newly employed nurses at university hospitals in the Republic of Korea: Han-Na Jung, Dongwhan Suh, Woo Chul Jeong, Jia Ryu, Yu-Mi Kim, Seohyun Yoon, Hyunjoo Kim; Ann Occup Environ Med 2023;35:e30. Published online August 4, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e30

Abstract Abstract in Korean PDF PubReader ePub: Background
Dysmenorrhea and menstrual cycle changes occur in women working shifts. Circadian rhythm disruption and sleep disturbances associated with shift work leads to health problems. We identified chronotypes and the occurrence of insomnia among newly employed university hospital nurses and investigated the association of these factors with menstrual problems.
Methods
We conducted pre-placement health examinations for shift workers using self-reported questionnaires between 2018 and 2020. A total of 463 nurses were included in the study. Sociodemographic data, shift work experience, and information on insomnia were collected from health examination data. In addition, details regarding chronotype, dysmenorrhea, irregular and abnormal menstrual cycles, amenorrhea, and contraceptive use were obtained from the questionnaire. Multiple logistic regression analysis was performed to study the association between chronotype, insomnia, and menstrual problems after controlling for age, body mass index, contraceptive use, amenorrhea, and prior shift work.
Results
The prevalence rates of dysmenorrhea, irregular menstrual cycles, and longer menstrual cycles were 23.8%, 14.9%, and 4.1%, respectively. The risk of dysmenorrhea increased in the evening-type (odds ratio [OR]: 3.209; 95% confidence interval [CI]: 1.685–6.113) and those with insomnia (OR: 1.871; 95% CI: 1.074–3.261). Additionally, the risk of an irregular menstrual cycle (OR: 2.698; 95% CI: 1.167–6.237) increased in the evening-type, and the risk of a longer menstrual cycle (OR: 4.008; 95% CI: 1.354–11.864) increased in individuals with insomnia.
Conclusions
Our findings suggest that dysmenorrhea is promoted in the evening-type and insomnia individuals. There may be an increased risk of irregular menstrual cycles among evening-type nurses and an increased risk of longer menstrual cycles among those with insomnia. Therefore, factors such as evening-type and insomnia should be considered for the prevention of menstrual problems in women performing shift work.; 대학병원 신입 간호사에서 수면 관련 요인과 월경 건강과의 연관성
목적
이 연구는 간호사의 건강증진을 위한 효과적인 전략을 개발하는 데 있어 근거자료를 제공하는 것을 목적으로 하며, 구체적으로 일주기리듬 유형(크로노 타입) 및 불면 증상과 월경 건강 관련 문제들과의 연관성을 파악하였다.
방법
연구 대상자는 야간작업에 대한 배치 전 건강진단을 받은 두 개 대학병원에서 근무 중인 463명의 신규 간호사이다. 배치 전 건강진단 자료에서 연령, 체질량지수, 흡연, 음주, 운동 정도, 이전 교대 근무 경험 여부, 불면 증상에 대한 정보를 확보하였다. 일주기 리듬 유형, 피임방법 사용 여부, 무월경 경험, 월경통 및 월경주기의 규칙성과 간격에 대한 정보는 설문조사로 확인하였다. 연령, 체질량지수, 피임방법 사용 여부, 무월경 경험, 교대 근무 경험을 통제하여 일주기리듬 유형 및 불면 증상의 월경 건강 관련 문제들에 대한 위험비를 산출하기 위해 다중 로지스틱 회귀 분석을 수행하였다.
결과
월경곤란증, 불규칙한 월경주기, 긴 월경주기의 유병률은 각각 23.8%, 14.9%, 4.1%였다. 월경통에서 저녁형 일주기리듬 유형의 오즈비가 저녁형 외 일주기리듬 유형 그룹에 비해 3.209배(95% C.I. 1.685-6.113) 높았고, 불면 증상이 있다면 1.871배 (95% C.I. 1.074-3.261) 높았다. 또한 저녁형 일주기 리듬은 월경주기 간격이 불규칙한 경우에(오즈비 2.698 95% C.I. 1.167-6.237), 불면 증상이 있다면 40일 이상의 긴 월경 주기에(오즈비 4.008 95% C.I. 1.354-11.864) 각각 통계적으로 유의한 영향을 미치는 것을 확인하였다.
결론
우리 연구 결과로 저녁형 일주기리듬 유형 간호사에서 월경통과 불규칙 월경 이상이 관찰될 확률이 더 높고, 불면 증상이 있는 집단에서 월경통과 긴 월경주기가 증가할 가능성을 유추할 수 있다. 저녁형 일주기리듬과 불면 증상 같은 요인들은 여성 근로자의 월경 건강에 악영향을 미치는 경로를 연구하는 데 있어 고려해야 할 것들 중 하나가 될 수 있다.

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Original Article

Relationship between chronotype and depressive symptoms among newly hired hospital nurses in the Republic of Korea: Semi Lee, Han-Na Jung, Jia Ryu, Woo-Chul Jung, Yu-Mi Kim, Hyunjoo Kim; Ann Occup Environ Med 2022;34:e32. Published online October 31, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e32

Abstract Abstract in Korean PDF PubReader ePub

Background

This study was conducted to examine the relationship between chronotype and depressive symptoms to provide grounded knowledge in establishing nurses’ health promotion strategies.

Methods

The subjects of this study were 493 newly hired nurses working in 2 general hospitals within the university from September 2018 to September 2020. Sociodemographic and work-related characteristics were collected from a medical examination database and a self-reported questionnaire. These included sex, age, marital status, living situation, education level, alcohol consumption, physical activity, prior work experience before 3 months, workplace, and departments. To analyze the associations between the chronotype and depressive symptoms, multiple logistic regression analyses were performed to calculate odds ratios (ORs).

Results

Among participants, 9.1% had depressive symptoms and 16.4% had insomnia. The subjects are divided into morningness (30.2%), intermediate (48.7%), and eveningness (21.1%). The multiple logistic regression analysis controlling for age, living status, education level, alcohol consumption, physical activity, workplace, prior work experience before 3 months, and insomnia, revealed that the OR of depressive symptoms in the eveningness group was 3.71 (95% confidence interval [CI]: 1.50–9.18) compared to the morningness group, and the R² value was 0.151. It also can be confirmed that insomnia symptoms have a statistically significant effect on depressive symptoms (OR: 2.16, 95% CI: 1.03–4.52).

Conclusions

Our findings suggest that evening-type nurses are more likely to have depression than morning-type nurses. We should consider interventions in a high-risk group such as the evening type nurses to reduce depressive symptoms in nurses.

신입 간호사에서 일주기리듬 유형과 우울 증상의 관련성
목적
이 연구는 간호사의 건강증진 전략 수립에 기초 지식을 제공하기 위해 일주기리듬 유형(크로노타입)과 우울 증상의 관련성을 살펴보기 위해 수행되었다.
방법
연구대상은 2018년 9월부터 2020년 9월까지 2개 대학병원에 근무하는 신입간호사 493명이었다. 사회인구학적 특성과 업무관련 특성은 건강검진 데이터베이스와 자기보고식 설문지를 통해 성별, 연령, 결혼 여부, 생활 상황, 교육 수준, 음주, 신체 활동, 3개월 내 업무 경험, 직장 및 부서 등에 대한 정보를 수집하였다. 일주기리듬 유형과 우울 증상 간의 연관성을 분석하기 위해 연령, 생활수준, 학력, 음주, 신체활동, 직장, 직장경력, 불면증 등을 통제한 다중 로지스틱 회귀 분석을 수행하였다.
결과
참가자의 9.1%가 우울 증상이 있었고, 16.4%가 불면 증상이 있었다. 일주기리듬 유형은 아침형(30.2%), 중간형(48.7%), 저녁형(21.1%)으로 구분하였다. 앞서 언급한 혼란 변수를 모두 통제한 다중 로지스틱 회귀분석 결과 저녁시간 집단의 우울 증상의 오즈비는 3.71(95% C.I. 1.50- 9.18) 아침형 그룹과 비교하여 R 제곱값은 0.151이었다. 또한 불면증 증상도 우울 증상에 통계적으로 유의한 영향을 미치는 것을 확인하였다 (OR = 2.16(95% C.I. 1.03-4.52)).
결론
우리 연구는 저녁형 간호사가 아침형 간호사보다 우울증에 걸릴 확률이 더 높다는 점을 시사한다. 간호사의 우울 증상을 줄이기 위해 저녁형 일주기리듬유형을 가진 간호사와 같은 고위험군에 대한 개입을 고려해야 한다.

Citations

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Mee-Ri Lee, Sung Min Jung, Seung Hee Choi, Hyeonji Hwang, Youngs Chang, Young Hwangbo
Chronobiology International.2024; 41(1): 1. CrossRef
Factors associated with chronotype, job burnout, and perceived stress among nurses in Chinese tertiary hospitals: A multicenter cross-sectional study
Lijun Li, Xingxing Wang, Jian Zhou, Min Liu, Sha Wang, Yi Zhou, Yuxuan Li, Yue Kang, Jianfei Xie, Andy S. K. Cheng
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Research Article

Working hours and depressive symptoms: the role of job stress factors: Yeogyeong Yoon, Jia Ryu, Hyunjoo Kim, Chung won Kang, Kyunghee Jung-Choi; Ann Occup Environ Med 2018;30:46. Published online July 13, 2018; DOI: https://doi.org/10.1186/s40557-018-0257-5

Abstract PDF PubReader ePub

Background

South Korea is one of the countries with the longest working hours in the OECD countries. The aim of this study was to evaluate the effect of working hours on depressive symptoms and the role of job stress factors between the two variables among employees in South Korea.

Methods

This study used data from the Korea Working Conditions Survey in 2014. Study subjects included 23,197 employees aged 19 years or older who work more than 35 h per week. Working hours were categorized into 35–39, 40, 41–52, 53–68, and more than 68 h per week. Depressive symptoms were assessed using the WHO’s Well-Being Index with a cut-off score of 13. We calculated prevalence ratios of depressive symptoms according to working hours using log-binomial regression. Through the percentage change in prevalence ratios, we identified the extent of the role of job stress factors that explain depressive symptoms.

Results

The risks of depressive symptoms were significantly higher in people who worked 35–39 h per week (PR: 1.09, CI: 1.01–1.18), 53–68 h/week (PR: 1.21, CI: 1.16–1.25), and more than 68 h/week (PR: 1.14, CI: 1.07–1.21) than 40 h/week, after adjusting for confounding variables. Job stress explained the effects of long working hours on depressive symptoms in about 20–40% of the groups working more than 40 h/week. Among the factors of job stress, social support was 10–30%, which showed the highest explanatory power in all working hours. Reward explained 15–30% in the more than 52 h working group, and reward was the most important factor in the working group that exceeded 68 h.

Conclusions

We showed the working hours could be an independent risk factor for depressive symptoms in employees. To improve workers’ mental health, it is important to strengthen social support in the workplace, to provide adequate rewards as they work, and ultimately to regulate the appropriate amount of working hours.

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Case Report

Two cases of methyl alcohol intoxication by sub-chronic inhalation and dermal exposure during aluminum CNC cutting in a small-sized subcontracted factory: Jia Ryu, Key Hwan Lim, Dong-Ryeol Ryu, Hyang Woon Lee, Ji Young Yun, Seoung-Wook Kim, Ji-Hoon Kim, Kyunghee Jung-choi, Hyunjoo Kim; Ann Occup Environ Med 2016;28:65. Published online November 15, 2016; DOI: https://doi.org/10.1186/s40557-016-0153-9

Abstract PDF PubReader ePub

Background

Methyl alcohol poisoning has been mainly reported in community. Two cases of methyl alcohol poisoning occurred in a small-sized subcontracted factory which manufactured smartphone parts in Korea.

Case presentation

One young female patient presented with dyspnea and visual disturbance. Another young male patient presented with visual disturbance and myalgia. They treated with sodium bicarbonate infusion and hemodialysis for metabolic acidosis. In addition, he received ethyl alcohol per oral treatment. Her and his urinary methyl alcohol concentration was detected as 7.632 mg/L, 46.8 mg/L, respectively, although they were treated hemodialysis. Results of the working environment measurement showed that the concentration of methyl alcohol (1030.1–2220.5 ppm) in the air exceeded the time weighted average (200 ppm). They were diagnosed with optic neuropathy due to methyl alcohol poisoning and still have visual impairment.

Conclusions

Workers who hired as dispatched employees in a small-sized subcontracted factory were exposed to high concentrations of methyl alcohol. The workplace had poor ventilation system. In addition, workers did not wear proper personal protect equipment. Working environment measurement and annual chekups for workers were not performed. They were in a blind spot to occupational safety and health. More attention is needed to protect vulnerable workers’ health.

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