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2 "Kidney failure"
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Original Article
Effect of night shift work on the reduction of glomerular filtration rate using data from Korea Medical Institute (2016-2020)
Beom Seok Ko, Sang Yop Shin, Ji Eun Hong, Sungbeom Kim, Jihhyeon Yi, Jeongbae Rhie
Ann Occup Environ Med 2023;35:e22.   Published online June 30, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e22
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Shift work increases the risk of chronic diseases, including metabolic diseases. However, studies on the relationship between shift work and renal function are limited. The aim of this study was to investigate the association between shift work and a decreased glomerular filtration rate (GFR).

Methods

Data were evaluated for 1,324,930 workers who visited the Korean Medical Institute from January 1, 2016 to December 31, 2020 and underwent a health checkup. Daytime workers were randomly extracted at a ratio of 1:4 after matching for age and sex. In total, 18,190 workers aged over 40 years were included in the analyses; these included 3,638 shift workers and 14,552 daytime workers. Participants were categorized into the shift work group when they underwent a specific health checkup for night shift work or indicated that they were shift workers in the questionnaire. The odds ratio was calculated using a conditional logistic regression to investigate the relevance of shift work for changes in GFR.

Results

35 workers in the shift group and 54 in the daytime group exhibited an estimated GFR (eGFR) value of < 60 mL/min/1.73m2 (p < 0.01). The difference in eGFR values between two checkups differed significantly depending on the type of work (p < 0.01); the difference in the shift work group (−9.64 mL/min/1.73 m2) was larger than that in the daytime work group (−7.45 mL/min/1.73 m2). The odds ratio for eGFR reduction to < 60 mL/min/1.73 m2 in the shift group versus the daytime group was 4.07 (95% confidence interval: 2.54–6.52), which was statistically significant.

Conclusions

The results of this study suggest that eGFR decreases by a significantly larger value in shift workers than in daytime workers; thus, shift work could be a contributing factor for chronic kidney disease (CKD). Further prospective studies are necessary to validate this finding and identify measures to prevent CKD in shift workers.

교대근무가 신사구체 여과율에 미치는 영향
목적
교대근무는 대사질환을 포함한 만성질환의 위험도를 증가시키는 것으로 알려져 있다. 하지만 교대근무와 신기능과 관련된 연구는 제한적이다. 때문에, 본 연구의 목적은 교대 근무와 사구체 여과율 감소와의 연관성을 보고자 하는 것이다.
방법
본 연구는 2016년 1월 1일부터 2020년 12월 31일까지 한국의학연구소(KMI)에 내원하여 건강검진을 받은 1,324,930명의 직장인을 대상으로 시행하였다. 나이와 성별에 대해 매칭한 후, 낮 근무자를 4:1의 비율로 무작위 추출하였다. 총 18,190 명의 40세 이상 근로자를 분석 대상으로 하였으며, 교대 근무자 3,638 명과 낮 근무자 14,552 명이 포함되었다. 참가자들은 야간 특수 건강검진을 받았거나 설문지에서 교대 근무자임을 표시했을 때 교대 근무 그룹으로 분류하였다. 조건부 로지스틱 회귀분석을 사용하여 교대 근무의 관련성과 신기능 변화 간의 상관 관계를 조사하였다.
결과
교대 근무 그룹의 35 명과 낮 근무 그룹의 54 명이 추정 GFR(eGFR) 값이 60 mL/min/1.73m2 미만임을 보였다(P<0.01). 두 검진 간 eGFR 값 차이는 근무 형태에 따라 유의하게 차이가 나며(P<0.01), 교대 근무 그룹(-9.64 mL/min/1.73m2)의 차이가 낮 근무 그룹(-7.45 mL/min/1.73m2)보다 크게 나타났다. 주간근무군에 비해 교대근무군에서 사구체 여과율이 60ml/min/1.73m2 미만으로 떨어질 교차비는 4.07(95% CI 2.54-6.52) 로 통계적으로 유의하게 증가하였다.
결론
본 연구 결과 교대 근무자들의 eGFR 값이 주간 근무자들보다 유의하게 감소하였으며, 교대 근무는 만성 신질환 발생의 요인이 될 수 있다는 것을 알 수 있었다.
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Case Report
A Case of Chronic Renal Failure and Renal Cancer in a Worker Exposed to Lead
Somin Park, Jongeun Kim, Jungwon Kim, Daegyun Hong, Sangbum Ye, Dongmug Kang, Euna Kim
Korean Journal of Occupational and Environmental Medicine 2008;20(3):272-281.   Published online September 30, 2008
DOI: https://doi.org/10.35371/kjoem.2008.20.3.272
AbstractAbstract PDF
INTRODUCTION: Studies evaluating rats and mice have provided convincing evidence that renal adenoma and carcinoma are induced by oral doses of lead acetate and lead subacetate, as well as by parenteral doses of lead phosphate. In addition, at least 2 cases of kidney cancer associated with heavy exposure to lead have been reported. However, there is still not enough information to confirm or rule out an association between kidney cancer and exposure to lead.
CASE
REPORT: In this study, we describe a case of kidney cancer in 54-year-old male worker that was exposed to lead-stearate while employed in the polyvinyl chloride processing industry for 17 years. The patient presented with gout and hypertension. Further examination revealed proteinuria, glucose in the urine and elevated blood urea nitrogen/creatinine levels. Renal ultrasonography, renal computed tomography and renal biopsy revealed chronic renal failure and renal cell cancer.
CONCLUSION
We concluded that the gout and chronic renal failure in this case was caused by chronic lead exposure. However, further study is required to determine if the renal cancer was induced by lead exposure.

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