Annals of Occupational and Environmental Medicine

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

Abstract Abstract in Korean PDF Supplementary Material PubReader 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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Research Article

Effect of night shift work on the control of hypertension and diabetes in workers taking medication: Juha Park, Sang-Yeop Shin, Yangwon Kang, Jeongbae Rhie; Ann Occup Environ Med 2019;31:e27. Published online October 10, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e27

Abstract PDF PubReader ePub

Background

Night shift work induces physiological and psychological stress by altering sleep and biological rhythms and is associated with hypertension, diabetes, obesity, and cardiovascular diseases. Few studies have been conducted on the control of hypertension and diabetes. This study aimed to examine the effect of night shift work on the control rate of hypertension and diabetes.

Methods

Subjects comprised workers aged 20–65 years who underwent specific health examination at a single facility in seven different affiliated examination centers from 1 January to 31 December 2016. Workers were categorised into day workers and night shift workers. Demographic and medical history were taken, and physical examination was done. Blood pressure (BP) and fasting glucose were measured. The control rate of each disease was evaluated based on treatment goals presented in the treatment guidelines of the Korean Society of Hypertension and the Korean Diabetes Association (systolic BP < 140 mmHg and diastolic BP < 90 mmHg; fasting glucose ≤ 130 mg/dL).

Results

Among 631,418 subjects, 11.2% (70,450) were night shift workers. Of whom 6.1% (4,319) were taking antihypertensive medication and 2.5% (1,775) were taking diabetes medication. Among patients taking antihypertensive medications, the proportion of those whose BP was controlled to suit treatment goals was 81.7% (26,635) of day workers and 77.4% (3,343) of night shift workers, which was significantly different (p < 0.001). Among patients taking diabetes medications, the proportion of those whose blood glucose was controlled to suit treatment goals was 37.4% (4,489) of day workers and 36.5% (647) of night shift workers, but the difference was not significant. The control rates for patients taking antihypertensive medications (odds ratio [OR]: 0.74, 95% confidence interval [CI]: 0.68–0.80) were lower among night shift workers than day workers with adjustment for age, sex, smoking history, alcohol consumption, exercise, and obesity. However, there were no differences in control rates for patients taking diabetes medications (OR: 0.99, 95% CI: 0.87–1.10) between day workers and night shift workers.

Conclusions

Night shift work can have an effect on the uncontrolled BP in workers taking antihypertensive medications. Therefore, additional efforts for disease control are necessary for night shift workers with hypertension.

Citations

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Research Article

The effect of a blue enriched white light on salivary antioxidant capacity and melatonin among night shift workers: a field study: Reza Kazemi, Rasoul Hemmatjo, Mokarami Hamidreza; Ann Occup Environ Med 2018;30:61. Published online October 19, 2018; DOI: https://doi.org/10.1186/s40557-018-0275-3

Abstract PDF PubReader ePub

Background

Because of their positive impact on individuals’ performance and alertness, blue enriched white light sources are gaining popularity in households and industries. However, these sources of blue light spectrum may cause oxidative stress. On the other hand, there are no empirical studies investigating the negative effect of blue enriched white light on oxidative stress. Thus, the current study aimed at empirical assessment of the effect of such light sources on oxidative stress among night shift workers.

Methods

The study, which adopted a cross-sectional design, focused on 30 control room operators of a petrochemical complex. The subjects followed a shift-work schedule comprising 7 night shifts, 7 day shifts, and 7 days off. The subjects were exposed to 6500 K, 3000 K, and 17,000 K light sources (which have various degrees of blue light) during three consecutive work cycles, with each cycle lasting for 7 nights. In each light condition, three salivary measurements were conducted (at the beginning, in the middle, and at the end of the shift). The measurements were used to assess catalase (CAT), total thiol molecules (TTG), and total antioxidant capacity (TAC), and melatonin.

Results

The results of repeated measures ANOVA showed that there was no significant difference among various light conditions with regard to salivary biomarkers (catalase, total thiol molecules, and total antioxidant capacity). There was however a significant difference between 3000 K and 17,000 K conditions with regard to the concentration of salivary melatonin (p = 0.001).

Conclusion

Given that there was no significant difference among various light conditions in terms of biomarkers, it is concluded that using sources of light with high color temperature can be recommended. Nonetheless, because of the limitations of the present study (e.g. short period of intervention), it is suggested that care should be exercised in using such light sources.

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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

Abstract PDF PubReader ePub

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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