Annals of Occupational and Environmental Medicine

Research Article

Risk factors including night shift work of colorectal polyp: Kanghyun Um, Chung-soo Park, Cheolin Yoo, Yeon-Soon Ahn, Moonchan Kim, Kyoung Sook Jeong; Ann Occup Environ Med 2020;32:e26. Published online July 13, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e26

Background

The destruction of circadian rhythms by night shift work affects major circadian genes, which are known to play a role in advancing or killing the cell cycle through tumor suppressor genes. To find out whether night shift work affects the incidence of colorectal cancer, which was found to be associated with long-term night shift work in previous studies, we surveyed effect of night shift work on colorectal polyps that have a higher incidence than colorectal cancer and can progress to colorectal cancer.

Methods

To examine the correlation between rotating night shifts and colorectal polyps, a survey was conducted with 299 men aged 40–60 years from two university hospitals. We examined lifestyle, work history, work patterns, and colonoscopy results. The differences in prevalence among the groups was compared, and prevalence ratio (PR) was calculated via generalized linear modeling.

Results

The prevalence of colorectal polyps in night shift and non-shift workers were 53.0% and 33.5%, respectively. After adjusting for age, smoking status, dietary habits, family history of colorectal cancer, obesity, job type, night shift work (PR: 1.13, 95% CI: 1.02–1.25) was a risk factor of colorectal polyps.

Conclusions

The risk of colorectal polyps was greater in night shift workers than non-shift workers. Also risk of colorectal polyp was higher in older group. Our study investigated colorectal polyp instead of colorectal cancer and lacks information about types and gene mutations of colorectal polyps. Further study is needed to clarify effect of night shift work on development of colorectal cancer.

Citations

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Spatial clustering of colorectal cancer in Malaysia
Sharifah Saffinas Syed Soffian, Azmawati Mohammed Nawi, Rozita Hod, Khairul Nizam Abdul Maulud, Ahmad Tarmizi Mohd Azmi, Mohd Hazrin Hasim Hashim, Huan-Keat Chan, Muhammad Radzi Abu Hassan
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Circadian regulation of digestive and metabolic tissues
Zainab Taleb, Phillip Karpowicz
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Do sleep quality and psychological factors link precancerous conditions of colorectal cancer? A retrospective case-control study
Wei Liu, Huijie Zhang
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Cellular and Molecular Gastroenterology and Hepatology.2021; 12(5): 1847. CrossRef

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Research Article

Night shiftwork and prostate-specific antigen level in a tire manufacturing factory: Seunghyeon Cho, Won-Ju Park, WonYang Kang, Dae-Young Lim, Suwhan Kim, Jai-Dong Moon; Ann Occup Environ Med 2019;31:e19. Published online August 22, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e19

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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.

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Consequences of Shift Work and Night Work: A Literature Review
Isabel Silva, Daniela Costa
Healthcare.2023; 11(10): 1410. CrossRef
Night Work and Its Health Effects: Focusing on the Relevant Laws and Regulations of the Republic of Korea
Won-Ju Park
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A Longitudinal Study of the Relationship between Shift Work and Prostate-Specific Antigen in Healthy Male Workers
Yesung Lee, Woncheol Lee, Hyoung-Ryoul Kim
International Journal of Environmental Research and Public Health.2021; 18(14): 7458. CrossRef

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Research Article

Sleepiness while driving and shiftwork patterns among Korean bus drivers: Seyoung Lee, Hyoung-Ryoul Kim, Junsu Byun, Taewon Jang; Ann Occup Environ Med 2017;29:48. Published online October 9, 2017; DOI: https://doi.org/10.1186/s40557-017-0203-y

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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.

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The Association Between Long Working Hours and High-Sensitivity C-Reactive Protein in Older Aged Individuals
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Research Article

Comparison of sleep quality based on direction of shift rotation in electronics workers: Youil Shon, Seungho Ryu, Byung-Seong Suh, Soo-Geun Kim, Won-Sool Kim, Hee-Seung Son, Hee-Yun Kim, Han-Seur Jeong; Ann Occup Environ Med 2016;28:37. Published online September 5, 2016; DOI: https://doi.org/10.1186/s40557-016-0122-3

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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.

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International Journal of Environmental Research and Public Health.2018; 15(9): 2038. CrossRef

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Review

Occupational Cancer Update: Yeon Soon Ahn; Korean Journal of Occupational and Environmental Medicine 2011;23(3):235-252. Published online September 30, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.3.235

Abstract PDF

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.

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Original Article

The Relations between Shiftwork and Sleep Disturbance in a University Hospital Nurses: Jung Tak Lee, Kyung Jong Lee, Jae Beom Park, Kyu Won Lee, Kyu Yeob Jang; Korean Journal of Occupational and Environmental Medicine 2007;19(3):223-230. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.223

Abstract PDF

OBJECTIVES
Nurses working in a hospital operate in a special environment where patients require a 24-hour day service. In order to meet the need for manpower, nurses in the wards, ICU, and ER work in 3 shifts per day. This study was designed to evaluate their sleeping patterns and the factors that influence them.
METHODS
The subjects were 114 female nurses working at a University Hospital in Kyungi-do. To evaluate their sleeping pattern, a survey containing 11 questions was used. Their were differentiated into insomnia, sleep deprivation, daytime sleepiness, and snoring. Statistical analysis was conducted with independent t test, chi-square test and analysis of covariance.
RESULTS
A statistical difference was found between shiftworkers and nonshiftworkers, in terms of sleep initiation time (p<0.05). The occurrences of insomnia, sleep deprivation, daytime sleepiness and snoring differed between the two groups, but not significantly.
CONCLUSIONS
Of the numerous factors affecting sleeping patterns, shiftwork has the most deteriorative effect.

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Original Article

Shiftwork Duration and Metabolic Risk Factors of Cardiovascular Disease: Mi na Ha, Sang Chul Roh, Jung sun Park; Korean Journal of Occupational and Environmental Medicine 2003;15(2):132-139. Published online June 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.2.132

Abstract PDF

AIMS: To explore the relationship between shiftwork duration and metabolic risk factors on cardiovascular disease in shiftworkers.
METHODS
The study subjects comprised of 226 nurses, from a hospital, and 130 male workers, from a diaper and feminine hygienic material manufacturing firm. The mean ages of the male workers and nurses were 29 and 28.5 years, respectively. The fasting blood sugar, serum cholesterol, blood pressure, height and weight, waist and hip circumferences (only in nurses), and number of step for a shift as indices of physical activity were measured. Using the Korean version of Karasek's job contents questionnaire, the job stress was assessed. Information about the number of years worked, duration of shiftwork, and past medical and behavioral histories, including smoking, were obtained by self-administrated questionnaires. Linear regression analyses were performed, to show the relationships between shiftwork duration and metabolic risk factors, using simple and multivariate models, adjusted for age, smoking, job strain and physical activity. The following criteria were defined: hypertension as a SBP>or160 or a DBP>or=90 mmHg at least once, hypercholesterolemia, as a serum total cholesterol >or=240 mg/dl, obesity as BMI (Body Mass Index) >or=25kg/m2 and central obesity as a WHR (Waist to Hip Ratio) >or=0.85; and the logistic regression analyses, according to years of shiftwork, were performed using simple and adjusted models.
RESULTS
The cholesterol and fasting blood sugar showed increasing trends, but without statistical significances, according to the increase in shiftwork duration of the male workers, although, the increases in the blood pressure and BMI were statistically significant. In the nurses, only the WHR showed a significant increase in relation to the shiftwork duration. In the logistic regression analyses, hypercholesterolemia and obesity showed significant increasing risks according to the number of years of shiftwork (OR=3.32 95%CI 1.27-8.72 and OR=3.21 95%CI 1.24-8.32 respectively) in the male workers, but hypertension showed no significance. In the nurses, only an increased central obesity was significant as a risk factor (OR=1.30 95%CI 1.05-1.62).
CONCLUSIONS
These results provide evidence of the associations between shiftwork and metabolic risk factors for cardiovascular disease, although healthy shiftworker effects might exist in our cross sectional study design.

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Original Article

Influence of Shiftwork Duration on Blood Pressure and Heart Rate Variability in Short Rotating 8-hour Shiftworkers: Mi Na Ha, Jai Young Kim, Jung Sun Park, Ho Keun Chung; Korean Journal of Occupational and Environmental Medicine 2001;13(2):180-189. Published online June 30, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.2.180

Abstract PDF

OBJECTIVES
This study was performed to investigate the chronic health effect of shiftwork on cardiovascular system.
METHODS
We checked blood pressure(BP) and heart rate variability(HRV) at every shift on 134 male workers whose shift type was 8-hour and short rotating of 3 days shift interval. As confoundings, job stress was measured by Karasek's JCQ 49 items questionnaire and circardian type was assessed by morningness-eveningness questionnaire. Smoking and alcohol drinking habit, marital status and past medical history were also acquired. We used the method of repeated measured data analysis with mixed model to show the association between shiftwork duration and BP or HRV.
RESULTS
Average age of workers was 29 years olds(range 25~44). Among them, 77.9 % were current smokers, 50 % were the passive type of job strain in Karasek's model. Mean shiftwork duration was 5.21 years(range 5.4 months~10 years). In circadian type, no one was definitely morning type or definitely evening type. In multivariate analyses adjusted by age, job strain, shift, circadian rhythm and smoking, blood pressure were showed significantly increasing trends according to shiftwork duration in both systolic and diastolic(p<0.05). Heart rate variability were also showed significantly decreasing trends according to shiftwork duration in both parasympathetic and sympathetic functions(p<0.05).
CONCLUSIONS
The results of this studs suggests the chronic negative health effect of shiftwork on cardiovascular system.

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Effect of shift work on hypertension: cross sectional study
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Original Article

Effects of Shiftwork on Sleep Patterns of Nurses: S S Hwang, S B Hong, Y W Hwang, E J Hwang, J U Hwang, R G Hwang, H Y Hwang, J G Park, Y S Ju, S J Lee, J H Sung, D H Kang, S H Cho, D R Yun; Korean Journal of Occupational and Environmental Medicine 1998;10(1):1-8. Published online February 28, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.1.1

Abstract PDF

Industrialization has introduced various working systems into the modern society. Shiftwork is a good representative among those. So far various adverse health effects, possibly caused by this shiftwork, have mainly been reported in the fields of manufacturing industry by many other researchers , sleep disorders, gastrointestinal disorders and cardiovascular disorders and so on. These health effects were thought to be caused by the changes of circadian rhythm on shiftworking. This study was especially planned to evaluate effects of shiftwork on sleep disorders among shift-working medical manpower like hospital nurses, important persons dealings with lives, and ultimately to provide them with basic evidence for improving work environment. The study subjects were arbitrarily selected among shift-working female nurses and day-working female pharmacists in one university hospital in Seoul, and finally 79 nurses and 58 pharmacists were enrolled. The research was conducted by using self administered questionnaire, consisting of items about socio-behavioral factors including demographic factors which can affect sleep patterns and questions which make it possible to evaluate sleep disorders (e. g. sleeping duration, sleep latency, re-sleep latency, days of insomnia per week, drug use for sleep, and subjective symptoms). The result showed that the shiftworkers had significantly longer sleep and re-sleep latency, more days of insomnia, and a stronger likelihood of using drugs when they had sleep difficulty than day-working pharmacists. And the number of nightshift duties per month was discovered as the only significant predictor of sleep latency. Additionally, the subjective symptoms related to sleep disorders when awake and at work, showed negligible differences between the shiftworkers and dayworkers. In conclusion, we found shiftwork was risk factor for sleep disorders.

Citations

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Occupational Psychiatric Disorders in Korea
Kyeong-Sook Choi, Seong-Kyu Kang
Journal of Korean Medical Science.2010; 25(Suppl): S87. CrossRef

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