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Original Article
Analysis of self-reported mental health problems among the self-employed compared with paid workers in the Republic of Korea
Yongho Lee, Junhyeong Lee, Ui-Jin Kim, Eunseun Han, Seunghon Ham, Won-Jun Choi, Seong-Kyu Kang, Wanhyung Lee
Ann Occup Environ Med 2022;34:e8.   Published online April 8, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e8
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

As self-employed workers are vulnerable to health problems, this study aimed to analyze mental health problems and sleep disturbances among self-employed workers compared with paid workers in Korea.

Methods

A total of 34,750 workers (23,938 paid workers and 10,812 self-employed workers) were analyzed from the fifth Korean Working Condition Survey, which included 50,205 households collected by stratified sampling in 2017. To compare mental health problems and sleep disturbance among self-employed workers and paid workers, multivariate logistic regression analyses were performed.

Results

The odds ratio in self-employed workers compared with paid workers was 1.25 (95% confidence interval [CI]: 1.09–1.42) for anxiety, 1.11 (95% CI: 1.04–1.17) for overall fatigue, 1.11 (95% CI: 1.04–1.20) for difficulty falling asleep, 1.10 (95% CI: 1.02–1.18) for difficulty maintaining sleep and 1.24 (95% CI: 1.16–1.32) for extreme fatigue after waking up.

Conclusions

Self-employed workers in Korea have a higher risk of self-reported mental health problems and sleep disturbances than paid workers. Further studies with a longitudinal design and structured evaluation are required to investigate the causal relationship between health problems and self-employment.

한국 자영업자의 주관적 정신건강 문제 : 제 5차 근로환경조사를 이용하여
목적
자영업자는 고용, 사업체 운영 등에 대한 스트레스를 받고 있으며 자신들의 건강관리에 취약한 것으로 여겨지고 있다. 이 연구는 자영업자들에게 초점을 맞춰 유급근로자들과 비교하여 정신건강 문제와 수면 장애를 분석하는 것을 목표로 하였다.
방법
이 연구는 한국의 5차 근로환경조사 데이터를 바탕으로 23,938명의 유급근로자와 10,812명의 자영업자들을 선택하여 분석을 수행하였다. 정신건강 문제는 ‘우울감’, ‘불안감’, ‘전신 피로’에 대한 설문과 수면 장애는 ‘잠들기가 어려움’, ‘자는 동안 반복적으로 깨어남’, ‘기진맥진함 또는 극도의 피곤함을 느끼며 깨어남’ 설문의 답변을 이용하였다. 자영업자의 정신건강 문제와 수면 장애를 분석하기 위해 다변량 로지스틱 회귀 분석을 시행하였다.
결과
자영업자에서의 ‘불안감’에 대한 보정된 오즈비는 1.25 (95% CI=1.09-1.42), ‘전신피로’는 1.11 (95% CI=1.04-1.17), ‘잠들기가 어려움’은 1.11 (95% CI=1.04-1.20), ‘자는 동안 반복적으로 깨어남’은 1.10 (95% CI=1.02-1.18) 그리고 ‘기진맥진함 또는 극도의 피곤함을 느끼며 깨어남’은 1.24 (95% CI=1.16-1.32)이었다.
결론
본 연구는 유급근로자에 비해 자영업자들의 정신건강 문제와 수면 장애의 위험성이 높은 것을 확인할 수 있었다. 자영업자들의 건강 보호와 증진을 위해 구조화된 설문, 전향적 연구 등의 추가적인 연구와 사회의 관심이 필요하다.

Citations

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  • Association between sickness presenteeism and depressive symptoms: a cross-sectional study using the 6th Korean working conditions survey
    Myeong-Hun Lim, Min-Seok Kim, Seong-Uk Baek, Tae-Yeon Kim, Jong-Uk Won, Jin-Ha Yoon
    International Archives of Occupational and Environmental Health.2024; 97(5): 537.     CrossRef
  • Sources of occupational stress in UK construction projects: an empirical investigation and agenda for future research
    Saad Sarhan, Stephen Pretlove, Faris Elghaish, Sandra Matarneh, Alan Mossman
    Smart and Sustainable Built Environment.2024;[Epub]     CrossRef
  • Occupational health and safety portrait of lobster fishers from a St. Lawrence Gulf community
    Mathieu Tremblay, Dave Bergeron, Andrée-Anne Parent, Jérôme Pelletier, Daniel Paré, Martin Lavallière
    International Journal of Occupational Safety and Ergonomics.2024; 30(3): 907.     CrossRef
  • Multidimensional typologies of precarious employment and their relationships with mental well-being in Korean wageworkers: A latent class analysis based on the Korean Working Conditions Survey (2020–2021)
    Seong-Uk Baek, Jong-Uk Won, Jin-Ha Yoon
    Preventive Medicine.2023; 177: 107787.     CrossRef
  • Association between Workers’ Anxiety over Technological Automation and Sleep Disturbance: Results from a Nationally Representative Survey
    Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
    International Journal of Environmental Research and Public Health.2022; 19(16): 10051.     CrossRef
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Research Article
Combined effect of emotional labor and job insecurity on sleep disturbance among customer service workers
Sunguk Choi, Kwon Ko, Jae Bum Park, Kyung-Jong Lee, Seungho Lee, Inchul Jeong
Ann Occup Environ Med 2020;32:e33.   Published online September 10, 2020
DOI: https://doi.org/10.35371/aoem.2020.32.e33
AbstractAbstract PDFPubReaderePub
Background

Job insecurity and emotional labor are poor job-related factors that are known to cause sleep disturbances in customer service workers. This study investigates the combined effect of emotional labor and job insecurity on sleep disturbance.

Methods

This study used data from the Fifth Korean Working Condition Survey and included 15,147 paid workers who serve customers below 65 years. We re-classified into 6 groups based on whether the degree of emotional labor increased (Rarely/Sometimes/Always) or whether job insecurity (No/Yes) was present. We performed propensity score matching for several covariates and calculated odds ratio (OR) and 95% confidence intervals (CIs) for sleep disturbance by logistic regression models using only matched subjects.

Results

Workers exposed to emotional labor and job insecurity had significantly higher risk for 3 dimensions of sleep disturbance (difficulty falling asleep, waking up repeatedly during the sleep, and waking up with feeling of fatigue) (OR [95% CI]: 1.44 [1.22–1.69], 1.18 [0.99–1.40], 1.52 [1.30–1.79] for emotional labor; and 2.00 [1.75–2.29], 2.20 [1.91–2.53], 1.67 [1.45–1.92] for job insecurity). Compared to those who were exposed to both emotional labor rarely and without job insecurity, when workers had both poor job factors, the OR (95% CI) for sleep disturbance for difficulty falling asleep, waking up repeatedly during the sleep, and waking up with feeling of fatigue were 3.05 (2.42–3.86), 2.89 (2.26–3.69), and 2.60 (2.06–3.29), respectively. The relative excess risk due to Interaction of job insecurity and emotional labor was significant only for difficulty falling asleep, but not the other 2 sleep disturbance dimensions.

Conclusions

Customer service workers suffered from severe sleep disturbances according to the existing degree of emotional labor and job insecurity. The combined effect of both could have an additive influence on serious sleep disturbance among customer service workers.


Citations

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  • Associations between precarious employment and smoking and regular exercise: Results from a Korean longitudinal panel study from 2005 to 2020
    Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
    Preventive Medicine.2023; 168: 107420.     CrossRef
  • Association between high emotional demand at work, burnout symptoms, and sleep disturbance among Korean workers: a cross-sectional mediation analysis
    Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
    Scientific Reports.2023;[Epub]     CrossRef
  • Association between Precarious Employment and Smoking and Regular Exercise: Results from Nationally Representative Surveys from 2005 to 2020
    Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
    SSRN Electronic Journal .2022;[Epub]     CrossRef
  • Association between Workers’ Anxiety over Technological Automation and Sleep Disturbance: Results from a Nationally Representative Survey
    Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
    International Journal of Environmental Research and Public Health.2022; 19(16): 10051.     CrossRef
  • The Importance of an Emotional Expression Guide to Prevent Work-Related Health Problems in Emotional Laborers
    Ji Sun Ha, Jin Ah Kim
    International Journal of Environmental Research and Public Health.2021; 18(13): 6710.     CrossRef
  • What Are the Experiences of Emotional Labor and Workplace Violence that Are More Harmful to Health in Korean Workforce?
    Won Ju Hwang, Hye Kyung Yang, Ji Hye Kim
    International Journal of Environmental Research and Public Health.2020; 17(21): 8019.     CrossRef
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Research Article
Association between change in working time arrangements and sleep disturbance
Ryun Ha, Jae Bum Park, Kyung-Jong Lee, Sunguk Choi, Inchul Jeong
Ann Occup Environ Med 2020;32:e18.   Published online June 18, 2020
DOI: https://doi.org/10.35371/aoem.2020.32.e18
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background

Change in working time arrangement (WTA) can be harmful to workers' sleep and health. This study aimed to investigate the association between change in working time arrangement and sleep disturbance.

Methods

This study used data from the Fifth Korean Working Condition Survey and included 33,203 paid workers. We performed a stratified analysis by sex. After dividing the participants into 6 groups based on whether or not they experienced WTA changes, and their weekly working hours (≤40, 41–52, ≥53 hours), we calculated odds ratio (OR) using the weekly working hours ≤40 hours and with no WTA change as the reference group.

Results

Of the 33,203 paid workers, participants who experienced change in working time arrangement had higher prevalence of all three types of sleep disturbance symptoms (difficulty in falling asleep, waking up repeatedly during sleep, and waking up with a feeling of exhaustion and fatigue) in both sexes. Compared to the reference group at 95% confidence interval (CI), the group with change in WTA showed elevated OR values of 1.91 (95% CI: 1.73–2.11), 1.93 (95% CI: 1.74–2.14), 2.47 (95% CI: 2.26–2.71) for male workers; and 1.93 (95% CI: 1.73–2.16), 2.02 (95% CI: 1.80–2.27), 2.24 (95% CI: 2.01–2.50) for female workers, for difficulty in falling asleep, waking up repeatedly during the sleep, waking up with a feeling of exhaustion, and fatigue, respectively.

Conclusions

Workers who experience change in work time arrangement show a high risk of sleep disturbance in both sexes.


Citations

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  • Diversity of flexible working time arrangements and workers' health: An analysis of a workers’ panel and linked employer-employee data for France
    Christine Erhel, Mathilde Guergoat-Larivière, Malo Mofakhami
    Social Science & Medicine.2024; 356: 117129.     CrossRef
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Research Article
Relationship of workplace violence and perpetrators on sleep disturbance-data from the 4th Korean working conditions survey
Taejun Yoo, Byeongjin Ye, Jung-Il Kim, Siwoo Park
Ann Occup Environ Med 2016;28:59.   Published online October 19, 2016
DOI: https://doi.org/10.1186/s40557-016-0142-z
AbstractAbstract PDFPubReaderePub
Objective

The present study analyzed relationship of workplace violence and perpetrators of violence on sleep disturbance among wage workers in Korea.

Methods

The present study used data from the 4th Korean Working Conditions Survey (KWCS) of 2014 in selecting a total of 25,138wage workers as the study population, which excluded those who failed or refused to respond to questions required for the present study. The workplace violence experience group included people who satisfied at least one of six relevant criteria (verbal abuse, unwanted sexual attention, threatening or humiliating behavior, physical violence, bullying/harassment, and sexual harassment) and the group was divided according to whether the perpetrator of violence was a client or colleague. Presence of sleep disturbance was determined based on subjective symptoms felt within the past 12 months by each individual. A multiple logistic regression analysis was performed to identify the effects on sleep distance according to general, occupational, and psychosocial characteristics, as well as the types of workplace violence and perpetrators of violence.

Results

Workplace violence was found as a factor affecting sleep disturbance (OR = 3.773, 95 % CI = 3.058–4.655), and with respect to perpetrators of violence, complaint of sleep disturbance symptoms was higher when the perpetrator was a colleague or boss (OR = 5.688, 95 % CI 4.189–7.723) than a client (OR = 2.992, 95 % CI 2.301–3.890).

Conclusion

Workplace violence had an effect on occurrence of sleep disturbance and when the perpetrators of violence was a boss or colleague at work, the risk for symptoms such as sleep disturbance increased, which indicated the need for appropriate intervention from a workplace healthcare perspective, including preventive education of workplace violence among employees.


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  • Exploring the Impact of Workplace Violence on the Mental Health of Chinese Correctional Officers: A JD-R Model Approach
    Zheng Zhang, Yan Li, Siyuan Wang, Jizhi Wang, Ying Huang, Xiaoping Wang, Huijuan Guo, Jiansong Zhou
    Psychology Research and Behavior Management.2024; Volume 17: 2865.     CrossRef
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    Eun-Mi Baek, BoKim Lee
    BMC Public Health.2023;[Epub]     CrossRef
  • Impact of Workplace Mistreatment on Employees’ Health and Well-Being in Chinese Firms: A Systematic Review
    Cynthia Atamba, John Kipngetich Mosonik, David Stuckler, Lincoln Jisuvei Sungu, Cornelia Melinda Adi Santoso, Halima Habuba Mohamed
    SAGE Open.2023;[Epub]     CrossRef
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    Hae Ran Kim
    Workplace Health & Safety.2022; 70(3): 161.     CrossRef
  • Relationship between workplace violence and work-related depression/anxiety, separating the types of perpetrators: a cross-sectional study using data from the fourth and fifth Korean Working Conditions Surveys (KWCS)
    Na-Rae Lee, Sang-Woo Kim, Jae-Han Joo, Jae-Han Lee, June-Hee Lee, Kyung-Jae Lee
    Annals of Occupational and Environmental Medicine.2022;[Epub]     CrossRef
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    Yeogyeong Yoon, Kyunghee Jung-Choi
    Safety and Health at Work.2022; 13(1): 93.     CrossRef
  • Predictors of Satisfaction With Work Environment in the Context of a Mismatch in Working Hours: A Nationwide, Large-Scale, Cross-Sectional Study
    Robert Kim
    INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2022; 59: 004695802211282.     CrossRef
  • Impact of workplace violence on anxiety and sleep disturbances among Egyptian medical residents: a cross-sectional study
    Safaa M. El-Zoghby, Maha E. Ibrahim, Nancy M. Zaghloul, Shaimaa A. Shehata, Rasha M. Farghaly
    Human Resources for Health.2022;[Epub]     CrossRef
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    Jungsun Park, Yangho Kim
    Safety and Health at Work.2021; 12(2): 217.     CrossRef
  • Associations between multiple occupational exposures and sleep problems: Results from the national French Working Conditions survey
    Sandrine Bertrais, Noëmie André, Marilyne Bèque, Jean‐François Chastang, Isabelle Niedhammer
    Journal of Sleep Research.2021;[Epub]     CrossRef
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    Nicola Magnavita, Enrico Di Stasio, Ilaria Capitanelli, Erika Alessandra Lops, Francesco Chirico, Sergio Garbarino
    Frontiers in Neuroscience.2019;[Epub]     CrossRef
  • The association between long working hours and work-related musculoskeletal symptoms of Korean wage workers: data from the fourth Korean working conditions survey (a cross-sectional study)
    Jae-Gwang Lee, Guang Hwi Kim, Sung Won Jung, Sang Woo Kim, June-Hee Lee, Kyung-Jae Lee
    Annals of Occupational and Environmental Medicine.2018;[Epub]     CrossRef
  • The association between perceived discriminations and well-being in Korean employed workers: the 4th Korean working conditions survey
    Hee Sung Lee, Guang Hwi Kim, Sung Won Jung, June-Hee Lee, Kyung-Jae Lee, Joo Ja Kim
    Annals of Occupational and Environmental Medicine.2017;[Epub]     CrossRef
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Research Article
The effect of aircraft noise on sleep disturbance among the residents near a civilian airport: a cross-sectional study
Kyeong Min Kwak, Young-Su Ju, Young-Jun Kwon, Yun Kyung Chung, Bong Kyu Kim, Hyunjoo Kim, Kanwoo Youn
Ann Occup Environ Med 2016;28:38.   Published online September 2, 2016
DOI: https://doi.org/10.1186/s40557-016-0123-2
AbstractAbstract PDFPubReaderePub
Background

Aircraft noise is a major environmental noise problem. This study was conducted in order to investigate the relationship between sleep disturbance and exposure to aircraft noise on the residents who are living near an airport.

Methods

There were 3308 residents (1403 in the high exposure group, 1428 in the low exposure group, and 477 in the non-exposure group) selected as the subjects for this study. The Insomnia severity Index (ISI) and Epworth Sleepiness Scale (ESS) questionnaires were used to evaluate sleep disturbance.

Results

The mean ISI and ESS scores were 6.9 ± 6.4 and 5.5 ± 3.7, respectively, and the average scores were significantly greater in the aircraft noise exposure group, as compared to the non-exposure group. The percentage of the abnormal subjects, which were classified according to the results of the ISI and ESS, was also significantly greater in the noise exposure group, as compared to the control group. The odd ratios for insomnia and daytime hypersomnia were approximately 3 times higher in the noise exposure group, as compared to the control group.

Conclusions

The prevalence of insomnia and daytime hypersomnia was higher in the aircraft noise exposure group, as compared to the control group. Further study is deemed necessary in order to clarify the causal relationship.


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    Melanie Schubert, Karla Romero Starke, Julia Gerlach, Matthias Reusche, Pauline Kaboth, Wolfram Schmidt, Dieter Friedemann, Janice Hegewald, Hajo Zeeb, Andrea Zülke, Steffi G. Riedel-Heller, Andreas Seidler
    International Journal of Environmental Research and Public Health.2023; 20(6): 4903.     CrossRef
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    Daniel D. Nguyen, Jonathan I. Levy, Chanmin Kim, Kevin J. Lane, Matthew C. Simon, Jaime E. Hart, Eric A. Whitsel, Trang VoPham, Andrew Malwitz, Junenette L. Peters
    Journal of Exposure Science & Environmental Epidemiology.2023;[Epub]     CrossRef
  • The impact of marine engine noise exposure on seafarer fatigue: A China case
    Renda Cui, Zhengjiang Liu, Xinjian Wang, Zaili Yang, Shiqi Fan, Yaqing Shu
    Ocean Engineering.2022; 266: 112943.     CrossRef
  • Environmental Noise and Effects on Sleep: An Update to the WHO Systematic Review and Meta-Analysis
    Michael G. Smith, Makayla Cordoza, Mathias Basner
    Environmental Health Perspectives.2022;[Epub]     CrossRef
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    Sam E. Wing, Timothy V. Larson, Neelakshi Hudda, Sarunporn Boonyarattaphan, Irish Del Rosario, Scott Fruin, Beate Ritz
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    Frank P Schmidt, Johannes Herzog, Boris Schnorbus, Mir Abolfazl Ostad, Larissa Lasetzki, Omar Hahad, Gianna Schäfers, Tommaso Gori, Mette Sørensen, Andreas Daiber, Thomas Münzel
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    Jiaqing O, Catrin Pugh-Jones, Bethany Clark, Jenna Trott, Lei Chang
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    Qi Meng, Jingwen Zhang, Jian Kang, Yue Wu
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    Laís Fajersztajn, Mariana Tavares Guimarães, Etienne Duim, Tarsila Guimarães Vieira da Silva, Mirna Namie Okamura, Suzan Lúcia Brancher Brandão, Ana Elisa Ribeiro, Ludmila Macêdo Naud, Shane O'Sullivan, Paulo Hilário Nascimento Saldiva, Maria Regina Alves
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  • Environmental Noise and Sleep Disturbance: Night-to-Night Variability of Sleep/Wake Pattern
    Seockhoon Chung, Soyoung Youn, Chul Lee, Min-Woo Jo, Jangho Park, Seong Woo Jo, Jiho Lee, Joo Hyun Sung, Chang Sun Sim
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Research Article
Association between Workplace Risk Factor Exposure and Sleep Disturbance: Analysis of the 2nd Korean Working Conditions Survey
Yong-Seok Heo, Sei-Jin Chang, Shin-Goo Park, Jong-Han Leem, Sung-Hwan Jeon, Bum-Joon Lee, Kyung-Yong Rhee, Hwan-Cheol Kim
Ann Occup Environ Med 2013;25:41-41.   Published online December 27, 2013
DOI: https://doi.org/10.1186/2052-4374-25-41
AbstractAbstract PDFPubReaderePub
Objectives

Sleep is essential for human beings to live and work properly. This study was conducted to investigate the relationship between occupational exposures to workplace risk factors and sleep disturbance in Korean workers.

Methods

The data were drawn from the second Korean Working Conditions Survey (KWCS); a total of 7,112 paid workers were analyzed. The independent variables were occupational exposures such as physical, chemical, biological, and psychosocial risk factor in the workplace, and psychosocial risk factor was divided into five categories (job demand, job control, social support, job insecurity, lack of reward). We estimated the relationship between various occupational exposures and sleep disturbance using multivariate logistic regression analysis.

Results

The results showed that people who exposed to physical, chemical, biological, and psychosocial (high job demand, inadequate social support, lack of reward) risk factors were more likely to increase the risk of sleep disturbance. Furthermore, after adjusting for general and occupational characteristics, we found significant positive associations between exposures to physical (odds ratios [OR] 1.47, 95% confidence interval [CI] 1.05-2.07) and psychosocial (high job demand (OR 2.93, 95% CI 2.16-3.98), inadequate social support (OR 1.57, 95% CI 1.14-2.15), lack of reward (OR 1.45, 95% CI 1.08-1.96)) risk factors and sleep disturbance.

Conclusion

These results suggest that occupational exposures to physical and psychosocial workplace risk factors are significantly related to sleep disturbance.


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    Seong-Sik Cho, Tae-Won Jang, Mo-Yeol Kang
    BMC Public Health.2024;[Epub]     CrossRef
  • Depressive symptoms of people living in areas with high exposure to environmental noise: a multilevel analysis
    Il Yun, Seung Hwan Lee, Sohee Park, Suk-Yong Jang, Sung-In Jang
    Scientific Reports.2024;[Epub]     CrossRef
  • Sleep Duration and Sarcopenia: An Updated Systematic Review and Meta-Analysis
    Xiaoyan Li, Jie He, Qiuhua Sun
    Journal of the American Medical Directors Association.2023; 24(8): 1193.     CrossRef
  • Factors associated with reduced risk of musculoskeletal disorders among office workers: a cross-sectional study 2017 to 2020
    Bukhari Putsa, Wattana Jalayondeja, Keerin Mekhora, Petcharatana Bhuanantanondh, Chutima Jalayondeja
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Original Article
Daytime Sleepiness and Fatigue in Male Adults in relation to Shift Work
Kyung Hyun Son, Soo Geun Kim, Young Woo Jin, Sung Hyo Kim, Soon Young Kim, Yoo Soon Bang, Sun Seog Kweon, Min Ho Shin, Seul Ki Jeong, Hae Sung Nam
Korean Journal of Occupational and Environmental Medicine 2005;17(3):199-207.   Published online September 30, 2005
DOI: https://doi.org/10.35371/kjoem.2005.17.3.199
AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to examine daytime sleepiness-related factors, including sleeping patterns and daytime activities, in shift and non-shift workers.
METHODS
One hundred and twenty two shift workers, and two hundred and fifty four non-shift workers, were selected and identified in terms of their general characteristics, such as age, tenure, educational level, marital status and religion. Screening questionnaires were composed of the Epworth Sleepiness Scale (ESS) for evaluation of daytime sleepiness, the Multidimensional Fatigue Scale (MFS) for fatigue, and the Korean version of the National Institute for Occupational Safety and Health (NIOSH) for sleeping patterns.
RESULTS
The shift worker group reported significantly higher rates of sleep disturbance and higher fatigue scores compared with the non-shift workers (all p<0.01). The prevalence of daytime sleepiness was higher in the shift workers (19.7%) than the non-shift workers (10.6%) (p<0.05). The significant daytime sleepiness-related factors were found to be shift work, tenure and difficulties in falling back to sleep once woken (p<0.05). Shift work was proved to be an important factor in workers aged less than 40 years (p<0.05). However, this association was not evident in workers aged 40 years and over.
CONCLUSIONS
The shift workers showed a significantly higher prevalence of daytime sleepiness compared with the non-shift workers. The present study suggests a need for the implementation of sleeping and fatigue management programs for shift workers in order to improve working efficiency and control safety accidents during shift work.

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