Annals of Occupational and Environmental Medicine

  • Volume 35
  • /
  • Pages.14.1-14.10
  • /
  • 2023
  • /
  • 1225-3618(pISSN)
  • /
  • 2052-4374(eISSN)
The Korean Society of Occupational & Environmental Medicine (대한직업환경의학회)
권호 표지
DOI QR코드

DOI QR Code

The relationship between shift work pattern and thyroid stimulating hormone in female workers

  • Hun Jeong (Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Chang Ho Chae (Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Jun Ho Lee (Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Hyo Won Chong (Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine)
  • Received : 2023.02.02
  • Accepted : 2023.05.24
  • Published : 2023.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Shift work is known to cause changes in the circadian rhythm of the human body and adversely affect not only physical health but also mental health. Some studies have demonstrated the correlation between shift work and thyroid stimulating hormone (TSH), a hormone that changes according to the diurnal rhythm, but few studies have reported the different TSH levels according to the shift work type. This study aimed to investigate changes in TSH according to the shift work type. Methods: This study included 1,318 female workers who had a medical checkup at a university hospital in Changwon from 2015 to 2019. Shift work types were classified as non-shift work, regular 2 shifts, and irregular three shifts, and a TSH ≥ 4.2 mIU/L was defined as abnormal. A general linear model (GLM) was used to compare the TSH levels and the risk of subclinical hypothyroidism in each year, and a binary logistic analysis was performed using a generalized estimation equation (GEE) to compare the risk of subclinical hypothyroidism over the 5-year period. Results: Of the 1,318 participants included in this study, 363, 711, and 244 were non-shift, two-shift, and irregular three-shift workers, respectively. In the GEE analysis, after adjusting for age, body mass index, smoking, and alcohol consumption, the odds ratios (ORs) were 1.81 (95% confidence interval [CI]: 1.15-2.86; p = 0.011) in 2 shifts and 2.02 (95% CI: 1.23-3.32; p = 0.006) in irregular three shifts, compared to non-shift. Conclusions: Our results showed that shift work had a higher risk of subclinical hypothyroidism than non-shift work and that there was a significant difference in the risk of subclinical hypothyroidism according to the shift work type. These findings suggest that the shift work type can be considered in future thyroid function tests and evaluations.

Keywords

References

  1. Korea Occupational Safety and Health Agency. The 6th Korean Working Conditions Survey. https://oshri.kosha.or.kr/oshri/researchField/research.do?mode=view&articleNo=427921&article.offset=0&articleLimit=10. Accessed December 20, 2022.
  2. Tucker P, Folkard S. Working Time, Health and Safety: A Research Synthesis Paper. Geneva, Switzerland: International Labor Organization; 2012.
  3. Morris CJ, Aeschbach D, Scheer FA. Circadian system, sleep and endocrinology. Mol Cell Endocrinol 2012;349(1):91-104. https://doi.org/10.1016/j.mce.2011.09.003
  4. Abu Farha R, Alefishat E. Shift work and the risk of cardiovascular diseases and metabolic syndrome among Jordanian employees. Oman Med J 2018;33(3):235-42. https://doi.org/10.5001/omj.2018.43
  5. Kawachi I, Colditz GA, Stampfer MJ, Willett WC, Manson JE, Speizer FE, et al. Prospective study of shift work and risk of coronary heart disease in women. Circulation 1995;92(11):3178-82. https://doi.org/10.1161/01.CIR.92.11.3178
  6. Knutsson A, Boggild H. Gastrointestinal disorders among shift workers. Scand J Work Environ Health 2010;36(2):85-95. https://doi.org/10.5271/sjweh.2897
  7. Hansen J. Night shift work and risk of breast cancer. Curr Environ Health Rep 2017;4(3):325-39. https://doi.org/10.1007/s40572-017-0155-y
  8. Cai C, Vandermeer B, Khurana R, Nerenberg K, Featherstone R, Sebastianski M, et al. The impact of occupational shift work and working hours during pregnancy on health outcomes: a systematic review and meta-analysis. Am J Obstet Gynecol 2019;221(6):563-76. https://doi.org/10.1016/j.ajog.2019.06.051
  9. Xu X, Ding M, Li B, Christiani DC. Association of rotating shiftwork with preterm births and low birth weight among never smoking women textile workers in China. Occup Environ Med 1994;51(7):470-4. https://doi.org/10.1136/oem.51.7.470
  10. International Agency for Research on Cancer. Agents classified by the IARC Monographs, Volumes 1-132. https://monographs.iarc.who.int/list-of-classifications. Accessed December 24, 2022.
  11. Akerstedt T, Wright KP Jr. Sleep loss and fatigue in shift work and shift work disorder. Sleep Med Clin 2009;4(2):257-71. https://doi.org/10.1016/j.jsmc.2009.03.001
  12. Driesen K, Jansen NW, Kant I, Mohren DC, van Amelsvoort LG. Depressed mood in the working population: associations with work schedules and working hours. Chronobiol Int 2010;27(5):1062-79. https://doi.org/10.3109/07420528.2010.489877
  13. Boivin DB, Boudreau P. Impacts of shift work on sleep and circadian rhythms. Pathol Biol (Paris) 2014;62(5):292-301. https://doi.org/10.1016/j.patbio.2014.08.001
  14. Herichova I. Changes of physiological functions induced by shift work. Endocr Regul 2013;47(3):159-70. https://doi.org/10.4149/endo_2013_03_159
  15. Spiegel K, Weibel L, Gronfier C, Brandenberger G, Follenius M. Twenty-four-hour prolactin profiles in night workers. Chronobiol Int 1996;13(4):283-93. https://doi.org/10.3109/07420529609020908
  16. Weibel L, Follenius M, Spiegel K, Gronfier C, Brandenberger G. Growth hormone secretion in night workers. Chronobiol Int 1997;14(1):49-60. https://doi.org/10.3109/07420529709040541
  17. Patel YC, Alford FP, Burger HG. The 24-hour plasma thyrotrophin profile. Clin Sci 1972;43(1):71-7. https://doi.org/10.1042/cs0430071
  18. Philippe J, Dibner C. Thyroid circadian timing: roles in physiology and thyroid malignancies. J Biol Rhythms 2015;30(2):76-83. https://doi.org/10.1177/0748730414557634
  19. Rodondi N, den Elzen WP, Bauer DC, Cappola AR, Razvi S, Walsh JP, et al. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA 2010;304(12):1365-74. https://doi.org/10.1001/jama.2010.1361
  20. Vanderpump MP, Tunbridge WM, French JM, Appleton D, Bates D, Clark F, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf ) 1995;43(1):55-68. https://doi.org/10.1111/j.1365-2265.1995.tb01894.x
  21. Weibel L, Brandenberger G, Goichot B, Spiegel K, Ehrhart J, Follenius M. The circadian thyrotropin rhythm is delayed in regular night workers. Neurosci Lett 1995;187(2):83-6. https://doi.org/10.1016/0304-3940(95)11344-4
  22. Park HU. Difference of thyroid stimulationg hormone concentration by shift work in adult male employees [master's thesis]. Ulsan: Ulsan University; 2013.
  23. Moon SH, Lee BJ, Kim SJ, Kim HC. Relationship between thyroid stimulating hormone and night shift work. Ann Occup Environ Med 2016;28(1):53.
  24. Wu AH. Tietz clinical Guide to Laboratory Tests. 4th ed. St. Louis, MO, USA: Elsevier Health Sciences; 2006.
  25. Bagchi N, Brown TR, Parish RF. Thyroid dysfunction in adults over age 55 years. A study in an urban US community. Arch Intern Med 1990;150(4):785-7. https://doi.org/10.1001/archinte.1990.00390160053012
  26. Golden L. Irregular work scheduling and its consequences. In: Economic Policy Institute Briefing Paper #394. Washington, D.C., USA: Economic Policy Institute; 2015.
  27. Fletcher B. Work, Stress, Disease and Life Expectancy. New York, NY, USA: John Wiley; 1991.
  28. Health Insurance Review and Assessment Service. Thyroid disease that women in their 30s should be careful of. http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=10&CONT_SEQ=348003. Accessed December 20, 2022.
  29. Kawabata W, Suzuki T, Moriya T, Fujimori K, Naganuma H, Inoue S, et al. Estrogen receptors (alpha and beta) and 17beta-hydroxysteroid dehydrogenase type 1 and 2 in thyroid disorders: possible in situ estrogen synthesis and actions. Mod Pathol 2003;16(5):437-44. https://doi.org/10.1097/01.MP.0000066800.44492.1B
  30. Lee YK, Shin DY, Shin H, Lee EJ. Sex-specific genetic influence on thyroid-stimulating hormone and free thyroxine levels, and interactions between measurements: KNHANES 2013-2015. PLoS One 2018;13(11):e0207446.
  31. Brabant G, Prank K, Ranft U, Schuermeyer T, Wagner TO, Hauser H, et al. Physiological regulation of circadian and pulsatile thyrotropin secretion in normal man and woman. J Clin Endocrinol Metab 1990;70(2):403-9. https://doi.org/10.1210/jcem-70-2-403
  32. Nollet M, Wisden W, Franks NP. Sleep deprivation and stress: a reciprocal relationship. Interface Focus 2020;10(3):20190092.
  33. Hwang HA, Jeon YJ. Relationship between shift work and subclinical hypothyroidism. Korean J Fam Pract 2020;10(1):3-8. https://doi.org/10.21215/kjfp.2020.10.1.3
  34. Coppeta L, Di Giampaolo L, Rizza S, Balbi O, Baldi S, Pietroiusti A, et al. Relationship between the night shift work and thyroid disorders: a systematic review and meta-analysis. Endocr Regul 2020;54(1):64-70. https://doi.org/10.2478/enr-2020-0008
  35. Luo J, Ding S, Wang W, Fan J, Duan X, Pan Q, et al. Assessment of the impact of shift work on thyroid disorders: a systematic review and meta-analysis. Sleep Breath 2023;27(2):703-8. https://doi.org/10.1007/s11325-022-02652-9
  36. Chen HH, Chiu HH, Yeh TL, Lin CM, Huang HY, Wu SL. The relationship between night shift work and the risk of abnormal thyroid-stimulating hormone: a hospital-based nine-year follow-up retrospective cohort study in Taiwan. Saf Health Work 2021;12(3):390-5. https://doi.org/10.1016/j.shaw.2021.05.006
  37. Bemben DA, Hamm RM, Morgan L, Winn P, Davis A, Barton E. Thyroid disease in the elderly. Part 2. Predictability of subclinical hypothyroidism. J Fam Pract 1994.38(6):583-8.
  38. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160(4):526-34. https://doi.org/10.1001/archinte.160.4.526
  39. Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf ) 1977;7(6):481-93. https://doi.org/10.1111/j.1365-2265.1977.tb01340.x
  40. Surks MI, Goswami G, Daniels GH. The thyrotropin reference range should remain unchanged. J Clin Endocrinol Metab 2005;90(9):5489-96. https://doi.org/10.1210/jc.2005-0170
  41. Azim S, Nasr C. Subclinical hypothyroidism: when to treat. Cleve Clin J Med 2019;86(2):101-10. https://doi.org/10.3949/ccjm.86a.17053
  42. Bekkering GE, Agoritsas T, Lytvyn L, Heen AF, Feller M, Moutzouri E, et al. Thyroid hormones treatment for subclinical hypothyroidism: a clinical practice guideline. BMJ 2019;365:l2006.
  43. Col NF, Surks MI, Daniels GH. Subclinical thyroid disease: clinical applications. JAMA 2004;291(2):239-43. https://doi.org/10.1001/jama.291.2.239
  44. Parker DC, Rossman LG, Pekary AE, Hershman JM. Effect of 64-hour sleep deprivation on the circadian waveform of thyrotropin (TSH): further evidence of sleep-related inhibition of TSH release. J Clin Endocrinol Metab 1987;64(1):157-61. https://doi.org/10.1210/jcem-64-1-157
  45. Attarchi M, Darkhi H, Khodarahmian M, Dolati M, Kashanian M, Ghaffari M, et al. Characteristics of menstrual cycle in shift workers. Glob J Health Sci 2013;5(3):163-72. https://doi.org/10.5539/gjhs.v5n3p163
  46. Davis S, Mirick DK, Chen C, Stanczyk FZ. Night shift work and hormone levels in women. Cancer Epidemiol Biomarkers Prev 2012;21(4):609-18. https://doi.org/10.1158/1055-9965.EPI-11-1128
  47. Mahoney MM. Shift work, jet lag, and female reproduction. Int J Endocrinol 2010;2010:813764.
  48. Holmback U, Forslund A, Lowden A, Forslund J, Akerstedt T, Lennernas M, et al. Endocrine responses to nocturnal eating--possible implications for night work. Eur J Nutr 2003;42(2):75-83. https://doi.org/10.1007/s00394-003-0386-6
  49. Boscolo P, Youinou P, Theoharides TC, Cerulli G, Conti P. Environmental and occupational stress and autoimmunity. Autoimmun Rev 2008;7(4):340-3. https://doi.org/10.1016/j.autrev.2007.12.003
  50. Magrini A, Pietroiusti A, Coppeta L, Babbucci A, Barnaba E, Papadia C, et al. Shift work and autoimmune thyroid disorders. Int J Immunopathol Pharmacol 2006;19(4 Suppl):31-6.