• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.14.1-14.10
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• 2023

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.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.33 no.2
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• pp.206-214
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• 2023

Objectives: To determine the effect of the various type and number of shift work on sociopsychological stress in the university hospital nurses in Seoul, South Korea. Methods: Data was collected through a self-administered questionnaire that included general characteristics, the type and number of shift work in the past 4 weeks and the an sociopsychological stress based on PWI-SF. Logistic regression analysis was conducted to analyze the effect of shift work by types on sociopsychological stress of university hospital nurses using SAS 9.4 and it adjusted general characteristics by the additional models. Results: When the number of night shift work 3 or 4 compared to 0, sociopsychological stress was significantly high(OR=2.16, 95% CI=1.29-3.65). When 5 or more, it was higher(OR=2.39, 95% CI=1.55-3.72). Two continuous night shift work compared to 0 increased sociopsychological stress(OR=2.37, 95% CI=1.49-3.81) and 3 or more even more(OR=2.70, 95% CI=1.72-4.27). If the shift work type changes 14 or 15 times compare to below 11, sociopsychological stress is increased and even higher when 15 or more times but it's not significant after adjusting for covariates. Conclusions: It suggests that workplace with nurse expose to shift work should be on lookout for more than three night shift work, more than two continuous night shift work and more than 14 shift work change which can lead to burnout, absenteeism, depression and decreased productivity.

• Safety and Health at Work
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• v.10 no.3
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• pp.254-259
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• 2019

Background: This cross-sectional study assessed the sleep quality using the ActiGraph and investigated the relationship between the parameters of sleep assessment and the type of shift work in Korean firefighters. Methods: The participants were 359 firefighters: 65 day workers (control group) and 294 shift workers (shift work group: 77 firefighters with 3-day shift, 72 firefighters with 6-day shift, 65 firefighters with 9-day shift, and 80 firefighters with 21-day shift). Sleep assessments were performed using the ActiGraph (wGT3X-BT) for 24 hours during day shift (control and shift work group) and night shift and rest day (shift work group). The participants recorded bed time and sleep hours during the measurement period. Results: Sleep efficiency, total sleep time, and percentage of wake after sleep onset during night work were lower in the shift work group than control group (p < 0.05). Sleep efficiency decreased in night shift and increased in rest day, whereas wake after sleep onset increased in night shift and decreased in rest day (p < 0.05). Among shift work groups, sleep efficiency of 6-day shift was higher in day shift, and sleep efficiency of 21-day shift was lower in night shift than other shift groups (p < 0.05). Conclusion: We found that the sleep quality in night shift of the shift work group was poorer than the control group. As to the type of shift work, sleep quality was good in 6-day shift and poor in 21-day shift. Thus, fast rotating shift such as 6-day shift may be recommended to improve the sleep quality of the firefighters.

• Journal of muscle and joint health
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• v.21 no.2
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• pp.135-144
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• 2014

Purpose: The purpose of this study was to analyze and clarify the concept of shift work maladaptation syndrome and to facilitate development of interventions for the shift work adaptation. Methods: This study used Walker and Avant's concept analysis process. Results: Shift work maladaptation syndrome can be defined as the following attributes: 1) destruction of the circadian rhythm, 2) existence of a threshold, 3) individual characteristics (year of career, type of personality, and type of coping) 4) somatization, and 5) negative emotional conditions. The antecedents of shift work maladaptation syndrome consist of counterclockwise shift work, irregular shift cycle, night work which is breaking circadian rhythm, and lifestyle changing. The consequences as a result of shift work maladaptation syndrome are deterioration of health (gastrointestinal, neuro-psychic, cardiovascular function), reduction of social relationships, and turnover or resign. Conclusion: The results of this study can be useful as the foundation of shift work adaptation implementation.

• Journal of Korean Biological Nursing Science
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• v.19 no.3
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• pp.198-205
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• 2017

Purpose: The purpose of this study was to identify sleep patterns, alertness, and fatigue of shift nurses according to circadian types. Methods: The researchers' enrolled 17 nurses doing shift work in a tertiary hospital. To evaluate circadian types, a morningness-eveningness questionnaire (MEQ) was administered. Sleep patterns were examined using an actigraph for 14 days. To assess alertness and fatigue, Visual Analogue Scale (VAS) was used. The data were analyzed using ANOVA and Kruskal-Wallis test with a SPSS 21.0 program. Results: The researchers found that 17.6% of participants reported morning type, 47.1% neither type, and 35.3% evening type. Mean total sleep time (TST) was 6.8 h, mean sleep efficacy was 82%, level of alertness was 6.54, and level of fatigue was 5.49, regardless of the type of shift work. Evening type nurses had higher variation in TST and alertness, according to the shift patterns than other circadian type nurses. Evening type nurses also had higher fatigue levels than other circadian type nurses. Conclusion: Sleep, alertness, and fatigue were related with circadian types. These results suggest that circadian rhythm management in shift work nurses, particularly in evening type nurses is urgently needed to improve sleep patterns, alertness, and to decrease the level of fatigue.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.33 no.2
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• pp.126-133
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• 2023

Objectives: This study was conducted to find out the prevalence and risk factors of anemia according to shift work. Methods: Data from the Korean National Health and Nutrition Survey (2016-2020) were used. 9,787 workers were divided into shift workers and non-shift workers. The work type between 6AM-6PM was defined as day work, and other work types were defined as shift work. A chi-square test was used to indicate the distribution of risk factors expected to affect shift work in both frequency and percentage. Multiple logistic regression analysis was performed to find out the relationship between anemia prevalence and shift work. Results: As a result of analysis, multiple logistic regression analysis of anemia prevalence and shift work, the OR (95% CI) of male workers on shift work was 2.186 (1.139 to 4.194) and there was a statistically significant difference. Conclusions: In conclusion, anemia in male shift workers should be considered a possibility of health problems. In the future, research based on various data collection should be conducted for research to reveal various causes or diseases of anemia in the future.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.4
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• pp.550-561
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• 2019

Objectives: The purpose of this study is to provide basic data for the improvement of the working environment for health prevention and related countermeasures for shift workers. This study was conducted based on the Fifth Korean Working Conditions Survey (KWCS), which analyzed the health effects of shift work forces and compared them with preceding studies. Methods: By analyzing secondary rates using raw data from the 5th KWCS, 4,870 (9.7%) of the 50,184 total study subjects were divided into shift work and 45,314 (90.3%) non-shift work groups based on the response to shift status. Variables that could affect work health issues were identified and corrected. A cross-analysis was conducted to examine demographic characteristics (gender, age, and education level) of the workers and occupation characteristics (monthly net earnings, employment type, occupation, working period up to now, workplace scale, type of work system, and weekly working hours). In order to find the work health issue ratio between the shift and non-shift work groups, logistic regression was analyzed and the association with health problems according to shift type by gender was looked at through cross-analysis. Results: According to the surveys conducted from the 1st KWCS (2006) to the 5th KWCS (2017), the proportion of shift workers continued to increase. Also, muscular pains in the lower limbs (hips, legs, knees, feet, etc.) (OR=1.135, 95%CI 1.031-1.251), headaches, eyestrain (OR=1.580, 95% CI 1.428-1.748), anxiety (OR=1.715, 95% CI 1.402-2.099), difficulty falling asleep (OR=1.391), and other problems (OR=7.392) were reported. In addition, back pain, muscular pains in shoulders, neck and/or upper limbs, muscular pains in lower limbs (hips, legs, knees, feet, etc.), headaches, eyestrain, depression, anxiety, overall fatigue resulted in significant results for both male and female shift workers. Depression and anxiety were higher in female shift/circulation compared to males. Conclusions: The social nets for the health and safety of shift workers should be explored in a variety of ways, including management and supervision of shift sites, attempts to reorganize and improve the shift system, development of workers' health recovery programs, promotion, systematic treatment, and compensation systems.

• Annals of Occupational and Environmental Medicine
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• v.34
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• pp.27.1-27.12
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• 2022

Background: Shift work that interferes with normal sleep patterns, is known to be a cause of sleep disturbance and has been studied through various occupational groups. However, it is not known which shift type is better for sleep health. Methods: This study included 568 firefighters. Sleep quality was evaluated using Pittsburgh Sleep Quality Index. Sleep quality was categorized into 2 groups; good quality (≤ 5 points) and poor quality (≥ 6 points). Demographic variables, depression, anxiety, type of shift, and job were collected by self-reported questionnaires. The χ² test, t-test, and multiple logistic regression analysis were used to evaluate the effect of shift type on the sleep quality of firefighters. Results: Three hundred thirty-seven firefighters (59.3%) have poor sleep quality. Compared to day workers, the odds ratios (ORs) of poor sleep quality were 2.169 (95% confidence interval: 1.137-4.134) in 6-day cycle, 2.161 (1.150-4.062) in 9-day cycle, 1.805 (1.087-2.997) in 21-day cycle, and 1.485 (0.718-3.069) in 3-day cycle. The ORs of poor sleep quality were 1.697(1.021-2.823) in fire suppression and 2.325 (1.213-4.455) in emergency medical service compared to administration. Conclusions: All shift work type except for the 3-day cycle was associated with poor sleep quality compared to day work.

• Journal of Nutrition and Health
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• v.47 no.6
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• pp.416-425
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• 2014

Purpose: The purpose of this study was to investigate the stress, dietary habits, dietary behaviors, and health-related behavior of nurses. Method: The subjects of this study were 161 nurses studying at a cyber university. The general characteristics, stress, dietary habits, dietary behaviors, and health-related behavior of the subjects were surveyed using a self-administered questionnaire in October, 2010. The subjects were divided into two groups according to the working pattern: shift workers (n = 110) and non-shift workers (n = 51). Results: In the general characteristics, there were significant differences in marriage, monthly income, employment type, and job satisfaction between the two groups. Total stress score did not differ significantly between the two groups. In dietary habits, significant differences in meal regularity, skipping meals, skipping reasons, having regular mealtimes, frequency of snack and the snack time between shift workers and non-shift workers (p<0.05). Total score of dietary behaviors in shift workers was significantly lower than that in non-shift workers (p<0.05). Score of shift workers in taking three meals per day regularly was significantly lower than that of non-shift workers. In health-related behavior, a significant difference in sleeping time was observed between shift workers and non-shift workers. Dietary behavior showed negative correlation with shift work (r = 0.176) and positive correlation with health consciousness (r = 0.210) and perceived health status (r = 0.198) in subjects after adjustment for age, marriage, monthly income, and employment type (p < 0.05). Multiple regression analysis revealed that shift work, health consciousness, and perceived health status affected dietary behavior in subjects. Conclusion: These results indicate that shift working nurses had poor dietary habits and dietary behaviors, and these dietary behaviors are affected by their shift work, health consciousness, and perceive health status.

• Safety and Health at Work
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• v.15 no.1
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• pp.102-109
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• 2024

Background: In today's modern world, longer working hours, shift work, and working at night have become major causes of the disruption of our natural circadian rhythms. This study aimed to investigate the effects of the type of shift work (rotating vs. fixed day), duty period (on-duty vs. off-duty), and working period within each shift (nighttime vs. daytime) on the circadian rhythm characteristics of nurses who provide direct patient care. Methods: This cross-sectional study used a purposive sampling method. Cosinor analysis was applied to analyze the actigraphy data of nurses providing direct patient care for seven consecutive days. The linear mixed effects model was then used to determine any variances between shift type, duty period, and working period within each shift for the nurses. Results: The mesor value did not differ according to nurses' shift type, duty period, and working period within each shift. The amplitude was statistically higher in on-duty nurses and in daytime working hours. The acrophase was significantly delayed in nighttime working hours. As well as nurses in rotating shift had experience. Conclusion: Our findings revealed that the peak activity of nurses occurs significantly later at night while working and nurses working during nighttime hours may have a weaker or less distinct circadian rhythm. Thus, this study suggests that limits be placed on the number of rotating nighttime shifts for nurses.