• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.52.1-52.13
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• 2023

Background: In 2019, the International Agency for Research on Cancer re-evaluated the carcinogenicity of night-shift work and reported that there is limited evidence that night-shift work is carcinogenic for the development of prostate cancer. Therefore, in 2020 and 2021, the Korean Epidemiologic Investigation Evaluation Committee concluded that 2 cases of prostate cancer were occupational diseases related to the night-shift work. Here, we report the 2 cases of prostate cancer in night-shift workers which were first concluded as occupational diseases by the Korean Epidemiologic Investigation Evaluation Committee. Case presentation: Patient A: A 61-year-old man worked as a city bus driver for approximately 17 years, from 2002 to 2019, and was exposed to night-shift work during this period. In March 2017, the patient was diagnosed with high-grade prostate cancer through core-needle biopsy after experiencing stinging pain lasting for 2 months. Patient B: A 56-year-old man worked as an electrician and an automated equipment operator in a cement manufacturing plant for 35 years from 1976 to 2013 and was exposed to night-shift work during this period. In 2013, the patient was diagnosed with high-grade prostate cancer through core needle biopsy at a university hospital because of dysuria that lasted for 6 months. Conclusions: The 2 workers were diagnosed with high-grade prostate cancer after working night shifts for 17 and 35 years respectively. Additionally, previous studies have reported that high-grade prostate cancer has a stronger relationship with night-shift work than low or medium-grade prostate cancer. Therefore, the Korean Epidemiologic Investigation Evaluation Committee concluded that night-shift work in these 2 patients contributed to the development of their prostate cancer.

• Korean Journal of Occupational Health Nursing
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• v.16 no.1
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• pp.37-47
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• 2007

Purpose: To find out the relationship between the shift work, and disrupted sleep and consequent fatigue symptoms. Methods: The questionnaires were given to 345 nurses of 4 hospitals with over 400 beds in Daejeon. Results: The shift workers showed worse subjective quality of sleep than the daytime workers, and had significantly higher frequency of "cannot get to sleep within 30 minutes", "wake up in the middle of the night" and "wake up in the early morning". The shift workers had significantly higher scores of subjective symptoms of fatigue than the daytime workers, and the fatigue was found to be the mental type. The subjective symptoms of fatigue scores were significantly higher in the group who had "cannot get to sleep within 30 minutes", "wake up in the middle of the night" and "wake up in the early morning". Conclusion: The study results indicated that the shift workers had the higher level of subjective symptoms of physical fatigue as well as the worse quality of sleep than the daytime workers. It is speculated that the factors attributable to the poor quality of sleep or sleep induction disorders of nurses of hospitals could be due in major part to adaptational difficulties resulting from frequent night shifts.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.26 no.2
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• pp.178-187
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• 2016

Objectives: Diisocyanates are a potent inducer of diseases of the airways, especially asthma. In this study, toluenediamine(TDA) and methylenedianiline(MDA) in urine were evaluated as biomarkers of exposure to tolunenediisocyanate(TDI) and methylenediphenyl diisocyanate(MDI), respectively. Methods: Workers exposed to TDI and MDI, as well as non-occupationally exposed subjects, were studied and pre- and post-shift urine samples were collected from 8 control subjects and 8 workers from a factory which manufactures polyurethane products for reducing noise and vibration in automobiles. Airborne TDI and MDI(n=8) were sampled on solvent-free glass filters impregnated with n-butylamine and detected by liquid chromatography atmospheric pressure ionization tandem mass spectrometry. Urinary TDA and MDA were detected as pentafluoropropionic acid anhydride(PFPA) derivatives by liquid chromatography electrospray ionization tandem mass spectrometry. Results: The median levels of urinary 2,6-TDA(p<0.001), 2,4-TDA(p=0.001), and MDA(p<0.001) of workers in post-shift samples were significantly higher than those of controls. The median levels of urinary 2,6-0TDA($0.63{\mu}g/g$ creatinine vs $0.34{\mu}g/g$ creatinine, p=0.017) and MDA($4.21{\mu}g/g$ creatinine vs $3.18{\mu}g/g$ creatinine, p=0.017) of workers in post-shift samples were significantly higher than those of the pre-shift samples. There were significant correlations between the urinary 2,6-TDA, 2,4-TDA, and MDA of workers in post-shift samples and the airborne 2,6-TDI(rho=0.952, p<0.001), 2,4-TDI(rho=0.833, p=0.001), and MDI(rho=0.952, p<0.001). Conclusions: These urinary diamines, metabolites of diisocyanates, in post-shift samples were useful biomarkers to assess occupational exposure to diisocyanates.

• 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.

• Korean Journal of Occupational Health Nursing
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• v.29 no.4
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• pp.306-315
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• 2020

Purpose: This study was conducted to identify the effects of caffeine intake by shift workers on sleep, considering various variable related to the sleep health of shift workers. Methods: A descriptive survey study was conducted with 128 employees who worked shifts. Respondents were surveyed on their of caffeine intake behavior, schedule type, quality of sleep, health promotion behavior, and occupational stress. Differences in their quality of sleep were assessed using the t-test and analysis of variance, while factors influencing the effect of caffeine intake on the quality of sleep were analyzed using hierarchical logistic regression. Results: The average Pittsburgh Sleep Index, Korean Version score of those surveyed was 7.3±3.25, indicating that their quality of sleep was low. On the other hand, their aveage daily intake of caffeine was 1.6±0.99 cups (1 cup =150 mL) and 116.4±77.58 mg/dL of caffeine. When the various variables that could have affected the quality of sleep were corrected, an increase in the amount of caffeine consumed was found to lead to a decrease in the quality of sleep (p=.015). Conclusion: Caffeine intake by shift workers has a significant bearing on their quality of sleep; therefore, such intake should be adjusted to improve their sleep health.

• Safety and Health at Work
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• v.6 no.3
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• pp.240-248
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• 2015

Background: Recovery from fatigue is important in maintaining night workers' health. This study compared the course of self-reported recovery after 2-week 12-hour schedules consisting of either night shifts or swing shifts (i.e., 7 night shifts followed by 7 day shifts) to such schedules consisting of only day work. Methods: Sixty-one male offshore employees-20 night workers, 16 swing shift workers, and 25 day workers-rated six questions on fatigue (sleep quality, feeling rested, physical and mental fatigue, and energy levels; scale 1-11) for 14 days after an offshore tour. After the two night-work schedules, differences on the $1^{st}$ day (main effects) and differences during the follow-up (interaction effects) were compared to day work with generalized estimating equations analysis. Results: After adjustment for confounders, significant main effects were found for sleep quality for night workers (1.41, 95% confidence interval 1.05-1.89) and swing shift workers (1.42, 95% confidence interval 1.03-1.94) when compared to day workers; their interaction terms were not statistically significant. For the remaining fatigue outcomes, no statistically significant main or interaction effects were found. Conclusion: After 2-week 12-hour night and swing shifts, only the course for sleep quality differed from that of day work. Sleep quality was poorer for night and swing shift workers on the $1^{st}$ day off and remained poorer for the 14-day follow-up. This showed that while working at night had no effect on feeling rested, tiredness, and energy levels, it had a relatively long-lasting effect on sleep quality.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.27 no.3
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• pp.201-209
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• 2017

Objectives: This study was conducted to assess the association between level of physical activity and depressive symptoms among Korean male workers. Methods: A self-administered questionnaire was distributed and anthropometric measurements were conducted with 1,379 male workers during a general health check. From this data, we identified the general characteristics, levels of physical activity(IPAQ), and depressive symptoms(CES-D) of the study population. We conducted univariate logistic regression to verify the variables that affect depressive symptoms and multivariate logistic regression to calculate odds ratios. Results: Among the 1,379 male workers, 43.4% were in the insufficiently active group(IPAQ category 1) and 22.8% were in the depressive symptom group($CES-D{\geq}16$). The odds ratio(OR) for depressive symptoms was statistically higher in the insufficiently active group, workers aged over 30, the shift work group, and the unmarried group. Adjusted for those variables, the ORs for depressive symptoms were found to be 1.45(95% CI=1.25-2.11), 1.15(OR=1.15, 95% CI=1.08-1.99) and 1.75(95% CI=1.48-2.02), for the insufficiently active group, workers aged over 30, and the shift work group, respectively. Conclusions: We found physical inactivity, age, marital status, and shift work to be associated with depressive symptoms among male workers. This study supports the suggestion that physical activity can be helpful to reduce depressive symptoms among workers.

• Journal of the Ergonomics Society of Korea
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• v.29 no.3
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• pp.337-345
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• 2010

The purpose of this study was to investigate the effects of sleep/wake behavior for shiftwork in air traffic controllers (ATCs) using wrist actigraph for ten workers on a continuous full-day three-team three-shift system of forward rotation including on-duty and off-duty periods. The wrist actigraph data were recorded for three days (one shift cycle) for each subject. The mean activity counts during an on-duty period progressively increased from the night, the swing, to the morning shifts. The doze length during on-duty periods showed decreases in the morning and swing shifts as compared to the night shift. Total sleep time (TST) and sleep efficiency (SE) during off-duty periods increased in the morning-1 and swing-night shift compared to the morning-2 shift. Finally, I discussed the role of doze-taking during the burden on night shift ATCs.

• Journal of environmental and Sanitary engineering
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• v.11 no.3
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• pp.1-7
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• 1996

Mandelic acid is the major metabolite and phenylglyoxylic acid is the minor metabolite of styrene in human. This study was conducted to investigate the correlation between exposure concentrations of styrene and concentration of the metabolites in urine The concentrations of metabolites in urine and exposure concentrations were measured in 60 workers who were occupationally exposed to styrene in FRP industry as well as paint industry and musical instrument manufacturing industry and the concentrations of metabolites in urine ware measured in 90 workers not occupationally exposed to styrene for review the background level in the unexposed population. The results obtained were as follows; 1. The mean exposure concentration is 16.6 $\pm $12.2 ppm (range 0.4-49.9ppm) in the styrene exposed workers. 2. The concentration of mandelic acid in urine collected at the end of shift from worker exposed 8 hours to 50ppm of styrene, based on extrapolation from correlation equations was 578.5 mg/g creatinine and 176.8 mg/g creatinine for next morning urine, the concentration of phenylglyoxylic acid in urine collected at the end of shift was 291.1 mg/g creatinine, 177.9 mg/g creatinine in next morning urine. In the sum of mandelic acid and phenylglyoxylic acid in the urine 870.2 mg/g creatinine in urine sampled at the end of shift corresponds to an exposure of 50ppm of styrene and 366.0 mg/g creatinine for next morning sample corresponds to 50ppm. 3. The correlation of the degree of exposed with sum concentration of mandeliacid and phenylglyoxylic acid in the urine was better(r=0.079 for end of shift, r=0.78 for next morning) than the correlation with single determinant measurement in urine(r=0.75 for mandelic acid at end of shift, r=0.73 for mandelic acid at next morning, r=0.69 for phenylglyoxylic acid at end of shift, r=0.62 for phenylglyoxylic acid at next morning). The monitoring of sum concentration of mandelic acid and phenylglyoxylic acid in urine is a valuable indicator of time weighted average daily exposure ti styrene. And the exposure standard of urinary metabolites produced by styrene should be set, in distinction urine at the end of shift from urine at next morning.

• Journal of Nutrition and Health
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• v.49 no.6
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• pp.495-505
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• 2016

Purpose: This study was conducted to investigate and analyze the association between stress from shift and non-shift work as well as the effects living habits have on eating habits in order to identify why and how workers can improve their health and form proper eating habits for higher working efficiency. Methods: The subjects of this study were 361 workers from K manufacturing company from April 7 to 11, 2014 and they were surveyed using a questionnaire. The subjects were divided into two groups according to working pattern: shift workers (n = 216) and non-shift workers (n = 110). Results: In the general characteristics, there were significant differences in age, work career, work time, marriage, monthly income, and education levels between the two groups. For healthy behaviors, significant differences in subjective health status, moderate physical activity, drinking, smoking, and sleep time were observed between shift workers and non-shift workers. For eating habits, scores of non-shift workers having a regular mealtime, balanced meal composition, and vegetable and seaweed intakes were significantly higher than those of shift workers. The sum score of dietary habits in non-shift workers was also significantly lower than that in shift workers (p < 0.05). Total job stress score did not significantly differ between the two groups. Conclusion: The sum of eating habit scores according to work types was $16.1{\pm}0.6$ in non-shift workers and $14.0{\pm}0.3$ in shift workers. These results suggest that it is necessary to provide food suitable to characteristics of different workers according to work type which should be provided along with daily nutrition counseling to help subjects recognize their status.