Annals of Occupational and Environmental Medicine

Original Article

The association of shift work and TyG index among male workers in a chemical plant of Korea: a cross-sectional study: Gwangin Baek, Yong-Jin Lee, Soon-Chan Kwon, Young-Sun Min, Jisuk Yun, Tae Jin Ahn, Eun-Chul Jang; Ann Occup Environ Med 2024;36:e18. Published online July 10, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e18

Abstract Abstract in Korean PDF: Background
Disturbance of circadian rhythms caused by shift work has adverse effects on insulin resistance. Many previous studies have confirmed that shift work and insulin resistance are related using homeostasis model assessment-insulin resistance, one of the insulin resistance indicators. However, the triglycerides and glucose index (TyG index) has recently been studied as an insulin resistance indicator. The aim of this study is to investigate the association of shift work and TyG index, one of the indirect indicators of insulin resistance, using results of health checkups in one workplace.
Methods
Based on medical examination data collected in February 2019, a total of 3,794 subjects from one chemical plant in Korea were selected for this study. Cut-off value of TyG index for predicting development of diabetes mellitus (DM) was 4.69. A multiple logistic regression analysis was performed after adjusting for age, employment period, obesity, abdominal obesity, smoking, drinking, physical activity, hypertension, stroke, heart disease.
Results
As a result of logistic regression analysis, compared to day workers, odds ratio (OR) with a TyG index above cut-off value for predicting development of DM in shift workers was 1.220 after adjusting for age, employment period, obesity, abdominal obesity, smoking, drinking, physical activity, hypertension, stroke, heart disease (Model 1, OR: 1.276; 95% confidence interval [CI]: 1.099–1.482; Model 2, OR: 1.232; 95% CI: 1.055–1.438; Model 3, OR: 1.220, 95% CI: 1.030–1.444).
Conclusions
There was a significant association between shift work and TyG index among male workers in a chemical plant. More research studies on the association between shift work and TyG index are needed in the future.; 한국의 한 화학 공장의 남성 근로자들에서 교대 근무와 TyG index의 관련성
목적
교대 근무와 인슐린 저항성이 관련이 있다는 연구가 기존에 있었으나, 인슐린 저항성의 지표로 기존에는 homeostasis model assessment-insulin resistance (HOMA-IR)을 이용하였다. 하지만 최근, 인슐린 저항성 지표 중 하나인 Triglycerides and Glucose (TyG) index가 당뇨병 발생의 예측을 위한 지표로서 기존 다른 인슐린 저항성 지표보다 우수하다는 연구들이 발표되었다. 이에 본 연구는 한국의 한 화학공장의 근로자들을 대상으로 교대근무와 당뇨병 발생의 예측인자로서의 TyG index의 관련성을 확인하고자 하였다.
방법
2019년 2월 한국의 한 화학공장 사업장에서 실시된 건강검진 기록을 활용하여 총 3,794명의 자료를 대상으로 자료를 수집하였다. 변수로 대상자의 일반적 특성 및 교대근무 여부, 근무 기간 등 직업적 특성이 포함되었다. 기존 연구를 토대로, 당뇨병 발생의 예측을 위한 TyG index의 컷오프 값은 4.69로 설정하였다. 다중 로지스틱 회귀 분석을 사용하여 교대 근무와 TyG index 사이의 연관성을 조사하였다.
결과
교대 근무와 TyG index 사이에 유의미한 연관성이 있었다. (OR 1.220, 95% CI 1.030-1.444)
결론
교대 근무와 TyG index 사이에 유의미한 연관성이 있었다. TyG index가 당뇨병 발생의 예측인자로서 가치가 있다는 근거를 토대로 하여서, 교대 근로자들의 당뇨병 발생의 관리를 위해서 TyG index를 이용하는 것을 고려할 필요가 있을 것이다.

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Original Article

Rotating shift and BMI increase among healthcare workers in a military hospital: pre- and post-pandemic analysis in Taiwan: Zong-Ming Chen, Ro-Ting Lin; Ann Occup Environ Med 2024;36:e15. Published online June 21, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e15

Abstract PDF: Background
The increasing prevalence of high body mass index (BMI) emphasizes the need for action. Understanding of BMI factors among military hospital healthcare workers remains limited. This study aims to address this gap by analyzing BMI risk factors and changes pre- and post-coronavirus 2019 pandemic among military hospital healthcare workers in central Taiwan from 2019 to 2021.
Methods
Conducted at a military hospital in central Taiwan, this study analyzed anonymized health examination data from 2019 to 2021 for 483 healthcare workers. We performed generalized estimating equations to investigate trends in BMI and its association with various factors, including age, sex, job titles, military status, job tenure, work shifts, and lifestyle habits.
Results
The risk of increased BMI was higher in 2021 compared to 2019 (risk ratio [RR]: 1.008, 95% confidence interval [CI]: 1.001–1.014). Individuals on rotating shifts had a higher risk of increased BMI compared to day shift workers (RR: 1.021; 95% CI: 1.008–1.035) and higher odds of obesity (odds ratio: 1.546; 95% CI: 1.099–2.175). Among obese individuals, BMI in soldiers was approximately 4.9% lower than in non-soldiers (RR: 0.951; 95% CI: 0.915–0.988).
Conclusions
This study identified a significant post-pandemic increase in BMI among healthcare workers in a Taiwanese military hospital, with rotating shifts being a key risk factor for both increased BMI and obesity. Work-related factors influenced BMI changes among obese individuals, while non-work-related factors were significant for non-obese individuals. These findings highlight the broader effects of the pandemic and the specific impact of work-related factors on obese healthcare workers.

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Case Report

Prostate cancer in workers exposed to night-shift work: two cases recognized by the Korean Epidemiologic Investigation Evaluation Committee: Sungkyun Park, Seongwon Ma, Hoekyeong Seo, Sang Gil Lee, Jihye Lee, Shinhee Ye; Ann Occup Environ Med 2023;35:e52. Published online December 7, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e52

Abstract Abstract in Korean PDF

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.

야간교대근무 근로자에서 발생한 전립선암 2례
배경
2019년 국제암연구소(IARC)은 야간교대근무의 발암성을 재평가하였고 야간교대근무와 전립선암이 양의 연관성을 가지고 있다고 보고하였다. 2020년과 2021년에 역학조사평가위원회는 두 명의 야간교대근무 근로자에서 발생한 전립선암이 야간교대근무와 관련된 직업병이라고 결론지었다. 따라서 국내에서 처음으로 직업병으로 인정된 야간교대근무 근로자에서 발생한 전립선암 2건의 사례를 소개하고자 한다.
증례
남성 근로자 A는 만 61세에 두 달간 지속된 찌르는 듯한 증상으로 비뇨기과를 방문하였고전립성특이항원 검사와 전립선 중심바늘생검을 받은 후 전립선암을 진단받았다. 근로자 A 는 2002년부터 2019년까지 시내버스를 운행하였고, 약 17년간 야간교대근무를 하면서 하루에 10시간 이상, 주당 6일간 업무를 수행하였다. 남성 근로자 B는 6개월간 지속된 배뇨곤란 증상으로 병원에서 중심바늘생검을 통해 전립선암을 진단받았다. 근로자 B는 1976년부터 2013년까지 시멘트 제조공장에서 전기기사와 자동화기기 오퍼레이터로 근무하였으며, 약 35년간 야간교대근무에 노출되었다. 근로자 A와 B는 전립선암 조직검사에서 Gleason’s score가 높은 공격적인 전립선암을 진단받았고, 업무 중 디젤엔진배출물질에도 노출되었다.
고찰
국제암연구소는 야간교대근무가 전립선암 발암성에 미치는 영향에 대해 제한적인 근거가 있다고 하였다. 이 외에도 2018년에 보고된 프랑스의 환자-대조군 연구는 긴 교대시간 길이(>10시간), 최소 6박 연속 야간근무, 장기간(20년 이상 또는 1,314일 이상)의 영구적인 야간근무가 공격적인 전립선암과 특히 유의한 연관성이 있다고 하였다. 몇 건의 메타분석 연구에서도 야간교대근무가 전립선암과 유의하다는 결과가 있었고, 특히 아시아 국가 남성에서 그 결과가 유의하다고 하였다. 또한, 디젤엔진배출물질과 전립선암이 유의한 연관성이 있다는 문헌이 일부 확인되었다. 따라서, 역학조사평가위원회는 두 근로자에서 발생한 전립선암에 대한 업무관련성의 과학적 근거가 상당하다고 판단하였다. 따라서, 야간교대근무가 전립선암 발병에 기여하는 위험성을 인지하고, 야간교대근무 근로자를 대상으로 작업시간 조절과 전립선암의 조기발견을 위한 적절한 건강검진 제공에 대한 고려가 필요하다.

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Relationship between non-standard work arrangements and work-related accident absence in Belgium
Hanan Alali, Lutgart Braeckman, Tanja Van Hecke, Bart De Clercq, Heidi Janssens, Magd Abdel Wahab
Journal of Occupational Health.2017; 59(2): 177. CrossRef

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Original Article

Association between shift work and the risk of hypothyroidism in adult male workers in Korea: a cohort study: Seonghyeon Kwon, Yesung Lee, Eunhye Seo, Daehoon Kim, Jaehong Lee, Youshik Jeong, Jihoon Kim, Jinsook Jeong, Woncheol Lee; Ann Occup Environ Med 2023;35:e41. Published online October 19, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e41

Abstract Abstract in Korean PDF Supplementary Material

Background

Shift work has been reported to have several harmful effects on the human body. However, a small number of studies have evaluated the association between shift work and adverse effects on the thyroid. In our longitudinal study, we examined the causal association between shift work and the risk of hypothyroidism.

Methods

A Kangbuk Samsung Cohort Study was conducted on 112,648 men without thyroid disease at baseline who were followed up at least once between 2012 and 2019. Shift work status and shift schedule types were categorized using standardized questionnaires. Hypothyroidism was defined using the reference ranges of serum thyroid-stimulating hormones and free thyroxine levels. Hazard ratios (HRs) and 95% confidence intervals (CIs) for incident hypothyroidism were estimated using Cox proportional hazards regression analyses with the daytime work group as the reference.

Results

During the 501,237 person-years of follow-up, there were 6,306 incident cases of hypothyroidism (incidence density, 1.26 per 100 person-years). The multivariable-adjusted HR of incident hypothyroidism for the shift work total group that included all shifts compared with the daytime work group was 1.27 (95% CI: 1.15–1.40). For the fixed evening, fixed night, rotating shift, and other shift workers, the multivariable-adjusted HRs (95% CI) were 1.11 (0.76–1.61), 2.18 (1.20–3.93), 1.39 (1.23–1.56), and 1.00 (0.82–1.22), respectively. In subgroup analyses by age, the association between shift work and hypothyroidism was more pronounced in younger participants (< 40 years; HR: 1.31; 95% CI: 1.16–1.47).

Conclusions

Our large-scale cohort study showed an association between shift work and the incidence of hypothyroidism, especially in younger workers with night shifts.

한국 성인 남성 근로자에서 교대근무와 갑상선 기능 저하증 위험의 연관성: 코호트 연구
목적
교대 근무는 인체에 여러 가지 해로운 영향을 미치는 것으로 보고되어 왔다. 그러나 소수의 연구만이 교대 근무와 갑상선에 대한 이상 반응 사이의 연관성을 평가하였다. 따라서 이번 종단 연구에서는, 교대 근무와 갑상선 기능 저하증의 위험 간의 인과 관계를 평가하고자 한다.
방법
본 강북삼성 코호트 연구는 2012년과 2019년 사이에 최소 한 번 이상 추적 검사를 받았고, 연구 시작 시점에서 갑상선 질환이 없는 112,648명의 남성을 대상으로 수행되었다. 표준화된 설문지를 이용하여 교대근무 현황 및 교대근무 유형을 분류하였다. 갑상선 기능 저하증은 혈청 갑상선 자극 호르몬과 유리 티록신 수치의 참고치를 기준으로 정의되었다. 갑상선 기능 저하증에 대한 위험비(HR)와 95% 신뢰구간(CI)은 주간 근무 그룹을 기준으로 콕스 비례위험 회귀분석을 사용하여 추정되었다.
결과
501,237인년의 추적 조사 기간 중 6,306건의 갑상선 기능 저하증 케이스가 발생하였다 (발생밀도, 100인년당 1.26). 주간 근무 그룹과 비교하여 모든 교대 근무 유형을 포함한 그룹에 대한 갑상선 기능 저하증의 다변량 조정 위험비는 1.27 (95% 신뢰구간, 1.15–1.40)이었다. 고정 저녁, 고정 야간, 윤번 교대 및 기타 교대 근무 그룹의 경우 다변량 조정 위험비 (95% 신뢰구간)는 각각 1.11 (0.76–1.61), 2.18 (1.20–3.93), 1.39 (1.23–1.56) 및 1.00 (0.82–1.22)이었다. 연령에 따른 하위집단 분석에서 교대근무와 갑상선 기능 저하증의 연관성은 젊은 참가자들에게서 더 두드러졌다 (<40세; 위험비, 1.31; 95% 신뢰구간, 1.16–1.47).
결론
본 대규모 코호트 연구를 통해 특히 야간 근무를 하는 젊은 근로자들에서, 교대 근무와 갑상선 기능 저하증 발생 사이의 연관성을 확인할 수 있었다.

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Science of The Total Environment.2025; 958: 178017. CrossRef

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Special Issue

Working hours and the regulations for night shift workers: Tae-Won Jang; Ann Occup Environ Med 2023;35:e19. Published online July 5, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e19

Abstract PDF Supplementary Material

There are several types of shift work in Korea: rotating shift, 24-hour shift, day-night shift, fixed night work, and.so on. As a result of analyzing the 8th Korea National Health and Nutrition Examination Survey and the 6th Korean Working Condition Survey, Korean shift workers accounted for 11.6%–13.9% of wage workers. Weekly working hours of shift workers were 57.69 ± 1.73 (24-hours shift) and 49.97 ± 0.67 (fixed night shift), which were significantly longer than day workers. To prevent health consequences of night work, many countries regulate the working hours of night work not to exceed 7–9 hours a day. However, Korea does not regulate working hours for night work, and some occupations may work more hours than the prescribed overtime hours. To prevent health consequences and reduce working hours for Korean night shift workers, it is necessary to regulate the working hours of night shift workers by law.

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Original Article

The relationship between shift work pattern and thyroid stimulating hormone in female workers: Hun Jeong, Chang Ho Chae, Jun Ho Lee, Hyo Won Chong; Ann Occup Environ Med 2023;35:e14. Published online June 22, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e14

Abstract Abstract in Korean PDF

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.

여성근로자에서 교대근무유형과 갑상선 자극 호르몬과의 연관성
목적
교대근무는 인체의 일중리듬에 변화를 일으키고 심혈관 질환, 소화기 질환 및 대사증후군과 같은 신체적 건강 뿐만 아니라 수면장애, 우울감 등을 포함한 정신건강에도 유해한 영향을 끼치는 것으로 알려져 있다. 일중리듬에 의해 변화하는 호르몬 중 하나인 갑상선 자극 호르몬(TSH)의 농도가 교대근무와의 연관성을 보여주는 연구들이 있으나 교대근무 유형에 따른 차이를 살펴본 연구는 부족한 실정이다. 본 연구는 교대근무의 유형에 따른 TSH의 변화를 알아보고자 하였다.
방법
2015년부터 2019년까지 창원의 일개 대학병원의 건강진단을 받은 1,318명의 여성근로자를 대상으로 연구를 진행하였다. 교대근무유형은 비교대근무, 규칙적 2교대 및 불규칙 3교대로 분류하였으며 TSH ≥ 4.2mIU/L인 경우 이상이 있는 것으로 정의하였다. 연도별로 TSH의 농도를 비교하기 위하여 일반선형모델을 사용하였으며 5년간의 불현성 갑상선기능저하증의 위험도를 비교하기 위하여 일반화추정방정식을 사용하여 이분형 로지스틱 분석을 시행하였다.
결과
연구 대상자 1,318명 중 비교대근무자는 총 363명, 2교대 근무자는 총 711명, 불규칙 3교대 근무자는 총 244명이었다. 연령, 체질량지수(BMI), 흡연, 음주를 보정하고 일반화추정방정식을 사용하여 이분형 로지스틱 분석을 시행한 결과, 비교대근무자를 기준으로 하였을 때, OR은 2교대 근무자에서 1.81(95% CI 1.15-2.86, P=0.011), 불규칙 3교대 근무자에서 2.02(95% CI 1.23-3.32, P=0.006)로 나왔다.
결론
본 연구의 결과는 교대근무가 비교대근무에 비해 불현성 갑상선기능저하증의 위험도가 높았으며 교대근무의 유형에 따른 불현성 갑상선기능저하증의 위험도에 있어 유의미한 차이를 보였다. 이는 이전 연구들의 결과를 뒷받침할 뿐만 아니라 향후 갑상선 기능 검사 및 평가에 있어 교대근무의 유형이 고려대상이 될 수 있을 것으로 생각된다.

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Night shift work and indicators of cardiovascular risk: A systematic review and meta-analysis
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Environmental Research.2025; 276: 121503. CrossRef
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Bulletin of Experimental Biology and Medicine.2024; 177(5): 592. CrossRef

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Original Article

Association between shift work and serum homocysteine level in female electronic manufacturing services workers: Jae Won Lim, Chan Woo Kim, Hyoung Ouk Park, Eui Yup Chung, Changho Chae, JunSeok Son, Young Hoo Shin, Seung Hyun Park, Sang Moon Choi; Ann Occup Environ Med 2023;35:e4. Published online March 10, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e4

Abstract Abstract in Korean PDF Supplementary Material

Background

Shift work has been shown to increase the risk of cardiovascular disease (CVD) based on several evidences. The classic risk factors of CVD include age, hypertension, smoking, obesity and diabetes. Recently, the serum homocysteine level has been reported to be a valuable indicator of CVD risk. This study aimed to determine the variation in serum homocysteine level as a cardiovascular risk indicator among female workers according to shift work.

Methods

The data of regular health examination of workers at an electronic manufacturing services company in Yeongnam region, South Korea in 2019 were examined in this study. The investigation was based on a cross-sectional study conducted on 697 female workers (199 day workers and 498 shift workers). The sociodemographic and biochemical characteristics were compared between day workers and shift workers. Through a logistic regression analysis, the odds ratio (OR) of the increased serum homocysteine level in relation to shift work was determined.

Results

Compared to female day workers, female shift workers showed significantly higher level of serum homocysteine (8.85 ± 2.16 vs. 9.42 ± 2.04 μmol/mL; p = 0.001). The OR of day workers against shift workers was 1.81 (95% confidence interval [CI]: 1.25–2.63). With the adjustment of variables that may influence the level of serum homocysteine, the adjusted OR was 1.68 (95% CI: 1.09–2.60).

Conclusions

The serum homocysteine level was significantly higher in shift workers than in day workers. It is thus likely to be a useful predictor of CVD in shift workers.

전자제조서비스업 회사의 여성 근로자에서 교대근무와 혈청 호모시스테인 수준과의 연관성
목적
교대근무가 심혈관계질환의 발병위험도를 증가시킨다는 여러 증거들이 있다. 심혈관계질환의 고전적 위험인자로는 나이, 고혈압, 흡연, 비만, 이상지질, 당뇨병 등이 있으며, 최근 혈청 호모시스테인 수치는 심혈관계 질환의 위험도 지표로 유용한 것으로 알려지고 있다. 본 연구에서는 여성 근로자에서 교대근무 여부에 따라 심혈관계 질환의 위험도 지표인 혈청 호모시스테인의 수준 차이가 있는지를 알아보고자 하였다.
방법
본 연구는 2019년 영남지방의 한 전자제조서비스업회사 근로자의 정기건강검진 자료를 이용하여 수행하였다. 총 697명의 여성근로자(주간근무자 199명, 교대근무자 498명)의 데이터로 단면연구를 수행하였다. 주간 근무자와 교대근무자의 인구사회학적, 생화학적 특성을 비교하였다. 로지스틱 회귀분석을 사용하여 교대근무와 상승된 혈청 호모시스테인 수치의 교차비를 조사하였다.
결과
여성 주간 근로자와 비교하여 여성 교대근무자의 혈청 호모시스테인 수치가 통계적으로 유의하게 더 높았다. (8.85 ± 2.16 vs 9.42 ± 2.04 μmol/ml ; p=0.001). 교대근무자에 비해 주간 근무자의 교차비는 1.81(95% CI : 1.25-2.63) 였으며, 혈청 호모시스테인 수치에 영향을 미칠 수 있는 변수를 보정한 후, 수정된 OR은 1.68(95% CI : 1.09-2.60) 이었다.
결론
혈청 호모시스테인 수치는 주간 근무자에 비해 교대근무자에서 통계적으로 유의하게 높았다. 교대근로자의 심혈관계 질환 발병의 예측에 있어 혈청 호모시스테인 수치가 유용하겠다.

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Environmental Research.2025; 276: 121503. CrossRef
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Svetlana Anđelković, Maja Babić
Srpski medicinski casopis Lekarske komore.2024; 5(1): 75. CrossRef

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Original Article

Association between working evening shifts and mental health among Korean employees: data from the 5th Korean Working Conditions Survey: Seongchan Heo, Yunrae Cho, Man-Joong Jeon; Ann Occup Environ Med 2022;34:e36. Published online November 8, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e36

Abstract Abstract in Korean PDF

Background

Many studies have been conducted to investigate the harmful effect of shift work on physical and mental health. Although, by definition, “working evening shift” is included in the scope of shift work, most related studies conducted thus far have focused on working night shifts, overtime work, or different types of shift work, with little research effort dedicated to “working evening shifts.” Therefore, to fill this research gap, we investigated the effect of working evening shifts on workers’ mental health.

Methods

The participants of this study were 16,692 employees of the 50,205 that participated in the 5^th wave of the Korean Working Conditions Survey. We performed χ² test and logistic regression analysis to analyze the effects of independent variables on health problems and calculated odds ratios and 95% confidence intervals (CIs).

Results

In the logistic regression analysis adjusted for sociodemographic characteristics, health-related factors, and work-related characteristics, employees who worked evening shifts showed higher levels of depression and anxiety compared to those that did not. In particular, the adjusted odds ratios of the group working evening shifts between one and nine times a month were the highest with 2.723 (95% CI: 2.014–3.682) for depression, 3.294 (95% CI: 2.547–4.259) for anxiety.

Conclusions

The results of our study suggest that working evening shifts has a negative effect on employees’ mental health. This trend decreased with an increase in the monthly frequency of evening work.

한국 근로자의 저녁 근무와 정신건강과의 관련성: 제 5차 한국 근로환경조사를 이용하여
목적
교대근무가 신체 및 정신건강에 미치는 유해한 영향에 대해서는 많은 연구가 이루어져왔다. 하지만 정의 상 저녁근무 또한 교대근무에 포함됨에도 불구하고 기존의 연구는 주로 야간근무 및 장시간 근무 또는 교대근무의 형태에 대해서 다뤘을 뿐 저녁시간 근무에 대한 검토는 거의 없었다. 따라서 본 연구에서는 저녁시간 근무가 근로자의 정신건강에 미치는 영향에 대해 알아보고자 하였다.
방법
이 연구는 제 5차 한국 근로환경조사에 포함된 50,205명의 참가자 중 임금 근로자 16,692명을 대상으로 진행되었다. 카이제곱 검정을 사용하여 대상자들의 각 특성과 건강문제와의 관련성을 파악하고, 이러한 결과를 기반으로 로지스틱 회귀분석을 시행하여 건강문제에 대한 독립변인의 영향력을 파악하고 교차비 (OR)와 95% 신뢰 구간 (CI)을 산출하였다.
결과
사회인구학적 특성, 건강관련 요인, 직업별 특성에 따라 조정된 로지스틱 회귀 분석에서 저녁 근무를 수행하는 근로자는 그렇지 않은 근로자에 비해 높은 수준의 우울, 불안, 피로감을 보였다. 특히 저녁 근무를 한 달에 1회이상 9회 이하 수행하는 군의 조정된 교차비는 우울 2.723 (95% confidence interval (CI): 2.014-3.682), 불안 3.294 (95% CI:2.547-4.259)으로 가장 높은 수치를 나타냈다.
결론
우리 연구의 결과는 저녁시간 근무가 근로자의 정신건강에 부정적 영향을 미침을 나타낸다. 이러한 경향은 한 달에 수행하는 저녁근무 횟수가 증가할수록 감소하는 결과를 보였다.

Citations

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Marius Gabriel Bunescu, Veronica Gheorman, Iulia Rahela Marcu, Cristian Virgil Lungulescu, Venera Cristina Dinescu
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Epidemiology and Health.2024; 46: e2024079. CrossRef

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Original Article

Association between shift work and inflammatory markers in workers at an electronics manufacturing company: Sung-Joon Woo, Chang-Ho Chae, Jae-Won Lim; Ann Occup Environ Med 2022;34:e35. Published online November 7, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e35

Abstract Abstract in Korean PDF

Background

Shift work is known to be associated with cardiovascular disease (CVD). It has been found that inflammatory reactions are involved in the onset and progression of CVD. Therefore, the purpose of this study was to investigate the association between shift work and inflammatory markers.

Methods

Among workers at an electronics manufacturing company, 2,329 workers who had a health checkup from January 2019 to December 2019 were targeted. The general and biochemical characteristics of daytime workers and shift workers were compared through the Independent-test and the χ² test. Through multiple linear regression analysis, the association with shift work and inflammatory markers was investigated. Through multiple logistic regression analysis, the association with shift work and high inflammatory markers

Results

The mean total leukocytes, neutrophils, monocytes, lymphocytes of shift workers were significantly higher than those of daytime worker. The mean high-sensitivity C-reactive protein (hs-CRP) of shift workers was also higher than that of daytime workers but not significantly. In multiple linear regression, shift work was associated with increase of total leukocyte count (β = 0.367, p < 0.001) and hs-CRP (β = 0.140, p = 0.005) after adjusting for all variables. In multiple logistic regression analysis, shift work showed 2.27 times risk of high leukocyte count and 1.8 times risk of high hs-CRP level compared to daytime work after adjusting for all variables.

Conclusions

This study confirmed that shift work is associated with high inflammatory markers. Considering that high inflammatory markers is independent indicator of CVD, the association between shift work and high inflammatory markers may help to understand the CVD risk of shift workers.

일개 전자제품 제조업 근로자에서 교대근무와 염증 표지자의 연관성
목적
교대근무는 심혈관 질환과 관련이 있는 것으로 알려져 있다. 염증반응이 심혈관질환의 발병과 진행에 관여하는 것으로 나타났다. 따라서 본 연구의 목적은 교대근무와 염증표지와의 연관성을 조사하는 것이었다..
방법
전자제품 제조업체 근로자 중 2019년 1월부터 2019년 12월까지 건강검진을 받은 근로자 2,329명을 대상으로 했다. Independent-test와 chi-square test를 통해 주간근로자와 교대근무자의 일반 및 생화학적 특성을 비교하였다. 다중선형회귀분석을 통해 교대근무와 염증표지와의 연관성을 조사하였고, 다중 로지스틱 회귀분석을 통해 교대근무와 높은 수준의 염증성 마커와의 연관성을 조사하였다.
결과
교대근무자의 평균 총 백혈구, 호중구, 단핵구, 림프구는 주간근무자에 비해 유의하게 높았다. 교대근무자의 평균 hs-CRP도 주간근무자에 비해 높았지만 유의미하지는 않았다. 다중 선형 회귀 분석에서 교대 근무는 모든 변수를 조정한 후 총 백혈구 수 증가(β = 0.367, p-value < 0.001)와 hs-CRP(β = 0.140, p-value = 0.005)와 관련이 있었다. 다중 로지스틱 회귀분석에서 교대근무는 모든 변수를 조정한 후 주간근무에 비해 높은 백혈구 수의 위험이 2.27배, 높은 hs-CRP 수준의 위험이 1.8배였다.
결론
이 연구는 교대 근무가 높은 염증 지표와 관련이 있다는 것을 확인 하였다. 높은 염증 지표는 심혈관 질환의 독립적인 지표라는 점을 고려할 때 교대 근무와 높은 염증 지표 사이의 연관성은 교대 근무자의 CVD 위험을 이해하는 데 도움이 될 수 있다.

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Environmental Research.2025; 276: 121503. CrossRef
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Original Article

Correlation between shift work and non-alcoholic fatty liver disease among male workers in the steel manufacturing company of Korea: a cross-sectional study: Kiseok Kim, Yong-Jin Lee, Soon-Chan Kwon, Young-Sun Min, Hyun Kyo Lee, Gwangin Baek, Sang Hyeon Kim, Eun-Chul Jang; Ann Occup Environ Med 2022;34:e33. Published online November 2, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e33

Abstract Abstract in Korean PDF

Background

Circadian rhythm disturbance caused by shift work has adverse effects on the metabolic homeostasis of the liver. Disruption of the metabolic homeostasis of the liver causes fat accumulation in the liver. The aim of this study was to investigate the correlation between shift work and non-alcoholic fatty liver disease (NAFLD) among male workers in the steel manufacturing industry of Korea.

Methods

Based on medical examination data collected in June 2020, 2,511 male subjects from one steel manufacturing company in Korea were selected in total. NAFLD was evaluated using abdominal ultrasound, which was performed by two experienced radiologists. The multinomial logistic regression analysis was performed by adjusting for age, physical activity, smoking history, alcohol consumption, body mass index, waist circumference, blood pressure, blood glucose, lipidemia, liver function test, employment duration, and hepatotoxic materials exposure status.

Results

Compared to daytime workers, the odds ratio (OR) of moderate-severe NAFLD in shift workers was 1.449 (95% confidence interval [CI], 1.028–2.043). Compared to daytime workers, the ORs of moderate-severe NAFLD were significantly higher for the group that engaged in total shift work for more than 20 years (OR, 2.285; 95% CI, 1.051–4.970), the group that was not allowed to sleep during night shift work (OR, 1.463; 95% CI, 1.030–2.078), and the group that consumed food during night shift work (OR, 1.580; 95% CI, 1.093–2.284).

Conclusions

There was a correlation between shift work and moderate-severe NAFLD in male steel manufacturing workers. There will be a need for more research related to the correlation of shift work with steatohepatitis and cirrhosis in the future.

한국 철강 제조업 남성 근로자의 교대근무와 비알코올성 지방간 질환의 상관관계 연구 : 단면연구.
목적
교대근무로 인한 일주기 리듬 교란은 간의 신진대사 항상성에 부정적인 영향을 미친다. 간의 신진대사 항상성 교란은 간에 지방 축적을 일으킨다. 본 연구의 목적은 한국 철강 제조업 남성 근로자의 교대근무와 비알코올성 지방간 질환의 상관관계를 조사하는 것이다.
방법
2020년 6월 수집한 건강검진 자료를 바탕으로 국내 1개 철강 제조업 사업장에서 총 2,511명의 대상자를 선정하였다. 비알코올성 지방간은 두 명의 숙련된 방사선사가 수행한 복부 초음파를 기준으로 평가되었다. 연령, 신체활동, 흡연력, 알코올 소비량, 체질량 지수, 허리둘레, 혈압, 혈당, 지질혈증, 간 기능 검사, 근무 기간 및 간 독성 물질 노출 상태에 대한 보정을 시행한 다항 로지스틱 회귀분석을 실시하였다.
결과
주간 근로자 대비 교대 근무자의 중등도-고도 비알코올성 지방간의 오즈 비는 1.499 (95% 신뢰구간: 1.028-2.043)이었다. 총 교대근무 종사 기간 20년 이상인 군, 야간교대근무 중 수면이 불가능한 군, 그리고 야간교대근무 중 음식 섭취를 하는 군에서 주간 근로자 대비 통계적으로 유의미하게 큰 중등도-고도 비알코올성 지방간의 오즈 비를 보였다.
결론
교대근무는 한국 철강 제조업에 종사하는 남성 근로자의 중등도-고도 비알코올성 지방간과 상관관계가 있다. 앞으로 교대근무와 지방간염, 간경변과의 상관관계와 관련된 추가 연구가 필요할 것이다.

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Original Article

Association between sleep quality and type of shift work in Korean firefighters: Hyun-Jeong Oh, Chang Sun Sim, Tae-Won Jang, Yeon Soon Ahn, Kyoung Sook Jeong; Ann Occup Environ Med 2022;34:e27. Published online October 11, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e27

Abstract Abstract in Korean PDF

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.

한국 소방관에서 수면의 질과 교대근무 유형의 연관성
목적
소방관의 수면의 질에 어떤 교대근무 유형이 적합한지 결정하는 것이다.
방법
이 연구는 568명의 소방관을 포함하여 피츠버그 수면의 질 지수를 사용하여 수면의 질을 평가하였고, 다른 교란 요인은 자기보고형태의 설문지를 통해 수집하였다. 소방관의 수면의 질에 대한 교대근무 유형의 영향을 평가하기 위하여 카이제곱 검정, t-검정, 다중 로지스틱 회귀 분석을 사용하였다.
결과
337명(59.3%)은 나쁜 수면의 질을 가졌다. 주간 근무자와 비교했을 때, 나쁜 수면의 질에 대한 오즈비는 6주기에서 2.161 (95% 신뢰구간 1.137-4.134), 9주기에서 2.161 (1.150-4.062), 21주기에서 1.805 (1.087-2.997), 3주기에서 1.485 (0.718-3.069). 직무별로는 행정에 비해 화재진압 소방관의 수면의 질이 나쁠 오즈비는 1.697 (1.021-2.823)이었고, 구급업무 소방관은 2.325 (1.213-4.455)이었다.
결론
3주기를 제외하고 다른 형태의 교대근무에서 수면의 질은 주간근무에 비해 에서 나쁜 것으로 나타났다.

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Original Article

Relationship between of working hours, weekend work, and shift work and work-family conflicts among Korean manufacturers: Yohan Lee, SooYoung Lee, Yoon-Ji Kim, Youngki Kim, Se-Yeong Kim, Dongmug Kang; Ann Occup Environ Med 2022;34:e20. Published online August 8, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e20

Abstract Abstract in Korean PDF Supplementary Material

Background

In the manufacturing industry, work-family conflict (WFC) is related to working hour characteristics. Earlier studies on the relationship between working hour characteristics and WFC in the manufacturing industry have been limited to some regions in Korea. No study has addressed the data on a national scale. Thus, this study investigated the impact of weekly working hours, weekend work, and shift work on WFC using national-scale data.

Methods

This study was based on the fifth Korean Working Conditions Survey of 5,432 manufacturers. WFC consists of 5 variables; WFC1 “kept worrying about work”; WFC2 “felt too tired after work”; WFC3 “work prevented time for family”; WFC4 “difficult to concentrate on work”; WFC5 “family responsibilities prevented time for work”. As WFC refers to the inter-role conflict between the need for paid work and family work, WFC has been measured in two directions, work to family conflict (WTFC: WFC1, 2, 3) and family to work conflict (FTWC: WFC4, 5). With these WFC variables, we conducted multiple logistic analyses to study how working hours, weekend work, and shift work impact WFC.

Results

Korean manufacturers’ prolonged working hours increased all aspects of WFCs. Odds ratios (ORs) of WFCs based on working hours (reference of under 40 hours) of 41–52, 53–60, over 61 were 1.247, 1.611, 2.279 (WFC1); 1.111, 2.561, 6.442 (WFC2); 1.219, 3.495, 8.327 (WFC3); 1.076, 2.019, 2.656 (WFC4); and 1.166, 1.592, 1.946 (WFC5), respectively. Shift-work in the WFC2 model showed a significantly higher OR of 1.390. Weekend work ‘only on Saturday’ had significant ORs with WFC2 (1.323) and WFC3 (1.552).

Conclusions

An increase in working hours leads to the spending of less time attending to problems between work and family, causing both WTFC and FTWC to increase. As weekends, evenings, and nighttime are considered to be family-friendly to people, working on weekends and shift-work were highly correlated to WTFC.

한국 제조업 노동자에서 근무시간, 주말근무 및 교대근무와 일-가정 양립의 관계
목적
현대 사회에서는 야간 근무를 포함하여 다양한 업무를 수행하는 교대 근무자가 증가하고 있다. 교대 근무는 장기적으로 근로자의 건강에 악영향을 미칠 수 있지만 교대 근무와 우울증의 관계에 대한 연구 결과는 일관성이 없는 것으로 나타났다. 본 연구는 PHQ-9로 예측한 우울증에 걸릴 위험이 높은 국내 야간 및 교대 근무 근로자 수가 주간 근로자보다 많은지 여부를 확인하고자 한다.
방법
본 연구는 제 6 차 및 제 7 차 국민 건강 영양 조사 자료 중 2014, 2016년 및 2018년의 자료를 바탕으로 진행되었다. 근무 일정은 주간 근무와 야간 및 교대근무로 구분 하였다. 이 연구는 우울증에 걸릴 위험이 있는 근로자를 결정하기 위해 자가 보고 우울증 선별 검사 인 PHQ-9를 사용하였다. SPSS 23.0을 이용하여 통계 분석을 수행하였고 통계적 방법으로는 기술 통계, 카이 제곱 분석, 로지스틱 회귀 분석을 사용 하였다.
결과
연령, 교육 수준, 주당 근무 시간 및 수입으로 보정 후 분석하였을 때, 야간 및 교대 근무 근로자에서 우울증 위험군에 해당하는 경우가 유의하게 더 높았으며(odds ratio [OR] = 1.407 (95% confidence interval [CI]: 0.937–2.113)), 이는 여성에서도 마찬가지로 나타났다(odds ratio [OR] = 1.564 (95% confidence interval [CI]: 1.176–2.081)).
결론
본 연구를 통해 야간 및 교대근무 근로자에서 PHQ-9 점수가 10점 이상인 우울증 위험군에 해당하는 경우가 유의하게 높음을 확인할 수 있었다. 현재 한국의 정신 병력과 증상의 유병률을 고려할 때 야간 근로자에게 현실적인 도움을 제공 할 수 있는 방법에 대한 추가 논의와 함께 추가 연구가 필요하다.

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Original Article

Association between metabolic syndrome and shift work in chemical plant workers: Seong-Ryol Chai, Soon-Chan Kwon, Yong-Jin Lee, Eun-Chul Jang, Young-Sun Min, Su-yeon Lee; Ann Occup Environ Med 2021;33:e31. Published online October 22, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e31

Abstract Abstract in Korean PDF

Background

The study aimed to determine the association between shift work and metabolic syndrome and the prevalence of metabolic syndrome in the shift and day work groups among workers working in chemical plants.

Methods

Based on medical examination data collected in February 2019, 3,794 workers working at a chemical plant in Korea were selected. Multiple logistic regression analysis was performed by adjusting for age, sex, body mass index (BMI), drinking, exercise, smoking, employment period and organic compounds exposure.

Results

The prevalence of metabolic syndrome in the entire study group was 23.4%, and the prevalence and components of metabolic syndrome in shift worker; waist circumference were higher than those of day workers (84.77 ± 8.64 vs. 83.41 ± 9.42, p < 0.001), systolic blood pressure (129.89 ± 9.47 vs. 127.57 ± 9.47, p < 0.001), diastolic blood pressure (81.22 ± 7.59 vs. 79.34 ± 7.46, p < 0.001), fasting blood glucose (99.27 ± 17.13 vs. 97.87 ± 13.07, p = 0.007), triglycerides (149.70 ± 101.15 vs. 133.55 ± 105.17, p < 0.001), and decreased high-density lipoprotein (53.18 ± 12.82 vs. 55.61 ± 14.17, p < 0.001). As a result of logistic regression analysis on the risk of metabolic syndrome, even after adjusting for age, sex BMI, drinking, smoking, exercise, employment period, organic compound exposure. the odds ratio (OR) for the shift group was 1.300 for daytime workers (Model 1, OR: 1.491; 95% confidence interval [CI]: 1.273–1.747; Model 2, OR: 1.260; 95% CI: 1.070–1.483; Model 3, OR: 1.309, 95% CI: 1.081–1.585; Model 4, OR: 1.300; 95% CI: 1.063–1.591).

Conclusions

Shift work in chemical plant workers increased the risk of metabolic syndrome, even after adjusting for general factors. To analyze the occupational cause and risk control, it is necessary to analyze the hazardous substances the workers were exposed to and their working environment. Additionally, a large-scale prospective analysis including general factors not analyzed in this study, such as eating habits, is required.

일개 화학공장 근로자에서의 교대근무와 대사증후군의 관계에 관한 연구
목적
이 연구는 화학공장에 근무하는 근로자를 대상으로 교대 근무 그룹과 주간 근무 그룹에서 대사 증후군의 유병율과 교대 근무와 대사 증후군 사이의 연관성을 확인하는 것을 목표로 했다.
방법
2019년 2월 실시한 건강검진 자료를 바탕으로 대한민국의 한 화학공장에 근무하는 근로자 3,794 명을 대상으로 선정하였다. 신장, 체중, 허리둘레, 혈압을 신체계측으로 측정하고 혈당, 콜레스테롤의 혈액학적 검사와 나이, 성별, 흡연, 음주, 운동, 근무기간, 유기화합물 노출 여부의 데이터를 수집하여 대사증후군을 진단하였다. 연구대상자의 일반적 특성, 건강 생활 행태 관련 특성에 따른 대사증후군 위험도를 검정하기 위해서 각각의 인자에 대해 단순 로지스틱 회귀 분석을 시행하였다. 이어서, 둘사이의 관계를 알기 위해 나이, 성별, BMI, 운동, 흡연, 음주, 유기화합물 노출여부, 근무기간을 조정하여 다중 로지스틱 회귀 분석을 실시하였다.
결과
전체 연구 대상 그룹에서 대사증후군의 유병률은 23.4% 로 나타났으며, 교대근무자는 대사증후군 유병률과 구성요소 – 허리둘레 (84.77±8.64 vs 83.41±9.42, p<0.001), 수축기 혈압 (129.89±9.47 vs 127.57±9.47, p<0.001), 이완기 혈압 (81.22±7.59 vs 79.34±7.46, p<0.001), 공복혈당 (99.27±17.13 vs 97.87±13.07, p=0.007), 중성지방 (149.70±101.15 vs 133.55±105.17, p<0.001), 고밀도 지단백 저하 (53.18±12.82 vs 55.61±14.17, p<0.001) 가 주간근로자에 비해 높았다. 대사증후군 위험도에 대한 로지스틱 회귀분석을 실시한 결과 나이, 성별, BMI, 흡연, 운동, 음주, 근무기간, 유기화합물 노출이 보정된 후에도 교대근무군의 교차비는 주간근로자에 대하여 1.300 으로 나타났다. (Model 1, OR: 1.491, 95% confidence interval [CI]: 1.273-1.747; Model 2, OR : 1.260, 95% CI : 1.070-1.483 ; Model 3, OR: 1.309, 95% CI: 1.081-1.585 ; Model 4, OR : 1.300, 95% CI: 1.063-1.591).
결론
화학 공장 근로자에서 교대근무는 일반적요인을 보정한 후에도 대사증후군의 위험도를 증가시켰다. 이에 대한 직업적 원인분석과 위험통제를 위해 노출되는 유해물질과 작업환경에 대한 추가 분석이 필요하며, 식습관과 같은 이번연구에서 분석하지못한 일반적 원인을 포함한 대규모 전향적 추가 분석이 필요하다.

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Original Article

Association between split shift work and work-related injury and disease absence: Kwon Ko, Jae Bum Park, Kyung-Jong Lee, Inchul Jeong; Ann Occup Environ Med 2021;33:e27. Published online August 19, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e27

Abstract PDF Supplementary Material

Background

Shift work (particularly split shifts) has been noted among the working conditions that hinder sustainable work. However, little is known regarding the effects of split shifts on health. This study aimed to investigate the association between split shift work and work-related injury and disease absence.

Methods

This study used data from the fifth Korean Working Conditions Survey and included 4,042 paid shift workers. Shift work type and self-reported work-related injury and disease absence were investigated using a questionnaire. Logistic regression analysis was performed to investigate the association between split shift work and work-related absence with rotating shift worker as the reference group.

Results

Of the 4,042 shift workers, 980 (24.3%) were split shift workers. The adjusted odds ratio (aOR) of split shift for absence due to work-related injury was high at 2.94 (95% confidence interval [CI]: 1.85–4.68) and the aOR of split shift for absence due to work-related disease was also high at 1.58 (95% CI: 1.09–2.29) compared to rotating shift.

Conclusions

Split shift work leads to an increased risk of absences due to work-related injury and disease.

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Annina ROPPONEN, Maria HIRVONEN, Mikael SALLINEN
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Research Article

Comparing risk of depression between day and night/shift workers using the PHQ-9: a study utilizing the 2014, 2016, and 2018 Korea National Health and Nutrition Examination Survey data: Jae-Han Lee, Sang-Woo Kim, Jae-Han Joo, Na-Rae Lee, June-Hee Lee, Kyung-Jae Lee; Ann Occup Environ Med 2021;33:e18. Published online June 9, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e18

Abstract Abstract in Korean PDF

Background

In today's work scenario, the number of shift workers, including those in night shifts, is increasing. Shift work can adversely affect workers' health in the long run, but studies on the relationship between shift work and depression have shown inconsistent results. This study aimed to determine whether the number of night/shift workers at risk of depression, as predicted by the Patient Health Questionnaire-9 (PHQ-9), is higher than that of day workers.

Methods

This study was conducted based on data from the 6th and 7th Korea National Health and Nutrition Examination Survey, 2014, 2016, and 2018. Work schedules were classified into 2 types: day work and night/shift work. This study used the PHQ-9, a self-reported depression screening test, to identify workers at risk of depression. Statistical analysis was performed using SPSS 26.0, and descriptive statistics, χ² test, and logistic regression analysis were employed.

Results

After adjusting for age, educational level, working hours per week, and income, men engaging in night/shift work were at a higher risk of depression (odds ratio [OR]: 1.407, 95% confidence interval [CI]: 0.937–2.113). The same was confirmed for women (OR: 1.564, 95% CI: 1.176–2.081).

Conclusions

Our results showed that the OR for those engaged in night/shift work with a PHQ-9 score of 10 or more increased. Considering the large volume of psychiatric history and symptoms in Korea, additional research is needed. Additionally, further discussion on ways to provide realistic help to night/shift workers is warranted.

교대근무 여부에 따른 PHQ-9을 이용한 근로자의 우울증 위험 비교: 2014, 2016 및 2018년 국민건강영양조사를 이용하여
목적
현대 사회에서는 야간 근무를 포함하여 다양한 업무를 수행하는 교대 근무자가 증가하고 있다. 교대 근무는 장기적으로 근로자의 건강에 악영향을 미칠 수 있지만 교대 근무와 우울증의 관계에 대한 연구 결과는 일관성이 없는 것으로 나타났다. 본 연구는 PHQ-9로 예측한 우울증에 걸릴 위험이 높은 국내 야간 및 교대 근무 근로자 수가 주간 근로자보다 많은지 여부를 확인하고자 한다.
방법
본 연구는 제 6 차 및 제 7 차 국민 건강 영양 조사 자료 중 2014, 2016년 및 2018년의 자료를 바탕으로 진행되었다. 근무 일정은 주간 근무와 야간 및 교대근무로 구분 하였다. 이 연구는 우울증에 걸릴 위험이 있는 근로자를 결정하기 위해 자가 보고 우울증 선별 검사 인 PHQ-9를 사용하였다. SPSS 23.0을 이용하여 통계 분석을 수행하였고 통계적 방법으로는 기술 통계, 카이 제곱 분석, 로지스틱 회귀 분석을 사용 하였다.
결과
연령, 교육 수준, 주당 근무 시간 및 수입으로 보정 후 분석하였을 때, 야간 및 교대 근무 근로자에서 우울증 위험군에 해당하는 경우가 유의하게 더 높았으며(odds ratio [OR] = 1.407 (95% confidence interval [CI]: 0.937–2.113)), 이는 여성에서도 마찬가지로 나타났다(odds ratio [OR] = 1.564 (95% confidence interval [CI]: 1.176–2.081)).
결론
본 연구를 통해 야간 및 교대근무 근로자에서 PHQ-9 점수가 10점 이상인 우울증 위험군에 해당하는 경우가 유의하게 높음을 확인할 수 있었다. 현재 한국의 정신 병력과 증상의 유병률을 고려할 때 야간 근로자에게 현실적인 도움을 제공 할 수 있는 방법에 대한 추가 논의와 함께 추가 연구가 필요하다.

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Yanchun Chen, Hongxi Yang, Yuan Zhang, Lihui Zhou, Jing Lin, Yaogang Wang
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Research Article

Relationship between shift work and age-related macular degeneration: a cross-sectional analysis of data from the 5th Korea National Health and Nutrition Examination Survey (2010–2012): Kibeom Kim, Seongyong Yoon, Jinseok Kim, Kuck-Hyun Woo, Seong-yong Cho, Ha-ram Jo; Ann Occup Environ Med 2021;33:e7. Published online February 8, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e7

Abstract PDF

Background

Age-related macular degeneration (AMD) is the leading cause of blindness. Shift work has well-known adverse effects on health. However, few studies have investigated the relationship between shift work and AMD. This study was conducted to investigate the relationship between shift work and AMD.

Methods

This study used aggregated data from the 2010–2012 cycles of the Korea National Health and Nutrition Examination Survey. The work schedules were classified into 2 types: day work and shift work. AMD was determined using fundus photographs. The χ² test and multiple logistic regression analysis were used to assess sex-stratified relationship between shift work and AMD.

Results

The odds ratio (OR) of AMD in male shift workers was higher (1.54 [95% confidence interval, CI: 1.01–2.36]) than that in male day workers after adjusting for covariates. After dividing into subgroups of the shift work pattern, the OR of AMD in male night shift workers was higher (1.75 [95% CI: 1.07–2.85]) than that in male day workers after adjusting for covariates. However, results of the female worker group were not significant.

Conclusions

The results of this study provide limited support for the hypothesis that shift work is related to AMD. Further prospective studies are needed to define the relationship between shift work and AMD.

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Assessment of metacognition and retinal optical coherence tomography findings in shift workers
Muhammed Batur, Pınar Güzel Özdemir, Rumeysa Bilmez Tan, Zeynep Şahin Taş
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Research Article

Relationship between long work hours and self-reported sleep disorders of non-shift daytime wage workers in South Korea: data from the 5th Korean Working Conditions Survey: Hongsuk Choi, Sungho Lee, Man-Joong Jeon, Young-Sun Min; Ann Occup Environ Med 2020;32:e35. Published online November 3, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e35

Abstract PDF

Background

Studies have investigated the relationship between long work hours and sleep disorders; however, they have focused on shift workers or specific workers who are at high risk of industrial accidents rather than wage workers in general. The purpose of this study is to investigate the effects of long work hours on sleep disorders among non-shift daytime wage workers.

Methods

We conducted a secondary analysis of data from the 5th Korean Working Conditions Survey. From the 50,205 total participants, we included 26,522 non-shift daytime wage workers after excluding self-employed people, business owners, unpaid family employees, and wage workers who work nights and shifts. Sleep disorders were categorized into “difficulty in falling asleep,” “frequent waking,” and “waking up with fatigue.” Logistic regression analysis was used to evaluate the influence of long work hours on sleep disorders, and the odds ratios (ORs) were calculated.

Results

The OR of working > 52 hours per week was 1.183 (95% confidence interval [CI]: 1.002–1.394) for the risk of developing insomnia compared with working ≤ 40 hours per week. The OR of waking up with fatigue was 1.531 (95% CI: 1.302–1.801). Long work hours showed no significant relationship with difficulty in falling asleep or with frequent waking.

Conclusions

Working for extended hours was associated with increased fatigue upon waking in non-shift daytime wage workers.

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Research Article

Multidimensional sleep quality of dependent self-employment workers: Sang Ha Lee, Dukyun Kang, Junhyeong Lee, Uijin Kim, Seunghon Ham, Wanhyung Lee, Won-Jun Choi, Seong-Kyu Kang; Ann Occup Environ Med 2020;32:e6. Published online January 22, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e6

Abstract PDF

Background

The number of workers in non-standard employment (NSE) is increasing due to industrial change and technological development. Dependent self-employment (DSE), a type of NSE, was created decades ago. Despite the problems associated with this new type of employment, few studies have been conducted on the effects by DSE on health, especially sleep quality. This study aims to determine the relationship between DSE and sleep quality.

Methods

This study analyzed data of 50,250 wage workers from the fifth Korean Working Conditions Survey. Workers that did not respond or refused to answer any questions related to variables were excluded, and finally 36,709 participants were included in this study. A total of 2,287 workers (6.2%) were compared with non-DSE (34,422; 93.8%) workers, and multiple logistic regression analyses were applied.

Results

DSE status had a significant association with difficulty falling asleep (odds ratio [OR]: 1.331, 95% confidence interval [CI]: 1.178–1.504), difficulty maintaining sleep (OR: 1.279; 95% CI: 1.125–1.455), and extreme fatigue after waking up (OR: 1.331; 95% CI: 1.184–1.496). A multiple logistic regression of the variables for sleep quality in DSE showed a significant association with exposure to physical factors for all types of poor sleep quality as well as shift work for difficulty maintaining sleep with extreme fatigue after waking up. Long working hours and emotional labor were also associated with extreme fatigue after waking up.

Conclusions

This study shows a significant association between DSE and poor sleep quality, especially when workers were exposed to physical risk factors (noise, vibration, abnormal temperature, etc.) and shift work.

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Research Article

Effect of night shift work on the control of hypertension and diabetes in workers taking medication: Juha Park, Sang-Yeop Shin, Yangwon Kang, Jeongbae Rhie; Ann Occup Environ Med 2019;31:e27. Published online October 10, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e27

Abstract PDF

Background

Night shift work induces physiological and psychological stress by altering sleep and biological rhythms and is associated with hypertension, diabetes, obesity, and cardiovascular diseases. Few studies have been conducted on the control of hypertension and diabetes. This study aimed to examine the effect of night shift work on the control rate of hypertension and diabetes.

Methods

Subjects comprised workers aged 20–65 years who underwent specific health examination at a single facility in seven different affiliated examination centers from 1 January to 31 December 2016. Workers were categorised into day workers and night shift workers. Demographic and medical history were taken, and physical examination was done. Blood pressure (BP) and fasting glucose were measured. The control rate of each disease was evaluated based on treatment goals presented in the treatment guidelines of the Korean Society of Hypertension and the Korean Diabetes Association (systolic BP < 140 mmHg and diastolic BP < 90 mmHg; fasting glucose ≤ 130 mg/dL).

Results

Among 631,418 subjects, 11.2% (70,450) were night shift workers. Of whom 6.1% (4,319) were taking antihypertensive medication and 2.5% (1,775) were taking diabetes medication. Among patients taking antihypertensive medications, the proportion of those whose BP was controlled to suit treatment goals was 81.7% (26,635) of day workers and 77.4% (3,343) of night shift workers, which was significantly different (p < 0.001). Among patients taking diabetes medications, the proportion of those whose blood glucose was controlled to suit treatment goals was 37.4% (4,489) of day workers and 36.5% (647) of night shift workers, but the difference was not significant. The control rates for patients taking antihypertensive medications (odds ratio [OR]: 0.74, 95% confidence interval [CI]: 0.68–0.80) were lower among night shift workers than day workers with adjustment for age, sex, smoking history, alcohol consumption, exercise, and obesity. However, there were no differences in control rates for patients taking diabetes medications (OR: 0.99, 95% CI: 0.87–1.10) between day workers and night shift workers.

Conclusions

Night shift work can have an effect on the uncontrolled BP in workers taking antihypertensive medications. Therefore, additional efforts for disease control are necessary for night shift workers with hypertension.

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Jyotirmayee Bahinipati, Rajlaxmi Sarangi, Mona Pathak, Srikrushna Mohapatra
Journal of Family Medicine and Primary Care.2022; 11(5): 1710. CrossRef
Circadian rhythms and renal pathophysiology
Rajesh Mohandas, Lauren G. Douma, Yogesh Scindia, Michelle L. Gumz
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A cross‐sectional study of the interaction between night shift frequency and age on hypertension prevalence among female nurses
Bin Zhao, Jing Li, Yun Li, Jie Liu, Di Feng, Yuming Hao, Yanjie Zhen, Xiaoran Hao, Menghui Xu, Ximin Chen, Xiulan Yang, Aifang Zuo, Rufu Jia, Ruiqin Zhang, Ailing Fan, Yun Wang, Meijin Yuan, Li Tong, Shuling Chen, Jing Cui, Meizhu Zhao, Wei Cui
The Journal of Clinical Hypertension.2022; 24(5): 598. CrossRef
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Samime ŞARLI GÜNDÜZ, Selma Arzu VARDAR
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Won-Ju Park
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Nour Makarem, Carmela Alcántara, Natasha Williams, Natalie A. Bello, Marwah Abdalla
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Research Article

Relationship between shift work and liver enzymes: a cross-sectional study based on the Korea National Health and Examination Survey (2007–2015): Hyeongyeong Choi, Hyun-Jeong Oh, Ji-Su Shin, MyeongSeob Lim, Sung-Kyung Kim, Hee-Tae Kang, Sung-Soo Oh, Sang-Baek Koh; Ann Occup Environ Med 2019;31:e15. Published online July 31, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e15

Abstract PDF

Background

Shift work has well-known adverse effects on health. However, few studies have investigated the relationship between shift work and hepatic disorders. This study aimed to evaluate the association between shift work and abnormal level of liver enzymes.

Methods

The aggregated data from the 2007–2009, 2010–2012, and 2013–2015 cycles of the Korea National Health and Nutrition Examination Survey was used for this study. The χ² test and multiple logistic regression analysis were used to assess relationship between shift work and abnormal level of liver enzymes stratified by gender.

Results

The odds ratio (OR) of abnormal serum level of alanine aminotransferase (abnormal ALT) in female shift workers was higher with 1.31 (95% confidence interval: 1.00–1.71) compared with day workers after adjusting for covariates. After dividing into subgroups of the shift work pattern, the ORs of abnormal liver enzymes for each pattern compared with day work were not significantly higher.

Conclusions

This study provides limited support for the hypothesis that shift work is related to liver enzyme abnormalities, but offers some evidence in favor of the idea that shift work affects female workers more than males on abnormal ALT. Further studies are needed to define the relationship between shift work and abnormal liver enzymes to be carried out as well as the gender difference in the association.

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Shift work, thyroid function and liver function among subway workers
F Yu, J Liu, T Qu, M Zhao, J Wang, S Jiang, L Ge, F Ye, L Liu, Z He, S Zhang
Occupational Medicine.2025; 74(9): 668. CrossRef
Investigating the relationship between shift work schedule and blood and metabolic parameters: a 10-years retrospective cohort study
Ahmad Soltanzadeh, Meysam Eyvazlou, Mostafa Mohammad-ghasemi, Mansoureh Sadeghi-Yarandi, Monireh Rahimkhani, Neda Ghasemi, Mojdeh Bonyadi, Mohsen Sadeghi-Yarandi
Scientific Reports.2024;[Epub] CrossRef
Night shift-induced circadian disruption: links to initiation of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis and risk of hepatic cancer
Anjali Singh, Baby Anjum, Qulsoom Naz, Sana Raza, Rohit A. Sinha, Mohammad Kaleem Ahmad, Abbas Ali Mehdi, Narsingh Verma
Hepatoma Research.2024;[Epub] CrossRef
Consequences of Shift Work and Night Work: A Literature Review
Isabel Silva, Daniela Costa
Healthcare.2023; 11(10): 1410. CrossRef
Shift work and nonalcoholic fatty liver disease incidence among Chinese rail workers: a 4-year longitudinal cohort study
Jiahui Xu, Shu Ni, Yuming Wang, Mengfan Yan, Xueli Yang, Han Ge, Zizhuo Jia, Ze Yang, Anqi Shan, Huanyu Liu, Nai-jun Tang
International Archives of Occupational and Environmental Health.2023; 96(1): 179. CrossRef
Correlation between shift work and non-alcoholic fatty liver disease among male workers in the steel manufacturing company of Korea: a cross-sectional study
Kiseok Kim, Yong-Jin Lee, Soon-Chan Kwon, Young-Sun Min, Hyun Kyo Lee, Gwangin Baek, Sang Hyeon Kim, Eun-Chul Jang
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef
Association between long working hours and liver enzymes: evidence from the Korea National Health and Nutrition Examination Survey, 2007–2017
Ji-Hun Song, Hyoung-Ryoul Kim, Dong-Wook Lee, Jeehee Min, Yu Min Lee, Mo-Yeol Kang
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef
Factors associated with elevated alanine aminotransferase in employees of a German chemical company: results of a large cross-sectional study
Matthias Claus, Christoph Antoni, Bernd Hofmann
BMC Gastroenterology.2021;[Epub] CrossRef
Relationship between shift work and age-related macular degeneration: a cross-sectional analysis of data from the 5th Korea National Health and Nutrition Examination Survey (2010–2012)
Kibeom Kim, Seongyong Yoon, Jinseok Kim, Kuck-Hyun Woo, Seong-yong Cho, Ha-ram Jo
Annals of Occupational and Environmental Medicine.2021;[Epub] CrossRef

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Research Article

The effect of shift work on high sensitivity C-reactive protein level among female workers: Ho Sung Kwak, Hyoung Ouk Park, Young Ouk Kim, Jun Seok Son, Chan Woo Kim, Jun Ho Lee, Young Hoo Shin, Seung Hyun Park, Eui Yup Chung, Chang Ho Chae; Ann Occup Environ Med 2019;31:e5. Published online May 28, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e5

Abstract PDF

Background

This study assessed the association between shift work and high-sensitivity C-reactive protein (hs-CRP) level, a risk factor for cardiovascular disease (CVD), in female workers in electronics manufacturing services (EMS).

Methods

Female EMS workers who received special medical examinations for workers in Gyeongnam, Korea between January 2017 and December 2017 were enrolled in this study. Their age, marital status, education level, alcohol consumption, smoking habit, regular exercise, quality of sleep, work stress, and depression were investigated, and blood tests were conducted. The t- and χ² tests were conducted to compare the general and biochemical characteristics between daytime and shift worker groups. Age-adjusted partial correlation analysis was performed to examine the linear relationship between hs-CRP level and other risk factors for CVDs. In addition, the difference in hs-CRP levels according to work schedule was analyzed by ANCOVA after adjusting for variables that could affect the hs-CRP level.

Results

Although the average hs-CRP levels did not differ significantly between daytime and shift workers (0.92 ± 1.87 and 1.07 ± 2.20 mg/dL, respectively), shift workers tended to show a higher hs-CRP level (p = 0.067). After adjusting for variables that can affect the hs-CRP level, the estimated average hs-CRP level was significantly higher in shift workers (1.325 ± 0.156 mg/dL) than that in daytime workers (0.652 ± 0.350 mg/dL) (p = 0.003).

Conclusions

The results of this study identified a relationship between shift work and hs-CRP level increase in women. Because multiple studies have reported associations between increased hs-CRP and CVD, follow-up of hs-CRP may help early detection of CVD in shift workers.

Citations

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Night shift work and indicators of cardiovascular risk: A systematic review and meta-analysis
Johanna Samulin Erdem, Mrinal K. Das, Evi De Ryck, Øivind Skare, Jenny-Anne S. Lie, Merete Bugge, Barbara Harding, Ingrid L. Jorgensen, Ingrid Sivesind Mehlum, Manolis Kogevinas, Karl-Christian Nordby, Shan Zienolddiny-Narui
Environmental Research.2025; 276: 121503. CrossRef
The association between precarious employment and stress among working aged individuals in the United States
Vanessa M. Oddo, Sherif Mabrouk, Sarah B. Andrea, Emily Q. Ahonen, Megan R. Winkler, Emilia F. Vignola, Anjum Hajat
Preventive Medicine.2024; 187: 108123. CrossRef
Associations between circadian disruption and cardiometabolic disease risk: A review
Velarie Ansu Baidoo, Kristen L. Knutson
Obesity.2023; 31(3): 615. CrossRef
Sleep Irregularity and Subclinical Markers of Cardiovascular Disease: The Multi‐Ethnic Study of Atherosclerosis
Kelsie M. Full, Tianyi Huang, Neomi A. Shah, Matthew A. Allison, Erin D. Michos, Daniel A. Duprez, Susan Redline, Pamela L. Lutsey
Journal of the American Heart Association.2023;[Epub] CrossRef
Consequences of Shift Work and Night Work: A Literature Review
Isabel Silva, Daniela Costa
Healthcare.2023; 11(10): 1410. CrossRef
Exposure to Radiation During Work Shifts and Working at Night Act as Occupational Stressors Alter Redox and Inflammatory Markers
Sanaa A. El-Benhawy, Rasha A. El-Tahan, Sameh F. Nakhla
Archives of Medical Research.2021; 52(1): 76. CrossRef
Analysis of the relationship between the level of high-sensitive C-reactive protein and the risk factors of cardiovascular diseases in young and middle-aged persons
O. A. Polyakova, A. A. Kirichenko, A. I. Kochetkov
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Association of working conditions including digital technology use and systemic inflammation among employees: study protocol for a systematic review
Helena C. Kaltenegger, Linda Becker, Nicolas Rohleder, Dennis Nowak, Matthias Weigl
Systematic Reviews.2020;[Epub] CrossRef

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Research Article

Association between shift work and hyperhomocysteinemia in male workers: Dukyun Kang, Seong-Kyu Kang, Won-Jun Choi, Sang Ha Lee, Jun-Hyung Lee, Kyeongmin Kwak; Ann Occup Environ Med 2019;31:e1. Published online May 1, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e1

Abstract PDF

Background

Shift work is associated with a higher risk of cardiovascular diseases. Here, we sought to assess the relationship between shift work and plasma homocysteine levels. Determining the correlations between shift work and homocysteine levels may provide a better understanding of the mechanisms underlying cardiovascular diseases.

Methods

This study was performed using data from routine health examinations of steel workers in 2017. In total, 431 male workers (70 daytime workers and 361 shift workers) employed on a rolling departure schedule were recruited. Plasma homocysteine levels > 15 μmol/L were considered elevated. The χ², analysis of variance, and multiple logistic regression analyses were used to examine the association between shift work and plasma homocysteine levels.

Results

In comparison to daytime workers, the odds ratio (OR) of hyperhomocysteinemia in individuals with < 10 years of shift work was 1.14 (95% confidence interval [CI]: 0.64–2.03), compared to 2.01 (95% CI: 1.14–3.54) for workers with ≥ 10 years of experience. After adjusting for confounding variables, the adjusted OR for shift workers with < 10 years of experience was 0.95 (95% CI: 0.50–1.80), compared to 2.00 (95% CI: 1.07–3.74) for workers with ≥ 10 years of experience.

Conclusions

The risk of hyperhomocysteinemia was significantly higher in shift workers compared to those working normal daytime hours, particularly among long-term shift workers.

Citations

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Night shift work and indicators of cardiovascular risk: A systematic review and meta-analysis
Johanna Samulin Erdem, Mrinal K. Das, Evi De Ryck, Øivind Skare, Jenny-Anne S. Lie, Merete Bugge, Barbara Harding, Ingrid L. Jorgensen, Ingrid Sivesind Mehlum, Manolis Kogevinas, Karl-Christian Nordby, Shan Zienolddiny-Narui
Environmental Research.2025; 276: 121503. CrossRef
Shift work is significantly and positively associated with dementia: A meta-analysis study
Kuo-Wei Lee, Chen-Cheng Yang, Chun-Hung Chen, Chih-Hsing Hung, Hung-Yi Chuang
Frontiers in Public Health.2023;[Epub] CrossRef
Association between shift work and serum homocysteine level in female electronic manufacturing services workers
Jae Won Lim, Chan Woo Kim, Hyoung Ouk Park, Eui Yup Chung, Changho Chae, JunSeok Son, Young Hoo Shin, Seung Hyun Park, Sang Moon Choi
Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef
Consequences of Shift Work and Night Work: A Literature Review
Isabel Silva, Daniela Costa
Healthcare.2023; 11(10): 1410. CrossRef
Different exposure metrics of rotating night shift work and hyperhomocysteinaemia among Chinese steelworkers: a cross-sectional study
Shengkui Zhang, Yongbin Wang, Qinglin Li, Zhende Wang, Han Wang, Chao Xue, Ying Zhu, Weijun Guan, Juxiang Yuan
BMJ Open.2020; 10(12): e041576. CrossRef

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Research Article

The association between shift work and chronic kidney disease in manual labor workers using data from the Korea National Health and Nutrition Examination Survey (KNHANES 2011–2014): Jun Young Uhm, Hyoung-Ryoul Kim, Gu Hyeok Kang, Young Gon Choi, Tae Hwi Park, Soo Young Kim, Seong Sil Chang, Won Oh Choo; Ann Occup Environ Med 2018;30:69. Published online December 14, 2018; DOI: https://doi.org/10.1186/s40557-018-0279-z

Abstract PDF

Objective

Kidneys are organs having a biological clock, and it is well known that the disruption of the circadian rhythm increases the risk of chronic kidney disease (CKD), including the decline of renal and proteinuria. Because shift work causes circadian disruption, it can directly or indirectly affect the incidence of chronic kidney disease. Therefore, the purpose of this study was to investigate the association between shift work and chronic kidney disease using a Korean representative survey dataset.

Methods

This study was comprised of 3504 manual labor workers over 20 years of age from data from the fifth and sixth Korea National Health and Nutrition Examination Survey (2011–2014). The work schedules were classified into two types: day work and shift work. The estimated glomerular filtration rate, which is the ideal marker of renal function, was estimated according to the Chronic Kidney Disease Epidemiology Collaboration creatinine equation, and chronic kidney disease was defined as urinary albumin to a creatinine ratio equal to or high than 30 mg/g and/or estimated glomerular filtration rate lower than 60 mL/min/1.73 m². The cross-tabulation analysis and multivariate logistic regression analysis were performed to confirm the association between shift work and chronic kidney disease stratified by gender.

Results

The risk of CKD showed a significant increase (odds ratio = 2.04, 95% confidence interval = 1.22, 3.41) in the female worker group. The same results were obtained after all confounding variables were adjusted (odds ratio = 2.34, 95% confidence interval = 1.35, 4.07). However, the results of the male worker group were not significant.

Conclusions

In this study using nationally representative surveys, we found that the risk of CKD was higher female workers and shift work. Future prospective cohort studies will be needed to clarify the causal relationship between shift work and CKD.

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The glomerular circadian clock temporally regulates basement membrane dynamics and the podocyte glucocorticoid response
Rebecca Preston, Ruby Chrisp, Michal Dudek, Mychel R.P.T. Morais, Pinyuan Tian, Emily Williams, Richard W. Naylor, Bernard Davenport, Dharshika R.J. Pathiranage, Emma Benson, David G. Spiller, James Bagnall, Leo Zeef, Craig Lawless, Syed Murtuza Baker, Qi
Kidney International.2025; 107(1): 99. CrossRef
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Neveen Adel Madbouly, Sahar Mostafa Kamal, Azza Mohamed El-Amir
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Yohan Bignon, Dmitri Firsov
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Jazmine I. Benjamin, Paramita Pati, Tha Luong, Xiaofen Liu, Carmen De Miguel, Jennifer S. Pollock, David M. Pollock
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Beom Seok Ko, Sang Yop Shin, Ji Eun Hong, Sungbeom Kim, Jihhyeon Yi, Jeongbae Rhie
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Che-Jui Chang, Hsiao-Yu Yang
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Ciaran J. McMullan, Andrew W. McHill, Joseph T. Hull, Wei Wang, John P. Forman, Elizabeth B. Klerman
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Ki Duk Kim, Suk-Yong Jang
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Lin Xing, Shanyu Wu, Ying Shi, Fangzhi Yue, Lin Wei, Ryan Russell, Dongmei Zhang
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Rajesh Mohandas, Lauren G. Douma, Yogesh Scindia, Michelle L. Gumz
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Research Article

Association between serum ferritin and hypertension according to the working type in Korean men: the fifth Korean National Health and nutrition examination survey 2010–2012: Dong-Hoon Lee, Seong-Kyu Kang, Won-Jun Choi, Kyeong Min Kwak, Dukyun Kang, Sang Ha Lee, Jun-Hyung Lee; Ann Occup Environ Med 2018;30:40. Published online June 11, 2018; DOI: https://doi.org/10.1186/s40557-018-0251-y

Abstract PDF

Background

Several studies suggest that serum ferritin concentrations reflect systemic inflammation, and high ferritin levels can increase the risk of hypertension in adult men. Shift work is also known to increase the risk of hypertension; however, there has been no study about the relationship between serum ferritin levels and the prevalence of hypertension according to the working type.

Methods

This cross-sectional study included 4,442 male participants (3,651 daytime workers and 791 shift workers) who participated in the fifth Korean National Health and Nutrition Examination Survey. Hypertension was defined as a systolic blood pressure greater than or equal to 140 mmHg, a diastolic blood pressure greater than or equal to 90 mmHg or the current use of antihypertensive medications regardless of blood pressure values. For the statistical analyses, serum ferritin levels were reclassified into quartiles, and complex sample analyses were used to evaluate the relationship between serum ferritin levels and the prevalence of hypertension according to the working type in this study.

Results

Serum ferritin and shift work were positively associated with the prevalence of hypertension. The effect of interaction was above multiplicative. When compared to participants in the lowest serum ferritin quartile, the odds ratio for hypertension for participants in the highest serum ferritin quartile was 1.372 (1.027–1.833) in daytime workers and 2.009 (1.042–3.873) in shift workers after adjustment.

Conclusions

The prevalence of hypertension increased as ferritin levels increased in individuals, especially in shift workers.

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Research Article

Association between working time quality and self-perceived health: analysis of the 3rd Korean working conditions survey (2011): Jaeyoup Jung, Gyuree Kim, Kyusung Kim, Domyung Paek, Sung-il Cho; Ann Occup Environ Med 2017;29:55. Published online November 13, 2017; DOI: https://doi.org/10.1186/s40557-017-0211-y

Abstract PDF

Background

Self-perceived health, a subjective assessment of one’s health condition, is an important health indicator at the level of quality of life. In this study, working time quality refer to job factors with qualitative aspects of working time. This study was conducted to investigate the association between working time quality and self-perceived health in paid workers in Korea.

Methods

In this study, 35,902 paid workers were analyzed based on the 3rd Korean working conditions survey. For independent variables, working time quality (working at night, working in the evenings, working on Sundays, working on Saturdays, and working more than 10 h a day) were set as major job-related variables. Other occupational characteristics were divided into 6 groups and general characteristics were divided into 6 groups, and univariate analysis was conducted with self-perceived health, a dependent variable. Variables that had significance in the univariate analysis were used for multivariate logistic regression analysis.

Results

In the univariate analysis using Chi-square test, variables showing significance in self-perceived health were age, income, education, occupation, employment type, work hours per week, and shift work. Working time quality showed a significant association with self-perceived health. After adjusting for these variables using logistic regression analysis, working at night, working in the evening, working on Sundays, and working more than 10 h a day showed significant association with self-perceived health.

Conclusions

This study showed a statistically significant association between working time quality of employees with self-perceived health.

Citations

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Association between sanitary toilets and health poverty vulnerability among rural western Chinese adults aged 45 years and older: A cross-sectional study
Ximin Ma, Qi Hu, Jiahui He, Chunsheng Li, Kexin Chen, Wenlong Wang, Hui Qiao, Alison Parker
PLOS ONE.2024; 19(9): e0308688. CrossRef
Examining the structural effect of working time on well-being: Evidence from Abu Dhabi
Masood Badri, Mugheer Al Khaili, Hamad Aldhaheri, Guang Yang, Muna Al Bahar, Asma Al Rashdi
Social Sciences & Humanities Open.2022; 6(1): 100317. CrossRef
The mediating role of unhealthy behavior in the relationship between shift work and perceived health
Karin I. Proper, Eva Jaarsma, Suzan J. W. Robroek, Jolinda L. D. Schram, Hendriek Boshuizen, H. Susan J. Picavet, W. M. Monique Verschuren, Sandra H. van Oostrom
BMC Public Health.2021;[Epub] CrossRef
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Seung-Hye Choi, Eun Young Choi, Haeyoung Lee
International Journal of Environmental Research and Public Health.2020; 17(13): 4819. CrossRef
Salaried Workers’ Self-Perceived Health and Psychosocial Risk in Guayaquil, Ecuador
Antonio Ramón Gómez-García, Cecilia Alexandra Portalanza-Chavarría, Christian Arturo Arias-Ulloa, César Eduardo Espinoza-Samaniego
International Journal of Environmental Research and Public Health.2020; 17(23): 9099. CrossRef
Impact of Self-Rated Health on Progression to a Metabolically Unhealthy Phenotype in Metabolically Healthy Obese and Non-Obese Individuals
Mi-Hyun Kim, Yoosoo Chang, Hyun-Suk Jung, Hocheol Shin, Seungho Ryu
Journal of Clinical Medicine.2019; 8(1): 34. CrossRef
Association of discrimination and presenteeism with cardiovascular disease: the Fourth Korean Working Conditions Survey
Kyusung Kim, Sung-il Cho, Domyung Paek
Annals of Occupational and Environmental Medicine.2019;[Epub] CrossRef

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Research Article

Association between shift work and microalbuminuria: data from KNHANES(2012–2014): Eun Kye Kang, Gu Hyeok Kang, Jun Young Uhm, Young Gon Choi, Soo Young Kim, Seong Sil Chang, Hyoung-Ryoul Kim; Ann Occup Environ Med 2017;29:37. Published online August 21, 2017; DOI: https://doi.org/10.1186/s40557-017-0194-8

Abstract PDF

Background

Shift work disturbs workers’ biological clocks and this condition can cause various health problems including cardiovascular disease. The elevated albuminuria level has been significantly associated with the risk of the cardiovascular disease even within a normal reference range. Therefore, this study aimed to investigate the association between shift work and microalbuminuria.

Methods

Workers aged over 20 years from the fifth and sixth Korea National Health and Nutrition Examination Survey(KNHANES 2012–2014; n = 3000) were included in this analysis. The multiple logistic regression analysis was performed to determine the association between shift work and microalbuminuria stratified by gender.

Results

The prevalence of microalbuminuria in male subjects was higher among day workers, but the difference was not significant. However, the prevalence of microalbuminuria among females was higher in shift workers with statistical significance. For female, the Odds ratio of microalbuminuria in shift workers was significantly higher with 1.86 (95% CI 1.02–3.39) compared with day workers. After dividing into 5 subgroups of the shift work pattern, the odds ratio of microalbuminuria for fixed night shift was significantly higher at 4.68 (95% CI 1.29–17.00) compared with day workers.

Conclusions

This study showed that shift work was associated with microalbuminuria in female workers. Especially we found out the association between fixed night shift and microalbuminuria in female workers.

Citations

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Effect of night shift work on the reduction of glomerular filtration rate using data from Korea Medical Institute (2016-2020)
Beom Seok Ko, Sang Yop Shin, Ji Eun Hong, Sungbeom Kim, Jihhyeon Yi, Jeongbae Rhie
Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef
Cardiometabolic traits mediate the association of past shift work and chronic kidney disease: the Dongfeng–Tongji cohort study
Xu Han, Fei Wang, Jing Wang, Meian He
International Archives of Occupational and Environmental Health.2022; 95(7): 1501. CrossRef
Rotating Night Shift Work, Exposure to Light at Night, and Glomerular Filtration Rate: Baseline Results from a Chinese Occupational Cohort
Shengkui Zhang, Yongbin Wang, Ying Zhu, Xiaoming Li, Yang Song, Juxiang Yuan
International Journal of Environmental Research and Public Health.2020; 17(23): 9035. CrossRef

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Research Article

Effect of shift work on hypertension: cross sectional study: Jeong Han Yeom, Chang Sun Sim, Jiho Lee, Seok Hyeon Yun, Sang Jin Park, Cheol-In Yoo, Joo Hyun Sung; Ann Occup Environ Med 2017;29:11. Published online April 11, 2017; DOI: https://doi.org/10.1186/s40557-017-0166-z

Abstract PDF

Background

The need of efficient resource management and full-time accessibility to resources has increased with the development of industry, resulting in the increase of shift workers. Previous researches of past decades show that there are various health effects on shift workers. However, the definition and the form of shift work have varied from each research and occupational harmful factors except for shift work have not been excluded completely in previous researches. Therefore, in this research, we tried to find out the effect of shift work focusing on the hypertension. To complement previously mentioned weakness of other researches, we performed our research on participants to whom we could minimize other risk factors excluding shift work.

Methods

This research examined 1,953 petrochemical plant male workers (shift work 1,075, day worker 878) who did medical checkup from 1st Jan. 2014 to 31th Dec. 2014 in a general hospital located in Ulsan, based on their medical records and questionnaires. With the questionnaire, we found out their basic information including age, social status, occupational history, and we took their physical measurements.

Results

Compared to day workers, shift workers’ odds ratio of developing hypertension was 1.31 (95% CI 0.98–1.75). After adjusting confounding variables, adjusted odds ratio for entire subjects was 1.51 (95% CI 1.11–2.06). Also, for subjects who were in continuous service for over 20 years, odds ratio was 1.51 (95% CI 1.08–2.11).

Conclusions

Shift workers had a higher chance of hypertension than day workers do. Particularly, the longer the workers work continuously, the risk of hypertension getting higher.

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Research Article

Effects of shift work on abdominal obesity among 20–39-year-old female nurses: a 5-year retrospective longitudinal study: Gyeong-Jin Lee, Kunhyung Kim, Se-yeong Kim, Jeong-Ho Kim, Chunhui Suh, Byung-Chul Son, Chae-Kwan Lee, Junghye Choi; Ann Occup Environ Med 2016;28:69. Published online December 5, 2016; DOI: https://doi.org/10.1186/s40557-016-0148-6

Abstract PDF

Background

This study aimed to investigate the effects of shift work on abdominal obesity among young and middle-aged female nurses during a 5-year retrospective study.

Methods

This retrospective study included female nurses (20–39 years old) who worked at a university hospital in Korea and had available health screening results from 2010–2015. Among 2,611 employees, 934 healthy 20–39-year-old female nurses were identified, and data regarding their demographic information (age and date of employment), waist circumferences (WC), and lifestyle factors (alcohol and exercise) were obtained. Abdominal obesity was defined as a WC of ≥80 cm, based on the World Health Organization’s Asia-West Pacific standard in 2000. The mean WC change from baseline was analyzed using the paired t test, and the association between shift work and abdominal obesity was analyzed using the generalized estimating equation.

Results

Compared to all day workers (both age groups), the 20–29-year-old nurses did not exhibit significant changes in WC at each follow-up. However, among the 30–39-year-old nurses, shift workers exhibited a significant change in WC (vs. baseline) during years 4 and 5, compared to day workers. After adjusting for effective confounders and stratifying the participants according to age, the 20–29-year-old nurses exhibited an odds ratio of 3.21 (95 % confidence interval: 1.29–7.98) for shift work-associated obesity, although the odds ratio for the 30–39-year-old nurses was not statistically significant.

Conclusion

In the study population, shift work was associated with a significant change in mean WC among 30–39-year-old nurses, and the shift work-associated risk of abdominal obesity was significant among 20–29-year-old nurses. These results indicate that shift work may influence abdominal obesity differently in 20–29-year-old and 30–39-year-old female nurses.

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Research Article

Night shift work and inflammatory markers in male workers aged 20–39 in a display manufacturing company: Seong-Woo Kim, Eun-Chul Jang, Soon-Chan Kwon, Wook Han, Min-Sung Kang, Young-Hyeon Nam, Yong-Jin Lee; Ann Occup Environ Med 2016;28:48. Published online September 20, 2016; DOI: https://doi.org/10.1186/s40557-016-0135-y

Abstract PDF

Background

This study aimed to determine the association between shift work and inflammatory markers, which are independent risk factors of cardiovascular diseases, in male manual workers at a display manufacturing company.

Methods

This study was conducted between June 1 and July 31, 2015 on 244 male manual workers aged 20–39 years old at a display manufacturing company and investigated age, marital status, education level, alcohol consumption habit, smoking habit, regular exercise habit, sleep duration, sleep debt, sleep insufficiency, past medical history, current and past shift work experience, duration of shift work, and weekly work hours through face-to-face interviews using structured questionnaires and performed blood tests. Study participants were divided into daytime, former shift, and current shift workers based on the work schedule. Chi-square tests and one-way analyses of variance were performed to compare inflammatory markers and cardiovascular disease risk factors, and analyses of covariance were conducted after adjusting for variables potentially affecting inflammatory markers.

Results

High-sensitivity C-reactive protein (hs-CRP; mean ± standard deviation) levels in daytime, former shift, and current shift workers were 0.65 ± 0.43, 0.75 ± 0.43, and 0.86 ± 0.72 mg/L, respectively (p = 0.029). The leukocyte count (mean ± standard deviation) was 5,556 ± 1,123, 6,210 ± 1,366, and 6,530 ± 1,216 cells/μL, respectively (p < 0.001). Both hs-CRP level and leukocyte count were significantly higher in current shift workers than in daytime workers, and leukocyte count was higher in former shift workers than in daytime workers. After adjusting for variables potentially affecting inflammatory markers, hs-CRP levels (adjusted mean ± standard deviation) in daytime and current shift workers were 0.59 ± 0.06 and 0.92 ± 0.07 mg/L, respectively (p = 0.002). The leukocyte count (adjusted mean ± standard deviation) was 5,557 ± 124 and 6,498 ± 144 cells/μL, respectively (p < 0.001).

Conclusions

A significant association between shift work and increases in inflammatory markers was confirmed. Because chronic low-grade inflammation plays an important role in the development of cardiovascular diseases, regular follow-up of inflammatory markers as a marker of cardiovascular diseases in shift workers may serve as an early indicator in predicting the effects of shift work on health.

Citations

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Research Article

Association between shift work and obesity according to body fat percentage in Korean wage workers: data from the fourth and the fifth Korea National Health and Nutrition Examination Survey (KNHANES 2008–2011): ManKi Son, Byeong Jin Ye, Jung-Il Kim, ShinUk Kang, Kap-Yeol Jung; Ann Occup Environ Med 2015;27:32. Published online December 23, 2015; DOI: https://doi.org/10.1186/s40557-015-0082-z

Abstract PDF

Background

Health problems in shift workers vary including obesity acting as a risk factor in cerebrovascular diseases. Recent studies have commonly determined the prevalence of obesity in shift workers on the basis of body mass index. The accuracy of BMI for diagnosing obesity are still limited apparently. Consequently, this study aimed to determine the relationship between shift work and obesity according to the total body fat percentage in Korean wage workers.

Methods

From the Fourth and the Fifth Korea National Health and Nutrition Examination Survey (2008–2011), after military personnel were excluded, a total of 2952 wage workers (20 ≤ age ≤ 65) whose current jobs were their longest jobs were selected as subjects of the study. The total body fat percentage was used to determine the obesity standards (≥25.7 % in males and ≥36.0 % in females). The subjects were divided into groups by gender and work type (manual vs non-manual), and chi-squared test was used to evaluate the relationship between socio-economic, health behavior, and work-related factors, on the one hand, and obesity, on the other. In addition, multivariate logistic regression analysis was performed to examine the effects of shift work on obesity.

Results

When other factors were controlled for, the risk of obesity in shift work showed a statistically significant increase (odds ratio = 1.779, 95 % confidence interval = 1.050-3.015) in the male manual worker group. However, there were no significant results in the male non-manual and female worker groups.

Conclusion

Shift work was related to a higher risk of obesity in the Korean male manual worker group.

Citations

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