Serum gastrin and pepsinogen in shift workers

Summary Gastrointestinal complaints, including peptic ulcer, are believed to be associated and enhanced by shift work (SW). However, there are no clear reports in the literature about this acquired pathology. Serum gastrin (G) and group I pepsinogen (PG1) are thought to play a role in the pathogenesis of peptic ulcer and may be considered a useful test of the gastric function. Five adult male foundry shift workers, without any demonstrated gastrointestinal pathology, were studied over a month's span during the following weekly rotating shift schedule: 07.45–16.45, 06.00–14.00, 14.00–22.00, 22.00–06.00. Six adult, day-working males acted as controls. Blood samples drawn at the beginning and at the end of each weekly shift were assayed for G and PG1 utilizing RIA kits. Our data showed that SW causes a prominent change in the gastrin/acidopepsin secretion system.     

Health disorders of shift workers

The effects of shift work on physiological function through disruption of circadian rhythms are well described. However, shift work can also be associated with specific pathological disorders. This article reviews the evidence for a relationship between specific medical disorders and working at night or on shift systems. The strongest evidence exists for an association with peptic ulcer disease, coronary heart disease and compromised pregnancy outcome.     

Serum lipoproteins in day and shift workers: a prospective study

This study was designed to assess changes in diet and serum lipoproteins in shift workers. Twelve shift workers and 13 day workers were examined before employment and after six months at work. Total cholesterol and serum triglycerides did not change significantly. In both groups a decrease in systolic blood pressure was observed. The ratio between apoB and apoA-1 lipoproteins increased by 18% in shift workers compared with 5% in day workers. The change in the ratio between apoB and apoA-1 lipoproteins showed a significant inverse correlation with the change in intake of dietary fibres.     

Metabolic syndrome in shift healthcare workers

Background:Shift work including night shifts is generally associated with chronic misalignment between the endogenous circadian timing system and behavior cycles, leading to metabolic disorders including metabolic syndrome (MS).Objectives:The purpose of this research was to analyze the latest developments in assessing and managing the occupational risk of MS in shift-healthcare workers (HCWs).Methods:According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, the authors used MEDLINE/Pubmed to perform a systematic review of literature from January 2008 to December 2018.Results:Six studies were selected; the topics, discussed in order of frequency from highest to lowest, were: risk assessment, occurrence rates, and risk management. The main occupational determinants for MS were the cumulative shift work including night shifts and the number of nights worked per month per worker. With regard to cumulative lifetime exposure to shift work, the findings of our review suggest a dose–response relationship between increasing years of shift work history and MS in shift-HCWs.Conclusions:The findings suggest the need to better investigate the impact of sleep deprivation in the assessment of MS risk in shift-HCWs and clarify the role of such variables as confounders, mediators, or effect modifiers. Moreover, to date the data regarding management interventions focused on the risk of MS are inconsistent and therefore a special effort is required to detect strategic ways to minimize the likelihood of MS occurring in shift-HCWs.Key words: Shift work, night work, healthcare worker, risk assessment, risk management     

Differences between fixed day shift workers and rotating shift workers in gastrointestinal problems: a systematic review and meta-analysis

This study comprised a review and compilation of literature to gain an in-depth understanding of the impact of rotating shift work on gastrointestinal health. PubMed, CINAHL, and the Cochrane Library were searched for studies published between January 1, 1985, and June 30, 2020. Fixed day shifts were defined as work shifts that began between 7:00 and 9:00 in the morning. Shifts beginning at any other time were classified as rotating shifts. A meta-analysis was performed using Comprehensive Meta-Analysis Software (CMA) version 3. In the end, 16 studies were included in the meta-analysis. An odds ratio (OR) of 1.56 (95% confidence interval (CI): 1.24–1.95), indicating that gastrointestinal problems are more common in rotating shift workers than in fixed day shift workers. Four gastrointestinal problems, namely, irritable bowel syndrome, constipation, indigestion, and peptic ulcers, were then analyzed separately. Significant differences between rotating shift workers and fixed day shift workers were found only for indigestion and peptic ulcers. For indigestion, the OR was 1.72 (95% CI: 1.28–2.30). For peptic ulcers, the OR was 1.66 (95% CI: 1.19–2.30). Thus, research indicates that rotating shift work may increase the risk of gastrointestinal problems, particularly indigestion and peptic ulcers.     

倒班作业女职工月经情况的调查

选择不同职业的270名倒班女职工(倒班组)和对应单位210名不倒班女职工(对照组)进行月经生理职业流行病学调查。结果显示,倒班组月经异常患病率、经期异常率、周期异常率和痛经率均明显高于对照组且差异具有统计学意义(P0.05)。倒班组女职工月经周期异常率随倒班工龄的增加有线性增高的趋势,经趋势卡方检验有统计学意义,不同职业女职工间月经异常患病率差异无统计学意义(P0.05)。提示建立合理、人性化的劳动制度对保护倒班作业女工的生殖健康十分必要。     

Mortality in a group of tar distillery workers and roofers

Objective: A retrospective cohort mortality study was conducted to assess long-term health risk in a group of tar distillery workers and roofers in order to investigate the existence of carcinogenic effects related to the occupational exposures. Methods: The study population consisted of 907 tar distillery workers and 866 roofers, employed at least one half-year between January 1947 and January 1980. This group was followed for mortality until January 1988. For the deceased workers the cause of death was provided by the Central Bureau of Statistics. The observed cause-specific mortality was compared with the expected cause-specific mortality calculated by means of the national mortality rates of The Netherlands. Results: Mortality from cancer of the lungs and trachea was higher than expected in both groups, but not statistically significant. In addition the roofers had experienced an excess mortality rate from external causes. Conclusions: The study provides some additional support for the carcinogenicity of coal tar exposures, but the findings were not statistically significant. Received: 28 October 1996 / Accepted: 7 February 1997     

Serum lipoproteins in day and shift workers: a prospective study.

This study was designed to assess changes in diet and serum lipoproteins in shift workers. Twelve shift workers and 13 day workers were examined before employment and after six months at work. Total cholesterol and serum triglycerides did not change significantly. In both groups a decrease in systolic blood pressure was observed. The ratio between apoB and apoA-1 lipoproteins increased by 18% in shift workers compared with 5% in day workers. The change in the ratio between apoB and apoA-1 lipoproteins showed a significant inverse correlation with the change in intake of dietary fibres.     

Food intake and circadian rhythms in shift workers with a high workload

Shift work is associated with nutritional and health problems. In the present study, the food intake of garbage collectors of the city of Florianopolis (Brazil) was investigated using a dietary survey method based on meal recording during 24 h and adapted for the Brazilian food context. Three different shifts (morning, afternoon, and night) were compared (n=22 per shift). Age, body weight and body mass index (BMI) were similar for all groups. Daily energy expenditure was high in all three shifts, especially in morning shift workers. No difference in daily energy intake was found, in spite of differences in food choices and circadian ingestion rhythms. Energy intake was high and close to levels previously reported in athletes. Several factors not associated with shifts had significant impact on ingestion: hour of the day, time since the last meal, age, and BMI. Ingested foods were analyzed in groups based on nutrient content. Shifts significantly influenced intake of starches, alcoholic drinks, and sweets. In different periods of the day, food and nutrient intake were considerably affected by shifts. The analysis of circadian distribution of food choices and nutrient intake is important in shift workers, because total daily intake may not reveal shift-associated differences.     

The productivity of female shift workers

The productivity of female shift workers, working on a weekly rotating three-shift system, was examined. The afternoon shift was found to be the most productive and the night shift the least productive one. The greatest difference in productivity between shifts was found in the first two days of the week, when the productivity on night shift was significantly lower than that on the other two shifts. From the third day on there were no longer significant differences in productivity between shifts. The most productive and the least productive workers on night shift did not significantly differ in extraversion or in sleep duration after the night shift. Family responsibility was found to be associated with the duration of sleep after the night shift: married women slept significantly shorter after the night shift than unmarried women. However, this difference in sleep duration was not associated with productivity on night shift. Sleep duration after the afternoon shift (8 hours 40 minutes) was on average two hours longer than after the other two shifts. The difference in sleep duration after different shifts, along with circadian variations in alertness, readiness for work and performance efficiency, could be responsible for differences in productivity between shifts.     

Sleep quality in noise exposed Brazilian workers

This study investigated the effect of chronic workplace exposure to excessive noise on sleep quality. It involved 40 male workers aged 33 to 50 years, 20 of whom had been exposed to environmental workplace noise levels of 85 dB or more on 40-hour-a-week jobs. Another 20 workers who were not exposed to excessive noise were used as controls. All subjects were interviewed and submitted to physical examination, pure tone and speech audiometry, immittance testing and nocturnal polysomnography. Comparative analysis demonstrated that the two groups were similar, except for the exposure to noise. Fisher's test comparison of pure tone and speech audiometry and immittance testing revealed mild to moderate noise-induced hearing loss (P < 0.001) in the > or = 85-dB group. Indicators of sleep continuity were abnormal in both groups, demonstrating poor sleep quality; however, sleep quantity was normal. Of the 40 individuals, 13 (32.5%) presented respiratory sleep disorders. Of those 13, 10 presented daytime somnolence according to the Epworth Scale. The Mann-Whitney test showed that sleep was identical in the two groups. Fisher's exact test revealed no association between altered sleep and hearing status in either group. Our results show that active men working 40-hour-a-week in the presence of excessive noise without adequate protection for more than eight years presented with noise-induced hearing loss but their quality or quantity of night sleep was unaffected. Sensori-neural deafness may represent an element of adaptation against noise during sleep.     

Preventive and compensatory measures for shift workers

Shift systems are known to be associated with a variety of psychosocial and physiological problems that can affect the health of workers. This review focuses on measures that can be taken to optimize the well-being of shift workers and to identify ill-health at an early stage. The discussion includes specific aspects of the design of shift systems, taking account of variation in the views and circumstances of employees, and strategies to combat sleepiness at work and elsewhere. Although an ideal shift system does not exist, a wholistic approach comprising education of managers, employees and their families can ameliorate some of the health consequences.     

Lead poisoning in a group of demolition workers.

The incidence of lead poisoning in industry has fallen dramatically since the beginning of the twentieth century. This reduction has been partly attributable to increased awareness, improved ventilation and hygiene facilities, and technical changes which have allowed other substances to replace lead, but improved medical surveillance of workers exposed to lead in certain defined industries has also been important. Not all industries where lead exposure can occur are at present covered by specific regulations dealing with lead, however. We report the diagnosis and treatment of eleven oxyacetylene metal burners involved in the demolition of a railway station, who rapidly developed frank lead poisoning. The most suitable measurements to employ in evaluating such a population are considered. The selection, based on blood lead and haemoglobin measurements, of those who should receive further treatment is discussed. Symptoms were found to be more nearly related to indices of effect or toxicity of lead than to indices of exposure or absorption. The effects of chelation therapy upon symptoms, blood lead, haemoglobin and urinary porphyrins are recorded. The need for careful follow-up is illustrated.     

Lead poisoning in a group of demolition workers.

The incidence of lead poisoning in industry has fallen dramatically since the beginning of the twentieth century. This reduction has been partly attributable to increased awareness, improved ventilation and hygiene facilities, and technical changes which have allowed other substances to replace lead, but improved medical surveillance of workers exposed to lead in certain defined industries has also been important. Not all industries where lead exposure can occur are at present covered by specific regulations dealing with lead, however. We report the diagnosis and treatment of eleven oxyacetylene metal burners involved in the demolition of a railway station, who rapidly developed frank lead poisoning. The most suitable measurements to employ in evaluating such a population are considered. The selection, based on blood lead and haemoglobin measurements, of those who should receive further treatment is discussed. Symptoms were found to be more nearly related to indices of effect or toxicity of lead than to indices of exposure or absorption. The effects of chelation therapy upon symptoms, blood lead, haemoglobin and urinary porphyrins are recorded. The need for careful follow-up is illustrated.     

Control of diabetes mellitus in shift workers.

OBJECTIVE--To determine whether the control of diabetes is different in insulin treated diabetic subjects who work shifts compared with those who do not work shifts and whether control is related to the type of shift worked. DESIGN--Prospective controlled study of 32 diabetic subjects working either regular days or shifts in a large car assembly factory. Insulin treated subjects who underwent a change in their pattern of shift work had diabetic control assessed before and six months after a change in shifts. MAIN OUTCOME MEASURES--Random plasma glucose, serum fructosamine, and haemoglobin A1 while at work. RESULTS--Diabetic control of insulin treated subjects who worked shifts was not significantly different from insulin treated subjects who worked days only. Diabetic control was poor in both groups and similar to that of diabetic subjects treated with oral hypoglycaemic agents. In those subjects that moved to a more rapidly rotating shift pattern there was a significant deterioration in control (serum fructosamine concentration before, 405 (SD 68); after, 481 (SD 90) mumol/l, p less than 0.01). CONCLUSIONS--The control of diabetes in insulin treated diabetic subjects who worked shifts was no worse than those who worked days only. Slowly rotating shifts were associated with better diabetic control than more rapidly rotating shifts.