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Health Consequences of Shift Work and Chronodisruption

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Occupational Safety and Health".

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 21419

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Special Issue Editor

Dr. Massimo Bracci

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Guest Editor

Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60121 Ancona, Italy
Interests: occupational medicine; shift workers; shift work schedule; night shift work; light-at-night; blue light; circadian rhythms; biological clock; chronobiology; melatonin; clock genes

Special Issue Information

Dear Colleagues,

The biological clock is involved in several key physiological processes, including mental well-being, metabolism, and aging. During night shifts, exposure to light during the biological night alters workers’ sleep/wake cycles, suppresses melatonin production, and deregulates circadian genes, leading to chronodisruption. The association between night shift work and breast cancer has recently been examined by the International Agency for Research on Cancer (IARC) and the National Toxicology Program (NTP). Altered biological rhythms may induce mood, metabolic, hormonal, and other disorders. Chronodisruption can also be due to mistimed exposure to other clock-resetting signals, such as nocturnal meals or light at night. Notably, blue light strongly influences the circadian rhythm; the passage from incandescence lamps to LED lighting and the growing use of electronic devices have also raised questions on the possible health consequences of increasing blue light exposure. This Special Issue aims to collect contributions that explore the health consequences of shift work and the disruption of the biological clock which are of interest to occupational medicine and public health. Papers which discuss how the effects of work or lifestyle factors that interfere with the biological clock can be prevented or minimized are particularly invited.

Dr. Massimo Bracci
Guest Editor

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Keywords

shift workers
shift work schedule
night shift work
chronodisruption
light-at-night
blue light
circadian rhythms
biological clock
melatonin
clock genes

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Published Papers (6 papers)

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12 pages, 1061 KiB

Open AccessArticle

Alterations in Pregnenolone and Testosterone Levels in Male Shift Workers

by Massimo Bracci, Laura Zingaretti, Margherita Martelli, Raffaella Lazzarini, Gianmaria Salvio, Monica Amati, Marijana Milinkovic, Alfio Ulissi, Anna Rita Medori, Ermanno Vitale, Caterina Ledda and Lory Santarelli

Int. J. Environ. Res. Public Health 2023, 20(4), 3195; https://doi.org/10.3390/ijerph20043195 - 11 Feb 2023

Cited by 5 | Viewed by 6513

Abstract

Steroid hormone levels are closely related to the endogenous circadian rhythm induced by sleep–wake and dark–light cycles. Shift work that disrupts the circadian rhythm may influence the levels of steroid hormones. The association between shift work and alterations in female sex steroid hormone levels has been studied, but little is known about testosterone and its precursor pregnenolone levels in male shift workers. The present study investigated serum pregnenolone and testosterone levels in a group of shift and daytime male workers. All participants were sampled at the beginning of the morning shift. Lower levels of serum pregnenolone and total testosterone were found in the shift workers compared to the daytime workers. Variations in pregnenolone levels may have consequences for well-being, and they might produce consequences for the levels of hormones downstream of the steroid hormone cascade, such as testosterone. The low levels of testosterone found in shift workers demonstrate the perturbative effect of shift work on testosterone serum levels, which may be independent and/or related to pregnenolone synthesis. Full article

(This article belongs to the Special Issue Health Consequences of Shift Work and Chronodisruption)

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9 pages, 330 KiB

Open AccessArticle

Health, Occupational Stress, and Psychosocial Risk Factors in Night Shift Psychiatric Nurses: The Influence of an Unscheduled Night-Time Nap

by Valérie Amiard, Frédéric Telliez, Florine Pamart and Jean-Pierre Libert

Int. J. Environ. Res. Public Health 2023, 20(1), 158; https://doi.org/10.3390/ijerph20010158 - 22 Dec 2022

Cited by 7 | Viewed by 3149

Abstract

Background: Occupational stress and shift work (including night shift work) are associated with physical and psychological health consequences in healthcare providers in general and those working in psychiatric establishments in particular. The aim of this study was to assess the impact of occupational risk factors and unscheduled night-time naps on self-reported health disorders among nurses working in a French psychiatric hospital. Methods: We performed a 12-month observational field study of experienced nurses working at Philippe Pinel Psychiatric Hospital (Amiens, France) between September 2018 and September 2019. A comparative descriptive study of two groups of nurses who filled out a questionnaire on health and occupational stress was performed: nurses working permanently on the night shift (the night shift group, who took unscheduled naps), and nurses rotating weekly between morning and afternoon shifts (the day shift group). Results: The night and day shift groups comprised 53 and 30 nurses, respectively. There were no intergroup differences in health disorders, sleep quality, occupational stress, and risk factor perception. Correlation analyses showed that in the day shift group, a low level of support from supervisors was associated with elevated levels of distress, anxiety, and gastrointestinal disorders. In the night shift group, a greater overall work load was associated with elevated levels of anxiety and distress. These findings indicated that the nurses on the night shift had adapted well to their working conditions. Conclusions: An organizational strategy including an unscheduled night-time nap might improve health among night shift nurses. Full article

(This article belongs to the Special Issue Health Consequences of Shift Work and Chronodisruption)

12 pages, 967 KiB

Open AccessArticle

Night Work and Sustainable Working Life—A Prospective Trajectory Analysis of Swedish Twins

by Annina Ropponen, Mo Wang, Auriba Raza, Jurgita Narusyte and Pia Svedberg

Int. J. Environ. Res. Public Health 2022, 19(17), 10857; https://doi.org/10.3390/ijerph191710857 - 31 Aug 2022

Cited by 1 | Viewed by 1615

Abstract

The aim was to investigate the changes in sustainable working life over 10–13 years of follow-up and the effect of baseline night work. Data from the Swedish national registers were used to define sustainable working life. Survey data in the 1998–2003 “SALT” with 34,680 twins or in the 2004–2006 “STAGE” with 19,637 twins were utilized to assess night work at baseline. Group-based trajectory and multinomial regression models were applied. The results of the SALT cohort yielded five trajectory solutions: stable sustainable working life (40%), stable lack of sustainable working life (25%), later decreasingly sustainable working life (15%), increasingly sustainable working life (14%), and early decreasingly sustainable working life (7%). In the STAGE cohort, four trajectories were detected: stable sustainable working life (83%), decreasingly sustainable working life (7%), stable lack of sustainable working life (5%), and increasing sustainable working life (5%). Night work was associated with the decreasing or increasing sustainable working life in the trajectory groups. To conclude, the largest parts of both cohorts followed trajectories of stable sustainable working lives. Night work was associated with both the trajectories of decreasing and increasing sustainable working lives. Full article

(This article belongs to the Special Issue Health Consequences of Shift Work and Chronodisruption)

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11 pages, 345 KiB

Open AccessArticle

Impact of Rotating Shifts on Lifestyle Patterns and Perceived Stress among Nurses: A Cross-Sectional Study

by Shang-Lin Chiang, Li-Chi Chiang, Wen-Chii Tzeng, Meei-Shyuan Lee, Chan-Chuan Fang, Chueh-Ho Lin and Chia-Huei Lin

Int. J. Environ. Res. Public Health 2022, 19(9), 5235; https://doi.org/10.3390/ijerph19095235 - 26 Apr 2022

Cited by 11 | Viewed by 4113

Abstract

Although rotating shifts have a negative health impact, their association with hospital nurses’ health risks remains controversial due to incomplete adjustment in lifestyle patterns and heterogeneity of work schedules. However, whether work schedule characteristics are associated with lifestyle patterns and perceived stress remains undetermined. We assessed the correlations of work schedule characteristics, lifestyle patterns, and perceived stress among hospital nurses. This cross-sectional study included 340 nurses from two hospitals. Final data from 329 nurses regarding work schedule characteristics, lifestyle patterns (physical activity, dietary behavior, and sleep pattern), and perceived stress were analyzed via linear regression models. Fixed-day-shift nurses had reduced perceived stress (β = 0.15, p = 0.007) compared with rotating-shift nurses. Additionally, among rotating-shift nurses, fixed-evening- and fixed-night-shift nurses had longer sleep duration (β = 0.27, p < 0.001; β = 0.25, p < 0.001) compared to non-fixed-rotating-shift nurses. Longer rotating-shift work was associated with healthier dietary behaviors (β = 0.15, p = 0.008), better sleep quality (β = −0.17, p = 0.003), lower perceived stress (β = −0.24, p < 0.001), and shorter sleep duration (β = −0.17, p = 0.003). Hospital nurses’ work schedule characteristics were associated with lifestyle patterns, dietary behavior, sleep pattern, and perceived stress. Fixed-shifts were beneficial for lifestyle and lower perceived stress. Longer rotating shifts could help nurses adjust their lifestyles accordingly. Full article

(This article belongs to the Special Issue Health Consequences of Shift Work and Chronodisruption)

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15 pages, 1086 KiB

Open AccessSystematic Review

Shift Work and Early Arterial Stiffness: A Systematic Review

by Waléria D. P. Gusmão, Isabele R. O. M. Pureza and Claudia R. C. Moreno

Int. J. Environ. Res. Public Health 2022, 19(21), 14569; https://doi.org/10.3390/ijerph192114569 - 6 Nov 2022

Cited by 7 | Viewed by 2288

Abstract

Shift work is a way of organizing rotating schedules throughout the day. This can include 1–3 shifts for the same person on a rotational basis with other workers. Schedules that include night work have been associated with cardiovascular risk, mainly due to circadian misalignment. This systematic review sought to determine whether shift work is a risk factor for increased arterial stiffness. A systematic review of different databases was performed, using the following keywords: work shift, night work, arteriosclerosis, vascular stiffness, arterial stiffness, pulse wave velocity, and their Medical Subject Headings. We selected and analyzed 11 articles regarding pulse wave velocity as an indicator of arterial stiffness. Two studies identified higher levels of arterial stiffness in shift workers compared to day workers, while two studies found the opposite. In addition, four studies found no differences in arterial stiffness between shifts, two studies associated shorter sleep duration with arterial stiffness, and one study observed that physical activity could prevent adverse cardiovascular outcomes in shift workers. The findings are heterogeneous and preclude any robust conclusions. However, the present review points to the need for further studies to investigate arterial stiffness in shift workers, with greater control for confounding factors and longitudinal design. Full article

(This article belongs to the Special Issue Health Consequences of Shift Work and Chronodisruption)

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15 pages, 3812 KiB

Open AccessSystematic Review

Shift Work and Serum Vitamin D Levels: A Systematic Review and Meta-Analysis

by Margherita Martelli, Gianmaria Salvio, Lory Santarelli and Massimo Bracci

Int. J. Environ. Res. Public Health 2022, 19(15), 8919; https://doi.org/10.3390/ijerph19158919 - 22 Jul 2022

Cited by 10 | Viewed by 2762

Abstract

Vitamin D deficiency and insufficiency are highly prevalent conditions worldwide due to several factors, including poor sun exposure. Shift workers may be exposed to the risk of hypovitaminosis D due to fewer opportunities for sunlight exposure compared to day workers. A systematic review of the PubMed, SCOPUS, and EMBASE databases was conducted according to the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) statement to investigate the effect of shift work on vitamin D levels. Mean differences (MD) and 95% confidence intervals (CI) of serum 25-OH-D levels in shift workers and non-shift workers were calculated. A total of 13 cross-sectional studies were included in the meta-analysis. We found significantly lower levels of serum 25-OH-D in shift workers compared with non-shift workers (MD: −1.85, 95% CI [−2.49 to −1.21]). Heterogeneity among included studies was high (I² = 89%, p < 0.0001), and neither subgroup analysis nor meta-regression were able to identify specific sources of the heterogeneity that may be related to the different characteristics of shift work among studies. The monitoring of serum vitamin D levels and prompt correction of any deficiencies should be considered in shift workers. Notably, since a large part of the observations are derived from Koreans, larger epidemiological studies are needed in other populations. Full article

(This article belongs to the Special Issue Health Consequences of Shift Work and Chronodisruption)

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