Restless Legs Syndrome/Willis-Ekbom Disease Is Prevalent in Working Nurses, but Seems Not to Be Associated with Shift Work Schedules.

Insomnia and excessive sleepiness are among the most commonly reported sleep problems related to shift work. Sleep-related movement disorders have, however, received far less attention in relation to such work schedules. The objective of this study was to investigate the association between different shift work schedules and the prevalence of Restless legs syndrome/Willis-Ekbom disease (RLS/WED) in a large sample of Norwegian nurses. Our hypothesis was that shift working nurses would report higher prevalence of RLS/WED compared to day workers. A total of 1,788 nurses with different work schedules (day work, two-shift rotation, night work, three shift rotation) participated in a cohort study, started in 2008/2009. Four questions about RLS/WED based on the diagnostic criteria were included in wave 4 (2012). RLS/WED prevalence rates across different shift schedules were explored by the Pearson chi-square test. Logistic regression analysis was used to assess the association between RLS/WED and work schedules and shift work disorder (SWD) with adjustment for sex, age, marital status, smoking, and caffeine use. In total, 90.0% of the nurses were females, mean age 36.5 years (SD = 8.6, range 25-67). The overall prevalence of RLS/WED was 26.8%. We found no significant differences between the prevalence of RLS/WED across the different shift schedules, ranging from 23.3% (day work) to 29.4% (night work). There was a significant difference (p < 0.001) in the prevalence of RLS/WED between nurses having SWD (33.5%) compared to nurses not having SWD (23.8%). SWD remained significantly associated with RLS/WED in the adjusted logistic regression analysis (1.56, CI: 1.24-1.97). This study did not support the hypothesis. RLS/WED was associated with SWD, which might indicate that nurses vulnerable to shift work also are sensitive to other complaints related to a misalignment of the biological clock.

A follow-up study of airway symptoms and lung function among residents and workers 5.5 years after an oil tank explosion.

BACKGROUND: Assess if people who lived or worked in an area polluted after an oil tank explosion had persistent respiratory health impairment as compared to a non-exposed population 5.5 years after the event. METHODS: A follow-up study 5.5 years after the explosion, 330 persons aged 18-67 years, compared lung function, lung function decline and airway symptoms among exposed persons (residents <6 km from the accident site or working in the industrial harbour at the time of the explosion) with a non-exposed group (residence >20 km away). Also men in the exposed group who had participated in accident related tasks (firefighting or clean-up of pollution) were compared with men who did not. Data were analysed using Poisson regression, adjusted for smoking, occupational exposure, atopy and age. RESULTS: Exposed men who had participated in accident related tasks had higher prevalence of lower airway symptoms after 5.5 years (n = 24 [73%]) than non-exposed men (28 [48%]), (adjusted relative risk 1.51 [95% confidence interval 1.07, 2.14]). Among men who participated in accident related tasks FEV1 decline was 48 mL per year, and 12 mL among men who did not (adjusted difference -34 mL per year [-67 mL, -1 mL]), and at follow-up FEV1/FVC ratio was 71.4 and 74.2% respectively, (adjusted difference -3.0% [-6.0, 0.0%]). CONCLUSION: Residents and workers had more airway symptoms and impaired lung function 5.5 years after an oil tank explosion, most significant for a group of men engaged in firefighting and clean-up of pollution after the accident. Public health authorities should be aware of long-term consequences after such accidents.

Subjective Health Complaints Among Workers in the Aftermath of an Oil Tank Explosion.

The aim of the study was to assess whether exposed workers had more subjective health complaints than controls 1 1/2 years after a chemical explosion involving a mixture of hydrocarbons and sulfurous compounds. A cross-sectional survey based on the Subjective Health Complaints Inventory (SHC) was conducted among 147 exposed workers and 137 controls. A significantly higher total SCH score (linear regression, p=.01) was found for the exposed workers compared with controls when adjusting for gender, age, smoking habits, and educational level. The exposed workers reported significantly more headache, hot flashes, sleep problems, tiredness, dizziness, and sadness/depression. The cause of these complaints is unknown, but health personnel should be aware that health complaints might be related to polluting episodes even when exposure levels are below occupational guideline levels.

Airway symptoms and lung function among male workers in an area polluted from an oil tank explosion.

OBJECTIVE: To assess whether working in an industrial harbor where an oil tank exploded was associated with more airway symptoms and lower lung function in men 1.5 years later. METHODS: In a cross-sectional study of 180 men, 18 to 67 years old, airway symptoms and lung function among men who worked in the industrial harbor at the time of the explosion was compared with those of working men with residence more than 20 km away. Regression analyses are adjusted for smoking, occupational exposure, atopy, recent infection, and age. RESULTS: Exposed men had significantly more upper (ORirritated nose = 2.89 [95% confidence interval = 1.31 to 6.37]) and lower (ORdyspnea uphill = 3.79 [95% confidence interval = 1.69 to 8.46]) airway symptoms, and some indication of more reversible airway obstruction than unexposed workers. CONCLUSIONS: Men working in an area with an oil tank explosion had more airway symptoms and indication of more airway obstruction 1.5 years after the event.

Upper limb disability in Norwegian workers with hand-arm vibration syndrome.

BACKGROUND: Hand-arm vibration syndrome (HAVS) is a well-known disease among workers using hand-held vibrating tools. These patients experience major symptoms from their upper limbs. However, there are few studies on disability in this patient group. In this study we wanted to describe the disability of HAVS patients. METHODS: All HAVS patients diagnosed at Haukeland University Hospital in Bergen, Norway in a five-year period were invited. The disabilities of the arm, shoulder and hand (DASH) questionnaire was sent by mail. Clinical data were extracted from their hospital journals. Descriptive statistics and regression analyses were performed. RESULTS: Thirty-eight patients were recruited. Mean DASH score was 41.2, while the mean of a normal population is 10. Ability to perform tasks related to work and everyday life was affected in these patients. We found a significant association between the DASH score, hand grip strength and tendinitis, also after adjustment for age and smoking in pack-years. CONCLUSION: HAVS patients demonstrate a high level of upper limb disability as assessed by the DASH score. Ability to perform tasks related to work and everyday life was affected. We found a significant association between the DASH score, hand grip strength and tendinitis. This should be focused upon in future research.

Sleep and health in oil rig workers--before and after a two week work period offshore.

This study compared subjective sleep and subjective health complaints among Norwegian oil rig workers, before and after a two week work period. The study also compared differences between two different work schedules. The workers worked either two weeks of day shift (n=90) or two weeks of a swing shift schedule (n=93), involving one week of night shifts, immediately followed by one week of day shifts. Overall, the workers reported significantly poorer sleep quality and more complaints of insomnia at the end compared to the start of the work period. However, there was no significant difference in terms of subjective health complaints. Furthermore, there were no clear differences in changes in sleep quality, insomnia or subjective health complaints during the work period between day- and swing shift workers. However, at the end of the work period a higher proportion of insomniacs were seen among swing shift workers compared with day workers. To conclude, sleep quality and complaints of insomnia became worse during the work period. However, there were few differences in changes in terms of sleep or subjective health complaints between day- and swing shift, suggesting that 12 h day shift affected sleep and health similarly to the schedule involving night work.

Airway symptoms and lung function in the local population after the oil tank explosion in Gulen, Norway.

BACKGROUND: Oil tanks containing a mixture of hydrocarbons, including sulphuric compounds, exploded and caught fire in an industrial harbour. This study assesses airway symptoms and lung function in the nearby population 1½ years after the explosion. METHODS: A cross-sectional study included individuals ≥18 years old. Individuals living <6 km (sub-groups <3km and 3-6 km) from the accident site formed the exposed group, individuals living >20 km away formed a control group. A questionnaire and spirometry tests were completed by 223 exposed individuals (response rate men 70%, women 75%) and 179 control individuals (response rate men 51%, women 65%). Regression analyses included adjustment for smoking, occupational exposure, atopy, infection in the preceding month and age. Analyses of symptoms were also adjusted for stress reactions related to the accident. RESULTS: Exposed individuals experienced significantly more blocked nose (odds ratio 1.7 [95% confidence interval 1.0, 2.8]), rhinorrhoea (1.6 [1.1, 3.3]), nose irritation (3.4 [2.0, 5.9]), sore throat (3.1 [1.8, 5.5]), morning cough (3.5 [2.0, 5.5]), daily cough (2.2 [1.4, 3.7]), cough >3 months a year (2.9 [1.5, 5.3]) and cough with phlegm (1.9 [1.2, 3.1]) than control individuals. A significantly increasing trend was found for nose symptoms and cough, depending on the proximity of home address to explosion site (daily cough, 3-6km 1.8 [1.0, 3.1], <3km 3.0 [1.7, 6.4]). Lung function measurements were significantly lower in the exposed group than in the control group, FEV1 adjusted mean difference -123 mL [95% confidence interval -232, -14]), FEV1% predicted -2.5 [-5.5, 0.5], FVC -173 mL [- 297, -50], FVC% predicted -3.1 [- 5.9, -0.4], and airway obstruction (GOLD II/III). CONCLUSIONS: Based on cross sectional analyses, individuals living in an area with air pollution from an oil tank explosion had more airway symptoms and lower lung function than a control group 1½ years after the incident.

Reduced lung function among sisal processors.

OBJECTIVES: The objective of this study was to examine lung function and chronic respiratory symptoms among sisal workers in Tanzania and compare the results with a control group. METHODS: A cross-sectional study on chronic respiratory symptoms and lung function was conducted in 2006 among male Tanzanian sisal processing workers from six sisal estates. Participants included 86 workers in decortication departments, 68 workers in brushing departments and 30 low exposed security guards. The response rate was 97%. Chronic respiratory symptoms and background information were obtained by structured interview. Forced ventilatory capacity (FVC) and forced expiratory volume in 1 s (FEV(1)) were estimated before and after a work shift, and FEV(1)/FVC ratio calculated. RESULTS: Workers were aged 19-85, with the oldest in the brushing and security departments. Chronic cough and chest tightness were experienced by 38% and 68% of workers in brushing departments, 20% and 6% of workers in decortication and 7% and 0% of security workers, respectively. A reduced FEV(1)/FVC ratio related to years of work was found among workers in brushing departments when adjusting for age, smoking, previous respiratory illnesses and body mass index, using regression analyses. Work in decortication departments was not related to reduced lung function parameters. The prevalence of FEV(1)/FVC<70 was above 50 for all three groups. Lung function parameters were similar before and after work shifts, except that peak expiratory flow increased among workers in brushing departments after work shifts. CONCLUSIONS: The results indicate a relationship between work in sisal brushing departments and the development of obstructive lung disorders.

Measures to counteract the negative effects of night work.

OBJECTIVES: Night work is associated with several negative health outcomes as well as accidents and reduced productivity. The aim of this study was to identify factors that may counteract the negative effects of night work. METHODS: We conducted searches for studies of scientifically based countermeasures of the negative effects of night work in PubMed and Thomson Reuters' ISI Web of Knowledge and inspected the reference lists of relevant literature. RESULTS: We identified studies describing countermeasures such as proper personnel selection, bright light therapy, melatonin administration, naps, exercise, sleepiness detection devices, and the use of stimulants to improve wakefulness and hypnotics to improve daytime sleep. CONCLUSIONS: There is some research supporting countermeasures (eg, bright light, melatonin, naps, use of stimulants, proper work scheduling) as a means to improve adaptation to night work. However, there is little evidence that such countermeasures reduce the long-term health consequences of night work. Future studies should aim at identifying both work and individual factors which are related to differential health outcomes of night work. Better study designs (eg, longitudinal designs and use of standardized outcome measures) are needed in future research.

Shift work disorder among oil rig workers in the North Sea.

STUDY OBJECTIVES: Shift work disorder (SWD) is a circadian rhythm sleep disorder caused by work hours during the usual sleep period. The main symptoms are excessive sleepiness and insomnia temporally associated with the working schedule. The aim of the present study was to examine SWD among shift workers in the North Sea. DESIGN AND PARTICIPANTS: A total of 103 shift workers (2 weeks on 7 nights/7days, 12-h shifts, 4 weeks off), mean age 39.8 years, working at an oil rig in the North Sea responded to a questionnaire about SWD. They also completed the Pittsburgh Sleep Quality Index, Bergen Insomnia Scale, Epworth Sleepiness Scale, Composite Morningness Questionnaire, Subjective Health Complaint Inventory, Demand/Control, and Instrumental Mastery Oriented Coping (based on the Utrecht Coping list). Most of these instruments were administered during the first day of the 2-week working period, thus reflecting symptoms and complaints during the 4-week non-work period. The shift workers were also compared to day workers at the oil rig. RESULTS: Twenty-four individuals were classified as suffering from SWD, yielding a prevalence for SWD of 23.3%. During the 4-week non-work period, individuals with SWD reported significantly poorer sleep quality, as measured by the Pittsburgh Sleep Quality Index, and more subjective health complaints than individuals not having SWD. There were no differences between the 2 groups in sleepiness, insomnia, circadian preference, psychological demands, or control. Individuals with SWD reported significantly lower scores on coping. The reports of shift workers without SWD were similar to those of day workers regarding sleep, sleepiness, subjective health complaints, and coping. CONCLUSIONS: The prevalence of SWD was relatively high among these shift workers. Individuals with SWD reported poorer sleep quality and more subjective health complaints in the non-work period than shift workers not having SWD.