Impaired kidney function among young healthcare workers with long working hours and night work.

OBJECTIVES: We aimed to evaluate the association between long working hours, night work, and estimated glomerular filtration rate (eGFR) among young healthcare workers. METHODS: We conducted a retrospective cohort study among healthcare workers in a tertiary medical center in Taiwan from 2002 to 2021. Other than physicians, all hospital employees aged 20-65 years with documented yearly working hours and an annual blood test including creatinine were eligible. We excluded participants with eGFR <60 ml/min/1.73 m2 and proteinuria at enrollment to focus on early renal impairment. Total working hours, night working hours, and eGFR in each year were collected. We assessed the relationship of total working hours and night and non-night working hours with eGFR using the generalized linear mixed model, adjusting for demographic, comorbidities, and laboratory profiles. RESULTS: The study included 10 677 participants with a mean age of 27.2 (standard deviation 7.1) years. The mean follow-up duration was 6.2 years. For every 10-hour increase in total weekly working hours, the eGFR decreased by 0.86 [95% confidence interval (CI) 0.61-1.11] ml/min/1.73 m2. For every 10-hour increase in weekly night working hours, the eGFR decreased by 0.25 (95% CI 0.07-0.42) ml/min/1.73 m2. In stratified analysis, the negative associations between total working hours and eGFR remained in the subgroups of individuals aged <40 years and those without hypertension or diabetes, with a P-value for interaction of <0.05. CONCLUSIONS: Longer working hours and night work were associated with lower eGFR among healthcare workers.

Effect of shift work on excessive daytime sleepiness in female nurses: results from the Japan Nurses' Health Study.

We investigated the relationship between shift work and excessive daytime sleepiness (EDS) among participants in the Japan Nurses' Health Study (JNHS). Responses of 9,728 female nurses to the 6th follow-up questionnaire were cross-sectionally analyzed. EDS was defined as an Epworth Sleepiness Scale score ≥11. EDS-associated factors were evaluated using Poisson regression analysis after adjustment for multiple confounders. Of the participants (mean age, 52.2 ± 8.0 yr), 28.7% were engaged in shift work, and the overall prevalence of EDS was 24.6%. EDS-associated factors were investigated separately in women aged <40 yr (n=250), 40-59 yr (n=7,467), and ≥60 yr (n=2,011). Current engagement in shift work (prevalence ratio: 1.92 [95% confidence interval: 1.20-3.06], compared with no experience of shift work) and obesity (2.08 [1.11-3.88] for BMI ≥30 and 1.39 [1.02-1.90] for BMI of 25.0-30.0, compared with BMI of 18.5-25.0) showed an independent association with EDS in women aged ≥60 yr. The effect of shift work on EDS in female nurses differed by age, as shift work and obesity contributed to EDS only in older participants. Shift work should be assigned after full consideration of age, sleep, and health status to minimize medical errors.

Sweat or no sweat: foreign workers in the garment industry in Malaysia.

In the last decade factory owners, in response to brand-name Corporate Social Responsibility (CSR) parameters, have joined associations that verify (through a monitoring and audit system) that management does not exploit labour. There have been no reports of violations of codes of conduct concerning Malaysian workers but for foreign workers on contract there are certain areas that have been reported. These areas, including trade union membership, the withholding of workers' passports and unsuitable accommodation, generally escape notice because auditors who monitor factory compliance do not question the terms of contracts as long as they comply with national labour standards. This paper is based on research with foreign workers in Malaysia and argues that despite the success of the anti-sweatshop movement in a global context, the neo-liberal state in Malaysia continues to place certain restrictions on transnational labour migrants which breach garment industry codes of conduct. Available evidence does not support the assumption that CSR practices provide sufficient protection for both citizen and foreign workers on contract in the garment industry.

Diet, Physical Activity, and Daylight Exposure Patterns in Night-Shift Workers and Day Workers.

Background: Night-shift work has been reported to have an impact on nutrition, daylight exposure, and physical activity, which might play a role in observed health effects. Because these exposures show diurnal variation, and shift work has been related with disturbances in the circadian rhythm, the timing of assessment of these factors requires careful consideration. Our aim was to describe the changes in patterns of diet, physical activity, and daylight exposure associated with night-shift work. Methods: We conducted an observational study among female healthcare workers either regularly working night shifts or not working night shifts. We assessed physical activity and daylight exposure using continuous monitoring devices for 48 h. We logged dietary patterns (24 h) and other health- and work-associated characteristics. Two measurement sessions were conducted when participants did 'not' work night shifts, and one session was conducted during a night-shift period. Results: Our study included 69 night-shift workers and 21 day workers. On days in which they conduct work but no night work, night-shift workers had similar physical activity and 24-h caloric intake, yet higher overall daylight exposures than day workers and were more often exposed around noon instead of mainly around 1800h. Night-shift workers were less exposed to daylight during the night-shift session compared to the non-night-shift session. Total caloric intakes did not significantly differ between sessions, but we did observe a shorter maximum fasting interval, more eating moments, and a higher percentage of fat intake during the night-shift session. Conclusion: Observed differences in diet, physical activity, and exposure to daylight primarily manifested themselves through changes in exposure patterns, highlighting the importance of time-resolved measurements in night-shift-work research. Patterns in daylight exposure were primarily related to time of waking up and working schedule, whereas timing of dinner seemed primarily governed by social conventions.

Vocal Change Patterns During a Teaching Day: Inter- and Intra-subject Variability.

OBJECTIVES: To describe the mean voice changes of 22 female teachers during a typical workday, examine the inter- and intra-subject variability, and establish a typology of different voice patterns during the workday. METHODS: For each participant, fundamental frequency (F0), harmonics-to-noise ratio (HNR), jitter, and shimmer were measured on sustained vowels at the beginning and at the end of the workday, at three different times during the school year. RESULTS: The group mean pattern showed significant increases in F0 and HNR during the workday and significant decreases in jitter and shimmer. However, considerable inter- and intra-subject variability was observed. Based on the variation in the acoustic parameters during the workday, three different voice patterns were identified. The first is characterized by a greater F0 increase during the day, interpreted as a common, appropriate adaptation to vocal load. The second is characterized by a greater increase in HNR during the day and greater decreases in jitter and shimmer, interpreted as hyperfunctional voice production. The third is characterized by greater decreases in F0 and HNR and greater increases in jitter and shimmer, suggesting acute inflammation or muscle fatigue following the workday. CONCLUSIONS: The observed variety of vocal patterns during the workday emphasizes the need to study this phenomenon individually and target different types of behaviors to develop tailored prevention and treatment methods.

Extended work periods.

A literature review of 105 studies on the effects of extended daily working hours was conducted. Potential negative effects of extended working hours are discussed: More accidents on the job; more accidents off the job; reduced duration and quality of sleep due to moonlighting; sleepiness; reduced alertness; fatigue; adverse effects on performance; prolonged toxic exposure; adverse effects on health; increased absenteeism; problems communicating with managers; and problems while driving home. Potential positive effects of extended working hours are discussed: Less travel time and costs; more time for the family, social life, and domestic duties; increased satisfaction with working hours; fewer handovers; and less overtime. No firm conclusions can be drawn because of the partly contradictory results and the methodological problems of many studies. However, caution is advised when considering the introduction of extended work shifts, particularly where public safety is at stake. A checklist is provided (concerning work load, breaks, staffing level, systematic assessments of health and safety factors) to support decisions for or against the use of extended work shifts.

[Body adaptive reactions to a change in the work and rest regimen]. / Adaptatsionnye reaktsii organizma pri izmenenii rezhima truda i otdykha.

The authors report that a transition of a human organism to a non-standard work and rest regimen in conditions of hermetization is followed by the development of adaptation reactions of body protecting functions. The strength of these reactions is determined by the correspondence of the twenty-four-hour activity cyclogram to the circadian physiologic rhythm. The depression of protecting reactions, the slowing down of adaptation process and the appearance of disadaptation sings occur more often among operators, whose twenty-four-hour activity algorithm demands working from 04.00 to 12.00 and from 16.00 to 24.00 with a four-hour shift cycle. The correspondence of the work and rest regimen to the twenty-four-hour cycle of physiologic functions in the conditions of chronophysiologic tension, decreases adaptation changes and prevents the development of body protective and accommodative insufficiency.

Effects of worksite health interventions involving reduced work hours and physical exercise on sickness absence costs.

OBJECTIVE: To investigate the effects of physical exercise during work hours (PE) and reduced work hours (RWH) on direct and indirect costs associated with sickness absence (SA). METHODS: Sickness absence and related costs at six workplaces, matched and randomized to three conditions (PE, RWH, and referents), were retrieved from company records and/or estimated using salary conversion methods or value-added equations on the basis of interview data. RESULTS: Although SA days decreased in all conditions (PE, 11.4%; RWH, 4.9%; referents, 15.9%), costs were reduced in the PE (22.2%) and RWH (4.9%) conditions but not among referents (10.2% increase). CONCLUSIONS: Worksite health interventions may generate savings in SA costs. Costs may not be linear to changes in SA days. Combing the friction method with indirect cost estimates on the basis of value-added productivity may help illuminate both direct and indirect SA costs.

Housework and recovery from work among nursing teams: a gender perspective.

The impact on health of work carried out within the household is recognized by several authors in the occupational health field. The purpose of this article is to verify whether and to what extent the need for recovery is related to professional work hours and to housework duties in female nursing workers. Workers (N = 1122) completed a questionnaire with data on household chores and professional work, as well as the Need for Recovery from Work scale. Regression analysis showed that the odds for reporting poor recovery were significantly higher for workers showing long domestic work hours, high total work load (professional plus domestic work hours), and housework overload. No association was found for professional work hours per se. Findings highlight the potential detrimental effects of housework, either by itself or in combination with professional work for the group studied, and can generate discussion on gender equality in both the public and private domains.

Shift work, safety, and aging.

It has long been recognized that older shift workers may have shorter and more disturbed day sleeps between successive night shifts than their younger colleagues. This has given rise to considerable concern over the safety of aging shift workers because of the increasing age of the work force and increases in retirement age. Because there have been no direct studies of the combined effects of shift work and age on safety, the present paper begins by reviewing the literature relating safety to features of shift systems. It then considers the general effect of age on occupational injury rates before examining existing evidence of the combined effects of shift work and age on performance capabilities. The results of the literature review indicate that when the a priori risk is constant, there is reasonably clear evidence that injury rates are higher at night, and that they increase over successive night shifts more rapidly than over successive day shifts. Further, although occupational injuries are less frequent in older workers, those that do occur tend to be more serious. Finally, there is some suggestive evidence from studies of objectively measured performance capabilities that older workers may be less able to both maintain their performance over the course of a night shift and cope with longer spans of successive night shifts. It is concluded that it seems possible, even though unproven as yet, that older workers may be at greater risk both to injury and accident on the night shift. There is a strong need for future epidemiological studies of the combined effects of shift work and age on injuries and accidents, and that these should attempt to separate the effects of age per se from those of generation.