Potency Biomarker Effect of Endothelial Microparticles (EMPs) for Early Prediction of Cardiovascular Risk in Shift Worker Nurses

Objectives. Shift work results in changing worker’s behavior, food, and sleep patterns, which can cause circadian rhythm disturbance, which is a cardiovascular risk. Until now, a biomarker of early prediction of cardiovascular risk on shift workers is still not developed. This study aimed to assess the cardiovascular risk of shift worker nurses by detecting endothelial microparticles (EMPs). Methods. This longitudinal study compared six shift nurses and five non-shift nurses by measuring the EMPs using antigen CD31+ flow cytometry. All met the inclusion criteria consisting of 28 blood samples followed in one week shift. Results. EMPs among non-shift nurses were below 200 μL. However, shift nurses’ EMPs increased above 200 μL with Man-Whitney U p = 0.000 on days 4 and 7 following a one shift per week schedule. Conclusion. There was an increase in shift workers’ endothelial microparticles (EMP) which was a sign of cardio-vascular risk.

A Systematic Review of Workplace-Based Employee Health Interventions and Their Impact on Sleep Duration Among Shift Workers

Background: Shift work is associated with long-term health risks. Workplace-based health interventions hold promise for improving or maintaining the health of shift workers; yet, the impact of workplace-based interventions on shift worker sleep duration has not been assessed. We conducted a systematic review of workplace interventions on shift worker sleep. Methods: We conducted searches in PubMed, Web of Knowledge, EMBASE, Scopus, and PsycINFO ( n = 6,868 records) of all studies published through May 15, 2019. Eligibility criteria included the following: (a) individuals aged ≥18 years; (b) a workplace-based employee intervention; (c) an employee population comprised predominantly of shift workers (>50%); and (d) sleep duration as a study outcome. Findings: Twenty workplace interventions met eligibility criteria. Mean intervention duration was 125 ( SD = 187) days and mean sample size was 116 employees ( SD = 256) with a mean age of 36.4 years ( SD = 6.5). Interventions most commonly focused on light exposure (25%) or shift timing (25%), followed by sleep hygiene (20%). Most interventions were conducted in the health care and social assistance sector (60%). Study quality on average was 64% ( SD = 7%). A majority of the studies found that a workplace-based health intervention was associated with a desirable increase in 24-hour total sleep duration (55%). The overall average increase in daily employee sleep duration achieved by interventions ranged for RCT studies from 0.34 to 0.99 hours and for non-RCT studies from 0.02 to 1.15 hours. Conclusions/Applications to Practice: More than half of the employee health interventions, especially yoga or mindfulness interventions, resulted in a desirable increase in sleep duration. Workplaces hold promise as an avenue? for delivering programs and policies that aim to improve sleep duration among shift workers.

Lack of food intake during shift work alters the heart transcriptome and leads to cardiac fibrosis and inflammation in rats

Many epidemiological studies revealed that shift work is associated with increased risk of cardiovascular diseases. However, the underlying mechanisms remain poorly understood. An experimental model of shift work in rats has been shown to recapitulate the metabolic disorders observed in human shift workers, and used to demonstrate that restricting food consumption outside working hours prevents shift work-associated obesity and metabolic disturbance. Here we used this model to characterize the effects of shift work in the heart. We show that experimental shift work reprograms the heart cycling transcriptome independently of food consumption. While phases of rhythmic gene expression are distributed across the 24-hour day in control rats, they are clustered towards discrete times in shift workers. Additionally, preventing food intake during shift work affects the expression level of hundreds of genes in the heart. Many of them are found in transcriptional signatures associated with pressure overload and cardiac hypertrophy, and encode for components of the extracellular matrix and inflammatory markers. Consistent with this, the heart of shift worker rats not eating during work exhibits fibrosis and is colonized by immune cells. While maintaining food access during shift work has less effects on gene expression, genes found in transcriptional signatures of cardiac hypertrophy remain affected, and the heart of shift worker rats exhibits fibrosis without inflammation. Together, our findings provide insights into how shift work affects cardiac function, and suggest that some interventions aiming at mitigating metabolic disorders in shift workers may have adverse effects on cardiovascular diseases.

Association of working shifts, inside and outside of healthcare, with severe COVID−19: an observational study

Background Health and key workers have elevated odds of developing severe COVID-19; it is not known, however, if this is exacerbated in those with irregular work patterns. We aimed to investigate the odds of developing severe COVID-19 in health and shift workers. Methods We included UK Biobank participants in employment or self-employed at baseline (2006–2010) and with linked COVID-19 data to 31st August 2020. Participants were grouped as neither a health worker nor shift worker (reference category) at baseline, health worker only, shift worker only, or both, and associations with severe COVID-19 investigated in logistic regressions. Results Of 235,685 participants (81·5% neither health nor shift worker, 1·4% health worker only, 16·9% shift worker only, and 0·3% both), there were 580 (0·25%) cases of severe COVID-19. The odds of severe COVID-19 was higher in health workers (adjusted odds ratio: 2·32 [95% CI: 1·33, 4·05]; shift workers (2·06 [1·72, 2·47]); and in health workers who worked shifts (7·56 [3·86, 14·79]). Being both a health worker and a shift worker had a possible greater impact on the odds of severe COVID-19 in South Asian and Black and African Caribbean ethnicities compared to White individuals. Conclusions Both health and shift work (measured at baseline, 2006–2010) were independently associated with over twice the odds of severe COVID-19 in 2020; the odds were over seven times higher in health workers who work shifts. Vaccinations, therapeutic and preventative options should take into consideration not only health and key worker status but also shift worker status.

Association of working shifts, inside and outside of healthcare, with risk of severe COVID-19: An observational study

ABSTRACTBackgroundHealth and key workers are at an increased risk of developing severe COVID-19; it is not known, however, if this risk is exacerbated in those with irregular work patterns. We aimed to investigate the risk of severe COVID-19 in health and shift workers.MethodsWe included UK Biobank participants in employment or self-employed at baseline and with linked COVID-19 data to 31st August 2020. Participants were grouped as neither a health worker nor shift worker (reference category), health worker only, shift worker only, or both and associations with severe COVID-19 investigated in logistic regressions.FindingsOf 235,685 participants (81·5% neither health nor shift worker, 1·4% health worker only, 16·9% shift worker only, and 0·3% both), there were 580 (0·25%) cases of severe COVID-19. The risk of severe COVID-19 was higher in health workers (adjusted odds ratio: 2.32 [95% CI: 1·33, 4·05]; shift workers (2·06 [1·72, 2·47]); and in health workers who worked shifts (7·56 [3·86, 14·79]). Being both a health worker and a shift worker had a possible greater impact on the risk severe COVID-19 in South Asian and Black and African Caribbean ethnicities compared to White individuals.InterpretationBoth health and shift work were independently associated with over twice the risk of severe COVID-19; the risk was over seven times higher in health workers who work shifts. Vaccinations, therapeutic and preventative options should take into consideration not only health and key worker status but also shift worker status.FundingNational Institute for Health Research, UK Research and Innovation.Research in contextEvidence before this studyThe risk of developing severe COVID-19 is greater in occupational groups with higher levels of viral exposure, e.g. health and key workers. We searched PubMed and medRxiv up to December 8, 2020 for papers on shift work patterns, health work and incidence of COVID-19 using the keywords “COVID-19”, “SARS-CoV-2”, “shift work” “health worker”. Recent evidence suggests shift workers are also at increased risk of severe COVID-19 but it is not clear if the risk is exacerbated in those who work shifts in healthcare.Added value of this studyThis study uses data from UK Biobank, a prospective cohort of >500,000 adults aged 40-69 years with baseline assessments between March 2006 and July 2010. Participants’ occupation was categorised according to whether or not they were health workers and/or shift workers at baseline. Results showed that being a health worker, or working shifts, were similarly and independently associated with over twice the population level risk of severe COVID-19 independent of age, sex, ethnicity, deprivation and co-morbidities. The risk was seven times higher in health workers with shift working patterns. The impact of health and shift work tended to be higher in males and in minority ethnic groups, who are already at an increased risk of severe COVID-19. In people over the age of retirement, the risk of developing severe COVID-19 associated with baseline health worker status was no longer apparent, suggesting the risk is likely explained by exposure to the virus. However, the elevated risk associated with baseline shift worker status persisted, albeit attenuated.Implications of all the available evidenceShift workers are at elevated risk of developing severe COVID-19. The persistence of an elevated risk in people who are now over retirement age, but had a shift worker status at baseline, suggests the risk may not be fully explained by increased exposure to the virus. Vaccination, therapeutic and prevention programmes are being prioritised for health care workers. Our data suggests that shift workers should also be prioritised for these preventive measures.

Fatigue in Shift Work on Stamping Division Workers of PT. Toyota Motor Manufacturing Indonesia

Various health problems are known from shift works. PT. Toyota Motor Manufacturing Indonesia (TMMIN) as a car manufacturing in Indonesia is a large industry that applies a shift work system for the workers. This study aims to see the relationship between shift work system in the Stamping Division of PT. TMMIN. The measurement works by using the reaction time method on the worker the shift (shift I/morning and shift II/night) and non-shift during the workday flash. Based on the average measurement of reaction time for the shift workers I was 284.79 milliseconds and shift worker II was 307.76 milliseconds. The risk of reaction time increase was 3.222 times due to shift works compared to non-shift workers. Based on the value of reaction time, shift workers in PT. TMMIN recommends a repair per shift after work on the eighth day for shift I and twelfth day for shift II.