Association between Shift Work and Reflux Esophagitis: The Kangbuk Samsung Health Study.

Eunchan Mun,Daehoon Kim,Yesung Lee,Woncheol Lee,Soyoung Park

doi:10.3390/ijerph18126189

Abstract

This cross-sectional study investigated the relationship between shift work and reflux esophagitis verified by endoscopic findings. Participants underwent a comprehensive health examination and esophagogastroduodenoscopy between January 2011 and December 2018. We examined endoscopic findings and performed multivariate-adjusted regression analysis of the association between shift work and reflux esophagitis using multiple demographic and clinical factors. Among the 247,450 participants, 49,767 (20.1%) had reflux esophagitis; Los Angeles (LA)-M (31,132, 12.6%) was most common, followed by LA-A (16,213, 6.6%), LA-B (2333, 0.9%), and ≥LA-C (89, 0.04%). The multivariate-fully adjusted odds ratio (OR) of overall reflux esophagitis for shift work compared to fixed day work was 1.15 (95% confidence interval [CI]: 1.11–1.19). When classified according to shift work type and severity of reflux esophagitis, the ORs of LA-A for regular day and night, and irregular shifts compared to fixed day works were 1.14 (95% CI: 1.03–1.26) and 1.26 (95% CI: 1.11–1.44), respectively. However, there was no significant association between any shift work schedule and ≥LA-B. Overall, we demonstrated the cross-sectional association between shift work (especially rotating and irregular shifts) and mild reflux esophagitis (≤LA-A) compared with daily fixed time shifts.

Highlights

Shift work has been an occupational health issue worldwide, especially among factory workers
This study demonstrated the shift work was positively associated with reflux esophagitis diagnosed using esophagogastroduodenoscopy (EGD)
Compared to fixed day work, shift work was significantly associated with the overall types of reflux esophagitis (OR: 1.15; 95% CI: 1.11–1.19), Los Angeles (LA)-M (OR: 1.17; 95% CI: 1.12–1.21), and LA-A (OR: 1.11; 95% CI: 1.05–1.18) in the full-adjusted model

Summary

Introduction

Shift work has been an occupational health issue worldwide, especially among factory workers. With the advent of the 24 h society, shift work has extended to those employed in white-collar occupations [1]. Of workers in Europe and the United States are engaged in shift work [2,3]. Approximately 9.7% of employed individuals in South Korea are estimated to be engaged in shift work, and this percentage is increasing steadily [4]. There are extensive publications on the health effects of shift work. Circadian disruption can decrease circulating melatonin responsible for gut motility, and affect the maintenance of the mucosal barrier, decreasing gastroprotective factors while increasing the secretion of gastric acid [13]. Shift work could increase the number of reflux events, induce damage to the esophagogastric junction, and

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Discussion

Conclusion