Male Shift Workers Research Articles

Food consumption patterns and Framingham cardiovascular risk score among shift workers: A NOVA-based approach

ObjectiveTo evaluate the association between dietary quantity and variety, by extent and purpose of processing, and Framingham cardiovascular disease (CVD) risk score among rotating shift workers. MethodsThe cross-sectional study included male shift workers. Dietary intake was assessed using a 24-hour recall method conducted by trained interviewers. Food items were classified using two approaches: the first was based on the amount of food consumed in each food group. Fruits, vegetables, and legumes (FVL) intake, is classified as recommended at 400g per day by WHO guidelines. Ultraprocessed foods (UPFs) were analyzed based on tertiles of daily caloric contribution. The second approach, the NOVA dietary diversity score (DDS-NOVA) assessed the variety of consumed items within each food group, assigning points for each unique item consumed, irrespective of quantity or frequency. The CVD-risk score was evaluated using the Framingham coronary heart disease risk score, categorizing participants as low risk (<5%) or intermediate to high risk (>5%). Descriptive, univariate, and multivariate logistic regression were used, with adjustments made for age, skin color, schooling, duration of shift work, physical activity, BMI and total caloric intake. ResultsThe study involved 213 participants, with an average age of 38.67 years (±6.96), a minimum of 26 and a maximum of 60. The majority (62.4%) were between 30 and 40 years old; 49.3% identified themselves as brown; 56.8% had completed high school; and 79.3% were married. The Framingham CVD-risk score indicated that 56.2% were at low risk (<5%) and 43.7% at intermediate to high risk (≥5%). The average consumption of FVL was 272.32g (±350.43), with 70.4% meeting the recommendation of ≥400g/day. Participants consumed an average of 3.46 fresh food items, 3.74 minimally processed food items, 2.54 processed food items and 3.39 ultra-processed food items. In the multivariate model, consuming ≥400g/day of FVL reduced the likelihood of cardiovascular risk ≥5% by 2.12 times (OR: 0.47; 95%CI: 0.23-0.98). Each additional item of fresh food reduced the risk by 49% (OR: 0.67; 95%CI: 1.01-1.66), while each additional item of ultra-processed food increased the risk by 30% (OR: 1.30; 95%CI: 0.52-0.87). There was no significant association between the calorie intake of ultra-processed foods and cardiovascular risk. ConclusionBoth adequate consumption of FVL quantity and a greater variety of fresh-foods were associated with a lower chance of CVD-risk, while a higher variety of consumption of UPF items increased this chance.

Personalized sleep and nutritional strategies to combat adverse effects of night shift work: a controlled intervention protocol

Abstract Background Working during the night interferes with the timing of normal daily activities and is associated with an increased risk of chronic diseases. Under controlled experimental conditions, interventions focusing on sleep and nutrition can mitigate the short-term adverse effects of shift work. However, it is unclear how these results translate to real-life, how they can be targeted to individual conditions, and how they relate to long-term health. Therefore, the current study aims to implement a personalized sleep and nutritional intervention among night shift workers in the field. Methods A non-blinded controlled intervention study is used, consisting of a run-in period, an intervention of 3 months, post-intervention measurements, and a follow-up after 12 months. Three study arms are included: sleep intervention, nutritional intervention, and control group (n = 25 each). Participants are healthy 18–60-year male night shift workers, with at least one year of experience in night shift work. Information from the run-in period will be used to personalize the interventions. The main outcomes are sleep measurements and continuous interstitial glucose levels. Furthermore, general health biomarkers and parameters will be determined to further evaluate effects on long-term health. Discussion This study aims to mitigate negative health consequences associated with night shift work by introducing two personalized preventive interventions. If proven effective, the personalized interventions may serve as practical solutions that can have a meaningful impact on the sustainable health and employability of night shift workers. This study will thereby contribute to the current need for high–quality data on preventative strategies for night shift work in a real-life context. Trial registration This trial has been registered under ClinicalTrials.gov Identifier NCT06147089. Registered 27 November 2023.

Healthily Nourished but Depleted? Is It Possible to Improve the Health of Shift Workers through Lifestyle Interventions?

The relationship between diet and health is well-researched, and there is also information regarding the effects of diet on mental health. This study aimed to investigate whether motivation to optimize lifestyles without regulations or restrictions could improve the health of rotating shift workers. In this pilot study, 18 male shift workers were randomly divided into two groups. All participants completed the Short Form Health Survey-36 questionnaire (SF-36) before the start and at the end of the study. Group I (n = 9, mean age 42 ± 6.6 y) received dietary and lifestyle information every other month for one year, and the other, Group II (n = 9 mean age 36 ± 7.3 y), one year later. All participants were motivated to follow the trained dietary recommendations and to engage in physical activity. Almost all scores had improved. Surprisingly, physical performance scores worsened, which was not expected. The impairment in mental health due to the change in ownership of the company could have been better explained. Nutritional advice over a longer period and the motivation to integrate more exercise into everyday life can potentially improve the health of rotating shift workers.

Tackling Shift Work: Cardiovascular Health in the Auto Industry.

Shift work, particularly in the auto industry, presents significant health challenges, notably in how it impacts cardiovascular health due to irregular work schedules and associated sleep disruptions. This prospective study evaluated 4683 workers from a single Romanian automotive enterprise to investigate the relationship between fixed shift work schedules and cardiovascular health outcomes. Our analysis focused on fixed-shift workers, excluding those on rotating shifts to reduce variability and enhance the clarity of the findings. The findings reveal that night shift workers are at a heightened risk of cardiovascular diseases (CVDs) compared to their day shift counterparts. Night shift workers demonstrated a higher CVD incidence (4.3%) compared to day shift workers (2.6%), with an odds ratio (OR) of 1.68 (95% CI: 1.08 to 2.62, p = 0.021). This association remained significant after adjusting for potential confounders, with an adjusted OR of 1.74 (95% CI: 1.09 to 2.75, p = 0.019). Male night shift workers exhibited a significantly higher CVD incidence (4.5%) compared to male day shift workers (3.0%), with an OR of 1.75 (95% CI: 1.07 to 2.89, p = 0.026). Female night shift workers also showed a higher CVD incidence (3.4%) compared to female day shift workers (1.3%), although this was not statistically significant. These findings underscore the urgent need for targeted interventions and effective strategies to mitigate these risks and promote the cardiovascular health and overall well-being of shift workers in the auto industry. This research contributes to a deeper understanding of how non-traditional work schedules affect health and provides a basis for implementing protective measures in occupational settings.

Associations between Serum 25-Hydroxyvitamin D Levels and Metabolic Syndrome in Male Shift Workers

Abstract Objective: We investigated the association between serum 25-hydroxyvitamin D (25(OH)D) levels and metabolic syndrome (MetS) in male shift workers vulnerable to serum 25(OH)D deficiency. Materials and methods: Laboratory measurements and self-questionnaire survey were conducted on 985 daytime and 755 shift workers. Shift workers comprised two-shift (n = 38) and three-shift (n = 717). Variables between daytime and shift workers were compared, the correlation between these variables and serum 25(OH)D levels and differences of variables according to quartiles of serum 25(OH)D levels were analyzed. Odds ratios (OR) of MetS and metabolic components depending on serum 25(OH)D levels were determined using multiple logistic regression analysis. Results: The prevalence of Met S in daytime and shift workers was 24.7% and 23.8%, respectively. In daytime workers, mean serum 25(OH)D level was lower and age, the number of alcohol drinker, worker who lack exercise and sleep, married worker was higher than shift workers with significance. After correction of confounding factors including lifestyle, sociodemographic factors and seasonal variation, MetS (OR = 1.580, 95% CI = 1.004-2.488, P = 0.048) and waist circumference (OR = 1.915, 95% CI = 1.217-3.013, P = 0.005) were statistically significant in daytime workers, but not in shift workers. Both groups with serum 25 (OH) D deficiency showed hypertriglyceridemia regardless of MetS. Conclusions: Associations between serum 25(OH)D levels and MetS in shift workers could be affected by confounding factors and working condition. Serum 25(OH) D deficiency is a risk factor of hypertriglyceridemia in male workers.

Night shift work and serum markers of bone turnover in male shift workers

ABSTRACT Night shift work is related to sleep disorders, disruption of circadian rhythm and low serum levels of vitamin D. It is known that all these conditions can adversely affect bone mass. The rate of bone turnover can be assessed through the measurement of molecules called bone turnover markers, including C-terminal telopeptide fragment of type I collagen (CTX) and procollagen type I N-terminal propeptide (P1NP). In this study, we evaluated the serum levels of CTX, P1NP and 25-Hydroxy Vitamin D in 82 male subjects (42 daytime workers and 40 night shift workers) to assess the possible risk of osteoporosis in male shift workers. Serum levels of CTX and P1NP were found to be higher in night shift workers than in daytime workers. No significant difference was found in vitamin D levels between night shift and daytime workers. The increased CTX and P1NP levels reveal a higher rate of bone turnover in night shift workers and thus a possible increased risk of osteoporosis in this category of workers compared with daytime workers. In view of this, our results highlight the importance of further studies investigating the bone health in male night shift workers.

Seeking Treatment Profile of Male Shift Workers With Hypertension and Diabetes.

This study was identified seeking treatment for hypertension and diabetes among male shift workers. This retrospective cohort study included nine large companies in Japan. Data were collected from health checkup, health insurance records, and self-administered questionnaires in 2017 and 2020. Data were analyzed using Kaplan-Meier curves and Cox regression. Person-days shift workers and day workers seeking treatment for hypertension were 41,604 and 327,301, respectively and, for diabetes, were 7326 and 60,735, respectively. The log ranks were statistically significant. Shift workers were 46% and 56% less likely to seek treatment for hypertension and diabetes, respectively, than day workers were after adjustment for age, marital status, education level, and intention to modify lifestyle (model 2) ( P < 0.01). Male shift workers are less likely to seek treatment for hypertension and diabetes compared with day workers.

Meal timing variability of rotating shift workers throughout a complete shift cycle and its effect on daily energy and macronutrient intake: a field study.

To evaluate the meal timing variability of rotating shift workers throughout a complete shift schedule and its effect on daily energy and macronutrient intake. Thirty male shift-workers from a mining company were evaluated in a complete rotation shift cycle over 240 consecutive hours (10days; two days of morning shifts, two days of evening shifts, 24h free, two days of night shifts and three days off). Food intake related variables [meal timing, energy (kcal) and macronutrient intake (%)] were assessed by 24h recall by a trained nutritionist. Mixed models were used to analyze the variation in meal timing and energy and macronutrient intake throughout the shift cycle, as well as the interaction between shift and time ranges (00:00-03:59, 04:00-07:59, 08:00-11:59, 12:00-15:59, 16:00-19:59, 20:00-23:59). The first meal of the day was earlier on night shifts [D6 (3:44 ± 0:33) and D7 (5:52 ± 0:42)] compared to the other shifts (p < 0.001), except for D4 (evening shift; 5:51 ± 0:47) versus D7 (p = 0.999). Night shifts also showed a shorter night fasting (D5-D6, 9.3h; D6-D7, 9.6h) than most other nights (p < 0.05), except for the fasting between D1-D2 (11.3h) and D3-D4 (11.2h) (p > 0.05). There was no difference in 24h energy intake throughout the shift cycle (p = 0.065). The analysis of interaction between shift and time ranges showed that night shift (D6) presented a higher intake of energy (441.5 ± 48.4kcal), percentage of energy (D6: 17.8 ± 1.8%), fat (17.6 ± 2.0%), carbohydrate (17.0 ± 1.7%) and protein (16.4 ± 1.8%) between 00:00 and 03:59 compared with the other shift days (p < 0.05). Night shifts seem to contribute to a longer eating window than other shifts. Moreover, there is a higher energy and macronutrients intake during night shifts, which reduces the night fast period and could have implications for metabolic dysregulation.

Alterations in Pregnenolone and Testosterone Levels in Male Shift Workers.

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.

GlycA, a Biomarker of Low-Grade Inflammation, Is Increased in Male Night Shift Workers.

Sustained night shift work is associated with various adverse health risks, including an increased risk of cardiovascular disease, type II diabetes, and susceptibility to infectious respiratory diseases. The extent of these adverse health effects, however, seems to greatly vary between night shift workers, yet the underlying reasons and the mechanisms underlying these interindividual differences remain poorly understood. Metabolomics assays in the blood have recently gained much attention as a minimally invasive biomarker platform capturing information predictive of metabolic and cardiovascular diseases. In this cross-sectional study, we explored and compared the metabolic profiles of 1010 night shift workers and 1010 age- and sex-matched day workers (non-shift workers) from the Lifelines Cohort Study. The metabolic profiles were determined using the 1H-NMR Nightingale platform for the quantification of 250 parameters of metabolism, including routine lipids, extensive lipoprotein subclasses, fatty acid composition, and various low-molecular metabolites, including amino acids, ketone bodies, and gluconeogenesis-related metabolites. Night shift workers had an increased BMI (26.6 vs. 25.9 kg/m2) compared with day workers (non-shift workers) in both sexes, were slightly more likely to be ever smokers (only in males) (54% vs. 46%), worked on average 5.9 ± 3.7 night shifts per month, and had been working in night shifts for 18.3 ± 10.5 years on average. We observed changes in several metabolic markers in male night shift workers compared with non-shift workers, but no changes were observed in women. In men, we observed higher levels of glycoprotein acetyls (GlycA), triglycerides, and fatty acids compared with non-shift workers. The changes were seen in the ratio of triglycerides and cholesterol(esters) to total lipids in different sizes of VLDL particles. Glycoprotein acetyls (GlycAs) are of particular interest as markers since they are known as biomarkers for low-grade chronic inflammation. When the analyses were adjusted for BMI, no significant associations were observed. Further studies are needed to better understand the relationship between night shift work and metabolic profiles, particularly with respect to the role of sex and BMI in this relationship.

The Effect of a 12 Week Mixed-Modality Training Intervention on the Cardio-Metabolic Health of Rotational Shift Workers

PurposeTo assess the effect of a 12 week resistance or aerobic training intervention on markers of cardio-metabolic function and sleep among male rotational shift workers.MethodThirty-eight sedentary, apparently healthy, male rotational shift workers were recruited and randomly allocated to a non-exercise control (CON) group, 3 sessions/week of moderate intensity continuous (MICT), or resistance training (RT) for 12 weeks in a semi-supervised setting. Pre- and post-testing assessed markers of cardio-metabolic function including peak oxygen uptake (VO2peak), glucose metabolism, insulin sensitivity, body composition, inflammatory markers, and 14 day actigraphy sleep assessment.ResultsMean session attendance across the intervention was 25 (± 7) of a possible 36 sessions. A significant group by time interaction was observed for MICT, with lower c-reactive protein (CRP) values observed post-training (P = 0.049). A significant effect for time was observed for both MICT (n = 9; P = 0.04) and RT (n = 10; P = 0.021), increasing total sleep time (TST) following a night shift post-intervention. Data redistribution regarding exercise adherence: < 24 (N-ADHERE) or ≥ 24 (ADHERE) resulted in significant pre-to-post reduction in body fat (P = 0.024) and fat mass percentage (P = 0.014) among ADHERE. No differences were observed for any intervention group on insulin sensitivity, glucose metabolism or oxygen uptake.ConclusionThe results of the current study support exercise as a valid intervention to improve the cardio-metabolic health of rotational shift workers. Average sessional attendance suggests shift workers face barriers to exercise that may need to be addressed to improve health outcomes.

The relationship between dietary patterns and sleep disorders in shift workers.

Few studies have been done on the association of dietary intakes with sleep disorders among shift workers, in particular those exposed to air pollution. We aimed to investigate the association of major dietary patterns with risk of sleep disorders in shift workers of a cement factory. This cross-sectional study was carried out on 257 male shift workers in a cement factory in Iran. Usual dietary intake of participants was assessed using a validated self-administrated 147-item dish-based food frequency questionnaire. To examine sleep disturbances of participants, we used the Epworth Sleepiness Scale. Three major dietary patterns including Classic Iranian, Modern Iranian, and High Protein Low Fruit and vegetables were identified. The Classic Iranian pattern was mainly consisted of high-protein animal foods, fruit, and vegetables, while the Modern Iranian pattern had high amounts of refined grains, solid oils, and caffeine drinks. No significant association was found between adherence to the Classic Iranian pattern and risk of sleep disorders (OR: 2.33; 95% CI: 0.69, 7.81) and also for the Modern Iranian dietary pattern (OR: 0.62; 95% CI: 0.20, 1.93). However, we found a significant direct association between the High Protein Low Fruit and vegetables dietary pattern and risk of sleep disorders (OR: 3.92; 95% CI: 1.03, 14.86). This study showed a significant direct association between a dietary pattern high in animal proteins and solid oils and low in fruit and vegetables with risk of sleep disorders among shift workers in the cement factory. However, no such association was found for the two other dietary patterns.

Shift work and job satisfaction among Palestinian nurses: a cross-sectional study

BackgroundRotating shift work is associated with job dissatisfaction, sleeping disturbances, and health problems compared with working only in the daytime. Whether the relationship between rotating shift work and job satisfaction differs between the sexes among nurses in occupied Palestinian territory is unclear. We investigated this relationship and compared it with that among regular day workers. MethodsWe did a cross-sectional study in Hebron district in August to October, 2008, involving all registered nurses with at least 1 year of practice. Those who worked fixed evening or night shifts or who were on leave were excluded. Job satisfaction was assessed with the Generic Job Satisfaction scale, containing ten items with scores from 1 to 5; a higher score indicated a higher (better) job satisfaction. Associations were assessed with β coefficients and 95% CIs and χ2 tests in linear regression analyses. Statistical analyses were done with Stata (version 10). The threshold for significance was set at p=0·05. The study was approved by the Palestinian Ministry of Health. Written informed consent was obtained from all participants. FindingsOf 472 eligible nurses, 426 (90%) were included in the study: 259 women and 167 men, among whom 217 worked shifts and 209 who worked only during the daytime. The mean job satisfaction score among female nurses was 32·6 (SD 6·4) and among male nurses was 31·7 (SD 7·0). Crude analyses showed that male and female shift workers reported lower job satisfaction than those working day shifts (mean score 30·8 [SD 6·5] vs 33·8 [6·4]). After adjustment for age, number of children, years of education, and job title, this effect remained statistically significant only among male nurses, as the men with rotating shift-work reported job scores 3·5 points lower than those working only during the daytime (β coefficient –3·5, 95% CI –5·9 to –1·1; p=0·005) whereas for women the β coefficient value was 0·10 (95% CI –1·8 to 2·1, p=0·90). InterpretationMale nurses working rotating shift patterns reported lower job satisfaction than men working only during the daytime, whereas no difference was found for female nurses. Because both exposure and outcome were measured using self-reported information and the study design was cross-sectional, interpretation of the results should be made with caution. However, further studies should investigate whether shift work affects the quality of patients’ care. FundingNorwegian Programme for Development, Research and Education.

Changes in intestinal parameters and their association with dietary patterns in rotational shift workers

ABSTRACT Circadian rhythm disturbances induced by rotating shift work contribute to development of metabolic disorders. However, their effects on intestinal parameters such as epithelial permeability and fecal short chain fatty acid (SCFA) levels have not been established yet. This study was planned to investigate the changes in intestinal integrity, fecal SCFA levels, gut microbiota and nutritional intake of rotational shift workers. The study was conducted on ten male rotational shift workers, 25–40 years old. Circadian rhythm disruption was assumed to have occurred after 14 days in the night shift. Dietary data which was obtained by using 24 h record for 7 days, physical activity data, anthropometric measurements, fecal and blood samples were collected during day and night shift. Changes in dietary consumption, anthropometric measurements, blood chemistry and intestinal epithelial permeability indicator according to day and night shifts were not significant (p > .05). Additionally, acetic, propionic and total SCFA were associated with the intestinal permeability biomarker in night shift, but not in day shift (p < .05). Consumption of dark green vegetables and beans and peas was positively associated with fecal isobutyric acid and fecal total SCFA concentration (r = 0.685, p = .029; r = 0.695, p = .026, respectively). The proportions of the genus including Blautia, Bifidobacterium, Dialister, and Ruminococcus gnavus group increased when individuals shifted to the night shift. Gut microbiota changes responding to circadian rhythm disruption became more prominent when consumed high sugar diet. So, changes have been observed in the gut microbiota of rotational shift workers, especially in individuals with certain dietary pattern. Moreover, in individuals with the circadian rhythm disruption SCFAs levels have been demonstrated to be associated with intestinal barrier integrity. A better understanding of the relation among fecal SCFAs, gut microbiota, intestinal epithelial permeability and circadian rhythm disruption is necessary for the development of new dietary strategies for gut health.

Slim larks and overweight owls? A two years dietary intervention in shift workers.

Previous studies have shown that shift workers are more prone to non-communicable diseases. The aim of the present crossover study is to investigate whether it is possible to improve the health status of shift workers. Nineteen male shift workers (38.5 years ± 7.4) received every other month a dietary counseling for one year. All subjects kept a seven-day diet diary during a night shift, received bioelectrical impedance analysis, and a laboratory examination was performed at the beginning of the study, after one year and at the end of the study. The laboratory blood test included the main metabolic parameters, melatonin and serotonin. Beside subjects were also motivated to incorporate more physical training into their daily routine. After the intervention period, participants reduced energy intake, mean portion size, table salt, consumption of sugar and saturated fat. C-reactive protein (CRP), mean corpuscular volume (MCV), liver enzymes, triglycerides, and uric acid decreased, while melatonin level increased. Participants lost body weight and reduced waist circumference after the intervention. Lifestyle modification and dietary information could contribute to the health of shift workers. However, further studies are needed to investigate whether this can prevent disease and whether melatonin production can be influenced by diet.

Impact of shift work on the risk of depression

ABSTRACT We studied the association between shift work and depressive symptoms in the prospective Heinz Nixdorf Recall Study, considering various demographic, lifestyle and work-related factors. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression (CES-D)-Scale (≥17 points defined as high symptoms) and the Patient Health Questionnaire (PHQ) with a cutoff ≥9, or prescription of an anti-depressant. The definition of shift work included work hours outside 7:00 to 18:00, whereas night work was defined as a shift including work between 0:00 and 5:00. Poisson regression with robust error variances was calculated to estimate relative risks (RR) and 95% confidence intervals (CI), adjusted for age at follow-up, diurnal preference, monthly household income and education. Analyses were stratified by sex. We performed various sensitivity and stratified analyses to test the robustness of our results. At baseline, 1,500 gainfully employed subjects, 45–73 years of age and without a history of depression, were included. Until the 5-year follow-up, 896 participants were observed, and 486 participants survived through the 10-year follow-up. Although most analyses did not reach the level of formal statistical significance, women working night shifts tended to show increased relative risks for depressive symptoms according to the PHQ (RR = 1.78; 95% CI 0.71–4.45), in particular when working night shifts for ≥20 years (RR = 2.70; 95% CI 0.48–15.4). Stratification by age group revealed no increased risks among women above 60 years of age. Stratified analyses indicated that over-commitment was associated with higher risks for depressive symptoms among women (RR = 4.59; 95% CI 0.95–22.2 in the CES-D and RR = 12.7; 95% CI 2.89–56.1 in the PHQ). Exclusion of subgroups for the purpose of sensitivity analyses generally strengthened associations in women, whereas little evidence for an increased risk of depression remained among male shift workers. In summary, negative effects on depression were suggested among female shift workers, although results were based on small numbers. Among men, we did not identify consistently increased risks for depressive symptoms in relation to shift work.

Diagnostic accuracy of the Berlin questionnaire and the NoSAS score in detecting risk for obstructive sleep apnea in rotating shift workers.

Data on the validity of tools for sleep apnea risk detection in rotating shift workers are limited. The aim was to evaluate the Berlin questionnaire (BQ) and the Neck, Obesity, Snoring, Age, Sex (NoSAS) score for the detection of obstructive sleep apnea risk in shift workers. This cross-sectional study included male rotating shift workers, drivers of heavy off-road machinery in an iron ore extraction company. Polysomnography was the gold standard for evaluation. Obstructive sleep apnea (OSA)was defined as an apnea-hypopnea index (AHI) of ≥ 5 events/h. The Shapiro-Wilk test verified the data distribution and comparative analysis was conducted using the chi-square analyses and U Mann-Whitney with Bonferroni correction. Receiver operating characteristic curve analysis, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and accuracy were used for evaluate BQ and NoSASwith OSAdiagnosis by polysomnograph. Among 119 male shift workers, ages 24 to 57 years, polysomnography showed that 84% had obstructive sleep apnea (AHI ≥ 5), and 46% had moderate to severe sleep apnea (AHI ≥ 15). For AHI ≥ 5, the NoSAS score had higher sensitivity and specificity than the BQ. For AHI ≥ 15 and AHI ≥ 30, the NoSAS score had a sensitivity higher than 70% while BQ was 60% and 58%, respectively. The accuracy of the NoSAS score was higher for all OSA criteria than that of BQ. In rotating shift workers, drivers of heavy off-road machinery, the NoSAS score showed higher accuracy in identifying patients at risk for sleep apnea than the BQ.

Shift-Work-Play: Understanding the positive and negative experiences of male and female shift workers to inform opportunities for intervention to improve health and wellbeing

Objective: Our primary study aims are to (i) examine positive and negative aspects associated with shift work, and (ii) identify any gender differences that exist in a healthcare workforce. A secondary aim of the study was to identify opportunities for intervention, particularly in males given they have greater exposure to shift work across the population. Background: Shift work has been associated with detrimental physical and psychosocial outcomes in many studies; however, there has been little consideration of any positive perceived aspects associated with shift work. Additionally, while there has been less consideration of gender differences in medical settings such as nursing where there is a higher proportion of females working shifts. Study design and methods: Our study utilised mixed-methods, comprising a cross-sectional workforce survey given to both shift workers and non-shift workers (N=1398), and a co-design workshop aimed at male nurses, in order to identify opportunities for intervention among this group. Results: Shift workers were more likely than their non-shift work counterparts to report poorer overall health, to have higher levels of psychological distress, and to engage in greater levels of unhealthy behaviours (e.g. higher alcohol consumption, and greater levels of smoking), with these differences highest in male shift workers. Discussion: Analysis of the shift work experience revealed that the majority responses were negative (affecting sleep, diet, exercise, mental health), however one-in-five statements were positive with flexibility, and the ability to engage with services highlighted. Examining both positive and negative elements is important for providing a balanced insight into shift workers’ lives, and to inform targets for improving their health and wellbeing. Conclusion: Through identifying positive and negative elements associated with shift work it is possible to intervene to minimise the negative elements, and maximise positive elements. Our analysis highlights the importance of considering gender differences in both individual and organisational-level responses. Implications for research, policy, and practice: To effectively address the negative aspects of shift work, interventions at multiple levels involving both organisations and individuals that simultaneously target multiple outcomes (sleep, diet, exercise, opportunities to connect with peers) are likely to be more effective than individual measures alone. What is known about the topic? Shift work is common across many different industries, and is an integral part of the nursing profession, where nurses and midwives make up almost 50% of the worldwide shift working workforce. Shift work has been associated with negative impacts on individual physical and psychological health and performance outcomes such as increased error rates. What this paper adds: This study confirms that shift work is associated with negative impacts however there are positive elements associated with shift work and these include flexibility and financial benefits. Gender differences were apparent with risky alcohol use, higher smoking rates, and poorer health noted in males compared with females. Our co-design workshop identified the potential for a holistic response based on the three pillars of health: sleep, diet and exercise as likely to be more effective than an intervention addressing only one of these domains.

296 Sex differences in sleep and wakefulness of police officers working shifts: evidence from a field study

Abstract Introduction National reports of work-related injuries found the excess risk of work injury attributed to shift work to be significantly higher among women. The Working Time Society (WTS) concluded that male sex is one of the few factors that is “consistently associated with perceived or actual shift work tolerance”. However, it is unclear if physiological parameters are involved. Laboratory-controlled studies report sex differences in circadian rhythms (body temperature, melatonin). In sleep deprivation protocols, alertness and cognitive performances were affected by sex, menstrual cycle phase and hormonal contraceptives [HC] use. Nevertheless, field studies that compare male and female shift workers are scarce. Methods An observational study including 76 police officers working on patrol: 56 males and 20 females (11 using [HC], 6 not using [non-HC] and 3 with unknown use of hormonal contraception) aged 32.0 ± 5.3 years. Participants were followed throughout a month-long work cycle (1,457 morning, evening, night, or other shifts, plus rest days). They filled out time-stamped questionnaires (Samn-Perelli, KSS, Visual Analogue Scales, ~5/day; sleep and work-related information, ~1–2/day), completed 5-min Psychomotor Vigilance Tasks (PVT, ~2/day), and wore an actigraph to collect activity data. Linear mixed-effects models were used to analyze the effects of group, time awake and time-of-day on fatigue, sleepiness, alertness, mood and PVT measures. Results Self-reported measures and psychomotor performance significantly varied with time awake and time-of-day. Fatigue and sleepiness levels were significantly higher among female compared to male police officers, both with time awake and across the 24-h day. These variations were similar between non-HC females and the other groups. Compared to males, HC females were more fatigued and less alert, both with time awake and across the 24-h day, and sleepier with time awake. Having children at home did not explain these differences. Conclusion The results of this study expand our knowledge on the sex differences in the sleep and circadian physiology and demonstrate a critical effect of HC on women fatigue, sleepiness and alertness when working shifts. Sex and hormonal parameters must be considered in occupational medicine as well as in future laboratory and field studies on shift workers and circadian rhythms. Support (if any) IRSST, FRQS.

Association of Sleep Duration and Working Hours with Suicidal Ideation in Shift Workers: The Korean National Health and Nutrition Examination Survey 2007-2018.

ObjectiveThis study investigated whether sleep duration and working hours were associated with the risk of suicidal ideation. MethodsData from 13,628 shift workers (age ≥19) were obtained from the nationwide cross-sectional Korea National Health and Nutrition Examination Surveys conducted in 2007–2018. We included healthy shift workers without depressive disorders and chronic medical illnesses. Sleep duration, working hours, and suicidal ideation were assessed using a self-reported questionnaire. Logistic regressions were used to examine the association of sleep duration and working hours with the risk of suicidal ideation. We examined interactions between sleep duration and working hours in association with suicidal ideation. In addition, interactions of sex or age were also analyzed. ResultsShift workers sleeping for <6 and ≥10 hours/day were associated with suicidal ideation compared with those sleeping for 7 to <9 hours/day. Individuals working >52 hours/week had a higher risk of suicidal ideation compared with those working ≤40 hours/week. In terms of interaction by sex or age groups in the association between working hours and the risk of suicidal ideation, the relationship was stronger for men than for women and for those aged <45 years than for those aged ≥45 years. ConclusionShorter or longer sleep durations, and long working hours were associated with a higher risk of suicidal ideation. Under long working hours, male shift workers or those aged <45 years were more vulnerable to suicidal ideation.