Nonstandard Shifts Research Articles

Workplace Psychosocial Factors, Work Organization, and Physical Exertion as Risk Factors for Low Back Pain Among US Workers: Data From the 2015 National Health Interview Survey.

To evaluate the association between workplace psychosocial, organization, and physical risk factors with low back pain (LBP) among US workers. 2015 National Health Interview Survey data were analyzed to calculate the prevalence rates and prevalence ratios for LBP across levels of workplace psychosocial and organizational risk factors among 17,464 US adult workers who worked ≥20 hours per week. Results were also stratified by workplace physical exertion. The adjusted prevalence rates of LBP were significantly elevated for workers reporting high job demand, low job control, work-family imbalance, bullying, job insecurity, working alternate shifts, and physical exertion. Job control and nonstandard shifts were significantly associated with LBP only among those who reported low/no physical exertion. LBP prevalence was associated with select workplace psychosocial and organization risk factors. Stratification by physical exertion modified multiple associations.

Improving the Production Efficiency Based on Algorithmization of the Planning Process

Planning and managing the production process are key challenges faced by every manufacturing organization. The main contribution of this article lies in the analysis and design of a planning algorithm that takes into consideration the specifics of this environment. The proposed algorithm encompasses elements of batch production, including a just-in-time approach. The article focuses on scenarios within batch production. Managers of manufacturing and supply companies must ensure smooth fulfillment and uninterrupted production of the agreed-upon quantity of parts. However, this task presents complex challenges. The product portfolio requires meticulous sequencing of production batches, and subsequent parts need to be temporarily stored in their raw state for further processing. Moreover, product variability necessitates frequent adjustments to the production line, resulting in delays. Shortages in manpower additionally place demands on shift organization. The company’s primary objective is to increase production efficiency while simultaneously reducing inventory and minimizing non-standard shift work. The challenge was to reconcile seemingly conflicting company requirements and to concentrate on solutions with swift implementation and minimal costs. Ensuring seamless production operation can be addressed by expanding supporting technologies or by increasing production capacity, such as acquiring an additional production line. However, these options entail costs and do not align with the company’s expectation for immediate impact and cost savings. However, improving production efficiency can also be achieved by altering the approach to production planning, which is the central theme of this article. The key element is ensuring that the customer plan is adhered to while working with a fixed production logic and variable input factors that must account for various non-standard situations.

0162 The neural bases of emotion dysregulation in rotating shift workers

Abstract Introduction Shift work is known to be associated with sleep disturbance and circadian misalignment and may contribute to alterations in the brain implicated in emotion dysregulation. In this study, we examined 1) neural correlates of emotion dysregulation, including emotional reactivity and regulation in shift workers and 2) relationships between neural correlates of emotion dysregulation, sleep disturbance, and circadian misalignment. Methods Fifty-six rotating shift workers (SW, 42 females, 30.80 ± 6.94 years old) who had non-standard shift schedules and 52 healthy controls (HC, 36 females, 31.69 ± 7.86 years old) who did not work as shift schedules participated in this study. Both SW and HC completed self-reported measures of sleep and mood problems, and wrote sleep diary and wore actigraphy to assess sleep quality and circadian rhythms. They also underwent one night polysomnography and were scanned while they were performing the emotion regulation task. We analyzed group differences in mood, sleep, circadian rhythms, and neural bases of emotional reactivity and regulation, and examined relationships between these variables. Results SW showed significant differences in actigraphy-estimated sleep (i.e., lower sleep efficiency) and circadian rhythms (e.g., greater motor activity [M10] and lower interdaily stability) compared to HC. SW also exhibited increased anterior insula (AI) activation in response to negative pictures, but reduced activation in the dorsomedial prefrontal cortex (dMPFC) and AI-dMPFC functional connectivity during emotion regulation compared to HC. AI activation and AI-dMPFC functional connectivity were significantly associated with sleep disturbance (i.e., sleep diary-estimated sleep onset latency) and circadian misalignment (e.g., M10 and interdaily stability). Furthermore, a mediation analysis revealed that shift work was associated with increased motor activity during the most active 10-hour period, which then contributed to increased AI activation in response to negative pictures. Conclusion Our findings suggest that shift work may contribute to sleep disturbance and circadian misalignment, and neural alterations associated with emotional reactivity and regulation. Furthermore, the mediation result suggests that increased motor activity along with misaligned circadian rhythm may serve as a pathway, through shift work contributes to heightened emotional reactivity to negative information. Support (if any) National Research Foundation (No. 2022R1A2C2008417, NRF-2022R1A2C1008209) and Korea Institute for Advancement of Technology (No. 20009210).

MP33-10 INCREASED GENITOURINARY CANCER INCIDENCE AND LOWER TESTOSTERONE LEVELS ARE FOUND IN MEN PERFORMING NON-STANDARD SHIFT WORK

You have accessJournal of UrologyCME1 Apr 2023MP33-10 INCREASED GENITOURINARY CANCER INCIDENCE AND LOWER TESTOSTERONE LEVELS ARE FOUND IN MEN PERFORMING NON-STANDARD SHIFT WORK Jordan Kassab and Larry Lipshultz Jordan KassabJordan Kassab More articles by this author and Larry LipshultzLarry Lipshultz More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003266.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Previous studies have documented hypogonadal serum hormone levels in men regularly involved in non-standard shift work (NSSW) schedules. This work schedule is defined as working outside of the normal 7am-6pm hours. Additionally, past literature have shown a marked correlation between sleep deprivation and cancer risk, prompting us to investigate the relationship between NSSW schedules and cancer. The objective of this study is to explore the impact of NSSW schedules on the incidence of cancer as well as its impact on urologic markers. METHODS: A retrospective chart review was conducted, having identified over 3000 patients from the electronic medical records of a university hospital. The accrued patient cohort included both those who were involved in NSSW schedules and those who were not. The database was then linked to the Texas Cancer Registry to identify which of these patients have had a documented cancer diagnosis since 1995. The data from the registry included the age of cancer diagnosis, primary site, histology type, and metastatic status. The statistical analyses were performed using SPSS software. RESULTS: The statistical analysis revealed that the average age of cancer diagnosis is more than six years younger in NSSW versus those with regular work schedules. Similarly, non-standard shift workers experienced higher levels of prostate-specific antigens (4.942 ng/mL vs. 1.204 ng/mL). As expected from previous studies, non-standard shift workers faced significantly lower levels of endogenous testosterone (358.6 ng/dL vs 618.6 ng/dL). Furthermore, the NSSW population’s incidence of cancer is roughly double the age-adjusted cancer incidence rate of men in Texas. Of the NSSW who had a cancer diagnosis (n=45), the most common cancer primary sites were the male genital organs (n=16), the urinary tract (n=5), and the hematopoietic and reticuloendothelial systems (n=5). CONCLUSIONS: Our study has demonstrated that NSSW are at higher risk of developing cancer than the general male population. NSSW who already represent a clinically vulnerable population, may be somewhat immunocompromised as evidenced by their increased cancer incidence. The increased incidence of urogenital cancers within the NSSW group emphasizes the greater need of urologic focus for these men in clinical practice. Source of Funding: None. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e453 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jordan Kassab More articles by this author Larry Lipshultz More articles by this author Expand All Advertisement PDF downloadLoading ...

The Roles of Family and School Members in Influencing Children's Eating Behaviours in China: A Narrative Review.

This review explores the influences of family and school members on children in China, in order to promote healthy eating behaviours among children and prevent childhood malnutrition in the Global South. Family members and school members are defined as parents, guardians (such as grandparents and other relatives), siblings, peers, and teachers. A search of four databases returned 94 articles, 18 of which met the eligibility criteria. Most of the included studies were from mainland China; a few were from Hong Kong and Taiwan. More quantitative than qualitative studies were found, among which, cross-sectional studies were dominant. The 18 papers included in the study explored the influences of family members and school members on the eating behaviours of children, based on seven themes: (1) social–demographic characteristics, (2) food intake of parents, (3) nutritional knowledge and health awareness of family or school members, (4) parents’ perceptions of their children’s body weight, (5) feeding strategies of family members, (6) family relationships, and (7) intergenerational differences of caregivers. In the current analysis, parental education levels, mother’s occupation, health awareness of parents and teachers, and positive feeding styles, such as encouraging healthy eating and controlling overeating, were positively correlated with the healthy eating behaviours of children. Meanwhile, healthy eating behaviours of children were negatively associated with caregivers’ lack of nutritional knowledge, misperception of weight, instrumental and/or emotional feeding, and working on nonstandard shifts. More related research using cross-disciplinary approaches is needed and there should be more discussions about how teachers, siblings, and peers affect the dietary behaviours of children.

The Cutoff Phenomenon in Wasserstein Distance for Nonlinear Stable Langevin Systems with Small Lévy Noise

This article establishes the cutoff phenomenon in the Wasserstein distance for systems of nonlinear ordinary differential equations with a dissipative stable fixed point subject to small additive Markovian noise. This result generalizes the results shown in Barrera, Högele, Pardo (EJP2021) in a more restrictive setting of Blumenthal-Getoor index α>3/2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\alpha >3/2$$\\end{document} to the formulation in Wasserstein distance, which allows to cover the case of general Lévy processes with some given moment. The main proof techniques are based on the close control of the errors in a version of the Hartman–Grobman theorem and the adaptation of the linear theory established in Barrera, Högele, Pardo (JSP2021). In particular, they rely on the precise asymptotics of the nonlinear flow and the nonstandard shift linearity property of the Wasserstein distance, which is established by the authors in (JSP2021). Main examples are the nonlinear Fermi–Pasta–Ulam–Tsingou gradient flow and dissipative nonlinear oscillators subject to small (and possibly degenerate) Brownian or arbitrary α\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\alpha $$\\end{document}-stable noise.

Gender and Educational Variation in How Temporal Dimensions of Paid Work Affect Parental Child Care Time.

Using the 2017-2018 American Time Use Survey, the authors investigate how a comprehensive set of temporal conditions of paid work affects parental child care time, with attention to gender and education. Temporal work conditions include access to leave, inflexible start and end times, short advance notice of work schedules, types of work shifts, and usual days worked. Among mothers, the only significant relationship is between usual days worked and routine care time. Among fathers, lacking access to paid leave and having inflexible start and end times are associated with reduced routine care time, and working on variable days of the week is related to less developmental care time. Temporal work conditions also shape the educational gap in parental child care time. Importantly, nonstandard shifts and working on weekends widen the educational gradient in mothers' developmental care time. The findings imply that temporal work conditions amplify gender inequality in work-family lives and families as agents of class reproduction.

Association of Employees' Meal Skipping Patterns with Workplace Food Purchases, Dietary Quality, and Cardiometabolic Risk: A Secondary Analysis from the ChooseWell 365 Trial.

Employed adults may skip meals due to time or financial constraints, challenging work schedules, or limited workplace food choices. Little is known about the relationship between employees' meal skipping patterns and workplace dietary choices and health. To examine whether hospital employees' meal skipping patterns were associated with workplace food purchases, dietary quality, and cardiometabolic risk factors (ie, obesity, hypertension, and prediabetes/diabetes). This is a secondary cross-sectional analysis of baseline data from the ChooseWell 365 randomized controlled trial. Employees reported meal-skipping frequency in a baseline survey. The healthfulness of workplace food purchases was determined with a validated Healthy Purchasing Score (HPS) (range= 0 to 100 where higher scores= healthier purchases) calculated using sales data for participants' purchases in the 3 months before study enrollment. Dietary quality was measured with the 2015 Healthy Eating Index (range= 0 to 100 where higher score= healthier diet) from two 24-hour recalls. Cardiometabolic risk factors were ascertained from clinic measurements. Participants were 602 hospital employees who regularly visited workplace cafeterias and enrolled in ChooseWell 365, a workplace health promotion study in Boston, MA, during 2016-2018. Primary outcomes were HPS, 2015 Healthy Eating Index, and cardiometabolic risk factors. Regression analyses examined differences in HPS, 2015 Healthy Eating Index, and cardiometabolic variables by meal skipping frequency, adjusting for demographic characteristics. Participants' mean (standard deviation) age was 43.6 (12.2) years and 478 (79%) were women. Overall, 45.8% skipped breakfast, 36.2% skipped lunch, and 24.9% skipped dinner ≥ 1 day/week. Employees who skipped breakfast ≥ 3 days/week (n= 102) had lower HPS (65.1 vs 70.4; P < 0.01) and 2015 Healthy Eating Index score (55.9 vs 62.8; P < 0.001) compared with those who never skipped. Skipping lunch ≥ 3 days/week and dinner ≥ 1 day/week were associated with significantly lower HPS compared with never skipping. Employees who worked nonstandard shifts skipped more meals than those who worked standard shifts. Meal skipping was not associated with obesity or other cardiometabolic variables. Skipping meals was associated with less healthy food purchases at work, and skipping breakfast was associated with lower dietary quality. Future research to understand employees' reasons for skipping meals may inform how employers could support healthier dietary intake at work.

Sleep-Scheduling Strategies in Hospital Shiftworkers.

IntroductionShiftwork causes circadian disruption and results in impaired performance, sleep, and health. Often, individuals on non-standard shifts cannot modify work schedules. At-home sleep schedules are a potentially modifiable point of intervention, yet sleep-scheduling strategies remain relatively understudied. Specifically, the adoption of multiple strategies and the employment of strategies for not only night shifts, but also early starts on days, have yet to be formally examined to our knowledge. We studied how adoption of specific and/or multiple sleep-scheduling strategies for day and night shifts relates to measures of adaptation to shiftwork, self-reported on-shift sleepiness, and individual characteristics (eg, age, chronotype, education in circadian and sleep health). We hypothesized: 1) strategies would differ by shift type, 2) individuals would adopt multiple strategies, 3) strategies better aligned with circadian principles would relate to measures of adaptation, and 4) individual characteristics, such as having dependents, would relate to strategy selection.MethodsA retrospective, online questionnaire (including items from the Survey of Shiftworkers and items related to sleep-scheduling strategies) was administered to both permanent and rotating hospital staff in four wards working 12-h day and/or night shifts (n=89). Additionally, reasons for strategy selection were explored.ResultsLevel of adaptation varied by sleep-scheduling strategy, with the least adaptation for those utilizing the Incomplete Shifter strategies. For night shifts, Night Stay and Switch Sleeper-N strategies were related to lower mid-shift sleepiness. Many night workers reported using strategies that restricted sleep, and most reported using multiple strategies, both of which also related to lower adaptation. Domestic considerations were the most common rationale for strategy selection. Strategies varied by several individual characteristics, including chronotype, dependents, and level of sleep education.DiscussionFuture work should investigate sleep strategies and circadian interventions to help mitigate the effects of circadian and sleep disruption in hospital staff.

Shift Work Sleep Disorder and Night Shift Work Significantly Impair Erectile Function

ObjectivesHere we examine the association between shift work sleep disorder (SWSD) and erectile dysfunction (ED) in shift workers. MethodsMen presenting to a single andrology clinic between January 2014 and July 2017 completed validated questionnaires: International Index of Erectile Function (IIEF), Patient Health Questionnaire-9 (PHQ-9), and the nonvalidated SWSD Questionnaire. Men were also asked about shift work schedule, comorbidities, phosphodiesterase 5 (PDE5) inhibitor use, and testosterone use. Serum total testosterone values were determined for each visit. Linear regression was performed controlling for testosterone use, testosterone levels, PDE5 inhibitor use, age, and comorbidities to determine the effect of SWSD on ED as assessed using the IIEF. ResultsOf the 754 men completing questionnaires, 204 reported nonstandard shift work (begins before 7 am or after 6 pm, regularly extends out of that frame, or rotates frequently) and 48 were found to have SWSD using a screening questionnaire. Nonstandard shift work alone did not result in worse IIEF-EF scores (P = .31), but those who worked nonstandard shifts and had SWSD demonstrated IIEF-EF scores 2.8 points lower than men without SWSD (P < .01). When assessing for the type of shift work performed, men who worked night shifts had IIEF-EF scores 7.6 points lower than men who worked during the day or evening (P < .01). Testosterone use improved IIEF-EF scores for men with SWSD by 2.9 points, ameliorating the effect of SWSD on ED. However, baseline testosterone levels were not associated with worse erectile function in this cohort. ConclusionMen with SWSD have worse erectile function, with men who work night shifts having even poorer erectile function. These findings suggest that circadian rhythm disturbance may significantly impact erectile function. While testosterone therapy may partly reverse the effects of SWSD, shift work is a potential risk factor for ED and should be assessed for as part of the evaluation of men with ED.Rodriguez KM, Kohn TP, Kohn JR, et al. Shift Work Sleep Disorder and Night Shift Work Significantly Impair Erectile Function. J Sex Med 2020;17:1687–1693.

Increased Risk of Hypogonadal Symptoms in Shift Workers With Shift Work Sleep Disorder

To examine the association between shift work sleep disorder (SWSD), a primary circadian rhythm disorder characterized by excessive day-time sleepiness associated with shift work, and hypogonadal symptoms in shift workers. Men presenting to an andrology clinic between July 2014 and June 2017 completed questionnaires assessing shift work schedule, SWSD risk, and hypogonadal symptoms ([quantitative] Androgen Deficiency in the Aging Male [qADAM, ADAM]). The impact of nonstandard shift work and SWSD on responses to qADAM and ADAM was assessed using ANOVA and linear regression. About 24.1% (619/2571) of men worked nonstandard shifts. Of those, 196 (31.7%) were considered to have SWSD. Controlling for age, comorbidities, and testosterone (T) levels, nonstandard shift workers had qADAM scores 1.12 points lower than day-time workers (P <.01). Subgroup analysis of nonstandard shift workers showed that those with SWSD had qADAM scores 5.47 points lower than men without SWSD (P <.01). In this same subgroup analysis, SWSD was independently associated with lower T levels (mean decrease 100.4 ng/dL, P <.01) when controlling for age, comorbidities, and prior T supplementation. Nonstandard shift workers with SWSD have even worse hypogonadal symptoms and lower T levels than day-time workers and nonstandard shift workers without SWSD. This suggests that poor sleep habits, as identified by SWSD, may contribute to the more severe hypogonadal symptoms seen in nonstandard shift workers.

Non-dipping and sleep outcomes in african-american non-standard shift workers

Non-dipping and sleep outcomes in african-american non-standard shift workers

Shift Workers With Shift Work Disorder Have Worse Lower Urinary Tract Symptoms

ObjectiveTo examine the association between shift work or shift work disorder (SWD) and lower urinary tract symptoms (LUTS). Nonstandard shift workers are defined as those working shifts outside of a normal 7 AM-6 PM work day. MethodsMen presenting to a single andrology clinic between July 2014 and June 2017 completed questionnaires that included questions about work schedules, shift work status, SWD[1][1], personal well-being via the Patient Health Questionnaire-9, and LUTS (International Prostate Symptom Score [IPSS]). Men who had previously undergone prostate surgery were excluded. Shift work and SWD on IPSS was assessed via multivariate linear regression. ResultsOf the 2571 men who completed all questionnaires, 619 (24.1%) reported working nonstandard shifts in the past month. Of these, 196 (31.7%) had high risk of SWD as determined by a questionnaire. When controlling for age, medications, surgical intervention for benign prostatic hyperplasia, comorbidities, and testosterone (T) levels, nonstandard shift work overall was not associated with worse LUTS (P = .82). However, nonstandard shift workers at high risk for SWD had IPSS scores that were clinically significantly higher (3.74 points ± 0.57 standard error) than nonstandard shift workers without SWD (P <.0001). ConclusionNonstandard shift workers at high risk for SWD have worse LUTS than those without SWD. However, no association between nonstandard shift work and LUTS was found.

Working Time Society consensus statements: Circadian time structure impacts vulnerability to xenobiotics-relevance to industrial toxicology and nonstandard work schedules.

The circadian time structure (CTS) has long been the subject of research in occupational medicine, but not to industrial toxicology, including methods of setting threshold limit values (TLVs) and employee biological monitoring. Numerous animal and human investigations document vulnerability to chemical, contagion, and other xenobiotics varies according to the circadian time of encounter. Permanent and rotating nightshift personnel are exposed to industrial contaminants in the same or higher concentration as dayshift personnel, and because of incomplete CTS adjustment to night work, contact with contaminants occurs during a different biological time than day workers. Thus, the amount of protection afforded by certain TLVs, especially for employees of high-risk settings who work night and other nonstandard shift schedules, might be inadequate. The CTS seems additionally germane to procedures of employee biological monitoring in that high-amplitude 24 h rhythms in biomarkers indicative of xenobiotic exposure may result in misjudgment of health risks when data are not gathered in sufficient frequency over time and properly interpreted. Biological reference values time-qualified for their rhythmic variation, currently of interest to laboratory medicine practice, are seemingly important to industrial medicine as circadian time and work-shift specific biological exposure indices to improve surveillance of personnel, particularly those working nonstandard shift schedules.

The Effect of Shift Work on Urogenital Disease: a Systematic Review.

Non-standard shift work schedules negatively impact the overall health of shift workers, and several studies have shown that shift work, specifically, is detrimental to urogenital health. The aims of this study are to systematically review the literature and determine the effect of shift work on the outcomes of hypogonadism, male infertility, lower urinary tract symptoms, and urogenital cancers. Recent evidence supports associations between non-standard shift work and an increase in the frequency of prostate cancer and the severity of erectile dysfunction, lower urinary tract symptoms, and hypogonadal symptoms, as well as worsening of semen parameters and fertility. These associations are strengthened by the presence of shift work sleep disorder (SWSD) which affects up to 20% of shift workers. No studies have assessed the impact of shift work on the frequency or severity of nephrolithiasis, interstitial cystitis, pelvic pain, prostatitis, or urinary tract infections. Non-standard shift work has been associated with a variety of negative health outcomes and urologic complications, especially with concurrent shift work sleep disorder. Recognition of these elevated risks among shift workers can aid in more effective screening for urologic conditions.

PD27-06 SHIFT WORK SLEEP DISORDER AND NIGHT SHIFT WORK SIGNIFICANTLY IMPAIR ERECTILE FUNCTION.

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation I1 Apr 2018PD27-06 SHIFT WORK SLEEP DISORDER AND NIGHT SHIFT WORK SIGNIFICANTLY IMPAIR ERECTILE FUNCTION. Katherine M. Rodriguez, Taylor P. Kohn, Jaden R. Kohn, E. Will Kirby, Stephen M. Pickett, Alexander W. Pastuszak, and Larry I. Lipshultz Katherine M. RodriguezKatherine M. Rodriguez More articles by this author , Taylor P. KohnTaylor P. Kohn More articles by this author , Jaden R. KohnJaden R. Kohn More articles by this author , E. Will KirbyE. Will Kirby More articles by this author , Stephen M. PickettStephen M. Pickett More articles by this author , Alexander W. PastuszakAlexander W. Pastuszak More articles by this author , and Larry I. LipshultzLarry I. Lipshultz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1357AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Non-standard shift workers, who regularly work hours outside a 7am-6pm workday, have been found to have worse general health when compared to men working standard shifts. Men working non-standard shifts are at increased risk for shift work sleep disorder (SWSD), a primary circadian rhythm disorder characterized by excessive daytime sleepiness associated with shift work. Here we examine the association between SWSD and erectile dysfunction (ED) in shift workers. METHODS Men presenting to a single andrology clinic between January 2014 - July 2017 completed validated questionnaires: IIEF, Patient Health Questionnaire (PHQ), and the SWSD Questionnaire. Men were also asked about shift work schedule, comorbidities, PDE5 inhibitor use, and testosterone use. Serum total testosterone values were determined for each visit. Linear regression was performed controlling for testosterone use, testosterone levels, PDE5-inhibitor use, age, and comorbidities to determine the effect of SWSD on erectile dysfunction as assessed using the IIEF-EF. RESULTS Of the 2,571 men completing questionnaires, 1,952 reported non-standard shift work and 196 were found to have SWSD. 802 men completed the IIEF-EF questionnaire. Non-standard shift work alone did not result in worse IIEF-EF scores (p = 0.31), but men with SWSD had IIEF-EF scores that were 2.8 points lower than men without SWSD (P<0.01). When assessing for the type of shift, we found that men who worked night shifts had IIEF-EF scores 7.58 points lower than men who worked during the day or evening (p < 0.01). Testosterone use improved IIEF-EF scores for men with SWSD by 2.90 points, ameliorating the effect of SWSD. Testosterone levels were not associated with worse erectile function. CONCLUSIONS Men with SWSD have statistically and clinically worse erectile function, and men who work night shifts have even worse ED. These findings suggest that circadian rhythm disturbance may significantly impact erectile function. Testosterone therapy may partly reverse the effects of SWSD. Shift work is a potential risk factor for ED and should be assessed for as part of the evaluation of men with ED. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e559 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Katherine M. Rodriguez More articles by this author Taylor P. Kohn More articles by this author Jaden R. Kohn More articles by this author E. Will Kirby More articles by this author Stephen M. Pickett More articles by this author Alexander W. Pastuszak More articles by this author Larry I. Lipshultz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

The Relationship Between Shift Work and Men's Health.

More than 21 million Americans and nearly 20% of the U.S. workforce are shift workers. Non-standard shift work, defined as work that falls outside of 6 am-6 pm, can lead to poor diet, exercise, and sleep habits that lead to decreased productivity, increased workplace accidents, and a variety of negative health outcomes. To investigate the associations between shift work exposure and chronic medical conditions such as metabolic syndromes, cardiovascular disease, gastrointestinal disturbances, and depression as well as urologic complications including hypogonadism, male infertility, lower urinary tract symptoms, and prostate cancer with a focus on the effects of shift work sleep disorder (SWSD) on the severity of these negative health outcomes. We reviewed the literature examining effects of shift work and SWSD on general and urologic health. We produced a summary of effects of shift work on health with focus on the increased risk of negative health outcomes in non-standard shift workers, particularly those with SWSD, when compared to daytime workers or workers without SWSD. Studies have associated non-standard shift work schedules and poor health outcomes, including increased risks of diabetes mellitus, dyslipidemia, hypertension, heart disease, peptic ulcer disease, and depression, in shift workers. However, few studies have focused on the role that shift work plays in men's urologic health. Current evidence supports associations between non-standard shift work and increased hypogonadal symptoms, poor semen parameters, decreased fertility, lower urinary tract symptoms, and prostate cancer. These associations are strengthened by the presence of SWSD, which affects up to 20% of shift workers. Unfortunately, interventions, such as planned naps, timed light exposure, melatonin, and sedative hypnotics, aimed at alleviating excessive nighttime sleepiness and daytime insomnia in non-standard shift workers experiencing SWSD, are limited and lack strong evidence to support their efficacy. Non-standard shift work has been associated with a variety of negative health outcomes and urologic complications, especially with concurrent SWSD. Recognition of these increased risks among shift workers can potentially aid in more effective screening of chronic health and urologic conditions. Non-pharmacologic treatment of SWSD focuses on behavioral therapy and sleep hygiene while melatonin, hypnotics, and stimulants are used to alleviate insomnia and excessive sleepiness of SWSD. Further research into both pharmacologic and non-pharmacologic therapies for SWSD is needed to establish more definitive guidelines in the treatment of SWSD in order to increase productivity, minimize workplace accidents, and improve quality of life for shift workers. Deng N, Kohn TP, Lipshultz LI, etal. The Relationship Between Shift Work and Men's Health. Sex Med Rev 2018;6:446-456.

Flexibility or Constraint? The Implications of Mothers’ and Fathers’ Nonstandard Schedules for Children’s Behavioral Outcomes

Approximately 17.7% of the U.S. workforce is employed in a nonstandard schedule. Research thus far indicates that these schedules negatively influence children’s behavioral development. However, few studies examine the roles of the child’s gender and age. To broaden understanding of the relationships between nonstandard schedules and child behavior, and how these relationships may depend on the gender and age of the child, I analyze data from the National Longitudinal Survey of Youth-1979 and its Child Supplement from 1992 to 2006. My findings show that some types of parental nonstandard shifts, such as evening and night shifts, are associated with fewer behavioral problems among children, though these results depend on the gender and age of the child. In contrast, parents’ rotating and split shifts are associated with more behavior problems among children, indicating that it is relatively unstable and unpredictable work schedules that may have the most harmful associations with children’s outcomes.

Parental nonstandard work schedules during infancy and children’s BMI trajectories

BACKGROUND: Empirical evidence has demonstrated adverse associations between parental nonstandard work schedules (i.e., evenings, nights, or weekends) and child developmental outcomes. However, there are mixed findings concerning the relationship between parental nonstandard employment and children’s body mass index (BMI), and few studies have incorporated information on paternal work schedules. OBJECTIVE: This paper investigated BMI trajectories from early to middle childhood (ages 3–11) by parental work schedules at 9 months of age, using nationally representative cohort data from the United Kingdom. This study is the first to examine the link between nonstandard work schedules and children’s BMI in the United Kingdom. METHODS: We used data from the Millennium Cohort Study (2001‒2013, n = 13,021) to estimate trajectories in BMI, using data from ages 3, 5, 7, and 11 years. Joint parental work schedules and a range of biological, socioeconomic, and psychosocial covariates were assessed in the initial interviews at 9 months. RESULTS: Compared to children in two-parent families where parents worked standard shifts, we found steeper BMI growth trajectories for children in two-parent families where both parents worked nonstandard shifts and children in single-parent families whose mothers worked a standard shift. Fathers’ shift work, compared to standard shifts, was independently associated with significant increases in BMI. CONCLUSIONS: Future public health initiatives focused on reducing the risk of rapid BMI gain in childhood can potentially consider the disruptions to family processes resulting from working nonstandard hours. CONTRIBUTION: Children in families in which both parents work nonstandard schedules had steeper BMI growth trajectories across the first decade of life. Fathers’ nonstandard shifts were independently associated with increases in BMI.

MP13-12 SHIFT WORKERS WITH SHIFT WORK SLEEP DISORDER HAVE INCREASED LOWER URINARY TRACT SYMPTOMS

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation1 Apr 2017MP13-12 SHIFT WORKERS WITH SHIFT WORK SLEEP DISORDER HAVE INCREASED LOWER URINARY TRACT SYMPTOMS John Sigalos, Javier Santiago, Edgar Kirby, Mark Hockenberry, Taylor Kohn, Stephen Pickett, Alexander Pastuszak, and Larry Lipshultz John SigalosJohn Sigalos More articles by this author , Javier SantiagoJavier Santiago More articles by this author , Edgar KirbyEdgar Kirby More articles by this author , Mark HockenberryMark Hockenberry More articles by this author , Taylor KohnTaylor Kohn More articles by this author , Stephen PickettStephen Pickett More articles by this author , Alexander PastuszakAlexander Pastuszak More articles by this author , and Larry LipshultzLarry Lipshultz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.455AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Non-standard shift workers, who regularly work hours outside a 7am-6pm workday, have an increased risk of lower urinary tract symptoms (LUTS) relative to daytime workers, and are also at increased risk for shift work sleep disorder (SWSD), a primary circadian rhythm disorder indicated by excessive daytime sleepiness associated with shiftwork. Here we examine the association between SWSD and LUTS in shift workers. METHODS Men presenting to a single andrology clinic between July 2014 and September 2016 completed questionnaires that assessed work schedule, SWSD risk, and LUTS (International Prostate Symptom Score (IPSS)). The impact of non-standard shift work and SWSD on IPSS score was assessed using ANOVA and linear regression. RESULTS Of the 2,487 men who completed the questionnaires, 766 (30.8%) reported working non-standard shifts in the past month. Of these, 282 (36.8%) were diagnosed with SWSD. Cohort characteristics are described in Table 1. When controlling for age, comorbidities (via the Charlson Comorbidity Index), and testosterone (T) levels, non-standard shift work was not associated with worse LUTS (P=0.99). However, non-standard shift workers diagnosed with SWSD had IPSS scores 3.1 points higher than non-standard shift workers without SWSD (P<0.0001). CONCLUSIONS Non-standard shift workers diagnosed with SWSD have worse LUTS than those without SWSD, suggesting that poor sleep habits, rather than shift work itself, contribute to worse LUTS. Modification of work and sleep schedules may reduce the risk for SWSD and subsequent LUTS. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e157-e158 Advertisement Copyright & Permissions© 2017MetricsAuthor Information John Sigalos More articles by this author Javier Santiago More articles by this author Edgar Kirby More articles by this author Mark Hockenberry More articles by this author Taylor Kohn More articles by this author Stephen Pickett More articles by this author Alexander Pastuszak More articles by this author Larry Lipshultz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...