Shift Schedule Research Articles

The Effects of Live-Fire Drills on Visual and Auditory Cognitive Performance among Firefighters.

Introduction:The nature of firefighters’ work is characterized by its unexpected emergencies, sleep deprivation, night shift schedules, and smoke exposure during firefighting.Methods:Eighteen firefighters were involved in simulated live-fire activities. Firefighters’ health status in terms of cardiovascular and mental conditions was checked by a physician and through reviewing their medical records. Firefighters’ cognitive functions were evaluated by visual and auditory continuous performance tests (VCPT and ACPT) and paced visual and auditory serial addition tests (PVSAT and PASAT).Results:VCPT and ACPT scores were lower after the activity relative to baseline. The results revealed that ACPT appears to be more difficult than VCPT. Also, PVSAT and PASAT scores decreased significantly after the experiment. PASAT scores following firefighting tasks experienced a more significant decline compared to those of the PVSAT.Conclusions:These findings suggest that firefighters have visual and auditory cognitive function problems following firefighting activities. In conclusion, auditory cognitive function was more influenced than the visual ability as a result of the experiment.

Healthcare worker attendance during the early stages of the COVID-19 pandemic: A longitudinal analysis of fingerprint-verified data from all public-sector secondary and tertiary care facilities in Bangladesh.

BackgroundThe COVID-19 pandemic has overwhelmed hospitals in several areas in high-income countries. An effective response to this pandemic requires health care workers (HCWs) to be present at work, particularly in low- and middle-income countries (LMICs) where they are already in critically low supply. To inform whether and to what degree policymakers in Bangladesh, and LMICs more broadly, should expect a drop in HCW attendance as COVID-19 continues to spread, this study aims to determine how HCW attendance has changed during the early stages of the COVID-19 pandemic in Bangladesh.MethodsThis study analyzed daily fingerprint-verified attendance data from all 527 public-sector secondary and tertiary care facilities in Bangladesh to describe HCW attendance from January 26, 2019 to March 22, 2020, by cadre, hospital type, and geographic division. We then regressed HCW attendance onto fixed effects for day-of-week, month, and hospital, as well as indicators for each of three pandemic periods: a China-focused period (January 11, 2020 (first confirmed COVID-19 death in China) until January 29, 2020), international-spread period (January 30, 2020 (World Health Organization’s declaration of a global emergency) until March 6, 2020), and local-spread period (March 7, 2020 (first confirmed COVID-19 case in Bangladesh) until the end of the study period).FindingsOn average between January 26, 2019 and March 22, 2020, 34.1% of doctors, 64.6% of nurses, and 70.6% of other health care staff were present for their scheduled shift. HCWs’ attendance rate increased with time in 2019 among all cadres. Nurses’ attendance level dropped by 2.5% points (95% confidence interval (CI) = -3.2% to -1.8%) and 3.5% points (95% CI = -4.5% to -2.5%) during the international-spread and the local-spread periods of the COVID-19 pandemic, relative to the China-focused period. Similarly, the attendance level of other health care staff declined by 0.3% points (95% CI = -0.8% to 0.2%) and 2.3% points (95% CI = -3.0% to -1.6%) during the international-spread and local-spread periods, respectively. Among doctors, however, the international-spread and local-spread periods were associated with a statistically significant increase in attendance by 3.7% points (95% CI = 2.5% to 4.8%) and 4.9% points (95% CI = 3.5% to 6.4%), respectively. The reduction in attendance levels across all HCWs during the local-spread period was much greater at large hospitals, where the majority of COVID-19 testing and treatment took place, than that at small hospitals.ConclusionsAfter a year of significant improvements, HCWs’ attendance levels among nurses and other health care staff (who form the majority of Bangladesh’s health care workforce) have declined during the early stages of the COVID-19 pandemic. This finding may portend an even greater decrease in attendance if COVID-19 continues to spread in Bangladesh. Policymakers in Bangladesh and similar LMICs should undertake major efforts to achieve high attendance levels among HCWs, particularly nurses, such as by providing sufficient personal protective equipment as well as monetary and non-monetary incentives.

Labor Planning and Shift Scheduling in Retail Stores Using Customer Traffic Data

Labor costs are one of the largest expenses of retail companies. This work develops a decision support tool to manage staffing levels and schedule working shifts, balancing the sales contribution of employees with salary costs. We extend recent empirical studies that estimate the impact of staffing levels on sales, combining detailed sales transaction and hourly customer traffic with employee staffing data. The empirical strategy uses exogenous deviations between the planned and actual schedule to identify the causal effect of staffing on conversion rates and basket value. This empirical model combined with traffic forecasting models are used as an input to a scheduling algorithm that optimizes the workforce schedule by balancing revenues with employee salaries, providing a feasible and detailed specification of working shifts that complies with labor regulations and other practical constraints. We also propose a robust optimization model to face uncertainties coming from the parameter estimation. The methodology is tested using real data from a children apparel retail chain in Latin America. The results suggest that most stores are understaffed during the weekends and at the same time overstaffed during lunch hours in weekdays, which is in part explained by the reduced flexibility imposed by regulatory restrictions for full-time workers. We show that our approach to optimize the workforce schedule can effectively improve the efficiency of the current labor plan of the company. Finally by using a robust approach we find staffing plans that produce less variance in the outcomes without losing too much in terms of expected revenue. The methods and models developed in this work have been integrated into a packaged solution for retail chains.

Work Characteristics, Body Mass Index, and Risk of Obesity: The National Quality of Work Life Survey.

To examine work characteristics in relation to body mass index (BMI) and risk of obesity. We analyzed data from 1150 participants working 20+ h week-1 from the 2014 National NIOSH Quality of Work Life Survey, based on a representative sample of US workers. We used multiple linear regression for BMI and multiple logistic regression for obesity to estimate associations with 19 different work characteristics plus one set of occupational categories controlling for age, gender, race/ethnicity, education, marital status, job physical exertion, and television watching. We found significant positive linear associations between BMI and night shift (versus day shift) schedule (B = 2.28, P = 0.008) and blue-collar (versus management/professional) work (B = 1.75, P = 0.008). Night shift schedule [odds ratio (OR) = 2.19, P = 0.029], sales/office work (OR = 1.55, P = 0.040), and blue-collar work (OR = 2.63, P = 0.006) were associated with increased risk of obesity versus 'healthy weight'. No other statistically significant associations between work characteristics and BMI or obesity were observed. Night shift schedule and blue-collar work were related to increased BMI and obesity risk in US workers in 2014. Identifying risk factors in blue-collar work and redesigning jobs to reduce those risk factors, and reducing night shift work, could play a role in reducing the prevalence of obesity in the USA.

Normal Tissue Complication Probability for Hematologic and Gastrointestinal Toxicity in Postoperative Whole Pelvic Radiotherapy for Gynecologic Malignancies using Intensity Modulated Proton Therapy with Robust Optimization

Hematologic toxicity (HT) and gastrointestinal toxicity (GI) are often observed in the postoperative whole pelvic radiotherapy (WPRT) for gynecologic malignancies since the irradiation field contains large volume of the bone marrow (BM) and bowel bag (BB). Although proton beam therapy with single field uniform dose optimization has a potential of the risk reduction of HT compared with intensity modulated X-ray therapy (IMXT), the risk reduction of GI has not been previously described. Thus, the aim of this in silico study was to evaluate the risk of HT and GI using intensity modulated proton therapy with robust optimization (robust IMPT). This dosimetric planning study included 9 patients who had previously undergone hysterectomy and WPRT at our institution from 2008 to 2020. For robust IMPT planning, we used two posterior oblique fields and a 3.5% beam specific margin from the distal and proximal edges of clinical target volume (CTV) in water equivalent space to discern the range uncertainty. The prescribed dose was 45 GyE in 25 fractions for 99% of the CTV (CTV D99). We evaluated CTV coverage using following indicators, CTV D99, conformity index (CI), homogeneity index (HI); dose volume statistics of BM received 10 and 20 GyE (BM V10 and BM V20), and BB received 40 GyE (BB V40); the planning robustness for CTV by shifting each 5 mm for six axes; and the risk of HT and GI using the Lyman-Kutcher-Burman normal tissue complication probability (LKB-NTCP) model. The parameters of LKB-NTCP model were determined to calculate the risk of grade ≥ 3 acute HT and chronic GI such as obstruction or perforation. We performed the comparative evaluation of NTCP value for HT and GI between robust IMPT and IMXT prescribed 45 GyE in 25 fractions for 95% of the planning target volume with 7-fields step and shoot technique. The Wilcoxon signed rank test was used for all statistical comparisons. In the LKB-NTCP modeling analysis, the NTCP values for robust IMPT were significantly lower than IMXT (HT: 0.06±0.02 for robust IMPT and 0.19±0.03 for IMXT, p<0.05, and GI: 0.01±0.004 for robust IMPT and 0.03±0.01 for IMXT, p<0.05, respectively). Moreover, robust IMPT was excellent CTV coverage; the mean and standard deviation of CTV D99, CI, and HI was 45.63±0.21 GyE, 1.00±0.001, and 0.03±0.01, respectively. The dose volume statistics for BM V10, BM V20 and BB V40 were 61.41±4.47%, 53.12±4.75%, and 17.77±3.45%, respectively. Changes in the mean value of CTV D99 in the shifted plan were within 2%, except for the anterior shift plan (left: -1.05%, right: -0.91%, superior: -0.97%, inferior: -1.17%, anterior: -2.59%, and posterior: -0.10%). Robust IMPT for WPRT reduced the risk of HT and GI without compromising CTV coverage, compared with IMXT. These results indicate that robust IMPT has a clinical advantage in reducing the risk of HT and GI in the treatment of gynecologic malignances.

A new mathematical formulation for a potash-mine shift scheduling problem with a simultaneous assignment of machines and workers

In this paper, we introduce a mixed-integer linear program for a shift scheduling problem in a German potash mine. In particular, we consider a short-term (work shift) production scheduling problem, where drill-and-blast mining operations have to be assigned to machines and workers simultaneously. Since we deal with several sequence-dependent setup, changeover, and removal times, TSP-variables are used in the mathematical program to determine the processing-sequence of the operations on each worker and each machine, respectively. In addition, several mining-specific requirements are taken into account to obtain a solution that can be put into practice. Computational experiments are conducted on problem instances of realistic size derived from real-world data. The results show that our new mixed-integer linear formulation outperforms both existing solution procedures for the problem at hand.

Efficient shift scheduling with multiple breaks for full-time employees: A retail industry case

A work shift scheduling methodology is presented that can assign shifts incorporating multiple breaks, providing the flexibility vital to service sector firms for reducing staff surpluses and shortages and thereby improve staff demand coverage. The proposed approach differs from previous works in the literature because it attempts to minimize the levels of overstaffing and understaffing, but also the possible negative impacts associated to a strategy of multiple breaks. The approach is built around four modules that implement a sequential iterative process to solve the scheduling problem. The first two modules use novel heuristic procedures to construct efficient break profiles that define the distribution of multiple breaks across a shift. The third module consists of a mixed-integer programming model that assigns shifts to full-time employees over a one-day planning horizon. The model uses the best break profiles constructed by the first two modules to minimize over/understaffing arising from demand seasonality. The fourth module compares the level of over/understaffing minimized by the model to the minimum possible level of over/understaffing, and if the former is not within a percentage considered to be satisfactory the entire procedure is iterated until a satisfactory solution is found. A test case using different daily demand profiles generated results showing that the level of over/understaffing obtained by the methodology under each profile was within 1 percentage point of the minimum possible despite assigning only one break additional to the mandatory meal break.

Learner Preference of Schedule Type Improves Engagement of Pediatric Residents: Results of a Mixed-Methods Analysis.

Determine whether a call or shift schedule is better for acquiring optimal knowledge and professionalism, while limiting fatigue for pediatric residents during the pediatric intensive care unit (PICU) rotation in a small residency program. This was a prospective, randomized, crossover, mixed-methods study in which pediatric residents were randomized to either a call or shift schedule during their PICU rotation. Attentiveness, bedside care, perceived knowledge, and professionalism were assessed by the resident participants, attending physicians, and nursing staff. Epworth Sleepiness Scale determined the level of resident fatigue. Statistical analysis utilized a t test of unequal variances. Two focus groups were conducted of resident non-participants and participants. Graduated resident participants and non-participants were surveyed via anonymous e-mail responses. Thirty residents participated in the study and twenty residents were surveyed and participated in a focus group. No major differences were detected between each participating group, whether assigned to a call or shift schedule in regard to perceived knowledge, professionalism, or fatigue. Overall themes from qualitative analysis identified advantages and disadvantages for both work schedules. Participants recognized a learner preference for schedule type depending on level of training, suggesting a shift schedule for junior residents and a call schedule for senior residents. There is no difference between the call or shift schedule in regard to residents' perceived knowledge, professionalism, and fatigue. Participants expressed learner preferences for one schedule over the other, recommending the shift schedule during the PGY-2 year and the call schedule during the PGY-3 year.

Features of modern approaches to the diagnosis and treatment of insomnia

Currently, insomnia is not only a medical, but also a social as well as an economic problem. Sleep disorders increase the risk of somatic, neurological and mental illnesses. The shift schedule has a significant impact on the employee’s health, increasing the risk of developing such disorders as metabolic syndrome, arterial hypertension and other. As a result of sleep disturbances, lipid peroxidation processes may intensify, which can lead to the disorders described above. Therefore, the prevention and treatment of sleep disorders is an important aspect of chronic diseases diagnostics. In our opinion, it is crucial to study possible sleep disorders for their timely correction. The article discusses the features of drug and non-drug treatment of sleep disorders, as well as approaches to the primary and secondary prevention of insomnia. It is recommended to begin the treatment of sleep disorders with cognitive-behavioral therapy. Cognitive-behavioral therapy for insomnia typically includes psycho-education, training in relaxation techniques, stimulation limitation method, sleep limitation therapy, and cognitive therapy. When developing recreational activities for employees with a shift work schedule, attention should be paid to work and rest regimes, prevention of fatigue and obesity, and the sleep disorders treatment. Training in sleep hygiene and improving its compliance in the target groups is regarded as a method of non-pharmacological treatment of sleep disorders and a means of primary and secondary prevention of insomnia. In our opinion, further research on the features of the prevention and treatment of insomnia in various population groups is needed. Effective primary and secondary prevention of sleep disorders will reduce the risks of developing neurological, somatic and mental diseases and significantly improve the quality of life.

The impact of the shift system on health and quality of life of sleep technicians

BackgroundSleep technicians are at high risk of shift work sleep disorders. We therefore aimed to identify the optimal shift system for sleep technicians. MethodsWe performed a nationwide survey of the work schedules, health and quality of life of sleep technicians using e-mail questionnaires including the Insomnia Severity Index (ISI), Epworth Sleep Scale (ESS), Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10), Short Form-12 Health Survey (SF-12), and Hospital Anxiety and Depression Scale (HADS) in Korea. A multivariate general linear model was used to assess the effect of shift schedules on health and quality of life. ResultsFifty-four technicians from 30 sleep laboratories participated. Their work schedules were classified as fixed night (F) (n = 18), slow rotation alternating from a night-only to a day-only schedule with a 3-months to one-year interval (S) (n = 20), rapid rotation within a week (R) (n = 5), night once a week (D+) (n = 5) and day (D) (n = 6). The adjusted ISI and HADS-anxiety scores were higher in F, S, and R than D and D+. Among night shift-dominant schedules, a less favorable profile was observed for R followed by F, and S regarding the ISI, FOSQ-10, mental SF-12 and HADS-depression. The physical SF-12 was lower in the order of R, S and F. The HADS-anxiety score was higher in the order of F, R and S. ConclusionsThe S system appears to have the least negative effect on health and quality of life among night shift-dominant systems. The development of consensus guidelines for scheduling shifts in sleep laboratories is urged.

"Baby Steps to Discharge": An Interprofessional, Developmental Milestone-Based Checklist for the Neonatal Intensive Care Unit.

"Baby Steps to Discharge": An Interprofessional, Developmental Milestone-Based Checklist for the Neonatal Intensive Care Unit.

A decision support system for scheduling the shifts of physicians during COVID-19 pandemic

The rapidly spreading COVID-19 pandemic has affected many people worldwide. Due to the high infectivity, countries make calls to stay at home or take measures such as lockdowns to ensure that people are least affected by the virus. Meanwhile, infected people are getting treatments: people who are slightly affected are quarantined at home, and those who are heavily affected are treated in hospitals. Hence there is an excessive increase in the hospital workload. This causes physical fatigue in healthcare professionals. Along with the increasing workload, the fear of being infected and infecting the environment causes psychological problems in healthcare professionals. It is important to protect healthcare professionals and provide them with suitable working conditions. For this reason, besides the provision of protective equipment such as gloves, overalls, mask, and glasses that are necessary for the protection of healthcare workers from the virus, healthcare services should also be planned very carefully. One of the critical issues is planning the shift schedules of the physicians. In this study, we handle the preparation of a physician shift schedule of a hospital in Turkey during the COVID-19 pandemic. The hospital has established three new COVID-19 related departments and the aim is to provide continuous service in the new departments while maintaining the workload in the existing departments. We propose a mixed integer programming (MIP) model to address the shift scheduling problem and transform it into a decision support system (DSS). The resulting schedules minimize the exposure of the physicians to the virus with a balanced workload while maintaining the healthcare service in all departments.

Eating Duration throughout a Rotating Shift Schedule: A Case Study

Objective The impact of the rotation between different shifts and free days within a short period of time on the food consumption is poorly addressed in the literature. Our objective was to characterize the eating duration (ED) over 10 d of clockwise rotating and to associate it with the intake of energy and macronutrients. Methods Thirty male shift-workers from a mining company were evaluated over a complete rotation shift schedule of 10 consecutive days (2 d of morning shifts, 2 d of afternoon shifts, 24 h free-day, 2 d of night shifts, and three free days). ED was defined as the interval between the first meal after awaking and last meal before sleep onset. Sleep/wake periods and food intake were evaluated by actigraphy and 24 h recalls, respectively. Generalized models were used to analyze the variation in ED and its association with nutrient intake over the shift schedule. Results ED periods showed significant variations throughout shift rotation and were associated with energy intake. The highest energy intake (3410 ± 235 kcal) and longest ED (20.7 ± 1.2 h) were found on Day 5, the day between afternoon and night shifts, and a part of Day 6 (night shift), i.e., in the longest period of wakefulness and the shortest sleep duration (4.7 ± 0.3 h) (p < 0.05 for all). The lowest energy intake (1284 ± 125 kcal) and shortest ED (4.96 ± 0.7 h) (p < 0.05) occurred after the last night shift (Day 7). The balance between the percentage of macronutrients did not differ statistically between the ED periods. Conclusions In general, longer periods of wakefulness showed greater energy intake, demonstrating the tendency of workers to eat around the clock during their shift. Even with the energy intake variation, the balance of macronutrients remained the same over the ED periods. Despite the need of confirmation in future studies, these results suggest that the management of ED period could be considered in the nutritional approach of shift workers.

Psychiatric care organization and mental health disorders in people of countries affected by the COVID-19 pandemic 2020 (Review)

In the context of the COVID-19 pandemic, 50 patients and 30 medical personnel were infected in a psychiatric hospital in Wuhan (Hubei Province, China), which required the Ministry of Health of China to urgently analyze the situation and develop a set of measures aimed at containing the spread of the virus and organizing a full and safe psychiatric care.&#x0D; The reasons for this situation could be the lack of reserve beds for psychiatric patients, low awareness of psychiatrists in diagnosing and treating infectious diseases, the separation of the psychiatric care system between the two departments, and the cramped living conditions of patients in psychiatric hospitals.&#x0D; More than 500 psychiatrists from across the country were sent to Wuhan to fill staff. Psychiatric patients with mild to moderate COVID-19 were transferred to temporary psychiatric hospitals organized in gymnasiums and exhibition centers. Severely ill psychiatric patients COVID-19 were transferred to hospital infectious diseases. A single patient routing system was organized, a shift schedule for doctors was introduced. To reduce the burden on public transport, the outpatient unit of psychiatric care was taken to regional hospitals, which had previously dealt only with forensic psychiatry and the control of patients with addictive disorders.&#x0D; Based on the experience of Wuhan, psychiatric communities from different countries proposed a list of practical recommendations designed to reduce the risks of spreading the infection and optimize the work of psychiatric care.&#x0D; All hospitals should have a reserve bed capacity, which can be used for the rehabilitation and socialization of patients in quiet times. Hospitals must be provided with a sufficient number of tests, drugs, and personal protective equipment. Outpatients need to be fully provided with access to medical and psychotherapeutic therapy using telemedicine technologies to minimize the risk of infection. It is crucial to restructure the appointment of doctors by introducing work on a shift schedule: two weeks in two weeks, which will not only ensure a good rest but also allow doctors to be quarantined after each shift.

Shift scheduling in multi-item production lines: a case study of a mineral water bottling company

It is well-known that the use of quantitative methods and modern analytics by companies in competitive markets is of vital importance both for their efficiency and financial profit. This study presents a novel, mathematical production-planning model for a real-world production optimisation problem of a company located in Northern Greece. The company produces non-alcoholic soft drinks and needs to continuously allocate its human resources in order to have the optimum profit. Therefore, the objective of the model is the minimisation of the company's idle human-hours subject to the fulfilment of the demand of customers. As algebraic modelling languages are well-suited for prototyping and developing optimisation models, this production planning, mathematical model is implemented in Python v3.7.3 and solved using Gurobi solver v9.0. Furthermore, we also describe the competitive advantages offered by our quantitative approach and the initial allocation plan by the company.

Introduction to the Special Issue “Parental work and family/child well-being”

The "new economy" is characterized by increasing levels of nonstandard employment. A significant proportion of employees work very long hours, work with high intensity, or have long commutes to work. Also, many workers struggle to secure adequate, stable employment or good quality jobs, and work evening and night shifts or work multiple jobs in order to make ends meet. This special issue examines the consequences of the new economy for the wellbeing of family and children. The studies included in this special issue address the impact of parents’ nonstandard work schedules (shift work), long work hours, temporary employment, and long commutes to work on parental and child health and wellbeing, relationship satisfaction, work-family balance, and the division of labour.

How to schedule night shift work in order to reduce health and safety risks.

Objectives:This discussion paper aims to provide scientifically based recommendations on night shift schedules, including consecutive shifts, shift intervals and duration of shifts, which may reduce health and safety risks. Short-term physiological effects in terms of circadian disruption, inadequate sleep duration and quality, and fatigue were considered as possible links between night shift work and selected health and safety risks, namely, cancer, cardio-metabolic disease, injuries, and pregnancy-related outcomes.Method:In early 2020, 15 experienced shift work researchers participated in a workshop where they identified relevant scientific literature within their main research area.Results:Knowledge gaps and possible recommendations were discussed based on the current evidence. The consensus was that schedules which reduce circadian disruption may reduce cancer risk, particularly for breast cancer, and schedules that optimize sleep and reduce fatigue may reduce the occurrence of injuries. This is generally achieved with fewer consecutive night shifts, sufficient shift intervals, and shorter night shift duration.Conclusions:Based on the limited, existing literature, we recommend that in order to reduce the risk of injuries and possibly breast cancer, night shift schedules have: (i) ≤3 consecutive night shifts; (ii) shift intervals of ≥11 hours; and (iii) ≤9 hours shift duration. In special cases – eg, oil rigs and other isolated workplaces with better possibilities to adapt to daytime sleep – additional or other recommendations may apply. Finally, to reduce risk of miscarriage, pregnant women should not work more than one night shift in a week.

Circulating Exosomal miRNAs Signal Circadian Misalignment to Peripheral Metabolic Tissues

Night shift work increases risk of metabolic disorders, particularly obesity and insulin resistance. While the underlying mechanisms are unknown, evidence points to misalignment of peripheral oscillators causing metabolic disturbances. A pathway conveying such misalignment may involve exosome-based intercellular communication. Fourteen volunteers were assigned to a simulated day shift (DS) or night shift (NS) condition. After 3 days on the simulated shift schedule, blood samples were collected during a 24-h constant routine protocol. Exosomes were isolated from the plasma samples from each of the blood draws. Exosomes were added to naïve differentiated adipocytes, and insulin-induced pAkt/Akt expression changes were assessed. ChIP-Seq analyses for BMAL1 protein, mRNA microarrays and exosomal miRNA arrays combined with bioinformatics and functional effects of agomirs and antagomirs targeting miRNAs in NS and DS exosomal cargo were examined. Human adipocytes treated with exosomes from the NS condition showed altered Akt phosphorylation responses to insulin in comparison to those treated with exosomes from the DS condition. BMAL1 ChIP-Seq of exosome-treated adipocytes showed 42,037 binding sites in the DS condition and 5538 sites in the NS condition, with a large proportion of BMAL1 targets including genes encoding for metabolic regulators. A significant and restricted miRNA exosomal signature emerged after exposure to the NS condition. Among the exosomal miRNAs regulated differentially after 3 days of simulated NS versus DS, proof-of-concept validation of circadian misalignment signaling was demonstrated with hsa-mir-3614-5p. Exosomes from the NS condition markedly altered expression of key genes related to circadian rhythm in several cultured cell types, including adipocytes, myocytes, and hepatocytes, along with significant changes in 29 genes and downstream gene network interactions. Our results indicate that a simulated NS schedule leads to changes in exosomal cargo in the circulation. These changes promote reduction of insulin sensitivity of adipocytes in vitro and alter the expression of core clock genes in peripheral tissues. Circulating exosomal miRNAs may play an important role in metabolic dysfunction in NS workers by serving as messengers of circadian misalignment to peripheral tissues.

Subjective and objective assessments after a change from a 4-crew, 12-h shift to a 3-crew, 12-h shift schedule: an observational study.

To clarify the subjective and objective impacts of a change in a 12-h shift schedule, involving a reduction in the number of crews, on workers at an electronic parts production company. Forty-two workers participated in this study. Subjective indicators (e.g. questionnaires) and objective indicators [e.g., psychomotor vigilance task (PVT)], as well as an activity monitor-based sleep assessment, were measured during a > 1-year period that encompassed the shift schedule change. The study outcome was a comparison of work-related injury rates measured 1year before and after the change in shift schedule. After the shift schedule change, questionnaire scores regarding work-related burdens and PVT performance parameters, including mean response time and number of lapses, increased significantly. However, we also observed divergences in the trends of the subjective and objective measures 1year after the change. Despite these variations in both types of measures, we observed no significant differences in work-related injury rates measured before and after the shift schedule change. This study revealed that a reduction in the number of crews in a 12-h shift schedule has a negative impact on the subjective and objective indicator after the change in shift schedule; only indicators of alertness did not recover at 1year after the change. Assessments of the workers' performances and the regular implementation of health and safety programs for more than 1year are needed to maintain workers' health after the change in shift schedule.

Ambulatory blood pressure monitoring among emergency medical services night shift workers

ObjectivesHigher 24-hour blood pressure (BP) and blunted BP dipping during sleep and night-time hours are associated with adverse health outcomes. Night shift work may affect 24-hour BP and dipping patterns,...