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Fagundo-Rivera J, Allande-Cussó R, Ortega-Moreno M, García-Iglesias JJ, Romero A, Ruiz-Frutos C, Gómez-Salgado J. Implications of Lifestyle and Occupational Factors on the Risk of Breast Cancer in Shiftwork Nurses. Healthcare (Basel) 2021; 9:649. [PMID: 34070908 PMCID: PMC8228409 DOI: 10.3390/healthcare9060649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 11/21/2022] Open
Abstract
Shift work that involves circadian disruption has been highlighted as a likely carcinogenic factor for breast cancer in humans. Also, unhealthy lifestyle habits observed in night work nurses could be causally related to an increase in the incidence of estrogen-positive breast tumours in this population. Assessing baseline risk of breast cancer in nurses is essential. The objective of this study was to analyze the risk of breast cancer that nurses had in relation to their lifestyle and labour factors related to shift work. A cross-sectional descriptive study through a questionnaire about sociodemographic variables, self-perception of health, and working life was designed. The sample consisted of 966 nurses. The relationship between variables was tested. A binary logistic regression and a classification and regression tree were performed. The most significant labour variables in relation to the risk of breast cancer were the number of years worked (more than 16 years; p < 0.01; OR = 8.733, 95% CI = 2.811, 27.134) and the total years performing more than 3 nights per month (10 or more years; p < 0.05; OR = 2.294, 95% CI = 1.008, 5.220). Also, the nights worked throughout life (over 500; OR = 4.190, 95% CI = 2.118, 8.287) were significant in the analysis. Nurses who had or ever had breast cancer valued their self-perceived health more negatively (p < 0.001) and referred a lower quality of sleep (p < 0.001) than the non-cases nurses. The occupational factors derived from night work could have several impacts on nurses' health and their family-work balance. Promoting healthy lifestyles, informing about shift work risks, and adjusting shift work schedules are critical methods to decrease the possible effects of circadian disruption in nurses.
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Affiliation(s)
- Javier Fagundo-Rivera
- Health Sciences Doctorate School, University of Huelva, 21071 Huelva, Spain;
- Centro Universitario de Enfermería Cruz Roja, University of Seville, 41009 Seville, Spain
- Escola Superior de Saúde, Universidade Atlântica, 2730-036 Barcarena, Portugal
| | | | - Mónica Ortega-Moreno
- Department of Economy, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain;
| | - Juan Jesús García-Iglesias
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain; (C.R.-F.); (J.G.-S.)
| | - Adolfo Romero
- Nursing and Podiatry Department, Health Sciences School, University of Malaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain
| | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain; (C.R.-F.); (J.G.-S.)
- Safety and Health Postgraduate Programme, Espíritu Santo University, Guayaquil 092301, Ecuador
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain; (C.R.-F.); (J.G.-S.)
- Safety and Health Postgraduate Programme, Espíritu Santo University, Guayaquil 092301, Ecuador
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Gómez-Salgado J, Fagundo-Rivera J, Ortega-Moreno M, Allande-Cussó R, Ayuso-Murillo D, Ruiz-Frutos C. Night Work and Breast Cancer Risk in Nurses: Multifactorial Risk Analysis. Cancers (Basel) 2021; 13:1470. [PMID: 33806956 PMCID: PMC8004617 DOI: 10.3390/cancers13061470] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/15/2021] [Accepted: 03/19/2021] [Indexed: 02/07/2023] Open
Abstract
Night work has been highlighted by the International Agency for Research on Cancer (IARC) as a likely carcinogenic factor for humans, associated with breast cancer and professions that require continuity of work. Knowing the impact that short and long-term night work has on the nurses' collective seems a priority, therefore, this study aims to analyse the relationship between night work and the development of breast cancer risk factors in nurses. For this, a cross-sectional study through an online questionnaire on breast cancer risk variables and working life was designed. The study was conducted in Spain and the sample consisted of 966 nurses, of whom 502 were healthy participants and 56 were breast cancer patients. These two groups were compared in the analyses. A descriptive analysis was performed, and the relationship was tested using χ2 independence test and OR calculation. The CHAID (Chi Square Automatic Interaction Detection) data mining method allowed for the creation of a segmentation tree for the main risk variables. The most significant risk variables related to working life have been the number of years worked, nights worked throughout life, and years working more than 3 nights per month. Exceeding 16 years of work has been significant for women and men. When the time worked is less than 16 years, the number of cases increases if there is a family history of cancer and if there have been more than 500 nights of work. High-intensity night work seems more harmful at an early age. The accumulation of years and nights worked increase the risk of breast cancer when factors such as sleep disturbance, physical stress, or family responsibilities come together.
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Affiliation(s)
- Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain;
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
| | - Javier Fagundo-Rivera
- Health Sciences Doctorate School, University of Huelva, 21071 Huelva, Spain;
- Centro Universitario de Enfermería Cruz Roja, University of Seville, 41009 Seville, Spain
- Escola Superior de Saúde, Universidade Atlântica, 2730-036 Barcarena, Portugal
| | - Mónica Ortega-Moreno
- Department of Economy, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain;
| | | | | | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain;
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
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Arechavala T, Continente X, Pérez-Ríos M, Fernández E, Cortés-Francisco N, Schiaffino A, Centrich F, Muñoz G, López MJ. Validity of self-reported indicators to assess secondhand smoke exposure in the home. ENVIRONMENTAL RESEARCH 2018; 164:340-345. [PMID: 29567419 DOI: 10.1016/j.envres.2018.03.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/06/2018] [Accepted: 03/08/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Questionnaires are widely used to assess secondhand smoke (SHS) exposure. However, the validity of self-reported SHS exposure indicators has been rarely assessed. We aimed to assess correlations, sensitivity, specificity, and predictive values between self-reported SHS exposure indicators and airborne nicotine concentrations. METHODS We performed a cross-sectional study with a convenience sample of 175 homes in Barcelona and Santiago de Compostela, Spain. Airborne nicotine samples were collected from participants' homes and a self-administered questionnaire was completed on SHS exposure in the home. Spearman correlations coefficients and sensitivity, specificity and predictive values were assessed between self-reported SHS exposure indicators and nicotine concentrations in the home. RESULTS All self-reported SHS exposure indicators correlated moderately strongly with airborne nicotine concentrations (Spearman correlations coefficient ranging from 0.58 to 0.65). Moreover, sensitivities and negative predictive values between self-reported indicators and the presence of nicotine in the home were below 66.4% while specificities and positive predictive values were over 78.4%. The "number of people usually smoking in the home" showed the best results (rs = 0.65, p < 0.001; sensitivity = 50.4%, specificity = 95.2%, PPV = 95.0, NPV = 51.3). CONCLUSIONS The self-reported SHS indicators assessed in this study showed moderate and strong correlations, low sensitivities, and high specificities. Among them, the best results were obtained with the "number of people usually smoking in the home".
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Affiliation(s)
- Teresa Arechavala
- Agència de Salut Pública de Barcelona, Servei d'Avaluació i Mètodes d'Intervenció, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, Madrid, Spain; Universitat Pompeu Fabra (UPF), Department of Experimental and Health Science, Barcelona, Spain
| | - Xavier Continente
- Agència de Salut Pública de Barcelona, Servei d'Avaluació i Mètodes d'Intervenció, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, Madrid, Spain; Institut d'investigació Biomèdica Sant Pau (IIB St. Pau), Barcelona, Spain
| | - Mónica Pérez-Ríos
- CIBER de Epidemiología y Salud Pública, Madrid, Spain; Epidemiology Unit, Galician Directorate for Public Health, Galician Health Authority, Xunta de Galicia, Santiago de Compostela, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Santiago de Compostela, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Campus de Bellvitge, School of Medicine and Health Sciences, Universitat de Barcelona, L'Hospitalet de llobregat, Barcelona, Spain
| | - Núria Cortés-Francisco
- Agència de Salut Pública de Barcelona, Servei d'Avaluació i Mètodes d'Intervenció, Barcelona, Spain; Institut d'investigació Biomèdica Sant Pau (IIB St. Pau), Barcelona, Spain
| | - Anna Schiaffino
- Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Direcció General de Planificació en Salut, Departament de Salut, Generalitat de Catalunya, Spain
| | - Francesc Centrich
- Agència de Salut Pública de Barcelona, Servei d'Avaluació i Mètodes d'Intervenció, Barcelona, Spain
| | - Glòria Muñoz
- Agència de Salut Pública de Barcelona, Servei d'Avaluació i Mètodes d'Intervenció, Barcelona, Spain
| | - María José López
- Agència de Salut Pública de Barcelona, Servei d'Avaluació i Mètodes d'Intervenció, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, Madrid, Spain; Universitat Pompeu Fabra (UPF), Department of Experimental and Health Science, Barcelona, Spain; Institut d'investigació Biomèdica Sant Pau (IIB St. Pau), Barcelona, Spain.
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Martínez-Sánchez JM, González-Marrón A, Martín-Sánchez JC, Sureda X, Fu M, Pérez-Ortuño R, Lidón-Moyano C, Galán I, Pascual JA, Fernández E. Validity of self-reported intensity of exposure to second-hand smoke at home against environmental and personal markers. GACETA SANITARIA 2017; 32:393-395. [PMID: 29102505 DOI: 10.1016/j.gaceta.2017.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/03/2017] [Accepted: 08/08/2017] [Indexed: 11/18/2022]
Abstract
The objective of this study was to assess the validity of two questions about the perception of intensity of exposure to secondhand smoke (SHS) at home using as a reference environmental markers (airborne nicotine and benzene) and biomarkers of exposure (cotinine in saliva and urine). This was a cross-sectional study in a convenience sample of 49 non-smoking volunteers. We found a high correlation between self-reported SHS exposure and airborne nicotine (rsp=0.806, p<0.05), salivary cotinine (rsp=0.752, p<0.05), and urinary cotinine (rsp=0.626, p<0.05). We did not find differences between the score question and the conventional ones (p >0.05). In conclusion, the significant correlation of the two questions proposed with environmental markers and personal markers indicates their potential validity to assess exposure to SHS at home.
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Affiliation(s)
- José M Martínez-Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain; Tobacco Control Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Adrián González-Marrón
- Group of Evaluation of Health Determinants and Health Policies, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Juan Carlos Martín-Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Xisca Sureda
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Raúl Pérez-Ortuño
- Group of Integrative Pharmacology and Systems Neuroscience, Neurosciences Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Cristina Lidón-Moyano
- Group of Evaluation of Health Determinants and Health Policies, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Iñaki Galán
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - José Antonio Pascual
- Group of Integrative Pharmacology and Systems Neuroscience, Neurosciences Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
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