1
|
da Silva Paula VM, de Moraes Bruna CQ, Ciofi Silva CL, de Souza Hajar K, Eduardo Galvão C, Uchikawa Graziano K. Fractional exhaled nitric oxide and respiratory symptoms in central sterile supply department workers exposed to different ventilation systems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2025:1-10. [PMID: 39812446 DOI: 10.1080/09603123.2025.2452299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 01/08/2025] [Indexed: 01/16/2025]
Abstract
OBJECTIVE To verify the association between different types of ambient ventilation in Central Sterile Supply Department (CSSD), fractional exhaled nitric oxide (FeNO) values, and respiratory symptoms of workers . METHODS CSSD workers from five hospitals were evaluated in three different ventilation systems: negative air pressure, air conditioning, and natural ventilation. The prevalence of respiratory symptoms was evaluated by The European Community Respiratory Health Survey. The respiratory inflammatory response was evaluated utilizing FeNO level measurements. RESULTS There was a general prevalence of respiratory symptoms in 5% of the workers investigated; there was no association between respiratory symptoms and ventilation systems (p = 0.170). Of the total workers investigated, 22% had FeNO levels ≥ 25 parts per billion (ppb), considered above the normal range, and there was a statistically significant difference between ventilation systems (p = 0.009) favoring natural ventilation. CONCLUSION Exposure to the natural ventilation system reduced the chance of developing FeNO levels ≥ 25 by 94.3%.
Collapse
Affiliation(s)
| | | | | | - Karina de Souza Hajar
- Department Outpatient Diagnostic Medicine Consultant, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Clóvis Eduardo Galvão
- Department of Clinical Immunology and Allergy, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | | |
Collapse
|
2
|
de Assis LVM, Kramer A. Circadian de(regulation) in physiology: implications for disease and treatment. Genes Dev 2024; 38:933-951. [PMID: 39419580 PMCID: PMC11610937 DOI: 10.1101/gad.352180.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2024]
Abstract
Time plays a crucial role in the regulation of physiological processes. Without a temporal control system, animals would be unprepared for cyclic environmental changes, negatively impacting their survival. Experimental studies have demonstrated the essential role of the circadian system in the temporal coordination of physiological processes. Translating these findings to humans has been challenging. Increasing evidence suggests that modern lifestyle factors such as diet, sedentarism, light exposure, and social jet lag can stress the human circadian system, contributing to misalignment; i.e., loss of phase coherence across tissues. An increasing body of evidence supports the negative impact of circadian disruption on several human health parameters. This review aims to provide a comprehensive overview of how circadian disruption influences various physiological processes, its long-term health consequences, and its association with various diseases. To illustrate the relevant consequences of circadian disruption, we focused on describing the many physiological consequences faced by shift workers, a population known to experience high levels of circadian disruption. We also discuss the emerging field of circadian medicine, its founding principles, and its potential impact on human health.
Collapse
Affiliation(s)
| | - Achim Kramer
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin, Laboratory of Chronobiology, Berlin Institute of Health, 10117 Berlin, Germany
| |
Collapse
|
3
|
Liu J, Wang P, Shang L, Ye F, Liu L, He Z. Adverse Associations of Long-Term Exposure to PM 2.5 and Its Components with Platelet Traits among Subway Shift-Workers without Air Purifier Use. TOXICS 2024; 12:529. [PMID: 39195631 PMCID: PMC11359941 DOI: 10.3390/toxics12080529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/09/2024] [Accepted: 07/11/2024] [Indexed: 08/29/2024]
Abstract
Air purifier use, shift work, and long-term exposure to fine particulate matter (PM2.5) are linked to platelet abnormality. However, the role of air purifier use and shift work in the individual or joint associations of PM2.5 and its components with platelet indices are largely unknown. A total of 8772 participants were recruited from a population of subway workers in China. PM2.5 and its component data were obtained from the Tracking Air Pollution in China dataset. The role of air purifier use and shift work in the association between PM2.5 and its components and platelet indices were analyzed. Among shift workers without air purifier use, positive associations of PM2.5 and each component in PM2.5 with the mean platelet volume (MPV) or platelet counts (PLT) were observed, whereas negative associations of PM2.5 and each component in PM2.5 with the platelet distribution width (PDW) were observed. Furthermore, estimated changes (95%CIs) in PLT, MPV, and PDW in response to each 10th percentile increment in the mixture of PM2.5 and its components were 0.8657 (0.2496, 1.4819), 0.0192 (0.0054, 0.0329), and -0.0648 (-0.0945, -0.0351), respectively, and sulfate in PM2.5 was the major contributor to those associations. Long-term exposure to PM2.5 and its components was related to increased platelet disorders among shift workers without air purifier use, and those associations were mainly attributed to sulfate in PM2.5.
Collapse
Affiliation(s)
- Junling Liu
- Wuhan Center for Disease Control and Prevention, Wuhan 430024, China; (J.L.); (P.W.); (L.S.)
| | - Pei Wang
- Wuhan Center for Disease Control and Prevention, Wuhan 430024, China; (J.L.); (P.W.); (L.S.)
| | - Lv Shang
- Wuhan Center for Disease Control and Prevention, Wuhan 430024, China; (J.L.); (P.W.); (L.S.)
| | - Fang Ye
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (F.Y.); (L.L.)
| | - Li Liu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (F.Y.); (L.L.)
| | - Zhenyu He
- Wuhan Center for Disease Control and Prevention, Wuhan 430024, China; (J.L.); (P.W.); (L.S.)
| |
Collapse
|
4
|
Thorkildsen MS, Gustad LT, Damås JK. The Effects of Shift Work on the Immune System: A Narrative Review. Sleep Sci 2023; 16:e368-e374. [PMID: 38196768 PMCID: PMC10773516 DOI: 10.1055/s-0043-1772810] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/23/2022] [Indexed: 01/11/2024] Open
Abstract
Working a shift work schedule has been hypothesized to have negative effects on health. One such described consequence is altered immune response and increased risk of infections. Former reviews have concluded that more knowledge is needed to determine how shift work affects the immune system. Since the last review focusing on this subject was published in 2016, new insight has emerged. We performed a search of the topic in PubMed, Scopus and Embase, identifying papers published after 2016, finding a total of 13 new studies. The articles identified showed inconsistent effect on immune cells, cytokines, circadian rhythms, self-reported infections, and vaccine response as a result of working a shift schedule. Current evidence suggests working shifts influence the immune system, however the clinical relevance and the mechanism behind this potential association remains elusive. Further studies need to include longitudinal design and objective measures of shift work and immune response.
Collapse
Affiliation(s)
- Marianne Stenbekk Thorkildsen
- Gemini Center for Sepsis Research at Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway
| | - Lise Tuset Gustad
- Gemini Center for Sepsis Research at Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Trøndelag, Norway
- Department of Medicine and Rehabilitation, Levanger Hospital, Levanger, Trøndelag, Norway
| | - Jan Kristian Damås
- Gemini Center for Sepsis Research at Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway
- Centre of Molecular Inflammation Research, Norwegian University og Science and Technology, Trondheim, Trøndelag, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway
- Department of Infectious Diseases, St. Olavs Hospital, Trondheim, Trøndelag, Norway
| |
Collapse
|
5
|
Wang H, Han M, Avouka T, Chen R, Wang J, Wei R. Research on fatigue identification methods based on low-load wearable ECG monitoring devices. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2023; 94:045103. [PMID: 38081271 DOI: 10.1063/5.0138073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/17/2023] [Indexed: 12/18/2023]
Abstract
The identification of fatigue in personal workers in particular environments can be achieved through early warning techniques. In order to prevent excessive fatigue of medical workers staying in infected areas in the early phase of the coronavirus disease pandemic, a system of low-load wearable electrocardiogram (ECG) devices was used as intelligent acquisition terminals to perform a continuous measurement ECG collection. While machine learning (ML) algorithms and heart rate variability (HRV) offer the promise of fatigue detection for many, there is a demand for ever-increasing reliability in this area, especially in real-life activities. This study proposes a random forest-based classification ML model to identify the four categories of fatigue levels in frontline medical workers using HRV. Based on the wavelet transform in ECG signal processing, stationary wavelet transform was applied to eliminate the main perturbation of ECG in the motion state. Feature selection was performed using ReliefF weighting analysis in combination with redundancy analysis to optimize modeling accuracy. The experimental results of the overall fatigue identification achieved an accuracy of 97.9% with an AUC value of 0.99. With the four-category identification model, the accuracy is 85.6%. These results proved that fatigue analysis based on low-load wearable ECG monitoring at low exertion can accurately determine the level of fatigue of caregivers and provide further ideas for researchers working on fatigue identification in special environments.
Collapse
Affiliation(s)
- Huiquan Wang
- School of Life Sciences, TianGong University, Tianjin 300387, China
- Tianjin Engineering Research Center of Biomedical Electronic Technology, Tianjin 300387, China
- Tianjin Key Laboratory of Quality Control and Evaluation Technology for Medical Devices, Tianjin 300384, China
| | - Mengting Han
- School of Life Sciences, TianGong University, Tianjin 300387, China
- Tianjin Engineering Research Center of Biomedical Electronic Technology, Tianjin 300387, China
- Tianjin Key Laboratory of Quality Control and Evaluation Technology for Medical Devices, Tianjin 300384, China
| | - Tasmia Avouka
- School of Life Sciences, TianGong University, Tianjin 300387, China
- Tianjin Engineering Research Center of Biomedical Electronic Technology, Tianjin 300387, China
- Tianjin Key Laboratory of Quality Control and Evaluation Technology for Medical Devices, Tianjin 300384, China
| | - Ruijuan Chen
- School of Life Sciences, TianGong University, Tianjin 300387, China
- Tianjin Engineering Research Center of Biomedical Electronic Technology, Tianjin 300387, China
- Tianjin Key Laboratory of Quality Control and Evaluation Technology for Medical Devices, Tianjin 300384, China
| | - Jinhai Wang
- School of Life Sciences, TianGong University, Tianjin 300387, China
- Tianjin Engineering Research Center of Biomedical Electronic Technology, Tianjin 300387, China
- Tianjin Key Laboratory of Quality Control and Evaluation Technology for Medical Devices, Tianjin 300384, China
| | - Ran Wei
- School of Life Sciences, TianGong University, Tianjin 300387, China
- Tianjin Engineering Research Center of Biomedical Electronic Technology, Tianjin 300387, China
- Tianjin Key Laboratory of Quality Control and Evaluation Technology for Medical Devices, Tianjin 300384, China
| |
Collapse
|
6
|
Stenger S, Grasshoff H, Hundt JE, Lange T. Potential effects of shift work on skin autoimmune diseases. Front Immunol 2023; 13:1000951. [PMID: 36865523 PMCID: PMC9972893 DOI: 10.3389/fimmu.2022.1000951] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/29/2022] [Indexed: 02/16/2023] Open
Abstract
Shift work is associated with systemic chronic inflammation, impaired host and tumor defense and dysregulated immune responses to harmless antigens such as allergens or auto-antigens. Thus, shift workers are at higher risk to develop a systemic autoimmune disease and circadian disruption with sleep impairment seem to be the key underlying mechanisms. Presumably, disturbances of the sleep-wake cycle also drive skin-specific autoimmune diseases, but epidemiological and experimental evidence so far is scarce. This review summarizes the effects of shift work, circadian misalignment, poor sleep, and the effect of potential hormonal mediators such as stress mediators or melatonin on skin barrier functions and on innate and adaptive skin immunity. Human studies as well as animal models were considered. We will also address advantages and potential pitfalls in animal models of shift work, and possible confounders that could drive skin autoimmune diseases in shift workers such as adverse lifestyle habits and psychosocial influences. Finally, we will outline feasible countermeasures that may reduce the risk of systemic and skin autoimmunity in shift workers, as well as treatment options and highlight outstanding questions that should be addressed in future studies.
Collapse
Affiliation(s)
- Sarah Stenger
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Hanna Grasshoff
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
| | - Jennifer Elisabeth Hundt
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
- Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
| | - Tanja Lange
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
- Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
- Center of Brain, Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| |
Collapse
|
7
|
Bjorvatn B, Merikanto I, Reis C, Korman M, Bjelajac AK, Holzinger B, De Gennaro L, Wing YK, Morin CM, Espie CA, Benedict C, Landtblom AM, Matsui K, Hrubos-Strøm H, Mota-Rolim S, Nadorff MR, Plazzi G, Chan RNY, Partinen M, Dauvilliers Y, Chung F, Forthun I. Shift workers are at increased risk of severe COVID-19 compared with day workers: Results from the international COVID sleep study (ICOSS) of 7141 workers. Chronobiol Int 2023; 40:114-122. [PMID: 36412198 DOI: 10.1080/07420528.2022.2148182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 11/23/2022]
Abstract
The present study had two main aims. First, to investigate whether shift/night workers had a higher prevalence and severity of COVID-19 compared with day workers. Second, to investigate whether people regularly working in face-to-face settings during the pandemic exhibited a higher prevalence and severity of COVID-19 compared with those having no need to be in close contact with others at work. Data consisted of 7141 workers from 15 countries and four continents who participated in the International COVID Sleep Study-II (ICOSS-II) between May and December 2021. The associations between work status and a positive COVID-19 test and several indications of disease severity were tested with chi-square tests and logistic regressions adjusted for relevant confounders. In addition, statistical analyses were conducted for the associations between face-to-face work and COVID-19 status. Results showed that shift/night work was not associated with an increased risk of COVID-19 compared to day work. Still, shift/night workers reported higher odds for moderate to life-threatening COVID-19 (adjusted odds ratio (aOR) = 2.71, 95%-confidence interval = 1.23-5.95) and need for hospital care (aOR = 5.66, 1.89-16.95). Face-to-face work was associated with an increased risk of COVID-19 (aOR = 1.55, 1.12-2.14) but not with higher disease severity. In conclusion, shift/night work was not associated with an increased risk of COVID-19, but when infected, shift/night workers reported more severe disease. Impaired sleep and circadian disruption commonly seen among shift/night workers may be mediating factors. Working face-to-face increased the risk of COVID-19, likely due to increased exposure to the virus. However, face-to-face work was not associated with increased disease severity.
Collapse
Affiliation(s)
- Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway and Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Ilona Merikanto
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland and Orton Orthopaedics Hospital, Helsinki, Finland
| | - Catia Reis
- Universidade Católica Portuguesa, Católica Research Centre for Psychological, Family and Social Wellbeing, Lisbon, Portugal and Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina de Lisboa, Lisboa, Portugal
| | - Maria Korman
- Department of Occupational Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | | | - Brigitte Holzinger
- Institute for Consciousness and Dream Research, Medical University of Vienna, Wien, Postgraduate, Sleep Coaching, Vienna, Austria
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Roma, Lazio, Italy and IRCCS Fondazione Santa Lucia, Roma, Italy
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Charles M Morin
- Centre de recherche CERVO/Brain Research Center, École de psychologie, Université Laval, Quebec, Quebec, Canada
| | - Colin A Espie
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Christian Benedict
- Department of Pharmaceutical Biosciences, Molecular Neuropharmacology, Uppsala University, Uppsala, Sweden
| | - Anne-Marie Landtblom
- Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Kentaro Matsui
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Harald Hrubos-Strøm
- Department of Otorhinolaryngology, Akershus University Hospital, Lørenskog, Norway and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sérgio Mota-Rolim
- Brain Institute, Physiology and Behavior Department and Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Michael R Nadorff
- Department of Psychology, Mississippi State University, Mississippi, Mississippi, USA
| | - Giuseppe Plazzi
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy; and Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Rachel Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Markku Partinen
- Department of Clinical Neurosciences, University of Helsinki Clinicum Unit, Helsinki, Finland and Helsinki Sleep Clinic, Terveystalo Healthcare Services, Helsinki, Finland
| | - Yves Dauvilliers
- Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier, Montpellier, France
| | - Frances Chung
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Ingeborg Forthun
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway and Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
8
|
He W, Ma P, Li X, Wang Y, Zhang Y. Comparison of peripheral blood T, B, and NK lymphocytes between frontline medical workers for treating patients of COVID-19 and normal outpatient and emergency medical workers in China. Front Psychiatry 2023; 14:1165614. [PMID: 37151983 PMCID: PMC10155498 DOI: 10.3389/fpsyt.2023.1165614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/30/2023] [Indexed: 05/09/2023] Open
Abstract
The outbreak of the novel coronavirus disease 2019 (COVID-19) has led to significant mental stress for frontline medical workers treating patients with confirmed COVID-19 in China. Psychological stress has an impact on the immune system. The number and percentage of lymphocyte subsets are standard indicators of cellular immune detection. Here, we reported the differences in CD3, CD4, CD8, CD19, and CD56 lymphocytes between 158 frontline medical workers and 24 controls from medical staffs of the outpatient and emergency departments. We found that frontline medical workers had significantly lower absolute values and percentages of CD19+ B cells, especially in the female and the aged ≥40 years subgroup. Stratification analysis showed that the absolute values of CD4+ T cells were significantly lower in the aged <40 years subgroup, while percentages of CD8+ T cells were lower and percentages of CD56+ NK cells were higher in the aged ≥40 years subgroup. In summary, this study suggests paying more attention to frontline medical workers' mental health and immune function, and properly providing them with psychological interventions and measures of care.
Collapse
Affiliation(s)
- Weijian He
- China-Japan Union Hospital of Jilin University, Changchun, China
- The Third Norman Bethune Clinical College of Jilin University, Changchun, China
| | - Piyong Ma
- Department of Critical Care Medicine, China–Japan Union Hospital of Jilin University, Changchun, China
| | - Xiuying Li
- Scientific Research Center, China–Japan Union Hospital of Jilin University, Changchun, China
| | - Yali Wang
- Department of Blood Transfusion, China–Japan Union Hospital of Jilin University, Changchun, China
- *Correspondence: Yucheng Zhang, ; Yali Wang,
| | - Yucheng Zhang
- Scientific Research Center, China–Japan Union Hospital of Jilin University, Changchun, China
- *Correspondence: Yucheng Zhang, ; Yali Wang,
| |
Collapse
|
9
|
Faraut B, Cordina-Duverger E, Aristizabal G, Drogou C, Gauriau C, Sauvet F, Lévi F, Léger D, Guénel P. Immune disruptions and night shift work in hospital healthcare professionals: The intricate effects of social jet-lag and sleep debt. Front Immunol 2022; 13:939829. [PMID: 36164341 PMCID: PMC9509137 DOI: 10.3389/fimmu.2022.939829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/29/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives We aimed to examine the effects of circadian and sleep rhythm disruptions on immune biomarkers among hospital healthcare professionals working night shifts and rotating day shifts. Methods Hospital nurses working either as permanent night shifters (n=95) or as day shifters rotating between morning and afternoon shifts (n=96) kept a daily diary on their sleep and work schedules over a full working week. Blood samples were collected at the beginning and end of the last shift during the week, and participants were categorized into three groups based on work shift: morning shift (39 day shifters sampled at 7:00 and 14:00), afternoon shift (57 day shifters sampled at 14:00 and 21:00), and night shift (95 night shifters sampled at 21:00 and 7:00). Circulating blood counts in immune cells, interleukin-6 and C-reactive protein concentrations as well as total sleep time per 24 hours during work days (TST24w) and free days (TST24f), sleep debt (TST24f - TST24w) and social jet-lag (a behavioral proxy of circadian misalignment) were assessed. Results Compared with day shifters, night shifters had shorter sleep duration (TST24w=5.4 ± 1.4h), greater sleep debt (3.2 ± 1.4 h) and social jet-lag (6.7 ± 2.4 h). Variations of immune biomarkers concentrations were consistent with the expected diurnal variations among day shifters (i.e., low level in the morning, increase during the day, peak value in the evening). By contrast, in night shifters, blood concentrations of total lymphocytes, T-helper cells, cytotoxic T-cells, memory B-cells and interleukin-6 were lower at 21:00, increased during the night, and reached higher values at 7:00. Multivariate analyses ruled out significant impact of TST24w, sleep debt, and social jet-lag on immune biomarkers concentrations among day shifters. In contrast, among night shifters, multivariate analyses indicated a combined effect of total sleep time (TST24w), sleep debt and social jet-lag for total lymphocytes and T-helper cells but only a social jet-lag effect for interleukin-6 and a single total sleep time effect for neutrophil and B-Cells. Conclusions Altogether, our results point to intricate response patterns of immune rhythms to circadian misalignment and sleep debt in night shifters. Specifically, these altered pattern expressions of immune cells may increase vulnerability to infections and reduce vaccination efficiency in night workers.
Collapse
Affiliation(s)
- Brice Faraut
- Université Paris Cité, VIFASOM (UPR 7330 Vigilance Fatigue, Sommeil et Santé Publique), Paris, France
- APHP, APHP-Centre Université de Paris, Hôtel Dieu, Centre du Sommeil et de La Vigilance, Paris, France
| | - Emilie Cordina-Duverger
- Inserm, CESP (Center for research in Epidemiology and Population Health), Team Exposome and Heredity, University Paris-Saclay, Gustave-Roussy, Villejuif, France
| | - Guillen Aristizabal
- Inserm, CESP (Center for research in Epidemiology and Population Health), Team Exposome and Heredity, University Paris-Saclay, Gustave-Roussy, Villejuif, France
| | - Catherine Drogou
- Université Paris Cité, VIFASOM (UPR 7330 Vigilance Fatigue, Sommeil et Santé Publique), Paris, France
- Institut de Recherche Biomédicale des Armées (IRBA), Unité Fatigue et Vigilance, Brétigny sur Orge, France
| | - Caroline Gauriau
- Université Paris Cité, VIFASOM (UPR 7330 Vigilance Fatigue, Sommeil et Santé Publique), Paris, France
- APHP, APHP-Centre Université de Paris, Hôtel Dieu, Centre du Sommeil et de La Vigilance, Paris, France
| | - Fabien Sauvet
- Université Paris Cité, VIFASOM (UPR 7330 Vigilance Fatigue, Sommeil et Santé Publique), Paris, France
- Institut de Recherche Biomédicale des Armées (IRBA), Unité Fatigue et Vigilance, Brétigny sur Orge, France
| | - Francis Lévi
- UPR “Chronothérapie, Cancers, et Transplantation”, Faculté de Médecine, Université Paris-Saclay, Villejuif, France
- Hepato-Biliary Center, Hôpital Paul Brousse, Villejuif, France
- Cancer Chronotherapy Team, Cancer Research Centre, Division of Biomedical Sciences, Warwick Medical School, Coventry, United Kingdom
| | - Damien Léger
- Université Paris Cité, VIFASOM (UPR 7330 Vigilance Fatigue, Sommeil et Santé Publique), Paris, France
- APHP, APHP-Centre Université de Paris, Hôtel Dieu, Centre du Sommeil et de La Vigilance, Paris, France
| | - Pascal Guénel
- Inserm, CESP (Center for research in Epidemiology and Population Health), Team Exposome and Heredity, University Paris-Saclay, Gustave-Roussy, Villejuif, France
| |
Collapse
|
10
|
The Intricate Web of Fatigue in Women. WOMEN 2021. [DOI: 10.3390/women1040023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The modern woman has taken her rightful place in society as a worker, a caregiver, a mother, and a world citizen. However, along with the privileges of these roles comes the great cost of stress and resultant exhaustion and fatigue. Psychosocial, physical, cultural, and disease-related realms of stress act as strands of a web that serve to bind and hinder women with chronic stress. New areas of research, such as exercise intervention, improved social programs (e.g., childcare), and supplementation are constantly evaluated for effectiveness alongside traditional remedies such as exercise. This review will highlight some of the key issues regarding stress in women and explore reports of new treatment modalities in light of the specific requirements of the modern woman.
Collapse
|
11
|
Bonilla-Jaime H, Zeleke H, Rojas A, Espinosa-Garcia C. Sleep Disruption Worsens Seizures: Neuroinflammation as a Potential Mechanistic Link. Int J Mol Sci 2021; 22:12531. [PMID: 34830412 PMCID: PMC8617844 DOI: 10.3390/ijms222212531] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 12/13/2022] Open
Abstract
Sleep disturbances, such as insomnia, obstructive sleep apnea, and daytime sleepiness, are common in people diagnosed with epilepsy. These disturbances can be attributed to nocturnal seizures, psychosocial factors, and/or the use of anti-epileptic drugs with sleep-modifying side effects. Epilepsy patients with poor sleep quality have intensified seizure frequency and disease progression compared to their well-rested counterparts. A better understanding of the complex relationship between sleep and epilepsy is needed, since approximately 20% of seizures and more than 90% of sudden unexpected deaths in epilepsy occur during sleep. Emerging studies suggest that neuroinflammation, (e.g., the CNS immune response characterized by the change in expression of inflammatory mediators and glial activation) may be a potential link between sleep deprivation and seizures. Here, we review the mechanisms by which sleep deprivation induces neuroinflammation and propose that neuroinflammation synergizes with seizure activity to worsen neurodegeneration in the epileptic brain. Additionally, we highlight the relevance of sleep interventions, often overlooked by physicians, to manage seizures, prevent epilepsy-related mortality, and improve quality of life.
Collapse
Affiliation(s)
- Herlinda Bonilla-Jaime
- Departamento de Biología de la Reproducción, Área de Biología Conductual y Reproductiva, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de Mexico CP 09340, Mexico;
| | - Helena Zeleke
- Neuroscience and Behavioral Biology Program, College of Arts and Sciences, Emory University, Atlanta, GA 30322, USA;
| | - Asheebo Rojas
- Department of Pharmacology and Chemical Biology, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Claudia Espinosa-Garcia
- Department of Pharmacology and Chemical Biology, School of Medicine, Emory University, Atlanta, GA 30322, USA
| |
Collapse
|
12
|
Cui J, Ren YH, Zhao FJ, Chen Y, Huang YF, Yang L, You XM. Cross-Sectional Study of the Effects of Job Burnout on Immune Function in 105 Female Oncology Nurses at a Tertiary Oncology Hospital. Med Sci Monit 2021; 27:e929711. [PMID: 33941757 PMCID: PMC8106256 DOI: 10.12659/msm.929711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Nurses who work in hospitals experience a high level of burnout and the relationship between immune variables and burnout syndrome has yet to be elucidated. The aim of the present study was to investigate the effects of job burnout on immune function in female oncology nurses in a tertiary oncology hospital in Guangxi, China. The aspects of the human immune system evaluated were humoral and cellular immunity and complement components 3 (C3) and 4 (C4). Material/Methods We administered the Maslach Burnout Inventory-General Survey (MBI-GS), which includes scales for emotional exhaustion, depersonalization (DP), and personal accomplishment (PA), to measure variables related to immune function in 105 female nurses in a tertiary oncology hospital in Guangxi, China. Levels of humoral immunity and C3 and C4 were detected with immune turbidimetry. Cellular immunity was assessed with indirect immunofluorescence. Results A Spearman rank correlation analysis revealed that levels of C3, C4, and CD4- and CD8-positive T cells were significantly associated with burnout symptoms (P<0.05, P<0.01, and P<0.05, respectively). Furthermore, there was a correlation between demographic data and humoral and cellular immunity (both P<0.05). Multivariable linear regression analysis showed that C4 levels were closely related to DP (P<0.05) and that CD4 and CD8 levels were closely related to PA (P<0.01). Conclusions These results suggest that DP and PA have an impact on immune function, and that timely psychological and behavioral interventions can be used to reduce the degree of job burnout among nurses and regulate their immunity, thus enabling them to better serve patients.
Collapse
Affiliation(s)
- Jing Cui
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
| | - Yun-Hong Ren
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
| | - Feng-Juan Zhao
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
| | - Ying Chen
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
| | - Ying-Fan Huang
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
| | - Ling Yang
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
| | - Xue-Mei You
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
| |
Collapse
|
13
|
Abdul Rahman H, Abdul Aziz A, Ibrahim MA, Suhaili NA, Daud AZ, Naing L. Implications of Islamic Governance towards Psychosocial Work Stressors and Work Productivity. JOURNAL OF RELIGION AND HEALTH 2021; 60:804-815. [PMID: 33389433 DOI: 10.1007/s10943-020-01134-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 06/12/2023]
Abstract
This is a cross-sectional study, using multivariate regression analysis, to explore the relationship of Islamic governance on psychosocial work stressors and work productivity in healthcare settings. The results revealed that Islamic governing components that are culturally assimilating were significantly related to positive aspects of psychosocial work stressors and increased productivity. Organisational goals that are re-directed towards the Maqasīd, i.e. higher order of objectives in Islam, had direct benefits in reducing work-family conflict, promoting general health, increasing job satisfaction and improving commitment to work. Benefits, challenges and recommendations for future studies to expand the field of Islamic governance in organisational and cross-disciplinary healthcare research were discussed.
Collapse
Affiliation(s)
- Hanif Abdul Rahman
- Universiti Brunei Darussalam, Tungku Link Road, Bandar Seri Begawan, BE1410, Brunei Darussalam.
| | - Amin Abdul Aziz
- Universiti Brunei Darussalam, Tungku Link Road, Bandar Seri Begawan, BE1410, Brunei Darussalam
| | - Muhamad Adib Ibrahim
- Universiti Brunei Darussalam, Tungku Link Road, Bandar Seri Begawan, BE1410, Brunei Darussalam
| | - Noor-Arpah Suhaili
- Universiti Brunei Darussalam, Tungku Link Road, Bandar Seri Begawan, BE1410, Brunei Darussalam
| | | | - Lin Naing
- Universiti Brunei Darussalam, Tungku Link Road, Bandar Seri Begawan, BE1410, Brunei Darussalam
| |
Collapse
|
14
|
Lahtinen A, Häkkinen A, Puttonen S, Vanttola P, Viitasalo K, Porkka-Heiskanen T, Härmä M, Paunio T. Differential DNA methylation in recovery from shift work disorder. Sci Rep 2021; 11:2895. [PMID: 33536559 PMCID: PMC7858604 DOI: 10.1038/s41598-021-82627-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/22/2021] [Indexed: 01/07/2023] Open
Abstract
The human DNA methylome is responsive to our environment, but its dynamics remain underexplored. We investigated the temporal changes to DNA methylation (DNAme) in relation to recovery from a shift work disorder (SWD) by performing a paired epigenome-wide analysis in an occupational cohort of 32 shift workers (25 men, age = 43.8 ± 8.8 years, 21 SWD cases). We found that the effect of vacation on DNAme was more prominent in the SWD-group as compared to controls, with respect to the amount of significantly differentially methylated positions (DMPs; Punadj < 0.05) 6.5 vs 3.7%, respectively. The vast majority (78%) of these DMPs were hypomethylated in SWD but not in controls (27%) during the work period. The Gene Ontology Cellular component "NMDA glutamate receptor" (PFDR < 0.05) was identified in a pathway analysis of the top 30 genes in SWD. In-depth pathway analyses revealed that the Reactome pathway "CREB phosphorylation through the activation of CaMKII" might underlie the recovery. Furthermore, three DMPs from this pathway, corresponding to GRIN2C, CREB1, and CAMK2B, correlated with the degree of recovery (Punadj < 0.05). Our findings provide evidence for the dynamic nature of DNAme in relation to the recovery process from a circadian disorder, with biological relevance of the emerging pathways.
Collapse
Affiliation(s)
- Alexandra Lahtinen
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Biomedicum 1, Haartmaninkatu 8, 00290, Helsinki, Finland. .,Genomics and Biobank UnitDepartment of Public Health Solutions, Finnish Institute for Health and Welfare (THL), PO Box 30, 00271, Helsinki, Finland.
| | - Antti Häkkinen
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sampsa Puttonen
- Work Ability and Working Careersareers, Finnish Institute of Occupational Health, PO Box 40, 00032, Helsinki, Finland
| | - Päivi Vanttola
- Work Ability and Working Careersareers, Finnish Institute of Occupational Health, PO Box 40, 00032, Helsinki, Finland
| | | | - Tarja Porkka-Heiskanen
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Biomedicum 1, Haartmaninkatu 8, 00290, Helsinki, Finland
| | - Mikko Härmä
- Work Ability and Working Careersareers, Finnish Institute of Occupational Health, PO Box 40, 00032, Helsinki, Finland
| | - Tiina Paunio
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Biomedicum 1, Haartmaninkatu 8, 00290, Helsinki, Finland. .,Genomics and Biobank UnitDepartment of Public Health Solutions, Finnish Institute for Health and Welfare (THL), PO Box 30, 00271, Helsinki, Finland.
| |
Collapse
|
15
|
Inoue S, Ikeda K, Goto K, Hieda K, Hayashi T, Teishima J. Comparison of Chief Surgeons' and Assistants' Feelings of Fatigue Between Laparoendoscopic Single-site and Conventional Laparoscopic Adrenalectomy. World J Surg 2021; 45:1466-1474. [PMID: 33506294 DOI: 10.1007/s00268-021-05962-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Our objective was to compare the surgical staff's feelings of fatigue between laparoendoscopic single-site adrenalectomy (LESS-A) and conventional laparoscopic adrenalectomy (CLA) before and after surgery. METHOD Data were collected for surgical procedures performed between June 2011 and September 2017 (57 LESS-A and 37 CLA). Each procedure in both groups was performed by the same chief surgeon. The subjective fatigue feelings of the key members of the surgical team (chief surgeon, scopist, assistant surgeon) were assessed using the "Jikaku-sho shirabe" questionnaire, which contained questions about work-related feelings of fatigue. It consisted of 25 subjective items for 5 factors drawn from factor analysis (drowsiness, instability, uneasiness, local pain or dullness, and eyestrain). For each item, the participants were requested to estimate the intensity of their feelings using a five-point rating scale before and after surgery. RESULTS There was no significant difference in operative time (p = 0.231) between the LESS-A and CLA procedure groups. For the chief surgeon, local pain or dullness (p = 0.603) and eyestrain (p = 0.086) were similar between the LESS-A and CLA procedures. The scopists and assistant surgeons in the LESS-A group did not suffer local pain or dullness (p = 0.793 and p = 0.240, respectively). They did, however, suffer more eyestrain than those in the CLA group (p = 0.001 and p = 0.001, respectively). CONCLUSION Although LESS-A is generally considered to be a technically difficult procedure, the results of this study demonstrate that the feelings of physical fatigue are roughly equivalent between LESS-A and CLA procedures.
Collapse
Affiliation(s)
- Shogo Inoue
- Department of Urology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Kenichiro Ikeda
- Department of Urology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Keisuke Goto
- Department of Urology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Keisuke Hieda
- Department of Urology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Tetsutaro Hayashi
- Department of Urology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Jun Teishima
- Department of Urology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| |
Collapse
|
16
|
Bjorvatn B, Axelsson J, Pallesen S, Waage S, Vedaa Ø, Blytt KM, Buchvold HV, Moen BE, Thun E. The Association Between Shift Work and Immunological Biomarkers in Nurses. Front Public Health 2020; 8:415. [PMID: 33042933 PMCID: PMC7521138 DOI: 10.3389/fpubh.2020.00415] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/10/2020] [Indexed: 01/23/2023] Open
Abstract
Objectives: Shift work is associated with several negative health effects. The underlying pathophysiological mechanisms are unclear, but low-grade inflammation has been suggested to play a role. This project aimed to determine whether levels of immunological biomarkers differ depending on work schedule, self-reported sleep duration, self-reported sleep quality, and presence of shift work disorder (study 1). Furthermore, we aimed to determine whether these biomarkers differ after a night of sleep vs. at the end of a night or a day shift (study 2). Methods: In study 1, 390 nurses provided blood samples after a night of sleep with the dried blood spot method. In study 2, a subset of 55 nurses also provided blood samples after a day shift and after a night shift. The following biomarkers were measured: interleukin-1alpha, interleukin-1beta, interleukin-4, interleukin-6, interleukin-8, interleukin-10, interleukin-13, monocyte chemoattractant protein-1, interferon-gamma, and tumor necrosis factor-alpha. Multiple linear regressions with adjustment for age, sex and body mass index (study 1) and ANOVAs with repeated measures (study 2) were conducted. Results: In study 1, neither work schedule, number of night shifts, number of quick returns (<11 h between consecutive shifts), sleep duration, poor sleep quality, nor shift work disorder were systematically associated with most of these biomarkers. Compared with day only work, day-evening work was associated with higher levels of IL-1alpha and IL-13, quick returns were associated with higher levels of IL-1beta and MCP-1, short sleep duration (<6 h) was associated with lower levels of IL-1beta and higher levels of TNF-alpha, and long sleep duration (8+ h) was associated with higher levels of IL-13. In study 2, IL-1beta levels were higher (large effect size) both after a day shift (14% increase) and a night shift (75% increase) compared with levels after a night of sleep. Similarly, TNF-alpha levels were higher (moderate-large effect size) after a day shift (50% increase) compared to after a night of sleep. In contrast, MCP-1 levels were lower (large effect size) both after a day shift (22% decrease) and a night shift (12% decrease) compared with after a night of sleep. Conclusions: We found some indications that shift work influenced immunological biomarkers. The results should be interpreted with caution due to limitations, e.g., related to the sampling procedure and to low levels of biomarkers in the blood samples.
Collapse
Affiliation(s)
- Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - John Axelsson
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Ståle Pallesen
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Siri Waage
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Øystein Vedaa
- Department of Health Promotion, National Institute of Public Health, Bergen, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kjersti M Blytt
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Hogne V Buchvold
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Bente E Moen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Eirunn Thun
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| |
Collapse
|
17
|
|
18
|
Mello MTD, Silva A, Guerreiro RDC, da-Silva FR, Esteves AM, Poyares D, Piovezan R, Treptow E, Starling M, Rosa DS, Pires GN, Andersen ML, Tufik S. Sleep and COVID-19: considerations about immunity, pathophysiology, and treatment. Sleep Sci 2020; 13:199-209. [PMID: 33381288 PMCID: PMC7755266 DOI: 10.5935/1984-0063.20200062] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/02/2020] [Indexed: 12/29/2022] Open
Abstract
The fear and uncertainty caused by the coronavirus disease 2019 (COVID-19) pandemic, threats to survival are one of the main problems of everyday life; however, mental health care must also be considered a priority. During social isolation also called self-quarantine, the restricted mobility and social contact, concern about financial resources and availability of supplies, fear of infection, questions about the duration of self-quarantine, cause anxiety, depression, stress, insomnia and reduced the quality and quantity of sleep, that may present a greater risk to the health of the general population. Sleep disorders are increasingly becoming a major health issue in modern society, and are influenced by retinal stimulation by electronic devices, as well extended and/or night shift-work, which may aggravate the systemic and lung inflammation during viral infections. Sleep disorders can induce pro-inflammatory states and be harmful during the COVID-19 pandemic. The possible interactions between many drugs used to treat COVID-19, and those used to treat sleep disorders are unknown, mostly due to the lack of a standard protocol to treat these patients. Insufficient sleep or irregular sleep-wake cycles may impair health, immune system, induce pro-inflammation state, and may lead to increased vulnerability to viral infections, involving inflammatory and oxidative/antioxidant imbalance. In this sense, obstructive sleep apnea has been associated with recognized COVID-19 risk comorbidities and considered a risk factor for COVID-19. During the COVID-19 pandemic, health care cannot stop, and telemedicine has presented itself as an alternative method of delivering services. When a face-to-face visit is mandatory, or in locations with minimal community transmission where sleep centers have resumed activities, it is important that the sleep center facilities are properly prepared to receive the patients during the COVID-19 pandemic, and follow all relevant safety rules. In this work we gathered a group of researchers, specialists in aspects related to chronobiology, sleep, sleep disorders, and the immune system. Thus, we conducted a narrative review in order to address the relationship between COVID-19 and sleep, as well as its immunological aspects and strategies that may be applied in order to mitigate the harmful effects on health that affects everyone during the pandemic.
Collapse
Affiliation(s)
- Marco Túlio De Mello
- Universidade Federal de Minas Gerais, Departamento de Esportes - Belo Horizonte - Minas Gerais - Brazil
| | - Andressa Silva
- Universidade Federal de Minas Gerais, Departamento de Esportes - Belo Horizonte - Minas Gerais - Brazil
| | | | - Flavia Rodrigues da-Silva
- Universidade Federal de Minas Gerais, Departamento de Esportes - Belo Horizonte - Minas Gerais - Brazil
| | - Andrea Maculano Esteves
- Universidade Estadual de Campinas, Faculdade de Ciências Aplicadas - Limeira - São Paulo - Brazil
| | - Dalva Poyares
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil
| | - Ronaldo Piovezan
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil
| | - Erika Treptow
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil
| | - Marcelo Starling
- Universidade Federal de Minas Gerais, Departamento de Esportes - Belo Horizonte - Minas Gerais - Brazil
| | - Daniela Santoro Rosa
- Federal University of São Paulo, Departament of Microbiology, Imunology and Parasitology - São Paulo - São Paulo - Brazil
| | - Gabriel Natan Pires
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil
- Santa Casa de São Paulo School of Medical Sciences, Department of Physiological Sciences - São Paulo - São Paulo - Brazil
| | - Monica Levy Andersen
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil
| | - Sergio Tufik
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil
| |
Collapse
|
19
|
Silva FRD, Guerreiro RDC, Andrade HDA, Stieler E, Silva A, de Mello MT. Does the compromised sleep and circadian disruption of night and shiftworkers make them highly vulnerable to 2019 coronavirus disease (COVID-19)? Chronobiol Int 2020; 37:607-617. [PMID: 32432519 DOI: 10.1080/07420528.2020.1756841] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Rotating and permanent night shiftwork schedules typically result in acute and sometimes chronic sleep deprivation plus acute and sometimes chronic disruption of the circadian time structure. Immune system processes and functionalities are organized as circadian rhythms, and they are also strongly influenced by sleep status. Sleep is a vital behavioral state of living beings and a modulator of immune function and responsiveness. Shiftworkers show increased risk for developing viral infections due to possible compromise of both innate and acquired immunity responses. Short sleep and sleep loss, common consequences of shiftwork, are associated with altered integrity of the immune system. We discuss the possible excess risk for COVID-19 infection in the context of the common conditions among shiftworkers, including nurses, doctors, and first responders, among others of high exposure to the contagion, of sleep imbalance and circadian disruption. ABBREVIATIONS ACE2: Angiotensin-converting enzyme 2; APC: Antigen.-presenting .cells; CCL: Chemokine (C-C motif) ligand; CD+: .Adhesion molecule expression; COVID-19: 2019 coronavirus disease; DCs: Dendritic cells; GH: Growth hormone; HPA: Hypothalamic-pituitary-adrenal; HSF: Heat shock factor; HSP70: Heat shock protein 70; HSP90: Heat shock protein 90; IL: Interleukin; INFγ: Interferon-gamma; LT/LB: T/B lymphocytes; MHC: Major histocompatibility complex; NK: Natural .killer; RAAS: renin-angiotensin-aldosterone system; SARS: .Severe acute respiratory syndrome; SCN: Suprachiasmatic nucleus;SD: Sleep deprivation; SNS: Sympathetic nervous system; Th1/Th2: T helper lymphocytes 1/2; TLR2/TLR4: Toll-like receptor 2/4; TNF-α: Tumor .necrosis .factor alpha; VEGF: Vascular endothelial growth factor.
Collapse
Affiliation(s)
| | | | | | - Eduardo Stieler
- Department of Sports, Universidade Federal de Minas Gerais , Belo Horizonte, Brazil
| | - Andressa Silva
- Department of Sports, Universidade Federal de Minas Gerais , Belo Horizonte, Brazil
| | - Marco Túlio de Mello
- Department of Sports, Universidade Federal de Minas Gerais , Belo Horizonte, Brazil
| |
Collapse
|
20
|
Adib Ibrahim M, Abdul Aziz A, Suhaili NA, Zahid Daud A, Naing L, Abdul Rahman H. A Study into Psychosocial Work Stressors and Health Care Productivity. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2019; 10:185-193. [PMID: 31586383 PMCID: PMC6820312 DOI: 10.15171/ijoem.2019.1610] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 08/07/2019] [Indexed: 01/27/2023]
Abstract
Background: World Health Organization's Healthy Workplace Framework and Model has emphasized addressing psychosocial work stressors as one of the important avenues toward creating a conducive workplace. Management and interventions of these adverse stressors have been unremarkable; impairing work productivity.
Objective:
To explore the effect of psychosocial work stressors on health service productivity. Methods: Using Copenhagen Psychosocial Questionnaire II and Healthcare Productivity Survey, a cross-sectional study was conducted on 225 health and allied health professionals in the largest referral hospital in Brunei. Multiple linear regression was used to explore the relationship of each domain of work productivity to indicators of psychosocial work stressors. Results: Psychosocial work stressors explained more than 50% of the variance for health care productivity. Influence at work, role clarity, rewards and job satisfaction were among the factors with the highest contributions to this relationship. Conclusion: Crucial factors were identified and discussed, however, due to complexity of this relationship, international collaborations and efforts are required to ameliorate adverse effects of psychosocial stressors and improve health service productivity.
Collapse
Affiliation(s)
| | | | | | | | - Lin Naing
- Universiti Brunei Darussalam, Brunei Darussalam
| | | |
Collapse
|
21
|
Ismail KM, Malak MZ, Alamer RM. Psychosocial correlates of work-related fatigue among Jordanian emergency department nurses. Perspect Psychiatr Care 2019; 55:486-493. [PMID: 30729538 DOI: 10.1111/ppc.12354] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 11/24/2018] [Accepted: 01/06/2019] [Indexed: 01/13/2023] Open
Abstract
PURPOSE This study purposed to assess the psychosocial correlates of work-related fatigue among Jordanian emergency department nurses. DESIGN AND METHODS A cross-sectional study was conducted among Jordanian emergency nurses (n = 220). Measures included Occupational Fatigue Exhaustion/Recovery Scale (OFER15) and Copenhagen Psychosocial Questionnaire version Two (COPSOQ II). FINDINGS The psychosocial factors correlated with all types of work-related fatigue (acute, chronic, and inter-shift [recovery]) were quantitative demands, work-family conflict, sexual harassment, threats of violence, physical violence, and bullying. Importantly, quantitative demands and sexual harassment were the main predictors of all types of work-related fatigue. PRACTICE IMPLICATIONS The psychosocial correlated factors should be considered when developing interventions to minimize work-related fatigue phenomenon. This would lead to a more positive working environment which will promote safe nursing care.
Collapse
Affiliation(s)
- Khaldoun M Ismail
- Department of Adult Health Nursing, Najran University, Najran, Saudi Arabia
| | - Malakeh Z Malak
- Department of Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Rasmieh M Alamer
- Department of Psychiatric Health Nursing, Faculty of Nursing, Isra University, Amman, Jordan.,Adjunct Fellow,, Western Sydney University, School of Nursing and Midwifery, Sydney, NSW, Australia
| |
Collapse
|
22
|
Loef B, van Baarle D, van der Beek AJ, Sanders EAM, Bruijning-Verhagen P, Proper KI. Shift Work and Respiratory Infections in Health-Care Workers. Am J Epidemiol 2019; 188:509-517. [PMID: 30475977 PMCID: PMC6395171 DOI: 10.1093/aje/kwy258] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/16/2018] [Accepted: 11/16/2018] [Indexed: 12/30/2022] Open
Abstract
Recently, there has been interest in whether shift work may enhance susceptibility to infection. Our aim was to determine whether shift workers in the health-care field have a higher incidence, duration, and/or severity of influenza-like illness (ILI) and acute respiratory infection (ARI) than non–shift workers. From September 2016 to June 2017, 501 rotating and/or night-shift workers and 88 non–shift workers from the Klokwerk+ Study (the Netherlands, 2016–2017) registered the occurrence of ILI/ARI symptoms daily using a smartphone application. The incidence rate of ILI/ARI (defined as ≥2 symptoms on the same day/≥1 symptom on 2 consecutive days), the mean duration of each episode, and the incidence rate of severe episodes were compared between shift workers and non–shift workers using negative binomial regression and linear mixed-model analysis. In total, participants completed 110,347 diaries. Shift workers’ incidence rate of ILI/ARI was 1.20 (95% confidence interval (CI): 1.01, 1.43) times higher than that of non–shift workers, and for severe ILI/ARI episodes, shift workers’ incidence rate was 1.22 (95% CI: 1.01, 1.49) times higher. The mean duration of an ILI/ARI episode did not differ (ratio between means = 1.02, 95% CI: 0.87, 1.19). In conclusion, shift workers in health care had more ILI/ARI episodes and more severe ILI/ARI episodes than non–shift workers, but with a similar duration. Insight into underlying mechanisms connecting shift work and infection susceptibility will contribute to the design of preventive initiatives.
Collapse
Affiliation(s)
- Bette Loef
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Department of Public and Occupational Health, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Debbie van Baarle
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Department of Immunology, Laboratory for Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Elisabeth A M Sanders
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Patricia Bruijning-Verhagen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Karin I Proper
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| |
Collapse
|
23
|
Khorasaniha R, Siassi F, Khajehnasiri F, Qorbani M, Sotoudeh G. Dietary patterns in relation to inflammation in shift workers. BMJ Mil Health 2019; 166:221-226. [PMID: 30765608 DOI: 10.1136/jramc-2018-001119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/21/2018] [Accepted: 12/23/2018] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Rotational shift work has a considerable effect on immune function and cause inflammation. In addition, it may lead to unhealthy dietary intake. No earlier study has examined the association between dietary patterns and inflammation in rotational shift workers. Therefore, this study was conducted to investigate the association between dietary patterns and circulating proinflammatory cytokines among shift workers. METHODS This cross-sectional study was conducted among 257 male shift workers. Dietary intake of participants was examined using the semiquantitative Food Frequency Questionnaire. Serum concentrations of interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) and high sensitivity C-reactive protein (hs-CRP) were measured using suitable commercial kits. RESULTS Three main dietary patterns included green vegetables, yellow vegetables and cruciferous vegetables (VEG), liquid oils and mayonnaise, fast food and eggs (LFE), as well as tea and coffee, refined grains and spice (TRS). Subjects with the highest adherence to VEG dietary pattern had a significantly lower concentration of IL-6 (p<0.01) and TNF-α (p<0.001) as compared with those with the lowest adherence. On the other hand, a significant negative association was found between LFE dietary pattern and serum concentrations of IL-6 (p=0.01) and TNF-α (p=0.02). However, no significant association was found between adherence to VEG (p=0.34) or LFE (p=0.99) dietary patterns and levels of hs-CRP and between adherence to TRS dietary pattern and any of the inflammatory cytokines. CONCLUSION Adherence to VEG and LFE dietary patterns was inversely and directly associated to serum IL-6 and TNF-α concentrations in shift workers, respectively. However, no significant association was found between adherence to these two dietary patterns and serum hs-CRP concentrations and between TRS dietary pattern and any of the inflammatory cytokines.
Collapse
Affiliation(s)
- Reihane Khorasaniha
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - F Siassi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - F Khajehnasiri
- Department of Social Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - M Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - G Sotoudeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
24
|
Wang CC, Shi HH, Zhang LY, Ding L, Xue CH, Yanagita T, Zhang TT, Wang YM. The rapid effects of eicosapentaenoic acid (EPA) enriched phospholipids on alleviating exercise fatigue in mice. RSC Adv 2019; 9:33863-33871. [PMID: 35528913 PMCID: PMC9073713 DOI: 10.1039/c9ra05181c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/05/2019] [Indexed: 12/29/2022] Open
Abstract
It has been reported that docosahexaenoic acid/eicosapentaenoic acid (DHA/EPA) and phospholipids (PLs) play an important role in alleviating exercise fatigue. However, the difference of DHA and EPA in ameliorating exercise fatigue is still unclear. Furthermore, the comparative study about DHA/EPA-PLs and nonpolar DHA/EPA on exercise fatigue has not been reported. In the present study, the effects of DHA and EPA on exercise fatigue was firstly compared by conducting an exhaustion test, and the results showed that triglyceride (TG) with high ratio of EPA had a more significant effect on alleviating exercise fatigue than TG with a low ratio of EPA in mice. Therefore, eicosapentaenoic acid–ethyl ester (EPA–EE) and EPA–PL were then selected to compare the rapid effects of polar and nonpolar DHA/EPA on exercise fatigue in mice by a weight-loaded swimming exhaustion test. A single intake of EPA–PL but not EPA–EE significantly alleviated exercise fatigue in mice by increasing the lactic acid recycling rate as well as inhibiting glycogen consumption and muscle injury, suggesting that EPA–PL exhibited a rapid effect on alleviating exercise fatigue. The study might represent a potential novel candidate or targeted dietary pattern for alleviating exercise fatigue. EPA-PL has rapid effects on alleviating exercise fatigue by inhibiting lactic acid accumulation, glycogen consumption and muscle injury.![]()
Collapse
Affiliation(s)
- Cheng-Cheng Wang
- College of Food Science and Engineering
- Ocean University of China
- Qingdao 266003
- P. R. China
| | - Hao-Hao Shi
- College of Food Science and Engineering
- Ocean University of China
- Qingdao 266003
- P. R. China
| | - Ling-Yu Zhang
- College of Food Science and Engineering
- Ocean University of China
- Qingdao 266003
- P. R. China
| | - Lin Ding
- College of Food Science and Engineering
- Ocean University of China
- Qingdao 266003
- P. R. China
| | - Chang-Hu Xue
- College of Food Science and Engineering
- Ocean University of China
- Qingdao 266003
- P. R. China
- Laboratory for Marine Drugs and Bioproducts of Qingdao National Laboratory for Marine Science and Technology
| | - Teruyoshi Yanagita
- Laboratory of Nutrition Biochemistry
- Department of Applied Biochemistry and Food Science
- Saga University
- Saga 840-8502
- Japan
| | - Tian-Tian Zhang
- College of Food Science and Engineering
- Ocean University of China
- Qingdao 266003
- P. R. China
| | - Yu-Ming Wang
- College of Food Science and Engineering
- Ocean University of China
- Qingdao 266003
- P. R. China
- Laboratory for Marine Drugs and Bioproducts of Qingdao National Laboratory for Marine Science and Technology
| |
Collapse
|
25
|
Sagherian K, Zhu S, Storr C, Hinds PS, Derickson D, Geiger-Brown J. Bio-mathematical fatigue models predict sickness absence in hospital nurses: An 18 months retrospective cohort study. APPLIED ERGONOMICS 2018; 73:42-47. [PMID: 30098641 DOI: 10.1016/j.apergo.2018.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 01/30/2018] [Accepted: 05/23/2018] [Indexed: 06/08/2023]
Abstract
This study examined the associations between bio-mathematical fatigue-risk scores and sickness absence (SA) in hospital nurses over 18 months. Work schedules and SA data were extracted from the hospital's attendance system. Fatigue-risk scores were generated for work days using the Fatigue Audit InterDyne (FAID) and Fatigue Risk Index (FRI). Over the study period, 5.4% of the shifts were absence shifts. FAID-fatigue ranged from 7 to 154; scores for a standard 9-5 work schedule can range from 7 to 40. Nurses with high FAID-scores were more likely to be absent from work when compared to standard FAID-scores (41-79, OR = 1.38, 95%CI = 1.21-1.58; 80-99, OR = 1.63, 95%CI = 1.37-1.94 and ≥ 100, OR = 1.73, 95%CI = 1.40-2.13). FRI-fatigue ranged from 0.9 to 76.8. When FRI-scores were >60, nurses were at 1.58 times (95%CI = 1.05-2.37) at increased odds for SA compared to scores in the 0.9-20 category. Nurse leaders can use these decision-support models to adjust high-risk schedules or the number of staff needed to cover anticipated absences from work.
Collapse
Affiliation(s)
- Knar Sagherian
- College of Nursing, The University of Tennessee Knoxville, TN, USA.
| | - Shijun Zhu
- School of Nursing, University of Maryland Baltimore, MD, USA
| | - Carla Storr
- School of Nursing, University of Maryland Baltimore, MD, USA
| | - Pamela S Hinds
- Department of Pediatrics, George Washington University, Washington, DC, USA; Department of Nursing Research and Quality Outcomes, Children's National Medical Center, Washington, DC, USA
| | | | | |
Collapse
|
26
|
Lee JS, Kim HG, Lee DS, Son CG. Oxidative Stress is a Convincing Contributor to Idiopathic Chronic Fatigue. Sci Rep 2018; 8:12890. [PMID: 30150620 PMCID: PMC6110864 DOI: 10.1038/s41598-018-31270-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/13/2018] [Indexed: 02/07/2023] Open
Abstract
The linkage between oxidative stress and idiopathic chronic fatigue (ICF) has not been explored in detail. This study thoroughly compared the serum levels of biomarkers for oxidative stress and antioxidants from 103 subjects with ICF (20 men and 83 women) to those of 82 healthy volunteers (27 men and 55 women). Oxidative parameters, which included reactive oxygen species (ROS), malondialdehyde (MDA) and F2-isoprotan, and tumor necrosis factor-alpha (TNF-α) were significantly elevated, while antioxidant parameters, which included total antioxidant activity (TAC), catalase, superoxide dismutase, SOD and GSH activity, were decreased compared to those of healthy subjects (by approximately 1.2- to 2.3-fold, p < 0.05 or 0.01). Our results confirmed that oxidative stress is a key contributor in the pathophysiology of ICF, and firstly explored the features of oxidative stress parameters in ICF subjects compared to a healthy population.
Collapse
Affiliation(s)
- Jin-Seok Lee
- Liver and Immunology Research Center, Dunsan Hospital of Daejeon University, Daejeon, 301-724, Republic of Korea
| | - Hyeong-Geug Kim
- Liver and Immunology Research Center, Dunsan Hospital of Daejeon University, Daejeon, 301-724, Republic of Korea
| | - Dong-Soo Lee
- Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, 64 Daeheung-ro, Jung-gu, Daejeon, 34943, Republic of Korea
| | - Chang-Gue Son
- Liver and Immunology Research Center, Dunsan Hospital of Daejeon University, Daejeon, 301-724, Republic of Korea.
| |
Collapse
|
27
|
Abstract
The purpose of this research was to study night shift work and its health effects on nurses. This was a quantitative study using descriptive design; it also incorporated three qualitative open-ended questions to complement the study. The data were collected using Survey Monkey, with an Internet-based confidential data collection tool. The population of relevance to this study was nurses employed in hospital settings in the United States. E-mail addresses and Facebook were used to recruit participants. Results indicated that there is an increased risk of sleep deprivation, family stressors, and mood changes because of working the night shift. Rotating shifts were mentioned as a major concern for night shift nurses. Respondents agreed that complaints about fatigue and fatigue-related illnesses in night shift workers were ignored. There was also a general perception among nurses working the night shift that sleep deprivation leads to negative health consequences including obesity; however, they were not as high a concern as rotating shifts or fatigue.
Collapse
|
28
|
Abdul Rahman H, Abdul-Mumin K, Naing L. Psychosocial factors, musculoskeletal disorders and work-related fatigue amongst nurses in Brunei: structural equation model approach. Int Emerg Nurs 2017. [PMID: 28629716 DOI: 10.1016/j.ienj.2017.04.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Psychosocial factors, musculoskeletal disorders and work-related fatigue have adverse effects on individual nurses and place a substantial financial burden on health care. Evidence of an association has been reported in the literature, but no theoretical explanation has been published to date. AIM To explore and develop a structural model to provide a theoretical explanation for this relationship. METHODS A cross-sectional study using data from 201 valid samples of emergency and critical care nurses across public hospitals in Brunei was performed via self-administered questionnaire. The structural equation model was assessed using partial least squares analysis. RESULTS A valid and robust structural model was constructed. This revealed that 61.5% of the variance in chronic fatigue could be explained by psychosocial factors and musculoskeletal disorders pathways. Among the psychosocial factors, work-family conflict was identified as a key mediator for progression of musculoskeletal problems and subsequent fatigue through stress and burnout. CONCLUSION This report provides a novel theoretical contribution to understanding the relationship between psychosocial factors, musculoskeletal disorders and work-related fatigue. These preliminary results may be useful for future studies on the development of work-related fatigue and musculoskeletal disorders, particularly the central role of work-family conflict.
Collapse
Affiliation(s)
- Hanif Abdul Rahman
- University of Brunei Darussalam, Tungku Link Road, BE1410, Brunei Darussalam.
| | | | - Lin Naing
- University of Brunei Darussalam, Tungku Link Road, BE1410, Brunei Darussalam.
| |
Collapse
|
29
|
Borniger JC, Cisse YM, Surbhi, Nelson RJ. Reciprocal Regulation of Circadian Rhythms and Immune Function. CURRENT SLEEP MEDICINE REPORTS 2017. [DOI: 10.1007/s40675-017-0070-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
30
|
Abdul Rahman H, Abdul-Mumin K, Naing L. Psychosocial Work Stressors, Work Fatigue, and Musculoskeletal Disorders: Comparison between Emergency and Critical Care Nurses in Brunei Public Hospitals. Asian Nurs Res (Korean Soc Nurs Sci) 2017; 11:13-18. [PMID: 28388975 DOI: 10.1016/j.anr.2017.01.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 01/11/2017] [Accepted: 01/11/2017] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Little evidence estimated the exposure of psychosocial work stressors, work-related fatigue, and musculoskeletal disorders for nurses working in South-East Asian region, and research on this subject is almost nonexistent in Brunei. The main aim of our study was to provide a comprehensive exploration and estimate exposure of the study variables amongst emergency (ER) and critical care (CC) nurses in Brunei. The study also aims to compare whether experiences of ER nurses differ from those of CC nurses. METHODS This cross-sectional study was implemented in the ER and CC departments across Brunei public hospitals from February to April 2016 by using Copenhagen Psychosocial Questionnaire II, Occupational Fatigue Exhaustion Recovery scale, and Cornell Musculoskeletal Discomfort Questionnaire. RESULTS In total, 201 ER and CC nurses (82.0% response rate) participated in the study. Quantitative demands of CC nurses were significantly higher than ER nurses. Even so, ER nurses were 4.0 times more likely [95% confidence interval (2.21, 7.35)] to experience threats of violence, and 2.8 times more likely [95% confidence interval: (1.50, 5.29)] to experience chronic fatigue. The results revealed that nurses experienced high quantitative demands, work pace, stress, and burnout. High prevalence of chronic and persistent fatigue, threats of violence and bullying, and musculoskeletal pain at the neck, shoulder, upper and lower back, and foot region, was also reported. CONCLUSION This study has provided good estimates for the exposure rate of psychosocial work stressors, work-related fatigue, and musculoskeletal disorders among nurses in Brunei. It provided important initial insight for nursing management and policymakers to make informed decisions on current and future planning to provide nurses with a conducive work environment.
Collapse
Affiliation(s)
- Hanif Abdul Rahman
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam.
| | - Khadizah Abdul-Mumin
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam
| | - Lin Naing
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam
| |
Collapse
|
31
|
Rahman HA, Abdul-Mumin K, Naing L. A study into psychosocial factors as predictors of work-related fatigue. ACTA ACUST UNITED AC 2017; 25:757-63. [PMID: 27409786 DOI: 10.12968/bjon.2016.25.13.757] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To explore and determine relationship between psychosocial factors and work-related fatigue among emergency and critical care nurses in Brunei. METHODS Cross-sectional study conducted on all emergency and critical care nurses across Brunei public hospitals from February to April 2016. RESULTS 201 nurses participated in the study (82% response rate). A total of 36% of the variance of chronic fatigue was explained by stress, trust in management, decision latitude, self-rated health, and work-family conflict. Burnout, self-rated health, commitment to workplace, and trust in management explained 30% of the variance of acute fatigue. Stress, work-family conflict and reward explained 28% of the variance of intershift recovery after controlling for significant sociodemographic variables. Smoking was identified as an important sociodemographic factor for work-related fatigue. CONCLUSIONS Psychosocial factors were good predictors of work-related fatigue. A range of psychosocial factors were established, however more research is required to determine all possible causation factors of nurses' work-related fatigue.
Collapse
Affiliation(s)
| | | | - Lin Naing
- Associate Professor (Biostatistics), Universiti Brunei Darussalam
| |
Collapse
|
32
|
Almeida CMOD, Malheiro A. Sleep, immunity and shift workers: A review. ACTA ACUST UNITED AC 2016; 9:164-168. [PMID: 28123655 PMCID: PMC5241621 DOI: 10.1016/j.slsci.2016.10.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 10/15/2016] [Accepted: 10/24/2016] [Indexed: 12/26/2022]
Abstract
To date, shift workers represent between 15% and 25% of the modern day workforce. Work time poses a great challenge to workers as it requires that they balance productivity and sleep time between shifts. As a result, these workers experience chronic sleep deprivation with increased fatigue and drowsiness due to this sleep deprivation. The impact of this kind of work on the immune system is not yet known. We conducted a literature review with the aim of evaluating articles on this specific type of work's effects on sleep and immunity.
Collapse
Affiliation(s)
- Carlos Mauricio Oliveira de Almeida
- Department of Neurology of the State University of Amazonas-UEA
- Correspondence to: Universidade Estadual do Amazonas-UEA, rua Carvalho Leal, no.1777, CEP, 3ª. andar., 69000-000 Manaus, Amazonas, Brasil.
| | - Adriana Malheiro
- Department of Immunolgy of the Federal University of Amazonas-UFAM, Brazil
- Hematology and Hemotherapy Foundation of Amazonas, HEMOAM, Brazil
| |
Collapse
|
33
|
Sagherian K, Geiger Brown J. In-depth review of five fatigue measures in shift workers. FATIGUE-BIOMEDICINE HEALTH AND BEHAVIOR 2016. [DOI: 10.1080/21641846.2015.1124521] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
34
|
|
35
|
Yu J, Wang S, Yu X. Health risk factors associated with presenteeism in a Chinese enterprise. Occup Med (Lond) 2015. [PMID: 26220679 DOI: 10.1093/occmed/kqv115] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Chronic health problems are prevalent in China and may lead to loss of work productivity through presenteeism. AIMS To investigate the prevalence of potential risk factors for presenteeism in Chinese workers and the strength of their association with reported presenteeism. METHODS A cross-sectional survey of employees in a Chinese petrochemical corporation included a medical examination report and questionnaire data on demographic characteristics, potential risk factors for presenteeism and presenteeism evaluation. Data were analysed using Pearson's chi-square tests, t-tests and logistic regression modelling. RESULTS There were 1506 responses available for analysis; response rate 92%. The prevalence of presenteeism was 15%. Univariate analysis indicated a significantly higher prevalence of presenteeism in employees who were male, age ≤35 years, single, divorced or widowed and overweight or obese. Higher presenteeism was found in participants with high blood pressure, hypertriglyceridemia, hypercholesterolemia, insufficient physical activity, cigarette smoking, alcohol use, insufficient cereal intake, life dissatisfaction and job dissatisfaction. The prevalence of presenteeism was significantly associated with the number of potential risk factors. Logistic regression disclosed six independent risk factors associated with presenteeism: hypercholesterolemia, high blood pressure, insufficient physical activity, alcohol drinking, insufficient cereal intake and life dissatisfaction. CONCLUSIONS Chronic conditions, health risk factors and presenteeism were prevalent in employees of a Chinese petrochemical corporation. Risk factors for other health conditions were associated with presenteeism. Health management programmes should be implemented to reduce risk factors and promote the health of employees in an effort to reduce presenteeism.
Collapse
Affiliation(s)
- J Yu
- School of Public Health, Harbin Medical University, Harbin 150081, Heilongjiang, China
| | - S Wang
- Department of General Medicine, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China
| | - X Yu
- School of Public Health, Harbin Medical University, Harbin 150081, Heilongjiang, China, Department of General Medicine, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China.
| |
Collapse
|
36
|
Martin JS, Laberge L, Sasseville A, Bérubé M, Alain S, Houle J, Hébert M. Day and night shift schedules are associated with lower sleep quality in Evening-types. Chronobiol Int 2015; 32:627-36. [PMID: 26035480 DOI: 10.3109/07420528.2015.1033425] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Eveningness has been suggested as a facilitating factor in adaptation to shift work, with several studies reporting evening chronotypes (E-types) as better sleepers when on night shifts. Conversely, eveningness has been associated with more sleep complaints during day shifts. However, sleep during day shifts has received limited attention in previous studies assessing chronotypes in shift workers. Environmental light exposure has also been reported to differ between chronotypes in day workers. Activity is also known to provide temporal input to the circadian clock. Therefore, the aim of this study was to compare objective sleep, light exposure and activity levels between chronotypes, both during the night and day shifts. Thirty-nine patrol police patrol officers working on a fast rotating shift schedule (mean age ± SD: 28.9 ± 3.2 yrs; 28 males) participated in this study. All subjects completed the Morningness-Eveningness Questionnaire (MEQ). Sleep and activity were monitored with actigraphy (Actiwatch-L; Mini-Mitter/Respironics, Bend, OR) for four consecutive night shifts and four consecutive day shifts (night work schedule: 00:00 h-07:00 h; day work schedule: 07:00 h-15:00 h). Sleep and activity parameters were calculated with Actiware software. MEQ scores ranged from 26 to 56; no subject was categorized as Morning-type. E-types (n = 13) showed significantly lower sleep efficiency, longer snooze time and spent more time awake after sleep onset than Intermediate-types (I-types, n = 26) for both the night and day shifts. E-types also exhibited shorter and more numerous sleep bouts. Furthermore, when napping was taken into account, E-types had shorter total sleep duration than I-types during the day shifts. E-types were more active during the first hours of their night shift when compared to I-types. Also, all participants spent more time active and had higher amount of activity per minute during day shifts when compared to night shifts. No difference was found regarding light exposure between chronotypes. In conclusion, sleep parameters revealed poorer sleep quality in E-types for both the night and day shifts. These differences could not be explained by sleep opportunity, light exposure or activity levels. This study challenges the notion that E-types adapt better to night shifts. Further studies must verify whether E-types exhibit lower sleep quality than Morning-types.
Collapse
Affiliation(s)
- Jeanne Sophie Martin
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec , Quebec City, Quebec , Canada
| | | | | | | | | | | | | |
Collapse
|
37
|
Ha EH. Attitudes towards rotating shift work in clinical nurses: a Q-methodology study. J Clin Nurs 2015; 24:2488-97. [DOI: 10.1111/jocn.12833] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Eun-Ho Ha
- Red Cross College of Nursing; Chung-Ang University; Seoul Korea
| |
Collapse
|
38
|
Khaleghipour S, Masjedi M, Kelishadi R. Circadian type, chronic fatigue, and serum IgM in the shift workers of an industrial organization. Adv Biomed Res 2015; 4:61. [PMID: 25802830 PMCID: PMC4361954 DOI: 10.4103/2277-9175.151882] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 06/16/2014] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Night shift workers are more vulnerable to immune-related diseases. Immunoglobulin M (IgM) is a potent activator of complement, and complement has a crucial role in defense against bacterial infections. Circadian type is known as an effective agent on vulnerability and adaptation with shift work due to non-compliance with shift stress. The objective of this study was to investigate the correlation of circadian type and chronic fatigue with the serum concentration of IgM in a group of shift workers. MATERIALS AND METHODS This cross-sectional study was performed in an industrial organization in Isfahan, Iran. The study population consisted of 221 male employees working at night shifts who were selected by random cluster sampling. The following questionnaires were used: composite morningness (Torsvall and Akerstedt), circadian type (Folkard), and chronic fatigue (Barton and colleagues). The serum concentration of IgM was measured by the nephelometric method. The data were analyzed with the Pearson coefficient correlation and the path analysis for finding the pattern of the structural equations to evaluate the direct and indirect relationships between variables, using the SPSS 15 and LISREL 8.5 statistical software. RESULTS Significant correlation was documented between morningness, flexibility, languidness, and chronic fatigue with the serum concentration of IgM (P < 0.01). CONCLUSION The results showed that the shift workers with morningness and languidness experienced more problems during the working hours due to more tiredness, and had decreased serum concentration of IgM. Correct management of shift work may attenuate fatigue in workers and also improve many health issues experienced by the shift workers.
Collapse
Affiliation(s)
| | - Mohsen Masjedi
- Department of Immunology, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
39
|
Abstract
OBJECTIVE The aim of this study was to examine current research related to nurse fatigue and identify effective prevention strategies. BACKGROUND Work-related fatigue negatively affects patient safety and nurses' well-being and increases employer costs. Preventing fatigue and minimizing its negative consequences require knowledge of the contributing factors if effective interventions are to be designed and implemented. METHODS This review targeted original research (2002-2013) examining fatigue among nurses working in acute care settings. RESULTS Nurses experience high rates of fatigue. Shifts longer than 12 hours contribute to increased fatigue and errors, but the evidence was inconsistent with regard to age and fatigue level. Individual lifestyle, unit culture, and organization policies influence the prevalence and intensity of work-related fatigue. CONCLUSIONS Preventing work-related fatigue requires multifaceted approaches involving the organization, the clinical unit, and the individual.
Collapse
|
40
|
Smith-Coggins R, Broderick KB, Marco CA. Night Shifts in Emergency Medicine: The American Board of Emergency Medicine Longitudinal Study of Emergency Physicians. J Emerg Med 2014; 47:372-8. [DOI: 10.1016/j.jemermed.2014.04.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 01/15/2014] [Accepted: 04/22/2014] [Indexed: 11/27/2022]
|
41
|
Faraut B, Bayon V, Léger D. Neuroendocrine, immune and oxidative stress in shift workers. Sleep Med Rev 2013; 17:433-44. [DOI: 10.1016/j.smrv.2012.12.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 12/11/2012] [Accepted: 12/20/2012] [Indexed: 10/26/2022]
|
42
|
Lind R, Berstad A, Hatlebakk J, Valeur J. Chronic fatigue in patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome: validation of a Norwegian translation of the Fatigue Impact Scale. Clin Exp Gastroenterol 2013; 6:101-7. [PMID: 23869173 PMCID: PMC3706251 DOI: 10.2147/ceg.s45760] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome (IBS) suffer from several health complaints, including fatigue. The aim of the present study was to validate a Norwegian translation of the Fatigue Impact Scale (FIS), and to assess the impact of fatigue in patients with self-reported food hypersensitivity and IBS, as compared with healthy controls. METHODS Thirty-eight patients with unexplained self-reported food hypersensitivity and IBS, who participated in the validation of the FIS completed the following additional questionnaires: the Short Form of Nepean Dyspepsia Index for assessment of quality of life, the Subjective Health Complaint Inventory, and questionnaires for diagnosis and severity of IBS. Impact of fatigue was studied in 43 patients with unexplained self-reported food hypersensitivity, 70% diagnosed with IBS, and 42 healthy controls. RESULTS Cronbach's α for the FIS was 0.98, indicating excellent agreement between individual items. Scores on the FIS correlated with scores on the Short Form of Nepean Dyspepsia Index (r = 0.50, P = 0.001), indicating good convergent validity, and were higher in patients (median 85.0, interquartile range 36.8-105.3) than in controls (median 14.0, interquartile range 3.0-29.0, P ≤ 0.0001). CONCLUSION The Norwegian translation of the FIS performed excellently in patients with unexplained self-reported food hypersensitivity and IBS, with patients reporting significantly more impact of chronic fatigue than healthy controls.
Collapse
Affiliation(s)
- Ragna Lind
- Department of Medicine, Haukeland University Hospital, Bergen
| | - Arnold Berstad
- Unger-Vetlesen Institute, Department of Medicine, Lovisenberg Diakonale Hospital, Oslo
| | - Jan Hatlebakk
- Department of Medicine, Haukeland University Hospital, Bergen
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Jørgen Valeur
- Unger-Vetlesen Institute, Department of Medicine, Lovisenberg Diakonale Hospital, Oslo
| |
Collapse
|
43
|
Golombek DA, Casiraghi LP, Agostino PV, Paladino N, Duhart JM, Plano SA, Chiesa JJ. The times they're a-changing: effects of circadian desynchronization on physiology and disease. ACTA ACUST UNITED AC 2013; 107:310-22. [PMID: 23545147 DOI: 10.1016/j.jphysparis.2013.03.007] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Circadian rhythms are endogenous and need to be continuously entrained (synchronized) with the environment. Entrainment includes both coupling internal oscillators to external periodic changes as well as synchrony between the central clock and peripheral oscillators, which have been shown to exhibit different phases and resynchronization speed. Temporal desynchronization induces diverse physiological alterations that ultimately decrease quality of life and induces pathological situations. Indeed, there is a considerable amount of evidence regarding the deleterious effect of circadian dysfunction on overall health or on disease onset and progression, both in human studies and in animal models. In this review we discuss the general features of circadian entrainment and introduce diverse experimental models of desynchronization. In addition, we focus on metabolic, immune and cognitive alterations under situations of acute or chronic circadian desynchronization, as exemplified by jet-lag and shiftwork schedules. Moreover, such situations might lead to an enhanced susceptibility to diverse cancer types. Possible interventions (including light exposure, scheduled timing for meals and use of chronobiotics) are also discussed.
Collapse
Affiliation(s)
- Diego A Golombek
- Laboratory of Chronobiology, National University of Quilmes/CONICET, Buenos Aires, Argentina.
| | | | | | | | | | | | | |
Collapse
|