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One fifth of today's workforce is engaged in shift work and exposed to various mental and physical health risks including shift work disorder. Efficiently recovering from shift work through physical and mental interventions allows us to mitigate negative effects on health, enables a better work-life balance and enhances our overall wellbeing. The aim of this review is to provide a state-of-the-art overview of the available literature. The role of sleep timing and naps, light therapy and psychotherapy, diet and exercise in recovery from shift work is presented here. We further review the impact of shift schedules and social support on post-shift unwinding. [ABSTRACT FROM AUTHOR]

(1) Background: Previous studies on the association between shift work and metabolic syndrome have had inconsistent results. This may be due to the cross-sectional study design and non-objective data used in those studies. Hence, this study aimed to identify risk factors for Metabolic syndrome using objective information provided by the relevant companies and longitudinal data provided in health examinations. (2) Methods: In total, 1211 male workers of three manufacturing companies, including shift workers, were surveyed annually for 4 years. Data on age, smoking, drinking, physical activity, length of shift work, type of shift, past history, waist circumference, blood pressure, blood sugar, triglyceride, and high-density cholesterol (HDL) were collected and analyzed using generalized estimating equations (GEE) to identify the risk factors for Metabolic syndrome. (3) Results: In the multivariate analysis of Metabolic syndrome risk factors, age (OR = 1.078, 95% CI: 1.045–1.112), current smoking (OR = 1.428, 95% CI: 1.815–5.325), and BMI (OR = 1.498, 95% CI: 1.338–1.676) were statistically significant for day workers (n= 510). Additionally, for shift workers (N = 701), age (OR = 1.064, 95% CI: 1.008–1.174), current smoking (OR = 2.092, 95% CI: 1.854–8.439), BMI (OR = 1.471, 95% CI: 1.253–1.727) and length of shift work (OR = 1.115, 95% CI: 1.010-1.320) were statistically significant. Shift work was associated with a higher risk of Metabolic syndrome (OR = 1.093, 95% CI: 1.137–2.233) compared to day workers. For shift workers, shift work for more than 20 years was associated with Metabolic syndrome (OR = 2.080, 95% CI: 1.911–9.103), but the dose–response relationship was not statistically significant. (4) Conclusions: This study revealed that age, current smoking, BMI, and shift work are potential risk factors for Metabolic syndrome. In particular, the length of shift work (>20 years) is a potential risk factor for Metabolic syndrome in shift workers. To prevent metabolic syndrome in shift workers, health managers need to actively accommodate shift workers (especially those who have worked for more than 20 years), current smokers, and obese people. A long-term cohort study based on objective data is needed to identify the chronic health impact and the risk factors of shift work. [ABSTRACT FROM AUTHOR]

Study Objective Shiftwork increases risk for numerous chronic diseases, which is hypothesized to be linked to disruption of circadian timing of lifestyle behaviors. However, empirical data on timing of lifestyle behaviors in real-world shift workers are lacking. To address this, we characterized the regularity of timing of lifestyle behaviors in shift-working police trainees. Methods Using a two-group observational study design (N  = 18), we compared lifestyle behavior timing during 6 weeks of in-class training during dayshift, followed by 6 weeks of field-based training during either dayshift or nightshift. Lifestyle behavior timing, including sleep–wake patterns, physical activity, and meals, was captured using wearable activity trackers and mobile devices. The regularity of lifestyle behavior timing was quantified as an index score, which reflects day-to-day stability on a 24-hour time scale: Sleep Regularity Index, Physical Activity Regularity Index, and Mealtime Regularity Index. Logistic regression was applied to these indices to develop a composite score, termed the Behavior Regularity Index (BRI). Results Transitioning from dayshift to nightshift significantly worsened the BRI, relative to maintaining a dayshift schedule. Specifically, nightshift led to more irregular sleep–wake timing and meal timing; physical activity timing was not impacted. In contrast, maintaining a dayshift schedule did not impact regularity indices. Conclusions Nightshift imposed irregular timing of lifestyle behaviors, which is consistent with the hypothesis that circadian disruption contributes to chronic disease risk in shift workers. How to mitigate the negative impact of shiftwork on human health as mediated by irregular timing of sleep–wake patterns and meals deserves exploration. [ABSTRACT FROM AUTHOR]

Summary: Shift work, defined as work occurring outside typical daytime working hours, is associated with an increased risk for metabolic syndrome (MetS) due to several biological and environmental changes. The MetS refers to the clustering of several known cardiovascular risk factors, including insulin resistance, obesity, dyslipidemia, and hypertension. This systematic review aims to evaluate the literature on the association between shift work and the risk of MetS in employees of the health sector. A systematic search was conducted in PubMed, Web of Science, and Scopus databases using appropriate keywords for studies published before September 1, 2021. Eligible studies were those that compared the prevalence of MetS between day and shift healthcare workers; had a cross‐sectional, case–control, or cohort study design; provided sufficient data for calculating odds ratios or relative risks with 95% confidence intervals; and articles in English. The Joanna Briggs Institute prevalence critical appraisal tool was used for quality analysis. Risk for MetS and related measures of effect size were retrieved from studies for meta‐analysis. Twelve studies met the criteria for inclusion in the review and meta‐analysis. Sample sizes ranged from 42 to 738, and the age range of subjects was between 18 and 65 years. Ten studies demonstrated high methodological quality, while two studies were of average quality. Ten out of 12 studies in the review demonstrated a higher risk in shift workers for developing MetS than day workers. The pooled OR of MetS in shift workers based on 12 studies was 2.17 (95% CI = 1.31–3.60, P = 0.003; I2 = 82%, P < 0.001). Shift workers exhibited more than a twofold increase in the chance of developing MetS in comparison with day workers. [ABSTRACT FROM AUTHOR]

The purpose of this study is to elucidate the multiple pathways linking shift work exposure to cardiometabolic risk (CMR) through the intermediates of circadian disruption, sleep disturbances, and stress. A cross-sectional study was conducted at Kingston Health Sciences Center that included female hospital workers, 160 who worked a day-only schedule and 168 who worked rotating days and nights. Participants completed questionnaires, a clinical exam, and wore accelerometers to collect sleep data for 8 days. Participants also collected urine samples at each void during a 24-h collection period, on the day shift for day-only workers and the night shift for rotating shift workers, for cortisol and melatonin measures. We adapted and tested a conceptual model proposed by Knutsson and Boggild for circadian disruption, sleep, and stress mechanistic pathways linking shift work to CMR using structural equation modeling techniques. Status as a rotating shift worker was associated with increased circadian disruption of cortisol and melatonin production compared to day-only workers (P <.001). Increased circadian disruption was associated with an increased CMR (P =.01). Rotating shift work was associated with sleep disturbances (P =.002) and increased job stress (P <.001), but neither was associated with CMR. We conclude that rotating shift work is associated indirectly with increased CMR. This association is mediated by circadian disruption as indicated by attenuated melatonin and cortisol, and flatter cortisol curves. [ABSTRACT FROM AUTHOR]

BACKGROUND: The metabolic syndrome is a complex of interdependent risk factors for cardiovascular disease and diabetes. Shift work might have an impact on metabolic variables, and be a risk factor for type 2 diabetes. To date, only few studies have been done on the prevalence of MetS in industrial work environments in Iran, and most of them have been conducted on a small sample size. OBJECTIVE: The aim of this study was to evaluate the impact of shift work on prevalence of metabolic syndrome in one of the petrochemical companies in Iran. METHODS: This cross-sectional study was conducted among 692 male workers of a petrochemical company in south-west Iran. Metabolic syndrome was diagnosed according to criteria recommended by Adult Treatment Panel III. In order to determine correlation between MetS and its factors with shift work odds ratio (ORs) for the MetS, 95% confidence level (95% CL), chi-square test and logistic regression analysis were performed. RESULTS: Overall 15.1% of workers were diagnosed with metabolic syndrome and 80% of them were shift workers. A significant difference for prevalence of metabolic syndrome and mean values for body mass index, blood pressure, fast blood sugar, waist circumference among shift workers and non-shift workers were identified (p < 0.001). Compared with the day workers, shift workers had a significantly higher risk of MetS (odds ratio = 4.852; 95% CI 2.34–9.974). CONCLUSIONS: There is an association between metabolic syndrome and shift work in petrochemical workers. Promising intervention strategies are needed for prevention of metabolic disorders for shift workers. [ABSTRACT FROM AUTHOR]

This study investigated the relationship between working rotating shifts and white blood cell (WBC) count, WBC differential count (DC), obesity, and metabolic syndrome of nurses. Samples were obtained from a total of 720 nurses who had received health checkups at a large teaching hospital in Taiwan. Among these nurses, 500 worked rotating shifts, and the remaining 220 nurses worked fixed daytime shifts. We used binary logistic regression to identify the risk factors of obesity or metabolic syndrome. The results indicate that nurses working rotating shifts had a significantly higher WBC count than those working fixed daytime shifts. WBC count was an independent factor relating to an overly large waist circumference or overly high body mass index (BMI) of nurses. For every 103/μL increase in WBC count, the risk of waist circumference exceeding 90 cm and 80 cm respectively in male and female nurses increased by 46%, and for every 103/μL increase in WBC count, the risk of a BMI 24 kg/m2 in nurses increased by 50%. Similarly, WBC count and work type were independent factors influencing the metabolic syndrome of nurses. For every 103/μL increase in WBC count, the risk of metabolic syndrome occurring in nurses increased by 65%. Nurses working rotating shifts were at a 3.34 times greater risk of having metabolic syndrome than those working fixed daytime shifts. The mean age of our participants was 29.54 years old, and only approximately 4% of the participants had metabolic syndrome. Among these nurses, we found that high WBC was correlated with an overly large waist circumference and overly high BMI. Furthermore, the nurses working rotating shifts may have been at greater risk of metabolic syndrome than those working fixed daytime shifts, and increases in WBC were also associated with the occurrence of metabolic syndrome. [ABSTRACT FROM AUTHOR]

This meta-analysis investigates the relationship between both shift work and long working hours and risk of developing metabolic syndrome (MetS). PubMed, EMBASE, and Web of Science databases were searched from the outset to December 10, 2019. Two reviewers independently screened studies, extracted data, and assessed the risk of bias of included studies. A total of 36 (30 cross-sectional, 5 cohort, and a nested case-control) studies, involving 274,263 participants, were included. The pooled odds ratio of shift work and development of MetS was 1.35 (95% confidence interval: 1.24–1.48), and the pooled odds ratio of long working hours and development of MetS was 1.19 (95% confidence interval: 0.97–1.46). In the subgroup analysis stratified by gender, the pooled odds ratios for male and female shift workers were 1.25 (95% confidence interval: 1.14–1.37) and 1.47 (95% confidence interval: 1.18–1.82), respectively. The dose–response (number of years of shift work and development of MetS) analysis showed the pooled odds ratio for 5 years of shift work was 1.07 (95% confidence interval: 1.05–1.09) and for 10 years of shift work 1.11 (95% confidence interval: 1.06–1.15). Our meta-analysis confirmed shift work is significantly associated with risk of metabolic syndrome, but the relationship between long working hours and MetS was not substantiated. Additionally, there was a nonlinear dose–response relationship between the number of years of shift work and risk of MetS, showing positive relationship to about 20 years of shift work but not for longer than 20 years. Prospective cohort studies regarding specific shift work schedules are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Shift work is associated with adverse chronic health outcomes. Addressing chronic disease risk factors including biomedical risk factors, behavioural risk factors, as well as sleep and perceived health status, affords an opportunity to improve health outcomes in shift workers. The present study aimed to conduct a systematic review, qualitative synthesis, and meta-analysis of nonpharmacological interventions targeting chronic disease risk factors, including sleep, in shift workers. A total of 8465 records were retrieved; 65 publications were eligible for inclusion in qualitative analysis. Random-effects meta-analysis were conducted for eight eligible health outcomes, including a total of thirty-nine studies. Interventions resulted in increased objective sleep duration (Hedges' g = 0.73; CI: 0.36, 1.10, k = 16), improved objective sleep efficiency (Hedges' g = 0.48; CI: 0.20, 0.76, k = 10) and a small increase in both subjective sleep duration (Hedges' g = 0.11; CI: -0.04, 0.27, k = 19) and sleep quality (Hedges' g = 0.11; CI: -0.11, 0.33, k = 21). Interventions also improved perceived health status (Hedges' g = 0.20; CI: -0.05, 0.46, k = 8), decreased systolic (Hedges' g = 0.26; CI: -0.54, 0.02, k = 7) and diastolic (Hedges' g = 0.06; CI: -0.23, 0.36, k = 7) blood pressure, and reduced body mass index (Hedges' g = -0.04; CI: -0.37, 0.29, k = 9). The current study suggests interventions may improve chronic disease risk factors and sleep in shift workers; however, this could only be objectively assessed for a limited number of risk factor endpoints. Future interventions could explore the impact of non-pharmacological interventions on a broader range of chronic disease risk factors to better characterise targets for improved health outcomes in shift workers. [ABSTRACT FROM AUTHOR]

Shift work during reproductive age can be a risk factor for metabolic syndrome. The present study evaluated the association between shift work and metabolic syndrome during reproductive age. This multi-center cross-sectional correlational study was performed between September 2017 and May 2018. A total of 419 female shift and day workers were purposively recruited to the study from three central cities in Mazandaran, Iran. To diagnose metabolic syndrome based on the National Cholesterol Education Program Adult Treatment Panel III guidelines, the anthropometric measures, blood pressure, and levels of serum triglyceride, high-density lipoprotein and fasting blood sugar were taken. Data were analyzed using the independent-sample t, Chi-square and the Fisher's exact tests as well as the logistic regression analysis. Among the 419 participants, 28 were excluded during the study. The total prevalence of metabolic syndrome was 16.3%, and its prevalence among shift workers and day workers was 17.3 and 14.9%, respectively. The most prevalent components of metabolic syndrome were low serum level of high-density lipoprotein and abdominal obesity. Following adjustments for the effects of potential cofounders, the logistic regression analysis revealed that the odds of metabolic syndrome among shift workers was ~2 times greater than day workers (odds ratio, 1.83; 95% confidence interval, 0.088-3.79), although this association was statistically insignificant (P=0.10). The results of the current study suggest that shift work is associated with a greater risk of metabolic syndrome for women. The most important components of metabolic syndrome are low serum level of high-density lipoprotein and abdominal obesity, which are attributable to limited physical activity and high occupational stress. The risk of metabolic syndrome among female shift workers of reproductive age may be reduced through strategies, including awareness raising, dietary educations and provision of physical activity facilities in the workplace. [ABSTRACT FROM AUTHOR]

Working in shifts, especially if night shifts are included, is associated with many adverse health effects varying from gastrointestinal disturbances to cardiovascular diseases, metabolic syndrome, and type 2 diabetes (1–4). The exact mechanisms for these associations are not firmly established (5). Short-term sleep restriction is known to induce insulin resistance and, for example, disturbances in fat metabolism (6), and shift workers are known to suffer from sleep loss. It is plausible that lifestyle factors related to shift work play a role as well. The accumulation of body fat leading to overweight and obesity is one of the key factors behind the development of metabolic disturbances in general population, and we can assume it to be so also among shift workers (7). There seems to be even a dose–response association, with an increasing trend in weight with increasing duration of shift work (8). But what exactly is it in shift work that predisposes those who do it to weight gain? And can we do something about it? In their systematic review of longitudinal studies, Van Drongelen et al (9) found a strong evidence for a crude association between shift work exposure and body weight increase; however the confounder-adjusted associations were found to be inconclusive. This indicates that it is not shift work per se but other factors related to or associated with shift work that lead to body fat accumulation. On the other hand, in a recent systematic review, Bonham et al (10) concluded that energy intake does not differ between day and shift workers, and suggest that other factors such as circadian misalignment, meal timing, food choice and diurnal variation of energy metabolism at night may be responsible for the increased rates of obesity observed among shift workers. In general, only minor differences in nutrient intake between day and shift workers have been identified, and the results have been somewhat conflicting. It has been suggested that shift workers have more eating events per day than day workers (11), and it seems that shift workers make more unfavorable food choices than day workers do, preferring snack foods and sugary drinks (11, 12). In a recent study, shift working men were less likely to consume vegetables and fruits daily and women had higher intake of saturated fat compared with day workers (13). In a paper by Hulsegge et al (14) in this issue, shift workers were found to have a higher energy intake than day workers (56 kcal/d) and a slightly higher consumption of grains, dairy products, meat and fish and lower consumption of cakes and biscuits. No difference in savory snacks, sweets, soft drinks or juices were found. The difference in energy intake was largest for shift workers with ≥5 night shifts/month, who consumed 103 kcal/d more than day workers. The authors conclude that shift and day workers’ dietary quality is the same, but suggest that a higher energy intake among shift workers may be one of the causes of shift-work-induced overweight, obesity, and other adverse health outcomes; a reasonable suggestion if we acknowledge as fact that overweight indeed develops as a result of positive energy balance. The study included a relatively large population-based sample of 683 and 7173 shift and day workers, respectively from the original cohort of 40 010 men and women. The analyses were cross-sectional, with dietary data collection based on a 178-item semi-quantitative food frequency questionnaire for the past year diet and retrospective data collection on work schedule 14–20 years earlier. The analyses were adjusted for several confounders, including age, sex, smoking, physical activity, and body mass index (BMI). No differences were presented for clinical risk factors, except that shift workers had slightly higher BMI compared with day workers. BMI is a crude measure of body adiposity, but does not tell anything about the actual body size, which is the most important predictor of energy expenditure (15). Due to the study’s cross-sectional study design, we do not know if the workers were eating more calories because they had higher BMI or if they had higher BMI because they were eating more calories. Furthermore, level of physical activity was estimated with a short questionnaire, including one question about type of work (sedentary, standing, physical, or heavy manual). This simple categorization may not be able to fully adjust for differing energy needs in different occupations. Therefore, Hulsegge at al’s conclusion that “…future studies need to confirm that shift workers indeed have a higher energy intake than day workers independent of energy requirements” is justified. Another important point in future studies is to use reliable and valid methods for dietary data collection. A review by Lowden et al (16) evaluated the results of shift workers’ dietary intake studies since 1967. They highlighted several shortcomings of dietary studies among shift workers, including unreliable methods used for nutrition research. Shift work can change food timing while a healthy diet can be difficult to maintain especially if the facilities for eating outside the normal working hours are not well organized and healthy food choices are not available. Having catering services in worksites may be associated with healthier eating habits (17). If and when food frequency questionnaires are used, they should specifically be designed to capture the typical nutritional features in shift work, such as the irregularities in dietary patterns. Food diaries collected for a sufficient number of days can still be regarded as the most reliable way of collecting data on both the pattern and composition of diet. They are not bound by fixed food items, dish compositions, and portion sizes but allow free, real-time recording of meals and snacks, without the need for retrospection and food-item classification. Can we improve shift worker’s diet? Nutrition advice should be a standard part of the shift workers’ lifestyle counselling in occupational healthcare and the obligatory health check-ups demanded by national legislation in many countries (18). Whether or not shift work in general predisposes individuals to poor food choices or increased energy intake is not definitively proven. Either way, every shift worker should be considered individually and lifestyle counselling based on personal situation and estimation of individual risk factors for metabolic and other chronic diseases should be provided. References 1. Pietroiusti A, Neri A, Somma G, Coppeta L, Iavicoli I, Bergamaschi A, Magrini A. Incidence of metabolic syndrome among night-shift healthcare workers. Occup Environ Med. 2010; 67:54-57. http://dx.doi.org/10.1136/oem.2009.046797 2. Knutsson A, Boggild H. Gastrointestinal disorders among shift workers. Scand J Work Environ Health. 2010; 36:85-95. http://dx.doi.org/10.5271/sjweh.2897 3. Vyas MV, Garg AX, Iansavichus AV, Costella J, Donner A, Laugsand LE, Janszky I, Mrkobrada M, Parraga G, Hackam DG. Shift work and vascular events: Systematic review and meta-analysis. BMJ. 2012; 345:e4800. http://dx.doi.org/10.1136/bmj.e4800 4. Hansen AB, Stayner L, Hansen J, Andersen ZJ. Night shift work and incidence of diabetes in the danish nurse cohort. Occup Environ Med. 2016; 73:262-268. http://dx.doi.org/10.1136/oemed-2015-103342 5. Puttonen S, Härmä M, Hublin C. Shift work and cardiovascular disease – pathways from circadian stress to morbidity. Scand J Work Environ Health. 2010; 36:96-108. http://dx.doi.org/10.5271/sjweh.2894 6. Broussard JL, Chapotot F, Abraham V, Day A, Delebecque F, Whitmore HR, Tasali E. Sleep restriction increases free fatty acids in healthy men. Diabetologia. 2015; 58:791-798. http://dx.doi.org/10.1007/s00125-015-3500-4 7. Proper KI, van de Langenberg D, Rodenburg W, Vermeulen RC, van der Beek AJ, van Steeg H, van Kerkhof LW. The relationship between shift work and metabolic risk factors: A systematic review of longitudinal studies. Am J Prev Med. 2016; 50:e147-57. http://dx.doi.org/10.1016/j.amepre.2015.11.013 8. van Amelsvoort LG, Schouten EG, Kok FJ. Duration of shiftwork related to body mass index and waist to hip ratio. Int J Obes Relat Metab Disord. 1999; 23:973-978. http://dx.doi.org/10.1038/sj.ijo.0801028 9. van Drongelen A, Boot CR, Merkus SL, Smid T, van der Beek AJ. The effects of shift work on body weight change - a systematic review of longitudinal studies. Scand J Work Environ Health. 2011; 37:263-275. http://dx.doi.org/10.5271/sjweh.3143 10. Bonham MP, Bonnell EK, Huggins CE. Energy intake of shift workers compared to fixed day workers: A systematic review and meta-analysis. Chronobiol Int. 2016; 33:1086-1100. http://dx.doi.org/10.1080/07420528.2016.1192188 11. de Assis MA, Kupek E, Nahas MV, Bellisle F. Food intake and circadian rhythms in shift workers with a high workload. Appetite. 2003; 40:175-183. http://dx.doi.org/10.1016/S0195-666302)00133-2 12. Waterhouse J, Buckley P, Edwards B, Reilly T. Measurement of, and some reasons for, differences in eating habits between night and day workers. Chronobiol Int. 2003; 20:1075-1092. http://dx.doi.org/10.1081/CBI-120025536 13. Hemio K, Puttonen S, Viitasalo K, Harma M, Peltonen M, Lindstrom J. Food and nutrient intake among workers with different shift systems. Occup Environ Med. 2015; 72:513-520. http://dx.doi.org/10.1136/oemed-2014-102624 14. Hulsegge G, Boer JMA, van der Beek AJ, Verschuren WMM, Sluijs I, Vermeulen R, et al. Shift workers have a similar diet quality but higher energy intake than day workers. Scand J Work Environ Health – online first. http://dx.doi.org/10.5271/sjweh.3593 15. Mifflin MD, St Jeor ST, Hill LA, Scott BJ, Daugherty SA, Koh YO. A new predictive equation for resting energy expenditure in healthy individuals. Am J Clin Nutr. 1990; 51:241-247. 16. Lowden A, Moreno C, Holmbäck U, Lennernäs M, Tucker P. Eating and shift work - effects on habits, metabolism and performance. Scand J Work Environ Health. 2010; 36:150-162. http://dx.doi.org/10.5271/sjweh.2898 17. Raulio S, Roos E, Prattala R. School and workplace meals promote healthy food habits. Public Health Nutr. 2010; 13:987-992. http://dx.doi.org/10.1017/S1368980010001199 18. Viitasalo K, Hemio K, Puttonen S, Hyvarinen HK, Leiviska J, Harma M, Peltonen M, Lindstrom J. Prevention of diabetes and cardiovascular diseases in occupational health care: Feasibility and effectiveness. Prim Care Diabetes. 2015; 9:96-104. http://dx.doi.org/10.1016/j.pcd.2014.07.008

Background: Shift work is vital in hotel businesses as these businesses run 24 h daily regardless of holidays to accommodate customers. The number of shift workers in hotel businesses is expected to increase consistently and it is crucial to study the impact of shift work on hotel workers' mental health. This study, therefore, aims to examine the association between depression and shift work in hotel workers. It especially focuses on investigating whether there is a difference in how closely these two are related depending on shift types. Methods: A survey was conducted with 768 hotel workers who worked at two first-class hotels in Seoul. Out of 659 respondents total (response rate of 85.8 %), 506 respondents were selected as the final research subjects, excluding 153 respondents whose responses were incomplete. The survey was composed of questionnaires related to general characteristics, work-related characteristics, shift work, shift type, and depression level. The Korean Center for Epidemiologic Studies Depression (CES-D) Scale was used to evaluate the subjects' depression level. Multiple logistic regression analysis was conducted with depression as a dependent variable and shift type as an independent variable after relevant general and work-related characteristics were adjusted to examine the relationship between shift type and depression. Results: After adjustment for relevant general and work-related characteristics, hotel workers had a significantly higher likelihood of belonging to the depression group than those with a fixed day shift, across all three shift types: rotating day shift (OR = 2.22, 95 % CI = 1.05-4.61), rotating night shift (OR = 2.63, 95 % CI = 1.11-6.24), and fixed night shift (OR = 3.46, 95 % CI = 1.02-11.74). Conclusions: The results showed that shift work was significantly related to depression in hotel workers and the risk of depression clearly differed among shift types. In particular, fixed night shift workers were most vulnerable to depression. Rotating day shift workers without night work could also have a higher risk of depression. [ABSTRACT FROM AUTHOR]

Background: Shift work is associated with negative health effects. Increased prevalence of several cardiovascular risk factors among shift workers/night workers compared with day workers have been shown resulting in increased risk of cardiovascular events among shift workers and night workers. Previous studies have taken a dichotomous approach to the comparison between day and night workers. The present study uses a continuous approach and provides such a new perspective to the negative effects of night work load as a possible risk factor for undesirable health effects.Methods: This cross sectional study (The SUrvey of Shift work, Sleep and Health (SUSSH)) uses data collected from December 2008 to March 2009. The study population consists of Norwegian nurses. The study collected information about demographic and lifestyle factors: Body Mass Index (BMI), smoking habits, alcohol consumption, caffeine consumption and exercise habits. The lifestyle parameters were evaluated using multiple hierarchical regression and binary logistic regression. Number of night shifts worked last year (NNL) was used as operationalization of night work load. Adjustment for possible confounders were made. Obesity was defined as BMI > 30. Alcohol Consumption was evaluated using the short form of the Alcohol Use Disorders Identification Test Consumption (AUDIT-C). Data were analyzed using SPSS version 22.Results: We had data from 2059 nurses. NNL was significantly and positively associated with BMI, both when evaluated against BMI as a continuous parameter (Beta = .055, p < .05), and against obesity (OR = 1.01, 95 % CI = 1.00-1.01). The AUDIT-C score was significantly and positively associated with hours worked per week (OR = 1.03, 95 % CI = 1.01-1.05).Conclusions: We found a positive significant association between night work load and BMI. This suggests that workers with a heavy night work load might need special attention and frequent health checks due to higher risk of undesirable health effects. [ABSTRACT FROM AUTHOR]

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Aims/hypothesis: The aim of this study was to assess shift work in relation to incident type 2 diabetes in African-American women. Methods: In the Black Women's Health Study (BWHS), an ongoing prospective cohort study, we followed 28,041 participants for incident diabetes during 2005-2013. They answered questions in 2005 about having worked a night shift. We estimated HR and 95% CIs for incident diabetes using Cox proportional hazards models. The basic multivariable model included age, time period, family history of diabetes, education and neighbourhood socioeconomic status. In further models, we controlled for lifestyle factors and BMI. Results: Over the 8 years of follow-up, there were 1,786 incident diabetes cases. Relative to never having worked the night shift, HRs (95% CI) for diabetes were 1.17 (1.04, 1.31) for 1-2 years of night-shift work, 1.23 (1.06, 1.41) for 3-9 years and 1.42 (1.19, 1.70) for ≥10 years ( p-trend < 0.0001). The monotonic positive association between night-shift work and type 2 diabetes remained after multivariable adjustment ( p-trend = 0.02). The association did not vary by obesity status, but was stronger in women aged <50 years. Conclusions/interpretation: Long duration of shift work was associated with an increased risk of type 2 diabetes. The association was only partially explained by lifestyle factors and BMI. A better understanding of the mechanisms by which shift work may affect the risk of diabetes is needed in view of the high prevalence of shift work among workers in the USA. [ABSTRACT FROM AUTHOR]

This study aims to quantitatively summarize the association between night shift work and the risk of metabolic syndrome ( MetS), with special reference to the dose-response relationship with years of night shift work. We systematically searched all observational studies published in English on Pub Med and Embase from 1971 to 2013. We extracted effect measures (relative risk, RR; or odd ratio, OR) with 95% confidence interval ( CI) from individual studies to generate pooled results using meta-analysis approach. Pooled RR was calculated using random- or fixed-effect model. Downs and Black scale was applied to assess the methodological quality of included studies. A total of 13 studies were included. The pooled RR for the association between 'ever exposed to night shift work' and MetS risk was 1.57 (95% CI = 1.24-1.98, pheterogeneity = 0.001), while a higher risk was indicated in workers with longer exposure to night shifts ( RR = 1.77, 95% CI = 1.32-2.36, pheterogeneity = 0.936). Further stratification analysis demonstrated a higher pooled effect of 1.84 (95% CI = 1.45-2.34) for studies using the NCEP- ATPIII criteria, among female workers ( RR = 1.61, 95% CI = 1.10-2.34) and the countries other than Asia ( RR = 1.65, 95% CI = 1.39-1.95). Sensitivity analysis confirmed the robustness of the results. No evidence of publication bias was detected. The present meta-analysis suggested that night shift work is significantly associated with the risk of MetS, and a positive dose-response relationship with duration of exposure was indicated. [ABSTRACT FROM AUTHOR]

Occupational engagement is a pre-requisite for continuous income opportunities. Among the changing social circumstances work-related conditions play an increasingly eminent role in psychological and mental well-being. The public discusses the question of a possible association between the demands of modern work life and the increases of psychological, psychosomatic and cardiovascular disorders. Given the socioeconomic implications of psychiatric and psychosomatic suffering in the general population, there is a need to further elucidate the causes of their increasing incidence. From a medical point of view, any organization of work disrupting the phased circadian rhythms for bio-psycho-social processes and functioning of the individual are interesting against the background of clock genes and certain biological functions that are organized in a circadian fashion. The authors review the influence of shift work as a form of systematic desynchronization of inner clock systems on the endocrine, the physical, and the mental level. The significance of the findings in the field is discussed along with future directions of conclusive research. [ABSTRACT FROM AUTHOR]

Background Shift work, including night work, has been hypothesized to increase the risk of chronic diseases, including cancer, cardiovascular disease (CVD), metabolic syndrome and diabetes. Recent reviews of evidence relating to these hypotheses have focussed on specific diseases or potential mechanisms, but no general summary of the current data on shift work and chronic disease has been published.Methods Systematic and critical reviews and recent original studies indexed in PubMed prior to 31 December 2009 were retrieved, aided by manual searches of reference lists. The main conclusions from reviews and principle results from recent studies are presented in text and tables.Results Published evidence is suggestive but not conclusive for an adverse association between night work and breast cancer but limited and inconsistent for cancers at other sites and all cancers combined. Findings on shift work, in relation to risks of CVD, metabolic syndrome and diabetes are also suggestive but not conclusive for an adverse relationship.Conclusions Heterogeneity of study exposures and outcomes and emphasis on positive but non-significant results make it difficult to draw general conclusions. Further data are needed for additional disease endpoints and study populations. [ABSTRACT FROM AUTHOR]

Shift work is affecting 20% to 25% employees and is becoming increasingly prevalent in contemporary life all over Europe and USA. It is associated with several health problems, such as e.g. metabolic syndrome, diabetes mellitus and cardiovascular disease. These diseases are possibly due to an impairment of biological rhythm. The metabolic syndrome is a complex of interrelated risk factors for cardiovascular disease and diabetes. Higher prevalence of the metabolic syndrome has been demonstrated among shift workers. Rotating shift work has an impact on each component of metabolic syndrome. Shift work might also have an impact on metabolic variables, and be a risk factor for type 2 diabetes. Only a few studies reported prevalence of impaired glucose metabolism and diabetes mellitus in relation to shift work. There is rather strong evidence in favour of association between shift work and coronary heart disease and that has been repeatedly demonstrated during over 20 years of research. Recent data increasingly reveal relations between shift work and plasma resistin, ghrelin, leptin and adiponectin. [ABSTRACT FROM AUTHOR]

Shift work that involves circadian disruption has been highlighted as a likely carcinogenic factor for breast cancer in humans. Also, unhealthy lifestyle habits observed in night work nurses could be causally related to an increase in the incidence of estrogen-positive breast tumours in this population. Assessing baseline risk of breast cancer in nurses is essential. The objective of this study was to analyze the risk of breast cancer that nurses had in relation to their lifestyle and labour factors related to shift work. A cross-sectional descriptive study through a questionnaire about sociodemographic variables, self-perception of health, and working life was designed. The sample consisted of 966 nurses. The relationship between variables was tested. A binary logistic regression and a classification and regression tree were performed. The most significant labour variables in relation to the risk of breast cancer were the number of years worked (more than 16 years; p < 0.01; OR = 8.733, 95% CI = 2.811, 27.134) and the total years performing more than 3 nights per month (10 or more years; p < 0.05; OR = 2.294, 95% CI = 1.008, 5.220). Also, the nights worked throughout life (over 500; OR = 4.190, 95% CI = 2.118, 8.287) were significant in the analysis. Nurses who had or ever had breast cancer valued their self-perceived health more negatively (p < 0.001) and referred a lower quality of sleep (p < 0.001) than the non-cases nurses. The occupational factors derived from night work could have several impacts on nurses' health and their family-work balance. Promoting healthy lifestyles, informing about shift work risks, and adjusting shift work schedules are critical methods to decrease the possible effects of circadian disruption in nurses. [ABSTRACT FROM AUTHOR]

(1) Background: Night shift workers have greater risks of developing cardiometabolic diseases compared to day workers due to poor sleep quality and dietary habits, exacerbated by circadian misalignment. Assessing effects of dietary interventions on health outcomes among this group will highlight gaps for future research. (2) Methods: A search of studies was conducted on PubMed, Cochrane Library, Embase, Embase Classic, Ovid Emcare, and Google Scholar, from earliest to June 2019. The population–intervention–comparator–outcomes–study design format determined inclusion criteria. (3) Results: 756 articles were retrieved; five met inclusion and exclusion criteria. Six-hundred-and-seventy night shift workers were from healthcare, industrial, and public safety industries. Dietary interventions included two longer-term nutrition programs and three shorter-term adjustments of meal composition, type, and timing. Outcome measures were varied but included weight and cardiometabolic health measures. Nutrition programs found no weight improvement at both six and 12 months; low-density lipoprotein (LDL)-cholesterol levels decreased at six months. Triglycerides peaked after meals at 7:30 pm; glucose and insulin area under the curve peaked after meals at 11:30 pm. (4) Conclusions: Weight loss was not achieved in the studies reviewed but LDL-cholesterol improved. Future studies should investigate the effects of energy reduction and altering meal timing on cardiometabolic risk factors of night shift workers in randomised controlled trials, while assessing hunger, sleepiness, and performance. [ABSTRACT FROM AUTHOR]