Impact of nightshift work on the prevalence of er

Authors: Tae Heum Chung Jiho Lee Moon Chan Kim

Publish Date: 2016/04/29

Volume: 89, Issue: 6, Pages: 961-966

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Abstract

A crosssectional study with 6040 male shipyard workers was performed Esophagogastroduodenoscopic examination and a survey about nightshift work status lifestyle medical history educational status and marital status were conducted in all workers The odds ratios of erosive esophagitis according to nightshift work status were calculated by using the logistic regression modelThe prevalence of erosive esophagitis increased in the nightshift workers odds ratio 95  confidence interval 141 103–194 According to multiple logistic regression models nightshift work obesity smoking and alcohol consumption of ≥140 g/week were significant risk factors for erosive esophagitis By contrast Helicobacter pylori infection was negatively associated with erosive esophagitisAfter the industrial revolutions the concept of shift work emerged and the type of work was divided into day and night shifts In a recent population survey 18  of the US labor force works in some form of shift work Mcmenamin 2007 Among the companies in South Korea 20  have adopted shift work and 80  of those companies that have adopted shift work have adopted a 12h day shift Son et al 2008 Working at night can affect health in various manners because it disrupts the circadian rhythm Knutsson 2003 Almost all physical functions including the control of appetite and digestion are regulated by the circadian rhythm Knutsson 2010Gastroesophageal reflux disease GERD is a condition developed when the reflux of stomach contents causes troublesome symptoms and/or complications Vakil et al 2006 Its prevalence is known to be 10–20  in the Western world and 5  in Asia The most common symptoms are heartburn regurgitation and dysphagia GERD symptoms cause a large burden among employers because of the high absence rate and poor performance Locke et al 1997Recent studies have indicated that disruption of the circadian system such as due to shift work is an important contributory factor in numerous important pathological conditions including gastrointestinal diseases Erren and Reiter 2009 Although many studies have investigated the association between shift work and gastrointestinal disorders these have focused on peptic ulcer disease or unspecific gastrointestinal symptoms Lundell et al 1999 A strong evidence links shift work to peptic ulcer disease Knutsson 2003 However only one study investigated the association between shift work and GERD this study used a questionnaire to diagnose GERD Li et al 2008 To date therefore no study has been published that has examined the possible association between nightshift work and GERD by using endoscopy Erosive esophagitis EE is a complication of GERD that can be easily detected on endoscopy and can be used as an objective criterion for the diagnosis of GERD Vakil et al 2006 In this study we assessed the impact of nightshift work and other factors on the prevalence of EE among shipyard male workers in South Korea to clarify the association between nightshift work and GERDData were obtained from 6040 shipyard workers who were at least 30 years old and underwent a routine health checkup that included esophagogastroduodenoscopy EGD at the Ulsan University Hospital Heath Promotion Center UUHHPC in Ulsan South Korea between March 2012 and February 2013 In South Korea the law mandates that all workers in big companies such as those in the shipyard industry must undergo an annual health checkup including health surveys During the study period 6505 subjects were examined of whom 271 had missing data pertaining to their characteristics and 105 had a history of gastrectomy or cancer or a current cancer These 376 subjects were excluded A total of 26 subjects who worked night shifts for less than 1 year and 63 subjects who worked night shifts on 8h shifts were also excluded Of the 6040 shipyard workers eligible 5577 worked on daytime and 463 worked on rotating night shift by twelvehour length working during 8 am to 8 pm for 1 week and then during 8 pm to 800 am alternately The study protocol was approved by the institutional review board of UUH

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