Shift work is associated with positive COVID-19 status in hospitalised patients

AbstractIntroductionShift work is associated with both mental, and physical ill health, including lung disease and infections. However, the impact of shift work on significant COVID-19 illness has not be assessed. We therefore investigated whether shift work is associated with COVID-19.Methods501,000 UK biobank participants were linked to secondary care SARS-CoV-2 PCR results from public health England. Healthcare workers and those without an occupational history were excluded from analysis.ResultsMultivariate logistic regression taking into account age, sex, ethnicity and deprivation index revealed that irregular shift work (OR 2.42 95%CI 1.92-3.05), permanent shift work (OR 2.5, 95%CI 1.95-3.19), day shift work (OR 2.01, 95%CI 1.55-2.6), irregular night shift work (OR 3.04, 95%CI 2.37-3.9) and permanent night shift work (OR 2.49, 95%CI 1.67-3.7) were all associated with positive COVID-19 tests compared to participants that did not perform shift work. This relationship persisted after adding sleep duration, chronotype, pre-morbid disease, BMI, alcohol and smoking. Work factors (proximity to a colleague combined with estimated disease exposure) were positively correlated with COVID-19 incidence (r2=0.248, p=0.02). If this was added to the model shift work frequency remained significantly associated with COVID-19. To control for non-measured occupational factors the incidence of COVID-19 in shift workers was compared to colleagues in the same job who did not do shift work. Shift workers had a higher incidence of COVID-19 (p<0.01).ConclusionsShift work is associated with a higher likelihood of in-hospital COVID-19 positivity. This risk could potentially be mitigated via additional workplace precautions or vaccination.

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Shift work is associated with positive COVID-19 status in hospitalised patients

Thorax ◽

10.1136/thoraxjnl-2020-216651 ◽

2021 ◽

pp. thoraxjnl-2020-216651

Author(s):

Robert Maidstone ◽

Simon G Anderson ◽

David W Ray ◽

Martin K Rutter ◽

Hannah J Durrington ◽

...

Keyword(s):

Shift Work ◽

Night Shift ◽

Uk Biobank ◽

Multivariate Logistic Regression ◽

Occupational History ◽

Night Shift Work ◽

Work Factors ◽

Hospitalised Patients ◽

Disease Exposure ◽

The Impact

IntroductionShift work is associated with lung disease and infections. We therefore investigated the impact of shift work on significant COVID-19 illness.Methods501 000 UK Biobank participants were linked to secondary care SARS-CoV-2 PCR results from Public Health England. Healthcare worker occupational testing and those without an occupational history were excluded from analysis.ResultsMultivariate logistic regression (age, sex, ethnicity and deprivation index) revealed that irregular shift work (OR 2.42, 95% CI 1.92 to 3.05), permanent shift work (OR 2.5, 95% CI 1.95 to 3.19), day shift work (OR 2.01, 95% CI 1.55 to 2.6), irregular night shift work (OR 3.04, 95% CI 2.37 to 3.9) and permanent night shift work (OR 2.49, 95% CI 1.67 to 3.7) were all associated with positive COVID-19 tests compared with participants that did not perform shift work. This relationship persisted after adding sleep duration, chronotype, premorbid disease, body mass index, alcohol and smoking to the model. The effects of workplace were controlled for in three ways: (1) by adding in work factors (proximity to a colleague combined with estimated disease exposure) to the multivariate model or (2) comparing participants within each job sector (non-essential, essential and healthcare) and (3) comparing shift work and non-shift working colleagues. In all cases, shift work was significantly associated with COVID-19. In 2017, 120 307 UK Biobank participants had their occupational history reprofiled. Using this updated occupational data shift work remained associated with COVID-19 (OR 4.48 (95% CI 1.8 to 11.18).ConclusionsShift work is associated with a higher likelihood of in-hospital COVID-19 positivity. This risk could potentially be mitigated via additional workplace precautions or vaccination.

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Immunological effects of shift work in healthcare workers

Scientific Reports ◽

10.1038/s41598-019-54816-5 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 9

Author(s):

Bette Loef ◽

Nening M. Nanlohy ◽

Ronald H. J. Jacobi ◽

Chantal van de Ven ◽

Rob Mariman ◽

...

Keyword(s):

T Cells ◽

Shift Work ◽

Cd8 T Cells ◽

Healthcare Workers ◽

Night Shift ◽

T Cell Subsets ◽

Shift Workers ◽

Night Shift Work ◽

Adverse Health Effects ◽

Immunological Effects

AbstractThe immune system potentially plays an important mechanistic role in the relation between shift work and adverse health effects. To better understand the immunological effects of shift work, we compared numbers and functionality of immune cells between night-shift and non-shift workers. Blood samples were collected from 254 night-shift and 57 non-shift workers employed in hospitals. Absolute numbers of monocytes, granulocytes, lymphocytes, and T cell subsets were assessed. As read out of immune function, monocyte cytokine production and proliferative capacity of CD4 and CD8 T cells in response to various stimuli were analysed. The mean number of monocytes was 1.15 (95%-CI = 1.05–1.26) times higher in night-shift than in non-shift workers. Furthermore, night-shift workers who worked night shifts in the past three days had a higher mean number of lymphocytes (B = 1.12 (95%-CI = 1.01–1.26)), T cells (B = 1.16 (95%-CI = 1.03–1.31)), and CD8 T cells (B = 1.23 (95%-CI = 1.05–1.45)) compared to non-shift workers. No differences in functional parameters of monocytes and lymphocytes were observed. The differences in numbers of monocytes and T cells suggest that chronic exposure to night-shift work as well as recent night-shift work may influence the immune status of healthcare workers. This knowledge could be relevant for preventive initiatives in night-shift workers, such as timing of vaccination.

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High risk of near-crash driving events following night-shift work

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1510383112 ◽

2015 ◽

Vol 113 (1) ◽

pp. 176-181 ◽

Cited By ~ 76

Author(s):

Michael L. Lee ◽

Mark E. Howard ◽

William J. Horrey ◽

Yulan Liang ◽

Clare Anderson ◽

...

Keyword(s):

High Risk ◽

Shift Work ◽

Occupational Safety ◽

Motor Vehicle ◽

Night Shift ◽

Driving Performance ◽

Previous Night ◽

Shift Workers ◽

Night Shift Work ◽

The Impact

Night-shift workers are at high risk of drowsiness-related motor vehicle crashes as a result of circadian disruption and sleep restriction. However, the impact of actual night-shift work on measures of drowsiness and driving performance while operating a real motor vehicle remains unknown. Sixteen night-shift workers completed two 2-h daytime driving sessions on a closed driving track at the Liberty Mutual Research Institute for Safety: (i) a postsleep baseline driving session after an average of 7.6 ± 2.4 h sleep the previous night with no night-shift work, and (ii) a postnight-shift driving session following night-shift work. Physiological measures of drowsiness were collected, including infrared reflectance oculography, electroencephalography, and electrooculography. Driving performance measures included lane excursions, near-crash events, and drives terminated because of failure to maintain control of the vehicle. Eleven near-crashes occurred in 6 of 16 postnight-shift drives (37.5%), and 7 of 16 postnight-shift drives (43.8%) were terminated early for safety reasons, compared with zero near-crashes or early drive terminations during 16 postsleep drives (Fishers exact:P= 0.0088 andP= 0.0034, respectively). Participants had a significantly higher rate of lane excursions, average Johns Drowsiness Scale, blink duration, and number of slow eye movements during postnight-shift drives compared with postsleep drives (3.09/min vs. 1.49/min; 1.71 vs. 0.97; 125 ms vs. 100 ms; 35.8 vs. 19.1; respectively,P< 0.05 for all). Night-shift work increases driver drowsiness, degrading driving performance and increasing the risk of near-crash drive events. With more than 9.5 million Americans working overnight or rotating shifts and one-third of United States commutes exceeding 30 min, these results have implications for traffic and occupational safety.

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P040 Night Shift Work and Disease: A Systematic Review of the Role of Oxidative Stress

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.088 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A34-A34

Author(s):

M Gibson

Keyword(s):

Oxidative Stress ◽

Reactive Oxygen Species ◽

Shift Work ◽

Night Shift ◽

Reactive Oxygen ◽

Oxygen Species ◽

Repair Capacity ◽

Shift Workers ◽

Night Shift Work ◽

The Impact

Abstract Night shift workers make up an essential part of the modern workforce. However, night shift workers have higher incidences of late in life diseases and earlier mortality. Night shift workers are exposed to constant light and experience circadian rhythm disruption. Sleep disruption is thought to increase oxidative stress, defined as an imbalance of excess pro-oxidative factors and reactive oxygen species over anti-oxidative activity. Oxidative stress can damage cells, proteins and DNA and can eventually lead to varied chronic diseases such as cancer, diabetes, cardiovascular disease, Alzheimer’s and dementia. This review aimed to understand whether night shift workers were at greater risk of oxidative stress and to contribute to a consensus on this relationship. Twelve studies published in 2001–2019 examining 2,081 workers were included in the review. Studies compared both the impact of working a single shift and in comparisons between those who regularly work night shifts and only day shifts. All studies had evidence to support this relationship across a range of oxidative stress indicators, including: increased DNA damage, reduced DNA repair capacity, increased lipid peroxidation, higher levels of reactive oxygen species, and to a lesser extent, a reduction in antioxidant defence. This research supports the theory that melatonin and the sleep wake cycle mediate the relationship between shift work and oxidative stress. It is concluded that night shift work increases the risk for oxidative stress and therefore future disease. Recommendations are made to promote the long-term health of shift workers considering these findings.

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Working the Night Shift: The Impact of Compensating Wages and Local Economic Conditions on Shift Choice

Economics Research International ◽

10.1155/2014/632506 ◽

2014 ◽

Vol 2014 ◽

pp. 1-15 ◽

Cited By ~ 1

Author(s):

Colene Trent ◽

Walter J. Mayer

Keyword(s):

Regression Model ◽

Shift Work ◽

Night Shift ◽

Economic Conditions ◽

Compensating Differentials ◽

Switching Regression ◽

Shift Workers ◽

Night Shift Work ◽

The Impact ◽

Night Shifts

The theory of compensating differentials asserts that night shift workers should receive compensating wage differentials due to undesirable work conditions. In weak local economies, workers may have difficulty finding jobs; thus, these workers might be more likely to accept night shift work and be less concerned with the size of the compensating differential for night shifts. Using CPS data from 2001, this paper employs maximum likelihood estimation of an endogenous switching regression model to analyze wages of day and night shift workers and shift choice. The findings indicate the presence of selection bias, thus emphasizing the importance of correcting for self-selection into night shifts. The average of the estimated wage differentials for night shift work is negative for the overall sample, with differentials varying by worker characteristics. The shift differential is found to be a statistically significant predictor of shift choice, indicating that shift premiums play an important role in motivating individuals to select night shift work. Using two measures of local economic conditions and a new method of analyzing interaction effects in the context of an endogenous switching regression model, this paper finds limited evidence that weak local economic conditions lessen the impact of compensating differentials on shift choice.

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The Impact Of Fatigue And Night Shift-work On Police Officer Use Of Force, Social Interaction, And Post-shift Driving Performance

PsycEXTRA Dataset ◽

10.1037/e505972017-001 ◽

2017 ◽

Author(s):

Stephen James ◽

Lois James ◽

Bryan Vila

Keyword(s):

Social Interaction ◽

Police Officer ◽

Shift Work ◽

Night Shift ◽

Use Of Force ◽

Driving Performance ◽

Night Shift Work ◽

The Impact ◽

Post Shift

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O4A.5 Night shift work is associated with abnormal liver function

Occupational and Environmental Medicine ◽

10.1136/oem-2019-epi.89 ◽

2019 ◽

Vol 76 (Suppl 1) ◽

pp. A33.2-A33

Author(s):

Lap Ah Tse ◽

Feng Wang ◽

Liuzhuo Zhang ◽

Zhimin Li

Keyword(s):

Liver Function ◽

Shift Work ◽

Night Shift ◽

Abnormal Liver Function ◽

Baseline Survey ◽

Shift Workers ◽

Night Shift Work ◽

Logistic Regression Models ◽

Biochemical Analyzer ◽

Stratified Analysis

ObjectiveTo examine the relationship between night shift work and elevated level of alanine transaminase (e-ALT) of workers, stratified by status of non-alcohol fatty liver.MethodsWe established a prospective cohort of night shift workers in Shenzhen, China. All 4740 male workers who had liver function data from the baseline survey of this night shift workers’ cohort were included in the current analysis. We collected information on demographics, lifestyles, and lifetime working schedule from standardized questionnaire. We examined workers’ NAFL status using liver sonography and their serum ALT levels using the automatic biochemical analyzer. Unconditional logistic regression models were used to evaluate odds ratios (ORs) and 95% confidence interval (95% CI).ResultsThis cohort contained 39.5% night shift workers. Compared with the day workers, night shift workers had higher odds of e-ALT (OR: 1.18; 95% CI 1.00–1.40). Stratified analysis showed that a positive gradient between night shift years and elevated e-ALT was only restricted to the night shift workers without NAFL. No similar trend was observed among those with NAFL.ConclusionsNight shift work is positively associated with the abnormal liver function in workers without NAFL, which indicates that shift work involving circadian disruption is likely to affect abnormal liver function.[National Natural Science Foundation of China (Project number 81273172 and 81372964), [email protected] (Lap Ah Tse)]

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Relationship of work-related stress with obesity among Brazilian female shift workers

Public Health Nutrition ◽

10.1017/s1368980020004243 ◽

2020 ◽

pp. 1-7

Author(s):

Janaína Cristina da Silva ◽

Anderson Garcez ◽

Gabriela Herrmann Cibeira ◽

Heloísa Theodoro ◽

Maria Teresa Anselmo Olinto

Keyword(s):

Shift Work ◽

Night Shift ◽

Cross Sectional Study ◽

Cross Sectional ◽

Work Related Stress ◽

Shift Workers ◽

Night Shift Work ◽

Work Related ◽

Prevalence Of Obesity ◽

Related Stress

Abstract Objectives: To explore the relationship between work-related stress and obesity among female shift workers. Additionally, we also aimed to test the interaction between shift work and work-related stress in this association. Design: A cross-sectional study was conducted among Brazilian female shift workers. Work-related stress was assessed through a demand–control questionnaire (Job Stress Scale). Work-related stress was defined by the presence of high psychological demands and low control at work. The obesity cases were defined as those with a BMI of 30 kg/m2 or more. Multivariate Poisson regression with robust variance was used to obtain the prevalence ratios (PR) and their respective 95 % CI. Setting: A group of industries located in southern Brazil in 2017. Participants: Four hundred and twenty female workers aged 18–59 years. Results: The overall prevalence of obesity was 30 % (95 % CI: 25·6, 34·4), and the presence of work-related stress was identified in 24 % (95 % CI: 19·9, 28·1) of the sample. We found an indication of interaction between work-related stress and night shift work on obesity (P = 0·026). After adjusting for confounding factors, work-related stress was associated with a 71 % greater probability of obesity (PR = 1·71; 95 % CI: 1·02, 2·87; P = 0·042) among female night shift workers. Conclusions: In this study, we revealed that exposure to work-related stress and night shift work were associated with obesity among female shift workers. Furthermore, the prevalence of obesity was high among female shift workers.

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