Night shift work and lymphoma: results from an Italian multicentre case–control study

BackgroundNight shift work can disrupt circadian rhythm and cause chronic sleep deprivation, which might increase the risk of lymphoma through immunosuppression and oxidative stress.Material and methodsWe investigated the association between night shift work and risk of lymphoma subtypes in 867 incident cases and 774 controls, who participated in a multicentre Italian study between 2011 and 2017. Based on questionnaire information, occupational experts assessed the lifetime probability of night shift work, the total number of night shifts and years of night shift work among study participants. OR and 95% CI for lymphoma and its major subtypes associated with night shift work was calculated with logistic regression, adjusting by age, gender, education, study area, marital status and family history of haemolymphatic cancer.ResultsEver working night shifts was associated with an increase in the risk of chronic lymphocytic leukaemia (CLL) (OR 1.9, 95% CI 1.14 to 3.32), which was highest after a 15–34 years latency. However, there was not a linear increase in risk by probability of exposure, years of night shift work, nor lifetime number of night shifts whether under rotating or permanent work schedules. Risk of lymphoma overall, B cell lymphoma (BCL), its major subtypes other than CLL, and other less prevalent BCL subtypes combined did not show an association.ConclusionsWe found conflicting evidence of an association between night shift work and the risk of CLL. We did not observe an association with other lymphoma subtypes.

The Awareness and Empowerment Aspects of the Needlesticks and Other Sharps Injuries and Reporting in Nursing Education: A Cross-Sectional Survey

Background Occurrence and underreporting of needlesticks and other sharps injuries (NSIs) are still immediate concerns among nursing students. This study examined the relationship between occupational health and safety (OHS) awareness and empowerment levels of nursing students and the occurrence and reporting of NSIs. Methods This cross-sectional study was conducted among purposively selected 840 students in a nursing school in 2018–2019. A self-report questionnaire was used to collect data about students’ sociodemographic characteristics, OHS awareness and empowerment levels, and NSIs characteristics. After bivariate analyses, multivariate logistic regression was used. Results The number of evaluated questionnaires was 469, for a response rate of 55.8%. Participants, 21.2% ( n = 99), had suffered NSIs, and 47.8% had reported their injuries. The NSIs were statistically related to age, academic year, working night shift, OHS awareness level of students, and the number of clinical placements completed by students. The odds of experiencing NSIs was 2.3 (95% confidence interval [CI] = [1.0, 5.3]) times higher in male students, 4.3 (95% CI = [2.4, 7.4]) times higher in those beyond the second academic year, and 2.5 (95% CI = [1.4, 4.4]) times higher in those who had received OHS training for a shorter period than the average duration. Conclusion/Application to practice The levels of awareness and empowerment were higher in students who received OHS and NSIs prevention training and those who received OHS training for the above-average duration. Increasing awareness and empowerment levels of nursing students through training can reduce the occurrence and the underreporting of NSIs.

Occupational Stress and Perceived Quality of Life Among Clinical Nurses: A Cross-Sectional Study in A Nigerian State

This study assessed the influence of occupational stress on perceived quality of life among clinical nurses in selected hospitals in Nigeria. A cross sectional descriptive research design was adopted while multiple sampling was used to select the respondents from hospitals in Ogun state. Slovin’s formula (n=N/[1+N (e²)]) was used to determine the sample size of 425. A structured questionnaire was used to obtain information from respondents. The analysis was done with SPSS version 25 while descriptive such as tables and bar charts and inferential statistics were used to present the data. Findings revealed that the mean age of the respondents is 36.37±8.90 years and majority of the respondents were between 30-49 years. Almost half of the respondents (48.0%) reported high occupational stress while 44.2% and 7.8% reported low & fair occupational stress respectively. High workload (83.9%), long hours of night shift (71.1%), lack of resources and equipment (67.8%), frequency night shift (67.5%), emotional load of dealing with aggressive and demanding patients (62.6%), poor salary (61.6%), and prolong standing with no time for break (58.5%) are factors responsible for stress among nurses. The results further showed that 52.2% of the respondents reported good work-related quality of life while 38.8% rated their work-related quality of life as poor. The study also showed that there was significant relationship between occupational stress (Organizational issues (P= 0.035), Occupational hazards (P= 0.024), Interpersonal relationships (p= 0.003) and unmet basic physiological needs (P= 0.005)) and work-related quality of life. Conclusion: This study concluded that occupational stress affects nurses’ work-related quality of life negatively and influence patients’ outcomes. Hence, there is an urgent need for development of health promotion programmes on stress reduction and stress management. Keywords: Influence, Occupational Stress, Quality of life, Clinical Nurses.

Social jetlag and sleep debts are altered in different rosters of night shift work

Background Night and shift work are suspected to cause various adverse effects on health and sleep. Sleep deprivation through shift work is assumed to be compensated on free days. So far it is not clear how different shift systems and shift lengths affect sleep structure on work and free days. Especially working night shifts disrupts the circadian rhythm but also extended working hours (12h) might affect sleep characteristics. Hitherto, the magnitude of sleep debt, social jetlag, and Locomotor Inactivity During Sleep (LIDS) in different shift systems is unknown. Methods Here, we investigated the impact of five different shift rosters on sleep in 129 industrial workers from Germany. Permanent night work with multiple shift systems with and without night shifts and with different shift lengths were compared. Wrist-activity was monitored over 28 days revealing sleep on- and offsets as well as LIDS as proxy for sleep quality. Overall, 3,865 sleep bouts comprising 22,310 hours of sleep were examined. Results The mean daily age-adjusted sleep duration (including naps) was 6:43h and did not differ between shift workers of different rosters. However, sleep duration on workdays was particularly low in rotational shift systems with 12h-shifts (5:00h), while overall sleep debt was highest. Shift workers showed a median absolute social jetlag of 3:03h, which differed considerably between shift types and rosters (p<0.0001). Permanent night workers had the highest social jetlag (5:08h) and latest mid-sleeps on workdays and free days. Sleep quality was reduced in permanent night shift workers compared with shift workers in other rosters and differed between daytime and nighttime sleep. Conclusions Shift work leads to partial sleep deprivation, which particularly affects workers in 12h-shifts and permanent night shifts. Working these shifts resulted in higher sleep debts and larger absolute social jetlag whereas sleep quality was especially reduced in permanent night shift workers compared with shift workers of other rosters.

Demographic Factors and Job Characteristics Associated With Burnout in Chinese Female Nurses During Controlled COVID-19 Period: A Cross-Sectional Study

Background: To investigate the prevalence of burnout syndrome among Chinese female nurses during the controlled coronavirus disease 2019 (COVID-19) period and explore its associated socio-demographic factors and job characteristics.Methods: With the multistage, stratified sampling method, a cross-sectional online survey was conducted from September to October 2020 in China. The survey tool included revised Maslach Burnout Inventory (MBI) with 15 items, socio-demographic and job characteristics. Univariate logistic regression analysis and multivariate factor logistic regression analysis were used to identify the risk factors for burnout of female nurses.Results: During controlled COVID-19 period in China, the overall prevalence of burnout symptoms among Chinese female nurses was 60.2% with a breakdown in severity as follows: 451 (39.8 %) mild, 163 (14.4%) moderate, and 68 (6.0%) severe burnout. Little variance was reported for burnout symptoms according to job tenure (Waldχ2 = 14.828, P &lt; 0.05,odds ratio [OR] &lt;1), monthly salary income (Waldχ2 = 12.460, P &lt; 0.05, OR &lt;1), and night shift (Waldχ2 = 3.821, P &lt; 0.05, OR &gt; 1).Conclusion: Burnout symptoms among Chinese female nurses were prevalent and associated with job tenure, monthly salary income, and night shift. Female nurses who were with shorter job tenure, worked at night shifts, and had lower monthly salaries tended to exhibit increasing high-level burnout than their counterparts. This study serves as an implication for administrators and policy-makers to improve the work conditions of nurses for promoting overall healthcare service quality.

Disturbance of the Circadian System in Shift Work and Its Health Impact

The various non-standard schedules required of shift workers force abrupt changes in the timing of sleep and light-dark exposure. These changes result in disturbances of the endogenous circadian system and its misalignment with the environment. Simulated night-shift experiments and field-based studies with shift workers both indicate that the circadian system is resistant to adaptation from a day- to a night-oriented schedule, as determined by a lack of substantial phase shifts over multiple days in centrally controlled rhythms, such as those of melatonin and cortisol. There is evidence that disruption of the circadian system caused by night-shift work results not only in a misalignment between the circadian system and the external light-dark cycle, but also in a state of internal desynchronization between various levels of the circadian system. This is the case between rhythms controlled by the central circadian pacemaker and clock genes expression in tissues such as peripheral blood mononuclear cells, hair follicle cells, and oral mucosa cells. The disruptive effects of atypical work schedules extend beyond the expression profile of canonical circadian clock genes and affects other transcripts of the human genome. In general, after several days of living at night, most rhythmic transcripts in the human genome remain adjusted to a day-oriented schedule, with dampened group amplitudes. In contrast to circadian clock genes and rhythmic transcripts, metabolomics studies revealed that most metabolites shift by several hours when working nights, thus leading to their misalignment with the circadian system. Altogether, these circadian and sleep-wake disturbances emphasize the all-encompassing impact of night-shift work, and can contribute to the increased risk of various medical conditions. Here, we review the latest scientific evidence regarding the effects of atypical work schedules on the circadian system, sleep and alertness of shift-working populations, and discuss their potential clinical impacts.

Multi-Modal Regulation of Circadian Physiology by Interactive Features of Biological Clocks

The circadian clock is a fundamental biological timing mechanism that generates nearly 24 h rhythms of physiology and behaviors, including sleep/wake cycles, hormone secretion, and metabolism. Evolutionarily, the endogenous clock is thought to confer living organisms, including humans, with survival benefits by adapting internal rhythms to the day and night cycles of the local environment. Mirroring the evolutionary fitness bestowed by the circadian clock, daily mismatches between the internal body clock and environmental cycles, such as irregular work (e.g., night shift work) and life schedules (e.g., jet lag, mistimed eating), have been recognized to increase the risk of cardiac, metabolic, and neurological diseases. Moreover, increasing numbers of studies with cellular and animal models have detected the presence of functional circadian oscillators at multiple levels, ranging from individual neurons and fibroblasts to brain and peripheral organs. These oscillators are tightly coupled to timely modulate cellular and bodily responses to physiological and metabolic cues. In this review, we will discuss the roles of central and peripheral clocks in physiology and diseases, highlighting the dynamic regulatory interactions between circadian timing systems and multiple metabolic factors.

Association of Sleep Characteristics and Night Shift Work with Polycystic Ovary Syndrome: A Cross-Sectional Study

Background: The association between polycystic ovary syndrome (PCOS) and circadian rhythm has been established, but to date, investigations that describe the sleep-wake behavior of PCOS in China are limited. Here, we examined the association of sleep characteristics and night shift work with the risk of PCOS in Chinese women, and investigated their relationship to infertility in PCOS. Methods: From March 21, 2021, to April 31, 2021, a total of 3 927 Chinese women with or without PCOS were recruited online. All participants completed the WeChat-based electronic questionnaires. Sleep characteristics were measured by the Pittsburgh Sleep Quality Index.Results: A total of 2 871 women were extracted for final analysis. Sleep duration (OR, 0.857; 95% CI, 0.763-0.963), sleep midpoint (OR, 1.142; 95% CI, 1.049-1.244), sleep disturbance (OR,1.320; 95% CI, 0.957-1.146), daytime dysfunction (OR, 1.136; 95% CI, 1.030-1.253) and night shift work (OR, 1.628; 95% CI, 1.264-2.097) were associated with higher risk of PCOS. After adjusting for confounders including age, body mass index, smoking status, coffee and tea drinking status, sleep disturbance (OR, 1.314; 95% CI, 1.111-1.555), daytime dysfunction (OR, 1.143; 95% CI, 1.034-1.264) and night shift work (OR, 1.800; 95% CI, 1.388-2.333) remained associated. In addition, sleep disturbance (OR, 1.887; 95% CI, 1.400-2.542) and subjective sleep quality (OR, 1.299; 95% CI, 1.037-1.627) were related to infertility in women with PCOS, and sleep disturbance (OR, 1.750; 95% CI, 1.281-2.390) remained significant after adjusting for confounders.Conclusions: These results suggest that sleep disturbance, daytime dysfunction and night shift work were significantly associated with PCOS. Screening for sleep disturbance and providing appropriate treatment could be potential strategies to manage PCOS and its long-term complications.