PDF
ePub
Citation
Print
Abstract
Objectives
The objectives of this study were to explore the association between shift work and the bone mineral density in a representative sample of Korean workers.
Methods
He data from the Fourth Korean National Health and Nutrition Examination Survey (2008-2009) was used. The participants were Korean workers aged 16 to 60 years. Logistic regression analysis was applied to determine the association between shift work and the bone mineral density after controlling for covariates using the SAS version 9.3 package program.
Results
The blood vitamin D level in shift workers was significantly lower than that of day workers in both males and females. In male shift workers, shift work was significantly associated with a decreased bone mineral density in the femoral neck (odds ratio(OR) 1.42, 95% confidence interval(CI)=1.05~1.92) and lumbar spine (OR 1.53, 95% CI=1.09~2.15) compared to day workers. After controlling for covariates, this association was still significant. In the case of female shift workers, shift work was significantly related to a decreased bone mineral density in the total femur (OR 2.84, 95% CI=1.69~4.79) and lumbar spine (OR 1.58, 95% CI=1.12~2.24). After controlling for covariates, this risk was not statistically significant.
Conclusions
The blood vitamin D level of shift workers was significantly lower than that of day workers. In male shift workers, shift work can decrease the bone mineral density in the femoral neck and lumbar spine. Prospective studies with information on the shift work intensity and duration and exposuredata to explain mechanisms will be needed.
Figures and Tables
Table 2
Results of other related characteristics with bone mineral density in both male and female workers by shift work
Table 3
Results of bone mineral density and related laboratory data in both male and female workers by shift work
Table 4
Odds ratios(OR) for decreased bone mineral density by T-score in shift workers by sex
*Crude model; day work versus shift work.
†Model 1; adjusted with work related variables, such as, job(manual vs non-manual), heavy material handling(yes or no), working time(hours).
‡Model 2; adjusted with individual factors(weight, smoking, alcohol consumption, exercise, family history of osteoporosis, coffee consumption, sleep hours), socioeconomic status factors(education, income), and hazardous material exposure factors(lead, cadmium).
§odds ratio.
∥onfidence interval.
References
1. European Foundation for the Improvement of Living and Working Conditions. Fifth European working conditions survey. Overview report. 2012. Luxembourg: Publications office of the European union;32.
2. Korean Statistical Information Service. Second Korean Working Conditions Survey(2010). cited 15 July 2012. Available: http://kosis.kr/abroad/abroad_01List.jsp?parentId=D.
3. Costa G. The impact of shift and night work on health. Appl Ergon. 1996. 27(1):9–16.
4. Åkerstedt T, Kecklund G, Selén J. Early morning work-prevalence and relation to sleep/wake problems: a national representative survey. Chronobiol Int. 2010. 27(5):975–986.
5. Åkerstedt T, Nordin M, Alfredsson L, Westerholm P, Kecklund G. Sleep and sleepiness: impact of entering or leaving shiftwork-a prospective study. Chronobiol Int. 2010. 27(5):987–996.
6. Lombardi DA, Folkard S, Willetts JL, Smith GS. Daily sleep, weekly working hours, and risk of work-related injury: US National Health Interview Survey (2004-2008). Chronobiol Int. 2010. 27(5):1013–1030.
7. Wagstaff AS, Sigstad Lie JA. Shift and night work and long working hours-a systematic review of safety implications. Scand J Work Environ Health. 2011. 37(3):173–185.
8. Caruso CC, Lusk SL, Gillespie BW. Relationship of work schedules to gastrointestinal diagnoses, symptoms, and medication use in auto factory workers. Am J Ind Med. 2004. 46(6):586–598.
9. Pietroiusti A, Forlini A, Magrini A, Galante A, Coppeta L, Gemma G, Romeo E, Bergamaschi A. Shift work increases the frequency of duodenal ulcer in H pylori infected workers. Occup Environ Med. 2006. 63(11):773–775.
10. Kawachi I, Colditz GA, Stamfer MJ, Willett WC, Manson JE, Speizer FE, Hennekens CH. Prospective study of shift work and risk of coronary heart disease in women. Circulation. 1995. 92(11):3178–3182.
11. Brown DL, Feskanich D, Sanchez BN, Rexrode KM, Schernhammer ES, Lisabeth LD. Rotating night shift work and the risk of ischemic stroke. Am J Epidemiol. 2009. 169(11):1370–1377.
12. Lie JA, Kjuus H, Zienolddiny S, Haugen A, Stevens RG, Kjaerheim K. Night work and breast cancer risk among Norwegian nurses: assessment by different exposure metrics. Am J Epidemiol. 2011. 173(11):1272–1279.
13. Hansen J, Stevens RG. Case-control study of shift-work and breast cancer risk in Danish nurses: impact of shift systems. Eur J Cancer. 2012. 48(11):1722–1729.
14. Conlon M, Lightfoot N, Kreiger N. Rotating shift work and risk of prostate cancer. Epidemiology. 2007. 18(1):182–183.
15. Schernhammer ES, Laden F, Speizer FE, Willett WC, Hunter DJ, Kawachi I, Fuchs CS, Colditz GA. Night-shift work and risk of colorectal cancer in the nurses' health study. J Natl Cancer Inst. 2003. 95(11):825–828.
16. Saurel-Cubizolles MJ, Zeitlin J, Lelong N, Papiernik E, Di Renzo GC, Bréart G;. Europop Group. Employment, working conditions, and preterm birth: results from the Europop case-control survey. J Epidemiol Community Health. 2004. 58(5):395–401.
17. Bonzini M, Palmer KT, Coggon D, Carugno M, Cromi A, Ferrario MM. Shift work and pregnancy outcomes: a systematic review with meta-analysis of currently available epidemiological studies. BJOG. 2011. 118(12):1429–1437.
18. Sanderson K, Andrews G. Common mental disorders in the workforce: recent findings from descriptive and social epidemiology. Can J Psychiatry. 2006. 51(2):63–75.
19. Driesen K, Jansen NW, Kant I, Mohren DC, van Amelsvoort LG. Depressed mood in the working population: associations with work schedules and working hours. Chronobiol Int. 2010. 27(5):1062–1079.
20. Nätti J, Anttila T, Oinas T, Mustosmäki A. Night work and mortality: prospective study among Finnish employees over the time span 1984 to 2008. Chronobiol Int. 2012. 29(5):601–609.
21. Han WJ. Shift work and child behavioral outcomes. Work Employ Soc. 2008. 22(1):67–87.
22. Lohstroh PN, Chen J, Ba J, Ryan LM, Xu X, Overstreet JW, Lasley BL. Bone resorption is affected by follicular phase length in female rotating shift workers. Environ Health Perspect. 2003. 111(4):618–622.
23. Feskanich D, Hankinson SE, Schernhammer ES. Nightshift work and fracture risk: the Nurses' Health Study. Osteoporos Int. 2009. 20(4):537–542.
24. Quevedo I, Zuniga AM. Low bone mineral density in rotating-shift workers. J Clin Densitom. 2010. 13(4):467–469.
25. Chung HY. Osteoporosis diagnosis and treatment 2007. J Korean Endocr Soc. 2008. 23(2):76–108. (Korean).
26. Kroger H, Tuppurainen M, Honkanen R, Alhava E, Saarikoski S. Bone mineral density and risk factors for osteoporosis-a population-based study of 1600 perimenopausal women. Calcif Tissue Int. 1994. 55(1):1–7.
27. Kim JY, Lim HS, Cheong HK, Lee HK, Kang HS. A study on the change of the bone density among workers exposed to hydrofluoric acid. Korean J Occup Environ Med. 1995. 7(1):120–127. (Korean).
28. Hwang HS, Choi HR. The effect of breath hold diving on bone mineral density of women fishery diver. Korean J Occup Environ Med. 2003. 15(4):411–421. (Korean).
29. Yoon JH, Koh SB, Oh SS, Park JH, Cha KT, Chang SJ, Lee KH, Cha BS. Difference of bone mineral density in between farmers and non-farmers. Proceedings of the Korean Society of Occupational and Environmental Medicine. 2009. –696. (Korean).
30. Korea Centers for Disease Control and Prevention. Korea Health Statistics 2008. Korea National Health and Nutrition Examination Survey (KNHANES IV-2). 2009. cited 10 July 2012. Available: http://knhanes.cdc.go.kr/(Korean).
31. Korea Centers for Disease Control and Prevention. Korea Health Statistics 2009. Korea National Health and Nutrition Examination Survey (KNHANES IV-3). 2010. cited 10 July 2012. Available: http://knhanes.cdc.go.kr/(Korean).
32. Korea Centers for Disease Control and Prevention. Education and quality control of bone mineral density test in the Fourth National Health and Nutrition Examination Survey (KNHANES IV-3). 2009. 2010. 47. (Korean).
33. Institute of Medicine. Dietary reference intakes for calcium and vitamin D. 2010. Washington DC, USA: The National Academies Press;487.
34. Kaplan FS, Soriano S, Fallon MD, Haddad JG. Osteomalacia in a night nurse. Clin Orthop Relat Res. 1986. 205:216–221.
35. Khosro S, Alireza S, Omid A, Forough S. Night work and inflammatory markers. Indian J Occup Environ Med. 2011. 15(1):38–41.
36. Davis S, Mirick DK, Chen C, Stanczyk FZ. Night shift work and hormone levels in women. Cancer Epidemiol Biomarkers Prev. 2012. 21(4):609–618.
37. Brzezinski A. Melatonin in humans. N Engl J Med. 1997. 336(3):186–195.
38. Cardinali DP, Ladizesky MG, Boggio V, Cutrera RA, Mautalen C. Melatonin effects on bone: experimental facts and clinical perspectives. J Pineal Res. 2003. 34(2):81–87.
39. Ostrowska Z, Kos-Kudla B, Swietochowska E, Marek B, Kajdaniuk D, Górski J. Assessment of the relationship between dynamic pattern of nighttime levels of melatonin and chosen biochemical markers of bone metabolism in a rat model of postmenopausal osteoporosis. Neuro Endocrinol Lett. 2001. 22(2):129–136.
40. Roth JA, Kim BG, Lin WL, Cho MI. Melatonin promotes osteoblast differentiation and bone formation. J Biol Chem. 1999. 274(31):22041–22047.
41. Kotlarczyk MP, Lassila HC, O'Neil CK, D'Amico F, Enderby LT, Witt-Enderby PA, Balk JL. Melatonin osteoporosis prevention study (MOPS): a randomized, double- blind, placebo-controlled study examining the effects of melatonin on bone health and quality of life in perimenopausal women. J Pineal Res. 2012. 52(4):414–426.
42. Khan AA, Syed Z. Bone densitometry in premenopausal women: synthesis and review. J Clin Densitom. 2004. 7(1):85–92.
43. Sun L, Peng Y, Sharrow AC, Iqbal J, Zhang Z, Papachristou DJ, Zaidi S, Zhu LL, Yaroslavskiy BB, Zhou H, Zallone A, Sairam MR, Kumar TR, Bo W, Braun J, Cardoso-Landa L, Schaffler MB, Moonga BS, Blair HC, Zaidi M. FSH directly regulates bone mass. Cell. 2006. 125(2):247–260.
44. Myong JP, Kim HR, Choi SE, Koo JW. The effect of socioeconomic position on bone health among Koreans by gender and menopausal status. Calcif Tissue Int. 2012. 90(6):488–495.
45. World Health Organization. WHO technical report series 921. Prevention and management of osteoporosis: report of a WHO scientific group. 2003. Geneva, Switzerland: 44.
46. Lee BK, Kim Y. Association between bone mineral density and blood lead level in menopausal women: analysis of 2008-2009 Korean National Health and Nutrition Examination Survey data. Environ Res. 2012. 115:59–65.
47. Burm EA, Ha M. Association between cadmium exposure and bone mineral density in Korea adults (KNHANES IV). Abstract proceedings from 2012 spring seminar of The Korean Society of Environmental Health and Toxicology. 2012. 174–175. (Korean).
48. Vuolo L, Di Somma C, Faggiano A, Colao A. Vitamin D and cancer. Front Endocrinol (Lausanne). 2012. 3:58.
49. Choi HS, Oh HJ, Choi H, Choi WH, Kim JG, Kim KM, Kim KJ, Rhee Y, Lim SK. Vitamin D insufficiency in Korea-a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. J Clin Endocrinol Metab. 2011. 96(3):643–651.
XML Download