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Association between shift work and inflammatory markers in workers at an electronics manufacturing company

  • Sung-Joon Woo (Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Chang-Ho Chae (Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Jae-Won Lim (Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine)
  • Received : 2022.05.05
  • Accepted : 2022.10.06
  • Published : 2022.12.31

Abstract

Background: Shift work is known to be associated with cardiovascular disease (CVD). It has been found that inflammatory reactions are involved in the onset and progression of CVD. Therefore, the purpose of this study was to investigate the association between shift work and inflammatory markers. Methods: Among workers at an electronics manufacturing company, 2,329 workers who had a health checkup from January 2019 to December 2019 were targeted. The general and biochemical characteristics of daytime workers and shift workers were compared through the Independent-test and the χ2 test. Through multiple linear regression analysis, the association with shift work and inflammatory markers was investigated. Through multiple logistic regression analysis, the association with shift work and high inflammatory markers Results: The mean total leukocytes, neutrophils, monocytes, lymphocytes of shift workers were significantly higher than those of daytime worker. The mean high-sensitivity C-reactive protein (hs-CRP) of shift workers was also higher than that of daytime workers but not significantly. In multiple linear regression, shift work was associated with increase of total leukocyte count (β = 0.367, p < 0.001) and hs-CRP (β = 0.140, p = 0.005) after adjusting for all variables. In multiple logistic regression analysis, shift work showed 2.27 times risk of high leukocyte count and 1.8 times risk of high hs-CRP level compared to daytime work after adjusting for all variables. Conclusions: This study confirmed that shift work is associated with high inflammatory markers. Considering that high inflammatory markers is independent indicator of CVD, the association between shift work and high inflammatory markers may help to understand the CVD risk of shift workers.

Keywords

Acknowledgement

The authors would like to thank Chung EY for technical assistance for this study.

References

  1. Internatonal Labour Organization. C171 - Night work convention, 1990 (No. 171). https://www.ilo.org/dyn/normlex/en/f?p=1000:12100:::NO:12100:P12100_INSTRUMENT_ID:312316. Accessed March 1, 2022.
  2. Knutsson A. Methodological aspects of shift-work research. Chronobiol Int 2004;21(6):1037-47.
  3. Rosa RR, Colligan MJ. Plain Language About Shiftwork. Atlanta, GA, USA: Centers for Disease Control and Prevention; 1997.
  4. Costa G. Shift work and occupational medicine: an overview. Occup Med (Lond) 2003;53(2):83-8.
  5. Occupational Safety and Health Research Institute (OSHRI). Sixth Korean Working Conditions Survey - Final Report. Ulsan, Korea: OSHRI; 2020.
  6. Papantoniou K, Pozo OJ, Espinosa A, Marcos J, Castano-Vinyals G, Basagana X, et al. Circadian variation of melatonin, light exposure, and diurnal preference in day and night shift workers of both sexes. Cancer Epidemiol Biomarkers Prev 2014;23(7):1176-86.
  7. Razavi P, Devore EE, Bajaj A, Lockley SW, Figueiro MG, Ricchiuti V, et al. Shift work, chronotype, and melatonin rhythm in nurses. Cancer Epidemiol Biomarkers Prev 2019;28(7):1177-86.
  8. Spiegel K, Tasali E, Leproult R, Van Cauter E. Effects of poor and short sleep on glucose metabolism and obesity risk. Nat Rev Endocrinol 2009;5(5):253-61.
  9. Voigt RM, Forsyth CB, Keshavarzian A. Circadian rhythms: a regulator of gastrointestinal health and dysfunction. Expert Rev Gastroenterol Hepatol 2019;13(5):411-24.
  10. Rohr SM, Vonessen S, Farr L. Overview of the medical consequences of shift work. Clin Occup Environ Med 2003;3(2):351-61.
  11. Erren TC, Morfeld P, Gross JV, Wild U, Lewis P. IARC 2019: "Night shift work" is probably carcinogenic: what about disturbed chronobiology in all walks of life? J Occup Med Toxicol 2019;14(1):29.
  12. Torquati L, Mielke GI, Brown WJ, Kolbe-Alexander T. Shift work and the risk of cardiovascular disease. A systematic review and meta-analysis including dose-response relationship. Scand J Work Environ Health 2018;44(3):229-38.
  13. Boggild H, Knutsson A. Shift work, risk factors and cardiovascular disease. Scand J Work Environ Health 1999;25(2):85-99.
  14. Alfaddagh A, Martin SS, Leucker TM, Michos ED, Blaha MJ, Lowenstein CJ, et al. Inflammation and cardiovascular disease: from mechanisms to therapeutics. Am J Prev Cardiol 2020;4:100130.
  15. Li J, Flammer AJ, Reriani MK, Matsuo Y, Gulati R, Friedman PA, et al. High leukocyte count is associated with peripheral vascular dysfunction in individuals with low cardiovascular risk. Circ J 2013;77(3):780-5.
  16. Kannel WB, Anderson K, Wilson PW. White blood cell count and cardiovascular disease. Insights from the Framingham study. JAMA 1992;267(9):1253-6.
  17. Ichihara Y, Ohno J, Suzuki M, Anno T, Sugino M, Nagata K. Higher C-reactive protein concentration and white blood cell count in subjects with more coronary risk factors and/or lower physical fitness among apparently healthy Japanese. Circ J 2002;66(7):677-84.
  18. Shrivastava AK, Singh HV, Raizada A, Singh SK. C-reactive protein, inflammation and coronary heart disease. Egypt Heart J 2015;67(2):89-97.
  19. Puttonen S, Viitasalo K, Harma M. Effect of shiftwork on systemic markers of inflammation. Chronobiol Int 2011;28(6):528-35.
  20. Khosro S, Alireza S, Omid A, Forough S. Night work and inflammatory markers. Indian J Occup Environ Med 2011;15(1):38-41.
  21. Kim SW, Jang EC, Kwon SC, Han W, Kang MS, Nam YH, et al. Night shift work and inflammatory markers in male workers aged 20-39 in a display manufacturing company. Ann Occup Environ Med 2016;28(1):48.
  22. Rifai N. High-sensitivity C-reactive protein: a useful marker for cardiovascular disease risk prediction and the metabolic syndrome. Clin Chem 2005;51(3):504-5.
  23. Welsh C, Welsh P, Mark PB, Celis-Morales CA, Lewsey J, Gray SR, et al. Association of total and differential leukocyte counts with cardiovascular disease and mortality in the UK Biobank. Arterioscler Thromb Vasc Biol 2018;38(6):1415-23.
  24. Tamakoshi K, Toyoshima H, Yatsuya H, Matsushita K, Okamura T, Hayakawa T, et al. White blood cell count and risk of all-cause and cardiovascular mortality in nationwide sample of Japanese--results from the NIPPON DATA90. Circ J 2007;71(4):479-85.
  25. Liu Q, Zhao D, Wang W, Liu J, Sun JY, Liu J, et al. The association between white blood cell count and 10-year cardiovascular risk in a large Chinese cohort aged 35-64 years. Zhonghua Xin Xue Guan Bing Za Zhi 2008;36(5):453-7.
  26. Lu LF, Wang CP, Tsai IT, Hung WC, Yu TH, Wu CC, et al. Relationship between shift work and peripheral total and differential leukocyte counts in Chinese steel workers. J Occup Health 2016;58(1):81-8.
  27. Streng AA, Loef B, Dolle ME, van der Horst GT, Chaves I, Proper KI, et al. Night shift work characteristics are associated with several elevated metabolic risk factors and immune cell counts in a cross-sectional study. Sci Rep 2022;12(1):2022.
  28. Prame Kumar K, Nicholls AJ, Wong CH. Partners in crime: neutrophils and monocytes/macrophages in inflammation and disease. Cell Tissue Res 2018;371(3):551-65.
  29. Hanprathet N, Lertmaharit S, Lohsoonthorn V, Rattananupong T, Ammaranond P, Jiamjarasrangsi W. Shift work and leukocyte count changes among workers in Bangkok. Ann Work Expo Health 2019;63(6):689-700.
  30. Loef B, Nanlohy NM, Jacobi RH, van de Ven C, Mariman R, van der Beek AJ, et al. Immunological effects of shift work in healthcare workers. Sci Rep 2019;9(1):18220.
  31. Wirth MD, Andrew ME, Burchfiel CM, Burch JB, Fekedulegn D, Hartley TA, et al. Association of shiftwork and immune cells among police officers from the Buffalo Cardio-Metabolic Occupational Police Stress study. Chronobiol Int 2017;34(6):721-31.
  32. Nea FM, Kearney J, Livingstone MB, Pourshahidi LK, Corish CA. Dietary and lifestyle habits and the associated health risks in shift workers. Nutr Res Rev 2015;28(2):143-66.
  33. Hicklin D, Schwander J. Shift work and sleep. Praxis (Bern 1994) 2019;108(2):119-24.
  34. Akerstedt T. Shift work and disturbed sleep/wakefulness. Sleep Med Rev 1998;2(2):117-28.
  35. Reddy P, Lent-Schochet D, Ramakrishnan N, McLaughlin M, Jialal I. Metabolic syndrome is an inflammatory disorder: a conspiracy between adipose tissue and phagocytes. Clin Chim Acta 2019;496:35-44. 
  36. Monteiro R, Azevedo I. Chronic inflammation in obesity and the metabolic syndrome. Mediators Inflamm 2010;2010:289645.
  37. Kyrou I, Tsigos C. Stress hormones: physiological stress and regulation of metabolism. Curr Opin Pharmacol 2009;9(6):787-93.
  38. Rea IM, Gibson DS, McGilligan V, McNerlan SE, Alexander HD, Ross OA. Age and age-related diseases: role of inflammation triggers and cytokines. Front Immunol 2018;9:586.
  39. Klein SL, Flanagan KL. Sex differences in immune responses. Nat Rev Immunol 2016;16(10):626-38.
  40. de Heredia FP, Gomez-Martinez S, Marcos A. Obesity, inflammation and the immune system. Proc Nutr Soc 2012;71(2):332-8.
  41. Pedersen KM, Colak Y, Ellervik C, Hasselbalch HC, Bojesen SE, Nordestgaard BG. Smoking and increased white and red blood cells. Arterioscler Thromb Vasc Biol 2019;39(5):965-77.
  42. Piano MR. Alcohol's effects on the cardiovascular system. Alcohol Res 2017;38(2):219-41.
  43. Petersen AM, Pedersen BK. The anti-inflammatory effect of exercise. J Appl Physiol (1985) 2005;98(4):1154-62.
  44. Lee JH, Chang TW, Kwon YJ, Kim YK, Ryu SC, Kim IS. The relationship between job stress and hsCRP. Korean J Occup Environ Med 2011;23(3):261-9.
  45. Soysal P, Arik F, Smith L, Jackson SE, Isik AT. Inflammation, frailty and cardiovascular disease. Adv Exp Med Biol 2020;1216:55-64.