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Shift Work and Respiratory Infections in Health-Care Workers - PubMed

  • ️Tue Jan 01 2019

Shift Work and Respiratory Infections in Health-Care Workers

Bette Loef et al. Am J Epidemiol. 2019.

Abstract

Recently, there has been interest in whether shift work may enhance susceptibility to infection. Our aim was to determine whether shift workers in the health-care field have a higher incidence, duration, and/or severity of influenza-like illness (ILI) and acute respiratory infection (ARI) than non-shift workers. From September 2016 to June 2017, 501 rotating and/or night-shift workers and 88 non-shift workers from the Klokwerk+ Study (the Netherlands, 2016-2017) registered the occurrence of ILI/ARI symptoms daily using a smartphone application. The incidence rate of ILI/ARI (defined as ≥2 symptoms on the same day/≥1 symptom on 2 consecutive days), the mean duration of each episode, and the incidence rate of severe episodes were compared between shift workers and non-shift workers using negative binomial regression and linear mixed-model analysis. In total, participants completed 110,347 diaries. Shift workers' incidence rate of ILI/ARI was 1.20 (95% confidence interval (CI): 1.01, 1.43) times higher than that of non-shift workers, and for severe ILI/ARI episodes, shift workers' incidence rate was 1.22 (95% CI: 1.01, 1.49) times higher. The mean duration of an ILI/ARI episode did not differ (ratio between means = 1.02, 95% CI: 0.87, 1.19). In conclusion, shift workers in health care had more ILI/ARI episodes and more severe ILI/ARI episodes than non-shift workers, but with a similar duration. Insight into underlying mechanisms connecting shift work and infection susceptibility will contribute to the design of preventive initiatives.

Keywords: acute respiratory infection; health-care workers; infection susceptibility; influenza-like illness; night-shift work; occupational health; respiratory infection; shift work.

© The Author(s) 2018. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

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Figures

Figure 1.
Figure 1.

Selection of participants for a study of shift work and respiratory infections in health-care workers, Klokwerk+ Study, the Netherlands, 2016–2017.

Figure 2.
Figure 2.

Effect estimates for differences in incidence rates of influenza-like illness/acute respiratory infection among shift workers versus non–shift workers according to frequency of night-shift work and duration of night-shift work (negative binomial regression analysis adjusted for age, sex, occupation, influenza vaccination status, and general perceived health), Klokwerk+ Study, the Netherlands, 2016–2017. Non–shift workers (reference group) were defined as workers who did not work rotating shifts or night shifts (i.e., workers who worked only day shifts). Shift workers were defined as workers who worked rotating shifts and/or night shifts. Non–night-shift workers were defined as a subgroup of the shift-worker group who worked rotating shifts without night shifts. Bars, 95% confidence intervals (CIs). IRR, incidence rate ratio.

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