長期夜間輪班工作者與肥胖、三高疾病探討及預防

Abstract

肥胖、三高為腦心血管疾病的危險因子，腦心血管疾病嚴重威脅著國人的健康，是一個不可忽視的健康問題。103年勞動部職業安全衛生署發布了「異常工作負荷促發疾病預防指引」，將腦心血管疾病列為過勞死之標的疾病，超時工作、輪班及夜間工作是過勞的高風險族群之一。流行病學實證研究顯示心肌梗塞、高血壓、糖尿病、肥胖、肌肉骨骼疾病、睡眠障礙、憂鬱、疲勞及其他身心症狀等與輪班、夜間及長時間工作有關。本研究的目的，我們探討夜班輪班工作與肥胖、三高疾病及代謝症候群的相關性。 本研究屬於描述性研究，以橫斷式研究設計，於107年招募某科技廠到職滿一年所有員工，由醫師進行理學檢查，並由護理師測量身高、體重、腰圍、血壓，收集血液、尿液樣本，以問卷方式調查工時及睡眠時數，分析固定日班與夜間輪班勞工身體質量指數、血壓、血脂、血糖、代謝症候群危險性差異，並以多變項迴歸分析，校正性別、年齡影響。研究共收集受試者1291人，對象包含固定日班(n = 878)、夜間輪班(n = 204)、日夜輪班(n = 209)，男性佔48.5%，平均年齡36.5歲，我們發現與白班工作者相比，夜班工作者的身體質量指數、腰圍、血壓、總膽固醇、低密度脂蛋白膽固醇顯著上升。在校正身體質量指數、年齡、性別影響後，夜間輪班工作血壓異常上升的勝算為1.42 (95% CI: 1.09,1.85)。研究建議工作場所的健康管理計畫必須減少腦心血管疾病的危險因子，並加強夜班工作勞工之體重控制與血壓管理。

Obesity, hypertension, hyperglycemia, and hyperlipidemia are risk factors for cardiovascular disease that seriously threaten the health of workers. In 2004, the Occupational Safety and Health Administration (OSHA) of the Ministry of Labor issued the 'Guidelines for the Prevention of Diseases Promoted by Abnormal Workload,' which listed cerebral cardiovascular diseases as the target diseases for overwork, overtime work, and night shift workers. Epidemiological studies have shown that myocardial infarction, hypertension, diabetes, obesity, musculoskeletal diseases, sleep disorders, depression, fatigue, and other physical and mental symptoms are related to rotating shift-work, night-shift work, and long working hours. The objective of this study was to assess the risk of obesity, hypertension, hyperglycemia, hyperlipidemia, and metabolic syndrome for working a night shift. A cross-sectional study was designed. In 2018, we enrolled all workers who had worked in a science and technology factory for more than one year. We arranged a health examination and obtained the working hours and sleep hours by questionnaire. We compared the body mass index (BMI), blood pressure, lipid profile, blood glucose, and metabolic syndrome among night-shift workers and day-shift workers. We used multivariable logistic regression to adjust the influence of age and sex. A total of 1291 subjects were enrolled in this study that included 204 fixed night-shift workers, 209 rotating day-night-shifts workers, and 878 fixed day-shift workers. Among them, 48.5% were males, and the mean age was 36.5. We found that night-shift workers had significantly higher BMI, waist circumference, blood pressure, total cholesterol, and LDL. After adjusting for the effects of BMI, age, and gender, the odds ratio of an abnormal rise in blood pressure during night shift work was 1.42 (95% CI: 1.09,1.85). We suggested that the health management plan in the workplace should reduce the risk factors of cerebral cardiovascular diseases, especially the control of body weight and blood pressure.