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[护士和助产士的夜班工作与健康——综述]

[Night work and health of nurses and midviwes--a review].

作者信息

Burdelak Weronika, Peplońska Beata

机构信息

Instytut Medycyny Pracy im. prof. J. Nofera, Nofer Institute of Occupational Medicine, Lodz, Poland.

出版信息

Med Pr. 2013;64(3):397-418.

Abstract

Night shift work has been thought to play a role in the etiology of chronic diseases through a disruption of the circadian rhythm, decreased synthesis of melatonin and sleep deprivation. Our aim was to review the epidemiological studies on the association between night shift work and some pathologies in nurses and midwives. We reviewed publications available in the MEDLINE database and published before June 2012, describing the cross-sectional (almost two thirds of all papers) and cohort studies. In total, we identified 26 original papers, including 5 epidemiological studies addressing diseases or disorders of the digestive system, 3--metabolic syndrome, 2--type 2 diabetes, 9--cardiovascular diseases and (CVD risk factors, 5--obesity/overweight, 2--menstrual disorders and 3--poor pregnancy outcomes. The analysis of the literature indicates that night shift work of nurses and midwives is most strongly associated with a higher risk ofobesity/overweight. In each of the five studies, which we identified this association was observed (confirmed by the statistical significance of the results), also after adjustment for confounders. The results for type 2 diabetes and disorders of the menstrual cycle are also suggestive. Epidemiological data on the other disorders or pathologies discussed in this article seem to be less certain - their results are inconsistent or their number is too small to draw definite conclusions. Further epidemiological studies of nurses and midwives working on night shifts and prospective observations in particular are recommended to find out whether potential association between the night work and discussed health issues is causal.

摘要

夜班工作被认为通过扰乱昼夜节律、减少褪黑素合成和睡眠剥夺在慢性疾病的病因学中发挥作用。我们的目的是回顾关于护士和助产士夜班工作与某些疾病之间关联的流行病学研究。我们检索了MEDLINE数据库中截至2012年6月发表的文献,描述了横断面研究(几乎占所有论文的三分之二)和队列研究。我们总共确定了26篇原创论文,其中包括5项针对消化系统疾病或紊乱的流行病学研究、3项针对代谢综合征的研究、2项针对2型糖尿病的研究、9项针对心血管疾病和心血管疾病风险因素的研究、5项针对肥胖/超重的研究、2项针对月经紊乱的研究以及3项针对不良妊娠结局的研究。文献分析表明,护士和助产士的夜班工作与肥胖/超重风险较高的关联最为密切。在我们确定的五项研究中,每项研究都观察到了这种关联(结果的统计学显著性证实了这一点),在对混杂因素进行调整后也是如此。2型糖尿病和月经周期紊乱的结果也具有提示性。本文讨论的其他疾病或病理的流行病学数据似乎不太确定——它们的结果不一致,或者数量太少无法得出明确结论。建议进一步开展针对夜班工作的护士和助产士的流行病学研究,尤其是前瞻性观察,以查明夜班工作与所讨论的健康问题之间的潜在关联是否具有因果关系。

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