Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
BMJ Open. 2020 Dec 29;10(12):e041595. doi: 10.1136/bmjopen-2020-041595.
Although the effects of long working hours on liver function remain unclear, in South Korea, there is a social perception that long working hours are associated with poor liver function. Thus, long working hours have recently become a major issue. This study aimed to determine the association between long working hours and liver function, as indicated by the alanine transaminase (ALT) levels.
Cross-sectional study.
Large university hospitals in Seoul and Suwon, South Korea.
Workers in formal employment who underwent a comprehensive health examination at the Kangbuk Samsung Hospital Total Healthcare Centre clinics in Seoul and Suwon, South Korea, between January 2011 and December 2018. Of the 386 488 participants, 212 421 met the inclusion criteria and were included in the analysis.
ALT elevation.
The participants were predominantly well-educated (86.1%), male (69.3%) and in their 30s (49.6%). In total, 13.4% of the participants presented ALT elevation (>40 IU/L). There was no significant association between working hours and ALT elevation in the general population and in the hepatitis B surface antigen (HBsAg)-negative group. Conversely, in the HBsAg-positive group, working >60 hours per week compared with 35-40 hours per week was significantly associated with ALT elevation. The association was more pronounced in those with ALT levels >80 IU/L (OR 1.94, 95% CI 1.24 to 3.01) than in those with ALT levels >40 IU/L (OR: 1.45, 95% CI 1.20 to 1.75). The p values for trend were <0.05.
Long working hours were associated with ALT elevation only in hepatitis B virus carriers and not in the general population. Provided that there is adherence to the legal working hours, there is no need to further restrict working hours for liver health, irrespective of HBsAg status.
尽管长时间工作对肝功能的影响尚不清楚，但在韩国，有一种社会观念认为长时间工作与肝功能不佳有关。因此，长时间工作最近已成为一个主要问题。本研究旨在确定长时间工作与肝功能之间的关系，以丙氨酸氨基转移酶（ALT）水平为指标。
横断面研究。
韩国首尔和水原的大型大学医院。
在韩国首尔和水原的康伯三星医院综合保健中心诊所接受全面健康检查的正式就业工人。在 2011 年 1 月至 2018 年 12 月期间的 386488 名参与者中，有 212421 名符合纳入标准并纳入分析。
ALT 升高。
参与者受教育程度较高（86.1%），男性（69.3%）居多，年龄在 30 多岁（49.6%）。共有 13.4%的参与者出现 ALT 升高（>40 IU/L）。在普通人群和乙型肝炎表面抗原（HBsAg）阴性组中，工作时间与 ALT 升高之间无显著关联。相反，在 HBsAg 阳性组中，每周工作超过 60 小时与每周工作 35-40 小时相比，与 ALT 升高显著相关。在 ALT 水平>80 IU/L 的人群中（比值比[OR]1.94，95%置信区间[CI]1.24 至 3.01），这种关联比在 ALT 水平>40 IU/L 的人群中（OR：1.45，95%CI 1.20 至 1.75）更为明显。趋势检验的 p 值均<0.05。
只有乙型肝炎病毒携带者的长时间工作与 ALT 升高相关，而在普通人群中则没有相关性。只要遵守法定工作时间，就无需进一步限制工作时间以保护肝脏健康，而不论 HBsAg 状态如何。
