Group of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway.
Group of Occupational Toxicology, National Institute of Occupational Health, Oslo, Norway.
Ann Work Expo Health. 2024 Jul 8;68(6):647-656. doi: 10.1093/annweh/wxae033.
Both exposure to occupational chemicals and to unusual working hours have well documented effects on health. Determination of occupational exposure limits is, however, usually based on chemical-only exposure and assumes an 8-h workday, 5 days/week and a 40-h work week. A significant proportion of the workforce is exposed to chemicals while working in other work schedules. This review thus aimed to synthesize and evaluate the scientific support for a combined effect of unusual working hours and chemical exposure and, if possible, give recommendations for OEL adjustments to account for unusual working hours.
The search for articles was made as part of the preparation of a report for the Nordic Expert Group for Criteria Documentation of Health Risks from Chemicals. In this report, unusual working hours were categorized as shift work or extended (>8 h) working hours. Inclusion criteria were observational studies in the English language published up to November 2021 in peer-reviewed journals, with explicit metrics of exposure (chemicals and unusual working hours) and of health outcome, and which explicitly tested the association between exposure and outcome. Search engines of seven databases were used.
Of the initially 15 400 identified papers, 9 studies published between 1985 and 2021 met the inclusion criteria, 7 of which showed significant associations. Results from a few of the studies, i.e. regarding effects of dust and endotoxin on lung function, effects of acetone on sleep quality and tiredness, effects of carbon disulphide on coronary artery disease and effects of chemicals on spontaneous abortion, suggested more pronounced effects during night shifts compared to during day shifts.
The reviewed data is considered insufficient to conclude on recommendations for OEL adjustment for shift work. Suggested areas of future studies are mentioned.
Further studies about the effects of the combined exposure to unusual working hours and chemical exposure are essential for risk assessment, and for recommendation of potential OEL adjustments. What is important about this paper? Effects of chemical agents at the workplace may depend not only on exposure level and duration but also on the time of exposure in relation to the circadian rhythm. This study reviewed the scientific support for a combined effect of unusual working hours and chemical exposure and revealed an obvious need for additional studies regarding the complex interplay of the two different exposures with respect to adverse health effects.
职业化学物质暴露和不寻常工作时间都对健康有明确的影响。然而，职业接触限值的确定通常基于仅化学物质暴露，并假设每天工作 8 小时，每周工作 5 天，每周工作 40 小时。相当一部分劳动力在其他工作时间表下工作时会接触到化学物质。因此，本综述旨在综合评估和评价不寻常工作时间和化学物质暴露综合效应的科学依据，并在可能的情况下为职业接触限值的调整以考虑不寻常工作时间提供建议。
文章的搜索是为北欧专家组编写一份关于化学物质健康风险标准文件的报告的一部分。在本报告中，不寻常工作时间分为轮班工作或延长（>8 小时）工作时间。纳入标准为截至 2021 年 11 月在同行评议期刊上发表的、使用明确的暴露（化学物质和不寻常工作时间）和健康结果指标、并明确测试暴露与结果之间关联的英语观察性研究。使用了七个数据库的搜索引擎。
最初确定的 15400 篇论文中，有 9 篇发表于 1985 年至 2021 年的研究符合纳入标准，其中 7 项研究显示出显著关联。一些研究的结果，如粉尘和内毒素对肺功能的影响、丙酮对睡眠质量和疲劳的影响、二硫化碳对冠心病的影响以及化学物质对自然流产的影响，表明夜间轮班的影响比白天轮班更明显。
审查的数据被认为不足以就轮班工作的职业接触限值调整提出建议。提到了未来研究的建议领域。
进一步研究化学物质暴露与不寻常工作时间暴露的综合效应对于风险评估和潜在职业接触限值调整的建议至关重要。这篇论文的重要性是什么？工作场所化学物质的影响可能不仅取决于暴露水平和持续时间，还取决于暴露时间与昼夜节律的关系。本研究综述了不寻常工作时间和化学物质暴露综合效应的科学依据，并揭示了对于复杂的两种不同暴露与不良健康影响之间相互作用的进一步研究的明显需求。
