Postal work is performed in very different settings, and the works are e.g., drivers, letter carriers, postal sorters, and counter clerks. A finding that a small group of parcel sorters with a good psychosocial work situation had much lower health complaints than comparable workers with a worse psychosocial situation at work, indicated that it might be possible to improve mental and physical health among postal employees by improving work organization. The theoretical framework for this thesis is the demands-control-support (DCS) model by Karasek, Theorell, and Johnson. Two cross-sectional studies were performed with questionnaires. In a study on 144 workers at a postal terminal it was found associations between low support from superiors and high psychological work demands, on one hand and gastrointestinal and sleep problems on the other. In another study on 655 postal workers in 6 different occupations, high psychological work demands and low skill discretion was associated with low-back pain, and low social support at work with neck pain. In this study, the associations differed significantly between men and women. A follow-up study on the postal terminal (136 persons) was performed 8 and 12 months after an organizational change took place. The changes were aimed at improving the shift system, and psychosocial work situation. Authority over decision and skill discretion increased, and sick-leave decreased during the follow up period. Changes in contact with superiors, team-mates, and skill discretion were associated with changes in gastrointestinal and sleep complaints. In another follow up study, 82 individuals were studied before and 1 year after improvement of the psychosocial work environment. Musculoskeletal complaints were significantly reduced in the intervention group but not in the control group. Increased support from superiors was associated with less symptoms. Younger age and higher authority over decisions at baseline was associated with reduced symptoms at follow-up. The main findings of this thesis are that there are significant associations between psychosocial work situation among postal workers and psychosomatic and musculoskeletal symptoms, and that it is possible to reduce symptoms and sick-leave, by changes of organization, and improvement of the psychosocial work situation

An increased risk for coronary heart disease among shift workers is earlier shown in the epidemiological literature. The aim of this thesis has been to penetrate metabolic disturbances and obesity among shift workers compared to day workers, and to compare if there are differences in total mortality or cause specific mortality of coronary heart disease (CHD), diabetes or ischaemic stroke in between the two groups. In an intervention study on female nurses (N=11), on night schedules in Umeå hospital, the highest peak value of glucose and insulin after meal ingestion was seen in the late evening (23:30). The post-prandial area under curve (AUC) of glucose and insulin was correspondingly largest after meal ingestion the same clock hour compared to meal ingestion other clock times. In two different cross-sectional studies Västerbotten Inventory Study (VIP) (N= 27,485) and in a subset of Work, Lipids and Fibrinogen Study (WOLF) (N= 1,324) metabolic differences in between shift and day workers has been evaluated. In both studies have obesity, high triglycerides and low HDL-cholesterol been more prevalent among the shift-working group compared to the day-working group. After adjustments for age and socio-economic factors in the VIP-study obesity and high triglycerides remained as risk factors in shift workers in both men and women. After directly age standardisation, a clustering effect, simultaneously, of two or more metabolic risk factors (obesity, hypertension, and high triglycerides) was seen in both genders among the shift workers compared to the day workers. Correspondingly, in the Wolf study low HDL-cholesterol and high triglycerides remained as significant risk factors after adjustments of confounders as age, socio-economic group, physical activity, current smoking, low social support and high job strain. In a cohort study from one company (MoDo) with two plants in the pulp and paper industry 2,354 male shift workers and 3,088 male day workers were followed from January 1, 1952 to December 31, 2001 regarding total and cause specific mortality due to CHD, diabetes and ischaemic stroke. Groups of workers defined by different duration of shift exposure were compared with day workers by calculating standardised relative rates (SRR). No increased risk of total mortality was seen among shift workers compared to day workers. Higher duration of shift work was associated with increased risk for CHD, and shift workers with 30 years or more had the highest risk. Diabetes was more common with increasing number of shift year exposure. Compared to day workers shift workers had also an increased risk to die because of ischaemic stroke, with the highest relative difference in the least shift exposed group (< 5 years).

Abstract Food and recuperation has a superior importance in human life and it is hard to deny the distinction of the food in everyday life. Nutritious food gives energy to benefit activities of the day and influences on behavior and performance as well as well being. The meaning of the terms meal and mealtime are key concepts in this study and the several beneficial aspects beyond the physiological function. Inadequate time for the meal might provide degenerative consequences for individual health and generate outgoings for society. The aim of this study was that from an individual perspective describe work environment conditions for meals and recovery potential among employees with irregular working hours using mixed methods with both questionnaire and interviews. Four (4) airline employees participated. Result from this study demonstrated that airline employees, especially cabin crew, rarely could effect on the surrounding environment of the meal. The participants indicated the irregularity of the meals and meal patterns at work along with constant time pressure and economic directives as the main underlying factors from their perspective. The study concluded that the time, place and money dictated the terms of the mealtime and that the potential of recovery was virtually nonexistent. Keywords: meal, eating habits, shift work, health promotion, recovery/recuperation

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Syftet i studien var att få en djupare förståelse för hur kvinnor som arbetar inom en mansdominerande industri förhåller sig till ohälsa. I bakgrunden presenteras kvinnor och mäns position i samhället samt hur kvinnlig sjukskrivning ser ut på ett nationellt och internationellt plan. Hur normer och synen på kvinnor ser ut och påverkas på en arbetsplats som domineras av män. Studier visar att kvinnor står för procentuellt högst antal sjukfrånvarodagar och att bidragande orsaker till detta kan vara biologiska skillnader.  Uppsatsen bygger på en kvalitativ ansats där sex intervjuer har använts som metod, detta för att få den djupa förståelse som studien annars hade kunnat gå miste om ifall andra metoder använts. Resultatet visade tydligt att majoriteten av de undersökta kvinnorna hade svårt att beskriva sina åsikter kring företaget. Sömnproblem och ryggsmärta visade sig vara vanliga problem, status inom företaget kretsade kring kön och lön samt att de äldre männen hade svårt att ta direktiv från kvinnor. Arbetet på företaget visade sig vara enformigt och inte underhållande vilket gjorde kvinnornas relationer till varandra kollegorna mycket viktiga. Samtliga av kvinnorna beskrev att det pågick ett utanförskap på arbetsplatsen samt att kommunikationsflödet mellan skiftarbetare och förmän/chefer var bristande.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Melatonin – is a hormone produced by the pineal gland during the dark time. Light during the night suppresses melatonin production. Melatonin is an important biological body regulator: it controls daily and seasonal biorhythms, glucose metabolism, gonadal activity, cardiovascular system, gastrointestinal tract and the activity of the immune system There is a lot of scientific information about the immunoregulative properties of melatonin. Melatonin modulates the development of some organs of the immune system, cell differentiation, immune response and cytokine production. The imunomodulatory activity of melatonin is usually determined by the following experimental models: surgical pinealectomy, in vivo treatment with melatonin or in vitro treatment of the immune cells with melatonin. However, during the experiments while keeping animals under constant light conditions, melatonin production was rarely naturally inhibited. For the experiments of this study, the method of constant lighting in the mouse model was applied. Our aim was to artificially evoke shift work conditions in order to find out how the deficiency of melatonin production influences the immune system of the shift workers. The results obtained showed that keeping mouse under constant lighting conditions the homeostasis of the immune system (antibody production, leukocyte and granulocyte migration) is disrupted. Therefore, shift work and its influence on the immune system could be considered as a factor for... [to full text] / Melatoninas – tamsiuoju paros metu kankorėžinėje liaukoje gaminamas hormonas. Šviesa nakties metu slopina melatonino produkciją. Melatoninas yra svarbus organizmo biologinis reguliatorius. Jis reguliuoja paros ir sezono bioritmus, gliukozės metabolizmą, lytinių liaukų aktyvumą, širdies ir kraujagyslių sistemos veiklą, virškinimo trakto veiklą, kitų endokrininių liaukų aktyvumą, imuninės sistemos veiklą. Literatūroje paskelbta nemažai duomenų apie imunoreguliacines melatonino savybes. Melatoninas panaikina su amžiumi susijusias užkrūčio liaukos ir blužnies involiucijas, skatina imuninės sistemos ląstelių proliferaciją, pagerina imuninį atsaką. Tyrinėjant imunoreguliacines melatonino savybes daugeliu atvejų taikomi tyrimo metodai, kurių metu atliekamos melatonino injekcijos arba pašalinama pagrindinė melatonino gamybos vieta - kankorėžinė liauka. Tačiau ankstesnių eksperimentų metu melatonino gamyba retai buvo natūraliai slopinama, laikant gyvūnus pastovaus apšvietimo sąlygomis. Disertacijos darbuose buvo taikytas pastovaus apšvietimo metodas modelinėje pelių sistemoje. Taip buvo siekta atkurti pamaininio darbo sąlygas ir ištirti galimą melatonino trūkumo poveikį žmonių, dirbančių pamaininį darbą, imuninei sistemai. Gauti rezultatai rodo, kad, laikant peles pastovaus apšvietimo sąlygomis, sutrinka jų imuninės sistemos homeostazė: antikūnų gamyba, leukocitų, granuliocitų migravimas. Dirbant pamaininį darbą reikėtų atkreipti dėmesį į jo poveikį imuninei sistemai ir įvertinti... [toliau žr. visą tekstą]

Melatoninas – tamsiuoju paros metu kankorėžinėje liaukoje gaminamas hormonas. Šviesa nakties metu slopina melatonino produkciją. Melatoninas yra svarbus organizmo biologinis reguliatorius. Jis reguliuoja paros ir sezono bioritmus, gliukozės metabolizmą, lytinių liaukų aktyvumą, širdies ir kraujagyslių sistemos veiklą, virškinimo trakto veiklą, kitų endokrininių liaukų aktyvumą, imuninės sistemos veiklą. Literatūroje paskelbta nemažai duomenų apie imunoreguliacines melatonino savybes. Melatoninas panaikina su amžiumi susijusias užkrūčio liaukos ir blužnies involiucijas, skatina imuninės sistemos ląstelių proliferaciją, pagerina imuninį atsaką. Tyrinėjant imunoreguliacines melatonino savybes daugeliu atvejų taikomi tyrimo metodai, kurių metu atliekamos melatonino injekcijos arba pašalinama pagrindinė melatonino gamybos vieta - kankorėžinė liauka. Tačiau ankstesnių eksperimentų metu melatonino gamyba retai buvo natūraliai slopinama, laikant gyvūnus pastovaus apšvietimo sąlygomis. Disertacijos darbuose buvo taikytas pastovaus apšvietimo metodas modelinėje pelių sistemoje. Taip buvo siekta atkurti pamaininio darbo sąlygas ir ištirti galimą melatonino trūkumo poveikį žmonių, dirbančių pamaininį darbą, imuninei sistemai. Gauti rezultatai rodo, kad, laikant peles pastovaus apšvietimo sąlygomis, sutrinka jų imuninės sistemos homeostazė: antikūnų gamyba, leukocitų, granuliocitų migravimas. Dirbant pamaininį darbą reikėtų atkreipti dėmesį į jo poveikį imuninei sistemai ir įvertinti... [toliau žr. visą tekstą] / Melatonin – is a hormone produced by the pineal gland during the dark time. Light during the night suppresses melatonin production. Melatonin is an important biological body regulator: it controls daily and seasonal biorhythms, glucose metabolism, gonadal activity, cardiovascular system, gastrointestinal tract and the activity of the immune system There is a lot of scientific information about the immunoregulative properties of melatonin. Melatonin modulates the development of some organs of the immune system, cell differentiation, immune response and cytokine production. The imunomodulatory activity of melatonin is usually determined by the following experimental models: surgical pinealectomy, in vivo treatment with melatonin or in vitro treatment of the immune cells with melatonin. However, during the experiments while keeping animals under constant light conditions, melatonin production was rarely naturally inhibited. For the experiments of this study, the method of constant lighting in the mouse model was applied. Our aim was to artificially evoke shift work conditions in order to find out how the deficiency of melatonin production influences the immune system of the shift workers. The results obtained showed that keeping mouse under constant lighting conditions the homeostasis of the immune system (antibody production, leukocyte and granulocyte migration) is disrupted. Therefore, shift work and its influence on the immune system could be considered as a factor for... [to full text]

O trabalho por turnos é definido como aquele realizado fora dos horários considerados “convencionais”, por exemplo: pelo trabalho no turno noturno ou o trabalho de forma contínua, através do revezamento de equipes. Durante as últimas décadas, a proporção de trabalhadores que executam as atividades em escalas de turnos vem aumentando e, com as mudanças nas condições de trabalho, a organização do ambiente social, familiar, dos hábitos de vida e das necessidades básicas desses trabalhadores passou por significativas transformações, que podem causar danos saúde. O desenvolvimento de doenças crônicas não transmissíveis e distúrbios metabólicos em trabalhadores de turnos já é bastante evidenciado na literatura, e os estudos epidemiológicos demonstram associações consistentes entre o trabalho por turnos e a ocorrência de doenças, como obesidade, diabetes e síndrome metabólica. Além da relação entre alterações dos ritmos biológicos, disruptura do sistema circadiano e alterações metabólicas, mudanças comportamentais experienciadas pelos trabalhadores de turnos são apontadas como potenciais fatores de risco adicionais ao desenvolimento de doenças. Dentre as alterações nos hábitos de vida, a alimentação parece ser alterada em decorrência do trabalho por turno. Mudanças nos horários de sono, vigília, da atividade laboral, bem como na disponibilidade de alimentos e tempo para realização das refeiçoes em locais adequados, são fatores determinantes nas escolhas alimentares desses indivíduos. Ainda que estudos voltados à avaliaçao da alimentação de trabalhadores de turnos tenham sido propostos e bastante discutidos na literatura, a real influência do turno de trabalho nos hábitos alimentares é pouco elucidada. Assim, o objetivo desse trabalho foi revisar sistematicamente os resultados de estudos que avaliaram os hábitos alimentares de trabalhadores de turnos, de forma a esclarecer como o turno de trabalho influencia, positiva ou negativamente na alimentação. A sumarização de evidências permite a elaboração de condutas e estratégias nutricionais específicas a esse grupo de risco. Além disso, destaca aspectos importantes a serem considerados no desenvolvimento de futuros estudos, visando contribuir com a qualidade das informações obtidas. / Shift work is defined as the one performed outside the "conventional" hours, for example by working the night shift or working continuously through the team relay. Over the last few decades, the proportion of workers performing turn-based activities has been increasing and, with changes in working conditions, the organization of the social, family, living, and basic needs of these workers has changed significantly which can cause health damage. The development of chronic noncommunicable diseases and metabolic disorders in shift workers is already well documented in the literature, and epidemiological studies demonstrate consistent associations between shift work and the occurrence of diseases such as obesity, diabetes and metabolic syndrome. In addition to the relationship between changes in biological rhythms, disruption of the circadian system and metabolic alterations, behavioral changes experienced by shift workers are indicated as potential additional risk factors for the development of diseases. Among the changes in life habits, food habits seems to be altered as a result of shift work. Changes in sleep schedules, wakefulness, labor activity, as well as food availability and time to make meals in appropriate places, are determining factors in the food choices of these individuals. Although studies aimed at evaluating the feeding of shift workers have been proposed and discussed in the literature, the real influence of work shift on eating habits is little elucidated. Thus, the objective of this study was to systematically review the results of studies that evaluated the eating habits of shift workers, in order to clarify how the work shift influences, positively or negatively in the diet. Summarizing evidence allows the elaboration of specific nutritional strategies and strategies for this risk group. In addition, it highlights important aspects to be considered in the development of future studies, aiming to contribute to the quality of the information obtained.

O trabalho em turnos tem crescido na sociedade moderna como um mecanismo importante para uma maior flexibilidade na organização dos horários de trabalho. Este termo refere-se a um horário de trabalho que envolve horários irregulares ou incomuns, como o trabalho noturno e por turnos rotativos, em contraste com trabalho diurno normal. Porém o trabalho em turnos é acompanhado por uma maior incidência de diversos problemas de saúde, tais como doenças cardiovasculares e metabólicas. Assim, o objetivo deste trabalho foi investigar os fatores associados à obesidade e à síndrome metabólica em trabalhadores de turnos de um frigorífico de frango do Sul do Brasil. Para tanto, foi conduzido um artigo de revisão da literatura e dois artigos originais. O artigo de revisão sistemática da literatura investigou a associação entre trabalho em turnos e síndrome metabólica. Os artigos incluídos foram escolhidos com base em critérios de inclusão estabelecidos; sua qualidade metodológica foi avaliada utilizando uma lista de verificação de qualidade validada, sendo que a maioria dos estudos foi classificada como tendo um baixo risco de viés. Entre os 10 estudos recuperados, oito encontraram uma associação positiva entre o trabalho por turnos e síndrome metabólica após o controle de fatores sócio-demográficos e comportamentais. Mas apenas três estudos incluíram duração do sono como um fator de confusão, e esses estudos apresentaram resultados discordantes. Assim, conclui-se que não existem provas suficientes sobre a associação entre trabalho por turnos e síndrome metabólica, especialmente quando os fatores de confusão são levados em conta. Os dois artigos originais foram elaborados através de um estudo transversal com uma amostra de 905 trabalhadores de ambos os sexos de um frigorifico, que funciona nas 24 horas do dia, no Sul do Brasil. O primeiro artigo teve por objetivo investigar a relação entre privação de sono e obesidade geral entre os trabalhadores, controlando na análise multivariável para possíveis fatores de confusão. A obesidade definida como índice de massa corporal 30 kg/m2 e a privação do sono definida através do número de horas de sono e eventuais cochilos. Como principais achados pode-se destacar que os diferentes níveis de privação de sono mostraram-se relacionadas à maior renda, ao número de refeições realizadas durante o dia e ao trabalho noturno. Após ajustes na análise multivariável, trabalhadores que reportaram privação severa de sono (dormiam ≤5 horas por noite e não realizavam cochilos) tiveram uma probabilidade 4,57 vezes maior de apresentar obesidade. Assim, nossos achados demonstram uma forte associação entre privação de sono e obesidade em trabalhadores de turnos. Além disso, evidencia que a privação do sono poder ser uma consequência direta do regime de trabalho noturno. O segundo artigo original investigou a prevalência de síndrome metabólica (SM) e a sua associação com fatores demográficos, socioeconômicos e comportamentais nos trabalhadores. O diagnóstico da SM foi realizado de acordo com as recomendações do “Harmonizing the Metabolic Syndrome”. A distribuição de cada um dos componentes da SM foi avaliada de acordo com as características demográficas, socioeconômicas e comportamentais da amostra. A análise multivariável seguiu um modelo teórico de determinação da SM em trabalhadores de turnos. Dessa forma, a prevalência de SM mostrou-se positivamente associada às mulheres, trabalhadores com mais de 40 anos e que relataram dormir cinco ou menos horas por dia. Por outro lado, a SM mostrou-se negativamente associada ao maior nível de instrução e a realizar mais do que três refeições por dia. Por outro lado, a SM mostrou-se negativamente associada ao maior nível de instrução e a realizar mais do que três refeições por dia. Já sexo, idade e escolaridade mostraram-se relacionados à maioria dos componentes da SM alterados. Entretanto, as variáveis comportamentais mostraram-se associadas apenas à CC e PA alteradas. Em suma, sexo, idade, escolaridade, hábitos alimentares e duração do sono mostraram-se como fatores de risco independentes para a ocorrência da SM em trabalhadores de turnos. / Shift work is increasing in modern society as an important mechanism for greater flexibility in the organization of work schedules. This term refers to a work schedule that involves irregular or unusual hours, such as night work and rotating shift work, in contrast to normal daytime work. Shift work is accompanied by a greater incidence of several health disorders, such as cardiovascular and metabolic disorders. The aim of this study was to examine the factors associated with obesity and metabolic syndrome in shift workers among a poultry processing plant in southern Brazil. For this, we conducted a systemic review of the literature and two original articles. The aim of this systematic review was to examine the association between shift work and Metabolic Syndrome. The included articles were chosen based on established inclusion criteria; their methodological quality was assessed using a validated quality checklist. A total of 10 articles were included in this review. Among the ten studies, eight found a positive association between shift work and MetS after controlling for socio-demographic and behavioral factors. Only three studies included sleep duration as a confounder, and these studies presented discordant results. We conclude that there was insufficient evidence regarding the association between shift work and prevalent MetS when the confounders are taken into account. The two original articles were developed by a cross-sectional study was conducted on a sample of 902 shift workers of both sexes in a poultry processing plant in Southern Brazil that functions 24 hours per day. The objective of first manuscript was to explore the association between sleep deprivation and obesity among shift workers, controlling for possible confounders. Obesity was defined as body mass index ≥ 30 kg/m2. Sleep deprivation were associated with increased income, number of meals consumed throughout the day and nightshift work. After controlling, the prevalence ratios of obesity were 4,57 in the workers with sleep deprivation compared to the reference group. These results show a strong association between sleep deprivation and obesity in shift workers, and that sleep deprivation may be a direct consequence of working at night. The second original manuscript investigated the prevalence of metabolic syndrome (MS) and its association with demographic, socioeconomic and behavioral factors in shift workers. The diagnosis of SM was determined according to the recommendations from “Harmonizing the Metabolic Syndrome”. The distribution of each of the components of MS was evaluated according to the demographic, socioeconomic and behavioral characteristics of the sample. The multivariate analysis followed a theoretical framework for determining MS on shift workers. The prevalence of MS was positively associated with women, workers of over 40 years of age and those who reported sleeping five or less hours per day. On the other hand, MS was negatively correlated with higher educational level and having more than three meals per day. In conclusion, sex, age, educational level, eating habits and duration of sleep appeared as independent risk factors for MS