Estimating the Circadian Rhythm in the Risk of Occupational Injuries and Accidents

The authors recently published a prototypic Risk Index (RI) to estimate the risk of critical errors associated with shift systems. This RI was based on published trends in the relative risk of injuries and accidents, and a simple additive model was proposed to estimate the risk for a given shift system. However, extending the RI to irregular work schedules requires an estimation of the phase and amplitude of the circadian rhythm in risk. This paper integrates the published evidence on three independent sources of data that allow such estimations to be made: the trend in risk over a 24 h day, over the course of the night shift, and across the three different (8 h) shifts. Despite potential confounders, maximum risk (i.e., acrophase=peak time) estimates across these three trends showed a remarkable consistency, with all three estimates occurring at about midnight, although the amplitude estimates varied considerably. The best estimate of the amplitude of the circadian rhythm in risk would appear to be that based on trend over the three (8 h) shifts, as this trend is the least confounded. The estimated acrophase (peak time) in risk appeared earlier than would be predicted from consideration of the circadian rhythm in alertness, fatigue, or performance on simple interpolated tasks, such as reaction time or performance on the Psychomotor Vigilance Test.     

Toward a “Risk Index” to Assess Work Schedules

This article describes our preliminary attempt to develop a Risk Index to estimate the risk of human error on different work schedules based on trends in the relative risk of accidents and injuries, rather than on hypothetical intervening variables such as alertness, fatigue, or performance on interpolated tasks. We briefly review trends in risk from the published epidemiological studies that have ensured that the a priori risk was constant. A simple Risk Index based on an additive model is developed on the basis of these trends, and we illustrate how it may be used to assess work schedules. Finally, we compare the results from this Risk Index with those from the UK HSE's Fatigue Index and point out the discrepancies that emerge. We conclude that our risk-based modeling approach may assist in developing safer work schedules and also increase our understanding of this complex, multifaceted area.     

Failure of extraocular light to facilitate circadian rhythm reentrainment in humans

Although extraocular light can entrain the circadian rhythms of invertebrates and nonmammalian vertebrates, almost all studies show that the mammalian circadian system can only be affected by light to the eyes. The exception is a recent study by Campbell and Murphy that reported phase shifts in humans to bright light applied with fiber-optic pads behind the knees (popliteal region). We tested whether this extraocular light stimulus could accelerate the entrainment of circadian rhythms to a shift of the sleep schedule, as occurs in shift work or jet lag. In experiment 1, the sleep/dark episodes were delayed 8h from baseline for 2 days, and 3h light exposures were timed to occur before the temperature minimum to help delay circadian rhythms. There were three groups: (1) bright (about 13,000 lux) extraocular light from fiber-optic pads, (2) control (dim light, 10-20 lux), and (3) medium-intensity (about 1000 lux) ocular light from light boxes. In experiment 2, the sleep/dark episodes were inverted, and extraocular light was applied either before the temperature minimum to help delay circadian rhythms or after the temperature minimum to help advance rhythms. Circadian phase markers were the salivary dim light melatonin onset (DLMO) and the rectal temperature minimum. There was no evidence that the popliteal extraocular light had a phase-shifting effect in either experiment. Possible reasons for phase shifts in the Campbell and Murphy study and not the current study include the many differences between the protocols. In the current study, there was substantial sleep deprivation before the extraocular light was applied. There was a large shift in the sleep/dark schedule, rather than allowing subjects to sleep each day from midnight to noon, as in the Campbell and Murphy study. Also, when extraocular light was applied in the current protocol, subjects did not experience a change from sleeping to awake, a change in posture (from lying in bed to sitting in a chair), or a change in ocular light (from dark to dim light). Further research is necessary to determine the conditions under which extraocular light might produce phase shifts in human circadian rhythms. (Chronobiology International, 17(6), 807-826, 2000).     

The Relation of Shift Work Tolerance to the Circadian Adjustment

The amplitude and phasing of circadian rhythms are under discussion as possible predictors of tolerance to night work. In a field study, subjective sleepiness and oral temperature of 147 female nurses were measured at 2-hour intervals during a period with one morning shift and two consecutive night shifts. The nurses also filled out a questionnaire. Two types of tolerance indices were constructed: The “health index” was based on questions referring to general fatigue, gastrointestinal symptoms, and sleep disturbances, and the “sleepiness index” on the actual subjective ratings of sleepiness. According to the health index, the group with good tolerance had a larger circadian amplitude of the oral temperature rhythm on the day of the morning shift than the group with poor tolerance. However, with regard to the sleepiness index, the corresponding difference between the groups with good or poor tolerance was not significant. The data did not confirm the hypothesis that predicts a quick adjustment of the circadian rhythm when the circadian amplitude is small before the change to night work. The contradictory results found in this and in other studies do not yet permit prediction of tolerance to night work.     

The Relation of Shift Work Tolerance to the Circadian Adjustment

The amplitude and phasing of circadian rhythms are under discussion as possible predictors of tolerance to night work. In a field study, subjective sleepiness and oral temperature of 147 female nurses were measured at 2-hour intervals during a period with one morning shift and two consecutive night shifts. The nurses also filled out a questionnaire. Two types of tolerance indices were constructed: The “health index” was based on questions referring to general fatigue, gastrointestinal symptoms, and sleep disturbances, and the “sleepiness index” on the actual subjective ratings of sleepiness. According to the health index, the group with good tolerance had a larger circadian amplitude of the oral temperature rhythm on the day of the morning shift than the group with poor tolerance. However, with regard to the sleepiness index, the corresponding difference between the groups with good or poor tolerance was not significant. The data did not confirm the hypothesis that predicts a quick adjustment of the circadian rhythm when the circadian amplitude is small before the change to night work. The contradictory results found in this and in other studies do not yet permit prediction of tolerance to night work.     

Occupational accidents and injuries in construction industry in Jeddah city

In Saudi Arabia, the construction industry has been growing remarkably during the past several years. However, the most hazardous worksites in the country may be found in this industry. This study identified the causes of accidents and injuries in the construction industry among 300 workers in Jeddah City, situated on the coast of the Red Sea. Results from the questionnaire showed that the major cause of accidents and injuries is the lack of awareness about occupational safety and lack of experience among the workers (>82%); and the most common type of accidents and injuries that occur in the construction industry, are workers falling from a height (>80%), and electrical shock (>60%). Recommendations to prevent accidents and injuries in this industry are provided in this paper.     

肠道菌群昼夜节律与宿主生物节律相互作用的研究进展

为了适应地球昼夜更替对机体的影响,哺乳动物进化出了一套内在的适应性计时机制,由此形成了生物钟系统（circadian clock）。昼夜节律作为该系统中的重要部分可与机体的代谢过程同步变化[1]。肠道菌群作为与机体共生的生物群落,在肠道功能方面发挥着重要作用。对肠道菌群的昼夜节律性波动以及与宿主生物节律之间的相互作用进行研究有重要意义。本文将着重阐述肠道菌群昼夜节律与宿主生物节律的相互作用,以及这种相互作用对宿主代谢的影响。     

Azadirachtin affects the circadian rhythm of locomotion in Leucophaea maderae

Abstract

Azadirachtin shortens the period length of the locomotor activity rhythm in the circadian rhythm of Leucophaea maderae and induces splitting of this rhythm in two components in about 40% of the animals. The phase relationship between the two components is 180°. Both shortening of period and splitting are more pronounced in animals possessing longer periods before the injection of azadirachtin.     

Melatonin modulates the ERG circadian rhythm in crayfish

One of the most important functions modulated by melatonin is the synchronization of circadian rhythms. In crayfish (Procambarus clarkii), we have obtained evidence that the amplitude of the electrical response to light of the retinal photoreceptors the receptor potential, is modified by the action of melatonin and that the magnitude of this action depends on the circadian time of melatonin application. In contrast, the electroretinogram (ERG) circadian rhythm can be synchronized by either single or periodic melatonin application. In this work we hypothesized that, in crayfish, melatonin acts on effectors and on pacemaker of ERG circadian rhythm as a non-photic synchronizer. Melatonin could be a hormone that sends a signal of darkness to the ERG circadian system.     

Psychosocial Work Characteristics Predicting Daytime Sleepiness in Day and Shift Workers

Characteristics of work organization other than working time arrangements may contribute importantly to daytime sleepiness. The present study was designed to identify the psychosocial factors at work that predict daytime sleepiness in a sample of day and shift workers. Participants working at a pulp and chemical factory completed an annual questionnaire regarding psychosocial factors at work using the U.S. National Institute for Occupational Safety and Health Generic Job Stress Questionnaire (i.e., quantitative workload, variance in workload, job control, support from supervisor, coworkers, or family/friends, job satisfaction, and depressive symptoms), as well as daytime sleepiness (through the Epworth Sleepiness Scale [ESS]) and sleep disturbances for three years starting in 2002 (response rates, 94.6–99.0%). The present analysis included 55 day workers (11 women) and 57 shift workers (all men) who participated in all three years of the study, worked under the same work schedule throughout the study period, and had no missing data on any of the daytime sleep items. A repeated‐measures analysis of covariance (ANCOVA) was used to test the effects of work schedule (day vs. shift work) and psychosocial factors at work in 2002 on the ESS scores in subsequent years, with sleep duration, insomnia symptoms, chronic diseases, and sleepiness levels at baseline as covariates. Given significant and near‐significant interactions of work schedules with psychosocial factor or study year, the ANCOVA, with the factors of psychosocial work characteristics and study year, was performed by type of work schedule. The results indicated a significant main effect of psychosocial work characteristics (p=0.010, partial ?²=0.14) and an almost significant main effect of study year (p=0.067, partial ?²=0.06) and interaction between psychosocial work characteristics and study year (p=0.085, partial ?²=0.06) for variance in workload among the day work group. The day workers reporting high variance in workload in 2002 exhibited significantly higher ESS scores in 2003 and 2004 than did those reporting low variance in workload. The ANCOVA for the shift work group showed a main effect of psychosocial work characteristics for job satisfaction (p=0.026, partial ?²=0.10) and depressive symptoms (p=0.094, partial ?²=0.06) with the interaction between psychosocial work characteristics and study year for job satisfaction (p=0.172, partial ?²=0.04) and depressive symptoms (p=0.035, partial ?²=0.07). The shift workers with low job satisfaction and high symptoms of depression in 2002 showed significantly greater ESS scores in 2003 and/or 2004 than did those with opposite characteristics. These results may suggest a potential predictive value of variance in workload for day workers as well as job satisfaction and depressive symptoms for shift workers with respect to daytime sleepiness. The present findings may imply that redesigning these aspects of work environment would be of help in managing daytime sleepiness.     

Disruptions of ultradian and circadian organization of core temperature in a rat model of African trypanosomiasis using periodogram techniques on detrended data

Periodogram techniques on detrended data were used to determine the incidence of Trypanosoma brucei brucei infection on the distribution of the core temperature of rats and the expression of temperature rhythms. In such an animal model, sudden episodic hypothermic bouts were described. These episodes of hypothermia are used here as temporal marks for the purpose of performing punctual comparisons on temperature organization. The experiment was conducted on 10 infected and 3 control Sprague-Dawley rats reared under a 24 h light-dark cycle. Core temperature was recorded continuously throughout the experiment, until the animals' death. Temperature distributions, analyzed longitudinally across the full duration of the experiment, exhibited a progressive shift from a bimodal to unimodal pattern, suggesting a weakening of the day/night core temperature differences. After hypothermic events, the robustness of the circadian rhythm substantially weakened, also affecting the ultradian components. The ultradian periods were reduced, suggesting fragmentation of temperature generation. Moreover, differences between daytime and nighttime ultradian patterns decreased during illness, confirming the weakening of the circadian component. The results of the experiments show that both core temperature distribution and temperature rhythm were disrupted during the infection. These disruptions worsened after each episode of hypothermia, suggesting an alteration of the temperature regulatory system.     

Postprandial Metabolic Profiles Following Meals and Snacks Eaten during Simulated Night and Day Shift Work

Shift workers are known to have an increased risk of developing cardiovascular disease (CVD) compared with day workers. An important factor contributing to this increased risk could be the increased incidence of postprandial metabolic risk factors for CVD among shift workers, as a consequence of the maladaptation of endogenous circadian rhythms to abrupt changes in shift times. We have previously shown that both simulated and real shift workers showed relatively impaired glucose and lipid tolerance if a single test meal was consumed between 00:00–02:00 h (night shift) compared with 12:00–14:00 h (day shift). The objective of the present study was to extend these observations to compare the cumulative metabolic effect of consecutive snacks/meals, as might normally be consumed throughout a period of night or day shift work. In a randomized crossover study, eight healthy nonobese men (20–33 yrs, BMI 20–25 kg/m²) consumed a combination of two meals and a snack on two occasions following a standardized prestudy meal, simulating night and day shift working (total energy 2500 kcal: 40% fat, 50% carbohydrate, 10% protein). Meals were consumed at 01:00/13:00 h and 07:00/19:00 h, and the snack at 04:00/16:00 h. Blood was taken after an overnight fast, and for 8 h following the first meal on each occasion, for the measurement of glucose, insulin, triacylglycerol (TAG), and nonesterified fatty acids (NEFA). RM-ANOVA (factors time and shift) showed a significant effect of shift for plasma TAG, with higher levels on simulated night compared to day shift (p < 0.05). There was a trend toward an effect of shift for plasma glucose, with higher plasma glucose at night (p = 0.08), and there was a time-shift interaction for plasma insulin levels (p < 0.01). NEFA levels were unaffected by shift. Inspection of the area under the plasma response curve (AUC) following each meal and snack revealed that the differences in lipid tolerance occurred throughout the study, with greatest differences occurring following the mid-shift snack. In contrast, glucose tolerance was relatively impaired following the first night-time meal, with no differences observed following the second meal. Plasma insulin levels were significantly lower following the first meal (p < 0.05), but significantly higher following the second meal (p < 0.01) on the simulated night shift. These findings confirm our previous observations of raised postprandial TAG and glucose at night, and show that sequential meal ingestion has a more pronounced effect on subsequent lipid than carbohydrate tolerance.     

Comparison of the circadian eclosion rhythm between non-diapause and diapause pupae in the onion fly,Delia antiqua

The influence of pupal diapause on adult eclosion rhythm of Delia antiqua was investigated. When non-diapause and diapause pupae were exposed to various photoperiods at 15, 20 and 25 °C, both of them emerged as adults close to the light-on time, but the phase of eclosion varied with photoperiod and temperature. Moreover, there was a significant difference in the eclosion time between non-diapause and diapause pupae; the eclosion peak of diapause pupae was earlier than that of non-diapause pupae. When non-diapause and diapause pupae were transferred to constant darkness (DD) after having experienced LD 12:12 at 15, 20 and 25 °C, both showed circadian rhythmicity in eclosion. Although the free-running period (τ) decreased slightly as temperature increased in both non-diapause and diapause pupae, the latter tended to show shorter τ than the former. This observation suggests that the observed difference in eclosion time in LD cycles between non-diapause and diapause pupae is due to differences in τ.     

Geographical and species variation in circadian rhythm parameters in nemobiine crickets

Abstract. . Locomotor activity rhythms were studied in eight species of nemobiine crickets with different habitat preferences. They showed similar patterns with a major peak of activity around dusk and a minor one around dawn. These patterns did not change within the natural range of daylengm (12–16 h). The acrophase time of the rhythm varied between -3.2 and +3.5 h as measured from dusk, and the free-running period (T) varied between 22.8 and 24.5 h. In the Dianemobius fascipes species complex these circadian parameters varied among nine local strains (8^oS to 43^oN) but did not show any latitudinal trend. In a temperate strain of this species complex (Dianemobius nigrofasciatus from Teshikaga, 43^oN), two lines which differed from each other in mean T by 1.4h were selected, and a high heritability of T, 0.78 + 0.20 (mean±SE) was obtained. On the other hand, in a subtropical strain (Dianemobius fascipes from Ishigaki Island, 24^oN), low heritabilities, 0.35 ± 0.15 for acrophase and 0.17 ± 0.21 for T, were obtained from the full-sib correlations. The variation in i seemed to be random and not related to fitness.     

A rapid circadian rhythm of carbon-dioxide metabolism in Bryophyllum fedtschenkoi

Leaves of Bryophyllum fedtschenkoi Hamet et Perrier maintained in a stream of normal air and at 15° C exhibit a circadian rhythm of CO₂ uptake in continuous light but not in continuous darkness. The rhythm is unusual in that it persists for at least 10 d, and has a short period of approximately 18 h. The mechanism by which this rhythm is generated is discussed.Abbreviation PEPCase phosphoenolpyruvate carboxylase     

Effects of early weaning on the circadian rhythm and behavioral satiety sequence in rats

The objective of this work was to study the effect of early weaning on circadian rhythm and the behavioral satiety sequence in adult rats. Male Wistar rat pups were weaned for separation from the mother at 15 (D15), 21 (D21) and 30 (D30) days old. Body weight and food intake was measured every 30 days until pups were 150 days old. At 90 days of age, the circadian rhythm of food intake was evaluated every 4 h for three days. Behavioral satiety was evaluated at 35 and 100 days of age. This work demonstrated that body weight and food intake were not altered, but the behavioral satiety sequence demonstrated that the D15 group delayed satiety compared with the D30 group at 100 days of age. In the circadian rhythm of the food intake study, early weaning (D15) changed food intake in the intermediary period of the light phase and in the intermediary period of the dark phase. In conclusion, our study showed that early weaning may alter the feeding behavior mainly in relation to satiety and the circadian rhythm of feeding. It is possible that the presence of other environmental stimuli during early weaning can cause hyperphagia and deregulate the mechanisms of homeostasis and body weight control. This study supports theories that depict insults during early life as determinants of chronic diseases.     

Impact of night-float rotation on sleep,mood, and alertness: the resident's perception

Night-float rotations were designed to alleviate the workload of residents on night call and thereby improve patient safety. However, the impact of the night float on residents is yet to be surveyed. We assessed the impact of the night-float rotation on pediatric residents using an anonymous questionnaire that covered topics, based on recall, about sleep, mood, alertness, adjustment, and others. The study was conducted in a major tertiary pediatric teaching hospital in the United States. Participants were pediatric residents who had completed one or two night-float rotations and were in active training at our teaching hospital at the time of the study. Fifty-two of 60 eligible residents (87%) responded. Sleep duration during the night-float rotation was shorter than during day-shift work in 24 residents (46%), longer in 20 (38%), and unchanged in eight (15%). A higher proportion of residents took longer to fall asleep, had more difficulty falling asleep, had more sleep interruptions, and felt less rested upon awakening. Twenty-four residents (46%) felt that their bodies never adjusted to the night shift. Also, 22 residents (43%) felt moody or depressed in contrast to seven (14%) who felt depressed during the daytime rotation (p=0.0001). Twenty-one residents (41%) felt they were slower in their thinking during the night float than daytime rotations. The results suggest that disturbances of sleep and mood and decreased alertness, typical of night shift, are present in the night-float rotation. Residency programs should monitor closely the impact of the night-float rotation on resident well being and patient safety. The impact of night-shift work should be considered in the design of night-float schedules, and teaching should be provided for residents to learn coping strategies for night-shift work.     

Food Intake in Healthy Young Adults: Effects of Time Pressure and Social Factors

Some factors influencing food intake and subjective responses to meals were assessed in 2 groups (n=40 and n=36) of healthy university students. Both groups were studied for 6 days and included both “structured” and “unstructured” times. A questionnaire was completed by all subjects at 3 h intervals while awake. The questionnaires asked the subjects to state the factors that led them to choose to eat or not to eat a meal in the previous 3 h. If they ate a meal, they were required to describe the type of meal eaten and their responses to it—their hunger before it, their enjoyment of the meal itself, and their degree of satisfaction afterwards. Subjects were also asked to describe the type of meal that they would like to have eaten (the desired meal) in the absence of any restraints due to time pressure, cost, and so on. In the first group, 3 “structured” (working) and 3 “unstructured” (rest) days were chosen. Consistant with our previous studies, structured days, as compared to unstructured days, were associated with smaller meals and less positive subjective responses to them. Also, the meals that were eaten were often smaller than those that were desired, or were even missed altogether, due to time pressure. Not only were the meals eaten on unstructured days larger and rated, to by the subjects more positively, but also there was an additional positive effect if the meal played a social role. In the second group, 6 days were chosen, during which there were structured and unstructured 3 h periods. Many of the findings (with regard to reasons for eating or not eating a meal, and the effect of meal size upon subjective responses to it, for example) were the same as in the first group. However, the effect of structured vs. unstructured 3 h periods was significantly less marked than the effect of structured vs. unstructured days that had been found in the first group, and effects due to social factors and time pressure were less reliably present. The results indicate that food intake is affected by whether the whole or only part of the day is “structured” or “unstructured.” These findings might be relevant to some problems faced by the workforce, in general, and by night workers, in particular.     

The Nutritional Status and Eating Habits of Shift Workers: A Chronobiological Approach

The eating habits of workers may vary according to the season of the year and corresponding work schedule. A study aiming at verifying the changes in their diet in summer and winter, as well as the nutritional status of those who work fixed shifts, was conducted. The distribution during the 24 h in the quantity of calories and macronutrients ingested and the circadian rhythm of calories consumed were also analyzed. The study was conducted on 28 workers subject to three fixed work (morning, afternoon, and night) shifts at a transport company in the city of São Paulo, Brazil. The mean age of the workers was 32.8 (SD ± 5.3) yrs. Their food intake was ascertained by the use of a 3-day dietary record, and their nutritional status was evaluated by their body mass index (BMI), both in winter and summer. Two-way ANOVA (shift and season) showed food consumption—measured in calories/24 h—was significantly higher in winter than summer (F_(1.25) = 11.7; p < 0.001). No statistically significant differences were found among shifts (F_(2.25) = 0.85; p < 0.44), and the interaction effect between shift and season was also not significant (F_(2.25) = 0.15; p < 0.86). No seasonal difference in BMI was detected (Kruskal-Wallis test). Cosinor analyses showed circadian rhythmicity in calories consumed by morning (p < 0.01) as well as afternoon shift workers (p < 0.001), both in the winter and summer. Circadian rhythmicity in calories consumed by night workers was found only in summer (p < 0.01). The changes observed in the workers’ eating habits from one season to another and during the 24 h period show the need for further studies to help develop educational programs to improve the nutrition of shift employees taking into consideration shift schedule and season of the year when work is performed.