輪班工作對勞工健康之影響研究

Health effect research of shift workers

林育正(Yu-Cheng Lin)

指導教授 ： 陳保中

共同指導教授 ： 陳仲達

國立臺灣大學/公共衛生學院/職業醫學與工業衛生研究所/博士(2011年)

https://doi.org/10.6342/NTU.2011.10183

摘要

中文摘要
研究背景：
輪班工作是一個相關於現代職場勞工健康的重要議題。然而對於台灣勞工，至今仍鮮有完整的追蹤研究著墨於探討日夜輪班工作如何影響勞工的身心健康。
研究方法：
本研究以一群電子產品製造公司的青壯員工為觀察對象，利用橫斷及世代分析方法，以工作相關疲勞及代謝症候群的發生為觀測結果，探討輪班工作對於勞工身心健康情況的影響。分析數據包括：工作相關疲勞問卷結果、職業暴露因子、教育程度、輪班狀況及常規健康檢查數據等。
結果與討論：
在調整各種可能的干擾因素後，分析顯示：輪班工作者較常日班員工有2.0 倍（95%信賴區間(CI): 1.5 - 2.6）疲勞難以回復之風險。以輪班狀態而言，與常日班員工對照比較，最近一年暴露於輪班工作的勞工有高達4.0 倍（95%CI: 2.7 - 5.9）疲勞難以回復之風險；而持續五年輪班的員工，及先前暴露輪班但最近一年不再輪班的員工分別有比常日班員工高出 2.2 倍（95%CI: 1.5 - 3.3）和2.1 倍（95%CI: 1.4 - 3.2疲勞難以回復之風險。勞工主觀的疲勞症狀，顯然與日夜輪班之工作型態相關。另一方面，女性員工暴露於持續日夜輪班者，其發生代謝症候群的風險為3.5 倍於常日班員工( 95%CI: 1.3 - 9.0）。而持續日夜輪班且同時有異常肝功能指數的男性員工，其發展成為代謝症候群的風險也顯著升高（較常日班健康男性工作者高出2.7 倍; 95%CI: 1.4 - 5.3）。以生理健康觀點言之，持續日夜輪班工作對於女性員工以及肝功能異常的男性員工，明顯增加了代謝症候群發生的風險。
結論：
從工作相關疲勞及代謝症候群的促發研究中發現，長期持續日夜輪班工作對於青壯勞工在心理及生理健康，均有顯著負面的影響。對長期暴露於日夜輪班的勞工，周全的身心健康風險評估及因應對策，應列為職場健康管理的重要課題。

關鍵字

輪班工作 ； 代謝症候群 ； 疲勞恢復 ； 青壯員工

並列摘要

Background and Objectives: Shift work is a worldwide health hazard among industrialized societies. However, for Taiwanese employees, limited comprehensive follow-up studies are available for modern workplaces as to whether day-night rotating shift work contributes to work related-fatigue and progression of metabolic syndrome (MetS).
Methods: Cross-sectional and longitudinal modern workplace surveys on shift work affecting health conditions including work related-fatigue and metabolic syndrome development of workers were conducted by utilizing registration records, job contents and general health evaluation data. Present study retrospectively examined a cohort of workers from an electronics manufacturing company from 2002-2007. Health records of workers with relatively homogeneous socioeconomic status were used for analysis. The health checkups included personal and need for recovery scale questionnaires, physical examinations, abdominal ultrasound, blood tests. Data analyzed included lifestyle factors, job type, occupational exposures and educational levels.
Results: After adjusted for potential confounders, shiftworkers had a 2.0-fold (95% CI = 1.5 - 2.6) increased risk for high need for recovery after work. The workers recently exposing to shift jobs had a 4.0-fold (95% confidence interval (CI) =2.7 – 5.9) increased risk of h-NFR compared with persistent daytime workers. The persistent 5-year shift workers and the workers formerly exposing to shift works had a 2.2-fold (95% CI = 1.5 – 3.3) and a 2.1-fold (95% CI = 1.4 – 3.2) increased risk of h-NFR, respectively. In terms of development of metabolic syndrome, significantly raised risks of developing MetS were found in the female workers with persistent rotating shift-work exposure (odds ration (OR), 3.5; 95% confidence interval (CI), (1.3 – 9.0) vs. day workers). Persistent rotating shift-works with elevated alanine aminotransferase posed a significant risk for MetS development (odds ratio, 2.7; 95% confidence interval, 1.4 – 5.3, vs. workers without baseline abnormal liver function nor rotating shift work exposures).
Conclusions:　For our apparently healthy workers, high need for recovery after work apparently is associated shift works. Physically, persistent day-night rotating shift work associate with the progression toward metabolic syndrome for middle-aged female workers; also, early middle-aged male employees with abnormal liver function should be evaluated and managed for metabolic syndrome. Particularly in terms of job arrangements, impacts of long-term rotating shift work on MetS development should be assessed for all the female and the male employees having baseline abnormal liver function.

並列關鍵字

shift work ； metabolic syndrome ； need for recovery ； early-middle aged adult

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