Effects of Fatigue on Immune Function in Nurses Performing Shift Work

Abstract

Effects of Fatigue on Immune Function in Nurses PerformingShift Work: Makie Nagai, et al. Department of Epidemiology and Public Health, Kanazawa Medical University-Objectives:We investigated the effects of fatigue on NK cell function and lymphocyte subpopulations in nurses performing shift work using a longitudinal design. Methods: Fiftyseven female nurses engaged in shift work at a hospital in Japan were selected for our study cohort. The hospital used a counterclockwise rotating three-shift system. Night shifts followed day shifts after a sevenhour interval. Immune parameters measured at the beginning of the day shift through to the end of the night shift were compared between two groups stratified by their level of fatigue. Statistical differences were evaluated after adjusting for baseline immune values and other demographic features. Results: Subjective feelings of fatigue increased progressively from the beginning of day shifts to the end of night shifts. From the beginning of day shifts to the end of night shifts, NK cell activity and CD16 + CD56 + lymphocytes decreased, while CD3 + and CD4 + lymphocytes increased. The group with the greater increase in fatigue showed a larger decrease in NK cell activity and a larger increase in CD4 + lymphocytes when compared with the group reporting less fatigue. These findings did not change after adjusting for demographic factors and sleep hours. Conclusion: Our data suggest that shift work has deleterious effects on NK cell function and that the effects depend on the degree of fatigue. Proper management of shift work may lessen fatigue in workers and also ameliorate many health problems experienced by shift workers. (J Occup Health 2011; 53: 312-319)

Day and night shift schedules are associated with lower sleep quality in Evening-types

“…lymphocytes and NK cells activity) and mental (e.g. oxidative stress, anxiety) systems (Froy, 2010;Guo et al, 2013;Ö zdemir et al, 2013;Nagai et al, 2011;Selvi et al, 2010). Also, peripheral clock gene expression was shown to be disturbed (Bracci et al, 2014;Takahashi et al, 2008).…”

Sleep, immunity and shift workers: A review

“…The observed changes in shift work, such as continuous sleep deprivation, stress and a change of the natural circadian pattern can also influence the immune response among individuals [63], [64], [65]. However, there is a scarcity of studies on the subject with even more conflicting results [66], [67] and perhaps their heterogeneity, using different populations and samples and types of shift work evaluated, makes such conclusions difficult (Table 2).…”

“…Nagai et al [65] demonstrated that shift work is also associated with depression of the innate immune response, exhibiting a decrease in NK cell activity associated with an increase in fatigue compared to day workers (p<0.001). However, in two other studies conducted at the same time [66], [67], different results were observed.…”

Effects of Circadian Disruption on Physiology and Pathology: From Bench to Clinic (and Back)

“…In addition, circadian disruption has profound effects on the immune system, which has been evidenced both in animal models and in human studies. Female nurses working in a three-shift rotating system showed a progressive decrease in natural killer (NK) cell activity and CD16 + CD56 + cells number (Nagai et al 2011). Shift working has also been linked to a higher risk for common infections, with the highest risk in workers going through three different shifts (Mohren et al 2002).…”