RESUMEN
BACKGROUND: Shift work and/or sleep quality may affect health. We investigated whether shift work and sleep quality, separately and jointly, were associated with abnormal levels of triglycerides, total cholesterol (TC), and low-and high-density lipoprotein cholesterol in 360 police officers (27.5% women). METHODS: Triglycerides, TC, and high-density lipoprotein were analyzed on the Abbott Architect; low-density lipoprotein was calculated. Shift work was assessed using City of Buffalo payroll work history records. Sleep quality (good, ≤ 5; intermediate, 6-8; poor, ≥ 9) was assessed using the Pittsburgh Sleep Quality Index questionnaire. A shift work + sleep quality variable was created: day plus good sleep; day plus poor sleep; afternoon/night plus good; and poor sleep quality. Mean values of lipid biomarkers were compared across categories of the exposures using analysis of variance/analysis of covariance. RESULTS: Shift work was not significantly associated with lipids. However, as sleep quality worsened, mean levels of triglycerides and TC gradually increased but only among female officers (age- and race-adjusted p = 0.013 and 0.030, respectively). Age significantly modified the association between sleep quality and TC. Among officers ≥ 40 years old, those reporting poor sleep quality had a significantly higher mean level of TC (202.9 ± 3.7 mg/dL) compared with those reporting good sleep quality (190.6 ± 4.0 mg/dL) (gender- and race-adjusted p = 0.010). Female officers who worked the day shift and also reported good sleep quality had the lowest mean level of TC compared with women in the other three categories (p = 0.014). CONCLUSION: Sleep quality and its combined influence with shift work may play a role in the alteration of some lipid measures.
RESUMEN
Police work is a high stress occupation and stress has been implicated in work absence. The present study examined (1) associations between specific types of police stress and work absences, (2) distinctions between "voluntary" (1-day) and "involuntary" (> 3-days) absences; and (3) the modifying effect of resiliency. Officers (n=337) from the Buffalo Cardio-Metabolic Occupational Police Stress study were included in the present study. The sample was 72% male, 77% Caucasian, 73% married, and 75% patrol officers. Mean age was 41 years (SD=6.4). Measures included: the Spielberger Police Stress Survey, 1-year payroll absence data, and the Dispositional Resilience Scale. The negative binomial regression was used to estimate rate ratios (RR) of 1-day and >3-days work absences for increasing stress scores. Models were adjusted for age, race/ethnicity, rank, smoking status, alcohol intake, and sleep duration. For one-unit increase in stress scores, the covariate adjusted RRs for one-day work absences were: total stress score (RR=1.19, 95% CI: 1.04-1.36); administrative stress (RR=1.52, 95% CI: 1.05-2.18); physical/psychological stress (RR=1.54, 95% CI: 1.14-2.07); and lack of support (RR=1.75, 95% CI: 1.01-3.05). Results suggest that officers were more likely to take voluntary 1-day absences due to specific types of stress at work. When the entire sample was considered, there was no significant association between police specific stress and episodes of work absence lasting at least three consecutive days. Hardy individuals, including those with high scores on the challenge sub-score, may use 1-day absences as a positive coping strategy.
RESUMEN
Shiftwork, regarded as a significant occupational stressor, has become increasingly prevalent across a wide range of occupations. The adverse health outcomes associated with shiftwork are well documented. Shiftwork is an integral part of law enforcement, a high-stress occupation with elevated risks of chronic disease and mortality. Sickness absence is an important source of productivity loss and may also serve as an indirect measure of workers' morbidity. Prior studies of shiftwork and sickness absenteeism have yielded varying results and the association has not been examined specifically among police officers. The objective of this study was to compare the incidence rate of sick leave (any, ≥3 consecutive days) among day-, afternoon-, and night-shift workers in a cohort of police officers and also examine the role of lifestyle factors as potential moderators of the association. Participants (N=464) from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study examined between 2004 and 2009 were used. Daily work history records that included the shift schedule, number of hours worked, and occurrence of sick leave were available for up to 15 yrs starting in 1994 to the date of the BCOPS study examination for each officer. Poisson regression analysis for ungrouped data was used to estimate incidence rates (IRs) of sick leave by shift, and comparison of IRs across shifts were made by computing incidence rate ratios (IRRs) and their 95% confidence intervals (CIs). Sick leave occurred at a higher rate on the night shift (4.37 per 10,000 person-hours) compared with either day (1.55 per 10,000 person-hours) or afternoon (1.96 per 10,000 person-hours) shifts. The association between shiftwork and sickness absence depended on body mass index (BMI). For overweight individuals (BMI≥25 kg/m2), the covariate-adjusted incidence rate of sick leave (≥1 day) was twice as large for night-shift officers compared with those working on the day (IRR=2.29, 95% CI: 1.69-3.10) or afternoon (IRR=1.74, 95% CI: 1.29-2.34) shift. The IR of three or more consecutive days of sick leave was 1.7 times larger for those working on night shift (IRR=1.65, 95% CI: 1.17-2.31) and 1.5 times larger for those working on afternoon shift (IRR=1.50, 95% CI: 1.08-2.08) compared with day shiftworkers. For subjects with normal BMI (<25 kg/m2), the incidence rates of sick leave did not differ significantly across shifts. In conclusion, shiftwork is independently associated with sickness absence, with officers who work the night shift having elevated incidence of sick leave. In addition, overweight officers who work the night shift may be at additional risk for sickness absence.