A Cross‐Sectional Study on the Relationship of Job Stress with Natural Killer Cell Activity and Natural Killer Cell Subsets among Healthy Nurses

Morikawa, Yuko; Kitaoka-Higashiguchi, Kazuyo; Tanimoto, Chie; Hayashi, Midori; Oketani, Reiko; Miura, Katsuyuki; Nishijo, Muneko; Nakagawa, Hideaki

doi:10.1539/joh.47.378

Cited by 41 publications

(43 citation statements)

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“…Shakhar et al 22) investigated the relationship between the level of fatigue and changes in immune parameters over a one-month interval among female workers engaged in day work and found that decreased fatigue and increased sleep hours resulted in an increase in NK cell activity. Studies that have investigated the impact of long work hours on immune function have identified fatigue as one of the most important factors [23][24][25] . These studies consistently identified suppressed NK cell activity in subjects with longer work hours.…”

Section: Discussionmentioning

confidence: 99%

Effects of Fatigue on Immune Function in Nurses Performing Shift Work

Nagai

Morikawa

Kitaoka-Higashiguchi

et al. 2011

Journal of Occupational Health

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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)

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Section: Discussionmentioning

confidence: 99%

Effects of Fatigue on Immune Function in Nurses Performing Shift Work

Nagai

Morikawa

Kitaoka-Higashiguchi

et al. 2011

Journal of Occupational Health

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“…Moreover, in spite of using multiple effector:target (E/T) ratios (5:1, 10:1, 20:1 and 40:1) in measurement of NK cell activity, we could not get the values of NK cell activity at E/T ratios of 5:1, 10:1 and 40:1 because the NK cell activity was measured by SRL Inc. at an E/T ratio of 20:1 only. However, since other studies have reported NK cell activity also using an E/T ratio of 20:1 15,16,25) , our data of NK cell activity are useful for comparative studies.…”

Section: Discussionmentioning

confidence: 88%

“…Conversely, healthy life styles (i.e., good sleep, adequate physical exercise, and so on) were associated with increases of NK cell functions [48][49][50] . Several occupational health studies [15][16][17][18][20][21][22][23][24][25] of workers have reported that reduction of NK cell functions (including CD56) was associated with night shift work 15) , long work 16,17) , depression 18) , job stress 20,25) , and burnout 24) . Morikawa et al recently reported that increased workload quantified by the Nursing Job Stressor Scale (NJSS) was significantly related to decreased NK cell activity among healthy Japanese nurses 25) .…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have shown that shift work, night shift and weekend work are associated with increased stress 10,11) , that emergency medicine is a high stress profession 12) , and that women among emergency medicine residents experience more stress and depression than men 13) . Several researchers have reported workers' immune function in terms of workload [15][16][17] , and mental health [18][19][20][21][22][23][24][25] . Kobayashi et al reported that nurses' NK cell activity was low during the night shift 15) , while Xu et al reported that truck drivers' NK cell activity significantly decreased after work 16) .…”

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confidence: 99%

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An Occupational Health Study of Emergency Physicians in Japan: Health Assessment by Immune Variables (CD4, CD8, CD56, and NK Cell Activity) at the Beginning of Work

Okamoto¹,

Tsunoda²,

Teruya

et al. 2008

Journal of Occupational Health

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An Occupational Health Study of E m e r g e n c y P h y s i c i a n s i n J a p a n : H e a l t h Assessment by Immune Variables (CD4, CD8, CD56, and NK cell activity) at the Beginning of Work: Hiroteru OKAMOTO, et al. Department of Preventive Medicine and Public Health, School of Medicine, Kyorin University-This study was conducted to evaluate the occupational health of Japanese physicians in emergency medicine. Subjects participating in this study were eighty-nine physicians working at 12 medical facilities (10 critical care emergency centers) in Japan. Participants were asked to complete a questionnaire of work conditions and to provide blood samples for immune variable measurements (CD4, CD8, CD56 and natural killer cell (NK cell) activity) before commencing their work. The data collected from seventy-four of 89 participating physicians were analyzed. The traditional work group comprised of 39 emergency physicians, who were significantly overworked compared to other two groups: the shift work group and the day work group. Among these three groups, no immune variable was significantly different except lymphocyte, number of CD4, and NK cell activity; and the NK cell activity of the shift work group was significantly lower than those of the traditional work group (p<0.01) and the day work group (p<0.01) in terms of Bonferroni's multiple comparison, probably due to circadian rhythm. It was indicated that NK cell activity was significantly lower in samples collected at night versus in the morning (OR=8.34, 95%CI: 1.95-35.6, p<0.01) through multiple logistic regression analyses. NK cell activity was significantly lower in individuals taking 0-3 days off per month, as compared to those taking 4 or more days off (OR=4.65, 95%CI: 1.27-17.0, p=0.02), according to multiple logistic regression analyses. Therefore, the low NK cell activity appears to have reflected the extent of fatigue arising from physicians' overwork. Overwork would have been a potential risk for the physicians' health, resulting in a lower quality of Japanese emergency medical services than that which could have been achieved otherwise. This study suggests that it would be better for the Japanese emergency physicians to take 4 or more days off per month for their health and the quality of their services. (J Occup Health 2008; 50: 136-146)

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“…Poor health behavior such as sleep deprivation and sleep loss is directly connected to a reduction of NK cells and increased inflammatory responses (24)(25)(26)(27) as well as depressed mood, stress symptoms, and obesity (10,28,29). Meanwhile, job stress has been shown to exert a negative impact on immune outcomes (30)(31)(32)(33)(34), and nocturnal sleep is known to be disturbed by overtime and job stress (23,(35)(36)(37). Based on this model, our study was undertaken to examine the association between overtime and cell-mediated immune markers, taking the potential mediating factors into account by stepwise analyses.…”

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confidence: 99%