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Examining The Relationship between Shift Work and Diabetes Mellitus among Nurses: An Evidence-based Case Report Arifianto, Angga; Widyahening, Indah Suci; Khoe, Levina Chandra; Mokoagow, M. Ikhsan
Occupational and Environmental Medicine Journal of Indonesia Vol. 2, No. 2
Publisher : UI Scholars Hub

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Abstract

Background : Work shifts could cause numerous health problems, such as sleep disorders, weight gain disorders, and unhealthy food intake consumption, leading to obesity and changes in blood glucose levels, that eventually lead to diabetes mellitus. This evidence-based case report aims to provide an evidence of association between shift work and the risk of diabetes mellitus among nurses. Methods : We performed a literature searching from Pubmed, Embase, Cochrane, Scopus, and Google Scholar in September 2023 using keywords ‘shift work’ AND ‘diabetes’ AND ‘nurse’. We included studies that assessed the association between shift work and diabetes among nurses using observational studies, meta-analysis, and systemic review as their study design. The outcome variable was the odd ratio or the relative risk of developing diabetes. We excluded cross-over studies, clinical trials, and cross-sectional studies. In addition, quality assessment was conducted according to The Oxford Center for Evidence-Based Medicine (OCEBM). Results : After title and abstract screening, we found seven out of twenty articles with a total of 689,273 participants. Among these articles, there were three cohort studies which found an increased relative risk (1.08 to 2.60) of diabetes among nurses who worked night and rotating shifts compared to those who did not. Another evidence from two cohort studies and one meta-analysis identified that nurses who worked in full shifts had an increased risk of diabetes (1.05 to 3.60) than those who worked non-shifts. Factors affecting the risk of diabetes were gender, unhealthy lifestyle, sleep disorders, and shift work duration (≥10 years). Conclusions : Shift work in nurses has a significant association with the risk of diabetes mellitus. Nurses had been working shift work for more than 10 years, particularly on night shift, had a higher risk compared to those who had been working for less than 10 years without night shift. Additional factors such as obesity, smoking, lack of physical activity, unhealthy diet, and sleep disorders would increase the risk of diabetes mellitus.
N-ACETYL-S-(N-METHYLCARBAMOYL)-CYSTEINE (AMCC) as Cumulative Biomonitoring of Dimethylformamide Exposure among Industrial Workers Arifianto, Angga; Ilyas, Muhammad; ., Herqutanto
Occupational and Environmental Medicine Journal of Indonesia Vol. 2, No. 2
Publisher : UI Scholars Hub

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Background: N,N-Dimethylformamide (DMF) is an aliphatic amide which is miscible with water and a majority of organic liquids. Due to its amphiphilic properties, it is a widely used industrial solvent, especially for polymers. DMF has been consistently hepatotoxic, inducing effects on the liver at lowest concentrations or doses. N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC) which is one major metabolites of DMF, found in urine after DMF exposure of the whole workweek. Objective: To determine the way of AMCC can be use as biomarker of DMF exposure and the best possible sampling time. Method: This study conducted a literature search using evidence-based databases focusing on clinical questions using the “PICO” method. The author searched the relevant articles using the following databases: “PubMed”, “Scopus”, and “Embase”. The keywords used included “Dimethylformamide”, “Workes,” “AMCC” (MESH Term), “N-Acetyl-S-(N-Methylcarbamoyl)cysteine,” along with their synonyms combined with Boolean operators. Inclusion criteria comprised studies involving workers populations, cohort, cross sectional, systematic reviews/meta-analyses, written in English, and with full-text availability. Exclusion criteria included case report, RCT, and articles with incomplete data or inaccessible full text. Results: Based on the analysis of five reviewed literature, the author obtained insights into the effectiveness of AMCC use as biomarker of DMF exposure. It can be use after several workdays exposure of DMF (3-5 days). The best of time sampling is at morning or afternoon of last day on the workweek. AMCC result is described as cumulative DMF exposure of a whole week, and more relevant associated with the hepatotoxicity of DMF than the other DMF metabolite, N-methylformamide (NMF). Conclusion: AMCC can be considered as a cumulative exposure of DMF of a whole week and more relevant associated with DMF induced hepatotoxicity. Keywords: Dimethylformamide, Worker, AMCC