Objectives Long working hours are linked to an increased risk of exposure to work safety hazards that threaten the health of workers. To date, only a few cross-sectional studies regarding the relationship between working characteristics, such as over-workload and chronic kidney disease (CKD) have been reported. Therefore, in this longitudinal study, we aimed to examine the direct relationship between long working hours and the incidence of CKD. Methods We included 97 856 participants without CKD in the Kangbuk Samsung Health Study. Using a self-report questionnaire, we evaluated weekly working hours, which were categorized into 35-40, 41-52, and >52 hours. CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m². Hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CKD were estimated using Cox proportional hazards regression analyses with weekly working 35-40 hours as the reference. Results During a median follow-up of 4.0 years, 185 participants developed incident CKD (incidence density, 4.83 per 10⁴ person-years). Multivariable-adjusted HRs (95% CI) of incident CKD for weekly working >52 hours compared with working 35-40 hours were 1.99 (1.22-3.25). In subgroup analyses, the significant association between working >52 hours and incident CKD was consistently observed in groups of age ≥40 years, men, and obesity with no interaction. Conclusions Our large-scale cohort study of young- to middle-aged men and women demonstrated a significant association between long working hours and an increased risk of incident CKD.

Seo E, et al. Ann Occup Environ Med. 2022 Mar;34(1):e4. https://doi.org/10.35371/aoem.2022.34.e4

Background: Non-alcoholic fatty liver disease (NAFLD), a common chronic liver disease, may progress to fibrosis, cirrhosis, hepatocellular carcinoma, and liver failure. But only a few cross-sectional studies have reported an association of NAFLD with working hours. This cohort study further examined the association between working hours and the development of NAFLD. Methods: We included 79,048 Korean adults without NAFLD at baseline who underwent a comprehensive health examination and categorized weekly working hours into 35–40, 41–52, 53–60, and >60 hours. NAFLD was defined as the presence of fatty liver, in the absence of excessive alcohol use, as observed by ultrasound. Results: During a median follow-up of 6.6 years, 15,095 participants developed new-onset NAFLD (incidence rate, 5.55 per 100 person-years). After adjustment for confounders, the hazard ratios (95% confidence interval) for the development of NAFLD in 41–52, 53–60, and >60 working hours compared with that in 35–40 working hours were 1.07 (1.02–1.13), 1.06 (1.00–1.13), and 1.13 (1.05–1.23), respectively. Furthermore, the association remained significant after confounders were treated as time-varying covariates. Conclusion: In this large-scale cohort, long working hours, especially >60 working hours a week, were independently associated with incident NAFLD. Our findings indicate that long working hours are a risk factor for NAFLD.

Seo E, et al. Ann Occup Environ Med. 2020 Jun;32:e22. https://doi.org/10.35371/aoem.2020.32.e22

This cross-sectional study investigated the relationship between shift work and reflux esophagitis verified by endoscopic findings. Participants underwent a comprehensive health examination and esophagogastroduodenoscopy between January 2011 and December 2018. We examined endoscopic findings and performed multivariate-adjusted regression analysis of the association between shift work and reflux esophagitis using multiple demographic and clinical factors. Among the 247,450 participants, 49,767 (20.1%) had reflux esophagitis; Los Angeles (LA)-M (31,132, 12.6%) was most common, followed by LA-A (16,213, 6.6%), LA-B (2333, 0.9%), and ≥LA-C (89, 0.04%). The multivariate-fully adjusted odds ratio (OR) of overall reflux esophagitis for shift work compared to fixed day work was 1.15 (95% confidence interval [CI]: 1.11–1.19). When classified according to shift work type and severity of reflux esophagitis, the ORs of LA-A for regular day and night, and irregular shifts compared to fixed day works were 1.14 (95% CI: 1.03–1.26) and 1.26 (95% CI: 1.11–1.44), respectively. However, there was no significant association between any shift work schedule and ≥LA-B. Overall, we demonstrated the cross-sectional association between shift work (especially rotating and irregular shifts) and mild reflux esophagitis (≤LA-A) compared with daily fixed time shifts.