Öz
Amaç: Meslek hastalıkları polikliniğine başvuranlarda tiroid hormon düzeyleri ile işle ilişkili faktörlerin
değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya üniversite hastanesi meslek hastalıkları polikliniğine Kasım 2015- Şubat 2020 tarihleri arasında başvuran 475 çalışan dahil edildi. Çalışanların verilerine; meslek hastalıkları poliklinik muayene formları ve laboratuvar kayıtları retrospektif olarak incelenerek ulaşıldı. Ortalama değerleri karşılaştırmak için Student t testi kullanıldı. İkili analizlerde tiroid stimulan hormon (TSH) değeri ile istatiksel olarak anlamlı ilişkili saptanan bağımsız değişkenler için çoklu lineer regresyon analizi yapıldı.
Bulgular: i475 çalışanın 433'ü (%91,2) erkek ve 173'ü (%36,4) gece vardiyasında çalışıyordu. İşyerinde 293’ü (%61,7) silika tozuna, 23'ü (%4,8) plastik dumana ve 80'i (%16,8) solvente maruz kaldığını ifade etti. 40 yaş üzeri olanlarda (p=0.026), gece vardiyalı çalışanlarda (p=0.023), silika tozuna maruz kalanlarda (p=0.002) daha düşük TSH değerleri; erkek çalışanlarda (p=0.017), 40 yaş altı olanlarda (p=0.042), vücut kitle indeksi (VKİ) 25’den küçük olanlarda (p=0.026) serbest T4 düzeyleri daha yüksek olarak bulundu. Regresyon analizinde VKİ, silika tozu maruziyeti, gece vardiyası çalışması ile azalmış TSH düzeyi arasında anlamlı bir ilişki olduğu görüldü (sırasıyla p=0.033, p=0.028, p=0.045).
Sonuç: Meslek hastalıkları polikliniğine başvuran çalışanlarda gece vardiyalı çalışma ve silika tozuna maruziyetin azalmış TSH seviyeleri ile ilişkili olduğu bulundu. Silika tozu maruziyeti ve gece vardiyalı çalışma önlenebilir risk faktörleri arasında yer almaktadır. Bu nedenle çalışma ortamı yeniden düzenlenmeli, periyodik sağlık muayeneleri yapılmalı, çalışanların iş sağlığı ve güvenliği kurallarına uymaları sağlanmalıdır.
Anahtar Kelimeler
Tiroid hormonları silika işyeri. Tiroid hormonları, silika, işyeri.
Kaynakça
- Leko MB, Gunjaca I, Pleic N, Zemunik T. Environmental Factors Affecting Thyroid-Stimulating Hormone and Thyroid Hormone Levels. Int. J. Mol. Sci. 2021; 22: 6521.
- Costa G. Shift work and health: current problems and preventive actions. Saf Health Work. 2010; 1 (2): 112-23.
- Liyanage YSH, Siriwardhana ID, Dissanayake M, Dayanath BKPT. Study on diurnal variation in TSH and freeT4 levels of healthy adults. Sri Lanka Journal of Diabetes Endocrinology and Metabolism.2018; 8 (1): 8- 16.
- Roelfsema F, Veldhuis JD. Thyrotropin Secretion Patterns in Health and Disease. Endocr Rev.2013; 34: 619-57.
- Moon SH, Lee BJ, Kim SJ. et al. Relationship between thyroid stimulating hormone and night shift work. Ann of Occup and Environ Med.2016; 28: 53.
- Ahmed SB, Aziz HM, Elserougy SM. Effect of Occupational Exposure to Silica Dust on the Thyroid Gland in Ceramic Workers. Central European Journal of Occupational and Environmental Medicine. 2007; 13 (1): 33- 42.
- Duntas LH. The thyroid under threat in a world of plastics. Facta Universitatis Series: Medicine and Biology Vol. 2017; 19 (2): 47-50.
- Poon R, Chu I, Bjarnason S, Potvin M, Vincent R, Miller RB, et al. Inhalation toxicity study of methanol, toluene and methanol/toluene mixtures in rats: effects of 28-days exposure. Toxicol Ind Health. 1994; 10 (3): 231-45.
- National Toxicology Program. NTP Toxicology and Carcinogenesis Studies of Ethylbenzene (CAS No. 100- 41-4) in F344/N Rats and B6C3F1 Mice (Inhalation Studies). Natl Toxicol Program Tech Rep Ser. 1999; 466: 1-231. Saad-Hussein A, Hamdy H, Aziz HM, Mahdy-Abdallah H. Thyroid functions in paints production workers and the mechanism of oxidative-antioxidants status. Toxicol Ind Health.2011; 27 (3): 257-63.
- Copertaro A, Bracci M. Working against the biological clock: a review for the Occupational Physician. Industrial Health. 2019; 57: 557-69.
- Allan JS, Czeisler CA: Persistence of the circadian thyrotropin rhythm under constant conditions and afterlight-induced shifts of circadian phase. J Clin Endocrinol Metab.1994; 79 (2): 508-12.
- Korompeli A, Sourtzi P, Tzavara C, Velonakis E. Rotating shift-related changes in hormone levels in intensive care unitnurses. J Adv Nurs. 2009; 65 (6): 1274-82.
- Malmberg B, Persson R, Jönsson BA, Erfurth EM, Flisberg P, Ranklev E, Orbaek P. Physiological restitution after night-call duty in anaesthesiologists: impact on metabolic factors. Acta Anaesthesiol. Scand. 2007; 51: 823–30.
- Leso V, Vetrani I, Sicignano A, Romano R, Ivo Iavicoli I. The Impact of Shift-Work and Night Shift-Work on Thyroid: A Systematic Review. Int. J. Environ. Res. Public Health. 2020; 17 (5): 1527.
- Hye-a Hwang, Young-jee Jeon. Relationship between Shift Work and Subclinical Hypothyroidism. Korean J Fam Pract 2020;10(1):3-8.
- Parker DC, Rossman LG, Pekary AE, Hershman JM. Effectof 64-hour sleep deprivation on the circadian wave form of thyrotropin (TSH): Furtherevidence of sleep-related inhibition of TSH release. J Clin Endocrinol Metab. 1987;64:157-61.
- Holmbäck U, Forslund A, Lowden A, Forslund J, Akerstedt T, Lennernäs M, et al. Endocrine responses to nocturnal eating–possible implications for night work. Eur J Nutr. 2003; 42: 75–83.
- Speck-Hernandez CA, Montoya-Ortiz G. Silicon, a Possible Link between Environmental Exposure and Autoimmune Diseases: The Case of Rheumatoid Arthritis. Arthritis. 2012; 2012: 604187.
- Mayeux JM, Escalante GM, Christy JM, Pawar RD, Kono DH and Pollard KM. Silicosis and Silica-Induced Autoimmunity in the Diversity Outbred Mouse. Front. Immunol. 2018; 9: 874.
- Muzaffar AR, Rohrich RJ. The silicone gel-filled breast implant controversy: an update. Plast Reconstr Surg. 2002; 109 (2): 742-7; quiz 748.
- Bar-Meir E, Teuber SS, Lin HC, Alosacie I, Goddard G, Terybery J, et al. Multiple autoantibodies in patients with silicone breast implants. J Autoimmun. 1995; 8 (2): 267-77.
- Karataş M. Silikozis tanılı seramik işçilerinde kan tiroid hormon düzeyinin değerlendirilmesi. Journal of Harran University Medical Faculty. 2019; 16 (1): 8-12.
Öz
Aim: This study purposed to evaluate thyroid hormone levels and work-related factors in workers.
Materials and Methods: This retrospective study was perfomed at 475 workers who applied to the outpatient clinic of occupational diseases between November 2015-February 2020. Sociodemographic variables, work-related factors and laboratory records were retrospectively evaluated. Student’s t-test was performed to compare mean values. Multiple linear regression analysis was used, including independent variables that were found to be statistically significantly related in binary analysis of thyroid-stimulating hormone (TSH) value.
Results: Of the 475 participants, 433 (91.2%) were male and 173 (36.4%) worked night shifts, 293 (61.7%) were exposed to silica dust, 23 (4.8%) to plastic fumes, and 80 (16.8%) to solvent. Study participants who were over 40 years of age, night shift workers, and workers with exposure to silica dust had significantly lower TSH values (p=0.026, p=0.023, p=0.002, respectively); male workers, workers under 40 years of age, and workers with body mass index (BMI) <25 had significantly higher free T4 levels (p=0.017, p=0.042, p=0.026, respectively). In the regression analysis, it was observed that there was a significant relationship BMI, silica dust exposure, night shift work and low TSH level (p=0.033, p=0.028, p=0.045).
Conclusion: It was found that night shift work and exposure to silica dust were associated with decreased TSH levels in workers. Silica dust exposure and night shift work are among the preventable risk factors. For this reason, the workplace environment should be reorganized, periodic health examinations should be carried out, and workers should be ensured to comply with occupational
health and safety rules.
Anahtar Kelimeler
Thyroid hormones silica workplace. Thyroid hormones, silica, workplace.
Kaynakça
- Leko MB, Gunjaca I, Pleic N, Zemunik T. Environmental Factors Affecting Thyroid-Stimulating Hormone and Thyroid Hormone Levels. Int. J. Mol. Sci. 2021; 22: 6521.
- Costa G. Shift work and health: current problems and preventive actions. Saf Health Work. 2010; 1 (2): 112-23.
- Liyanage YSH, Siriwardhana ID, Dissanayake M, Dayanath BKPT. Study on diurnal variation in TSH and freeT4 levels of healthy adults. Sri Lanka Journal of Diabetes Endocrinology and Metabolism.2018; 8 (1): 8- 16.
- Roelfsema F, Veldhuis JD. Thyrotropin Secretion Patterns in Health and Disease. Endocr Rev.2013; 34: 619-57.
- Moon SH, Lee BJ, Kim SJ. et al. Relationship between thyroid stimulating hormone and night shift work. Ann of Occup and Environ Med.2016; 28: 53.
- Ahmed SB, Aziz HM, Elserougy SM. Effect of Occupational Exposure to Silica Dust on the Thyroid Gland in Ceramic Workers. Central European Journal of Occupational and Environmental Medicine. 2007; 13 (1): 33- 42.
- Duntas LH. The thyroid under threat in a world of plastics. Facta Universitatis Series: Medicine and Biology Vol. 2017; 19 (2): 47-50.
- Poon R, Chu I, Bjarnason S, Potvin M, Vincent R, Miller RB, et al. Inhalation toxicity study of methanol, toluene and methanol/toluene mixtures in rats: effects of 28-days exposure. Toxicol Ind Health. 1994; 10 (3): 231-45.
- National Toxicology Program. NTP Toxicology and Carcinogenesis Studies of Ethylbenzene (CAS No. 100- 41-4) in F344/N Rats and B6C3F1 Mice (Inhalation Studies). Natl Toxicol Program Tech Rep Ser. 1999; 466: 1-231. Saad-Hussein A, Hamdy H, Aziz HM, Mahdy-Abdallah H. Thyroid functions in paints production workers and the mechanism of oxidative-antioxidants status. Toxicol Ind Health.2011; 27 (3): 257-63.
- Copertaro A, Bracci M. Working against the biological clock: a review for the Occupational Physician. Industrial Health. 2019; 57: 557-69.
- Allan JS, Czeisler CA: Persistence of the circadian thyrotropin rhythm under constant conditions and afterlight-induced shifts of circadian phase. J Clin Endocrinol Metab.1994; 79 (2): 508-12.
- Korompeli A, Sourtzi P, Tzavara C, Velonakis E. Rotating shift-related changes in hormone levels in intensive care unitnurses. J Adv Nurs. 2009; 65 (6): 1274-82.
- Malmberg B, Persson R, Jönsson BA, Erfurth EM, Flisberg P, Ranklev E, Orbaek P. Physiological restitution after night-call duty in anaesthesiologists: impact on metabolic factors. Acta Anaesthesiol. Scand. 2007; 51: 823–30.
- Leso V, Vetrani I, Sicignano A, Romano R, Ivo Iavicoli I. The Impact of Shift-Work and Night Shift-Work on Thyroid: A Systematic Review. Int. J. Environ. Res. Public Health. 2020; 17 (5): 1527.
- Hye-a Hwang, Young-jee Jeon. Relationship between Shift Work and Subclinical Hypothyroidism. Korean J Fam Pract 2020;10(1):3-8.
- Parker DC, Rossman LG, Pekary AE, Hershman JM. Effectof 64-hour sleep deprivation on the circadian wave form of thyrotropin (TSH): Furtherevidence of sleep-related inhibition of TSH release. J Clin Endocrinol Metab. 1987;64:157-61.
- Holmbäck U, Forslund A, Lowden A, Forslund J, Akerstedt T, Lennernäs M, et al. Endocrine responses to nocturnal eating–possible implications for night work. Eur J Nutr. 2003; 42: 75–83.
- Speck-Hernandez CA, Montoya-Ortiz G. Silicon, a Possible Link between Environmental Exposure and Autoimmune Diseases: The Case of Rheumatoid Arthritis. Arthritis. 2012; 2012: 604187.
- Mayeux JM, Escalante GM, Christy JM, Pawar RD, Kono DH and Pollard KM. Silicosis and Silica-Induced Autoimmunity in the Diversity Outbred Mouse. Front. Immunol. 2018; 9: 874.
- Muzaffar AR, Rohrich RJ. The silicone gel-filled breast implant controversy: an update. Plast Reconstr Surg. 2002; 109 (2): 742-7; quiz 748.
- Bar-Meir E, Teuber SS, Lin HC, Alosacie I, Goddard G, Terybery J, et al. Multiple autoantibodies in patients with silicone breast implants. J Autoimmun. 1995; 8 (2): 267-77.
- Karataş M. Silikozis tanılı seramik işçilerinde kan tiroid hormon düzeyinin değerlendirilmesi. Journal of Harran University Medical Faculty. 2019; 16 (1): 8-12.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 12 Eylül 2022 |
| Gönderilme Tarihi | 29 Mart 2022 |
| Yayımlandığı Sayı | Yıl 2022Cilt: 61 Sayı: 3 |
