국내 응급의학과 전공의의 24시간 연속근무 및 빈번한 야간근무 현황

임재관,이형민,조광현,기동훈 대한응급의학회 2019 대한응급의학회지 Vol.30 No.6

Objective: The newly implemented Training Rule Standard limits the amount of resident working hours to serve the interests of the patients and residents alike. On the other hand, the law does not sufficiently protect emergency medicine residents from a long shift length and frequent night shift. Excessive shift work can cause physical and neuropsychological problems for residents. Therefore, this study examined the 24-hour shifts and night shifts status of emergency medicine residents at the training hospitals. Methods: The 30 training hospitals were divided into three groups according to the number of residents (≤4, 5-8, and ≥ 9) and the associations between each group and the 24-hour shifts, night shifts, number of working days, working hours, and annual patients per resident were checked. The associations between the resident grades and 24-hour shifts, night shifts, number of working days and working hours were also examined. Results: Hospital groups with fewer residents had the highest number of patients per resident with the highest number of 24-hour shifts and the highest number of night shifts. The first year residents had the highest number of 24-hour shifts, the highest number of night shifts, and the highest number of working hours. Conclusion: More 24-hour shifts and more night shifts occur at hospitals that lack work force. Therefore, there is a need for new standards for limiting the working hours and frequency of night shifts in emergency rooms, and there is a need for discussions on reinforcing the work force.

산업체 주.야간 근로자의 식생활 행동 및 영양소 섭취량

박연옥,최인선,이성숙,오승호 대한지역사회영양학회 2002 대한지역사회영양학회지 Vol.7 No.5

The purpose of this study was to examine the eating habits and nutrient intake of industrial workers who work day and night shifts. In the area of percentage of skipped meals, the day shift workers responded that they usually skipped breakfast and the night shift workers often skipped lunch and dinner. The day shift workers answered that they skipped meals because of lack of time. The night shift workers cited poor appetite as their main reason for skipping meals. The intake of calories, Vitamin $B_2$ and calcium of the industrial workers who worked day and night shift was lower than the Korean RDA. The intake of iron of the male night shift workers was lower than the Korean RDA The intake of calories, protein, calcium, iron, Vitamin $B_2$and niacin, vitamin C of the female night shift workers was lower than the Korean RDA. In the area of nutrient intake, the night shift workers both male and female got lower scales than the day shift workers. The nutrient intake of the female night shift workers was the worst. Because they cook for themselves and live alone, their nutrient intake and eating habits were bad. The night shift workers were worse than the day shift workers and the female night shift workers were the worst. Considering the above results, night shift workers should correct their poor eating habits, their nutrient intake and have a well-balanced diet.

근로시간 및 교대근무편성의 문제점과 개선방향

서유진,박영만,문세근,Seo, Yu-Jin,Park, Yeong-Man,Mun, Se-Geun 대한인간공학회 2003 大韓人間工學會誌 Vol.22 No.3

The purpose of this study is to investigate the present conditions of the night work and shift work systems in the heavy chemical industrial complexes found in Changwon, Masan, and Chinhae. Korea. We will attempt to define and classify their problems; and to discover further ways to improve their systems. Fifty production factories were carefully selected as the subjects for this study. The shift systems were classified into five categories. The consecutive night shifts were long in almost all cases with 6 days (36 factories) and 7 days (13 factories). It was found that the night work of about] 2 hours continues for a long period in the weekly rotation full-day shift systems and the night-including non-full-day shift systems, and there was no holiday during a shift cycle in the continuous full-day shift systems. The work time in most shift systems was longer than the 44-hours/week permitted by Korean law. Considering the characteristics of these various types of shift systems, the most essential thing to reduce the shift workers' work load may be to shorten their working hours and improve the schedule of shift systems. It is highly recommended as a fundamental solution. to reduce the portal-to-portal hours from 12 to 8 in the night-including non-full-day shift systems and the weekly rotation full-day shift systems, and at least to employ a 4-team 3-shift system in the continuous full-day shift systems. In addition to this, it should from now on be taken as a goal to restructure the types of shift systems by taking such measures as avoiding continuous night work if possible, providing sufficient off-duty intervals both before and after night shift, providing increased opportunities for workers to nap during night work. and increasing the number of holidays.

야간근로자의 유형과 보호

채희태 성균관대학교 법학연구원 2019 성균관법학 Vol.31 No.4

야간근로는 신체적 피로와 스트레스를 발생시켜 건강의 문제를 발생시킨다. 하지만 야간노동에 대한 개념과 누가 야간근로자인가에 대한 연구는 부족하다. ILO와 유럽연합, 프랑스, 독일, 일본에서는 야간근로에 대한 특정 시간대를 정하고 있다. 그리고 야간근로자의 보호를 위한 여러 조치들을 마련해놓고 있다. 우리나라에서도 근로기준법에서 야간근로에 대해 규정하고 있으며, 안전보건기술지침을 통해 야간근로자 보호에 대한 조치들을 마련해놓고 있다. 야간근로자의 수는 정확히 파악되고 있지 않으나, 2013년 고용노동부 조사에서는 야간근로자를 약 127만 명에서 134만 명으로 추정하고 있다. 산업안전보건법 시행규칙 제98호 제2호에서는 야간작업을 유해인자로 보아 야간작업 특수건강진단을 실시하도록 규정하고 있다. 야간작업 특수건강진단 통계에 의하면 약 182만 명 이상이 야간근로를 하는 것으로 나타났다. 야간근로자는 완전 야간근로자, 부분 야간근로자, 임시 야간근로자의 3가지 유형으로 분류할 수 있다. 완전 야간근로자는 근로시간의 대부분이 야간근로시간대에 있는 근로자이다. 부분 야간근로자는 교대제 근무 등을 통해 근로시간의 일부가 야간근로시간대에 있는 근로자이다. 임시 야간근로자는 특정일이나 특정 주에 야간근로가 예정되어 있거나, 물량 또는 일감의 일시적인 증가로 야간근로를 하는 근로자이다. 야간근로자 보호에 대해 여러 조치들이 있지만 여전히 부족한 실정이다. 현행 야간근로자 보호에 관한 조치에 대하여 다음과 같은 개선방안을 제시한다. 1. 완전 야간근로는 교대제근로를 활용하여 순환 야간근로제로 작업형태를 변경해야 한다. 2. 야간작업 특수건강진단제도를 개선하여 실효성을 확보해야 한다. 3. 현행법 개정으로 야간 안전관리자를 확보하고 야간근로자를 위한 응급시설과 응급수송대책을 마련해야 한다. Night work causes physical fatigue and stress, which can cause health problems. However, there is a lack of research on the concept of night work and who is the night worker. ILO, EU, Japan, France and Germany set specific time zones for night work. In addition, various measures are in place to protect night workers. In Korea, the Labor Standards Act also stipulates night duty, and measures are in place to protect night workers through safety and health technology guidelines(KOSHA GUIDE). The number of night workers is not known exactly. A 2013 survey by the Ministry of Employment and Labor estimates the number of night workers at about 1.27 million to 1.34 million. Regulation No. 98(2) of the Enforcement Rules of the Industrial Safety and Health Act regards night work as a harmful factor and conduct a health examination for night work. The special health examination at night showed that more than 1.82 million people are working at night. Night workers can be classified as full night workers, partial night workers, or temporary night workers. Full night workers are workers who spend most of their time working at night. Partial night shift workers are workers in which part of the working time is in night shift through overtime shift. Temporary night workers are workers who are scheduled for night work on specific days or weeks, or who work at night due to temporary increases in supply or work. There are a number of measures to protect night workers, but they are lacking. The following actions are proposed for current actions on night worker protection. 1. Full night work should be shifted to rotational night work using shift work. 2. The special health examination system for night work should be improved to ensure its effectiveness. 3. The revision of the current law should secure night safety managers and provide emergency facilities and emergency transport measures for night workers.

Field Study of Effects of Night Shifts on Cognitive Performance, Salivary Melatonin, and Sleep

Reza Kazemi,Majid Motamedzade,Rostam Golmohammadi,Hamidreza Mokarami,Rasoul Hemmatjo,Rashid Heidarimoghadam 한국산업안전보건공단 산업안전보건연구원 2018 Safety and health at work Vol.9 No.2

Background: Night shift work is associated with many problems such as sleep deprivation, sleepiness, decreased cognitive performance, increased human errors, and fatigue. This study set out to measure cognitive performance, melatonin rhythms, and sleep after different consecutive night shifts (7 vs. 4) among control room operators (CORs). Methods: The participants included 60 CORs with a mean age of 30.2 years (standard deviation, 2.0) from a petrochemical complex located in Southern Iran. Cognitive performance was assessed using the n-back task and continuous performance test. To evaluate melatonin, saliva was collected and tested by enzymelinked immunosorbent assay. To assess sleep and sleepiness, the Pittsburgh Sleep Quality Index and Karolinska Sleepiness Scale were used, respectively. Results: Individuals who worked 7 consecutive night shifts had a significantly better cognitive performance and sleep quality than those who worked 4 consecutive night shifts. However, salivary melatonin profile and sleepiness trend were not affected by shift type. Conclusion: The main duty of CORs working night shifts at the studied industry included managing safety-critical processes through complex displays; a responsibility that demands good cognitive performance and alertness. It is suggested that an appropriate number of consecutive night shifts in a rotating shift system should be planned with the ultimate aim of improving CROs performance/alertness and enhancing safety.

Field Study of Effects of Night Shifts on Cognitive Performance, Salivary Melatonin, and Sleep

Kazemi, Reza,Motamedzade, Majid,Golmohammadi, Rostam,Mokarami, Hamidreza,Hemmatjo, Rasoul,Heidarimoghadam, Rashid Occupational Safety and Health Research Institute 2018 Safety and health at work Vol.9 No.2

Background: Night shift work is associated with many problems such as sleep deprivation, sleepiness, decreased cognitive performance, increased human errors, and fatigue. This study set out to measure cognitive performance, melatonin rhythms, and sleep after different consecutive night shifts (7 vs. 4) among control room operators (CORs). Methods: The participants included 60 CORs with a mean age of 30.2 years (standard deviation, 2.0) from a petrochemical complex located in Southern Iran. Cognitive performance was assessed using the n-back task and continuous performance test. To evaluate melatonin, saliva was collected and tested by enzyme-linked immunosorbent assay. To assess sleep and sleepiness, the Pittsburgh Sleep Quality Index and Karolinska Sleepiness Scale were used, respectively. Results: Individuals who worked 7 consecutive night shifts had a significantly better cognitive performance and sleep quality than those who worked 4 consecutive night shifts. However, salivary melatonin profile and sleepiness trend were not affected by shift type. Conclusion: The main duty of CORs working night shifts at the studied industry included managing safety-critical processes through complex displays; a responsibility that demands good cognitive performance and alertness. It is suggested that an appropriate number of consecutive night shifts in a rotating shift system should be planned with the ultimate aim of improving CROs performance/alertness and enhancing safety.

보건복지부 야간근무 가이드라인에 따른 일반병동 간호사의 교대근무 현황과 근무표에 대한 인식

홍경진l조성현l정은희 병원간호사회 2021 임상간호연구 Vol.27 No.2

Purpose: To analyze nurses’ shift work according to the government guidelines for night work and their perceptions of their work schedules. Methods: The study sample included 487 nurses who provided information on their schedules, including the normal working hours of each shift, and overtime per shift during September 2020. Nurses’ perceptions were measured in terms of satisfaction, appropriateness for work-life balance, and fairness to their work schedule. Results: One-third of the respondents worked more than 40 hours per week. The average overtime hour was 1.14 hours per shift. Unsocial hours (8 pm to 6 am on weekdays, midnight to midnight on weekends and public holidays) accounted for 56.4% of all working hours. During their last night shift, on average, nurses worked 9.62 hours and had a break of 39 minutes, although 20.5% reported no break. Sixty-eight percent of nurses had at least one between-shift break shorter than 48 hours after a consecutive night shifts. Fifty-seven percent were satisfied with their schedule. One-third perceived their schedule as appropriate for work-life balance, and two-thirds perceived that days off on weekends and nights were fairly distributed within the unit. Working and overtime hours had an inverse relationship with all three aspects of nurses’ perceptions. A higher proportion of unsocial hours and having no breaks during the night shift were associated with lower perceptions of fairness. Conclusion: Reducing working hours, ensuring breaks during night shifts, and increasing rewards for unsocial hours are required to improve nurses’ perceptions and reduce turnover due to shift work.

종합병원 간호사의 밤번고정근무제도와 이직의도에 관한 인식

이미애(Mi Aie Lee),조혜진(Hye Jin Cho),안성희(Sung Hee Ahn),김효주(Hyo Ju Kim) 한국간호행정학회 2015 간호행정학회지 Vol.21 No.5

This study was performed to identify perceptions on fixed night shift system and turnover intention of general hospital nurses and to explore a desirable application plan for a fixed night shift system. Methods: This study was a cross-sectional survey. Participants were 300 nurses working at one general hospital in GyeongGi-Do, Korea. Data were collected from November 3 to 7, 2014, with a structured questionnaires and analyzed using SPSS/PC ver 20.0 programs. Results: Of the participants 73.5% had thought about turnover because of night shifts and the preconditions for desirable fixed night shift system were a payment plan differentiated according to work conditions and an adequate number of nursing staff. Economic and administrative supports like ‘raising extra-pay for night shift’ and ‘increasing the number of paid holidays’ were very important for a desirable fixed night shift system. Conclusion: The results indicate that the most important factor for a desirable fixed night shift system to decrease nurses’ turnover intention is economic and administrative support according to the needs of the nurses. So nursing managers need to find a desirable fixed night shift system considering nurses’ demographic characteristics and organizational characteristics.

Relationship Between Shift Intensity and Insomnia Among Hospital Nurses in Korea: A Cross-sectional Study

Chung, Yuhjin,Kim, Hyunjoo,Koh, Dong-Hee,Park, Ju-Hyun,Yoon, Seohyun The Korean Society for Preventive Medicine 2021 예방의학회지 Vol.54 No.1

Objectives: This study explored the relationship between shift intensity and insomnia among hospital nurses. Methods: The participants were 386 female hospital nurses who underwent a special health examination for night workers in 2015. The Korean Insomnia Severity Index (ISI), indices of shift work intensity, and other covariates such as amount of exercise, level of alcohol consumption, employment duration, and hours worked were extracted from the health examination data. The indices for shift intensity were (1) number of 3 consecutive night shifts and (2) number of short recovery periods after a previous shift, both assessed over the prior 3 months. Multiple logistic regression analysis adjusted for the aforementioned covariates was performed to evaluate the association of shift intensity with insomnia, defined as an ISI score of ≥8. Results: The nurses with insomnia tended to be younger (p=0.029), to have worked 3 consecutive night shifts more frequently (p<0.001), to have experienced a greater number of short recovery periods after the previous shift (p=0.021), and to have worked for more hours (p=0.006) than the nurses without insomnia. Among the other variables, no statistically significant differences between groups were observed. Experiences of 3 or more consecutive night shifts (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.29 to 4.20) and 3 or more short recovery periods (OR, 2.01; 95% CI, 1.08 to 3.73) were associated with increased odds of insomnia. Conclusions: The results suggest that decreasing the shift intensity may reduce insomnia among hospital nurses working rotating shifts.

Occupational and Psychological Factors Associated With Burnout in Night Shift Nurses

Young-Sun Min,Hyeon-Ah Lee,Soon-Chan Kwon,Inho Lee,Kiseok Kim,Ji Sun Kim,Jae Hyun Han,Hwa-Young Lee 대한신경정신의학회 2023 PSYCHIATRY INVESTIGATION Vol.20 No.10

Objective Providing inpatient nursing care inevitably involves night shift work. However, night shift work nurses often face psychiatric health problems such as burnout. If night shift work is an essential work type for nurses, it is necessary to select personnel suitable for night shift work or establish improvement measures such as psychiatric intervention through psychiatric evaluation. The objective of this study was to identify factors that could be interventional among factors affecting burnout in shift-working nurses. Methods A total of 231 night shift female nurses participated in this study. A questionnaire survey was given to assess their general characteristics. To assess burnout, the Maslach Burnout Inventory-General Survey Korean version was adopted. In addition, several mental health scales were used to identify individual psychological characteristics. To identify variables associated with the presence of burnout, odds ratios were calculated using a logistic regression model taking three dimensions of burnout as a dependent variable after adjusting for psychological and occupational factors. Results High resilience was a significant preventive factor in the three dimensions of burnout. Regarding occupational factor, the longer the duration of employment, the higher depersonalization, but the professional efficacy was good. Conclusion Our results indicate that resilience and social support could be prevention factors for burnout. This study is meaningful in examining items that require active intervention and support for burnout targeting night shift nurses who are indispensable for patient care.