換班式女性輪班工作人員之飲食及生理狀況評估
Assessment of Dietary and Physiological Status of Female Rotating Shift Workers
中文摘要
輪班工作對個人健康、身心、家庭、社交均可能會造成不良影響，其中包括睡眠 障礙、
心理及精神疾病、飲食不正常、生理時鐘失調及內分泌改變等，並伴隨有心血管 相關疾病
之危險性增加。本研究之目的主要是評估換班式三班制女性輪班工作人員之飲食 及生理狀
況，並同時評估員工於夜班換回早班第二日及第七日之睡眠及生理狀況。
研究對象是臺北縣二家紡織業相關工廠之員工，選取常日班(N＝48)及換班式輪 班
(N＝90)人員，以問卷調查收集員工之基本資料、睡眠品質、身心健康狀況、工 作壓力、
營養知識、飲食及生活習慣等，且由受過訓練的營養系學生以食物模型進行飲食 頻率問卷
訪視，詢問有關「近三個月內」之飲食攝取情形。並收集血液樣本分析血脂質、
維生素 A、
C、E 含量、抗氧化狀態(total antioxidant status、glutathione、uric acid)、脂質過 氧化物質（malondialdehyde 及 4-hydroxy-2(E)-nonenal(MDA+4-HNE)、
thiobarbituric
acid-reactive substance(TBARS））及生理週期相關物質（melatonin、cortisol）。
結果顯示，在輪班組顯著較常日班組有「睡前吃點心的習慣」，且有「在工作飲
用茶
或咖啡」和「工作很忙時，會不吃飯或延後至少２小時吃飯」等習慣，且輪班組 之總熱量、
蛋白質、醣類及膽固醇之攝取量顯著較高。常日班組之主觀睡眠品質有優於輪班 組之趨勢；
換班第二日之主觀睡眠品質及總睡眠品質顯著較第七日差；且輪班組較有「工作 時容易感到
精神緊張及腸胃不舒服」的情形發生。血壓及血脂質於兩組間無顯著性差異，但 輪班組於換
班第二日時之 TC、LDL-C、LDL-C/HDL-C 均顯著高於換班第七日。輪班組血液 中維生素 E、
glutathione 含量顯著低於常日班組，而換班第二日之 MDA+4HNE、TBARS 顯著
高於換班第七日
。輪班組之 melatonin 顯著高於常日班組，而換班第二日之 melatonin 顯著高於換 班第七日，
但 cortisol 則顯著低於換班第七日。因此，換班式輪班工作人員之飲食型態、睡 眠品質、生
理週期較有適應不良的情形，但在心理健康狀況及體內抗氧化狀態尚未發現不良 情形。
英文摘要
Shift work may affect on worker''s health, family and social life. The possible deteriorated effects including sleep and psychophysiological
disturbance, abnormal dietary habit, disturbanced circadian rhythms, and changed secretory hormones. It may also be to the was related with risk of coronary vascular disease. This study was aimed at comparing permanent day and three-shift workers with respect to dietary patterns and physiological status.
This investigation was conducted in June 1997 in two plants in Taiwan.
Total 138 workers consisting of 48 day workers and 90 rotating shift workers were recruited. A questionnaire was contributed for basic demographic data, sleep quality, physiological health, work stress status, nutritional
knowledge, dietary habits and the amount of food intake was analyzed by food model and food frequency questionnaire interview. The fasting venous blood was collected to detect the concentration of plasma lipids, vitamin A, C, E, antioxidative substances(including total antioxidant status(TAS), glutathione and uric acid), lipid peroxides(including malondialdehyde and 4-hydroxy-2(E)- nonenal (MDA+4-HNE), thiobarbituric acid-reactive substances(TBARS))and circadian rhythms substances(including melatonin and cortisol).
The results showed that rotating shift workers had the habits for eating snacks before sleep, drinking tea or coffee in the work and delayed meal time when working. Rotating shift workers had significantly higher amounts of total energy, protein, carbohydrate, cholesterol and lower sleep quality, especially in shift day2. The study also indicated that blood pressure and lipids were not different for the two groups, but TC, LDL-C levels, and LDL-C/HDL-C ratio in shift day2 were significantly higher than day7.
MDA+4-HNE and TBARS in shift day2 were significantly higher than day7. In circadian rhythms substances, the melatonin concentration of rotating shift workers in shift day2 was higher than day7, but cortisol was lower than day7.
In conclusion, the dietary pattern, sleep quality and circadian rhythms
were not as good as in rotating shift workers than in day workers, however, there was no difference on psychological health and antioxidative status between both groups.
