Prevalence of duodenal ulcer disease in H. pylori infected shift workers

Previous works on the association between shift work and peptic ulcer did not consider the role of Helicobacter pylori (H. pylori), the main causative agent of this disorder. Aim of this study was to evaluate whether shift work was associated with an increased rate of peptic ulcer in H. pylori infected workers. During a 2 year period, consecutive dyspeptic workers underwent non invasive evaluation of H. pylori status. Those testing positive were included in the study and divided into two main categories according to their job schedule: day-time workers and shift workers. An upper gastrointestinal endoscopy was performed in all workers, and biopsies were taken from the stomach to confirm the presence of infection. A total of 247 day-time workers and 101 shift workers were included. The prevalence of duodenal ulcer was significantly higher in shift workers than in day-time workers (29 out of 101, 28.7% vs 23 out of 247, 9.3%; odds ratio [OR]=S.92, 95% confidence interval [CI] 2.13 to 7.21; p<0.0001), and persisted after multivariate analysis taking into account possible confounding factors: OR 3.96, 95% CI 2.10 to 7.47. Conclusion: Shift work increases the ulcerogenic potential of H. pylori, and is therefore a risk factor in these workers.