title: Peptic Ulcer Disease in Healthcare Workers: A Nationwide Population-Based Cohort Study.
abstract: Health care workers (HCWs) in Taiwan have heavy, stressful workloads, are on-call, and have rotating nightshifts, all of which might contribute to peptic ulcer disease (PUD). We wanted to evaluate the PUD risk in HCWs, which is not clear. Using Taiwan's National Health Insurance Research Database, we identified 50,226 physicians, 122,357 nurses, 20,677 pharmacists, and 25,059 other HCWs (dieticians, technicians, rehabilitation therapists, and social workers) as the study cohort, and randomly selected an identical number of non-HCW patients (i.e., general population) as the comparison cohort. Conditional logistical regression analysis was used to compare the PUD risk between them. Subgroup analysis for physician specialties was also done. Nurses and other HCWs had a significantly higher PUD risk than did the general population (odds ratio [OR]: 1.477; 95% confidence interval [CI]: 1.433-1.521 and OR: 1.328; 95% CI: 1.245-1.418, respectively); pharmacists had a lower risk (OR: 0.884; 95% CI: 0.828-0.945); physicians had a nonsignificantly different risk (OR: 1.029; 95% CI: 0.987-1.072). In the physician specialty subgroup analysis, internal medicine, surgery, Ob/Gyn, and family medicine specialists had a higher PUD risk than other physicians (OR: 1.579; 95% CI: 1.441-1.731, OR: 1.734; 95% CI: 1.565-1.922, OR: 1.336; 95% CI: 1.151-1.550, and OR: 1.615; 95% CI: 1.425-1.831, respectively). In contrast, emergency physicians had a lower risk (OR: 0.544; 95% CI: 0.359-0.822). Heavy workloads, long working hours, workplace stress, rotating nightshifts, and coping skills may explain our epidemiological findings of higher risks for PUD in some HCWs, which might help us improve our health policies for HCWs.
authors: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
authors: Hong-Yue
authors: HY
authors: Lin
authors: Departments of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan; Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Shih-Feng
authors: SF
authors: Weng
authors: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan; Department of Emergency Medicine, Taipei Medical University, Taipei, Taiwan.
authors: Hung-Jung
authors: HJ
authors: Lin
authors: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
authors: Chien-Chin
authors: CC
authors: Hsu
authors: Departments of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan.
authors: Jhi-Joung
authors: JJ
authors: Wang
authors: Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan; Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Medical Research, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
authors: Shih-Bin
authors: SB
authors: Su
authors: Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors: How-Ran
authors: HR
authors: Guo
authors: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Child Care and Education, Southern Taiwan University of Science and Technology, Tainan, Taiwan; Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan, Taiwan.
authors: Chien-Cheng
authors: CC
authors: Huang
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006282:Health Personnel; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010437:Peptic Ulcer / Q000453:epidemiology* / Q000382:microbiology; D010595:Pharmacists; D010820:Physicians; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology; D013624:Taiwan