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Vestergaard JM, Dalbøge A, Bonde JPE, Garde AH, Hansen J, Hansen ÅM, Larsen AD, Härmä M, Costello S, Böttcher M, Kolstad HA. Night shift work characteristics and risk of incident coronary heart disease among health care workers: national cohort study. Int J Epidemiol 2023; 52:1853-1861. [PMID: 37741924 DOI: 10.1093/ije/dyad126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/13/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Night work has been associated with coronary heart disease. The present study examined exposure-response relations between quantitative night work characteristics and coronary heart disease (angina pectoris or myocardial infarction) with the aim to contribute to evidence-based recommendations for low-risk night work schedules. METHODS We followed 100 149 night workers (80% women) and 153 882 day workers (78% women), all health care workers in Denmark with day by day payroll information on night shifts from 2007 to 2015. We analysed data with Poisson regression stratified by sex and adjusted for age, calendar year, diabetes, family history of cardiovascular disease, educational level, occupation, indicators for obesity, hypercholesterolaemia, and hypertension. RESULTS Female and male night workers worked on average 1.7 and 1.8 night shifts per month for an average duration of less than 4 years. During follow-up, 1198 night and 2128 day workers were hospitalized with first-time coronary heart disease. When compared with day workers, the overall incidence rate ratios for female and male night workers were 1.06 [95% confidence interval (CI): 0.97, 1.17] and 1.22 (95% CI 1.07, 1.39). Highest risks were observed in top exposure categories for several night work characteristics. However, no consistent exposure-response relations by number of monthly night shifts, cumulative night shifts, years with rotating night shifts, years with any night shift and consecutive night shifts were observed among the night workers of either sex. CONCLUSIONS This study of a population with low exposure to night work does not indicate that reducing extent of monthly night shifts, cumulative night shifts, years with rotating night shifts, years with any night shift and consecutive night shifts would reduce the risk of coronary heart disease.
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Affiliation(s)
- Jesper Medom Vestergaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Goedstrup Hospital, Herning, Denmark
| | - Annett Dalbøge
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Peter Ellekilde Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Anne Helene Garde
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Johnni Hansen
- Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
| | - Åse Marie Hansen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Mikko Härmä
- Finnish Institute for Occupational Health, Helsinki, Finland
| | - Sadie Costello
- Environmental Health Science, School of Public Health, University of California, Berkeley, CA, USA
| | - Morten Böttcher
- Department of Cardiology, Gødstrup Hospital, NIDO, Herning, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Su F, Huang D, Wang H, Yang Z. Associations of shift work and night work with risk of all-cause, cardiovascular and cancer mortality: a meta-analysis of cohort studies. Sleep Med 2021; 86:90-98. [PMID: 34479052 DOI: 10.1016/j.sleep.2021.08.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/27/2021] [Accepted: 08/13/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Epidemiological studies on the relationship of shift work or night work with risk of total and cause-specific mortality have given conflicting results. We aimed at conducting a meta-analysis to summarize the evidence from cohort studies. METHODS Embase, PubMed, Web of Science and Scopus databases were searched for eligible studies up to Mar 2021. Cohort studies evaluating the associations of shift work or night work with risk of all-cause, cardiovascular or cancer mortality were reviewed. Study-specific risk estimates were pooled by fixed-effect models when the heterogeneity was not detected; otherwise, random-effect models were employed. RESULTS We identified seventeen eligible articles (sixteen cohorts). A total of 958,674 cohort participants were included, with 38,413 total deaths, 24,713 cardiovascular deaths and 10,219 cancer deaths during follow-up. According to the Newcastle-Ottawa Scale, fifteen studies were considered as relatively high quality with low risk of bias. Compared with regular daytime workers, the pooled relative risks for all-cause, cardiovascular and cancer mortality were 1.02 (95% CI: 0.99, 1.06), 1.18 (95% CI: 0.94, 1.47) and 1.05 (95% CI: 0.83, 1.34) for those ever exposing to shift work, respectively. Compared with daytime workers or those never exposing to night work, the pooled relative risks for all-cause, cardiovascular and cancer mortality were 1.06 (95% CI: 1.03, 1.08), 1.15 (95% CI: 1.03, 1.29) and 1.04 (95% CI: 1.00, 1.08) for those ever exposing to night work, respectively. Moderate to high level of heterogeneity across the studies was detected. Publication bias was not detected. CONCLUSION Night work may be associated with higher risk of all-cause, cardiovascular and cancer mortality, suggesting that night workers compared with daytime workers may be at higher risk of death, especially due to cardiovascular disease.
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Affiliation(s)
- Fuxiang Su
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ding Huang
- Department of Cardiology, The Fourth People's Hospital of Shenyang, Shenyang, China
| | - Hongyu Wang
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhiyong Yang
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China.
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3
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Li W, Yu K, Jia N, Xu X, Yuan Y, Peng R, Niu R, You X, Yang H, Qiu G, Guo H, He M, Zhang X, Pan A, Tse LA, Wu T. Past Shift Work and Incident Coronary Heart Disease in Retired Workers: A Prospective Cohort Study. Am J Epidemiol 2021; 190:1821-1829. [PMID: 33728442 DOI: 10.1093/aje/kwab074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 03/04/2021] [Accepted: 03/12/2021] [Indexed: 11/12/2022] Open
Abstract
Present shift work has been associated with coronary heart disease (CHD) among employed workers, but it remains unclear whether shift work performed in the past is still associated with CHD in retired workers. We recruited 21,802 retired workers in Shiyan, China, in 2008-2010 and 2013 and followed them for CHD events occurring up to December 31, 2018. Retired workers with longer durations of past shift work (rounded to 0.25 years) had higher CHD risks (for those with ≤5.00, 5.25-10.00, 10.50-20.00, and >20.00 years of past shift work, hazard ratios were 1.05 (95% confidence interval (CI): 0.94, 1.16), 1.08 (95% CI: 0.94, 1.25), 1.23 (95% CI: 1.07, 1.42), and 1.28 (95% CI: 1.08, 1.51), respectively). The association was substantially higher among service or sales workers than among manufacturing or manual-labor workers (for every 5-year increase in past shift work, hazard ratio = 1.11 (95% CI: 1.05, 1.16) vs. hazard ratio = 1.02 (95% CI: 0.98, 1.06)). Moreover, the risk was lower among those who were physically active than among their inactive counterparts (P for interaction = 0.019). Longer duration of past shift work was associated with higher risk of incident CHD among these retired workers, especially those from the service or sales sectors. Physical exercise might be beneficial in reducing the excess risk.
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4
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Feng X, Qiu W, Cheng M, Liang R, Xu T, Zhou M, He M, Zhang X, Yuan J, Wang D, Chen W. Association of shift work with cardiovascular disease risk among Chinese workers. Chronobiol Int 2021; 38:1186-1194. [PMID: 33910438 DOI: 10.1080/07420528.2021.1917593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
To evaluate the association of shift work with 10-year cardiovascular disease (CVD) risk among Chinese workers. We included 23,064 workers in the first follow-up of the Dongfeng-Tongji cohort study. Questionnaires and physical examinations were conducted to collect data for all participants. Framingham Risk Score was calculated according to the multivariable risk algorithms, and used to evaluate 10-year CVD risk. Logistic regression models were used to assess the relationship between shift work and 10-year CVD risk. Among 23,064 individuals, 51.92% of workers suffered shift work, and the proportions of shift work duration of 1-<10, 10-<20, and ≥20 years were 17.29%, 17.35% and 17.30%, respectively. Compared with individuals without a shift work history, the odds ratios (ORs) and 95% confidence intervals (CIs) of 10-year CVD were 1.027 (0.900-1.173), 1.058 (0.927-1.206) and 1.191 (1.036-1.368) for individuals with shift work duration of 1-<10 years, 10-<20 years, and ≥20 years, respectively, after adjusting for potential confounders. And the association was more obvious in males. When shift work and obesity were combined, the OR (95%CI) of high 10-year CVD risk (3.373, 2.390-4.761) was significantly increased for obese individuals with shift work of ≥20 years. Besides, the OR (95%CI) for higher 10-year CVD risk associated with shift work decreased as the leaving shift work duration prolonged. Shift work is associated with a higher 10-year CVD risk, especially among males. Obesity has a synergistic effect on such association while leaving shift work reduces such association.
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Affiliation(s)
- Xiaobing Feng
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Weihong Qiu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Man Cheng
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ruyi Liang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tao Xu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Min Zhou
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Meian He
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaomin Zhang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Yuan
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dongming Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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5
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Ferri GM, Cavone D, Intranuovo G, Macinagrossa L. Healthy Diet and Reduction of Chronic Disease Risks of Night Shift Workers. Curr Med Chem 2019; 26:3521-3541. [PMID: 28730970 DOI: 10.2174/0929867324666170720160632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 05/05/2017] [Accepted: 05/05/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND The large increase in epidemiological studies on night shift work is due to the important effects of night shift work on workers' health and psychophysical wellbeing. The short-term effects-insomnia, difficulties in managing work and private life, lower work performance, and more work and extra-work accidents-are easily studied. However, there are several long-term effects that are difficult to study because of the need for detailed exposure assessment and the long latency periods of these diseases. OBJECTIVE The aim was to collect epidemiologic evidence of diseases in night shift workers, describing their biological pathways and a set of dietary guidelines. METHODS This is a review on diet and health effects in night shift workers. RESULTS Significant increases in the rate ratios and hazard ratios of different diseases were associated with modified eating behaviours and poor eating habits among night shift workers. Night shift work is a risk factor for disruption of the circadian rhythms and for some genetic deregulation because it produces the inversion of the sleep/wake cycle and modifies the alternation between activity and rest. CONCLUSION A healthy diet and improved dietary practices, together with other factors, can reduce shift workers' chronic disease risk. The literature showed the importance of eating behaviour in order to prevent diseases in these workers; therefore, educational programmes are necessary to encourage several important lifestyle changes. The target of our future research will be the role of food components in some dietetic habits for the prevention of disease in night shift workers.
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Affiliation(s)
- G M Ferri
- Interdisciplinary Department of Medicine (DIM), Section "B. Ramazzini", Unit of Occupational Medicine, University Regional Hospital "Policlinico - Giovanni XXIIIth", Bari, Italy
| | - D Cavone
- Interdisciplinary Department of Medicine (DIM), Section "B. Ramazzini", Unit of Occupational Medicine, University Regional Hospital "Policlinico - Giovanni XXIIIth", Bari, Italy
| | - G Intranuovo
- Interdisciplinary Department of Medicine (DIM), Section "B. Ramazzini", Unit of Occupational Medicine, University Regional Hospital "Policlinico - Giovanni XXIIIth", Bari, Italy
| | - L Macinagrossa
- Interdisciplinary Department of Medicine (DIM), Section "B. Ramazzini", Unit of Occupational Medicine, University Regional Hospital "Policlinico - Giovanni XXIIIth", Bari, Italy
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6
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Cheng M, He H, Wang D, Xu L, Wang B, Ho KM, Chen W. Shift work and ischaemic heart disease: meta-analysis and dose–response relationship. Occup Med (Lond) 2019; 69:182-188. [DOI: 10.1093/occmed/kqz020] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Man Cheng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Heng He
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dongming Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei, China
| | - Luli Xu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bin Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Kim Myong Ho
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Public Health Faculty, Pyongyang Medical College, Kim Il Sung University
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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7
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Schuster M, Oberlinner C, Claus M. Shift-specific associations between age, chronotype and sleep duration. Chronobiol Int 2019; 36:784-795. [PMID: 30880475 DOI: 10.1080/07420528.2019.1586719] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The objective of this study was to examine the association of age with chronotype and sleep duration in day workers and rotating shift workers, including night shift work. Between October 2012 and February 2015, a cross-sectional study was conducted in a German chemical company. Using the "Munich ChronoType Questionnaire" (MCTQ), data about sleep onset and sleep offset during workdays and work-free days were retrieved and the chronotype was computed during regular voluntary occupational health check-ups. Associations between age and chronotype, as well as sleep duration, were assessed using linear regression analyses. Potential effect modification by the working time system was examined. Within the study period, 4,040 employees (82.3% and 17.7% were engaged in day work and rotating shift work, respectively) completed the questionnaire. Study participants were on average 41.8 years old (Min = 18.0, Max = 65.0, SD = 10.2) and predominantly male (75.4%). Mean chronotype and overall sleep duration was 03:22 (SD = 54 min) and 7.2 h (SD = 1.0 h) respectively. Older age was associated with earlier chronotype and reduced overall sleep duration in both day workers and rotating shift workers (p < 0.001 for all models). Compared to day workers, employees whom engaged in rotating shift work were later chronotypes and had overall a longer sleep duration. With older age, the difference between day and rotating shift workers regarding chronotype increased, while the difference regarding overall sleep duration decreased (pinteraction<0.005 for both models). This finding could indicate that both changes in circadian physiology and exposure to certain work schedules contribute to the age-related changes. Older rotating shift workers, with early chronotypes may have issues with night shifts, while day work and morning shifts may be best compatible to earlier chronotypes. Differences in sleep timing across age groups, might indicate that the same work hours will affect shift workers differently, dependent on their age, suggesting that more flexible and chronotype-adapted work hours could provide useful; especially for older employees. Sleep education in the form of courses and health campaigns could be a way to raise awareness of the importance of a healthy sleep pattern. This could be achieved by learning strategies to better adjust individual sleep patterns to work hours.
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Affiliation(s)
- Michael Schuster
- a Corporate Health Management, BASF SE , Ludwigshafen am Rhein , Germany
| | | | - Matthias Claus
- a Corporate Health Management, BASF SE , Ludwigshafen am Rhein , Germany
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8
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Wang D, Ruan W, Chen Z, Peng Y, Li W. Shift work and risk of cardiovascular disease morbidity and mortality: A dose–response meta-analysis of cohort studies. Eur J Prev Cardiol 2018; 25:1293-1302. [DOI: 10.1177/2047487318783892] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Previous studies have suggested that shift work is associated with a higher risk of cardiovascular disease. However, the quantitative dose–response relationship between duration of shift work and cardiovascular disease risk is still unknown. We aimed to evaluate the dose–response association between duration of shift work and risk of cardiovascular disease morbidity and mortality. Design A systematic review and meta-analysis. Methods PubMed and Embase were searched from inception to 1 December 2017. Prospective cohort studies that reported the associations between duration of shift work and cardiovascular disease risk with at least three categories were included. Data were pooled by using fixed or random effect models. The continuous dose–response associations were assessed by using fixed effect restricted cubic splines with four knots. Results Five prospective cohort studies with 10 reports were included. No evidence of a curvilinear association was observed between duration of shift work and risk of cardiovascular disease, similar findings were observed in cardiovascular disease morbidity and mortality. The summary relative risk (RR) of an increase of 5 years of shift work was 1.05 (1.04–1.07) with moderate heterogeneity ( P = 0.142, I2 = 33.2%) for cardiovascular disease, 1.06 (1.04–1.08) with low heterogeneity ( P = 0.279, I2 = 21.7%) for cardiovascular disease morbidity, and 1.04 (1.02–1.06) with moderate heterogeneity ( P = 0.135, I2 = 38.5%) for cardiovascular disease mortality, respectively. Conclusions Shift work could probably increase the risk of cardiovascular disease and cardiovascular disease mortality in a dose–response way. These findings could have implications for guideline recommendations regarding the risk related to shift schedules.
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Affiliation(s)
- Dongming Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, China
| | - Wenyu Ruan
- Department of Clinical Medicine, Xi’an Medical University, China
| | - Zhenlong Chen
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, China
| | - Ying Peng
- Department of Emergency, Wuhan Centers for Diseases Prevention and Control, China
| | - Wenzhen Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
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9
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Hammer GP, Emrich K, Nasterlack M, Blettner M, Yong M. Shift Work and Prostate Cancer Incidence in Industrial Workers: A Historical Cohort Study in a German Chemical Company. DEUTSCHES ARZTEBLATT INTERNATIONAL 2016. [PMID: 26214232 DOI: 10.3238/arztebl.2015.0463] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is inconsistent evidence for a possible carcinogenic effect of shift work. In particular, little is known about the putative association of shift work with prostate cancer. METHOD We studied a cohort of 27,828 male industrial production workers residing in the German federal state of Rhineland-Palatinate who worked for at least one year in a chemical company in the period 1995-2005. We obtained data on shift work and potential confounders including age, occupational task, and duration of employment from personnel files and from the records of the occupational health service. New cases of cancer in the period 2000-2009 were ascertained from the state cancer registry. Differences in risk between shift workers and daytime workers were analyzed with Cox regression, stratified by stage of cancer, and adjusted for potential confounding effects. RESULTS There were 146 new cases of prostate cancer in 12,609 rotating shift workers and 191 in 15,219 daytime workers. The median year of birth was 1960 in the first group and 1959 in the second. The shift workers did not have an elevated hazard ratio for prostate cancer in comparison to the daytime workers (HR = 0.93, 95% confidence interval [CI] 0.73-1.18). Some differences were seen depending on tumor stage. Both groups of workers had a higher incidence of prostate carcinoma than the general population (standardized incidence rate [SIR] = 1.44, 95% CI 1.22-1.70 for daytime workers; SIR = 1.51, 95% CI 1.30-1.74 for shift workers). CONCLUSION In this well-documented, large-scale cohort study, the incidence of prostate cancer among shift workers did not differ from that among daytime workers. In the authors' opinion, further follow-up of this relatively young cohort is required.
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Affiliation(s)
- Gaël P Hammer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) at the University Medical Center of the Johannes Gutenberg University Mainz, Registre Morphologique des Tumeurs, Laboratoire National de Santé, Luxembourg, Cancer Registry Rhineland-Palatinate, Institute of Medical Biostatistics, Epidemiology and Informatics IMBEI) at the University Medical Center of the Johannes Gutenberg University Mainz, Occupational Medicine and Health Protection, BASF SE, Ludwigshafen
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10
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Gu F, Han J, Laden F, Pan A, Caporaso NE, Stampfer MJ, Kawachi I, Rexrode KM, Willett WC, Hankinson SE, Speizer FE, Schernhammer ES. Total and cause-specific mortality of U.S. nurses working rotating night shifts. Am J Prev Med 2015; 48:241-52. [PMID: 25576495 PMCID: PMC4339532 DOI: 10.1016/j.amepre.2014.10.018] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 10/01/2014] [Accepted: 10/24/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND Rotating night shift work imposes circadian strain and is linked to the risk of several chronic diseases. PURPOSE To examine associations between rotating night shift work and all-cause; cardiovascular disease (CVD); and cancer mortality in a prospective cohort study of 74,862 registered U.S. nurses from the Nurses' Health Study. METHODS Lifetime rotating night shift work (defined as ≥3 nights/month) information was collected in 1988. During 22 years (1988-2010) of follow-up, 14,181 deaths were documented, including 3,062 CVD and 5,413 cancer deaths. Cox proportional hazards models estimated multivariable-adjusted hazard ratios (HRs) and 95% CIs. RESULTS All-cause and CVD mortality were significantly increased among women with ≥5 years of rotating night shift work, compared to women who never worked night shifts. Specifically, for women with 6-14 and ≥15 years of rotating night shift work, the HRs were 1.11 (95% CI=1.06, 1.17) and 1.11 (95% CI=1.05, 1.18) for all-cause mortality and 1.19 (95% CI=1.07, 1.33) and 1.23 (95% CI=1.09, 1.38) for CVD mortality. There was no significant association between rotating night shift work and all-cancer mortality (HR≥15years=1.08, 95% CI=0.98, 1.19) or mortality of any individual cancer, with the exception of lung cancer (HR≥15years=1.25, 95% CI=1.04, 1.51). CONCLUSIONS Women working rotating night shifts for ≥5 years have a modest increase in all-cause and CVD mortality; those working ≥15 years of rotating night shift work have a modest increase in lung cancer mortality. These results add to prior evidence of a potentially detrimental effect of rotating night shift work on health and longevity.
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Affiliation(s)
- Fangyi Gu
- Division of Cancer Epidemiology & Genetics, Genetic Epidemiology Branch, National Cancer Institute, Bethesda, Maryland
| | - Jiali Han
- Channing Division of Network Medicine, Harvard School of Public Health, Boston; Clinical Research Program, Department of Dermatology, Harvard School of Public Health, Boston; Department of Epidemiology, Richard M. Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana
| | - Francine Laden
- Department of Environmental Health, Harvard School of Public Health, Boston; Department of Epidemiology, Harvard School of Public Health, Boston
| | - An Pan
- Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Neil E Caporaso
- Division of Cancer Epidemiology & Genetics, Genetic Epidemiology Branch, National Cancer Institute, Bethesda, Maryland
| | - Meir J Stampfer
- Channing Division of Network Medicine, Harvard School of Public Health, Boston; Department of Epidemiology, Harvard School of Public Health, Boston
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston
| | - Kathryn M Rexrode
- Division of Preventive Medicine, Harvard School of Public Health, Boston
| | - Walter C Willett
- Department of Nutrition, Harvard School of Public Health, Boston
| | - Susan E Hankinson
- Channing Division of Network Medicine, Harvard School of Public Health, Boston; Division of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Massachusetts
| | - Frank E Speizer
- Channing Division of Network Medicine, Harvard School of Public Health, Boston
| | - Eva S Schernhammer
- Channing Division of Network Medicine, Harvard School of Public Health, Boston; Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Harvard School of Public Health, Boston; Applied Cancer Research-Institution for Translational Research Vienna (ACR-ITR VIEnna), Vienna, Austria.
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