Bøggild H, Knutsson A
Centre for Working Time Research, Department of Occupational Medicine, Aalborg Regional Hospital, Denmark.
Scand J Work Environ Health. 1999 Apr;25(2):85-99. doi: 10.5271/sjweh.410.
The literature on shift work, morbidity and mortality from cardiovascular disease, and changes in traditional risk factors is reviewed. Seventeen studies have dealt with shift work and cardiovascular disease risk. On balance, shift workers were found to have a 40% increase in risk. Causal mechanisms of this risk via known cardiovascular risk factors, in relation to circadian rhythms, disturbed sociotemporal patterns, social support, stress, behavior (smoking, diet, alcohol, exercise), and biochemical changes (cholesterol, triglycerides, etc) are discussed. The risk is probably multifactorial, but the literature has focused on the behavior of shift workers and has neglected other possible causal connections. In most studies methodological problems are present; these problems are related to selection bias, exposure classification, outcome classification, and the appropriateness of comparison groups. Suggestions for the direction of future research on this topic are proposed.
本文回顾了关于轮班工作、心血管疾病的发病率和死亡率以及传统风险因素变化的文献。有17项研究涉及轮班工作与心血管疾病风险。总体而言，发现轮班工作者的风险增加了40%。本文讨论了通过已知心血管风险因素导致这种风险的因果机制，这些因素与昼夜节律、社会时间模式紊乱、社会支持、压力、行为（吸烟、饮食、饮酒、运动）以及生化变化（胆固醇、甘油三酯等）有关。这种风险可能是多因素的，但文献主要关注轮班工作者的行为，而忽略了其他可能的因果联系。在大多数研究中存在方法学问题；这些问题与选择偏倚、暴露分类、结果分类以及对照组的适宜性有关。本文还提出了关于该主题未来研究方向的建议。
