Fujino Yoshihisa, Iso Hiroyasu, Tamakoshi Akiko, Inaba Yutaka, Koizumi Akio, Kubo Tatsuhiko, Yoshimura Takesumi
Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
Am J Epidemiol. 2006 Jul 15;164(2):128-35. doi: 10.1093/aje/kwj185. Epub 2006 May 17.
This study prospectively examined the association between shift work and the risk of ischemic heart disease among Japanese male workers. A baseline survey, which involved 110,792 inhabitants (age range: 40-79 years) from 45 areas throughout Japan, was conducted between 1988 and 1990. The causes of death were identified from death certificates. The analysis was restricted to 17,649 men (age range: 40-59 years) who were employed at the time of the baseline survey. All subjects were asked to indicate the most regular shift work that they had undertaken previously: day work, rotating-shift work, or fixed-night work. The Cox proportional hazards model was used to estimate the risks of shift work for ischemic heart disease. During the 233,869 person-years of follow-up, a total of 1,363 deaths were recorded, 86 of which were due to ischemic heart disease. Compared with the day workers, the rotating-shift workers had a significantly higher risk of death due to ischemic heart disease (relative risk = 2.32, 95% confidence interval: 1.37, 3.95; p = 0.002), whereas fixed-night work was not associated with ischemic heart disease (relative risk = 1.23, 95% confidence interval: 0.49, 3.10; p = 0.658). In addition, subjects with coronary risk factors, such as hypertension, overweight, habitual alcohol consumption, and smoking, were highly susceptible to the effect of rotating-shift work on the risk of death due to ischemic heart disease.
本研究前瞻性地考察了日本男性工人的轮班工作与缺血性心脏病风险之间的关联。1988年至1990年间，对来自日本45个地区的110,792名居民（年龄范围：40 - 79岁）进行了基线调查。从死亡证明中确定死亡原因。分析仅限于在基线调查时就业的17,649名男性（年龄范围：40 - 59岁）。所有受试者被要求指出他们以前从事的最常规的轮班工作：日班、轮班工作或固定夜班。使用Cox比例风险模型来估计轮班工作导致缺血性心脏病的风险。在233,869人年的随访期间，共记录了1,363例死亡，其中86例死于缺血性心脏病。与日班工人相比，轮班工人死于缺血性心脏病的风险显著更高（相对风险 = 2.32，95%置信区间：1.37, 3.95；p = 0.002），而固定夜班与缺血性心脏病无关（相对风险 = 1.23，95%置信区间：0.49, 3.10；p = 0.658）。此外，患有高血压、超重、习惯性饮酒和吸烟等冠心病危险因素的受试者，极易受到轮班工作对缺血性心脏病死亡风险的影响。
