Biggi Nicoletta, Consonni Dario, Galluzzo Valeria, Sogliani Marco, Costa Giovanni
Occupational Health Service, AMSA, Milano, Italy.
Chronobiol Int. 2008 Apr;25(2):443-54. doi: 10.1080/07420520802114193.
Night and shift work might be risk factors for metabolic and cardiovascular disorders due to interference with diet, circadian metabolic rhythms, and lifestyle. The relationship between permanent night work and metabolic and cardiovascular risk factors was explored in a retrospective longitudinal study of workers employed in a large municipal enterprise in charge of street cleaning and domestic waste collection. All subjects who had worked night shifts between 1976 and 2007 as hand sweepers, motor sweepers, and delivery tricar drivers were compared with subjects who always worked the same jobs but on day shifts. From the periodical medical surveillance files, we identified 488 male workers who had been examined on average five times (minimum 2, maximum 14) during the study period, for a total of 2,328 medical examinations; 157 always had worked day shifts, 12 always the night shift, and 319 both (initially day and subsequently night shifts). Their age ranged from 22 to 62 yrs, and work experience varied from 1 to 28 yrs. Lifestyle habits (smoking, alcohol consumption), body mass index, serum glucose, total cholesterol, tryglicerides, hepatic enzymes, blood pressure, resting electrocardiogram, diabetes, coronary heart disease, hypertension, and related drugs were taken into consideration for the analysis. We used generalized estimating equations (GEE) models (exchangeable correlation matrix) to analyze the relationship between night work and health effects while accounting for within-subject correlations and adjusting for study period, job, age, and lifestyle variables. As a whole, night workers smoked more and had significantly higher BMI, serum total cholesterol, and triglycerides than day workers. Both the inter-individual comparison between day and night workers and the intra-individual comparison among the workers, who were day workers at the beginning of their employment and later became night workers, showed a significant increase in BMI, total cholesterol, and tryglicerides associated with night work. No consistent effect was seen on fasting glucose, hepatic enzymes, and blood pressure, whereas a higher incidence of coronary heart disease was recorded in night workers.
由于对饮食、昼夜代谢节律和生活方式的干扰，夜间及轮班工作可能是代谢和心血管疾病的风险因素。在一项针对一家负责街道清洁和生活垃圾收集的大型市政企业员工的回顾性纵向研究中，探讨了长期夜间工作与代谢和心血管风险因素之间的关系。将1976年至2007年间担任手扫工人、机动清扫车司机和三轮送货车司机的所有夜班工人与从事相同工作但上日班的工人进行比较。从定期医疗监测档案中，我们确定了488名男性工人，他们在研究期间平均接受了5次检查（最少2次，最多14次），总共进行了2328次医学检查；其中157人一直上日班，12人一直上夜班，319人两者都做过（最初上日班，后来上夜班）。他们的年龄在22岁至62岁之间，工作经验从1年到28年不等。分析时考虑了生活方式习惯（吸烟、饮酒）、体重指数、血清葡萄糖、总胆固醇、甘油三酯、肝酶、血压、静息心电图、糖尿病、冠心病、高血压及相关药物。我们使用广义估计方程（GEE）模型（可交换相关矩阵）来分析夜间工作与健康影响之间的关系，同时考虑个体内相关性，并对研究期间、工作、年龄和生活方式变量进行调整。总体而言，夜班工人吸烟更多，体重指数、血清总胆固醇和甘油三酯显著高于日班工人。日班和夜班工人之间的个体间比较以及那些入职时是日班工人后来变成夜班工人的工人之间的个体内比较均显示，与夜间工作相关的体重指数、总胆固醇和甘油三酯显著增加。在空腹血糖、肝酶和血压方面未观察到一致的影响，而夜班工人冠心病的发病率较高。
