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倒班工作与心血管疾病:一项基于人群的 22 年随访研究。

Shift-work and cardiovascular disease: a population-based 22-year follow-up study.

机构信息

Brain@Work Research Center, Finnish Institute of Occupational Health, Helsinki, Finland.

出版信息

Eur J Epidemiol. 2010 May;25(5):315-23. doi: 10.1007/s10654-010-9439-3. Epub 2010 Mar 14.

Abstract

Studies on the association between shift-work and cardiovascular disease (CVD), in particular coronary heart disease (CHD), have given conflicting results. In this prospective population-based study we assessed the association of shift-work with three endpoints: CHD mortality, disability retirement due to CVD, and incident hypertension. A cohort of 20,142 adults (the Finnish Twin Cohort) was followed from 1982 to 2003. Type of working time (daytime/nighttime/shift-work) was assessed by questionnaires in 1975 (response rate 89%) and in 1981 (84%). Causes of death, information on disability retirement and hypertension medication were obtained from nationwide official registers. Cox proportional hazard models were used to obtain hazard ratios (HR) for each endpoint by type of working time. Adjustments were made for 14 socio-demographic and lifestyle covariates. 76.9% were daytime workers and 9.5% shift-workers both in 1975 and in 1981. During the follow-up, 857 deaths due to CHD, 721 disability retirements due to CVD, and 2,642 new cases of medicated hypertension were observed. However, HRs for shift-work were not significant (mortality HR men 1.09 and women 1.22; retirement 1.15 and 0.96; hypertension 1.15 and 0.98, respectively). The results were essentially similar after full adjustments for all covariates. Within twin pairs, no association between shift work and outcome was observed. Our results do not support an association between shift-work and cardiovascular morbidity.

摘要

关于轮班工作与心血管疾病(CVD),特别是冠心病(CHD)之间的关系的研究结果相互矛盾。在这项前瞻性的基于人群的研究中,我们评估了轮班工作与三个终点的关联:CHD 死亡率、因 CVD 导致的残疾退休以及高血压发病。一项由 20142 名成年人组成的双胞胎队列(芬兰双胞胎队列)从 1982 年随访到 2003 年。工作时间类型(白班/夜班/轮班)通过 1975 年的问卷(应答率为 89%)和 1981 年的问卷(应答率为 84%)进行评估。死亡原因、残疾退休信息和高血压药物治疗的信息从全国性的官方登记处获得。使用 Cox 比例风险模型根据工作时间类型获得每个终点的风险比(HR)。调整了 14 项社会人口统计学和生活方式协变量。1975 年和 1981 年,76.9%为白班工人,9.5%为轮班工人。在随访期间,观察到 857 例 CHD 死亡、721 例因 CVD 导致的残疾退休和 2642 例新的高血压药物治疗病例。然而,轮班工作的 HR 并不显著(男性死亡率 HR 为 1.09,女性为 1.22;退休 HR 为 1.15 和 0.96;高血压 HR 为 1.15 和 0.98)。在对所有协变量进行充分调整后,结果基本相似。在双胞胎对中,没有观察到轮班工作与结果之间的关联。我们的结果不支持轮班工作与心血管发病率之间的关联。

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