MRC Centre for Epidemiology of Child Health, UCL Institute of Child Health, London, UK.
Eur J Epidemiol. 2010 May;25(5):305-14. doi: 10.1007/s10654-010-9438-4. Epub 2010 Mar 18.
This study examined associations between exposure to shift-work and risk factors for cardiovascular disease (CVD) and whether the associations are explained by socio-economic circumstances, occupational factors or health behaviours. Biological risk factors for CVD were measured in 7,839 participants of the 1958 British birth cohort at age 45 years who were in paid employment. Regular (>or=1/week) shift-workers included 46% working evenings (1800-2200), 28% weekends, 13% nights (2200-0400) and 14% early mornings (0400-0700). Adverse levels of several CVD risk factors were found in association with increasing participation in any shift-work. Men regularly working all four shift-work types had increased CVD risk factors of approximately 0.1-0.2 standard deviations (e.g. 0.8 kg/m(2) for body mass index; 1.2 cm for waist circumference) than those not regularly working shifts; for women, there was a positive linear trend for triglyceride levels, but a negative trend for diastolic blood pressure. Separate analyses of shift-work types showed associations primarily for night/morning working rather than evening/weekend working. Men had adverse levels of all CVD risk factors except blood pressure and total-cholesterol in association with night or early morning work and women had adverse triglyceride levels. Adjustment for socioeconomic, occupational factors and health behaviours explained most associations except for adiposity and C-reactive protein. Our results highlight night and early morning working associations with an adverse profile of CVD risk factors, which are partly explained by socioeconomic, other occupational factors and health behaviours.
本研究旨在探讨轮班工作与心血管疾病(CVD)风险因素之间的关联,以及这些关联是否可以用社会经济状况、职业因素或健康行为来解释。在参与 1958 年英国出生队列研究、年龄在 45 岁且有薪工作的 7839 名参与者中,测量了 CVD 的生物风险因素。将每周至少一次轮班工作的人定义为:轮班工人中 46%的人上夜班(1800-2200),28%的人上周末班,13%的人上夜班(2200-0400),14%的人上早班(0400-0700)。研究发现,随着轮班工作参与程度的增加,与多种 CVD 风险因素呈负相关。经常从事所有四种轮班工作的男性,其 CVD 风险因素增加了约 0.1-0.2 个标准差(例如,体重指数增加 0.8 公斤/平方米;腰围增加 1.2 厘米),而不经常轮班的男性则没有这种风险;对于女性,甘油三酯水平呈正线性趋势,而舒张压呈负线性趋势。对轮班工作类型进行单独分析显示,与夜班/周末班相比,主要与夜班/早班工作有关。男性从事夜班或早班工作与所有 CVD 风险因素呈负相关,除了血压和总胆固醇外,女性的甘油三酯水平也偏高。调整社会经济、职业因素和健康行为后,除了肥胖和 C 反应蛋白外,大部分关联都得到了解释。我们的研究结果突出了夜班和早班工作与 CVD 风险因素不良状况之间的关联,这些关联部分可以用社会经济、其他职业因素和健康行为来解释。