轮班工作与慢性疾病：流行病学证据。
Shift work and chronic disease: the epidemiological evidence.
机构信息
Cancer Epidemiology Unit, University of Oxford, Oxford, UK.
出版信息
Occup Med (Lond). 2011 Mar;61(2):78-89. doi: 10.1093/occmed/kqr001.
BACKGROUND
Shift work, including night work, has been hypothesized to increase the risk of chronic diseases, including cancer, cardiovascular disease (CVD), metabolic syndrome and diabetes. Recent reviews of evidence relating to these hypotheses have focussed on specific diseases or potential mechanisms, but no general summary of the current data on shift work and chronic disease has been published.
METHODS
Systematic and critical reviews and recent original studies indexed in PubMed prior to 31 December 2009 were retrieved, aided by manual searches of reference lists. The main conclusions from reviews and principle results from recent studies are presented in text and tables.
RESULTS
Published evidence is suggestive but not conclusive for an adverse association between night work and breast cancer but limited and inconsistent for cancers at other sites and all cancers combined. Findings on shift work, in relation to risks of CVD, metabolic syndrome and diabetes are also suggestive but not conclusive for an adverse relationship.
CONCLUSIONS
Heterogeneity of study exposures and outcomes and emphasis on positive but non-significant results make it difficult to draw general conclusions. Further data are needed for additional disease endpoints and study populations.
背景
轮班工作，包括夜班，据推测会增加患慢性病的风险，包括癌症、心血管疾病（CVD）、代谢综合征和糖尿病。最近对这些假说的证据进行了审查，重点是特定的疾病或潜在的机制，但尚未发表关于轮班工作和慢性病的现有数据的综合总结。
方法
检索了 2009 年 12 月 31 日之前在 PubMed 中索引的系统和批判性综述以及最近的原始研究，并通过手动搜索参考文献进行了补充。从综述中得出的主要结论和最近研究中的主要结果以文字和表格的形式呈现。
结果
已发表的证据表明夜班与乳腺癌之间存在不利关联，但证据并不确定，而夜班与其他部位癌症和所有癌症的关联的证据有限且不一致。关于轮班工作与心血管疾病、代谢综合征和糖尿病风险之间的关系，研究结果也表明存在不利关联，但证据不确定。
结论
研究暴露和结果的异质性以及对阳性但非显著结果的强调使得难以得出一般性结论。需要进一步的数据来研究其他疾病终点和研究人群。
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