National Institute of Occupational Health, Oslo, Norway.
Am J Epidemiol. 2011 Jun 1;173(11):1272-9. doi: 10.1093/aje/kwr014. Epub 2011 Mar 31.
Associations between night work and breast cancer risk were investigated in a nested case-control study within a cohort of 49,402 Norwegian nurses. A total of 699 (74%) of the live cases diagnosed in 1990-2007 and 895 (65%) controls, cancer free at the time of sampling, were interviewed about work history and potential risk factors. The odds ratios for risk of breast cancer in relation to different exposure metrics were estimated by multivariate unconditional logistic regression models. No increase of risk was found after long duration of work by nurses working ≥3 night shifts per month. Small, nonsignificantly increased risks were observed for exposure to ≥30 years in hospitals or other institutions (odds ratio (OR) = 1.1), ≥12 years in schedules including night work (OR = 1.3), ≥1,007 night shifts during the lifetime (OR = 1.2), and lifetime average number of ≥4 night shifts per month (OR = 1.2). Nonsignificantly increased risks of breast cancer were observed in nurses who worked ≥5 years with ≥4 (OR = 1.4) and ≥5 (OR = 1.6) consecutive night shifts. Significantly increased risks were seen in nurses who worked ≥5 years with ≥6 consecutive night shifts (OR = 1.8, 95% confidence interval: 1.1, 2.8). The results suggest that risk may be related to number of consecutive night shifts.
本研究采用巢式病例对照设计,对 49402 名挪威护士队列中的病例进行了研究,以探讨夜班与乳腺癌风险之间的关系。在 1990-2007 年诊断出的 699 名(74%)存活病例和 895 名(65%)未患癌症的对照者(抽样时)接受了关于工作史和潜在危险因素的访谈。采用多变量非条件逻辑回归模型估计了不同暴露指标与乳腺癌风险之间的比值比。结果发现,每月至少上 3 次夜班的护士,其工作时间长短与乳腺癌风险之间无关联。暴露于医院或其他机构≥30 年(比值比(OR)=1.1)、包括夜班在内的轮班≥12 年(OR=1.3)、一生中累计上夜班≥1007 次(OR=1.2)以及一生中平均每月上夜班≥4 次(OR=1.2),乳腺癌风险略有增加,但无统计学意义。护士连续上夜班≥5 年且≥4 次(OR=1.4)或≥5 次(OR=1.6)时,乳腺癌风险略有增加,但无统计学意义。当连续上夜班≥5 年且≥6 次时,乳腺癌风险显著增加(OR=1.8,95%置信区间:1.1,2.8)。这些结果表明,风险可能与连续上夜班的次数有关。