School of Population and Public Health, University of British Columbia, V2206 East Mall, Vancouver, BC, Canada, V6T 1Z3.
Scand J Work Environ Health. 2014 Nov;40(6):543-56. doi: 10.5271/sjweh.3445. Epub 2014 Jul 1.
Associations between shift work and chronic disease have been observed, but relatively little is known about how to mitigate these adverse health effects. This critical review aimed to (i) synthesize interventions that have been implemented among shift workers to reduce the chronic health effects of shift work and (ii) provide an overall evaluation of study quality.
MeSH terms and keywords were created and used to conduct a rigorous search of MEDLINE, CINAHL, and EMBASE for studies published on or before 13 August 2012. Study quality was assessed using a checklist adapted from Downs & Black.
Of the 5053 articles retrieved, 44 met the inclusion and exclusion criteria. Over 2354 male and female rotating and permanent night shift workers were included, mostly from the manufacturing, healthcare, and public safety industries. Studies were grouped into four intervention types: (i) shift schedule; (ii) controlled light exposure; (iii) behavioral; and, (iv) pharmacological. Results generally support the benefits of fast-forward rotating shifts; simultaneous use of timed bright light and light-blocking glasses; and physical activity, healthy diet, and health promotion. Mixed results were observed for hypnotics. Study quality varied and numerous deficiencies were identified.
Except for hypnotics, several types of interventions reviewed had positive overall effects on chronic disease outcomes. There was substantial heterogeneity among studies with respect to study sample, interventions, and outcomes. There is a need for further high-quality, workplace-based prevention research conducted among shift workers.
已经观察到轮班工作与慢性病之间存在关联，但对于如何减轻这些不良健康影响知之甚少。本项关键性评论旨在：(i) 综合分析已经在轮班工人中实施的干预措施，以减轻轮班工作对慢性健康的影响；(ii) 对研究质量进行总体评估。
创建了 MeSH 术语和关键词，并用于在 MEDLINE、CINAHL 和 EMBASE 中进行严格搜索，以检索截至 2012 年 8 月 13 日发表的研究。使用 Downs 和 Black 改编的清单评估研究质量。
在检索到的 5053 篇文章中，有 44 篇符合纳入和排除标准。超过 2354 名男性和女性轮班和固定夜班工人被纳入研究，主要来自制造业、医疗保健和公共安全行业。研究分为四种干预类型：(i) 轮班时间表；(ii) 控制光照；(iii) 行为；以及 (iv) 药理学。结果普遍支持快速轮转班次的好处；同时使用定时强光和遮光眼镜；以及体育活动、健康饮食和促进健康。催眠药的结果则喜忧参半。研究质量参差不齐，存在许多缺陷。
除催眠药外，所审查的几种干预措施对慢性病结果均具有总体积极影响。研究在研究样本、干预措施和结果方面存在很大的异质性。需要在轮班工人中进一步开展高质量的基于工作场所的预防研究。
