Jørgensen Jeanette Therming, Karlsen Sashia, Stayner Leslie, Hansen Johnni, Andersen Zorana Jovanovic
Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen. Denmark.
Scand J Work Environ Health. 2017 Mar 1;43(2):117-126. doi: 10.5271/sjweh.3612.
Objectives Evidence of an effect of shift work on all-cause and cause-specific mortality is inconsistent. This study aims to examine whether shift work is associated with increased all-cause and cause-specific mortality. Methods We linked 28 731 female nurses (age ≥44 years), recruited in 1993 or 1999 from the Danish nurse cohort where they reported information on shift work (night, evening, rotating, or day), to the Danish Register of Causes of Death to identify deaths up to 2013. We used Cox regression models with age as the underlying scale to examine the associations between night, evening, and rotating shift work (compared to day shift work) and all-cause and cause-specific mortality in models adjusted for potentially confounding variables. Results Of 18 015 nurses included in this study, 1616 died during the study time period from the following causes: cardiovascular disease (N=217), cancer (N= 945), diabetes (N=20), Alzheimer's disease or dementia (N=33), and psychiatric diseases (N=67). We found that working night [hazard ratio (HR) 1.26, 95% confidence interval 95% CI) 1.05-1.51] or evening (HR 1.29, 95% CI 1.11-1.49) shifts was associated with a significant increase in all-cause mortality when compared to working day shift. We found a significant association of night shift work with cardiovascular disease (HR 1.71, 95% CI 1.09-2.69) and diabetes (HR 12.0, 95% CI 3.17-45.2, based on 8 cases) and none with overall cancer mortality (HR 1.05, 95% CI 0.81-1.35) or mortality from psychiatric diseases (HR 1.17, 95% CI 0.47-2.92). Finally, we found strong association between evening (HR 4.28, 95% CI 1.62-11.3) and rotating (HR 5.39, 95% CI 2.35-12.3) shift work and mortality from Alzheimer's disease and dementia (based on 8 and 14 deaths among evening and rotating shift workers, respectively). Conclusions Women working night and evening shifts have increased all-cause, cardiovascular, diabetes, and Alzheimer's and dementia mortality.
目的 轮班工作对全因死亡率和特定病因死亡率影响的证据并不一致。本研究旨在探讨轮班工作是否与全因死亡率和特定病因死亡率增加有关。方法 我们将1993年或1999年从丹麦护士队列中招募的28731名年龄≥44岁的女性护士（她们报告了轮班工作情况，如夜班、晚班、轮岗或白班）与丹麦死亡原因登记册相链接，以确定截至2013年的死亡情况。我们使用以年龄为基本尺度的Cox回归模型，在对潜在混杂变量进行调整的模型中，研究夜班、晚班和轮岗工作（与白班工作相比）与全因死亡率和特定病因死亡率之间的关联。结果 本研究纳入的18015名护士中，有1616人在研究期间因以下原因死亡：心血管疾病（N = 217）、癌症（N = 945）、糖尿病（N = 20）、阿尔茨海默病或痴呆症（N = 33）以及精神疾病（N = 67）。我们发现，与白班工作相比，从事夜班（风险比[HR] 1.26，95%置信区间[CI] 1.05 - 1.51）或晚班（HR 1.29，95% CI 1.11 - 1.49）工作与全因死亡率显著增加相关。我们发现夜班工作与心血管疾病（HR 1.71，95% CI 1.09 - 2.69）和糖尿病（基于8例病例，HR 12.0，95% CI 3.17 - 45.2）存在显著关联，而与总体癌症死亡率（HR 1.05，95% CI 0.81 - 1.35）或精神疾病死亡率（HR 1.17，95% CI 0.47 - 2.92）无关。最后，我们发现晚班（HR 4.28，95% CI 1.62 - 11.3）和轮岗（HR 5.39，95% CI 2.35 - 12.3）工作与阿尔茨海默病和痴呆症死亡率之间存在强烈关联（晚班和轮岗工作人员中分别有8例和14例死亡）。结论 从事夜班和晚班工作的女性全因、心血管、糖尿病以及阿尔茨海默病和痴呆症死亡率增加。
