Conway Sadie H, Pompeii Lisa A, Gimeno Ruiz de Porras David, Follis Jack L, Roberts Robert E
Am J Epidemiol. 2017 Jul 15;186(2):173-183. doi: 10.1093/aje/kwx003.
Working long hours has been associated with adverse health outcomes. However, a definition of long work hours relative to adverse health risk has not been established. Repeated measures of work hours among approximately 2,000 participants from the Panel Study of Income Dynamics (1986-2011), conducted in the United States, were retrospectively analyzed to derive statistically optimized cutpoints of long work hours that best predicted three health outcomes. Work-hours cutpoints were assessed for model fit, calibration, and discrimination separately for the outcomes of poor self-reported general health, incident cardiovascular disease, and incident cancer. For each outcome, the work-hours threshold that best predicted increased risk was 52 hours per week or more for a minimum of 10 years. Workers exposed at this level had a higher risk of poor self-reported general health (relative risk (RR) = 1.28; 95% confidence interval (CI): 1.06, 1.53), cardiovascular disease (RR = 1.42; 95% CI: 1.24, 1.63), and cancer (RR = 1.62; 95% CI: 1.22, 2.17) compared with those working 35-51 hours per week for the same duration. This study provides the first health risk-based definition of long work hours. Further examination of the predictive power of this cutpoint on other health outcomes and in other study populations is needed.
长时间工作与不良健康后果相关。然而,尚未确定相对于不良健康风险的长时间工作的定义。对美国收入动态面板研究(1986 - 2011年)中约2000名参与者的工作时间重复测量进行回顾性分析,以得出能最佳预测三种健康结果的长时间工作的统计优化切点。分别针对自我报告的总体健康状况差、心血管疾病发病和癌症发病这三种结果,评估工作时间切点的模型拟合度、校准度和区分度。对于每种结果,能最佳预测风险增加的工作时间阈值是每周52小时或更长时间,且至少持续10年。与每周工作35 - 51小时相同时长的工人相比,处于此水平的工人自我报告总体健康状况差(相对风险(RR)= 1.28;95%置信区间(CI):1.06,1.53)、患心血管疾病(RR = 1.42;95% CI:1.24,1.63)和患癌症(RR = 1.62;95% CI:1.22,2.17)的风险更高。本研究提供了首个基于健康风险的长时间工作定义。需要进一步研究该切点对其他健康结果以及其他研究人群的预测能力。