Behrens Thomas, Rabstein Sylvia, Wichert Katharina, Erbel Raimund, Eisele Lewin, Arendt Marina, Dragano Nico, Brüning Thomas, Jöckel Karl-Heinz
Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
Scand J Work Environ Health. 2017 Nov 1;43(6):560-568. doi: 10.5271/sjweh.3666. Epub 2017 Sep 7.
Objectives We investigated the association of shift and night work with the incidence of prostate cancer using data of the population-based prospective Heinz Nixdorf Recall Study from the highly industrialized Ruhr area in Germany. Methods Participants of the baseline survey were recruited between 2000-2003. A follow-up survey including, a detailed interview on shift and night work, was conducted from 2011-2014. We included 1757 men who did not report a history of prostate cancer at baseline. We assessed shift- and night-work exposure up to time of the baseline interview. Incident prostate cancers were recorded from baseline through September 2014. We calculated hazard ratios (HR) of shift- and night-work exposure using Cox proportional hazards regression with age at event as timescale, adjusting for smoking status, family history of prostate cancer, education (≤13, 14-17, ≥18 years), and equivalent income (low, medium, high). Results We observed a twofold increased HR for prostate cancer among shift and night workers. Ever employment in shift work was associated with HR 2.29, 95% confidence interval (CI) 1.43-3.67 and night work with HR 2.27, 95% CI 1.42-3.64. HR increased steadily with duration of employment in shift or night work. Stratifying analyses by preferred midpoint of sleep, yielded strongly elevated HR among subjects with early sleep preference, although these analyses were limited by small number of cases. Conclusions We identified increased risks for prostate cancer among men with employment in shift or night work. HR were strongly elevated among long-term employed shift workers and men with early preferred midpoint of sleep.
我们利用德国高度工业化的鲁尔地区基于人群的前瞻性海因茨·尼克斯多夫召回研究的数据，调查轮班和夜班工作与前列腺癌发病率之间的关联。方法：基线调查的参与者于2000年至2003年招募。2011年至2014年进行了一项随访调查，包括关于轮班和夜班工作的详细访谈。我们纳入了1757名在基线时未报告前列腺癌病史的男性。我们评估了直至基线访谈时的轮班和夜班工作暴露情况。从基线到2014年9月记录了新发前列腺癌病例。我们使用Cox比例风险回归，以事件发生时的年龄为时间尺度，计算轮班和夜班工作暴露的风险比（HR），并对吸烟状况、前列腺癌家族史、教育程度（≤13、14 - 17、≥18岁）和同等收入（低、中、高）进行调整。结果：我们观察到轮班和夜班工作者患前列腺癌的HR增加了两倍。曾经从事轮班工作与HR 2.29相关，95%置信区间（CI）为1.43 - 3.67，夜班工作与HR 2.27相关，95%CI为1.42 - 3.64。HR随着轮班或夜班工作的就业时间持续稳定增加。按偏好的睡眠中点进行分层分析，在有早睡偏好的受试者中HR大幅升高，尽管这些分析因病例数少而受到限制。结论：我们发现从事轮班或夜班工作的男性患前列腺癌的风险增加。长期从事轮班工作的工人和有早睡偏好中点的男性的HR大幅升高。
