Adams Charleen D, Blacksher Erika, Burke Wylie
MRC Integrative Epidemiology Unit (IEU) & School of Social and Community Medicine, University of Bristol.
Department of Bioethics and Humanities, University of Washington.
Public Health Ethics. 2018 Mar 12;12(1):44-53. doi: 10.1093/phe/phy005. eCollection 2019 Apr.
Shift work (working outside of 6:00 AM to 6:00 PM) is a fixture of our 24-hour economy, with approximately 18 per cent of workers in the USA engaging in shift work, many overnight. Since shift work has been linked to an increased risk for an array of serious maladies, including cardiometabolic disorders and cancer, and is done disproportionately by the poor and by minorities, shift work is a highly prevalent economic and occupational health disparity. Here we draw primarily on the state of science around shift work and breast cancer to argue that shift work represents a public health threat serious enough to warrant a precautionary stance. We use the precautionary principle to advance our case and view it as a moral compass for shift work research, empowering public health to cast shift work within the domain of health disparities deserving action despite scientific uncertainty. With the precautionary principle, we call for a deliberative decision-making process and formation of a broad shift work research collaboration to protect the health of many millions who work at night.
轮班工作（早上6点至下午6点之外的工作时间）是我们24小时经济体系的一个固定组成部分，在美国约有18%的工人从事轮班工作，其中许多是通宵工作。由于轮班工作与一系列严重疾病的风险增加有关，包括心脏代谢紊乱和癌症，而且从事轮班工作的人群中贫困者和少数族裔的比例过高，因此轮班工作是一种极为普遍的经济和职业健康差距问题。在此，我们主要依据围绕轮班工作与乳腺癌的科学现状，来论证轮班工作构成了严重到足以采取预防立场的公共卫生威胁。我们运用预防原则来推进我们的观点，并将其视为轮班工作研究的道德指南，使公共卫生能够将轮班工作置于尽管存在科学不确定性但仍值得采取行动的健康差距领域内。基于预防原则，我们呼吁进行深思熟虑的决策过程，并组建广泛的轮班工作研究合作团队，以保护数百万从事夜间工作的人的健康。
