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轮班制夜班工作与多发性硬化症风险在护士健康研究中的关系。

Rotating night shift work and risk of multiple sclerosis in the Nurses' Health Studies.

机构信息

Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

出版信息

Occup Environ Med. 2019 Oct;76(10):733-738. doi: 10.1136/oemed-2019-106016. Epub 2019 Aug 12.

Abstract

OBJECTIVES

Night shift work has been suggested as a possible risk factor for multiple sclerosis (MS). The objective of the present analysis was to prospectively evaluate the association of rotating night shift work history and MS risk in two female cohorts, the Nurses' Health Study (NHS) and NHSII.

METHODS

A total of 83 992 (NHS) and 114 427 (NHSII) women were included in this analysis. We documented 579 (109 in NHS and 470 in NHSII) incident physician-confirmed MS cases (moderate and definite diagnosis), including 407 definite MS cases. The history (cumulative years) of rotating night shifts (≥3 nights/month) was assessed at baseline and updated throughout follow-up. Cox proportional hazards models were used to estimate HRs and 95% CIs for the association between rotating night shift work and MS risk adjusting for potential confounders.

RESULTS

We observed no association between history of rotating night shift work and MS risk in NHS (1-9 years: HR 1.03, 95% CI 0.69 to 1.54; 10+ years: 1.15, 0.62 to 2.15) and NHSII (1-9 years: HR 0.90, 95% CI 0.74 to 1.09; 10+ years: 1.03, 0.72 to 1.49). In NHSII, rotating night shift work history of 20+ years was significantly associated with MS risk, when restricting to definite MS cases (1-9 years: HR 0.88, 95% CI 0.70 to 1.11; 10-19 years: 0.98, 0.62 to 1.55; 20+ years: 2.62, 1.06 to 6.46).

CONCLUSIONS

Overall, we found no association between rotating night shift work history and MS risk in these two large cohorts of nurses. In NHSII, shift work history of 20 or more years was associated with an increased risk of definite MS diagnosis.

摘要

目的

夜班工作被认为是多发性硬化症(MS)的一个可能的危险因素。本分析的目的是前瞻性评估轮班夜班工作史与两个女性队列(护士健康研究(NHS)和 NHSII)中 MS 风险的关联。

方法

本分析共纳入 83992 名(NHS)和 114427 名(NHSII)女性。我们记录了 579 例(NHS 中 109 例,NHSII 中 470 例)经医生确诊的 MS 病例(中度和明确诊断),其中包括 407 例明确的 MS 病例。基线时评估了轮班夜班(≥3 次/月)的历史(累计年数),并在随访期间进行了更新。使用 Cox 比例风险模型估计轮班夜班工作与 MS 风险之间的 HRs 和 95%置信区间,调整了潜在混杂因素。

结果

我们在 NHS(1-9 年:HR 1.03,95%CI 0.69 至 1.54;10+年:1.15,0.62 至 2.15)和 NHSII(1-9 年:HR 0.90,95%CI 0.74 至 1.09;10+年:1.03,0.72 至 1.49)中均未观察到轮班夜班工作史与 MS 风险之间存在关联。在 NHSII 中,当限制为明确的 MS 病例时,20 年以上的轮班夜班工作史与 MS 风险显著相关(1-9 年:HR 0.88,95%CI 0.70 至 1.11;10-19 年:0.98,0.62 至 1.55;20 年以上:2.62,1.06 至 6.46)。

结论

总体而言,我们在这两个大型护士队列中均未发现轮班夜班工作史与 MS 风险之间存在关联。在 NHSII 中,20 年或以上的轮班夜班工作史与明确的 MS 诊断风险增加相关。

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